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Infectious Diseases - Disease Topic Overview

An infectious disease is caused by the transmission of a pathogen (bacterium, fungus, virus, parasite, prion) that will cause a harmful or lethal disorder in the host-organism.¹

Infectious diseases kill more than 14 million people each year, mainly in developing countries.² Nearly 90% of these deaths are attributable to five major infectious diseases (AIDS, tuberculosis, malaria, and acute diarrheal and respiratory infections in children).² In Europe, programs against infectious diseases have controlled, and even eliminated some of these diseases (cholera³, polio⁴). However, during the last ten years, European physicians have seen the appearance or reappearance of some diseases^5,6 which are threatening the economy and global public health.²

Pathogens causing infectious diseases evolve and spread rapidly.² The horizontal transfer of their genes, and their high mutation rates allow them to respond to environmental stress and to survive in new environments.⁷ Within a relatively short period of time after the first antimicrobial drugs were introduced, bacteria began exhibiting varying degrees of resistance.⁸ The excessive use of antibiotics in agriculture, and in both human and veterinary medicine, has played a critical causative role in the development of antibiotic resistance.⁸ This resistance has severely restricted treatment options and may eventually lead to therapeutic dead-ends.⁷ Sometimes these changes allow them to cross the species barrier from animals to humans and infect new hosts, such as Ebola virus and severe acute respiratory syndrome (SARS).²

The large number of passengers and freight traveling through Europe is also a major risk factor for the spread of infectious diseases.⁹ In 2008, Europeans continued to represent the majority of international travellers (55.2%), and Europe remained the world’s largest destination region (53%).⁹ Such intense international traffic between Europe and the rest of the world results in greater vulnerability to the transmission of infectious diseases.⁹

1. Beers M.H. et al. The Merck manual of medical information. Merck research laboratories. Second home edition. 2003, 1085-1184.
2. Marcus B.A. et al. Deadly diseases and epidemics: Malaria. InfoBase Publishing. Second edition. 2009 : 119 pages.
3. WHO. Cholera annual report 2009. Weekly Epidemiological Record. 2010 ; 85 (31) : 293-308, (available online).
4. Nathanson N. et al. From emergence to eradication: Tthe epidemiology of poliomyelitis deconstructed. American Journal of Epidemiology. December 2010 ; 172 (11) : 1213–1229.
5. Fears R. et al. Drug-resistant tuberculosis in the European Union: Opportunities and challenges for control. Tuberculosis. May 2010 ; 90 (3) : 182-187.
6. Sabbe M. et al. Measles resurgence in Belgium from January to mid-April 2011: a preliminary report. Euro Surveillance. April 2011 ; 16 (16).
7. Song J.-H. et al. Respiratory infections due to drug-resistant bacteria. Infectious Disease Clinics of North America. September 2010 ; 24 (3) : 639-653.
8. Rosen T. Antibiotic resistance: an editorial review with recommendations. Journal of Drugs in Dermatology. July 2011 ; 10 (7) : 724-33.
9. Field V. et al. Travel and migration associated infectious diseases morbidity in Europe, 2008. BMC Infectious Diseases. 2010 ; 10 : 330.

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How Flu Attacks the Human Body - An Animation

Infectious Diseases Drug Data - A-Z English

Drug Updates

Sustiva 50 mg, 100 mg and 200 mg Hard Capsules

SUSTIVA is indicated in antiviral combination treatment of human immunodeficiency virus-1 (HIV-1) infected adults, adolescents and children 3 years of age and older.

Erythroped A 500 mg Tablets

For the prophylaxis and treatment of infections caused by erythromycin-sensitive organisms.

Nystatin-Dome Suspension 100,000 I.U./ml

The prevention and treatment of candidal infections of the oral cavity, oesophagus and intestinal tract.

Latest Drug News

CHMP recommends Nimenrix vaccine (GSK) for Meningococcal Diseases - 20-02-2012

The CHMP has adopted a positive opinion, recommending the granting of a marketing authorisation for the medicinal product Nimenrix, powder and solvent for solution for injection from GSK, intended for active immunisation of individuals from the age of 12 months and above against invasive meningococcal diseases caused by Neisseria meningitidis group A, C, W-135 and Y.

Novel antibacterial ozenoxacin (Ferrer) enters Phase III for treatment for Impetigo - 21-01-2012

Ferrer has received approval to initiate Phase III clinical trials of ozenoxacin as a topical treatment for infectious dermatological conditions such as Impetigo. Ozenoxacin is a novel second generation non-fluorinated quinolone antibacterial agent. The first patients are expected to enter the trials in February 2012 and the studies are scheduled to complete in the first quarter, 2013. The multicentre clinical study comparing ozenoxacin one per cent cream versus placebo will be conducted in about 465 patients up to two years old with a clinical diagnosis of non-bullous or bullous Impetigo at approximately 50 centres in the USA, South Africa, Germany, Romania, India and the Ukraine, subject to completion of additional regulatory approvals. In addition to development in Impetigo and other dermatological conditions, ozenoxacin is being assessed for its potential to be developed in a variety of systemic indications, such as bone and joint infections and pulmonary infections.

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Latest Clinical Trials

Q-Trial in Patients With Hepatitis C

The goal of this study is to translate laboratory findings that Quercetin, a bioflavonoid, is safe and has antiviral activity in people with hepatitis C.

Viral Kinetics and Liver Gene Expression in Response to Ribavirin and Peginterferon Therapy of Chronic Hepatitis C

Up to 120 patients with chronic hepatitis C will be enrolled in a study of viral kinetics and liver gene expression before and during combination therapy with peginterferon and ribavirin. Adult patients with chronic hepatitis C virus (HCV) infection who have compensated liver disease and have not received interferon in the past will be randomized into one of four groups. Groups A and C will undergo liver biopsy before starting peginterferon therapy and Groups B and D will undergo biopsy 6 hours after the initial dose of peginterferon. Furthermore, Groups C and D will receive a run-in period of 4 weeks of ribavirin therapy before starting peginterferon. All patients will receive the standard recommended doses of peginterferon alfa 2a (180 mcg sc weekly) and ribavirin (1000 or 1200 mg daily for genotypes 1, 4-6 and 800 mg daily for genotype 2 and 3) for up to 48 weeks (24 weeks for genotype 2 and 3). All patients in Groups C and D, irrespective of genotype, will be pretreated with ribavirin at a dose of 1000 or 1200 mg, depending on patient body-weight. After the initial peginterferon injection, patients will have blood taken and symptoms recorded at 6, 24, 48, 72 hours and weekly thereafter for four weeks to assess viral kinetic response. Liver biopsy tissue taken before or 6 hours after the initial dose of peginterferon will be assessed by standard light microscopy and also subjected to RNA extraction and microarray analysis of mRNA expression. Patients will be monitored carefully during therapy and tested regularly for HCV RNA levels. Therapy will be given for 48 weeks, but will be discontinued early for patients with genotype 1 infection if HCV RNA levels do not decline by at least 2 log IU/ml by week 12 (lack of an early virological response) or do not decline to undetectable levels by week 24 (lack of HCV RNA clearance). Patients with other genotypes with be treated for a full course of therapy regardless of early responses. After completing therapy, patients will be followed at 4 to 8 week intervals and undergo repeat medical evaluation with liver biopsy 24 weeks after stopping therapy. The primary clinical criterion for success of therapy is a sustained virological response, as marked by the absence of HCV RNA from serum at least 24 weeks after stopping. The focus of this study, however, will be on viral kinetics comparing patients who were pretreated with ribavirin (Groups C and D) to those who were not (Groups A and B) as well as on gene expression studies assessing the effects of peginterferon on intrahepatic mRNA profiles by comparing Group A and B and the effects of ribavirin by comparing Group A to Group C and Group B to Group D. Results will also be compared between different HCV genotypes. These studies are aimed at assessing the mechanisms of action of peginterferon and ribavirin against HCV and evaluating the basis for the lack of virologic response to combination therapy.

Latest Journal Publications

Journal of Medical Virology

Human metapneumovirus (hMPV) causes acute respiratory infections in children and adults. It is classified into two major genetic lineages and each lineage into two sublineages. The purpose of the study was to identify and characterize hMPV in children who presented to the All India Institute of Medical Sciences, New Delhi, India with acute respiratory infection from April 2005 to March 2007. By reverse-transcription polymerase chain reaction, hMPV was detected in 21 (3%) of the 662 nasopharyngeal samples from children with acute respiratory infection and in none of the 120 control children. Seven of the 21 (33%) children infected with hMPV required hospital admission for pneumonia or bronchiolitis. Most hMPV detections were during the winter and spring seasons. The majority (67%, 11/21) of children positive for hMPV were within 24 months of age. Phylogenetic analysis of partial F and N gene and the full G gene sequences showed three sub-lineages of hMPV circulated during the study period, B1, B2, and the novel sub-lineage A2b. The circulation pattern of hMPV genotypes varied by season. Comparison of the F and G genes of eight strains revealed incongruencies in lineage assignments, raising the possibility that recombination had occurred. Sequence analysis also revealed the F gene was relatively conserved whereas the G gene was more variable between the A and B lineages. This study demonstrates that hMPV is an important contributor to acute respiratory infection in children in India, resulting in both outpatient visits and hospitalizations.

Journal of Medical Virology

Human metapneumovirus (hMPV) has been recognized as an important cause of respiratory tract infections in all age groups and in all geographical area. The role of hMPV in causing respiratory tract infections in Kuwait was not yet investigated. The aim of this study was to determine the prevalence of hMPV infection in Kuwait among patients with respiratory tract infection with respect to other respiratory viruses. During January–December 2009, 460 respiratory samples from 388 patients with respiratory tract infection were collected from different hospitals. They were tested for hMPV RNA by real-time PCR, and for other respiratory viruses by conventional PCR. Out of 388 patients, 110 (28%) were positive for viral respiratory infections; 21 (5.4%) were positive for hMPV, 29 (7.5%) were positive for rhinovirus, 13 (4%) were positive for respiratory syncytial virus, and 10 (3%) were positive for adenovirus. Most (n = 19, 90.5%) of hMPV-positive patients were admitted to the intensive care unit, 76% of them were of age 2 years and below, and 24% of age 59 years and above. All hMPV-positive elderly patients had pneumonia while 50% of hMPV-positive infants had bronchopneumonia. Children with hMPV/rhinovirus co-infection (n = 3, 1%) had recurrent chest infection and frequent intensive care unit admission. The hMPV infection was mostly detected between December and May, and genotype B was more prevalent than genotype A. This is the first study demonstrating the prevalence of hMPV infection in Kuwait, and suggests that hMPV infection is prevalent in infants and elderly patients with lower respiratory tract infection.

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