Atypical Plasmodium vivax malaria in a traveler: bilateral hydronephrosis, severe thrombocytopenia, and hypotension.

We report a case of Plasmodium vivax infection manifested as severe thrombocytopenia, bilateral hydronephrosis, and hypotension in a returning traveler from a malaria-endemic area in Venezuela. While most of the efforts to prevent malaria in travelers focus on the life-threatening consequences of Plasmodium falciparum malaria, nonimmune travelers who encounter infection with P vivax may also develop serious complications. This case highlights the importance of preventing malaria cases among nonimmune or semi-immune individuals traveling to P vivax-endemic areas.

Trends in fatal snakebites in Venezuela, 1995-2002.

OBJECTIVE: There have been few studies evaluating snakebite mortality in Venezuela and South America. In this study we evaluate trends in fatal snakebites occurring in Venezuela between 1995 and 2002. METHODS: Epidemiological data for this study were retrieved from the records of the Ministry of Health of Venezuela. Using these data, we analyzed the impact of snakebites in Venezuela during the study period. RESULTS: During the study period, there were 266 reports of death due to snakebite; 79.7% were males, and 20.3% were females (P < .01). Annual mean deaths numbered 33 per year. Of total deaths, 24.1% occurred in victims 55-70 years old. Deaths in young children (<5 years old) accounted for 7.1% of the total. Mortality rate by age showed an age-dependent rate, with higher rates in older ages (P = .038). CONCLUSION: Snake envenomations are an important cause of injury and deaths in Venezuela as in many American countries. Surveillance of envenomations is essential for establishing guidelines, planning therapeutic supplies, and training medical staff on snakebite treatment, as well as assessing risk zones for travelers.

Epizootics of yellow fever in Venezuela (2004-2005): an emerging zoonotic disease.

Epidemics and epizootics of yellow fever (YF) have been occurring in the border area of eastern Colombia and western Venezuela since 2003; for this reason many epidemiological control measures were adopted by the Ministry of Health (MOH) trying to prevent their spreading. These activities included monkey deaths surveillance as well as immunization of susceptible individuals with YF vaccine. In this setting, we analyzed epidemiological and epizootical issues related to YF in Venezuela during 2004-2005. In this period, YF epizootics occurred initially without geographical links to the 2003 outbreaks (which occurred at the Southern Maracaibo lake epizootic wave), but in relation with the Guayana epizootic wave; beginning in Monagas state and then affecting Anzoátegui, Guárico, and Sucre states. Just months later, Apure was also affected. Mérida and Táchira also report epizootics for the end of 2004. This year concluded with 15 human deaths due to YF and more than 100 howler monkey deaths. In the same year, 715 suspected cases were investigated confirming YF in 0.7% of them. For these reasons, between 2002 and 2004, Venezuela's MOH has vaccinated approximately 1.9 million people in areas considered to be enzootic. The country's goal for 2006 is to have 7 million people residing in high-risk cities and towns vaccinated, and in this way, preventing and controlling this emerging zoonotic disease.

Ecoepidemiological and Social Factors Related to Rabies Incidence in Venezuela during 2002-2004.

Rabies in Venezuela has been important in last years, affecting dogs, cats, and human, among other animals, being a reportable disease. In Zulia state, it is considered a major public health concern. Recently, a considerable increase in the incidence of rabies has been occurring, involving many epidemiological but also ecoepidemiological and social factors. These factors are analyzed in this report. During 2002-2004, 416 rabies cases were recorded. Incidence has been increasingly significantly, affecting mainly dogs (88.94%). Given this epidemiology we associated ecoepidemiological and social factors with rabies incidence in the most affected state, Zulia. In this period 411 rabies cases were recorded. Zulia has varied environmental conditions. It is composed mostly of lowlands bordered in the west by mountain system and in the south by the Andes. The mean is temperature 27.8°C, and mean yearly rainfall is 750 mm. Climatologically, 2002 corresponded with El Niño (drought), middle 2003 evolved to a Neutral period, and 2004 corresponded to La Niña (rainy); this change may have affected many diseases, including rabies. Ecological analysis showed that most cases occurred in lowland area of the state and during rainy season (p<0.05). Additionally, there is an important social problem due to educational deficiencies in the native population. Many ethnic groups live un Zulia, many myths about rabies are in circulation, and the importance of the disease is not widely realized. The full scale of the rabies burden is unknown, owing to inadequate disease surveillance. Although there have been important advances in our knowledge and ability to diagnose and prevent it, enormous challenges remain in animal rabies control and provision of accessible-appropriate human prophylaxis worldwide. Human and animal surveillance including ecological and social factors is needed.