Health officials announce first Zika-related death in Puerto Rico.

A patient with Zika virus infection in Puerto Rico has died of complications related to severe thrombocytopenia, according to a recent Morbidity and Mortality Weekly Report (MMWR). It is the first Zika virus-associated death to be reported in the country. “Although Zika virus-associated deaths are rare, the first identified death in Puerto Rico highlights the possibility of severe cases, as well as the need for continued outreach to raise health care providers’ awareness of complications that might lead to severe disease or death,” Emilio Dirlikov, PhD, of the Puerto Rico Department of Health’s Office of Epidemiology and Research and the CDC’s Division of Scientific Education and Professional Development, and colleagues wrote. Zika virus infections continue to rise the researchers reported that weekly case counts of Zika virus infection have gradually increased in the country since late November. As of April 14, health officials from the Puerto Rico Department of Health (PRDH) and CDC Dengue Branch in San Juan, identified 6,157 patients with suspected arbovirus infections. Among them, 11% of patients, including 65 symptomatic pregnant women, were identified as probable or laboratory-confirmed Zika virus cases. The most common symptoms among these patients included rash (74%), myalgia (68%), headache (63%), fever (63%) and arthralgia (63%). Seventeen patients required hospitalization, including five with suspected Guillain-Barré syndrome. culled from healio.com

First confirmed human infection of zoonotic parasite reported in Vietnam.

Researchers have reported the first laboratory-confirmed case of Trypanosoma evansi infection in a Vietnamese woman with no deficiencies. They linked transmission of the parasite with bovid exposure. Over half of Vietnam’s population resides in rural areas, and most participate in small-scale animal production, which likely facilitates the transfer of pathogens from animals into humans,” the researchers wrote. “T. evansi is associated with acute disease in camels and horses and chronic disease in cattle and buffalo, and can be found in South America, North Africa, the Middle East, South and Southeast Asia.” There have been four probable cases of T. evansi infection reported worldwide that lacked molecular parasite speciation. One previous case was reported in India in 2005 with molecular confirmation, although the patient had a deficiency of Apolipoprotein L1 (APOL1), a serum component with trypanocidal activity. The present case, a previously healthy Vietnamese woman aged 38 years with no APOL1 deficiency, first presented to a health care facility with 18 days of fever, headache and arthralgia. She had no history of travel to any regions where T. evansi has been observed. Although initially treated for malaria, microscopic examination of blood samples revealed unicellular flagellate protozoa with the morphology of Trypanosoma. The patient received a treatment reported to have trypanocidal activity for 7 days, but returned with symptoms 6 weeks after discharge and subsequently treated with a first-line anti-trypanosomal treatment and eventually recovered with no complications. PCR amplification and serological testing of the patient’s serum confirmed the infecting species as T. evansi, and APOL1 testing found the patient’s concentrations to be within a healthy range. As the patient reported potential exposure while butchering locally reared beef, the researchers conducted a census of livestock farms surrounding the patient’s relatives’ household. Blood samples from some cattle and buffalo were indicative of T. evansi infection, and some farmers reported a mystery illness affecting their livestock. These data helped the researchers conclude that these bovid were the likely source of the patient’s infection. Furthermore, the parasite may have been circulating among Vietnamese livestock for some time while avoiding detection, and if endemic could have further economic and human health consequences for the region. “Subsequent field investigations demonstrated a high prevalence of bovids in the immediate environs of the patient with clinical and molecular evidence of T. evansi infection,” the researchers wrote. “Further research is required to better understand this zoonotic pathogen, including host susceptibility factors, potential vectors and therapeutic options for both human and animal infections.” – story source; Helio infectious news.oo