Integration of climate, transmission, and spread of dengue hemorrhagic fever in endemic areas

Introduction. Dengue Hemorrhagic Fever (DHF) is still a public health problem even in the era of the COVID-19 pandemic in 2020, including in Indonesia. This study aimed to analyze the incidence of DHF based on the integration of climatic factors, including rainfall, humidity, air temperature, and duration of sunlight and their distribution. Materials and Methods. This was an ecological time series study with secondary data from the Surabaya City Health Office covering the incidence of DHF and larva-free rate and climate data on rainfall, humidity, air temperature, and duration of sunlight obtained from the Meteorology and Geophysics Agency (BMKG). Silver station in Surabaya, the distribution of dengue incidence during 2018-2020. Results and Discussion. The results showed that humidity was correlated with the larvae-free rate. Meanwhile, the larva-free rate did not correlate with the number of DHF cases. DHF control is estimated due to the correlation of climatic factors and the incidence of DHF, control of vectors and disease agents, control of transmission media, and exposure to the community. Conclusions. The integration of DHF control can be used for early precautions in the era of the COVID-19 pandemic by control-ling DHF early in the period from January to June in Surabaya. It is concluded that humidity can affect the dengue outbreak and it can be used as an early warning system and travel warning regarding the relative risk of DHF outbreak.Copyright © the Author(s), 2023.

Generalized Linear Regression Model to Determine the Threshold Effects of Climate Variables on Dengue Fever: A Case Study on Bangladesh

One of the leading causes of the increase in the intensity of dengue fever transmission is thought to be climate change. Examining panel data from January 2000 to December 2021, this study discovered the nonlinear relationship between climate variables and dengue fever cases in Bangladesh. To determine this relationship, in this study, the monthly total rainfall in different years has been divided into two thresholds: (90 to 360 mm) and (<90 or >360 mm), and the daily average temperature in different months of the different years has been divided into four thresholds: (16degreeC to <=20degreeC), (>20degreeC to <=25degreeC), (>25degreeC to <=28degreeC), and (>28degreeC to <=30degreeC). Then, quasi-Poisson and zero-inflated Poisson regression models were applied to assess the relationship. This study found a positive correlation between temperature and dengue incidence and furthermore discovered that, among those four average temperature thresholds, the total number of dengue cases is maximum if the average temperature falls into the threshold (>28degreeC to <=30degreeC) and minimum if the average temperature falls into the threshold (16degreeC to <=20degreeC). This study also discovered that between the two thresholds of monthly total rainfall, the risk of a dengue fever outbreak is approximately two times higher when the monthly total rainfall falls into the thresholds (90 mm to 360 mm) compared to the other threshold. This study concluded that dengue fever incidence rates would be significantly more affected by climate change in regions with warmer temperatures. The number of dengue cases rises rapidly when the temperature rises in the context of moderate to low rainfall. This study highlights the significance of establishing potential temperature and rainfall thresholds for using risk prediction and public health programs to prevent and control dengue fever.Copyright © 2023 Shamima Hossain.

Lymphoproliferation- a clue towards an underlying monogenic disorder of immune dysregulation- a retrospective analysis from a single center in India

Background: Lymphoproliferation is the persistent proliferation of lymphoid cells and it's incidence in inborn errors of immunity varies from 0.7 to 18%. Material(s) and Method(s): This is a retrospective analysis of patients referred to the department of Immunology, B. J. Wadia Hospital for Children, Mumbai between March 2017 to December 2022. Inclusion criteria consisted of 3 months duration of significant lymphadenopathy and/or splenomegaly or history of lymphoma. The clinical characteristics, laboratory and molecular findings of the included patients were analyzed. Result(s): A total of 66 patients were included. There was a male preponderance with male:female ratio of 25:8. Median age of onset of lymphoproliferation was 4.75 years(Range 1 year to 60 years). Splenomegaly was seen in 75%. Infections included recurrent pneumonia (14/66), recurrent ear infections(5/66), COVID(4/66), one episode of pneumonia(6/66), herpes zoster(3/66), recurrent subcutaneous abscess (3/66), abdominal koch(3/66), chronic sinusitis(2/66), dermatophytosis(2/66), esophageal candidiasis(2/66), recurrent malaria(1/66), recurrent varicella(1/66), cryptococcal meningitis(1/66), gram negative sepsis(1/66), BCG adenitis(1/66), pseudomonas osteomyelitis(1/66), impetigo (1/66), pseudomonas urinary tract infection (1/66), chicken pox(1/66), herpes keratitis(1/66), dengue(1/66), Other manifestations included Evans plus phenotype(10/66), Evans phenotype(8/66), Autoimmune hemolytic anemia(5/66), bronchiectasis(5/66), Type 1 diabetes(3/66), hyper reactive airway disease(2/66), inflammatory bowel disease(4/66), autoimmune thrombocytopenia(2/66), stroke(3/66), hemophagocytic lymphohistiocytosis(2/66), hypertriglyceridemia(2/66), hypothyroidism(2/66), celiac disease(1/66), Type 2 diabetes(1/66), autoimmune encephalitis(1/66), autoimmune hepatitis(2/66), anti-parietal cell antibody(1/66), arthritis(1/66), autoimmune enteropathy(1/66), systemic lupus erythromatosus(1/66), primary biliary cirrhosis requiring liver transplant(1/66), nephrotic syndrome(1/66), lymphoedema(1/66), hypersplenism(1/66), recurrent oral ulcers(1/66), gout(1/66), dermatitis(1/66), ovarian teratoma(1/66), alopecia areata(1/66). Hodgkin's lymphoma(HL) was the most common malignancy(9/66), followed by non Hodgkin lymphoma(NHL)(6/66), transformation from NHL to HL(1/66), Burkitt to T-cell lymphoma(1/66), HL to DLBCL(1/66), HL to anaplastic T-cell lymphoma(1/66). EBV driven lymphoproliferation was seen in biopsy of21/66. Genetic testing showed mutations in LRBA(11/66), PIK3CD(5/66), CTLA4(3/66), TET2(2/66), IL2RA (1/66), IL12RB1(1/66), BACH2(1/66), PRKCD(1/66), TNFSFR13B(1/66), TNFAIP3(1/66), FAS(2/66), FASL(1/66), Caspase8(1/66), CARD11(1/66), RTEL1(1/66), AICD(1/66), PIK3R1(1/66), IKBKB(1/66). Treatment included IVIG, chemotherapy, rituximab, sirolimus, abatacept, HSCT. Conclusion(s): All children with persistent lymphoproliferation, with or without autoimmunity and/or infections should be worked up for an underlying monogenic disorder of immune dysregulation. Lymphomas presenting at abnormal site and/or age, relapse and EBV driven lymphomas require further evaluation. Presence of monogenic cause helps in providing targeted therapy.Copyright © 2023 Elsevier Inc.

A comprehensive insight on the challenges for COVID-19 vaccine: A lesson learnt from other viral vaccines.

The aim of this study is to comprehensively analyze previous viral vaccine programs and identify potential challenges and effective measures for the COVID-19 vaccine program. Previous viral vaccine programs, such as those for HIV, Zika, Influenza, Ebola, Dengue, SARS, and MERS, were evaluated. Paramount challenges were identified, including quasi-species, cross-reactivity, duration of immunity, revaccination, mutation, immunosenescence, and adverse events related to viral vaccines. Although a large population has been vaccinated, mutations in SARS-CoV-2 and adverse events related to vaccines pose significant challenges. Previous vaccine programs have taught us that predicting the final outcome of the current vaccine program for COVID-19 cannot be determined at a given state. Long-term follow-up studies are essential. Validated preclinical studies, long-term follow-up studies, alternative therapeutic approaches, and alternative vaccines are necessary.

An in vitro workflow to create and modify infectious clones using replication cycle reaction.

Reverse genetics systems are critical tools in combating emerging viruses which enable a better understanding of the genetic mechanisms by which viruses cause disease. Traditional cloning approaches using bacteria are fraught with difficulties due to the bacterial toxicity of many viral sequences, resulting in unwanted mutations within the viral genome. Here, we describe a novel in vitro workflow that leverages gene synthesis and replication cycle reaction to produce a supercoiled infectious clone plasmid that is easy to distribute and manipulate. We developed two infectious clones as proof of concept: a low passage dengue virus serotype 2 isolate (PUO-218) and the USA-WA1/2020 strain of SARS-CoV-2, which replicated similarly to their respective parental viruses. Furthermore, we generated a medically relevant mutant of SARS-CoV-2, Spike D614G. Results indicate that our workflow is a viable method to generate and manipulate infectious clones for viruses that are notoriously difficult for traditional bacterial-based cloning methods.

Heart failure after dengue infection- a population-based self-controlled case-series study.

BACKGROUND: Major cardiovascular events (MACEs) have been described with dengue infection. Among these MACEs, heart failure (HF) is the most common but has not been thoroughly assessed. This study aimed to evaluate the association between dengue and HF. METHODS: Under the self-controlled case-series study design, we used the Notifiable Infectious Disease dataset linkage with the National Health Insurance claims data to obtain the study subjects. All laboratory-confirmed dengue cases who were hospitalized for HF after dengue infection within one year between 2009 and 2015 in Taiwan were included. We identified the first 7 and 14 days after dengue infection as the risk intervals. The incidence rate ratio (IRR) and 95% confidence interval (CI) for HF were estimated by conditional Poisson regression. RESULTS: Among the 65,906 dengue patients, 230 had admission for HF after dengue infection within one year. The IRR of HF admission within the first week after dengue infection was 56.50 (95% C.I. 43.88-72.75). This risk was highest in >60 years (IRR = 59.32, 95% C.I. 45.43-77.43) and lower in 0-40 years (IRR = 25.82, 95% C.I. 2.89-231.02). The risk was nearly nine times higher among admission (for dengue infection) than among nonadmission cases (IRR 75.35 vs. 8.61, p < 0.0001). The risks increased slightly in the second week 8.55 and became less obvious after the third and fourth week. CONCLUSIONS: Patients with dengue infection have a risk of developing acute heart failure within one week, especially in >60 years, men, and dengue admission subjects. The findings emphasize the awareness of diagnosis and further appropriate treatment of HF.

Vaccine development for mosquito-borne viral diseases.

Mosquito-borne viral diseases are a group of viral illnesses that are predominantly transmitted by mosquitoes, including viruses from the Togaviridae and Flaviviridae families. In recent years, outbreaks caused by Dengue and Zika viruses from the Flaviviridae family, and Chikungunya virus from the Togaviridae family, have raised significant concerns for public health. However, there are currently no safe and effective vaccines available for these viruses, except for CYD-TDV, which has been licensed for Dengue virus. Efforts to control the transmission of COVID-19, such as home quarantine and travel restrictions, have somewhat limited the spread of mosquito-borne viral diseases. Several vaccine platforms, including inactivated vaccines, viral-vector vaccines, live attenuated vaccines, protein vaccines, and nucleic acid vaccines, are being developed to combat these viruses. This review analyzes the various vaccine platforms against Dengue, Zika, and Chikungunya viruses and provides valuable insights for responding to potential outbreaks.

Modeling of Survival Analysis of Recovery Rate of Dengue Hemorrhagic Fever Patients at Dr. M. Djamil Padang Hospital

BACKGROUND: Dengue hemorrhagic fever (DHF) is one of the endemic diseases with the highest cases in Indonesia. According to the World Health Organization data in 2020, the incidence of DHF has increased more than 8 times over the last two decades, from 505,430 cases in 2000, to more than 2.4 million in 2010 and 5.2 million in 2019. AIM: This study aims to analyzed the recovery rate of DHF patients at Dr. M. Djamil Padang Hospital during the COVID-19 period and the factors that influence it. METHOD(S): This study is a quantitative study with a retrospective cohort study design. Data were taken from the medical records of DHF patients during the COVID-19 period (March 2020-February 2022). The sampling technique used was simple random sampling. The analysis used the Kaplan-Meier, Cox Regression method, and the Cox Proportional Hazard analysis. RESULT(S): The average time it takes a patient to recover from DHF at Dr. M. Djamil Padang is 10 days. Patients who experienced the event were 32.7%, with an incidence rate of 0.061%. DHF patients at RSUP Dr. M. Djamil Padang, most of them were >14-years-old, male, duration of fever before hospitalization >4 days, platelet level 100,000, hematocrit level >20%, and patients using insurance. CONCLUSION(S): DHF patients aged >14 years, duration of fever before hospitalization 4 days, hematocrit level 20% had a longer recovery rate. It is recommended to the hospital to be better prepared to handle DHF patients according to risk factors and to collaborate for health education.Copyright © 2023 Masrizal Masrizal, Yudi Pradipta, Sari.

Dengue virus, measles, TBI and TB disease: Are they being overlooked because of the pandemic?

[...]many elementary and secondary schools were closed in 2020;when they reopened in 2021, masks and social distancing were in place. [...]these factors may have significantly reduced children and unvaccinated families from contracting and spreading the measles virus. Pediatric tuberculosis A diagnosis of pediatric tuberculosis (TB), for either latent TB (referred to as tuberculosis infection [TBI]7) or TB disease (active TB), is made for patients aged less than 15 years who have either a positive tuberculin skin test or a positive interferongamma release assay.7,8 Both tests have a high positive predictive value when used for children who have had a direct contact exposure to an adult with TB disease.7 Infants and young children are at increased risk of developing life-threatening forms of the disease, including TB meningitis and disseminated TB, compared with older children and adults.8 The greatest numbers of TB cases occur in children under 5 years old, with 38% of pediatric cases occurring within this age range.7 In addition, in 2020, 28% of the 10- to 14-year-old population had a diagnosis of pediatric TB.8 Data from TB cases in children aged less than 18 years living in the United States from 2010 to 2017 revealed that 32% of children with TB disease were born in other countries.9 Adults who have the TB bacterium, Mycobacterium tuberculosis, spread the organism via airborne transmission by coughing, speaking, or singing. [...]children with pediatric TB do not spread the organism as readily as adults, because pediatric TB is less infectious than the adult form.8 Children may present with a cough, weakness, weight loss, fever, change in playtime behaviors, and/or night sweats.8 Children younger than 4 years are at the highest riskof progressing from TBI to TB disease, with data showing a risk of 40% to 50% for infants less than 1 year old and 25% for 1- to 2-year-olds.8 However, children with a diagnosis of TBI who receive drug therapy and whose parents adhere to the regimen have a 90% reduced risk of developing TB disease.8 Adolescents older than 12 years have a risk of progression to adult-type TB disease. Providers need to be aware that the Centers for Disease Control and Prevention does not recommend the 4-month rifapentine-moxifloxacin TB regimen for children younger than 12 years.8 Best practices for pediatric providers include consulting a TB expert prior to beginning the treatment course, based on the available data showing that young children have a high risk of developing life-threatening TB disease.8 Conclusions Pediatric health care providers are on the frontlines for identifying infectious diseases and, to prevent poor outcomes, must react quickly to diagnose and treat cases in children and adolescents.

Emerging Pandemic Infectious Disease Threats

Pandemic infectious diseases are caused by pathogens that have adapted well to growth and reproduction within the human host and that through unique environmental, socioeconomic, and cultural circumstances are able to rapidly spread across national boundaries and even globally. Although uncommon and caused by relatively few pathogens, the extraordinary human, economic, and societal losses caused by pandemic diseases as exemplified by coronavirus disease 2019 (COVID-19) make pandemic diseases of unique importance to clinicians, immunologists, and many other scientists and healthcare professionals. The pathogenesis of pandemic diseases is complex and unique to each pathogen, but common to all is widespread immunologic naïveté within the host population. In this chapter, we consider the pathogens of greatest concern for their pandemic potential. Most of these organisms are viruses, including betacoronaviruses, alpha influenza virus, Ebola virus, and the flaviviruses, but numerous bacteria are also emerging with pandemic disease potential. For each organism, we consider the factors, especially immunologic, that lead to pandemic spread and prospects for effective therapy and prevention. © 2023 Elsevier Ltd. All rights reserved.

DENGUE PROGNOSTIC BIOMARKERS PREDICT DENGUE HAEMORRHAGIC FEVER WITH HIGH SENSITIVITY AND SPECIFICITY

Ninety-six million people are symptomatically infected with Dengue globally every year. Under the current standard-of-care, up to 20% of Dengue patients may be hospitalized, while only 500,000 develop Dengue Haemorrhagic Fever (DHF) and require hospitalization. This leads to unnecessary overwhelming of hospitals in tropical countries during large Dengue epidemics, especially when healthcare systems are grappling with large numbers of COVID-19 patients. Our research team set out to discover biomarkers to prognosticate Dengue patients, and augment the infectious disease clinician's decision-making process to hospitalize Dengue patients. Host biomarkers with concentrations significantly different between pooled serum samples of Dengue Fever (DF) patients and DHF patients were identified using protein array. The prognostication capabilities of selected biomarkers were then validated over 283 adult Dengue patients recruited from three Singapore tertiary hospitals, prior to the diagnosis of DHF. Three biomarkers (A2M, CMA1 and VEGFA) were identified that provide independent prognostication value from one another, and from clinical parameters commonly monitored in Dengue patients. The combination of all three biomarkers was able to identify from as early as Day 1 after the onset of fever, DF patients whose conditions will deteriorate into DHF. The biomarkers are robust and able to predict DHF well when trained on different AI/ML algorithms (logistic regression, support vector machine, decision tree, random forest, AdaBoost and gradient boosting). When stacked, prediction models based on the biomarkers were able to predict DHF with 97.3% sensitivity, 92.7% specificity, 66.7% PPV, 99.6% NPV and an AUC of 0.978. To the best of our knowledge, our panel of three biomarkers offers the highest accuracy in prognosticating Dengue to date. Further studies are required to validate the biomarkers in different geographical settings and pilot their implementation as part of the standard-of-care workflow for Dengue patients. [ FROM AUTHOR] Copyright of International Journal of Infectious Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Re-Emergence of Measles

In 2018-19, even before the pandemic, the world experienced major outbreaks of measles with 140,000 reported deaths mostly in low income countries where children suffer from malnutrition and overcrowding. In areas recovering from natural disasters and conflict areas and most children remain unvaccinated, outbreaks occur. The Philippines suffered similarly, with a devastating outcome and deaths of more than 800 children, even adults, in more than 40,000 hospitalized cases reported in 2019 over a 2 month period. A massive loss of vaccine confidence in 2018, brought about by the controversial introduction of a dengue vaccine reduced childhood vaccination coverage at an all-time low of 40-50%. Previous rates were in the 80-90% and measles was almost on the verge of elimination with no deaths and no cases between 2005-2009. The basic elements of complacency, convenience and confidence plus frequent occurrence of natural disasters over the years contributed much to these measles outbreaks. As a strategy, the government went into a massive supplementary immunization program with measles campaign including home visits to prevent another outbreak in the next 2 years after the pandemic begun. It has been implemented but targets are still wanting. The lessons learned from Measles resurgence are echoing all throughout the world and as the global response to the COVID19 continues, the measles as well as polio and other vaccine- preventable diseases need to be addressed with strategies that each country would find appropriate for them. Without sustained attention, the gains that have been achieved previously could easily get lost.Copyright © 2023

Pediatric Inflammatory Multisystem Syndrome (Pims) and Dengue Fever during Sars-Cov-2 Pandemic

Intro: The COVID-19 pandemic continues to spread worldwide, and it is likely to overlap with the dengue epidemics in tropical countries. Although most children and young people who develop COVID-19 have no symptoms or very mild ones at the time, we now know that a small number develop Paediatric Inflammatory Multisystem Syndrome (PIMS) a few weeks afterwards. Due to overlapping of clinical and laboratory features, it may be difficult to distinguish PIMS from dengue fever. So this study was undertaken to analyse the clinical features and laboratory investigations in these patients. Method(s): We retrospectively studied the case records of 21 patients diagnosed as pediatric inflammatory multisystem syndrome (based on WHO case definition) and dengue fever (either NS1 antigen positive or IgM antibody positive). A total of 106 patients were diagnosed with dengue fever. Out of these SARS-CoV-2 antibodies were positive in 57 patients. However, only 21 patients full filled the case definition for multi-inflammatory syndrome in children (MIS-C). Clinical features and laboratory investigations were entered in a proforma and results analysed. Finding(s): Out of 21 children's maximum children were older than 10 years age (76.2%). Commonest finding on abdominal sonography was gall bladder wall edema followed by ascites. Thrombocytopenia was seen in 18 (85.7 %) patients at admission and in 14 (66.7%) platelets were less than 50000/mm3.LDH was raised in 19 (90.4%), Ferritin in 18 (85.7%) and D-Dimer in 13 (61.9%) of patients (Table 2). Fever was seen in all the patients,17 (80.9%) patients had shock on admission. Rash was seen in 15 (71.4 %) of the patients. All the patients were discharged. Conclusion(s): Many of clinical features are common to both diseases. However, increased levels of serum ferritin, d-dimer and CRP are more commonly seen in pediatric inflammatory multisystem syndrome due to covid as compared to lower platelet counts which are more frequently seen in dengue fever patients.Copyright © 2023

Systemic Viral Infections and the Eye

Ocular manifestations of systemic viral infections are common. Because viral infection syndromes may be nonspecific, diagnosis of a particular viral infection often requires understanding of the risk factors and transmission modes of viral pathogens. Careful review of both history of the disease and the ocular exam findings can be helpful in narrowing down the differential diagnosis for the systemic condition and vice versa. A history of exposures, including animal exposures, sexual exposures, and travel, as well as the vaccination history and general medical history helps guide the workup and treatment of viral infections. Diagnostic testing for viral infections may include blood testing for serologic studies and viral detection, samples from involved extraocular organs, as well as ocular samples that can confirm a diagnosis and facilitate initiation of optimal therapy while minimizing side effects from exposure to unnecessary antiviral agents. Importantly, patients with HIV or other immunocompromising conditions may simultaneously have more than one active infection and also may manifest with syndromes that are atypical and have serologic testing that is less accurate. Careful and aggressive diagnostic evaluation of ocular symptoms is especially important in these patients, as are efforts to improve immune function while monitoring for the possible impact of immune reconstitution on the clinical course. © Springer Nature Switzerland AG 2022.

Digitisation & Health - Reflections from the Covid Pandemic

When COVID-19 reached Dr. Helmi Zakariah's home country of Malaysia in January 2020, he was consulting in Brazil as CEO of Artificial Intelligence in Medical Epidemiology (AIME) on Machine Learning application for dengue outbreak forecasting. A trained physician, public health professional, and digital health entrepreneur, Dr. Zakariah found himself in high demand as the Malaysian government began to mount it's COVID-19 response. He was asked to return home to his state of Selangor to lead the Digital Epidemiology portfolio for the Selangor State Task Force for COVID-19, and upon arrival immediately began to address the many challenges COVID-19 presented. This session will bring the audience along the sobering journey of health digitisation & adoption in the heat of the pandemic and beyond-not only what works, but more importantly-what doesn't-and to reflect on the case that the cost of underinvestment and inaction for digital innovation in health is simply too high in the face of another pandemic.Copyright © 2023

Dengue/Covid-19, Epidemiological and Clinical Interactions

COVID-19 pandemic is an important public health concern in dengue endemic areas due to overlapping of clinical and laboratory features, representing a significant challenge for health care providers that often hampers a correct diagnosis and management of both diseases. Therefore, during the COVID-19 pandemic, healthcare providers in areas where dengue is endemic or who treat patients with recent travel history to these areas, need to consider dengue and COVID-19 in the differential diagnosis of acute febrile illnesses. Global Implications and Opportunities and COVID-19 have mild illness and do not require hospitalization, both diseases can cause severe illness that may result in death. Indeed, clinical management for people with severe illness due to either of these two diseases is quite different, often requiring hospital-based care. High index of suspicion is necessary in handling COVID-19 cases in tropical setting where dengue is endemic. Acute febrile cases with leucopenia and thrombocytopenia should be screened for dengue. Since false positive dengue serology or cross-reactivity with SARS-Cov-2 infections are known to occur, and have a potential impact on clinical outcome, or else, result in delay in COVID-19 or dengue appropriate treatment, the risk of occurrence of complications and death is increased.Copyright © 2023

Dengue fever after the covid-19 pandemic: a statistical software analysis of its current situation in Ecuador

Dengue is an acute viral disease that is transmitted by the bite of mosquitoes. Today, dengue infection is the most notable arbovirus infection worldwide in terms of mortality and morbidity. The first case of dengue fever was reported in China in 992 and in 1975 this disease covered much of the world and caused many deaths, especially among children, later in the 1980s it became a common epidemic, at the beginning of the 2000s dengue became the second most common vector-borne disease, it is composed of four distinguishable viral serotypes 1,2,3 and 4 any of them is capable of producing severe forms of the disease, however serotype 2.3 are associated with a greater number of serious cases and deaths, dengue disease has 3 stages, initial phase that occurs from the moment of contagion until the first symptoms occur, Clinical phase of the disease begins to show characteristic symptoms, when the disease exceeds the barrier of six months it becomes chronic and an appropriate treatment must be applied to ensure a prompt recovery without sequelae, then we have the resolution phase in this phase there are several aspects it may be that the disease ends or passes be chronic or even become terminal, according to reports in the last 50 years its incidence has increased annually, an assumption of 50 million infected occur, in America in 2018 560,586 cases were reported with an incidence of 57.3 per 100,000 inhabitants of which 3,535 were classified as severe dengue. Dengue in Ecuador represents a priority problem in public health, this is due to the fact that each year there are a large number of cases, in 2018 Ecuador reported 3,094 cases, of which 2,965 were dengue without an alarm sign and 123 cases were reported with alarm sign, in the last six years Ecuador has reported a greater number of cases in 2018 and 2020. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Computer-Aided vaccine design for selected positive-sense single stranded RNA viruses

Spontaneous mutations and lack of replication fidelity in positive-sense single stranded RNA viruses (+ssRNA virus) result in emergence of genetic variants with diverse viral morphogenesis and surface proteins that affect its antigenicity. This high mutability in +ssRNA viruses has induced antiviral drug resistance and ability to overcome vaccines that subsequently resulted in rapid viral evolution and high mortality rate in human and livestock. Computer aided vaccine design and immunoinformatics play a crucial role in expediting the vaccine production protocols, antibody production and identifying suitable immunogenic regions or epitopes from the genome sequences of the pathogens. T cell and B cell epitopes can be identified in pathogens by immunoinformatics algorithms and methods that enhance the analysis of protective immunity, vaccine safety, immunity modelling and vaccine efficacy. This rapid and cost-effective computational vaccine design promotes development of potential vaccine that could induce immune response in host against rapidly mutating pathogens like +ssRNA viruses. Epitope-based vaccine is a striking concept that has been widely employed in recent years to construct vaccines targeting rapidly mutating +ssRNA viruses. Therefore, the present review provides an overview about the current progress and methodology in computer-aided vaccine design for the most notable +ssRNA viruses namely Hepatitis C virus, Dengue virus, Chikungunya virus and Coronaviruses. This review also highlights the applications of various immunoinformatics tools for vaccine design and for modelling immune response against +ssRNA viruses. © 2023, National Institute of Science Communication and Policy Research. All rights reserved.

COVID-19 vaccination, dengue hepatitis, and recurrent unilateral anterior uveitis.

A 36-year-old Asian Indian male presented with redness and pain in his right eye of 1 week duration. He was diagnosed to have right acute anterior uveitis and had a history of being admitted at a local hospital for dengue hepatitis a month earlier. He had been on adalimumab 40 mg three weekly once and oral methotrexate 20 mg/week for human leucocyte antigen (HLA) B27 spondyloarthropathy and recurrent anterior uveitis. Our patient had re-activation of his anterior chamber inflammation on three distinct occasions: first, 3 weeks following recovery from coronavirus disease 2019 (COVID-19), the second after the second dose of COVID-19 vaccination, and the third after recovery from dengue fever-associated hepatitis. We propose molecular mimicry and bystander activation as the postulated mechanisms for the re-activation of his anterior uveitis. In conclusion, patients with auto-immune diseases can have recurrent ocular inflammation following COVID-19 or its vaccination or dengue fever as seen in our patient. The anterior uveitis is usually mild and responds to topical steroids. Additional immuno-suppression may not be needed. Mild ocular inflammation following vaccination should not deter individuals from getting COVID-19 vaccination.