Rabies: Epidemiological update and pre- and post-exposure management

Rabies is a deadly neurotropic viral infection but is preventable through vaccination. Its impact on human and animal health is often devastating. Despite advances in research and control of this disease, along with an effective vaccine, rabies continues to be a lingering threat in many parts of the world. Its high incidence reinforces the constant need to address it with scientific and public health measures. In this review article, we will explore the most important characteristics of the disease, its distribution, symptoms, prevention methods, and the global efforts that have been made to eradicate this deadly disease. The most recent research and advancements in the field of rabies will also be discussed in an effort to understand and combat this deadly disease more effectively.

Effect of an awareness campaign on the diagnosis and clinical impact of primary immunodeficiency

BACKGROUND AND OBJECTIVES

Predominantly antibody deficiencies are the most prevalent primary immunodeficiency (PID) in adults. These are rare diseases difficult to diagnose. Therefore, they are diagnosed late. This study aims to evaluate whether an awareness campaign of PIDs among physicians is associated with an increase in number of diagnoses, a reduction in diagnostic delay and diagnosis at earlier stages.

PATIENTS AND METHODS

A single centre, interventional, quasi-experimental study was designed that included 2 periods, period 1 pre-intervention (1986-2008) and period 2 post-intervention (2009-2018). A descriptive comparative study of variables was carried out in both periods.

RESULTS

116 patients were included [27 (23.3%) in period 1 and 89 (76.7%) in period 2]. The incidence rate increased significantly (0.204 and 1.236/100,000habs./year; P < 0.05), the diagnosis delay tended to be lower (4 vs. 3.73 years). The reasons for diagnostic suspicion were diverse and the burden disease at diagnosis (expressed by bronchiectasis, altered spirometry, ability to generate antibodies by thymus-independent mechanism and need for substitute treatment) tended to decrease in period 2.

CONCLUSIONS

Given the potentially serious complications of patients with late diagnosis of PIDs, it is necessary to create specialized multidisciplinary units, to unify assistance protocols and to design interventions to increase the knowledge of these entities.

[Risk factors related to cardiovascular complications in patients diagnosed with Kawasaki disease in northwestern Mexico]

Background

Kawasaki disease (KD) is an acute systemic vasculitis of small and medium vessels, which occurs primarily in children; it manifests itself as a febrile syndrome coupled with vasculitis data and can cause coronary artery abnormalities in 25% of untreated patients. The objective of this study was to describe the clinical behavior and to identify risk factors for cardiovascular complications in pediatric patients with KD, in a second level hospital in Northwestern Mexico.

Methods

Under a case series design, we studied pediatric patients with diagnosis of KD. We measured clinical variables, laboratory values and the presence of cardiac complications; the probability of risk was determined with odds ratio (OR) and the association with chi squared test.

Results

12 patients were included, and the female gender predominated; the mean age of presentation of KD was 2 years. The clinical presentation was complete in 100 % of the cases and patients also presented atypical manifestations. 50% of the patients studied had cardiovascular complications, the most common of which was coronary disease (33%). The variables male gender, age under 2 years and anemia reported OR of 5.5 and 10 to present cardiovascular complications.

Conclusions

Cardiovascular complications of KD are frequent (more than 30%). Male gender, age under 2 years and anemia increase the probability of risk for the presence of cardiovascular complications.