Ebola is the common term for a group of viruses belonging to genus Ebolavirus, family Filoviridae, which cause Ebola hemorrhagic fever. The disease can be lethal and encompasses a range of symptoms, usually including vomiting, diarrhea, general body pain, internal and external bleeding, and fever. Mortality rates are generally high, ranging from 50% - 90%, with the cause of death usually due to hypovolemic shock or multiple organ failure.

Ebola is believed to be a zoonotic virus, although despite considerable effort by the World Health Organization no animal reservoir capable of sustaining the virus between outbreaks has been identified. One candidate reservoir are fruit batsFruit bats may carry Ebola virus, BBC News, December 1, 2005. The virus is named after the Ebola River in the African state of the Democratic Republic of the Congo (formerly Zaïre), near the site of the first outbreaks.

Discovery

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It is traditional to name viral species after the locations in which they were first discovered. The first documented outbreaks of Ebola occurred in the Democratic Republic of the Congo and Sudan in 1976, resulting in the virus being named for a tributary of the Congo River so that it might represent both outbreaks. Two species were further identified later that year: Zaïre ebolavirus (ZEBOV) and Sudan ebolavirus (SEBOV) with case-fatality rates of 83% and 54%, respectively. The first electronmicrograph of Ebola was also obtained in 1976 by Dr. F.A. Murphy, who was then working at the Center for Disease Control.

More on [ Ebola ]

Current Opinion in Infectious Diseases - Current Table Of Contents

Editorial introductions.
Page: viiDOI: 10.1097/QCO.0b013e3283117e55
Charles Anthony Hart: 25 February 1948 - 21 September 2007.
Page: 453DOI: 10.1097/QCO.0b013e328313ba91Authors: Beeching, Nick
Tuberculosis in the developing world: recent advances in diagnosis with special consideration of extensively drug-resistant tuberculosis.
Page: 454DOI: 10.1097/QCO.0b013e32830ce783Authors: Grandjean, Louis a; Moore, David AJ b

NEJM — Collection Updates for Infectious Diseases

REVIEW ARTICLE: Infection in Solid-Organ Transplant Recipients
Jay A. Fishman, M.D.Increasingly potent immunosuppressive agents have dramatically reduced the incidence of rejection of transplanted organs while increasing patients' susceptibility to opportunistic infections and cancer.12 At the same time, patterns of opportunistic...
IMAGES IN CLINICAL MEDICINE: Peripheral Smear with
Parul Bhargava, M.B., B.S. and Lorinda P. Longhi, B.S., M.T.A 53-year-old man with crohn's disease, short-bowel syndrome that required total parenteral nutrition, a history of recurrent catheter infections, hypertension, chronic renal insufficiency, and mitral regurgitation presented with fevers of...
ORIGINAL ARTICLE: A Multicenter, Randomized Trial of Prophylactic Fluconazole in Preterm Neonates
Paolo Manzoni, M.D., Ilaria Stolfi, M.D., Lorenza Pugni, M.D., Lidia Decembrino, M.D., Cristiana Magnani, M.D., Gennaro Vetrano, M.D., Elisabetta Tridapalli, M.D., Giuseppina Corona, M.D., Chiara Giovannozzi, M.D., Daniele Farina, M.D., Riccardo Arisio, M.D., Franco Merletti, M.D., Ph.D., Milena Maule, M.D., Fabio Mosca, M.D., Ph.D., Roberto Pedicino, M.D., Mauro Stronati, M.D., Michael Mostert, M.D., and Giovanna Gomirato, M.D., for the Italian Task Force for the Study and Prevention of Neonatal Fungal Infections and the Italian Society of NeonatologyBackground: Invasive candida infections are a major cause of morbidity and mortality in preterm infants. We performed a multicenter, randomized, double-blind, placebo-controlled trial of fluconazole for the prevention of fungal...

Centers for Disease Control and Prevention

CDC Recommends Shingles Vaccine
People age 60 and older should be vaccinated against shingles, or herpes zoster, a condition often marked by debilitating chronic pain...
New CDC Study Finds Arthritis Can be a Barrier for Adults Seeking to Manage Diabetes through Physical Activity
More than half of adults with diagnosed diabetes also have arthritis, a painful condition that can be a barrier to physical activity—an important health strategy for managing diabetes...
Falls a Leading Cause of Injury-Related Emergency Department Visits for Infants Each Year, CDC Study Shows
Half of the estimated 328,500 infants 12 months of age or younger who were treated for injuries in hospital emergency departments each year from 2001 to 2004 were injured as a result of a fall, according to a study by the Centers for Disease Control and Prevention.

BMC Infectious Diseases - Latest articles

Rabies trend in China (1990-2007) and post-exposure prophylaxis in the Guangdong province
Han Si, Zhong-Min Guo, Yuan-Tao Hao, Yu-Ge Liu, Ding-Mei Zhang, Shao-Qi Rao and Jia-Hai Lu Thu, 21 Aug 2008 00:00:00 -0000
Background: Rabies is a major public-health problem in developing countries such as China. Although the recent re-emergence of human rabies in China was noted in several epidemiological studies, little attention was paid to the reasons behind this phenomenon paralleling the findings of the previous reports. The purpose of this study is thus first to characterize the current trends of human rabies in China from 1990 to 2007, and then to define better recommendations for improving the post-exposure prophylaxis (PEP) schedules delivered to rabies patients. Methods: The most updated epidemiological data for 22527 human rabies cases from January 1990 to July 2007, retrieved from the surveillance database of reportable diseases managed by the Ministry of Health of China, were analysed. To investigate the efficiency for the post-exposure treatment of rabies, the details of 244 rabies patients, including their anti-rabies treatment of injuries or related incidents, were ascertained in Guangdong provincial jurisdiction. The risk factors to which the patients were predisposed or the regimens given to 80 patients who received any type of PEP were analysed to identify the reasons for the PEP failures. Results: The results from analysis of the large number of human rabies cases showed that rabies in China was largely under control during the period 1990-1996. However, there has been a large jump in the number of reported rabies cases since 2001 up to a new peak (with an incidence rate of 0.20 per 100000 people) that was reached in 2004, and where the level has remained until present. Then, we analysed the PEP in 244 rabies cases collected in the Guangdong province in 2003 and 2004, and found that 67.2% of the patients did not seek medical services or did not receive any PEP. Further analysis of PEP for the 80 rabies patients who received any type of PEP indicated that almost all of the patients did not receive proper or timely treatment on the wounds or post-exposure vaccination or rabies immunoglobulins.
Neonatal tetanus in Turkey; what has changed in the last decade?
Bunyamin Dikici, Hakan Uzun, Ebru Yilmaz-Keskin, Taskin Tas, Ali Gunes, Halil Kocaman, Capan Konca and Mehmet A Tas Tue, 19 Aug 2008 00:00:00 -0000
Background: Neonatal tetanus (NT)is still considered as one of the major causes of neonatal death in many developing countries. The aim of the present study was to assess the characteristics of sixty-seven infants with the diagnosis of neonatal tetanus followed-up in the Pediatric Infectious Diseases Ward of Dicle University Hospital, Diyarbakir, between 1991 and 2006, and to draw to factors that may contribute (or may have contributed) to the elimination of the disease in Diyarbakir. Methods: The data of sixty-seven infants whose epidemiological and clinical findings were compatible with neonatal tetanus were reviewed. Patients were stratified into two groups according to whether they survived or not to assess the effect of certain factors in the prognosis. Factors having a contribution to the higher rate of tetanus among newborn infants were discussed. Results: A total of 55 cases of NT had been hospitalized between 1991 and 1996 whereas only 12 patients admitted in the last decade. All of the infants had been delivered at home by untrained traditional birth attendants (TBA), and none of the mothers had been immunized with tetanus toxoid during her pregnancy. Twenty-eight (41.8%) of the infants died during their follow-up. Lower birth weight, younger age at onset of symptoms and at the time admission, the presence of opisthotonus, risus sardonicus and were associated with a higher mortality rate. Conclusions: Although the number of neonatal tetanus cases admitted to our clinic in recent years is lower than in the last decade efforts including appropriate health education of the masses, ensurement of access to antenatal sevices and increasing the rate of tetanus immunization among mothers still should be made in our region to achieve the goal of neonatal tetanus elimination.
Seroprevalence of HHV-8, CMV, and EBV among the general population in Ghana, West Africa
Andrew A Adjei, Henry B Armah, Foster Gbagbo, Isaac Boamah, Clement Adu-Gyamfi and Isaac Asare Mon, 18 Aug 2008 00:00:00 -0000
Background: Human herpesvirus 8 (HHV-8), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are prevalent in Africa, but less common elsewhere and the modes of transmission are still subject to debate. Generally, they rarely cause disease in the immunocompetent host but are highly oncogenic when associated with immunosuppression. Although the high prevalence of HHV-8, CMV and EBV has been well documented in Africa, such data are sparse from Ghana. Methods: Serum samples from 3275 HIV-seronegative healthy blood donors and 250 HIV-AIDS patients were tested for antibodies specific for HHV-8, CMV and EBV by IgG ELISA assays. Differences in seropositivity rates by gender and age were evaluated using the Chi-square test with Yates correction. Results: Of the 3275 HIV-seronegative healthy blood donors tested, 2573 (78.6%) were males and 702 (21.4%) were females, with ages ranging from 18 to 65 years (median 32.6; mean 31.2; mode 30). Of the 250 HIV-AIDS patients tested, 140 (56%) were males and 110 (44%) were females, with ages ranging from 17 to 64 years (median 30.8; mean 30.3; mode 28). Among the HIV-seronegative healthy blood donors, overall seroprevalence of HHV-8, CMV and EBV was 23.7%, 77.6% and 20.0%, respectively. Among the HIV-AIDS patients, overall seroprevalence of HHV-8, CMV and EBV was 65.6%, 59.2% and 87.2%, respectively. The seroprevalence of HHV-8 (p 0.05) for all three infections among HIV-seronegative healthy blood donors and HIV-AIDS patients in Ghana. Conclusions: The results presented herein indicate that HHV-8, CMV and EBV infections are hyperendemic in both HIV-seronegative and HIV-seropositive Ghanaians, and suggest primarily a horizontal route of transmission of these three viral infections in Ghana.
Schistosomiasis transmission at high altitude crater lakes in Western Uganda
Rubaihayo John, Moghusu Ezekiel, Clouds Philbert and Abaasa Andrew Mon, 11 Aug 2008 00:00:00 -0000
Background: Contrary to previous reports which indicated no transmission of schistosomiasis at altitude >1,400 m above sea level in Uganda, in this study it has been established that schistosomiasis transmission can take place at an altitude range of 1487–1682 m above sea level in western Uganda. Methods: An epidemiological survey of intestinal schistosomiasis was carried out in school children staying around 13 high altitude crater lakes in Western Uganda. Stool samples were collected and then processed with the Kato-Katz technique using 42 mg templates. Thereafter schistosome eggs were counted under a microscope and eggs per gram (epg) of stool calculated. A semi-structured questionnaire was used to obtain demographic data and information on risk factors. Results: 36.7% of the pupils studied used crater lakes as the main source of domestic water and the crater lakes studied were at altitude ranging from 1487–1682 m above sea level. 84.6% of the crater lakes studied were infective with over 50% of the users infected.The overall prevalence of Schistosoma mansoni infection was 27.8% (103/370) with stool egg load ranging from 24–6048 per gram of stool. 84.3%( 312) had light infections (400 egg/gm of stool). Prevalence was highest in the age group 12–14 years (49.5%) and geometric mean intensity was highest in the age group 9–11 years (238 epg). The prevalence and geometric mean intensity of infection among girls was lower (26%; 290 epg) compared to that of boys (29.6%; 463 epg) (t = 4.383, p < 0.05). Though 61%(225) of the pupils interviewed were aware of the existence of the disease, 78% (290)didn't know the mode of transmission and only 8% (30) of those found infected were aware of their infection status. In a multivariate logistic regression model, altitude and water source (crater lakes) were significantly associated with infection.Conclusion and recommendationsThe altitudinal threshold for S. mansoni transmission in Uganda has changed and use of crater water at an altitude higher than 1,400 m above sea level poses a risk of acquiring S. mansoni infection in western Uganda. However, further research is required to establish whether the observed altitudinal threshold change is as a result of climate change or other factors. It is also necessary to establish the impact this could have on the epidemiology of schistosomiasis and other vector-borne diseases in Uganda. In addition, sensitisation and mass treatment of the affected community is urgently required.
The Recent-Transmission of Mycobacterium tuberculosis Strains among Iranian and Afghan Relapse Cases: a DNA-fingerprinting using RFLP and spoligotyping
Parissa-Farnia, Mohammad Reza Masjedi, Mohammad Varahram, Mehdi Mirsaeidi, Mojtaba Ahmadi, Mehdi Khazampour, Payam Tabarsi, Parvaneh Baghei, Mojtaba Marjane, Muslam Bahadori, Abolhasan Zia Zarifi and Ali Akbar Velayati Wed, 06 Aug 2008 00:00:00 -0000
Background: Relapse of tuberculosis (TB) may develop as the result of reactivation of the endogenous primary infection, or as a result of a exogenous reinfection. This survey evaluated the rate of reactivation versus recent transmission among Iranian and Afghan relapse cases. Methods: The sputum specimens were digested, examined microscopically for acid-fast bacilli, and inoculated into Löwenstein-Jensen slants by standard procedures. Thereafter, the susceptibility and identification tests were performed on culture positive specimens. Subsequently, the strains that were identified as Mycobacterium tuberculosis (258 isolates) were subjected to IS6110 restriction fragment length polymorphism (RFLP) and spoligotyping. Additional patient's information was collected for further epidemiological analysis. Patients whose isolates had identical genotyping patterns were considered a cluster with recent transmission episode. Results: Out of 258 available isolates, 72(28%) had multi-drug resistant (MDR-TB) in ratio and 42 (16.2%) had other resistant. Notably, 38 of MDR-TB cases (52%) were isolated from Afghan patients. By IS6110-RFLP typing method, 65 patients (25%) were clustered in 29 clusters. In cluster cases, the intra-community transmissions between Iranian and Afghan patients were 41%. All MDR-TB patients in clusters had either Haarlem I or Beijing characteristic. The risk factors like sex, family history, close contact, living condition, PPD test result and site of TB infection were not associated with clustering. Although, the MDR-TB strains were more frequent in non-cluster cases (31%) than cluster one(18%) (P < 0.05). Majority of M. tuberculosis strains isolated from non-cluster cases were belong to EAI3 (51; 30%) and CASI(32;18.6%) superfamilies. Conclusion: During the studied period, reactivation of a previous infection remain the more probable cause of recurrence. Although, the evidence of intra- community transmission between Iranian and Afghan TB cases, highlighted the impact of afghan immigrants in national tuberculosis control program (NTP) of Iran.
Regional differences in HIV prevalence among drug users in China: potential for future spread of HIV?
Mirjam Kretzschmar, Weidong Zhang, Rafael T Mikolajczyk, Lan Wang, Xinhua Sun, Alexander Kraemer and Fan Lv Mon, 04 Aug 2008 00:00:00 -0000
Background: Drug use and in particular injecting drug use has been at the forefront of the explosive spread of HIV in general populations in many countries in Asia. There is concern that also in China increased HIV incidence in drug users might spark off a generalized epidemic in the wider population. Close monitoring of HIV incidence and risk factors in drug users is therefore important to be able to target interventions effectively. Second generation surveillance was launched to assess HIV prevalence and risk behaviours jointly with the purpose of describing trends and predicting future developments. To assess whether these goals were fulfilled among drug users in China we provide an analysis of risk factors for HIV infection and of regional differences in HIV prevalence. Methods: We analysed data collected in 2005 in 21 drug user second generation surveillance sentinel sites from 14 provinces in China. We used random effects logistic regression to test for risk factors for HIV infection and regional differences. Results: The overall HIV-1 antibody prevalence was 5.4% (279/5128); 4.9% among injecting drug users (IDU) not sharing needles and 3.7% among non-injecting drug users. We found substantial heterogeneity among the surveillance sites with prevalence rates ranging between 0% and 54%. HIV status was strongly affected by the regional prevalence of HIV. Risk behaviours were highly prevalent in regions where HIV prevalence is still low. The distribution of duration of drug use in different sites indicated different stages of the drug use epidemics. Conclusion: ]Regional differences in HIV prevalence in China reflect different stages of the drug use and HIV epidemics rather than differences in risk behaviours. Therefore, outbreaks of HIV among drug users in regions where prevalence is still low can be expected in the future. However, methodological limitations of surveillance embedded into routine systems limit the usability of existing data. More standardized approaches to data collection in secondary generation HIV surveillance are necessary to better understand regional differences in risk behaviour and prevalence and to design targeted intervention for those regions at risk of experiencing outbreaks.

Current Opinion in Infectious Diseases - Current Table Of Contents

Editorial introductions.
Page: viiDOI: 10.1097/QCO.0b013e3283117e55
Charles Anthony Hart: 25 February 1948 - 21 September 2007.
Page: 453DOI: 10.1097/QCO.0b013e328313ba91Authors: Beeching, Nick
Tuberculosis in the developing world: recent advances in diagnosis with special consideration of extensively drug-resistant tuberculosis.
Page: 454DOI: 10.1097/QCO.0b013e32830ce783Authors: Grandjean, Louis a; Moore, David AJ b

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