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Rabbit viral hemorrhagic disease (VHD) is a transmittable and lethal viral illness of rabbits. In this study, genetic identification and genetic analysis of the rabbit hemorrhagic disease virus (RHDV) was made in three governorates in Egypt from 2014 to 2019. Livers from 18 freshly dead rabbits, which was guessed to be VHD epidemics in Egypt (Giza, Menofia, and Fayoum governorates) from 2014 to 2019, were examined for RHDV. The examination was based on the hemagglutination assay (HA) test against different mammalian (human O-type and sheep) and avian (chicken and pigeon) erythrocytes, reverse transcriptase-polymerase chain reaction (RT-PCR), and sequencing of the segment of VP60. 33% of the examined samples' virus titers were 5 log to 8 log hemagglutination of human O-type erythrocytes when compared to 28%, 11%, and 28% of sheep, chicken, and pigeon erythrocytes, respectively. Four RHDV isolates out of eight RT-PCR positives were sequenced and phylogenetically analyzed. Sequenced isolates were designed and submitted to GenBank with accession numbers MN904506, MN904507, MN904508, and MN904509. These four RHDV isolates were related to classic G3 (GI.1d/RHDV). Twelve amino acid differences were detected between the vaccine strain sequence (Giza-2006) and RHDV isolates. Amino acid differences at 416, 423, and 476 positions seem interesting as they changed polarity that could change the protein structure and affect host interaction. There is antigenic variation between circulating RHVD strains and the vaccinal strain. This may be the leading cause of vaccination failure and may increase the need to check out the vaccination program against RHVD.

Yellow fever virus, transmitted by infected Aedes spp. mosquitoes, causes an acute viral hemorrhagic disease. During October 2021-February 2022, a yellow fever outbreak in some communities in Ghana resulted in 70 confirmed cases with 35 deaths (case-fatality rate 50%). The outbreak started in a predominantly unvaccinated nomadic community in the Savannah region, from which 65% of the cases came. The molecular amplification methods we used for diagnosis produced full-length DNA sequences from 3 confirmed cases. Phylogenetic analysis characterized the 3 sequences within West Africa genotype II; strains shared a close homology with sequences from Cote d'Ivoire and Senegal. We deployed more sensitive advanced molecular diagnostic techniques, which enabled earlier detection, helped control spread, and improved case management. We urge increased efforts from health authorities to vaccinate vulnerable groups in difficult-to-access areas and to educate the population about potential risks for yellow fever infections.

Background Lassa fever (LF) is a viral hemorrhagic disease caused by the Lassa virus (LASV) and endemic in West African countries with an estimation of 300,000 to 500,000 cases and 5,000 deaths annually. The Margibi County Health Team of Liberia received a report of an unidentified febrile illness case from the Kakata district. We conducted the investigation to identify the causative agent and the source of infection to support treatment, control and prevention interventions. Case presentation We identified LASV in the blood specimens’ of two patients by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). Both the confirmed cases have manifested respiratory distress, weakness, and difficulty of swallowing, muscle, joint and back pains, and vomiting with blood. The symptoms started with mild fever and gradually developed. Initially, the primary health facilities have miss-diagnosed the patients as malaria and respiratory tract infections. The primary health facilities have referred the patients to the referral hospital as the patients have failed to respond to antimalarial and antibiotics. The hospital suspected LF and sent blood specimens to the National Reference Laboratory while the patients were on supportive treatment in the isolation room. At the time when the laboratory result returned to the hospital, the patients died of LF illness before ribavirin administered. Conclusions Our investigation revealed that the two hospitalized and deceased febrile cases were associated with LASV. The primary health facilities have failed to recognize the cases as suspected LF at the earliest time possible. The clinicians and health facilities, especially primary health facilities, need to consider LF as a differential diagnosis when the patient failed to respond to anti-malaria and broad-spectrum antibiotics.

Background Marburg virus disease (MVD) is a deadly illness caused by the zoonotic Marburg virus, which has led to outbreaks with fatality rates up to 100% in some African countries. On March 21, 2023, Tanzania had its first MVD outbreak, resulting in nine cases and six deaths, leading to a fatality rate of 66.7%. Following that, the Risk Communication and Community Engagement (RCCE) approach was promptly initiated to create community awareness regarding the MVD. A descriptive cross-sectional assessment was conducted in May 2023 in Bukoba District Council and Bukoba Municipal Council in the Kagera region to document the community awareness and sources of information regarding MVD during the outbreak. Data were collected using a structured questionnaire developed using the WHO COVID-19 RCCE Rapid Quantitative Assessment Tool. Descriptive analysis was conducted using Microsoft Excel 2021. Results There were a total of 714 community respondents, of whom 456 (63.9%) were from Bukoba District Council. The majority 628 (88%) were aged 18 years and above. There were 393 (55%) females, and 407 (57%) of respondents had completed primary education. All respondents reported being informed about MVD through different channels, with 588 (82.4%) receiving information from Community Health Workers. Most of them 573 (80.3%) were satisfied with implemented RCCE interventions, 651 (91.2%) perceived MVD to be an extremely severe disease, and 698 (97.76%) mentioned hand washing as one of the recommended preventive measures. Conclusions During the Marburg virus disease outbreak response, where risk communication and community engagement interventions were implemented, the community was aware of the Marburg virus disease and community health workers emerged as the most frequently mentioned channel of communication during the outbreak.

Background: Dengue Fever, also known as break-bone fever, is a viral illness and transmitted to humans by bites of infected Aedes aegypti and Aedes albopictus mosquitoes. Objective: To determine the outcomes of patients presenting with dengue infection and describe the risk factors for mortality. Study type, settings & duration: This prospective observational study was conducted in Intensive Care Units (ICUs) and Medical Wards, Department of Medicine, Fatima Memorial Hospital, Lahore from October 2021 to October 2023.   Methodology: A total of 215 patients presenting with characteristic symptoms and NS1 antigen and IgM. Anti Dengue antibodies positivity were included in current study. The hematological variables were recorded on day 1,3 and 5 after admission. Clinical and biochemical parameters were recorded on the day of admission. Clinical course of the patient was monitored and outcomes were recorded. Results: Out of 215 patients, 11 (5.1%) expired. A significant association between female gender and the necessity for packed cell volume and fresh frozen plasma transfusion was observed (OR (95% CI: 10.26 (2.23 – 96.24), p =0.0005).The significant risk factors for mortality were: presence of ascites, pleural effusion, organ dysfunction, need for PCV, FFP and platelet megaunit transfusion. Higher hemoglobin on day 1 and 5 (P=0.05), higher WBCs on day 3 and 5 (p =0.0), platelets on day 5 (p =0.009), O2 saturations (p=0.0) and mean BP on presentation (p =0.008) (day 1) were significant predictors of death. Conclusion: In patients with dengue infection, trend of hematological parameters should be be monitored closely on ...

Background: Dengue Fever, also known as break-bone fever, is a viral illness and transmitted to humans by bites of infected Aedes aegypti and Aedes albopictus mosquitoes. Objective: To determine the outcomes of patients presenting with dengue infection and describe the risk factors for mortality. Study type, settings & duration: This prospective observational study was conducted in Intensive Care Units (ICUs) and Medical Wards, Department of Medicine, Fatima Memorial Hospital, Lahore from October 2021 to October 2023.   Methodology: A total of 215 patients presenting with characteristic symptoms and NS1 antigen and IgM. Anti Dengue antibodies positivity were included in current study. The hematological variables were recorded on day 1,3 and 5 after admission. Clinical and biochemical parameters were recorded on the day of admission. Clinical course of the patient was monitored and outcomes were recorded. Results: Out of 215 patients, 11 (5.1%) expired. A significant association between female gender and the necessity for packed cell volume and fresh frozen plasma transfusion was observed (OR (95% CI: 10.26 (2.23 – 96.24), p =0.0005).The significant risk factors for mortality were: presence of ascites, pleural effusion, organ dysfunction, need for PCV, FFP and platelet megaunit transfusion. Higher hemoglobin on day 1 and 5 (P=0.05), higher WBCs on day 3 and 5 (p =0.0), platelets on day 5 (p =0.009), O2 saturations (p=0.0) and mean BP on presentation (p =0.008) (day 1) were significant predictors of death. Conclusion: In patients with dengue infection, trend of hematological parameters should be be monitored closely on ...

European wild rabbits (Oryctolagus cuniculus) are frequently translocated for hunting and conservation purposes. Quarantining these animals prior to release reduces the risk of releasing rabbits incubating field infections of myxomatosis or viral haemorrhagic disease (RHD), and it provides a way to vaccinate these animals against both diseases. However the optimal quarantine period needed to achieve these goals is not known. We therefore assessed the effects of quarantine lengths (2, 4, 6, 8 weeks) on rabbit biochemical parameters, immunity induced by vaccination against myxomatosis and RHD, and survival of translocated rabbits. We found that levels of total bilirubin, urea nitrogen, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) enzymatic activities were significantly (P < 0.05) decreased during quarantine, independent of quarantine length, whereas hematocrit levels increased significantly. All pregnant female rabbits aborted or lost litters during quarantine. Seroconversion against myxomatosis and RHD following vaccination was not related to any biochemical parameter at vaccination time, but the proportion of seronegative rabbits that seroconverted was moderate. The heterophil/lymphocyte ratio, conjugated to unconjugated bilirubin ratio, and the serum AST and creatinine levels we measured after capture and transport were directly related to mortality through the quarantine period, whereas we found total serum protein level was negatively related to mortality. Mortality after release was positively related to urea nitrogen concentration and negatively related to hematocrit and the albumin/globulin ratio, but it was independent of quarantine length. Based on our findings, rabbit translocation programs that include a quarantine period could be improved by decreasing the acute stress induced by capture and handling prior to quarantine; facilitating a more rapid access to high quality feed during quarantine; and improving the vaccination protocol. In addition, the release from quarantine of rabbits should be determined by their physical condition, not merely by elapsed time in quarantine.

Rabbit hemorrhagic disease is a rapidly lethal infection caused by a calicivirus, characterized by acute liver damage and disseminated intravascular coagulation (DIC). Following morphological criteria and using a specific in situ labeling technique, we have found that liver cell death induced upon infection is due to apoptosis, and that programmed cell death is a constant feature in rabbits experimentally infected with RHDV. The process affected mainly hepatocytes, but also macrophages and endothelial cells presented morphologic hallmarks of apoptosis, expressing all these cell types viral antigens as determined by immunohistochemistry. The occurrence of programmed cell death was correlated with the appearance of the RHDV induced pathology in tissues by DNA fragmentation detection in situ. Hepatocyte apoptosis produced extensive parenchymal destruction causing a lethal, acute fulminant hepatitis that is characteristic of RHD. Apoptosis of intravascular monocytes and endothelial cell was observed together with fibrin thrombi in blood vessels. Since apoptotic cells are known sites of enhanced procoagulant activity, apoptosis of these cell populations might constitute a first step in the pathogenesis of DIC and a common pathway to other viral hemorrhagic fevers. In conclusion, apoptosis in RHD may be determinant in the development of the pathogenesis of this disease.

This chapter contains sections titled: Infectious hematopoietic necrosis virus Infectious pancreatic necrosis virus Infectious salmon anemia virus Viral hemorrhagic septicemia Erythrocytic inclusion body syndrome Salmonid herpesviruses Salmon pancreas disease/sleeping disease in rainbow trout Epizootic hematopoietic necrosis virus Other salmonid virus diseases Salmon swim bladder sarcoma virus Management of salmonid viruses References