Case reports in tropical medicine

MIAMI: Texas reported a case of the Zika virus being sexually transmitted Tuesday, fueling fears over the rapid spread of the disease blamed for a surge in the number of brain-damaged babies. With concern growing that an outbreak sweeping Latin America could spread much farther, health authorities in the southern US state said they had confirmation of the virus being transmitted by sexual contact and not just tropical mosquitoes.
That is a troubling prospect for the United States, Canada and Europe, where Zika had so far only appeared in travelers returning from affected areas.
The CDC confirmed the Zika infection but did not investigate how it was transmitted, a spokesman told AFP. Last month, the CDC said it was aware of one reported case of sexual transmission of Zika and one case of the virus being present in a man’s semen after it disappeared from his blood.
Zika, which was first identified in Uganda in 1947, causes relatively mild flu-like symptoms and a rash.
But there is growing alarm over an apparent link between the current outbreak and both a rise in birth defects and a potentially crippling neurological disorder called Guillain-Barre syndrome. The virus is spread primarily by the Aedes aegypti mosquito, whose habitat is concentrated in the tropics — giving temperate countries an apparent reprieve.
A day after declaring the spike in serious birth defects in South America an international emergency, the World Health Organization said it had created a global Zika response unit to contain the virus. WHO expert Anthony Costello emphasized the urgency of rapid action, stressing there was no reason to believe the crisis would remain limited to Latin America. Underlining Costello’s point, Thai officials announced a man had contracted the virus in the country.
French pharmaceutical giant Sanofi meanwhile announced it had begun research into a vaccine for Zika, for which there is currently no specific treatment.
In Brazil, which has been hardest hit, Olympics organizers said they are concerned but downplayed fears — one day after the government warned pregnant women not to attend the Games.
The Olympics will be held in Rio de Janeiro from August 5 to 21, during the southern hemisphere winter, which means there will be fewer mosquitoes, organizers underlined. A Dutch women’s rights group meanwhile offered to send free pills to trigger an abortion to pregnant women in Latin America, a region known for its restrictive abortion laws.
Since October, Brazil has reported some 4,000 suspected cases of microcephaly, of which 270 have been confirmed — up from 147 in 2014. Colombia, Ecuador, El Salvador, Jamaica and Puerto Rico have all warned women not to get pregnant. Health Secretary Ana Rius said Thursday that the unidentified patient had not traveled recently and lives in the island's eastern region. Officials say symptoms are similar to those of dengue and chikungunya and can include a slight fever, headache and pain in the hands and feet. Scientists in Brazil have linked Zika infections to cases of babies being born with abnormally small heads, or microcephaly. Since last July, at least 739 cases of babies born with microcephaly have been detected in Brazil, a number five times greater than usually occurs in an entire year. A laboratory exam of a baby with microcephaly and other congenital illnesses performed at the Evandro Chagas Institute, known for its groundbreaking studies of tropical diseases and located in Belen in the northern Brazilian state of Para, confirmed that the newborn had the Zika virus. Preliminary analyses suggest that the greatest risk of contagion occurs during the first three months of pregnancy.

According to media reports, farmers in the Ganges River delta in Eastern India are using ancient seeds in the hopes of fighting off famine and keeping their crops sustainable in a climate-changed India.
Media reports say in a case study in the Ganges River delta, scientists are distributing these ancient seeds to farmers free of charge. Cyclone Aila crashed into the Bangladesh-India border about four years ago, according to reports. According to experts, the seeds that failed were the modern variety that the farmers had started using after the so called green revolution of the 1960s.
According to scientists, densely populated river deltas across the globe have had to face similar challenges as climate change is forcing coastlines to retreat and allowing salt to invade on lands which were once upon a time fertile farmlands.
To adapt to challenges of rising sea levels and powerful storms brought on by climate change, a case study found that ancient seeds, developed more than a hundred years ago were found successful in keeping crops sustainable.
According to media reports, this field study found, for example, that the only variety of rice that will grow in the contaminated Ganges River delta is a salt-tolerant rice variety developed more than a century ago by small-scale farmers. Media reports say that Debal Deb, a scientist and a rice conservator is now in a race against time and determined to save as many traditional seeds as possible.
And we have at least six varieties of salt-tolerant rice which can withstand seawater intrusion.
According to reports, nonprofit organizations are working with farmers to restore these traditional seeds which went out of use because farmers after 1960 started to use high-yielding seeds of the green revolution. Deb told reporters that governments and agribusiness are just now coming to the recognition of how vital and critical these ancient seeds are to the future of agriculture and feeding billions.
He added that the importance of these traditional seeds cannot be overemphasized to the future of agriculture as climate change envelopes the planet. The US Advisory Committee on Immunization Practices has eliminated the day 28 vaccine as of 2010 but would not distinguish between category II and III wounds (i.e. Vaccine doses should be given in the deltoid (shoulder) and never into the gluteal region where they are less effective.
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Dallas county subsequently tweeted that the virus was contracted from someone who had travelled to Venezuela. This case study was launched after farmers found that the high yielding modern seeds they had used since the 1960s failed after a massive tropical storm intruded inland and contaminated their farmlands with salty sea water in 2009. Asish Ghosh, Director of the Kolkata-based Center for Environmental Development, said in a recent interview that growing crops is a challenge because the sea water, after it receded, left salt in the farm soil.
Indian scientists told reporters that there were more than a hundred thousand varieties of rice alone at one time. In the last decade, he has traveled across India to salvage what is left of those traditional seeds. He said that in spite of billions of dollars spent on plant breeding and genetic engineering programs, these programs have yet to produce seeds that rival the tolerance of the traditional seeds to extreme weather-related conditions. With enhanced national vaccination of nearly 200,000 dogs and control efforts, the number of reported human cases fell to five deaths in 2007.3 According to the CDC website, preliminary surveillance assessments from January to May 2010, based upon clinical signs alone, suggest as many as 17 possible human rabies cases.

It then enters local nerves where it migrates towards the spinal cord at a rate of 50 to 100 mm per day.
If after 10 days, the animal shows no signs of rabies, post-exposure prophylaxis may be discontinued. This is not mandatory for travelers to Haiti unless significant animal contact is anticipated.
Vaccine and immune globulin should be given at different sites to avoid cross-neutralization.
In Haiti, this means any dog bite unless the dog is definitively known to be free of rabies.
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Four years later, according to international agencies, the tragedy is still having a devastating effect on the lives of many people in the country.
Most tragic of all, farmers are having a hard time growing crops because of the salt in the farmland.
Indeed, any dog bite in Haiti is to be considered to be a potential source of rabies until proven otherwise.
This form is characterized by excessive salivation, hyperactivity, fever and a fluctuating level of consciousness. The initiation of post-exposure prophylaxis should NEVER be delayed in order to observe the attacking animal.
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According to international agencies, the storm is said to have impacted about three million people. Four years after this devastation, farmers say growing food is a challenge on these farmlands because of the salt. At this point there is massive viral replication and dissemination of the virus throughout the nervous system. Most patients also demonstrate aerophobia (fear of drafts) and hydrophobia (fear of drinking water) as these typically provoke painful pharyngeal (throat) spasms.
However, unless clinical symptoms have developed, it is never too late to initiate such care. FMT also holds the right to remove comments that violate the letter or spirit of the general commenting rules.The views expressed in the contents are those of our users and do not necessarily reflect the views of FMT.
A less well known (and less prevalent) rabies syndrome is that of “paralytic” or “dumb” rabies.

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