The malaria and typhoid fever burden in the slums of Kolkata, India: data from a prospective community-based study.

Recent research has indicated that the malaria burden in Asia may have been vastly underestimated. We conducted a prospective community-based study in an impoverished urban site in Kolkata, India, to estimate the burden of malaria and typhoid fever and to identify risk factors for these diseases. In a population of 60452 people, 3605 fever episodes were detected over a 12-month period. The blood films of 93 febrile patients contained Plasmodium (90 P. vivax, 2 P. falciparum and 1 P. malariae). Blood cultures from 95 patients grew Salmonella enterica serotype Typhi. Malaria patients were found to be significantly older (mean age 29 years) compared with patients with typhoid fever (15 years; P<0.001) but had similar clinical features on presentation. Having a household member with malaria, illiteracy, low household income and living in a structure not built of bricks were associated with an increased risk for malaria. Having a household member with typhoid fever and poor hygiene were associated with typhoid fever. A geographic analysis of the spatial distribution of malaria and typhoid fever cases detected high-risk neighbourhoods for each disease. Focal interventions to minimise human-vector contact and improved personal hygiene and targeted vaccination campaigns could help to prevent malaria and typhoid fever in this site

Fever Palm

Poetry by Carol A. Alexander

The Human Virome in Children and its Relationship to Febrile Illness

This study investigates the relationship of viruses to febrile illness in children. Subjects are normal children 2-36 months of age with fever along with normal children of the same age without fever, plus immunocompromised children with fever along with immunocompromised children without fever. Specimens obtained include blood, nasopharyngeal secretions, and feces. Specimens are analyzed using a panel of virus-specific PCR assays and also by high throughput sequencing using 454 and Illumina platforms

Neurogenic Fever after Acute Traumatic Spinal Cord Injury: A Qualitative Systematic Review.

STUDY DESIGN: Systematic review. OBJECTIVE: To determine the incidence, pathogenesis, and clinical outcomes related to neurogenic fevers following traumatic spinal cord injury (SCI). METHODS: A systematic review of the literature was performed on thermodysregulation secondary to acute traumatic SCI in adult patients. A literature search was performed using PubMed (MEDLINE), Cochrane Central Register of Controlled Trials, and Scopus. Using strict inclusion and exclusion criteria, seven relevant articles were obtained. RESULTS: The incidence of fever of all origins (both known and unknown) after SCI ranged from 22.5 to 71.7% with a mean incidence of 50.6% and a median incidence of 50.0%. The incidence of fever of unknown origin (neurogenic fever) ranged from 2.6 to 27.8% with a mean incidence of 8.0% and a median incidence of 4.7%. Cervical and thoracic spinal injuries were more commonly associated with fever than lumbar injuries. In addition, complete injuries had a higher incidence of fever than incomplete injuries. The pathogenesis of neurogenic fever after acute SCI is not thoroughly understood. CONCLUSION: Neurogenic fevers are relatively common following an acute SCI; however, there is little in the scientific literature to help physicians prevent or treat this condition. The paucity of research underscored by this review demonstrates the need for further studies with larger sample sizes, focusing on incidence rate, clinical outcomes, and pathogenesis of neurogenic fever following acute traumatic SCI

Quantifying Economic Losses due to Milk Fever in Dairy Farms

Milk fever, a metabolic disease, affects dairy animals usually within one or two days after calving, resulting in a huge reduction in milk production and thus becomes economically most important. This study, conducted in five milkshed districts of Tamil Nadu, has estimated the economic losses arising from milk fever, based on the data collected from a random sample of 557 milk fever affected bovines (516 cows and 41 she buffaloes) during 2005-08. For assessing economic losses caused by milk fever, cost of medicines, veterinarian’s fee, cost of additional labour utilized, loss due to reduction in milk output, cost of animals dead and culled have been considered. The prevalence of milk fever has been found 13.67 per cent in cows and 11.99 per cent in buffaloes across the study districts. The total loss has been found as Rs 1,068 per affected cow and Rs 665 per buffalo. Taking into account the observed prevalence of milk fever, the population of milch cows and buffaloes and the per animal loss due to milk fever has been estimated to be of Rs 40.62 crore in the state, which is a substantial damage to the dairy farming community. Some suggestions for prevention and management of milk fever have been given in the study.Agricultural and Food Policy,

Investigation of a Q fever outbreak in a Scottish co-located slaughterhouse and cutting plant

Outbreaks of Q fever are rare in the UK. In 2006, the largest outbreak of Q fever in Scotland occurred at a co-located slaughterhouse and cutting plant with 110 cases. Preliminary investigations pointed to the sheep lairage being the potential source of exposure to the infective agent. A retrospective cohort study was carried out among workers along with environmental sampling to guide public health interventions. A total of 179 individuals were interviewed of whom 66 (37%) were migrant workers. Seventy-five (41.9%) were serologically confirmed cases. Passing through a walkway situated next to the sheep lairage, a nearby stores area, and being male were independently associated with being serologically positive for Q fever. The large proportion of migrant workers infected presented a significant logistical problem during outbreak investigation and follow up. The topic of vaccination against Q fever for slaughterhouse workers is contentious out with Australasia, but this outbreak highlights important occupational health issues

Spatial analysis of risk factors for childhood morbidity in Nigeria

Recent Demographic and Health Surveys (DHS) from Sub-Saharan Africa (SSA) indicate a decline in childhood vaccination coverage but a high prevalence of childhood diarrhea, cough, and fever. We used Nigerian DHS data to investigate the impact of geographical factors and other important risk factors on diarrhea, cough, and fever using geoadditive Bayesian semiparametric models. A higher prevalence of childhood diarrhea, cough, and fever is observed in the northern and eastern states, while lower disease prevalence is observed in the western and southern states. In addition, children from mothers with higher levels of education and those from poor households had a significantly lower association with diarrhea; children delivered in hospitals, living in urban areas, or from mothers having received prenatal visits had a significantly lower association with fever. Our maps are a novel and relevant tool to help local governments to improve health-care interventions and achieve Millennium Development Goals (MDG4)

Post-Pericardiotomy Syndrome Disguised as Fever of Unknown Origin

Introduction: Post -Pericardiotomy syndrome (PPS) is a clinical diagnosis characterized by fever, pericardial or pleural effusions, and a pericardial friction rub occurring over several days after cardiac surgery. The infrequency of PPS can cause delay in recognition and management, thus leading to significant morbidity. We present a case of fever of unknown origin, pericardial and pleural effusion secondary to postpericardiotomy syndrome 10 days after an Aortic Valve Replacement (AVR) Poster presented at: American College of Physicians Southeast Regional Meeting on October 15th, 201

Cation-anion balance in organic silage in relation to prevention of milk fever

Studies of organic farms in Norway have documented that cows in organic herds are less prone to milk fever compared to the overall average incidence of milk fever in Norway. Milk fever occurs most frequently in high-yielding cows, fat cows and older cows. On average, cows on organic farms are lower yielding, but also older. Dry cow diets relatively high in the anion chloride (Cl–) and low in the cations potassium (K+) and sodium (Na+) can prevent milk fever. In organic farming no inorganic fertilisers are used. This may result in low content of K in the plants and with that a low content of K in the fodder. Often there also is greater diversity of plants (clover, herbs, “weeds”) in an organic meadow than in a conventional meadow. Plants vary in their uptake of different elements. One can therefore expect a different composition of minerals in organically produced fodder compared to fodder from conventionally managed fields. Therefore, the mineral content in fodder from eight organic farms and eight conventional control farms was examined to see if low frequency of milk fever is connected to the cation-anion balance (CAB) in the fodder. Seven cows were selected from each farm. Fodder given to the cows in the dry period was analysed for Na, K and Cl, and the botanical composition of the roughage were determined. The cows’ urinary pH was measured during the dry period, using pH-papers. The fodder was also analysed for other minerals (Ca, Mg, P, Mn, Fe, Cu, Zn and Mo) to get a broader picture of the ration. The cows’ body condition scores in the dry period were measured. The mean CAB in both the organic and conventional fodder was 366 mEq kg-1 DM, and the cows’ urinary pH was around 8.5. Based on results from this project we cannot see any connection between the lower frequency of milk fever in organic milk production and CAB in organic fodder. Not unexpectedly, the organic fodder contained more Ca and Mg. There was no difference in content of Fe, Cl, Na, K, P, Mn, Zn and Cu. Several fodder samples had more then 2% K of DM. The Ca/P ratio was high, together with a relatively low content of P. Both high K content and high Ca/P ratio together with low P content are connected to increasing risk for milk fever. The results from the mineral analysis of the fodder samples indicate an unfavourable mineral composition regarding milk fever in both conventionally and organically produced fodder

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