Suspected VHF in Juba, southern Sudan

On 24 October 2008, the Ministry of Health of the Government of southern Sudan [MOH/GOSS] reported a suspected case of viral fever to WHO. The patient was a twenty-six years old, male, Lebanese working for a construction company as a foreman since May 2008. At the time of his illness he was working in a county 50km southwest of Juba. He fell sick on 14 October and was evacuated to Juba the next day. His main complains were: pain in the throat, fever and persistent headache and general malaise. The patient was empirically treated for malaria in a private clinic, but showed no improvement. On 21 October 2008, the patient collapsed and had convulsions as he was boarding a plane to be evacuated to Lebanon for further treatment. He developed bleeding tendencies from multiple sites and was deeply jaundiced. He was later admitted to Juba Teaching Hospital [JTH]. where further clinical assessment was done. The initial laboratory test conducted in Kenya Medical Research Institute [KEMRI] tested the patient positive for Dengue virus. The condition of the patient continued to deteriorate, and the patient died on 26 October 2008 at the JTH. The specimen of the deceased was sent to a WHO CC for further test [cell culture]. All of the 40 close contacts of this patient, identified before the laboratory test, were closely followed up but none of them, till date, developed any symptom

Febres hemorrágicas por vírus no Brasil / Viral hemorrhagic fevers in Brazil

Chamando a atencão para as febres hemorrágicas por vírus, que em sua maioria tem escassa informacão divulgada e provavelmente são subnotificadas, mostra-se neste artigo casos clínicos das 4 doencas deste tipo que ocorrem no Brasil: febre amarela, dengue hemorrágico/síndrome de choque do dengue, febre hemorrágica por arenavírus e síndrome pulmonar e cardiovascular por hantavírus. Também, relevantes aspectos clínicos, laboratoriais e epidemiológicos destas viroses são aqui abordados. São doencas que têm alta letalidade e induzem extravasamento capilar e coagulopatia, que podem ser evidenciados pela elevacão do hematócrito e plaquetopenia. A suspeita clínica e o tratamento precoce são fundamentais à sobrevida dos pacientes.

Hepatopatias fulminantes/febres hemorrágicas na Amazônia: revisão histórica, padrões de lesão hepática e diagnóstico etiológico / Fulminant hepatic failure/hemorrhagic fevers in Amazon Basin: historical review, hepatic damage patterns and etiological diagnosis

Esta análise morfológica e imuno-histoquímica de hepatopatias fulminantes da Amazônia incluindo a série histórica original de Hepatite de Lábrea (HL) e casos de Febre Amarela (FA) concentrou-se em padrões de lesão . Mostraram-se características da FA: morte celular por apoptose medio-zonal, balonização hepatocelular, elevado índice de proliferação celular avaliado pelo PCNA e flebite portal. Os casos de HL mostraram extensa necrose hepatocelular lítica, células “em mórula”, regeneração hepatocelular com multinucleações e transformação pseudo-acinar, flebite portal e centro-lobular, com extinção parenquimatosa, depósitos portais de fibras elásticas e colágeno tipo I e depósitos lobulares de colágeno III / This morphologic and immunohistochemical analysis of fulminant hepatic failure from Amazon Basin, including the original historical series of Labrea Hepatitis (LH) and of Yellow fever (YF) cases was concentrated on lesion patterns. Midzonal apoptotic cellular death, hepatocellular ballooning degeneration, high cellular proliferation index assessed by PCNA and portal phlebitis were shown to be characteristics of YF. LH cases showed extensive lytic hepatocellular necrosis, “morula cells”, hepatocellular regeneration with multinucleation and pseudo-acinar transformation, portal and hepatic vein phlebitis, with parenchymal extinction, portal elastic fibers and type I collagen fibers and lobular type III collagen fiber deposition...

O vírus Ébola e sua infecçäo / The ebola virus and its infection

As propriedades epidemiológicas, ecológicas, biológicas, patogenéticas e o diagnóstico do vírus Ébola e sua infecçåo, bem como seu controle såo apresentadas neste artigo. Embora seja um vírus endêmico em certas regiöes da Africa, o risco de disseminaçåo deste vírus para fora do continente africano tem despertado a atençåo e o interesse da comunidade médica mundial, e acionado a vigilåncia sanitária internacional para este vírus