Rising meningitis in USA and Mexico: insights from the fatal outbreak

Meningitis, an inflammatory disease affecting the meningeal layers of the brain and the spinal cord, poses a significant public health concern globally. Most meningitis cases are caused by viral infections, bacterial infections being the second most common cause, while fungal or parasitic infections are deemed rare. Despite the decrease in bacterial meningitis because of vaccination and treatment, a recent meningitis outbreak in the United States and Mexico highlighted ongoing challenges. The current meningitis outbreak is caused by a pathogenic fungus and is associated with surgical procedures performed under spinal anaesthesia as reported by the Centers for Disease Control and Prevention (CDC) on the 11 May of 2023. Around 20 cases with clinical suspicion of meningitis, including two fatalities, have been attributed to this rampant outbreak. Timely diagnosis, utilising diagnostic modalities such as lumbar puncture and pathogen detection methods, is crucial for appropriate management. Iatrogenic meningitis must be avoided by enhancing surveillance, infection control procedures, and adherence to aseptic practices. To lessen the effects of meningitis and enhance patient outcomes, the WHO's roadmap and preventive interventions, such as targeted immunisations, are essential.

Upsurge of Powassan virus disease in northeastern United States: a public health concern-a short communication

Powassan virus (POWV) is a tick-borne Flavivirus primarily transmitted through ticks in North America which is a significant public health threat in the northeastern United States. POWV infection spans from Ontario to the Mid-Atlantic, Northeast, and Midwest regions in the USA. Climate change, ecological factors, and human-related changes, including shifts in migration and agriculture, contribute to the dissemination of POWV. Symptoms include sore throat, fatigue, headache, and severe neuroinvasive conditions. Specialized attention is required for diagnosing and managing. MRI scans detect central nervous system abnormalities, while neuromonitoring identifies metabolic distress. Severe cases may necessitate ICU hospitalisation with continuous monitoring. Prevention measures, such as awareness, controlling mammals, and protecting pets, reduce POWV infection risk. The recent outbreak of POWV in Maine, USA, highlights the importance of worldwide collaboration for prevention. With the global prevalence of POWV increasing due to climate and socioeconomic changes, implementing preventative measures and promoting awareness are crucial in reducing infection risk.

Outbreak of severe myocarditis in England: Havoc by a harmless virus

Background

The World Health Organization (WHO) has been alerted to a concerning upsurge of severe myocarditis, an inflammatory heart condition, in neonates within Wales and South West England. The myocarditis cases are being intricately associated with enterovirus infection, belonging to the Picornaviridae family. The concerned pathogen poses a significant global disease burden, with an estimated 10 to 15 million symptomatic cases occurring annually in the United States alone. Neonates are particularly vulnerable with children under the age of one accounting for approximately 40% of enterovirus infections.

Material and Methods

A comprehensive literature search was conducted using various databases including ClinicalTrials, Google Scholar, PubMed, ScienceDirect, MEDLINE, and Ovid Resources. The search strategy included utilizing keywords such as "myocarditis," "Randomized controlled trials (RCTs). Only articles written in English were considered, and selection criteria included relevance to the research objectives, reasonable sample sizes, and robust methodology. In addition to the identified articles, meta-analyses, animal models and studies, and references from the selected articles were also examined to ensure a comprehensive review of the literature.

Results

Ten hospitalized neonates, reported in the United Kingdom (UK), with positive PCR tests were reported to have myocarditis, predominantly caused by coxsackieviruses. The current situation in the region has brought global attention. With this study, we hope to draw attention to the critical aspects of the illness and, more crucially, the present strategies required to control the disease outbreak in England.

Discussion

Current European Society of Cardiology (ESC) recommendations for the treatment of acute heart failure apply. Emerging research supports the use of immunosuppressive medication in some circumstances. Patients are advised to avoid aerobic activities for several months after healing. Neonatal enterovirus infections can vary in how they respond to IVIG therapy. The majority of enterovirus infections are self-limited, require no special therapy, and only little supportive care is required.

Conclusion

The recent elevation in numbers for reported severe myocarditis in neonates within Wales and South West England, linked to enterovirus infection, poses a significant public health concern. Myocarditis caused by enteroviruses, particularly Group B coxsackieviruses, is associated with significant mortality rates. Diagnosis is supported by non-invasive techniques and cardiac enzyme blood tests. Treatment modalities primarily involve a palliative approach.

Current Management of Acute Ischemic Stroke in Africa: A Review of the Literature

BACKGROUND

Acute ischemic stroke is one of the leading causes of disability and mortality globally, with increasing incidence in Africa, as the continent is already burdened with infectious diseases. Rapid diagnosis and efficient treatment are crucial, as even a slight delay to reperfuse the brain significantly affects the recovery outcome. Neuroimaging is vital for optimal care and thrombolytic or endovascular therapy in specialised stroke care units. This review aims to discuss the burden of acute ischemic stroke in Africa and how healthcare systems have tried to reduce the incidence and improve outcomes for the disease.

METHODOLOGY

Data was collected from online databases and medical journal published on PubMed, Ovid MEDLINE, ScienceDirect and Embase bibliographical data. All articles related to acute ischemic stroke in Africa were considered.

RESULTS

The medical care for acute ischemic stroke in Africa is far from optimal with little adherence to recommended protocols. There is a lack of public awareness of the disease, imaging infrastructure, personnel, stroke care units and recovery facilities, due to poor funding. Poor knowledge of stroke signs and symptoms results in delay in treatment and poor prognosis.

CONCLUSION

We urge African leaders and private entities to invest in stroke care by building appropriate infrastructures, providing medical equipments, implementing guidelines, and sustainable follow-up systems. Telehealth is a suggested strategy to mitigate the scarcity of health personnel, and international and national efforts to increase treatment affordability should be doubled. Further extensive research on the impact of acute ischemic stroke on the African continent population is encouraged.

Neurological disorders in HIV: Hope despite challenges

Introduction

Human Immunodeficiency virus (HIV) is a virus that causes several diseases by attacking the human immune system. It is transmitted by contact with certain bodily fluids of an infected person, most commonly during unprotected sex, through sharing needles, or from mother to baby during pregnancy, birth or breastfeeding. The central nervous system is not spared from this virus, as HIV has been shown to induce several neurological disorders. However most neurological pathologies (such as dementia, infections, meningitis, and neuropathy) rarely show until late stages, in this case, after the patients develop acquired immunodeficiency syndrome (AIDS). This article aims to review the neurological disorders in the HIV population and the attempts initiated to limit the disease.

Methodology

Data were collected from medical journals published on PubMed, Ovid MEDLINE, Science Direct and Embase bibliographical databases with a predefined search strategy. All articles considering neurological disorders associated with HIV were considered.

Results

To date, the pathogenesis of HIV‐associated neurological complications remains poorly elucidated; thus, imposing a hindrance and limitations on the treatment options. Nevertheless, some studies have reported alterations in dendritic spine as the causative agent for developing brain damage.

Conclusion

HIV remains one of the most serious global health challenges, with neurological manifestations imposing a major concern among patients with HIV. Despite the availability and efficacy of antiretroviral therapies, yet, the risk of developing neurological complications remains relatively high among patients with HIV. Thus, the 2030 HIV vision must focus on further preventive measures to protect HIV patients from developing such neurological complications.

Chemically specific imaging of cryptosporidium oocysts using coherent anti-Stokes Raman scattering (CARS) microscopy

We demonstrate the application of coherent anti-Stokes Raman scattering microscopy for the rapid, label-free chemical imaging of waterborne pathogens. Chemically selective images of cryptosporidium were acquired in just a few seconds using coherent anti-Stokes Raman scattering microscopy, demonstrating its capability for the rapid detection of cryptosporidium at the single oocyst level. We discuss the applicability of such a technique in a near-real time automated water testing system.

Generation of 11 fs pulses by using hollow-core gas-filled fibers at a 100 kHz repetition rate

Using self-phase modulation in a hollow-core fiber filled with xenon, we were able to produce 2.3 microJ laser pulses with a duration of 10.9 fs at a repetition rate of up to 100 kHz. We started with 45 fs, 4.4 microJ, 800 nm pulses generated by a Coherent RegA Ti:sapphire regenerative amplifier system, then spectrally broadened the 30 nm bandwidth to more than 100 nm. Dispersion compensation was achieved with two pairs of chirped mirrors. This is believed to be the first time this type of compression was achieved at a repetition rate as high as 100 kHz. This brings the advantages of few-cycle laser pulses to experiments that require high-repetition-rate, low-energy laser systems, for example, coincidence experiments.