ECHOViruses Reoviruses

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To date, no deaths have been reported. VP4 also undergoes a second rearrangement, in which the oligomer reorganizes and each subunit folds back on itself, translocating a potential membrane-interaction peptide from one end of the spike to the other. This rearrangement resembles the conformational transitions of membrane fusion proteins of enveloped viruses ref. Replication of dsRNA is partially inhibited, despite there being no reduction in virus titre, demonstrating for the first time a key role for NSP5 during the virus replicative cycle ref.

NSP5 is produced soon after viral infection and localizes in cytoplasmic viroplasms, where virus replication takes place. RNA interference by small interfering si RNAs targeted to genome segment 11 mRNA of 2 different strains blocked production of NSP5 in a strain-specific manner, with a strong effect on the overall replicative cycle : inhibition of viroplasm formation, decreased production of other structural and non-structural proteins, synthesis of viral genomic dsRNA and production of infectious particles ref.

Fusion of tags induces spurious phosphorylation of rotavirus NSP5 ref. The tagged VP1 was able to replace VP1 structurally by being incorporated into progeny viral particles. Dehydration sunken eyes is common and if not dealt with promptly has serious consequences. Severe diarrhea and dehydration occur primarily among children 3 months to 35 months of age. There are increasing reports of cases in which patients who have seizures after an episode of rotavirus diarrhea have evidence of rotavirus in their CSF. Although evidence suggesting that rotavirus is a cause of central nervous system sequelae remains inconclusive, the 2 case reports presented in this study further illustrate a possible association.

All rotavirus-positive stools were to be evaluated for vaccine strains by viral culture with the use of a plaque assay and RNA electropherotyping. Electron microscopy shows abundance of virus particles in the feces; ethyl dodecanoate which smells of pears in diarrhea Therapy : approximately 1 out of every 40 children with gastroenteritis caused by rotavirus will require hospitalization and therapy providing fluids intravenously.

Prevention : there are no approved attenuated vaccines for rotavirus. Efforts to develop an effective and safe vaccine resulted in licensing in of a live oral vaccine RotaShield that was withdrawn less than one year later, after 9 reports of intussusception occurred within the 1st 7 months of vaccine use, more than double the cases reported in the previous 7 years. Intussusception occurs when the intestine telescopes into itself, causing an obstruction of the bowel that may have to be repaired surgically.

An investigation of vaccinated infants confirmed that the vaccine was indeed the cause of the complication.

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Most of these infants had intussusception shortly after their vaccination. The risk of intussusception was 10 times higher than normal, and within the 1st 7 days after vaccination, the risk was 14 times higher than normal. This experience with RotaShield has resulted in the development of new candidate rotavirus vaccines that are currently in late phase III clinical trials.

Web resources : International Rotavirus Symposium.

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Seadornavirus, Reoviridae. Numerous isolates were also obtained from other patients with encephalitis ref1 , ref2 33, First isolation of 8 strains of new orbivirus Banna from patients with innominate fever in Xinjiang. Endemic Dis Bull. Virus isolates from pigs and cattle with genomes having the same electropherotype as BAV were also reported ref.

BAV is now classified as a biosafety level 3 arboviral agent ref. Genomics : Seadornavirus has 7 structural proteins, 5 of which are present in the core ref. The viruses are icosahedral with a diameter of 60—70 nm, and the core has a diameter of 50 nm. The surface of virus has spikes that are similar to those of rotaviruses. The viruses are stable at pH 7. Organic solvents such as Freon or Vertrel XF can be used for purification of viral particles from cell lysates and do not affect infectivity. The seadornavirus genome consists of 12 segments of dsRNA known as Seg-1 to Seg in order of decreasing molecular mass observed by gel electrophoresis.

During replication, viruses are found in the cell cytoplasm within vacuolelike structures that are believed to be involved in morphogenesis ref. Infected cells are not lysed, and the virus leaves cells by budding, thus acquiring a temporary envelope ref. Late infection results in cell lysis from cell death. Intracellular radiolabeling of viral polypeptides has shown termination of host cell protein synthesis ref. In addition to its capacity to replicate in a large number of mosquito cell lines, LNV is the only seadornavirus that replicates in a variety of transformed or primary mammalian cell lines such as Hep-2 human carcinoma cells , BGM, Vero, BHK, L, and MRC-5 human lung fibroblasts.

Infection with LNV results in a massive lytic effect and also kills adult mice. Antigenic relationships between seadornaviruses were investigated by using mouse immune sera. BAV from southern China and Indonesia and KDV from Indonesia are classified as distinct species ref and show no cross-reactivity in neutralization tests. These viruses are also antigenically distinct from LNV. Antigenic variations were observed in many isolates from China that showed cross-reactivity with BAV. Based on a seroneutralization assay, these 2 genotypes were found to represent 2 serotypes of BAV ref.

This finding was further confirmed when the crystal structure of BAV VP9 was determined and showed structural similarities to rotavirus VP8 ref. In addition, VP3 of BAV, which is the guanylyltransferase of the virus ref , exhibited significant amino acid identity with the VP3 of rotavirus, which is also a guanylyltransferase.

These data suggest an evolutionary relationship between rotaviruses and seadornaviruses. Transmission : Seadornaviruses have been isolated from Culex vishnui , Culex fuscocephala , Anopheles vagus , Anopheles aconitus , Anopheles subpictus , and Aedes dorsalis. Seadornaviruses were shown to replicate in adult laboratory mice and were detected in infected mouse blood at 3 days postinfection until day 5 postinfection ref.

New orbiviruses isolated from patients with unknown fever and encephalitis in Yunnan province. Chin J Virol. A serologic diagnostic assay was developed ref based on VP9, the outer coat protein responsible for cell attachment and neutralization. RT-PCR assays were validated in infected murine model, in which the genome could be detected as early as 3 days postinfection. PCR assays identify differences between genotypes A and B of BAV based on the length of the amplicon obtained by specific primers in segment 9. A PCR assay was recently developed for LNV based on sequence of segment 12 that allows detection of the genome in infected mouse blood H.

Attoui, unpub. At least a 4-fold up to fold increase in IgG antibodies was observed in 7 cases. An additional 1, serum specimens of patients from a large number of health institutes in China, who supposedly had JE or viral encephalitis, were tested for anti-BAV IgM antibodies; samples were positive ref.

Mice experimentally infected with BAV develop viremia.

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Clearance of the virus from the circulation occurs concomitantly with the appearance of anti-BAV antibodies ref1 , ref2. Epidemiology : isolated in ; affects mainly adults 20 to 40 years of age during the late winter months. Guide for the care and use of laboratory animals. LCMV primarily targets the liver in these small South American monkeys, producing an acute fatal viral hepatitis with jaundice and milder lymphocytic meningitis.

Callitrichid hepatitis CH broke out in zoos in the US in the s and early s and was associated mostly with the feeding of newborn mice as a dietary supplement. Wild mice were also implicated in some of the documented cases. Seroconversion to LCMV antibodies occurred in 2 individuals involved in some of the episodes one of whom was an attending veterinarian but with no history of clinical disease.

The incidence declined significantly with recommended management practices of not feeding mice and improving rodent control in the zoo settings. Outbreaks of human infection have been recorded in laboratories, and, as a consequence, a laboratory-adapted strain with reduced hazard for humans is commonly used in laboratories now. Animals can become ill or can be asymptomatic. Although other animals could possibly become infected with the virus, documented infections in humans have occurred only after exposure to infected mice, guinea pigs, and hamsters ref1 , Traub E.

The epidemiology of lymphocytic choriomeningitis in white mice. J Exp Med ; Infection in humans occurs primarily through exposure to secretions or excretions of infected animals ref.

Reoviruses I

A large outbreak associated with pet hamsters sold by a single distributor was reported in , when symptomatic cases among persons with hamster contact were identified in 12 states; no deaths occurred ref. The outbreak was brought under control by voluntary cessation of sale and destruction of the infected breeding stock. In mice the virus is maintained both by vertical transmission in utero and via the gastrointestinal tract. Rodent-to-human transmission probably occurs via aerosols and fomites.

Unmanipulated mice all succumb to lethal choriomeningitis within 7 days after LCM i. Death is caused by excessive immunopathology due to the antiviral CD8 response and depends on lytic effector function as well as IFN- g production. Importantly, mice that are harboring LCMV-specific memory lymphocytes at the time of i. Conversely, mice without LCMV memory will only survive the more widespread i. The potential tradeoff is lack of viral clearance and persistent infection if immunity is lowered beyond a certain threshold.

LCMV infection is a well-known occupational risk for laboratory workers who work with LCMV-infected laboratory rodents ref human-to-human transmission of LCMV has not been reported, with the exception of vertical transmission from an infected mother to fetus ref1 , ref2.

Pathology of fatal lymphocytic choriomeningitis virus infection in multiple organ transplant recipients from a common donor. Mod Pathol ;18 Suppl AA , and no exposures to rodents were found. A thorough evaluation was not suggestive of infection. Family members of the woman consented to donation; organs and tissues were recovered, including the liver, the lungs, both kidneys, both corneas, and skin. Within 3 weeks after transplantation, the 4 persons who received the liver, lungs, and 2 kidneys had abnormalities of liver function and blood coagulation, and dysfunction of the transplanted organ.

Signs, symptoms, and clinical laboratory test results varied in these patients and included fever, localized rash, diarrhea, hyponatremia, thrombocytopenia, hypoxia, and kidney failure. The 4th patient, a kidney recipient, survived. Histopathologic findings varied in the 4 cases, but hepatocellular necrosis was common to all 3 decedents on autopsy. The 2 cornea recipients were asymptomatic. Skin was not transplanted. When the cause of illness among the recipients was not identified through extensive diagnostic testing and suspicion of transplant-transmitted infection arose, tissue and blood samples from the donor and recipients were sent from the Rhode Island Department of Health and the Massachusetts Department of Public Health to CDC.

Sequencing of the virus genome confirmed its identity as LCMV. Based on the diagnosis of LCMV infection, the surviving kidney transplant recipient was treated with intravenous ribavirin and reduction in his immunosuppressive drug regimen; the patient improved clinically. Interviews with family members of the donor determined that a pet hamster had been acquired recently.

The hamster was cared for primarily by another family member. Family members of the donor were tested for LCMV antibodies. Genetic sequencing to enable comparison of patient and rodent virus isolates is planned. Public health officials announced the deaths on Mon 23 May There are no plans to begin testing other donor organs for the virus since it is so rare and testing could take several days, potentially making the organs unusable.

He said he believed there was no commercially available test for the virus. Only one previous instance of LCMV causing a transplant-related death has been reported -- in Wisconsin in December -- but it wasn't definitively linked to rodent exposure. CDC investigators were testing the dead hamster, purchased at a Warwick pet shop, to confirm the virus as the cause of the recent deaths.

The Petsmart pet shop where the donor bought the hamster has stopped selling mice and hamsters and has given its import and sales records to the state Department of Environmental Managemen. Jennifer Pflugfelder, spokeswoman for Phoenix-based Petsmart, said the CDC took away about 60 hamsters, mice, and rats last week, and the remaining animals were taken from the shop Mon morning, she said. These inflammatory cytokines lead to the destruction of splenic architecture and immunodeficiency with reduced and delayed virus-specific neutralizing antibody responses.

It has also been associated with neurological illness and miscarriage in pregnant women ref Prevention : persons can minimize risk of LCMV infection from pet rodents by being attentive to proper hand hygiene and environmental cleaning ref1 , ref2 , ref3 control of wild rodents : environmental modifications and hygiene practices that deter rodents from colonizing the home and work environment are the best means of reducing risk for exposure to infectious rodents. In addition, if rodents are found in work or living areas, safe practices for cleaning rodent waste and nesting materials are recommended.

Preventing wild rodent entry also reduces opportunity for infection of pet rodents. Basic precautions can reduce the risk for acquiring LCMV and other infections from pet rodents. Because rodents might not always exhibit signs of ill health resulting from LCMV infection, CDC recommends taking appropriate precautions with any rodent: the public should be apprised of the risk for LCMV infection from rodents purchased from any pet store.

All pets are potential carriers of infectious diseases and should always be handled by using appropriate precautions. Anyone handling or keeping pet rodents should take the following precautions to reduce the risk for LCMV infection: wash hands with soap and water or alcohol-based hand sanitizers when soap is unavailable and hands are not visibly soiled after handling pet rodents or cleaning up pet droppings, cages, or areas where pets have been.

Never kiss or hold pet rodents close to the face. Cover pet rodent cages and food supplies and always supervise pet rodents when they are not in their cages. Pet Stores with Potentially Infected Rodents in Stock : 2 national retail chains have temporarily stopped the sale of potentially affected rodents e. Pet stores that have received rodents from MidSouth Distributors since February should contact the appropriate authority in their states i. Although LCMV is known to infect hamsters and guinea pigs, data are insufficient to determine the potential for infection of other rodent species e.

However, husbandry practices in breeding facilities, distribution centers, and pet stores make cross-contamination with LCMV of other species a possibility. CDC is working with retailers in the pet industry to consider appropriate testing of these other rodent species. Practices that can lead to cross-contamination of rodents include housing healthy rodents in the same room or bin or in cages near potentially infected rodents i. Pet rodents that did not originate from MidSouth Distributors of Ohio and were not exposed to potential ross-contamination can be sold or distributed as normal.

In addition, non-rodent species e. Pet stores are advised to work with state authorities to minimize the risk for transmission of LCMV from affected rodents to humans. Options considered by state authorities include : stopping sale or distribution of all rodents originating from MidSouth Distributors of Ohio since February stopping sale or distribution of hamsters and guinea pigs originating from MidSouth Distributors of Ohio since February allowing distribution i. Educational material should disclose the specific LCMV risk in this population of pet rodents and potential outcomes in humans, including birth defects and fetal deaths.

If sale of rodents is allowed to continue, populations at high risk i. Preventing LCMV infection in new supplies of rodents : efforts are under way to ensure that animal facilities and equipment in retail outlets are disinfected, that new supplies of rodents come from sources free from LCMV, and that cross-contamination between new supplies of rodents and potentially infected animals will not occur.

Surfaces, cages, and any reusable equipment that has been in contact with affected animals, their waste, or bedding material should be cleaned and disinfected by using a household disinfectant according to the manufacturer's instructions. Persons who are pregnant or have compromised immune systems should not engage in cleaning and disinfection related to these affected animals or other rodents. CDC and other partners will work with breeders and retailers in the pet industry to implement quality-assurance programs to minimize the risk for LCMV infection in rodents that are sold to the public.

Previously purchased pet rodents : testing of individual pet rodents in households is not a recommended strategy to minimize risk for LCMV infection; the probability of any one rodent in the United States being infected is low. The greatest infection risk for a pet owner is likely to occur soon after purchase of a pet rodent.

Thus, most exposures likely already have occurred for existing owners and substantial added risk is unlikely to result from continued ownership of the rodent. However, women who are or who plan to become pregnant and persons who are immunocompromised should avoid contact with all rodents. To prevent any possible infection of other rodents in stores, owners should not return pet rodents from MidSouth Distributors to pet stores.

Reoviruses I - Kenneth L Tyler, Michael B A Oldstone - Häftad () | Bokus

For legal, ethical, and wildlife conservation considerations, owners should not release pet rodents into the wild. Persons who no longer wish to keep their pet rodent should consult a veterinarian. CDC continues to work with state public health officials and retailers in the pet industry to educate the public regarding safe handling of pet rodents and has prepared educational material for reducing the risk for LCMV infection from pet rodents. Rodents and other pets from any pet store pose some risk for transmitting certain infectious diseases and should be handled appropriately.

The following precautions can be taken to reduce the risk for acquiring LCMV infection during pregnancy: avoid contact with wild rodents. Pregnant women who reside in a household with a wild rodent infestation should have the infestation addressed promptly by a professional pest control company or another member of the household. Pregnant women should ask another family member or friend to clean the cage and care for the pet or arrange for temporary adoption of the pet by a responsible person.

Pregnant women should avoid prolonged stays in any room where a rodent resides. Persons with impaired immune-system function should avoid contact with all rodents. Serologic testing on rodents can be inaccurate and misleading. All pet animals should be assumed capable of transmitting certain infectious diseases. Similarly, testing persons with previous history of LCMV-compatible illness generally is not useful.

Persons with active disease suggestive of LCMV should seek medical care and report any exposures to wild or pet rodents. A physician should determine whether testing for LCMV is indicated. Physicians should work closely with their respective state health departments to discuss forwarding of samples to state laboratories or CDC for testing The major problem is the assumption that personal protective measures will protect owners of LCMV-infected pets from infection.

There can be disastrous consequences of infection of the fetus of an exposed woman, and potentially of all immunosuppressed persons, so that definitive protection against infection is mandated. Although the incidence of central nervous system disease after LCMV infection of the average person is unknown, the disease is not trivial when it occurs, and an antibody prevalence of approximately 5 percent in the general population suggests there are quite a number of infections. The recommendations listed certainly would reduce the risk of infection if one were working with infected animals, but would not be considered at all adequate for laboratory or animal care of known infected animals.

In particular, the recommendation to "Closely supervise young children when cleaning cages or handling rodents" is ridiculous. The LCMV-infected rodent should not be sold to pet stores or passed along to consumers. LCMV is a chronic, vertically transmitted infection of house mice Mus musculus , and no other host supports it as a chronic infection. In commercial breeding colonies, horizontal infection with chronic virus excretion among hamsters can be sustained, but this form of infection is not known among wild rodents.

Guinea pigs suffer fatal infection, but the outcome of LCMV infection in gerbils and other potential pet rodents is not well-documented.

Cytolytic replication of echoviruses in colon cancer cell lines

Thus, the key element for keeping mouse and hamster colonies free of LCMV is to establish known "clean" colonies and exclude contact with wild Mus , so that the colonies cannot be infected in this way. Because of the difficulty of definitively excluding wild Mus , periodic testing of colonies should be carried out to assure virus is not introduced. This is the norm for breeders of mice and hamsters for scientific use, but there are no statutory requirements for pet animals. It is important to recognize that the goal of maintaining LCMV-free mouse and hamster colonies is readily achievable and has been accomplished by the scientific suppliers.

One also has to appreciate the biology of LCMV; it is uniquely linked to wild house mice, the control point. The potential for aerosol transmission is high and thus measures to reduce human contact with fomites cannot by themselves provide safety. Contrast this with the relation between Toxoplasma gondii and domestic cats.

It is virtually impossible to rid felines of this highly infectious human pathogen, and the strategy for protection of humans and the highly sensitive fetus does involve the kind of protective measures suggested. We strongly urge the adoption of measures to assure that breeding centers for pet animals be properly tested for LCMV infection, that animals sent from infected colonies be traced and destroyed, and that we be able to assure a source of pet rodents safe from infection with virus. The tragedy of fetal infection with LCMV and the morbidity from this virus can be reduced to virtually zero.

Callitrichid marmosets and tamarins hepatitis occurred in zoos in the US in the s and early s and was associated mostly with the feeding of newborn mice as a dietary supplement. In these cases, newborn mice were not obtained from sources known to be properly controlled against LCMV infection. Wild mice were also implicated in some of the documented cases ref. Infection beyond the major colonies would be horizontal and thus not be a problem with mice. It could be more of a problem with hamsters, but would be more likely to lead to overt disease ref1 , ref2 , ref3.

The colonies could be monitored easily. Studies during outbreaks in the past show that infection can occur when infected animals are kept in homes even without direct contact, and laboratory workers have been infected presumably by aerosols after only a single entrance into a laboratory ref1 , ref2 , ref3. The bottom line is that there appears to be a lack of political will to take the necessary steps. Telling people who likely will never see the recommendations to "be careful" and not mentioning that close supervision of young children when cleaning cages or handling rodents is essentially irrelevant or that it would be better to have strict surveillance of the hamster or any pet , rather than the child, seems irresponsible.

The best solution is to legislate requirements for pet shops and other sources of rodents or to eliminate these sources of disease altogether and suggest acquiring a real pet or go to a baseball game. Half a century of experience with LCMV plus the repeated experiences with nfectious agents found among prairie dogs tularemia, monkeypox, plague, hantaviruses should have changed the landscape in all this but obviously has not. No spread to other lab or hospital staff was seen ref in a tube containing concentrated Sabia virus broke in a centrifuge at the Yale Arbovirus Research Unit.

The centrifuge did not have screw-top caps on the buckets, so the contents of the tube were sprayed around the interior of the machine. The researcher cleaned it up as best he could, but became infected. While in the incubation period of the disease, before feeling very ill but probably already infectious, he attended a conference in the USA attended by a large number of people.

Not one of them became infected, and neither did any of the staff who attended him at the hospital during his illness. He made a full recovery ref. Transmission : the reservoir is unknown but assumed to be a rodent. Tacaribe virus : isolated from bats in Trinidad, it is immunologically related to the Junin and Machupo viruses. Viral person-to-person transmission of ANDV Sout lineage was described for the first time during an HPS outbreak due to ANDV Sout lineage in southwest Argentina in , in which 16 persons were involved ref1 , ref2 , ref3 , but in general, clusters of HPS cases are mainly attributed to a common source of rodent exposure.

This mechanism of interhuman virus spread, which makes ANDV unique among the hantaviruses, is not the only exclusive feature of this virus. ANDV was the only American hantavirus isolated from human serum ref. Clinicians at referral centers were concerned because some of the primary care providers from whom they received referrals displayed a less than thorough degree of awareness that mortality due to HCPS is nearly always due to cardiac insufficiency. In contrast to mechanical ventilation, which is available at any referral center, ECMO offers the distinct advantage of supporting patients whose cardiac function is markedly impaired by disease, as is almost universal in patients with severe "HPS".

The intensive care unit physicians hoped that the adoption of the nomenclature "hantavirus cardiopulmonary syndrome" would improve the understanding among referring physicians of the importance of providing cardiac support for patients with HCPS. This hope may be justified, as referring physicians appear to be more aware of the cardiac manifestations of HCPS in the wake of the use of the term by referral center providers. In the case of Andes virus infection, renal insufficiency and muscle inflammation are observed more frequently than is the case with Sin Nombre virus infection in North America.

Epidemiology : Asia Transmission : reservoir : Apodemus agrarius. Severity of the illness varies, mild or subclinical infections common. More severe cases are characterized by a febrile stage lasting days with abrupt onset of fever , headache , photophobia , blurred vision, prostration, nausea and vomiting , facial flushing extending to neck and shoulders, conjunctival petechiae, periorbital edema, acute pharyngitis , axillary petechiae, lumbar back pain and CVA tenderness lasting days. The illness may gradually resolve after this febrile stage or a systemic arterial hypotension stage may begin as the temperature falls.

The hypotensive stage is characterized by decreased blood pressure, tachycardia, and sometimes shock. Proteinuria, thrombocytopenia , leukocytosis , and acute renal failure occur in some cases. Renal function returns as the oliguric phase resolves and the polyuric phase ensues. Electrolyte imbalances and dehydration may occur in the polyuric phase. Disseminated intravascular coagulation may occur relatively early in the course of illness.

Treatment is supportive. TGNV represents the 2nd hantavirus from Africa and the 2nd in the world in a shrew isolated from Crocidura theresae collected in the grassland savannah around the village Tanganya. However, it does seem likely that Seoul hantavirus is also present in Africa, since it is widely disseminated around the world with the inadvertent transport of infected rats Rattus spp.

One hopes that these researchers will isolate and sequence all of Tan virus to permit a complete molecular comparison with the other hantaviruses, and as a candidate for in vivo studies of pathogenesis. Its low sequence similarity to other hantaviruses should make this virus serologically distinct from other hantaviruses, as shown for TPMV. Therefore, human infections by TGNV might be missed when using antibody detection assays based on antigens from conventional hantaviruses ref Thottapalayam virus TPMV is the only hantavirus so far isolated from a non-rodent, hence its peculiar place on the genotypic tree of hantaviruses.

It was isolated from the spleen of a house shrew Suncus murinus in July i. Subsequently there have been no other reports of hantavirus infections in India : it is the only hantavirus isolated in India so far. Not known to have any association with human disease. Hjelle, New Mexico , in Indian sera of cases, suspected for leptospirosis. These sera were kindly forwarded to us by Prof. Terpstra and Dr. Title: Hantavirus-induced hemorrhagic fever with renal syndrome HFRS has to be considered in the differential diagnosis of leptospirosis-suspected cases in the New and the Old World.

Am J Trop Med Hyg ; Dengue infection was likewise serologically excluded. The 2nd fatal case was a Cochin female patient 64 y , who presented with fever, myalgiae, dyspnea and abdominal pain. An adult respiratory distress syndrome ARDS picture with extreme hypoxia prompted mechanical ventilation.

The patient died in refractory shock on hospital day 7. These preliminary results were published as an abstract in: Clement J. First fatal cases of hantavirus nephropathy in India. Clin Inf Dis ; SEOV can induce thrombocytopenia with concomitant kidney and liver involvement, thus perfectly mimicking leptospirosis. The clinical picture is most often of intermediate severity. Although we found evidence of a SEOV-like infection in 12 percent of the Indian "leptospirosis-like" cases, the more severe cases were suggestive rather of a PUUV-like infection, which was surprising.

Indeed, whereas in Europe and Russia, PUUV-infections are spread by red bank voles, this rodent and consequently also the virus carried by bank voles are absent from India. In this hypothesis, the low yield in our screening for hantaviruses in India may be explained by the fact that we were using only or in part cross-reacting antigens.

From a clinical point of view, it is also unlikely that the severe hospital courses as depicted above could be attributed to a true PUVV infection, whiih is mostly rather mild. Epidemiology : human infections typically occur in late autumn or early winter, when the bank voles often invade human dwellings. NE is a notifiable disease in Finland. According to national statistics, a drastic change in the human epidemiology has been seen recently. Since the late s until the late s, there were around human cases annually in Finland, and the yearly variation was not large at the national scale.

However, a change took place in , when a record cases was reached; in , a new record of ; and in , human cases were diagnosed. In addition, the numbers of human cases have been higher than earlier in the between-peak years.

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The Finnish population is 5. For comparison, the same incidence rate would cause nearly human cases in the U. There are 2 clear trends in the Finnish data. The long-term increasing trend is apparently based on better awareness and diagnostics of the disease. The increasing trend is also clear in local data sets and in between-peak years. However, the most important feature is that the human epidemiology has changed from a rather stable national multi-annual pattern to a strongly cyclic one.

The change in NE dynamics is obviously due to the change in the geographic synchrony of vole fluctuations in Finland. In the southern half on Finland, where most people live and most human NE data come from, a vole cycle usually lasts for 3 years, though 4-year cycles are also known. Vole cycles are monitored by the Finnish Forest Research Institute, e. From the s until the late s, the geographic coverage of a vole peak was not as extensive as it is presently.

For example, earlier, a vole peak occurred simultaneously in western and south-central Finland, and a year later in southeastern Finland. In the late s, a change in geographic synchrony took place, and since then, the vole peak has occurred in the same year through most of the southern half of Finland from the western coast to the eastern border. As a result, the number of human cases that earlier were dispersed over 2 or 3 years in geographically different areas now occur in the same year in the whole area. The reason for this geographic change in the synchrony of vole cycles is not well known, but changes like this have taken place earlier and may therefore not be related to any present sudden environmental change.

Therefore, we expected a new record in human NE numbers in However, the numbers remained at the same level as n This might have been because the autumn was exceptionally warm and the autumnal movements of bank voles to human settlements were probably delayed. Consequently, also the seasonal peak in human NE incidence was delayed from late autumn to mid-winter, and over to early Bank vole numbers were also high on coastal regions in southern and southwestern Finland, resulting in times more NE cases than normally in these regions, where NE usually is not common Russia Bashkortostan earlier Bashkiriya , its capital Ufa, and the surrounding area : large focus which extends from Samara, on the river Volga, and surrounding areas east to Bashkortostan and south to Uralsk on the Kazakhstan side.

Over the past few years, reports of outbreaks of HFRS have been reported regularly from Tatarstan and other regions along the Volga River, where Puumala virus is the likely etiologic agent : bank vole populations in these regions fluctuate naturally, and the peaks seem to follow a 3-year pattern. A huge epidemic occurred along the Volga River with thousands of human cases in the late s. On average, the number of HFRS cases recorded in the Khabarovsk region annually ranges from 20 to cases. However, in the Khabarovsk region was not included in the list of high risk regions for HFRS infection.

The Khabarovsk region is located in the far eastern part of Russia, bounded in the east by the Sea of Okhotsk and the Sea of Japan. In the south, the Khabarovsk region borders the Heilongjiang province of China. In the southwest and west, it borders the Amur region; in the northwest and north, the Republic of Sakha; and in the northeast, the Magadan region.

The mountain ranges of Sykgote-Alin, Jzhugzhur, and Suntar-Khayat occupy the greater part of the territory. In Germany, laboratory-confirmed hantavirus cases were reported between 1 Jan and 30 Jun and, in contrast to previous annual trends, the increase in cases has occurred earlier in The total numbers of cases for and were, respectively, and 47 in Belgium, and 55 in France. In Germany the numbers of reported cases for and from 1 Jan to 30 Jun were 72 and 64, respectively. In , most cases have been in men; the male:female sex ratio was 3. Their mean age was around 41 years in all 3 countries: 43 range: 11 to 82 years in Belgium, 43 range: 16 to 83 years in France and 41 range: 5 to 75 years in Germany.

Belgium : the area most affected in this outbreak is Luxembourg province, where there have been 34 cases, an incidence of 2. A large number of cases in Liege province was observed in In Belgium, hantavirus epidemics are characterised by a minor spring peak and a major summer peak, and so a further increase in the registered number of cases is anticipated for According to local health professionals, part of this increase is due to a greater awareness among health professionals and a higher recourse to hantavirus testing. Risk factors for Belgian cases are not yet available.

Since Known endemic areas are the provinces of Hainaut, Namur and Luxembourg. Until with epidemics in with 62 cases, with cases, with cases, with cases a 3-year cycle in increased hantavirus infection activity could be observed, from this year on and up until a 2-year cycle occurred epidemics in with cases, with cases and with cases.

Surprisingly, resulted in cases and was the 1st epidemic year with no preceding non-epidemic year Heyman, P. Distribution of hantavirus foci in Belgium. Acta Trop. A major outbreak of hantavirus infection in Belgium in and Incidence of hantavirus infections in Belgium. Virus Res. Larger than usual increase in cases of hantavirus infections in Belgium, France and Germany, June The Departement of Jura bordering on Switzerland is also an epidemic area, with 13 cases to 15 Jun 5.

Since , over cases of hantavirus infection have been diagnosed in France. Hantavirus outbreaks have been described in , , , , , , and , with most cases having onset in summer. The known endemic areas in previous years have been northeastern France, along the Belgian and German borders in the Administrative Departements of Ardennes, Aisne, Nord and the administrative regions of Lorraine, Picardie and Franche-Comte.

Clusters of hantavirus infections have rarely been reported in the Jura before In France, the national reference laboratory for hantavirus infections is in charge of surveillance of human infections. Germany : the increase of hantavirus infections in Germany between 1 Jan and 30 Jun has also been seen in federal states such as Nordrhein-Westfalen, Niedersachsen and Hessen, that have not had high hantavirus prevalence in previous years.

The federal states most affected are Nordrhein-Westfalen 92 cases, 0. In Germany, the average incidence for hantavirus infections over the time period was 0. An increase in hantavirus infections was observed in and In both years the increase was due to outbreaks in a known endemic area of Baden-Wuerttemberg, and an outbreak of 38 cases also occurred in Niederbayern in In Germany, the known regions with higher prevalence of human hantavirus infections are Schwaebische Alb in Baden-Wuerttemberg and parts of Unterfranken in Bayern Bavaria.

Hantavirus infection became a notifiable disease in Germany with the introduction of the Infektionsschutzgesetz the Protection against Infection Act in In many forest and agricultural regions of Belgium, France and Germany, a significant increase in the population density of rodents, especially voles, has been observed since the autumn of , with no sign of this increase abating. General recommendations for avoiding hantavirus infection include preventing rodent access to houses or buildings. Any factor that could attract rodents inside, such as keeping uncovered food, should be avoided.

When cleaning a previously unoccupied building where rodents may have settled, soil and surfaces should be sprayed with a disinfectant before dust is removed. People living in endemic areas should be informed about the risk factors and clinical symptoms of the disease, and advised to seek medical attention and report their risk exposure if they develop symptoms consistent with haemorrhagic fever with renal syndrome HFRS.

Information has been released to the general public in Liege province in Belgium, and general information is available on the website of the Scientific Institute of Public Health IPH , Brussels and the national reference laboratory's website. An update of the situation on 24 Jun is also available on the IPH website ref.

Printed versions of the leaflet have been widely distributed and more copies can be obtained from the IPH. In France, information about the disease and recommendations for avoiding infection have been issued in the national media to alert the resident population in affected areas and tourists. A leaflet is being printed by the Ministry of Health describing the clinical features of hantavirus infection and general recommendations protecting homes from rodents and avoiding infection when working or spending leisure time outdoors, and this will be soon available in camping sites, leisure centres and tourist information offices.

The InVS [Institut de veille sanitaire] has published a press release ref and more information is available at the websites of the Ministry of Health and the Institut Pasteur. In Germany, a further increase in human cases is expected during the following months. Health care professionals around Germany are increasingly aware of the disease, and guidelines for preventing hantavirus infection are available on the RKI website ref. In collaboration with the federal and local health departments, the RKI is conducting a nationwide case control study to identify more specific risk factors for human hantavirus infections in Germany ref.

There are plans to trap rodents in affected areas to test for hantavirus infection. The larger than usual increase in hantavirus infections in France, Belgium and Germany in that was recently reported ref is also being observed in Luxembourg, which is surrounded by these 3 countries.

Since March , 14 cases of Puumala virus infection have been laboratory-confirmed in Luxembourg, compared with 2 cases in and no cases in The other 12 patients living in Luxembourg are clustered in the rural region of Mullerthal and surrounding areas in the east of the country, which suggests that the outbreak in Luxembourg is quite localised.

The Mullerthal is an area characterised by beech forests and sandstone formations. The mean age of patients is 41 years range 21 to 70 , similar to that observed in the neighbouring countries ref. The male-to-female ratio is 1. Most cases so far confirmed occurred in June and it is not clear whether the incidence has already peaked.

Hantaviruses are carried by bank voles and their population size is known to vary according to the availability of food. This means that there were unusually large seed crops, and is the most likely reason for an increase of the bank vole population this year. In the past, the peak of human hantavirus cases in the Ardennes region which encompasses parts of northeastern France, Belgium, Luxembourg and Germany have tended to occur in spring and summer, unlike the cases in northern Europe which tended to peak in autumn and early winter ref.

Given the direct epidemiological link between bank voles and hantavirus, it is quite likely that a higher incidence of human hantavirus infections is to be expected in other areas belonging to the western European broadleaf forests, where beech mast years may also have occurred in Transmission : reservoir : Clethrionomys glareolus. HFRS cases are usually coincident with invasion of human dwellings by field and forest rodents with the onset of colder weather.

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  8. Indirect infection of humans occurs by inhalation of rodent detritus, although some outbreaks have been related to fecal contamination of food supplies. Epidemiology : all North America, except the extreme southeastern states and southern Mexico. International catalogue of arboviruses, including certain other viruses of vertebrates.

    Previous serosurveys have indicated that humans in some parts of the USA are commonly infected by Bunyamwera serogroup viruses. Such results, however, are often difficult to interpret because of nonrandom sampling, multiple Bunyamwera serogroup members circulating in the same area, inclusion of a limited number of viruses in tests, and serologic cross-reactivity among members of the serogroup.

    The vertebrate amplifying hosts of CVV have been little studied, but a high prevalance of neutralizing antibody to this virus is often found in ungulates ref , including deer, sheep, horses, and cattle ref1 , ref2 , ref3. The virus has been isolated from a healthy cow and a sick sheep in Texas ref and from a healthy horse in Michigan ref.

    It is teratogenic in sheep ref. Unfortunately, because no details about this case or the method of diagnosis were provided, and because the known range of Tensaw virus does not include Indiana, the validity of this report is uncertain. Few CSF specimens are cultured for arboviruses because relatively few diagnostic laboratories have the expertise to do so and because even in acute, serologically confirmed cases of neuroinvasive arboviral disease, the isolation rate from CSF is generally low.

    No tests for CVV immunoglobulin M, such as enzyme immunoassay, are available. Tests for neutralizing antibody to this virus require handling live virus under biosafety level 2 containment and thus are only available by special request at CDC through state health departments and selected reference laboratories.

    Epidemiology : first isolated in the Slovakian village of Tahyna in Austria : isolated from mosquitoes Aedes caspius on the eastern shore of Lake Neusied. Antibodies against Tahyna virus have been documented among wild and domestic mammals in the eastern Neusiedlersee area. Croatia : seropositivity toward Tahyna virus is found among wild bears Ursus arctos. Czech Republic : evidence for Tahyna virus infection has been demonstrated in the Czech Republic including midges and humans in West Bohemia; and in humans and cormorants in Moravia.

    Tahnya virus was isolated from mosquitoes Ae. Seroprevalence toward Tahyna Batai virus has been demonstrated in wild animals. France : identified in mosquitoes Culex modestus in France. Italy : seropositivity toward Tahyna virus has been demonstrated in small mammals. Macedonia : seropositivity toward Tahyna virus is found among wild bears Ursus arctos. Norway : viruses related or identical to Tahnya virus have been isolated from mosquito species Aedes sticticus , Ae.

    Poland : antibodies to Tahnya virus have been detected in house sparrows Passer domesticus and tree sparrows P. Romania : seropositivity toward Tahyna virus has been demonstrated in humans. Russian Federation : Tahyna, Inkoo, and other variants are present. Rates are highest in summer and in persons below age Over human infections were documented during to Highest risk exists in western Siberia Ryazan region, Sverdlovsk. Seropositivity is documented among humans in Irkutsk.

    Mosquito infection rates to vary: 0. Vectors include Aedes communis , A. Ochlerotatus cataphylla , A.

    10 Replication of dsRNA virus

    Serbia and Montenegro : human infection by Tahyna virus has been reported. Seropositivity toward this agent is found among wild animals. Slovakia : seropositive birds and sheep are reported. Natural infection of mosquitoes Aedes vexans and midges Ceratopogonidae has been identified.

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    Spain : seropositivity toward Tahyna virus has been demonstrated in small mammals. Tajikistan : Tahyna virus has been identified in the blood of febrile patients, and in mosquitoes collected in Dushanbe. Transmission : the principal vector is Aedes vexans ; with additional transmission by Ae. Epidemiology : originally reported in Trinidad in , when the prototype virus strain was isolated from the blood of a febrile patient and from a pool of Coquillettidia venezuelensis mosquitoes ref.

    Oropouche fever. In: Feigin RD, editor. Textbook of pediatric infectious diseases. Philadelphia: W. Saunders Co. Nunes, unpub. In Peru, only genotype II has been identified. ICTVdB management. New York: Columbia University; Epidemiology : isolated from Aedes circumluteolus and Eretmapoditeschrysogaster in Africa; serologically related species infect humans and other animals. Enzootic hepatitis or Rift Valley fever: an undescribed virus disease of sheep cattle and man from East Africa.

    Rift Valley fever. In: Monath TP, ed. The arboviruses: epidemiology and ecology. They are less than 0. Transcriptional regulation. Regulation of transcription controls when transcription occurs and how much RNA is created. Transcription of a gene by RNA polymerase can Cell Membrane. Cell membrane also called the plasma membrane, plasmalemma, or "phospholipid bilayer" is a selectively permeable lipid bilayer f Western Blot Animation.

    The western blot alternately, immunoblot is a method of detecting specific proteins in a given sample of tissue homogenate or extract. Irritable Bowel Syndrome. Irritable bowel syndrome IBS is a functional bowel disorder characterized by mild to severe abdominal pain, discomfort, bloating and alter Cleft Palate. Cleft lip and cleft palate, which can also occur together as cleft lip and palate are variations of a type of clefting congenital deformity Muscle Architecture.

    Paramecium Dividing. Paramecia are unicellular organisms usually less than 0. They are Olfactory Pathway Animation. The olfactory system is the sensory system used for olfaction. Most mammals and reptiles have two distinct parts to their olfactory system Our Services Click to join Biosolutions.

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