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wasthereamassshootingtoday · 5 years ago

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COVID- 3/12 Update

Wow! A lot can change in so little time, can’t it? But not all for the bad!

Almost 63,000 of the 81,000 cases in China have recovered! Around 3,000 people have died and the rest are still recovering. Those are very good numbers! Especially considering that cases in China appear to have leveled off. This is a good sign.

As of 3/12/2020 7:16pm EST, there are 1,315 active cases in the United States. 373 of these have been in Washington State and 216 in New York.

However, only 7,695 people have been tested for COVID in the United States. This is an alarmingly low number and signals to me that we have many more cases in the US that re not yet reported to due to the lack capability of our current medical infrastructure to perform COVID tests quickly.

Per capita, the US performs 23 tests per million people. Compare this to South Korea who is running 3,692 tests per million people. Our testing capability is only 16,000. This delay in testing is dangerous and will lead to further disease spread. We cannot be truly sure of how many people in the US have COVID right now and we likely won’t have true numbers until the outbreak has passed. Visit this link for more information.

Please visit this website for the most up-to-date information, maps, and statistics.

As you have probably heard, there have been some major COVID developments in the news recently.

Firstly, Italy has entered a nationwide lock-down. All nonessential travel and group gatherings have been halted through April 3rd in an effort to curb the outbreak. My friend in Italy tells me there are high fines for being outside without a good reason. Many “nonessential” shops and services have been shut down.

This is in response to the spike in COVID deaths in the country, which killed almost 800 people in 24 hours. The current death toll is around 1,000. There are about 12,500 reported cases in Italy thus far. This appears to be an extremely high mortality rate, especially when the rest of the world is hovering at 2-4% and for Italy it is around 8%.

There are many reasons this rate appears so high and why the outbreak there is worse that in so many countries and this article explains it all well. Basically, Italy is older than many other European countries, the fact that the disease was going around for a while without people realizing, and they tested a lot of people recently explains a lot of the high rate of disease there.

I have a feeling that the number of cases will continue to rise but the death rate will decrease. People with mild cases tend not to go to the doctor and there are asymptomatic carriers transmitting the disease as well. So in times like this were the disease is still relatively new and tests can only be done so fast, many milder cases no diagnosed. This makes the death rate seem higher than it is. So don’t panic. Italy is having a pretty bad outbreak right now, but the mortality rate will even out and the government has input good disease control measures.

Second thing in the news: no more travel from Europe to the US for a month! (Except Great Britain) Trump inputted this measure to prevent further disease spread after being called out for his inaction. I hate to agree with Trump on anything and I find just about everything he has said about the disease insensitive and borderline inane, but I think this was a decent move.

Thirdly, sports. I know nothing about sports, but apparently the NCAA Tournament was canceled, the NHL suspended its season, and the MLB is halting spring training. So there’s that. This is part of something public health workers call social distancing. Basically, you stop large crowds of people from forming as not to further spread disease.

Fourth, the economy? Apparently the DOW is tanking. I know less about economics than I do about sports so I will let someone else explain this.

Next, hoarding! This is not the apocalypse so please stop buying mass quantities of soap, hand sanitizer, canned goods, masks, and toilet paper. It is not helping and is causing shortages. You won’t need all of it. Please stop. This is creating further panic and creating more stress and disruptions.

Lastly, WHO has declared COVID-19 a pandemic. Don’t be alarmed. This is not a measure of disease severity, but rather just how far it has spread. This does not change the disease; it is merely a classification that will hopefully spur global action. We actually have several pandemics currently going on, such as HIV/AIDS and cholera, which has been ongoing for many years. The last declared outbreak was H1N1 in 2009.

Shout out to all my college kids out there! Following the lead of Harvard, many colleges around the country are shutting down, extending spring breaks, or moving to online classes. Personally, my university announced today that it is moving to online classes after spring break. I think this is an overreaction, but is is an effective means of stopping disease spread. So, there’s that.

Also, coronaviruses have existed for decades (they are the most cause of the common cold). Think of the term coronavirus like dogs, and COVID, SARS, and MERS and MERS are breeds of dogs. COVID is merely a sub-type of coronavirus. It is new and likely came from a live animal market.

So all those Facebook people declaring that coronavirus is governmental conspiracy because it appears on the back of a Lysol bottle are wrong. COVID was also not created in a lab, it was not designed to distract from an election, and it is not from bioterrorism.

Sometimes diseases just occur. It happens. It is actually very common for imaginal viruses to spillover and spread into humans. (COVID likely went from bat to pangolin to human, mutating along the way). It happens all the time; this virus just happened to be a bit more popular than the others.

Finally, the disease itself. It is not the flu. Please stop saying it is. COVID causes fever, cough, and shortness of breath. If you are young (<65) and not immunocompromised you will likely have a short illness and be fine relatively quickly. If you are in an at-risk demographic, then you have the possibility of developing pneumonia and having an extended hospital stay.

I know all of this sounds really scary! People are reacting very strongly, the media is stirring up panic, and our government is focused on the wrong things. But you will be alright. Just practice everyday precautions:

1. Wash your hands for at least 20 seconds after touching your face, using the bathroom, coming in contact with a sick person, handling food, etc.

2. Wear a face mask ONLY if you are sick.

3. Don’t hang out around sick people.

4. Don’t be around other people if you are sick.

5. Avoid large gatherings and unnecessary travel when you can.

6. And above all don’t panic. You will be fine. Just use reasonable precautions and use your common sense.

Stay safe and healthy everyone!

#covid #sorry for the long post at least theres pictures #coronavirus #corona #covid19 #covid 19 #covid-19 #outbreak #other #also please dont try and explain economics to me i really dont care

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noccalula-writes · 5 years ago

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What are your favorite games and franchises? Top 5?

OH BOY have I got feelings on this subject.

Please keep in mind - I’m a storyteller and a writer. I fucking /love/ a good story. I DM a DnD game and my biggest weakness is that I don’t often include enough combat because I am so much more interested in telling a story. So for me, there’s got to be an emotional investment for a game to really land. I also hyperfixate like a motherfucker so I often refuse to pick up new things purely because there’s not enough space in my head for them at the time, so I’m slow getting to things as they come out.

So, I’m first and foremost a survival horror bitch. I cut my teeth on Parasite Eve before I played any others - my mother scrimped and saved and fought her way through Wal-mart back in like 1998 to get me the original Playstation gaming console and Tekken 2 (which was my first PS game, I played it in an arcade near her barber shop as a child - Tomb Raider 2 was my second). The old Playstation discs at that time came with demos for different games, including Metal Gear Solid, which I replayed until I could have done it in my sleep because poverty meant I wasn’t likely to get another game anytime soon. I mention this because the Parasite Eve trailer used to give me nightmares but I was super, super hooked.

I am a huge Silent Hill fan. Huge. That is a tragedy I could write a whole ‘nother post about, because as excited as I am to finally get my hands on Death Stranding (again, poverty, so it’ll be another minute before we can get a PS4), we’ll never get another SH game again unless some major reconciliation happens with Kojima and Konami, which is unlikely (and also hard to hope for - I’m happy Kojima now has the creative freedom to go as balls to the wall as he wants).

I am an equally huge Resident Evil fan. I’ve always maintained that my first fandom was The X Files, but my wife pointed out a few nights ago that my RE love started around the same time in the late 90′s, so now it’s a chicken and egg kind of thing. Point being, it’s either The or One Of my longest lasting fandoms/interests. RE and Silent Hill get compared to one another a lot - RE7 did nothing to help that - but they really are apples and oranges to me. Fruit, sure, but two totally different tones and experiences.

I’ve been a huge Tomb Raider fan for forever - my first high school boyfriend was loaded and bought me Angel of Darkness to come play at his house and while it was def critically panned, I do recall enjoying it - so that’s been fun to get those games remade with updated graphics. I’ve only played the one but the others are def on The List.

So now that I’ve talked for an hour, my Top 5 fave games ever -

#1 - Resident Evil 3 I am beyond jazzed for this remake, and a lot of people in the 90′s complained about RE3′s lack of clear cut boss battles, but I don’t know what they’re talking about. The entire fucking game is a boss battle - Jill vs. Raccoon City, and of course, Nemesis, who used to give my mother nightmares and caused me to sleep with a leaf-stabber by my bed for years. Jill is far and away my favorite protagonist in RE; she’s got a resilience of the spirit that somehow isn’t conflated with naivety, which is uncommon in ‘nice’ female protags. She’s savvy but she’s still kind, and she’s committed as fuck to survival - not to mention, as zealotous a Chris and Jill shipper as I am, she and Carlos had hella chemistry and I’m excited to see where that goes (JD Pardo would have made a fuck of a Carlos Oliviera, btw). It was An Experience and it’s forever at my #1.

#2 - The Last of Us

There is no comparison for emotional weight in video games, as far as I’m concerned. SPOILERS if you don’t already know the ending (this game came out in what, 2014?) but to me one of the biggest thing in the game’s favor is that the protagonist made the wrong choice. He had an option to potentially eradicate the cordyceps fungus and maybe save the world, turn the tides back for humanity, and with the weight of the world in the balance, he chose to save Ellie instead. It was, on a global scale, the wrong choice - but it was the human choice. It was the thing that a dad who never properly grieved his dead daughter would do for the surrogate daughter he inherited by accident. As for Ellie, there is no other character quite like her in games, and she’s fucking quality LGBT representation, especially considering how little we see queer children in media. I still cry every time, we play this game twice a year like clockwork and every single time, I still cry.

#3 - Silent Hill 3

All of SH’s games will have a special place in my heart - and if you wanna talk shit about Downpour, I’ll meet you in the Denny’s parking lot at 11, you better square the fuck up because I will defend Murphy with fists - but 3 is the best, hands down. I felt like it did the best job of streamlining the series’ ... uhm... somewhat complicated lore into something more understandable. SPOILERS: The villains are horrific - the Missionaries strike fear into my heart every time I play, and Claudia eating a miscarried god fetus to become god herself? Fucked up on a level you rarely see. I suppose if you didn’t catch it in the last sentence - your protag Heather vomits up a fetal god late in the game. Yes, you read that right. The best thing about this game though? Heather. I could climb up my feminist soapbox and talk about Heather as a subversion to video game tropes all fucking day - she’s a nonsexualized teenage girl whose father is killed for her character development. She’s self-sufficient, tough but still vulnerable, and hard as nails in a fight. As I might have mentioned a time or six, she also voluntarily aborts a god because Fuck Your Plans, She’s Got Her Own.

#4 - Final Fantasy X

Listen. I don’t know how much of this is because of actually enjoying playing the game and how much of it is emotional attachment. As most of you who follow me know, my mother died when I was sixteen. When I was about fourteen, I dated a rich kid who used to bring his PS2 to our very not-rich house and play games for us to watch - the sort of neophyte version of Watching Guys Play Videogames, if you will, which is another rant for another time. He got a Gamecube specifically so I could play RE Zero and Hunter The Reckoning. He was a neckbeard but he was also desperate to keep me from ditching so he did the smart thing and plied my very poor ass with money and food. The #1 game in the watching roster, though, was FFX - and if you know anything about the game, you know how heavily spirituality features into the story. My mother, very caught up in a very Eastern Philosphy Meets Quantum Physics internal seeking about the nature of things, was hooked from the word Go. She used to sit and watch Trey play for hours - we all did, but having her join us and love it that much? Wonderful. Half my memories of this game are both of us crying - crying when Yuna dances to send the souls, crying when Yuna reveals she’s on a suicide mission, crying when she and Tidus fall in love anyway, crying when she sends her Aeons to die in the final fight, crying over ‘the fayts are waking up’, crying when the big reveal about Auron comes up, crying crying crying. My wife bought it in 2011 and I watched her play through it again and while it suffers from the same issue as all FF games - too much filler and weird battle scenarios - it was cathartic. I miss my mom.

#5 - Resident Evil 6

Eat my entire ass. You already knew this was coming. I will defend this game to my grave for the fact that we have complex, interesting narratives surrounding female characters who have actual personalities. Was it perfect? No. Did it take RE out of horror territory and move it more into action? Woefully, yes. Is this series deeply problematic for where it chooses to set down your mostly-white protags and have them kill their way through? Big time. Don’t gloss those facts. But it’s got emotional punch in spades and a few weird character breaks that ended up being kind of brilliant - Chris has been so resiliently relentless in his fight against bioterrorism that a major PTSD break was inevitable. Leon would of course risk life and limb to help Helena, even though she implicated herself in something terrible. The icing on the cake to me was a grown up Sherry Birkin, wide eyed and believing like hell in the fight she thought she was on the right side of and getting knocked down only to get back up. Ada’s entire side campaign was brilliant. I hate some of the control choices they made in this game - the running from the Haos scenes near the end of Chris and Piers’ campaign makes me want to eat my own fist - but so it goes with most RE games (until RE4, moving your protag was like driving a tank). Jake and Sherry are My Unsinkable Ship. There are at least six scenes across this game that never get easier to watch - when the bomb hits the city and the cut scene of the mass infections begin, I still get sick to my stomach - and that, to me, is the mark that this game struck a hell of a chord in terms of storytelling.

This was long.

#noccalula answers #this was fucking long #ask and ye shall receive #vidja games

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thahxa · 2 years ago

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I posted 4,531 times in 2022

That's 2,054 more posts than 2021!

204 posts created (5%)

4,327 posts reblogged (95%)

Blogs I reblogged the most:

@official-kircheis

@triviallytrue

@casioa168w

@st-just

@transgenderer

I tagged 1,388 of my posts in 2022

#shitpost - 144 posts

#lmfao - 117 posts

#the concept of a person - 75 posts

#bad post - 68 posts

#lol - 53 posts

#armchair chemistry - 53 posts

#endorsed - 49 posts

#armchair biology - 31 posts

#lmao - 25 posts

#but like also unironically - 23 posts

Longest Tag: 140 characters

#actually just wonderin how many hanzi have you seen thru the cards? iirc most of them are sentences or phrases but not individual characters

My Top Posts in 2022:

love how the normie take is that you should be allowed to get invasive surgery to get bigger tits but playing with your hormones to get bigger tits (or even worse: to become stronger!) is a bridge too far

44 notes - Posted April 5, 2022

now that we're all Discoursing about Education lemme add in my own take:

why the fuck am I not able to (easily, in high school/college) take the test for a course and get the credit for it instead of going to class?

if tests are (and they should be!) designed to test your knowledge and the receiving of a credit for the course be an indicator that you know something about that course, why can't I skip the step where I have to spend 4-6 months of my life performing tasks to "learn" something I already knew?

58 notes - Posted September 18, 2022

type of guy who used to think waterboarding was torture but doesnt anymore after they’ve been waterboarded

92 notes - Posted February 27, 2022

one of the worst parts about the human brain is that its (almost definitely) very optimized, meaning that even with magic tricks (chemicals) theres only so much you can squeeze out of there

213 notes - Posted September 15, 2022

My #1 post of 2022

so there are 10k global cases of monkeypox and it looks like the outbreak isnt stopping anytime soon, with an unknown (but up to 1%) death rate

the smallpox vaccine (the old, live one - the newer one is safer) has a ~3 in one million life-threatening side effect rate (with risk of death after that being around 20%, apparently, according to the paper). As an intervention, it’s been tested, it is easy to manufacture, and was already being produced in mass quantities (to prevent bioterror attacks)

yet I, as a young adult who is at low risk of any side effects without any immune issues whatsoever (which is where most of the side effects of the live virus vaccine appear) cannot go to the doctor and get it administered to me due to absurd FDA rules mandating that it can only be administered to some tiny portion of the population

302 notes - Posted July 19, 2022

Get your Tumblr 2022 Year in Review →

#tumblr2022 #year in review #my 2022 tumblr year in review #your tumblr year in review #i got waterboarded again this year btw and i still think its torture #but its literally like an adrenaline shot to ur brain i feel like there would b ppl into this #its an automatic fight or flight response

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germanischer-junge · 4 years ago

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Skandalöses UN-Strategie-Papier: Pandemien als Vorwand zur Überwachung

27. Mai 2021

Hinter dem harmlosen Titel „Covid-19: Make it the Last Pandemic“ verbirgt sich ein bedrohliches UN-Strategie-Papier.

Zur Vorbeugung künftiger Pandemien wird mehr Macht für die WHO empfohlen und der Aufbau eines weltumspannenden Warn- und Überwachungssystems gefordert.

An allen Ecken und Enden trieft das UN-Strategie-Papier auf 68 Seiten von globalistischen Machtfantasien.

Die Demokratie hat bereits schweren Schaden genommen. Mehr denn je stehen wir am Scheideweg zwischen Freiheit und Knechtschaft. Jetzt entscheidet sich das Schicksal der kommenden Generationen – Eine schonungslose Analyse »>.

Skandalöses UN-Strategie-Papier: Pandemien als Vorwand zur Überwachung

Dieses UN-Strategie-Papier wurde vom sogenannten „Independent Panel on Pandemic Preparedness and Response“ ausgearbeitet.

Diesen Arbeitskreis leiten unter anderen die frühere neuseeländische Premierministerin Helen Clark, die ehemalige Präsidentin von Liberia, Ellen Johnson Sirleaf, und andere Ex-Politiker.

Das Horrorszenario stammt nicht aus dem Drehbuch eines Hollywood-Blockbusters sondern direkt aus einem aktuellen Bericht aus dem Dunstkreis der Vereinten Nationen (UNO).

Die meisten der Überlegungen gehen in Richtung mehr Zentralisierung, Globalisierung und Totalitarismus – und weniger Souveränität, Mündigkeit und Freiheit.

Andernorts gab etwa Clark bereits zu, dass für sie nur ein „multilaterales System“ infrage kommt. Dieses sollte „handeln, um die Welt sicher zu halten“.

Seit Louis Pasteur und Robert Koch gilt es als unumstößliches Gesetz: Bakterien und insbesondere Viren sind für die meisten Krankheiten verantwortlich. Neueste Erkenntnisse widerlegen diese Behauptungen! Wie Krankheiten entstehen, wie sie sich verbreiten und wie sie zu Pandemien werden – hier weiter.

UN-Strategie-Papier: Sieben große Punkte für den Globalisten-Umbau

Ein maßnahmenkritischer Blog spricht davon, dass es im gesamten UN-Strategie-Papier nur so von „bürokratischen Doppelzüngigkeiten wimmelt“ und hebt sieben besonders alarmierende Punkte hervor.

1. Die Vorbereitung und Reaktion auf globale Gesundheitsbedrohungen soll nur mehr auf höchster Ebene geschehen, um ein „gerechtes, verantwortliches und Sektor-übergreifendes Handeln“ zu gewährleisten.

2. Die „Unabhängigkeit“ der WHO müsse ebenso wie ihre Autorität gestärkt werden, ihre Finanzierung besser abgesichert werden.

3. Bereits jetzt müsse in die Prophylaxe gegen Gesundheitsbedrohungen investiert werden. Dies diene dem Zweck, künftig „funktionsfähige Kapazitäten auf nationaler, regionaler und globaler Ebene zu schaffen“. Dezidiert meint dies auch Bedrohungen der „Umweltgesundheit“.

4. Es geht um die Einrichtung eines „verbesserten Systems der Überwachung und Alarmierung“ – und zwar auf internationaler Ebene. Dieses müsse auf der „vollen Transparenz aller Parteien“ basieren und auf „digitalen Werkzeugen am Stand der Technik“ aufbauen, die „Informations-Zentren weltweit verbinden“.

5. Es brauche die Einrichtung einer vorverhandelten Plattform zur Produktion von Impfstoffen, Diagnostika, Therapeutika und Medizinbedarf“ sowie deren „schnelle und gerechte Verteilung als wichtige globale Gemeingüter“.

6. Die Beschaffung neuer internationaler Finanzmittel für ebendiese „globalen Gemeingüter“, welche für die Pandemiebereitschaft und -reaktion wichtig seien.

7. Die Länder mögen eine nationale Koordinationsstelle auf höchster Ebene für die Pandemievorsorge und -reaktion einrichten (welche dann mutmaßlich die Befehle seitens der WHO empfängt und ausführt).

Globaler Pandemieplan seit Monaten im Raum

Selbst jene Punkte, die auf den ersten Blick harmlos aussehen, haben es in sich.

So ist die Idee eines globalen Pandemieplans, bei der alle Gesundheitsentscheidungen nur mehr auf höchster Ebene getroffen werden – bei gleichzeitiger Ausschaltung der Nationalstaaten (nach Clarks Ansicht waren „Nationalismen“ im Kampf gegen Corona schädlich) – nicht mehr neu.

Diese Idee wurde bereits vor einigen Monaten von den mächtigen Regierungschefs über einen Gastbeitrag in großen Tageszeitungen verlautbart.

Auch die Netzwerke rund um die Beschaffung, Verteilung und Vermarktung von Impfstoffen und weiteren Mitteln und „Werkzeugen“ direkt im Umfeld der Bill & Melinda Gates-Stiftung deckten wir bereits vor Monaten auf.

Selbst der floskelhaft erscheinende Punkt mit der „höchsten Ebene“ ist eigentlich ziemlich pikant: Laut der Empfehlung des Papiers soll der WHO-Generaldirektor nach Gutdünken Pandemien ausrufen können.

UN-Strategie-Papier: Neue internationale Ordnung ist im Anmarsch

Besonders alarmierend mutet allerdings die Offenheit an, mit der dieser UN-Bericht nach mehr Überwachung der Bürger schreit.

Dies untermauern die Autoren von diesem skandalösen UN-Strategie-Papier im Lauftext sogar noch zusätzlich, indem sie Länder mit besonders restriktiven Corona-Maßnahmen loben und solche mit wenigen oder gar keinen Maßnahmen entgegen jedweder Datenlage pauschal abqualifizieren.

Auch mit den Hoffnungen, in der Folge der Pandemie eine neue „internationale Ordnung“ in Form eines „Multilateralismus“ erschaffen zu wollen, halten die Eliten längst nicht mehr hinter dem Berg.

Dass sich der Gründer des Weltwirtschaftsforums einst in totaler Enteignung gipfelnde Wiederaufbaustrategien (Stichwort: „Great Reset“) unter dem Deckmantel sogenannter Nachhaltigkeit vorstellen kann, ist längst kein Geheimnis mehr.

Und wie sich das etwa Merkel, Macron & die EU-Granden vorstellen, dürfte den meisten schon seit längerem bekannt sein. Bereits im Februar wechselten sich Überwachungs- und Zensurideen ab.

Das Internet müsse etwa so eingeschränkt werden, dass man keinen „Hass verbreiten“ kann – gemeint ist dabei am ehesten Kritik an ihrer Agenda.

UN-Strategie-Papier: Erfüllt die Politik die Globalisten-Vorgaben im Eiltempo?

Die Regulierung des schwer zu kontrollierenden Internets unter dem Vorwand der „Hassrede“ und die weitreichende Überwachung der Bürger durch die Sammlung einer Fülle an scheinbar nicht zusammenhängenden Daten – dies müsste jedem bereits hinreichend bekannt vorkommen.

Sowohl beim Kampf gegen vermeintlichen „Hass im Netz“ als auch beim „Grünen Pass“, der die Menschen in eine Zweiklassengesellschaft einteilt – Überwachte und Entrechtete – handelt es sich um aktuelle Prestigeprojekte der Corona-Politik. Ist es vorauseilender Gehorsam?

Unter dem Schein, dem Volk wohlgesonnen zu sein, pflegen die führenden Politiker von Deutschland und Österreich regelmäßig Kontakte zu wichtigen globalistischen Akteuren.

Über die Treffen mit WEF-Leiter Klaus Schwab, Impf- und Big-Tech-Guru Bill Gates und dem offen linke und liberale Projekte unterstützenden „Philanthropen“ George Soros wird jedoch der Mantel des Schweigens ausgebreitet.

Die Frage, worüber wirklich in diesen lockeren Gesprächen gemauschelt wurde, das will nie so recht an die Öffentlichkeit dringen. Mit Kalkül?

Der Weg in die neue Weltordnung war geplant

Durch das UN-Strategie-Papier wird immer deutlicher, dass die Coronakrise als Auslöser für einen globalen Staatsstreich von monumentalem Ausmaß genutzt wird.

Es ist die Einleitung in eine neue Ära, in der eine andere internationale Ordnung gelten soll – Event 201 war bereits die Generalprobe für die neue Weltordnung.

Die Freiheiten der Menschen werden weltweit dauerhaft vollständig eingeschränkt bleiben, denn die Corona-Politik hat das Ziel, um uns mit Zwang in eine „klima-intelligente“ und „gesunde“ Welt zu steuern.

Paul Schreyer zeigt im folgenden Video, dass die Politik in der Corona-Krise nicht aus heiterem Himmel kam. Der „Kampf gegen die Viren“ begann schon in den 1990er Jahren als „Kampf gegen den Bioterror“.

Pandemie-Planspiele – Vorbereitung einer neuen Ära

https://youtu.be/SSnJhHOU_28

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biogenericpublishers · 4 years ago

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Review on Q Fever: Epidemiology, Public Health Importance and Preventive Measures by Gizaw Mekonnen in Open Access Journal of Biogeneric Science and Research

Summary

Q fever is worldwide zoonotic disease which is caused by obligate intracellular gram-negative bacteria, called Coxiella burnetii. Q fever is air born disease and thus inhalation is considered as primary mode of transmission in both animal and human, sometimes through ingestion they may be infected and ticks play essential role in transmission. The agent is spread a long distance through the wind. The geographical distribution of Q fever is worldwide except New Zealand. The main reservoirs for human infections are cattle, goat, sheep, and pets and ticks are the natural primary reservoir for animal. Coxiella burnetii in ruminant cause reproductive problems like miscarriage, infertility and reduced milk production. The organism can be found in the milk, urine, feces placenta and birth fluids of animals. The airborne transmission of C. burnetii associated with its highly resistance to environments and the ability to easily produce huge quantities of C. burnetii in the after birth of aborted ewes or goats have led to classify C. burnetii as a Category-B, biological terrorism agent. The incubation period of Q fever is depending on the size of infectious. The recommended treatment for ruminant administering two injection of Oxytetracycline during the last month of gestation, also Doxycycline is the best drug. C. burnetii can be reduced in the farm environment by regular cleaning and disinfection of animal facilities. Q fever is global health problem and it is an OIE notifiable disease. Q fever is one of infectious disease which is considered as being having economic and public health importance in Ethiopia. Therefore, awareness creation and, application of prevention and control method has paramount importance in reduce the hazardous effect of this disease.

Abbreviations: SCV: Small cell variant; LCV: Large cell variant; CFSPH: Central food security public Heath; PCR: Polymerase chain reaction; LPS: Lipopolysaccharide; IFA: Indirect fluorescent antibody; OIE: Office international des Epizooties

Introduction

Q fever is a serious zoonotic disease caused by an obligate intracellular bacterium Coxiella burnetii and it is presumed to be one of the most widespread zoonosis in the world. The disease has known since the 1930s and has a worldwide distribution, with the exception of the Antarctica and possibly New Zealand [1]. The disease first identified in Queensland, Australia, in 1935, after an outbreak of febrile illness among slaughterhouse workers [2]. Some authors suggested that the Q stood of Queensland, the state in which the disease was first founds [3], but after testing all those who were affected and could not arrive at a diagnosis from the patients’ history, physical examination, and a few investigations, Derrick termed the illness “Q” for Query fever, because its etiopathogenesis was not known at the time [4]. It also known by several synonyms such as Abattoir fever, Australian Q fever, Balkan influenza, Coxiellosis, Nine-mile fever, and Pneumorickettsiosis [5].

Domestic animals such as cattle, sheep and goats are considered as the mainreservoir for the pathogen which can infect a large variety of animals, humans, birds, and arthropods [5]. Q fever is a mainly airborne zoonosis; infection is most acquired by breathing infectious aerosols or contaminated dust [6]. Infection can occur also in individuals not having direct contact with animals, such as persons living along a road used by farm vehicles or those handling contaminated clothing. The infection result from inhalation of endospores and from contact with the milk, urine, feces, vaginal mucus or semen of infected animals [7]. The pathogen is highly resistant to adverse physical conditions and chemical agents, so it can survive for months and even years in the environment which create conducive condition for infection [8].

Q fever is frequently asymptomatic, in sheep and goats it causes abortion, stillbirth, premature delivery, and delivery of weak offspring and in cattle and camel may develop infertility, metritis, and mastitis [9]. The majority of human coxiella burnetii infections are asymptomatic, especially among high-risk groups such as veterinary and slaughterhouse workers, other livestock handlers, and laboratory workers [10]. In more recent dates Q fever is classified as a “Category “B” critical biological agent” by the Centre for Diseases Control and Prevention (CDC) and is considered a potential weapon for bioterrorism [11]. The disease so is considered has having public health concern throughout the worldalongside with its economic importance. On top this, although Qfever is an OIE notifiable disease, it remains poorly reported and its surveillance is frequently severely neglected [12]. Review of the disease epidemiologic status, public health significance is lacking in different countries, including Ethiopia.

Therefore, the objectives of this seminar paper are: i. To overview Q Fevers Epidemiology, Public health importance, and preventive measures ii. To highlight current status of Q fever in Ethiopia

History of Q Fever

Q fever was first described in 1935 by Edward Holbrook Derrick [2] in abattoir workers in Brisbane, Queensland, Australia. The “Q” stands for “query” and was applied at a time when the causative agent was unknown; it was chosen over suggestions of “abattoir fever” and “Queensland rickettsial fever,” to avoid directing negative connotations at either the cattle industry or the state of Queensland [13]. Derrick inoculated guinea pigs with blood or urine from the "Q" fever patients. The guinea pigs became febrile. Derrick was unable to isolate the agent responsible for the fever so he sent a saline emulsion of infected guinea pig liver to Macfarlane Burnet in Melbourne. Burnet was able to isolate organisms, which "appeared to be of rickettsia nature" [7].

In 1936, Herald Rea Cox joined Davis at the Rocky Mountain Laboratory to additional characterize the “Nine Mile agent.” Burnet and Freeman, as well as Davis and Cox, demonstrated that the etiological agent was filterable and displayed properties of both viruses and rickettsiae. A major advance obtained in 1938, when Cox succeeded in propagating the infectious agent in embryonated eggs. Cox termed the Nine Mile Agent Rickettsia diaporica (diaporica means having the ability to pass through) a reference to the filterable property of the agent. In intervening time in Australia, Derrick suggested the name of Rickettsia burnetii for the Q fever agent. In 1948, Cornelius B. Philip proposed that R. burnetii considered as the single species of a distinct genus since it was now apparent that this organism was unique among the rickettsiae. He proposed the name Coxiella. The Q fever agent is known as Coxiella burnetii. C. burnetii, a namewhichhonors bothCox and Burnet who had identified the Q fever agent as a new rickettsial species [14].

Etiology and Taxonomy

Coxiella burnetii, the causative agent of Q fever, is a small (3–5mm) polymorphic obligate intracellular gram-negative bacteria belonging to the genus Coxiella, family Coxiellaceae, order Legionellales, class Gammaproteobacteria, and phylum Proteobacteria [15]. C. burnetii display two antigenic phases based on changes that occur in the organism during in vitro culture, such as phase I and phase II [16]. They are liable to the Lipopolysaccharide (LPS) of the membrane. Phase-I Coxiella burnetii antigenare more highly infectious and are corresponds to the smooth phase of Gram-negative bacteriaand phase-II antigen is corresponding to the granular (Rough) phase which has a lower virulence [17]. C. burnetii has a biphasic life cycle, alternating between a large cell variant (LCV), which is the replicating form within a cell, and a small cell variant (SCV), the non-replicating, infectious form. The SCV has an unusual spore-like structure with highly condensed chromatin, and it is highly resistant to environmental conditions [18].

Since, Coxiella burnetii thought the only species member of genus Coxella but recently several Candidatespecies have been recognized in reptiles, birds, and humans like C. cheraxi, C. avium and C. massiliensis. Coxiella-like bacteria are also common in ticks, and one of these organisms was recently found in horses. The newly-recognized relatives of C. burnetii have the potential to alter some aspects of its epidemiology for instance, C. burnetii is often said to occur in more than 40 species of ticks; however, the current PCR tests can also amplify Coxiella-like bacteria, and whether all of these ticks were truly infected with C. burnetii is now in doubt [19].

Genomic group contains reference Coxiella burnetii strain that were isolated from infected human end/or animals. Strain in genomic group 1, 2 and 3 have been isolated from tick, human blood (acute Q fever), from milk of persistently infected dairy cattle, and/or aborted fetal tissue. Strains in genomic group 4 and 5 have been isolated from the heart of humans with chronic Q fever and/ or aborted tissue of animals. Strains in genomic group 6 have been isolated only from rodents; these strains are of unknown virulent for humans and animals [20].

Epidemiology

1.1. Reservoirs of Q Fever

The reservoir includes many wild and domestic mammals, birds, and arthropods such as tick [21] Over 40 species of ticks are naturally infected. The organisms multiply in the cell of the midgut and stomach of the ticks. After multiplying ticks excrete bacteria in the faces and saliva [12]. Throughout the world the most commonly identified reservoirs of human infections are farm animals such as cattle, goats, and sheep, Pets, including cats, rabbits, and dogs, have also been demonstrated to be potential sources of urban outbreaks of disease [22].

1.2. Geographical Distribution

Q fever disease outbreak occurs primarily in Queensland, Australia, in 1935 in slaughterhouse workers [2]. Q fever has described worldwide except New Zealand [23]. Two characteristics of the organism are important in the epidemiologic distribution of the disease. These are its ability to withstand harsh environmental conditions, probably as a result of spore formation and its extraordinary virulence for man. C. burnetii has been a very successful pathogen because of this a single organism can cause disease in man. In 1955, Q fever had been reported from 51 countries on five continents. From 1999 to 2004, there were 18 reported outbreaks of Q fever from 12 different countries [24].

1.3. Transmission and Source of infection

The organism can be found in the milk, urine and feces of the animals as well as the placenta and birth fluids. Humans are most commonly infected through inhalation of contaminated dust or aerosols generated by livestock operations involving these animals [25]. Accordingly, Q fever is an occupational hazard for veterinarians, abattoir workers, dairy farmers and anyone with regular contact with livestock or their products [7]. Urban outbreaks of Q fever are also associated with contact with infected domestic cats [26]. Inhalation is the primary mode of transmission in both human and animal. Under experimental conditions, inhalation of a single C. burnetii can produce infection and clinical disease in humans. Coxiella burnetii also spreads by wind causing infections at adistance from the initial source of bacteria. In domestic ruminants, milk is the most regular route of pathogen shedding and thus recently, OIE advises not to drink raw milk originating from the infected livestock farms [27].

Tick may play important role in transmission of C. burnetii among the wild vertebrates, especially in rodents, lagomorphs, wild birds. Dog can also be infected by tick bites. Although experimental transmission of C. burnetii from infected to uninfected guinea pigs via tick bites has been performed with Ixodes holocyclus, Haemaphysalis bispinosa, Rhipicephales sanguineus,ticks are not important in natural cycle of C. burnetii infection in livestock. Tick expels C. burnetii with their faces in the skin of animal host at the time of feeding [28]. Human-to-human transmission does not usually occur [12].

1.4. Risk Factors

Agent Factors: The severity of the infection depends on the strains of the infecting bacteria. Phase I type bacteria are more virulent than the phase II type. Acute infection in humans is caused by Coxiella burnetii genomic type IIII, whereas type IV and V are responsible for chronic infection. The virulence of type VI is unknown [29,30].

Host Factors: Age and gender are the two risk factors which are shown to influence the occurrence of Q fever in humans. Old people are the most vulnerable and the clinical disease is mostly prevalent in men [31]. An interaction of Coxiella burnetii infection with age and sex was also found in animals, particularly in cattle. The prevalence of Coxiella burnetii infection increases with age or with the number of parity in cattle and sheep. Prevalence is higher in dairy cows than in beef cattle. Veterinarians, animal farm workers, abattoir workers, laboratory personnel, and immunosuppressed people are at a higher risk of being infected or seropositive than others; and highly prevalent [32].

Environmental Factors: Seasonal variation is observed in the occurrence of human Q fever. This variation, however, varies according to geographical region. But most cases of Q fever have been reported in the spring or early summer. Human Q fever has been shown to have a relationship with rainfall rather than season [31,33].

A high prevalence of Q fever was observed among people living in close proximity to infected animals or in areas with a high livestock density. Several management factors such as housing systems, isolation of a newly introduced animal may also contribute to the seroprevalence of Coxiella burnetii infection in animals [32].

Pathogenesis

The pathogenesis of Coxiella burnetii infectionin humans and animals is not clearly understood. But, it is believed that bacterial LPS play an important role in the pathogenesis of Q fever in both humans and animals. The organism probably follows the oropharyngeal route as its port of entry into the lungs and intestine of both humans and animals. The disease is highly infectious, and a very low dose is enough to initiate infection. Primary multiplication takes place in the regional lymph nodes after the initial entry, and a transient bacteremia develops which persists for five to seven days [17].

The SCVs are shed by infected animals. After infection the organism attaches to the cell membrane of phagocytic cells. After phagocytosis, the phagosome containing the SCV fuses with the lysosome. The SCVs can undergo vegetative growth to form LCVs. The LCVs and the activated SVCs can both divide by binary fission and the LCV can also undergo sporogenic differentiation. The spores that are produced can undergo further development to become metabolically inactive SCVs and both spores and SCVs can then be released from the infected host cell by either cell lysis or exocytosis. The entire development cycle of metabolically active C. burnetii takes place in acidic phagolysosomes; C. burnetii are resistant to microbicidal activities in the host macrophages. The acidic environment also protects C. burnetii from the effects of antibiotics. The SCV and spore forms are more difficult to denature than LCVs [34].

Clinical Sign

In animals, during the acute phase, C. burnetii can be found in the blood, lungs, spleen, and liver whereas during the chronic phase it is presented as a persistent shedding of C. burnetii in feces and urine. Most animals remain totally asymptomatic, including a lack of fever. However, low birth weight animals can occur. Clinical symptom of Q fever in sheep and goats are pneumonia, abortion, stillbirth, premature delivery, and delivery of weak offspring or reproductive failure. In cattle, Q fever is frequently asymptomatic. Clinically infected cows develop infertility, metritis, and mastitis. In addition, C. burnetiid was found to be significantly associated with placentitis. Placental necrosis and fetal bronchopneumonia were also significantly associated with the presence of Coxiella burnetii in the trophoblasts. In most abortive cases, the aborted foetus appears normal but discolored exudates and intracotyledonary fibrous thickening may be observed in an infected placenta. Severe myometrial inflammation and metritis are the frequently observed clinical manifestations in goats and cows, soabortion rate is comparatively higher in ewes and goats than in cows. Abortion is usually observed in late pregnancy in ewes, goats, and cattle [1].Infection in most domestic animals remains unrecognized. Coxiellosis is considered a cause of abortion and reproductive disorders in domestic animals.

Temperature is an important factor related to abortion rates in herds, since fewer abortions take place between months of November and December, the occurrence of abortion rate increases gradually from January to February, decreasing again in March [1]. In Humans Coxiella burnetiid infection can cause either an asymptomatic, acute, or chronic disease. Clinical manifestations of Q fever in human are Prolonged fever, Pneumonia, Hepatitis, Endocarditis, Osteomyelitis, Neurological manifestations, Skin rash and Myocarditis. A prolonged fever, which may reach 39-40oC, usually stays for 2-4 days and then gradually decreases to a normal level through the following 5-14 days. The fever is usually accompanied by severe headaches. However, in untreated patients, fever may last from 5 to 57 days. Pneumonia is mild in most cases being characterized by a dry cough, fever, and minimal respiratory distress.

Almost all patients suffering from acute Q fever pneumonia present with a fever usually associated with fatigue, chills, headaches, myalgia, and sweats. Myocarditis is a rare but life-threatening clinical manifestation of acute Q fever and it isfound in 2% of patients with the acute illness and it may be associated with pericarditis, and a pericardial effusion may be observed on chest radiographs. Clinical manifestations of Q fever pericarditis are not specific and most often correspond to a fever with thoracic pain [35]. Q fever hepatitis is usually only revealed by an increase in hepatic enzyme levels. Q fever hepatitis is usually accompanied clinically by fever and less frequently by abdominal pain (especially in the right hypochondrium), anorexia, nausea, vomiting, and diarrhea. Progressive jaundice and palpation of a mass in the right hypochondrium have also been reported. Extensive destruction of liver tissue leading to hepatic coma and death has occasionally been reported. Skin rashes and neurologic disorders such as meningoencephalitis or encephalitis, lymphocytic meningitis and peripheral neuropathy have also been observed in acute Q fever. Skin lesions have been found in 5–21% of Q fever patients in different series. The Q fever rash is nonspecific and may correspond to pink macular lesions or purpuric red papules of the trunk. There are 3 major neurological entities associated with Q fever: (1) meningoencephalitis or encephalitis; (2) lymphocytic meningitis and (3) peripheral neuropathy.

Spontaneous abortion, intrauterine fetal death, premature delivery or retarded intrauterine growth may occur in women that become infected during pregnancy. When a woman is infected by C. burnetii during pregnancy, the bacteria settle in the uterus and in the mammary glands [36]. Q fever endocarditis is the most frequent clinical presentation of chronic Q fever. It occurs almost exclusively in patients with a previous cardiac defect or in immune compromised patients. Unspecific signs like intermittent fever, cardiac failure, weakness, fatigue, weight loss or anorexia may be present. Other manifestations are osteomyelitis, osteoarthritis, chronic hepatitis, hepatomegaly, splenomegaly, digital clubbing, purpuric rash and an arterial embolism. The incubation period is depending on the size of the infectious doses, usually 2 to 3 weeks. Chronic Q fever can develop years after an initial infection [37].

Diagnosis, Differential Diagnosis and Treatment

1.1. Diagnosis

The clinical signs of Q fever are nonspecific both in human and animal because of this laboratory evidence of infection is needed for diagnosis. Four categories of diagnostic tests are available: isolation of the organism, which must be conducted in a biosafety-level 3 laboratory using tissue-culture; laboratory animals, or embryonated eggs; serologic tests, including indirect fluorescent antibody (IFA), enzyme immunoassay, and complement fixation test; antigen detection assays, including immunohistochemical staining (IHC); and nucleic acid detection assays, including polymerase chain reaction (PCR)assays [5]. Routine diagnosis of Q fever in animals is usually established by examination of fixed impressions or smears prepared from the placenta stained by the Stamp, Gimenez or Machiavello methods, associated with serological tests [38].

1.2. Differential diagnosis

There is some disease that we appreciate the same sign with Q fever such as Salmonellosis, Brucellosis, Leptospirosis, Campylobacteriosis, Listeriosis, Elective Abortion, Influenza, and Rickettsial Infection. At initial stages, i.e., before pulmonary symptoms are present, influenza may be suspected. Listeriosis is called circling disease, affected animal circle in one direction only and show swallowing, fever, blindness and head pressings. There is necrosis of placenta which leads to abortion and the fetus may be macerated or delivered weak and moribund, paralysis and death follow in 2 to 3 weeks later. Listerial abortion occurs in late gestation. Brucella is life longer infection it causes in female animal abortion around seventh month of pregnancy and retention of placenta and metritis are common and in male it causes orchitis, epididymitis, synovitis and sterility. Salmonellosis has sign like fever, dehydration and foul-smelling diarrhea and cause abortion in the last two months of gestation. Leptospirosis is show sign like excessive salivation, muscular rigidity, conjunctivitis, hemoglobinuria, pallor of mucosa and jaundice. Leptospiral abortion occurs with or without placental degeneration and encephalitis, Abortion usually occurs 3-4 weeks later. Most affected animals are found dead, apparently from septicemia [32].

1.3. Treatment

Antibiotics can shorten the course of acute Q fever, and may reduce its severity. The recommended administrations for human acute Q fever are Doxycycline (100 mg daily for 14 days), Fluoroquinolones (200mg three times a day or Pefloxacin (400mg) for 14-21 days), Rifampin (1200mg per day for 21 day). For pregnant patient we use drug like Trimethoprim (320mg) and Sulfamethoxazole (1600mg) for >5 weeks. Doxycycline (100mg per day for 10-14 days) is suitable. Fluoroquinolones are considered to be a reliable alternative and have been supported for patients with Q fever meningoencephalitis, because they penetrate the cerebrospinal fluid. Cotrimoxazole and rifampin can be used in case of allergy to tetracyclines or contraindication). Erythromycin and other new macrolides such as clarithromycin and roxithromycin, could be considered a reasonable treatment for acute C. burnetii infection [39].

The recommended administration for human chronic Q fever is Doxycycline (100mg per day) and Hydroxychloroquine (600mg) for >18 months for adult, Trimethoprim and Sulfamethoxazole for >18 months for children. Doxycycline is the first choice of drug treatment for all adults and children in both acute and chronic case those have sever illines . Tetracyclines are recommended most often in non-pregnant patients, but other drugs are sometimes used such as Quinolones, and Trimethoprim/ sulfamethoxazole (“cotrimoxazole”). Cotrimoxazole is much employed in pregnant women to avoid side effects from other drugs. Treatment of chronic Q fever is more difficult because of this single antibiotic are not generally effective. Tetracyclines combined with hydroxychloroquine are traditionally used, typically for 18-24 months, but tetracyclines combined with quinolones have also been used successfully. The recommended treatment for ruminant(animal) is consist in administering two injection of oxytetracycline (20 mg per kg body weight) during the last month of gestation. This treatment does not completely suppress the abortions and shedding of C. burnetii at lambing.

Prevention and Control

To prevent and reduce the animal and environmental contamination, several actions can be proposed. When introducing a new animal into a Q fever free flocks, in order to avoid the spread of infection, specific care taken. An antibody investigation for Q fever should be performed in the flock of the seller and animals from seropositive flocks can only be introduced in seropositive or vaccinated flocks. C. burnetii can be reduced in the farm environment by regular cleaning and disinfection of animal facilities, with particular care of parturition areas, using 10% sodium hypochlorite. In the UK, Health Protection Agency guidelines mention the use of 2% formaldehyde, 1% Lysol, 5% hydrogen peroxide, 70% ethanol, or 5% chloroform for decontamination of surfaces. Pregnant animals must be kept in separate pens, placentas and aborted fetuses must be removed quickly and disposed under hygienic condition to avoid being ingested by dogs, cats or wildlife. Since parturition is critical for the transmission of the disease, in infected flocks, birth must take place in a specific location, which must be disinfected as well as every utensil used for delivery.

Appropriate tick control strategies and good hygiene practice can decrease environmental contamination. Infected fetal fluids and membranes, aborted fetuses and contaminated bedding should be incinerated or buried. In addition, manure must be treated with lime or calcium cyanide 0.4% before spreading on fields; this must be done in the absence of wind to avoid spreading of the microorganism faraway. The best methods available for prevention and control of Coxiellosis are antibiotic treatment and vaccination. In-feed addition of tetracycline or injectable oxytetracycline pre-partum has not been shown to prevent C. burnetii shedding in feces, milk and vaginal secretions [40].

Human-to-human transmission is extremely rare and Q fever is mainly an airborne disease, measures of prevention are aimed at avoiding the exposure of humans and particularly persons at risk, to animal and environmental contamination. At human level, prevention of exposure to animals or wearing gloves, boots, and masks during manipulation of animals. Pasteurization at 72 °C during 15 s, or sterilization of milk from infected flocks is regularly recommended even if the oral route is not the main one [41].

C. burnetii is able to survive for long periods in the environment and in wild animals. The only way to really prevent the disease in ruminants is to vaccinate uninfected flocks, with an efficient vaccine. Three types of vaccine have been proposed for providing human protection against Q fever: the attenuated live vaccine (produced and trialled in Russia but subsequently abandoned because of concern about its safety); chloroform–methanol residue extracted vaccine or other extracted vaccines (trialled in animals but not humans); and the whole-cell formalin-inactivated vaccine, which is considered acceptably safe for humans [40]. Vaccines can prevent abortion in animals, and it is evident that a phase I vaccine must be used to control the disease and to reduce environmental contamination and thus, the risk of transmission to humans. The widespread application of such a vaccine in cattle in Slovakia in the 1970s and 1980s significantly reduced the occurrence of Q fever in that country [42].

Public Health Importance of Q Fever

Q fever is a global public health concern, as is reported from more than 59 countries of the world [43]. Human infections occur after inhalation of aerosols generated from contaminated dust resulting from contaminated manure and desiccation of infected placenta.

The existence of C. burnetii in the environment allows it to be disseminated by wind far away from its original source. This indicates the appearance of Q fever cases in urban areas, where an important percentage of patients fail to report direct contact with animals [44]. Apparently without animal contact, birds can also be responsible for human cases in urban areas since they are able to transmit Q fever via their feces or their ectoparasites [45].

C. burnetii receivedas a Category-B, biological terrorism agent. The attention of public health personnel and medical on Q fever, which could be responsible for the apparent increase of Q fever cases and its apparent reemergence, has been focused. Less efficient route of contamination is ingestion of contaminated raw milk or raw milk products. Without clinical signs, seroconversions in human volunteers have been induced by drinking of contaminated milk, but none of them presented aggravating risk factors. Nevertheless, some studies have reported clinical disease linked to the ingestion of cheese; but these outcomes are sometimes contested since it is difficult to guarantee even for prisoners that the patients did not inhale contaminated dust or aerosols [46].

It is highly infectious for risky groups including veterinarians, laboratory workers, farmers and abattoir workers. Surveys have shown that significant numbers of livestock handlers have antibodies indicating exposure to the organism. Less than half of people infected become ill, and most infections are mild. But affected persons can develop a high fever with headache, muscle pains, sore throat nausea and vomiting, chest and stomach pains. The fever can last for one or two weeks, and lead to pneumonia or affect the liver. People with suppressed immune systems and those with pre-existing heart valve problems are at risk of this complication, which is often fatal. There is also a post Q fever syndrome of chronic fatigue. Q fever is the second most commonly reported laboratory infection with several recorded outbreaks involving 15 or more persons [47].

Status of Q Fever in Ethiopia

In Ethiopia, the existence of antibody against Coxiella burnetii was reported in goats and sheep slaughtered at Addis Ababa abattoir, and its peri-urban zone. A seroprevalence of 6.5% was also reported in Addis Ababa abattoir workers according to [48]. A seroprevalence of 31.6%, 90%, and 54.2% of C. burnetii was recorded in cattle, camels and goats respectively in South Eastern Ethiopian pastoral zones of the Somali and Oromia regional states as reported by Abebe [49]. Ticks were tested for C. burnetii in Ethiopia by quantitative real time polymerase chain reaction targeting two different genes followed by multispacer sequence typing (MST).

An overall prevalence of 6.4% of C. burnetii was recorded. C. burnetii was detected in 28.6% of Amblyomma gemma, 25% of Rhipicephalus pulchellus, 7.1% of Hyalomma marginatum rufipes, 3.2% of Amblyomma variegatum, 3.1% of Amblyomma cohaerens, 1.6% of Rhihipicephalus praetextatus, and 0.6% of Rhipicephalus (Boophilus) decoloratus. Significantly higher overall frequencies of C. burnetii DNA were observed in Amblyomma gemma and Rhihipicephalus pulchellusthan in other tick species as reviewed by Tagesu.

Abortion is one of the most important reproductive health problems of dairy cows in Ethiopia in terms of economic impact. Both infectious and non-infectious agents may cause abortion in cattle. Q fever is one of infectious disease which cause abortion in Ethiopia [50].

Conclusion and Recommendation

Q fever is airborne disease caused by obligate intracellular bacteria of the genus Coxella. It affects both human and animal in the worldwide except New Zealand. It is the second most commonly reported laboratory infection. It is a serious zoonotic disease which affects both human and animal. In Ethiopia it has been reported by causing abortion in dairy cattle and the existence of antibody in sheep and goat. The main source of infection is contaminated dust with birth fluid, faces, urine, and milk and tick. The reservoirs of human infections are farm animals such as cattle, goats, sheep, and Pets, including cats, rabbits, and dogs, have also been demonstrated to be potential sources of urban outbreaks of disease C. burnetii is transmitted through inhalation and sometimes also transmitted through ingestion. C. burnetii is highly resistant to physical conditions and chemical agents, so it can survive for months and even years in the environment. Q fever is diagnosed by serological test. Tetracycline is recommended drug in the treatment of Q fever. It can be controlled by controlling tick by using insecticide. The prevention of Q fever is done by burning contaminated bedding and good hygiene practice.

Therefore, based on the above conclusion the following recommendations are forwarded:

a) Public awareness should be created in consumption of dairy products

b) Public awareness should be created in proper handling and disposing of aborted birth products.

c) Government should wide and the availability and accessibility of effective diagnostic techniques.

d) Government should vaccinate animals were found in endemic area.

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The Law Around Creating Your Own Vaccine

By Madeline Trost, Florida State University Class of 2020

July 9, 2020

Since the beginning of the pandemic, scientists have been racing to create a vaccine. Scientists around the world are working to find a solution and have turned to biohackers for help[1]. Biohackers are individuals or communities that conduct their own scientific experiments on their own bodies[2]. Some do not have formal scientific training and most do not operate within a formal scientific research team. Biohacking is controversial, with most of the debate coming from bioethics. Because biohackers do not have to follow federal guidelines for building vaccines, there are questions on how the trials for potential vaccines will be conducted[3].

The independent study biohacking provides allows citizens who do not have a strict scientific background, or do not have the opportunity to receive institutionalized scientific training, to participate in scientific study. These individuals, and the biohacking communities they are part of, could bring ideas and possible solutions to finding a vaccine for COVID-19 and future pandemics[1]. New methods and ideas are being explored, such as a plasma vaccine or a genetic vaccine[4]. This vaccine uses the virus’s DNA to build an immune response instead of injecting an inactive, or ‘dead’, version of the virus to build immunity. This type of solution prevents direct handling of the virus and possible contamination[4]. Some biohackers are also injecting themselves with this vaccine, using their own bodies as test subjects rather than going through the required trial periods a vaccine normally goes through.

Because biohackers do not have to follow federal regulations, there are many concerns about biohacking groups. Bioterrorism is an increasing concern for citizens and the federal government, giving incentive to heavily regulate the independent biohacker community[5]. The lack of enforceable ethics and environmental policies opens the possibility that public health and the environment is harmed. While these are serious concerns, the FBI has not strictly enforced regulations but rather has engaged with communities to ensure public health is maintained[4]. The federal government working with these communities indicates that they are more of a benefit to have for the scientific community, something that is becoming prevalent with the ongoing pandemic. Also, lawmakers that want to address biohacking are more concerned with genetic hacking, hoping to discourage people wanting to change their own genes, or someone else’s. California passed a law in 2019 stating all genetic modification kits, called CRISPR, were to put a warning label on the package saying the product was not for self-administration[6]. But this law was proven ineffective as the Food and Drug Administration regulates the sale of any medical product and people buying the CRISPR kits are intending to use it on themselves.

In 1902, Congress passed the Biologics Control Act after several cities experienced vaccine contamination[7]. This act began the federal control of the quality of drugs and vaccines. Then in 1944, the Unites States Public Services Act created licenses for drugs and vaccine production and sale, limiting who could create and sell these products to increase safety for the public[7]. Organizations such as pharmaceutical companies and research teams were then supervised and regulated further with oversight from the Food and Drug Administration. These laws and regulations include multiple trial periods for vaccines and possible approval from the FDA for production and sale.

These regulations have made it harder for vaccines to get approval. One group, called CoroHope, is using bitcoin to fund research for a coronavirus vaccine[4,8]. They site the FDA regulations and the global hesitancy for this pandemic as being a hindrance to finding a vaccine[8]. A spokesperson for CoroHope says “FDA-compliant manufacturing is absurdly overregulated: paperwork for the paperwork, quadruple-checking, endless committees … just the worst of bureaucracy. So, we can be more nimble.”[8] Every person working with CoroHope is kept anonymous for liability reasons.

Even with a group like CoroHope, the lack of bioethics is concerning[8]. If things go wrong and their testing of the vaccine has adverse effects, there is no accountability. They are relying on the community for animal and human trial testing after they have created a possible vaccine[8]. But there are overwhelming benefits to allowing this organization to continue. Nancy E. Kass, a professor of bioethics and public health at John Hopkins University states that she “has no concerns with someone trying to develop something in a novel way.”[8] Since Socrates and Aristotle, science has been about independent study and exploring curiosities[3]. With as many people working on a vaccine as possible, the chances of a vaccine being successfully created and passing trials is increased.

________________________________________________________________

[1] Paul, Kari. “Biohackers team up online to help develop coronavirus solutions” The Guardian, 18 March, 2020, https://www.theguardian.com/world/2020/mar/18/biohacking-online-forums-coronavirus-vaccines-testing

[2] Michels, Spencer. “What is biohacking and why should we care?” PBS, 23 September, 2014, https://www.pbs.org/newshour/science/biohacking-care

[3] Castelyn, Camille. “Oversight of biohacking when the stakes are high: Ethics police or FBI?” Voices in Bioethics, 26 March, 2020, http://www.voicesinbioethics.net/voices-in-bioethics/2020/3/26/oversight-of-biohacking-when-the-stakes-are-high-ethics-police-or-fbi

[4] “CoroNope is a coronavirus vaccine by biohackers.” Biohackinfo News, 12 March, 2020, https://biohackinfo.com/news-coronavirus-coronope-vaccine-diy-corohope-covid-19/

[5] Zettler, J. Patricia. “Regulating Genetic Biohacking.” NCBI, 5 July, 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004414/

[6] Gent, Edd. “California Passed the Country’s First Law to Prevent Genetic Biohacking.” Singularity Hub, 19 August, 2019, https://singularityhub.com/2019/08/19/california-passed-the-countrys-first-law-to-prevent-genetic-biohacking/

[7] Offit, Paul. “Vaccine Development, Testing, and Regulation.” The College of Physicians of Philadelphia, 17 January, 2018, https://www.historyofvaccines.org/content/articles/vaccine-development-testing-and-regulation

[8] Hertig, Alyssa. “Bitcoiners Are Biohacking a DIY Coronavirus Vaccine.” 12 March, 2020, https://www.coindesk.com/bitcoiners-are-biohacking-a-diy-coronavirus-vaccine

Photo Credit: Zuzanna K. Filutowska

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uncrcow · 8 years ago

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Q: How will the world end?

A Whodunnit of Cosmic Proportions

What is to be the ultimate fate of humanity? Might we be mastered by Martians, or will robots rule? Shall we suffer for our sins at the hands of the horsemen? Or be decimated by the dark lord in a Death Star blast? Methodology aside, one inevitable truth remains…

PSA: The world is going to end.

How? Let’s explore the possibilities:

Some say the world will end in fire…

1. SOLAR STORMS

In 1989, a Coronal Mass Ejection (CME) erupted from the sun, causing geomagnetic storms on Earth which triggered dangerous electrical currents, leaving 6 million Canadians without power. The Carrington Event of 1859 was TEN TIMES more intense. Another CME of that magnitude could leave entire continents in the dark, inciting widespread panic and chaos. But our sun isn’t the only star which poses a danger.

2. GAMMA RAY BURST

A nearby explosion of electromagnetic radiation from a hypernova or a pair of neutron stars could damage to the earth’s ozone layer, leaving mankind vulnerable to the sun’s ultraviolet radiation. That is, if we don’t deplete it on our own.

3. GLOBAL WARMING

It’s getting hot in here. An increase of more than 2° Celsius would lead to catastrophic global consequences, even mass extinctions. Experts predict that as a result of the greenhouse effect and continued burning of fuels and waste at the current rate, global temperatures will rise at least 2°C by the end of the century.

4. THE RED GIANT

If all else fails, the sun will exhaust its supply of hydrogen in 5-6 billion years and slowly expand to 256 times its current size, engulfing any planet in its wake. Long before it dies (in approximately 7.72 billion years) it will incinerate (what’s left of) Earth.

Some say in ice…

5. COSMIC COLLISION

The dinosaurs were obliterated 65 million years ago when a 10-kilometer rock fell on Mexico. But an asteroid or comet of even 1/10th that size could cast the earth into an “impact winter,” blocking out the sun for months on end and effecting mass starvation.

6. SUPERVOLCANIC ERUPTION

It is theorized that the eruption of Mount Toba in Indonesia over 70,000 years ago nearly wiped us out. There are about twenty such supervolcanoes spread across the planet, the closest residing in Yellowstone National Park. Another eruption of such magnitude could plunge humanity into decades of famine induced by the resulting “volcanic winter.”

7. NUCLEAR WAR

In the event of mutually assured destruction, (provided the bombs don’t kill us all) the resulting ash and dust may be enough to block out the light of the sun, effecting a “nuclear winter.”

…but any number of disasters will suffice.

Other potential catalysts for global annihilation include:

Overpopulation and global poverty

Bioterrorism via bioengineered pandemic

Malevolent or self-replicating artificial intelligence

Being eaten by a rogue supermassive black hole

Alien invasion/intergalactic warfare

Zombie apocalypse

The Rapture

The End…?

One way or another, WE’RE ALL GOING TO DIE.

So live your best life today, because the world could end at any mo—

Resources:

Choi, C. Q. (2014, December 08). Did Deadly Gamma-Ray Burst Cause a Mass Extinction on Earth? Retrieved September 15, 2017, from https://www.livescience.com/49040-gamma-ray-burst-mass-extinction.html

Dinosaur Extinction Information and Facts. (2017, March 02). Retrieved September 15, 2017, from http://www.nationalgeographic.com/science/prehistoric-world/dinosaur-extinction/

Institute of Physics. The end of the world? (n.d.). Retrieved September 15, 2017, from http://www.iop.org/resources/topic/archive/end-of-the-world/index.html

Klein, C. (2012, March 14). A Perfect Solar Superstorm: The 1859 Carrington Event. Retrieved September 15, 2017, from http://www.history.com/news/a-perfect-solar-superstorm-the-1859-carrington-event

Krulwich, R. (2012, October 22). How Human Beings Almost Vanished From Earth In 70,000 B.C. Retrieved September 15, 2017, from http://www.npr.org/sections/krulwich/2012/10/22/163397584/how-human-beings-almost-vanished-from-earth-in-70-000-b-c

Rosen, J. (2017, July 26). Here's how the world could end-and what we can do about it. Retrieved September 15, 2017, from http://www.sciencemag.org/news/2016/07/here-s-how-world-could-end-and-what-we-can-do-about-it

Strickland, A. (2017, July 31). Earth to warm 2 degrees Celsius by the end of this century, studies say. Retrieved September 15, 2017, from http://www.cnn.com/2017/07/31/health/climate-change-two-degrees-studies/index.html

Image Resources:

Cataclysm [Digital image]. (n.d.). Retrieved from https://me.me/i/8120748

Star Wars GIF [Digital image]. (n.d.). Retrieved from https://giphy.com/gifs/star-wars-doom-c3po-UQYtr98lNNrWw

Winter is coming [Digital image]. (n.d.). Retrieved from https://imgflip.com/i/qr1cz

WTF GIF [Digital image]. (n.d.). Retrieved from https://giphy.com/gifs/burning-dr-steve-brule-4TMqcN59kg3Yc

Written by Tabitha Frahm

#UNC Chapel Hill #UNCLibraries #uncRCOW #ask a librarian #end of the world #star wars #cats #game of thrones #Jon Snow #fire #winter #astronomy #solar storms #volcanos #extinction #university of north carolina #chapel hill #carolina

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rohinic123-blog · 5 years ago

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Clinical Laboratory Services Market: Business Overview and Global Development Trends

The presence of large numbers of global players and regional participants vying against one another for strong foothold makes the global clinical laboratory services market increasingly fragmented, finds Transparency Market Research (TMR). Several of these are focusing on bringing advancement in laboratory technologies, mainly by including advanced automation features. TMR notes that a growing number of providers in the global clinical laboratory services strive to offer better services to meet the current variety of end-user needs. Top players intend to get a competitive edge over their rivals by providing clinical laboratory services that can diagnose emerging threats of disease strains. Moreover, focus on capacity addition may be an integral part of robust strategy for players in the global clinical laboratory services market.

Well-entrenched players in the global clinical laboratory services market include Sonic Healthcare, Eurofins Scientific, Laboratory Corporation of America Holdings, Fresenius Medical Care, and NeoGenomics Laboratories Inc.

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The global clinical laboratory services market was worth at a whopping US$208.0 bn in 2016. Expanding at a CAGR of more than 6.0% during 2017–2025, the opportunities in the global clinical laboratory services market are forecast to reach US$361.3 bn by the end of this period

Of the various types of tests offered, clinical chemistry presently holds the leading share in the global clinical laboratory services market. The segment is anticipated to clock a CAGR of over 6% during 2017–2025. The growth is fueled by rapid advancements in analytical techniques such as mass spectrometry and flow cytometry.

Regionally, North America is presently dominant revenue contributor and is projected to garner an impressive CAGR during the assessment period. The growth is propelled by rising public and private investments in laboratory infrastructures in the region.

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Rising Incidence of Infectious and Chronic Diseases propels Clinical Laboratory Services Market

The global clinical laboratory services market is driven by the rising worldwide demand for better diagnostics for a variety of disease types, in order to guide therapeutic decisions for better healthcare outcomes. In various developing and developed nations, the rising demand for cutting-edge diagnostics for infectious and chronic diseases is bolster the growth in the clinical laboratory services market. These disease have grown in prevalence in numerous developing economies over the past few years. Moreover, the rising incidence of lifestyle-driven diseases in various parts of the world is propelling advances in the global clinical laboratory services market.

In recent years, private laboratories have expanded their footprints, especially in developing countries, which has imparted a marked impetus to the market’s growth. To this end, even governments have increased their spending on laboratory infrastructure.

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The global clinical laboratory services market is witnessing new avenues by technological advances in lab testing. These advances notably pertain to the adoption of high-throughput assays. In addition, providers of clinical laboratory services are also developing customized assays to explore new streams of revenues in the market.

Application of High-Throughput Assays in Drug Development Programs opens New Avenues

Having said that, the global clinical laboratory services market also faces some setback. The unmet need of improved diagnostic devices in laboratories and the overall lack of clinical expertise in still developing nations hamper prospects.

On the other hand, emerging threat of bioterrorism in global healthcare systems is a notable trend creating new, exciting opportunities in the global clinical laboratory services market. Moreover, clinical laboratory infrastructures in various developing regions are witnessing the wave of modernization. The rising awareness about the timely diagnosis of diseases, especially in a rapidly aging population, imparts a momentum to the demand for various clinical laboratory services. The growing application of high-throughput assays in drug development programs expands the potential of the global clinical laboratory services market.

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marymosley · 5 years ago

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Microbial Forensics: A Tool Used in Forensic Investigation

Microbial Forensics is defined as a scientific method used for analyzing evidence from a Bioterrorism Act, Bio crime or inadvertent microorganism or toxin release for attribution process. The main aim is to identify the person who has committed the bio crime and was it intentionally or by mistake [1]. Microbial forensics is a combination of knowledge of other fields like classical microbiology, microbial genomics, phylogenetics, and bioinformatics. This field of forensic science is in the developing stage and faces some scientific challenges to properly identify the threat and which is a causative agent. This unlawful use of biological agents is considered harmful to individuals, the environment, the economies of nations, and global peace.[2]

Pathogens and toxins are converted into bioweapons and used for bioterrorism. The use of pathogens and toxins is done because they are the smallest creatures that cannot be detected easily. They attack more populations in less time and the cure or medication is hard to find. The pathogens can multiply very rapidly within a few mins and which can cause great harm [3]. The microbial investigation is the same as a forensic investigation like crime scene investigation, maintaining chain of custody, gathering of evidence, handling, preservation ad collection of evidence for analyzing them. The additional thing is the identification of the pathogen by the use of strains to find the family in which it belongs. There are many groups that have made lists of pathogens that can be used for bioterrorism. Microorganism relevant to food and water is also considered. Computer-based networks should be established to track the outbreak of infectious microorganisms in real-time. After the biological pathogen is identified various types of methods are used for identifying the microorganism and to study the details of the organisms to stop it from spreading [4].

Scientific Working Group on Microbial Genetics and Forensics (SWGMGF) the newly formed group hosted by FBI known as SWGMGF and has membership drawn from other federal agencies. The group brings all other expert individuals and organizations to use their knowledge for solving the challenges related to bioterrorism and bio crime. The goals are to provide the guidelines and rules so that the physical evidence can be collected and information can be obtained about the organism or toxin, the persons involved, the places, the processes, the instrumentation, and/or the time of the criminal act. The primary focus of this program is quality assurance.

The missions of SWGMGF are:

(1) define criteria for the development and validation of forensic methods which will help in finding biological toxins and microbial agents.

(2) define the need and criteria of forensic infrastructure and capabilities to support the investigation. [5]

TOOLS USED IN MICROBIAL FORENSIC

A small group of individuals gets killed by biological agent and biological agents are used for bio-crimes. While investigating bio-crime, epidemiology, and forensics play analogous roles. After knowing the cause of bio-crime forensic scientist proceeds for a further forensic investigation which includes Chain of custody of the evidence and detail analysis of the pathogen which is used as bioweapon and strain or substrain of the organism which caused the drastic impact on society. Evidence collection protocols include collection and preservation, challenging samples encountered such soil, mud, swamp water. National Bioforensic Analysis Centre (NBFAC) in partnership with the Federal Bureau of India provides a central laboratory for analysis of microbial forensic evidence. DNA typing methodology is considered extremely important in the imputation of the pathogenic weapon. The first step is the extraction. The extraction procedures that are considered to be more challenging as they are not adequate for a more challenging environment sample. The recovery rate efficiency is low and PCR inhibitors may not remove effectively when the DNA extraction is done. There are various biological tools and biomarkers to assist analysis which include:

– Sequencing

– Microarray analysis

– Pathogenicity array analysis

– Single Nucleotide Polymorphisms (SNP) characterization

– 16S rRNA sequencing

– Variable number of tandem repeats

– Antibiotic Resistance Gene characterization

For the determination of the severity of pathogenicity and for better resolution of strain or substrain of pathogen assay needs to be developed.

The microbial forensic toxin may be characterized by:

– Immunoassays

– Biofunctional assay

– Peptide or protein-based assay

– Mass spectrometry

According to a report by the American Academy of Microbiology, the traditional physical evidence described they are not based on DNA but consider for microbial forensic. They include:

1. The physical characteristic such as morphology and microstructure of microorganism which are used for attribution and weaponization.

2.Isotope analysis used for determinations of age and origin of microorganisms.

3. Identification of microorganisms can be done by traditional physiologic methods using fatty acid composition, phage typing, serotyping.

4. The sign to origin to the weapon or technique used to prepare material from the residue of growth media attach to the microorganisms.

5. Stabilizer and additives are used in the preparation of samples which may be critical that can guide about criminals.

6. Location and time of year the sample was prepared can be identified by using incidental bio-contaminants such as environmental pollen and fungi which play a crucial role.

7. The occurrence of strains of Bacteria founded at one place or hardly at another place to geolocate the place of preparation detection of the subsidiary bacteria synchronized in a weaponized sample.

8. IgM and IgG immunological reactions to determinants show recent disclosure to microorganisms.

9. Rapid detection methods such as immunoassays are especially applicable to field-deployable assay. It is important to consider other tools besides solely DNA – based assay [5].

CASE STUDIES

CASE STUDY 1:

The case study is regarding an anthrax epidemic. In April 1979, in a military compound, Sverdlovsk, Russia, an explosion occurred. After a few days after the explosion, the residents and people working in the radius of 4km developed a high fever and had breathing difficulty. The medical doctors identified it as an outbreak of pulmonary anthrax. Death of 200 people occurred. The Government Officials declared that the outbreak was due to the consumption of meat. A doubt raised when the symptoms of gastric and skin anthrax caused by the consumption of beef were absent in the people infected. And on further investigation, it was found that cattle near about 50km Southeast also died of anthrax. Autopsies of people who died were performed and they revealed the cause of death to be severe pulmonary edema and toxemia. DNA analysis done revealed that there was more than one strain of anthrax and it could not be possible if they were infected from the consumption of beef. Then on further investigation, it was found out that the cause of the disease was due to an accidental outbreak of a compound from the Russian bioweapon facility. [5]

CASE STUDY 2:

The next case study is regarding the source identification of HIV. In the late 1980s, a lot of people from Florida were identified to be infected from HIV even though their histories never indicated those types of lifestyles. An epidemiological investigation then gave a lead regarding the transmittance from a dentist with AIDS. The dentist was first diagnosed with HIV in 1986. For confirming that the dentist was the reason behind the transmittance bioinformatics/phylogenetics were employed. DNA sequence data were collected from the lymphocytes of the patients, the dentist, a local control group(to find out if there is any other reason), and an outgroup was compared. The analysis showed that the HIV nucleotide sequence was closely related to the sequence of a dentist rather than patients of the controlled groups. On the basis of the phylogenetic comparison, it was identifiable that sequences that are more similar were more closely related and have a few common ancestral sequences. [5]

REFERENCES

1. Microbial Forensics: A New Forensic Discipline Jain S. Kumar A, Gupta Prasad R 0971- 0973.

2. Introduction: What is microbial forensic and Why is it important. Roadmap C, Sciences B, Studies D, Council N 2014.

3. Budowle B, Murch R, Chakraborty R. Microbial forensics: the next forensic challenge. Int J Legal Med. 2005;119(6):317-330. DOI:10.1007/s00414-005-0535-y.

4. Microbial Forensic: a Scientific assessment Keim, Paul 2003 OSTI 808025.

5. Microbial Forensic Budowle B, Wilson M, Burans J, Breeze R Microbial Forensic: Not Just a Health Matter Anymore 2005, Doi – 10.1016/B978-0-12-088483-4.50004-4.

Author

Nikhil V. Rathod

Intern, Department of Forensic Science & Criminal Investigation, Legal Desire Media & Insights

Nikhil Vijay Rathod is pursuing a Master’s degree in Forensic Science. He has an interest in Forensic Biology and Serology and DNA fingerprinting. He has knowledge of various instruments such as a microscope, UV-visible spectroscopy, VSC 6000, HPLC, FT-IR, etc.

The post Microbial Forensics: A Tool Used in Forensic Investigation appeared first on Legal Desire.

Microbial Forensics: A Tool Used in Forensic Investigation published first on https://immigrationlawyerto.tumblr.com/

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berniesandersniece · 5 years ago

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Climate Change: Next Steps

Olivia Johnson

1The Human Planet: How we Created the Anthroposcene

The conversation on climate change is often dominated by the latest technologies, products, and methods created to combat the degradation and destruction human activities are inflicting upon our earth. While these are certainly necessary in cleaning up the mess we have caused with our unsustainable actions, there is a much more difficult conversation that needs to be had. Ultimately, our philosophy of the earth and how we see ourselves in relation to nature determines if we will truly be able to prevent our species and many others from impending doom. An adequate, lasting solution to climate change and other environmental problems requires a change of lifestyle and mindset, a challenge which, although necessary, is certainly not an easy goal to accomplish. Simon L. Lewis and Mark A. Maslin’s work The Human Planet: How we Created the Anthropocene discusses these complex tasks for humanity, and offers equally as complex solutions. Chapter 11, “Can Homo dominatus become Wise?” examines how climate change could lead to a mass collapse of societies, our current efforts to prevent this, and what changes are required by humanity in order to address this. The authors argue that what is ultimately needed is a complete restructuring of social systems worldwide. They state, “It is under this scenario that it is possible to envisage a near-future network of civilizations developing that is considered thoughtful and wise in our relations to each other and our home planet.”2 One factor that is currently preventing this is capitalism; while it does have its strengths and has led to a decrease in poverty and increase in human lifespan, capitalism has also created extreme inequality, alienation, and an unhealthy focus on competition instead of cooperation. Capitalism has arguably imposed socially and environmentally destructive effects on the entire planet, and there it is necessary that people acknowledge this if we are going to successfully curb our deadly impact on the earth. While humanity also faces threats of nuclear war and bioterrorism, the authors state, “...the central, pressing, existential threat to human civilization results from a core contradiction in today’s mode of living: it is powered by energy sources that are undermining the ability of today’s globally integrated network of cultures to persist.”3 It is quite alarming to consider the breakdown of society by its own hands, and even more terrifying to see global leaders and the general public fail to acknowledge just how devastating the effects of climate change will be.

The current efforts to combat climate change are largely based on the Paris Agreement, which set a goal to limit global warming “well below” 2°C and “pursue efforts” to limit warming to 1.5°C; however, there are not clear penalties for violating the pledge, and even if it was fully implemented, it would not be enough to stop emission from rising. The global fossil fuel industry is an extremely lucrative business, and the United States alone pours $5 trillion into the market annually in subsidies. As many more-developed countries are making sincere efforts to curb their emissions and even reduce them to net zero, many less-developed countries do not have the infrastructure to do this, and also see this as an obstacle to building a stable economy. This of course is not because these nations do not feel a need to address climate change, but because they have been suppressed for so long by more-developed nations while the latter has polluted the earth at an ungodly rate. Equality is something that must be addressed while combating climate change; it would be extremely unfair for more-developed countries to impose these same conditions on less-developed after they essentially got rich from plunder the rest of the world and using up most of the world’s global carbon budget. A third of carbon dioxide currently in the atmosphere came from the United States alone. To address this, the authors state, “The West therefore owes the rest for its historical debt, and has a clear obligation to pay for the future damage that its emissions will cause.”4 A failure to accept this and deal with the consequences is one of the basic problems that has slowed climate talks for over two decades.

The ravenous cycle of consumer capitalism must be slowed. Lewis and Maslin state, “Growth matters. This is the path, which at some stage, ensures environmental breakdown as an ever greater fraction of humanity follow it with vigour. Could this cycle end before it is too late?” 5There is a need for change in the current standard mode of living for nations consuming unsustainably. Human needs must take priority over the greatest financial profit on investments, something much easier said than done. However, the authors remind their audience that there is hope; the fossil fuel market is proving to be a bad long-term investment, a large scale implementation of clean energy sources is quickly becoming viable, and some countries have made sincere efforts with already promising results. Lewis and Maslin propose two critical and complex ideas that could hold possible solutions to climate change. The first concerns how the need to sell our labor produces a dependency relationship, and results in inequality and sometimes outright abuse. To reduce and even eliminate this, they argue, people should receive a Universal Basic Income, a financial payment to every citizen without an obligation to work, which would result in increased autonomy and reduced consumption and environmental impacts. The second big idea is Half-Earth rewilding; originally proposed by biologist E. O. Wilson, this would allocate half the Earth’s surface primarily for the benefit of other species, while letting humans have the other half. The authors state, “Radical changes in society tend to change our views on nature, aesthetics, and our relationship with the natural world.”6 If these changes are implemented, the society that could potentially result from these changes could establish a beautiful relationship with nature and each other.

A concept I found particularly interesting in this chapter was Lewis and Maslin’s connection between climate change and other social injustices. A change in how we treat our environment would mean, they state, “...to see and deal with the domination of men over women, old over young, one class over another, and of people over the rest of nature, which may as well all be linked.”7 In our capitalistic society, our current view of our relationship was largely formed during the Industrial Revolution, which exacerbated racism, sexism, inequality, and abuses to our environment. This explains why injustices, such as the construction of the Dakota Access Pipeline that seriously threatens the Standing Rock Sioux and the Flint Water Crisis that has seriously harmed communities of color, continue to happen. Profit trumps people, and this facet of capitalism is largely why environmental degradation has continued to occur despite concrete scientific evidence that it will harm us. In order to address climate change, we must address how we treat each other, and how our unsustainable actions are not only detrimental to the earth, but to many vulnerable populations throughout the world that are suffering as a result of our selfishness. Although our society is seriously ill, I am hopeful that change will continue to happen if the efforts of grassroots campaigns and other individuals who continue to fight are seen and heard.

Question: The Industrial Revolution led to the period of Romanticism; what social movement will come out of this time, or already is being developed?

Words: 1236

1Lewis, Simon, and Mark Maslin. The Human Planet: How We Created the Anthropocene: a Pelican Book. London: Pelican, 2018.

2Lewis, 371.

3Lewis, 378.

4Lewis, 389.

5Lewis, 399.

6Lewis, 410

7Lewis, 404.

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denialisnotpolicy · 5 years ago

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Let’s Talk about the Future: The Anthropocene & Transformation

In The Human Planet: How We Created the Anthropocene, authors Lewis and Maslin begin their discussion of whether or not “Homo dominatus [can] become wise” by speculating on the three possible futures of the world: “continued development of the consumer capitalist mode of living towards greater complexity; a collapse; or a new mode of living” [1]. The first is essentially continuing life as usual, while successfully using innovation and technology to avoid a collapse or switch to a new mode of living. The second entails a global collapse taking place as environmental degradation catches up to us. The final outcome sees civilization adapting to a new mode of living, something drastically different from our current way of life, as suggested by the previous modes of living: the hunter-gatherer, agricultural, mercantile, industrial, and consumer capitalist. Currently, our capitalist mode engages in two main feedback loops. We solve problems using the scientific method and invest profits into the production of more profits. While these positive feedback loops can be applauded for things like decreasing poverty and increasing lifespans, they can also be criticized for causing environmental degradation, extreme inequality, and uncooperative, competitive communities.

Lewis and Maslin argue that the second and third options are not as far off as we may think. However, “energy availability, information flows and our collective human agency are increasing at ever faster rates,” they say, pointing to the transformations of the generation and processing of information, the increasing human demand for energy, and the increasing population size growth and interconnectedness [2]. All of these factors demonstrate how transformations now will not take as long as they have in the past, because with each transformation the world changes so drastically it is no longer under the same set of conditions to accurately be compared to itself. While this could point to a new mode of living, it also raises the possibility of collapse, since exponential trends cannot continue infinitely on a finite planet.

When investigating the possibility of collapse, a general conclusion we can draw is that “the greater the power humans have, the greater the opportunity for such power to be used for the most damaging of ends” [3]. While an Anthropocene collapse could happen, that is, one caused by human-related environmental change, a human-caused technological collapse is also a possibility. Threats such as nuclear warfare and bioterrorism are growing. The biggest threat we face is climate change, which emerges from the fact that “[today’s mode of living] is powered by energy sources that are undermining the ability of today’s globally integrated network of cultures to persist” [4]. A study found that economic growth, population, and other factors showed steady increases between 1970 and 2000, yet the environmental effects of those increases put a strain on the system in the early twenty-first century that eventually led to collapse by mid-century.

To assess the rate and magnitude of climate change, the book examines cumulative emissions of carbon dioxide. The degree of warming deemed acceptable differs country-to-country, and even between politicians within a country. Generally, limits between 1.5 and 2°C are acceptable. However, for small island states, any warming is troubling due to the threat of rising sea levels. Because the rise in temperature does not directly correlate to cumulative carbon emissions, we are left to guess exactly what level of global carbon emissions is okay. To have even an okay chance at not exceeding the 1.5-2°C limit, greenhouse gas emissions need to decrease drastically, nearing zero by 2050. In order to do this, Lewis and Maslin point out an absolutely critical need: valuing the eradication of greenhouse gas emissions at the same level of importance as the pursuit of economic growth.

As discussed many times in previous blog posts, climate change is a direct outcome of our capitalistic-consumer mindset and tendencies, which value economic growth over just about any other factor, whether that be the environment or human quality of life. We’ve seen governments giving subsidies that directly harm the environment in order to boost economic growth. We’ve seen individuals sacrificing quality of life in order to please capitalistic governments in participating in competitive innovation-centered markets. And we’ve seen how this way of living is not sustainable in “The Impossible Hamster” graphic demonstration which taught us that infinite growth is not sustainable on a finite planet.

Our systems are plagued by greed for money and power that makes it difficult to conceive of this goal as possible. For example, “fossil fuel extraction and use is subsidized at a rate of about US$5 trillion a year … Tax breaks and financial transfers are hard to reduce because nineteen out of the top twenty-six oil and gas companies in the world are partly or fully nationalized” [5]. Since these companies make money for the governments that own them, they will continue to receive special treatment in an effort to compete with other nations. The interconnectedness between the economy, fossil fuel companies, and nations’ governments makes the necessary banning of fossil fuels an incredibly daunting task.

This raises another concern: the balance of economic power. The global economy is roughly split between North America, Europe, and Asia, meaning the West cannot solve climate change alone. It must be solved by global cooperation, planning, and action. As we’ve discussed in previous posts, affluent nations like the U.S. are wealthy because they exploited other nations and are responsible for at least a third of the extra carbon dioxide in the atmosphere. Less-developed nations are entirely less responsible for climate change, but experience more of the harmful effects of it. This leads to the Anthropocene conundrum: “how to equalize resource consumption across the world within sustainable limits” [6]. The UN Paris Agreement shows how we are tackling this issue, by expecting high-emitting countries to do more to reduce emissions, and providing income-poor countries with financial and technological assistance.

Some pathways to reduce emissions involve technologies like Bioenergy Carbon Capture and Storage (BECCS), which actively removes carbon dioxide from the atmosphere. This is an attractive method because it delays when we need to take action, perhaps giving us time to develop climate change-combatting technologies. While it makes sense in an economic model, as it shows that “a million dollars of impacts today, once discounted to 100 years in the future, amounts to just $6232 of damage” [7], it does not hold strong in an ethical sense. How we leave the Earth for future generations is a conversation of ethics.

Another important thing to consider is the realistic nature of economic growth. Lewis and Maslin point out that “a century from now the global economy is expected to have doubled four times over” [8]. In addition to the environmental effects of an economy sixteen times larger, is it possible for people to be sixteen times more productive at work? We cannot physically accomplish working a 128-hr week into a day. Neither the environment nor humans can cope with such growth.

To conclude their discussion, Lewis and Maslin explain two important ideas to further investigate dealing with the Anthropocene. The first is how we spend our time, and the second is that the Earth’s surface should be allocated half to humans and half to the other millions of living species on Earth. They advocate for a Universal Basic Income, Half-Earth rewilding, clean energy, Artificial Intelligence, and the Internet as helpful tools in the combat against climate change, but not the answer. An absolutely necessary factor is collective action of individuals in order to accomplish a redistribution of power and wealth. An environmentally sustainable future will also have greater equality, as the two go hand-in-hand.

Word Count: 1270

Question: Can the capitalistic-consumer mindset be transformed into something more sustainable, or does greed for money and power run too deep in humanity and human structures? Can a future mode of life only come about if our current capitalist mindset fails and causes collapse, or can the transition happen more smoothly?

[1] Lewis, Simon L., and Mark A. Maslin. “Chapter 11: Can Homo Dominatus Become Wise.” In The Human Planet: How We Created the Anthropocene, 369.

[2] Lewis, Simon and Mark Maslin, The Human Planet, 372.

[3] Lewis, Simon and Mark Maslin, The Human Planet, 378.

[4] Lewis, Simon and Mark Maslin, The Human Planet, 378.

[5] Lewis, Simon and Mark Maslin, The Human Planet, 383.

[6] Lewis, Simon and Mark Maslin, The Human Planet, 390.

[7] Lewis, Simon and Mark Maslin, The Human Planet, 398.

[8] Lewis, Simon and Mark Maslin, The Human Planet, 403.

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amisurjo83-blog · 5 years ago

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Abstract

Ebola virus disease (EVD), a fatal viral hemorrhagic illness, is due to infection with the Ebola virus of the Filoviridae family. The disease has evolved as a global public health menace due to a large immigrant population. Initially, the patients present with nonspecific influenza-like symptoms and eventually terminate into shock and multiorgan failure. There exists no specific treatment protocol for EVD and only supportive and symptomatic therapy is the line of treatment. This review article provides a detailed overview of the Ebola virus; it's clinical and oral manifestations, diagnostic aids, differential diagnosis, preventive aspects, and management protocol.

Keywords: Ebola virus, oral manifestations, public health menace, symptomatic therapy

Introduction

Ebola, earlier termed as Ebola hemorrhagic fever (EHF), is a critically lethal ailment which primarily affects the humans and nonhuman primates. Ebola virus disease (EVD) occurs due to a virus infection which belongs to the family Filoviridae and genus Ebolavirus.[1] EVDs has posed diagnostic challenges and has been a universal public health threat since its discovery. While investigating an alleged yellow fever case, Dr. Peter Piot in the year 1976 first detected the disease in Zaire, Africa (presently the Democratic Republic of Congo).[2] The name “Ebola” was termed as the disease was noticed near the Ebola river in Congo.[3]

Fruit bats of Pteropodidae family, such as Hypsignathus monstrous, Epomops franqueti, and Myonycteris torquata serve as the natural hosts of the EBOV in Africa. Nonhuman primates may develop the infection by eating the partly eaten fruits and may also transmit the infection to humans.[4] Indian population is an impending threat to EVD, as India falls in the home range of Pteropodidae family of fruit bats.[5]

Ebola virus transmission primarily takes place through close bodily contact with the infected patient or their fluids, contaminated tissue surfaces, and clothing from alive, infected or deceased individuals. Unsafe traditional burial practices also play a pivotal role in the disease transmission.[6] There is documented evidence regarding the sexual mode of disease transmission, although transmission through the air is unlikely.[7]

EVD present with bizarre and atypical manifestations mimicking other viral diseases, especially in the initial disease phase. Constitutional symptoms, such as fever, myalgia, headache, vomiting, and diarrhea are the early presenting features. Hemorrhagic rash, internal and external bleeding are usually the warning manifestations in the late stages.[8] Bleeding from the body apertures is a distinguishing EVD manifestation.[9] Gum bleeding, odynophagia, and atypical oral manifestations constitute the oral features of EVD.[10]

Till date, there is no precise antiviral management or vaccination for EVD. The management protocol mainly relies on supportive and symptomatic therapy, along with monitoring coagulopathies and multiorgan dysfunction.[2]

The World Health Organization (WHO) affirmed the EVD outbreak as a “Public Health Emergency of International Concern” on August 8th, 2014.[5]

With the enormous immigrant population, India is estimating the likelihood of a probable EVD outbreak. The Ministry of Health and Family Welfare, Government of India, in collaboration with other agencies has appraised the situation and recommended travel instructions by air, land, and sea and health care professionals.[11]

Taxonomy

The virus belongs to the Ebola virus genus, Filoviridae family, and Mononegavirales order.[12] The genus Ebolavirus includes the following species- Zaire ebolavirus (EBOV), Reston ebolavirus (RESTV), Bundibugyo ebolavirus (BDBV), Taï Forest ebolavirus (TAFV), Sudan ebolavirus (SUDV), and the newly identified Bombali ebolavirus (BOMV).[13] Except for exclusive identification of RESTV in the Philippines, all the other species causes endemic West African EVD.[14]

EBOV responsible for the EHF causes the highest human mortality (57%–90%), followed by SUDV (41%–65%) and Bundibugyo virus (40%). TAFV has caused only two nonlethal human infections to date, whereas RESTV causes asymptomatic human infections.[15]

Figure 1 shows the taxonomy of Ebola virus.

Figure 1

Taxonomy of Ebola virus

Transmission

Based on the Centers for Disease Control and Prevention (CDC) classification, Ebola virus is considered as a biosafety level 4 and category A bioterrorism pathogen with an immense likelihood for massive nationwide transmission.[16]

Source of Infection

Intimate physical contact with the patients in the acute disease stages and contact with the blood/fluids from the dead individuals constitutes the most important modes of transmission.[17]

The long-established funeral ceremonies in the African countries entail direct handling of the dead bodies, thus significantly contributing to the disease dissemination. Unsafe conventional burial procedures accounted for 68% infected cases in 2014 EVD outburst of Guinea.[18]

EBOV RNA may be identified for up to a month in rectal, conjunctival, and vaginal discharges and semen specimens may demonstrate the virus presence up to 3 months, thus signifying the presence of EBOV in recuperating patients.[14] The sexually transmitted case of EVD has been reported between a convalescent patient and close family member. Another study demonstrated a case in a recuperating male patient. The patient's semen specimen tested positive with Ebola viral antigen almost 3 months after the disease onset.[19]

Asymptomatic EBOV carriers are not infectious and do not have a major role play in the EVD outburst, and the field practice in Western Africa supported this assumption.[20] However, this presumption was refuted after the documentation of a pioneer asymptomatic carrier case in North Gabon epidemic (1996).[21]

EBOV has been detected from blood, saliva, semen, and breast milk, while RNA has been isolated from sweat, tears, stool, and on the skin, vaginal, and rectal swabs, thus highlighting that exposure to infected blood and bodily secretions constitute the major means of dissemination.[22]

Eating uncooked infected animal meat such as bats or chimpanzees account significantly to oral EVD transmission, especially in the African countries.[23] The demonstration of the Ebola virus in the Filipino pigs in 2008 triggered the likelihood of an extensive range of possible animal hosts.[24]

EVD dissemination has also been reported with hospital-acquired infections, particularly in areas with poor hygiene conditions. The infected needles usage was responsible for the 1976 EVD outbreak in Sudan and Zaire.[25,26] Improper hygiene and sterilization were the crucial factors for the 1967 Yambuku EVD outburst.[27]

EVD dissemination may also occur through the inanimate materials with infected body secretions (fomites).[19] However, disease transmission through the airborne and droplet infection is ambiguous.[10]

Figure 2 shows the primary and secondary transmission of disease.

Figure 2

Primary and secondary transmission

Table 1 depicts the possible routes of transmission.

Table 1

Possible routes of transmission

Epidemiology

The vast majority of EVD cases and outbursts have been endemic to African continent ever since the disease detection in 1976,[28] and 36 such outbreaks have occurred in six African countries.[29]

Table 2 shows Ebola epidemiological outbreaks between 1976 and 2014.

Table 2

Ebola outbreaks between 1976 and 2014 (Adapted from WHO 2014)

The 2014–2016 EVD started in South East Guinea rural surroundings and eventually became a global public health menace by rapidly disseminating to urban localities and other countries.[28]

Figure 3 depicts the geographical distribution of Ebola virus disease.

Figure 3

Geographic distribution of Ebola virus disease outbreaks

The conducive environmental surroundings of the African continent facilitate EVD endemicity. However, intermittent imported Ebola cases have also been noticed in United States, United Kingdom, Canada, Spain, and Thailand.[30,31]

Figure 4 depicts the distribution of Ebola virus disease in West African Countries.

Figure 4

Distribution of Ebola virus disease in West African Countries

Out of the unparalleled globally reported 28,616 cases and 11,310 casualties, Liberia accounted for almost 11,000 cases and over 4,800 deaths.[32]

Table 3 shows the statistics of the 2014–16 West African outbreak.

Table 3

Statistics of 2014-16 West African outbreak

Pathogenesis

Ebola viruses penetrate the human body through mucous membranes, skin lacerations/tear, close contact with infected patients/corpse, or by direct parental dissemination.[33] EBOV has a predilection to infect various cells of immune system (dendritic cells, monocytes, and macrophages), endothelial and epithelial cells, hepatocytes, and fibroblasts where it actively replicates by gene modulation and apoptosis and demonstrate significantly high viremia.[34] The virus reaches the regional lymph nodes causing lymphadenopathy and hematogenous spread to the liver and spleen promote an active inflammatory response.[35] Release of chemical mediators of inflammation (cytokines and chemokines) causes a dysregulated immune response by disrupting the vasculature system harmony, eventually causing disseminated intravascular coagulation and multiple organ dysfunction.[36]

Figure 5 demonstrates the pathogenesis of Ebola virus disease.

Figure 5

Pathogenesis of Ebola virus disease

Clinical Features

Due to the bizarre and atypical manifestations in the initial phase, mimicking dengue fever, typhoid fever, malaria, meningococcemia, and other bacterial infections, EVD poses diagnostic dilemmas.[37]

The incubation period ranges from 2 to 21 days. However, symptoms usually develop 8–11 days following infection.[38,39]

The initial disease phase is represented by constitutional symptoms.[40] High-grade fever of >38o C is the most frequently reported symptom (85–95%), followed by other vague symptoms such as general malaise (85–95%), headaches (52–74%), dysphagia, sore throat (56–58%), and dry cough.[41,42] The progressively advanced disease is accompanied by abdominal pain (62–68%), myalgia (50–79%), nausea, vomiting, and diarrhea (84–86%).[41]

Variety of hemorrhagic manifestations forms an integral component of the late disease phase.[38] Gastrointestinal tract bleeding manifests as petechiae, hematuria, melena, conjunctival bleeding, contusion, or intraperitoneal bleeding. Mucous membrane and venipuncture site bleeding, along with excess clot formation may also occur. As the features advances with time, the patients experience dehydration, confusion, stupor, hypotension, and multiorgan dysfunction, resulting in fulminant shock and ultimately death.[43,44]

Maculopapular exanthema constitutes a characteristic manifestation of all Filovirus infection, including EVD.[45] The rash usually appears during the 5th to 7th day of disease and occur in 25–52% of patients in the past EVD outbreaks.[46]

Table 4 shows the clinical manifestations of Ebola virus disease.

Table 4

Clinical manifestations of Ebola virus disease

Although EVD has a number of similar features with other viral hemorrhagic fevers (e.g. dengue), there are differences that set them apart.

Table 5 depicts the differentiating features of the Ebola virus and dengue virus infection.

Table 5

Differentiating features of Ebola and dengue virus infection

Orofacial features

Gum bleeding, atypical mucosal lesions, and odynophagia comprise the distinctive oral manifestations. Epistaxis (nasal bleed), bleeding from venipuncture sites, conjunctivitis, and cutaneous exanthema are the other manifestations.[9] Bleeding tendencies and gum bleeding is not seen in asymptomatic or initial EBOV patients reporting to the dental hospital.

EVD dissemination in the field of oral and dental health may appear nonsignificant; although, probable situations which may pose a risk to dental health professional have been appraised by Samaranayake et al.[21] and Galvin et al.[10]

Table 6 depicts the various orofacial manifestations of Ebola virus disease

Table 6

Orofacial manifestations of Ebola virus disease

Diagnosis

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biogenericpublishers · 4 years ago

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Veterinary Medicine Articles in JBGSR

Review on Q Fever: Epidemiology, Public Health Importance and Preventive Measures by Gizaw Mekonnen* in Open Access Journal of Biogeneric Science and Research (JBGSR)

Summary

Introduction

Therefore, the objectives of this seminar paper are: i. To overview Q Fevers Epidemiology, Public health importance, and preventive measures ii. To highlight current status of Q fever in Ethiopia

History of Q Fever

#Q Fever #Milk #Animals #Coxiella burnetii #JBGSR #Open Access JBGSR

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