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Severe Influenza Pneumonia and Its Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Key medical history questions should be of priority as well. Respiratory symptoms after an “aircraft travel” raises the possibility of Legionnaire’s disease or avian influenza H5N1 or swine H1N1 influenza. Rodent exposure points to hantavirus pneumonia or plague. Deer, rabbit, and ticks raise concerns about tularemia. Close contact with people with the same symptomatology may relate to human influenza A, swine influenza H1N1 virus, or adenovirus. Flooding and constructions history may relate to Legionella pneumonia [18].
Unexplained Fever In Infectious Diseases: Section 2: Commonly Encountered Aerobic, Facultative Anaerobic, And Strict Anaerobic Bacteria, Spirochetes, And Parasites
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Tularemia is a rare infection caused by a Gram-negative coccobacillus, Francisella tularensis. It is characterized by high fever and severe constitutional symptoms that may persist for weeks to several months, if not treated appropriately. There are four clinical types: the most frequent, ulceroglandular, comprises over 80% of cases; the remainder being the glandular, oculoglandular and typhoidal forms. Problems of unexplained fever may arise in the typhoidal and ulceroglandular forms: the former, because the disease may be manifested only by fever without a primary lesion; the latter, because the primary lesion at the site of infection (papule, ulceration of the skin or mucous membrane) may be overlooked. In these two forms, the clinical and the differential diagnosis may be very difficult. The onset occurs suddenly 3 to 7 days after the infective contact, with high fever, chills, headache, nausea, vomiting, drenching sweats, severe prostration, regional lymph nodes, and splenomegaly.
Infectious Diseases
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Vas Novelli, Delane Shingadia, Huda Al-Ansari
Tularaemia is a zoonosis caused by the bacterium Francisella tularensis, a gram-negative pleomorphic coccobacillus. The source of the organism is usually wild animals (e.g. rabbits, hares, rats, voles and other rodents), some domestic animals (e.g. sheep, cattle), blood-sucking arthropods that bite these animals (e.g. ticks) and water and soil contaminated by infected animals. People at greatest risk of infection are those with occupational or recreational exposure to infected animals or their habitats.
Improving protein glycan coupling technology (PGCT) for glycoconjugate vaccine production
Published in Expert Review of Vaccines, 2020
Jennifer Mhairi Dow, Marta Mauri, Timothy Alexander Scott, Brendan William Wren
Francisella tularensis and Burkholderia pseudomallei are potential biothreat agents causing tularemia and melioidosis, respectively [115,116]. Tularemia is a curable, but potentially life-threatening disease [115], while melioidosis has limited treatment and high mortality rates [116] urging the development of protective vaccines. Glycoconjugate vaccines against F. tularensis [117] and B. pseudomallei [39] were made by coupling the corresponding O-antigens to the acceptor proteins EPA and AcrA, respectively. Both vaccines were partially protective in murine infection models [39,117]. Further development of a hyperglycosylated version of EPA (GT-EPA) made by increasing the number of glycosylation sequons from 2 to 10, resulting in a vaccine protective in murine and rat aerosol models of pulmonary tularemia [82].
Gold nanoparticles for preparation of antibodies and vaccines against infectious diseases
Published in Expert Review of Vaccines, 2020
Conjugates of 15-nm GNPs with two isolated Francisella tularensis antigens, a protective antigenic complex and a glycosylated protein complex, were used to obtain antitularemia sera and vaccinate animals [140]. Subcutaneous immunization of mice with GNPs decorated with a glycosylated protein complex was more effective than was immunization with an unconjugated antigen. This greater effectiveness was manifested as an increase in the protection ability and titers of antibodies. The conjugation of GNPs to both antigens in the immunization of rabbits afforded sera with a high titer of specific antibodies in a relatively short period and with minimal consumption of the antigen. The use in ELISA of the immunoglobulins isolated from the sera allowed detection of F. tularensis cells of different subspecies, enabling their further use in the manufacture of diagnostic agents for tularemia.
Emerging and threatening vector-borne zoonoses in the world and in Europe: a brief update
Published in Pathogens and Global Health, 2019
Tularemia is caused by the gram-negative bacteria Francisella tularensis, which is one of the most virulent microorganisms currently known [93]. The lifecycle of F. tularensis takes place through terrestrial or aquatic environment. In terrestrial lifecycle, lagomorphs, rodents, and ticks are the main source of human infection and tularemia incidence is related to changes in rodent dynamics and to the expanding zone of ticks [94]. In aquatic lifecycle, the source is the water contaminated by carcasses and excrements of infected animals [94]. Tularemia outbreaks related to the aquatic lifecycle are more frequent [94]. Tularemia is highly infectious, can be easily transmitted by aerosol droplets, has a high mortality rate (up to 30%), remains in the environment for a long period of time and there is no vaccine available [93,95]. These alarming characteristics led to the consideration of tularemia as a potential bio-warfare weapon and it is currently classified as the most dangerous, category A infectious agent [81] F. tularensis was used for manufacturing of biological weapons during World War 2, although its use has never been reported [94]. Recently, tularemia has been detected in an increasing number of wild animal species, including lagomorphs, rodents, carnivores, fish and invertebrate arthropods [93]. The incidence of human tularemia is steeply increasing in Balkan countries and in Turkey [96]. In the rest of Europe, human incidence has declined, probably because of a more urban life style, decreasing number of people working outside in the countryside and a low exposition to infected wild animals [78]. However, it can represent a real threat to forest and field workers or to people living at the edge of society, such as homeless people; the transmission can be very fast and easy between them and they may comprise a center of infection outbreaks [78].