Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
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Query Trace: Erin Staples J [original query] |
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Yellow fever resurgence: An avoidable crisis
Lindsey NP , Horton J , Barrett ADT , Demanou M , Monath TP , Tomori O , Van Herp M , Zeller H , Fall IS , Cibrelus L , Erin Staples J . NPJ Vaccines 2022 7 (1) 137 Yellow fever (YF), an acute viral hemorrhagic disease transmitted by infected mosquitoes, has the potential to spread rapidly and cause serious public health impact. The disease predominantly affects people in sub-Saharan Africa and tropical South America, where 40 countries are considered endemic and at high-risk for YF outbreaks1. Despite the availability of safe and effective vaccines since the 1930s, YF outbreaks continue to occur resulting in an estimated 109,000 severe cases and 51,000 deaths annually2. These figures are likely underestimates as most mild YF cases go undetected due to nonspecific symptoms and limited surveillance or laboratory diagnostic capacity in many at-risk regions. | | Because of large explosive outbreaks in the last five years, YF has reemerged as a major international public health threat. In 2016, an explosive outbreak occurred in Angola, spreading to neighboring areas in the Democratic Republic of Congo and infecting expatriate workers, including at least 11 workers who returned to China while ill3. At the time of the outbreak in Angola, vaccination coverage and disease awareness were low as the last YF outbreak was in 1971. In addition, control measures, such as requiring a valid international certificate of vaccination for travelers, were not enforced4. Thirty million doses of YF vaccine were needed to stop the outbreak, which both outstripped the available global vaccine supply and led to the unprecedented use of fractional doses of the vaccine to prevent further disease spread5. In late 2016–2017, outbreaks of YF were also detected in coastal areas of Brazil where cases had not been reported since the 1940s and vaccination was not routinely recommended6. Again, fractional doses of the vaccine were needed to protect those residing in affected areas. Although fractional doses have been demonstrated to provide good short-term protection, questions remain if they will provide the same long-term protective immunity as a full dose7–9. Until these questions can be adequately answered, fractional doses should only be considered in emergency scenarios if there are insufficient doses of the vaccine to respond to active or imminent threats of large-scale amplification of YF10,11. |
Transfusion-Transmitted Cache Valley Virus Infection in a Kidney Transplant Recipient with Meningoencephalitis.
Al-Heeti O , Wu EL , Ison MG , Saluja RK , Ramsey G , Matkovic E , Ha K , Hall S , Banach B , Wilson MR , Miller S , Chiu CY , McCabe M , Bari C , Zimler RA , Babiker H , Freeman D , Popovitch J , Annambhotla P , Lehman JA , Fitzpatrick K , Velez JO , Davis EH , Hughes HR , Panella A , Brault A , Erin Staples J , Gould CV , Tanna S . Clin Infect Dis 2022 76 (3) e1320-e1327 BACKGROUND: Cache Valley virus (CVV) is a mosquito-borne virus that is a rare cause of disease in humans. In the Fall of 2020, a patient developed encephalitis six weeks following kidney transplantation and receipt of multiple blood transfusions. METHODS: After ruling out more common etiologies, metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) was performed. We reviewed the medical histories of the index kidney recipient, organ donor, and recipients of other organs from the same donor and conducted a blood traceback investigation to evaluate blood transfusion as a possible source of infection in the kidney recipient. We tested patient specimens by reverse transcription-polymerase chain reaction (RT-PCR), plaque reduction neutralization test (PRNT), cell culture, and whole genome sequencing. RESULTS: CVV was detected in CSF from the index patient by mNGS, and this result was confirmed by RT-PCR, viral culture, and additional whole genome sequencing. The organ donor and other organ recipients had no evidence of infection with CVV by molecular or serologic testing. Neutralizing antibodies against CVV were detected in serum from a donor of red blood cells received by the index patient immediately prior to transplant. CVV neutralizing antibodies were also detected in serum from a patient who received the co-component plasma from the same blood donation. CONCLUSION: Our investigation demonstrates probable CVV transmission through blood transfusion. Clinicians should consider arboviral infections in unexplained meningoencephalitis after blood transfusion or organ transplantation. The use of mNGS testing might facilitate detection of rare, unexpected infections, particularly in immunocompromised patients. |
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