Attenuated patella alta is an extremely rare condition affecting mobility and leg strength. It is characterized by an unusually small knee cap (patella) that develops out of and above the joint. Typically, as the knee cap sits in the joint, it is stimulated to growth by abrasion from the opposing bones. When not situated properly in the joint, the knee cap does not experience such stimulation and remains small and undeveloped. Note that the cartilage under and around the kneecap is eight times smoother than ice, so "abrasion" may not be the best term.A similar condition, patella alta, can occur as the result of a sports injury, though the large majority of the time it is a congenital/developmental condition that is unrelated to trauma. A kneecap in an "alta" position sits above the "trochlear groove" and therefore is less stable. The "patellar tendon" that connects the kneecap to the tibia (shinbone) is elongated (longer than normal). This cannot happen by way of trauma, unless there has been a rupture of the tendon and a less-than-optimal surgical repair. There have been only three documented case of the disorder noted from birth. In 1988, three-year-old Eric Rogstad of Minneapolis, Minnesota was discovered to have the condition in both knees after several attempts by his parents and family physician to discover the cause of his difficulties with walking and running. After surgery and physical therapy, Eric gained the ability to walk and run without significant difficulty. Surprisingly, in 2016, two cases were discovered.
Chapare mammarenavirus or Chapare virus is a virus from the family Arenaviridae which causes a hemorrhagic fever in humans known as Chapare hemorrhagic fever. It was first described after an outbreak of a novel zoonotic mammarenavirus infection occurred in the village of Samuzabeti, Chapare Province, Bolivia, in January 2003. A small number of people were infected and one person died.In 2019, nine people became infected with the virus in the La Paz regional area, four of whom died. Nosocomial and human-to-human transmission of the virus occurred in at least three of the cases which resulted in the death of a medical intern and a gastroenterologist. Like other members of the Arenavirus family, the specific zoonotic reservoir and primary transmission vector is suspected to be a rodent, probably the small-eared pygmy rice rat. Virology
The Chapare virus is an enveloped virus with a bi-segmented single-stranded ambisense RNA genome. The two RNA segments are denoted Small (S) and Large (L). It belongs to the New World Clade B lineage of mammarenaviruses and is most closely related to the Sabia virus. Symptoms
After an incubation period of around 9–19 days, initial symptoms include fever, malaise, headache, myalgia, back pain, dizziness, nausea, vomiting and diarrhoea. The disease often progresses to include hemorrhagic and neurological symptoms, such as gingival hemorrhage, anaemia, leukopaenia, confusion, seizures, echymoses, bleeding from mucous membranes, hemorrhagic shock and multi-organ failure.Chapare virus RNA was detected in the blood, urine, conjunctiva, semen and in broncho-alveolar and nasopharyngeal samples of the infected patients.