Infectious Disease 2016: Chikungunya

Dr. Sheila Fallon-Friedlander

Dr. Sheila Fallon-Friedlander

Dr. Sheila Fallon-Friedlander

Chikungunya: Dengue-lite?

Chikungunya is an arthropod-borne virus (arbovirus) endemic to West Africa that causes acute febrile polyarthralgia and arthritis. The name chikungunya is derived from a local language of Tanzania meaning “that which bends up” or “stooped walk” because of the incapacitating arthralgia caused by the disease. Chikungunya in neonates is a very rare entity and a diagnostic challenge. Newborns with this infection generally require admission to pediatric intensive care, and related support, due to severe clinical manifestations, which include respiratory distress, sepsis, necrotizing enterocolitis, meningoencephalitis, myocarditis, edema, bullous dermatitis and pericarditis. The case fatality rate for congenital Chikungunya virus infection has been reported to be >30%.

In the acute stage, diagnosis is possible with reverse transcription polymerase chain reaction or serology. Anti-Chikungunya virus IgM antibodies are detectable after an average of 2 days (range = 1-12 days) by enzyme-linked immunosorbent assay and remains positive for several weeks to 3 months.

Infectious Disease 2016: MRSA

Dr. Theodore Rosen

Dr. Theodore Rosen

Dr. Theodore Rosen

Smoking and treatment of methicillin-resistant Staphylococcus aureus (MRSA): apparently cigarette smoke isn’t deadly for all living creatures

Results from a recent study have shown that cigarette smoke may make MRSA more virualent. Researchers at the University of California in San Diego infected macrophages with MRSA that were grown normally or with exposure to cigarette smoke extract. While macrophages were equally able to take up the two bacterial populations, smoke-exposed MRSA were more resistant to killing by reactive oxygen species (i.e., the macrophage oxygen burst). In addition, the smoke-exposed MRSA were more resistant to killing by naturally produced antimicrobial peptides and more adherent to keratonocytes. Additional in vivo experiments in mice showed pneumonia resulting from that smoke-exposed MRSA pneumonia was associated with higher mortality (40% vs 10%) and increased bacterial burden compared to control MRSA-infected mice