Conclusion: The commercially prepared vaccine did not induce a robust, measurable humoral response in captive deer. Killed virus vaccines have previously ...
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Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
Conclusion: The commercially prepared vaccine did not induce a robust, measurable humoral response in captive deer. Killed virus vaccines have previously been shown to provide effective protection from BTV in sheep. Efficacy of autogenous vaccines depends on multiple factors including the similarity of viruses in the vaccine to the wild-type strain, the use of a proper adjuvant to induce immune response, and purity of the vaccine. Vaccine makers must conduct proper testing of purity and efficacy of vaccine prior to offering its project to the market, and cervid owners are advised to test for antibody production if they are going to use autogenous vaccines. http://dx.doi.org/10.1016/j.ijid.2016.11.366 20.181 The changing patterns of Dengue and malarial infections -study from a Hospital in Mumbai India A. Barua ∗ , M.E. Yeolekar K J Somaiya Medical College and Hospital, Internal Medicine, Mumbai/IN Purpose: A definite change in the trend of Dengue and malarial infections, their clinical features and outcomes has been noticed recently. The present study, in a Mumbai hospital, during three consecutive monsoons, was carried out,to observe and compare the changing patterns of Dengue and malarial infections, in Mumbai, India. Methods & Materials: A comparative, retrospective cross sectional study of Dengue, Malaria and their coinfections was carried out, during three consecutive monsoons (June to November;20132015) in a Mumbai hospital. Febrile patients, during this period, were investigated for both Dengue and Malaria simultaneously. Elisa (NS-1/IgM) and peripheral smear examination was done to confirm Dengue and Malaria, respectively. Clinical comparison of signs and symptoms, severity and outcomes was systematically carried out. Results: During 2013,of the diagnosed acute febrile cases,41 were Malaria,39 being P.vivax and 2 mixed Malaria.52 cases of Dengue were confirmed.2014 saw a total of 55 malaria cases,23 being P.falciparum and 16 cases of P.vivax and mixed Malaria each. During the year,84 Dengue cases were detected. 2015 saw a surge of acute febrile illnesses.117 cases were of Malaria, 107 being P.vivax and only ten positive for P.falciparum. No mixed Malaria cases were encountered; whereas Dengue cases escalated to 206. During 2014, 16 (10.25%) coinfection (Dengue and Malaria) cases were noted, whereas in 2015, 28(6.7%)were coinfection cases. No coinfection cases were observed during 2013. Mortality during 2013 and 2014 were three each, all being P.vivax during 2013 whereas one was coinfection and two malarial deaths in 2014. Recovery was total in 2015. Conclusion: Within the three consecutive years, it was observed that Dengue cases exceeded Malaria, as a major cause of monsoon related febrile illnesses. Within the malarial infections, P.falciparum appears to be on the decline. P.vivax has increased in incidence and severity, thus not considered benign any longer. Focussed malaria control probably led to fewer malaria cases. Dengue formed the largest group, the surge being probably related to increased Aedes breeding sites. Changing clinical trends require close monitoring. Enhanced surveillance and public health measures can contribute to better disease control. http://dx.doi.org/10.1016/j.ijid.2016.11.367
20.182 West Nile virus neuroinvasive disease: The first confirmed case in Bulgaria M. Baymakova a,∗ , I. Trifonova b , E. Panayotova b , S. Dakova a , M. Pacenti c , L. Barzon c , E. Lavezzo c , K. Ramshev a , K. Plochev a , I. Christova a a
Military Medical Academy, Sofia/BG National Center of Infectious and Parasitic Diseases, Sofia/BG c University of Padova, Padua/IT b
Purpose: The first confirmed human case of WNV infection in Bulgaria was presented as a West Nile neuroinvasive illness with fatal outcome in a Bulgarian elderly man. Methods & Materials: For the etiological diagnosis of WNV infection specific serological tests were applied for detection of IgM in CSF and IgM and IgG in serum. WNV RNA was detected by real-time RT-PCR. Full genome sequencing was performed. Results: In the summer 2015, a 69-year old man with cardiovascular disorder and a history of mosquito bites and no recent travels outside Bulgaria, developed a febrile syndrome, tremor, and weakness, followed by neurological disturbances with coma and lethal outcome. CSF examination showed mild lymphocytic pleocytosis. WNV-specific IgM antibodies were detected in CSF and WNV-specific IgM and IgG antibodies were found in serum, WNV RNA was detected in a urine sample. Sequencing of the full viral genome and phylogenetic analysis demonstrated that the virus belonged to Southern-European WNV lineage 2 clade and had high sequence similarity with WNV strains circulating in Greece and in Hungary. Conclusion: This case report demonstrates the presence of WNV lineage 2 in Bulgaria and supports public health interventions for vector control and prevention of WNV transmission because of the risk of severe neuroinvasive disease and the high mortality rate, especially in elderly patients with co-morbidity. http://dx.doi.org/10.1016/j.ijid.2016.11.368 20.183 Severe clinical forms of Mediterranean Spotted Fever: A case series from an endemic area in Bulgaria M. Baymakova a,∗ , L. Pekova b , K. Plochev a , P. Parousheva b a b
Military Medical Academy, Sofia/BG Stara Zagora University Hospital, Stara Zagora/BG
Purpose: The aim of this study was to describe clinical, epidemiological and laboratory characteristics in patients with severe forms of Mediterranean spotted fever admitted to Bulgarian university hospital in endemic region. Methods & Materials: A retrospective study was conducted at the Department of Infectious Diseases, Stara Zagora University Hospital (Southeastern Bulgaria) between April 2015 and June 2016. For the analyzed period 54 cases had clinical and laboratory data for Mediterranean spotted fever (MSF). Raoult diagnostic criteria were used for the evaluation of severity. For the etiological diagnosis serological tests were applied. MSF-specific IgM and IgG antibodies were detected in serum by indirect immunoenzyme assay (ELISA IgG/IgM, Vircell, Spain). Rickettsia conorii ELISA IgG Sensitivity 85%, Specificity 100% and Rickettsia conorii ELISA IgM Sensitivity 94%, Specificity 95%. Statistical analyze was done by MS Excel 2007 and SPSS Statistics, version 19.0.
Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
Results: Seventeen patients presented as severe forms. The predominant gender of them was male, 82% were men and 18% women. The median age of the analyzed group of seventeen cases was 59 years (range: 14-78 years). Ten patients developed hepatic disorder, three had neurological signs, and three cases evolved pulmonary involvement. Laboratory data found thrombocytopenia in 14 patients, mean value of thrombocytes count (PLT) for the whole group was 108.1±55.4x109 /L. Liver enzymes were elevated with mean value of aspartate aminotransferase (AST) 154.9±88.4IU/L and alanine aminotransferase (ALT) 162.0±83.6IU/L. Acute phase reactant as C-reactive protein (CRP) had mean value of 143 mg/L (range: 9-230 mg/L). Kidney function was impaired in some cases, the calculated mean value of Creatinine for the studied group was 147.3 mol/L (range: 85-313 mol/L) and mean value of Urea was 10.4mmol/L (range: 4.3-27.4mmol/L). Conclusion: Bulgaria is an endemic area for tick-borne diseases. Annually cases of Mediterranean spotted fever are reported. Severe and “malignant” forms of MSF are not rare. Typical clinical and laboratory markers for severity would be actively searching for. Early diagnose and proper treatment is the key to avoid complications and patient’s recovering. http://dx.doi.org/10.1016/j.ijid.2016.11.369 20.184 One Health approach gap analysis of leishmaniasis detection, prevention, and response in the Republic of Albania S. Bino a,∗ , A. Vasili a , T. Myrseli a , E. Dikolli a , K. Mersini b , L. Alla a , J. Sulo c , J. Crilly c , K. Yotebieng d , A.M. Bersani e a
Institute of Public Health, Tirana/AL Food Safety and Veterinary Institute, National Veterinary Epidemiology Unit, Tirana/AL c Southeast European Center for Surveillance and Control of Infectious Diseases (SECID), Tirana/AL d The Ohio State University, Anthropology, Columbus/US e Connecting Organizations for Regional Disease Surveillance (CORDS), Lyon/FR b
Purpose: One Health approach gap analysis of leishmaniasis surveillance, prevention, and response to evaluate critical capacities in Albania for early detection, case management, vector and reservoir control, and intersectoral collaboration. Methods & Materials: A cross-sectional study, SWOT analysis, and community interviews were conducted between April November 2015, by adapting the WHO European region strategic framework for leishmaniasis control in 2014–2020. Results: Visceral leishmaniasis (VL) due to L. infantum is the main form of the disease in Albania with 30-100 cases annually, of which 70% are in children under 14 years of age, and among children 70% are from 1-4 years old. There is under-reporting of cases from the district to national levels. There is no active surveillance for canine leishmaniasis and no population control measures for street dogs. There is vector surveillance and the main vector is Phlebotomus neglectus with P. tobbi playing a secondary role but the vector control programme for sand flies is not well established. Ambisome was used for paediatric cases in the main university hospital centre, but it is not supplied in the whole country and currently there is no treatment available for adults. Case detection and clinical management protocols are out-dated with low capacity for early detection at regional or district level.
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Availability of kits and reagents for diagnosis were lacking in hospitals with no access to PCR or Rapid Diagnostic Tests (RDTs). Albania has not established a One Health control program as the disease is not perceived as a public health priority. Public awareness of leishmaniasis is low in all areas. Conclusion: The gap analysis highlighted the need to improve early detection and treatment of VL in Albania, ensuring that all patients have access to appropriate anti-leishmania medication. One Health principles should be applied to improve interagency cooperation (i.e. MoH/MoA, municipalities) for the better control of leishmaniasis in vector and reservoir species. There is a need for similar gap analyses in other countries in the region together with capacity-building activities such as training workshops and joint surveillance activities to better control vectorborne and zoonotic diseases. http://dx.doi.org/10.1016/j.ijid.2016.11.370 20.185 Gap analysis of leishmaniasis detection, prevention, and response lessons learned for vectorborne diseases in Albania, Jordan, and Pakistan S. Bino a , S.A. Sheikh Ali b , S.M. Mursalin c , J. Crilly d,∗ , K. Yotebieng e , A.M. Bersani f a
Institute of Public Health, Tirana/AL Ministry of Health, Directorate of Communicable Diseases, Head of Data Management Department, Middle East Consortium on Infectious Disease Surveillance (MECIDS) Coordinator, Amman/JO c Pak One Health Alliance (POHA), President/Executive Director, Isalamabad/PK d Southeast European Center for Surveillance and Control of Infectious Diseases (SECID), Tirana/AL e The Ohio State University, Anthropology, Columbus/US f CORDS - Connecting Organizations for Regional Disease Surveillance, Lyon/FR b
Purpose: The gap analysis of leishmaniasis detection, prevention and response utilised the Strategic Framework for Leishmaniasis Control in the WHO European Region 2014–2020 to determine critical capacities for reducing the burden of visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL). The objective of the gap analysis was to identify constraints in implementing the WHO strategy in three different environments. Connecting Organizations for Regional Disease Surveillance (CORDS) facilitated this project by bringing together two of its networks, Albania from the Southeast European Consortium (SECID/SEEHN), and Jordan from the Middle East Consortium (MECIDS), along with a partner from Pakistan (POHA). Methods & Materials: A multidimensional, cross-sectional approach was utilized in each country study, from April – November 2015, which included: An objective description of the current status of leishmaniasis surveillance, treatment and control activities. A critical evaluation of the effectiveness of these activities, identifying weaknesses/opportunities for improvement. Collation and analysis of clinical case data to map endemic zones and calculate incidence rates; vector distribution and prevalence rates in reservoir hosts were similarly reported. 1-2 week study tour and in-country workshops. On-going dissemination and collaboration activities via Leishmaniax.net platform. Results: Detailed reports were produced for each of the three countries as well as a combined summary report.
