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Dengue virus (DENV), an arbovirus transmitted by mosquitoes, has become a major threat to American human life, reaching approximately 23 million cases from 1980 to 2017. Brazil is among the countries most affected by this terrible...
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Dengue virus (DENV), an arbovirus transmitted by mosquitoes, has become a major threat to American human life, reaching approximately 23 million cases from 1980 to 2017. Brazil is among the countries most affected by this terrible viral disease, with 13.6 million cases. DENV has four different serotypes, DENV1-4, which show a broad clinical spectrum. Dengue creates a staggering epidemiological and economic burden for endemic countries. Without a specific therapy and with a commercial vaccine that presents some problems relative to its full effectiveness, initiatives to improve vector control strategies, early disease diagnostics and the development of vaccines and antiviral drugs are priorities. In this study, we present the probable origins of dengue in America and the trajectories of its spread. Overall, dengue diagnostics are costly, making the monitoring of dengue epidemiology more difficult and affecting physicians' therapeutic decisions regarding dengue patients, especially in developing countries. This review also highlights some recent and important findings regarding dengue in Brazil and the Americas. We also summarize the existing DENV polymerase chain reaction (PCR) diagnostic tests to provide an improved reference since these tests are useful and accurate at discriminating DENV from other flaviviruses that co-circulate in the Americas. Additionally, these DENV PCR assays ensure virus serotyping, enabling epidemiologic monitoring.
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Coffee may have hepatoprotective effects and higher coffee consumption has been associated inversely with levels of liver enzymatic markers. However, it is unclear whether decaffeinated coffee is also associated with liver enzymes...
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Coffee may have hepatoprotective effects and higher coffee consumption has been associated inversely with levels of liver enzymatic markers. However, it is unclear whether decaffeinated coffee is also associated with liver enzymes. The study population included 27,793 participants, age 20 or older, in the U.S. National Health and Nutrition Examination Survey (1999-2010). Coffee intake was evaluated by 24-hour dietary recall. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transaminase (GGT) were measured. We examined the relationship between coffee intake and enzymatic levels using weighted multiple variable logistic (abnormally elevated levels of enzymes) and linear regression (continuous enzymatic levels). Total coffee consumption was inversely associated with abnormal levels of all four liver enzymes and continuous levels of AST, ALP, and GGT. Compared to those reporting no coffee consumption, participants reporting ≥3 cups per day had an odds ratio (OR; 95% confidence interval [CI]) of 0.75 (0.63, 0.89), 0.82 (0.68, 0.98), 0.73 (0.55, 0.95), and 0.69 (0.57, 0.83) for abnormal levels of ALT, AST, ALP, and GGT, respectively. Similar inverse associations were found with decaffeinated coffee intake and abnormal levels of ALT (OR ≥2 vs 0 cup/d: 0.62 [0.41, 0.94]), AST (0.74 [0.49, 1.11]), and GGT (0.70 [0.49-1.00]). Conclusion: Higher intakes of coffee, regardless of its caffeine content, were associated with lower levels of liver enzymes. (Hepatology 2014;60:2090-2097)
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In Minas Gerais, Brazil, almost 500,000 dengue fever cases were reported to the State Surveillance System between November 2012 and July 2013. An analysis of the laboratory-confirmed cases revealed a higher age-specific incidence ...
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In Minas Gerais, Brazil, almost 500,000 dengue fever cases were reported to the State Surveillance System between November 2012 and July 2013. An analysis of the laboratory-confirmed cases revealed a higher age-specific incidence in adults and a higher case fatality rate in people aged ≥ 50. Dengue virus serotypes 1 and 4 (the latter of which is an emerging serotype in Brazil) were responsible for the outbreak.
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We present the data of 13 dengue cases diagnosed between 1 August and 15 September 2015 among 240 Israeli expatriates residing in Delhi. Attack rates were similar between adults (6/128, 4.7%) and children (7/112, 6.3%). dengue vir...
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We present the data of 13 dengue cases diagnosed between 1 August and 15 September 2015 among 240 Israeli expatriates residing in Delhi. Attack rates were similar between adults (6/128, 4.7%) and children (7/112, 6.3%). dengue virus (DENV-2) was identified in two and DENV-1 in one dengue-seropositive sample. Another febrile patient was diagnosed with chikungunya virus infection. The reported incidence of dengue fever among people living in Delhi was lower than 0.1% as of September 2015. Based on our results, we hypothesize that the incidence of dengue fever in Delhi is grossly underestimated.
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Dengue virus DENV causes a profound burden of morbidity and mortality, and its global burden is rising due to the co-circulation of four divergent DENV serotypes in the ecological context of globalization, travel, climate change, ...
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Dengue virus DENV causes a profound burden of morbidity and mortality, and its global burden is rising due to the co-circulation of four divergent DENV serotypes in the ecological context of globalization, travel, climate change, urbanization, and expansion of the geographic range of the Ae.aegypti and Ae.albopictus vectors. Understanding DENV evolution offers valuable opportunities to enhance surveillance and response to DENV epidemics via advances in RNA virus sequencing, bioinformatics, phylogenetic and other computational biology methods. Here we provide a scoping overview of the evolution and molecular epidemiology of DENV and the range of ways that evolutionary analyses can be applied as a public health tool against this arboviral pathogen.
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Dengue is the most important and widely distributed arthropod-borne viral disease affecting humans. The number of dengue virus infections has steadily grown and more than 100 countries survey dengue incidence every year. Due to th...
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Dengue is the most important and widely distributed arthropod-borne viral disease affecting humans. The number of dengue virus infections has steadily grown and more than 100 countries survey dengue incidence every year. Due to the lack of an approved antiviral treatment or licensed preventative vaccine, accurate and opportune diagnosis is commended for efficient dengue epidemiological surveillance, to propose control measures in order to curtail outbreaks timely and treat patients satisfactorily. In this review, the basis, application and indications for different diagnostic tests are described, and their advantages and limitations considered. At the end of this piece, we speculate what the future may hold for the diagnosis of dengue infections.
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Highlights ? The role of asymptomatic dengue infections was explored through SIR models. ? One model was taken further by inclusion of the vector and stochasticity. ? This lead to an endemic state. ? Stochasticity showed duration ...
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Highlights ? The role of asymptomatic dengue infections was explored through SIR models. ? One model was taken further by inclusion of the vector and stochasticity. ? This lead to an endemic state. ? Stochasticity showed duration of asymptomatic infection to be key to persistence. ? Results highlight the value of expansion factors in estimating disease incidence. Abstract It is estimated that 20–97% of all dengue infections could be asymptomatic. I used SIR models to investigate the epidemiological role of such infections, by adding an asymptomatic class (SAIR models). Upon infection in one of the models, a human becomes either symptomatic or asymptomatic. In the other, a human becomes asymptomatic and may progress to being symptomatic. The robustness of results from these models is examined by incorporating the mosquito-vector into one of the models, followed by simulating epidemic dynamics stochastically. Results from the first two models were very similar, with epidemics typically lasting less than one year. When mosquitoes were explicitly modelled in a high-transmission setting, if the level or duration of infectivity from asymptomatic infections was high relative to symptomatic infections, dengue would become endemic. Under stochastic simulation this effect of asymptomatic infections leading to dengue persisting was no longer guaranteed. Longer durations in asymptomatic infections had a higher chance of causing dengue's persistence in stochastic simulation, indicating that this may be more of a key determinant for dengue's persistence to 10 years than the infectivity of such infections. Otherwise, the level and duration of infectivity from asymptomatic infections had similar effects on R 0 and other epidemiological measures. With all models, outbreaks often led to a larger proportion of the population being immune than suggested by monitoring symptomatic dengue infections. This population would be at risk of developing severe dengue in a subsequent outbreak with a different dengue serotype, and would have to be determined via expansion factors.
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Background: A tetravalent dengue vaccine demonstrated its protective efficacy in two phase III efficacy studies. Results from these studies were used to derive vaccination impact in the five Asian (Indonesia, Malaysia, Philippines...
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Background: A tetravalent dengue vaccine demonstrated its protective efficacy in two phase III efficacy studies. Results from these studies were used to derive vaccination impact in the five Asian (Indonesia, Malaysia, Philippines, Thailand, Vietnam) and the five Latin American countries (Brazil, Colombia, Honduras, Mexico and Puerto Rico) participating in these trials.
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Dengue is the most important mosquito-borne, human viral disease in many tropical and sub-tropical areas. In India the disease has been essentially described in the form of case series. We reviewed the epidemiology of dengue in In...
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Dengue is the most important mosquito-borne, human viral disease in many tropical and sub-tropical areas. In India the disease has been essentially described in the form of case series. We reviewed the epidemiology of dengue in India to improve understanding of its evolution in the last 50 years and support the development of effective local prevention and control measures. Early outbreak reports showed a classic epidemic pattern of transmission with sporadic outbreaks, with low to moderate numbers of cases, usually localized to urban centres and neighbouring regions, but occasionally spreading and causing larger epidemics. Trends in recent decades include: larger and more frequent outbreaks; geographic expansion of endemic transmission; spread of the disease from urban to peri-urban and rural areas; an increasing proportion of severe cases and deaths; and progression to hyperendemicity, particularly in large urban areas. The global picture of dengue in India is currently that of a largely endemic country. Understanding demographic differences in infection rates and severity of dengue has important implications for the planning and implementation of effective public health prevention and control measures and targeting of future vaccination campaigns.
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Dengue is the most common mosquito-borne viral disease in humans. Over the past several years, the epidemiological profile of dengue has been changing progressively and is currently characterized by an increase in the number of ca...
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Dengue is the most common mosquito-borne viral disease in humans. Over the past several years, the epidemiological profile of dengue has been changing progressively and is currently characterized by an increase in the number of cases in adults. Between 2006 and 2015, there were 5,633 dengue patients at Thammasat University Hospital (TUH) including 4,132 (73.4%) with dengue fever (DF), 1,501 (26.6%) with dengue hemorrhagic fever (DHF). Of all dengue patients, 3,542 (62.9%) were treated in the outpatient department (OPD), and 2,091 (37.1%) were treated in theinpatient department (IPD). During the years 2006 to 2015, 1,540 cases (27.3%) were children (aged <15 years), and 4,093 cases (72.7%) were adults. The highest numbers of dengue cases were reported in individuals aged 15-19 years (17.5%), followed by 20-24 years (17.1%), and 10-14 years (13.3%). Rates have constantly been high amongst adolescents and young adults (aged 10-24 years). The overall case fatality rate from dengue was 0.1%. The case fatality rate was higher for children (0.19%) than for adults (0.07%). The epidemiology has certainly changed and appears to be shifting from child to adult aged population. However, children still remain at risk for infection and death. This changing epidemiology is important for our public health control programs.
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