Differences in clinical features and dengue severity between local and migrant Chinese with dengue infection in Singapore

Migrations in Latin America: the corridor to the American dream is a public health problem

Introduction

Migrant movements have tripled, and it is evident throughout the Americas. On the way to North America, people come from South America, the Caribbean, mainly Haiti, Cuba, Asia, and Africa. People migrate for work, study, humanitarian situations, poverty, violence in their territories, lifestyle change, or family reunification.

Objetive

The aim of this study is to assess the impact of most frequent infectious conditions of the population exposed to migratory movement through the Americas.

Materials and Methods

The present review focuses on the leading infectious diseases migrants acquired during the arduous journey through the tropical areas. Official migration web sides, journals, and scientific journals were used to get information.

Results

Some infectious diseases have re-emerged in transit countries used by migrants, and the increase in migratory phenomena, triggered cases of HIV/AIDS, Tuberculosis, arbovirosis, Malaria, and hepatitis, among others.

Conclusions

Migrants suffer infectious diseases as they pass the countries to the USA; besides, they suffer violence and even sexual assault. The receiving countries should establish public policies to regularize the access of migrants to health services, which include preventive programs and easily accessible vaccination plans. Some of the pathologies suffered by migrants are preventable, although there are groups of populations in extreme social conditions and with compromised nutritional status. The need to establish a primary medical care center to apply an innovative border and transnational protocols for infectious diseases for migrant populations is highlighted.

Direct and indirect effects of age on dengue severity: The mediating role of secondary infection

Severe dengue occurrence has been attributed to increasing age and different dengue virus (DENV) serotypes that cause secondary infections and immune-enhancing phenomena. Therefore, we examined if the effect of age on dengue severity was mediated by infectivity status while controlling for sex and region. Further, we assessed the spatial clustering of dengue severity for individuals with primary and secondary infection across Mexican municipalities. Health data from 2012 to 2017 was retrieved from Mexico's Ministry of Health. A mediation analysis was performed using multiple logistic regression models based on a directed acyclic graph. The models were explored for the direct effect of age on dengue severity and its indirect impact through secondary infection. In addition, severe dengue clusters were determined in some Northeastern and Southeastern municipalities through spatial analysis. We observed a nonlinear trend between age and severe dengue. There was a downward trend of severe dengue for individuals between 0 and 10 years and an upward trend above 10 years. The effect of age on dengue severity was no longer significant for individuals between 10 and 60 years after introducing infectivity status into the model. The mediating role of infectivity status in the causal model was 17%. Clustering of severe dengue among individuals with primary infection in the Northeastern region may point to the high prevalence of DENV-3 in the region. Public health efforts may prevent secondary infection among infants and the aged. In addition, there should be a further investigation into the effect of DENV-3 in individuals with primary disease.

Epidemiology of Indigenous Dengue Cases in Zhejiang Province, Southeast China

Objective

Autochthonous transmission of the dengue virus (DENV) occurred each year from 2014 to 2018 in Zhejiang province, and became an emerging public health problem. We characterized the autochthonous transmission of the DENV and traced the source of infection for further control and prevention of dengue.

Methods

Descriptive and spatiotemporal cluster analyses were conducted to characterize the epidemiology of autochthonous transmission of the DENV. Molecular epidemiology was used to identify the infection source.

Results

In total, 1,654 indigenous cases and 12 outbreaks, with no deaths, were reported during 2004-2018. Before 2017, all outbreaks occurred in suburban areas. During 2017-2018, five out of eight outbreaks occurred in urban areas. The median duration of outbreaks (28 days) in 2017-2018 was shortened significantly (P = 0.028) in comparison with that in 2004-2016 (71 days). The median onset-visiting time, visiting-confirmation time, and onset-confirmation time was 1, 3, and 4 days, respectively. The DENV serotypes responsible for autochthonous transmission in Zhejiang Province were DENV 1, DENV 2, and DENV 3, with DENV 1 being the most frequently reported. Southeast Asia was the predominant source of indigenous infection.

Conclusions

Zhejiang Province witnessed an increase in the frequency, incidence, and geographic expansion of indigenous Dengue cases in recent years. The more developed coastal and central region of Zhejiang Province was impacted the most.

CLEC5A: A Promiscuous Pattern Recognition Receptor to Microbes and Beyond

CLEC5A is a spleen tyrosine kinase (Syk)-coupled C-type lectin that is highly expressed by monocytes, macrophages, neutrophils, and dendritic cells and interacts with virions directly, via terminal fucose and mannose moieties of viral glycans. CLEC5A also binds to N-acetylglucosamine (GlcNAc) and N-acetylmuramic acid (MurNAc) disaccharides of bacterial cell walls. Compared to other C-type lectins (DC-SIGN and DC-SIGNR) and TLRs, CLEC5A binds its ligands with relatively low affinities. However, CLEC5A forms a multivalent hetero-complex with DC-SIGN and other C-type lectins upon engagement with ligands, and thereby mediates microbe-induced inflammatory responses via activation of Syk. For example, in vivo studies in mouse models have demonstrated that CLEC5A is responsible for flaviviruses-induced hemorrhagic shock and neuroinflammation, and a CLEC5A polymorphism in humans is associated with disease severity following infection with dengue virus. In addition, CLEC5A is co-activated with TLR2 by Listeria and Staphylococcus. Furthermore, CLEC5A-postive myeloid cells are responsible for Concanavilin A-induced aseptic inflammatory reactions. Thus, CLEC5A is a promiscuous pattern recognition receptor in myeloid cells and is a potential therapeutic target for attenuation of both septic and aseptic inflammatory reactions.