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Old Infections in New Clothes

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Old Infections in New Clothes Old Infections in new clothes Hiten Thaker Consultant in Infection Hull and east Yorkshire Hospitals NHS Trust 1985, At the Infectious Diseases Society of America's “the millennium where fellows in infectious disease will culture one another is almost here” Dr. William H. Stewart was the US Surgeon General during 1965–1969 [1]. Despite his significant accomplishments, Dr. Stewart is remembered primarily for his infamous statement: “It is time to close the book on infectious diseases, and declare the war against pestilence won” US Department of Health & Human Services. Office of the Surgeon General: William H. Stewart (1965–1969). Petersdorf RG. Whither infectious diseases? Memories, manpower, and money. J Infect Dis 1986;153:189-95 . 1985, At the Infectious Diseases Society of America's “the millennium where fellows in infectious disease will culture one another is almost here” Dr. William H. Stewart was the US Surgeon General during But maybe that was not true ! 1965–1969 [1]. Despite his significant accomplishments, Dr. Stewart is remembered primarily for his infamous statement: “It is time to close the book on infectious diseases, and declare the war against pestilence won” US Department of Health & Human Services. Office of the Surgeon General: William H. Stewart (1965–1969). Petersdorf RG. Whither infectious diseases? Memories, manpower, and money. J Infect Dis 1986;153:189-95 . In 1947, scientists researching yellow fever placed a rhesus macaque in a cage in the Zika Forest (zika meaning "overgrown" in the Luganda language), near the East African Virus Research Institute in Entebbe, Uganda. The monkey developed a fever, and researchers isolated from its serum a transmissible agent that was first described as Zika virus in 1952 DISEASE MANIFESTATIONS Acute Rash Syndrome • About 1 in 5 people infected with Zika virus become ill. • The most common symptoms of Zika are fever, rash, joint pain, or red eyes. • Other symptoms include muscle pain, headache, pain behind the eyes, and vomiting. • The illness is usually mild with symptoms lasting for several days to a week. • Severe disease requiring hospitalization is uncommon. It is clear that increases in the incidence of the Guillain–Barré syndrome to a level that is 2.0 and 9.8 times as high as baseline, as we have reported here, im- pose a substantial burden on populations and health services in this region. Boeuf et al. BMC Medicine (2016) 14:112 DOI 10.1186/s12916-016-0660-0 ZIKA IN UK AND TRAVEL Zika cases diagnosed in the UK ZIKV does not occur naturally in the UK. However, as of 23 November 2016, 263 travel- associated cases have been diagnosed since 2015. Of these, 178 are confirmed cases including: 134 cases with virus detected [PCR positive] 44 cases with antibody evidence indicating recent infection [seroconversion] 85 cases that have antibody evidence highly indicative of recent infection (Zika-specific IgM) [probable cases]. Region of travel Total Caribbean 188 South America 33 Central America 33 North America* 2 Oceania 1 South-Eastern Asia 1 Total 263 *The cases acquired in North America had travelled to the high risk area of Miami-Dade County in Florida The majority of Zika cases in the UK have travelled to the Caribbean and South and Central America. More than two-thirds of cases have travelled to the Caribbean. The largest number reported travel to Barbados (43), followed by Jamaica (37), St Lucia (21), Grenada, and Trinidad and Tobago – all countries popular with UK travellers GOV.UK Home (https://www.gov.uk/) Guidance Zika virus: preventing infection by sexual transmission From: Public Health England (https://www.gov.uk/government/organisations/public-health-england) Part of: Zika virus (ZIKV): clinical and travel guidance (https://www.gov.uk/government/collections/zika-virus-zikv-clinical-and-travel-guidance) First published: 26 January 2016 Last updated: 23 November 2016, see all updates Guidance on the likelihood of sexual transmission of Zika virus and ways to prevent this. Contents Risk of Zika virus sexual transmission Recommendations for prevention Individuals at greatest Zika virus risk All other individuals Last possible Zika virus exposure Further information Risk of Zika virus sexual transmission The greatest likelihood of acquiring Zika virus infection is from travelling to a country with high or moderate Zika virus risk (https://www.gov.uk/guidance/zika-virus-country-specific-risk#atoz). However, sexual transmission of Zika virus is occasionally reported. While Zika is usually an asymptomatic or mild illness for the majority of people, it presents the greatest risk to the developing fetus. It is therefore imperative that women who are pregnant take enhanced measures to avoid exposure to Zika virus (https://www.gov.uk/guidance/zika-virus-travel-advice#pregnant-women- and-their-male-partners-who-are-planning-to-travel), including during sexual contact. Women who are planning a pregnancy or are of child-bearing age and who may be exposed to Zika virus (either through travel or from their sexual partner), should also take enhanced precautions to prevent pregnancy and exposure to the virus during the specified risk periods (see below). Recommendations for prevention GOV.UK Home (https://www.gov.uk/) Barrier method options recommended for preventing Zika Guidance virus transmission include male or female condoms for Zika virus: preventing infection by sexual penetrative sex (including sex toys) and male or female condoms or dental dams for oral-genital or oral-anal transmission sexual contact. Sex toys should not be shared. To increase From: Public Health England (https://www.gov.uk/government/organisations/public-health-england) their effectiveness barrier methods should be used Part of: Zika virus (ZIKV): clinical and travel guidance consistently and correctly, for the entire duration of sexual (https://www.gov.uk/government/collections/zika-virus-zikv-clinical-and-travel-guidance) First published: 26 January 2016 contact. Last updated: 23 November 2016, see all updates Guidance on the likelihood of sexual transmission of Zika virus and ways to prevent this. Contents Risk of Zika virus sexual transmission Recommendations for prevention Individuals at greatest Zika virus risk All other individuals Last possible Zika virus exposure Further information Risk of Zika virus sexual transmission The greatest likelihood of acquiring Zika virus infection is from travelling to a country with high or moderate Zika virus risk (https://www.gov.uk/guidance/zika-virus-country-specific-risk#atoz). However, sexual transmission of Zika virus is occasionally reported. While Zika is usually an asymptomatic or mild illness for the majority of people, it presents the greatest risk to the developing fetus. It is therefore imperative that women who are pregnant take enhanced measures to avoid exposure to Zika virus (https://www.gov.uk/guidance/zika-virus-travel-advice#pregnant-women- and-their-male-partners-who-are-planning-to-travel), including during sexual contact. Women who are planning a pregnancy or are of child-bearing age and who may be exposed to Zika virus (either through travel or from their sexual partner), should also take enhanced precautions to prevent pregnancy and exposure to the virus during the specified risk periods (see below). Recommendations for prevention GOV.UK Home (https://www.gov.uk/) Barrier method options recommended for preventing Guidance Zika virus transmission include male or female Zika virus: preventing infection by sexual condoms for penetrative sex (including sex toys) and male or female condoms or dental dams for oral- transmission genital or oral-anal sexual contact. Sex toys should not From: Public Health England (https://www.gov.uk/government/organisations/public-health-england) be shared. To increase their effectiveness barrier Part of: Zika virus (ZIKV): clinical and travel guidance methods should be used consistently and correctly, for (https://www.gov.uk/government/collections/zika-virus-zikv-clinical-and-travel-guidance) First published: 26 January 2016 the entire duration of sexual contact. Last updated: 23 November 2016, see all updates Guidance on the likelihood of sexual transmission of Zika virus and ways to prevent this. Contents Risk of Zika virus sexual transmission Recommendations for prevention Individuals at greatest Zika virus risk All other individuals The Sun Last possible Zika virus exposure Further information ZIKA WARNING UPDATE Brits visiting Florida warned against having unprotected sex and sharing their sex toys over Zika Risk of Zika virus sexual transmission virus threat The greatest likelihood of acquiring Zika virus infection is from travelling to a country with high or moderate Zika virus risk (https://www.gov.uk/guidance/zika-virus-country-specific-risk#atoz). However, sexual Warning comes as Public Health England raises threat level of transmission of Zika virus is occasionally reported. Brits catching virus in range of global holiday destinations While Zika is usually an asymptomatic or mild illness for the majority of people, it presents the greatest risk to the developing fetus. It is therefore imperative that women who are pregnant take enhanced measures to avoid exposure to Zika virus (https://www.gov.uk/guidance/zika-virus-travel-advice#pregnant-women- and-their-male-partners-who-are-planning-to-travel), including during sexual contact. Women who are planning a pregnancy or are of child-bearing age and who may be exposed to Zika virus (either through travel or from their sexual partner), should also take enhanced precautions to prevent pregnancy and exposure to the virus during the specified risk periods (see below). Recommendations for prevention History of syphilis • Syphilis brought through by Christopher Columbus • Pre-Columbian evidence of treponemal disease abounds in cemeteries in both the New and Old World , with diagnoses given for what were perceived to have been isolated individuals with periosteal reaction. Over 240 skeletons exhumed at the site of a medieval friary in Hull. It is claimed that some 60% of the skeletons show leg bone changes compatible with a diagnosis of syphilis.
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