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Hungwe FTT, Laycock KM, Ntereke TD, Mabaka R, Paganotti GM. A historical perspective on arboviruses of public health interest in Southern Africa. Pathog Glob Health 2024; 118:131-159. [PMID: 38082563 PMCID: PMC11141323 DOI: 10.1080/20477724.2023.2290375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
Arboviruses are an existing and expanding threat globally, with the potential for causing devastating health and socioeconomic impacts. Mitigating this threat necessitates a One Health approach that integrates vector surveillance, rapid disease detection, and innovative prevention and control measures. In Southern Africa, limited data on the epidemiology of arboviruses, their vectors, and their hosts prevent an effective response. We reviewed the current knowledge on arboviruses in Southern Africa and identified opportunities for further research. A literature search was conducted to identify studies published on arboviruses in 10 tropical and temperate countries of the Southern African Development Community (SADC) from 1900 onward. We identified 280 studies, half (51.1%) originating from South Africa, that described 31 arboviral species, their vectors, and their clinical effects on hosts reported in the region. Arboviral research flourished in the SADC in the mid-20th century but then declined, before reemerging in the last two decades. Recent research consists largely of case reports describing outbreaks. Historical vector surveillance and serosurveys from the mid-20th century suggest that arboviruses are plentiful across Southern Africa, but large gaps remain in the current understanding of arboviral distribution, transmission dynamics, and public health impact.
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Affiliation(s)
- Faith T. T. Hungwe
- School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Stockholm, Sweden
- Department of Molecular Medicine, Karolinska Institute, Stockholm, Sweden
- Department of Biochemistry and Biophysics, Stockholm University, Stockholm, Sweden
| | - Katherine M. Laycock
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Rorisang Mabaka
- School of Allied Health Sciences, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Giacomo M. Paganotti
- Botswana-University of Pennsylvania Partnership, Gaborone, Botswana
- Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biomedical Sciences, University of Botswana, Gaborone, Botswana
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Bob NS, Dia M, Ndiaye O, Ba A, Prudhomme J, Diagne MM, Faye O, Faye O, Sall AA, Fall G. Detection and Diagnosis of Rift Valley Fever Virus. Methods Mol Biol 2024; 2824:35-65. [PMID: 39039405 DOI: 10.1007/978-1-0716-3926-9_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Rift Valley fever virus (RVFV) is a globally important mosquito-borne virus that can also be directly transmitted via aerosolization of body fluids from infected animals. RVFV outbreaks cause mass mortality of young livestock and abortions in animals. In most severe human cases, the disease can progress to hemorrhagic fever and encephalitis, leading to death. RVF has a significant economic impact due to the loss of livestock that is a great challenge for people who depend on animals for income and food. Several vaccines are available for animal use, but none are yet licensed for use in human populations. This situation emphasizes the need to have robust and efficient diagnostic methods that can be used for early case confirmation, assessment of seroprevalence, and virus surveillance as well as vaccine efficacy evaluation. Despite the existence of different diagnostic methods for RVFV, we still have untimely reporting or underreporting of cases, probably due to lack of appropriate surveillance systems or diagnostic tools in some endemic countries. Here, we describe different methods available for detection and diagnosis of RVFV.
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Affiliation(s)
- Ndeye Sakha Bob
- Virology Pole-WHO collaborating Center for Arbovirus and viral hemorrhagic fevers, Institut Pasteur de Dakar, Dakar, Senegal
| | - Moussa Dia
- Virology Pole-WHO collaborating Center for Arbovirus and viral hemorrhagic fevers, Institut Pasteur de Dakar, Dakar, Senegal
| | - Oumar Ndiaye
- Virology Pole-WHO collaborating Center for Arbovirus and viral hemorrhagic fevers, Institut Pasteur de Dakar, Dakar, Senegal
| | - Arame Ba
- Virology Pole-WHO collaborating Center for Arbovirus and viral hemorrhagic fevers, Institut Pasteur de Dakar, Dakar, Senegal
| | - Julie Prudhomme
- Virology Pole-WHO collaborating Center for Arbovirus and viral hemorrhagic fevers, Institut Pasteur de Dakar, Dakar, Senegal
- Pays de la Loire Regional Office, Santé Publique France, The French National Public Health Agency, Nantes, France
| | - Moussa Moise Diagne
- Virology Pole-WHO collaborating Center for Arbovirus and viral hemorrhagic fevers, Institut Pasteur de Dakar, Dakar, Senegal
| | - Oumar Faye
- Virology Pole-WHO collaborating Center for Arbovirus and viral hemorrhagic fevers, Institut Pasteur de Dakar, Dakar, Senegal
| | - Ousmane Faye
- Virology Pole-WHO collaborating Center for Arbovirus and viral hemorrhagic fevers, Institut Pasteur de Dakar, Dakar, Senegal
| | - Amadou Alpha Sall
- Virology Pole-WHO collaborating Center for Arbovirus and viral hemorrhagic fevers, Institut Pasteur de Dakar, Dakar, Senegal
| | - Gamou Fall
- Virology Pole-WHO collaborating Center for Arbovirus and viral hemorrhagic fevers, Institut Pasteur de Dakar, Dakar, Senegal.
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MacIntyre C, Lourens C, Mendes A, de Villiers M, Avenant T, du Plessis NM, Leendertz FH, Venter M. West Nile Virus, an Underdiagnosed Cause of Acute Fever of Unknown Origin and Neurological Disease among Hospitalized Patients in South Africa. Viruses 2023; 15:2207. [PMID: 38005884 PMCID: PMC10674603 DOI: 10.3390/v15112207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
West Nile virus (WNV), a mosquito-borne flavivirus, is endemic to South Africa. However, its contribution to acute febrile and neurological disease in hospitalized patients in South Africa is unknown. This study examined two patient cohorts for WNV using molecular testing and IgM serology with confirmation of serological results by viral neutralization tests (VNT) to address this knowledge gap. Univariate analysis was performed using collected demographic and clinical information to identify risk factors. In the first cohort, 219 cerebrospinal fluid (CSF) specimens from patients with acute neurological disease in Gauteng hospitals collected in January to June 2017 were tested for WNV. The study identified WNV in 8/219 (3.65%, 95.00% CI (1.59-7.07)) patients with unsolved neurological infections. The second cohort, from 2019 to 2021, included 441 patients enrolled between January and June with acute febrile or neurological disease from urban and rural sites in Gauteng and Mpumalanga provinces. West Nile virus was diagnosed in 40/441 (9.07%, 95.00% CI (6.73-12.12)) of patients, of which 29/40 (72.50%, 95.00% CI (56.11-85.40)) had neurological signs, including headaches, encephalitis, meningitis, and acute flaccid paralysis (AFP). Notably, most of the cases were identified in children although adolescents and senior adults had a significantly higher risk of testing WNV positive. This suggests a previously underestimated disease burden and that WNV might be underrecognized as a cause of febrile and neurological diseases in hospitalized patients in South Africa, especially in children. This emphasizes the importance of further research and awareness regarding arboviruses of public health concern.
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Affiliation(s)
- Caitlin MacIntyre
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
| | - Carla Lourens
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
| | - Adriano Mendes
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
| | - Maryke de Villiers
- Department of Internal Medicine, Kalafong Provincial Tertiary Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa;
| | - Theunis Avenant
- Department of Pediatrics, Kalafong Provincial Tertiary Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (T.A.); (N.M.d.P.)
| | - Nicolette M. du Plessis
- Department of Pediatrics, Kalafong Provincial Tertiary Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (T.A.); (N.M.d.P.)
| | - Fabian H. Leendertz
- Helmholtz Institute for One Health and University of Greifswald, 17489 Greifswald, Germany;
| | - Marietjie Venter
- Zoonotic Arbo- and Respiratory Virus Program, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0031, South Africa; (C.M.); (C.L.); (A.M.)
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Kim KW, Lee B, Eom S, Shin D, Park C, Kim S, Yi H. Universal primers for rift valley fever virus whole-genome sequencing. Sci Rep 2023; 13:18688. [PMID: 37907670 PMCID: PMC10618441 DOI: 10.1038/s41598-023-45848-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023] Open
Abstract
Rift Valley fever (RVF) is a mosquito-borne zoonotic disease causing acute hemorrhagic fever. Accurate identification of mutations and phylogenetic characterization of RVF virus (RVFV) require whole-genome analysis. Universal primers to amplify the entire RVFV genome from clinical samples with low copy numbers are currently unavailable. Thus, we aimed to develop universal primers applicable for all known RVFV strains. Based on the genome sequences available from public databases, we designed eight pairs of universal PCR primers covering the entire RVFV genome. To evaluate primer universality, four RVFV strains (ZH548, Kenya 56 (IB8), BIME-01, and Lunyo), encompassing viral phylogenetic diversity, were chosen. The nucleic acids of the test strains were chemically synthesized or extracted via cell culture. These RNAs were evaluated using the PCR primers, resulting in successful amplification with expected sizes (0.8-1.7 kb). Sequencing confirmed that the products covered the entire genome of the RVFV strains tested. Primer specificity was confirmed via in silico comparison against all non-redundant nucleotide sequences using the BLASTn alignment tool in the NCBI database. To assess the clinical applicability of the primers, mock clinical specimens containing human and RVFV RNAs were prepared. The entire RVFV genome was successfully amplified and sequenced at a viral concentration of 108 copies/mL. Given the universality, specificity, and clinical applicability of the primers, we anticipate that the RVFV universal primer pairs and the developed method will aid in RVFV phylogenomics and mutation detection.
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Affiliation(s)
- Kwan Woo Kim
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Republic of Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
- Center for Study of Emerging and Re-emerging Viruses, Korea Virus Research Institute, Institute for Basic Science (IBS), Daejeon, Republic of Korea
| | - Banseok Lee
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
- Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Sujeong Eom
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
- Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Donghoon Shin
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
- Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul, Republic of Korea
| | - Changwoo Park
- Microbiological Analysis Team, Group for Biometrology, Korea Research Institute of Standards and Science (KRISS), Daejeon, Republic of Korea
- Convergent Research Center for Emerging Virus Infection, Korea Research Institute of Chemical Technology (KRICT), Daejeon, Republic of Korea
- Department of Agricultural Biotechnology, Seoul National University, Seoul, Republic of Korea
| | - Seil Kim
- Microbiological Analysis Team, Group for Biometrology, Korea Research Institute of Standards and Science (KRISS), Daejeon, Republic of Korea.
- Convergent Research Center for Emerging Virus Infection, Korea Research Institute of Chemical Technology (KRICT), Daejeon, Republic of Korea.
- Department of Bio-Analysis Science, University of Science and Technology, Daejeon, Republic of Korea.
| | - Hana Yi
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.
- Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul, Republic of Korea.
- School of Biosystems and Biomedical Sciences, Korea University, Seoul, Republic of Korea.
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Comparison of RT-qPCR and RT-ddPCR with Rift valley fever virus (RVFV) RNA. Sci Rep 2023; 13:3085. [PMID: 36813787 PMCID: PMC9944419 DOI: 10.1038/s41598-023-29023-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/30/2023] [Indexed: 02/24/2023] Open
Abstract
Rift valley fever (RVF) is an important zoonotic disease caused by the Rift valley fever virus (RVFV) which can affect ruminants and humans. In this study, a comparison was done of the reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and reverse transcription-droplet digital PCR (RT-ddPCR) assays with synthesized RVFV RNA, cultured viral RNA, and mock clinical RVFV RNA samples. The genomic segments (L, M, and S) of three RVFV strains (BIME01, Kenya56, and ZH548) were synthesized and used as templates for in vitro transcription (IVT). Both the RT-qPCR and RT-ddPCR assays for RVFV did not react with any of the negative reference viral genomes. Thus, both the RT-qPCR and RT-ddPCR assays are specific to RVFV. The comparison of both the RT-qPCR and RT-ddPCR assays with serially diluted templates showed that the LoD of both assays are similar, and a concordant of the results was observed. The LoD of both assays reached the practical measurable minimum concentration. Taken altogether, the sensitivity of the RT-qPCR and RT-ddPCR assays is similar, and the material measured by RT-ddPCR can be used as a reference material for RT-qPCR.
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Li Y, Liu J, Zhu Y, Peng C, Dong Y, Liu L, He Y, Lu G, Zheng Y. Alterations of oral microbiota in Chinese children with viral encephalitis and/or viral meningitis. J Microbiol 2022; 60:429-437. [PMID: 35157224 PMCID: PMC8852926 DOI: 10.1007/s12275-022-1560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/15/2021] [Accepted: 01/06/2022] [Indexed: 11/23/2022]
Abstract
The role of oral microbiota in viral encephalitis and/or viral meningitis (VEVM) remains unclear. In this hospital-based, frequency-matched study, children with clinically diagnosed VEVM (n = 68) and those with other diseases (controls, n = 68) were recruited. Their oral swab samples were collected and the oral microbiota was profiled using 16S rRNA gene sequencing. The oral microbiota of children with VEVM exhibited different beta diversity metrics (unweighted UniFrac distance: P < 0.001, R2 = 0.025, Bray-curtis dissimilarity: P = 0.045, R2 = 0.011, and Jaccard dissimilarity: P < 0.001, R2 = 0.017) and higher relative abundances of taxa identified by Linear discriminant analysis (LDA) with effect size (Enterococcus, Pedobacter, Massilia, Prevotella_9, Psychrobacter, Butyricimonas, Bradyrhizobium, etc., LDA scores > 2.0) when compared with the control group. The higher pathway abundance of steroid hormone biosynthesis predicted by oral microbiota was suggested to be linked to VEVM (q = 0.020). Further, a model based on oral microbial traits showed good predictive performance for VEVM with an area under the receiver operating characteristic curve of 0.920 (95% confidence interval: 0.834–1.000). Similar results were also obtained between children with etiologically diagnosed VEVM (n = 43) and controls (n = 68). Our preliminary study identified VEVM-specific oral microbial traits among children, which can be effective in the diagnosis of VEVM.
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Meno K, Yah C, Mendes A, Venter M. Incidence of Sindbis Virus in Hospitalized Patients With Acute Fevers of Unknown Cause in South Africa, 2019-2020. Front Microbiol 2022; 12:798810. [PMID: 35197942 PMCID: PMC8860305 DOI: 10.3389/fmicb.2021.798810] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/31/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sindbis virus (SINV) is a mosquito-borne alphavirus that is widely distributed worldwide. Little is known about the febrile and neurological disease burden due to SINV in South Africa. PATIENTS AND METHODS Clinical samples of patients with acute febrile disease of unknown cause (AFDUC) were collected through the African Network for Improved Diagnostics, Epidemiology and Management of Common Infectious Agents at three sentinel hospital surveillance sites in South Africa. In total, 639 patients were screened using a PCR-based macroarray that can simultaneously detect nucleic acids of 30 pathogens, including SINV, from January 2019 to December 2020. Serum samples were randomly selected from the arbovirus season (January-June) and also screened with a commercial indirect immunofluorescence assay for anti-SINV IgM. In addition, 31 paired cerebrospinal fluid (CSF) specimens from the same patients were screened for IgM. Micro-neutralization assays were performed on all IgM-positive samples. RESULTS None of the specimens tested positive for SINV by molecular screening; however, 38/197 (19.0%) samples were positive for SINV-specific IgM. A total of 25/38 (65.8%) IgM-positive samples tested positive for SINV-neutralizing antibodies, giving an overall incidence of 12.7%. Furthermore, 2/31 (6.5%) CSF specimens tested positive for IgM but were negative for neutralizing antibodies. There was a higher incidence of SINV-positive cases in Mpumalanga (26.0%) than Gauteng province (15.0%). The most significant months for IgM-positive cases were April 2019 (OR = 2.9, p < 0.05), and May 2020 (OR = 7.7, p < 0.05). CONCLUSION SINV or a closely related virus contributed to 12.7% of AFDUC cases in hospitalized patients during the late summer and autumn months in South Africa and was significantly associated with arthralgia, meningitis, and headaches.
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Affiliation(s)
| | | | | | - Marietjie Venter
- Zoonotic Arbo and Respiratory Virus Program, Department of Medical Virology, Centre for Viral Zoonoses, University of Pretoria, Pretoria, South Africa
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Fourie I, Williams J, Ismail A, Jansen van Vuren P, Stoltz A, Venter M. Detection and genome characterization of Middelburg virus strains isolated from CSF and whole blood samples of humans with neurological manifestations in South Africa. PLoS Negl Trop Dis 2022; 16:e0010020. [PMID: 34979534 PMCID: PMC8722727 DOI: 10.1371/journal.pntd.0010020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 11/24/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The Old world Alphavirus, Middelburg virus (MIDV), is not well known and although a few cases associated with animal illness have previously been described from Southern Africa, there has been no investigation into the association of the virus with human illness. The current study aimed to investigate possible association of MIDV infection with febrile or neurological manifestations in hospitalized or symptomatic patients fromGauteng, South Africa. METHODS This study is a descriptive retrospective and prospective laboratory based study. Archived cerebrospinal fluid (CSF) samples submitted to the National Health Laboratory Service (NHLS), Tshwane Academic division for viral investigation from public sector hospitals in Gauteng as well as EDTA (ethylenediaminetetraacetic acid) whole blood samples from ad hoc cases of veterinary students, presenting with neurological and febrile illness, were selected and screened for the presence of alphaviruses using real-time reverse transcription(rtRT) PCR.Virus isolations from rtRT-PCR positive samples were conducted in Vero cell culture and used to obtain full genome sequences. Basic descriptive statistical analysis was conducted using EpiInfo. RESULTS MIDV was detected by rtRT-PCR in 3/187 retrospective CSF specimens obtained from the NHLS from hospitalised patients in the Tshwane region of Gauteng and 1/2 EDTA samples submitted in the same year (2017) from ad hoc query arbovirus cases from veterinary students from the Faculty of Veterinary Science University of Pretoria.Full genome sequences were obtained for virus isolates from two cases; one from an EDTA whole blood sample (ad hoc case) and another from a CSF sample (NHLS sample).Two of the four Middelburg virus positive cases,for which clinical information was available, had other comorbidities or infections at the time of infection. CONCLUSION Detection of MIDV in CSF of patients with neurological manifestations suggests that the virus should be investigated as a human pathogen with the potential of causing or contributing to neurological signs in children and adults.
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Affiliation(s)
- Isabel Fourie
- Zoonotic Arbo-and Respiratory Virus (ZARV) program, Centre for Viral Zoonoses (CVZ), University of Pretoria, Pretoria, South Africa
| | - June Williams
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - Arshad Ismail
- Sequencing Core Facility, National Institute of Communicable Diseases (NICD), Division of National Health Laboratory Service (NHLS), Sandringham, South Africa
| | - Petrus Jansen van Vuren
- Australian Centre for Disease Preparedness, CSIRO-Health and Biosecurity, Geelong, Australia
| | - Anton Stoltz
- Infectious diseases, Steve Biko Hospital, Pretoria, South Africa
| | - Marietjie Venter
- Zoonotic Arbo-and Respiratory Virus (ZARV) program, Centre for Viral Zoonoses (CVZ), University of Pretoria, Pretoria, South Africa
- * E-mail:
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Navien TN, Yeoh TS, Anna A, Tang TH, Citartan M. Aptamers isolated against mosquito-borne pathogens. World J Microbiol Biotechnol 2021; 37:131. [PMID: 34240263 DOI: 10.1007/s11274-021-03097-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/21/2021] [Indexed: 11/27/2022]
Abstract
Mosquito-borne diseases are a major threat to public health. The shortcomings of diagnostic tools, especially those that are antibody-based, have been blamed in part for the rising annual morbidity and mortality caused by these diseases. Antibodies harbor a number of disadvantages that can be clearly addressed by aptamers as the more promising molecular recognition elements. Aptamers are defined as single-stranded DNA or RNA oligonucleotides generated by SELEX that exhibit high binding affinity and specificity against a wide variety of target molecules based on their unique structural conformations. A number of aptamers were developed against mosquito-borne pathogens such as Dengue virus, Zika virus, Chikungunya virus, Plasmodium parasite, Francisella tularensis, Japanese encephalitis virus, Venezuelan equine encephalitis virus, Rift Valley fever virus and Yellow fever virus. Intrigued by these achievements, we carry out a comprehensive overview of the aptamers developed against these mosquito-borne infectious agents. Characteristics of the aptamers and their roles in diagnostic, therapeutic as well as other applications are emphasized.
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Affiliation(s)
- Tholasi Nadhan Navien
- Advanced Medical & Dental Institute (AMDI), Universiti Sains Malaysia, Bertam, 13200, Kepala Batas, Penang, Malaysia
| | - Tzi Shien Yeoh
- Advanced Medical & Dental Institute (AMDI), Universiti Sains Malaysia, Bertam, 13200, Kepala Batas, Penang, Malaysia
| | - Andrew Anna
- Advanced Medical & Dental Institute (AMDI), Universiti Sains Malaysia, Bertam, 13200, Kepala Batas, Penang, Malaysia
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), 94300, Kota Samarahan, Sarawak, Malaysia
| | - Thean-Hock Tang
- Advanced Medical & Dental Institute (AMDI), Universiti Sains Malaysia, Bertam, 13200, Kepala Batas, Penang, Malaysia.
| | - Marimuthu Citartan
- Advanced Medical & Dental Institute (AMDI), Universiti Sains Malaysia, Bertam, 13200, Kepala Batas, Penang, Malaysia.
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Schubert G, Achi V, Ahuka S, Belarbi E, Bourhaima O, Eckmanns T, Johnstone S, Kabore F, Kra O, Mendes A, Ouedraogo AS, Poda A, Some AS, Tomczyk S, Couacy-Hymann E, Kayembe JM, Meda N, Muyembe Tamfum JJ, Ouangraoua S, Page N, Venter M, Leendertz FH, Akoua-Koffi C. The African Network for Improved Diagnostics, Epidemiology and Management of common infectious Agents. BMC Infect Dis 2021; 21:539. [PMID: 34098893 PMCID: PMC8184052 DOI: 10.1186/s12879-021-06238-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background In sub-Saharan Africa, acute respiratory infections (ARI), acute gastrointestinal infections (GI) and acute febrile disease of unknown cause (AFDUC) have a large disease burden, especially among children, while respective aetiologies often remain unresolved. The need for robust infectious disease surveillance to detect emerging pathogens along with common human pathogens has been highlighted by the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. The African Network for Improved Diagnostics, Epidemiology and Management of Common Infectious Agents (ANDEMIA) is a sentinel surveillance study on the aetiology and clinical characteristics of ARI, GI and AFDUC in sub-Saharan Africa. Methods ANDEMIA includes 12 urban and rural health care facilities in four African countries (Côte d’Ivoire, Burkina Faso, Democratic Republic of the Congo and Republic of South Africa). It was piloted in 2018 in Côte d’Ivoire and the initial phase will run from 2019 to 2021. Case definitions for ARI, GI and AFDUC were established, as well as syndrome-specific sampling algorithms including the collection of blood, naso- and oropharyngeal swabs and stool. Samples are tested using comprehensive diagnostic protocols, ranging from classic bacteriology and antimicrobial resistance screening to multiplex real-time polymerase chain reaction (PCR) systems and High Throughput Sequencing. In March 2020, PCR testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and analysis of full genomic information was included in the study. Standardised questionnaires collect relevant clinical, demographic, socio-economic and behavioural data for epidemiologic analyses. Controls are enrolled over a 12-month period for a nested case-control study. Data will be assessed descriptively and aetiologies will be evaluated using a latent class analysis among cases. Among cases and controls, an integrated analytic approach using logistic regression and Bayesian estimation will be employed to improve the assessment of aetiology and associated risk factors. Discussion ANDEMIA aims to expand our understanding of ARI, GI and AFDUC aetiologies in sub-Saharan Africa using a comprehensive laboratory diagnostics strategy. It will foster early detection of emerging threats and continued monitoring of important common pathogens. The network collaboration will be strengthened and site diagnostic capacities will be reinforced to improve quality management and patient care.
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Affiliation(s)
| | - Vincent Achi
- Centre Hospitalier Universitaire Bouaké, Bouaké, Côte d'Ivoire.,Université Alassane Ouattara de Bouaké, Bouaké, Côte d'Ivoire
| | - Steve Ahuka
- Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | | | - Ouattara Bourhaima
- Centre Hospitalier Universitaire Bouaké, Bouaké, Côte d'Ivoire.,Université Alassane Ouattara de Bouaké, Bouaké, Côte d'Ivoire
| | | | - Siobhan Johnstone
- National Institute for Communicable Diseases, Johannesburg, Republic of South Africa
| | | | - Ouffoue Kra
- Centre Hospitalier Universitaire Bouaké, Bouaké, Côte d'Ivoire.,Université Alassane Ouattara de Bouaké, Bouaké, Côte d'Ivoire
| | - Adriano Mendes
- University of Pretoria, Pretoria, Republic of South Africa
| | - Abdoul-Salam Ouedraogo
- Centre Hospitalier Universitaire Sourô Sanou de Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | - Armel Poda
- Centre Hospitalier Universitaire Sourô Sanou de Bobo-Dioulasso, Bobo-Dioulasso, Burkina Faso
| | | | | | - Emmanuel Couacy-Hymann
- Laboratoire National d'Appui au Développement Agricole / Laboratoire Central de Pathologie Animale, Bingerville, Côte d'Ivoire
| | - Jean-Marie Kayembe
- Hôpital Universitaire/Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | - Jean-Jacques Muyembe Tamfum
- Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.,Hôpital Universitaire/Université de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | - Nicola Page
- National Institute for Communicable Diseases, Johannesburg, Republic of South Africa.,University of Pretoria, Pretoria, Republic of South Africa
| | | | | | - Chantal Akoua-Koffi
- Centre Hospitalier Universitaire Bouaké, Bouaké, Côte d'Ivoire. .,Université Alassane Ouattara de Bouaké, Bouaké, Côte d'Ivoire.
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11
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López-Vázquez C, Bandín I, Dopazo CP. Design and Evaluation of a Macroarray for Detection, Identification, and Typing of Viral Hemorrhagic Septicemia Virus (VHSV). Animals (Basel) 2021; 11:841. [PMID: 33809757 PMCID: PMC8002285 DOI: 10.3390/ani11030841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/17/2022] Open
Abstract
The viral hemorrhagic septicemia virus (VHSV) is the causative agent of an important disease in freshwater and marine fishes. Its diagnosis officially relies on the isolation of the virus in cell culture and its identification by serological or polymerase chain reaction (PCR) methodologies. Nowadays, reverse transcription real-time quantitative PCR (RT-qPCR) is the most widely employed technique for the detection of this virus and some studies have reported the validation of RT-qPCR procedures for the detection, typing, and quantification of VHSV isolates. However, although the efficacy of this technique is not in doubt, it can be cumbersome and even impractical when it comes to processing large numbers of samples, a situation in which cross-contamination problems cannot be ruled out. In the present study, we have designed and validated a macroarray for the simultaneous detection, typing, and quantification of VHSV strains. Its analytical sensitivity (5-50 TCID50/mL), analytical specificity (intra and intergroup), efficiency (E = 100.0-101.1) and reliability (repeatability and reproducibility with CV < 5%, and standard curves with R2 < 0.95) with strains from any VHSV genotype have been widely demonstrated. The procedure is based on the 'binary multiplex RT-qPCR system (bmRT-qPCR)' previously reported by the same team, applied to arrays of 96-well PCR strip tubes plates, which can be stored at -25 °C for three months and up to one year before their use, without significant loss of efficiency.
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Affiliation(s)
- Carmen López-Vázquez
- Unidad de Ictiopatología, Instituto de Acuicultura y Departamento de Microbiología, Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Isabel Bandín
- Unidad de Ictiopatología, Instituto de Acuicultura y Departamento de Microbiología, Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Carlos P Dopazo
- Unidad de Ictiopatología, Instituto de Acuicultura y Departamento de Microbiología, Universidad de Santiago de Compostela, 15782 Santiago de Compostela, Spain
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12
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Abstract
Rift Valley fever (RVF) is a zoonotic, vector-borne infectious disease of ruminants and camels transmitted mainly by the Aedes and Culex mosquito species. Contact with the blood or organs of infected animals may infect humans. Its etiological factor is the Rift Valley fever virus (RVFV) of the Phlebovirus genus and Bunyaviridae family. Sheep and goats are most susceptible to infection and newborns and young individuals endure the most severe disease course. High abortion rates and infant mortality are typical for RVF; its clinical signs are high fever, lymphadenitis, nasal and ocular secretions and vomiting. Conventional diagnosis is done by the detection of specific IgM or IgG antibodies and RVFV nucleic acids and by virus isolation. Inactivated and live-attenuated vaccines obtained from virulent RVFV isolates are available for livestock. RVF is endemic in sub-Saharan Africa and the Arabian Peninsula, but in the last two decades, it was also reported in other African regions. Seropositive animals were detected in Turkey, Tunisia and Libya. The wide distribution of competent vectors in non-endemic areas coupled with global climate change threaten to spread RVF transboundarily. The EFSA considers the movement of infected animals and vectors to be other plausible pathways of RVF introduction into Europe. A very low risk both of introduction of the virus through an infected animal or vector and of establishment of the virus, and a moderate risk of its transmission through these means was estimated for Poland. The risk of these specific modes of disease introduction into Europe is rated as very low, but surveillance and response capabilities and cooperation with the proximal endemic regions are recommended.
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13
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Nielsen SS, Alvarez J, Bicout DJ, Calistri P, Depner K, Drewe JA, Garin-Bastuji B, Rojas JLG, Schmidt CG, Michel V, Chueca MÁM, Roberts HC, Sihvonen LH, Stahl K, Calvo AV, Viltrop A, Winckler C, Bett B, Cetre-Sossah C, Chevalier V, Devos C, Gubbins S, Monaco F, Sotiria-Eleni A, Broglia A, Abrahantes JC, Dhollander S, Stede YVD, Zancanaro G. Rift Valley Fever - epidemiological update and risk of introduction into Europe. EFSA J 2020; 18:e06041. [PMID: 33020705 PMCID: PMC7527653 DOI: 10.2903/j.efsa.2020.6041] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Rift Valley fever (RVF) is a vector-borne disease transmitted by a broad spectrum of mosquito species, especially Aedes and Culex genus, to animals (domestic and wild ruminants and camels) and humans. Rift Valley fever is endemic in sub-Saharan Africa and in the Arabian Peninsula, with periodic epidemics characterised by 5-15 years of inter-epizootic periods. In the last two decades, RVF was notified in new African regions (e.g. Sahel), RVF epidemics occurred more frequently and low-level enzootic virus circulation has been demonstrated in livestock in various areas. Recent outbreaks in a French overseas department and some seropositive cases detected in Turkey, Tunisia and Libya raised the attention of the EU for a possible incursion into neighbouring countries. The movement of live animals is the most important pathway for RVF spread from the African endemic areas to North Africa and the Middle East. The movement of infected animals and infected vectors when shipped by flights, containers or road transport is considered as other plausible pathways of introduction into Europe. The overall risk of introduction of RVF into EU through the movement of infected animals is very low in all the EU regions and in all MSs (less than one epidemic every 500 years), given the strict EU animal import policy. The same level of risk of introduction in all the EU regions was estimated also considering the movement of infected vectors, with the highest level for Belgium, Greece, Malta, the Netherlands (one epidemic every 228-700 years), mainly linked to the number of connections by air and sea transports with African RVF infected countries. Although the EU territory does not seem to be directly exposed to an imminent risk of RVFV introduction, the risk of further spread into countries neighbouring the EU and the risks of possible introduction of infected vectors, suggest that EU authorities need to strengthen their surveillance and response capacities, as well as the collaboration with North African and Middle Eastern countries.
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14
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Guillebaud J, Bernardson B, Randriambolamanantsoa TH, Randrianasolo L, Randriamampionona JL, Marino CA, Rasolofo V, Randrianarivelojosia M, Vigan-Womas I, Stivaktas V, Venter M, Piola P, Héraud JM. Study on causes of fever in primary healthcare center uncovers pathogens of public health concern in Madagascar. PLoS Negl Trop Dis 2018; 12:e0006642. [PMID: 30011274 PMCID: PMC6062140 DOI: 10.1371/journal.pntd.0006642] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 07/26/2018] [Accepted: 06/28/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The increasing use of malaria diagnostic tests reveals a growing proportion of patients with fever but no malaria. Clinicians and health care workers in low-income countries have few tests to diagnose causes of fever other than malaria although several diseases share common symptoms. We propose here to assess etiologies of fever in Madagascar to ultimately improve management of febrile cases. METHODOLOGY Consenting febrile outpatients aged 6 months and older were recruited in 21 selected sentinel sites throughout Madagascar from April 2014 to September 2015. Standard clinical examinations were performed, and blood and upper respiratory specimens were taken for rapid diagnostic tests and molecular assays for 36 pathogens of interest for Madagascar in terms of public health, regardless of clinical status. PRINCIPAL FINDINGS A total of 682 febrile patients were enrolled. We detected at least one pathogen in 40.5% (276/682) of patients and 6.2% (42/682) with co-infections. Among all tested patients, 26.5% (181/682) had at least one viral infection, 17.0% (116/682) had malaria and 1.0% (7/682) presented a bacterial or a mycobacterial infection. None or very few of the highly prevalent infectious agents in Eastern Africa and Asia were detected in this study, such as zoonotic bacteria or arboviral infections. CONCLUSIONS These results raise questions about etiologies of fever in Malagasy communities. Nevertheless, we noted that viral infections and malaria still represent a significant proportion of causes of febrile illnesses. Interestingly our study allowed the detection of pathogens of public health interest such as Rift Valley Fever Virus but also the first case of laboratory-confirmed leptospirosis infection in Madagascar.
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Affiliation(s)
- Julia Guillebaud
- Virology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
| | - Barivola Bernardson
- Virology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
- Epidemiology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
| | | | | | - Jane Léa Randriamampionona
- Epidemiology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
- Direction de la Veille Sanitaire et de la Surveillance Epidémiologique, Ministry of Public Health 101, Antananarivo, Madagascar
| | | | - Voahangy Rasolofo
- Mycobacterial Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
| | | | - Ines Vigan-Womas
- Immunology of Infectious Diseases Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
| | - Voula Stivaktas
- Emerging and Respiratory Virus Program, Centre for Viral Zoonoses, University of Pretoria, Pretoria, South Africa
| | - Marietjie Venter
- Emerging and Respiratory Virus Program, Centre for Viral Zoonoses, University of Pretoria, Pretoria, South Africa
| | - Patrice Piola
- Epidemiology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
| | - Jean-Michel Héraud
- Virology Unit, Institut Pasteur de Madagascar 101, Antananarivo, Madagascar
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15
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Abstract
OBJECTIVES The aim of this prospective study is to investigate the central nervous system involvement in Crimean-Congo haemorrhagic fever (CCHF) with magnetic resonance imaging (MRI) in conjunction with clinical and laboratory findings. METHODS Between July 2015 and August 2016, 36 patients with CCHF were undergone brain MRI including SWI. Two MRIs, one at the time of admission and the second in the convalescent period, were performed for each patient in order to see if there is any sign of central nervous system (CNS) involvement, especially in terms of intracranial haemorrhage or viral encephalitis. Clinical severity scoring was also done and laboratory findings were noted in order to correlate with clinical and imaging findings. RESULTS None of the 36 patients showed any MRI findings of an acute intracranial event during the course of the disease. There was a significant difference between mild cases and moderate cases in terms of some laboratory parameters (p < 0.05). CONCLUSIONS Although CCHF is a highly lethal disease which involves multiple organs and systems, CNS involvement seems to be extremely rare in mild and moderate cases. KEY POINTS • MRI is the imaging method of choice to diagnose microbleeds and encephalitis • Although CCHF causes multisystem bleeding, intracranial haemorrhage seems to be very rare • CNS complications are uncommon, even in the setting of suggestive symptoms • Death usually results from extracranial bleeding and multiorgan failure • Severity scoring is associated with some laboratory abnormalities in CCHF.
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16
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Mori D, Khanam W, Sheikh RA, Tabib SMSB, Ikebe E, Hossain MM, Iha H, Ahmed K. Increased serum vascular endothelial growth factor is associated with acute viral encephalitis in Bangladeshi children. Sci Rep 2017; 7:16181. [PMID: 29170534 PMCID: PMC5700941 DOI: 10.1038/s41598-017-16474-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/13/2017] [Indexed: 11/30/2022] Open
Abstract
Encephalitis causes significant global morbidity and mortality. A large number of viruses cause encephalitis, and their geographic and temporal distributions vary. In many encephalitis cases, the virus cannot be detected, even after extensive testing. This is one challenge in management of the encephalitis patient. Since cytokines are pivotal in any form of inflammation and vary according to the nature of the inflammation, we hypothesized cytokine levels would allow us to discriminate between encephalitis caused by viruses and other aetiologies. This pilot study was conducted in a tertiary care hospital in Dhaka, Bangladesh. Viral detection was performed by polymerase chain reaction using patient cerebrospinal fluid. Acute phase reactants and cytokines were detected in patient serum. Of the 29 biomarkers assessed using the Wilcoxon rank-sum test, only vascular endothelial growth factor (VEGF) was significantly higher (P = 0.0015) in viral-positive compared with virus–negative encephalitis patients. The area under the curve (AUC) for VEGF was 0.82 (95% confidence interval: 0.66–0.98). Serum VEGF may discriminate between virus-positive and virus-negative encephalitis. Further study will be needed to confirm these findings.
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Affiliation(s)
- Daisuke Mori
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, 88400, Malaysia
| | - Wahida Khanam
- Department of Paediatrics, Institute of Child and Mother Health, Dhaka, 1362, Bangladesh
| | - Rahamot Ali Sheikh
- Department of Paediatrics, Institute of Child and Mother Health, Dhaka, 1362, Bangladesh
| | - S M Shahnawaz Bin Tabib
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, 88400, Malaysia
| | - Emi Ikebe
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, 879-5593, Oita, Japan
| | | | - Hidekatsu Iha
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, 879-5593, Oita, Japan
| | - Kamruddin Ahmed
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, 88400, Malaysia.
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17
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Simultaneous detection of 13 viruses involved in meningoencephalitis using a newly developed multiplex PCR Mag-array system. Int J Infect Dis 2016; 49:80-6. [DOI: 10.1016/j.ijid.2016.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 04/27/2016] [Accepted: 05/19/2016] [Indexed: 02/07/2023] Open
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18
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Mansfield KL, Banyard AC, McElhinney L, Johnson N, Horton DL, Hernández-Triana LM, Fooks AR. Rift Valley fever virus: A review of diagnosis and vaccination, and implications for emergence in Europe. Vaccine 2015; 33:5520-5531. [PMID: 26296499 DOI: 10.1016/j.vaccine.2015.08.020] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/12/2015] [Accepted: 08/05/2015] [Indexed: 12/14/2022]
Abstract
Rift Valley fever virus (RVFV) is a mosquito-borne virus, and is the causative agent of Rift Valley fever (RVF), a zoonotic disease characterised by an increased incidence of abortion or foetal malformation in ruminants. Infection in humans can also lead to clinical manifestations that in severe cases cause encephalitis or haemorrhagic fever. The virus is endemic throughout much of the African continent. However, the emergence of RVFV in the Middle East, northern Egypt and the Comoros Archipelago has highlighted that the geographical range of RVFV may be increasing, and has led to the concern that an incursion into Europe may occur. At present, there is a limited range of veterinary vaccines available for use in endemic areas, and there is no licensed human vaccine. In this review, the methods available for diagnosis of RVFV infection, the current status of vaccine development and possible implications for RVFV emergence in Europe, are discussed.
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Affiliation(s)
- Karen L Mansfield
- Wildlife Zoonoses and Vector-borne Diseases Research Group, Animal and Plant Health Agency, Woodham Lane, New Haw KT15 3NB, UK.
| | - Ashley C Banyard
- Wildlife Zoonoses and Vector-borne Diseases Research Group, Animal and Plant Health Agency, Woodham Lane, New Haw KT15 3NB, UK
| | - Lorraine McElhinney
- Wildlife Zoonoses and Vector-borne Diseases Research Group, Animal and Plant Health Agency, Woodham Lane, New Haw KT15 3NB, UK; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool L69 7BE, UK
| | - Nicholas Johnson
- Wildlife Zoonoses and Vector-borne Diseases Research Group, Animal and Plant Health Agency, Woodham Lane, New Haw KT15 3NB, UK
| | - Daniel L Horton
- School of Veterinary Medicine, University of Surrey, Guildford GU2 7XH, UK
| | - Luis M Hernández-Triana
- Wildlife Zoonoses and Vector-borne Diseases Research Group, Animal and Plant Health Agency, Woodham Lane, New Haw KT15 3NB, UK
| | - Anthony R Fooks
- Wildlife Zoonoses and Vector-borne Diseases Research Group, Animal and Plant Health Agency, Woodham Lane, New Haw KT15 3NB, UK; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool L69 7BE, UK; Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool L69 7BE, UK
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