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General issues of Vaccine
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General issues of Tropical med.
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General issues of Travel med.
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Trematode (fluke, distoma)
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epidemiology
- outreaks
- 2004-06 Indian Ocean countries
- 2014-16 Caribbean region and USA
- 1.3 bil. people living in endemic area
virology
- mutation A226V enhanced replication ability in Ae. albopictus
clinical
- incubation 3-7 days
- polyarthralgia 2-5 days after onset
- severe complication >65 y/o
- meningoencephalitis, hepatitis, renal failure, myocarditis
- persistent symptoms
- polyarthralgia, polyarthritis, tenosynovitis, Ranaud's phenomena