Risk of Serious Infection Associated with Agents that Target T-Cell Activation and Interleukin-17 and Interleukin-23 Cytokines
Co-stimulatory T-cell inhibitors are used in the treatment of rheumatoid arthritis and to prevent rejection of renal transplants. Inhibitors of the intereukin (IL-17) cytokine are indicated for psoriasis, psoriatic arthritis and ankylosing spondylitis and anti- IL-23 drugs for psoriasis. Serious infections occur in 4.2% to 25.0% of co-stimulatory inhibitors and 1.0% to 2.0% with IL-17 or IL-23 inhibitors. Underlying disease, steroid dose greater than 7.5 to 10.0 mg, and comorbidities influence risk in individual patients. Opportunistic infections or reactivation of tuberculosis are rare. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Authors: Stanford Shoor Source Type: research

Herpesvirus Infections Potentiated by Biologics
Herpesviruses such as herpes simplex virus (HSV) type 1 and 2, varicella-zoster virus (VZV), and cytomegalovirus (CMV) maintain lifelong latency in the host after primary infection and can reactivate periodically either as asymptomatic viral shedding or as clinical disease. Immunosuppression, including biologic therapy, may increase frequency and severity of herpesvirus reactivation and infection. Licensed biologics are reviewed regarding their risks of potentiating HSV, VZV, and CMV reactivation and infection. Approaches to prophylaxis against HSV, VZV, and CMV infection or reactivation are discussed. (Source: Infectious ...
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Authors: Dora Y. Ho, Kyle Enriquez, Ashrit Multani Source Type: research

JC Polyomavirus Infection Potentiated by Biologics
The risk of JC polyomavirus encephalopathy varies among biologic classes and among agents within the same class. Of currently used biologics, the highest risk is seen with natalizumab followed by rituximab. Multiple other agents have also been implicated. Drug-specific causality is difficult to establish because many patients receive multiple immunomodulatory medications concomitantly or sequentially, and have other immunocompromising factors related to their underlying disease. As use of biologic therapies continues to expand, further research is needed into pathogenesis, treatment, and prevention of JC polyomavirus encep...
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Authors: Ashrit Multani, Dora Y. Ho Source Type: research

Infectious Complications of Tyrosine Kinase Inhibitors in Hematological Malignancies
Tyrosine kinase inhibitors represent the standard of care for several diseases and drug targets in hematologic malignancies. Infectious complications vary by disease status and prior therapy, but overall incidence of infections generally is low. In chronic diseases, such as chronic myeloid leukemia and chronic lymphocytic leukemia, patients can remain on tyrosine kinase inhibitor therapy for many years, with few infectious complications from therapy. Bruton tyrosine kinase inhibitors overall are well tolerated in lymphoproliferative disorders, with long-term follow-up of many years in patients with chronic lymphocytic leuk...
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Authors: Andrew Kin, Charles A. Schiffer Source Type: research

Mycobacterial Infections Potentiated by Biologics
This article highlights the incidence and drug-specific risk of tuberculous and nontuberculous mycobacterial infection in the setting of biologics, screening and prevention, and treatment of latent tuberculosis in this setting. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Authors: Cassandra Calabrese, Kevin L. Winthrop Source Type: research

Infectious Risks Associated with Biologics Targeting Janus Kinase-Signal Transducer and Activator of Transcription Signaling and Complement Pathway for Inflammatory Diseases
This article reviews the mechanism of action and the approved and off-label indications of the agents with most clinical experience within this drug classes. It discusses the associated risks of infection, proposing screeni ng, prevention, and risk mitigation strategies. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Authors: Esther Benamu Source Type: research

Infections Related to Biologics
Biologics as a class of therapeutics are revolutionizing medicine by providing successful new treatment options for cancers, autoimmune diseases, neurodegenerative conditions, and many other devastating diseases. These drugs are large molecules that are manufactured using recombinant DNA technology in living systems, such as bacterial, fungal, animal, or plant cells. The field has expanded rapidly since 1982, when the first recombinant form of human insulin was approved by the Food and Drug Administration (FDA). (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Authors: Dora Y. Ho, Aruna K. Subramanian Tags: Preface Source Type: research

Infections Related to Biologics
INFECTIOUS DISEASE CLINICS OF NORTH AMERICA (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Authors: Dora Y. Ho, Aruna K. Subramanian Source Type: research

Copyright
Elsevier (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Source Type: research

Contributors
HELEN W. BOUCHER, MD, FIDSA, FACP (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Source Type: research

Contents
Dora Y. Ho and Aruna K. Subramanian (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Source Type: research

Infectious Disease Clinics of North America
The Ongoing Challenge of Antimicrobial Resistance (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - May 20, 2020 Category: Infectious Diseases Source Type: research

Direct T-cell Inhibition and Agents Targeting T-cell Migration and Chemotaxis
Lymphocyte depletion and blockade of T-cell activation and trafficking serve as therapeutic strategies for an enlarging number of immune-mediated diseases and malignancies. This review summarizes the infection risks associated to monoclonal antibodies that bind to the α chain of the interleukin-2 receptor, the cell surface glycoprotein CD52, and members of α4- and β2-integrin families acting as cell-adhesion molecules. An outline of the mechanisms of action, approved indications and off-label uses, expected impact on the host immune response, and available cli nical evidence is provided for each of these a...
Source: Infectious Diseases Clinics of North America - April 22, 2020 Category: Infectious Diseases Authors: Mario Fern ández-Ruiz, José María Aguado Source Type: research

Infectious Implications of Interleukin-1, Interleukin-6, and T Helper Type 2 Inhibition
Targeting interleukins that drive innate inflammation has expanded treatments of autoinflammatory and autoimmune disorders. Interleukin (IL)-1 inhibition has proven useful for monogenic autoinflammatory syndromes, and IL-6 inhibition for autoimmune arthritides. Biological therapies impeding these pathways impair detection and containment of pathogens, particularly invasive bacteria, reflecting the importance of IL-1 and IL-6 in communicating danger throughout the immune system. Biologics targeting T helper type 2 inflammation are used to treat specific allergic, atopic, and eosinophilic diseases. They may impair protection...
Source: Infectious Diseases Clinics of North America - April 22, 2020 Category: Infectious Diseases Authors: Anne Y. Liu Source Type: research

Infectious Complications of Immune Checkpoint Inhibitors
The clearance of both tumors and microbes depends on highly coordinated immune responses that are sufficiently potent to kill malignant or microbial cells while avoiding immunopathology from an overly exuberant inflammatory response. A molecular understanding of the immune pathways that regulate these responses paved the way for the development of checkpoint inhibitors (CPIs) as a therapeutic strategy to boost endogenous antitumor immunity. CPIs have demonstrated survival benefits across a wide spectrum of cancers. While infectious complications of CPIs are uncommon, immune-related adverse events occur frequently and often...
Source: Infectious Diseases Clinics of North America - April 22, 2020 Category: Infectious Diseases Authors: Michael S. Abers, Michail S. Lionakis Source Type: research

Epidermal Growth Factor Receptor Inhibitors and Other Tyrosine Kinase Inhibitors for Solid Tumors
This article analyzes the risk of infection associated with small molecule kinase inhibitors used to treat solid organ malignancies and establishes specific recommendations. Most of these drugs are orally administered and have the ability to inhibit distinct kinases, which play a major role in cancer initiation and progression. Although the true extent of adverse events is not yet known, risk of infection does not seem to be a major problem with these drugs. Because of the limited clinical experience and the constant evolution of targeted therapies, recommendations may evolve in the near future. (Source: Infectious Disease...
Source: Infectious Diseases Clinics of North America - April 22, 2020 Category: Infectious Diseases Authors: Isabel Ruiz-Camps, Juan Aguilar-Company Source Type: research

Hepatitis B Virus Reactivation Potentiated by Biologics
Hepatitis B virus (HBV) reactivation can be a serious complication for patients with chronic or resolved HBV infection when treated with biologics. For HBsAg-positive patients receiving biologics, the risk of HBV reactivation is moderate to high. HBsAg-negative/anti-HBc positive patients are at lower risk of HBV reactivation than HBsAg-positive patients. However, patients taking anti-CD20 agents, such as rituximab, have high risk of HBV reactivation (>10%), so antiviral prophylactic therapies are required. This review provides the different classes of biologics associated with HBV reactivation, stratifies the various re...
Source: Infectious Diseases Clinics of North America - April 22, 2020 Category: Infectious Diseases Authors: Eiichi Ogawa, Mike T. Wei, Mindie H. Nguyen Source Type: research

Fungal Infections Potentiated by Biologics
Biologic therapies including monoclonal antibodies, tyrosine kinase inhibitors, and other agents represent a notable expansion in the pharmacotherapy armamentarium in treatment of a variety of diseases. Many of these therapies possess direct or indirect immunosuppressive and immunomodulatory effects, which have been associated with bacterial, viral, and fungal opportunistic infections. Careful screening of baseline risk factors before initiation, targeted preventive measures, and vigilant monitoring while on active biologic therapy mitigate these risks as use of biologics becomes more commonplace. This review compiles repo...
Source: Infectious Diseases Clinics of North America - April 22, 2020 Category: Infectious Diseases Authors: Matthew R. Davis, George R. Thompson, Thomas F. Patterson Source Type: research

Vaccinations and Biologics
The objective of this review is to summarize recent articles, including guidelines, published that address vaccinations among patients on biologics. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - April 22, 2020 Category: Infectious Diseases Authors: Betty Hsiao, Aisha Khan, Insoo Kang Source Type: research

Infections Related to Biologics
B cells are an essential component of the adaptive immune system. Since the late 1990s biologic drugs targeting B cells have been used to treat not only lymphoproliferative diseases of B-cell lineage cells but also autoimmune diseases, in particular, those associated with autoantibody production. Although some of these agents are relatively safe, they have been associated with serious infections including opportunistic infections. To what extent the infectious complications reported are directly related to the use of the B-cell targeting agent or to previous and/or concomitant immunosuppressive therapies and/or the specifi...
Source: Infectious Diseases Clinics of North America - April 22, 2020 Category: Infectious Diseases Authors: Maria J. Leandro Source Type: research

Collaborative Antimicrobial Stewardship in the Emergency Department
This article details ED-focused AS strategies on empiric antimicrobial selection, prompt administration, preventing ED return and readmissions, suggested collaborations between ED AS leadership and other key partners, and potential future strategies for expansion. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Authors: Nicole M. Acquisto, Larissa May Source Type: research

Recommendations for Improving Antimicrobial Stewardship in Long-Term Care Settings Through Collaboration
This article suggests that collaboration at the level of health care facilities and systems, with public health departments, with laboratory partners, and among personnel, including nursing staff, prescribers, and pharmacists, can lead to effective antimicrobial stewardship programs in LTC settings. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Authors: Cullen Adre, Robin L.P. Jump, Steven Schaeffer Spires Source Type: research

Nurses and Antimicrobial Stewardship
Successful antimicrobial stewardship programs must be a truly collaborative multidisciplinary team effort. Nurses have critical contributions and are recognized more in publications about antimicrobial stewardship. Examination of patient care workflow patterns indicates the central role of nurses in the application of stewardship concepts in patient care. Education about antimicrobial resistance and antimicrobial stewardship is important not only for nurses and other health care providers but also for the general public. Analysis of the health care workforce population shows the importance of integrating this largest segme...
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Authors: Rita Drummond Olans, Nicholas Bowditch Hausman, Richard Neal Olans Source Type: research

Stewardship-Hospitalist Collaboration
Hospitalists represent a rapidly emerging specialty group that treats a large proportion of hospitalized patients with infections. Antimicrobial stewardship programs and hospitalist groups that focus on building a collaborative approach have been extremely successful in optimizing antimicrobial prescribing and improving patient outcomes. We discuss the tools needed to build collaborative relationships, summarize published examples of successful stewardship-hospitalist collaboration, and provide guidance on developing collaborative interventions. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Authors: Megan Mack, Adamo Brancaccio, Kayla Popova, Jerod Nagel Source Type: research

Collaborative Antimicrobial Stewardship for Surgeons
Antimicrobial stewardship efforts that include surgeons rely on healthy and open communications between surgeons, infectious diseases specialists, and pharmacists. These efforts most frequently are related to surgical prophylaxis, the management of surgical infections, and surgical critical care. Policy should be based on best evidence and timely interactions to develop consensus on how to develop appropriate guidelines and protocols. Flexibility on all sides leads to increasingly strong relationships over time. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Authors: Evan D. Robinson, David F. Volles, Katherine Kramme, Amy J. Mathers, Robert G. Sawyer Source Type: research

Regarding Collaboration in Antimicrobial Stewardship
Clinicians were not meant to practice alone; instead, at best, medicine should be practiced as a team composed of multiple disciplines engendering a collective accountability for patient care. This type of practice highlights the strengths of individual health care professionals and depends on collaboration for success. Successful antimicrobial stewardship embodies this type of multidisciplinary collaboration, beginning with the combined leadership of a pharmacist and physician and drawing in the unique expertise and skillsets of each to build a team pulling from all areas in the health system involving antibiotic use. (So...
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Authors: Elizabeth Dodds Ashley, Steven Schaeffer Spires Tags: Preface Source Type: research

Collaborative Antimicrobial Stewardship
INFECTIOUS DISEASE CLINICS OF NORTH AMERICA (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Authors: Elizabeth Dodds Ashley, Steven Schaeffer Spires Source Type: research

Copyright
Elsevier (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Source Type: research

Contributors
HELEN W. BOUCHER, MD, FIDSA, FACP (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Source Type: research

Contents
Elizabeth Dodds Ashley and Steven Schaeffer Spires (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Source Type: research

Forthcoming Issues
Infections Related to Biologics (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - January 31, 2020 Category: Infectious Diseases Source Type: research

Bugs and Drugs
Overall goals of antibiotic stewardship and infection prevention programs are to improve patient safety as it pertains to risk of infection or multidrug-resistant organism (MDRO) acquisition. Although the focus of day-to-day activities may differ, the themes of surveillance, education, clinician engagement, and multidisciplinary interactions are prevalent in both programs. Synergistic work between programs has yielded benefits in prevention of MDROs, surgical site infections, Clostridioides difficile infection, and reducing inappropriate testing and treatment for asymptomatic bacteriuria. Collaboration between programs can...
Source: Infectious Diseases Clinics of North America - December 10, 2019 Category: Infectious Diseases Authors: Erin M. Gentry, Shelley Kester, Kristin Fischer, Lisa E. Davidson, Catherine L. Passaretti Source Type: research

Collaborative Antimicrobial Stewardship in the Health Department
This article discusses existing public health stewardship activities, opportunities for collaboration between public health and key partners in antibiotic stewardship programs, the potential for improvement and expansion of current activities, and possible new modes of collaboration that could be pursued. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - December 10, 2019 Category: Infectious Diseases Authors: Christopher D. Evans, James W.S. Lewis Source Type: research

Collaborative Antimicrobial Stewardship
This article provides guidance on strategies for engaging hospital and health system administration to support antimicrobial stewardship, including recommendations for designing a successful antimicrobial stewardship program structure, pitching resource requests, setting meaningful and measurable goals, achieving and communicating results, and fostering ongoing relationships with hospital and health system administration. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - December 10, 2019 Category: Infectious Diseases Authors: Whitney R. Buckel, Keith S. Kaye, Payal K. Patel Source Type: research

Collaborative Antimicrobial Stewardship
Information technology (IT) is vitally important to making antimicrobial stewardship a scalable endeavor in modern health care systems. Without IT, many antimicrobial interventions in patient care would be missed. Clinical decision support systems and smartphone apps, either stand-alone or integrated into electronic health records, can all be effective tools to help augment the work of antimicrobial stewardship programs and support the management of infectious diseases in any health care setting. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - December 10, 2019 Category: Infectious Diseases Authors: Kristi M. Kuper, Keith W. Hamilton Source Type: research

Collaborative Antimicrobial Stewardship
There have been tremendous advances in methodologies available for detection and identification of organisms causing infections. Providers can now obtain identification results and antimicrobial susceptibility results in a shorter period of time. However, declining health care resources highlight the importance of selecting the right test at the right time to maximize diagnostic benefits. Therefore, the role of the antimicrobial stewardship team in the clinical microbiology laboratory has expanded to include diagnostic stewardship and provision of guidance on test selection for diagnosis and management of infection. This r...
Source: Infectious Diseases Clinics of North America - December 10, 2019 Category: Infectious Diseases Authors: Elizabeth L. Palavecino, John C. Williamson, Christopher A. Ohl Source Type: research

Antibiotic-Resistant Enteric Infections
Rising rates of antimicrobial resistance (AMR) in enteric infections are now observed across the globe in low-income and middle-income as well as high-income settings owing to global travel and overlapping social drivers. Pathogen-specific risk factors for spread are now also associated with specific AMR phenotypes and profiles. Several of the drivers of AMR intersect with risk factors for enteric infections and are preventable. Concerted focus on OneHealth prevention strategies for enteric infections and AMR are likely to be of significant benefit in optimizing public health outcomes. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Sadia Shakoor, James A. Platts-Mills, Rumina Hasan Source Type: research

Opportunistic Infections in Transplant Patients
This article focuses on opportunistic infections in the solid organ transplant recipient. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Rebecca Kumar, Michael G. Ison Source Type: research

Severe Acute Respiratory Syndrome
Severe acute respiratory syndrome coronavirus (SARS-CoV), emerged from China and rapidly spread worldwide. Over 8098 people fell ill and 774 died before the epidemic ended in July 2003. Bats are likely an important reservoir for SARS-CoV. SARS-like CoVs have been detected in horseshoe bats and civet cats. The main mode of transmission of SARS-CoV is through inhalation of respiratory droplets. Faeco-oral transmission has been recorded. Strict infection control procedures with respiratory and contact precautions are essential. Fever and respiratory symptoms predominate, and diarrhea is common. Treatment involves supportive c...
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: David S.C. Hui, Alimuddin Zumla Source Type: research

Antibiotic-Resistant Community-Acquired Bacterial Pneumonia
Antimicrobial resistance is a global concern, and prudent use of antibiotics is essential to preserve the current armamentarium of effective drugs. Acute respiratory tract infection is the most common reason for antibiotic prescription in adults. In particular, community-acquired pneumonia poses a significant health challenge and economic burden globally, especially in the current landscape of a dense and aging population. By updating the knowledge on the common antimicrobial-resistant pathogens in community-acquired respiratory tract infections, their prevalence, and resistance may pave the way to enhancing appropriate an...
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Jeffery Ho, Margaret Ip Source Type: research

Novel Avian Influenza A Virus Infections of Humans
A high index of suspicion and early diagnosis of avian influenza A virus infection is essential reduce transmission risk. Clinical suspicion relies on eliciting a history of recent exposure to poultry or to sick persons. Diagnosis requires collection of appropriate respiratory specimens. Patients with suspected infection should be isolated immediately and patients with lower respiratory tract disease should be placed on airborne precautions if possible. Antiviral treatment should be started as soon as possible based upon clinical suspicion while awaiting specific viral diagnosis. Corticosteroids and salicylates should be a...
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Timothy M. Uyeki, Malik Peiris Source Type: research

The Middle East Respiratory Syndrome (MERS)
The Middle East respiratory syndrome (MERS) is a novel lethal zoonotic disease of humans caused by the MERS coronavirus (MERS-CoV). Although MERS is endemic to the Middle East, travelers have exported MERS-CoV on return to their home countries. Clinical manifestations range from mild to severe acute respiratory disease and death. The elderly, immunocompromised, and those with chronic comorbid liver, lung, and hepatic conditions have a high mortality rate. There is no specific treatment. Person-to-person spread causes hospital and household outbreaks, and thus improved compliance with internationally recommended infection c...
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Esam I. Azhar, David S.C. Hui, Ziad A. Memish, Christian Drosten, Alimuddin Zumla Source Type: research

Lassa Fever
Lassa fever outbreaks West Africa have caused up to 10,000 deaths annually. Primary infection occurs from contact with Lassa virus-infected rodents and exposure to their excreta, blood, or meat. Incubation takes 2 to 21  days. Symptoms are difficult to distinguish from malaria, typhoid, dengue, yellow fever, and other viral hemorrhagic fevers. Clinical manifestations range from asymptomatic, to mild, to severe fulminant disease. Ribavirin can improve outcomes. Overall mortality is between 1% and 15%. Lassa fever s hould be considered in the differential diagnosis with travel to West Africa. There is an urgent need for...
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Danny A. Asogun, Stephan G ünther, George O. Akpede, Chikwe Ihekweazu, Alimuddin Zumla Source Type: research

Viral Hemorrhagic Fevers Other than Ebola and Lassa
Viral hemorrhagic fevers represent a group of diseases caused by enveloped RNA viruses. The epidemiology is broadly variable, ranging from geographically localized to more diffuse infections. Viral hemorrhagic fevers are classified as category A bioweapon agents by the Centers for Disease Control and Prevention. Viral hemorrhagic fevers are severe febrile illnesses with hemorrhagic phenomena. Laboratory diagnosis takes place in highly specialized reference laboratories. Treatment is essentially supportive. In this article, we focus the attention on yellow fever and viral hemorrhagic fevers other than Ebola and Lassa virus ...
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Marco Iannetta, Antonino Di Caro, Emanuele Nicastri, Francesco Vairo, Honorati Masanja, Gary Kobinger, Ali Mirazimi, Francine Ntoumi, Alimuddin Zumla, Giuseppe Ippolito Source Type: research

Viral Hepatitis
Viral hepatitis is a major global public health problem affecting hundreds of millions of people and is associated with significant morbidity and mortality. Five major biologically unrelated hepatotropic viruses cause most of the global burden of viral hepatitis. Hepatitis B and hepatitis C are associated with a significant number of chronic infections. Most deaths from viral hepatitis are due to hepatitis B and hepatitis C. An estimated 257  million people were living with HBV and 71 million people were living with HCV. Most people are asymptomatic. New diagnostics and highly effective, pangenotypic direct-a...
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Simone Lanini, Andrew Ustianowski, Raffaella Pisapia, Alimuddin Zumla, Giuseppe Ippolito Source Type: research

Ebola Virus Disease
This article highlights the epidemiology, clinical features, diagnosis, management, and prevention of EVD. The emerging diagnostic technologies, rapid viral characterization, geospatial mapping of EVD transmission, and new treatments and vaccines are discussed. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Emanuele Nicastri, Gary Kobinger, Francesco Vairo, Chiara Montaldo, Leonard E.G. Mboera, Rashid Ansunama, Alimuddin Zumla, Giuseppe Ippolito Source Type: research

Chikungunya
, a zoonotic disease caused by the Chikungunya virus (CHIKV), is transmitted by infected Aedes spp mosquitoes. CHIKV has now spread to more than 100 countries and is listed on the WHO Blueprint priority pathogens. After an incubation period of 1 to 12  days, symptoms similar to other febrile infections appear, with a sudden onset of high fever, nausea, polyarthralgia, myalgia, widespread skin rash, and conjunctivitis. Serious complications include myocarditis, uveitis, retinitis, hepatitis, acute renal disease, severe bullous lesions, meningoenc ephalitis, Guillain-Barré syndrome, myelitis, and cranial nerve pa...
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Francesco Vairo, Najmul Haider, Richard Kock, Francine Ntoumi, Giuseppe Ippolito, Alimuddin Zumla Source Type: research

Invasive Pneumococcal and Meningococcal Disease
This review focuses on current knowledge of the epidemiology, prevention, and treatment of invasive pneumococcal (IPD) and meningococcal disease (IMD). IPD decreased significantly with the introduction of effective conjugate vaccines but is on the rise again. Effective antibiotic therapy of IPD includes the combination of a beta-lactam and a macrolide with additional considerations in meningitis. Steroids are mandatory in pneumococcal meningitis but not indicated in pneumococcal pneumonia except in the setting of refractory shock. There is increasing concern about the cardiovascular complications of IPD. IMD continues to b...
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Deirdre Fitzgerald, Grant W. Waterer Source Type: research

Emerging and Reemerging Infectious Diseases: Global Overview
New emerging and reemerging infectious disease outbreaks have continued to cause much human suffering and loss of life worldwide. During the past 2 decades, several landmark events in the field of infectious diseases with epidemic potential have occurred. The SARS (severe acute respiratory syndrome) pandemic (2002 –2004), the Ebola virus disease (EVD) outbreak in West Africa (2013–2016), the cholera outbreak in Yemen (2015–2018), the Zika virus in the Americas and southeast Asia (2016–2018), Lassa fever (LF) in Nigeria (2018), diphtheria in Venezuela (2016-2017) and in Yemen (2017-2018), Yellow feve...
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Alimuddin Zumla, David S.C. Hui Tags: Preface Source Type: research

Multidrug and Extensively Drug-resistant Tuberculosis
This article reviews epidemiology, clinical features, management, and treatment, with new updates and recent changes in guidelines that offer patients better tolerated and shorter regimens for enabling therapeutic outcomes. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - October 26, 2019 Category: Infectious Diseases Authors: Simon Tiberi, Alimuddin Zumla, Giovanni Battista Migliori Source Type: research