Acute viral hepatitis morbidity and mortality associated with hepatitis E virus infection: Uzbekistan surveillance data

<p>Abstract</p> <p>Background</p> <p>In Uzbekistan, routine serologic testing has not been available to differentiate etiologies of acute viral hepatitis (AVH). To determine the age groups most affected by hepatitis E virus (HEV) during documented AVH epidemics, trends in AVH-associated mortality rate (MR) per 100,000 over a 15-year period and reported incidence of AVH over a 35-year period were examined.</p> <p>Methods</p> <p>Reported AVH incidence data from 1971 to 2005 and AVH-associated mortality data from 1981 to 1995 were examined. Serologic markers for infection with hepatitis viruses A, B, D, and E were determined from a sample of hospitalized patients with AVH from an epidemic period (1987) and from a sample of pregnant women with AVH from a non-epidemic period (1992).</p> <p>Results</p> <p>Two multi-year AVH outbreaks were identified: one during 1975–1976, and one during 1985–1987. During 1985–1987, AVH-associated MRs were 12.3–17.8 per 100,000 for the general population. Highest AVH-associated MRs occurred among children in the first 3 years of life (40–190 per 100,000) and among women aged 20–29 (15–21 per 100,000). During 1988–1995 when reported AVH morbidity was much lower in the general population, AVH-associated MRs were markedly lower among these same age groups. In 1988, AVH-associated MRs were higher in rural (21 per 100,000) than in urban (8 per 100,000) populations (RR 2.6; 95% CI 1.16–5.93; p < 0.05). Serologic evidence of acute HEV infection was found in 280 of 396 (71%) patients with AVH in 1987 and 12 of 99 (12%) pregnant patients with AVH in 1992.</p> <p>Conclusion</p> <p>In the absence of the availability of confirmatory testing, inferences regarding probable hepatitis epidemic etiologies can sometimes be made using surveillance data, comparing AVH incidence with AVH-associated mortality with an eye to population-based viral hepatitis control measures. Data presented here implicate HEV as the probable etiology of high mortality observed in pregnant women and in children less than 3 years of age in Uzbekistan during 1985–1987. High mortality among pregnant women but not among children less than 3 years has been observed in previous descriptions of epidemic hepatitis E. The high mortality among younger children observed in an AVH outbreak associated with hepatitis E merits corroboration in future outbreaks.</p

An evolving jet from a strongly magnetized accreting X-ray pulsar

© 2018, Springer Nature Limited. Relativistic jets are observed throughout the Universe and strongly affect their surrounding environments on a range of physical scales, from Galactic binary systems1 to galaxies and clusters of galaxies2. All types of accreting black hole and neutron star have been observed to launch jets3, with the exception of neutron stars with strong magnetic fields4,5 (higher than 1012 gauss), leading to the conclusion that their magnetic field strength inhibits jet formation6. However, radio emission recently detected from two such objects could have a jet origin, among other possible explanations7,8, indicating that this long-standing idea might need to be reconsidered. But definitive observational evidence of such jets is still lacking. Here we report observations of an evolving jet launched by a strongly magnetized neutron star accreting above the theoretical maximum rate given by the Eddington limit. The radio luminosity of the jet is two orders of magnitude fainter than those seen in other neutron stars with similar X-ray luminosities9, implying an important role for the properties of the neutron star in regulating jet power. Our result also shows that the strong magnetic fields of ultra-luminous X-ray pulsars do not prevent such sources from launching jets

The awakening of BL Lacertae: observations by Fermi, Swift and the GASP-WEBT

Since the launch of the Fermi satellite, BL Lacertae has been moderately active at gamma-rays and optical frequencies until 2011 May, when the source started a series of strong flares. The exceptional optical sampling achieved by the GLAST-AGILE Support Program of the Whole Earth Blazar Telescope in collaboration with the Steward Observatory allows us to perform a detailed comparison with the daily gamma-ray observations by Fermi. Discrete correlation analysis between the optical and gamma-ray emission reveals correlation with a time lag of 0 +/- 1 d, which suggests cospatiality of the corresponding jet emitting regions. A better definition of the time lag is hindered by the daily gaps in the sampling of the extremely fast flux variations. In general, optical flares present more structure and develop on longer time-scales than corresponding gamma-ray flares. Observations at X-rays and at millimetre wavelengths reveal a common trend, which suggests that the region producing the mm and X-ray radiation is located downstream from the optical and gamma-ray-emitting zone in the jet. The mean optical degree of polarization slightly decreases over the considered period and in general it is higher when the flux is lower. The optical electric vector polarization angle (EVPA) shows a preferred orientation of about 15 degrees, nearly aligned with the radio core EVPA and mean jet direction. Oscillations around it increase during the 2011-2012 outburst. We investigate the effects of a geometrical interpretation of the long-term flux variability on the polarization. A helical magnetic field model predicts an evolution of the mean polarization that is in reasonable agreement with the observations. These can be fully explained by introducing slight variations in the compression factor in a transverse shock waves model