Abstract We investigated an outbreak of exanthematous illness in Maceió by using molecular surveillance; 76% of samples tested positive for chikungunya virus. Genetic analysis of 23 newly generated genomes identified the East/Central/South African genotype, suggesting that this lineage has persisted since mid-2014 in Brazil and may spread in the Americas and beyond.
Abstract Background Chikungunya fever is a globally spreading mosquito-borne disease that shows an unexpected neu- rovirulence. Even though the neurological complications have been a major cause of intensive care unit admission and death, to date, there is no systematic analysis of their spectrum available. Objective To review evidence of neurological manifesta- tions in Chikungunya fever and map their epidemiology, clinical spectrum, pathomechanisms, diagnostics, therapies and outcomes. Methods Case report and systematic review of the litera- ture followed established guidelines. All cases found were assessed using a 5-step clinical diagnostic algorithm assigning categories A–C, category A representing the highest level of quality. Only A and B cases were con- sidered for further analysis. After general analysis, cases were clustered according to geospatial criteria for subgroup analysis. Results Thirty-six of 1196 studies were included, yielding 130 cases. Nine were ranked as category A (diagnosis of Neuro-Chikungunya probable), 55 as B (plausible), and 51 as C (disputable). In 15 cases, alternative diagnoses were more likely. Patient age distribution was bimodal with a mean of 49 years and a second peak in infants. Fifty per- cent of the cases occurred in patients <45 years with no reported comorbidity. Frequent diagnoses were encephali- tis, optic neuropathy, neuroretinitis, and Guillain–Barre ́ syndrome. Neurologic conditions showing characteristics of a direct viral pathomechanism showed a peak in infants and a second one in elder patients, and complications and neurologic sequelae were more frequent in these groups. Autoimmune-mediated conditions appeared mainly in patients over 20 years and tended to show longer latencies and better outcomes. Geospatial subgrouping of case reports from either India or Re ́union revealed diverging phenotypic trends (Re ́union: 88% direct viral vs. India: 81% autoimmune). ConclusionsDirect viral forms of Neuro-Chikungunya seem to occur particularly in infants and elderly patients, while autoimmune forms have to be also considered in middle-aged, previously healthy patients, especially after an asymptomatic interval. This knowledge will help to identify future Neuro-Chikungunya cases and to improve outcome especially in autoimmune-mediated conditions. The genetics of Chikungunya virus might play a key role in determining the course of neuropathogenesis. With further research, this could prove diagnostically significant.
Invitation to complete quick survey to improve Kaplan-Meier plots (KMunicate) ProblemThe standard way to present time-to-event data, such as survival, is with Kaplan-Meier plots. These are formatted by journals and reported in a number of ways, but we find they commonly lack some key information. The key problems are:
- Expressing how many people are contributing data at any point in the graph, including the pattern of censoring
- Expressing that the uncertainty of the estimate increases over time
This is a great video of a talk given at the Oxford Martin School by Professor Kevin Marsh.
Epidemic curves are an important component of the public health and global health toolbox. Learn more about creating and interpretting them.
AREF is calling for researcher applications to participate in its 2nd Essential Grant Writing Skills Workshop, to be held in Dakar, Senegal, in May 2017.
Around half of the clinical trials done on medicines we use today are not published; a tragic truth that needs to be changed.
This video seminar describes research to develop a low-cost, field-based test to detect several slow-clearing ACT drug compounds from unprocessed fingerstick blood samples
The team interview panel members talking about the Novartis Access Initiative's work on NCDs.
This review describes the landscape of schistosomiasis clinical research. The volume of data and the methodological and reporting heterogeneity identified all indicate that there is scope for an individual participant-level database, to allow for standardised analyses.
The European Mobile Laboratory, EMLab, was the first EBOV diagnostics unit deployed to the outbreak epicentre by WHO in March 2014.
Tropical Medicine Global Health Video Seminar, University of Oxford
Laboratory systems and diagnostic technologies are a critical pillar in the fight against malaria. The World Health Organization (WHO) recommends diagnostic testing for all people with suspected malaria before treatment is administered.
U.S. efforts to combat the Zika virus in the US and abroad
If you're interested in Global Health then keep an eye on This Week in Global Health (TWiGH). TWiGH is a live, interactive, weekly global health news update. With Dr Greg Martin.
Travel Medicine and Infectious Diseases have evolved rapidly in recent decades as outbreaks such as SARS, Avian Influenza, Ebola, MERS, Chikungunya, and Zika virus have demonstrated how quickly infections can cross international borders.
The Zika virus appears to have emerged from nowhere, causing widespread health concerns throughout the world after decades of relative silence.
This Week in Global Health or TWiGH presents Global Health Out Loud with Sulzhan Bali & Jessica Taaffe.
The Zika virus is another wild card dealt to us by nature. It was first discovered in 1947.
Video seminar by Chelsea McMullen, Operational Support Officer, International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC), presented at the University of Oxford, 21st October 2015