Endemic Infectious Diseases of Afghanistan

Wallace, Mark R.; Hale, Braden; Utz, Gregory; Olson, Patrick E.; Earhart, Kenneth C.; Thornton, Scott A.; Hyams, Kenneth C.

doi:10.1086/340704

Cited by 81 publications

(65 citation statements)

References 193 publications

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“…DENV IgG was noticed in 19.7% (180/913) of the AFI patient sera. This is similar to previous reports suggesting frequent exposure in Afghanistan [11] and surrounding countries [15]. The 16.1% (29/180) of the DENV IgG positive sera were also reactive to WNV IgG, indicating previous exposure to multiple diseases or relatively low assay specificity.…”

Section: Resultssupporting

confidence: 90%

“…Most patients who developed IgM antibodies against TBEV reported consumption of raw milk, a possible method of infection declared earlier [14, personal communication]. This is the first report to suggest serologic evidence of TBEV infection in Afghanistan, although it has been historically observed in Central Asia and many of the former Soviet republics [15]. Limited cross reactivity of TBE IgM with other flaviviridae may occur as per the manufacturer of the employed TBEV kits.…”

Section: Resultsmentioning

confidence: 81%

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Serological evidence of Flaviviruses infection among acute febrile illness patients in Afghanistan

Elyan

Moustafa

Noormal

et al. 2014

J Infect Dev Ctries

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Introduction: Current published reports on the causative agents of acute febrile illness (AFI) in Afghanistan are scarce, and the burden of disease due to flaviviruses is unknown. Methodology: A hospital-based surveillance study for AFI was established in 2008 through 2010 to determine the seroepidemiology of West Nile virus (WNV), tick-borne encephalitis virus (TBEV) and dengue viruses (DENV) using commercial ELISA kits. Due to major logistical challenges, only acute sera were collected. Results: Serological analysis for IgG were as follows: WNV 30.4% (277/913); TBEV 23.4% (214/913); DENV 19.7% (180/913). Single positive IgG reactions for WNV, TBEV and DENV were noted in 11% (100/913), 7.2% (66/913), and 5% (47/913), respectively. Reactivity for all three screened flaviviruses was detected in 44.5% (406/913) of sera. IgM positivity was uncommon, with only 0.5% (5/913), 2.2% (20/913) and 2.6% (8/312) of samples positive for WNV, TBEV, and DENV, respectively. Serological findings were confirmed in random positive samples by neutralization assay. Conclusions: These serological results suggest circulation of WNV, TBEV, and DENV within Afghanistan, with evidence of current or prior infection noted in a significant proportion of patients seeking care for AFI. Obtaining additional information on the prevalence of these and other causes of AFI is paramount for improving the distribution of available limited syndromic treatment and improving the existing health protection policy in Afghanistan.

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Section: Resultssupporting

confidence: 90%

Section: Resultsmentioning

confidence: 81%

Serological evidence of Flaviviruses infection among acute febrile illness patients in Afghanistan

Elyan

Moustafa

Noormal

et al. 2014

J Infect Dev Ctries

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“…The virus is almost present in Afghanistan and neighboring countries [8]. In Pakistan military personnel admitted to a hospital for evaluation of febrile illness was evaluated and antibody to WNV was present in 33-41 % [9].…”

Section: Discussionmentioning

confidence: 99%

Frequency of West Nile Virus Infection in Iranian Blood Donors

Aghaie

Aaskov

Chinikar

et al. 2015

Indian J Hematol Blood Transfus

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West Nile virus (WNV) can be transmitted by blood transfusions and organ transplants. This study was a retrospective study which was performed in Blood Transfusion Center to evaluate the WNV infection in blood donors in Iran. A total of 540 blood samples were taken from volunteer healthy donors who referred for blood donation to Chabahar Blood Center. The presence of WNV was studied by detecting immunoglobulin G (IgG) WNV by enzyme linked immune sorbent assay (ELISA). Demonstration of elevated WNV IgG confirmed by immunoflouorescence assay (IFA) Euroimmun kit. Out of the 540 samples 17.96 % (97 cases) were seropositive by ELISA and 1.48 % (8 cases) was seropositive by IFA. This means that 8.24 % of ELISA seropositive samples were confirmed by IFA. Special attention should be paid to criteria of donor selection, albeit positive results may be due to a previous infection in these donors.Keywords West Nile virus (WNV) Á Blood donor Á Iran Á Donor selection Á Epidemiology Á Enzyme linked immune sorbent assay (ELISA) Á Immunoflouorescence assay (IFA)

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“…Later, a virus isolated from the Congo was identified as the same virus, resulting in the name Crimean-Congo hemorrhagic fever virus (CCHFV). 2 Infection with CCHFV is manifested as an acute viral disease (fever, myalgia, and arthralgia) and in severe cases, hemorrhagic manifestations may ensue. It is transmitted mainly through tick bite or animal contact but repeatedly has caused nosocomial outbreaks.…”

mentioning

confidence: 99%

Crimean-Congo Hemorrhagic Fever Virus as a Nosocomial Pathogen in Iran

Mardani¹,

Keshtkar-Jahromi²,

Ataie³

et al. 2009

Am J Trop Med Hyg

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Abstract. Crimean-Congo hemorrhagic fever (CCHF) is a viral disease with several different modes of transmission. We describe the manifestations, outcome, and likely modes of transmission for three nosocomial cases. All threee cases were healthcare workers (two men and one woman). They had fever, myalgia, and petechia. Disseminated intravascular coagulation resulted in the death occurred in the woman. Because this disease is manifested with non-specific influenzalike symptoms, diagnosis can be difficult. Data for these patients can be used to investigate airborne or sexual transmission of this virus, although neither route was substantiated for these patients. Use of universal precautions and early case detection are the most helpful strategy for preventing nosocomial transmission of CCHF.Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease that has been reported in more than 30 countries in Africa, Asia, southeastern Europe, and the Middle East.1 It was first described in the Crimea in 1944. Later, a virus isolated from the Congo was identified as the same virus, resulting in the name Crimean-Congo hemorrhagic fever virus (CCHFV).2 Infection with CCHFV is manifested as an acute viral disease (fever, myalgia, and arthralgia) and in severe cases, hemorrhagic manifestations may ensue. It is transmitted mainly through tick bite or animal contact but repeatedly has caused nosocomial outbreaks.3-7 Human-to-human transmission occurs by infected blood or secretions, but airborne transmission of the disease has not been documented. 8 We describe the manifestations and outcomes in three confirmed cases of CCHF in healthcare workers in Iran. The risk factors and routes of transmission in a hospital setting are discussed. INDEX CASE 1On August 2, 1999, a 55-year-old man (a shepherd) was referred to the emergency room of a hospital with hematemesis. He had a history of animal contact. Epistaxis developed after a nasogastric tube was inserted in an attempt to control gastrointestinal (GI) bleeding. Unfortunately, he died of intractable GI bleeding and disseminated intravascular coagulation (DIC) four days later. SECONDARY CASE 1On August 16, 1999, a 32 -year -old man (a physician) came to a clinic in Shahrekord in central Iran with severe headache, malaise, fever, vomiting, and diarrhea for one week. Petechiae, epistaxis and gum bleeding then developed, which resulted in his referral to the clinic. He was admitted to a hospital and treated with broad-spectrum antibiotics. There was no history of recent travel or contact with domestic animals. It was later discovered that he had been in contact with index case 1, who had died of severe GI bleeding two weeks before his first symptoms. The index case had coughed and splashed blood on the physician's face while he was trying to insert a nasogastric tube. Physical examination showed right cervical lymphadenopathy and a palpable spleen, but the patient was not febrile. Laboratory examinations showed leukopenia, thrombocytopenia, increased levels of aminotransferase...

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Endemic Infectious Diseases of Afghanistan

Cited by 81 publications

References 193 publications

Serological evidence of Flaviviruses infection among acute febrile illness patients in Afghanistan

Serological evidence of Flaviviruses infection among acute febrile illness patients in Afghanistan

Frequency of West Nile Virus Infection in Iranian Blood Donors

Crimean-Congo Hemorrhagic Fever Virus as a Nosocomial Pathogen in Iran

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