Displaying publications 21 - 40 of 61 in total

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  1. Fulltext Plasmodium knowlesi malaria an emerging public health problem in Hulu Selangor, Selangor, Malaysia (2009-2013): epidemiologic and entomologic analysis
    Vythilingam I, Lim YA, Venugopalan B, Ngui R, Leong CS, Wong ML, et al.
    Parasit Vectors, 2014;7:436.
    PMID: 25223878 DOI: 10.1186/1756-3305-7-436
    While transmission of the human Plasmodium species has declined, a significant increase in Plasmodium knowlesi/Plasmodium malariae cases was reported in Hulu Selangor, Selangor, Malaysia. Thus, a study was undertaken to determine the epidemiology and the vectors involved in the transmission of knowlesi malaria.
    Matched MeSH terms: Communicable Diseases, Emerging/epidemiology; Communicable Diseases, Emerging/parasitology; Communicable Diseases, Emerging/transmission*
  2. Fulltext Incidence, risk factors and clinical epidemiology of melioidosis: a complex socio-ecological emerging infectious disease in the Alor Setar region of Kedah, Malaysia
    Hassan MR, Pani SP, Peng NP, Voralu K, Vijayalakshmi N, Mehanderkar R, et al.
    BMC Infect Dis, 2010;10:302.
    PMID: 20964837 DOI: 10.1186/1471-2334-10-302
    Melioidosis, a severe and fatal infectious disease caused by Burkholderia pseudomallei, is believed to an emerging global threat. However, data on the natural history, risk factors, and geographic epidemiology of the disease are still limited.
    Matched MeSH terms: Communicable Diseases, Emerging/mortality; Communicable Diseases, Emerging/epidemiology*; Communicable Diseases, Emerging/pathology
  3. Fulltext "Discovery to treatment" window in patients with smear-positive pulmonary tuberculosis
    Loh LC, Codati A, Jamil M, Noor ZM, Vijayasingham P
    Med J Malaysia, 2005 Aug;60(3):314-9.
    PMID: 16379186
    Delay in commencing treatment in patients diagnosed with smear-positive pulmonary tuberculosis (PTB) may promote the spread of PTB in the community. Socio-demographic and clinical data from 169 patients (119 retrospectively and 50 prospectively collected) treated for smear-positive PTB in our hospital Chest Clinic from June 2002 to February 2003 were analysed. One hundred and fifty eight (93.5%) patients were started on treatment in less than 7 days from the time when the report first became available while 11 (6.5%) patients had their treatment started > or = 7 days. The median 'discovery to treatment' window was 1 day (range, 0 to 24 days). Of the factors studied, longevity of symptoms, absence of fever or night sweats and having sought traditional medicine were associated with delay in treatment commencement. The urgency and importance of anti-TB treatment should be emphasized especially to patients who are inclined towards treatment with traditional medicine.
    Keywords: Smear positive, pulmonary tuberculosis, treatment delay, traditional medicine, Malaysia, Seremban, Negeri Sembilan
    Matched MeSH terms: Communicable Diseases, Emerging/diagnosis; Communicable Diseases, Emerging/drug therapy; Communicable Diseases, Emerging/microbiology
  4. Conservation medicine and a new agenda for emerging diseases
    Daszak P, Tabor GM, Kilpatrick AM, Epstein J, Plowright R
    Ann N Y Acad Sci, 2004 Oct;1026:1-11.
    PMID: 15604464
    The last three decades have seen an alarming number of high-profile outbreaks of new viruses and other pathogens, many of them emerging from wildlife. Recent outbreaks of SARS, avian influenza, and others highlight emerging zoonotic diseases as one of the key threats to global health. Similar emerging diseases have been reported in wildlife populations, resulting in mass mortalities, population declines, and even extinctions. In this paper, we highlight three examples of emerging pathogens: Nipah and Hendra virus, which emerged in Malaysia and Australia in the 1990s respectively, with recent outbreaks caused by similar viruses in India in 2000 and Bangladesh in 2004; West Nile virus, which emerged in the New World in 1999; and amphibian chytridiomycosis, which has emerged globally as a threat to amphibian populations and a major cause of amphibian population declines. We discuss a new, conservation medicine approach to emerging diseases that integrates veterinary, medical, ecologic, and other sciences in interdisciplinary teams. These teams investigate the causes of emergence, analyze the underlying drivers, and attempt to define common rules governing emergence for human, wildlife, and plant EIDs. The ultimate goal is a risk analysis that allows us to predict future emergence of known and unknown pathogens.
    Matched MeSH terms: Communicable Diseases, Emerging/diagnosis; Communicable Diseases, Emerging/epidemiology; Communicable Diseases, Emerging/therapy*
  5. Fulltext Determination of Leptospira borgpetersenii serovar Javanica and Leptospira interrogans serovar Bataviae as the persistent Leptospira serovars circulating in the urban rat populations in Peninsular Malaysia
    Benacer D, Mohd Zain SN, Sim SZ, Mohd Khalid MK, Galloway RL, Souris M, et al.
    Parasit Vectors, 2016;9:117.
    PMID: 26927873 DOI: 10.1186/s13071-016-1400-1
    Leptospirosis is an emerging infectious disease of global significance, and is endemic in tropical countries, including Malaysia. Over the last decade, a dramatic increase of human cases was reported; however, information on the primary vector, the rat, and the Leptospira serovars circulating among the rat population is limited. Therefore, the present study was undertaken to isolate Leptospira and characterise the serovars circulating in the urban rat populations from selected main cities in Peninsular Malaysia.
    Matched MeSH terms: Communicable Diseases, Emerging
  6. [Emergence of transmissible disorders, a continuous process--a new type of viral meningoencephalitis]
    Ivan A, Indrei LL
    Rev Med Chir Soc Med Nat Iasi, 2000 Apr-Jun;104(2):51-5.
    PMID: 12089991
    In the interval 1994-1999, in Australia, Malaysia and Singapore, epizootic and epidemiological episodes of meningoencephalitis and severe acute respiratory syndromes were reported. Highly lethal in horses, swine and humans, the episodes were proved to be caused by the "new" viruses Hendra (HeV) and Nipah (NiV). At the same time three "new" viral agents have been isolated: Lyssavirus, Menanglevirus and Tupaia paramyxovirus. The intense contemporary circulation of people, animals and food products together with changes in human ecosystem favor new relations between humans and the "natural reservoirs" of biologic agents with a pathogenic potential for domestic and peridomestic animals and humans.
    Matched MeSH terms: Communicable Diseases, Emerging/epidemiology; Communicable Diseases, Emerging/veterinary; Communicable Diseases, Emerging/virology*
  7. Fulltext Defending against the Novel Coronavirus (COVID-19) outbreak: How can the Internet of Things (IoT) help to save the world?
    Rahman MS, Peeri NC, Shrestha N, Zaki R, Haque U, Hamid SHA
    Health Policy Technol, 2020 Jun;9(2):136-138.
    PMID: 32322475 DOI: 10.1016/j.hlpt.2020.04.005
    •IoT within infectious disease epidemiology is an emerging field of research, however the ubiquitous availability of smart technologies, as well as increased risks of infectious disease spread through the globalization and interconnectedness of the world necessitates its use for predicting, preventing and controlling emerging infectious diseases.•Considering the present situation in China, IoT based smart disease surveillance systems have the potential to be a major breakthrough in efforts to control the current pandemic. With much of the infrastructure itself in place already (i.e. smartphones, wearable technologies, internet access) the role this technology can have in limiting the spread of the pandemic involves only the collection and analysis of data already gathered.•More research must be carried out for the development of automated and effective alert systems to provide early and timely detection of outbreaks of such diseases in order to reduce morbidity mortality and prevent global spread.
    Matched MeSH terms: Communicable Diseases, Emerging
  8. Nipah virus: an emergent paramyxovirus causing severe encephalitis in humans
    Bellini WJ, Harcourt BH, Bowden N, Rota PA
    J Neurovirol, 2005 Oct;11(5):481-7.
    PMID: 16287690
    Nipah virus is a recently emergent paramyxovirus that is capable of causing severe disease in both humans and animals. The first outbreak of Nipah virus occurred in Malaysia and Singapore in 1999 and, more recently, outbreaks were detected in Bangladesh. In humans, Nipah virus causes febrile encephalitis with respiratory syndrome that has a high mortality rate. The reservoir for Nipah virus is believed to be fruit bats, and humans are infected by contact with infected bats or by contact with an intermediate animal host such as pigs. Person to person spread of the virus has also been described. Nipah virus retains many of the genetic and biologic properties found in other paramyxoviruses, though it also has several unique characteristics. However, the virologic characteristics that allow the virus to cause severe disease over a broad host range, and the epidemiologic, environmental and virologic features that favor transmission to humans are unknown. This review summarizes what is known about the virology, epidemiology, pathology, diagnosis and control of this novel pathogen.
    Matched MeSH terms: Communicable Diseases, Emerging/diagnosis*; Communicable Diseases, Emerging/epidemiology*; Communicable Diseases, Emerging/virology*
  9. Fulltext Malaria elimination in Malaysia and the rising threat of Plasmodium knowlesi
    Chin AZ, Maluda MCM, Jelip J, Jeffree MSB, Culleton R, Ahmed K
    J Physiol Anthropol, 2020 Nov 23;39(1):36.
    PMID: 33228775 DOI: 10.1186/s40101-020-00247-5
    BACKGROUND: Malaria is a major public-health problem, with over 40% of the world's population (more than 3.3 billion people) at risk from the disease. Malaysia has committed to eliminate indigenous human malaria transmission by 2020. The objective of this descriptive study is to understand the epidemiology of malaria in Malaysia from 2000 through 2018 and to highlight the threat posed by zoonotic malaria to the National Malaria Elimination Strategic Plan.

    METHODS: Malaria is a notifiable infection in Malaysia. The data used in this study were extracted from the Disease Control Division, Ministry of Health Malaysia, contributed by the hospitals and health clinics throughout Malaysia. The population data used in this study was extracted from the Department of Statistics Malaysia. Data analyses were performed using Microsoft Excel. Data used for mapping are available at EPSG:4326 WGS84 CRS (Coordinate Reference System). Shapefile was obtained from igismap. Mapping and plotting of the map were performed using QGIS.

    RESULTS: Between 2000 and 2007, human malaria contributed 100% of reported malaria and 18-46 deaths per year in Malaysia. Between 2008 and 2017, indigenous malaria cases decreased from 6071 to 85 (98.6% reduction), while during the same period, zoonotic Plasmodium knowlesi cases increased from 376 to 3614 cases (an 861% increase). The year 2018 marked the first year that Malaysia did not report any indigenous cases of malaria caused by human malaria parasites. However, there was an increasing trend of P. knowlesi cases, with a total of 4131 cases reported in that year. Although the increased incidence of P. knowlesi cases can be attributed to various factors including improved diagnostic capacity, reduction in human malaria cases, and increase in awareness of P. knowlesi, more than 50% of P. knowlesi cases were associated with agriculture and plantation activities, with a large remainder proportion linked to forest-related activities.

    CONCLUSIONS: Malaysia has entered the elimination phase of malaria control. Zoonotic malaria, however, is increasing exponentially and becoming a significant public health problem. Improved inter-sectoral collaboration is required in order to develop a more integrated effort to control zoonotic malaria. Local political commitment and the provision of technical support from the World Health Organization will help to create focused and concerted efforts towards ensuring the success of the National Malaria Elimination Strategic Plan.

    Matched MeSH terms: Communicable Diseases, Emerging
  10. Livestock-associated meticillin-resistant Staphylococcus aureus in Asia: an emerging issue?
    Chuang YY, Huang YC
    Int J Antimicrob Agents, 2015 Apr;45(4):334-40.
    PMID: 25593014 DOI: 10.1016/j.ijantimicag.2014.12.007
    In addition to being a human pathogen, Staphylococcus aureus causes an array of infections in economically important livestock animals, particularly pigs. In Asia, there have been few reports on livestock-associated meticillin-resistant S. aureus (LA-MRSA), mostly from developed countries, with very few data available from resource-limited countries, not because of low prevalence but probably due to a shortage of diagnostic facilities. Unlike the wide spread of sequence type 398 (ST398) LA-MRSA in European countries and North America, ST9 predominates in most Asian countries. The prevalence of LA-MRSA among pigs in Asian countries varied widely (0.9-42.5%). The prevalence may vary by geographic location, age of pigs and sampling methodologies. Among pig farmers, the prevalence of nasal MRSA colonisation varied from 5.5% in Malaysia to 15% in China and 19.2% in Taiwan. Although most LA-MRSA isolates in Asia are of the same ST, molecular characteristics are not all the same. Dominant isolates in China were characterised as spa type t899-SCCmec III and t899-SCCmec IVb or V for isolates in Hong Kong, and t899-untypeable SCCmec for Taiwan. Dominant isolates in Malaysia were spa type t4358-SCCmec V and t337-SCCmec IX for isolates in Thailand. In addition, MRSA ST221 was reported in Japan and MRSA ST398 was isolated from commercial pigs in South Korea. Attention should be paid because pigs could become an important reservoir for MRSA and spread them to humans, as observed in many countries. There is a potential risk from the livestock reservoir to community and hospitals.
    Matched MeSH terms: Communicable Diseases, Emerging/microbiology; Communicable Diseases, Emerging/epidemiology*; Communicable Diseases, Emerging/veterinary*
  11. Fulltext A golden hamster model for human acute Nipah virus infection
    Wong KT, Grosjean I, Brisson C, Blanquier B, Fevre-Montange M, Bernard A, et al.
    Am J Pathol, 2003 Nov;163(5):2127-37.
    PMID: 14578210 DOI: 10.1016/S0002-9440(10)63569-9
    A predominantly pig-to-human zoonotic infection caused by the novel Nipah virus emerged recently to cause severe morbidity and mortality in both animals and man. Human autopsy studies showed the pathogenesis to be related to systemic vasculitis that led to widespread thrombotic occlusion and microinfarction in most major organs especially in the central nervous system. There was also evidence of extravascular parenchymal infection, particularly near damaged vessels (Wong KT, Shieh WJ, Kumar S, Norain K, Abdullah W, Guarner J, Goldsmith CS, Chua KB, Lam SK, Tan CT, Goh KJ, Chong HT, Jusoh R, Rollin PE, Ksiazek TG, Zaki SR, Nipah Virus Pathology Working Group: Nipah virus infection: Pathology and pathogenesis of an emerging paramyxoviral zoonosis. Am J Pathol 2002, 161:2153-2167). We describe here a golden hamster (Mesocricetus auratus) model that appears to reproduce the pathology and pathogenesis of acute human Nipah infection. Hamsters infected by intranasal or intraperitoneal routes died within 9 to 29 days or 5 to 9 days, respectively. Pathological lesions were most severe and extensive in the hamster brain. Vasculitis, thrombosis, and more rarely, multinucleated endothelial syncytia, were found in blood vessels of multiple organs. Viral antigen and RNA were localized in both vascular and extravascular tissues including neurons, lung, kidney, and spleen, as demonstrated by immunohistochemistry and in situ hybridization, respectively. Paramyxoviral-type nucleocapsids were identified in neurons and in vessel walls. At the terminal stage of infection, virus and/or viral RNA could be recovered from most solid organs and urine, but not from serum. The golden hamster is proposed as a suitable model for further studies including pathogenesis studies, anti-viral drug testing, and vaccine development against acute Nipah infection.
    Matched MeSH terms: Communicable Diseases, Emerging/mortality; Communicable Diseases, Emerging/pathology; Communicable Diseases, Emerging/virology
  12. Fulltext Emerging trends of Nipah virus: A review
    Sharma V, Kaushik S, Kumar R, Yadav JP, Kaushik S
    Rev Med Virol, 2019 Jan;29(1):e2010.
    PMID: 30251294 DOI: 10.1002/rmv.2010
    Since emergence of the Nipah virus (NiV) in 1998 from Malaysia, the NiV virus has reappeared on different occasions causing severe infections in human population associated with high rate of mortality. NiV has been placed along with Hendra virus in genus Henipavirus of family Paramyxoviridae. Fruit bats (Genus Pteropus) are known to be natural host and reservoir of NiV. During the outbreaks from Malaysia and Singapore, the roles of pigs as intermediate host were confirmed. The infection transmitted from bats to pigs and subsequently from pigs to humans. Severe encephalitis was reported in NiV infection often associated with neurological disorders. First NiV outbreak in India occurred in Siliguri district of West Bengal in 2001, where direct transmission of the NiV virus from bats-to-human and human-to-human was reported in contrast to the role of pigs in the Malaysian NiV outbreak. Regular NiV outbreaks have been reported from Bangladesh since 2001 to 2015. The latest outbreak of NiV has been recorded in May, 2018 from Kerala, India which resulted in the death of 17 individuals. Due to lack of vaccines and effective antivirals, Nipah encephalitis poses a great threat to public health. Routine surveillance studies in the infected areas can be useful in detecting early signs of infection and help in containment of these outbreaks.
    Matched MeSH terms: Communicable Diseases, Emerging/epidemiology; Communicable Diseases, Emerging/veterinary; Communicable Diseases, Emerging/virology
  13. Fulltext Melioidosis: an emerging infectious disease
    Raja NS, Ahmed MZ, Singh NN
    J Postgrad Med, 2005 Apr-Jun;51(2):140-5.
    PMID: 16006713
    Infectious diseases account for a third of all the deaths in the developing world. Achievements in understanding the basic microbiology, pathogenesis, host defenses and expanded epidemiology of infectious diseases have resulted in better management and reduced mortality. However, an emerging infectious disease, melioidosis, is becoming endemic in the tropical regions of the world and is spreading to non-endemic areas. This article highlights the current understanding of melioidosis including advances in diagnosis, treatment and prevention. Better understanding of melioidosis is essential, as it is life-threatening and if untreated, patients can succumb to it. Our sources include a literature review, information from international consensus meetings on melioidosis and ongoing discussions within the medical and scientific community.
    Matched MeSH terms: Communicable Diseases, Emerging/epidemiology*
  14. Emerging and re-emerging diseases in Malaysia
    Lam SK
    Asia Pac J Public Health, 2002;14(1):6-8.
    PMID: 12597511 DOI: 10.1177/101053950201400103
    Emerging and re-emerging infectious diseases have become a major global problem. Malaysia appears to be an epicenter for such infections and in recent years, several outbreaks have occurred resulting in loss of lives and economic hardships. In this paper, we discussed the outbreaks of leptospirosis, enterovirus 71 encephalitis, chikungunya polyarthritis and Nipah encephalitis and how a developing country such as Malaysia managed the situation with the help of international agencies and organisations. Many valuable lessons were learned and by sharing our experience, it is hoped that we will be in a better position to handle future outbreaks and prevent their spread to countries in the region.
    Matched MeSH terms: Communicable Diseases, Emerging/epidemiology*
  15. The ecology of emerging neurotropic viruses
    Olival KJ, Daszak P
    J Neurovirol, 2005 Oct;11(5):441-6.
    PMID: 16287685
    The authors review common themes in the ecology of emerging viruses that cause neurological disease. Three issues emerge. First, 49% of emerging viruses are characterized by encephalitis or serious neurological clinical symptoms. Second, all of these viruses are driven to emerge by ecological, environmental, or human demographic changes, some of which are poorly understood. Finally, the control of these viruses would be enhanced by collaborative multidisciplinary research into these drivers of emergence. The authors highlight this review with a case study of Nipah virus, which emerged in Malaysia due largely to shifts in livestock production and alterations to reservoir host habitat. Collaboration between virologists, ecologists, disease modelers and wildlife biologists has been instrumental in retracing the factors involved in this virus's emergence.
    Matched MeSH terms: Communicable Diseases, Emerging/virology*
  16. Fulltext Changing epidemiology of SARS-CoV in the context of COVID-19 pandemic
    Bhattacharya S, Basu P, Poddar S
    J Prev Med Hyg, 2020 Jun;61(2):E130-E136.
    PMID: 32802995 DOI: 10.15167/2421-4248/jpmh2020.61.2.1541
    SARS-CoV-2 is a new form of β-coronavirus that has been recently discovered and is responsible for COVID 19 pandemic. The earliest infection can be traced back to Wuhan, China. From there it has spread all over the world. Keeping in view the above perspective, an attempt is made in order to find out the epidemiological pattern of COVID 19 pandemic, if any, in different geo-climatological regions of the world in terms of case incidence and mortality. This study is also an endeavor to review and analyze the gradual changes of the genetic makeup of SARS-CoV from evolutionary and epidemiological perspectives. The raw data of COVID-19 cases and death incidences were collected from the World Health Organization (WHO) website from the time period: 1st April to 6th April, 2020. The data that are utilized here for general and Case fatality rate (CFR) based analysis. Western pacific region, European region and Americas have the greatest number of infected cases (P < 0.001); whereas deaths have been found to be significantly higher in Europe (P < 0.001). Total number of confirmed cases and deaths in south-east Asia are comparatively lower (P < 0.001). Case fatality rate (CFR) has also found significant for European region. SARS-CoV-2 is considered to be a strain of SARS-CoV that has a high rate of pathogenicity and transmissibility. Result indicated that the European region has been affected mostly for both cases and death incidences. The novel mutations in SARS-CoV-2 possibly increase the virus infectivity. Genetic heterogeneity of this virus within the human population might originate as the representatives of naturally selected virus quasispecies. In this context, the presence of the asymptomatic individuals could be a significant concern for SARS-CoV-2 epidemiology. Further studies are required to understand its genetic evolution and epidemiological significance.
    Matched MeSH terms: Communicable Diseases, Emerging/epidemiology*
  17. Fulltext Reemergence of endemic Chikungunya, Malaysia
    AbuBakar S, Sam IC, Wong PF, MatRahim N, Hooi PS, Roslan N
    Emerg Infect Dis, 2007 Jan;13(1):147-9.
    PMID: 17370532
    Chikungunya virus infection recently reemerged in Malaysia after 7 years of nondetection. Genomic sequences of recovered isolates were highly similar to those of Malaysian isolates from the 1998 outbreak. The reemergence of the infection is not part of the epidemics in other Indian Ocean countries but raises the possibility that chikungunya virus is endemic in Malaysia.
    Matched MeSH terms: Communicable Diseases, Emerging/epidemiology
  18. The re-emerging of orf virus infection: A call for surveillance, vaccination and effective control measures
    Bala JA, Balakrishnan KN, Abdullah AA, Mohamed R, Haron AW, Jesse FFA, et al.
    Microb Pathog, 2018 Jul;120:55-63.
    PMID: 29709684 DOI: 10.1016/j.micpath.2018.04.057
    Orf disease is known to be enzootic among small ruminants in Asia, Africa, and some other parts of the world. The disease caused by orf virus is highly contagious among small ruminant species. Unfortunately, it has been neglected for decades because of the general belief that it only causes a self-limiting disease. On the other hand, in the past it has been reported to cause huge cumulative financial losses in livestock farming. Orf disease is characterized by localized proliferative and persistent skin nodule lesions that can be classified into three forms: generalized, labial and mammary or genitals. It can manifest as benign or malignant types. The later type of orf can remain persistent, often fatal and usually causes a serious outbreak among small ruminant population. Morbidity and mortality rates of orf are higher especially in newly infected kids and lambs. Application of antibiotics together with antipyretic and/or analgesic is highly recommended as a supportive disease management strategy for prevention of subsequent secondary microbial invasion. The presence of various exotic orf virus strains of different origin has been reported in many countries mostly due to poorly controlled cross-border virus transmission. There have been several efforts to develop orf virus vaccines and it was with variable success. The use of conventional vaccines to control orf is a debatable topic due to the concern of short term immunity development. Following re-infection in previously vaccinated animals, it is uncommon to observe the farms involved to experience rapid virus spread and disease outbreak. Meanwhile, cases of zoonosis from infected animals to animal handler are not uncommon. Despite failures to contain the spread of orf virus by the use of conventional vaccines, vaccination of animals with live orf virus is still considered as one of the best choice. The review herein described pertinent issues with regard to the development and use of potential effective vaccines as a control measure against orf virus infection.
    Matched MeSH terms: Communicable Diseases, Emerging/epidemiology; Communicable Diseases, Emerging/prevention & control*; Communicable Diseases, Emerging/veterinary*; Communicable Diseases, Emerging/virology
  19. Nipah virus infection: pathology and pathogenesis of an emerging paramyxoviral zoonosis
    Wong KT, Shieh WJ, Kumar S, Norain K, Abdullah W, Guarner J, et al.
    Am J Pathol, 2002 Dec;161(6):2153-67.
    PMID: 12466131
    In 1998, an outbreak of acute encephalitis with high mortality rates among pig handlers in Malaysia led to the discovery of a novel paramyxovirus named Nipah virus. A multidisciplinary investigation that included epidemiology, microbiology, molecular biology, and pathology was pivotal in the discovery of this new human infection. Clinical and autopsy findings were derived from a series of 32 fatal human cases of Nipah virus infection. Diagnosis was established in all cases by a combination of immunohistochemistry (IHC) and serology. Routine histological stains, IHC, and electron microscopy were used to examine autopsy tissues. The main histopathological findings included a systemic vasculitis with extensive thrombosis and parenchymal necrosis, particularly in the central nervous system. Endothelial cell damage, necrosis, and syncytial giant cell formation were seen in affected vessels. Characteristic viral inclusions were seen by light and electron microscopy. IHC analysis showed widespread presence of Nipah virus antigens in endothelial and smooth muscle cells of blood vessels. Abundant viral antigens were also seen in various parenchymal cells, particularly in neurons. Infection of endothelial cells and neurons as well as vasculitis and thrombosis seem to be critical to the pathogenesis of this new human disease.
    Matched MeSH terms: Communicable Diseases, Emerging/diagnosis; Communicable Diseases, Emerging/epidemiology; Communicable Diseases, Emerging/pathology*; Communicable Diseases, Emerging/virology
  20. Fulltext Agricultural intensification, priming for persistence and the emergence of Nipah virus: a lethal bat-borne zoonosis
    Pulliam JR, Epstein JH, Dushoff J, Rahman SA, Bunning M, Jamaluddin AA, et al.
    J R Soc Interface, 2012 Jan 7;9(66):89-101.
    PMID: 21632614 DOI: 10.1098/rsif.2011.0223
    Emerging zoonoses threaten global health, yet the processes by which they emerge are complex and poorly understood. Nipah virus (NiV) is an important threat owing to its broad host and geographical range, high case fatality, potential for human-to-human transmission and lack of effective prevention or therapies. Here, we investigate the origin of the first identified outbreak of NiV encephalitis in Malaysia and Singapore. We analyse data on livestock production from the index site (a commercial pig farm in Malaysia) prior to and during the outbreak, on Malaysian agricultural production, and from surveys of NiV's wildlife reservoir (flying foxes). Our analyses suggest that repeated introduction of NiV from wildlife changed infection dynamics in pigs. Initial viral introduction produced an explosive epizootic that drove itself to extinction but primed the population for enzootic persistence upon reintroduction of the virus. The resultant within-farm persistence permitted regional spread and increased the number of human infections. This study refutes an earlier hypothesis that anomalous El Niño Southern Oscillation-related climatic conditions drove emergence and suggests that priming for persistence drove the emergence of a novel zoonotic pathogen. Thus, we provide empirical evidence for a causative mechanism previously proposed as a precursor to widespread infection with H5N1 avian influenza and other emerging pathogens.
    Matched MeSH terms: Communicable Diseases, Emerging/epidemiology*; Communicable Diseases, Emerging/transmission
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