Monocytes are important target cells of various hemorrhagic fever viruses. In viral hemorrhagic fevers (VHFs), monocytes can be infected by viruses and produce different kinds of cytokines, which contribute to the antiviral immune response and participation in the immunopathogenesis of VHFs. During the pathogenesis of various VHFs (early stage), monocytes change in cell counting, subpopulation distribution and expression of surface molecules with an activated phenotype. Several hemorrhagic fever viruses can infect monocytes and induce immune response, which may play an important role in immunopathological injury. Monocytes and the cytokines they produce may interact with platelets and vascular endothelial cells, contributing to disease progression.
Humans ; Monocytes ; Endothelial Cells ; Hemorrhagic Fevers, Viral/pathology* ; Immunity ; Cytokines

The level of terrorist threats using chemical, biological, and radiological agents has been continuously increasing, and it is an undeniable truth that these agents are actually in use today. The fact that most chemical, biological, and radiological agents cause skin-related symptoms, and that the skin symptoms are observed at a relatively early stage of the condition, leads to the conclusion that dermatologists could be the first point of contact for potential victims of these agents. It is highly important that first responders are able to recognize symptoms caused by these agents early and react quickly. Therefore, dermatologists do have a responsibility to take on a role in dealing with chemical, biological, and radiological attacks, and pre-equip themselves with professional knowledge in this field. Among the various types of chemical agents, typical examples of agents causing skin-related symptoms are blistering agents, which lead to bullae and necrosis on the skin. Biological agents are classified from Category A to C according to their respective risk factors. The most dangerous Category A agents include anthrax, smallpox, plague, tularemia, and viral hemorrhagic fever, all of which are known to show characteristic skin-related symptoms. Upon exposure to a certain level of radiation, radiological agents can also lead to erythema on the skin. In this article, we will discuss various characteristics and up-to-date treatment methods of potential chemical, biological, and radiological agents to help dermatologists advance their knowledge in this field.
Anthrax ; Biological Factors ; Blister ; Erythema ; Hemorrhagic Fevers, Viral ; Necrosis ; Plague ; Risk Factors ; Skin ; Smallpox ; Terrorism ; Tularemia ; Weapons

The level of terrorist threats using chemical, biological, and radiological agents has been continuously increasing, and it is an undeniable truth that these agents are actually in use today. The fact that most chemical, biological, and radiological agents cause skin-related symptoms, and that the skin symptoms are observed at a relatively early stage of the condition, leads to the conclusion that dermatologists could be the first point of contact for potential victims of these agents. It is highly important that first responders are able to recognize symptoms caused by these agents early and react quickly. Therefore, dermatologists do have a responsibility to take on a role in dealing with chemical, biological, and radiological attacks, and pre-equip themselves with professional knowledge in this field. Among the various types of chemical agents, typical examples of agents causing skin-related symptoms are blistering agents, which lead to bullae and necrosis on the skin. Biological agents are classified from Category A to C according to their respective risk factors. The most dangerous Category A agents include anthrax, smallpox, plague, tularemia, and viral hemorrhagic fever, all of which are known to show characteristic skin-related symptoms. Upon exposure to a certain level of radiation, radiological agents can also lead to erythema on the skin. In this article, we will discuss various characteristics and up-to-date treatment methods of potential chemical, biological, and radiological agents to help dermatologists advance their knowledge in this field.
Anthrax ; Biological Factors ; Blister ; Erythema ; Hemorrhagic Fevers, Viral ; Necrosis ; Plague ; Risk Factors ; Skin ; Smallpox ; Terrorism ; Tularemia ; Weapons

Viral hemorrhagic fevers (VHFs) refer to a group of acute infections with high case fatality rates that are caused by four distinct families of RNA viruses belonging to the families Bunyaviridae, Flaviviridae, Filoviridae and Arenaviridae, the main clinical symptoms of these diseases are accompanied by fever and bleeding. For the reason that these infections have similar primary clinical symptoms, it is difficult to diagnose and distinguish them; rapid and reliable laboratory diagnostic tests are required in suspected cases for epidemiological investigation and controlling the spread of VHFs. This review addresses the laboratory diagnostics of VHFs, covering etiological classification and different diagnostic techniques, such as virus isolation, nucleic acid detection, as well as antigen and antibody assays. Prospects for novel diagnostic tools are also discussed.
Clinical Laboratory Techniques ; methods ; Hemorrhagic Fevers, Viral ; diagnosis ; immunology ; virology ; Humans ; RNA Viruses ; genetics ; immunology ; isolation & purification

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Hemorrhagic Fevers, Viral ; epidemiology ; Hospitalization ; Humans ; Male ; Middle Aged

PURPOSE:Yellow fever, a mosquito-borne viral hemorrhagic fever, is one of the most lethal diseases. Recently there have been an increasing number of Korean children who have travelled to yellow fever endemic zones and were administered yellow fever vaccine (YFV). Therefore, we carried out this study to provide child travelers with safety information of YFV. METHODS:This study was conducted at the International Clinic of National Medical Center in Seoul between April 2007 and June 2008 for the evaluation of adverse events of YFV. One hundred twenty- five children received YFV (17-DD) and were prospectively monitored for adverse events through telephone interviews on day 3, 6, 9, 16, 23 and 30 after vaccination. RESULTS:Adverse events were observed in 31 (24.8%) of 125 child travelers who received the YFV. The mean age was 12.5+/-5.0 years. Sixty-six of the child travelers (52.8%) were males. The common adverse events were pain in 11 (8.8%), swelling in 8 (6.4%) and redness in 7 children (5.6%) at the injection site. The systemic adverse events included mild fever in 5 (4.0%), headache in 5 (4.0%), cough in 4 (3.2%), abdominal pain in 3 (2.4 %), and vomiting in 2 children (1.6%). Most of the adverse events were detected within 7 days of administration and there were no differences in adverse events by gender or age. All travelers who had complained of symptoms improved spontaneously or following symptomatic treatment. CONCLUSION:This study showed that YFV is well-tolerated and there were no reports of severe adverse events. Studies are ongoing to clarify the cause and risk factors for rare adverse events.
Abdominal Pain ; Child ; Cough ; Fever ; Headache ; Hemorrhagic Fevers, Viral ; Humans ; Interviews as Topic ; Male ; Prospective Studies ; Risk Factors ; Vaccination ; Vomiting ; Yellow Fever ; Yellow Fever Vaccine

Yellow fever is the original viral hemorrhagic fever (VHF), a pansystemic viral sepsis with viremia, fever, prostration, hepatic, renal, and myocardial injury, hemorrhage, shock, and high lethality. Yellow fever was one of the most feared lethal diseases before the development of an effective vaccine. Yellow fever (YF) can be prevented by an attenuated vaccine. The yellow-fever 17D vaccine developed in the 1930s has been regarded as one of the most successful live attenuated vaccines, with few side effects or adverse events. The adverse effects associated with yellow-fever vaccine are generally mild and include headache, myalgia, and low-grade fever. Recently, however, some cases of severe neurologic disease and multi-organ system disease have been described in individuals who received yellow-fever vaccine. We report the case of a 39-year-old female with meningitis following vaccination with 17D yellow-fever vaccine.
Adult ; Female ; Fever ; Headache ; Hemorrhage ; Hemorrhagic Fevers, Viral ; Humans ; Meningitis ; Sepsis ; Shock ; Vaccination ; Vaccines, Attenuated ; Viremia ; Yellow Fever

BACKGROUNDTo further probe into the role of CD178 in the pathogenesis of hemorrhagic fever with renal syndrome (HFRS).

METHODSThe expression of CD178 and HLA-DR on T cell subsets in peripheral blood of patients with HFRS and their dynamic changes were detected by Flow cytometry.

RESULTSCD4+ CD178+ and CD8+ CD178+ T lymphocytes both in fever and polyuria phases were significantly higher than those in normal controls, while there was no significant difference between the both phases of HFRS (P > 0.05). CD178 expression on CD4+ HLA-DR+ and CD8+ HLA-DR+ T lymphocytes were significantly higher than those in normal controls (P < 0.05, P < 0.01, P < 0.001, P < 0.001), while there was no significant difference between CD4+ HLA-DR+ and CD8+ HLA-DR+ T lymphocytes (P > 0.05).

CONCLUSIONCD178 was expressed on both CD4+ and CD8+ T cell subsets, but mainly on CD8+ T cell subsets both in early stage and in later stage in the pathogenesis of HFRS. Cytotoxic T lymphocyte (CTL) might kill target cells infected by hantavirus (HV) and eliminate HV via cell apoptosis mediated by CD178 in early stage of HFRS. In later stage of HFRS, CD178 might reduce antigen-specific T lymphocytes by activation induced cell death (AICD) and help to maintain the homeostasis of immune system.

Adolescent ; Adult ; CD4-Positive T-Lymphocytes ; cytology ; immunology ; CD8-Positive T-Lymphocytes ; cytology ; immunology ; Fas Ligand Protein ; immunology ; Female ; Flow Cytometry ; Hemorrhagic Fever with Renal Syndrome ; blood ; immunology ; Hemorrhagic Fevers, Viral ; blood ; immunology ; Humans ; Male ; Middle Aged ; T-Lymphocyte Subsets ; cytology ; immunology ; Young Adult

42 cases of death due to hemorrhagic fever in the year 2002 showed that: they were mainly (90.5%) in South provinces, mainly at the age under 15 (90.5%). The most died within 48 hours after the admission into hospital (73.8%), 26.2% after 3nd day and 92.2% within 5-6 days after the recovery. 85.7% of deaths were at commune level and provincial level. Hemorrhagic common symptoms were usually: blood vomitting (47.6%), hemorrhagic points (42.9%), nasal hemorrhagic 47.6%, gengive hemorrhage 16.7% and erythema (11.9%)
Hemorrhagic Fevers, Viral ; Mortality ; Death

Hypoalbuminemia frequently occurs in Hemorrhagic Fever with Renal Syndrome (HFRS), but clinical significance of hypoalbuminemia is not well known. This study was designed to evaluate hypoalbuminemia as a marker of severity of disease in patients with HFRS. We evaluated the relationship between the level of serum albumin and clinical parameters representing the severity of disease in 144 patients with HFRS. The patients were divided into three groups based on the level of serum albumin; Group I (normal serum albumin), Group II (serum albumin <3.5 g/dL and > or =3.0 g/dL), and Group III (serum albumin <3.0 g/dL). Of the total of 144 patients, 42 patients (29.2%) were categorized as Group I, 39 patients (27.1%) as Group II, and 63 patients (43.8%) as Group III. Group III had a higher rate of incidence in episode of hypotension, pulmonary edema than did Group I and Group II. The lowest level of serum albumin was positively correlated with platelet count (r=0.505, p<0.001) and was negatively correlated with leukocyte count (r=-0.329, p<0.001), BUN (r=-0.484, p<0.001), serum creatinine (r=-0.394, p<0.001), and AST (r=-0.251, p=0.002). Our data suggest that hypoalbuminemia frequently occurs in the acute stage of HFRS, and level of serum albumin is associated with the disease severity of HFRS.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Fluorescent Antibody Technique, Indirect ; Hemorrhagic Fevers, Viral/*blood/mortality ; Human ; Hypoalbuminemia/blood ; Kidney Diseases/*blood/mortality ; Male ; Middle Aged ; Retrospective Studies ; Serum Albumin/*biosynthesis ; Treatment Outcome