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Vientiane, Laos

Katangwe T.,Queen Elizabeth Central Hospital | Purcell J.,University of Malawi | Bar-Zeev N.,Queen Elizabeth Central Hospital | Bar-Zeev N.,University of Malawi | And 12 more authors.
Emerging Infectious Diseases | Year: 2013

A case of human melioidosis caused by a novel sequence type of Burkholderia pseudomallei occurred in a child in Malawi, southern Africa. A literature review showed that human cases reported from the continent have been increasing. Source

Garges S.,U.S. National Institutes of Health | Aurigemma R.,U.S. National Institutes of Health | Baccam P.,IEM Inc | Blaney D.D.,Centers for Disease Control and Prevention | And 20 more authors.
Emerging Infectious Diseases | Year: 2012

The US Public Health Emergency Medical Countermeasures Enterprise convened subject matter experts at the 2010 HHS Burkholderia Workshop to develop consensus recommendations for postexposure prophylaxis against and treatment for Burkholderia pseudomallei and B. mallei infections, which cause melioidosis and glanders, respectively. Drugs recommended by consensus of the participants are ceftazidime or meropenem for initial intensive therapy, and trimethoprim/sulfamethoxazole or amoxicillin/clavulanic acid for eradication therapy. For postexposure prophylaxis, recommended drugs are trimethoprim/sulfamethoxazole or co-amoxiclav. To improve the timely diagnosis of melioidosis and glanders, further development and wide distribution of rapid diagnostic assays were also recommended. Standardized animal models and B. pseudomallei strains are needed for further development of therapeutic options. Training for laboratory technicians and physicians would facilitate better diagnosis and treatment options. As of 2010, the literature did not contain broadly developed consensus recommendations for melioidosis therapy and postexposure prophylaxis (PEP) that could inform US government preparedness activities. The Public Health Emergency Medical Countermeasures Enterprise convened the 2010 HHS Burkholderia Workshop to generate expert consensus recommendations for use during a public health emergency. This enterprise is a coordinated interagency effort that is responsible for defining and prioritizing requirements for public health emergency medical countermeasures, focusing research, development, and procurement activities on the identified requirements, and establishing deployment and use strategies for medical countermeasures in the Strategic National Stockpile. A comprehensive literature review revealed consensus recommendations for other biological threat pathogens that served as a template for recommendations made during the workshop. Use of these Burkholderia recommendations will improve US government efforts in preparing for public health emergencies as well as assist clinicians in case management of melioidosis. This workshop hosted internationally recognized leaders in the field of Burkholderia spp. research and diagnostics and eminent clinicians whose expertise in the treatment for endemic melioidosis is unparalleled. The results of the workshop were achieved through structured dialogue and question-and-answer sessions. The workshop recommendations stem largely from clinical experience with melioidosis. However, the workshop participants noted that although Burkholderia mallei is sensitive to gentamicin and macrolides (in contrast to B. pseudomallei), the recommended treatment regimens and PEP for melioidosis were considered to also be appropriate for glanders. The US government will consider these expert recommendations when developing its formal policies. Source

Cheng A.C.,Monash University | Currie B.J.,Charles Darwin University | Dance D.A.B.,Mahosot Hospital | Funnell S.G.P.,Public Health England | And 3 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2013

Clinical definitions of melioidosis and inhalation-acquired melioidosis (Burkholderia pseudomallei infection) are described together with the evidence used to develop these definitions. Such definitions support accurate public health reporting, preparedness planning for deliberate B. pseudomallei release, design of experimental models, and categorization of naturally acquired melioidosis. Copyright © 2013 by The American Society of Tropical Medicine and Hygiene. Source

Sayasone S.,National Institute of Public Health | Sayasone S.,Swiss Tropical and Public Health Institute | Sayasone S.,University of Basel | Mak T.K.,Swiss Tropical and Public Health Institute | And 10 more authors.
PLoS Neglected Tropical Diseases | Year: 2011

Background:Detailed investigations of multiparasitism are scarce in the Mekong River basin. We assessed helminth (trematode, nematode, and cestode), and intestinal protozoa infections, and multiparasitism in random population samples from three different eco-epidemiological settings in Champasack province, southern Lao People's Democratic Republic (Lao PDR), and determined underlying risk factors.Methodology:Two stool samples were collected from 669 individuals aged ≥6 months over consecutive days and examined for helminth infections using the Kato-Katz method. Additionally, one stool sample per person was subjected to a formalin-ethyl acetate concentration technique for diagnosis of helminth and intestinal protozoa infections. Questionnaires were administered to obtain individual and household-level data pertaining to behavior, demography and socioeconomic status. Risk factors for hepato-biliary and intestinal parasitic infections and multiparasitism were determined using multiple logistic regressions analyses.Principal Findings:Multiple species intestinal parasite infections were common: 86.6% of the study participants harbored at least two and up to seven different parasites concurrently. Regarding nematode infections, hookworm was the most prevalent species (76.8%), followed by Ascaris lumbricoides (31.7%) and Trichuris trichiura (25.0%). Regarding trematodes, Opisthorchis viverrini and Schistosoma mekongi infections were found in 64.3% and 24.2% of the participants, respectively. Infections with intestinal protozoa were rare.Conclusions/Significance:There is a pressing need to intensify and sustain helminth control interventions in the southern part of Lao PDR. Given the high prevalence with nematode and trematode infections and the extent of multiparasitism, preventive chemotherapy is warranted. This intervention should be coupled with health education and improved access to clean water and adequate sanitation to consolidate morbidity control and enhance sustainability. © 2011 Sayasone et al. Source

News Article
Site: http://news.yahoo.com/science/

LONDON (Reuters) - Scrub typhus, a deadly disease common in southeast Asia and spread by microscopic biting mites known as chiggers, has now taken hold in a part of South America and may have become endemic there, scientists said on Wednesday. The tropical disease, which kills at least 140,000 people a year in the Asia-Pacific region, has been confirmed in a cluster of cases on a large island off Chile, some 12,000 kilometres from its usual haunts on the other side of the Pacific. Scrub typhus has been known of for years and the bacteria that causes it was first identified in Japan in 1930. It is caused by the bacteria, Orientia tsutsugamushi, transmitted by chiggers, and spreads through the lymphatic fluid. Those infected find the illness can begin quite suddenly, with shaking chills, fever, severe headache, infection of the mucous membrane in the eyes, and lymph node swelling. Until 2006, scrub typhus was thought to be limited to an area called the "tsutsugamushi triangle", from Pakistan in the west to far eastern Russia in the east to northern Australia in the south. But writing in the New England Journal of Medicine, researchers from Britain's Oxford University and the Pontificia Universidad Católica and Universidad del Desarrollo in Chile the cases found off of Chile’s mainland "suggest there may be a much wider global distribution than previously understood." In 2006, two cases of scrub typhus were found outside the triangle. One, in the Middle East, was caused by a previously unrecorded bacteria related to tsutsugamushi and named Orientia Chuto. The second was found on Chiloé island, just off mainland Chile. In January 2015 and again in early 2016, three more cases were discovered in Ancud, on the northern coast of Chiloé. "Scrub typhus is a common disease but a neglected one," said Paul Newton, director of the Lao–Oxford–Mahosot Hospital Wellcome Trust Research Unit, which collaborated in the study. "Given that it is known to cause approximately a million clinical cases, and kills at least 140,000 people each year, this evidence of an even bigger burden of disease in another part of the world highlights the need for more research and attention to it."

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