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A variety of newly discovered pathogens and new forms of older infectious agents threaten to reemerge. Typical symptoms of acute infection are fever, headache, malaise, vomiting, and diarrhea. Some of the better-known emerging viral infections include dengue, filoviruses (Ebola, Marburg), hantaviruses, hepatitis B, hepatitis C, HIV, influenza, lassa fever, measles, rift valley fever, rotavirus, and yellow fever. Emerging bacterial infections include cholera, Escherichia coli 0157:H7, legionnaires disease (Legionella), lyme disease, streptococcus infections (group A), tuberculosis, and typhoid. Emerging parasitic infections include cryptosporidium and other waterborne pathogens and malaria. The causes of many diseases are still shrouded in mystery; thus, treatments and cures for them are as yet unknown.
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PMID:The threat of emerging infections. 1234 57

The ethnographic study was conducted in two communities in Oyo State in Southwestern Nigeria. The study sites consisted of a rural and an urban local government area located in the tropical rain forest zone of Nigeria. The study was designed to obtain information on febrile illnesses and herbal remedies for treatment with the aim of identifying potential antimalarial drugs. The study revealed that fever is a general term for describing illnesses associated with elevated body temperature. The indigenous Yoruba ethnic population has categorized fever based on symptoms and causes. The present communication is the result of focus group discussion and semi-structured questionnaire administered to traditional healers, herb sellers, elders and mothers. This was on types of fevers, symptoms and causes of febrile illnesses. The investigation also included use of traditional herbs in the prevention and treatment of the illnesses in the two communities.A total of 514 respondents were interviewed. This was made up of 266 (51.8%) from Atiba local government area (LGA), an urban centre while 248 (48.2%) respondents were interviewed from Itesiwaju LGA, a rural community. The LGAs are located in Oyo State of Nigeria. The respondents proffered 12 types of febrile illnesses in a multiple response answering system in Yoruba language. The most common ones (direct translation into English) were: yellow fever (39.1%), typhoid (34.8%), ordinary (28.8%), rainy season (20.8%) and headache (10.5%) fevers, respectively. Perceived causes of each of the febrile illnesses included stress, mosquito bites, unclean water, rains and over exposure to the sun. Methods of fever prevention were mainly with the use of herbal decoctions, powdered herbs, orthodox medications and maintenance of proper hygiene. Of a total of 112 different herbal remedies used in the treatment of the febrile illnesses compiled from the study, 25 recipes are presented. Recipes consisted of 2-7 ingredients. Oral decoctions (84%), oral powders (63%), use as soaps and creams (40%) in a multiple response system, were the most prevalent routes of administration of prepared herbs used in the treatment of the fevers. Boiling in water or alcohol was the most common method used in the preparation of the remedies. The four most frequently mentioned (multiple response system) plants in the Southwest ethnobotany for fevers were Azadirachta indica (87.5%), Mangifera indica (75.0%), Morinda lucida (68.8%) and Citrus medica (68.8%).
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PMID:Cultural categorization of febrile illnesses in correlation with herbal remedies used for treatment in Southwestern Nigeria. 1263 38

Brucellosis is a common zoonotic disease transmittable to humans from infected animal reservoirs. Malta, Rock, Gibraltar, Cyprus or Mediterranean fever, Bang's disease, intermittent typhoid or typho-malarial fever, undulant fever, etc. are just various synonyms for brucellosis. Patients suffering from this disease show unspecific symptoms, e.g. fever, chills, malaise, arthralgia, headache, tiredness and weakness. Human brucellosis may be caused by four of totally six genetically and phenotypically closely related Brucella species, i.e. B. melitensis, B. abortus, B. suis and B. canis. Although many organ systems may be involved, brucellosis is rarely fatal. Therapeutic failure and relapses, chronic courses and severe complications like bone and joint involvement, neurobrucellosis and endocarditis are characteristic for the disease. A definite diagnosis requires the isolation of Brucellae from blood, bone marrow or other tissues. However, cultural examinations are time-consuming, hazardous and not sensitive. Thus, clinicians often rely on the indirect proof of infection. The detection of high or rising titers of specific antibodies in the serum allows a tentative diagnosis. A variety of serological tests has been applied, but at least two serological tests have to be combined to avoid false negative results. Usually, the serum agglutination test is used for a first screening and complement fixation or Coombs' test will confirm its results. As Brucella ELISAs are more sensitive and specific than other serological tests, they may replace them step by step. This review will summarize advantages and disadvantages of the serological techniques used in clinical laboratories for indirect verification of human brucellosis.
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PMID:Laboratory-based diagnosis of brucellosis--a review of the literature. Part II: serological tests for brucellosis. 1465 29

More than 60 species of medicinal plants belong to the genus Angelica (Family: Apiaceae). Many of these species have long been used in ancient traditional medicine systems, especially in the far-east. Various herbal preparations containing Angelica species are available over-the-counter, not only in the far-eastern countries, but also in the western countries like USA, UK, Germany, etc. For centuries, many species of this genus, e.g. A. acutiloba, A. archangelica, A. atropupurea, A. dahurica, A. japonica, A. glauca, A. gigas, A. koreana, A. sinensis, A. sylvestris, etc., have been used traditionally as anti-inflammatory, diuretic, expectorant and diaphoretic, and remedy for colds, flu, influenza, hepatitis, arthritis, indigestion, coughs, chronic bronchitis, pleurisy, typhoid, headaches, wind, fever, colic, travel sickness, rheumatism, bacterial and fungal infections and diseases of the urinary organs. Active principles isolated from these plants mainly include various types of coumarins, acetylenic compounds, chalcones, sesquiterpenes and polysaccharides. This review evaluates the importance of the genus Angelica in relation to its traditional medicinal uses, alternative medicinal uses in the modern society and potential for drug development, and summarises results of various scientific studies on Angelica species or Angelica-containing preparations for their bioactivities including, antimicrobial, anticancer, antitumour, analgesic, anti-inflammatory, hepatoprotective, nephroprotective, etc.
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PMID:Natural medicine: the genus Angelica. 1518 May 79

Rickettsia africae was identified in seven (6%) of 118 patients with acute fevers of unknown etiology proven not to be malaria or typhoid fever from clinics along the coastal region of Cameroon by polymerase chain reaction (PCR) amplification and sequencing of the citrate synthase (gltA) and outer membrane protein A (ompA) genes of Rickettsia. The majority (71%) of the patients were female. Clinical manifestations included fever (100%), headache (71%), myalgia (71%), arthralgia (43%), pulmonary involvement (29%), and diffuse rash (14%). Moreover, R. africae was detected by PCR amplification and sequence analysis of the gltA and ompA genes in 62 (75%) of 83 adult Amblyomma variegatum ticks collected from cattle in the same region. These results confirm the presence of a previously unrecognized infectious disease in the indigenous Cameroonian population, as well as extend the established range of R. africae.
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PMID:Detection of Rickettsia africae in patients and ticks along the coastal region of Cameroon. 1538 20

Typhoid fever is endemic in Lebanon. Usual presentation includes fever, headache, abdominal pain and constipation or diarrhea. Extra-intestinal manifestations are not uncommon and involve variety of organ systems. Rhabdomyolysis is rare and has been reported in various Salmonella infections. We present a case of rhabdomyolysis and renal failure that was successfully treated with imipenem/cilastatin and hemodialysis.
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PMID:Rhabdomyolysis and Salmonella typhi infection: case report and review of the literature. 1570 75

Successful communicable disease surveillance depends on effective bidirectional information flow between clinicians at the periphery and communicable disease control units at regional, national and global levels. Resource-poor countries often struggle to establish and maintain the crucial link with the periphery. A simple syndrome-based outbreak surveillance system initially developed and evaluated in Mpumalanga Province, South Africa was adapted for the Pacific island nation of Tuvalu. Eight syndromes were identified for surveillance: acute flaccid paralysis (poliomyelitis), profuse watery diarrhoea (cholera), diarrhoea outbreak, dysentery outbreak, febrile disease with abdominal symptoms and headache (typhoid), febrile disease with generalized non-blistering rash (measles), febrile disease with intense headache and/or neck stiffness with or without haemorrhagic rash (meningococcal meningitis), and outbreaks of other febrile diseases of unknown origin. A user-oriented manual, the Tuvalu Outbreak Manual (http://www.wepi.org/books/tom/), was developed to support introduction of the surveillance system. Nurses working in seven outer island clinics and the hospital outpatient department on the main island rapidly report suspected outbreaks and submit weekly zero-reports to the central communicable disease control unit. An evaluation of the system after 12 months indicated that the Outbreak Manual was regarded as very useful by clinic nurses, and there was early evidence of improved surveillance and response to the disease syndromes under surveillance.
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PMID:Short communication: Strengthening sub-national communicable disease surveillance in a remote Pacific Island country by adapting a successful African outbreak surveillance model. 1639 51

One hundred and twelve cases of typhoid fever presenting in outpatient and emergency department of Dhulikhel Hospital in Nepal were studied. In this study, it was found that 71% typhoid fever cases were less than 30 years of age group with male to female ratio of 3:1. Fever over 5 days followed by headache and chills were major presenting symptoms. Widal test and blood culture for Salmonella typhi were positive in 59% and 49% cases respectively. Two third of our study population had total leucocyte count of normal range. The fever clearance time was significantly better with ofloxacin compared to ciprofloxacin (p < 0.05) and ceftriaxone compared to chloramphenicol (p < 0.05). The release from treatment was significantly shorter with ceftriaxone compared to ofloxacin, ciprofloxacin and chloramphenicol (p < 0.01). Ceftriaxone was found to be 100% sensitive to salmonella typhi. Amoxicillin was only 52.1% sensitive to Salmonella typhi. Early diagnosis and institution of appropriate antibiotic therapy is of paramount importance in the management of typhoid patients.
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PMID:Typhoid fever in Dhulikhel hospital, Nepal. 1640 Feb 12

Clinical and laboratory features, complications and treatment were retrospectively studied in 70 patients with bacteriologically documented typhoid fever, treated between January 1995 and June 2002 at Principal Hospital in Dakar, Senegal. Data analysis was done on a global basis as well as comparatively between the 37 children (under 15 years) and 33 adults. Mean age was 16.7 years (range, 1 to 52). The sex ratio was 1.4. Clinical manifestations included fever (97%), headache (50%), vomiting (71%), abdominal pain (54%), diarrhoea (49%), nnd splenomegaly (10%) without statistically significant difference between children and adults. Lyinphopenia was found in 51% of patients and anaemia in 78%. Coexisting illnesses Included malaria in 25.5% (mainly children) and hepatitis (transminases > 10N) in 24%. Complications included cholecystitis in 3 patients, gastrointestinal haemorrhage in 2, peritonitis in one, endocnrditis in one and osteomyelitis in one. Only one patient (HIV-positive) died. The incidence of antibiotic resistance was low, i.e., ainoxicilline: 2%, nalidixic acid: 1% and cotrimoxazole: 8.2%. No multidrug resistance was observed. This study shows that typhoid fever remains a major health problem in Dakar with slow resolution and potential complications. Amoxicililne and chloramphenicol can still be used for first-line treatment of typhoid fever. Little difference was found between children and adults.
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PMID:[Clinical and laboratory features of typhoid fever in Senegal. A 70-case study]. 1655 13

A case of a patient is reported who was admitted with massive intestinal haemorrhaging after 10 days of medical discomfort, characterized by persistent fever, headache and abdominal pain. The patient did not respond to medical treatment: antibiotics, blood transfusions and fluid replacement and required emergency surgical intervention. Intestinal resection with primary anastomosis was performed, controlling the bleeding. Following the testing of blood cultures and histopathological study infection by the S. tiphy bacteria was recorded by testing. In Latin America this strain of typhoid fever was common until the beginning of the 90's, before the cholera epidemic and has rarely been seen in the past 15 years.
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PMID:[Reappearance of severe typhoid forms following a case of massive gastrointestinal haemorrhaging]. 1743 38


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