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Copyright of Innere Medizin (2731-7080) is the property of Springer Nature 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 abstract 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 abstract. (Copyright applies to all Abstracts.)

Objective: Kyasanur Forest Disease (KFD) is a viral zoonosis reported from Karnataka, India. We investigated cases in the Shivamogga district, Karnataka, to describe the epidemiology and identify risk factors in the affected block in 2022. Methods: A case was defined as a laboratory-confirmed KFD-positive resident of Shivamogga from 1 January-31 May 2022. We extracted the records of KFD cases from district surveillance. We conducted a 1:3 case-control study in the Thirthahalli block. We enrolled laboratory-confirmed KFD-positive Thirthahalli residents from January to May 2022 as cases, and residents without "fever with myalgia" as controls. We reported adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: Shivamogga reported 35 cases, with a median age of 46 (4-75) years, of which 51% were men, and one death. Among 25 cases and 90 controls, knowledge of avoiding recent monkey death sites was low (cases = 0%, controls = 11%). Monkey death sites within 500 m [aOR = 8.6 (1.8-41.9)] and household tick exposure [aOR = 3.7 (1.3-10.7)] were independent risk factors. Conclusion: This was a laboratory-confirmed cluster of KFD cases in Thirthahalli, with residence near a monkey death site and household tick exposure considered significant risk factors. We recommend evaluating monkey carcass disposal procedures and increasing awareness of tick protective measures. [ABSTRACT FROM AUTHOR]

Acute Disseminated Encephalomyelitis (ADEM) is a demyelinating immune‐mediated disease characterized by bilateral and confluent lesions in white matter (WM), with an acute onset. This condition may arise due to a myriad of etiological factors, encompassing mainly vaccines and viral infections. This case report describes a 39‐y‐old patient who presented with a sudden onset of fever, confusion, and reduced level of consciousness, associated with paraparesis in the lower limbs and urinary retention, 2 d before admission to the neurological emergency department. The work‐up included analysis of the cerebrospinal fluid (CSF), which showed 1.6 cells/mm3 and elevated proteins (91 g/dL); in addition to magnetic resonance imaging (MRI) of the brain and the spinal cord, in which hyperintense ovoid lesions with asymmetrical and bilateral distribution in the WM and basal ganglia were observed in the T2 and FLAIR. Later, chikungunya virus was detected in a molecular viral panel in the CSF. The patient exhibited an improvement radiologically, and in his condition following pulse with methylprednisolone and intravenous immunoglobulin therapy, and 40 mg of prednisone was prescribed for management during outpatient follow‐up. This study highlights arbovirus infections as a possible cause of acute neurological conditions, involving both the brain and the spinal cord. Furthermore, the findings observed in the report were compared with those described in the literature, including other arboviruses. In conclusion, it was observed that the majority of patients responded to treatment with corticosteroids or immunoglobulins, with some neurological deficits eventually persisting. Therefore, more studies are needed to better investigate therapeutic options. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the distribution and prevalence of Japanese encephalitis virus (JEV) antibody (as evidence of past infection) in northern Victoria following the 2022 Japanese encephalitis outbreak, seeking to identify groups of people at particular risk of infection; to investigate the distribution and prevalence of antibodies to two related flaviviruses, Murray Valley encephalitis virus (MVEV) and West Nile virus Kunjin subtype (KUNV). Study design: Cross‐sectional serosurvey (part of a national JEV serosurveillance program). Setting: Three northern Victorian local public health units (Ovens Murray, Goulburn Valley, Loddon Mallee), 8 August – 1 December 2022. Participants: People opportunistically recruited at pathology collection centres and by targeted recruitment through community outreach and advertisements. People vaccinated against or who had been diagnosed with Japanese encephalitis were ineligible for participation, as were those born in countries where JEV is endemic. Main outcome measures: Seroprevalence of JEV IgG antibody, overall and by selected factors of interest (occupations, water body exposure, recreational activities and locations, exposure to animals, protective measures). Results: 813 participants were recruited (median age, 59 years [interquartile range, 42–69 years]; 496 female [61%]); 27 were JEV IgG‐seropositive (3.3%; 95% confidence interval [CI], 2.2–4.8%) (median age, 73 years [interquartile range, 63–78 years]; 13 female [48%]); none were IgM‐seropositive. JEV IgG‐seropositive participants were identified at all recruitment locations, including those without identified cases of Japanese encephalitis. The only risk factors associated with JEV IgG‐seropositivity were age (per year: prevalence odds ratio [POR], 1.07; 95% CI, 1.03–1.10) and exposure to feral pigs (POR, 21; 95% CI, 1.7–190). The seroprevalence of antibody to MVEV was 3.0% (95% CI, 1.9–4.5%; 23 of 760 participants), and of KUNV antibody 3.3% (95% CI, 2.1–4.8%; 25 of 761). Conclusions: People living in northern Victoria are vulnerable to future JEV infection, but few risk factors are consistently associated with infection. Additional prevention strategies, including expanding vaccine eligibility, may be required to protect people in this region from Japanese encephalitis. [ABSTRACT FROM AUTHOR]

Objectives: To determine the proportion of people in New South Wales towns at high risk of Japanese encephalitis virus (JEV) infections during the 2022 outbreak; to identify risk factors for JEV infection. Study design: Cross‐sectional serosurvey study of the seroprevalence of JEV‐specific antibodies in NSW. Setting, participants: Convenience sample of people (all ages) from five regional NSW towns deemed to be at high risk of JEV infections after first outbreak of Japanese encephalitis in southeastern Australia in early 2022 (Balranald, Corowa, Dubbo, Griffith, Temora), 21 June – 22 July 2022. Main outcome measures: Proportion of people seropositive for JEV total antibody, assayed by defined epitope‐blocking enzyme‐linked immunosorbent assay; prevalence odds ratios for exposure risk factors and protective behaviours. Results: Eighty of 917 eligible participants (559 girls or women, 61%; 42 Aboriginal and Torres Strait Islander people, 4.6%; median age, 52 years [IQR, 37–62 years]) were seropositive for JEV‐specific total antibody (8.7%); the median age of seropositive people was 61 years (IQR, 48–70 years). The seropositivity proportion was largest for people aged 65 years or more (30 of 192; weighted proportion, 13.7%) and larger for male than female participants (30 of 358, 10.6% v 50 of 559, 7.5%). Five of 42 samples from Aboriginal and Torres Strait Islander participants were seropositive (12%). We found mixed associations with a range of potential risk factors. Conclusion: We found evidence for a substantial number of JEV infections in five regional NSW towns during a single arbovirus season in 2022. Public health responses, including effective surveillance, vaccination against JEV, and mosquito management, are critical for controlling outbreaks. Promoting behaviours that reduce exposure to mosquitoes is a core component of prevention, particularly when the vaccine supply is limited. [ABSTRACT FROM AUTHOR]

ObjectiveKyasanur Forest Disease (KFD) is a viral zoonosis reported from Karnataka, India. We investigated cases in the Shivamogga district, Karnataka, to describe the epidemiology and identify risk factors in the affected block in 2022.MethodsA case was defined as a laboratory-confirmed KFD-positive resident of Shivamogga from 1 January-31 May 2022. We extracted the records of KFD cases from district surveillance. We conducted a 1:3 case-control study in the Thirthahalli block. We enrolled laboratory-confirmed KFD-positive Thirthahalli residents from January to May 2022 as cases, and residents without “fever with myalgia” as controls. We reported adjusted odds ratios (aOR) with 95% confidence intervals (CI).ResultsShivamogga reported 35 cases, with a median age of 46 (4–75) years, of which 51% were men, and one death. Among 25 cases and 90 controls, knowledge of avoiding recent monkey death sites was low (cases = 0%, controls = 11%). Monkey death sites within 500 m [aOR = 8.6 (1.8–41.9)] and household tick exposure [aOR = 3.7 (1.3–10.7)] were independent risk factors.ConclusionThis was a laboratory-confirmed cluster of KFD cases in Thirthahalli, with residence near a monkey death site and household tick exposure considered significant risk factors. We recommend evaluating monkey carcass disposal procedures and increasing awareness of tick protective measures.

ABSTRACT Dengue is an arbovirus infection whose etiologic agent is transmitted by the Aedes aegypti mosquito. Since the early 1980s, when the circulation of the dengue virus (DENV) was confirmed in Brazil, the disease has become a growing multifactorial public health problem. This article presented the main factors that have contributed to the frequent dengue epidemics in recent years, such as the behavior of the vector, climate change, and social, political, and economic aspects. The intersection between these different factors in the dynamics of the disease is highlighted, including the increase in the mosquito population due to higher temperatures and rainy periods, as well as the influence of socioeconomic conditions on the incidence of dengue. Some mosquito control strategies are also addressed, including the use of innovative technologies such as drones and the Wolbachia bacterium, as well as the hope represented by the dengue vaccine. Nevertheless, the need for integrated and effective public policies to reduce social inequalities and the impacts of climate change on the spread of dengue is emphasized.

Background: Nonspecific acute tropical febrile illnesses (NEATFI) are common in the Latin American tropics. Dengue, Chikungunya, Zika, Mayaro, and Usutu, among others, can coexist in the American tropics. This study aimed to surveil the arboviruses that cause| acute febrile syndrome in patients in the Meta department, Colombia. Methods: Between June 2021 and February 2023, an epidemiological surveillance study was conducted in the Llanos of the Meta department in Eastern Colombia. Results: One hundred patients in the acute phase with typical prodromal symptoms of NEATFI infection who attended the emergency department of the Villavicencio Departmental Hospital were included. ELISA tests were performed for Dengue, Usutu, Chikungunya, and Mayaro. RT-qPCR was performed to detect the arboviruses Usutu, Dengue, Zika, Mayaro, and Oropouche. The seroprevalence for the Chikungunya, Mayaro, and Usutu viruses was 41 % (28/68), 40 % (27/67), and 62 % (47/75), respectively. Seroconversion for Chikungunya was observed in one patient; two seroconverted to Mayaro and one to Usutu. The NS5 gene fragment of the Usutu virus was detected in nine febrile patients. RT-qPCR of the remaining arboviruses was negative. The clinical symptoms of the nine Usutu-positive patients were very similar to those of Dengue, Chikungunya, Zika, and Mayaro infections. Conclusions: The pervasive detection of unexpected viruses such as Usutu and Mayaro demonstrated the importance of searching for other viruses different from Dengue. Because Usutu infection and Mayaro fever have clinical features like Dengue, a new algorithm should be proposed to improve the accuracy of acute tropical fevers.

Objectives: The anticipated increase in international tourist flows and the first locally acquired dengue cases in the Paris region in October 2023 have raised concerns about potential arbovirus outbreaks during the 2024 Olympics. Unlike previous mass sporting events at risk of arbovirus outbreaks, Paris is a nonendemic arbovirus area, requiring a unique investigation. Methods: Therefore, we analyzed factors conducive to possible arbovirus epidemics in temperate regions: vector distribution in the Paris area, seasonal global arboviral disease patterns, projected visitor demographics, and international flight bookings. Results and conclusion: Our results suggest that the expected visitors’ profile for the summer of 2024 should not increase the risk of arbovirus importation into the Paris region compared to a typical year. Conversely, the primary risk of arbovirus outbreaks is likely to come from within France, particularly from the French West Indies, where a notable, albeit declining, dengue outbreak is underway. Vigilant surveillance by French health authorities will ensure that this trend continues.

Mosquito studies are important for understanding their role in the transmission of pathogens including arboviruses, parasites, and protozoa. This study characterized the prevalence of Culicidae fauna in rural and peri-urban areas with human populations in the Colombian Caribbean region to establish the risk of transmission of mosquito-borne pathogens. From 2016 to 2017, adult mosquitos were collected in Turbaco (Bolívar), Sabanalarga (Atlántico) and Pueblo Bello (Cesar). The collections in rural areas were in the forest fragments using CDC, Shannon, and human bait traps. In peri-urban areas, Prokopack aspirator collections were used inside households. Entomological and ecological indicators were also calculated. A total of 11,566 mosquito specimens, from 13 genera and 63 species, were collected. The forests fragments of Sabanalarga and Turbaco had the highest species abundance and richness. Turbaco had the highest adult Aedes aegypti index. Arbovirus vectors were among the identified species, including Ae. aegypti, Culex quinquefasciatus, Haemagogus janthinomys, Sabethes chloropterus, Aedes angustivittatus, Mansonia titillans, Coquillettidia venezuelensis and the subgenera Culex Melanoconion. Overall, the diversity and abundance of mosquitoes present in these municipalities establish a potential disease transmission risk by these vectors.

Background: Orthoflavivirus ilheusense (ILHV) is a member of the Flaviviridae family. It was first isolated in 1944 from pools of Aedes serratus and Psorophora ferox mosquitoes; however, it has also been detected in species of the genus Culex, such as Cx. portesi and Cx. coronator. The objective of this study was to examine the vector competence of Cx. quinquefasciatus mosquitoes to ILHV infection and the subsequent transmission of the virus through their saliva during feeding on blood. Methods: F1 generation females of Cx. quinquefasciatus (Ananindeua/PA) were orally infected with goose blood infected with strain BeH7445, and body, head and saliva samples were analyzed at 7, 14, and 21 dpi using the techniques of virus isolation in cells and indirect immunofluorescence. Results: The presence of ILHV was not detected in the body and head samples of Cx. quinquefasciatus females at any of the three dpi's analyzed, indicating that the lineage of mosquitoes analyzed was resistant to ILHV. Conclusions: According to the results obtained in this study, the species Cx. quinquefasciatus proved resistant to ILHV, regardless of the virus titers to which it was exposed, which suggests the possibility that this species does not act as a vector in the ILHV transmission cycle. [ABSTRACT FROM AUTHOR]

Introduction: Dengue is an asymptomatic infection or present symptoms like low fever to disabling high fever, severe headache, retroocular, muscle and joint pain, in addition to skin rashes, and if associated with COVID-19, it can worsen the illness condition. Objective: investigate the epidemiological evolution of dengue in the pre-pandemic, pandemic and post-pandemic periods from an American and Brazilian perspective. Methodology: descriptive study, based on the search for information in epidemiological bulletins, data from DATASUS and the Pan American Health Organization/World Health Organization, in addition to articles available in databases provided by SciELO, ScienceDirect and Pubmed. Results: In the period before the pandemic, the high number of notifications was due to the DENV2 serotype, causing a large epidemic. In the years 2020-2021 there was a drop in the number of notifications due to the introduction of social and public health measures, misdiagnosis between the signs/symptoms of dengue and COVID-19, inaccurate serological tests and underreporting. In 2022 and 2023, the epidemiological scenario again points to increasing notification of dengue cases, mainly due to changes in routine vector control during the pandemic, combined with favorable environmental factors, such as increased rainfall. Conclusion: the neglect of both dengue fever and other diseases has negatively impacted the population today, since in order to mitigate the damage caused by the pandemic, actions to promote and prevent the health of endemic diseases in our territory, when placed in the background, have caused the underreporting of cases, influenced by changes in the political, economic and health spheres of society.

Background Chikungunya is a mosquito-borne disease caused by the chikungunya virus (CHIKV) and can lead to neurological complications in severe cases.

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The Chikungunya Virus (CHIKV) already has endemic circulation in about 100 countries and the number of infected patients increases every year, due to the effectiveness of the vector and human universal susceptibility to infection. The virus can also be transmitted from mother to child, more frequently intrapartum. About 50 % of neonates with CHIKV symptoms will have neurodevelopmental delay. It is therefore an infection of worldwide concern with a great impact on people's quality of life. The objective of this work is to describe two cases of confirmed vertical transmission by chikungunya virus, one of them with intrauterine infection and death of the neonate. Neonates with vertical chikungunya infection may present with clinical sepsis in the first few days of life, which is why this is a very important diagnosis, especially during outbreaks of the infection.

Abstract Objective: To create a protocol for performing minimally invasive autopsies (MIA) in detecting deaths from arboviruses and report preliminary data from its application in Ceará state, Brazil. Methods: Training was provided to medical pathologists on MIA. Results: A protocol was established for performing MIA, defining criteria for sample collection, storage methods, and diagnoses to be carried out according to the type of biological sample; 43 MIAs were performed in three months. Of these, 21 (48.8%) arrived at the Death Verification Service (SVO) with arboviruses as a diagnostic hypothesis, and seven (16.3%) were confirmed (six chikungunya cases and one dengue case); cases of COVID-19 (n = 9), tuberculosis (n = 5), meningitis (n = 4), cryptococcosis (n = 1), Creutzfeldt-Jakob disease (n = 1), breast cancer (n = 1), and human rabies (n = 1) were also confirmed. Conclusion: The protocol implemented enabled identification of a larger number of suspected arbovirus-related deaths, as well as confirmation of other diseases of interest for surveillance.

ABSTRACT Purpose: to analyze the absolute latencies of waves I. III and V and the interpeak intervals I-III. III-V and I-V of the ABR recorded from different age groups of children with congenital zika virus infection and their peers without risk indicators for hearing impairment. Methods: 84 newborns and infants (N=51 study group and N=33 control group) divided into groups with different post-conceptual ages. with the results of their hearing exams analyzed by age group and compared with their peers without other risk indicators for hearing impairment. The assessment of the auditory pathway was conducted through tympanometry. otoacoustic emissions and auditory brain stem responses. Results: only the latency of wave I and the interpeak III-V showed no significant difference between the study and control groups. The absolute latency and interpeak values found in the study group were significantly lower than those found in the control group. Conclusion: the maturation of the brain stem in children with ZIKV infection occurred within normal limits. with no retrocochlear disorders until the age of 5 years.

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The article discusses the seroprevalence of Japanese encephalitis virus (JEV) in five New South Wales towns, highlighting the need to understand transmission pathways and identify probable hosts of infection. It emphasizes the importance of capturing social-ecological risk factors at various levels and calls for stronger partnerships within One Health. The authors stress the need for epidemiological studies to include data on exposure history, behavior, and risk perceptions to support public health measures and vaccine acceptance in the community. The article suggests using social science intelligence to gather information on activities, risk history, and community perceptions to inform future approaches in preventing JEV outbreaks in Australia. [Extracted from the article]

Background: Orthoflavivirus ilheusense (ILHV) is a member of the Flaviviridae family. It was first isolated in 1944 from pools of Aedes serratus and Psorophora ferox mosquitoes; however, it has also been detected in species of the genus Culex, such as Cx. portesi and Cx. coronator. The objective of this study was to examine the vector competence of Cx. quinquefasciatus mosquitoes to ILHV infection and the subsequent transmission of the virus through their saliva during feeding on blood. Methods: F1 generation females of Cx. quinquefasciatus (Ananindeua/PA) were orally infected with goose blood infected with strain BeH7445, and body, head and saliva samples were analyzed at 7, 14, and 21 dpi using the techniques of virus isolation in cells and indirect immunofluorescence. Results: The presence of ILHV was not detected in the body and head samples of Cx. quinquefasciatus females at any of the three dpi’s analyzed, indicating that the lineage of mosquitoes analyzed was resistant to ILHV. Conclusions: According to the results obtained in this study, the species Cx. quinquefasciatus proved resistant to ILHV, regardless of the virus titers to which it was exposed, which suggests the possibility that this species does not act as a vector in the ILHV transmission cycle.

Dengue (DENV), chikungunya (CHIKV), and Zika (ZIKV) virus infections are widespread throughout the Rio de Janeiro state. The co-circulation of these emergent arboviruses constitutes a serious public health problem, resulting in outbreaks that can spatially and temporally overlap. Environmental conditions favor the presence, maintenance, and expansion of Aedes aegypti, the primary vector of these urban arboviruses. This study assessed the detection of clusters of urban arboviruses in the Rio de Janeiro state from 2010 to 2019. Notified cases of dengue, chikungunya, and Zika were grouped by year according to the onset of symptoms and their municipality of residence. The study period recorded the highest number of dengue epidemics in the state along with the simultaneous circulation of chikungunya and Zika viruses. The analyzes showed that the central municipalities of the metropolitan regions were associated with higher risk areas. Central municipalities in metropolitan regions were the first most likely clusters for dengue and Zika, and the second most likely cluster for chikungunya. Furthermore, the northwest and north regions were comprised clusters with the highest relative risk for the three arboviruses, underscoring the impact of these arboviruses in less densely populated regions of Brazil. The identification of high-risk areas over time highlights the need for effective control measures, targeted prevention and control interventions for these urban arboviral diseases. [ABSTRACT FROM AUTHOR]

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Objectives. To characterize the distribution profile of dengue, chikungunya, and Zika virus infections in Latin America and the Caribbean and to identify possible factors associated with the risk of dissemination and severity of these arboviruses. Methods. The protocol of this review was registered on the PROSPERO platform. Searches were carried out in the following databases: Virtual Health Library, MEDLINE/PubMed, and Embase. The search terms were: Zika virus, Zika virus infection, dengue, dengue virus, chikungunya virus, chikungunya fever, epidemiology, observational study, Latin America, and Caribbean region. Studies that addressed the distribution of these arboviruses and the risk factors associated with dengue, Zika virus disease, and chikungunya, published between January 2000 and August 2020 in English, Portuguese, and Spanish, were included. Results. Of 95 studies included, 70 identified risk factors, clinical manifestations, and outcomes for arbovirus infections and 25 described complications and/or deaths. The highest frequency of confirmed cases was for dengue. Brazil reported most cases of the three arboviruses in the period analyzed. Environmental and socioeconomic factors facilitated the proliferation and adaptation of vectors, and host-related factors were reported to aggravate dengue. Most deaths were due to chikungunya, Zika virus disease caused most neurological alterations, and dengue resulted in greater morbidity leading to more frequent hospitalization. Conclusions. The review provides a broad view of the three arboviruses and the intrinsic aspects of infections, and highlights the factors that influence the spread of these viruses in the populations studied.

Not just a disease of children In endemic regions where most people are first exposed to JEV at a young age, Japanese encephalitis is largely a disease of childhood. Keywords: Encephalitis, viral; Arbovirus infections; Vaccination; Central nervous system infections EN Encephalitis, viral Arbovirus infections Vaccination Central nervous system infections 344 347 4 05/03/23 20230501 NES 230501 A structured diagnostic approach is required when assessing for JEV in patients with encephalitis The Japanese encephalitis virus (JEV) has been a long-standing public health concern in Asia, where it is the most common cause of viral encephalitis in many countries. A prospective assessment of the accuracy of commercial IgM ELISAs in diagnosis of Japanese encephalitis virus infections in patients with suspected central nervous system infections in Laos. [Extracted from the article]

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Several mosquito-borne diseases affecting humans are emerging or reemerging in the United States. The early detection of pathogens in mosquito populations is essential to prevent and control the spread of these diseases. In this study, we tested the potential applicability of the Lawrence Livermore Microbial Detection Array (LLMDA) to enhance biosurveillance by detecting microbes present in Aedes aegypti, Aedes albopictus, and Culex mosquitoes, which are major vector species globally, including in Texas. The sensitivity and reproducibility of the LLMDA were tested in mosquito samples spiked with different concentrations of dengue virus (DENV), revealing a detection limit of >100 but

The global population at risk from mosquito-borne diseases-including dengue, yellow fever, chikungunya and Zika-is expanding in concert with changes in the distribution of two key vectors: Aedes aegypti and Aedes albopictus. The distribution of these species is largely driven by both human movement and the presence of suitable climate. Using statistical mapping techniques, we show that human movement patterns explain the spread of both species in Europe and the United States following their introduction. We find that the spread of Ae. aegypti is characterized by long distance importations, while Ae. albopictus has expanded more along the fringes of its distribution. We describe these processes and predict the future distributions of both species in response to accelerating urbanization, connectivity and climate change. Global surveillance and control efforts that aim to mitigate the spread of chikungunya, dengue, yellow fever and Zika viruses must consider the so far unabated spread of these mosquitos. Our maps and predictions offer an opportunity to strategically target surveillance and control programmes and thereby augment efforts to reduce arbovirus burden in human populations globally.

Japanese encephalitis virus (JEV) is a mosquito-borne flavivirus that causes encephalitis in humans. In 2021, an outbreak of JEV genotype IV occurred in pigs in eastern Australia, leading to 44 cases of human disease. The emergence of this genotype raised questions about the origin and incidence of JEV in Australia. Two studies conducted in New South Wales and Victoria found evidence of past exposure to JEV in a small but significant proportion of people tested. The studies did not identify specific risk factors for exposure to the virus. Accurate serological studies are challenging due to cross-reactivity with other flaviviruses, but the findings of these studies suggest that the 2022 JEV outbreak was more extensive than initially thought. [Extracted from the article]