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Laboratory findings for patient during hospital stay
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Case Presentation. Arboviruses primarily consist of RNA, which favours greater genetic plasticity, with a higher frequency of mutations that allow the virus to adapt to different hosts. The initial symptomatology is nonspecific, in that the patient can present fever, myalgia, arthralgia, rash and headache. This makes a clinical diagnosis using labo...
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Macrophages in the kidney play a pathogenic role in inflammation and fibrosis. Our study aimed to understand the polarisation of the M1 and M2 phenotypic profiles of macrophages in injured kidney tissue retrieved from fatal cases of yellow fever virus (YFV). A total of 11 renal tissue biopsies obtained from patients who died of yellow fever (YF) we...
The yellow fever virus (YFV) is an emerging RNA virus and has caused large outbreaks in Africa and Central and South America. The virus is often transmitted through infected mosquitoes and spreads from area to area because of international travel. Being an acute viral hemorrhagic disease, yellow fever can be prevented by an effective, safe, and rel...
Arbovirus, a critical threat to human health, have complex and dynamic life cycles. With reports of Yellow fever virus (YFV) causing spillover from sylvatic transmission cycles, and dengue (DENV), chikungunya (CHIKV), and Zika (ZIKV) viruses expanding from urban to rural areas. We explored a multidisciplinary approach to analyze arbovirus transmiss...
Yellow fever is endemic in Ghana and outbreaks occur periodically. The prodromal signs due to Yellow Fever Virus (YFV) infection are non-specific, making clinical signs unreliable as the sole criteria for diagnosis. Accurate laboratory confirmation of suspected yellow fever cases is therefore vital in surveillance programs. Reporting of ELISA IgM t...
Background
Early detection of human yellow fever (YF) infection in YF-endemic regions is critical to timely outbreak mitigation. African National Laboratories chiefly rely on serological assays that require confirmation at Regional Reference Laboratories, thus delaying results, which themselves are not always definitive often due to antibody cross-...
Citations
... However, the interpretation of PRNT 90 positivity with high antibody titre amidst co-infections may be confounded by the concept of 'original antigenic sin' (antibody to the earlier virus may be higher than the new) [38]. Additionally, 13.8% of ZIKV nAb did not cross-react with other flaviviruses indicating possible monotypic infections while 86.0% did so with DENV, WNV, and YFV in agreement with previous reports [39,40]. These cross-reactions may be co-infections since these viruses are also endemic in the country. ...
Introduction
Although environmental and human behavioral factors in countries with Zika virus (ZIKV) outbreaks are also common in Nigeria, such an outbreak has not yet been reported probably due to misdiagnosis. The atypical symptoms of malaria and ZIKV infections at the initial phase could leverage their misdiagnosis. This study randomly recruited 496 malaria-suspected patients who visited selected health institutions in Adamawa, Bauchi, and Borno states for malaria tests. These patients’ sera were analyzed for ZIKV antibodies using ELISA and plaque reduction neutralization tests (PRNT) at 90% endpoint. About 13.8% of Zika virus-neutralizing antibodies (nAb) did not cross-react with dengue, yellow fever, and West Nile viruses suggesting possible monotypic infections. However, 86% of the sera with ZIKV nAb also neutralized other related viruses at varied degrees: dengue viruses (60.7%), West Nile viruses (23.2%), yellow fever virus (7.1%) and 39.3% were co-infections with chikungunya viruses. Notably, the cross-reactions could also reflect co-infections as these viruses are also endemic in the country. The serum dilution that neutralized 90–100% ZIKV infectivity ranged from 1:8 to 1:128. Also, our findings suggest distinct protection against the ZIKV between different collection sites studied. As indicated by nAb, acute ZIKV infection was detected in 1.7% of IgM-positive patients while past infections occurred in 8.5% of IgM-negatives in the three states. In Borno State, 9.4% of IgG neutralized ZIKV denoting past infections while 13.5% were non-neutralizing IgM and IgG indicating other related virus infections. The age, gender, and occupation of the patients and ZIKV nAb were not significantly different. ZIKV nAb from samples collected within 1–7 days after the onset of symptoms was not significantly different from those of 7–10 days. A wider interval with the same techniques in this study may probably give better diagnostic outcomes. ZIKV nAb was significantly distinct among recipients and non-recipients of antibiotic/antimalaria treatments before seeking malaria tests. The inhibiting effect of these drugs on ZIKV infection progression may probably contribute to the absence of neurological disorders associated with the virus despite being endemic in the environment for several decades. Also, protection against ZIKV as marked by the nAb was different among the vaccinated and unvaccinated YF vaccine recipients. Thus, the YF vaccine may be a good alternative to the Zika vaccine in resource-constrained countries.
Conclusion
The cryptic ZIKV infections underscore the need for differential diagnosis of malaria-suspected febrile patients for arboviruses, especially the Zika virus. The absence of systemic surveillance for the virus is worrisome because of its association with neurological disorders in newborns. Co-infections with other arboviruses may impact adversely on the management of these diseases individually.
... An outbreak of YF occurred in Brazil (São Paulo, Minas Gerais, Espiritu Santo, and Rio de Janeiro states), from December 2016 to May 2018 causing 2154 confirmed cases and 745 deaths, being the largest YF outbreak recorded in Latin America [3,[6][7][8]. Afterwards, from 2018 to 2019, 12 confirmed human cases of YF including six deaths were reported in the same region, and from July 2020 and June 2021, 9 cases were reported [9]. ...
... Rights reserved. outbreak in Brazil [6]. In Angola, a study reported a coinfection between Japanese encephalitis and YF [18]. ...
Purpose of Review
The aim of this study was to compile all cases of yellow fever (YF) recorded in the Guiana Shield (GS), a region located on the northeastern shore of South America.
Recent Findings
Yellow fever causes several deaths in French Guiana during the last years. In this context, we wanted to know if it was due to a lack of vaccination or a reemergence of YF as in Brazil and if it was the same trouble in the neighborhood countries.
Summary
People living in or returning from the GS with YF-compatible symptoms confirmed by reverse transcriptase polymerase chain reaction between 1990 and 2022 were included. In French Guiana (FG), patients were identified through results from the National Reference Center for Arboviruses at the Pasteur Institute in FG and hospital medical charts. For the other countries, medical literature and the WHO database were reviewed. Public health and infectious diseases specialists were solicited to identify unknown and unpublished cases. Nine patients were identified in the study period: five in FG, two in Venezuela, one in Suriname, one in Brazil, including six autochthonous people, Guiana Shield native, and three tourists. The case fatality rate was 7/9 (78%) within 8 days (range: 7–11 days). The M/F sex ratio was 6/3 (2). They had severe liver involvement progressing to multivisceral failure in 89% of cases. Only the two native Amerindian patients in FG had previously benefited from a YF vaccination in childhood and/or for more than 10 years. In conclusion, the sylvatic cycle of the YF virus is likely to persist in this region. Absence of vaccination or unknown immunization status was documented in most patients (78%). The mortality rate of this case series was high thus highlighting the need to strengthen vaccination coverage for the population and travelers to the GS.
... Neurotropic flavi-and alphaviruses can cause simultaneous infections in the cases of ZIKV, YFV and CHIKV co-infections by two or all these viruses, which has been previously reported [79][80][81][82][83][84][85]. Unfortunately, there are relatively few prophylactics or therapeutics treatments for these viruses and they are mostly very specific for one virus-associated target and generally developed for a single virus or viral strain. ...
Several neurotropic viruses are members of the flavivirus and alphavirus families. Infections caused by these viruses may cause long-term neurological sequelae in humans. The continuous emergence of infections caused by viruses around the world, such as the chikungunya virus (CHIKV) (Alphavirus genus), the zika virus (ZIKV) and the yellow fever virus (YFV) (both of the Flavivirus genus), warrants the development of new strategies to combat them. Our study demonstrates the inhibitory potential of the water-soluble vitamin riboflavin against NS2B/NS3pro of ZIKV and YFV and nsP2pro of CHIKV. Riboflavin presents a competitive inhibition mode with IC50 values in the medium µM range of 79.4 ± 5.0 µM for ZIKV NS2B/NS3pro and 45.7 ± 2.9 μM for YFV NS2B/NS3pro. Against CHIKV nsP2pro, the vitamin showed a very strong effect (93 ± 5.7 nM). The determined dissociation constants (KD) are significantly below the threshold value of 30 µM. The ligand binding increases the thermal stability between 4 °C and 8 °C. Unexpectedly, riboflavin showed inhibiting activity against another viral protein; the molecule was also able to inhibit the viral entry of CHIKV. Molecular dynamics simulations indicated great stability of riboflavin in the protease active site, which validates the repurposing of riboflavin as a promising molecule in drug development against the viruses presented here.
... Las dos patologías presentaron tiempo de enfermedad corto (5 en fiebre amarilla severa y 7 días en dengue grave) y esto concuerda con otros estudios realizados (Gehrke et al., 2021;Guindo et al., 2022). ...
En los centros de Emergencia con poco apoyo de laboratorio, es difícil diferenciar a los pacientes con dengue grave y fiebre amarilla severa. El objetivo fue comparar el perfil clínico y de laboratorio de los pacientes con dengue grave y fiebre amarilla severa en Urgencias. Se realizó un estudio observacional retrospectivo de pacientes con diagnóstico confirmado de dengue y fiebre amarilla en el período 2018 a 2020 atendidos en la Unidad de Emergencia del Hospital Carrión, Huancayo-Perú. Se evaluaron un total de 35 pacientes, 11 pacientes (31,4%) fueron diagnosticados con fiebre amarilla severa y 24 pacientes (68,5%) con dengue grave. La media de los resultados de laboratorio con fiebre amarilla severa fueron bilirrubina indirecta 4,7 ml/dL, aspartato transaminasa 4463 UI/L, transaminasa aminotransferasa 4329 UI/L, creatinina 4,9 mg/dl. En pacientes con dengue grave el hematocrito promedio fue 51,8, hemoglobina 17,6 g/dl, plaquetas 24 × 103/mm. En pacientes con síndrome ictérico-febril la presencia de bradicardia, bilirrubina indirecta elevada y transaminasas muy elevadas debe hacer sospechar de fiebre amarilla; mientras que los pacientes que acuden por ascitis, derrame pleural, aumento de hematocrito y deficiencia de plaquetas, se debe tratar como dengue grave sobre todo en Unidades de Emergencia con poco apoyo de laboratorio.
