scholarly journals An outbreak of veno-occlusive disease of the liver in northern Iraq

1998 ◽  
Vol 4 (1) ◽  
pp. 142-148
Author(s):  
Moayad Y. Altaee ◽  
Muntaha H. Mahmood
Keyword(s):  
Abdominal Pain ◽  
Clinical Features ◽  
Case Fatality Rate ◽  
Pyrrolizidine Alkaloids ◽  
Case Fatality ◽  
Occlusive Disease ◽  
Fatality Rate ◽  
Northern Iraq

Thispaper describes an outbreak of veno-occlusive disease of the liver which occurred in Mosul, northern Iraq in 1994. It was caused by the consumption of wheat accidentally contaminated with Senecio seeds which produced toxic pyrrolizidine alkaloids. The outbreak involved 14 people [eight males and six females] who were members of three Bedouin families. Half of the cases were under the age of 15 years. The striking clinical features were abdominal pain, rapidly filling ascites and hepatomegaly. Two deaths occurred during hospitalization, with an estimated case fatality rate of 14%

Fifty years of imported Lassa fever: a systematic review of primary and secondary cases

2020 ◽  
Vol 27 (4) ◽  
Author(s):  
Timo Wolf ◽  
Regina Ellwanger ◽  
Udo Goetsch ◽  
Nils Wetzstein ◽  
Rene Gottschalk
Keyword(s):  
Systematic Review ◽  
Early Diagnosis ◽  
West Africa ◽  
Clinical Features ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Lassa Fever ◽  
Fatality Rate ◽  
Imported Cases ◽  
Epidemiological Characteristics

Abstract Rationale for Systematic Review Lassa fever is the most common cause of imported haemorrhagic fevers cases in non-endemic countries. As a disease with a high case fatality rate that has regularly caused clusters of nosocomial transmission in endemic areas, prompt diagnosis is vital. We conducted a systematic review of imported cases of the last 50 years with the aim of defining the clinical and epidemiological characteristics that will enhance early diagnosis, prompt initiation of treatment and an appropriate public health response to Lassa fever cases. Methods We performed a retrospective, systematic review of 36 primary and two secondary cases of Lassa fever in non-endemic countries outside West Africa by searching the PubMed database. This yielded 56 relevant publications that were included in our analysis. Results The case fatality rate of 35.1% for imported cases was higher than that reported for endemic countries. The majority of patients showed clinical features consistent with Lassa fever and had a typical exposure. There was a considerable delay in diagnosis in imported cases with high associated numbers of contacts. Ribavirin was rarely used for post-exposure prophylaxis. Only two secondary transmissions occurred. Thirty-one percent of patients received Lassa fever-specific treatment and five required intensive care. Conclusions Although importation of Lassa fever to non-endemic countries is a rare event, it has repeatedly happened over five decades. Suspicion of Lassa fever should be based on careful consideration of clinical features and exposure history in order to assist early diagnosis in returning travellers from West Africa.

scholarly journals New data on clinical features, incubation period, and case fatality rate of SARS in Hong Kong and Canada

2003 ◽  
Vol 7 (19) ◽  
Author(s):  
P Horby
Keyword(s):  
Hong Kong ◽  
Severe Acute Respiratory Syndrome ◽  
Incubation Period ◽  
Clinical Features ◽  
Clinical Data ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Fatality Rate ◽  
New Findings ◽  
Epidemiological Parameters

New findings arising from the outbreaks of severe acute respiratory syndrome (SARS) in Hong Kong and Canada have been reported in two early online publications (1, 2). The authors of the Hong Kong paper used demographic, epidemiological, and clinical data from 1425 SARS cases reported up to 28 April to describe the epidemic in Hong Kong and to estimate key epidemiological parameters. The paper from Canada reviews the clinical features and outcomes of 144 SARS patients admitted to hospital between 7 March and 10 April in Toronto.

Defibrotide for the Treatment of Veno-Occlusive Disease Post SCT: Preliminary Results of EU Compassionate Use Program in 332 Patients Confirm Promising Activity and Manageable Toxicity.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 613-613 ◽  
Author(s):  
Enric Carreras ◽  
Eduardo Olavarria ◽  
Benedicte Neven ◽  
Johan Maertens ◽  
Jaap J. Boelens ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Severe Disease ◽  
Case Fatality ◽  
Complete Response ◽  
Occlusive Disease ◽  
Fatality Rate ◽  
Compassionate Use ◽  
Median Dose ◽  
Cns Dysfunction ◽  
Suspected Adverse Drug Reactions

Abstract Introduction: Hepatic veno-occlusive disease (VOD) is one of the most significant regimen-related toxicities of stem cell transplantation (SCT), which when complicated by multi-organ failure (MOF) has a case fatality rate >90%. Defibrotide (DF) is a polydisperse oligonucleotide, with anti-thrombotic, anti-ischemic and thrombolytic properties, especially on microvasculature. Results in earlier studies of DF therapy for VOD/MOF have consistently shown manageable toxicity with promising complete response (CR) rates and D+100 survival post SCT. We report the results of the largest compassionate use program (CUP) performed to date. Methods: Physicians in Europe requesting DF for the treatment of pts with VOD obtained the drug on a named patient basis and were requested to collect data by a standardized CRF. Patients (pts) were reviewed to identify the nature and frequency of Suspected Adverse Drug Reactions (SADR). CR and D+100 survival post-SCT were assessed with CR defined as bilirubin <2 mg/dl and resolution of VOD-related end-organ dysfunction. From February 1999 to July 2007, 332 pts (215 men (65%), 117 women (35%), with a median age of 28 years) from 96 European centers received DF (Gentium SpA, Como, Italy). Pts were both adults (208 pts 63%, range: 18–66 yrs) and pediatric (124 pts, 37%, range: 2 months-17 years). 253 pts underwent allo-SCT (77%), and 76 auto-SCT (23%). At entry, all pts had VOD defined by either Baltimore criteria (205, 62%), modified Baltimore criteria [within 35 days of SCT] (n=42, 13%), Seattle criteria (84, 25%) or were biopsy proven (n=1). MOF was present in 113 pts (34%): 90/332 (27%) pts had renal, 53/332 (16%) had respiratory and 15/332 (5%) had CNS dysfunction. Median dose of DF was 37 mg/kg/d (range: 10–120 mg/kg/d). Median duration of DF therapy was 14d. Overall, D+100 survival was 46% (154 pts). CR was achieved in 173 pts (52%), with 142 alive in CR at D+100 (82%). NR was seen in 159 (48%), with only 12 alive at D+100 (8%). In a subset of 73 pts with severe VOD (defined by Baltimore criteria and MOF), survival at D+100 was 34% (25 pts). The overall incidence of attributable SADRs was 8% (n=28) and consisted predominantly of haemorrhages (n=27, 8%), most of which proved reversible. Conclusions: In this largest study of pts treated with DF to date, no unexpected toxicities were reported and side effects were generally manageable. CR was obtained in 52% with D+100 survival in 46%, including 34% in those pts with severe disease. This is consistent with prior studies and suggests that DF offers a relatively safe and effective treatment for hepatic VOD post SCT.

scholarly journals A retrospective descriptive study characterizing coronavirus disease epidemiology among people in the Kurdistan Region, Iraq

2020 ◽  
Vol 12 (1) ◽  
pp. e2020061
Author(s):  
Nawfal R Hussein ◽  
Ibrahim A Naqid ◽  
Zana Sidiq M. Saleem
Keyword(s):  
Case Fatality Rate ◽  
Case Fatality ◽  
Control Measures ◽  
Fatality Rate ◽  
Shortness Of Breath ◽  
Kurdistan Region ◽  
High Recovery ◽  
Northern Iraq ◽  
Disease Epidemiology ◽  
First Case

Abstract On March 1, 2020, the first case of severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) infection was diagnosed in the Kurdistan Region of Northern Iraq. The highest number of infections was recorded in Erbil city (233 cases) and Sulaymaniyah (178 cases). Among diagnosed patients, 20% had symptoms. The most common symptoms were fever (9.5%), dry cough (12%), and shortness of breath (6.5%). There was a sharp marked increase in the number of cases after relaxing of the control measures on May 1. The case fatality rate was 1.1% (5/452). Case fatality was significantly associated with advanced age (p=0.001) but not sex (p=0.68). Overall, 385/452 patients (85.2%) recovered without complications. Most patients were asymptomatic. The case fatality rate was low but increased with age. Further research is needed to determine the high recovery and low case fatality rates relative to those reported in other countries.  

Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

2020 ◽  
Author(s):  
Ahmed Youssef Kada
Keyword(s):  
Case Fatality Rate ◽  
Doubling Time ◽  
Case Fatality ◽  
World Health ◽  
Fatality Rate ◽  
Therapeutic Protocol ◽  
First Case ◽  
The World ◽  
The Impact ◽  
At Home

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

scholarly journals Author Correction: Calcium channel blocker amlodipine besylate therapy is associated with reduced case fatality rate of COVID-19 patients with hypertension

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Lei-Ke Zhang ◽  
Yuan Sun ◽  
Haolong Zeng ◽  
Qingxing Wang ◽  
Xiaming Jiang ◽  
...  
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Case Fatality Rate ◽  
Channel Blocker ◽  
Case Fatality ◽  
Fatality Rate ◽  
Amlodipine Besylate

A Correction to this paper has been published: https://doi.org/10.1038/s41421-021-00267-0

scholarly journals Early determination of case fatality rate of COVID-19 pandemic during the ongoing Yemeni armed conflict

2021 ◽  
pp. 1-15
Author(s):  
Abdulla Salem Bin Ghouth ◽  
Ali Ahmed Al-Waleedi ◽  
Marhami Fahriani ◽  
Firzan Nainu ◽  
Harapan Harapan
Keyword(s):  
Young Adults ◽  
Intensive Care ◽  
Armed Conflict ◽  
Case Fatality Rate ◽  
Preventive Measures ◽  
Case Fatality ◽  
Fatality Rate ◽  
Mechanical Ventilators ◽  
Poor Outcomes

Abstract Objectives: To determine the case-fatality rate (CFR) of coronavirus disease 2019 (COVID-19) and its associated determinants in order to understand the true magnitude of the problem during ongoing conflict in Yemen. Methods: The CFR among confirmed COVID-19 cases in Yemen was calculated. The data was retrieved from national COVID-19 surveillance between April 10, when the first COVID-19 case reported, and May 31, 2020. Results: A total of 419 confirmed COVID-19 cases were reported. There were 14.1% and 5.7% of cases who required intensive care and mechanical ventilators, respectively. Out of total cases, 95 deaths were reported, giving CFR of 22.6% which is much higher compared to other countries. CFR was significantly higher among elderly compared to young adults and varied between governorates. Mortality was associated with preexisting hypertension (OR: 2.30; 95%CI: 1.58, 3.54) and diabetes (OR: 1.68; 95%CI: 1.08, 2.61). Conclusions: Elderly and those with comorbidities, in particular hypertension and diabetes, have higher risk for poor outcomes and therefore should receive more attention in the clinical setting. Preventive measures should also be prioritized to protect those groups in order to reduce the severe cases and deaths-associated COVID-19 in armed-conflict.

scholarly journals Regional Variability in COVID-19 Case Fatality Rate in Canada, February–December 2020

2021 ◽  
Vol 18 (4) ◽  
pp. 1839
Author(s):  
Eunha Shim
Keyword(s):  
British Columbia ◽  
Case Fatality Rate ◽  
Case Reports ◽  
Case Fatality ◽  
Health Interventions ◽  
Fatality Rate ◽  
Older Individuals ◽  
Regional Variability ◽  
Provincial Level ◽  
Mortality Burden

A total of 475,214 COVID-19 cases, including 13,659 deaths, had been recorded in Canada as of 15 December 2020. The daily reports of confirmed cases and deaths in Canada prior to 15 December 2020 were obtained from publicly available sources and used to examine regional variations in case fatality rate (CFR). Based on a factor of underestimation and the duration of time from symptom onset to death, the time-delay adjusted CFR for COVID-19 was estimated in the four most affected provinces (Quebec, Ontario, Alberta, and British Columbia) and nationwide. The model-based adjusted CFR was higher than the crude CFR throughout the pandemic, primarily owing to the incorporation in our estimation of the delay between case reports and deaths. The adjusted CFR in Canada was estimated to be 3.36% nationwide. At the provincial level, the adjusted CFR was the highest in Quebec (5.13%)—where the proportion of deaths among older individuals was also the highest among the four provinces—followed by Ontario (3.17%), British Columbia (1.97%), and Alberta (1.13%). Provincial-level variations in CFR were considerable, suggesting that public health interventions focused on densely populated areas and elderly individuals can ameliorate the mortality burden of the COVID-19 pandemic.

scholarly journals Age and Infectious Dose Significantly Affect Disease Progression after RHDV2 Infection in Naïve Domestic Rabbits

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1184
Author(s):  
Robyn N. Hall ◽  
Tegan King ◽  
Tiffany O’Connor ◽  
Andrew J. Read ◽  
Jane Arrow ◽  
...  
Keyword(s):  
New Zealand ◽  
Disease Progression ◽  
Case Fatality Rate ◽  
Low Dose ◽  
Case Fatality ◽  
Wild Rabbit ◽  
Fatality Rate ◽  
Infectious Dose ◽  
Welfare Impacts ◽  
Rabbit Haemorrhagic Disease

Rabbit haemorrhagic disease virus 2 (RHDV2 or GI.2, referring to any virus with lagovirus GI.2 structural genes) is a recently emerged calicivirus that causes generalised hepatic necrosis and disseminated intravascular coagulation leading to death in susceptible lagomorphs (rabbits and hares). Previous studies investigating the virulence of RHDV2 have reported conflicting results, with case fatality rates ranging from 0% to 100% even within a single study. Lagoviruses are of particular importance in Australia and New Zealand where they are used as biocontrol agents to manage wild rabbit populations, which threaten over 300 native species and result in economic impacts in excess of $200 million AUD annually to Australian agricultural industries. It is critically important that any pest control method is both highly effective (i.e., virulent, in the context of viral biocontrols) and has minimal animal welfare impacts. To determine whether RHDV2 might be a suitable candidate biocontrol agent, we investigated the virulence and disease progression of a naturally occurring Australian recombinant RHDV2 in both 5-week-old and 11-week-old New Zealand White laboratory rabbits after either high or low dose oral infection. Objective measures of disease progression were recorded through continuous body temperature monitoring collars, continuous activity monitors, and twice daily observations. We observed a 100% case fatality rate in both infected kittens and adult rabbits after either high dose or low dose infection. Clinical signs of disease, such as pyrexia, weight loss, and reduced activity, were evident in the late stages of infection. Clinical disease, i.e., welfare impacts, were limited to the period after the onset of pyrexia, lasting on average 12 h and increasing in severity as disease progressed. These findings confirm the high virulence of this RHDV2 variant in naïve rabbits. While age and infectious dose significantly affected disease progression, the case fatality rate was consistently 100% under all conditions tested.

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