Most vaccines get injected into muscle,swallowed by mouth,or squirted into the nose.But in a clinical study reported in January 2025 in Nature Medicine[1],researchers in the Netherlands used a less conventional method...Most vaccines get injected into muscle,swallowed by mouth,or squirted into the nose.But in a clinical study reported in January 2025 in Nature Medicine[1],researchers in the Netherlands used a less conventional method to deliver an investigational vaccine:mosquito bites.The mosquitoes carried malaria-causing Plasmod-ium falciparum parasites that had been genetically engineered to trigger a productive immune response without making people sick.Nine of ten study participants who each,in a single session,with-stood 50 bites from this laboratory strain of mosquitoes,success-fully fended off infection when challenged with infective malaria parasites six weeks later.展开更多
Snakebite has become a serious public health problem with high mortality and disability rates.Ultrasound can provide imaging basis for diagnosis and treatment of snakebites and relative complications.The application p...Snakebite has become a serious public health problem with high mortality and disability rates.Ultrasound can provide imaging basis for diagnosis and treatment of snakebites and relative complications.The application progresses of ultrasound in snakebites and complications were reviewed in this article.展开更多
Objective:To investigate the distribution pattern of animal bites in Mirjaveh,Iran from 2015 to 2020.Methods:The data on animal bites were collected from the Department of Infectious Diseases,the provincial health cen...Objective:To investigate the distribution pattern of animal bites in Mirjaveh,Iran from 2015 to 2020.Methods:The data on animal bites were collected from the Department of Infectious Diseases,the provincial health center.Monthly climatic data on precipitation and temperature during the study period were also collected.The correlation between incidence and temperature,precipitation rate,land type,and altitude was also analyzed.Results:The results showed that men were more affected by animal bites than women(76.4%,P<0.001),and the highest incidence rate occurred in the age group of 5-19 years.The incidence rate of animal bites was found to be correlated with temperature and altitude.An increase in temperature was associated with a rise in the incidence rate of animal bites.The number of animal bites increased until 2019,possibly due to an increase in the number of dogs in the area.Conclusions:Targeted interventions should be implemented to reduce the incidence of animal bites,particularly among children,housewives,and students.Improving access to appropriate treatments,increasing public awareness of the hazards of animal bites,and increasing the number of vaccinated dogs in the area are essential strategies to be considered.展开更多
OBJECTIVE: To evaluate the effects of Jidesheng anti-venom used externally for skin and soft-tissue necrosis from Chinese cobra bite.METHODS: A retrospective review was performed according to the clinical data recorde...OBJECTIVE: To evaluate the effects of Jidesheng anti-venom used externally for skin and soft-tissue necrosis from Chinese cobra bite.METHODS: A retrospective review was performed according to the clinical data recorded from January 2002 to December 2012. A total of 126 patients(116 females and 10 males) with skin and soft-tissue necrosis due to Chinese cobra bite were divided into two groups. The control group was treated externally with 40% glyceride magnesium sulfate(n=52), and the treatment group was given Jidesheng anti-venom externally(n=74). The data collected included maximum local necrotic area of skin and soft tissues, de-tumescence time, healing time,and skin-grafting rate.RESULTS: There were no significant differences in gender, age, and disease condition between the control and treatment groups(P>0.05). No statistically significant difference was found in de-tumescence time between the two groups(P>0.05). The maximum local necrotic area of skin and soft tissues was(19.9 ± 7.3) cm2in the treatment group,while it was(23.3±6.4) cm2in the control group.The healing time of the treatment group was shorter than that of the control group [(32.1 ± 3.7) vs(34.4±4.5) days)] The skin-grafting rate in the treatment group was lower than that of the control group(10.81% vs 25.00%). There were statistically significant differences in maximum local necrotic area of skin and soft tissues, healing time, and skin-grafting rate between the control and treatment groups(all P<0.05).CONCLUSION: External application of Jidesheng anti-venom may help to promote wound healing and reduce the skin-grafting rate in cases of skin and soft-tissue necrosis due to Chinese cobra bite.展开更多
Objective:To investigate the epidemiological pattern of animal bites in Yazd Province,central Iran.Methods:In this cross-sectional study,8 545 individuals with animal bites who were referred to the Yazd Province Rabie...Objective:To investigate the epidemiological pattern of animal bites in Yazd Province,central Iran.Methods:In this cross-sectional study,8 545 individuals with animal bites who were referred to the Yazd Province Rabies Treatment Center were investigated using the census method from April 2013 to March 2017.The variables included:demographic information,household living condition,the type of biting animals,the domesticated and wild animals,the time of biting based on year,the residence location (urban or rural),and the treatment status.Data were analyzed by descriptive statistics using Excel 2013,SPSS version 25 and Arc GIS 14.1 Software.Results:A total of 8 545 cases of animal bites were reported in Yazd province from 2013 to 2017.The most animal bites (with 4 253 case of bites) and the lowest animal bites (with 121 case of bites) occurred in Yazd and Bahabad district,respectively.The incidence of animal bites was 168.4 per 100 000 people during the five-year period.Most of cases (73.9%) occurred in urban areas.Dog and cat bites accounted for 47.6% and 47.4% of all cases,respectively.Most of animal bites were reported in the summer (29.4%).Sixty percent of the cases received incomplete treatments,while 40% of them received complete treatments.During this study,three positive cases of fatal rabies from dog bites were reported.Conclusions:The incidence of animal bites is high in Yazd province,and more patients are bitten by dog and cat.Hence,educational,preventive,and informative programs are required to reduce the incidence of animal bites.展开更多
The current Zika outbreak is largest of its kind with 1.4 million cases in Brazil alone.World Health Organization declared the current outbreak as the public health emergency of international concerns.The major route ...The current Zika outbreak is largest of its kind with 1.4 million cases in Brazil alone.World Health Organization declared the current outbreak as the public health emergency of international concerns.The major route of Zika virus transmission is mosquito bites.Sexual transmission and monkey bites are also observed in few cases.There is dire need to evaluate the other routes of transmission like blood transfusion,lactation and contact with body fluids.Zika virus is infecting infants,not only causing microcephaly but also creating number of complications resulting in bad outcomes of pregnancy.In Brazil alone,4 000 cases of microcephaly have observed during the current outbreak.The incidence of Guillian-Barre(GB) syndrome is also observed during the current Zika virus outbreak.GB syndrome is acute medical condition leading the patients to death due to weakness of respiratory muscles or can cause the life time disability.There is no anti-viral drug or vaccine available for Zika virus.Zika infection can be prevented by using mosquito repellents,mosquito nets,cooling rooms by air conditions and wearing full sleeves or permethrin treated clothes.The current outbreak of Zika has not only affected the health care but also caused great economic loss.Estimated loss in Latin America and Caribbean is US$3.5 billion.United Nation's sustainable development goal 3.d stresses the strengthening of early warning,risk reduction and management of national and global health risks.The world will keep on facing new challenges in the form of Ebola or Zika;there is strong need to prepare ourselves for any disease outbreak.展开更多
Dear Editor, Hypersensitivity to mosquito bites （HMB） is primarily seen in children and adolescents in Asia and Central America. HMB may be related to the reactivation of Eps- tein-Barr virus （EBV） in infectzd nat...Dear Editor, Hypersensitivity to mosquito bites （HMB） is primarily seen in children and adolescents in Asia and Central America. HMB may be related to the reactivation of Eps- tein-Barr virus （EBV） in infectzd natural killer （NK） cells and is directly associated with chronic active EBV infection （CAEBV） and NK/T-cell leukemia/lymphoma. The median age at diagnosis of HMB is 6.7 years, and local cutaneous reactions include erythema, bullae, ne- crosis, and ulceration. In addition, systemic symptoms, including high-grade fever, malaise, lymphadenopathy, hepatosplenomegaly, hepatic dysfunction, hematuria, and proteinuria, are often present. While the etiology of HMB remains unclear, mosquito salivary gland extract may trigger EBV reactivation in latently infected NK cells. Upon reactivation, EBV oncogenes, such as latent membrane protein 1 （LMP1）, may induce immortaliza- tion of NK cells, eventually progressing to lymphoma.展开更多
Objective:To investigate the trend of animal bites in southern Iran from 2015 to 2019.Methods:This is a cross-sectional study of patients with animal bites who were referred to the Center for Disease Control in the th...Objective:To investigate the trend of animal bites in southern Iran from 2015 to 2019.Methods:This is a cross-sectional study of patients with animal bites who were referred to the Center for Disease Control in the three cities of Larestan,Evaz,and Khonj in Fars province,southern Iran from 2015 to 2019.The trend of animal bites incidence was analyzed using the Cochran-Armitage trend test.Results:In total,from 2015 to 2019,1944 cases of animal bites were reported.A total of 79.8%of the cases were men.The overall average incidence of animal bites was 142.93 per 100000 people.The incidence of animal bites was significantly increased(Ptrend<0.001).The highest incidence was in November(79.04 per 100000 people)followed by January(76.1 per 100000 people)and February(69.48 per 100000 people);also,the lowest incidence was in August(47.42 per 100000 people)and July(50.0 per 100000 people).Conclusions:The incidence of animal bites has significantly increased.Given the importance of rabies,control and management of animal bites should be emphasized and considered.展开更多
Objective:To investigate the epidemiological situation of animal bites in Rostam city of Fars province.Methods:This is a cross-sectional study.Cases of animal bites registered in health centers of Rostam city of Fars ...Objective:To investigate the epidemiological situation of animal bites in Rostam city of Fars province.Methods:This is a cross-sectional study.Cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020 were analyzed using the census method.The tool for collecting information was the portal of the Ministry of Health and the registration offices of people who were referred to the rabies center.Results:A total of 628 cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020.The mean age of the injured was(31.3±20.2)years.Of the total injured cases,414(65.9%)were male,and 491(78.2%)lived in villages.Most of the cases were bitten by dogs(n=420,66.8%)and the upper limb was involved in 280(55.2%)cases.In addition,an increasing trend was observed in the incidence of animal bites from 2015 to 2020.Conclusions:The incidence of animal bites in Rostam City is high,and most of the cases occur in rural areas.Considering the injuries caused by animal bites,the risk of rabies transmission,and the high costs of vaccination and serum therapy,it is necessary to hold control,educational,and vaccination programs.展开更多
Objective:To explore the modeling of time series of animal bite occurrence in northwest Iran.Methods:In this study,we analyzed surveillance time series data for animal bite cases in the northwest Iran province of Iran...Objective:To explore the modeling of time series of animal bite occurrence in northwest Iran.Methods:In this study,we analyzed surveillance time series data for animal bite cases in the northwest Iran province of Iran from 2011 to 2017.We used decomposition methods to explore seasonality and long-term trends and applied the Autoregressive Integrated Moving Average(ARIMA)model to fit a univariate time series of animal bite incidence.The ARIMA modeling process involved selecting the time series,transforming the series,selecting the appropriate model,estimating parameters,and forecasting.Results:Our results using the Box Jenkins model showed a significant seasonal trend and an overall increase in animal bite incidents during the study period.The best-fitting model for the available data was a seasonal ARIMA model with drift in the form of ARIMA(2,0,0)(1,1,1).This model can be used to forecast the frequency of animal attacks in northwest Iran over the next two years,suggesting that the incidence of animal attacks in the region would continue to increase during this time frame(2018-2019).Conclusion:Our findings suggest that time series analysis is a useful method for investigating animal bite cases and predicting future occurrences.The existence of a seasonal trend in animal bites can also aid in planning healthcare services during different seasons of the year.Therefore,our study highlights the importance of implementing proactive measures to address the growing issue of animal bites in Iran.展开更多
Objective:To investigate the trend of animal bites between 2015-2021 in Neyshabur,Iran.Methods:In this cross-sectional descriptive study,data were retrieved from the vice-chancellery of the Neyshabur University of Med...Objective:To investigate the trend of animal bites between 2015-2021 in Neyshabur,Iran.Methods:In this cross-sectional descriptive study,data were retrieved from the vice-chancellery of the Neyshabur University of Medical Sciences.The data included person variables,place and time variables,and animal variables.Results:There were 13190 cases of animal bites and the trend was increasing during 2015-2020.Most injuries were caused by dogs(86%),most animal bites(76.6%)occurred in males,and 28.1%of all cases were farmers.The most common bitten parts were the lower limbs(64.8%),often reported as a scratch(83.4%).Most of the biting animals(67.9%)were not strays,and 83.3%of them had bitten their owners.No rabies death was reported during the study period.Conclusions:The incidence of animal bites increases and is higher than the national statistics in Neyshabur,Iran.Serious attention and intervention should be given to control and prevent this health threat.展开更多
Dog bites are a major cause for transmission of rabies virus to humans.Pakistan ranks fifth among most rabies affected countries in the world.There are a few regional(ecological)studies that investigated factors that ...Dog bites are a major cause for transmission of rabies virus to humans.Pakistan ranks fifth among most rabies affected countries in the world.There are a few regional(ecological)studies that investigated factors that explain geographic disparities in incidence of dog bite injuries.The main objective of this research was to document findings of spatial exploratory data analysis of incidence of reported cases of dog bite in Punjab province of Pakistan(2016-2019).In addition,we have quantified the association between incidence of dog bites and a set of selected socio-economic and demographic variables.District-wise data about reported cases of dog bites from 2016 to 2019 were used to map annual crude incidence per 100,000 of population.There was an obvious spatial variation in incidence of dog bites but there was no evidence of spatial autocorrelation.The risk of dog bite attacks was relatively higher in districts with low human population density(per sq.km),poor literacy rate,more rural population(%of total population),and lower median nighttime lights.展开更多
Objective:To describe the epidemiology of snake bite in the region and attempt to compare proven Russell’s viper with hump-nosed viper bites.Methods:All snake bite admissions to the Toxicology Unit of Teaching Hospit...Objective:To describe the epidemiology of snake bite in the region and attempt to compare proven Russell’s viper with hump-nosed viper bites.Methods:All snake bite admissions to the Toxicology Unit of Teaching Hospital Peradeniya over three year from 2006 were included. Results:Of the 776 snakebites,665(86%) were unidentified and non-envenomed.Humpnosed viper and Russell’s viper accounted for 55(7%) and 40(5%) bites respectively,of them, incriminated snakes were found in 36(65%) and 19(48%) cases.The cobra bites-5,krait bites-0. The median ages:Russell’s viper bites-41(range 16-66),hump-nosed viper bites-42(range 15- 75).The gender incidence,time of bite(】58%daytime) were similar.In hump-nosed viper bite; upper limb involved in 13(36%),happened at home garden in 22(61%),none in paddy fields.In Russell’s viper bite;6(33%) occurred in paddy fields.Dry bites were similar at 5%.In humpnosed viper bite:local effects 94%,coagulopathy 3%,acute renal failure 3%and one patient died.In Russell’s viper bite;local effects 84%,coagulopathy 53%,neurotoxicity 21%.Abdominal pain occurred only in Russell’s viper bites 10(53%).Conclusions:Overwhelming numbers of unidentified,non-envenomed snakebites are common in the central hills.Some distinctive differences were observed between Russell’s viper and hump-nosed viper bites.展开更多
In this study, we assess coral health by detecting the severity of coral diseases and compromised health states on massive Porites. Field surveys are conducted at twenty-two sites covering the eastern, inner and weste...In this study, we assess coral health by detecting the severity of coral diseases and compromised health states on massive Porites. Field surveys are conducted at twenty-two sites covering the eastern, inner and western Gulf of Thailand as well as the Andaman Sea during 2010–2015. A total of nine coral diseases and signs of compromised health are observed in the waters of Thailand, consisting of pigmentation responses(pink lines, pink patches,pink spots and pink borers), white syndromes(white patches, white bands and ulcerative white spots), growth anomalies, and unusual bleaching patterns. The highest severity of all observed coral diseases and signs of compromised health are found at Ko Khang Khao in the inner Gulf of Thailand, while that observed in the Andaman Sea is relatively low. Composition of the diseases vary across the study sites. Four groups of study sites,in which there is an 80% similarity of diseases or signs of compromised health composition, are clustered and detected based on the Bray-Curtis similarity. The canonical analysis of principal coordinates reveal that most study sites in the Gulf of Thailand, especially the inner Gulf of Thailand, tend to show a high severity of the diseases. The association of disease severity and composition and the level of human impact are also detected.The study sites located near the shores and/or the areas with intensive tourism tend to have higher human impact, especially on poor water quality, which may be linked to the higher severity and composition of coral diseases and signs of compromised health in the Gulf of Thailand. Fish bites are also observed in many study sites.The severity of fish bites in the Gulf of Thailand is much lower compared to the Andaman Sea. Ko Rawi exhibits the highest severity, following by Ko Surin Nua and Ko Butang. The study sites within marine national park boundaries have a significantly higher severity of fish bites than those outside of the marine national park boundaries. This study suggests that higher coral diseases and signs of compromised health severity might be linked to anthropogenic disturbances on coral communities in the waters of Thailand.展开更多
Objective:To identify the clinical manifestations of hump nosed viper envenomation and to recognize the available treatment methods to prevent complications.Methods:Descriptive observational study involving a series o...Objective:To identify the clinical manifestations of hump nosed viper envenomation and to recognize the available treatment methods to prevent complications.Methods:Descriptive observational study involving a series of 1 543 patients admitted with hump nosed viper bite to 5 major hospitals in Sri Lanka was conducted.Data collection was done consecutively during February 1990 and February 2008.Except Hypnale,identification of the biting snake was made by the corresponding author after visual examination of the dead or live snakes,which were brought to hospital.Results:Sixty seven(4.34%) patients developed systemic effects and two (0.1%) patients died due to effects of envenomation or complications of treatment.Systemic effects varied from coagulopathy,nephropathy to some neurological manifestations.Fifty nine (3.8%) patients had only coagulopathy and they received either,intravenous isotonic saline to ensure adequate urine out put i.e.0.5 mL/kg /hour or 15 mL/kg of fresh frozen plasma(FFP). None of the patients that had coagulopathy developed renal failure.Contamination of the sample by mildly venomous species of Hypnale may have contributed to the low incidence of systemic complications.Conclusions:It is likely that early hydration with normal saline or FFP can prevent acute renal failure.FFP showed a tendency for early correction of coagulopathy.Role of FFP in hump nosed viper envenomation is worth studying in randomized double blind controlled clinical trials.展开更多
BACKGROUND It is necessary for clinicians to be aware of a rare but possible acute respiratory distress syndrome(ARDS)complication caused by multiple wasp stings.Severe ARDS has a high mortality rate but no specific p...BACKGROUND It is necessary for clinicians to be aware of a rare but possible acute respiratory distress syndrome(ARDS)complication caused by multiple wasp stings.Severe ARDS has a high mortality rate but no specific pharmacotherapies have been identified to date.This case study presents the first case of severe ARDS caused by multiple wasp stings,treated successfully with extracorporeal membrane oxygenation(ECMO).It also emphasizes the effectiveness of early ECMO treatment for severe ARDS with persistent hypoxemia.CASE SUMMARY A 24-year-old woman was admitted to the emergency department after being stung by more than 10 wasps within a 30-min period,with clinical symptoms of multiple rashes,dizziness,chest tightness,nausea,and vomiting.On the 2nd day of admission,the patient developed progressive dyspnea.The patient was diagnosed with ARDS based on clinical manifestations and lung computed tomography(CT)scan.Because of the progressive dyspnea,the intensive care unit physician performed endotracheal intubation and continued to provide ventilator support,but the patient’s respiratory distress worsened,as indicated by the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen.Veno-venous ECMO was initiated for 6 d.On day 7 of admission,ECMO was stopped.On the 11th day of admission,CT scan of the lungs revealed significant reduction of ground-glass opacities and consolidations.After about 2 wk,the patient recovered completely from ARDS and was discharged to home.At the 2-mo follow-up,the patient was in good health with no recurrence of dyspnea nor chest tightness.CONCLUSION ARDS complication caused by multiple wasp stings may be fatal when mechanical ventilation becomes dangerous due to persistent hypoxemia and despite optimization of ARDS management.We propose that the early implementation of ECMO is a relatively effective treatment,although the evidence is relatively limited.展开更多
Rabies is still a deadly disease, but it is 100% preventable through vaccination. In 2016, Senegal notified 1214 cases of dog bites. In the same year, the district of Sokone recorded 50 cases of dog bites, of which 31...Rabies is still a deadly disease, but it is 100% preventable through vaccination. In 2016, Senegal notified 1214 cases of dog bites. In the same year, the district of Sokone recorded 50 cases of dog bites, of which 31.2% of the cases were notified in the region of Fatick. The objective of this study is to assess the level of knowledge, attitudes and practices of communities and healthcare providers when faced with a case of exposure to rabies in Sokone health district. This quantitative estimation study is of a descriptive cross-sectional type, which took place during the third quarter of 2017. It targeted the community and health care providers in the Sokone health district. Three-stage cluster sampling was carried out in the community. The recruitment of healthcare providers has been comprehensive. A questionnaire was administered to the community in the form of individual interviews and another questionnaire was sent to health care providers in the form of self-administration. Knowledge, attitude and practice rating grids were developed for the two categories of interviewees. Data entry and analysis was done with Epi Info 3.5.3 software and R 3.3.1. Out of 813 community members surveyed, 6.8% had already been bitten by an animal. A good level of knowledge about rabies was found in 22.4% of the community members. The attitude to a bite was correct for 94.1%. Of the 38 healthcare providers surveyed, only 5.6% had a good understanding of rabies. No provider knew the indications for rabies vaccination and the post-exposure vaccination schedule. In the Sokone health district, communities knew little about rabies. Healthcare providers who are supposed to inform and supervise them in the fight against rabies know less about it. Strengthening the skills of healthcare staff in dealing with bites exposing them to rabies is of urgency in the Sokone health district.展开更多
Objective:To determine the healthcare utilization patterns and estimate the economic burden of animal bites in Golestan province,north part of Iran.Methods:This cross-sectional study was performed based on the data of...Objective:To determine the healthcare utilization patterns and estimate the economic burden of animal bites in Golestan province,north part of Iran.Methods:This cross-sectional study was performed based on the data of 12181 animal-bite patients from Golestan province who were referred to the rabies prophylaxis centers between March 2019 and March 2020.The study was a societal perspective,and all patients were investigated by census method.The micro-costing method with a bottom-up approach as well as the human capital approach were used to estimate the economic burden.Results:In our study,the economic burden caused by animal bites was estimated at$1383639(275354672060 Rials).The largest share of costs was related to direct healthcare costs,direct non-healthcare costs,and indirect costs accouting for 91%,5%,and 4%,respectively.In addition,the average cost of a animal-bite patient was estimated at$113.5(22605260 Rials)(The average cost of a case in type 2 and 3 exposures was$45 and$412.8,respectively).The largest share of direct healthcare costs was related to immunoglobulin,vaccine,and personnel expenses accounting for 61.3%,19.8%,and 11.65%,respectively.Conclusions:Our study shows that animal bites in Golestan province,north of Iran impose a high economic burden on the communities,especially the healthcare system,which indicates the need to review management and control programs of animal bites and rabies based on animal-bite patterns of the area.展开更多
文摘Most vaccines get injected into muscle,swallowed by mouth,or squirted into the nose.But in a clinical study reported in January 2025 in Nature Medicine[1],researchers in the Netherlands used a less conventional method to deliver an investigational vaccine:mosquito bites.The mosquitoes carried malaria-causing Plasmod-ium falciparum parasites that had been genetically engineered to trigger a productive immune response without making people sick.Nine of ten study participants who each,in a single session,with-stood 50 bites from this laboratory strain of mosquitoes,success-fully fended off infection when challenged with infective malaria parasites six weeks later.
文摘Snakebite has become a serious public health problem with high mortality and disability rates.Ultrasound can provide imaging basis for diagnosis and treatment of snakebites and relative complications.The application progresses of ultrasound in snakebites and complications were reviewed in this article.
文摘Objective:To investigate the distribution pattern of animal bites in Mirjaveh,Iran from 2015 to 2020.Methods:The data on animal bites were collected from the Department of Infectious Diseases,the provincial health center.Monthly climatic data on precipitation and temperature during the study period were also collected.The correlation between incidence and temperature,precipitation rate,land type,and altitude was also analyzed.Results:The results showed that men were more affected by animal bites than women(76.4%,P<0.001),and the highest incidence rate occurred in the age group of 5-19 years.The incidence rate of animal bites was found to be correlated with temperature and altitude.An increase in temperature was associated with a rise in the incidence rate of animal bites.The number of animal bites increased until 2019,possibly due to an increase in the number of dogs in the area.Conclusions:Targeted interventions should be implemented to reduce the incidence of animal bites,particularly among children,housewives,and students.Improving access to appropriate treatments,increasing public awareness of the hazards of animal bites,and increasing the number of vaccinated dogs in the area are essential strategies to be considered.
基金Supported by Guangxi Natural Science Foundation (No.2012GXNSFAA276011 and No.2013GXNSFBA019163)Youth Science Foundation of Guangxi Medical University (No.GXMUYSF201216)
文摘OBJECTIVE: To evaluate the effects of Jidesheng anti-venom used externally for skin and soft-tissue necrosis from Chinese cobra bite.METHODS: A retrospective review was performed according to the clinical data recorded from January 2002 to December 2012. A total of 126 patients(116 females and 10 males) with skin and soft-tissue necrosis due to Chinese cobra bite were divided into two groups. The control group was treated externally with 40% glyceride magnesium sulfate(n=52), and the treatment group was given Jidesheng anti-venom externally(n=74). The data collected included maximum local necrotic area of skin and soft tissues, de-tumescence time, healing time,and skin-grafting rate.RESULTS: There were no significant differences in gender, age, and disease condition between the control and treatment groups(P>0.05). No statistically significant difference was found in de-tumescence time between the two groups(P>0.05). The maximum local necrotic area of skin and soft tissues was(19.9 ± 7.3) cm2in the treatment group,while it was(23.3±6.4) cm2in the control group.The healing time of the treatment group was shorter than that of the control group [(32.1 ± 3.7) vs(34.4±4.5) days)] The skin-grafting rate in the treatment group was lower than that of the control group(10.81% vs 25.00%). There were statistically significant differences in maximum local necrotic area of skin and soft tissues, healing time, and skin-grafting rate between the control and treatment groups(all P<0.05).CONCLUSION: External application of Jidesheng anti-venom may help to promote wound healing and reduce the skin-grafting rate in cases of skin and soft-tissue necrosis due to Chinese cobra bite.
文摘Objective:To investigate the epidemiological pattern of animal bites in Yazd Province,central Iran.Methods:In this cross-sectional study,8 545 individuals with animal bites who were referred to the Yazd Province Rabies Treatment Center were investigated using the census method from April 2013 to March 2017.The variables included:demographic information,household living condition,the type of biting animals,the domesticated and wild animals,the time of biting based on year,the residence location (urban or rural),and the treatment status.Data were analyzed by descriptive statistics using Excel 2013,SPSS version 25 and Arc GIS 14.1 Software.Results:A total of 8 545 cases of animal bites were reported in Yazd province from 2013 to 2017.The most animal bites (with 4 253 case of bites) and the lowest animal bites (with 121 case of bites) occurred in Yazd and Bahabad district,respectively.The incidence of animal bites was 168.4 per 100 000 people during the five-year period.Most of cases (73.9%) occurred in urban areas.Dog and cat bites accounted for 47.6% and 47.4% of all cases,respectively.Most of animal bites were reported in the summer (29.4%).Sixty percent of the cases received incomplete treatments,while 40% of them received complete treatments.During this study,three positive cases of fatal rabies from dog bites were reported.Conclusions:The incidence of animal bites is high in Yazd province,and more patients are bitten by dog and cat.Hence,educational,preventive,and informative programs are required to reduce the incidence of animal bites.
基金University Medical College,Foundation University Islamabad,DHA-I Islamabad(44000),Pakistan
文摘The current Zika outbreak is largest of its kind with 1.4 million cases in Brazil alone.World Health Organization declared the current outbreak as the public health emergency of international concerns.The major route of Zika virus transmission is mosquito bites.Sexual transmission and monkey bites are also observed in few cases.There is dire need to evaluate the other routes of transmission like blood transfusion,lactation and contact with body fluids.Zika virus is infecting infants,not only causing microcephaly but also creating number of complications resulting in bad outcomes of pregnancy.In Brazil alone,4 000 cases of microcephaly have observed during the current outbreak.The incidence of Guillian-Barre(GB) syndrome is also observed during the current Zika virus outbreak.GB syndrome is acute medical condition leading the patients to death due to weakness of respiratory muscles or can cause the life time disability.There is no anti-viral drug or vaccine available for Zika virus.Zika infection can be prevented by using mosquito repellents,mosquito nets,cooling rooms by air conditions and wearing full sleeves or permethrin treated clothes.The current outbreak of Zika has not only affected the health care but also caused great economic loss.Estimated loss in Latin America and Caribbean is US$3.5 billion.United Nation's sustainable development goal 3.d stresses the strengthening of early warning,risk reduction and management of national and global health risks.The world will keep on facing new challenges in the form of Ebola or Zika;there is strong need to prepare ourselves for any disease outbreak.
文摘Dear Editor, Hypersensitivity to mosquito bites （HMB） is primarily seen in children and adolescents in Asia and Central America. HMB may be related to the reactivation of Eps- tein-Barr virus （EBV） in infectzd natural killer （NK） cells and is directly associated with chronic active EBV infection （CAEBV） and NK/T-cell leukemia/lymphoma. The median age at diagnosis of HMB is 6.7 years, and local cutaneous reactions include erythema, bullae, ne- crosis, and ulceration. In addition, systemic symptoms, including high-grade fever, malaise, lymphadenopathy, hepatosplenomegaly, hepatic dysfunction, hematuria, and proteinuria, are often present. While the etiology of HMB remains unclear, mosquito salivary gland extract may trigger EBV reactivation in latently infected NK cells. Upon reactivation, EBV oncogenes, such as latent membrane protein 1 （LMP1）, may induce immortaliza- tion of NK cells, eventually progressing to lymphoma.
文摘Objective:To investigate the trend of animal bites in southern Iran from 2015 to 2019.Methods:This is a cross-sectional study of patients with animal bites who were referred to the Center for Disease Control in the three cities of Larestan,Evaz,and Khonj in Fars province,southern Iran from 2015 to 2019.The trend of animal bites incidence was analyzed using the Cochran-Armitage trend test.Results:In total,from 2015 to 2019,1944 cases of animal bites were reported.A total of 79.8%of the cases were men.The overall average incidence of animal bites was 142.93 per 100000 people.The incidence of animal bites was significantly increased(Ptrend<0.001).The highest incidence was in November(79.04 per 100000 people)followed by January(76.1 per 100000 people)and February(69.48 per 100000 people);also,the lowest incidence was in August(47.42 per 100000 people)and July(50.0 per 100000 people).Conclusions:The incidence of animal bites has significantly increased.Given the importance of rabies,control and management of animal bites should be emphasized and considered.
文摘Objective:To investigate the epidemiological situation of animal bites in Rostam city of Fars province.Methods:This is a cross-sectional study.Cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020 were analyzed using the census method.The tool for collecting information was the portal of the Ministry of Health and the registration offices of people who were referred to the rabies center.Results:A total of 628 cases of animal bites registered in health centers of Rostam city of Fars province from the beginning of 2014 to 2020.The mean age of the injured was(31.3±20.2)years.Of the total injured cases,414(65.9%)were male,and 491(78.2%)lived in villages.Most of the cases were bitten by dogs(n=420,66.8%)and the upper limb was involved in 280(55.2%)cases.In addition,an increasing trend was observed in the incidence of animal bites from 2015 to 2020.Conclusions:The incidence of animal bites in Rostam City is high,and most of the cases occur in rural areas.Considering the injuries caused by animal bites,the risk of rabies transmission,and the high costs of vaccination and serum therapy,it is necessary to hold control,educational,and vaccination programs.
文摘Objective:To explore the modeling of time series of animal bite occurrence in northwest Iran.Methods:In this study,we analyzed surveillance time series data for animal bite cases in the northwest Iran province of Iran from 2011 to 2017.We used decomposition methods to explore seasonality and long-term trends and applied the Autoregressive Integrated Moving Average(ARIMA)model to fit a univariate time series of animal bite incidence.The ARIMA modeling process involved selecting the time series,transforming the series,selecting the appropriate model,estimating parameters,and forecasting.Results:Our results using the Box Jenkins model showed a significant seasonal trend and an overall increase in animal bite incidents during the study period.The best-fitting model for the available data was a seasonal ARIMA model with drift in the form of ARIMA(2,0,0)(1,1,1).This model can be used to forecast the frequency of animal attacks in northwest Iran over the next two years,suggesting that the incidence of animal attacks in the region would continue to increase during this time frame(2018-2019).Conclusion:Our findings suggest that time series analysis is a useful method for investigating animal bite cases and predicting future occurrences.The existence of a seasonal trend in animal bites can also aid in planning healthcare services during different seasons of the year.Therefore,our study highlights the importance of implementing proactive measures to address the growing issue of animal bites in Iran.
文摘Objective:To investigate the trend of animal bites between 2015-2021 in Neyshabur,Iran.Methods:In this cross-sectional descriptive study,data were retrieved from the vice-chancellery of the Neyshabur University of Medical Sciences.The data included person variables,place and time variables,and animal variables.Results:There were 13190 cases of animal bites and the trend was increasing during 2015-2020.Most injuries were caused by dogs(86%),most animal bites(76.6%)occurred in males,and 28.1%of all cases were farmers.The most common bitten parts were the lower limbs(64.8%),often reported as a scratch(83.4%).Most of the biting animals(67.9%)were not strays,and 83.3%of them had bitten their owners.No rabies death was reported during the study period.Conclusions:The incidence of animal bites increases and is higher than the national statistics in Neyshabur,Iran.Serious attention and intervention should be given to control and prevent this health threat.
文摘Dog bites are a major cause for transmission of rabies virus to humans.Pakistan ranks fifth among most rabies affected countries in the world.There are a few regional(ecological)studies that investigated factors that explain geographic disparities in incidence of dog bite injuries.The main objective of this research was to document findings of spatial exploratory data analysis of incidence of reported cases of dog bite in Punjab province of Pakistan(2016-2019).In addition,we have quantified the association between incidence of dog bites and a set of selected socio-economic and demographic variables.District-wise data about reported cases of dog bites from 2016 to 2019 were used to map annual crude incidence per 100,000 of population.There was an obvious spatial variation in incidence of dog bites but there was no evidence of spatial autocorrelation.The risk of dog bite attacks was relatively higher in districts with low human population density(per sq.km),poor literacy rate,more rural population(%of total population),and lower median nighttime lights.
文摘Objective:To describe the epidemiology of snake bite in the region and attempt to compare proven Russell’s viper with hump-nosed viper bites.Methods:All snake bite admissions to the Toxicology Unit of Teaching Hospital Peradeniya over three year from 2006 were included. Results:Of the 776 snakebites,665(86%) were unidentified and non-envenomed.Humpnosed viper and Russell’s viper accounted for 55(7%) and 40(5%) bites respectively,of them, incriminated snakes were found in 36(65%) and 19(48%) cases.The cobra bites-5,krait bites-0. The median ages:Russell’s viper bites-41(range 16-66),hump-nosed viper bites-42(range 15- 75).The gender incidence,time of bite(】58%daytime) were similar.In hump-nosed viper bite; upper limb involved in 13(36%),happened at home garden in 22(61%),none in paddy fields.In Russell’s viper bite;6(33%) occurred in paddy fields.Dry bites were similar at 5%.In humpnosed viper bite:local effects 94%,coagulopathy 3%,acute renal failure 3%and one patient died.In Russell’s viper bite;local effects 84%,coagulopathy 53%,neurotoxicity 21%.Abdominal pain occurred only in Russell’s viper bites 10(53%).Conclusions:Overwhelming numbers of unidentified,non-envenomed snakebites are common in the central hills.Some distinctive differences were observed between Russell’s viper and hump-nosed viper bites.
基金The budget for research promotion from the Government of Thailand to Ramkhamhaeng University
文摘In this study, we assess coral health by detecting the severity of coral diseases and compromised health states on massive Porites. Field surveys are conducted at twenty-two sites covering the eastern, inner and western Gulf of Thailand as well as the Andaman Sea during 2010–2015. A total of nine coral diseases and signs of compromised health are observed in the waters of Thailand, consisting of pigmentation responses(pink lines, pink patches,pink spots and pink borers), white syndromes(white patches, white bands and ulcerative white spots), growth anomalies, and unusual bleaching patterns. The highest severity of all observed coral diseases and signs of compromised health are found at Ko Khang Khao in the inner Gulf of Thailand, while that observed in the Andaman Sea is relatively low. Composition of the diseases vary across the study sites. Four groups of study sites,in which there is an 80% similarity of diseases or signs of compromised health composition, are clustered and detected based on the Bray-Curtis similarity. The canonical analysis of principal coordinates reveal that most study sites in the Gulf of Thailand, especially the inner Gulf of Thailand, tend to show a high severity of the diseases. The association of disease severity and composition and the level of human impact are also detected.The study sites located near the shores and/or the areas with intensive tourism tend to have higher human impact, especially on poor water quality, which may be linked to the higher severity and composition of coral diseases and signs of compromised health in the Gulf of Thailand. Fish bites are also observed in many study sites.The severity of fish bites in the Gulf of Thailand is much lower compared to the Andaman Sea. Ko Rawi exhibits the highest severity, following by Ko Surin Nua and Ko Butang. The study sites within marine national park boundaries have a significantly higher severity of fish bites than those outside of the marine national park boundaries. This study suggests that higher coral diseases and signs of compromised health severity might be linked to anthropogenic disturbances on coral communities in the waters of Thailand.
文摘Objective:To identify the clinical manifestations of hump nosed viper envenomation and to recognize the available treatment methods to prevent complications.Methods:Descriptive observational study involving a series of 1 543 patients admitted with hump nosed viper bite to 5 major hospitals in Sri Lanka was conducted.Data collection was done consecutively during February 1990 and February 2008.Except Hypnale,identification of the biting snake was made by the corresponding author after visual examination of the dead or live snakes,which were brought to hospital.Results:Sixty seven(4.34%) patients developed systemic effects and two (0.1%) patients died due to effects of envenomation or complications of treatment.Systemic effects varied from coagulopathy,nephropathy to some neurological manifestations.Fifty nine (3.8%) patients had only coagulopathy and they received either,intravenous isotonic saline to ensure adequate urine out put i.e.0.5 mL/kg /hour or 15 mL/kg of fresh frozen plasma(FFP). None of the patients that had coagulopathy developed renal failure.Contamination of the sample by mildly venomous species of Hypnale may have contributed to the low incidence of systemic complications.Conclusions:It is likely that early hydration with normal saline or FFP can prevent acute renal failure.FFP showed a tendency for early correction of coagulopathy.Role of FFP in hump nosed viper envenomation is worth studying in randomized double blind controlled clinical trials.
文摘BACKGROUND It is necessary for clinicians to be aware of a rare but possible acute respiratory distress syndrome(ARDS)complication caused by multiple wasp stings.Severe ARDS has a high mortality rate but no specific pharmacotherapies have been identified to date.This case study presents the first case of severe ARDS caused by multiple wasp stings,treated successfully with extracorporeal membrane oxygenation(ECMO).It also emphasizes the effectiveness of early ECMO treatment for severe ARDS with persistent hypoxemia.CASE SUMMARY A 24-year-old woman was admitted to the emergency department after being stung by more than 10 wasps within a 30-min period,with clinical symptoms of multiple rashes,dizziness,chest tightness,nausea,and vomiting.On the 2nd day of admission,the patient developed progressive dyspnea.The patient was diagnosed with ARDS based on clinical manifestations and lung computed tomography(CT)scan.Because of the progressive dyspnea,the intensive care unit physician performed endotracheal intubation and continued to provide ventilator support,but the patient’s respiratory distress worsened,as indicated by the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen.Veno-venous ECMO was initiated for 6 d.On day 7 of admission,ECMO was stopped.On the 11th day of admission,CT scan of the lungs revealed significant reduction of ground-glass opacities and consolidations.After about 2 wk,the patient recovered completely from ARDS and was discharged to home.At the 2-mo follow-up,the patient was in good health with no recurrence of dyspnea nor chest tightness.CONCLUSION ARDS complication caused by multiple wasp stings may be fatal when mechanical ventilation becomes dangerous due to persistent hypoxemia and despite optimization of ARDS management.We propose that the early implementation of ECMO is a relatively effective treatment,although the evidence is relatively limited.
文摘Rabies is still a deadly disease, but it is 100% preventable through vaccination. In 2016, Senegal notified 1214 cases of dog bites. In the same year, the district of Sokone recorded 50 cases of dog bites, of which 31.2% of the cases were notified in the region of Fatick. The objective of this study is to assess the level of knowledge, attitudes and practices of communities and healthcare providers when faced with a case of exposure to rabies in Sokone health district. This quantitative estimation study is of a descriptive cross-sectional type, which took place during the third quarter of 2017. It targeted the community and health care providers in the Sokone health district. Three-stage cluster sampling was carried out in the community. The recruitment of healthcare providers has been comprehensive. A questionnaire was administered to the community in the form of individual interviews and another questionnaire was sent to health care providers in the form of self-administration. Knowledge, attitude and practice rating grids were developed for the two categories of interviewees. Data entry and analysis was done with Epi Info 3.5.3 software and R 3.3.1. Out of 813 community members surveyed, 6.8% had already been bitten by an animal. A good level of knowledge about rabies was found in 22.4% of the community members. The attitude to a bite was correct for 94.1%. Of the 38 healthcare providers surveyed, only 5.6% had a good understanding of rabies. No provider knew the indications for rabies vaccination and the post-exposure vaccination schedule. In the Sokone health district, communities knew little about rabies. Healthcare providers who are supposed to inform and supervise them in the fight against rabies know less about it. Strengthening the skills of healthcare staff in dealing with bites exposing them to rabies is of urgency in the Sokone health district.
文摘Objective:To determine the healthcare utilization patterns and estimate the economic burden of animal bites in Golestan province,north part of Iran.Methods:This cross-sectional study was performed based on the data of 12181 animal-bite patients from Golestan province who were referred to the rabies prophylaxis centers between March 2019 and March 2020.The study was a societal perspective,and all patients were investigated by census method.The micro-costing method with a bottom-up approach as well as the human capital approach were used to estimate the economic burden.Results:In our study,the economic burden caused by animal bites was estimated at$1383639(275354672060 Rials).The largest share of costs was related to direct healthcare costs,direct non-healthcare costs,and indirect costs accouting for 91%,5%,and 4%,respectively.In addition,the average cost of a animal-bite patient was estimated at$113.5(22605260 Rials)(The average cost of a case in type 2 and 3 exposures was$45 and$412.8,respectively).The largest share of direct healthcare costs was related to immunoglobulin,vaccine,and personnel expenses accounting for 61.3%,19.8%,and 11.65%,respectively.Conclusions:Our study shows that animal bites in Golestan province,north of Iran impose a high economic burden on the communities,especially the healthcare system,which indicates the need to review management and control programs of animal bites and rabies based on animal-bite patterns of the area.
