refugee health and the risk of cutaneous leishmaniasis in europe

Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163 19.205 Dengue virus nonstructural protein induces platelet activation and promotes platelet aggregation C.-H Chao Basic medical sciences of National Cheng Kung University, Tainan/TW Purpose: Dengue virus (DV) infection is currently regarded as the most important mosquito-borne viral infection The clinical symptoms of dengue have a large spectrum from febrile illness to severe syndromes accompanied with bleeding and shock Thrombocytopenia and vascular leak are the two common features of severe dengue Recently, it was found that DV nonstructural protein (NS1) which can be secreted into blood during DV infection, can cause vascular leak However, whether secreted NS1 is involved in the pathogenesis of thrombocytopenia is still unclear In this study, we investigated whether NS1 could directly bind to platelet and studied its effect on platelet activation Methods & Materials: Freshly isolated platelets were incubated with DV NS1 produced by Drosophila S2 cells The binding of NS1 on platelets was observed by immunofluorescent confocal microscopy The effects of NS1 binding on platelet activation were measured by src phosphorylation, P-selectin expression, cytokine secretion and platelet aggregation Results: We demonstrated that NS1 could co-localized with TLR4 on platelets by confocal microscopy In addition, binding of NS1 to platelets induced Src-Y418 phosphorylation within to 15 minutes, and this effect could be blocked by the presence of certainly anti-NS1 monoclonal antibody P-selectin expression and macrophage migration inhibitory factor secretion were increased in platelet after NS1 stimulation In addition, NS1-activated platelet have higher aggregation response in the presence of suboptimal dose of ADP or thrombin stimulation Conclusion: Our results suggested that DV NS1 could directly bind to platelets and induce platelet activation through src signal transduction, which may enhance platelet aggregation These results may explain part of the causes of thrombocytopenia and re-emphasize the critical role of DV NS1 in dengue pathogenesis http://dx.doi.org/10.1016/j.ijid.2016.11.238 19.206 Dengue transmission through human movement in regular and seasonal patterns on Koh Chang island in Thailand C.Y Hou a,∗ , P Kittayapong b , J Mumford a , L.R Carrasco c a Imperial College London, London/UK Mahidol University, Bangkok/TH c National University of Singapore, Singapore/SG b Purpose: Mosquitoes serve as vectors for many infectious diseases, of which a growing concern is dengue in Southeast Asia Control of vector-borne diseases is a substantial public cost and personal mosquito control imposes a burden on many individual households Average annual national dengue incidence in Thailand from 2000-2011 was 115 cases per 100,000 people, while on the island of Koh Chang in the Trat province of Thailand the annual incidence was on average 196 cases per 100,000 people over a similar time period Movement from mainland Thailand and from nearby Cambodia may be driving the dengue dynamics at this local scale As a case study of a location with high tourism and seasonal 95 movement, this work aims to estimate the ranges of relevant parameters that could impact local disease transmission in order to understand disease dynamics influenced by human movement Methods & Materials: This study investigates non-seasonal and seasonal human movement through networks of human and mosquito populations in residential communities in Koh Chang Using 2-patch and 3-patch metapopulation models, we estimate the range of secondary cases, the basic reproductive ratio R0 , in response to two parameters: the rate of movement between Koh Chang and Cambodia and the rate of infection in Cambodia Results: We present results from multi-patch metapopulation models that show how movement at local and regional scales may impact R0 We graph potential dengue cases resulting from ranges of parameters estimating human movement and dengue incidence to suggest what may lead to a local R0 ≥ in Koh Chang Conclusion: The aim of this work is to model dynamics in disease risk and dispersal involving human movement, human disease cases, and mosquitoes in a case study of Koh Chang, Thailand An understanding of human movement at the local and regional scale may be helpful for disease management and preparation http://dx.doi.org/10.1016/j.ijid.2016.11.239 19.207 Refugee health and the risk of cutaneous Leishmaniasis in Europe A Khamesipour a,∗ , B Rath b a Tehran University of Medical Sciences, Center for Research and Training in Skin Diseases and Leprosy, Tehran/IR b Vienna Vaccine Safety Initiative, Berlin/DE Purpose: Leishmaniasis is a vector-borne neglected disease caused by different species of intracellular Leishmania parasites transmitted by sandfly species The clinical manifestations of the disease range from cutaneous leishmaniasis (CL), the most common form of the disease, to the potentially lethal forms of visceral leishmaniasis CL may be transmitted as a zoonotic disease caused mostly by L major in the Old World with small rodents serving as the animal reservoir Anthroponotic CL on the other hand, is caused by L tropica and transmitted through P sergenti sandflies In Syria, CL is a well-known disease (“Aleppo boil”), but incidence rates had decreased significantly prior to the civil war Methods & Materials: Risk assessments are based on World Health Organization estimates that currently, a tenth of the world population are at risk of leishmaniasis The disease has been reported from 98 countries on four continents leading to a loss in disability-adjusted life years (DALYs) of about 2.4 million Leishmaniasis is endemic to 14 of 22 EMRO/WHO countries, including regions where the highest number of refugees to Europe originate, including Syria, Iraq and Afghanistan, where L tropica predominates Results: Although currently there is little information on the prevalence of CL in Iraq and Syria, we found that >50,000 cases have been reported in 2015 from the areas under Syrian government control, representing a dramatic increase in CL incidence in the region Refugees may be spreading L tropica during migration, and cases have been observed in Lebanon, Turkey, Greece and other parts of Europe The vector, P sergenti, is wide-spread in the Mediterranean, including Cyprus, France, Greece, Italy, Malta, Portugal and Spain The authors present a needs-assessment for the timely detection of leishmaniasis in Europe, along with an update on the current state of diagnostics, therapy and vaccine development 96 Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163 Conclusion: The possibility of transmission is high as long as the vector is present Permissive vectors, i.e those supporting the development of most of Leishmania species, exist in many parts of Europe Physicians taking care of refugees and migrants in Europe should be educated to identify cases early and to develop adequate management and surveillance systems http://dx.doi.org/10.1016/j.ijid.2016.11.240 19.208 Three patients from Suriname with possibly Zika virus associated Guillain-Barré syndrome T Langerak a,∗ , H Yang b , J Codrington c , H Alberga b , B Jacobs d , C Geurts van Kessel e , C Reusken f , M Koopmans g , E van Gorp h , S Vreden b a Erasmus Medical Centre, Viroscience, Rotterdam/NL Academic Hospital Paramaribo, Neurology, Paramaribo/SR c Academic Hospital Paramaribo, Diagnostic Laboratory, Paramaribo/SR d Erasmus MC, Neurology&Immunology, Rotterdam/NL e Erasmus MC, Viroscience, Rotterdam/NL f Erasmus Medical Center, Viroscience, Rotterdam/NL g Erasmus Medical Centre, Rotterdam/NL h Erasmus Medical Center, Rotterdam/NL b Purpose: Since the Zika virus (ZIKV) outbreak in South-America, an increased incidence of microcephaly and the Guillain-Barré syndrome (GBS) is reported in several countries in South-America Here we present three patients with GBS during the ZIKV outbreak in Suriname who were diagnosed in February and March 2016 This case series shows the diagnostic challenge to prove the clinical diagnosis of GBS in relation to ZIKV infection Methods & Materials: Plasma, serum and urine samples were collected from the patients RT-PCR for ZIKV was performed in the urine and plasma Presence of ZIKV antibodies in the serum was tested with a ZIKV ELISA (Euroimmun, Lübeck, Germany) and a virus neutralisation test A multiplex serological protein microarray using recombinant proteins was used for detection of Flaviviruses and Chikungunya antibodies in the serum samples ELISA was used to detect IgM and IgG anti-ganglioside antibodies in the serum Results: The three patients had clinical signs and symptoms of GBS, and the diagnosis was confirmed by the findings in cerebrospinal fluid and nerve conduction studies (NCS) The clinical course of GBS in these patients was relatively mild and specific treatment was not administered The antiganglioside antibodies were negative in all patients One patient had a positive ZIKV urine real-time PCR (RT-PCR) result The other two patients had a negative ZIKV urine RT-PCR but a positive virus neutralisation test and presence of IgG antibodies against ZIKV in the serum Serological testing for recent infections with Campylobacter jejuni, Cytomegalovirus and Epstein-Bar virus were negative Conclusion: To prove that a GBS case is triggered by ZIKV is difficult, especially after the viraemic period of ZIKV However, taken into account the increased GBS incidence that coincided with the ZIKV outbreak in Suriname and the absence of most prevalent preceding infections of GBS in these patients, it is plausible that the GBS in these patients is triggered by ZIKV infection in the recent past http://dx.doi.org/10.1016/j.ijid.2016.11.241 19.211 Malaria - a new re-merging disease in Albania P Pipero a , N Como a , A Harxhi a , E Meta b , A Ndreu b , T Kalo b , S Bino c,∗ , M Kokici d , T Myrseli e , D Kraja a a Medical University of Tirana, Infectious Disease Clinic, Tirana/AL b University Hospital Centre, Infectious Disease Clinic, Tirana/AL c Institute of Public Health, Department of Infectious Diseases, Tirana, ALBANIA/AL d Medical University of Tirana, Clinical Laboratory, Tirana/AL e Public Health Institution, Infectious Disease, Tirana/AL Purpose: Albania was listed as an endemic area from the beginning of the 20th century It was eradicated in 1967 and around 1994 the movement of people for work purposes and tourism to tropical areas,malaria reappeared again, already imported The aim is to note that malaria is re-emerging diseases in Albania Methods & Materials: We analyzed the etiological aspect, the cause was determined on UHC laboratory and IPH, using method the point of thin and thick blood Epidemiological aspects-defined the countries from which they came after the epidemiological investigation It was determined the age group and gender, season and month of occurrence of malaria Clinical aspect - the patients were grouped according to clinical-biological data’s and preclinical manifestations of different bodies taking into account the classification of cases according to the gravity and possible complications We included 27 cases of imported malaria in our country, the age group 19-58 years old, during the period 2012 to 2016 on the infectious diseases service UHC Results: Based on etiological causes we found out 17 cases P Falciparum, case P Vivax, cases P Oval, mixes (P Oval and P falciparum) Epidemiological data: case from Ghana, from Greece,1 from Papua New Guinea,1from Cad, from Nigeria,21 from Ecuatorial Guinea All cases were male,19-30 years old 12 cases,31-40 years old 9, 41-50 years old 5, 51-58 years Based on seasonality cases in the spring (april-may), summer 5, autumn 8(Octobernovember),in winter Clinical classification:simple attacs 7, with hematological, hepatic and renal alterations 16, cerebral malaria cases where was died Clinical progress classification: primary attacks 19, recrudesence 3, relapses 3, reinfections Conclusion: We identified etiological factors, P.falciparum 62.9%, P Vivax 3.70%, P Oval 22.3% and mix causes 11.1% (P falciparum and P Oval) Distinguished in different countries Malaria was present in all seasons Exitus in 3.7% Malaria already considered a re-emerging disease in Albania The presence of transmitting vectors not excludes the possibility of return to its native form, which is in the attention of public health institute http://dx.doi.org/10.1016/j.ijid.2016.11.242 ... after the viraemic period of ZIKV However, taken into account the increased GBS incidence that coincided with the ZIKV outbreak in Suriname and the absence of most prevalent preceding infections of. .. IgM and IgG anti-ganglioside antibodies in the serum Results: The three patients had clinical signs and symptoms of GBS, and the diagnosis was confirmed by the findings in cerebrospinal fluid and. .. according to clinical-biological data’s and preclinical manifestations of different bodies taking into account the classification of cases according to the gravity and possible complications We included