Khan Erum, Farooqi Joveria Q, Barr Kelli L, Prakoso Dhani, Nasir Amna, Kanji Akbar, Shakoor Sadia, Malik Faisal Riaz, Hasan Rumina, Lednicky John A, Long Maureen T
Department of Pathology, Aga Khan University, Karachi, Pakistan; Department of Microbiology, Aga Khan University, Karachi, Pakistan.
Emerging Diseases and Arbopathogens Research and Testing Laboratory, Department of Infectious Diseases and Pathology, University of Florida , Gainesville, FL , USA.
Front Public Health. 2016 Feb 16;4:8. doi: 10.3389/fpubh.2016.00008. eCollection 2016.
Arboviral diseases are expanding worldwide, yet global surveillance is often limited due to diplomatic and cultural barriers between nations. With human encroachment into new habitats, mosquito-borne viruses are also invading new areas. The actual prevalence of expanding arboviruses is unknown in Pakistan due to inappropriate diagnosis and poor testing for arboviral diseases. The primary objective of this study was to document evidence of flavivirus infections as the cause of undifferentiated fever in Pakistan. Through a cooperative effort between the USA and Pakistan, patient exposure to dengue virus (DENV), West Nile virus (WNV), and Japanese encephalitis virus (JEV) was examined in Sindh Province for the first time in decades. Initial results from the 2015 arbovirus season consisting of a cross-sectional study of 467 patients in 5 sites, DENV NS1 antigen was identified in 63 of the screened subjects, WNV IgM antibodies in 16 patients, and JEV IgM antibodies in 32 patients. In addition, a number of practical findings were made including (1) in silico optimization of RT-PCR primers for flavivirus strains circulating in the Middle East, (2) shipping and storage of RT-PCR master mix and other reagents at ambient temperature, (3) Smart phone applications for the collection of data in areas with limited infrastructure, and (4) fast and reliable shipping for transport of reagents and specimens to and from the Middle East. Furthermore, this work is producing a group of highly trained local scientists and medical professionals disseminating modern scientific methods and more accurate diagnostic procedures to the community.
虫媒病毒疾病正在全球范围内蔓延，但由于国家之间的外交和文化障碍，全球监测往往受到限制。随着人类侵入新的栖息地，蚊媒病毒也在侵入新的地区。由于对虫媒病毒疾病的诊断不当和检测不力，巴基斯坦虫媒病毒不断扩散的实际流行情况尚不清楚。本研究的主要目的是记录黄病毒感染作为巴基斯坦不明原因发热病因的证据。通过美国和巴基斯坦的合作，几十年来首次在信德省对患者感染登革热病毒（DENV）、西尼罗河病毒（WNV）和日本脑炎病毒（JEV）的情况进行了检测。2015年虫媒病毒季节的初步结果来自对5个地点467名患者的横断面研究，在63名筛查对象中检测到DENV NS1抗原，16名患者检测到WNV IgM抗体，32名患者检测到JEV IgM抗体。此外，还取得了一些实际成果，包括：（1）对中东地区流行的黄病毒株进行RT-PCR引物的电子优化；（2）将RT-PCR预混液和其他试剂在室温下运输和储存；（3）利用智能手机应用程序在基础设施有限的地区收集数据；（4）实现试剂和标本往返中东地区的快速可靠运输。此外，这项工作培养了一批训练有素的当地科学家和医学专业人员，他们正在向社区传播现代科学方法和更准确的诊断程序。
