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Situación actual de la Fiebre Hemorrágica Argentina
Full text linkFil: Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina
Emerging viral zoonoses: hantavirus infections
No full textFil: Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Levis, Silvana. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Hantaviruses are rodent-borne agents belonging to the Bunyaviridae family. These viruses, which are found throughout Europe, Asia and the Americas, are maintained by different species of rodents, in which they produce chronic, inapparent infections. Humans become infected through contact with urine, saliva or faeces from infected rodents, mainly via the aerosol route. In humans, clinical disease occurs in the form of two major syndromes: haemorrhagic fever with renal syndrome (HFRS) or hantavirus pulmonary syndrome (HPS). Haemorrhagic fever with renal syndrome mainly occurs in Europe and Asia and HPS has only ever been reported in the Americas. Person-to-person transmission of hantaviruses, although uncommon, was described during an outbreak of HPS in southern Argentina. Most epidemics of HFRS and HPS occur in areas with large populations of rodents that have a relatively high prevalence of infection
Rodent-borne emerging viral zoonosis. Hemorrhagic fevers and hantavirus infections in South America
Full text linkFil: Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Pinheiro, F. Communicable Disease Program, Pan American Health Organization/World Health Organization, Washington, DC (FP); Estados Unidos.Hantaviruses and arenaviruses are naturally occurring viruses of rodents. Four South American hemorrhagic fevers caused by arenaviruses have emerged in the last 5 decades. All have similar clinical manifestations, with a case-fatality rate as high as 15% to 30%. Hantavirus infections have been increasingly recognized in South America since the description in 1993 of Hantavirus pulmonary syndrome. Given the diversity of rodent species in the region, it can be foreseen that many other viruses will be discovered, and some of them will be causing human illnesses of high public health impact
Antiviral treatment of Argentine hemorrhagic fever
No full textFil: Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Maiztegui, Julio I. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Argentine hemorrhagic fever is a systemic viral disease caused by Junin virus, with a mortality of 15-30% in untreated individuals. Current specific therapy is highly effective in reducing mortality, and consists of the early administration of immune plasma in defined doses of specific neutralizing antibodies per kg of body weight. However, several reasons suggest the need to investigate alternative therapies. Ribavirin, a broad spectrum antiviral agent, is effective in the treatment of other viral hemorrhagic fevers, and the studies done with Junin virus infections to date indicate that this drug may also have a beneficial effect in Argentine hemorrhagic fever
Relationship between hematopoietic growth factors levels and hematological parameters in Argentine hemorrhagic fever
No full textFil: Marta, R F. Sección Hematología Investigación, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires; Argentina.Fil. Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Molina, Fabiana.Sección Hematología Investigación, Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires; Argentina.Argentine hemorrhagic fever (AHF) is a viral disease caused by Junin virus and characterized by hematologic and neurological involvement. The main hematologic features are leukopenia, thrombocytopenia, and bone marrow hypoplasia. Hematopoietic growth factors serum levels were measured by ELISA technique in forty-eight patients with confirmed diagnosis of AHF. Patients were classified according to the clinical picture in 15 severe (SCF), 17 moderate (MoCF), and 16 mild (MiCF) cases. Erythropoietin levels were decreased in 28 of 45 patients and raised in 4 SCF patients. Twenty-four of 38 patients had high G-CSF levels at admittance in accordance with clinical picture severity, while IL-3, GM-CSF, and TGF-beta were normal in most cases. A direct correlation was found between G-CSF and TNF-alpha levels. Thrombopoietin levels were found to be raised in 19 of 21 patients. In conclusion, the low levels of Epo may contribute to the severe bone marrow erythroblastopenia described in AHF patients, while G-CSF seems to be a marker of illness severity
An overview of the epidemiological, ecological and preventive hallmarks of Argentine haemorrhagic fever (Junin virus)
No full textFil: Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Briggiler, Ana M. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.FIl: Feuillade, María Rosa. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.As a result of the intensive agricultural practices in the humid pampas of Argentina, a “new” arenaviral haemorrhagic fever emerged more than 50 years ago. With the aim of contributing to a better understanding of rodent-borne diseases, the epidemiology and ecology of Junin virus and the public health experience with Argentine haemorrhagic fever are reviewed here
Treatment of Argentine hemorrhagic fever
No full textFil: Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Briggiler, Ana M. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Sánchez, Zaida. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Argentine hemorrhagic fever (AHF) is a rodent-borne illness caused by the arenavirus Junin that is endemic to the humid pampas of Argentina. AHF has had significant morbidity since its emergence in the 1950s, with a case-fatality rate of the illness without treatment between 15% and 30%. The use of a live attenuated vaccine has markedly reduced the incidence of AHF. Present specific therapy involves the transfusion of immune plasma in defined doses of neutralizing antibodies during the prodromal phase of illness. However, alternative forms of treatment are called for due to current difficulties in early detection of AHF, related to its decrease in incidence, troubles in maintaining adequate stocks of immune plasma, and the absence of effective therapies for severely ill patients that progress to a neurologic-hemorrhagic phase. Ribavirin might be a substitute for immune plasma, provided that the supply is guaranteed. Immune immunoglobulin or monoclonal antibodies should also be considered. New therapeutic options such as those being developed for systemic inflammatory syndromes should also be valuated in severe forms of AHF
Análisis de la utilidad de la vacuna Candid 1 en la prevención de la fiebre hemorrágica argentina en niños
No full textFil: Feuillade, María Rosa. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui; Argentina.Fil: Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas Dr. Julio Maiztegui; Argentina.Objetivo. Determinar la estrategia más racional de vacunación con Candid 1 para prevenir la fiebre hemorrágica argentina (FHA) en los menores de 15 años que viven en el área endémica. Métodos.Para el análisis de la efectividad estimada se diseñó un modelo de árbol de decisión, con dos posibles opciones: vacunar a todos los menores del área endémica (vacunación ampliada) o vacunar solamente a los menores de 15 años con mayor riesgo (vacunación selectiva). Estas opciones se compararon con la alternativa de no vacunar. La evaluación se complementó con un análisis de sensibilidad para identificar los valores umbral de las variables críticas que podrían modificar la decisión tomada. Las probabilidades empleadas se tomaron de estudios clínicos y epidemiológicos previos. Resultados. Según el modelo empleado, la estrategia de vacunación ampliada fue la mejor opción, con una utilidad total esperada de 9,99998 (siendo 10 el valor máximo posible). El análisis de sensibilidad demostró que la vacunación selectiva sería la estrategia de mayor utilidad si la incidencia en la población de bajo riesgo se reduce a menos de 3 por 1 000 000 habitantes o si la tasa de reacciones adversas graves a la vacuna asciende a más de 9 por 100 000 habitantes. Ninguna variación de los parámetros empleados en el modelo respaldó la opción de no vacunar. Conclusiones. Con los parámetros de riesgo y de beneficio empleados, se recomienda vacunar con Candid 1 a todos los menores de 15 años que viven en el área endémica de FHA. El modelo propuesto puede adaptarse a las necesidades futuras y ayudar a tomar decisiones mediante la incorporación de los datos prospectivos de la vigilancia de la enfermedad. Estos resultados pueden usarse como base para estudios de costo y eficacia y para otros análisis cuantitativos
Radiologic manifestations of potential bioterrorist agents of infection
Full text linkFil: Ketai, Loren. Department of Radiology, University of New Mexico Health Science Center; Estados Unidos.Fil: Alrahji, Abdulrahman A. Department of Internal Medicine, Section of Infectious Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh; Arabia Saudita.Fil: Hart, Blaine. Department of Radiology, University of New Mexico Health Science Center; Estados Unidos.Fil: Enria, Delia. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Mettler, Fred. Department of Radiology, University of New Mexico Health Science Center; Estados Unidos.In this article, we survey the imaging literature on biologic agents that could potentially be used as weapons. Because respiratory delivery is the most likely method of attack, in most cases we have focused on the manifestations of disease that can be seen after inhalation of the infectious organism. Many of the diseases that can serve as biologic weapons currently occur sporadically (plague, tularemia, eastern equine encephalitis) or as epidemics in localized geographic regions (Rift Valley fever) [8]. Other infections are largely prevented by public health measures (e.g., anthrax prevention by animal vaccination). Smallpox has been eradicated and can recur only if purposefully introduced into the human population. Because these diseases are not widespread, imaging information is limited and, in many cases, relies on radiography. Cross-sectional imaging data are limited. Until the fall of 2001, for instance, no cross-sectional imaging of inhalational anthrax had been reported
Junin Virus Vaccines
No full textFil: Enria, Delia A. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Virales Humanas; Argentina.Fil: Barrera Oro, J. G. ANLIS Dr.C.G.Malbrán. CONICET; Argentina.Argentine hemorrhagic fever (AHF) was recognized as a new clinical entity from the richest farming region of Argentina in the 1950s (Arribalzaga 1955). The etiologic agent of this disease, Junin virus (JUN), was isolated in 1958 (Parodi et al. 1958; Piroski et al. 1959). JUN belongs to the Arenaviridae family, which includes other rodent-borne pathogens which are important causes of hemorrhagic fever in Africa, (Lassa) and South America (Machupo, Guanarito, and Sabia viruses). The Arenaviridae comprises at least 20 recognized members. Arenaviruses are enveloped RNA viruses, and are divided into two groups, with low level antigenic relatedness: the Old World group, and New World group or Tacaribe complex. Two antigenic subgroups were defined within the New World arenaviruses. JUN is contained into the first group, together with Amapari, Latino, Machupo and Tacaribe viruses. Phylogenetic analysis have shown that Old World and New World arenaviruses occupied two distinct clades, and that New World arenaviruses comprise three evolutionary lineages, named A, B, and C. JUN is contained in lineage B, together with the other three agents causing South American hemorrhagic fevers (Enria et al. 1999a)
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