... reported. But recent years have seen spikes in measles outbreaks, including 131 cases in the first half of ... nutrition or weakened immune systems. Exposure During a measles outbreak, an injection of measles antibodies (called immune globulin) ...
Measles is an infectious disease caused by a virus. It spreads easily from person to person. It ... down Tiny white spots inside the mouth Sometimes measles can lead to serious problems. There is no ...
... children aged 1 year; reduce and maintain annual measles incidence to less than 5 cases per million; and ... pdf, 1.39Mb Based on current trends of measles vaccination coverage and incidence and the report from the mid-term strategy ...
Congenital syphilis is caused by the bacteria Treponema pallidum , which is passed from mother to child during fetal development or at birth. Nearly half of all children infected with syphilis while they ...
... for treatment because it is dangerous to the unborn baby. Erythromycin may not prevent congenital syphilis in ... be permanently disabling, and it may lead to death. Possible Complications Complications of syphilis may include: Cardiovascular ...
... sore (chancre) is present. It involves obtaining a scraping of the sore, placing it on a slide, ... the central nervous system. Direct detection: If a scraping from a suspected syphilis sore reveals presence of ...
Tali, E Turgut; Koc, A Murat; Oner, A Yusuf
Spinal involvement in human brucellosis is a common condition and a significant cause of morbidity and mortality, particularly in endemic areas, because it is often associated with therapeutic failure. Most chronic brucellosis cases are the result of inadequate treatment of the initial episode. Recognition of spinal brucellosis is challenging. Early diagnosis is important to ensure proper treatment and decrease morbidity and mortality. Radiologic evaluation has gained importance in diagnosis and treatment planning, including interventional procedures and monitoring of all spinal infections.
Lee, Sang Wook; Kim, Kyung Soo; Hur, Don [Chosun University College of Medicine, Kwangju (Korea, Republic of)
In recent years, marked increase in incidence of congenital syphilis has occurred throughout the world due to changes in social norms and development of penicillin-resistant strains. Early diagnosis plays an important role in congenital syphilis as the clinical manifestations may simulate many other conditions in the paediatric age group. The authors analyzed 52 cases of congenital syphilis admitted to the department of paediatrics, Chosun University Hospital, clinically and radiologically. Among them, 18 cases were born in this hospital and 34 cases were admitted from OPD, during the period of 8 years from January, 1975 to December, 1982. The results obtained were as follows; 1. In 28 of 34 cases (82%), the first clinical manifestations were below the age of 3 months. 2. Among the 52 cases, a male predominance was observed with a male to female ratio of 2 : 1. 3. The serologic test (VDRL) of the 52 studied cases showed reactive response in 49 cases (94%), and that of syphilitic mothers except 6 cases, reactive in all studied cases. 4. The major manifestations of the 52 cases were bone tenderness (12%) and swelling of the joints (7%) in skeletal system, hepatosplenomegaly (79%) and skin lesions (73%) in extraskeletal one. 5. The radiological skeletal changes were detected in 45 of 52 cases (87%), and the commonest findings were detected in 45 of 52 cases (87%), and the commonest findings were metaphysitis (83%) and periostitis (81%). The most characteristic type of metaphysitis were transverse trophic line (74%) and zone of rarefaction (65%). 6. The commonest bones to be affected were growing metaphyses of the long bones, particulary about the wrist and the knee. The order of frequency were radius (80%), uina (80%), tibia (77%), femur (69%) and humerus (40%)
Beginning May 19, 1998, and lasting through the middle of June, a follow-up vaccination campaign which used measles-mumps-rubella vaccine targeted 2,223,210 children, 1-4 years of age, in Venezuela. The vaccinations were performed at day care centers, health posts, and orphanages; door-to-door vaccination was conducted in rural areas. The measles epidemic began in 1992, with 22,321 confirmed cases of measles and 77 deaths; it lasted until early 1994, when there were 16,561 cases and 47 deaths. In 1994, the country launched a "catch-up" vaccination campaign which targeted all children between 9 months and 14 years of age; 98% coverage was reached. Between 1994 and 1996, when routine immunization services were used, the average coverage was 75%. Since the catch-up campaign, the number of confirmed measles cases decreased from 172 in 1995, to 89 in 1996, and to 27 in 1997. As of July 18, 1998, (epidemiological week 28), 452 suspected cases of measles were reported; none were confirmed. Another follow-up campaign will be conducted. In Bolivia, the measles outbreak began May 21, 1998, in areas bordering Argentina. The municipality of Yacuiba, in the department of Tarija, is primarily affected. The municipality, especially the localities of Yacuiba and Pocitos, borders the province of Salta in Argentina, and people cross the border often to shop. As of July 24, 1998, there were 49 suspected measles cases: 22 in Pocitos; 24 in Yacuiba; and 3 in El Palmar. 28 had serum samples taken, and 18 tested positive. The population group most affected were those between 1-4 years of age. A follow-up measles vaccination campaign, which targeted all children under 6 years of age regardless of their vaccination history, was conducted from June 1 to 21, 1998, in Salvador Masa (Argentina), in Pocitos, and in Yacuiba. As of August 10, 1998, in Argentina, 1874 confirmed measles cases and 11 deaths (6 under the age of 1 year) were reported. The first cases appeared in August 1997, in the
... at Each Vaccine: MMR (Measles, Mumps and Rubella) Vaccine Children's Hospital of Philadelphia (CHOP): Learn about measles, how ... Disease Control and Prevention AAP Urges Parents to Vaccinate Children to Protect Against Measles (1/23/15) American ...
... PARENTS | DISEASES and the VACCINES THAT PREVENT THEM | Measles and the Vaccine (Shot) to Prevent It Last ... July 2015 The best way to protect against measles is to get the measles-mumps-rubella shot ( ...
Guimarães, Tais Ferreira; Novis, Camila Freitas Lobo; Bottino, Caroline Bertolini; D'Acri, Antonio Macedo; Lima, Ricardo Barbosa; Martins, Carlos José
Gastric syphilis is an uncommon extracutaneous manifestation of syphilis, occurring in less than 1% of patients, presenting nonspecific clinical manifestations. In general, it occurs on secondary stage. The critical point is the recognition of the syphilitic gastric involvement, without which there may be incorrect diagnosis of malignancy of the digestive tract. In this report, a case of secondary syphilis with gastric involvement that had complete remission with benzathine penicillin will be described. PMID:27828649
... Your 1- to 2-Year-Old Rubella (German Measles) KidsHealth > For Parents > Rubella (German Measles) Print A A A What's in this article? ... Rubéola About Rubella Rubella — commonly known as German measles or 3-day measles — is an infection that ...
Fabiansen, C.; Knudsen, J.D.; Lebech, A.M.
Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9......Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9...
Ortigosa, Yara Martins; Bendazzoli, Paulo Salomão; Barbosa, Angela Marques; Ortigosa, Luciena Cegatto Martins
Early malignant syphilis is a rare and severe variant of secondary syphilis. It is clinically characterized by lesions, which can suppurate and be accompanied by systemic symptoms such as high fever, asthenia, myalgia, and torpor state. We report a diabetic patient with characteristic features of the disease showing favorable evolution of the lesions after appropriate treatment. PMID:28300925
van Voorst Vader, PC
Syphilis poses a serious health problem in many developing countries and in some areas of North America and Europe, especially Eastern Europe. This article initially addresses the state of the art regarding the interaction between syphilis and HIV infection and its consequences for management and tr
Eduardo Chaida Sonda
Full Text Available Syphilis is an infectious disease caused by Treponema pallidum and has high rates of vertical transmission, which can reach 100% depending on the maternal disease and stage of pregnancy. The diagnosis of gestational syphilis is simple and its screening is required during the prenatal period. However, this disease still has a high prevalence, affecting two million pregnant women worldwide. The procedures performed in newborns with congenital syphilis represent costs that are three-fold higher than the ones spent with a baby without this infection. The treatment is generally carried out with penicillin and must be extended to sexual partners. Inadequate or lack of treatment of congenital syphilis can result in miscarriage, premature birth, acute complications and other fetal sequelae. KEYWORDS: Congenital syphilis. Treponema pallidum. Vertical transmission.
Patil, M Y; Antin, S M; Gupta, Abhishek
Brucellosis is a bacterial infection causing severe public and socioeconomic problem, most prevalent in human beings in those areas in which infection of cattle, dogs, pigs, and goats is common. Out of a total number of 100 patients, there were 65 males (65%) and 35 females (35%). Forty patients lost to follow-up. Detection of specific antibodies was done by brucella agglutination test. In majority of the patients the titre was 1:320; the highest titre was 1:2560 and least titre was 1:40. All the patients were treated by combination therapy of doxycycline 100 to 200 mg/day, rifampicin 600 to 900 mg/day and streptomycin one g/day (for high titres above 600 IU) for six weeks. To check the efficacy of treatment the titres were repeated after four weeks, in 42 (70%) the titres were negative, 1:40 in 8 (13%), 1:80 in 4 (7%), 1:160 in 4 (7%) and 1:640 in 2 (3%). Brucella is a zoonotic disease and found most commonly in person who handles the animal most frequently but can occur in other persons also by other modes of infection. The most common joint involved was sacro-iliac joint in 31 (52%) and least common joints involved were ankle and elbow 2 (3%) each. The patients responded well to three-drug regimen and their antibody titre came down drastically following four weeks of treatment.
... this? Submit What's this? Submit Button NCHS Home Measles, Mumps, and Rubella Recommend on Facebook Tweet Share ... for the U.S. Morbidity Reported number of new measles (rubeola) cases: 187 (2013) Reported number of new ...
Wareth, Gamal; Hikal, Ahmed; Refai, Mohamed; Melzer, Falk; Roesler, Uwe; Neubauer, Heinrich
Brucellosis is a highly contagious zoonosis that affects the public health and economic performance of endemic as well as non-endemic countries. In developing nations, brucellosis is often a very common but neglected disease. The purpose of this review is to provide insight about brucellosis in animal populations in Egypt and help to understand the situation from 1986 to 2013. A total of 67 national and international scientific publications on serological investigations, isolation, and biotyping studies from 1986 to 2013 were reviewed to verify the current status of brucellosis in animal populations in Egypt. Serological investigations within the national surveillance program give indirect proof for the presence of brucellosis in cattle, buffaloes, sheep, goats, and camels in Egypt. Serologic testing for brucellosis is a well-established procedure in Egypt, but most of the corresponding studies do not follow the scientific standards. B. melitensis biovar (bv) 3, B. abortus bv 1, and B. suis bv 1 have been isolated from farm animals and Nile catfish. Brucellosis is prevalent nationwide in many farm animal species. There is an obvious discrepancy between official seroprevalence data and data from scientific publications. The need for a nationwide survey to genotype circulating Brucellae is obvious. The epidemiologic situation of brucellosis in Egypt is unresolved and needs clarification.
Goodson, James L; Seward, Jane F
In response to severe measles, the first measles vaccine was licensed in the United States in 1963. Widespread use of measles vaccines for more than 50 years has significantly reduced global measles morbidity and mortality. However, measles virus continues to circulate, causing infection, illness, and an estimated 400 deaths worldwide each day. Measles is preventable by vaccine, and humans are the only reservoir. Clinicians should promote and provide on-time vaccination for all patients and keep measles in their differential diagnosis of febrile rash illness for rapid case detection, confirmation of measles infection, isolation, treatment, and appropriate public health response.
Full Text Available Late congenital syphilis is a very rare clinical entity, and its early diagnosis and treatment is essential. Dental findings often provide valuable evidence for the diagnosis of late congenital syphilis. It occurs due to the transmission of the disease from an infected mother to her fetus through placenta. This long forgotten disease continues to effect pregnant women resulting in perinatal morbidity and mortality. Congenital syphilis is a preventable disease, and its presence reflects a failure of prenatal care delivery system, as well as syphilis control programs. We are reporting a case of late congenital syphilis with only Hutchinson′s teeth.
Ümmü Sena Sarı; Figen Kaptan
Atypical measles has been described in persons who were exposed to wild measles virus several years after they were immunized with killed measles vaccine. Occasionally, it can be caused by live measles vaccines also. It is a clinical picture different from typical measles. In this report, an adult patient with a history of immunization, who presented with high fever, maculopapular rash starting at the palms and soles, and pneumonia, is presented. Atypical measles that was ...
Full Text Available Human brucellosis, more specifically neurobrucellosis, is a less commonly reported disease in India; although, animal brucellosis and seroprevalence in specific areas is well reported. We are reporting 4 cases of neurobrucellosis presenting as meningoencephalitis. Diagnosis was confirmed by serological test and agglutination titre was > 1:320 in all the patients. All these patients had close contact with animals and history of raw milk ingestion was present in 3 cases. The aim of presenting these cases is to create awareness among physicians while treating meningitis in persons, engaged in occupations related to brucellosis or having a history of ingestion of raw milk or milk product.
Full Text Available Congenital syphilis (CS is mainly a consequence of the lack of antenatal care and control of sexually transmitted infections.The bedrock of the prevention of CS is syphilis diagnosis by serological screening during pregnancy.Current Italian guidelines suggest that all the pregnant women should be tested in the first trimester. Due to the frequently absence of specific signs of infection at birth, laboratory tests are often the only method for a correct CS diagnosis. The aim of this study was to evaluate the usefulness of Treponema pallidum IgM Western Blot (WB and Polymerase Chain Reaction (PCR on cerebrospinal fluid (CSF as an aid in the diagnosis of CS during a prospective surveillance study carried out at St. Orsola Hospital in Bologna, Italy, from November 2000 through June 2010. All pregnant women during pregnancy and at delivery were screened for syphilis by ARCHITECT® Syphilis TP, Abbott. Positive samples were further analysed by Treponema Pallidum Hemagglutination Test (TPHA and Rapid Plasma Reagin (RPR tests, Radim.An in-house Western Blot (WB was also performed. Infants born to syphilis seropositive mothers were enrolled in a prospective follow up. At birth, tests were performed (including IgM WB. Infants with positive RPR tests at birth born to mothers not adequately treated received also a long bone radiograph as well as a complete CSF analysis, including Veneral Disease Research Laboratori (VDRL (Siemens Healthcare Diagnostics and PCR testing. All seroreactive infants received careful follow up examinations and serological testing at 0, 3, 6, 9, 12 months or until the tests became negative. In this study, positive syphilis serology was noted in 151 pregnant women delivering in our hospital. Fifteen women had never been adequately treated, and 9 out 15 gave birth to infected newborns.All these 9 infants had positive IgM WB results on serum samples. Two babies had characteristic long bone lesions at X-ray examination and 3 were born
Chelli Bouaziz, Mouna; Ladeb, Mohamed Fethi; Chakroun, Mohamed; Chaabane, Skander [Institut M T Kassab d' orthopedie, Department of Radiology, Ksar Said (Tunisia)
Brucellosis is a zoonosis of worldwide distribution, relatively frequent in Mediterranean countries and in the Middle East. It is a systemic infection, caused by facultative intra-cellular bacteria of the genus Brucella, that can involve many organs and tissues. The spine is the most common site of musculoskeletal involvement, followed by the sacroiliac joints. The aim of this study was to assess the clinical, biological and imaging features of spinal brucellosis. (orig.)
N.W.H.M. Dekkers (Nico)
textabstractThe involvement of the cornea in the acute stage of measles is the subject of the present study. The best study on the measles-keratitis now available is still the one by Trantas in 1903. It seems wo.:thwhile therefore to study this self-limiting keratitis with the investigative tools no
Full Text Available Eponym has originated from the Greek word "eponymos" meaning "giving name". It is a tribute to the pioneers in the field who have significantly contributed towards present understanding of the subject. Syphilis has amazed and plagued mankind since eternity. This disease is a great masquerade and can humble best of physicians with its varied presentations. Keen and immaculate observations of these workers have eased our understanding of many signs and phenomenon associated with this disease. This has led to evolution of number of eponyms, perhaps no other disease has as many eponyms associated with it, as does syphilis. Eponyms such as Kassowitz′s law, Clutton′s joints, Higoumenaki sign, Argyll-Robertson pupil etc. help in providing easy milieu for remembering. Besides paying tributes to stalwarts in the field, who dedicated their lives for this cause, they also facilitated our current understanding of the great masquerade.
Alnemri, Abdul Rahman M; Hadid, Adnan; Hussain, Shaik Asfaq; Somily, Ali M; Sobaih, Badr H; Alrabiaah, Abdulkarim; Alanazi, Awad; Shakoor, Zahid; AlSubaie, Sarah; Meriki, Naema; Kambal, Abdelmageed M
Although brucellosis is not uncommon in Saudi Arabia, neonatal brucellosis has been infrequently reported. In this case of neonatal brucellosis, Brucella abortus was isolated by blood culture from both the mother and the neonate. Serology was positive only in the mother.
Roushan, Mohammad R H; Amiri, Mohammad J S
In endemic regions of brucellosis, childhood brucellosis includes up to one-third of all cases of human brucellosis. The main source of infection in children is consumption of unpasteurized dairy products and traditional local foods containing dairy products. The older boys are more involved in animal care. Boys are more commonly infected than girls. Common symptoms and signs include fever, arthralgia, sweating, peripheral arthritis and splenomegaly. Peripheral arthritis especially monoarthritis is more common and the most commonly affected joints are hip and knee. All organs may involve during the course of the disease. Isolation of Brucella spp. from the blood, bone marrow or other tissue fluids is the hallmark of diagnosis. Serologic tests are the main tools of diagnosis of brucellosis in endemic regions. Standard agglutination test (SAT) with titers > 1:160 and the 2-mercaptoethanol (2ME) test ≥ 1:80 are suggestive of active infection. Children older than 8 years should be treated with doxycycline for 45 days or 8 weeks plus gentamicin for 7 or 5 days respectively or doxycycline for 45 days and streptomycin for 14 days. Also doxycycline plus rifampin or cotrimoxazole plus rifampin for 45 days may be alternative regimens. Cotrimoxazole plus rifampin for six weeks is the regimen of choice for the treatment of patients younger than 8 years old. Gentamicin for 5 days plus cotrimoxazole for six weeks may be a suitable alternative regimen. The article presented few of the patents associated with Brucellosis.
Full Text Available The second part of the article discusses differential diagnosis during different measles periods. Routine and confirmatory laboratory diagnosis, including cytological, serological and molecular genetic methods is outlined. Criteria of suspected, probable and proved diagnosis of measles cases are provided. Principles of diagnosis formulation according to WHO criteria are described. Complications of measles ac¬cording to cause (viral and bacterial, by different systems and particularities in high risk patients are considered. Complications of measles from central nervous system are described in details. Therapeutic management of measles is described in details, including indications for hospital admission, etiotropic therapy, strict indications for steroids and immunoglobulins prescription, vitamin A in dosages, therapy of complications, indications for antibiotics usage and other pathogenetic therapy. Specific therapy of measles complications from central nervous system is outlined. Active and passive immunization, anti-epidemic activities, patient follow-up after episode of measles and disease prognosis are described. The literature reference list consists of 121 items, including Cyrillic, Latin articles and electronic resources.
Bazzazi, Nooshin; Yavarikia, Alireza; Keramat, Fariba
A 29-year-old male diagnosed with brucellosis a week earlier was referred to the ophthalmology clinic with visual complaints. On examination, visual acuity was 20/25, he had conjunctival injection on slit lamp examination. There was also bilateral optic disk swelling plus retinal hyperemia (optic disc hyperemia and vascular tortuosity) and intraretinal hemorrhage on funduscopy. The patient was admitted and treated with cotrimoxazole, rifampin, doxycycline and prednisolone for 2 months. Ocular manifestations subsided gradually within 6 months after treatment. Brucellosis can affect the eye and lead to serious ocular complications. Early diagnosis and prompt treatment should be considered in endemic areas.
Brucella suis is a significant zoonosis that is present in domestic livestock and wildlife in many countries worldwide. Transmission from animal reservoirs is the source of human infection as human to human transmission is very rare. Although swine brucellosis causes economic losses in domestic liv...
Goodwin, Zakia I; Pascual, David W
Brucellosis is a livestock disease responsible for fetal loss due to abortions. Worldwide, this disease has profound economic and social impact by reducing the ability of livestock producers to provide an adequate supply of disease-free meat and dairy products. In addition to its presence in domesticated animals, brucellosis is harbored in a number of wildlife species creating new disease reservoirs, which adds to the difficulty of eradicating this disease. Broad and consistent use of the available vaccines would contribute in reducing the incidence of brucellosis. Unfortunately, this practice is not common. In addition, the current brucellosis vaccines cannot provide sterilizing immunity, and in certain circumstances, vaccinated livestock are not protected against co-mingling Brucella-infected wildlife. Given that these vaccines are inadequate for conferring complete protection for some vaccinated livestock, alternatives are being sought, and these include genetic modifications of current vaccines or their reformulations. Alternatively, many groups have sought to develop new vaccines. Subunit vaccines, delivered as a combination of soluble vaccine plus adjuvant or the heterologous expression of Brucella epitopes by different vaccine vectors are currently being tested. New live attenuated Brucella vaccines are also being developed and tested in their natural hosts. Yet, what is rarely considered is the route of vaccination which could improve vaccine efficacy. Since Brucella infections are mostly transmitted mucosally, mucosal delivery of a vaccine has the potential of eliciting a more robust protective immune response for improved efficacy. Hence, this review will examine these questions and provide the status of new vaccines for livestock brucellosis.
V. N. Timchenko
Full Text Available A clinical observation and treatment of 36 children between the ages of 5 months up to 3 years old with measles. In 34 persons. (94.4% diagnosed with typical moderate forms, from 2 people (5.6% — atypical (mitigirovannaya a mild form of the disease. All children are vaccinated against measles. Typical measles char-acterized by moderate forms of cyclical flow with the change of the classical period and the presence of characteristic clinical syndromes. Pathognomonic symptom found: spots Belsky — Filatov — Koplik (67.7%, stages a rash (100%, stages of pigmentation (100%. Causal therapy was VIFERON®. Revealed the rapid disappearance of intoxication and normalization of body temperature, the early decline in the severity and duration of catarrhal syndrome, reducing the severity and frequency of complications, no stratification of SARS.
Smith, B.; Roffe, T.J.
With the challenges confronting North America's elk herds today, a bacteria that causes a nonfatal disease in a few elk herds seems an unlikely addition to the list. Fragmentation of habitat, dwindling bull-cow ratios, grazing competition from livestock on public rangelands, or the crowding of favorite hunting spots all seem like far more urgent matters to elk junkies. But a twist of fate an a national campaign to eradicate this seemingly innocuous bacterium have put brucellosis on the front burner.
Street, L; Grant, W W; Alva, J D
Brucellosis has always been an unusual disease in children and, concomitant with the control of the disease in domestic animals, reports have become sparse. The pediatrician, therefore, may not be aware of the protean clinical manifestations of childhood brucellosis. In 1973, nine cases occurred during a three-month period in El Paso, Texas. All cases were marked by spiking fevers and lethargy of four days to four weeks in duration. Tender hepatomegaly or splenomegaly was striking in seven patients. Other characteristics included epistaxis, arthralgia, myalgia, and weight loss. Leukopenia and leukemoid reaction were found in five patients. All of the patients tested had elevated liver enzymes. Febrile agglutinins were invaluable in screening for an early clue to diagnosis. When Brucella abortus antigen agglutinated serum from patients with a positive screen in dilutions greater than 1:320, a presumptive diagnosis of brucellosis was made. Brucella was isolated from the blood or bone marrow in seven patients and the time of incubation proved crucial for successful recovery. Bacterial blood cultures are usually discarded at ten days of age, as were cultures from the only two patients from whom the organism was not recovered. All of the cultures incubated for 12 to 15 days grew B. melitensis, an unusual causative species in the United States. However, several patients admitted eating cheese from the State of Chihuahua, Mexico, made from unpasteurized goat's milk, the presumed source of the infection. Within one to three days, all patients responded dramatically to antibiotics; tetracycline was given orally for 21 days and streptomycin intramuscularly for 14 days. Pediatricians caring for patients in areas where consumption of unpasteurized milk products is likely would do well to consider brucellosis in a child with obscure fever or toxic hepatosplenomegaly.
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Caseris, M; Burdet, C; Lepeule, R; Houhou, N; Yeni, P; Yazdanpanah, Y; Joly, V
Measles is a highly contagious infectious disease, which needs more than 95% worldwide vaccination coverage of 2 doses to be eradicated. Despite an important involvement of the WHO for massive immunization, goals have not bean reached, and outbreaks can occur at any time in many countries, including Western Europe. In France, 22,000 cases were identified between 2009 and 2011, mainly in infants and young adults, which are not or not enough vaccinated (one dose). In 2012, even though the number of cases has drastically decreased, the outbreak is still going on, especially in South of France. That is why every clinician needs to be concerned about the clinical manifestations of the disease, and its complications. Besides a febrile rash, measles is often responsible of pneumonia and biologic hepatitis in adults. Hepatitis does not seem frequent in children. Clinicians need to be aware of specific complications, like encephalitis in case of cellular immunodepression, high risk of pneumonia in pregnant women. In patients previously vaccinated, incidence of complications is the same but patients are not contagious. Even if measles diagnosis is clinical, blood confirmation by serology is recommended in France when possible. Outcome is mainly favourable, but measles is not well-tolerated with high levels of hospitalisation even without any complication. Vaccination is the only way to protect against it.
Dardis, Melissa R.
Measles, once a common childhood illness that many older school nurses could recognize without difficulty, needs review again after reemerging from Europe and other continents. A highly contagious disease, which has been referenced since the seventh century, the virus can cause serious illness and death, despite the fact that it is vaccine…
The number of adults with syphilis in Russia has increased 15-fold since the collapse of the Soviet Union. The rate in children is 20 times higher than it was 4 years ago. 126,500 cases were registered with the health ministry over the past year, while 7900 were in 1990. The number of cases in children increased from 38 in 1991 to 761 this year; most of these cases were acquired via sexual transmission. Lilia Tikhonova, the health ministry's chief specialist on sexually transmitted diseases (STDs), blamed the increases on "the complete perversion of our society's morals," the rapid growth of child prostitution, the influx of homeless people and refugees into the cities, and miracle cures that are used in place of seeing a specialist. In communist Russia, patients were required to register passport details and previous sexual contacts, and future sexual contact was forbidden for a period; anyone breaking these rules faced 5 years in jail. Current law only punishes those who knowingly infect their sexual partners. Health officials in the Ukraine, where a similar increase in the number of STDs has been noted, blame black market condoms. Over the past 5 years, cheap foreign condoms have flooded the market.
Attenuvax® Measles Vaccine ... R-Vax® II (as a combination product containing Measles Vaccine, Rubella Vaccine) ... M-R® II (as a combination product containing Measles Vaccine, Mumps Vaccine, Rubella Vaccine)
Bittencourt, Maraya de Jesus Semblano; de Brito, Arival Cardoso; Nascimento, Bianca Angelina Macêdodo; Carvalho, Alessandra Haber; Drago, Marion Guimarães
Acquired syphilis can be divided into primary, secondary, latent, and tertiary stages. About 25% of patients with untreated primary syphilis will develop late signs that generally occur after three to five years, with involvement of several organs. The authors present an immunocompetent female who developed a tertiary stage syphilis presenting with long-standing nodular plaques. PMID:27579755
Khurana, Ananta; Singal, Archana; Gupta, Seema
Syphilis is a disease known for centuries, but still continues to be a diagnostic challenge as the myriad manifestations of secondary syphilis can mimic a lot many dermatological disorders. Lichenoid syphilis is an uncommon entity, reported only occasionally in the penicillin era. We present the case of a 32-year-old woman presenting with localized annular lichenoid lesions on the neck.
Hasanjani-Roushan Mohammad Reza
Full Text Available Objective: Brucellosis is considered as an important zoonotic and worldwide infection with more than half of million human cases, which it occurs more and more in animals like as wild and live stocks. Sheep, cattle, and goats are animal samples that listed. Symptoms of this disease in human are consisted of: undulant fever, back pains, faint, spondylitis, arthritis and orchitis. This infection causes abortion in livestock, and this point is one of the important economic losses. Reduction in milk production is another problem in this disease too. Materials and Methods: This study is conducted by reviewing of the literatures, which are related to this concern, and also visiting PubMed, ISI and other websites. Results: We must pay heed that most zoonoses are maintained in the animal reservoir. These diseases, such as leptospirosis, Q-fever, brucellosis etc. which among them brucellosis can transfer to human via close contact with infected animals or consumption of unpasteurized dairy. Therefore, eradication of this infection in human population is depended on omission of that in possible methods among animals reservoir. Such methods are like test-slaughter and vaccination of livestock. Hence, vaccination is not alone method for controlling, but it is probably economic one. Conclusion: Nowadays a vaccine which is effective for this disease control in human is not available. Of course presented some different vaccines for this infection in livestock that cleave live attenuated, killed bacteria and sub unit. Therefore, for eradication of this disease some vaccines with more effectiveness protection mid fewer side effects are necessary.
Retief, F P; Wessels, A
The evidence that Adolf Hitler might have suffered from incapacitating syphilis is reviewed. Rumors that he acquired syphilis from a prostitute at the age of 20 years, with possible re-infection during World War I, can no longer be verified. Evidence is that he was sexually rather inactive throughout his life. Suggestions that Hitler's cardiac lesion and complaints such as transitory blindness, tremor of his left arm and leg, recurring abdominal pain and a skin lesion of the leg were of syphilitic aetiology cannot be supported. Hitler's progressive mental and physical deterioration after 1942, his growing paranoia, fits of rage, grandiosity and symptoms of possible dementia would fit in neurosyphilis. There are, however, also other explanations for his terminal syndrome, and evidence that repeated clinical examinations did not show the characteristic signs of dementia paralytica or tabes dorsalis, swings the balance of probability away from tertiary syphilis.
Full Text Available Introduction Brucella endocarditis, although an uncommon complication of brucellosis, is the main cause of the mortality related to this disease. The best therapy is a combination of antibiotic administration with valve replacement. After treatment of the first episode of endocarditis, new infection may be occurred as a relapse or reinfection. Case Presentation In this report, we described a patient with brucella endocarditis complicated with a reinfection of the mechanical prosthetic valve after one year of follow-up. Conclusions Both medical and surgical management should be done for better treatment of brucella endocarditis. Repeat infection is a problem during follow-up.
Sunil R Vaidya
Interpretation & conclusions: Altogether, 94 measles and rubella outbreaks were confirmed in 2013 in the State of Maharasthra indicating the necessity to increase measles vaccine coverage in the State.
.... Troy Bigelow, Swine Health Programs, Aquaculture, Swine, Equine, and Poultry Programs, National Center... treated for brucellosis with antibiotics. The brucellosis regulations in 9 CFR part 78 (referred to...
Majid Avijgan; Masoud Hafizi; Ardeshir Salemi; Shams al-sadate Izadi Dehkordi
Objective:To investigate the unusual presentation of brucellosis.Methods:This prospective study was carried out on 46 patients suspected to brucellosis.The diagnosis was made with isolation of brucella species by Bone Marrow culture.Results:Among 40 culture positive patients,there were two unusual presentations of brucello-sis;Afebrile culture positive and culture positive seronegative brucellosis.Conclusion:Some brucellosis pa-tients would not match with criteria for diagnosis of brucellosis.Although it is needed to have positive serology or culture for diagnosis of brucellosis but sometimes,it is the clinical experiences,which help to diagnose and treat these kinds of patients.
Antona, Denise; Baudon, Claire; Freymuth, François; Lamy, Mathieu; Maine, Catherine; Parent du Chatelet, Isabelle; Lévy-Bruhl, Daniel
From January 2008 to May 2012, over 22,000 cases of measles were reported in France. The highest incidence rate was observed in children below one year of age. Over 50% of cases were reported in young adults. Almost 5,000 patients were hospitalised including 1,023 with severe pneumonia, 27 with encephalitis and/or myelitis : 10 died. This situation is linked to insufficient and heterogeneous vaccination coverage with pockets of susceptible people allowing virus circulation. Although the vaccine coverage in children has now improved for both doses, the issue of convincing young susceptible adults to catch up for measles vaccination remains critical, if the elimination target is to be met, and in order to protect the most vulnerable population unable to benefit from this vaccination (children below 1 year, immunodeficient people, pregnant women).
Measles kills about 1.4 million children each year. To bring about reductions in measles cases and deaths, WHO has made some recommendations. Public health officials at the community, district, and national levels need to achieve at least 90% measles vaccine coverage. This coverage level reduces cases and deaths, but may not stop transmission. The primary goal should be that health workers deliver at least 1 dose of measles vaccine to all children at the scheduled age. Several complementary strategies are needed within each country to achieve this high coverage. In situations where there is a high incidence of measles in a defined subgroup of older children, older children should receive extra doses of vaccine when they enter school. In-service training of hospital and clinic staff should reduce the number of missed opportunities (i.e., children who visit health facilities but who are not screened and administered needed immunizations). Public health workers need to identify reasons for high drop-out rates and take corrective action. Limited resources should be directed to high risk areas: areas with high population density, low measles immunization coverage, known vitamin A deficiency, or high reported measles incidence or death rate. Unimmunized urban poor children, underserved ethnic minorities, refugees, people in underserved border areas, children admitted to the hospital, and infants of HIV positive mothers comprise high risk groups. Measles outbreaks occur even in areas where measles immunization coverage is high. Control measures are not always effective, especially if taken late in an epidemic. At the very least, health officials should gather data on cases and death (e.g., date of onset and immunization status). They should determine why the outbreak took place. If possible, they should conduct a vaccine efficacy study. To reduce deaths from measles by 95%, immunization, treatment of measles and its complications at an early stage, and vitamin A
Full Text Available The authors present a case of a 20-year old student from Belgrade, who was admitted to the Institute of Infectious Diseases with fever, muscle and spine pains, strong headacke and malice. During the clinical examination bilateral sacroileitis was found. Serological analyses confirmed brucellosis. Epidemiological data showed that she lived in Kosovo and Metohia in 1997, where she consumed diary products from domestic animals this might be the reason of the acquired infection. With appropriate antibiotic therapy (aminoglycoside, doxicyclin, rifampicin, symptomatic therapy and rehabilitation the disease had favorable outcome; there was no recidive. The authors point out the importance of specific microbiological examinations of patients with fever of unknown origin, especially if the patient has the symptoms that are compatible with brucellosis. In our case it was sacroileitis, as a characteristic complication. As brucellosis is endemic in some parts of our country, there is always a possibility of brucellosis in general medical practice.
Purwar, Shashank; Metgud, S C; Gokale, Shilpa K
A male patient of 32 years was referred for surgical drainage and orchidectomy of the right testis following a cycling injury. A Venereal Disease Research Laboratory (VDRL) test was requested by the surgery department to rule out secondary syphilis. Although serum samples gave a negative result in the VDRL test, qualitative screening was performed for Brucella antibodies, as per hospital policy, since brucellosis is endemic in this region. Following a positive reaction, a quantitative standard tube agglutination test was carried out yielding titres that were exceptionally high (STAT = 40 960 IU ml(-1); 2-ME = 1 : 5120). This finding correlated with the patient's history which included a number of predisposing factors for contracting brucellosis including exposure to cattle, consumption of raw milk and assisting in the parturition of cattle. Consequently, surgery was postponed and treatment was changed from injections of ceftriaxone to the WHO regimen for the treatment of brucellosis: 1 g streptomycin once daily, administered intra-muscularly, plus 100 mg doxycycline twice daily, taken orally. Following 3 days of this treatment, the testicular swelling reduced considerably and orchidectomy was not required. Indeed, after a week, swelling was completely resolved and the patient was discharged. To our knowledge, this is the first case of such high titres in a patient as a result of epididymo-orchitis without the typical clinical presentation of fever and joint pain that is normally associated with brucellosis.
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Measles Vaccine. 113.313 Section 113... Vaccines § 113.313 Measles Vaccine. Measles Vaccine shall be prepared from virus-bearing cell culture..., less than 12 weeks of age and free of measles antibody, shall be used as test animals (20...
Opstelten, W.; Ruijs, W.L.M.; Warris, A.; Binnendijk, R.S. van; Wolfs, T.F.; Hahne, S.J.
Since the vaccination of Dutch children against the measles through the National Immunisation Programme started in 1976, the incidence of measles has greatly decreased. Local epidemics do still occur, however; these are largely confined to minority groups of orthodox Protestants who object to vaccin
... Address What's this? Submit What's this? Submit Button Measles Cases and Outbreaks Language: English Español (Spanish) Recommend ... ol: Casos y brotes de sarampiÃ³n Number of measles cases by year since 2010 Year Cases 2010 ...
Full Text Available Abstract Background Resurgence or outbreak of measles recently occurred in both developed and developing countries despite long-standing widespread use of measles vaccine. Measles incidence in China has increased since 2002, particularly in infants and in persons ≥ 15 years of age. It is speculated that infants may acquire fewer measles IgG from their mothers, resulting in the reduced duration of protection during their early months of life. This study aimed to clarify the reason of increased susceptibility to measles in young infants in China. Measles IgG in 24 measles infants ≤ 9 months of age and their vaccinated mothers was quantitatively measured. The mean measles neutralizing titer in the vaccinated mothers and in 13 age-match women with the histories of clinical measles were compared. Results All the mothers were confirmed to be vaccinated successfully by the presence of measles IgG. Six vaccinated mothers were positive for measles IgM and had high concentrations of measles IgG and the neutralizing antibody, indicating underwent natural boosting. The mean measles neutralizing titer in 18 vaccinated mothers without natural boosting were significantly lower than that in 13 age-match women with the histories of clinical measles (1:37 vs 1:182, P Conclusions Our results suggest that infants born to mothers who acquired immunity to measles by vaccination may get a relatively small amount of measles antibody, resulting in loss of the immunity to measles before the vaccination age. Measures to improve the immunity in young infants not eligible for measles vaccination would be critical to interrupt the measles transmission in China.
Makker, Jasbir; Bajantri, Bharat; Nayudu, Suresh Kumar
Syphilis, a chronic multisystem disease, is caused by a spirochete, Treponema pallidum. Clinical presentation may expand to several stages including primary, secondary and latent syphilis, which may present as early or late syphilis. Nephrotic syndrome and acute hepatitis are well-known complications of secondary syphilis. To the best of our knowledge, secondary syphilis with coexisting renal and hepatic complications has rarely been reported. Here we present a rare case of concurrent nephrotic syndrome and acute hepatitis in a patient with secondary syphilis.
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Brucellosis. 311.15 Section 311.15... CERTIFICATION DISPOSAL OF DISEASED OR OTHERWISE ADULTERATED CARCASSES AND PARTS § 311.15 Brucellosis. Carcasses affected with localized lesions of brucellosis may be passed for human food after the affected parts...
ROMAO, Elen A.; BOLELLA, Valdes R.; NARDIN, Maria Estela P.; HABIB-SIMAO, Maria Lucia; FURTADO, João Marcelo; MOYSES-NETO, Miguel
We present a case of ocular syphilis after a renal transplantation involving progressive vision loss without clinically identifiable ocular disease. Electroretinography showed signs of ischemia, especially in the internal retina. A serological test was positive for syphilis. Lumbar puncture revealed lymphocytic meningitis and a positive serologic test for syphilis in the cerebrospinal fluid. The patient was treated with penicillin, and had a quick vision improvement. In the case of transplant recipients, clinicians should always consider the diagnosis of ocular syphilis in cases with unexplained visual acuity decrement, as this condition may cause serious complications if not treated. PMID:27253748
Noriega, Leandro; Gioia Di Chiacchio, Nilton; Cury Rezende, Flávia; Di Chiacchio, Nilton
Several countries experience a new epidemic of syphilis, mainly due to the changes in risk behaviors. Dermatologists play an important role in the diagnosis, since cutaneous manifestations are frequent during disease progression. We report a rare case of secondary syphilis with periungual involvement. Syphilis, especially in the secondary form, may present with different clinical features, affecting different organs, and mimicking many diseases. Although nail apparatus lesions are more common in the primary form of the disease, they may also be present in the secondary and tertiary forms. Therefore, a comprehensive knowledge of the diverse forms of syphilis presentation is important for an early diagnosis and timely treatment.
De Keukeleire, Steven; Desmet, Stefanie; Lagrou, Katrien; Oosterlynck, Julie; Verhulst, Manon; Van Besien, Jessica; Saegeman, Veroniek; Reynders, Marijke
The performance of Elecsys Syphilis was compared to Architect Syphilis TP and Reformulated Architect Syphilis TP. The overall sensitivity and specificity were 98.4% and 99.5%, 97.7% and 97.1%, and 99.2% and 99.7% respectively. The assays are comparable and considered adequate for syphilis screening.
López-Merino, A; Migranas-Ortiz, R; Pérez-Miravete, A; Magos, C; Salvatierra-Izaba, B; Tapia-Conyer, R; Valdespino, J L; Sepúlveda, J
Brucellosis is an important and widely distributed zoonosis in Mexican cattle which also affects an unknown proportion of the human population. This report presents the brucellosis antibody levels registered in the National Seroepidemiology Survey (NAS) in sera obtained from 66,982 healthy persons from one to 98 years of age and determined by the test of plaque microagglutination. Seroprevalences by states ranged from 0.24 per cent in Morelos to 13.5 per cent in the state of Mexico. The national mean was estimated to be 3.42 per cent. The analysis showed no statistical differences for brucellosis antibody levels by urban and rural residence and by density of family sleeping areas (three or more persons vs. one or two persons per bedroom). Adults between 20 and 39 years of age had greater seropositivity and children from one to nine years had the least. Women were most affected and had 48 per cent more seropositivity than men. According to the information obtained in the study, brucellosis in Mexico has the following characteristics: it is related to gender but not to occupation; affects persons in all age groups, social strata and is independent of size of the community of residence. Historically, brucellosis has been an endemic disease in Mexico. Recently an increasing incidence has been reported, and this is possibly due to a better national notification system.
Boyaci, Ahmet; Boyaci, Nurefsan; Tutoglu, Ahmet; Dokumaci, Dilek Sen
Involvement of the skeletal system is a common complication of brucellosis. However, muscle involvement or paraspinal abscess formation are rare complications. Paraspinal abscess usually develops secondary to spondylitis. A case is reported here of a 33-year-old woman with symptoms of night sweats, fever and low back pain. Rose-Bengal test for brucellosis was positive and Brucella standard tube agglutination test was positive at a titre of 1/160. The diagnosis was made on MRI. The patient was treated with doxycycline and rifampin daily for 16 weeks. On day 14 of treatment, decline was observed in the patient's symptoms. In the presence of inflammatory lower back pain and fever, brucellosis should be considered particularly in the endemic areas. Furthermore, tuberculosis should be remembered in the differential diagnosis when a spinal epidural abscess is determined.
Full Text Available Context :Acute pancreatitis can be caused by a variety of infectious agents but it is regarded as an extremely rare complication of brucellosis. Case report: We briefly describe a 56-yearold man who presented with acute pancreatitis, fever, myalgia, and other clinical symptoms. Brucella melitensis was cultured from his blood. All clinical manifestations gradually resolved with the institution of intramuscular streptomycin and oral doxycycline therapy. Conclusion :Acute pancreatitis may rarely be a complication of infection with B. melitensis. In areas where brucellosis is endemic, it should be kept in mind that acute pancreatitis may result from infection with brucella organisms..
Duggan, M B; Milner, R D
A model predicting the nutritional cost of measles has been based on data from a study of energy balance in Kenyan children during and after measles. The energy shortfall, consequent upon a reduction in energy intake and a sustained level of energy expenditure, is met by tissue catabolism. The magnitude of resulting weight loss will be greater in lean than in plump children. During recovery, the intake of gross dietary energy to regain lost weight must take account of obligatory energy losses...
Full Text Available Measles immunization of 192 under 5 years of age children was undertaken and the overall seroconversion was 76.0%. Seroconversion rate in the age group of 9-12 months was 70.9% and it was 100% after one year. Immune response in malnourished children was more as compared to normal children. There were negligible side reactions after measles vaccination, and this vaccine passed normal potency tests under field conditions.
Full Text Available Syphilis is a multi systemic infection caused by Treponema pallidum. Ocular manifestations of Syphilis have a myriad of presentations and severity. A 31year old male patient was referred from ophthalmology department as a case of chorioretinitis for screening for syphilis. Patient had diminished vision and redness of right eye for 2 months duration. History of premarital exposure and extramarital contact was present. Ocular examination revealed - Rt eye: conjunctival congestion and Argyll Robertson pupil; Lt eye: normal. Fundoscopy of right eye showed yellowish white retinal lesions, macular edema and hyperaemia and left eye was normal .No genital lesion, scars or cutaneous lesion was present.VDRL was reactive in 1 dilution,TPHA was positive ; HIV test was negative ; CSF revealed VDRL - Negative and TPHA -Negative.Patient was treated with Injection procaine penicillin 1.2 Million units intramuscularly daily for 21 days. The patient responded well to treatment and there was improvement in his vision. Ocular Syphilis can occur at any stage of Syphilis and may be the only presenting sign. Syphilis serology was positive confirming the disease.This case highlights the importance of syphilis with ocular manifestation - there by proving that diagnosis of syphilis based on ocular finding is clinically challenging.
Full Text Available Syphilis is an infectious disease presenting stages associated with specific oral lesions. Therefore, health professionals should be familiar with the different syphilis oral manifestations at each stage and be prepared to refer any suspected patient for further evaluation. This report describes the most important clinical factors of each stage, emphasizing the oral manifestations.
Cousteau, C; Leyder, P; Laufer, J
There recently treated cases of primary buccal syphilis are reported. The lesions are discussed, with the aid of photographs, and overall symptomatology described with the aim of providing permanent training of the young. A review of primary, secondary and tertiary syphilis is followed by a summary of diagnostic criteria and therapy.
Wu Qiaozhen; Hu Yali; Lu Pei-Shan; Zhao Hong; Yao Wenhu; Zhou Yi-Hua
Abstract Background Resurgence or outbreak of measles recently occurred in both developed and developing countries despite long-standing widespread use of measles vaccine. Measles incidence in China has increased since 2002, particularly in infants and in persons ≥ 15 years of age. It is speculated that infants may acquire fewer measles IgG from their mothers, resulting in the reduced duration of protection during their early months of life. This study aimed to clarify the reason of increased...
Aaby, Peter; Martins, Cesário L; Ravn, Henrik; Rodrigues, Amabelia; Whittle, Hilton C; Benn, Christine S
WHO recommends delaying measles vaccination (MV) until maternal antibody has waned. However, early MV may improve child survival by reducing mortality from conditions other than measles infection. We tested whether early MV improves child survival compared with later MV. We found 43 studies comparing measles-vaccinated and measles-unvaccinated children; however, only 16 studies had specific information that MV had been provided at 4-13 months of age, many before 9 months of age. In the 10 best studies (4 randomized trials and 6 observational studies) control children did not receive MV during follow-up. In eight of these studies the vaccine efficacy against death (VED) was 60% or more. In four studies with information on MV provided both before and after 12 months of age, the all-cause mortality reduction was significantly larger for children vaccinated in infancy (VED=74%; 95% CI 51-86%) than for children vaccinated after 12 months of age (VED=29%; CI 8-46%). Prevention of measles explained little of the reduction in mortality. In five studies with information on measles infection, VED was 67% (51-78%) and when measles deaths were excluded, VED was only reduced to 65% (47-77%). One natural experiment compared MV at 4-8 months versus MV at 9-11 months of age and found significantly lower all-cause mortality with early vaccination, the difference being 39% (8-60%). Child mortality may be reduced if MV is given earlier than currently recommended by international organizations.
McNeil, Candice J; Bachmann, Laura H
Syphilis continues to be a burden on the public health system. While men who have sex with men and HIV-infected individuals are the most affected populations, syphilis rates have also increased in reproductive-aged women, resulting in concurrent increases in congenital syphilis. Prompt diagnosis and treatment are requisite components of syphilis control.
Full Text Available Prozone phenomenon is a false negative response resulting from high antibody titer which interferes with formation of antigen- antibody lattice, necessary to visualize a positive flocculation test. We present a case of secondary syphilis who presented to us with features of contact irritant dermatitis. She initially tested non- reactive for VDRL testing but tested positive with higher dilution. The prozone phenomenon is attaining importance because of increasing prevalence of Acquired immune deficiency syndrome. So one needs to be familiar with the occurrence of prozone phenomenon.
Full Text Available Although it has been known as a separate etiological entity for almost 150 years, brucellosis is, on a global scale, one of the most frequent diseases that is transferred from animals to humans. It is present as an endemic disease in almost all countries of the Mediterranean Sea, which indicates that a large number of aspects in connection with the control and epizootiology of this disease still remain unexplained. Three of the six types of brucella have been officially confirmed in our country as well. They are Brucella melitensis biotip 3, Brucella suis biotip 2 and Brucella canis. Brucellosis is endemically present in Kosovo and Metohija province and in southern Serbia proper; over the past few years, the spread of brucellosis in sheep and goats as primary hosts for B. melitensis to new territories, mostly in Vojvodina province, has shown that risk analysis is one of the main factors in selecting and implementing control programmes. A correctly selected set of diagnostic tests yields reliable data in most cases, but interpretations of results are prone to result in subjective assessments as well. A special problem in the serological diagnosis of brucellosis is the cross reactivity of brucellas and some other bacteria, often a weak immunological response of the animal, or that the type of brucella that causes the infection determines the sensitivity and specificity of the applied tests, most often screenings tests. Due to the big economic losses resulting from disease control and eradication, and the serious risk to human health, brucellosis still poses an epizootiological, and, in particular, a diagnostic challenge.
Mariana Souza Varella Frazão
Full Text Available Introduction. Considered as a rare event, gastric syphilis (GS is reported as an organic form of involvement. Low incidence of GS emphasizes the importance of histopathological analysis. Objective. We aim to characterize GS endoscopic aspects in an immunocompetent patient. Case Report. A 23-year-old man presented with epigastric pain associated with nausea, anorexia, generalized malaise and 11 kg weight loss that started 1 month prior to his clinical consultation. Physical examination was normal except for mild abdominal tenderness in epigastrium. Endoscopy observed diminished gastric expandability and diffuse mucosal lesions, from cardia to pylorus. Gastric mucosa was thickened, friable, with nodular aspect, and associated with ulcers lesions. Gastric biopsies were performed, and histopathological analysis resulted in dense inflammatory infiltration rich in plasmocytes. Syphilis serologies were positive for VDRL and Treponema pallidum reagents. Immunohistochemical tests were positive for Treponema pallidum and CD138. The patient was treated with penicillin, leading to resolution of his clinical complaints and endoscopic findings. Conclusion. Diagnosis suspicion of GS is important in view of its nonspecific presentation. Patients with gastric symptoms that mimic neoplastic disease should be investigated thoroughly based on the fact that clinical, endoscopic, and histological findings can easily be mistaken for lymphoma or plastic linitis.
K.J. Stittelaar (Koert); R.L. de Swart (Rik); A.D.M.E. Osterhaus (Albert)
textabstractMeasles, a highly contagious viral disease, is a major childhood killer in developing countries, accounting for almost 1 million deaths every year globally. Measles virus normally does not cause a persistent infection, no animal reservoir for measles virus exists, no vector is involved i
Colakoglu Onder; Taskiran Bengur; Adnan Kirci; Tunakan Mine; Buyrac Zafer; Unsal Belkis; Aksoz Kadir; Yorukoglu Gazi
To show that brucellosis may trigger autoimmune hepatitis(AIH), in addition to nonspecific liver involvement and toxic hepatitis, due to a class effect of tetracycline family used for treatment. We present a female patient admitted to our hospital due to partially improved fatigue and elevated liver enzymes following doxycycline and streptomycin usage for brucellosis. Brucellosis is endemic in our country, Turkey. It may involve any organ in the body. Liver is frequently involved. Doxycycline used for treatment occasionally may lead to hepatotoxicity. AIH is a necroinflammatory disease of the liver. Certain drugs (e.g. Minocycline), toxins, and viruses (hepatitis B, hepatitis C, EBV, etc.) can trigger AIH. Only one case of AIH probably caused by doxycycline and brucellosis was reported. We discuss the relationship between brucellosis, AIH, and hepatotoxicity of doxycycline. Brucellosis may trigger AIH.
Luna-Martínez, J Eduardo; Mejía-Terán, Claudia
Traditionally, Mexico has been recognized as endemic with brucellosis. The improvements in diagnostics techniques and vaccination strategies and the enforcement of a national eradication policy have contributed significantly to making progress in the control of brucellosis. The current status of brucellosis and its risk factors, in the different production species as well as in human population is reviewed. Also the trends in control and eventual eradication strategies and perspectives for the near future of Mexico are presented.
Thomas, Walter B., III
A flight printed wiring board (PWB) for a satellite project was observed to have a high incidence of measling. Other PWB's produced for the program by the same manufacturer did not exhibit the degree of measling as did the 'measle-prone' board. Measling susceptibility during hand soldering and measling effects on PWB insulation resistance were investigated for three production PWB's. Measling resistance was significantly different between the three boards: the 'worst' exhibited five times the number of measles as the 'best' board. 'Severe' measling (that which is likely to affect board reliability) did not exist on the 'best' board, even under extreme soldering conditions (399 degrees C for 12-15 sec.), whereas the 'worst' board showed an average of one 'severe' measle for every two pads under more normal soldering conditions (288-343 degrees C for 2-5 sec.). Both soldering time and temperature affected measling, with time having a slightly greater influence (2 percent versus 12 percent). Measling effects on PWB insulation resistance were inconclusive. These were evaluated by in situ resistance measurements on the same three boards at elevated temperature and humidity. The measured resistance for all three boards decreased for exposures greater than 50 degrees C and 50 percent relative humidity. The 'measle-prone' board showed a resistance decrease at only 25 degrees C and 50 percent relative humidity. However, no definitive difference was detected between measled and not-measled (control) samples. The boards evaluated were production boards, so the effect of interlayer traces connecting the plated-through holes was not controlled. It is likely the resistance measurements were over different volumes of PWB laminate, which would account for the widely varying resistances measured. Thermomechanical measurements on board laminate materials did not reveal any differences attributed to measling. Differences in glass transition temperature were significantly different
Mohsenpour, Behzad; Hajibagheri, Katayon; Afrasiabian, Shahla; Ghaderi, Ebrahim; Ghasembegloo, Saeideh
The relationship between blood groups and some infections such as norovirus, cholera, and malaria has been reported. Despite the importance of brucellosis, there is a lack of data on the relationship between blood groups and brucellosis. Thus, in this study, we examined the relationship between blood groups and brucellosis. In this case-control study, the blood groups of 100 patients with brucellosis and 200 healthy individuals were studied. Exclusion criteria for the control group consisted of a positive Coombs Wright test or a history of brucellosis. The chi-square test was used to compare qualitative variables between the two groups. The variables that met inclusion criteria for the regression model were entered into the logistic regression model. A total of 43% patients were female and 57% male; 27% were urban and 73% rural. Regression analysis showed that the likelihood of brucellosis infection was 6.26 times more in people with blood group AB than in those with blood group O (Pbrucellosis infection. Thus, there is a relationship between blood group and brucellosis. People with blood group AB were susceptible to brucellosis, but no difference was observed for brucellosis infection in terms of blood Rh type.
Ahmed, Mohamed O; Abouzeed, Yousef M; Bennour, Emad M; van Velkinburgh, Jennifer C
Brucellosis is a global bacterial zoonosis responsible for high morbidity in humans and significant livestock economic losses. While brucellosis remains a public health concern worldwide, its global geographic distribution is variable, largely due to different management schemes; however, paucity of information renders the status of brucellosis unclear and incomplete in many countries, especially those with low income and under-developed infrastructure. This short article summarizes and discusses recent important updates on brucellosis from the North African countries, with a particular brief emphasis on the current status and recent updates in Libya.
Saraswathy, T S; Zahrin, H Nor; Norhashmimi, H; Az-Ulhusna, A; Zainah, S; Rohani, J
In Malaysia, the two dose measles - mumps - rubella (MMR) vaccine was introduced in the Expanded Program on Immunization in 2002. The Ministry of Health then initiated a measles elimination strategy which included enhanced case-based surveillance with laboratory testing of all suspected cases. The objective of our study was to analyse national measles laboratory data from 2004 to 2008 to study the impact of the nationwide strategy on measles case incidence. Blood samples collected from suspected measles cases during the acute stage of the illness were investigated for measles specific IgM. The estimated incidence of measles ranged from 22.3 cases (in 2004) to 2.27 cases (in 2006) per 100,000 population. During this time, the measles vaccination coverage was above 85%. Laboratory confirmed measles cases dropped from 42.2% in 2004, when sporadic outbreaks were reported, to 3.9% in 2007. Screening for measles IgG levels in 2008 showed that 82.8% of those > 7 years old had adequate immunity. The measles control strategy appears to have been successful in reducing the incidence of measles. Continuing high vaccination coverage rates and ongoing measles surveillance are necessary to achieve our goal of measles elimination.
... Respond to Pre-Award Requests Manage Your Award Negotiation & Initial Award After Award ... New Trial Launched in West Africa to Evaluate Three Vaccination Strategies , April 6, 2017 Monoclonal Antibody Cures Marburg Infection ...
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Bojić Biljana; Vujošević Milica; Nikolić Svetlana; Dulović Olga; Grebenarević Jelica; Milinković Zoran; Gvozdenović Jasna J.
The authors present a case of a 20-year old student from Belgrade, who was admitted to the Institute of Infectious Diseases with fever, muscle and spine pains, strong headacke and malice. During the clinical examination bilateral sacroileitis was found. Serological analyses confirmed brucellosis. Epidemiological data showed that she lived in Kosovo and Metohia in 1997, where she consumed diary products from domestic animals this might be the reason of the acquired infection. With appropriate ...
Morley, David C.; Woodland, Margaret; Krugman, Saul; Friedman, Harriet; Grab, Bernard
Over the last five years, a number of reports have appeared drawing attention to the serious results of measles in young West African children. This is borne out by observations over a three-year period on children in the village of Imesi, which showed measles to be a severe and often fatal disease. The original live attenuated measles vaccine developed by Enders has been shown to give good protection and, in combination with immune serum, has been widely used in the USA. However, the need to combine it with immune serum severely limits its usefulness, owing to the small quantities of serum available and the high cost. In the present study, the reaction produced by the original vaccine with immune serum was compared with the reaction produced by a further attenuated vaccine without serum. The latter gave significantly fewer and less severe reactions, but produced a satisfactory serological response. This new vaccine should facilitate large-scale immunization of children in areas such as West Africa where protection against measles is urgently required. PMID:14196817
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Brucellosis exposed swine. 78.32... AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS BRUCELLOSIS Restrictions on Interstate Movement of Swine Because of Brucellosis § 78.32 Brucellosis exposed swine....
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Brucellosis exposed bison. 78.23... AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS BRUCELLOSIS Restrictions on Interstate Movement of Bison Because of Brucellosis § 78.23 Brucellosis exposed...
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Brucellosis reactor cattle. 78.7... AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS BRUCELLOSIS Restrictions on Interstate Movement of Cattle Because of Brucellosis § 78.7 Brucellosis reactor cattle....
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Brucellosis exposed cattle. 78.8... AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS BRUCELLOSIS Restrictions on Interstate Movement of Cattle Because of Brucellosis § 78.8 Brucellosis exposed...
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Validated brucellosis-free States. 78.43 Section 78.43 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT... BRUCELLOSIS Designation of Brucellosis Areas § 78.43 Validated brucellosis-free States. Alabama,...
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Brucellosis reactor swine. 78.31... AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS BRUCELLOSIS Restrictions on Interstate Movement of Swine Because of Brucellosis § 78.31 Brucellosis reactor swine....
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Brucellosis reactor bison. 78.22... AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS BRUCELLOSIS Restrictions on Interstate Movement of Bison Because of Brucellosis § 78.22 Brucellosis reactor bison....
Jacques, J; Sauter, M
In many African countries measles is considered to be an important cause of blindness. On the basis of his observations in Kenya and Tanzania in 1972 Franken presumed, however, that in the majority of these cases xerophthalmia was the real cause of blindness, precipitated by the "catalyst" measles. In order to gain a better understanding of this important complicated problem, we performed in the first half of 1974 an investigation in Kenya into the prevalence of xerophthalmia. In December 1974 we had the opportunity to evaluate our Kenyan findings on Java, in the company of Dr. J. ten Doesschate and Professor H.A.P.C. Oomen. The results of this investigation in Kenya and Indonesia are presented in this thesis. (see article) 1. Xerophthalmia occurred nearly everywhere in Kenya in 1974. This demonstrates the prevalence of xerophthalmia in communities which - do not have rice but - have maize for their staplefood. 2. Xerophthalmia appears to be the main cause of blindness in Kenyan children. 3. Measles often plays - by means of local and general "catalysing" effects - an important role in the development of blindness caused by xerophthalmia. 4. In well-nourished children measles is of no consequence as a cause of blindness. 5. Vital staining by 1% rose bengal or 1% lissamine green appears to be a real asset for the early diagnosis of xerophthalmia in Health Centres and in field surveys. This method is therefore of great importance for the prevention of severe, blindness inducing vitamin A deficiency.
Jick, Hershel; Hagberg, Katrina Wilcox
We identified all children in the UK General Practice Research Database diagnosed with measles from 1990 to 2008 and calculated annual incidence according to age and geographic region by dividing the number of cases per year by the number of children who were active in the population. We evaluated the effectiveness of the measles vaccines by comparing the vaccination histories of children who were diagnosed with measles (cases) to children who were not (controls). The annual incidence of measles fell after the introduction of the MMR vaccine in late 1988. However, a modest outbreak of measles occurred in 1994, leading to large nationwide programs to immunize children. Since 1996, the incidence of measles has fallen by more than 80%. Prior measles vaccination is highly effective and has substantially reduced the risk of measles.
Zhengyi Zhang; Yuan Zhao; Lili Yang; Changhong Lu; Ying Meng; Xiaoli Guan; Hongjin An; Meizhong Zhang; Wenqin Guo; Bo Shang; Jing Yu
Measles is caused by measles virus belonging to genus Morbillivirus of the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85%) tested ...
The studies included in this PhD thesis examined the interactions of syphilis, which is caused by Treponema pallidum, and HIV. Syphilis reemerged worldwide in the late 1990s and hereafter increasing rates of early syphilis were also reported in Denmark. The proportion of patients with concurrent...... HIV has been substantial, ranging from one third to almost two thirds of patients diagnosed with syphilis some years. Given that syphilis facilitates transmission and acquisition of HIV the two sexually transmitted diseases are of major public health concern. Further, syphilis has a negative impact...... on HIV infection, resulting in increasing viral loads and decreasing CD4 cell counts during syphilis infection. Likewise, HIV has an impact on the clinical course of syphilis; patients with concurrent HIV are thought to be at increased risk of neurological complications and treatment failure. Almost ten...
The developments in neuro syphilis in the 19 th century are integral parts of the history of psychiatry. The delineation of various aspects of neuro syphilis by Sir Arthur Conan Doyle in three of his stories is discussed in brief.
Shin, U.; Song, C. H.; Lee, H. Y.; Chung, H. K.; Joo, K. B. [Han Gang Sacred Heart Hospital, Hallym College, Seoul (Korea, Republic of)
Measles is important infectious disease of pediatrics and pneumonia is the most commonest complication of measles. We have experienced 20 cases of pneumonia among 31 cases of measles in infant nursing home of Chae Chun during of December. 1981. The results a are as follows; 1. The incidence of measles pneumonia is 64.5%. 2. The patterns of pneumonic infiltration is : The pneumonia may have a bronchopneumonia (60%), Lobar pneumonia (15%), or combined form (35%). 3. Both lungs are involved by measles pneumonia: Right lung only (30%), Left lung only (5%), or Bilateral (65%). 4. Hilar lymphadenopathy (51.6%). Hilar lymphadenopathy with pneumonia (82.2%) and hilar lymphadenopathy without pneumonia (17.8%). 5. There is no pulmonary nodule which is noted frequently in atypical measles pneumonia as a seguale.
Anindya Sekhar Bose; Hamid Jafari; Stephen Sosler; Arvinder Pal Singh Narula; V M Kulkarni; Nalini Ramamurty; John Oommen; Jadi, Ramesh S; Banpel, R. V.; Ana Maria Henao-Restrepo
BACKGROUND: According to WHO estimates, 35% of global measles deaths in 2011 occurred in India. In 2013, India committed to a goal of measles elimination by 2020. Laboratory supported case based measles surveillance is an essential component of measles elimination strategies. Results from a case-based measles surveillance system in Pune district (November 2009 through December 2011) are reported here with wider implications for measles elimination efforts in India. METHODS: Standard protocols...
Tsachouridou, Olga; Skoura, Lemonia; Christaki, Eirini; Kollaras, Panagiotis; Sidiropoulou, Eleni; Zebekakis, Pantelis; Vakirlis, Efstratios; Margariti, Apostolia; Metallidis, Symeon
Introduction Sexually transmitted diseases (STDs) are a major public health issue in Europe. Numerous outbreaks of syphilis have been described recently and an increased prevalence of high-risk sexual practices has raised concern about the transmission of HIV and other STDs. Similarly, an increase in sexually transmitted infections has been recorded in Northern Greece. Methods This report describes a recent outbreak of syphilis in people living with HIV. The demographic, clinical, and serologic data of HIV patients diagnosed with syphilis were recorded and analyzed. Data on syphilis incidence from the general population was also compared to HIV patients’ data. Results Fifty-eight HIV-patients of the Infectious Diseases Unit of a tertiary hospital (5.2%) were diagnosed with syphilis during a three-year period (2008-2010). Highly active antiretroviral therapy (HAART) and coexistence of other STDs were independent predictors of syphilis (OR: 2.4, 95CI%: 1.26, 4.63, p=0.008; OR: 9.4, 95%CI: 4.49, 19.64, phomosexual contact (p=0.003), were separate risk factors for syphilis in the general population in the same area. Conclusion Diagnosis of a sexually transmitted disease in an HIV patient is a crucial clinical event that should trigger the clinician’s suspicion for high-risk sexual behavior. Sexual health assessments should be a routine process for HIV patients. PMID:27622160
Holzmann, Heidemarie; Hengel, Hartmut; Tenbusch, Matthias; Doerr, H W
Measles virus (MeV) is an aerosol-borne and one of the most contagious pathogenic viruses known. Almost every MeV infection becomes clinically manifest and can lead to serious and even fatal complications, especially under conditions of malnutrition in developing countries, where still 115,000 to 160,000 patients die from measles every year. There is no specific antiviral treatment. In addition, MeV infections cause long-lasting memory B and T cell impairment, predisposing people susceptible to opportunistic infections for years. A rare, but fatal long-term consequence of measles is subacute sclerosing panencephalitis. Fifteen years ago (2001), WHO has launched a programme to eliminate measles by a worldwide vaccination strategy. This is promising, because MeV is a human-specific morbillivirus (i.e. without relevant animal reservoir), safe and potent vaccine viruses are sufficiently produced since decades for common application, and millions of vaccine doses have been used globally without any indications of safety and efficacy issues. Though the prevalence of wild-type MeV infection has decreased by >90 % in Europe, measles is still not eliminated and has even re-emerged with recurrent outbreaks in developed countries, in which effective vaccination programmes had been installed for decades. Here, we discuss the crucial factors for a worldwide elimination of MeV: (1) efficacy of current vaccines, (2) the extremely high contagiosity of MeV demanding a >95 % vaccination rate based on two doses to avoid primary vaccine failure as well as the installation of catch-up vaccination programmes to fill immunity gaps and to achieve herd immunity, (3) the implications of sporadic cases of secondary vaccine failure, (4) organisation, acceptance and drawbacks of modern vaccination campaigns, (5) waning public attention to measles, but increasing concerns from vaccine-associated adverse reactions in societies with high socio-economic standards and (6) clinical
Ulu-Kilic, Aysegul; Metan, Gökhan; Alp, Emine
Brucellosis is a worldwide zoonosis caused by Brucella species. The disease remains a significant economic and public health problem particularly in the Mediterranean countries. Clinical manifestations of brucellosis are variable and often nonspecific, simulating infectious and noninfectious diseases. Osteoarticular involvement is the most common focal complication of brucellosis and morbidity. Mortality rate due to brucellosis is low, mostly secondary to endocarditis and central nerve involvement of disease. The diagnosis of brucellosis depends on the clinical presentations and laboratory tests. Detection of Brucella species by culture method is sometimes unsuccessful; therefore, serological tests are preferred. These tests are easy to perform, and results can be obtained within a short span of time. Several serologic tests have been developed for the diagnosis of human brucellosis, including the standard agglutination tube (SAT) test, anti-human globulin (Coombs) test, indirect fluorescence antibody (IFA) test, and enzyme-linked immunosorbent assay (ELISA). SAT is the primary test used in many clinical laboratories. IFA and ELISA are simple and reliable for the detection of immunoglobulin classes especially in complicated cases. Polymerase chain reaction (PCR) technique is highly sensitive and specific for the determination of Brucella spp. from peripheral blood and other tissues. Recent patents are especially based on molecular assays in the diagnosis of brucellosis. However, PCR is still expensive and may not be appropriate for daily practice.
Susan Maphilindawati Noor
Full Text Available Brucellosis, a bacterial zoonosis, is a disease caused by members of the genus Brucella . In Indonesia, brucellosis has known as a contagious reproductive disease in animals, however, only certain people know that brucellosis can be transmitted to human . Bovine brucellosis is characterised by one or more of the following signs : abortion, retained placenta . orchitis, epididymitis and, rarely, arthritis, with excretion of the organisms in uterine discharges and in milk . The Brucella organism is transmitted to human most commonly by ingestion of untreated milk or milk products or through the mucous membranes and wound of the skin . The severity of human disease varies, depending largely upon the infecting strain . Brucella abortus, B . melitensis. B . suis and B. canis are highly pathogenic for humans . Clinical symptoms of human brucellosis may include an intermittent fever, headaches, weakness, arthalgia, myalgia and weight loss . Occasional complications include arthritis, endocarditis, hepatitis granuloma, meningitis, orchitis dan osteomyelitis have also been reported . Brucellosis can also produce spontaneous abortion in pregnant woman . Diagnosis is based on the isolation of the organism and serology . Antibiotics are usually the mainstay of treatment and long-term treatment may be required . Brucellosis can be controlled by comprehensive campaigns to eradicate the disease by vaccination programme followed by test and slaughter of domestic animals which exhibit positive serologic reactions to brucellae.
Wyplosz, Benjamin; Lafarge, Marion; Escaut, Lélia; Stern, Jean-Baptiste
The treatment of measles pneumonitis in immunocompromised adults is not established. We describe a patient with Hodgkin's lymphoma who developed acute pneumonia during a measles infection. On day 13, intravenous ribavirin and immunoglobulins were administrated. On day 18, the patient developed acute respiratory failure. An examination of transbronchial pulmonary biopsies showed Warthin-Finkeldey giant cells that are pathognomonic of measles pneumonitis. The patient died despite aggressive supportive care. Our case and a review of literature show that measles pneumonitis is routinely fatal in patients with cancer. We suggest that antiviral drugs should be considered as soon as the diagnosis has been established.
Emine Qehaja Buçaj; Edmond Puca; Sadie Namani; Muharem Bajrami; Valbon Krasniqi; Lindita Ajazaj Berisha; Xhevat Jakupi; Bahrie Halili; Dhimiter Kraja
Objective: Brucellosis became a remarkable disease in Kosovo. But there is not a comprehensive epidemiological study about epidemiology and clinical course of this disease from Kosovo. The aim of our study is to present demographic and clinical data of patients with brucellosis at University Clinical Center of Kosovo. Methods: A retrospective study was performed for the patients with brucellosis treated in our clinic during years 2011- 2012. The data about demography, history of the diseas...
Verhave, Jan Peter
Until the end of the Second World War, syphilis was a common sexually transmitted infection. This stigmatising infectious disease caused mental decline, paralysis and eventually death. The history of syphilis was given public attention because of 'malaria therapy', which had been applied from the First World War onwards in patients with paralytic dementia. In 1917, the Austrian physician Julius Wagner-Jauregg (1857-1940) induced fever in these patients by infecting them with malaria parasites; in 1927, he received the Nobel Prize for his discovery of the healing properties of malarial fever. One source, not cited anywhere, is an interview that the American bacteriologist and science writer/medical journalist Paul de Kruif conducted with Wagner-Jauregg in 1930. The reporting of this meeting, and De Kruif's later involvement in the mechanical heat treatment of patients with syphilis, form the inspiration for this article. When penicillin became available, both treatments became obsolete.
Ross, John J
Shakespeare's obsessive interest in syphilis, his clinically exact knowledge of its manifestations, the final poems of the sonnets, and contemporary gossip all suggest that he was infected with "the infinite malady." The psychological impact of venereal disease may explain the misogyny and revulsion from sex so prominent in the writings of Shakespeare's tragic period. This article examines the possibility that Shakespeare received successful treatment for syphilis and advances the following new hypothesis: Shakespeare's late-life decrease in artistic production, tremor, social withdrawal, and alopecia were due to mercury poisoning from syphilis treatment. He may also have had anasarca due to mercury-related membranous nephropathy. This medical misadventure may have prematurely ended the career of the greatest writer in the English language.
Vollmar, Patrick; Zange, Sabine; Zöller, Lothar; Erkel, Joseph; Robert Thoma, Bryan
Although brucellosis, a zoonosis mostly associated with sheep, goats and cattle, is not endemic in Germany, it is a relevant imported infectious disease. If patients suffer from fever of unknown origin after a stay in highly endemic countries like the Mediterranean area or the Arab world, it is mandatory to formally exclude brucellosis. Cultural methods are the diagnostic gold standard, but due to special methodical and infrastructural requirements it is essential to inform the laboratory at suspicion of infection. The treatment of brucellosis is challenging and usually based on a long-term combination regime using doxycycline and rifampin for at least 6 weeks.
r•. • -- J 4"•:,••’• ’W#,•Q ’-’• ’’ ... •.... . -•- . ’, .• ... • 61 than Area C herd owners. 12. BRUCELLOSIS INFECTION IN SWINE, GOAT , SHEEP AND...replacement heifers? 1. Yes 2. No 3. Not Sure 12. Were you aware that brucellosis could also infect swine, goats , sheep, dogs and horses? 1. Yes 2. No 3. Only...94.6 Not Sure 0 No Response 2 5.4 100.0 TOTAL 37 100.0 - - 102 Q 12 Area C - BRUCELLOSIS INFECTION IN SWINE. GOAT , SHEEP, HORSES RELATIVE CUM ABSOLUTE
Garip, Y; Eser, F; Erten, S; Yilmaz, O; Yildirim, P
Spondyloarthritis are a group of chronic inflammatory diseases that affect the axial skeleton, entheses and peripheral joints and may have extraarticular manifestations such as uveitis, psoriasis and inflammatory bowel disease. Brucellosis is a systemic infectious disease, endemic in Middle East, Latin America, and Mediterranean countries, which may present manifestations that resemble other diseases posing serious problems of differential diagnosis. Some hallmarks of Brucellosis may mimic a spondyloarthritis flare. In this paper, authors present a clinical case of brucellosis occurring in a patient with spondyloarthritis. Clinical symptoms initially mimicked exacerbation of spondyloarthritis.
D. G. Ponomarenko
Full Text Available Abstract. The new cytometric method for laboratory diagnosis of brucellosis in vitro conditions based on detection of hypersensitivity to Brucella has been developed. This test allows to differentiate vaccinal and infectious processes in case of chronic brucellosis, and to measure the level of patient sensibilization to Brucella. Thus, the test might be used to estimate intensity of post-vaccination immunity before re-immunization against brucellosis. Using of flow cytometry in the test excludes additional antigenic influence on human organism and allows to provide testing within 1 hour.
.... FOR FURTHER INFORMATION CONTACT: Dr. Troy Bigelow, Swine Health Programs, Aquaculture, Swine, Equine... conditions, including arthritis. Humans can be treated for brucellosis with antibiotics. In an interim...
G. P. Martynova
Full Text Available The paper presents a case of delayed diagnosis of early congenital syphilis in a child whose mother was observed in prenatal clinic starting from the 14th week of pregnancy. The child had specific skin rash already in maternity. The child was discharged home without examination in the hospital. Only manifestations of nephritis lead to admission of the child into an inpatient hospital. Only at the age of 1 month and 23 days the child was suspected of early congenital syphilis with severe polisimptomnym, and the patient was transferred to specialized hospital.
Hernandez, Isabel; Johnson, Ayesha; Reina-Ortiz, Miguel; Rosas, Carlos; Sharma, Vinita; Teran, Santiago; Naik, Eknath; Salihu, Hamisu M; Teran, Enrique; Izurieta, Ricardo
There is a reemergence of syphilis in the Latin American and Caribbean region. There is also very little information about HIV/Syphilis co-infection and its determinants. The aim of this study is to investigate knowledge, attitudes, and practices regarding sexually transmitted infections (STIs), in particular syphilis infection and HIV/Syphilis co-infection, as well as to estimate the prevalence of syphilis among men who have sex with men (MSM) in a city with one of the highest HIV prevalence rates in Ecuador. In this study, questionnaires were administered to 291 adult MSM. Questions included knowledge about STIs and their sexual practices. Blood samples were taken from participants to estimate the prevalence of syphilis and HIV/syphilis co-infection. In this population, the prevalence of HIV/syphilis co-infection was 4.8%, while the prevalence of syphilis as mono-infection was 6.5%. Participants who had syphilis mono-infection and HIV/syphilis co-infection were older. Men who had multiple partners and those who were forced to have sex had increased odds of syphilis and HIV/syphilis co-infection. A high prevalence of syphilis and self-reported STI was observed, which warrants targeted behavioral interventions. Co-infections are a cause for concern when treating a secondary infection in a person who is immunocompromised. These data suggest that specific knowledge, attitudes, and behaviors among MSM are associated with increased odds of STIs (including HIV/syphilis co-infections) in this region of Ecuador.
Kutlu, Murat; Ergonul, Onder; Sayin-Kutlu, Selda; Guven, Tumer; Ustun, Cemal; Alp-Cavus, Sema; Ozturk, Serife Barcın; Acicbe, Ozlem; Akalin, Serife; Tekin, Recep; Tekin-Koruk, Suda; Demiroglu, Yusuf Ziya; Keskiner, Ramazan; Gönen, Ibak; Sapmaz-Karabag, Sevil; Bosnak, Vuslat; Kazak, Esra
Veterinarians and veterinary technicians are at risk for occupational brucellosis. We described the risk factors of occupational brucellosis among veterinary personnel in Turkey. A multicenter retrospective survey was performed among veterinary personnel who were actively working in the field. Of 712 veterinary personnel, 84 (11.8%) had occupational brucellosis. The median number of years since graduation was 7 (interquartile ranges [IQR], 4-11) years in the occupational brucellosis group, whereas this number was 9 (IQR, 4-16) years in the non-brucellosis group (pbrucellosis. We suggest that all veterinary personnel should be trained on brucellosis and the importance of using personal protective equipment in order to avoid this infection.
Full Text Available Brucellosis continues to be a common infectious disease in some parts of the world. Although the disease has different presentations, but chest wall involvement, as a manifestation of brucellosis is rare. In this study, we report three cases of chest wall involvement as manifesting feature of Brucellosis in Iran. They presented with a history of parasternal masses revealed to a diagnosis of Brucellosis and responded well to the treatment. Brucellosis may present with strange and unpredictable manifestations and can be misdiagnosed with tuberculosis and malignancies, especially in endemic areas for both TB and brucellosis.
Full Text Available Brucellosis is a zoonosis that affects several organs or systems. Skin involvement is nonspecific and it is reported to range between 0,4 and 17% of the patients with brucellosis. Here, we defined a 36-year-old female patient presented to our clinic with a clinical picture of recurrent attacks of vasculitis due to brucellosis for the first time. Skin involvement and vasculitic lesions as a finding of skin involvement are nonspecific in brucellosis. Therefore, in the regions like Turkey where brucellosis is endemic, brucellosis should be kept in mind necessarily in the differential diagnosis of vasculitis.
Al Dahouk, Sascha; Nöckler, Karsten
Brucellosis is a worldwide zoonosis with a huge economic impact on animal husbandry and public health. The diagnosis of human brucellosis can be protracted because the disease primarily presents as fever of unknown origin with unspecific clinical signs and symptoms. The isolation rate of the fastidious etiologic agent from blood cultures is low, and therefore laboratory diagnosis is mainly based on serologic and molecular testing. However, seronegative brucellosis patients have been described, and antibody titers of diagnostic significance are difficult to define. Whether the molecular detection of Brucella DNA in clinical samples should be followed by long-term antibiotic treatment or not is also a matter of debate. The aim of this article is to review and discuss the implications of laboratory test results in the diagnosis of human brucellosis on disease therapy.
Valderrama, Julia; Zacarías, Fernando; Mazin, Rafael
From the data submitted to the Pan American Health Organization (PAHO) by nationwide programs against sexually transmitted diseases (STD), HIV infection, and AIDS (2002), one can estimate the overall prevalence of syphilis among pregnant women to be 3.1% and to range from 1.00% in Peru to 6.21% in Paraguay. According to these data, the incidence of congenital syphilis ranges from 1.4 per 1000 live births in El Salvador to 12.0 per 1000 live births in Honduras. Among men who engage in sex with other men, who often classify themselves as heterosexual, as well as in female sex workers, the prevalence of syphilis ranged from 5% to 15%. Factors that determine the persistence of congenital syphilis as public health problem include a lack of awareness of the seriousness of the problem among politicians, health officials, and health care providers, difficult access to prenatal care, and screening services, a low demand for the test among users, and the stigma and discrimination that surround sexually transmitted diseases (STD). This paper seeks to focus the attention of health professionals on maternal and congenital syphilis so they will undertake actions, using an interprogrammatic approach, to eliminate congenital syphilis from Latin America and the Caribbean. Eliminating congenital syphilis will only become possible if interventions targeting vulnerable groups are also implemented. PAHO's role in eliminating congenital syphilis includes determining the baseline situation in the Region as a whole and in each country, developing communication and procurement strategies, supporting nationwide programs, promoting operational research, and facilitating interprogrammatic coordination.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Rubeola (measles) virus serological reagents. 866... Rubeola (measles) virus serological reagents. (a) Identification. Rubeola (measles) virus serological... to rubeola virus in serum. The identification aids in the diagnosis of measles and...
Meina, Li; Xiaodong, Liu; Lulu, Zhang
Despite the tremendous progress in controlling measles in China, there was measles outbreak in Beijing which was a result of cluster of unvaccinated people or people failure to vaccinate. In order to accelerate measles control efforts and achieve and high levels of measles immunity, it is helpful to implement more targeted management strategy.
B.M. Laksono (Brigitta); R. de Vries (René); S. McQuaid (Stephen); W.P. Duprex (Paul); R.L. de Swart (Rik)
textabstractMeasles virus is a highly contagious negative strand RNA virus that is transmitted via the respiratory route and causes systemic disease in previously unexposed humans and non-human primates. Measles is characterised by fever and skin rash and usually associated with cough, coryza and co
Dr. Paul Rota, team lead for the Measles Laboratory, Division of Viral Diseases, at CDC, talks about a measles virus survey in Europe, 2008-2011. Created: 10/6/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) and National Center for Immunization and Respiratory Diseases (NCIRD). Date Released: 10/6/2011.
Toole, M J; Steketee, R W; Waldman, R J; Nieburg, P
Outbreaks of measles continue to be a common occurrence among refugee and famine-affected children in emergency relief camps. Extremely high measles-associated mortality rates have been reported from refugee camps--where undernutrition is common--in several countries over the past 10 years. Mortality from measles is, however, preventable, and immunization against the disease is a high priority in emergency relief programmes, second only in importance to the provision of adequate food rations. All children aged 6 months to 5 years should be immunized with measles vaccine as soon as they enter an organized camp or settlement. Should supplies of measles vaccine be inadequate, children in feeding centres, or those otherwise identified as undernourished, are the top priority for immunization. The occurrence of measles in a camp is not a contraindication to conducting an immunization campaign. Strong coordination by a designated lead agency is needed if such campaigns are to be successful; however, cooperation with the local expanded programme on immunization is essential to ensure that existing cold chain equipment, training protocols, and management manuals are used. If additional equipment is necessary, a complete immunization kit developed by the Office of the United Nations High Commissioner for Refugees, the World Health Organization, and Oxfam can be procured from Oxfam headquarters in the United Kingdom. Vitamin A supplements should be given routinely at the time of measles immunization in situations where malnutrition is severe. Mortality and morbidity in children with clinical measles can be reduced by administering high doses of vitamin A.
Ting, I W; Ho, M W; Sung, Y J; Tien, N; Chi, C Y; Ho, H C; Huang, C C
Brucellosis is one of the most common systemic zoonotic diseases transmitted by consumption of unpasteurized dairy products or by occupational contact with infected animals. Brucellosis is rare in renal transplant recipients. Only 3 cases have been reported in the literature. We report a case of brucellosis with hematologic and hepatobiliary complications in a patient 3 years after renal transplantation. The mean time from transplantation to the diagnosis of brucellosis in these 4 reported patients was 5.1 years (range 17 months to 13 years). All patients had fever and constitutional symptoms, and all attained clinical cure after combination antibiotic therapy. Given the small number of patients, further study is needed to identify the characteristics of brucellosis in renal transplant recipients. Drug interactions and acute renal failure developed in our patient during antibiotic treatment. Therefore, we should monitor the levels of immunosuppressive agents frequently. Several studies have shown in vitro susceptibilities of Brucella melitensis to tigecycline. In our patient, fever finally subsided after tigecycline administration. The minimum inhibitory concentration of tigecycline using Etest was 0.094 μg/mL. Tigecycline may be a potential option for treatment of brucellosis in the setting of transplantation.
... The finding might explain why new and repeat cases of syphilis in gay and bisexual men have risen sharply compared to other sexually transmitted infections over the past decade, the researchers wrote. The study team was led by Dr. Michael Rekart, from ...
Full Text Available Objective. Tenosynovitis, inflammation of a tendon and its synovial sheath, is a rare manifestation of secondary syphilis and if diagnosed early is reversible. Background. A 52-year-old male with past medical history of untreated syphilis presented with gradual onset of swelling and pain of the right fourth metacarpophalangeal joint (MCP. He reported a history of painless penile lesions after having sexual intercourse with a new partner approximately five months ago which was treated with sulfamethoxazole/trimethoprim. An RPR done at that time came back positive with a high titer; however, patient was lost to follow-up. On examination, patient had an edematous, nonerythematous right fourth proximal interphalangeal (PIP joint. Urgent irrigation, debridement, and exploration of the right hand into the tendon sheath were performed. With his history of syphillis, an RPR was done, which was reactive with a titer of 1 : 64. A confirmatory FTA-ABS test was completed, rendering a positive result. Based on his history of untreated syphilis, dormancy followed by clinical scenario of swelling of the right fourth finger, and a high RPR titer, he was diagnosed with secondary syphilis manifesting as tenosynovitis.
Anindya Sekhar Bose
Full Text Available BACKGROUND: According to WHO estimates, 35% of global measles deaths in 2011 occurred in India. In 2013, India committed to a goal of measles elimination by 2020. Laboratory supported case based measles surveillance is an essential component of measles elimination strategies. Results from a case-based measles surveillance system in Pune district (November 2009 through December 2011 are reported here with wider implications for measles elimination efforts in India. METHODS: Standard protocols were followed for case identification, investigation and classification. Suspected measles cases were confirmed through serology (IgM or epidemiological linkage or clinical presentation. Data regarding age, sex, vaccination status were collected and annualized incidence rates for measles and rubella cases calculated. RESULTS: Of the 1011 suspected measles cases reported to the surveillance system, 76% were confirmed measles, 6% were confirmed rubella, and 17% were non-measles, non-rubella cases. Of the confirmed measles cases, 95% were less than 15 years of age. Annual measles incidence rate was more than 250 per million persons and nearly half were associated with outbreaks. Thirty-nine per cent of the confirmed measles cases were vaccinated with one dose of measles vaccine (MCV1. CONCLUSION: Surveillance demonstrated high measles incidence and frequent outbreaks in Pune where MCV1 coverage in infants was above 90%. Results indicate that even high coverage with a single dose of measles vaccine was insufficient to provide population protection and prevent measles outbreaks. An effective measles and rubella surveillance system provides essential information to plan, implement and evaluate measles immunization strategies and monitor progress towards measles elimination.
Dorigo-Zetsma, J.W.; Hall, M.A.; Vreeswijk, J.; Vries, J.J. de; Vossen, A.C.; Hulscher, H.I. Ten; Kerkhof, J.; Smits, G.P.; Ruijs, W.L.M.; Koopmans, M.P.; Binnendijk, R.S. van
BACKGROUND: Following the recognition of a measles case in a hospital in The Netherlands, health care workers (HCW) from the premises were screened by a commercial enzyme immunoassay (EIA) for measles IgG to identify persons at risk for measles. At least 10% of the HCW were tested measles IgG-negati
Abdool Karim, S S; Abdool Karim, Q; Chamane, M
During May and June 1990, a national mass measles immunisation campaign was undertaken in South Africa. This study is an assessment of the impact of the campaign on measles admissions to a provincial referral hospital that has specifically designated wards for children with communicable diseases. Data from the measles ward admissions book for the 18 months before the campaign (1 January 1989-30 June 1990) and 6 months after the campaign (1 July 1990-31 December 1990) were compared. Since the campaign, the average number of measles admissions has declined by 64.4% from 87 to 31 per month (P less than 0.01). Before the campaign, 21.3% of measles patients admitted were aged 7-9 months compared with 27.6% after the campaign, highlighting the urgent need to improve the measles vaccination coverage in this age group. An analysis of the geographical source of patients showed that measles continued to occur after the campaign in most of the areas where it existed before the campaign. It is concluded that important gains have been achieved by the campaign. These will be rapidly eroded and epidemics of measles may occur if measles vaccination efforts wane and slump back to pre-campaign levels. It is important to capitalise on the momentum generated through the campaign by continuing to support efforts of existing health care services to improve and maintain high levels of measles immunisation coverage.
Lehrer, Steven; Green, Sheryl; Rendo, Angela; Rosenzweig, Kenneth E.
Background A possible risk factor for brain tumor might be measles, since late neurologic sequelae are part of measles pathology. Subacute sclerosing panencephalitis, a devastating neurologic illness, is prone to develop years after measles infection. Methods Because measles damage to the brain might increase the risk of brain tumor, we examined the relationship of measles incidence in 1960 and brain tumor incidence in 50 US States and the District of Columbia, 2004-2007. Data on number of ca...
Pınar Korkmaz; Mehtap Kıdır; Nazlı Dizen Namdar; Ahmet Özmen; Cemile Uyar; Ayşe Nur Değer
Brucellosis is a zoonosis that affects several organs or systems. Skin involvement is nonspecific and it is reported to range between 0,4 and 17% of the patients with brucellosis. Here, we defined a 36-year-old female patient presented to our clinic with a clinical picture of recurrent attacks of vasculitis due to brucellosis for the first time. Skin involvement and vasculitic lesions as a finding of skin involvement are nonspecific in brucellosis. Therefore, in the regions like Turkey where ...
...; ] DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service Bovine Tuberculosis and Brucellosis... framework being developed for the bovine tuberculosis and brucellosis programs in the United States. The... tuberculosis (TB) and bovine brucellosis in the United States. In keeping with its commitment to...
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Brucellosis-reactor goats. 309.14... INSPECTION AND CERTIFICATION ANTE-MORTEM INSPECTION § 309.14 Brucellosis-reactor goats. Goats which have reacted to a test for brucellosis shall not be slaughtered in an official establishment....
... Animal and Plant Health Inspection Service Bovine Tuberculosis and Brucellosis; Program Framework AGENCY... extending the comment period on a new framework being developed for the bovine tuberculosis and brucellosis... bovine brucellosis in the United States. The notice stated that USDA would hold four public...
龚向东; 张国成; 叶顺章; 张君炎; 邵长庚; 梁国钧; 俞进
Objectives: To understand trends and epidemiological features of syphilis over the recent years in China and provide a scientific basis for developing prevention strategies. Methods: From 1985 to 2000, syphilis case-reporting data collected from all provinces, autonomous regions and municipalities were analyzed by applying epidemiological methods. Results: (1) Epidemic trends: syphilis incidence has steadily risen in China from 1985 to 2000, especially after 1993, when it assumed an exponential growth pattern. 80,406 cases of syphilis were reported in the country in 1999, which was almost 40 times the number reported in 1993. During the period of 1993-1999, the annual average growth of the syphilis incidence rate was 83.55%. Perhaps due to a recent national law enforeement campaign, the number of reported syphilis cases dropped slightly in 2000. (2) Geographical distribution: Syphilis spread from coastal, ""open"" cities (especially some cities in Fujian province) to inland urban areas, then to rural areas.Regions with a high incidence rate of syphilis in China were the Minjiang, Yangtze, and Zhujiang River Deltas, Beijing and Tianjin municipalities, and Northeast China. There was a significant difference of syphilis incidence rates and growth rates between these areas. A serious epidemic occurred in some areas, with an incidence rate reaching over 200 cases out of 100,000. (3) Population distribution: the ratio of male and female cases gradually changed from 1.57:1 in 1993 to 1.02:1 in 2000. The rate was the highest in the 20-29 age group and the lowest in 10-14 age group. A great difference existed in prevalence between different population groups and different areas,and some areas with serious epidemics had high prevalence rates even amoung the general population. (4) Clinical stage of syphilis: Primary and secondary syphilis cases have been dominating with a percentage of 90% of all syphilis cases. Primary syphilis was the most common in males and secondary
Hall, Robert; Jolley, Damien
Measles is exquisitely sensitive to immunization programs. We investigated the decline in measles incidence after immunization with 1 or 2 doses of measles-containing vaccine (MCV), with or without supplementary immunization activities (SIAs). Using data from the World Health Organization, we modeled the impact of measles immunization using a negative binomial regression model. All countries offer measles immunization, and 192 of 193 countries offer a second dose of MCV (MCV2), using either a routine second dose, SIAs, or both. The incidence of measles fell from a median of 70.9 cases/100,000/year when coverage with a first dose of MCV (MCV1) was in the range of 0%-39% to a median of .9 cases/100,000/year when MCV1 coverage was 90%-100%, in both cases with no MCV2. Further reductions followed the introduction of MCV2 and SIAs. Modeling showed that each 1% increase in MCV1 coverage was followed by a 2.0% decrease in incidence in the same and following years (95% confidence interval [CI], 2.0%-1.9%, and 2.1%-1.9%, respectively). For a second dose, a rise of 1% in MCV2 coverage was followed by a decrease in measles incidence by .4% (95% CI, .3%-.5%) in the same year and .3% (95% CI, .2%-.5%) in the following year. SIAs were followed by decreases of measles incidence by 40.3% (95% CI, 46.3%-33.8%) in the same year and 45.2% (95% CI, 51.1%-48.7%) in the following year. A herd immunity effect was demonstrated with MCV1 coverage of >80%, and SIAs are an extraordinarily effective strategy for measles control.
Yogo, Norihiro; Nichol, Aran Cunningham; Campbell, Thomas B; Erlandson, Kristine M
Retinal detachment and testicular lesions are 2 rare presentations of syphilis. We describe a man with bilateral retinal detachment from ocular syphilis and syphilitic orchitis as a manifestation of syphilis and HIV coinfection.
Hawkes, Sarah J; Yin, Yue-Pin; Peeling, Rosanna W; Cohen, Myron S; Chen, Xiang-Sheng
Abstract China is experiencing a syphilis epidemic of enormous proportions. The regions most heavily affected by syphilis correspond to regions where sexually transmitted HIV infection is also a major public health threat. Many high-risk patients in China fail to receive routine syphilis screening. This missed public health opportunity stems from both a failure of many high-risk individuals to seek clinical care and a disconnect between policy and practice. New point-of-care syphilis testing enables screening in non-traditional settings such as community organizations or sex venues. This paper describes the current Chinese syphilis policies, suggests a spatiotemporal framework (based on targeting high-risk times and places) to improve screening and care practices, and emphasizes a syphilis control policy extending beyond the clinical setting. PMID:20539859
Full Text Available At the beginning of a new millennium, syphilis incidence has been increasing worldwide, occurring primarily among men who have sex with men (MSM. The clinical features of primary syphilis among MSM is described, a case-note review of the primary syphilis (PS patients who attended the Institute of Skin and Venereal Diseases. The diagnosis was assessed based upon the clinical features and positive syphilis serology tests. Among 25 patients with early syphilis referred during 2010, PS was diagnosed in a total of 13 cases. In all patients, unprotected oral sex was the only possible route of transmission, and two out of 13 patients had HIV co-infection. Overall, 77% of men presented with atypical penile manifestation. The VDRL test was positive with low titers. The numerous atypical clinical presentations of PS emphasize the importance of continuing education of non-experienced physicians, especially in countries with lower reported incidence of syphilis.
Oseguera Montiel, D.; Frankena, K.; Udo, H.M.J.; Keilbach Baer, N.M.; Zijpp, van der A.J.
Brucellosis is a major constraint for small-scale goat farming systems in Mexico. This study estimated the prevalence of testing positive to brucellosis and identified and quantified risk factors in goats from small-scale farms of Michoacán that had participated in a brucellosis campaign (i.e. vacci
... Animal and Plant Health Inspection Service 9 CFR Part 78 RIN 0579-AD22 Brucellosis Class Free States and Certified Brucellosis-Free Herds; Revisions to Testing and Certification Requirements AGENCY: Animal and... are extending the comment period for an interim rule modifying brucellosis testing,...
... be treated for brucellosis with antibiotics. The brucellosis regulations, contained in 9 CFR part 78... disease control. APHIS has announced its intention to take a new approach to managing the bovine.... (See ``A Concept Paper for a New Direction for the Bovine Brucellosis Program,'' 74 FR...
Knudsen, Andreas; Benfield, Thomas; Kofoed, Kristian
syphilis.IL-10 and TNF-alpha levels correlated positively with plasma HIV RNA values at the time of diagnosis (r = 0.38, P = 0.023, and r = 0.64, P ... stage syphilis coinfection were associated with an increase in IL-10. IL-10 and TNF-alpha both decreased after treatment of syphilis. TNF-alpha and IL-10 correlated with low CD4 T cell counts and high plasma HIV RNA values....
郑占才; 张荣富; 溪茜
Objective: To evaluate the clinical utility of testing serum anti-treponema pallidum IgM antibody in the diagnosis of syphilis patients. Methods: Seventy-two cases of syphilis were tested for specific IgM antibody with ELISA, and the results were compared with RPR and TPPA.Results: The sensitivity of IgM antibody was 73.3 %(11/15) in primary syphilis, 88.9% (16/18) in sec-ondary syphilis, and there was no significant differ-ence between these values (x2=1.6363, P>0.10). The sensitivity of IgM antibody in diagnosing latent syphi-lis was only 26.1% (6/23), much lower than the detec-tion rate in symptomatic earlv svDhilis (x2=17.6189. P<0.005). RPR and TPPA were both 100% sensitive in latent and early symptomatic syphilis. Two were posi,five for IgM in the 16 cases who had received regular treatments 2 to 24 months before enrolled.Conclusions: Specific IgM antibody detection doees not appear superior to RPR and TPPA in diagnosing primary syphilis. The diagnosis of latent syphilis should mainly rely on RPR and TPPA, since there are low titers of IgM antibody at that stage. IgM antibody testing alone should not be recommended for monitor-ing syphilis development or treatment efficacy. Fur-ther studies should be concerned.
Full Text Available Malignant syphilis or Lues maligna, commonly reported in the pre-antibiotic era, has now seen a resurgence with the advent of human immunodeficiency virus (HIV. Immunosuppression and sexual promiscuity set the stage for this deadly association of HIV and Treponema pallidum that can manifest atypically and can prove to cause diagnostic problems. We report one such case in a 30-year-old female who responded favorably to treatment with penicillin.
Full Text Available Epididymoorchitis caused by Brucella species is a rare infection. In this report two cases of epididymoorchitis due to brucellosis are presented with their clinical and laboratory findings. The patients complained of fever, and painful testicles with swelling, the duration of which varied between 7 to 10 days. They had unilateral epididymoorchitis. Brucellosis was diagnosed serologically in all patients, whereas Brucella spp. was isolated from the blood culture of one patient. One patient was given rifampicin and doxycycline, and the other streptomycin, doxycycline and rifampicin. In all cases, complete resolution was achieved with medical treatment and relapse did not occur. Brucellosis should be considered in differential diagnosis of epididymoorchitis in endemic areas.
Bodilis, H; Goffinet, F; Krivine, A; Andrieu, T; Anselem, O; Tsatsaris, V; Rozenberg, F; Launay, O
Non-immune pregnant women are at risk of severe measles. As the measles vaccination is contraindicated during pregnancy, women should be vaccinated before conception or during the postpartum period. Nevertheless, measles serology is not recommended during pregnancy in France, and there are no data available concerning measles susceptibility and its associated risk factors among pregnant women. The socio-demographic determinants of measles seronegativity have been identified in a prospective cohort of 826 pregnant women in Paris, France. Measles seronegativity was 10.41% (95% CI 8.32-12.50). Women from higher socio-economic groups, born in France after 1980, were more frequently seronegative.
Dorman, John M.; And Others
Stanford University (California) has developed a list of medical immunization requirements for incoming students to help stop incidence of rubella and measles. A discussion of these requirements is offered. (DF)
Full Text Available The incidence of syphilis has historically been cyclical in nature, often in relation to the rise and fall of public health initiatives directed toward eradication along with social attitudes toward sexual practices. The incidence of syphilis has increased by 15% in the last 6 years in the United States, with similar increases worldwide. Herein, we present an atypical case of syphilis presenting with severe septic shock and multiple anogenital lesions in an immunocompetent host. A 22-year-old male with no significant past medical history presented with fevers, chills, sore throat, diaphoresis, and diarrhea. He was febrile, tachycardic, hypotensive, and unresponsive to fluid resuscitation requiring short-term vasopressor support. Physical exam revealed diffuse lymphadenopathy; lower extremity macular rash involving the soles of the feet; papular non-pustular lesions on the scrotum; and a 0.5 cm non-tender irregular, healing lesion on the shaft of the penis. Laboratory analysis was significant for leukocytosis and elevated creatinine. Serum screening rapid plasma reagin was positive, and further testing revealed a titer of 1:32, with confirmation via fluorescent treponemal antibody absorption test. The patient was diagnosed with secondary syphilis, which was determined to be the underlying etiology of the sepsis as all other serological evaluations were negative. He was treated with penicillin G benzathine 2.4 million units intramuscular and supportive management, with improvement of symptoms. The patient engaged in high-risk sexual behaviors, including prior unprotected sexual contact with males. New research indicates that up to one-third of patients may present with atypical cutaneous manifestations, as demonstrated by this patient. It is important for physicians to familiarize themselves with the varied clinical presentations of syphilis, which include multiple anogenital lesions and tender primary lesions in primary or secondary syphilis.
Full Text Available Oncolytic virotherapeutic agents are likely to become serious contenders in cancer treatment. The vaccine strain of measles virus is an agent with an impressive range of oncolytic activity in pre-clinical trials with increasing evidence of safety and efficacy in early clinical trials. This paramyxovirus vaccine has a proven safety record and is amenable to careful genetic modification in the laboratory. Overexpression of the measles virus (MV receptor CD46 in many tumour cells may direct the virus to preferentially enter transformed cells and there is increasing awareness of the importance of nectin-4 and signaling lymphocytic activation molecule (SLAM in oncolysis. Successful attempts to retarget MV by inserting genes for tumour-specific ligands to antigens such as carcinoembryonic antigen (CEA, CD20, CD38, and by engineering the virus to express synthetic microRNA targeting sequences, and “blinding” the virus to the natural viral receptors are exciting measures to increase viral specificity and enhance the oncolytic effect. Sodium iodine symporter (NIS can also be expressed by MV, which enables in vivo tracking of MV infection. Radiovirotherapy using MV-NIS, chemo-virotherapy to convert prodrugs to their toxic metabolites, and immune-virotherapy including incorporating antibodies against immune checkpoint inhibitors can also increase the oncolytic potential. Anti-viral host immune responses are a recognized barrier to the success of MV, and approaches such as transporting MV to the tumour sites by carrier cells, are showing promise. MV Clinical trials are producing encouraging preliminary results in ovarian cancer, myeloma and cutaneous non-Hodgkin lymphoma, and the outcome of currently open trials in glioblastoma multiforme, mesothelioma and squamous cell carcinoma are eagerly anticipated.
Full Text Available BACKGROUND: The pathogenesis of acute measles encephalitis (AME is poorly understood. Treatment with immune-modulators is based on theories that post-infectious autoimmune responses cause demyelination. The clinical course and immunological parameters of AME were examined during an outbreak in Vietnam. METHODS AND FINDINGS: Fifteen measles IgM-positive patients with confusion or Glasgow Coma Scale (GCS score below 13, and thirteen with uncomplicated measles were enrolled from 2008-2010. Standardized clinical exams were performed and blood collected for lymphocyte and measles- and auto-antibody analysis. The median age of AME patients was 21 years, similar to controls. Eleven reported receiving measles vaccination when aged one year. Confusion developed a median of 4 days after rash. Six patients had GCS <8 and four required mechanical ventilation. CSF showed pleocytosis (64% and proteinorrhachia (71% but measles virus RNA was not detected. MRI revealed bilateral lesions in the cerebellum and brain stem in some patients. Most received dexamethasone +/- IVIG within 4 days of admission but symptoms persisted for ≥3 weeks in five. The concentration of voltage gated calcium channel-complex-reactive antibodies was 900 pM in one patient, and declined to 609 pM ∼ 3 months later. Measles-reactive IgG antibody avidity was high in AME patients born after vaccine coverage exceeded 50% (∼ 25 years earlier. AME patients had low CD4 (218/µl, p = 0.029 and CD8 (200/µl, p = 0.012 T-cell counts compared to controls. CONCLUSION: Young adults presenting with AME in Vietnam reported a history of one prior measles immunization, and those aged <25 years had high measles-reactive IgG avidity indicative of prior vaccination. This suggests that one-dose measles immunization is not sufficient to prevent AME in young adults and reinforces the importance of maintaining high coverage with a two-dose measles immunization schedule. Treatment with
Bai, Zhenguo; Liu, Dan
A discrete-time deterministic measles model with periodic transmission rate is formulated and studied. The basic reproduction number R0 is defined and used as the threshold parameter in determining the dynamics of the model. It is shown that the disease will die out if R0 1 . Parameters in the model are estimated on the basis of demographic and epidemiological data. Numerical simulations are presented to describe the seasonal fluctuation of measles infection in China.
Zhang, Zhengyi; Zhao, Yuan; Yang, Lili; Lu, Changhong; Meng, Ying; Guan, Xiaoli; An, Hongjin; Zhang, Meizhong; Guo, Wenqin; Shang, Bo; Yu, Jing
Measles is caused by measles virus belonging to genus Morbillivirus of the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85%) tested positive for IgM antibodies against the measles virus and 50 patients (83.3%) tested positive for measles virus RNA. Surprisingly, 73.3% of the infected individuals had been previously immunized against measles. Since there is no infection division in our hospital, the fever clinics are located in the Emergency Division. In addition, the fever and rash were not recognized as measles symptoms at the beginning of the outbreak. These factors result in delay in isolation and early confirmation of the suspected patients and eventually a measles outbreak in the hospital. Our report highlights the importance of following a two-dose measles vaccine program in people including the healthcare workers. In addition, vigilant attention should be paid to medical staff with clinical fever and rash symptoms to avoid a possible nosocomial transmission of measles infection. PMID:27366157
V. A. Liashenko
Full Text Available Abstract. The review article considers different variants of measles vaccine that may be classified into two groups, i.e., vaccines that do not contain viable measles virus, and attenuated measles vaccines which could be employed in unusual manner.The first group includes DNA-vaccines, recombinant vaccine strains encoding synthesis of measles hemagglutinin and fusion protein, as well as peptide vaccines containing molecular fragments of these proteins. The mentioned variants of vaccines were effective in animal experiments, but they have not been tested in humans. The second group includes live attenuated mucosal measles vaccins applied in combination with immunomodulator(s, as aerosol and intranasally. Efficiency of these vaccines was tested and confirmed by immunization of children and adults. Mucosal measles vaccine induces local production of IgA measles antibodies, along with induced synthesis of circulating IgM and IgG antibodies against measles. The latter experimental variant could be a live attenuated measles vaccine containing some immunity-modulating agent. Elaboration of these variant was based on the known data about transient immunosuppressive activity of measles vaccine. An appropriate experimental variant represents a mixture of attenuated measles vaccine and synthetic immunomodulating agent (MP-2 peptide which protects T-lymphocytes from inhibitory effect of the measles virus. In present revue, some data are presented concerning the mechanisms of immunogenic activity and adverse effects of measles vaccines.
Full Text Available Measles is caused by measles virus belonging to genus Morbillivirus of the family Paramyxoviridae. Vaccination has played a critical role in controlling measles infection worldwide. However, in the recent years, outbreaks of measles infection still occur in many developing countries. Here, we report an outbreak of measles among healthcare workers and among the 60 measles infected patients 50 were healthcare workers including doctors, nurses, staff, and medics. Fifty-one patients (85% tested positive for IgM antibodies against the measles virus and 50 patients (83.3% tested positive for measles virus RNA. Surprisingly, 73.3% of the infected individuals had been previously immunized against measles. Since there is no infection division in our hospital, the fever clinics are located in the Emergency Division. In addition, the fever and rash were not recognized as measles symptoms at the beginning of the outbreak. These factors result in delay in isolation and early confirmation of the suspected patients and eventually a measles outbreak in the hospital. Our report highlights the importance of following a two-dose measles vaccine program in people including the healthcare workers. In addition, vigilant attention should be paid to medical staff with clinical fever and rash symptoms to avoid a possible nosocomial transmission of measles infection.
Rosenlund, H.; Bergstrom, A.; Alm, J.; Swartz, J.; Scheynius, A.; van Hage, M.; Johansen, K.; Brunekreef, B.; von Mutius, E.; Ege, M.; Riedler, J.; Braun-Fahrlander, C.; Waser, M.; Pershagen, G.
OBJECTIVE: Our aim was to investigate the role of measles vaccination and measles infection in the development of allergic disease and atopic sensitization. METHODS: A total of 14 893 children were included from the cross-sectional, multicenter Prevention of Allergy-Risk Factors for Sensitization in
Rosenlund, Helen; Bergstrom, Anna; Alm, Johan S.; Swartz, Jackie; Scheynius, Annika; van Hage, Marianne; Johansen, Kari; Brunekreef, Bert; von Mutius, Erika; Ege, Markus J.; Riedler, Josef; Braun-Fahrlaender, Charlotte; Waser, Marco; Pershagen, Goran
OBJECTIVE. Our aim was to investigate the role of measles vaccination and measles infection in the development of allergic disease and atopic sensitization. METHODS. A total of 14 893 children were included from the cross-sectional, multicenter Prevention of Allergy-Risk Factors for Sensitization in
Mentzer, D; Meyer, H; Keller-Stanislawski, B
Although effective monovalent and combined measles vaccines have been available for several decades in Germany, measles outbreaks continue to occur leading to severe cases of measles and even death. Possible reasons for the low acceptance of the measles vaccination are concerns about adverse events and serious complications following vaccination. In this report, we have summarized and assessed all adverse events reported in Germany from 2001 to 2012 after vaccination with monovalent- and combined measles-containing vaccines. A total of 1,696 suspected adverse reaction reports describing 5,297 adverse events were sent to the Paul Ehrlich Institute (PEI) between 1 January 2001 and 31 December 2012. The calculated mean reporting rate was 5.7 reports per 100,000 vaccine doses released by the PEI. Analysis of the reports indicates that measles-containing vaccines are well tolerated with a constantly low rate of adverse events reported. Compared to the high rate of serious complications following wild-type measles infection, the benefit of measles-containing vaccines clearly outweighs the anticipated risks of adverse events.
Eskazan, Ahmet Emre; Dal, Mehmet Sinan; Kaya, Safak; Dal, Tuba; Ayyildiz, Orhan; Soysal, Teoman
Brucellosis is a worldwide zoonotic disease associated with hemolytic complications, including thrombotic microangiopathy (TMA) and hemolytic anemia. Autoimmune hemolytic anemia (AIHA) is a rare clinical presentation of this disease. In this report, we describe the cases of two patients with brucellosis who presented with Coombs-positive AIHA. We also include a review of the literature on the hemolytic complications of brucellosis. Both patients were successfully treated with a combination of doxycycline and rifampicin in addition to steroids. In the medical literature, there are several cases of TMA associated with brucellosis, although only a few cases of Coombs test-positive AIHA have been reported. Antibiotic therapy is the mainstay of treatment, and the selection of antibiotics and duration of treatment do not differ between brucellosis patients with and without hemolysis. Although rare, the potential for brucellosis should always be kept in mind in patients who present with hemolysis, especially those living in areas where brucellosis is endemic.
... courtesy of NLM NLM Grantee's "HealthMap" Helps Uncover Measles Vaccination Gap Inadequate vaccine coverage is likely a driving force behind the ongoing Disneyland measles outbreak, according to calculations by a research team ...
Gauthier, A; Graffe, A; Beucher, A-B
Whereas syphilis is a classical cause of uveitis, it is still often under-recognized. Treatment recommendations are not based on specific clinical studies.......Whereas syphilis is a classical cause of uveitis, it is still often under-recognized. Treatment recommendations are not based on specific clinical studies....
Chris Richard Kenyon
Full Text Available Background. Syphilis is curable but Herpes Simplex Virus-2 (HSV-2 is not. As a result, the prevalence of syphilis but not HSV-2 may be influenced by the efficacy of national STI screening and treatment capacity. If the prevalence of syphilis and HSV-2 is found to be correlated, then this makes it more likely that something other than differential STI treatment is responsible for variations in the prevalence of both HSV-2 and syphilis. Methods. Simple linear regression was used to evaluate the relationship between national antenatal syphilis prevalence and HSV-2 prevalence in women in two time periods: 1990–1999 and 2008. Adjustments were performed for the laboratory syphilis testing algorithm used and the prevalence of circumcision. Results. The prevalence of syphilis was positively correlated with that of HSV-2 for both time periods (adjusted correlations, 20–24-year-olds: 1990–99: R2=0.54, P<0.001; 2008: R2=0.41, P<0.001 and 40–44-year-olds: 1990–99: R2=0.42, P<0.001; 2008: R2=0.49, P<0.001. Conclusion. The prevalence of syphilis and HSV-2 is positively correlated. This could be due to a common set of risk factors underpinning both STIs.
Full Text Available Late congenital syphilis is a rare entity and its early diagnosis and treatment is essential to prevent significant morbidity. We are reporting a case of late congenital syphilis presenting with Hutchinson′s triad at an age of 14 years.
... have found no connection between this or any vaccine and autism. Reviews by all major health organizations in the ... elsewhere all found NO LINK between the MMR vaccine and autism. The study that had first reported a risk ...
Piampiano, P.; McLeary, M.; Young, L.W. [Dept. of Radiology, Division of Pediatric Radiology, Loma Linda University Children' s Hospital, Loma Linda, CA (United States); Janner, D. [Div. of Pediatric Infectious Disease, Loma Linda University Medical Center and Children' s Hospital, Loma Linda, CA (United States)
Two boys presented with variable signs and symptoms of infectious disease that challenged diagnosis. One of the two patients had aortic valve vegetations and lower extremity aneurysms, and the other had calvarial osteomyelitis, epidural abscess, pleural effusions, and pulmonary nodules. Only after a battery of bacterial and fungal agglutination tests was the unsuspected diagnosis made in each of brucellosis from Brucella canis. (orig.)
Biserka I. Vasileva
Full Text Available Background: Brucellosisis an infectious and contagious disease caused by bacterial species of the genus Brucella. It is a major zoonosis with an important social and economic impact. Objective: The objective of this study was to investigate and analyze the measures application for control and eradication of brucellosis occurred in the region of Pleven. Methods: We conducted a retrospective epidemiological study. Respective documents were reviewed. We analyzed Case report form and Questionnaire for persons suspected of having brucellosis. Conclusions were made of the possible source of the disease and the risk factors leading to infection of humans. Results: A focus of Brucellosis among the animals to private goat farm in August was detected. The connection to other existing in the country focuses has been proved. Two of the persons, having had contacts with the animals developed clinical symptoms of the disease; referenced persons have consumed fresh goat cheese and milk. A joint epidemiological investigation with representatives of responsible authorities was carried out and measures undertook to restrict and liquidate the focus. Conclusion: Brucellosis in man can only be prevented effectively by elimination of the animal reservoir. This necessitates a close interaction between the medical authorities concerned with public health authorities on the one hand and the veterinary authorities on the other.
Basappa G Mantur; Satish K Amarnath
Brucellosis is an important re-emerging zoonosis with a worldwide distribution. It is still an uncontrolled serious public health problem in many developing countries including India. Brucellosis in India is yet a very common but often neglected disease. Currently, Brucella melitensis accounts for most recorded cases globally with cattle emerging as a important reservoir with the few cases of B. suis. Isolated cases of non-terrestrial brucellosis and continuing transmission from wild animals have raised important epidemiological issues. Routine serological surveillance along with high clinical suspicion and screening of family members of index cases would be essential in delineating the real magnitude of human brucellosis in endemic countries. Increased business and leisure travel to endemic countries have led to diagnostic challenge in non-endemic areas. Laboratory testing is indispensable for diagnosis. Advances in newer rapid, sensitive, and specific testing methodologies and alternate treatment strategies are urgently needed. A safe and effective vaccine in human is not yet available. Prevention is dependent upon increasing public awareness through health education programmes and safe livestock practices. Active co-operation between health and veterinary services should be promoted. This review collates world literature and its impact to the discovery, isolation and diagnosis and epidemiology along with the control measures adapted in the Indian scenario.
SPINK, W W
A special study was made of the problem of brucellosis due to Brucella melitensis in visits to Mexico City in 1948, to the FAO/WHO Brucellosis Centres at Montpellier (France), Florence (Italy), and Rijeka (Yugoslavia) in 1951, and to Spain in 1952. Br. melitensis infection in human beings causes more severe illness than Br. abortus infection. It develops primarily in rural communities living in close contact with goats and sheep; cattle and swine may also harbour the infection.In diagnosis, the agglutination test has proved the most satisfactory procedure; testing would be more uniformly reliable if a single antigen were used. Lack of funds and technical assistance have in many instances limited the bacteriological studies upon which a more definitive diagnosis of brucellosis depends.Antibiotics, Brucella vaccines, and colloidal preparations of gold and silver-used separately and in combination-have proved of varying therapeutic value, although response to antibiotics is less favourable than in cases of Br. abortus infection.While the drastic measures-involving the slaughter of about 10,000 sheep-taken in Slovenia, Yugoslavia, in the late 1940's, against an outbreak of brucellosis, is an inspiring example of how the disease can be eradicated, the removal of all diseased animals is rarely feasible economically. It is hoped that future research will reveal a practicable alternative in the immunization of sheep and goats against the disease.
Widespread use of measles vaccine since 1980 has led to a substantial decline in global measles morbidity and mortality; measles elimination has been achieved and sustained in the World Health Organization (WHO) Region of the Americas (AMR) since 2002. In 2010, the World Health Assembly established three milestones for measles eradication to be reached by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged 1 year to ≥90% nationally and ≥80% in every district or equivalent administrative unit; 2) reduce and maintain annual measles incidence to measles mortality by 95% from the 2000 estimate. The Global Vaccine Action Plan (GVAP) includes monitoring progress toward achievement of goals to reduce or eliminate measles in four WHO regions by 2015 and five WHO regions by 2020. This report updates the previous report and describes progress in global control and regional elimination of measles during 2000-2011. Estimated global MCV1 coverage increased from 72% in 2000 to 84% in 2011, and the number of countries providing a second dose of measles-containing vaccine (MCV2) through routine services increased from 97 (50%) in 2000 to 141 (73%) in 2011. During 2000-2011, annual reported measles incidence decreased 65%, from 146 to 52 cases per 1 million population, and estimated measles deaths decreased 71%, from 542,000 to 158,000. However, during 2010-2011, measles incidence increased, and large outbreaks of measles were reported in multiple countries. To resume progress toward achieving regional measles elimination targets, national governments and partners are urged to ensure that measles elimination efforts receive high priority and adequate resources.
... National Park Service Bison Brucellosis Remote Vaccination, Draft Environmental Impact Statement... Availability of the Draft Environmental Impact Statement for a Bison Brucellosis Remote Vaccination Program...(2)(C), the National Park Service announces the availability of the Bison Brucellosis...
Conclusions: A small proportion of confirmed seroreactive donors in this sample had any recall of symptoms or treatment for yaws or syphilis. These data suggest that clinical questioning adds little further information to the current screening algorithm. The relative contribution of yaws and syphilis to frequent positive tests in endemic areas remains speculative.
Ulu-Kilic, A; Karakas, A; Erdem, H; Turker, T; Inal, A S; Ak, O; Turan, H; Kazak, E; Inan, A; Duygu, F; Demiraslan, H; Kader, C; Sener, A; Dayan, S; Deveci, O; Tekin, R; Saltoglu, N; Aydın, M; Horasan, E S; Gul, H C; Ceylan, B; Kadanalı, A; Karabay, O; Karagoz, G; Kayabas, U; Turhan, V; Engin, D; Gulsun, S; Elaldı, N; Alabay, S
We evaluated the efficacy and tolerability of antibiotic regimens and optimal duration of therapy in complicated and uncomplicated forms of spinal brucellosis. This is a multicentre, retrospective and comparative study involving a total of 293 patients with spinal brucellosis from 19 health institutions. Comparison of complicated and uncomplicated spinal brucellosis was statistically analysed. Complicated spinal brucellosis was diagnosed in 78 (26.6%) of our patients. Clinical presentation was found to be significantly more acute, with fever and weight loss, in patients in the complicated group. They had significantly higher leukocyte and platelet counts, erythrocyte sedimentation rates and C-reactive protein levels, and lower haemoglobulin levels. The involvement of the thoracic spine was significantly more frequent in complicated cases. Spondylodiscitis was complicated, with paravertebral abscess in 38 (13.0%), prevertebral abscess in 13 (4.4%), epidural abscess in 30 (10.2%), psoas abscess in 10 (3.4%) and radiculitis in 8 (2.7%) patients. The five major combination regimens were: doxycycline 200 mg/day, rifampicin 600 mg/day and streptomycin 1 g/day; doxycycline 200 mg/day, rifampicin 600 mg/day and gentamicin 5 mg/kg; doxycycline 200 mg/day and rifampicin 600 mg/day; doxycycline 200 mg/day and streptomycin 1 g/day; and doxycycline 200 mg/day, rifampicin 600 mg/day and ciprofloxacin 1 g/day. There were no significant therapeutic differences between these antibiotic groups; the results were similar regarding the complicated and uncomplicated groups. Patients were mostly treated with doxycycline and rifampicin with or without an aminoglycoside. In the former subgroup, complicated cases received antibiotics for a longer duration than uncomplicated cases. Early recognition of complicated cases is critical in preventing devastating complications. Antimicrobial treatment should be prolonged in complicated spinal brucellosis in particular.
S. P. Kaplina
Full Text Available The data on the current vaccination process and specific antibody in 212 children with pathology of nervous systems in age from 1 year to 6 years old, vaccinated against measles. The comparison group consisted of 36 children without neurological disease. 86 children (40,6% were vaccinated measles – mumps vaccine, and 126 children (59,4% only measles vaccine. Post-vaccination period in 77,8% immunized against measles, was uneventful, layering intercurrent infections was noted in 22,2% of vaccine’s, and demonstrated the development of viral respiratory infections, bronchitis, otitis media and exacerbation of underlying disease. It is shown that the level of specific antibody to measles in children with pathology of nervous systems at 30 days after vaccination was 5,04±0,16 log 2, which did not differ from the comparison group (5,88±0,31 log 2. No significant differences in the level of antibody in a smooth and complicated course of vaccination period were found. Immunization of children with disorders of the nervous system of live vaccines is quite effective and leads to the formation of protective antibody titers in all vaccinated.
Mengeloglu, Zafer; Sünnetcioglu, Mahmut; Tosun, Mehmet; Kücükbayrak, Abdülkadir; Ceylan, Mehmet Resat; Baran, Ali Irfan; Karahocagil, Mustafa; Akdeniz, Hayrettin
Asymmetric dimethylarginine (ADMA) is the main endogenous inhibitor of nitric oxide synthase and is considered to be associated with endothelial dysfunction. Brucellosis, a zoonotic disease caused by Brucella spp., can manifest as vasculopathy. The present study was performed to investigate the relationship between ADMA and brucellosis. Serum samples from 39 patients with an accurate diagnosis of brucellosis and from 18 healthy control individuals were included in this study. ADMA levels were significantly higher in the patient group than the controls (P brucellosis and high levels of ADMA. In conclusion, ADMA levels should be tested in brucellosis cases and that further studies to clarify the mechanism underlying the association between ADMA and brucellosis are required.
Full Text Available Following the introduction of measles immunization in Serbia in 1971, measles outbreaks were recorded every 3 to 5 years until 1997. The outbreak in 1997 with 4000 cases was the last large outbreak in Serbia. In 2007, an outbreak with 191 laboratory confirmed or epidemiologically linked cases was reported in Vojvodina. In 2008 and 2009, only 3 cases were confirmed. From 2007-2009, measles infections were most frequently detected in the Roma population but also in non-immunized or partially immunized persons from the general population.
Full Text Available BACKGROUND: Brucellosis is a zoonosis of veterinary, public health and economic significance in most developing countries. Human brucellosis is a severely debilitating disease that requires prolonged treatment with a combination of antibiotics. The disease can result in permanent and disabling sequel, and results in considerable medical expenses in addition to loss of income due to loss of working hours. A study was conducted in Northern Tanzania to determine the risk factors for transmission of brucellosis to humans in Tanzania. METHODS: This was a matched case-control study. Any patient with a positive result by a competitive ELISA (c-ELISA test for brucellosis, and presenting to selected hospitals with at least two clinical features suggestive of brucellosis such as headache, recurrent or continuous fever, sweating, joint pain, joint swelling, general body malaise or backache, was defined as a case. For every case in a district, a corresponding control was traced and matched by sex using multistage cluster sampling. Other criteria for inclusion as a control included a negative c-ELISA test result and that the matched individual would present to hospital if falls sick. RESULTS: Multivariable analysis showed that brucellosis was associated with assisted parturition during abortion in cattle, sheep or goat. It was shown that individuals living in close proximity to other households had a higher risk of brucellosis. People who were of Christian religion were found to have a higher risk of brucellosis compared to other religions. The study concludes that assisting an aborting animal, proximity to neighborhoods, and Christianity were associated with brucellosis infection. There was no association between human brucellosis and Human Immunodeficiency Virus (HIV serostatus. Protecting humans against contact with fluids and tissues during assisted parturition of livestock may be an important means of reducing the risk of transferring brucellosis from
Meky, F A; Hassan, E A; Abd Elhafez, A M; Aboul Fetouhl, A M; El-Ghazali, S M S
This study aimed to describe the trend and to identify possible risk factors for brucellosis in Alexandria in northern Egypt. We enrolled 72 confirmed cases of brucellosis and 144 age-matched controls in this study. Participants were interviewed at home using a structured questionnaire. Working with animals, breeding goats and eating ice cream bought from street vendors were significantly associated (P brucellosis by univariate and multivariate analysis. Contact with infected animals and their products was the most important method of transmission.
Lai, Liying; Yao, Dongmei
Brucellosis is far more frequent in a pasturing area in the northern part of our country and it has many clinical manifestations. It may cause multiple organ damage and its features lack specificity. It is rare in the south, so it is extremely easy to be misdiagnosed or overlooked. The retrospective analysis of a case with Brucellosis misdiagnosed as osteoarthrosis provides a guide for clinical doctors to understand Brucellosis, so that early diagnosis would be accessible, and prognosis could be improved.
P. Del Duca
Full Text Available CLINICAL CASE A 43-year-old Romanian woman was referred with the clinical suspicion of gastric lymphoma; she had complained from two months nausea, vomiting and weight loss (7 kg; 3 esophagogastroduodenoscopic examinations had evidenced reduced distensibility of stomach body and antrum, ulcered and congestive mucosa, the histopathological examinations revealed a non specific inflammation. There was no response to therapy with omeprazolo. A computer-assisted tomoghraphy scan of the thorax and abdomen, obtained after the oral and intravenous administration of contrast material, showed diffuse thickening of the gastric wall, lymphadenopathies were seen in the retrocrural space, lesser curvature, and paraaortic region. It was performed another upper endoscopy with “deep” biopsy specimen, comprehensive of spirochetal immunohistochemistry, that was diagnostic for gastric syphilis. DISCUSSION Even though gastritis is a rare clinical manifestations of the secondary stage of syphilis, it must be considered in the differential diagnosis of erosive gastritis unresponsive to medical therapy, especially in young patients; screening tests like VDRL (routinely used until few years ago in internal medicine divisions may be useful to identify those patients needing a further diagnostic evaluation.
Edelson, Paul J
With advanced air handling systems on modern aircraft and the high level of measles immunity in many countries, measles infection in air travelers may be considered a low-risk event. However, introduction of measles into countries where transmission has been controlled or eliminated can have substantial consequences both for the use of public health resources and for those still susceptible. In an effort to balance the relatively low likelihood of disease transmission among largely immune travelers and the risk to the public health of the occurrence of secondary cases resulting from importations, criteria in the United States for contact investigations for measles exposures consider contacts to be those passengers who are seated within 2 rows of the index case. However, recent work has shown that cabin air flow may not be as reliable a barrier to the spread of measles virus as previously believed. Along with these new studies, several reports have described measles developing after travel in passengers seated some distance from the index case. To understand better the potential for measles virus to spread on an airplane, reports of apparent secondary cases occurring in co-travelers of passengers with infectious cases of measles were reviewed. Medline™ was searched for articles in all languages from 1946 to week 1 of March 2012, using the search terms "measles [human] or rubeola" and ("aircraft" or "airplane" or "aeroplane" or "aviation" or "travel" or "traveler" or "traveller"); 45 citations were returned. Embase™ was searched from 1988 to week 11 2012, using the same search strategy; 95 citations were returned. Papers were included in this review if they reported secondary cases of measles occurring in persons traveling on an airplane on which a person or persons with measles also flew, and which included the seating location of both the index case(s) and the secondary case(s) on the plane. Nine reports, including 13 index cases and 23 apparent secondary cases
Zhen, Q; Lu, Y; Yuan, X; Qiu, Y; Xu, J; Li, W; Ke, Y; Yu, Y; Huang, L; Wang, Y; Chen, Z
Human brucellosis is mainly caused by contact with Brucella-infected animals and their secretions and carcasses. Individuals who are continuously in contact with animals are considered to be at a high risk but only some show symptoms and are diagnosed as cases of brucellosis. Here, we showed that asymptomatic brucellosis infections occur among humans. Asymptomatic infections mainly result from less frequent contact with Brucella and/or contact with low-virulence Brucella. In our study, patients with asymptomatic infection had low antibody titres and different contact patterns. Awareness of asymptomatic infection is important for early diagnosis of brucellosis and prevention of chronic infection.
Perry, Robert T; Gacic-Dobo, Marta; Dabbagh, Alya; Mulders, Mick N; Strebel, Peter M; Okwo-Bele, Jean-Marie; Rota, Paul A; Goodson, James L
In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan with the objective to eliminate measles in four World Health Organization (WHO) regions by 2015. Member states of all six WHO regions have adopted measles elimination goals. In 2010, the World Health Assembly established three milestones for 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged 1 year to ≥90% nationally and ≥80% in every district; 2) reduce global annual measles incidence to measles mortality by 95% from the 2000 estimate. This report updates the 2000-2012 report and describes progress toward global control and regional measles elimination during 2000-2013. During this period, annual reported measles incidence declined 72% worldwide, from 146 to 40 per million population, and annual estimated measles deaths declined 75%, from 544,200 to 145,700. Four of six WHO regions have established regional verification commissions (RVCs); in the European (EUR) and Western Pacific regions (WPR), 19 member states successfully documented the absence of endemic measles. Resuming progress toward 2015 milestones and elimination goals will require countries and their partners to raise the visibility of measles elimination, address barriers to measles vaccination, and make substantial and sustained additional investments in strengthening health systems.
Full Text Available Abstract Background Since the schools vaccination campaign in 1994, measles has been eliminated from England. Maintaining elimination requires low susceptibility levels to keep the effective reproduction number R below 1. Since 1995, however, MMR coverage in two year old children has decreased by more than 10%. Methods Quarterly MMR coverage data for children aged two and five years resident in each district health authority in England were used to estimate susceptibility to measles by age. The effective reproduction numbers for each district and strategic health authority were calculated and possible outbreak sizes estimated. Results In 2004/05, about 1.9 million school children and 300,000 pre-school children were recorded as incompletely vaccinated against measles in England, including more than 800,000 children completely unvaccinated. Based on this, approximately 1.3 million children aged 2–17 years were susceptible to measles. In 14 of the 99 districts, the level of susceptibility is sufficiently high for R to exceed 1, indicating the potential for sustained measles transmission. Eleven of these districts are in London. Our model suggests that the potential exists for an outbreak of up to 100,000 cases. These results are sensitive to the accuracy of reported vaccination coverage data. Conclusion Our analysis identified several districts with the potential for sustaining measles transmission. Many London areas remain at high risk even allowing for considerable under-reporting of coverage. Primary care trusts should ensure that accurate systems are in place to identify unimmunised children and to offer catch-up immunisation for those not up to date for MMR.
Byberg, S.; Thysen, Sanne Marie; Rodrigues, A;
Background Measles vaccination campaigns targeting children aged 9–59 months are conducted every three years in Guinea-Bissau. Studies have demonstrated beneficial non-specific effects of measles vaccine. We compared mortality one year after the December 2012 measles vaccination campaign in Bissau...... city for children who received campaign measles vaccine with children who did not receive campaign measles vaccine. Methods Field workers from Bandim Health Project registered all children living in the Bandim Health Project's study area who received measles vaccination at the campaign posts. Children...... not seen during the campaign were visited at home and campaign participation status was assessed. We compared mortality rates of participants vs. non-participants in Cox regression models. Results 5633 children aged 9–59 months (85%) received campaign measles vaccination and 1006 (15%) did not. During...
Full Text Available Although the measles vaccine has been part of routine national childhood vaccination programs throughout Europe, measles remains a public health concern. High numbers of cases and outbreaks have occurred throughout the European continent since 2011, and an increasing number of cases have been reported in Turkey since 2012. During a recent measles outbreak in Turkey, 2 pregnant women contracted measles prior to delivering preterm infants at Hacettepe University Hospital. Measles virus genomic RNA and IgM antibodies against measles were detected in the cord blood of infants and mothers in both cases. The infants were treated with intravenous immunoglobulin (IVIG and vitamin A. Transient thrombocytopenia was present in 1 infant and treated with an additional dose of IVIG and vitamin A. The infants were discharged, without complications, within 10 days of birth. The successful treatment of these cases suggests that infants who have been exposed to, or infected with, measles may benefit from cotreatment of vitamin A and IVIG.
Full Text Available This report describes a rare case of congenital syphilis in a two-month-old Romanian infant. Diagnosis was possible when the baby showed decrease in the left upper limb movements and a papular rash. Her father had been infected and transmitted the infection to the mother, who had two non-treponemal serological tests during pregnancy, both with negative results. Congenital syphilis was confirmed by serological tests and the newborn was successfully treated. A global overview on diagnosis and treatment of children with suspected congenital syphilis is presented.
Patel, Minal K; Gacic-Dobo, Marta; Strebel, Peter M; Dabbagh, Alya; Mulders, Mick N; Okwo-Bele, Jean-Marie; Dumolard, Laure; Rota, Paul A; Kretsinger, Katrina; Goodson, James L
Adopted in 2000, United Nations Millennium Development Goal 4 set a target to reduce child mortality by two thirds by 2015, with measles vaccination coverage as one of the progress indicators. In 2010, the World Health Assembly (WHA) set three milestones for measles control by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged 1 year to ≥90% nationally and ≥80% in every district; 2) reduce global annual measles incidence to measles mortality by 95% from the 2000 estimate (1,2).* In 2012, WHA endorsed the Global Vaccine Action Plan(†) with the objective to eliminate measles in four World Health Organization (WHO) regions by 2015. Countries in all six WHO regions have adopted measles elimination goals. Measles elimination is the absence of endemic measles transmission in a region or other defined geographical area for ≥12 months in the presence of a well performing surveillance system. This report updates a previous report (3) and describes progress toward global measles control milestones and regional measles elimination goals during 2000-2015. During this period, annual reported measles incidence decreased 75%, from 146 to 36 cases per 1 million persons, and annual estimated measles deaths decreased 79%, from 651,600 to 134,200. However, none of the 2015 milestones or elimination goals were met. Countries and their partners need to act urgently to secure political commitment, raise the visibility of measles, increase vaccination coverage, strengthen surveillance, and mitigate the threat of decreasing resources for immunization once polio eradication is achieved.
Aaby, Peter; Martins, Cesário L; Garly, May-Lill
mortality than children with no maternal antibody, the MRR being 0.22 (95% CI, .07-.64) between 4-6 months and 5 years. CONCLUSIONS: Child mortality in low-income countries may be reduced by vaccinating against measles in the presence of maternal antibody, using a 2-dose schedule with the first dose at 4......BACKGROUND: Measles vaccine (MV) has a greater effect on child survival when administered in early infancy, when maternal antibody may still be present. METHODS: To test whether MV has a greater effect on overall survival if given in the presence of maternal measles antibody, we reanalyzed data...... from 2 previously published randomized trials of a 2-dose schedule with MV given at 4-6 months and at 9 months of age. In both trials antibody levels had been measured before early measles vaccination. RESULTS: In trial I (1993-1995), the mortality rate was 0.0 per 1000 person-years among children...
Full Text Available Brucellosis is a zoonosis caused by Brucella species. Brucella epididymo-orchitis had been reported in up to 20% of patients with brucellosis. This case was a male patient who developed Brucella epidiymo-orchitis and testicular abscess. He had fever, arthralgia and his right epididymis and right testicle were enlarged and tender. Ultrasound evaluation showed hypertrophy of the right epididymis and testis and moreover hypoechoic area within the testis. Brucella serology was positive and the patient did not respond completely to treatment with streptomycin, doxycycline, and rifampicina. Unilateral orchidectomy was decided. In areas where brucella infection is endemic brucella epididymo-orchitis should be considered in the differential diagnosis. Effective and rapid treatment is important. It should be noted that these patients may develop testicular abscess.
Figueroa Damian, R; Rojas Rodríguez, L; Marcano Tochon, E S
Brucellosis is a zoonosis that affect cows, goats and pigs, but in endemic zones human beings are frequently infected. Brucella infection in animals is associated with a high incidence of abortion, in humans a cause-effect relationship has not been proven. We present four cases of pregnant women with Brucella infection, all were treated only with rifampin, the patients had adequate obstetric evolution, the deliveries were at term and there were not birth defects or intrauterine growth retardation. One woman had a relapse during her puerperium. In the medical literature review there were not enough support to attribute to brucellosis as causal factor of abortion in humans. The treatment during pregnancy must include the combination of rifampin with another antibiotic with intracellular action.
Full Text Available Brucellosis is hyperendemic in the Kingdom of Saudi Arabia (KSA with more than 8,000 cases reported each year to the public health authorities. The disease can affect almost any organ system in the body including the gastrointestinal system. In some instances, gastrointestinal manifestations may be the only presenting features of the disease. These range from milder complaints like diarrhea, vomiting to more serious complications like involvement of the liver, the spleen and the gallbladder to rarely life-threatening complications like colitis, pancreatitis, peritonitis and intestinal obstruction. Recognition of this type of presentation of brucellosis is important because early diagnosis and treatment usually result in complete recovery without complications
Erdem, H; Elaldi, N; Ak, O; Gulsun, S; Tekin, R; Ulug, M; Duygu, F; Sunnetcioglu, M; Tulek, N; Guler, S; Cag, Y; Kaya, S; Turker, N; Parlak, E; Demirdal, T; Ataman Hatipoglu, C; Avci, A; Bulut, C; Avci, M; Pekok, A; Savasci, U; Kaya, S; Sozen, H; Tasbakan, M; Guven, T; Bolukcu, S; Cesur, S; Sahin-Horasan, E; Kazak, E; Denk, A; Gonen, I; Karagoz, G; Haykir Solay, A; Alici, O; Kader, C; Senturk, G; Tosun, S; Turan, H; Baran, A I; Ozturk-Engin, D; Bozkurt, F; Deveci, O; Inan, A; Kadanali, A; Sayar, M S; Cetin, B; Yemisen, M; Naz, H; Gorenek, L; Agalar, C
This study reviewed the clinical, laboratory, therapeutic and prognostic data on genitourinary involvement of brucellosis in this largest case series reported. This multicentre study pooled adult patients with genitourinary brucellar involvement from 34 centres treated between 2000 and 2013. Diagnosis of the disease was established by conventional methods. Overall 390 patients with genitourinary brucellosis (352 male, 90.2%) were pooled. In male patients, the most frequent involved site was the scrotal area (n=327, 83.8%), as epididymo-orchitis (n=204, 58%), orchitis (n=112, 31.8%) and epididymitis (n=11, 3.1%). In female patients, pyelonephritis (n=33/38, 86.8%) was significantly higher than in male patients (n=11/352, 3.1%; pbrucellosis occurred in one patient. A localized scrotal infection in men or pyelonephritis in women in the absence of leucocytosis and with mild to moderate increases in inflammatory markers should signal the possibility of brucellar genitourinary disease.
Full Text Available Members of the genus Brucella are pathogenic bacteria exceedingly well adapted to their hosts. The bacterium is transmitted by direct contact within the same host species or accidentally to secondary hosts, such as humans. Human brucellosis is strongly linked to the management of domesticated animals and ingestion of their products. Since the domestication of ungulates and dogs in the Fertile Crescent and Asia in 12000 B.P. and 33000 B.P., respectively, a steady supply of well adapted emergent Brucella pathogens causing zoonotic disease has been provided. Likewise, anthropogenic modification of wild life may have also impacted host susceptibility and Brucella selection. Domestication and human influence on wild life animals are not neutral phenomena. Consequently, Brucella organisms have followed their hosts' fate and have been selected under conditions that favor high transmission rate. The arm race between Brucella and their preferred hosts has been driven by genetic adaptation of the bacterium confronted with the evolving immune defenses of the host. Management conditions, such as clustering, selection, culling and vaccination of Brucella preferred hosts have profound influences in the outcome of brucellosis and in the selection of Brucella organisms. Countries that have controlled brucellosis systematically used reliable smooth live vaccines, consistent immunization protocols, adequate diagnostic tests, broad vaccination coverage and sustained removal of the infected animals. To ignore and misuse tools and strategies already available for the control of brucellosis may promote the emergence of new Brucella variants. The unrestricted use of low-efficacy vaccines may promote a false sense of security and works towards selection of Brucella with higher virulence and transmission potential.
Aydın, Saliha; Günal, Özgür; Taşkın, Mehmet Hakan; Atilla, Aynur; Kılıç, Süleyman Sırrı
Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome of excessive inflammation and tissue destruction due to abnormal immune activation and inflammation. HLH can occur primarily due to genetic etiology, or secondarily associated with malignancies, autoimmmune diseases or infections. There are a number of reports that revealed the relationship of hemophagocytosis with brucellosis. In this report, we described a brucellosis-related HLH case. A 73-year-old male who work as farmer was admitted to our hospital with the complaints of fever continuing for 10 days, loss of appetite and back pain. Physical examination revealed right upper quadrant tenderness and hepatomegaly. Since the patient exhibited five of the diagnostic criteria for HLH (fever, hepatosplenomegaly, bicytopenia, hypertriglyceridemia and high ferritin level), he was diagnosed as secondary HLH. PCR, microscopic agglutination and indirect fluorescent antibody tests gave negative results for the diagnosis of Crimean-Congo hemorrhagic fever, leptospirosis and Q fever, respectively. On the other hand, Rose Bengal test for brucellosis was positive, while standard tube agglutination test (STA) was negative. The patient's serum yielded a very high positive (1/1280) result when Coombs' test was performed in terms of the possibility of blocking antibodies or prozone phenomenon. Additionally, B.melitensis was isolated from his blood culture on the sixth day. The patient was treated with doxycycline and rifampicin, and on the 10th day of antibiotic therapy the patient was discharged and recommended to complete his treatment up to 6 weeks. In conclusion, in patients with secondary HLH symptoms especially in the endemic areas, brucellosis should be considered as a predisposing infection.
Wyatt, H V
The disease we now know as brucellosis was first discovered in the 1850s in Malta. It came to the attention of British medical officers serving on the island after the Crimean War. It was easy to eliminate the disease in British servicemen, but very difficult to reach Maltese citizens. Over the decades, more and more Maltese were infected asthe control measures introduced were half-hearted and were often not even enforced. The work of Dr Themistocles Zammit showed that infected goats transmitted brucellosis and that banning use of their milk would be effective. Pasteurisation was not introduced onto the island until the 1930s, when the production of cheap, small sterile containers became possible. Transmission was also possible through sexual contact and by inhalation when people were crowded in hot airless conditions. Success in controlling the disease requires sensible, strict control of animals and the elimination of infected ones, but will fail without an educated public willing to help. In Malta, failure to control rogue flocks and small flocks kept for family use led to an epidemic caused by the sale of cheeselets (small cheeses). In 2005, nearly a century after Zammit's discovery, Malta was finally free of brucellosis.
Full Text Available Since the first case of brucellosis detected in a dolphin aborted fetus, an increasing number of Brucella ceti isolates has been reported in members of the two suborders of cetaceans: Mysticeti and Odontoceti. Serological surveys have shown that cetacean brucellosis may be distributed worldwide in the oceans. Although all B. ceti isolates have been included within the same species, three different groups have been recognized according to their preferred host, bacteriological properties and distinct genetic traits: B. ceti dolphin type, B. ceti porpoise type and B. ceti human type. It seems that B. ceti porpoise type is more closely related to B. ceti human isolates and B. pinnipedialis group, while B. ceti dolphin type seems ancestral to them. Based on comparative phylogenetic analysis, it is feasible that the B. ceti ancestor radiated in a terrestrial artiodactyl host close to the Raoellidae family about 58 million years ago. The more likely mode of transmission of B. ceti seems to be through sexual intercourse, maternal feeding, aborted fetuses, placental tissues, vertical transmission from mother to the fetus or through fish or helminth reservoirs. The B. ceti dolphin and porpoise types seem to display variable virulence in land animal models and low infectivity for humans. However, brucellosis in some dolphins and porpoises has been demonstrated to be a severe chronic disease, displaying significant clinical and pathological signs related to abortions, male infertility, neurobrucellosis, cardiopathies, bone and skin lesions, strandings and death.
Sarkodie, Francis; Owusu-Dabo, Ellis; Hassall, Oliver;
) and later by rapid plasma reagin (RPR) test, 526 were seroreactive. Four hundred and seventy-one (89.5%) of these subjects were confirmed with the Ortho-Vitros Syphilis TP test as the gold standard and were interviewed to determine past or present clinical manifestations of yaws and syphilis. Results......: Of the 471 respondent donors, 28 (5.9%) gave a history of skin lesions and sores; four (14.3%) of these subjects, who were all male and RPR-positive, recalled a diagnosis of syphilis. All four reported having had skin lesions/bumps with slow-healing sores, but only one of them had had these symptoms before...
Full Text Available Objective: On 7 April 2012, a recently returned traveller from Thailand to Australia was confirmed to have measles. An outbreak of measles subsequently occurred in the state of New South Wales, prompting a sustained and coordinated response by public health authorities. The last confirmed case presented on 29 November 2012. This report describes the outbreak and its characteristics. Methods: Cases were investigated following Australian protocols, including case interviews and assessment of contacts for post-exposure prophylaxis. Results: Of the 168 cases identified, most occurred in south-western and western Sydney (92.9%, n = 156. Notable features of this outbreak were the disproportionately high number of cases in the 10–19-year-old age group (29.2%, n = 49, the overrepresentation among people of Pacific Islander descent (21.4%, n = 36 and acquisition in health-care facilities (21.4%, n = 36. There were no reported cases of encephalitis and no deaths. Discussion: This was the largest outbreak of measles in Australia since 1997. Its occurrence highlights the need to maintain vigilant surveillance systems for early detection and containment of measles cases and to maintain high population immunity to measles through routine childhood immunization. Vaccination campaigns targeting susceptible groups may also be necessary to sustain Australia’s measles elimination status.
Deniz, Secil; Baykam, Nurcan; Celikbas, Aysel; Yilmaz, Sirin Menekse; Guzel, Tugba Cirkin; Dokuzoguz, Basak; Ergonul, Onder
Early diagnosis and treatment of acute brucellosis cases were targeted by screening the household members of the index cases. We also aimed to describe the causal relations of brucellosis in an endemic region. A cross-sectional study was performed among household members (29 index cases, 113 household members). Brucellosis was diagnosed on the basis of clinical findings, serum agglutinin titer of ≥1/160 in standard tube agglutination test (STA), or a positive blood culture. Index cases were defined as patients who had been admitted to the clinic on suspicion of brucellosis and then confirmed as brucellosis cases. The people who lived in the same house as the index cases were defined as household members. The risk factors for seropositivity were studied by multivariate analysis. Independent variables of gender, consuming fresh cheese, blood groups, dealing with husbandry, and contact with the placenta of infected animals were included to the model. Backward and forward selections were performed. Nineteen out of 113 (17%) screened individuals had agglutination titers ≥1/160. The mean ages of index cases and household members were 43 years (standard deviation [SD] 18) and 29 years (SD 19), respectively. In multivariate analysis, consuming fresh cheese (odds ratio [OR]=3.1, confidence interval [CI] 1.07-9.68, p=0.049), blood group A (OR=2.6, CI 1.18-5.96, p=0.018), contact with the placenta of the infected animals (OR=3.7, CI 1.42-9.68, p=0.007), and age >30 years (OR=2.8, CI 1.25-6.51, p=0.13) were found to be associated with brucellosis. In univariate analysis, the individuals with blood group B were protected from brucella infection (p=0.013). In conclusion, screening of the people in brucellosis-endemic areas should be considered for early diagnosis and treatment. To our knowledge, blood groups were studied for the first time by this study. Higher prevalence of brucellosis among the individuals with blood group A and less prevalence among the individuals with
张晓东; 脱朝伟; 张庆瑞; 宋芳吉
Objective: For the purpose of understanding the changing process of syphilis histomorphology and its injury mechanism,the ultrastructure of dermatic tissues of secondary syphilis was studied.Methods: Different skin injury tissues of secondary syphilis patients, whose serum RPR and TPHA tests in the lab both appeared positive reaction, were observed through transmission electron microscope (TEM).Results: Inflammations appeared on epidermides and coria,a great deal of neutrocytes, lymphocytes and a small amount of plasma infiltrated them. Karyopyknosis, karyorrhexis,epicyte lysis and mitochondrion vacular degeneration occurred. Spirocheta pallida was distributed on intercellular substances, epicytes and coilagenous fibers. The epicytes were pressed to foveation. Conclusion The pathological change of characteristic tissue ultrastructure reported here is a histomorphological foundation to study the organism injury mechanism caused by syphilis.
Full Text Available Presently, the diagnosis of syphilis is dependent mainly on serological tests. The most widely used screening tests for syphilis are the VDRL and the rapid plasma reagin (RPR and for confirmation, the fluorescent treponemal antibody (FTA and the treponema pallidum hemagglutination (TPHA tests. The four alternative modes for diagnosis of syphilis can be a VDRL + FTA, b VDRL + TPHA, c RPR + FTA and d RPR + TPHA. Here the author reports an evaluation of cost utility of these tests in medical practice. It is shown that the cost per accurate diagnosis with VDRL + TPH is the least expensive choice. Therefore, this alternative is the best method for serological diagnosis for syphilis, based on medical laboratory economics principles
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2017. In this Table, provisional cases of selected notifiable diseases (â¥1,000 cases reported during...
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2016. In this Table, provisional* cases of selectedâ notifiable diseases (â¥1,000 cases reported during...
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2014.In this Table, all conditions with a 5-year average annual national total of more than or equals...
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2015.In this Table, provisional cases of selected notifiable diseases (â¥1,000 cases reported during the...
Full Text Available Research question: 1. Will measles vaccination reduce the incidence and during of diarrhoeal episodes in children? 2. Will measles vaccination reduce the morbidity load because of diarrhoea? Objectives: 1. To provide measles immunization to rural children 9 to 24 months of age. 2. to study the occurrence of diarrhoeal episodes by domicillary visits every month for a period of 1 year. Design: Longitudinal study. Setting: Rural area in the state of Haryana. Participants: Children between the ages of 9 and 24 months with parental informed consent. Study variables: diarrhoeal episodes per child/year, duration of diarrhoea. Outcome Variable: the difference between the two groups (immunized and non- immunized of attack rate and duration of diarrhoeal episodes. Statistical Analysis: Chi square test. Results: immunization coverage was 75%. Attack rates of diarrhoea in immunized children (1.6/child/year was no different to that in the non- immunized (1.5/child/year. The mean duration of diarrhoea in both groups was 2.3 days. The prevalence diarrhoea in immunized and non-immunized was 3.85 and 3.67 respectively. Conclusion: Measles vaccination has no impact on diarrhoeal morbidity.
CFR of this outbreak is higher than the national CFR. Vaccine efficacy of 50% points towards the need for investigation of vaccine logistics and cold chain system. Moreover, this laboratory test confirmed an outbreak showing that the measles virus could be imported from an endemic region and rapidly spread through a susceptible population who were previously not immunized.
K.J. Stittelaar (Koert)
textabstractMeasles, also called morbilli or rubeola, is a highly contagious disease of humans. After an incubation period of 9-11 days characteristic clinical signs develop like coryza, cervical lymphadenitis, so-called Koplik's spots in the mouth, conjunctivitis, photophobia, myalgia, malaise, sne
Narain, Jai P.; And Others
In 1981, a measles outbreak in an Arkansas university involved 16 students and 4 others. The first two cases were in students who had recently returned from Honduras. Only two of the students were considered adequately immunized. A voluntary immunization clinic held on campus resulted in 67 percent of 3,076 students being vaccinated. (Author/KH)
Edens, Chris; Collins, Marcus L; Ayers, Jessica; Rota, Paul A; Prausnitz, Mark R
Measles vaccination programs would benefit from delivery methods that decrease cost, simplify logistics, and increase safety. Conventional subcutaneous injection is limited by the need for skilled healthcare professionals to reconstitute and administer injections, and by the need for safe needle handling and disposal to reduce the risk of disease transmission through needle re-use and needlestick injury. Microneedles are micron-scale, solid needles coated with a dry formulation of vaccine that dissolves in the skin within minutes after patch application. By avoiding the use of hypodermic needles, vaccination using a microneedle patch could be carried out by minimally trained personnel with reduced risk of blood-borne disease transmission. The goal of this study was to evaluate measles vaccination using a microneedle patch to address some of the limitations of subcutaneous injection. Viability of vaccine virus dried onto a microneedle patch was stabilized by incorporation of the sugar, trehalose, and loss of viral titer was less than 1 log10(TCID50) after storage for at least 30 days at room temperature. Microneedle patches were then used to immunize cotton rats with the Edmonston-Zagreb measles vaccine strain. Vaccination using microneedles at doses equaling the standard human dose or one-fifth the human dose generated neutralizing antibody levels equivalent to those of a subcutaneous immunization at the same dose. These results show that measles vaccine can be stabilized on microneedles and that vaccine efficiently reconstitutes in vivo to generate a neutralizing antibody response equivalent to that generated by subcutaneous injection.
Benharroch, Daniel; Ariad, Samuel; Tadmor, Noa; Nalbandyan, Karen; Lazarev, Irena
Evidence of an association between classical Hodgkin lymphoma and the measles virus has previously been presented by our group. Arguments held against our thesis were reevaluated. Substantiation of a relationship between the measles virus and additional solid tumors was submitted. Moreover, a pathogenic pathway was suggested to support a possible contribution of the measles virus to the development of classical Hodgkin lymphoma. We have chosen to exclude a discussion of measles virotherapy, since this carries distinct implications. We now add new evidence regarding the expression of the measles virus phosphoprotein in a few cancers. We also suggest a role in this context for atypical measles syndrome in malignant tumors. Last, we propose a collaboration which may make the best, on the one hand of our cohort of classical Hodgkin lymphoma, half of which carry the measles virus expression in their tumor cells. The planned study will also look into the patients vaccination records and into a previous history of the measles disease. On the other hand, cohorts of patients diagnosed with late onset measles will be assessed for the eventual diagnosis of atypical measles syndrome and will be followed up for the subsequent development of a malignant tumor.
Full Text Available Abstract Background The last decade has seen enormous advances in HIV treatment and care, but how to implement scaled up HIV testing, prevention, and treatment in low-income areas still presents a formidable public health challenge. South China faces expanding syphilis and sexually transmitted HIV epidemics, but health systems characteristics important for scaling up syphilis and HIV testing have not been defined. Methods A purposive sample to ensure public, private, and public-private hybrid STI clinic inclusion was selected in a South China city. Eight key informant interviews were conducted with the STI clinic manager, followed by eight focus group discussions with physicians. Data collection relied on a semi-structured format that included questions in each of the following domains: 1 clinical facilities; 2 laboratory capacity with a focus on syphilis/HIV diagnosis; 3 clinic personnel; 4 physical space with a focus on locations to disclose confidential results; 5 financial support. Results Public STI clinics had free syphilis testing/treatment and laboratory facilities to perform essential syphilis and HIV tests. However, despite serving a large number of STI patients, private STI clinics lacked nontreponemal syphilis testing, HIV testing, and had fewer connections to the public health infrastructure. Formally trained assistant physicians were 2.5 times as common as physicians at STI clinics. Only one of the 8 sites had onsite voluntary counseling and testing (VCT services available. Conclusion These STI case studies reveal the potential for expanding integrated syphilis/HIV services at public STI clinics in China. More health services research is needed to guide scale-up of syphilis/HIV testing in China.
Renan Albert Mendonça Rodrigues; Heloisa Moraes do Nascimento; Cristina Muccioli
Here we report the occurrence of pale yellowish perivascular preretinal dots in 12 patients with ocular syphilis. A case series of these patients was examined between March and October 2012 at the Uveitis Sector of Universidade Federal de São Paulo. After diagnostic confirmation of syphilis, fundus photographs and optical coherence tomography (OCT) were performed to verify the localization of the dots, and patients were treated with IV crystalline penicillin for 14 days. The study comprised 1...
39 per 100 000 population in 2009 to 29 per 100 000 in 2012. We identified 3 “hot spots,” in urban areas of Trinidad. Young men and particularly young women in childbearing age 15–35 living in urban high density populations were commonly infected groups. Conclusion. The incidence of syphilis continues to be very high in Trinidad. New initiatives will have to be formulated in order to attain the global initiative to eradicate syphilis by 2015.
Melissa M. Coughlin
Full Text Available Measles is a highly contagious, vaccine preventable disease. Measles results in a systemic illness which causes profound immunosuppression often leading to severe complications. In 2010, the World Health Assembly declared that measles can and should be eradicated. Measles has been eliminated in the Region of the Americas, and the remaining five regions of the World Health Organization (WHO have adopted measles elimination goals. Significant progress has been made through increased global coverage of first and second doses of measles-containing vaccine, leading to a decrease in global incidence of measles, and through improved case based surveillance supported by the WHO Global Measles and Rubella Laboratory Network. Improved vaccine delivery methods will likely play an important role in achieving measles elimination goals as these delivery methods circumvent many of the logistic issues associated with subcutaneous injection. This review highlights the status of global measles epidemiology, novel measles vaccination strategies, and describes the pathway toward measles elimination.
Coughlin, Melissa M.; Beck, Andrew S.; Bankamp, Bettina; Rota, Paul A.
Measles is a highly contagious, vaccine preventable disease. Measles results in a systemic illness which causes profound immunosuppression often leading to severe complications. In 2010, the World Health Assembly declared that measles can and should be eradicated. Measles has been eliminated in the Region of the Americas, and the remaining five regions of the World Health Organization (WHO) have adopted measles elimination goals. Significant progress has been made through increased global coverage of first and second doses of measles-containing vaccine, leading to a decrease in global incidence of measles, and through improved case based surveillance supported by the WHO Global Measles and Rubella Laboratory Network. Improved vaccine delivery methods will likely play an important role in achieving measles elimination goals as these delivery methods circumvent many of the logistic issues associated with subcutaneous injection. This review highlights the status of global measles epidemiology, novel measles vaccination strategies, and describes the pathway toward measles elimination. PMID:28106841
Perry, Robert T; Murray, Jillian S; Gacic-Dobo, Marta; Dabbagh, Alya; Mulders, Mick N; Strebel, Peter M; Okwo-Bele, Jean-Marie; Rota, Paul A; Goodson, James L
In 2000, the United Nations General Assembly adopted the Millennium Development Goals (MDG), with MDG4 being a two-thirds reduction in child mortality by 2015, and with measles vaccination coverage being one of the three indicators of progress toward this goal.* In 2010, the World Health Assembly established three milestones for measles control by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged 1 year to ≥90% nationally and ≥80% in every district; 2) reduce global annual measles incidence to fewer than five cases per million population; and 3) reduce global measles mortality by 95% from the 2000 estimate (1).† In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan§ with the objective to eliminate measles in four World Health Organization (WHO) regions by 2015. WHO member states in all six WHO regions have adopted measles elimination goals. This report updates the 2000–2013 report (2) and describes progress toward global control and regional measles elimination during 2000–2014. During this period, annual reported measles incidence declined 73% worldwide, from 146 to 40 cases per million population, and annual estimated measles deaths declined 79%, from 546,800 to 114,900. However, progress toward the 2015 milestones and elimination goals has slowed markedly since 2010. To resume progress toward milestones and goals for measles elimination, a review of current strategies and challenges to improving program performance is needed, and countries and their partners need to raise the visibility of measles elimination, address barriers to measles vaccination, and make substantial and sustained additional investments in strengthening health systems.
Khanal, Sudhir; Sedai, Tika Ram; Choudary, Ganga Ram; Giri, Jagat Narain; Bohara, Rajendra; Pant, Rajendra; Gautam, Mukunda; Sharapov, Umid M; Goodson, James L; Alexander, James; Dabbagh, Alya; Strebel, Peter; Perry, Robert T; Bah, Sunil; Abeysinghe, Nihal; Thapa, Arun
In 2013, the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region (SEAR) established a goal to eliminate measles and to control rubella and congenital rubella syndrome (CRS) in SEAR by 2020. Current recommended measles elimination strategies in the region include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) in every district, delivered through the routine immunization program or through supplementary immunization activities (SIAs); 2) developing and sustaining a sensitive and timely measles case-based surveillance system that meets minimum recommended performance indicators; 3) developing and maintaining an accredited measles laboratory network; and 4) achieving timely identification, investigation, and response to measles outbreaks. In 2013, Nepal, one of the 11 SEAR member states, adopted a goal for national measles elimination by 2019. This report updates a previous report and summarizes progress toward measles elimination in Nepal during 2007-2014. During 2007-2014, estimated coverage with the first MCV dose (MCV1) increased from 81% to 88%. Approximately 3.9 and 9.7 million children were vaccinated in SIAs conducted in 2008 and 2014, respectively. Reported suspected measles incidence declined by 13% during 2007-2014, from 54 to 47 cases per 1 million population. However, in 2014, 81% of districts did not meet the measles case-based surveillance performance indicator target of ≥2 discarded non-measles cases per 100,000 population per year. To achieve and maintain measles elimination, additional measures are needed to strengthen routine immunization services to increase coverage with MCV1 and a recently introduced second dose of MCV (MCV2) to ≥95% in all districts, and to enhance sensitivity of measles case-based surveillance by adopting a more sensitive case definition, expanding case-based surveillance sites nationwide, and ensuring timely transport of
Live attenuated brucellosis vaccines have been available for protecting domestic livestock against B. melitensis or B. abortus for more than 60 years. Current vaccines are effective in preventing abortion and transmission of brucellosis, but poor at preventing infection or seroconversion. In addit...
Conclusions: This is the largest series of brucellosis in pregnancy reported in the literature. Brucella presents adverse obstetric outcomes including fetal and maternal/neonatal death. Cases with unexplained spontaneous abortion should be investigated for brucellosis. Prompt treatment is paramount to decrease the devastating outcomes.
Full Text Available Background: Human brucellosis is a disease with protean clinical manifestations. Despite many awareness programmes, it is still missed or wrongly diagnosed. This leads to chronic morbidity leading to misery and loss of working days. Aim and Objectives: To assess the microbiological, clinical and epidemiological aspects of human brucellosis. Materials and Methods: Patients with positive brucella screening test constituted the study material. A detailed laboratory, clinical, epidemiological study along with response to the treatment was analyzed. Results: Seroprevalence of brucellosis was found to be 1.75%. Brucellosis was clinically diagnosed in only 12.73% of cases. Fever, joint pain and low backache were the commonest symptoms. Close contact with animals and raw milk ingestion were the major sources of infection. Knowledge regarding brucellosis and its prevention was lacking in patients. Brucellosis was not considered as one of the differential diagnosis by the treating physicians. Conclusion: Brucellosis should be considered as one of the differential diagnosis in cases presenting with fever, low backache, arthritis and arthralgia. Laboratories should screen all the serum samples for brucella agglutinins by Rose Bengal Plate Test. Awareness regarding the prevention of brucellosis in the general population and regarding the existence of the disease among the doctors practicing in rural areas is needed
... Collection; Brucellosis Program AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Extension...-Federal Brucellosis Eradication Program. DATES: We will consider all comments that we receive on or before... State-Federal Brucellosis Eradication Program, contact Dr. Debbi Donch, Brucellosis Program Manager,...
Schmid, G P
Serologic testing for syphilis is a cornerstone of syphilis control efforts, but our objectives for doing it and the costs involved are not always recognized. Tests applied to individuals with symptoms or signs may be viewed as diagnostic tests, and tests applied to individuals with no clinical indications for testing may be viewed as screening tests. Infected individuals whom we detect through screening efforts are important, mostly from an individual and economic standpoint, because treatment will prevent the late complications of syphilis and thus avoid high medical costs. Because they are uncommonly infectious for others, however, they are relatively unimportant from a public health intervention standpoint. The prevalence of infection above which we should screen is based mostly on economic grounds, but is undetermined. We intuitively recognize such a threshold, however, when we use epidemiologic markers to restrict our efforts to groups in whom we think the yield is worth the effort (i.e., targeted [focused] screening). In deciding whether to institute or increase screening efforts for syphilis, we must consider not only the dollar costs of these efforts, but also the opportunity costs (i.e., what programs we will forgo so that we can devote our resources to the increased efforts). Similarly, because syphilis is not the only priority with which governments, health departments, and sexually transmitted disease programs must contend, any broader plan to significantly enhance syphilis control must acknowledge this reality and show the benefit, economic and otherwise, of its adoption.
In August 1996, health officials, program managers, epidemiologists, laboratory representatives, UNICEF, Rotary International, and Pan American Health Organization staff attended the VII Andean EPI Meeting in Quito, Ecuador, to review the progress of the Expanded Program on Immunization (EPI). All Andean countries have conducted catch-up measles vaccination campaigns targeting children 9 months to 15 years old. These campaigns achieved 90% vaccine coverage and a strong reduction in measles incidence (only 7 confirmed cases in 1996). Follow-up campaigns were conducted during 1995-1996 in Colombia, Peru, and Chile. They were expected in Bolivia, Ecuador, Peru, and Venezuela during 1997-1999. The Andean countries implemented a national surveillance system for measles in 1995. Meeting representatives made eight recommendations regarding measles. For example, health officials should reach and maintain routine vaccination coverage greater than 95% for children 12-23 months old in each municipality. Laboratory representatives proposed recommendations on uniform criteria for measles diagnosis. The last indigenous wild poliovirus in the Americas was isolated in 1991. Imported wild poliovirus remains a concern. The Andean countries are expanding surveillance of neonatal tetanus activities. Since 1989 the frequency of neonatal tetanus has been falling in the Andean region, especially in Bolivia and Peru. The impact of migration on the control of neonatal tetanus should be a higher priority. Participants repeated the need for systematic use and continuous monitoring of EPI indicators (e.g., vaccination coverage). Three countries plan on analyzing surveys on missed opportunities for vaccination in 1996. Three countries presented progress reports on hepatitis B vaccination and surveillance. Participants issued recommendations on quality control of vaccines. The responsibility for quality control lies with the manufacturers and the government. Vaccines for invasive diseases (e
Kurata, Takako; Kanbayashi, Daiki; Nishimura, Hiroshi; Komano, Jun; Kase, Tetsuo; Takahashi, Kazuo
In 2013, a rubella outbreak was observed in Japan, Romania, and Poland. The outbreak in Japan was accompanied by an increase of measles reports, especially from a region where measles is highly controlled. This was attributed to the adult populations affected by this rubella outbreak, similarity of clinical signs between rubella and measles, sufficiently small impact of measles outbreaks from neighboring nations, and elimination levels of measles endemicity. Current and future concerns for measles control are discussed.
Abdoel, Theresia; Dias, Isabel Travassos; Cardoso, Regina; Smits, Henk L
Four simple and rapid field tests for the serodiagnosis of brucellosis in cattle, goat, sheep and swine were developed. The performance of the assays was investigated using serum samples collected in Portugal from animals originating from herds with a defined sanitary status with respect to the presence of brucellosis. The sensitivity calculated for the bovine, caprine, ovine and swine Brucella lateral flow assays based on results obtained for samples collected from animals with culture confirmed brucellosis was 90%, 100%, 90% and 73%, respectively. None of the samples from animals from herds free of brucellosis reacted in the flow assays indicating a high specificity. However, as expected, some degree of reactivity was observed when testing selected serum samples that reacted non-specific in reference tests for brucellosis.
Full Text Available INTRODUCTION. In view of the goal of measles elimination, it is of great importance to assess the circulation of wild-type measles virus (MV. Genetic analysis is indispensable to understand the epidemiology of measles. A large measles outbreak occurred in Italy in 2008, with over 4000 cases reported to the enhanced measles surveillance system introduced in 2007, 37% of which were laboratory confirmed. METHODS. Urine and saliva samples were collected during 2008. A phylogenetic analysis of measles sequences was performed in order to understand the epidemiological situation of wild-type (MV circulation in that period. RESULT AND DISCUSSION. Data showed predominant circulation of the genotype D4. Genotypes A, D8, D9 and H1 were also detected in a small number of samples, probably representing imported cases.
Turner, A; Jeyaratnam, D; Haworth, F; Sinha, M D; Hughes, E; Cohen, B; Jin, L; Kidd, I M; Rigden, S P A; MacMahon, E
Two children, boys of 8 and 13 years, presented with measles-associated encephalopathy several years after kidney transplantation for congenital nephrotic syndrome. In the absence of prior clinical measles, the neurological symptoms initially eluded diagnosis, but retrospective analysis of stored samples facilitated the diagnosis of measles-associated encephalopathy without recourse to biopsy of deep cerebral lesions. Each had received a single dose of measles mumps and rubella vaccine before 12 months of age. Prior vaccination, reduction of immunosuppression and treatment with intravenous immunoglobulin and ribavirin may have contributed to their survival. Persistent measles virus RNA shedding, present in one child, was not controlled by treatment with i.v. ribavirin. Two years later, both patients continue to have functioning allografts with only minimal immunosuppression. These cases illustrate the difficulty in diagnosing measles-associated encephalopathy in the immunocompromised host, even in the era of molecular diagnostics, and highlight the renewed threat of neurological disease in communities with incomplete herd immunity.
Martins, Cesario; Bale, Carlitos; Garly, May-Lill
levels being 1.65 (0.98-2.78) (p=0.054) and the geometric mean titre was significantly higher for girls (p=0.007). Children who lived in houses with known measles cases were more likely to have protective levels at 9 months of age even though they had not reported measles infection. Since we had excluded...
Full Text Available Abstract Background Recent epidemiological data show an increased trend of official estimates for syphilis infection in the general population. Many of the infected cases remain undetected leaving an underestimation of the true prevalence of syphilis in the general population, but also among subpopulations such as illicit drug users. There is limited epidemiological data published on the proportion and risk factors of syphilis infections associated with illicit drug abuse. Methods Illicit drug addicts (n = 1223 in inpatients units in Germany were screened (2000–01 for syphilis and interviewed regarding patterns of drug use and sexual behaviour. TPHA-test for initial screening and FTA-ABS-IgM test in TPHA-positive patients were used. Results In total, TPHA-tests were positive in 39 (3.3% and 7 patients (0.6% were IgM positive. The prevalence rate for syphilis in males was 1.9% and for women it was 8.5%. Female patients were 4.56 (CI 95% 2.37–8.78 times more likely to have a positive TPHA test than males. Sexual behaviours such as high number of sexual partners, sex for drugs/money, sex on the first day were associated with syphilis infection only in women. Females with frequent sex for drugs or money had 4.31 (CI 95% 2.32–8.52 times more likely a reactive TPHA test than remaining patients. Neither the sociodemographic factors nor sexual behaviour were statistically significant associated with syphilis infection among men at all. Conclusion Our data suggest the need for screening for syphilis among these illicit drug users in inpatient settings, in particular among sexual active women. This conclusion is corroborated by the finding of increasing numbers of syphilis infections in the general population. The identification of syphilis cases among drug addicts would give treatment options to these individuals and would help to reduce the spread of infection in this population, but also a spread into heterosexual populations related to
Emine Qehaja Buçaj
Full Text Available Objective: Brucellosis became a remarkable disease in Kosovo. But there is not a comprehensive epidemiological study about epidemiology and clinical course of this disease from Kosovo. The aim of our study is to present demographic and clinical data of patients with brucellosis at University Clinical Center of Kosovo. Methods: A retrospective study was performed for the patients with brucellosis treated in our clinic during years 2011- 2012. The data about demography, history of the disease, clinical presentations, serological test, serum biochemistry and reatment were collected from hospital medical records. The diagnosis of brucellosis based on clinical and laboratory findings. Results: This descriptive study included 47 patients, who 33 of them (70.2% were males. The mean age was 37.9 ± 19.3 years. The route of transmission of the disease was known in 28 59.5% of them. Direct contact with livestock in 22 (46.8% and ingestion of dairy products in six cases (12.7% were reported as the transmission route. The majority of patients (27 patients, 57.4% were from rural area. The main presenting symptoms were atigue, fever and arthralgia. Osteoarticular manifestations were the common forms of localized disease. Regarding to the therapy, 45 (95.7% of patients were treated with streptomycin and doxycycline for the first three weeks. Conclusion: Human brucellosis is not a common in Kosovo but there is a potential risk. Osteoarticular symptoms were the most common presentation reasons. The most effective and preferred treatment regimen was Streptomycin plus Doxycycline for the first three weeks, and Doxycycline plus Rifampicin thereafter. J Microbiol Infect Dis 2015;5(4: 147-150
Plemper, Richard K; Hammond, Anthea L
Introduction Measles virus is a major human pathogen responsible for approximately 150,000 measles deaths annually. The disease is vaccine preventable and eradication of the virus is considered feasible in principle. However, a herd immunity exceeding 95% is required to prevent sporadic viral outbreaks in a population. Declining disease prevalence combined with public anxieties about vaccination safety has increased vaccine refusal especially in the European region, which has resulted in measles resurgence in some areas. Areas covered Here, we discuss whether synergizing effective measles therapeutics with vaccination could contribute to solving an endgame conundrum of measles elimination by accelerating the eradication effort. Based on an anticipated use for protection of high-risk contacts of confirmed measles cases through post-exposure prophylaxis, we identify key elements of the desirable drug profile, review current disease management strategies and the state of experimental inhibitor candidates, evaluate the risk associated with viral escape from inhibition, and consider the potential of measles therapeutics for the management of persistent viral infection of the CNS. Assuming a post-measles world with waning measles immunity, we contemplate the possible impact of therapeutics on controlling the threat imposed by closely related zoonotic pathogens of the same genus as measles virus. Expert opinion Efficacious therapeutics given for post-exposure prophylaxis of high-risk social contacts of confirmed index cases may aid measles eradication by closing herd immunity gaps due to vaccine refusal or failure in populations with overall good vaccination coverage. The envisioned primarily prophylactic application of measles therapeutics to a predominantly pediatric and/or adolescent patient population dictates the drug profile; the article must be safe and efficacious, orally available, shelf-stable at ambient temperature, and amenable to cost-effective manufacture
Zapanta, Ma Justina; de los Reyes, Vikki Carr; Tayag, Enrique; Magpantay, Rio
Introduction Measles is a highly infectious viral illness that remains one of the leading causes of death among children worldwide. In the Philippines, decreasing routine vaccination coverage from 2007 to 2011 led to local measles outbreaks. A team investigated a measles outbreak reported in Cordillera of the Philippines in May 2013. Methods Measles case data with symptom onset from 2 February to 27 May 2013 were obtained from official sources and verified on site. Data included age, sex, residential address, signs and symptoms and vaccination status. Active case-findings were also conducted for contacts of these cases. The living environments of the cases were investigated. A survey was conducted with the cases and caregivers to understand their knowledge and attitudes about measles. Results There were 50 measles cases identified with an age range from six months to 32 years (median: 16 years). Thirty-two were male (64%). Twenty (40%) were hospitalized with one death. Thirty-two (64%) cases were laboratory confirmed, and 36 (72%) received a single dose of measles vaccine. Overcrowded living environments were observed among many cases. The majority of respondents (46/48, 96%) knew about measles, but there were misconceptions about the cause of measles and how it can be prevented and managed. Conclusion This measles outbreak occurred in an area with low immunization coverage. Achieving 95% measles immunization coverage and strengthening routine immunization strategies to address high-risk populations are recommended. Also, we recommend health education campaigns to include components that address misconceptions about measles. PMID:27766180
Paola Katrina Ching
Full Text Available Introduction: Measles is a highly infectious viral illness that remains one of the leading causes of death among children worldwide. In the Philippines, decreasing routine vaccination coverage from 2007 to 2011 led to local measles outbreaks. A team investigated a measles outbreak reported in Cordillera of the Philippines in May 2013. Methods: Measles case data with symptom onset from 2 February to 27 May 2013 were obtained from official sources and verified on site. Data included age, sex, residential address, signs and symptoms and vaccination status. Active case-findings were also conducted for contacts of these cases. The living environments of the cases were investigated. A survey was conducted with the cases and caregivers to understand their knowledge and attitudes about measles. Results: There were 50 measles cases identified with an age range from six months to 32 years (median: 16 years. Thirty-two were male (64%. Twenty (40% were hospitalized with one death. Thirty-two (64% cases were laboratory confirmed, and 36 (72% received a single dose of measles vaccine. Overcrowded living environments were observed among many cases. The majority of respondents (46/48, 96% knew about measles, but there were misconceptions about the cause of measles and how it can be prevented and managed. Conclusion: This measles outbreak occurred in an area with low immunization coverage. Achieving 95% measles immunization coverage and strengthening routine immunization strategies to address high-risk populations are recommended. Also, we recommend health education campaigns to include components that address misconceptions about measles.
Abstract Since the start of 2010 there has been a flare-up of measles in France, following on the resurgence observed in 2008. The aim of this study was to present results of the epidemiological surveillance of measles in the French armed forces and to describe the increase in incidence. Measles was surveyed from 1992 to 2010. Criteria for report were those used for French national compulsory notification. The data, concerning active military personnel, were provided by the physici...
To eliminate the indigenous measles and rubella virus by 2012 in Japan, the strategy fro prevention of measles and rubella prevalence with measles-rubella (MR) vaccine was proposed. Since the vast majority of 1-year old infants are susceptible to measles and rubella, the first MR vaccine, the first MR vaccine should be administered at 1-year old to sustain the herd immunity. Since significant elevation of measles and rubella antibody titers were eliminated in a half of children after the second dose, the second dose of of MR vaccine within 1 year before elementary school entry is the effective maneuver. Moreover, supplement MR vaccination to the teenage group and 20-29 years' group might be necessary, because the mean measles antibody titers in this group were significantly lower compared with those in the older individuals' groups.
Wairagkar, Niteen; Chowdhury, Deepika; Vaidya, Sunil; Sikchi, Sarika; Shaikh, Naseem; Hungund, Laxman; Tomar, R S; Biswas, D; Yadav, K; Mahanta, J; Das, V N R; Yergolkar, Prasanna; Gunasekaran, P; Raja, D; Jadi, R; Ramamurty, Nalini; Mishra, A C
Measles is a childhood disease that causes great morbidity and mortality in India and worldwide. Because measles surveillance in India is in its infancy, there is a paucity of countrywide data on circulating Measles virus genotypes. This study was conducted in 21 of 28 States and 2 of 7 Union Territories of India by MeaslesNetIndia, a national network of 27 centers and sentinel practitioners. MeaslesNetIndia investigated 52 measles outbreaks in geographically representative areas from 2005 through June 2010. All outbreaks were serologically confirmed by detection of antimeasles virus immunoglobulin M (IgM) antibodies in serum or oral fluid samples. Molecular studies, using World Health Organization (WHO)-recommended protocols obtained 203 N-gene, 40 H-gene, and 4 M-gene sequences during this period. Measles genotypes D4, D7, and D8 were found to be circulating in various parts of India during the study period. Further phylogenetic analysis revealed 4 lineages of Indian D8 genotypes: D8a, D8b, D8c, and D8d. This study generated a large, countrywide sequence database that can form the baseline for future molecular studies on measles virus transmission pathways in India. This study has created support and capabilities for countrywide measles molecular surveillance that must be carried forward.
A. Ashraf, M.D.
Full Text Available AbstractManifestations involving the nervous system (neurobrucellosis, is a treatable infection, however it is not well documented. Direct invasion of the central nervous system occurs in fewer than 5% of cases. Acute or chronic meningitis is the most frequent nervous system complication. However, hemiplegia and cranial nerve involvement are rarely encountered. In this report we present a patient with “seventh cranial nerve palsy” and “hemiplegia,” as the manifestations of probable neurobrucellosis.Thus, in endemic area, brucellosis should be ruled out in patients who develop unexplained neurological symptoms such as hemiplegi
Full Text Available AIM: We evaluated retrospectively laboratory test results of 520 patient who has brucellosis suspect between 2002-2004 years. METHOD: We use to Rose-Bengal test, Wright agglutination test and the other laboratory results and demographic properties for diagnosis. RESULTS: Rose-Bengal test was positive in 39 patients (11.3 % sera. Wright agglutination test was found positive for 1/160 or higher titers in 18 (3.4% sera. CONCLUSION: Wright agglutination test gave higher positive results in summer and autumn months. [TAF Prev Med Bull 2009; 8(6.000: 485-488
Solmaz, Soner; Asma, Süheyl; Ozdoğu, Hakan; Yeral, Mahmut; Turunç, Tuba
Febrile neutropenia which is a common complication of cancer treatment, is one of the major causes of morbidity and mortality. Several gram-negative and gram-positive bacteria are responsible for infections in neutropenic patients, however the most common microorganisms are Escherichia coli and coagulase-negative staphylococci, in decreasing order. Although Brucella spp. infections are endemic in Turkey, brucellosis-related febrile neutropenia has only rarely been reported. In this report, a case of brucellosis-related febrile neutropenia in a patient with acute myeloblastic leukemia (AML) was presented. A 56-year-old male patient presenting with fever, petechiae/purpura, leukocytosis, thrombocytopenia, and anemia was admitted to our hospital. Laboratory studies revealed a hemoglobin level of 8.27 g/dl, leukocyte count of 77.100 k/ml, absolute neutrophil count of 200 k/ml, and platelets at 94.200 k/ml. The patient was diagnosed as AML-M1 and piperacillin/tazobactam was started as the first-line antibiotic therapy due to the febrile neutropenia. On admission, blood and urine cultures were negative. Once the fever was controlled, remission/induction chemotherapy was initiated. However, fever developed again on the eight day, and vancomycin was added to the therapy. Since the fever persisted, the antibiotic therapy was gradually replaced with meropenem and linezolid. However, fever continued and the patient's general condition deteriorated. Subsequently performed Brucella tube agglutination test revealed positivity at 1/320 titer and the microorganism grown in blood culture (Bactec 9050; BD, USA) was identified as B.melitensis by conventional methods. Rifampicin and doxycycline therapy was started immediately, however, the patient died due to septic shock. If the tests for brucellosis were performed earlier when response to second step antibiotic therapy lacked in this patient, it was assumed that mortality could be prevented by the prompt initiation of the
Renato L. Santos
Full Text Available Brucellosis is an important zoonosis of worldwide distribution. Reliable epidemiologic brucellosis data covering approximately 90% of the cattle population in Brazil have been recently published. Therefore, considering the scarcity of information regarding the economic impact of bovine brucellosis in Brazil, the goal of this study was to estimate economic impact of brucellosis on the Brazilian cattle industry. Several parameters including abortion and perinatal mortality rates, temporary infertility, replacement costs, mortality, veterinary costs, milk and meat losses were considered in the model. Bovine brucellosis in Brazil results in an estimated loss of R$ 420,12 or R$ 226,47 for each individual dairy or beef infected female above 24 months of age, respectively. The total estimated losses in Brazil attributed to bovine brucellosis were estimated to be approximately R$ 892 million (equivalent to about 448 million American dollars. Every 1% increase or decrease in prevalence is expected to increase or decrease the economic burden of brucellosis in approximately 155 million Reais.
Full Text Available Background: After the transition from socialism to a market economy in 1990, human brucellosis re-emerged in Mongolia. The aim of our study was to estimate a representative seroprevalence of Brucella spp. and to determine risk factors for brucellosis seropositivity among rural people. Methods: A cross-sectional study with multistage random selection was conducted in eight provinces of Mongolia. Study participants were interviewed using a questionnaire to obtain their brucellosis history, current symptoms and likely risk factors. Blood samples were drawn to determine brucellosis seroprevalence. Results: A total of 2856 randomly selected rural people aged four to 90 years were enrolled in the study. The seroprevalence of Brucella spp. was 11.1% (95% confidence interval [CI]: 10.0–12.1, ranging between 2.3% and 22.6% in the eight provinces; 39.2% (n = 609 of nomadic camps had at least one seropositive participant. Risk factors associated with brucellosis seropositivity were being older than 45 years (adjusted odds ratio [AOR] = 6.9, 95% CI = 5.1–8.7 and being a veterinarian (AOR = 2.8, 95% CI = 1.5–5.0. Conclusion: Our study confirms that human brucellosis seroprevalence among rural people in Mongolia is high. Human brucellosis can be effectively controlled if high-coverage livestock mass vaccination is implemented with a coverage survey after the vaccinations to ensure completeness. This mass vaccination should be accompanied by public awareness and educational programmes.
Zhang, Xiaoyu; Kou, Guangping; Du, Hongzhong; Ju, Zhoufeng; Zhong, Li; Cui, Xiuling; Ling, Hongbing
In this study, we analyzed the epidemiology of measles cases from January 2004 to December 2011 and measles immunity levels among a healthy population from January to June 2012, in Baoji, Shaanxi Province. This study aimed to identify susceptible populations to measles and to establish methods of measles prevention and control. Measles incidence was at the lowest level in 2011 (0.32 per 100,000 populations). Among these patients, the proportion of those younger than 8 months and those older than 27 years of age was relatively high. The overall antibody positive rate was 78.90%, and the average antibody geometric mean concentration was 562.15 mIU/ml. Measles immunity level was high among children aged 8 months to 6 years and low among infants aged 1-7 months. To reduce the incidence of measles among infants younger than 8 months, implementation of measles vaccine (MV) for women of childbearing age is recommended. Measles immunity level was low among some individuals vaccinated with aqueous MV and lyophilized MV. Supplementary immunization will be recommended for freshmen in universities and colleges, where many students are recruited from various parts of China.
Bankamp, Bettina; Takeda, Makoto; Zhang, Yan; Xu, Wenbo; Rota, Paul A
The complete genomic sequences of 9 measles vaccine strains were compared with the sequence of the Edmonston wild-type virus. AIK-C, Moraten, Rubeovax, Schwarz, and Zagreb are vaccine strains of the Edmonston lineage, whereas CAM-70, Changchun-47, Leningrad-4 and Shanghai-191 were derived from 4 different wild-type isolates. Nucleotide substitutions were found in the noncoding regions of the genomes as well as in all coding regions, leading to deduced amino acid substitutions in all 8 viral proteins. Although the precise mechanisms involved in the attenuation of individual measles vaccines remain to be elucidated, in vitro assays of viral protein functions and recombinant viruses with defined genetic modifications have been used to characterize the differences between vaccine and wild-type strains. Although almost every protein contributes to an attenuated phenotype, substitutions affecting host cell tropism, virus assembly, and the ability to inhibit cellular antiviral defense mechanisms play an especially important role in attenuation.
Ahmadinejad, Zahra; Abdollahi, Alireza; Ziaee, Vahid; Domiraei, Zeinab; Najafizadeh, Seyed-Reza; Jafari, Sirus; Ahmadinejad, Mahdi
Brucellosis is a chronic infectious disease with articular involvement. Discrimination between brucellosis and rheumatologic disorders is difficult in regions endemic for brucellosis. There are few studies about the rate of positive autoantibodies as rheumatologic biomarkers in brucellosis, and the prevalence is variable. In this study, the rheumatologic tests were studied in brucellosis patients. This cross sectional study was performed in two teaching hospitals in Tehran, Iran. Forty-nine patients with brucella infection and 42 healthy participants were enrolled in this study. Brucellosis was diagnosed on the basis of the clinical symptoms and positive serology for brucellosis. Rheumatic factor (RF) and antinuclear antibodies (ANA) were evaluated in all patients. Cyclic citrullinated peptides antibody (ACPA) and anti-double strand DNA (anti-dsDNA) were checked in all patients and control groups. Out of 49 patients, 15 (30.6 %) were RF positive and 4 (8.2 %) were ANA positive. Anti-dsDNA was concurrently positive with ANA in 1 patient (2 %) but ACPA titer was positive in 8 patients (16.3 %). None of the patients with positive autoantibody biomarkers fulfilled the criteria for rheumatologic disorders. The rate of positive RF in healthy people was significantly lower than patient group (2.4 vs. 30.6 %), but the positiveness rate of other biomarkers did not have significant difference in two groups. Sixty percent of the patients with positive RF and 75 % with positive ACPA had skeletal involvement (P brucellosis. Rheumatologists should be aware of brucellosis in patients with musculoskeletal involvement and positive autoantibody biomarkers in endemic regions.
Chen, Xiang-Sheng; Yin, Yue-Ping; Shen, Crystal; Liu, Guo-Gu; Zhu, Zheng-Jun; Wei, Wan-Hui; Wang, Hong-Chun; Huang, Shui-Jie; Li, Jing; Tucker, Joseph D.; Mabey, David C.; Peeling, Rosanna W.
Background Accessibility of syphilis testing services is critical in syphilis control programs for female sex workers (FSWs), but few FSWs attend public STI clinics or other testing sites. Introduction of free rapid syphilis testing (RST) into outreach programs for FSWs will help improve test uptake. Methods Commercial sex venues were identified in two cities in South China. In cooperation with health advocacy organizations, health outreach teams from local public health or medical facilities approached all types of sex venues in study areas to offer free RST. Acceptability and uptake of RST among FSWs were evaluated. Results A total of 2812 FSWs were offered RST and 2670 (95.0%) accepted syphilis testing. 182 (6.8%) FSWs had a positive RST result among whom 136 (74.7%) were willing to attend an STD clinic for confirmatory testing and treatment. More than half (89, 66.4%) of those with syphilis were not willing to notify their sex partners. Multivariate logistic analysis showed that syphilis test uptake was associated with residing in Jiangmen (AOR, 1.78; 95% CI, 1.15–2.77), older age (AOR, 2.11, 95% CI, 1.17–3.79 for age of 31 years or above), and not working at a service venue (AOR, 1.60; 95% CI, 1.10–2.34). Conclusions RST at sex venues is well accepted by FSWs when it is integrated into ongoing outreach services. Such programs provide excellent opportunities for expanding syphilis screening efforts among specific subgroups of FSW who are difficult to reach through clinic-based programs. PMID:23300709
Full Text Available BACKGROUND: Accessibility of syphilis testing services is critical in syphilis control programs for female sex workers (FSWs, but few FSWs attend public STI clinics or other testing sites. Introduction of free rapid syphilis testing (RST into outreach programs for FSWs will help improve test uptake. METHODS: Commercial sex venues were identified in two cities in South China. In cooperation with health advocacy organizations, health outreach teams from local public health or medical facilities approached all types of sex venues in study areas to offer free RST. Acceptability and uptake of RST among FSWs were evaluated. RESULTS: A total of 2812 FSWs were offered RST and 2670 (95.0% accepted syphilis testing. 182 (6.8% FSWs had a positive RST result among whom 136 (74.7% were willing to attend an STD clinic for confirmatory testing and treatment. More than half (89, 66.4% of those with syphilis were not willing to notify their sex partners. Multivariate logistic analysis showed that syphilis test uptake was associated with residing in Jiangmen (AOR, 1.78; 95% CI, 1.15-2.77, older age (AOR, 2.11, 95% CI, 1.17-3.79 for age of 31 years or above, and not working at a service venue (AOR, 1.60; 95% CI, 1.10-2.34. CONCLUSIONS: RST at sex venues is well accepted by FSWs when it is integrated into ongoing outreach services. Such programs provide excellent opportunities for expanding syphilis screening efforts among specific subgroups of FSW who are difficult to reach through clinic-based programs.
Antonio, Andréa Gonçalves; Kelly, Alice; Maia, Lucianne Cople
Congenital syphilis is an infectious disease transmitted by an infected mother to her fetus. Several reports in the literature have focused on oral manifestations of congenital syphilis, mainly about Hutchinson's teeth and dysplastic molars, which are more common. However, this paper describes an unusual feature of congenital syphilis in a four-year-old child. A case of premature loss of primary teeth associated with congenital syphilis is reported.
An, Jingna; Chen, Qixia; Liu, Qianqian; Rao, Chenli; Li, Dongdong; Wang, Tingting; Tao, Chuanmin; Wang, Lanlan
The resurgence of syphilis in recent years has become a serious threat to public health worldwide, and the serological detection of specific antibodies against Treponema pallidum remains the most reliable method for laboratory diagnosis of syphilis. This study examined the performance of the recently launched HISCL anti-Treponema pallidum (anti-TP) assay as a screening test for syphilis in a high-volume laboratory. The HISCL anti-TP assay was tested in 300 preselected syphilis-positive sample...
In the pre-antibiotics era, syphilis was an extremely common disease. The first well-recorded European outbreak of what is now known as syphilis occurred in 1494, when it appeared among French troops besieging Naples. Thereafter, the disease spread all over Europe and, in the 18th and 19th centuries, many artists became victims of syphilis, among them poets, painters, philosophers, and musicians and composers. This review presents biographies of several musicians and composers that probably suffered from syphilis.
Job, J. S.; John, T J; Joseph, A.
Antibody response to measles vaccine was measured in 238 subjects aged 6-15 months. Seroconversion rates ranged from 74% at 6 months of age to 100% at 13-15 months; the differences in age-specific rates were not statistically significant. The postimmunization antibody titres increased with increasing age of the vaccinee. Seroconversion rates and antibody titres in 49 subjects with grades I and II malnutrition were not significantly different from those in the 189 normal subjects.
Full Text Available PURPOSE: To analyse the prevalence of syphilis in the apparently healthy population and to provide data for implementation of the joint STD/HIV control programme, a population based study was undertaken by using ′probability proportional to size′ cluster survey method in three randomly chosen districts of Tamil Nadu, India namely Dindigul, Ramnad and Tanjore. METHODS: Blood samples were collected from adults (n=1873 aged 15-45 years, from the selected households enrolled in this study. The sera were tested parallelly by rapid plasma reagin (RPR and Treponema pallidum haemagglutination (TPHA tests. Reactive samples by RPR and/or TPHA were later analysed by fluorescent treponemal antibody absorption (FTA-ABS test. RESULTS: The prevalence of syphilis in the community of Tamil Nadu as per RPR positivity was 2.7% (50/1873 as against 0.7% by TPHA (13/1873. FTA-ABS positivity was observed in only 12 out of 48 (25% RPR/TPHA reactive samples tested. By taking the positivity by two of the three tests, the community prevalence of acute ongoing syphilis in Tamil Nadu was determined as 1.1% (20/1873. CONCLUSIONS: The results confirmed that no single serological test for syphilis can act as the marker of ongoing acute infection in an apparently healthy population. The study suggests that for specific diagnosis of ongoing syphilis, the FTA-ABS test may be performed along with RPR and TPHA.
Full Text Available Presence of genital ulcer disease facilitates human immunodeficiency virus (HIV transmission and their -diagnosis is essential for the proper management. Venereal Disease Research Laboratory (VDRL test is used as a screening test for the diagnosis of syphilis. However, unusual VDRL test results have been reported in HIV-infected persons with syphilis. There are reports showing higher than expected VDRL titers as well as biological false positive in most of the studies. A negative Rapid Plasma Reagin (RPR test or VDRL test result may not rule out syphilis in patients with HIV infection. For laboratory confirmation of syphilis, one specific Treponemal test, namely, Fluroscent Treponemal Antibody Absorption (FTA-ABS test or Treponema Pallidum Haemagglutination Assay (TPHA should be done along with VDRL. In the present study, 88 HIV-seropositive patients with history of high-risk behaviour were screened for syphilis by VDRL test. Out of these 88 cases, 42 (47.7% patients were positive for TPHA and eight (9.1% patients were reactive for VDRL in various titers. All the eight patients who were reactive for VDRL test were also positive for TPHA test. Persons with HIV infection acquired through sexual route should be screened for sexually transmitted infections (STIs, and all patients with STIs should be counselled for HIV testing. This will help in proper management of patients having STIs and HIV coinfection.
Hızlı, Ömer; Hızlı, Pelin; Kaya, Serdar; Monsanto, Rafael da Costa; Paparella, Michael M; Cureoglu, Sebahattin
To the best of our knowledge, histopathologic studies of syphilitic ears have generally focused on hydropic changes; so far, no such studies have investigated peripheral vestibular otopathology using differential interference contrast microscopy, in patients with syphilis. For this study, we examined 13 human temporal bone samples from 8 patients with a history of syphilis. Using conventional light microscopy, we performed qualitative histopathologic assessment. In addition, using differential interference contrast microscopy, we performed type I and type II vestibular hair cell counts on each vestibular sense organ with minimal autolysis; in which the neuroepithelium was oriented perpendicular to the plane of section. We then compared vestibular hair cell densities (cells per 0.01 mm² surface area) in the syphilis group vs. the control group. In the syphilis group, we observed precipitate in the endolymphatic or perilymphatic spaces in 1 (7.7 %) of the samples and endolymphatic hydrops in eight (61.5 %) of the samples. Hydrops involved the cochlea (four samples) and/or saccule (four samples). In addition, the syphilis group experienced a significant loss of type II vestibular hair cells in the maculae of the utricle and saccule, and in the cristae of the lateral and posterior semicircular canals, as compared with the control group (P < 0.05).
Kanmaz, Lutfi; Karakeçili, Faruk; Çıkman, Aytekin; Özçiçek, Fatih; Karavaş, Erdal
Brucellosis is a common zoonotic infection caused by Brucella bacteria. Brucella infections are usually presented with various clinical manifestations, and often accompanied by multiple organ involvements. In this article, we present a case of brucellosis with suppurative parotitis involvement accompanied by parotid abscess and fistula in a 60-year-old male patient. According to the literature review we conducted regarding complications of brucellosis, our case is the first case reported in the literature. Significant improvement in patient's suppurative parotitis and clinical findings was observed at the fifth week of combination antibiotic therapy. Patient's complaints resolved completely after eight weeks of treatment.
Takashima, Yoshihiro; Schluter, W William; Mariano, Kayla Mae L; Diorditsa, Sergey; de Quiroz Castro, Maricel; Ou, Alan C; Ducusin, Maria Joyce U; Garcia, Luzviminda C; Elfa, Dulce C; Dabbagh, Alya; Rota, Paul; Goodson, James L
In 2005, the Regional Committee for the World Health Organization (WHO) Western Pacific Region (WPR) established a goal to eliminate measles by 2012.The recommended elimination strategies in WPR include 1) ≥95% 2-dose coverage with measles-containing vaccine (MCV) through routine immunization services and supplementary immunization activities (SIAs); 2) high-quality case-based measles surveillance; 3) laboratory surveillance with timely and accurate testing of specimens to confirm or discard suspected cases and detect measles virus genotypes; and 4) measles outbreak preparedness, rapid response, and appropriate case management. In the WPR, the Philippines set a national goal in 1998 to eliminate measles by 2008. This report describes progress toward measles elimination in the Philippines during 1998-2014 and challenges remaining to achieve the goal. WHO-United Nations Children's Fund (UNICEF)-estimated coverage with the routine first dose of MCV (MCV1) increased from 80% in 1998 to 90% in 2013, and coverage with the routine second dose of MCV (MCV2) increased from 10% after nationwide introduction in 2010 to 53% in 2013. After nationwide SIAs in 1998 and 2004, historic lows in the numbers and incidence of reported measles cases occurred in 2006. Despite nationwide SIAs in 2007 and 2011, the number of reported cases and incidence generally increased during 2007-2012, and large measles outbreaks occurred during 2013-2014 that affected infants, young children, older children, and young adults and that were prolonged by delayed and geographically limited outbreak response immunization activities during 2013-2014. For the goal of measles elimination in WPR to be achieved, sustained investments are required in the Philippines to strengthen health systems, implement the recommended elimination strategies, and develop additional strategies to identify and reduce measles susceptibility in specific geographic areas and older age groups.
Manoj V Murhekar
Full Text Available BACKGROUND: Updated estimates of measles case fatality rates (CFR are critical for monitoring progress towards measles elimination goals. India accounted for 36% of total measles deaths occurred globally in 2011. We conducted a retrospective cohort study to estimate measles CFR and identify the risk factors for measles death in Bihar-one of the north Indian states historically known for its low vaccination coverage. METHODS: We systematically selected 16 of the 31 laboratory-confirmed measles outbreaks occurring in Bihar during 1 October 2011 to 30 April 2012. All households of the villages/urban localities affected by these outbreaks were visited to identify measles cases and deaths. We calculated CFR and used multivariate analysis to identify risk factors for measles death. RESULTS: The survey found 3670 measles cases and 28 deaths (CFR: 0.78, 95% confidence interval: 0.47-1.30. CFR was higher among under-five children (1.22% and children belonging to scheduled castes/tribes (SC/ST, 1.72%. On multivariate analysis, independent risk factors associated with measles death were age <5 years, SC/ST status and non-administration of vitamin A during illness. Outbreaks with longer interval between the occurrence of first case and notification of the outbreak also had a higher rate of deaths. CONCLUSIONS: Measles CFR in Bihar was low. To further reduce case fatality, health authorities need to ensure that SC/ST are targeted by the immunization programme and that outbreak investigations target for vitamin A treatment of cases in high risk groups such as SC/ST and young children and ensure regular visits by health-workers in affected villages to administer vitamin A to new cases.
Escobar, Gabriela I; Jacob, Néstor R; López, Gustavo; Ayala, Sandra M; Whatmore, Adrian M; Lucero, Nidia E
Seventeen workers in a pig slaughterhouse with signs and symptoms compatible with brucellosis were clinically examined at the outpatient service of different health institutions and studied by serological tests during the period 2005-2011. Eleven blood cultures were taken and six Brucella suis strains were isolated, three biovar 1 and three with atypical characteristics. In order to confirm that these cases had no common source, a variable number of tandem repeat (VNTR) analyses were performed on 5 of the 6 strains whose results showed substantial heterogeneity in the genotypes, thereby demonstrating that the immediate origin was not the same. Two hundred adult pigs admitted for slaughter at the plant were sampled by convenience and tested by buffered antigen plate test (BPAT), serum agglutination test (SAT) and 2-mercapto-ethanol test (MET). Seven of 62 males (11%) and 25/138 (18%) females tested positive. The study results contribute information on risk scenarios for packing plant workers and underscore the need to improve plant workers' education on appropriate containment measures and to actively screen animals for swine brucellosis.
Shi, Jingwei; Zheng, Jingtong; Huang, Honglan; Hu, Yu; Bian, Jiang; Xu, Deqi; Li, Fan
The incidence of measles in China has increased over the last decade. To evaluate the genetic variation of measles strains, 16 measles wild-type virus strains were isolated from 14 vaccinated cases and 2 nonvaccinated cases in Jilin Province during 2005-2006, and their nucleoprotein (N) and hemagglutinin (H) genes were amplified by RT-PCR. The amplified products were sequenced and compared with the Edmonston virus and the existing vaccine strains (Changchun-47 and Shanghai-191). The results showed that the variation rate between the vaccine and wild-type strains was 9.8-12.0% in the N gene and 5.9-6.9% in the H gene, respectively. In addition, cross-neutralization assays revealed that although sera obtained from infants following primary vaccination effectively neutralized vaccine strains, the capacity in neutralizing H1 wild-type measles virus isolates was decreased fourfold. Antigenic ratios testing revealed that the antigenic relatedness between wild-type measles viruses and existing vaccine strains was notably low. These data suggest that the increased incidence of measles in Jilin Province may be attributed to the antigenic drift between wild-type and vaccine strains. Our findings strengthen the recommendation of supplemental immunization with existing vaccines and also strongly suggest a need for developing new vaccines to better control measles virus outbreaks.
Li, Juan; LU, Li; Pang, Xinghuo; Sun, Meiping; Ma, Rui; Liu, Donglei; Wu, Jiang
Background China pledged to join the global effort to eliminate measles by 2012. To improve measles control strategy, the epidemic trend and population immunity of measles were investigated in 1951–2011 in Beijing. Methods The changing trend of measles since 1951 was described based on measles surveillance data from Beijing Centre of Disease Control and Prevention (CDC). The measles vaccination coverage and antibody level were assessed by routinely reported measles vaccination data and twenty...
Zhuang, Y-H; Tian, Y; Chen, Y; Tang, J; Wang, J-Q; Li, P; Li, Q; Jiang, Y-Q
Currently, infectious syphilis has been resurgent in China and has become a significant public health problem. The rapid expansion of syphilis screening programs is urgently required. In the present study, the performance of the Determine Syphilis TP assay (Determine TP assay) for the detection of antibodies against Treponema pallidum (T. pallidum) for syphilis serodiagnosis was evaluated. In total, 300 serum samples were tested for the presence of treponemal-specific antibodies using the Treponema pallidum particle agglutination (TPPA) assay, the Determine TP assay, and the InTec immunochromatography assay (InTec assay). The Determine TP assay detected 99, 11, and 5 positive results, whereas the InTec assay detected 97, 3, and 3 positive samples from group I (100 TPPA-positive sera), group II (13 TPPA 1:80 +/- sera), and group III (187 TPPA-negative sera), respectively. The sensitivity, specificity, and the rate concordant with TPPA for the Determine TP assay were 97.35, 98.91, and 97.33%, respectively. In comparison to the TPPA, the Determine TP assay is simple to perform and time-saving, making it a favorable alternative for the detection of T. pallidum-specific antibodies where other T. pallidum-specific confirmatory tests are not available. In addition, this rapid treponemal test promotes prompt treatment for syphilis by providing early laboratory diagnosis.
Conclusions: Hospital exposure 1–2 weeks before infection with measles was the main cause of the measles outbreak. We must be fully aware of the possibility of nosocomial infection in an outbreak of measles; controlling nosocomial infections is a vital step in the prevention and control of the propagation of measles.
Hersh, Bradley S.; And Others
Reports a retrospective cohort study among students living in campus dormitories to examine potential risk factors for measles vaccine failure. As in secondary schools, measles outbreaks can occur among highly vaccinated college populations. Requiring two doses of measles vaccine for college entrants should help reduce measles outbreaks in college…
Amler, Robert W.; Orenstein, Walter A.
The current effort to eliminate measles in the United States has caused record low levels of the disease. This strategy must continue to be applied in order to break the transmission of measles on college campuses through high immunization levels, promotion of rapid reporting of cases, and quick responses to outbreaks. (Author/DF)
Masa Calles, Josefa; López Perea, Noemí; Torres de Mier, Maria de Viarce
To achieve the goal of eliminating measles and rubella two key strategies have been defined: sustain very low level of population susceptibility and strengthen surveillance system by rigorous case investigation and rapid control measures implementation. Surveillance of measles, rubella and CRS are included into the Spanish Surveillance System (RENAVE); surveillance is mandatory, passive, nationwide and case-based with laboratory information integrated. Information flows from sub national to national level (National Centre for Epidemiology) and then, to the WHO-Europe through ECDC. In the final phase of elimination, good surveillance and documented evidences are keys. Information on epidemiology of measles, rubella and CRS cases and outbreaks, pattern of importation, genotypes circulating and performance of measles and rubella surveillance are required at national and international level. Also all investigated and discarded measles or rubella cases should be reported. Currently the system faces some challenges gathering needed information for documenting the elimination. As long as the disease incidence declines, increases difficulties in identifying clinical measles and rubella because of non-specific prodromal signs and atypical cases. Differential diagnosis for fever and rash including measles and rubella should be performed in all clinical settings. Three clinical specimens must be collected to confirm or discard cases and to allow the virus characterization in order to know the pattern of importation of measles and rubella.
H.S. El Mubarak
textabstractDespite the availability of safe and effective live attenuated vaccines, measles remains endemic in many developing countries. Little is known about the pathogenesis of measles virus (MV) infections in the areas of itsendemicity, largely due to the limited infrastructure and political in
Metin, Ozge; Teke, Turkan A; Gayretli Aydin, Zeynep G; Kaman, Ayse; Oz, Fatma N; Bayhan, Gulsum I; Tanir, Gonul
Brucellosis is a zoonotic disease caused by Brucella spp. that is transmitted to humans by the ingestion of unpasteurized milk and other dairy products from infected animals or through close contact with secretions. Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease caused by a virus that is transmitted to humans by ixoid tick bites, contact with blood and tissue of infected animals or contact with infected humans. The symptoms of brucellosis are non-specific; it can mimic other diseases. In this paper, we present a case of brucellosis that was initially evaluated as CCHF. We emphasize that brucellosis should be considered in the differential diagnosis of CCHF, especially in endemic countries.
US Fish and Wildlife Service, Department of the Interior — The brucellosis program, created by the Wildlife Health, is a combination of technical assistance and research. The National Park Service (NPS), the U.S. Fish and...
Goksugur, Sevil Bilir; Bekdas, Mervan; Gurel, Safiye; Tas, Tekin; Sarac, Esma Gokcen; Demircioglul, Fatih; Kismet, Erol
Brucellosis is a zoonotic infection, which is still a major public health concern worldwide. Common clinical findings are usually nonspecific involving fever, arthralgia, myalgia, weakness and malaise. Since none of the symptoms of brucellosis is pathognomonic, it may have a similar course with various multisystemic diseases. In terms of focal involvement, sacroiliitis is the most common musculoskeletal manifestation in adult patients, while it is quite rare in pediatric patients. Blood culture is the gold standard in the diagnosis of brucellosis. In the absence of culture facilities, the diagnosis traditionally relies on serologic testing with a variety of agglutination tests such as the Rose Bengal test and the serum agglutination test. However, these agglutination tests are accompanied by frequent false negative results such as seen in prozone phenomenon, which may lead to diagnostic delays. In this article we present a rarely encountered pediatric brucellosis patient who had sacroiliitis-spondylitis, which are rarely reported in children, and exhibited prozone phenomenon in agglutination tests.
Tapisiz, A; Polat, M; Kara, S S; Tezer, H; Simsek, H; Aktas, F
Since measles is a highly contagious respiratory infection with significant airborne transmission risk in hospitals, effective prevention measures are crucial. After a mother accompanying her child on a paediatric ward lacking a negative pressure room was diagnosed with measles, exposed persons without evidence of immunity (documentary evidence of receiving two doses of measles-mumps-rubella vaccine) were treated with vaccination or intravenous immunoglobulin (IVIG). The interruption of transmission with these treatments was evaluated. There were 44 children and 101 adults exposed to the index patient. Twenty-five children and 88 adults were considered immune, providing evidence of immunity. Nineteen children and 13 adults were either given vaccination or IVIG for post-exposure prophylaxis (PEP). There were no additional cases of measles after 3 weeks follow-up. We conclude that measles is highly preventable by adequate PEP with vaccination or IVIG in a healthcare setting that lacks the benefit of a negative pressure room.
Full Text Available INTRODUCTION: The European Regional Office of the World Health Organization (WHO/Europe developed a strategic approach to stop the indigenous transmission of measles in its 53 Member States by 2015. This study describes the measles laboratory surveillance activity performed by the National Reference Laboratory for Measles and Rubella at the Italian National Institute of Health (Istituto Superiore di Sanità during 2010. METHODS: Urine, oral fluid and capillary blood samples from 211 suspected measles cases arrived to the NRL from different regions of Italy for confirmation of the clinical diagnosis. Serological and/or molecular assays were performed; after molecular detection, positive samples were sequenced and genotyped. RESULTS AND DISCUSSION: 85% (180/211 of the specimens were confirmed as measles cases and 139 of these were analyzed phylogenetically. The phylogenetic analysis revealed a co-circulation of D4 and D8 genotypes for the reviewed period.
Full Text Available Objective: The aim of the study is to stand out the measles which is a highly contagious re-emerging viral illness and may cause severe complications in susceptible population. Methods: This retrospective study was conducted on patients who were diagnosed with measles in the department of Infectious Diseases, Erciyes University Hospital, between January 2013 and February 2014. The diagnosis of measles was confirmed by measles specific immunoglobulin M (IgM antibody positivity in serum samples. Results: Nine patients were included the study. Three patients had a co-morbid condition including hematopoietic stem cell transplantation, pregnancy and diabetes mellitus. Four of the patients had hepatitis and one of them had pneumonia as a complication. Conclusion: Susceptible population, especially immunocompromised people are still at risk about measles. Adherence to universal vaccination programs is determinative in terms of breaking out of an outbreak. J Microbiol Infect Dis 2016;6(1: 19-22
Limia Sánchez, Aurora
The current Plan for the elimination of measles and rubella is made of the Plan for the elimination of measles in Spain, set up in 2001, and the Surveillance protocol of rubella and congenital rubella syndrome in the phase of elimination, established in 2007. The monitoring of the elimination of both diseases conducted from the European Region of World Health Organization (WHO) has been reinforced since 2010. An annual report with information on the situation of measles and rubella in The Member Estates is being requested since 2013. The Ministry of Health, Social Services and Equality nominated a National Committee for Verification of Measles and Rubella Elimination in 2013, for the review and delivery of the requested information. The strategies and activities currently recommended from the WHO European Region, the verification process in Spain, and the steps to follow for the updating of the Plan for the elimination of measles and rubella in Spain are mentioned in this article.
V. D. Zavadovskaya
Full Text Available A peculiarity of the congenital syphilis of recent years is an increase of the number of cases of latent forms of the disease, marked with osteopathy. With the help of an examination of 50 children with early congenital syphilis, the following ultrasonic signs of a musculoskeletal system lesion were revealed: osteochondritis 90%, osteosclerosis 80%, and periostitis 30%.The comparison of the nature of a musculoskeletal system lesion with serological data of the specific process activity showed that complex manifestations of lesions with periostitis being a component were of the greatest clinical significance.
Kunda John; Julie Fitzpatrick; Nigel French; Rudovick Kazwala; Dominic Kambarage; Mfinanga, Godfrey S; Alastair MacMillan; Sarah Cleaveland
BACKGROUND: Brucellosis is a zoonosis of veterinary, public health and economic significance in most developing countries. Human brucellosis is a severely debilitating disease that requires prolonged treatment with a combination of antibiotics. The disease can result in permanent and disabling sequel, and results in considerable medical expenses in addition to loss of income due to loss of working hours. A study was conducted in Northern Tanzania to determine the risk factors for transmission...
Van H. Pham
Conclusions: Measles viruses responsible for outbreaks in Southern Vietnam belonged to a genotype D8 variant group which had unique amino acid sequences in the N gene. Our report provides important genomic information about the virus for measles elimination in Southeast Asia.
Bonfoh, Bassirou; Kasymbekov, Joldoshbek; Dürr, Salome; Toktobaev, Nurjan; Doherr, Marcus G; Schueth, Tobias; Zinsstag, Jakob; Schelling, Esther
Kyrgyzstan reported 77.5 new human brucellosis cases per 100,000 people in 2007, which is one of the highest incidences worldwide. In Kyrgyzstan, the currently used diagnostic tests in humans and animals are the Rose Bengal Test and the Huddleson test. A national representative cross-sectional study using cluster sampling proportional to size in humans, cattle, sheep, and goats was undertaken to assess the apparent seroprevalence in humans and animals. A total of 4,936 livestock sera and 1,774 human sera were tested in Naryn, Chuy, and Osh Oblasts. The overall apparent seroprevalences of brucellosis were 8.8% in humans (95% CI 4.5-16.5), 2.8% (95% CI 1.6-4.9%) in cattle, 3.3% (95% CI 1.5-6.9%) in sheep, and 2.5% (95% CI 1.4-4.5%) in goats. Naryn Oblast had the highest seroprevalences in humans and sheep. More men than women were seropositive (OR = 1.96; P brucellosis exposure, measured by serological tests, was more than ten times higher than the annual incidence of reported clinical brucellosis cases. This indicates an under-reporting of human brucellosis cases, even if only a fraction of seropositive people have clinical symptoms. In conclusion, this study confirms the high seroprevalence of brucellosis in Kyrgyzstan and warrants rapid effective intervention, among others, by mass vaccination of sheep and goats but also of cattle.
Maichak, Eric J.; Scurlock, Brandon M.; Cross, Paul C.; Rogerson, Jared D.; Edwards, William H.; Wise, Benjamin; Smith, Scott G.; Kreeger, Terry J.
Zoonotic diseases in wildlife present substantial challenges and risks to host populations, susceptible domestic livestock populations, and affected stakeholders. Brucellosis, a disease caused by the bacterium Brucella abortus, is endemic among elk (Cervus canadensis) attending winter feedgrounds and adjacent areas of western Wyoming, USA. To minimize transmission of brucellosis from elk to elk and elk to livestock, managers initiated a B. abortus strain 19 ballistic vaccination program in 1985. We used brucellosis prevalence (1971–2015) and reproductive outcome (2006–2015) data collected from female elk attending feedgrounds to assess efficacy of the strain 19 program while controlling for potentially confounding factors such as site and age. From our generalized linear models, we found that seroprevalence of brucellosis was 1) not lower following inception of vaccination; 2) not inversely associated with proportion of juveniles vaccinated over time; 3) not inversely associated with additional yearlings and adults vaccinated over time; and 4) associated more with feeding end-date than proportion of juveniles vaccinated. Using vaginal implant transmitters in adult females that were seropositive for brucellosis, we found little effect of vaccination coverage at reducing reproductive failures (i.e., abortion or stillbirth). Because we found limited support for efficacy of the strain 19 program, we support research to develop an oral vaccine and suggest that continuing other spatio-temporal management actions will be most effective to minimize transmission of brucellosis and reduce dependency of elk on supplemental winter feeding.
Full Text Available Abstract Background Globally syphilis is an important yet preventable cause of stillbirth, neonatal mortality and morbidity. Objectives This review sought to estimate the effect of detection and treatment of active syphilis in pregnancy with at least 2.4MU benzathine penicillin (or equivalent on syphilis-related stillbirths and neonatal mortality. Methods We conducted a systematic literature review of multiple databases to identify relevant studies. Data were abstracted into standardised tables and the quality of evidence was assessed using adapted GRADE criteria. Where appropriate, meta-analyses were undertaken. Results Moderate quality evidence (3 studies supports a reduction in the incidence of clinical congenital syphilis of 97% (95% c.i 93 – 98% with detection and treatment of women with active syphilis in pregnancy with at least 2.4MU penicillin. The results of meta-analyses suggest that treatment with penicillin is associated with an 82% reduction in stillbirth (95% c.i. 67 – 90% (8 studies, a 64% reduction in preterm delivery (95% c.i. 53 – 73% (7 studies and an 80% reduction in neonatal deaths (95% c.i. 68 – 87% (5 studies. Although these effect estimates were large and remarkably consistent across studies, few of the studies adjusted for potential confounding factors and thus the overall quality of the evidence was considered low. However, given these large observed effects and a clear biological mechanism for effectiveness the GRADE recommendation is strong. Conclusion Detection and appropriate, timely penicillin treatment is a highly effective intervention to reduce adverse syphilis-related pregnancy outcomes. More research is required to identify the most cost-effective strategies for achieving maximum coverage of screening for all pregnant women, and access to treatment if required.
Getahun, Mekonen; Beyene, Berhane; Ademe, Ayesheshem; Teshome, Birke; Tefera, Mesfin; Afework, Aklog; HaileMariam, Yoseph; Assefa, Esete; Hailegiorgis, Yonas; Asha, Anjelo
Background In Ethiopia, measles case-based surveillance was introduced in 2004 as one strategy for measles control by laboratory confirmation of suspected cases. In this article, epidemiological distribution of laboratory-confirmed measles cases were reported from the Southern Nation Nationalities and Peoples Region (SNNPR) of Ethiopia between 2007 and 2014, as the region is one of the highly measles affected areas in Ethiopia. Method A serum sample was collected from all measles suspected ca...
Melissa M. Coughlin; Beck, Andrew S.; Bankamp, Bettina; Rota, Paul A.
Measles is a highly contagious, vaccine preventable disease. Measles results in a systemic illness which causes profound immunosuppression often leading to severe complications. In 2010, the World Health Assembly declared that measles can and should be eradicated. Measles has been eliminated in the Region of the Americas, and the remaining five regions of the World Health Organization (WHO) have adopted measles elimination goals. Significant progress has been made through increased global cov...
Sanders, W.M.; Harlan, B.L.
Our initial study of the USDA/TAHC Brucellosis Indemnity Program in Texas has shown that both the efficiency and rate of claim payments can be increased by the application of present day computer technologies. Two main factors contribute to these increases: the number of discrepancies that are caused by poor penmanship, transposition of numbers, and other human errors can be monitored and minimized; and the documented information can be indexed, sorted, and searched faster, more efficiently, and without human error. The overall flow of documentation that is used to control the movement of infected or exposed animals through commerce should be studied. A new system should be designed that fully utilizes present day computer and electronic technologies.
Oseguera Montiel, David; Frankena, Klaas; Udo, Henk; Keilbach Baer, Nícola Maria; van der Zijpp, Akke
Brucellosis is a major constraint for small-scale goat farming systems in Mexico. This study estimated the prevalence of testing positive to brucellosis and identified and quantified risk factors in goats from small-scale farms of Michoacán that had participated in a brucellosis campaign (i.e. vaccination, serological testing, culling and awareness) and of Jalisco that had negligible brucellosis campaign participation. A cross-sectional serological survey was conducted among 1,713 goats of 83 flocks. The prevalence of testing positive to brucellosis was higher (38%) in Jalisco than in Michoacán (11%). Logistic regression analysis indicated that goats from Michoacán had lower odds to test positive for brucellosis (odds ratio (OR) = 0.32, 95% confidence interval (CI) 0.21-0.48) compared to goats from Jalisco. Goats in zero-grazing systems had lower odds than goats in grazing systems (OR = 0.22, 95% CI 0.09-0.57). When goats were kept in pens with low density (0.002 to 0.22 goat/m(2)), odds was lower (OR = 0.44, 95% CI 0.28-0.67) compared to goats kept in pens with higher density (0.23 to 1 goat/m(2)). Odds was higher for testing positive when farmers bought goats from goat traders (OR = 1.82, 95% CI 1.15-2.87) compared to farmers who did not. If scavenger poultry had access to goat pens, the odds was half (OR = 0.52, 95% CI 0.33-0.83) of those where poultry had no access. Regular disinfection of the pen reduced the odds (OR = 0.66, 95% CI 0.44-0.99) compared to where disinfection was not regular. The brucellosis control campaign was effective in reducing brucellosis seropositivity.
Kate M Mitchell
Full Text Available BACKGROUND: In China, female sex workers (FSWs are at high risk of syphilis infection, but are hard to reach for interventions. Point-of-care testing introduces opportunities for expanding syphilis control measures. Modelling is used to estimate the impact of using rapid tests to screen FSWs for syphilis. In other settings, modelling has predicted large rebounds in infectious syphilis following screening, which may undermine any impact achieved. METHODS: A deterministic syphilis transmission model among FSWs and clients was fitted to data from Yunnan Province (FSW syphilis prevalence = 7.5%, and used to estimate the impact of rapid syphilis testing and treatment for FSWs. Impact projections were compared for different model structures that included risk heterogeneity amongst FSWs, incoming syphilis infections amongst new FSWs and clients and re-infection from FSWs' regular non-commercial partners. The rebound in syphilis prevalence after screening ceased was explored. RESULTS: All model structures suggest yearly syphilis screening could substantially reduce (by 72-88% syphilis prevalence amongst FSWs in this setting over five years. However, incoming syphilis infections amongst new FSWs and clients or re-infections from regular non-commercial partners of FSWs can considerably reduce (>30% the proportion of infections averted. Including heterogeneity in risk amongst FSWs had little effect upon the proportion of infections averted. In this setting, the rebound in syphilis prevalence after screening ceased is predicted to be slight, but it could be large in high prevalence settings. CONCLUSIONS: Rapid test screening could dramatically reduce syphilis prevalence amongst hard-to-reach groups, but strategies to reduce re-infection from regular non-commercial partners are needed to maximise impact.
Mitchell, Kate M.; Cox, Andrew P.; Mabey, David; Tucker, Joseph D.; Peeling, Rosanna W.; Vickerman, Peter
Background In China, female sex workers (FSWs) are at high risk of syphilis infection, but are hard to reach for interventions. Point-of-care testing introduces opportunities for expanding syphilis control measures. Modelling is used to estimate the impact of using rapid tests to screen FSWs for syphilis. In other settings, modelling has predicted large rebounds in infectious syphilis following screening, which may undermine any impact achieved. Methods A deterministic syphilis transmission model among FSWs and clients was fitted to data from Yunnan Province (FSW syphilis prevalence = 7.5%), and used to estimate the impact of rapid syphilis testing and treatment for FSWs. Impact projections were compared for different model structures that included risk heterogeneity amongst FSWs, incoming syphilis infections amongst new FSWs and clients and re-infection from FSWs' regular non-commercial partners. The rebound in syphilis prevalence after screening ceased was explored. Results All model structures suggest yearly syphilis screening could substantially reduce (by 72–88%) syphilis prevalence amongst FSWs in this setting over five years. However, incoming syphilis infections amongst new FSWs and clients or re-infections from regular non-commercial partners of FSWs can considerably reduce (>30%) the proportion of infections averted. Including heterogeneity in risk amongst FSWs had little effect upon the proportion of infections averted. In this setting, the rebound in syphilis prevalence after screening ceased is predicted to be slight, but it could be large in high prevalence settings. Conclusions Rapid test screening could dramatically reduce syphilis prevalence amongst hard-to-reach groups, but strategies to reduce re-infection from regular non-commercial partners are needed to maximise impact. PMID:23383249
Full Text Available Abstract Objective To assess the sensitivity, specificity, and feasibility of a new chemiluminescence immunoassay (CLIA in the diagnosis of syphilis. Methods At first, a retrospective study was conducted, using 135 documented cases of syphilis and 30 potentially interfering samples and 80 normal sera. A prospective study was also performed by testing 2, 071 unselected samples for routine screening for syphilis. CLIA was compared with a nontreponemal test (TRUST and a treponemal test (TPPA. Results There was an agreement of 100% between CLIA and TPPA in the respective study. The percentage of agreement among the 245 sera tested was 100.0%. Compared with TPPA, the specificity of CLIA was 99.9% (1817/1819, the sensitivity of CLIA was 100.0% (244/244 in the prospective study. CLIA showed 99.5% agreement with TPPA by testing 2, 071 unselected samples. And CLIA seemed to be more sensitive than TPPA in detecting the samples of primary syphilis. Conclusions CLIA is easy to perform and the indicator results are objective and unequivocal. It may be suitable for large-scale screening as a treponemal test substituted for TPPA.
Full Text Available A 40-year-old promiscuous man presented with nodulo ulcerative lesions all over the body and a healing genital ulcer. Blood VDRL was reactive in 64 dilutions and HIV (Elisa was positive. Patient was diagnosed to have malignant syphilis (leas inaligna and was given appropriate treatment. Lesions healed with hypopigmented macules suggestive of ′Icukoderma colli′.
Conclusions: Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening blood donations for syphilis. These data show a considerable mismatch between recommendations and practice, with serious consequences for blood safety and public health.
Pace, J. L.; Csonka, G. W.
An elderly Bedouin woman originally thought, on clinical and histological grounds, to have tuberculosis of the larynx was found to have gummatous laryngitis due to late endemic syphilis (bejel). This disease is highly prevalent in the Bedouin tribes of the Middle East. Doctors dealing with Arab patients, either in the Middle East or elsewhere, should be aware of this possibility.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR National Park Service Bison Brucellosis Remote Vaccination, Draft Environmental Impact Statement... Service announces the reopening of the public comment period on the Bison Brucellosis Remote...
Gahr, Pamala; DeVries, Aaron S; Wallace, Gregory; Miller, Claudia; Kenyon, Cynthia; Sweet, Kristin; Martin, Karen; White, Karen; Bagstad, Erica; Hooker, Carol; Krawczynski, Gretchen; Boxrud, David; Liu, Gongping; Stinchfield, Patricia; LeBlanc, Julie; Hickman, Cynthia; Bahta, Lynn; Barskey, Albert; Lynfield, Ruth
Measles is readily spread to susceptible individuals, but is no longer endemic in the United States. In March 2011, measles was confirmed in a Minnesota child without travel abroad. This was the first identified case-patient of an outbreak. An investigation was initiated to determine the source, prevent transmission, and examine measles-mumps-rubella (MMR) vaccine coverage in the affected community. Investigation and response included case-patient follow-up, post-exposure prophylaxis, voluntary isolation and quarantine, and early MMR vaccine for non-immune shelter residents >6 months and measles cases were identified. The median age was 12 months (range, 4 months to 51 years) and 14 (67%) were hospitalized (range of stay, 2-7 days). The source was a 30-month-old US-born child of Somali descent infected while visiting Kenya. Measles spread in several settings, and over 3000 individuals were exposed. Sixteen case-patients were unvaccinated; 9 of the 16 were age-eligible: 7 of the 9 had safety concerns and 6 were of Somali descent. MMR vaccine coverage among Somali children declined significantly from 2004 through 2010 starting at 91.1% in 2004 and reaching 54.0% in 2010 (χ(2) for linear trend 553.79; P measles outbreak in Minnesota in 20 years, and aggressive response likely prevented additional transmission. Measles outbreaks can occur if undervaccinated subpopulations exist. Misunderstandings about vaccine safety must be effectively addressed.
al Faraj, S
Abdominal involvement in brucellosis is seen in the acute, subacute and chronic disease. It is not typical, however, that acute abdomen is the presenting feature of brucellosis. In this paper, two cases of serologically diagnosed brucellosis are reported, both presenting initially with acute abdomen and fever. In brucella-endemic regions of the world, brucellosis has to be considered in the differential diagnosis of acute abdomen and fever. With definitive diagnosis, unnecessary laparotomy ca...
Full Text Available Background: We report an assessment of measles outbreak during the months of February 2014 to April 2014 in Dwarahat block of district Almora and the response mounted to it. Materials and Methods: An intensive door-to-door search to six measles affected villages in Dwarahat block of district Almora, covering a population of 2,408 was carried out to identify the cases of measles by a rapid response team (RRT. A total of ten blood samples were randomly collected for detecting IgM antibody against measles. For all cases, information on personal details, place of residence, time of onset and status of immunization were obtained. Results: Overall attack rate (AR was 2.8%. AR among the population of age-group 0-16 was 7.2%. Statistically significant higher AR (16.26% was seen for the age-group of 0-5 years as compare to 6-10 and 11-16 years of age (AR-8.71, relative risk-0.53, 95% confidence interval-0.32-0.88, P value-0.012 and AR-0.57%, relative risk-0.035, 95% confidence interval-0.00-0.14, P value-0.000, respectively. Males were affected more often than females 35 [59.2%] vs. 24 [40.8%]. Measles-related complications were seen in three children. No death was reported. Of the 10 samples, nine were positive for measles IgM antibodies by enzyme-linked immunosorbent assay (ELISA. Conclusion: The recognition of early warning signals, timely investigation and application of specific control measures can contain the outbreak. The unvaccinated or partially protected human beings serve as the reservoir of measles virus. Hence, there is a need for sero surveillance for measles in Uttarakhand and one catch up measles immunisation campaign to prevent future outbreak.
Baljinnyam, Zolzaya; Suuri, Bujinlkham; Dashbal, Enkhbayar; Oidov, Baatarkhuu; Roth, Felix; Zinstag, Jakob; Schelling, Esther; Dambadarjaa, Davaalkham
Background After the transition from socialism to a market economy in 1990, human brucellosis re-emerged in Mongolia. The aim of our study was to estimate a representative seroprevalence of Brucella spp. and to determine risk factors for brucellosis seropositivity among rural people. Methods A cross-sectional study with multistage random selection was conducted in eight provinces of Mongolia. Study participants were interviewed using a questionnaire to obtain their brucellosis history, current symptoms and likely risk factors. Blood samples were drawn to determine brucellosis seroprevalence. Results A total of 2856 randomly selected rural people aged four to 90 years were enrolled in the study. The seroprevalence of Brucella spp. was 11.1% (95% confidence interval [CI]: 10.0–12.1), ranging between 2.3% and 22.6% in the eight provinces; 39.2% (n = 609) of nomadic camps had at least one seropositive participant. Risk factors associated with brucellosis seropositivity were being older than 45 years (adjusted odds ratio [AOR] = 6.9, 95% CI = 5.1–8.7) and being a veterinarian (AOR = 2.8, 95% CI = 1.5–5.0). Conclusion Our study confirms that human brucellosis seroprevalence among rural people in Mongolia is high. Human brucellosis can be effectively controlled if high-coverage livestock mass vaccination is implemented with a coverage survey after the vaccinations to ensure completeness. This mass vaccination should be accompanied by public awareness and educational programmes. PMID:25685600
Salado-Rasmussen, Kirsten; Katzenstein, Terese Lea; Gerstoft, Jan
in men diagnosed with one of these sexually transmitted diseases indicate a high frequency of unsafe sex in the Danish MSM population. As one-third of the HIV-infected persons diagnosed with syphilis had high viral loads, our data support initiation of antiretroviral therapy in all HIV-infected MSM...
... Animal and Plant Health Inspection Service Notice of Availability of a Swine Brucellosis and Pseudorabies... swine brucellosis and pseudorabies available for public review and comment. This action will allow... a potential new approach to managing swine brucellosis and pseudorabies available for public...
... Animal and Plant Health Inspection Service Notice of Availability of a Swine Brucellosis and Pseudorabies... approach to managing swine brucellosis and pseudorabies available for public review and comment. Swine brucellosis and pseudorabies have been eliminated from commercial swine herds within the United States,...
... destroyed because of brucellosis. 51.5 Section 51.5 Animals and Animal Products ANIMAL AND PLANT HEALTH... DISEASES ANIMALS DESTROYED BECAUSE OF BRUCELLOSIS Indemnity for Cattle, Bison, and Swine § 51.5 Identification of animals to be destroyed because of brucellosis. (a) The claimant shall be responsible...
Melzer, Falk; Wareth, Gamal; El-Adawy, Hosny; Henning, Klaus; Pletz, Mathias W.; Heller, Regine; Kariuki, Samuel; Fèvre, Eric; Neubauer, Heinrich
During 2014–2015, patients in northeastern Kenya were assessed for brucellosis and characteristics that might help clinicians identify brucellosis. Among 146 confirmed brucellosis patients, 29 (20%) had negative serologic tests. No clinical feature was a good indicator of infection, which was associated with animal contact and drinking raw milk. PMID:27662463
Yoldas, Tamer; Tezer, Hasan; Ozkaya-Parlakay, Aslinur; Sayli, Tulin Revide
Brucellosis is a disease transmitted to humans by consumption of unpasteurized animal milk, or through direct contact with infected animals. The aim of this study was to evaluate clinical, laboratory findings of pediatric patients with brucellosis. Data of 97 patients diagnosed with brucellosis between January 2000 and December 2010 were evaluated retrospectively.
Chris Richard Kenyon
Full Text Available How can we explain the uneven decline of syphilis around the world following the introduction of penicillin? In this paper we use antenatal syphilis prevalence (ASP to investigate how syphilis prevalence varied worldwide in the past century, and what risk factors correlate with this variance.1 A systematic review using PubMed and Google Scholar was conducted to identify countries with published data relating to ASP estimates from before 1952 until the present. Eleven countries were identified (Canada, Denmark, Finland, India, Japan, Norway, Singapore, South Africa, United States of America (USA, United Kingdom (UK and Zimbabwe. The ASP epidemic curve for each population was depicted graphically. In South Africa and the USA, results are reported separately for the black and white populations. 2 National antenatal syphilis prevalence estimates for 1990 to 1999 and 2008 were taken from an Institute for Health Metrics and Evaluation database on the prevalence of syphilis in low risk populations compiled for the Global Burden of Diseases study and from a recent review paper respectively. National ASPs were depicted graphically and regional median ASPs were calculated for both time periods. 3 Linear regression was used to test for an association between ASP in 1990-1999 and 2008 and four risk factors (efficacy of syphilis screening/treatment, health expenditure, GDP per capita and circumcision prevalence. WHO world regions were included as potential explanatory variables.In most populations, ASP dropped to under 1% before 1960. In Zimbabwe and black South Africans, ASP was high in the pre-penicillin period, dropped in the post-penicillin period, but then plateaued at around 6% until the end of the 20th century when ASP dropped to just above 1%. In black Americans, ASP declined in the post penicillin period, but plateaued at 3-5% thereafter. ASP was statistically significantly higher in sub-Saharan Africa in 1990-1999 and 2008 than in the other world
Lund, G.A.; Salmi, A.A. (Turku Univ. (Finland))
Guinea pig and rabbit antisera from animals immunized with purified measles virus hemagglutinin (G) protein were used to establish a solid-phase four-layer radioimmunoassay for quantitative measurement of the G protein. The sensitivity of the assay was 2 ng of purified G protein, and 200 ..mu..g of protein from uninfected Vero cells neither decreased the sensitivity nor reacted non-specifically in the assay. Radioimmunoassay standard dose-response curves were established and unknown values interpolated from these using the logit program of a desktop computer. Using this procedure, a measles virus growth curve in infected Vero cells was determined by measurement of G protein production. Under these same conditions, hemagglutination was not sensitive enough to detect early hemagglutinin production. Viral antigens in canine distemper virus, Newcastle disease virus, parainfluenza viruses 1-4, simian virus 5, and respiratory syncytial virus-infected cell lysates did not cross-react in the radioimmunoassay. A small degree of cross-reactivity was detected with mumps viral antigens, both with Vero cell-derived (wild-type strain) and egg-derived (Enders strain) purified virus preparations and with a cell lysate antigen prepared from wild-type mumps virus-infected Vero cells.
Elmegreen, Debra M.; Elmegreen, B. G.
The Kiso sample of several thousand local ultraviolet-bright galaxies includes galaxies classified as irregular disk galaxies with large star-forming complexes (I,g). We selected a sample of all I,g galaxies with both Sloan Digital Sky Survey images and spectra. They contain up to several dozen giant clumps each, so we refer to them as measle galaxies. We determined ages and masses of the clumps based on a comparison of photometry with population synthesis models of cluster evolution. The spectra were used to determine global star formation rates. Several hundred clumps were measured in the sample, with masses ranging from 10^5 to several x10^8 solar masses, scaling with galaxy absolute g magnitude of -14 to -21 mag. The galaxies are starbursting, sitting above the Groth strip “main sequence” of star formation rate versus galaxy mass by an order of magnitude. These Kiso measle galaxies have 10x the star formation rates of the Kiso tadpole galaxies. We compare their clump luminosity distribution functions with normal disk galaxies.
Full Text Available Background and Objectives: Syphilis is one of the most common preventable causes of adverse effects during pregnancy. Antenatal screening prevents the delay between diagnosis and treatment there by reducing the risk of congenital syphilis. The objective of this study was to evaluate the utility of an immunochromatographic assay as a point of care test for antenatal screening of syphilis. Materials and Methods: Sera of 200 antenatal mothers were evaluated for serodiagnosis of syphilis by the venereal disease research laboratory (VDRL, Treponema pallidum hemagglutination assay (TPHA and SD BIOLINE Syphilis 3.0 test. The performance of SD BIOLINE Syphilis 3.0 test was compared with VDRL as screening assay and TPHA as a confirmatory test. Results: The antenatal prevalence of syphilis was found to be 2% by both VDRL and TPHA. The sensitivity, specificity, positive predictive value, and the negative predictive value of SD BIOLINE Syphilis 3.0 test were 75%, 100%, 100%, and 99.45%, respectively. Conclusions: Antenatal screening and treatment of maternal syphilis are cost-effective health interventions even under the low prevalence of infection. SD BIOLINE Syphilis 3.0 test, although having less sensitivity than the existing testing strategy, can have a tremendous impact on the disease burden if used prudently for the screening of antenatal mothers in peripheral health settings.
Full Text Available
A 21-year-old female was referred for severe bilateral visual loss 3 weeks after a diagnosis of brucellosis. On ocular examination she had bilateral optic nerve head swelling, preretinal hemorrhages and retinal vasculitis. The patient was diagnosed with bilateral optic neuritis secondary to brucellosis and developed optic atrophy and severe visual loss despite medical treatment. Brucellosis can lead to various types of ocular involvement including vasculitis, optic neuritis and retinal hemorrhage.
Shahcheraghi, Seyed Hossein; Ayatollahi, Jamshid
Brucellosis is the most widespread zoonotic infection in the world. The disease is endemic in countries bordering the Mediterranean Sea. It is an important re-emerging infectious disease. This disease is closely associated with the evolution of mankind as an agrarian society linked to the practice of shepherding and popularization of animal husbandry. The patients with this disease are typically present with chills, fever, asthenia and sweating. This paper describes a patient with brucellosis and skin rashes on the leg. A 41-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd. The patient reported the loss of appetite, arthralgia and weight loss during previous five months. Finally, he was diagnosed with brucellosis by positive blood culture and high titer for Brucella agglutination test. The clinical manifestation of brucellosis is very broad, ranging from asymptomatic infection to serious debilitating disease. Current patient had skin rashes on his leg. Brucellosis must be considered in the differential diagnosis of acute infections, especially if there is a history of fresh milk product ingestion and living in an endemic region.
Godfroid, J; DeBolle, X; Roop, R M; O'Callaghan, D; Tsolis, R M; Baldwin, C; Santos, R L; McGiven, J; Olsen, S; Nymo, I H; Larsen, A; Al Dahouk, S; Letesson, J J
One Health is an interdisciplinary collaboration that aims at mitigating risks to human health arising from microorganisms present in non-human animal species, which have the potential to be transmitted and cause disease in humans. Different degrees of scientific collaboration and sectoral integration are needed for different types of zoonotic diseases, depending on the health and associated economic gains that can be expected from a One Health approach. Indeed, mitigating zoonotic risks related to emerging diseases with pandemic potential is different from mitigating risks related to endemic zoonotic diseases like brucellosis. Likewise, management of brucellosis at the wildlife-livestock interface in wildlife conservation areas is in essence different from mitigating transmission of a given Brucella species within its preferential host species, which in turn is different from mitigating the spillover of a given Brucella species to non-preferential host species, humans included. Brucellosis economic models often oversimplify and/or wrongly assess transmission between reservoir hosts and spillover hosts. Moreover,they may not properly value non-market outcomes, such as avoidance of human disease, consumer confidence and conservation biology issues. As a result, uncertainty is such that the economic predictions of these models can be questionable. Therefore, understanding the infection biology of Brucella species is a prerequisite. This paper reviews and highlights important features of the infection biology of Brucella species and the changing epidemiology of brucellosis that need to be integrated into a true One Health perspective of brucellosis.
Measles cases are increasing in Ireland, with 320 cases notified since August 2009. Nearly two-thirds of these cases (n=206) were unvaccinated. In the early stages of the outbreak a substantial number of cases were linked to the Traveller community with some cases also reported among the Roma community, other citizens from eastern Europe and children whose parents objected to vaccination. By February 2010, there had been considerable spread to the general population.
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Singh, Vijendra K; Jensen, Ryan L
Virus-induced autoimmunity may play a causal role in autism. To examine the etiologic link of viruses in this brain disorder, we conducted a serologic study of measles virus, mumps virus, and rubella virus. Viral antibodies were measured by enzyme-linked immunosorbent assay in the serum of autistic children, normal children, and siblings of autistic children. The level of measles antibody, but not mumps or rubella antibodies, was significantly higher in autistic children as compared with normal children (P = 0.003) or siblings of autistic children (P molecular weight. The antibody to this antigen was found in 83% of autistic children but not in normal children or siblings of autistic children. Thus autistic children have a hyperimmune response to measles virus, which in the absence of a wild type of measles infection might be a sign of an abnormal immune reaction to the vaccine strain or virus reactivation.
Zipprich, Jennifer; Winter, Kathleen; Hacker, Jill; Xia, Dongxiang; Watt, James; Harriman, Kathleen
On January 5, 2015, the California Department of Public Health (CDPH) was notified about a suspected measles case. The patient was a hospitalized, unvaccinated child, aged 11 years with rash onset on December 28. The only notable travel history during the exposure period was a visit to one of two adjacent Disney theme parks located in Orange County, California. On the same day, CDPH received reports of four additional suspected measles cases in California residents and two in Utah residents, all of whom reported visiting one or both Disney theme parks during December 17-20. By January 7,seven California measles cases had been confirmed, and CDPH issued a press release and an Epidemic Information Exchange (Epi-X) notification to other states regarding this outbreak. Measles transmission is ongoing.
Frey, H M; Krugman, S
The atypical measles syndrome is a relatively new disease that was first recognized 15 years ago. Initially, it occurred in children who were exposed to wild measles virus several years after they were immunized with killed measles vaccine. It was characterized by a two- to three-day prodrome of high fever, cough, headache, and myalgia followed by a rash that resembled Rocky Mountain spotted fever, scarlet fever, or varicella and associated with roentgenographic evidence of pneumonia with or without pleural effusion. This report highlights three unusual manifestations of this syndrome: 1) transient hepatitis, 2) persistence of pulmonary lesions for several years, and 3) occurrence of excessively high measles hemagglutination-inhibition antibody titers. Today, this syndrome occurs predominantly in adolescents and young adults.
Full Text Available Measles is a highly contagious disease. By the end of 2013, 84% of children had received at least a single dose of measles vaccine by their second birthday, and 148 countries had included a second dose as part of routine immunization. In 2002, the Iranian Ministry of Health and Medical Education developed a comprehensive strategy to eliminate Measles including mass immunization campaign for people aged 5-25 years (1. Suburban areas where residents usually are nomads or migrants with low socio-economic status (SES, pose a serious threat to the success of any prevention program(2 . There are a huge yet unknown number of Iranian immigrants and illegal refugees living in suburbs of large cities in Iran, where low participation of families in vaccination services might be a challenge (3. In this report, we try to highlight the importance of migrants and immigrants on the success of Measles vaccination programs.
Yaman, Yöntem; Gözmen, Salih; Özkaya, Ahmet Kağan; Oymak, Yeşim; Apa, Hurşit; Vergin, Canan; Devrim, İlker
Brucellosis is a systemic zoonotic infectious disease that may cause fever, fatigue, sweating, arthritis, hepatosplenomegaly, cytopenia, and lymphadenopathy. It continues to be an important health problem worldwide. Hemophagocytic lymphohistiocytosis (HLH) is characterized by fever, hepatosplenomegaly, cytopenias, high serum levels of ferritin and triglycerides, low serum fibrinogen levels, and hemophagocytosis in bone marrow, lymph nodes, spleen, or liver. Hemophagocytic lymphohistiocytosis associated with brucellosis is a very rare condition in the pediatric age group. Here, three pediatric cases of secondary HLH associated with brucellosis are reported. Hemophagocytic lymphohistiocytosis should be considered in patients with brucellosis having cytopenias. Hemophagocytosis in brucellosis seems to be cured with appropriate antibiotics and intravenous immunoglobulin.
Olt, Serdar; Ergenç, Hasan; Açıkgöz, Seyyid Bilal
Here we wanted to investigate predictive value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in the diagnosis of brucellosis. Thirty-two brucellosis patients diagnosed with positive serum agglutination test and thirty-two randomized healthy subjects were enrolled in this study retrospectively. Result with ROC analyzes the baseline NLR and hemoglobin values were found to be significantly associated with brucellosis (P = 0.01, P = 0.01, resp.). Herein we demonstrated for the first time that NLR values were significantly associated with brucellosis. This situation can help clinicians during diagnosis of brucellosis.
Sklyarov, Oleg; Shumilov, Konstantin; Klimanov, Arkadii; Denisov, Aleksander
The article presents a brief history of the brucellosis prevention in animals in the world and in the Russian Federation. Data are taken from studies on the immunogenic activity and epizootic efficacy of vaccines against brucellosis in animals, which made it possible, in the final analysis, to regard these preparations as highly important for brucellosis prevention. The relationship between the epizootic brucellosis situation in Russia and the employment of specific agents in targeted prevention of brucellosis in cattle, sheep, and goats, and the sequence of their use, are presented briefly, substantiating the feasibility of their use and improvement.
Salado-Rasmussen, Kirsten; Knudsen, Andreas; Krarup, Henrik Bygum;
BACKGROUND: Treponema pallidum, the causative agent of syphilis, elicits a vigorous immune response in the infected host. This study sought to describe the impact of syphilis infection on hepatitis C virus (HCV) RNA levels in patients with HIV and chronic HCV infection. METHODS: Patients...... with chronic HIV/HCV and syphilis co-infection were identified by their treating physicians from 1 October 2010 to 31 December 2013. Stored plasma samples obtained before, during, and after syphilis infection were analysed for interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, tumour necrosis factor alpha (TNF......-α), interferon gamma (IFN-γ), and IFN-γ-inducible protein 10 kDa (IP-10). RESULTS: Undetectable HCV RNA at the time of early latent syphilis infection was observed in 2 patients with HIV and chronic HCV infection. After treatment of the syphilis infection, HCV RNA levels increased again in patient 1, whereas...
Masresha, Balcha G; Kaiser, Reinhard; Eshetu, Messeret; Katsande, Reggis; Luce, Richard; Fall, Amadou; Dosseh, Annick R G A; Naouri, Boubker; Byabamazima, Charles R; Perry, Robert; Dabbagh, Alya J; Strebel, Peter; Kretsinger, Katrina; Goodson, James L; Nshimirimana, Deo
In 2008, the 46 member states of the World Health Organization (WHO) African Region (AFR) adopted a measles preelimination goal to reach by the end of 2012 with the following targets: 1) >98% reduction in estimated regional measles mortality compared with 2000, 2) annual measles incidence of fewer than five reported cases per million population nationally, 3) >90% national first dose of measles-containing vaccine (MCV1) coverage and >80% MCV1 coverage in all districts, and 4) >95% MCV coverage in all districts by supplementary immunization activities (SIAs). Surveillance performance objectives were to report two or more cases of nonmeasles febrile rash illness per 100,000 population, one or more suspected measles cases investigated with blood specimens in ≥80% of districts, and 100% completeness of surveillance reporting from all districts. This report updates previous reports and describes progress toward the measles preelimination goal during 2011-2012. In 2012, 13 (28%) member states had >90% MCV1 coverage, and three (7%) reported >90% MCV1 coverage nationally and >80% coverage in all districts. During 2011-2012, four (15%) of 27 SIAs with available information met the target of >95% coverage in all districts. In 2012, 16 of 43 (37%) member states met the incidence target of fewer than five cases per million, and 19 of 43 (44%) met both surveillance performance targets. In 2011, the WHO Regional Committee for AFR established a goal to achieve measles elimination by 2020. To achieve this goal, intensified efforts to identify and close population immunity gaps and improve surveillance quality are needed, as well as committed leadership and ownership of the measles elimination activities and mobilization of adequate resources to complement funding from global partners.
Gastañaduy, Paul A; Budd, Jeremy; Fisher, Nicholas; Redd, Susan B; Fletcher, Jackie; Miller, Julie; McFadden, Dwight J; Rota, Jennifer; Rota, Paul A; Hickman, Carole; Fowler, Brian; Tatham, Lilith; Wallace, Gregory S; de Fijter, Sietske; Parker Fiebelkorn, Amy; DiOrio, Mary
Background Although measles was eliminated in the United States in 2000, importations of the virus continue to cause outbreaks. We describe the epidemiologic features of an outbreak of measles that originated from two unvaccinated Amish men in whom measles was incubating at the time of their return to the United States from the Philippines and explore the effect of public health responses on limiting the spread of measles. Methods We performed descriptive analyses of data on demographic characteristics, clinical and laboratory evaluations, and vaccination coverage. Results From March 24, 2014, through July 23, 2014, a total of 383 outbreak-related cases of measles were reported in nine counties in Ohio. The median age of case patients was 15 years (range, Measles-mumps-rubella (MMR) vaccination coverage with at least a single dose was estimated to be 14% in affected Amish households and more than 88% in the general (non-Amish) Ohio community. Containment efforts included isolation of case patients, quarantine of susceptible persons, and administration of the MMR vaccine to more than 10,000 persons. The spread of measles was limited almost exclusively to the Amish community (accounting for 99% of case patients) and affected only approximately 1% of the estimated 32,630 Amish persons in the settlement. Conclusions The key epidemiologic features of a measles outbreak in the Amish community in Ohio were transmission primarily within households, the small proportion of Amish people affected, and the large number of people in the Amish community who sought vaccination. As a result of targeted containment efforts, and high baseline coverage in the general community, there was limited spread beyond the Amish community. (Funded by the Ohio Department of Health and the Centers for Disease Control and Prevention.).
A. Yu. Popova
Full Text Available Measles remains one of the main reasons for child mortality in developing countries and periodically leads to the emergence of large outbreaks in different countries. This problem became especially urgent after WHO accepted the strategic plan to fight against measles. The plan has set the goal to decrease measles on a global scale. In 2010–2011 the large outbreaks of measles were registered on the African continent: in the Democratic Republic of Congo in the south of Africa, in Nigeria and in some other African countries. In the Republic of Guinea vaccination against measles is carried out singly to children aged 9 months. In 2014–2015 the increase of measles incidence was noted. Materials and methods. Using ELISA 22 blood serum samples of healthy adult Guineans aged 24–71 and 136 blood serum samples received from children and adults — the patients of hospital in the town of Kindi (Republic of Guinea have been examined. The clinical samples were received in 2015–2016. The following test systems were used: the test systems produced by Euroimmun Medizinische Labordiagnostika AG (Germany: «Anti-Measles Virus ELISA (IGM», «Anti-Measles Virus ELISA (IgG»; «Avidity: Anti-Measles Virus ELISA (IgG», and also ELISA Vector-Best IgM-measles test system (Russia. Results and discussion. Only one out of 22 examined healthy individuals hasn’t revealed IgG-antibodies to measles virus. The quantitative titre test of IgG-antibodies, and also their avidity among other 21 individuals testify experiencing measles in the recent or remote past. Having examined 116 blood serum samples of hospital patients in Kindi for IgM-measles-antibodies, the measles case with a 2.5-year-old child has been retrospectively revealed. Having examined 130 blood serum samples for IgG-antibodies to measles virus, 12.3% of seronegative to measles individuals have been revealed. All examined individuals aged 23 and older were seropositive to measles virus, and 60% of them
Kamali Aghdam, Mojtaba; Davari, Kambiz; Eftekhari, Kambiz
Severe thrombocytopenia with bleeding is rarely reported in children with brucellosis, and recurrent epistaxis is extremely rare. Brucellosis with hemorrhage should be differentiated from viral hemorrhagic fever, malignancy, and other blood disorders. Bone marrow aspiration (BMA) is mandatory to differentiate from other blood diseases. An 8-year-old boy was admitted with recurrent epistaxis, petechiae and purpura on face and extremities and bleeding from the gums. During the hospitalization, he was febrile and complained of muscle pain. Leukopenias associated with thrombocytopenia were observed. BMA showed to be normal. Among the multiple tests requested, only serum agglutination test (SAT) and 2-MercaptoEthanol test (2-ME) were positive. He was treated with Intravenous immunoglobulin (IVIG) associated with co-trimoxazole and rifampin. Finally, fever subsided, and he was discharged with good condition and normal platelet count. Brucellosis should be a differential diagnosis in patients with fever and bleeding disorders and a history of consumption of unpasteurized dairy, in endemic areas.
Nannyonga, B; Mwanga, G G; Luboobi, L S
A mathematical model is used to study the dynamics of ovine brucellosis when transmitted directly from infected individual, through contact with a contaminated environment or vertically through mother to child. The model developed by Aïnseba et al. [A model for ovine brucellosis incorporating direct and indirect transmission, J. Biol. Dyn. 4 (2010), pp. 2-11. Available at http://www.math.u-bordeaux1.fr/∼pmagal100p/papers/BBM-JBD09.pdf. Accessed 3 July 2012] was modified to include culling and then used to determine important parameters in the spread of human brucellosis using sensitivity analysis. An optimal control analysis was performed on the model to determine the best way to control such as a disease in the population. Three time-dependent controls to prevent exposure, cull the infected and reduce environmental transmission were used to set up to minimize infection at a minimum cost.
Abo-Shehada, M N; Abu-Halaweh, M
Little is known about the risk factors of human brucellosis in Jordan. A case-control study was conducted involving 56 Jordanians who had been treated for brucellosis and at least 3 matched controls for each case (n = 247). Matching was for sex, age, locality (the same village) and socioeconomic standard. Univariate and multivariate logistic regression analyses were used. In all, 17 risk factors were examined related to: contact with various livestock, milk and milk product consumption, drinking-water treatment and disease awareness. Most variables were associated with brucellosis in the univariate analysis but the final logistic model included only 4: milking sheep and goats (OR 3.5), consumption of raw feta cheese made from sheep and goat milk (OR 2.8) and consumption of cows' milk (OR 0.4) and boiled feta cheese (OR 0.4). Small ruminant farmers need to be trained in safer milking practices and feta cheese making procedures.
Full Text Available Brucellosis is a sistemic infectious disease and it is a major public health problem in our country. It can involve many organs and systems and epididymoorchitis can be a rare presentation of this zoonotic disease in children. Here we report an adolescent patient who presented only with scrotal sweeling and brucella epididymoorchitis diagnosed later. Brucellosis can be rarely seen as epididimoorchitis. So it should be especially considered in the differential diagnosis in endemic areas of brucellosis. It can be diagnosed with a well documented history and relevant laboratory investigations and appropriate treatments can prevent a number of serious complications such as necrotizing orchitis, oligospermia and azospermia. (Journal of Current Pediatrics 2013; 11: 150-2
D. R. Atakhodjayeva
Full Text Available Background: Brucellosis is acute zoonotic, multi-systemic infection caused by Brucella bacteria kind. Brucellosis is met everywhere on all continents of the world, especially in the countries where livestock sector is developed. Nowadays in spite of significant success in the struggle against brucellosis this infection is a social problem. Brucellosis has specific clinical manifestations during various age periods. Problems interrelated with the study of the pathogenesis of brucellosis infection, particularly immune genesis, defining the progress and the outcome of the disease have great importance. Object of the research: to study peculiarities of the progress of acute brucellosis in children taking into account clinical-immunologic data. Materials and methods of the research: the research was based on the results of examinations of 23 children from 3 to 14 years old with brucellosis mostly living in endemic foci of the Republic of Uzbekistan. The diagnosis was defined based on epidemiologic anamnesis, clinical symptoms and laboratory data. All examined children got the analysis of detailed blood immunogramm. The corresponding data of 20 healthy children served to be controlling ones. Results and discussion: The analysis of epidemiologic anamnesis showed, that 78.3% of the examined patients with brucellosis were villagers keeping sheep, goats and cattle. In 73.9% cases source of infection was sheep and goats, 8.7% - cattle, and in 17.4% cases we could observe mixed type of infection. 78% of patients applied to hospital during prodromal period. Main complaints were weakness, frustration, headache, fatigue, bad appetite. These symptoms lasted not more than 3-5 days, after which there were symptoms of intoxication of organism with the rise of cardinal symptoms such as fever with chill (100%, arthalgia (69%, slight sweating (70%, hepato-lienal syndrome (68%. 32.9% of patients had tachycardia. Objective visual examination showed enlargement of
Akyol, Lütfi; Aslan, Kerim; Özgen, Metin; Sayarlioglu, Mehmet
We present a rare case of a comorbidity of sacroiliitis and brucellosis infection. A 28-year-old woman received irregular medication due to ongoing backache and hip pain for 5 years. The patient presented to our hospital for evaluation of visual loss and was diagnosed with uveitis. Sacroiliac MRI was performed to investigate the inflammatory backache and hip pain, and the aetiology of the uveitis, revealing the presence of sacroiliitis. The patient's blood test results were as follows: positive brucellosis Rose Bengal test and positive tube agglutination test with a titre of 1/640. The patient was treated with doxycycline and rifampicin for 8 weeks for the brucellosis infection, and with acemetacin for the ankylosing spondylitis. The patient's back and hip pain decreased significantly 8 weeks later; however, the uveitis was not controlled by the treatment. Therefore, anti-tumour necrosis factor (infliximab) treatment was started.
Full Text Available INTRODUCTION: The European Regional Office of the World Health Organization developed a strategic approach to stop the indigenous transmission of measles in its 53 Member States by 2015. In Italy, laboratory surveillance activity is implemented by the National Reference Laboratory for Measles and Rubella at the Italian National Institute of Health (Istituto Superiore di Sanità, Rome. The role of the National Reference Laboratory is to strengthen surveillance systems through rigorous case investigation and laboratory confirmation of suspected sporadic cases and outbreaks. Genetic characterization of wild-type measles virus is an essential component of the laboratory-based surveillance. This study describes the molecular characterization of measles virus strains isolated during 2010. METHODS: Dried blood spots, urine and oral fluid samples were collected from patients with a suspected measles infection. Serological tests were performed on capillary blood, and viral detection was performed on urine and oral fluid samples through molecular assay. Positive samples were sequenced and phylogenetically analysed. RESULTS AND DISCUSSION: The phylogenetic analysis showed a co-circulation of genotypes D4 and D8, and sporadic cases associated to genotypes D9 and B3. Then, molecular epidemiology of measles cases permitted to establish that D4 and D8 were the endemic genotypes in Italy during 2010.
Full Text Available Abstract Background Syphilis is a growing public health problem among men who have sex with men (MSM globally. Rapid and accurate detection of syphilis is vital to ensure patients and their contacts receive timely treatment and reduce ongoing transmission. Methods We evaluated a PCR assay for the diagnosis of Treponema pallidum using swabs of suspected early syphilis lesions in longitudinally assessed MSM. Results We tested 260 MSM for T pallidum by PCR on 288 occasions: 77 (26.7% had early syphilis that was serologically confirmed at baseline or within six weeks, and 211 (73.3% remained seronegative for syphilis. Of 55 men with primary syphilis, 49 were PCR positive, giving a sensitivity of 89.1% (95% CI: 77.8%-95.9% and a specificity of 99.1% (95% CI: 96.5%-99.9%. Of 22 men with secondary syphilis, 11 were PCR positive, giving a sensitivity of 50% (95% CI: 28.2%-71.8% and a specificity of 100% (95% CI: 66.4%-71.8%. Of the 77 syphilis cases, 43 (56% were HIV positive and the sensitivity and specificity of the PCR test did not vary by HIV status. The PCR test was able to detect up to five (10% primary infections that were initially seronegative, including one HIV positive man with delayed seroconversion to syphilis (72 to 140 days and one HIV positive man who did not seroconvert to syphilis over 14 months follow-up. Both men had been treated for syphilis within a week of the PCR test. Conclusions T pallidum PCR is a potentially powerful tool for the early diagnosis of primary syphilis, particularly where a serological response has yet to develop.
Yang Fan(杨帆); Zhou Hua(周华); Hong Fuchang(洪福昌); Luo Bin(罗斌); Cai Yumao(蔡于茂); Wen Lizhang(文立章); Zhang Chunlai(张春来)
Abstract Background: The Nnewly reported cases of congenital syphilis have been increaseding substantially over the past few years. To control the epidemic, a municipal program aimed at preventing mother-to-child transmission of syphilis was introduced in July, 2001,which was designed aimed to screen all pregnant women for syphilis at their first visit to antenatal clinics or at admission to hospitals in Shenzhen.Objectives: The aim of the study is tTo determine the prevalence of syphilis among women attending antenatal clinics and other medical institutions in Shenzhen and identifies its patterns of infection.Methods: Upon giving informed consent, w Women who attended antenatal care centers in Shenzhen from January to December 2003 were included in this study subject to obtaining informed consent. A blood sample was harvested for syphilis screened for syphilising by using rapid plasma reagent test (RPR) and confirmed by TPHA for those who were RPR positive. The women with pregnant syphilispositive serology were systematically interviewed to obtain. During the interview, their demographic detailsinformation, patterns of risk behaviors and other data. Data were collected andwere analyzed retrospectively.Results: Among Of 118,235 pregnant women surveyed,555 pregnant women were confirmed to have syphilis (prevalence of 4.69%), with a incidence of 4.69‰. 123women were excluded from the analysis because of incomplete medical records. Of 432 infected subjects with complete medical records, the average age was 26.8, with a range of 19 to 41. 7.41% (32/432) of them suffered from primary syphilis, 3.24% (14/432) were ofhad secondary syphilis, and 89.35%(386/432) had latent syphilis. Without any conspicuous clinical signs and symptoms. Conclusions: The prevalence of syphilis among the pregnant women in our series was high an most of them were asymptomatic. Screening for syphilis among pregnant women in Shenzhen is of importantce for the prevention of mother
Full Text Available Introduction & Objective : There are some reports about influence of the rare nutrients such as copper and zinc on immune system. Serum concentrations of copper alter in patients with brucellosis. Brucellosis is a common and endemic disease and a health problem in Iran. We compared serum concentrations of copper in patients with brucellosis and healthy individuals.Materials & Methods: In a cross sectional study, serum concentrations of copper was measured in patients with brucellosis and control group. Eighty six subjects were enrolled in the study, including 43 patients with brucellosis (34 men and 9 women and 43 healthy individuals. Serum concentrations of copper was measured by automatic absorptive spectrophotometer in patients with brucellosis and compared with control group. We employed a non parametrical test, kolmogrov – smirnov, to determine if data distribution was normal or not. Results: Mean age of patients with brucellosis was 40.1415.10 years with the range of 14-60 years. The most frequent symptoms were arthralgia (86%. Serum concentrations of copper in patients with brucellosis were significantly higher than healthy subjects (160.8454.61, 101.7427.37 g/dl respectively, p<0.001.Conclusion: Serum concentrations of copper in patients with brucellosis showed significant alterations in comparison with healthy subjects. So, we recommend using serum copper concentrations in patients with brucellosis as a marker in brucellosis diagnosis. Also we recommend another study for detection of serum copper concentrations before and during treatment.
Sowjanya Dasari; Kushal Naha; Mukhyaprana Prabhu
Objective:To identify characteristic features of tuberculosis in patients with culture proven brucellosis.Methods:A retrospective analysis was performed on patients diagnosed with culture proven brucellosis betweenJanuary andDecember2011, based on review of their medical records.Patients with demonstrable co-infection with tuberculosis were excluded.Clinical features, laboratory parameters and tissue histopathology reports where available were noted. Results:Thirty-two patients with brucellosis were included in the study.Twenty-one(65.63%) patients had chronic fever, thirteen(40.63%) had a productive cough, while significant weight loss, evening rise of temperature and night sweats were reported by eight(25.00%), eleven(34.38%) and five(15.63%) patients respectively.Nine(28.13%) patients had atleast three of these symptoms. Lymphadenopathy, hepatomegaly and splenomegaly were noted on examination in seven(21.88%), fifteen(46.88%) and twelve(37.50%) patients respectively.Eight(25.00%) patients had hepato-splenomegaly, of these only two had associated significant lymphadenopathy.Respiratory examination was normal in all patients.ElevatedESR greater than50 mm/hr was seen in eight (25.00%), it was greater than100 mm/hr in five(15.63%) patients.Hypergammaglobulinemia was seen in eight(25.00%) cases.Bone marrow biopsy showed non-caseating granulomas in three (9.38%) cases, lymph node biopsy showed granulomas in one case.Overall, three(9.38%) patients had known risk factors for tuberculosis, while six(18.75%) had risk factors for brucellosis. Conclusions:There is a clear overlapbetween brucellosis and tuberculosis both in terms of clinical presentation and laboratory parameters.It is essential to carefully rule out tuberculosis in all cases of suspected or proven brucellosis before initiating antimicrobial therapy, in order to forestall development of drug-resistant tuberculosis.
Al-Shaar, L; Chaaya, M; Ghosn, N; Mahfoud, Z
A study was conducted to determine risk factors associated with brucellosis infection in an outbreak in Chouf district of Lebanon during summer 2009. Cases of brucellosis reported to the Ministry of Public Health were identified, and for each case 2 controls were matched by sex, age and residence. Sociodemographic data, exposure to animals and animal products, knowledge about brucellosis, symptoms and history of past brucellosis infections were collected. Consumption of raw cheese was a significant risk factor for contracting brucellosis (matched OR = 29.5), whereas wearing gloves when in contact with animals and animal products and self-preparing dairy products were protective factors (OR = 0.08 and 0.13 respectively). Low and inaccurate knowledge about brucellosis was prevalent among subjects, with a common misconception about human-human transmission. Ensuring animal vaccination, educating people on correct ways of milk pasteurization and handling meat products, and elevating food safety monitoring threshold are key elements in controlling brucellosis.
Mounia Lakhdar Idrissi
Full Text Available Alors qu�elle est actuellement oubliee dans les pays developpes, la syphilis congenitale se voit encore chez nous faute du depistage antenatal. Ses formes cliniques sont polymorphes et orientent a tord vers d�autres pathologies surtout en periode neonatale. Le diagnostic n�est donc pas toujours facile. La revelation d�une syphilis congenitale par une fracture spontanee est exceptionnellement decrite. Nous rapportons dans ce travail le cas d�un nourrisson de 2 mois ramene en consultation pour limitation douloureuse des mouvements du bras droit. Le diagnostic est evoque sur les donnees radiologiques et confirme par la serologie syphilitique. Le traitement a repose essentiellement sur l�administration de la penicilline G avec une bonne evolution clinique.
Sarkodie, Francis; Hassall, Oliver; Owusu-Dabo, Ellis
OBJECTIVES: The primary objective of this study was to compare laboratory practices for screening blood donors for syphilis at blood transfusion facilities in Ghana with the recommendations of the World Health Organization and the National Blood Service, Ghana (NBSG). The prevalence of syphilis.......9%, compared to 4.0% in family donations (p=0.001). Only 6.9% of the health facilities were using standard operating procedures (SOPs). CONCLUSIONS: Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening...... antibodies in blood donors in Ghana was also estimated. METHODS: Over an 11-month period, from February 2014 to January 2015, a semi-structured questionnaire was administered to 122 laboratory technical heads out of a total of 149 transfusion facilities in Ghana. The response rate was 81.9%. RESULTS: A total...
Une, T; Nakajima, R; Otani, T; Katami, K; Osada, Y; Otani, M
Ofloxacin, a new pyridone-carboxylic acid derivative, was evaluated in experimental syphilis in rabbits in comparison with penicillin G. Experimental syphilis was established by intradermal injection of Treponema pallidum subsp. pallidum Nichols. Ten days after infection, the dermal lesions were characterized by syphilitic papula accompanied with central necrosis. These animals were subsequently treated either with ofloxacin twice a day at an oral dose of 10 mg/kg or with penicillin G once a day at an intramuscular dose of 10,000 U/kg for 21 consecutive days. In penicillin G-treated animals, the dermal lesions became smaller as early as day 3 of treatment and almost disappeared during the therapy. In marked contrast to remarkable efficacy of penicillin G was further development of the lesions in ofloxacin-treated animals, showing no difference in pathological manifestations as compared to untreated animals. The results of nontreponemal serologic test correlated well with the response of animals to treatment.
Silverstein, Arthur M; Ruggere, Christine
In 1894, Dr. Arthur Conan Doyle wrote "The Third Generation," a short story involving the transmission of congenital syphilis from generation to generation. Analysts of his writings have interpreted the pathogenetic mechanism involved in modern terms: infection of mother by father and then transplacental infection of the fetus. However, a review of the contemporary literature and the history of the concepts of congenital and "hereditary" syphilis demonstrates that the late 19th-century understanding of the process involved a Lamarckian transmission of paternal infection, via the sperm at the moment of conception. It was undoubtedly this concept that Doyle learned in medical school in the late 1870s and that provided the background to his story.
Full Text Available Syphilis is a venereal disease. Morocco has witnessed syphilis since the fifteenth century and the treatment of this disease remained archaic until the Protectorate was established.With the establishment of the colonial system in Morocco, the phenomenon of prostitution spread. Protectorate authorities designated a particular place in Casablanca for such activity that developed: Bousbir district. The authorities’ efforts failed to regulate and organize such activity because of the development of clandestine prostitution in relation to urban growth and the increase of employed, poor and downgraded urban population, especially among women who practice prostitution, and due to lack of a real social policy of the Protectorate concerning the policy of land-use planning or control that were a priority.
Jun-Fa Chen; Wei-Xia Chen; Hong-Ying Zhang; Wen-Yan Zhang
Peliosis hepatis is a rare benign vascular disorder of the liver that may be associated with malignancy, infection and drugs. The imaging manifestation of this disorder is often variable and nonspecific making its diagnosis difficult. We describe a rare case of peliosis hepatis and gummatous syphilis of the liver with emphasis on CT findings. Image characteristics of our patient included pseudotumoral appearance of peliosis hepatis, isodensity to the adjacent liver parenchyma on unenhanced and dual-phase scanning. To our knowledge, peliosis hepatis associated with syphilis and unique enhancement pattern has not been reported. Considering the imaging features of peliosis hepatis, it should be considered in the differential diagnosis of atypical focal hepatic lesion.
Lee, K.Y.; Cho, W.H.; Kim, S.H. [Department of Radiology, Sanggye Paik Hospital, Inje University, 760-1 Sanggye-7 dong, Nowon-gu, Seoul 139707 (Korea); Kim, H.D. [Department of Paediatrics, Sanggye Paik Hospital, Inje University, 760-1 Sanggye-7 dong, Nowon-gu, Seoul 139707 (Korea); Kim, I.O. [Department of Radiology, Seoul National University Hospital, 28, Yongon-dong, Chongno-gu, Seoul 110744 (Korea)
We document the MRI features in six patients aged 5-14 years with acute encephalitis following measles. The diagnosis was made on a characteristic morbiliform rash and detection of specific IgM and IgG antibodies. The symptoms of encephalitis occurred 1-11 days after the appearance of the rash. All patients underwent MRI within 1-4 days of the onset of neurological symptoms. Diffusion weighted images (DWI) were obtained in three patients. In all patients, T2-weighted images showed widely distributed, multifocal high signal in both cerebral hemispheres with swelling of the cortex, with bilateral, symmetrical involvement of the putamen and caudate nucleus. The lesions had showed low apparent diffusion coefficients. Three patients showed subacute gyriform haemorrhage, and asymmetrical gyriform contrast enhancement on follow-up MRI. (orig.)
Mathai, E; Singhal, A; Verghese, S; D'Lima, D; Mathai, D; Ganesh, A; Thomas, K; Moses, P
Brucela serology using ELISA and standard agglutination test was performed on 23 patients with prolonged fever where the test was requested, on 26 randomly chosen patients with prolonged fever where it was not requested and on 17 controls. ELISA was positive in 39.1, 26.9 and 0 per cent respectively in these groups. Brucellosis may often be unsuspected because of its varied clinical manifestations and may be a more important cause of fever than previously considered. Our data reaffirm that ELISA is superior to the standard agglutination test for the diagnosis of brucellosis.
Çelik, Aygul Dogan; Yulugkural, Zerrin; Kilincer, Cumhur; Hamamcioglu, Mustafa Kemal; Kuloglu, Figen; Akata, Filiz
Two cases of brucellar spondylodiscitis of the lumbar area were presented. Although both cases showed typical radiological changes, serological tests could not detect Brucella agglutinating antibodies. One of the patients was bacteremic and Brucella spp. was identified from blood culture. In the second patient needle biopsy was required for definite diagnosis. Although small, serologic tests have a certain rate of false negative results in brucellosis. Thus, a negative serology should not exclude the diagnosis of brucellosis, as it is demonstrated in the current cases.
Massasso, David; Gibson, Kathryn
A young male immigrant from Syria with a vasculitic-appearing leg rash, asymmetrical polyarthritis, microscopic haematuria, and raised inflammatory markers was provisionally diagnosed with Henoch-Schönlein purpura. Skin biopsy showed leukocytoclastic vasculitis. Low-grade fevers persisted despite non-steroidal anti-inflammatory therapy, and Brucella sp. was subsequently grown from both blood and synovial fluid aspirates. Further tests gave positive results for B. abortus, and triple antibiotic therapy produced a rapid clinical response. Cutaneous vasculitis has rarely been described in brucellosis, and this is the first report in the English medical literature of brucellosis mimicking Henoch-Schönlein purpura.
Full Text Available Rectal syphilis is rare and it is easily diagnosed as rectal cancer. We report a case of a 32-year-old male patient complained of intermittent blood stool for 2 months. The patient was initially diagnosed suffering from rectal cancer based on clinical findings, Computed Tomography (CT and sigmoidoscopy examination, but rectal biopsy specimens and lymph node biopsy revealed no cancer cells. After knowing that he had a history of homosexuality, rectal syphilis was diagnosed because of positive syphilis-related indices. CT imaging of rectal syphilis was retrospectively evaluated and it may play a role in directing the adequate diagnosis with subsequent effective treatment of such patient population.
Full Text Available Reverse sequence screening for syphilis (RSSS (screening with treponemal tests, followed by confirmation with nontreponemal tests has been increasingly adopted. CDC recommends confirmation of discordant results (reactive EIA/CIA and nonreactive nontreponemal test with Treponema pallidum particle agglutination assay (TP-PA. We characterized sera with discordant results from RSSS with Architect Syphilis TP CIA. Among 15,713 screening tests using Architect Syphilis TP at Seoul National University Gangnam Center between October 2010 and May 2011, 260 (1.7% showed reactive results. Rapid plasma reagin (RPR and TP-PA were performed on 153 available sera among them. On sera with discordant results between Architect Syphilis TP and TP-PA, INNO-LIA Syphilis Score and FTA-ABS were performed. Among 153 sera, RPR was nonreactive in 126 (82.4%. Among them, TP-PA was positive in 103 (81.7%, indeterminate (± in 7 (5.6%, and negative in 16 (12.7%. Out of 16 CIA(+/RPR(−/TP-PA(− sera, INNO-LIA Syphilis Score and/or FTA-ABS were negative on 14 sera. Out of 7 CIA(+/RPR(−/TP-PA(± sera, INNO-LIA Syphilis Score and FTA-ABS were positive/reactive in 6 sera. RSSS with confirmation by TP-PA on sera with discordant results between Architect Syphilis TP and RPR effectively delineated those discordant results and could be successfully adopted for routine checkup for syphilis.
Lomholt, Hans; Poulsen, Asmus; Brandrup, Flemming;
The optimal dosage and duration of penicillin treatment for the various stages of syphilis are not known. We present data on 20 patients with syphilis (primary, secondary or latent) treated with high-dose, short-time penicillin infusion therapy. Patients were given 10 MIU of penicillin G intraven......The optimal dosage and duration of penicillin treatment for the various stages of syphilis are not known. We present data on 20 patients with syphilis (primary, secondary or latent) treated with high-dose, short-time penicillin infusion therapy. Patients were given 10 MIU of penicillin G...
Hazra B. R
Full Text Available The study assesses the prevalence of seropositivity for syphilis amongst cases presenting with genital ulcer to STD Clinic, Medical College, Calcutta during July 1994 to January 1995, and their epidemiological characteristics. Of the 157 cases studied, 142 (90.9% were males and 15 (9.1% were females. Prevalence of seropositivity for syphilis was in 22.93% cases of genital ulcers. In the age distribution of males, 9% were below 21 years, 33.8% between 21-25 years and 23.9% between 26-30 years. In females, the highest proportion (33.3% was in the age range 16-20 years. While all the female patients were Hindus, 87.3% of males were Hindus and 12.7% were Muslims. Large Majority (70% of the cases were literate. Amongst male patients, unskilled labourers constituted the highest proportion (35.2%, and majority in females (53.3% were from middle income group and 16.6% from high income group. 90.1% of males were unmarried single against 87.9% in females. The type of family for both male and female patients was overwhelmingly nuclear (86.6% to 87.3% and 2.8% of the males and 13.3% of the females were orphans. Amongst the seropositive patients, primary syphilis was present in 71.4% males and 62.5% females and the figures for secondary syphilis were 28.6% in males and 30.6% in females, 42% males and 26.7% females had knowledge about source of infection. While 85.9% males got infection from prostitutes, 66.7% females got it from clients. In females, 20% had been infected by friends and neighbours and 13.3% by casual contact.
Renan Albert Mendonça Rodrigues
Full Text Available Here we report the occurrence of pale yellowish perivascular preretinal dots in 12 patients with ocular syphilis. A case series of these patients was examined between March and October 2012 at the Uveitis Sector of Universidade Federal de São Paulo. After diagnostic confirmation of syphilis, fundus photographs and optical coherence tomography (OCT were performed to verify the localization of the dots, and patients were treated with IV crystalline penicillin for 14 days. The study comprised 11 men (91.6%, 19 eyes, median presentation age of 38.1 years, and panuveitis as the main clinical manifestation (seven patients, 58.3%, being bilateral in four. Ten patients were taking oral prednisone (83.3%. Serum panels performed by the Venereal Disease Research Laboratory (VDRL showed positive results in eight patients (66.7%, whereas VDRL cerebrospinal fluid (CSF tests were negative in seven of nine collected (77.8%. However, serum FTA-Abs was positive in 100% of patients, and eight patients (66.7% had HIV infection. The best corrected visual acuity (BCVA presented after treatment improved in 10 eyes (55.6%, did not change in seven eyes (38.9%, and worsened in one eye (5.6%. Although not yet acknowledged in the literature as a typical manifestation of ocular syphilis, these are very common findings in clinical practice. We believe that preretinal dots are due to perivasculitis secondary to treponema infection. It is important recognize them and remember that syphilis can present in several forms, including the one presented in this study.
Before the microbiologic era, venereal diseases were poorly distinguished. Congenital syphilis was believed to be transmitted during conception by the father's sperm, during delivery in the birth canal, or from infected milk or breasts. The most frequent maternofetal transmission was not considered because the mother's primary infection remained undiagnosed. The concept of treating infants with mercury transmitted by nurses' milk prompted the founding of a specialized infant hospital in Vaugirard in 1780: lactating syphilitic women received mercury orally and by rubbing it into the skin. Their own infant and a second infected infant from the foundling hospital were believed to be cured by their milk. Underwood described snuffles in 1789 and Bertin periosteal bone disease in 1810. Tardive congenital lues with keratitis, deafness, and notched upper incisors were described by Hutchinson in 1863. Feeding remained difficult, as wet nursing transmitted syphilis to the nurse and other infants. Specialized institutions tried goat or donkey milk. A debate between contagionists assuming exclusively maternal infection and hereditists assuming germinal transmission by the father's sperm continued throughout the 19th century. Schaudinn and Hoffmann identified Spirochaeta pallida in 1905. When Ehrlich discovered the efficacy of salvarsan in 1910, Noeggerath treated infants with the new drug, pioneering the injection into scalp veins. In 1943, Lentz and Ingraham established penicillin treatment for congenital syphilis. Whereas this drug effectively prevented maternofetal transmission, treating infants remained difficult due to the Jarisch-Herxheimer reaction.
Genevie M Ntshoe
Full Text Available BACKGROUND: Since 1995, measles vaccination at nine and 18 months has been routine in South Africa; however, coverage seldom reached >95%. We describe the epidemiology of laboratory-confirmed measles case-patients and assess the impact of the nationwide mass vaccination campaign during the 2009 to 2011 measles outbreak in South Africa. METHODS: Serum specimens collected from patients with suspected-measles were tested for measles-specific IgM antibodies using an enzyme-linked immunosorbent assay and genotypes of a subset were determined. To estimate the impact of the nationwide mass vaccination campaign, we compared incidence in the seven months pre- (1 September 2009-11 April 2010 and seven months post-vaccination campaign (24 May 2010-31 December 2010 periods in seven provinces of South Africa. RESULTS: A total of 18,431 laboratory-confirmed measles case-patients were reported from all nine provinces of South Africa (cumulative incidence 37 per 100,000 population. The highest cumulative incidence per 100,000 population was in children aged 5 years.
Zhang, Y; Wang, H; Xu, S; Mao, N; Zhu, Z; Shi, J; Huang, G; Liu, C; Bo, F; Feng, D; Lu, P; Liu, Y; Wang, Y; Lei, Y; Chen, M; Chen, H; Wang, C; Fu, H; Li, C; He, J; Gao, H; Gu, S; Wang, S; Ling, H; Liu, Y; Ding, Z; Ba, Z; Feng, Y; Zheng, H; Tang, X; Lei, Y; Xiong, Y; Bellini, W J; Rota, P A; Jee, Y; Xu, W
With the achievement of high coverage for routine immunization and supplementary immunization activities (SIAs), measles incidence in mainland China reached its lowest level in 2010. The proportion of measles cases in the vaccination-targeted population decreased during 2007-2010 after the SIAs. More than 60% of measles cases were in adults or infants, especially in the coastal and eastern provinces during 2009 and 2010. A total 567 isolates of measles virus were obtained from clinical specimens from 27 of 31 provinces in mainland China during 2009 and 2010. Except for two vaccine-associated cases, one genotype D4 strain, two genotype D9 strains, and four genotype D11 strains, the other 558 strains were genotype H1 cluster H1a. Genotype H1 has been the only endemic genotype detected in China since surveillance began in 1993. Only genotype H1 was found in mainland China during 1993-2008, except for one detection of genotype H2. More recently, multiple genotypes of imported measles were detected even with the background of endemic genetotype H1 viruses. Analysis of the 450-nucleotide sequencing window of the measles virus N gene showed that the overall genetic diversity of the recent geneotype H1 strains decreased between 2008 and 2010. The lower genetic diversity of H1 strains suggested that enhanced vaccination may have reduced the co-circulating lineages of endemic genotype H1 strains in mainland China.
... STATEMENT MMRV Vaccine What You Need to Know (Measles, Mumps, Rubella and Varicella) Many Vaccine Information Statements ... and V aricella (chickenpox) can be serious diseases: Measles • Causes rash, cough, runny nose, eye irritation, fever. • ...
Nah, Byung Sik; Chung, Ung Ki [Chonnam National University College of Medicine, Kwangju (Korea, Republic of)
Congenital syphilis is transmitted through the placenta by the infected mother after 16 weeks of gestation. Since the incidence of syphilis is again on the increase, syphilis remains at the present time a public problem of major and increasing proportions. Recently, congenital syphilis has different formas of presentation. The authors observed clinically and radiologically 27 cases of congenital syphilis in the neonates and infants treated at the pediatric ward of Chonnam National University Hospital from Jan. 1977 to Mar. 1982. The results are as follows: 1. The number of observed patients was 27 cases, 22 cases in male, 5 cases in female. 2. Onset of first clinical symptoms and signs was within the 4th week life in 14 cases (52%), 1-2 months in 6 cases (22%), 2-3 months in 4 cases (15%), 3-4 months in 3 cases (11%). All cases was within 6 months. 3. The order of the frequency of common clinical manifestations was hepatomegaly (96%), splenomegaly (78%), skin lesion (63%), anemia (63%), nasal snuffle (56%). 4. Of 11 cases with known birth weight, 10 cases were low birth weight. 5. The serologic test (VDRL slide test) of 27 tested caes revealed reactive response in 26 cases, non-reactive response in 1 case, and that of syphilitic mothers except one revealed reactive in 23 cases, non- reactive in 3 cases. 6. Roentgenographic syphilitic bony changes were detected in 26 cases (96%), of 27 studied cases, osteochondritis was present in 24 cases (89%), periostitis in 21 case (78%), osteomyelitis in 11 cases (41%). 7. The most common sites affected were as follows. Radius and ulna were the most frequently affected, the next were in order of tibia and fibula. Considering osteochondiritis only, the distal end of radius and ulna (78% respectively) and proximal end of tibra (67%) were the most frequently affected sites, the proximal end of femur (33%) was least frequently affected site. 8. On chest films of 27 case, osseous changes (mainly periostitis) of clavicle were noted
Verguet, Stéphane; Johri, Mira; Morris, Shaun K; Gauvreau, Cindy L.; Jha, Prabhat; Jit, Mark
Background The Measles & Rubella Initiative, a broad consortium of global health agencies, has provided support to measles-burdened countries, focusing on sustaining high coverage of routine immunization of children and supplementing it with a second dose opportunity for measles vaccine through supplemental immunization activities (SIAs). We estimate optimal scheduling of SIAs in countries with the highest measles burden. Methods We develop an age-stratified dynamic compartmental model of mea...
Choe, Young June; Jee, Youngmee; Oh, Myoung-don; Lee, Jong-koo
We describe the global status of measles control and elimination, including surveillance and vaccination coverage data provided by the World Health Organization (WHO). Since 2000, two doses of measles vaccine (MCV2) became recommended globally and the achievement of high vaccination coverage has led to dramatic decrease in the measles incidence. Our finding indicates that, in the Western Pacific Region (WPR), substantial progress has been made to control measles transmission in some countries...
谢正德; 申昆玲; 许文波; 照日格图; 朱贞
@@ The hemagglutinin (H) and nucleoprotein (N) genes are the most variable regions on the genome of the measles virus. Nucleotide sequence analysis of the H and/or N genes has been used to describe different genetic groups of wild-type measles virus.1-3 This genetic information has been used in molecular epidemiological studies to identify the transmission pathways of measles virus. The present study was conducted to reveal the genotype of measles viruses which circulated in Beijing in 2001.
Helfand, RF; Moss, WJ; Harpaz, R; Scott, S; Cutts, F.
OBJECTIVE: To estimate the impact of the HIV pandemic on vaccine-acquired population immunity to measles virus because high levels of population immunity are required to eliminate transmission of measles virus in large geographical areas, and HIV infection can reduce the efficacy of measles vaccination. METHODS: A literature review was conducted to estimate key parameters relating to the potential impact of HIV infection on the epidemiology of measles in sub-Saharan Africa; parameters include...
Massari Marco; Maggio Cavallaro Gianluca; Panà Augusto; Brenna Antonio; Filia Antonietta; Ciofi degli Atti Marta L
Abstract Background A large measles outbreak occurred in Italy in 2002–2003. This study evaluates the health burden and economic impact of measles-related hospitalizations in Italy during the specified period. Methods Hospital discharge abstract data for measles hospitalizations in Italy during 2002–2003 were analysed to obtain information regarding number and rates of measles hospitalizations by geographical area and age group, length of hospital stay, and complications. Hospitalization cost...
Nakayama, Tetsuo; Sawada, Akihito; Yamaji, Yoshiaki; Ito, Takashi
Further attenuated measles vaccines were developed more than 50 years ago and have been used throughout the world. Recombinant measles vaccine candidates have been developed and express several heterologous virus protective antigens. Immunogenicity and protective actions were confirmed using experimental animals: transgenic mice, cotton rats, and primates. The recent development of measles vaccine-based vectored vaccine candidates has been reviewed and some information on recombinant measles vaccines expressing respiratory syncytial virus proteins has been shown and discussed.
El Shazly, M K; Atta, H Y; Kishk, N A
Vaccine-preventable diseases constitute a major health problem contributing to the morbidity and mortality in many developing countries including Egypt. WHO adopted resolutions to eradicate poliomyelitis by the year 2000, eliminate neonatal tetanus by the year 1995, and reduce measles mortality by 95% and morbidity by 90%, compared to the pre-immunization levels by 1995. Evaluation of preventive programs for these diseases necessitates availability of up to date information on their occurrence. The present study was undertaken to determine the current epidemiological features of poliomyelitis, neonatal tetanus and measles, to identify the trends of these diseases as well as to determine their outcomes and hospital loads. Data about the admitted cases of poliomyelitis, neonatal tetanus and measles were collected from the hospital register of Alexandria fever hospital for five successive years (1992-96). Available information on age, sex, residence, diagnosis, outcome of treatment, dates of admission and discharge were collected. The total number of cases of the three diseases admitted to the hospital during the period 1992-96 were 1406, measles represented 85.4%, neonatal tetanus 13.9% and poliomyelitis 0.7%. The results revealed that in the year 1994 only one case of poliomyelitis was admitted and since then no other cases were reported. The number of measles cases increased gradually in the latter years and about 78% of them were older than five years of age. A significant increase in the age of measles occurrence was observed. A gradual decline in the number of neonatal tetanus cases was observed. These cases were more apt to occur among early neonates but still clustered in certain geographical areas. The results of the study pinpoint the long term impact of the well run program aiming at eradicating poliomyelitis in Alexandria. However, for elimination of neonatal tetanus and controlling measles morbidity, further activities are required including strengthening
Jeremy D Goldhaber-Fiebert
Full Text Available BACKGROUND: This study characterizes the historical relationship between coverage of measles containing vaccines (MCV and mortality in children under 5 years, with a view toward ongoing global efforts to reduce child mortality. METHODOLOGY/PRINCIPAL FINDINGS: Using country-level, longitudinal panel data, from 44 countries over the period 1960-2005, we analyzed the relationship between MCV coverage and measles mortality with (1 logistic regressions for no measles deaths in a country-year, and (2 linear regressions for the logarithm of the measles death rate. All regressions allowed a flexible, non-linear relationship between coverage and mortality. Covariates included birth rate, death rates from other causes, percent living in urban areas, population density, per-capita GDP, use of the two-dose MCV, year, and mortality coding system. Regressions used lagged covariates, country fixed effects, and robust standard errors clustered by country. The likelihood of no measles deaths increased nonlinearly with higher MCV coverage (ORs: 13.8 [1.6-122.7] for 80-89% to 40.7 [3.2-517.6] for ≥95%, compared to pre-vaccination risk levels. Measles death rates declined nonlinearly with higher MCV coverage, with benefits accruing more slowly above 90% coverage. Compared to no coverage, predicted average reductions in death rates were -79% at 70% coverage, -93% at 90%, and -95% at 95%. CONCLUSIONS/SIGNIFICANCE: 40 years of experience with MCV vaccination suggests that extremely high levels of vaccination coverage are needed to produce sharp reductions in measles deaths. Achieving sustainable benefits likely requires a combination of extended vaccine programs and supplementary vaccine efforts.
Tucker, Joseph D; Wang, Cheng; Shen, Song-Ying; Chen, Xiang-Sheng; Yang, Bin; Peeling, Rosanna
Abstract Objective To examine syphilis testing capacity, screening coverage rates and types of syphilis tests used in medical facilities in southern China. Methods Eleven of the 14 municipalities in Guangdong province participated. Data on syphilis testing capacity, screening coverage and types of syphilis tests used were collected from all types of public medical facilities offering prenatal care (n = 109). A total of 494 680 women who delivered during 2004–2008 were studied. Findings In 2008, 54 196 pregnant women (43.1%) were not screened for syphilis. Among such women, 32 863 (60.6%) attended clinics without any syphilis testing capacity and 21 333 (39.4%) attended clinics that performed testing but were not screened. The likelihood of not having syphilis test capacity was much higher for hygiene stations (odds ratio, OR: 10; 95% confidence interval, CI: 4–25), services at the township level (OR: 33; 95% CI: 10–100) and services with ≤ 1000 deliveries per year (OR: 1.002; 95% CI: 1.001–1.003). These same service characteristics correlated with lower screening coverage rates (P < 0.01). Only one antenatal clinic had the capacity to conduct both treponemal and non-treponemal tests for diagnosing syphilis. Conclusion Syphilis screening is available in very few of the basic medical facilities offering prenatal care where most neonates in southern China are delivered. In light of this and of the increasing incidence of syphilis in the area, expanding point-of-care rapid syphilis testing is a priority. PMID:22084525
Mireille B. Kalou
Full Text Available Background: Use of rapid diagnostic tests for HIV and syphilis has increased remarkably in the last decade. As new rapid diagnostic tests become available, there is a continuous need to assess their performance and operational characteristics prior to use in clinical settings.Objectives: In this study, we evaluated the performance of the Chembio Dual Path Platform (DPP® HIV–Syphilis Assay to accurately diagnose HIV, syphilis, and HIV/syphilis co-infection.Method: In 2013, 990 serum samples from the Georgia Public Health Laboratory in Atlanta, Georgia, United States were characterised for HIV and syphilis and used to evaluate the platform. HIV reference testing combined third-generation Enzyme Immunoassay and Western Blot, whereas reference testing for syphilis was conducted by the Treponema pallidum passive particle agglutination method and the TrepSure assay. We assessed the sensitivity and specificity of the DPP assay on this panel by comparing results with the HIV and syphilis reference testing algorithms.Results: For HIV, sensitivity was 99.8% and specificity was 98.4%; for syphilis, sensitivity was 98.8% and specificity was 99.4%. Of the 348 co-infected sera, 344 (98.9% were detected accurately by the DPP assay, but 11 specimens had false-positive results (9 HIV and 2 syphilis due to weak reactivity.Conclusion: In this evaluation, the Chembio DPP HIV–Syphilis Assay had high sensitivity and specificity for detecting both HIV and treponemal antibodies. Our results indicate that this assay could have a significant impact on the simultaneous screening of HIV and syphilis using a single test device for high-risk populations or pregnant women needing timely care and treatment.
Thapa, Arun; Khanal, Sudhir; Sharapov, Umid; Swezy, Virginia; Sedai, Tika; Dabbagh, Alya; Rota, Paul; Goodson, James L; McFarland, Jeffrey
In 2013, the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region adopted the goal of measles elimination and rubella and congenital rubella syndrome control by 2020 after rigorous prior consultations. The recommended strategies include 1) achieving and maintaining ≥95% coverage with 2 doses of measles- and rubella-containing vaccine in every district through routine or supplementary immunization activities (SIAs); 2) developing and sustaining a sensitive and timely case-based measles surveillance system that meets recommended performance indicators; 3) developing and maintaining an accredited measles laboratory network; and 4) achieving timely identification, investigation, and response to measles outbreaks. This report updates previous reports and summarizes progress toward measles elimination in the South-East Asia Region during 2003-2013. Within the region, coverage with the first dose of a measles-containing vaccine (MCV1) increased from 67% to 78%; an estimated 286 million children (95% of the target population) were vaccinated in SIAs; measles incidence decreased 73%, from 59 to 16 cases per million population; and estimated measles deaths decreased 63%. To achieve measles elimination in the region, additional efforts are needed in countries with measles case-based surveillance and laboratory diagnosis of measles.
Hai, Le Thanh; Thach, Hoang Ngoc; Tuan, Ta Anh; Nam, Dao Huu; Dien, Tran Minh; Sato, Yuko; Kumasaka, Toshio; Suzuki, Tadaki; Hanaoka, Nozomu; Fujimoto, Tsuguto; Katano, Harutaka; Hasegawa, Hideki; Kawachi, Shoji; Nakajima, Noriko
During a 2014 measles outbreak in Vietnam, postmortem pathologic examination of hospitalized children who died showed that adenovirus type 7 pneumonia was a contributory cause of death in children with measles-associated immune suppression. Adenovirus type 7 pneumonia should be recognized as a major cause of secondary infection after measles.
Cristina V. Cardemil
Conclusions: Late in a large measles outbreak, 13% of pregnant women in Namibia, and almost one in four 15–19-year-old pregnant women, remained susceptible to measles. In Namibia, immunization campaigns with measles-containing vaccine should be considered for adults.
Measles is a highly communicable, acute viral illness with potential for severe complications, including death. Although endemic measles was eliminated in the United States in 2000 as a result of widespread vaccination, sporadic measles outbreaks still occur, largely associated with international travel from measles-endemic countries and pockets of unvaccinated persons. On August 26, 2011, the Los Angeles County Department of Public Health (LACDPH) was notified of suspected measles in a refugee from Burma who had arrived in Los Angeles, California, on August 24, after a flight from Kuala Lumpur, Malaysia. Passengers on the flight included 31 other refugees who then traveled to seven other states, widening the measles investigation and response activities. In California alone, 50 staff members from LACDPH and the California Department of Public Health (CDPH) interviewed and reinterviewed 298 contacts. Measles was diagnosed in three contacts of the index patient (patient A). The three contacts with measles were two passengers on the same flight as patient A and a customs worker; no secondary cases were identified. Delayed diagnosis of measles in patient A and delayed notification of health officials precluded use of measles-mumps-rubella (MMR) vaccine as an outbreak intervention. This outbreak emphasizes the importance of maintaining a high level of vaccination coverage and continued high vigilance for measles in the United States, particularly among incoming international travelers; clinicians should immediately isolate persons with suspected measles and promptly report them to health authorities.
Lai, Shengjie; Zhou, Hang; Xiong, Weiyi; Gilbert, Marius; Huang, Zhuojie; Yu, Jianxing; Yin, Wenwu; Wang, Liping; Chen, Qiulan; Li, Yu; Mu, Di; Zeng, Lingjia; Ren, Xiang; Geng, Mengjie; Zhang, Zike; Cui, Buyun; Li, Tiefeng; Wang, Dali; Li, Zhongjie; Wardrop, Nicola A.; Tatem, Andrew J.
Brucellosis, a zoonotic disease, was made statutorily notifiable in China in 1955. We analyzed the incidence and spatial–temporal distribution of human brucellosis during 1955–2014 in China using notifiable surveillance data: aggregated data for 1955–2003 and individual case data for 2004–2014. A total of 513,034 brucellosis cases were recorded, of which 99.3% were reported in northern China during 1955–2014, and 69.1% (258, 462/374, 141) occurred during February–July in 1990–2014. Incidence remained high during 1955–1978 (interquartile range 0.42–1.0 cases/100,000 residents), then decreased dramatically in 1979–1994. However, brucellosis has reemerged since 1995 (interquartile range 0.11–0.23 in 1995–2003 and 1.48–2.89 in 2004–2014); the historical high occurred in 2014, and the affected area expanded from northern pastureland provinces to the adjacent grassland and agricultural areas, then to southern coastal and southwestern areas. Control strategies in China should be adjusted to account for these changes by adopting a One Health approach. PMID:28098531
Kushal Naha; Suman Karanth; Sowjanya Dasari; Mukhyaprana Prabhu
Diffuse myositis with progression to rhabdomyolysis has been reported in association with wide range of viral infections.We report a case of polymyositis-like syndrome complicated by rhabdomyolysis secondary to brucellosis.This case report thus contributes yet another atypical presentation to a disease already infamous for its protean manifestations.
Muhammad Abubakar*, Mehwish Mansoor and Muhammad Javed Arshed
Full Text Available Brucellosis is considered to be one of the most widespread zoonoses in the world. According to OIE, it is the second most important zoonotic disease in the world after rabies. The disease affects cattle, swine, sheep, goats, camels and dogs. It may also infect other ruminants and marine mammals. The disease is manifested by late term abortions, weak calves, still births, infertility and characteristic lesions are primarily placentitis, epididymitis and orchitis. The organism is excreted in uterine discharges and milk. The disease is economically important, is one of the most devastating transboundary animal diseases and also a major trade barrier. Although not yet reported, some species of Brucella (e.g., B. abortus are zoonotic and could be used as bioweapons. Brucellosis has a considerable impact on animal and human health, as well as wide socio-economic impacts, especially in countries in which rural income relies largely on livestock breeding and dairy products. Considering the poor health infrastructure and manpower in rural areas, the focus should be on preventive measures coupled with strengthening the curative health care services for early diagnosis and treatment. The incidence of brucellosis is increasing particularly in large dairy herds in Pakistan. Several studies have been conducted using sero-diagnostic techniques to determine the prevalence of brucellosis in different provinces, districts and livestock farms in government and private sector.
Çıraklı, Sevgi; Karlı, Arzu; Şensoy, Gülnar; Belet, Nurşen; Yanık, Keramettin; Çıraklı, Alper
Brucellosis is a systemic infectious disease that leads to various clinical pictures and is still a significant health problem in Turkey. In this study, 52 pediatric patients diagnosed with brucellosis between January 2008 and December 2013 were examined. Clinical and laboratory findings, response to treatment, prognosis and complications were evaluated. Diagnosis of brucellosis was made based on a clinical picture compatible with the disease, together with standard tube agglutination test (SAT) positivity (1/160 or higer titer) or isolation of Brucella spp. in a sterile body fluid culture. The cases comprised 10 females and 42 males. In 75% of cases, there was a history of consumption of unpasteurized milk or dairy products. The most commonly seen symptoms and findings were fever (75%), arthralgia (54%), fatigue (19%), splenomegaly (44%), hepatomegaly (42%) and arthritis (19%). Atypical presentations were seen in one case of epidydymo-orchitis and three cases of bleeding of the nose and gums. In the laboratory examinations, anemia was determined in 56% of cases, leukopenia in 40% and thrombocytopenia in 27%. In blood cultures taken from 41 patients, Brucella spp. were isolated in 23 (56.1%). All patients recovered, and sequelae were seen only in a patient with osteoarthritis. In conclusion, although brucellosis leads to many different clinical pictures, a very good response to treatment can be obtained. If effective treatment cannot be implemented in time, the disease may become chronic, and complications and relapses may be encountered. Therefore, early diagnosis and treatment is of great importance.
El-Fekhfakh, Effat Abdel-Monaem; Hassanain, Nawal Abdel-Hafiz; El-Folly, Runia Fouad; El-Hariri, Hazem
A total of 30 patients suffering from brucellosis were suspected based on history taking, clinical manifestations and positive serum tube agglutination test (at titer > or = 1/160). The followings were done for all cases; complete blood picture (differential leucocytic count) and liver function tests, serodiagnosis of Brucella (serum tube agglutination test (STAT) as well as Rose Bengal test (RBT) and PCR. The study aimed to analyze the diagnostic value of RBT as compared to STAT and PCR for human brucellosis, and to evaluate the sensitivity, specificity, accuracy, the cost and the time consuming of RBT as compared to STAT and PCR. There was a significant difference between diagnosis by RBT and both STAT > or = 1/640, & STAT > or = 1/1280. Also, there was a significant difference between PCR and both STAT > or = 1/640, and STAT > or = 1/1280. No significant difference was detected between RBT in diagnosing acute and chronic infection. STAT > or = 1/320 proved to be better than STAT at other titers and RBT in diagnosis of brucellosis. RBT proved to be suitable as screening test regarding time (faster) and cost. But, STAT > or = 1/320 from a practical and economic point of views proved to be the best one in diagnosing human brucellosis.
Smetana, Jan; Chlibek, Roman; Hanovcova, Irena; Sosovickova, Renata; Smetanova, Libuse; Gal, Peter; Dite, Petr
Aims In recent years, Europe has recorded an increase in the number of measles outbreaks despite the implementation of vaccination into the National Immunization Programs. The Czech Republic introduced vaccination against measles into National Immunization Program in 1969. The aim of this study was to determine seroprevalence of IgG antibodies against measles in adults. Methods Our study was designed as a prospective, multicenter cohort study. Samples of blood were taken from adults aged 18 years and over. Specific IgG antibodies were determined by ELISA method. Results A number of 1911 sera samples were obtained. The total seropositivity reached 83.3%, 14.3% of the results were negative and 2.4% were borderline. When comparing the individual age groups, the highest antibody seropositivity (> 96%) was detected in persons aged 50 years and over who were naturally infected in pre-vaccine era. The lowest seropositivity was recorded in the age groups 30–39 years (61.5%), 40–49 years (77.5%) and 18–29 years (81.1%). Conclusions A long term high rate of seropositivity persists after natural measles infection. By contrast, it decreases over time after vaccination. Similarly, the concentrations of antibodies in persons with measles history persist for a longer time at a higher level than in vaccinated persons. Our results indicate possible gap in measles protection in adults born after implementation of vaccination into the National Immunization Programs. There are two probable reasons, decrease of measles antibody seropositivity in time after vaccination in setting of limited natural booster and one-dose vaccination schedule used in the first years after implementation. PMID:28085960
Pomerai Kufakwanguzvarova W
Full Text Available Abstract Background A measles outbreak was detected at Ndanga Hospital in Zaka district Masvingo Province on the 5th of May 2010 and there were five deaths. Source of infection was not known and an investigation was carried out to determine factors associated with contracting measles in Zaka district. Materials and methods A 1:1 unmatched case control study was conducted. A case was a person residing in Zaka district who developed signs and symptoms of measles or tested IgM positive from 06 May 2010 to 30 August 2010. A control was a person residing in the same community who did not have history of signs and symptoms of measles during the same period. A structured interviewer administered questionnaire (translated into shona was used to solicit information from cases and controls. Ethical consideration like written consent from all participants, respect and confidentiality were observed. Permission to carry out the study was obtained from the medical research Council of Zimbabwe and the provincial Medical Directors Masvingo. Epi info was used to calculate frequencies, odds ratios and perform logistic regression to control for confounding variables. Findings A total of 110 cases and 110 controls were recruited. Most cases (63.03% were from the apostolic sect while 44.7% of controls were from orthodox churches. Contact with a measles case [AOR= 41.14, 95% CI (7.47-226.5],being unvaccinated against measles [AOR= 3.96, 95%CI (2.58-6.08] and not receiving additional doses of measles vaccine [AOR 5.48, 95% CI (2.16-11.08] were independent risk factor for contracting measles. Measles vaccination coverage for Zaka district was 75%. The median duration for seeking treatment after onset of illness was three days (Q1=2; Q3=7. There were no emergency preparedness plans in place. Conclusion This outbreak occurred due to a large number of unvaccinated children and a boarding school that facilitated person to person transmission. We recommend mandatory
İlke Mungan Akın
Full Text Available Brucellosis remains as an endemic infection of humans in many parts of the world; Latin America, Asia including Middle East and Mediterranean region including Turkey. Neonatal brucellosis is very rare and clinical manifestations as well as transmission route are not well-defined. The neonate can be either infected transplacentally, or by ingestion of mother’s secretions and blood during delivery, or by ingestion of breast milk. Here, we present two cases with two different transmission route and clinical findings. First case is a premature infant born after 31 weeks of gestation and hospitalized for respiratory distress in addition to hepatosplenomegaly and leukocytosis. Brucella species were isolated from the initial blood culture obtained just after birth. Clinical and laboratory findings improved with decreased ventilatory support after replacement of antibiotherapy with trimethoprim-sulfamethoxazole (TMP-SMX and rifampicin. Second case was a 28 days old, term infant. Her sibling was diagnosed as brucellosis and during evaluation of the family members, her mother was found to have brucellosis just before delivery. Initial evaluation of the baby after birth was totally normal. Beside medical advice, she was breastfed and in the 4th week of life she was found to have leucopenia and neutropenia, and brucella tube agglutination test turned to be positive. After antibiotherapy, laboratory findings were normalized. Breastfeeding was ceased during the treatment periods of both mothers. Both families were from rural regions of Turkey, who were using unpasteurized dairy products. Both patients were treated with TMP-SMX and rifampicin for 6 weeks without any complication. Brucella spp must be sought as a causative agent in the differential diagnosis of intrauterine and neonatal infections in endemic countries. Family members of patients from rural areas of the country must be questioned about traditional food consumption, as findings of neonatal
Moti Yohannes Gemechu
Full Text Available Studies have been done on public health significance of brucellosis using serology with little or no emphasis to risk factors. Therefore, this study was designed to investigate seroprevalence of brucellosis and assess epidemiological variables associated with human brucellosis. After obtaining verbal consent, 241 peripheral blood samples were collected from occupationally exposed groups with and without pyrexia of unknown origin. A structured questionnaire was prepared to gather risk factors, such as occupation, age, sex, history of consuming raw milk and other unpasteurised dairy products, direct contact with domestic animals, general knowledge about the route of transmission and awareness level. Purposive sampling was used to select the key informants. All serum samples were first screened by Rose Bengal Plate Test (RBPT and further analysed by Standard Tube Agglutination Test (STAT. The results revealed that 24.5% were positive by RBPT and diagnosis was established in 26.6% using STAT with a titre range between 80 and 1,280 IU/ml. Among occupational groups, prevalence was 17.8% in veterinarians and pharmacists but was not statistically significant. The most common clinical symptoms at presentation were fever, headache, back pain, arthralgia and myalgia. No female reactor was found and the mean age and standard deviation of seropositive patients was 34.69±10.97 years. Risk factors such as residence in rural area, participation in vaccination of animals and eating during working hours were significantly associated (P<0.05 with brucellosis by univariate and multivariate analysis. In conclusion, to deal with occupation-related disease like brucellosis, awareness on risk factors must be part of extension education campaign. Besides, regular surveillance of the disease needs to be integrated into control and prevention programme at a local and national level.
Oude Munnink, Bas B; Phan, My V. T.; Kellam, Paul; Cotten, Matthew; ,
A large measles virus outbreak occurred across Vietnam in 2014. We identified and obtained complete measles virus genomes in stool samples collected from two diarrheal pediatric patients in Dong Thap Province. These are the first complete genome sequences of circulating measles viruses in Vietnam during the 2014 measles outbreak.
Full Text Available Background: Measles reporting is mandatory in Albania. Despite the very high immunization coverage for MMR a measles outbreak was reported by district epidemiologist to national public health institute in june 2006. All affected persons were from a Roma community living in the town of Elbasan. We report the epidemiological features of this epidemic. Method: Active surveillance was conducted and cases analyzed had to meet the national case definition “rash maculopapular with fever”. The diagnosis was established by clinical signs, confirmed by serologic results. Sera samples from all the suspected cases were tested for Measles IgM by ELISA and molecular genotyping of virus by the regional reference laboratory. Results: According to the case definition 16 cases were actively found, 13 (77% were female and 3 (23% male. The mean age was 7.1 years (range: three months to 23 years. Most of the patients had Koplik spots, coryza and conjunctivitis. All cases were unvaccinated. All patients recovered and no fatal cases. Conclusion: Gaps of low vaccine coverage facilitated the measles infection to spread. The vaccination of this community it difficult despite the commitement of the health staff. Families with their children are in ongoing migration all over the country and abroad. As a response to stop the spread of the measles outbreak, the district epidemiological service in Elbasan with the support from the national institute of public health, organised a mass vaccination campaign.
Mayet, A; Verret, C; Haus-Cheymol, R; Duron, S; De Laval, F; Sbai-Idrissi, K; Imbert, P; Janville, M; Munoz, P; Armand-Tolvy, M; Thauvin, X; Decam, C; Meynard, J-B; Deparis, X; Migliani, R
Since the start of 2010 there has been a flare-up of measles in France, following on the resurgence observed in 2008. The aim of this study was to present results of the epidemiological surveillance of measles in the French armed forces and to describe the increase in incidence. Measles was surveyed from 1992 to 2010. Criteria for report were those used for French national compulsory notification. The data, concerning active military personnel, were provided by the physicians in the armed forces using anonymous data collection forms. Between 1992 and July 2010, 689 cases of measles were notified. Since 2002, the mean incidence rate was 1 case per 100,000. A significant increase has been observed for 2010 (13.9 cases per 100,000 in 2010 versus 1.8 in 2009). The 28 cases reported in 2010 involved five clusters and three isolated cases. The mean age of affected subjects was 27 years. Only 30% of cases had been vaccinated. The epidemic resurgence of measles observed in 2010 in the French armed forces follows the same pattern as that observed nationally and at European level, and can be seen as the likely consequence of inadequate vaccination cover.
Ramsay, M E
In 1964, the Medical Research Council undertook a trial of measles vaccine in over 36,000 United Kingdom children; 9577 of whom received live vaccine, 10,625 received inactivated followed by live vaccines, and 16,328 acted as unvaccinated controls. Participants in this study have been followed to determine the long term protection from measles vaccine and follow-up data were available on 4194, 4638 and 274 respectively. During the 5-year period 1986-90, the protective efficacy of live measles vaccine has remained high at 87%, but the 95% confidence interval was wide (-43 to 99%) due to the small numbers of cases. Between 1976 and 1990, however, the overall efficacy of the live vaccine was 92% (95% confidence interval 86 to 95%) and there was no evidence of a decline in efficacy (P = 0.13) over the 15-year period. This study suggests that the protection from live measles vaccine persists for up to 27 years after vaccination, and that no change in the current United Kingdom measles immunization policy should be made on the grounds of waning immunity.
Lee, Monica I.; Lee, Annie W.C.; Sumsion, Sean M.; Gorchynski, Julie A.
This case describes an emergency department (ED) presentation of ocular syphilis in a human immunodeficiency virus (HIV) infected patient. This is an unusual presentation of syphilis and one that emergency physicians should be aware of. The prevalence of syphilis has reached epidemic proportions since 2001 with occurrences primarily among men who have sex with men (MSM). This is a case of a 24-year-old male who presented to our ED with bilateral painless vision loss. The patient’s history and ED workup were notable for MSM, positive rapid plasmin reagin (RPR) and HIV tests and fundus exam consistent with ocular syphilis, specifically uveitis. Ocular manifestations of syphilis can present at any stage of syphilis. The 2010 Centers for Disease Control and Prevention guidelines now recommend that ocular syphilis be treated as neurosyphilis regardless of the lumbar puncture results. There is a paucity of emergency medicine literature on ocular syphilis. For emergency physicians it is important to be aware of iritis, uveitis, or chorioretinitis as ocular manifestations of neurosyphilis especially in this high-risk population and to obtain RPR and HIV tests in the ED to facilitate early diagnosis, and treatment and to prevent irreversible vision loss. PMID:27429702
Monica I. Lee
Full Text Available This case describes an emergency department (ED presentation of ocular syphilis in a human immunodeficiency virus (HIV infected patient. This is an unusual presentation of syphilis and one that emergency physicians should be aware of. The prevalence of syphilis has reached epidemic proportions since 2001 with occurrences primarily among men who have sex with men (MSM. This is a case of a 24-year-old male who presented to our ED with bilateral painless vision loss. The patient’s history and ED workup were notable for MSM, positive rapid plasmin reagin (RPR and HIV tests and fundus exam consistent with ocular syphilis, specifically uveitis. Ocular manifestations of syphilis can present at any stage of syphilis. The 2010 Centers for Disease Control and Prevention guidelines now recommend that ocular syphilis be treated as neurosyphilis regardless of the lumbar puncture results. There is a paucity of emergency medicine literature on ocular syphilis. For emergency physicians it is important to be aware of iritis, uveitis, or chorioretinitis as ocular manifestations of neurosyphilis especially in this high-risk population and to obtain RPR and HIV tests in the ED to facilitate early diagnosis, and treatment and to prevent irreversible vision loss.[West J Emerg Med. 2016;17(4:473-476.
Chris Richard Kenyon
Conclusions: AIDS mortality may have played an important role in the decline in syphilis in this region. Consequently, with AIDS deaths declining in Sub-Saharan Africa, vigilant surveillance of syphilis prevalence will be necessary to detect a potential re-emergence, as has occurred in high-income countries, and to render a timely public health response.
Moreno-Sánchez, Manuel; González-García, Raúl; García, Carlos Moreno; Monje, Florencio
Syphilis rarely presents with cervical lymphadenopathy. We describe a patient with a cervical mass associated with weight loss, asthenia, and night sweats. The mass was excised and histological examination suggested Piringer-Kuchinka lymphadenitis, which is usually present in cervical toxoplasmosis. To the best of our knowledge, Piringer-Kuchinka lymphadenitis has not previously been reported in cervical syphilis.
Meier, J L; Mollet, E
Acute periostitis affecting the long bones is a characteristic but uncommon manifestation of syphilis in the adult with an early acquired infection. This report describes the history of a jogger who developed acute localized periostitis of the shaft of both tibiae during the early stage of acquired syphilis. Symptomatology was initially attributed to the medial tibial stress syndrome.
Full Text Available Abstract Sexually transmitted infections (STI cases in province of Papua in 2013 were 1,213 cases, then in 2014 the number of visits to STI services were 19 945 cases with the number of STI patients of 10,995 cases and the number of syphilis patients was 2,150 cases, while cases of syphilis in adolescent at the health center Wamena City District Jayawijaya in 2015 were 91 cases. The method used in this research is quantitative correlation type with cross sectional study. The population in this study was all teenagers who visited the health center Jayawijaya Wamena town, with 578 teenagers. The sampling technique used was purposive sampling, obtained a sample of 236 respondents. The data collection is done by distributing questionnaires to the respondents. Analysis of the data in this study is analysis of univariate and bivariate. The results showed a correlation between free association with syphilis in adolescence (p-value = 0.000, there is a relationship between the use of condoms with syphilis in adolescence (p-value = 0.000, there is no relationship between early sex education with disease syphilis in adolescence (p-value = 0.151, there is no relationship between the supervision of parents with syphilis in adolescence (p-value = 0.265, there is a relationship between personal hygiene with syphilis in adolescence (p-value = 0.001 , there is no relationship between the mass media with syphilis in adolescence (p-value = 0.569.
Full Text Available Background: Brucellosis (Malta fever is a major contagious zoonotic disease, with economic and public health importance. Methods To assess the effect of meteorological (temperature, rainfall, humidity, and wind and climate parameters on incidence of brucellosis, brucellosis distribution and meteorological zoning maps of Zanjan Province were prepared using Inverse Distance Weighting (IDW and Kriging technique in Arc GIS medium. Zoning maps of mean temperature, rainfall, humidity, and wind were compared to brucellosis distribution maps. Results: Correlation test showed no relationship between the mean number of patients with brucellosis and any of the four meteorological parameters. Conclusion: It seems that in Zanjan province there is no correlation between brucellosis and meteorological parameters.
Wang, Hua-Cheng; Chen, Cha; Wang, Li-Na; Long, Yi-Fei; Zhang, Wei-Zheng; Li, You-Qiang; Xiao, Qian; Yuan, Hui
The rapid increase of syphilis underscores a tremendous need to carefully evaluate many new serological tests for syphilis and choose efficient and economical strategies for syphilis screening, especially in the case of primary infection with low antibody titer. Between 2011 and 2012, 73 patients' sera samples were included in this retrospective study. They were either TRUST or TPPA reactive, either LA (latex agglutination) based auto3 TP or CLIA (chemiluminescence assay) based Architect Syphilis TP assay reactive. The contradictory weak response samples were further examined by FTA-Abs method. TPPA could not give reactive results in samples with antibody concentration less than 10 mIU. Auto3 TP reagent shows good linearity at low antibody titers and was more sensitive than TPPA, while the former does not show significant superiority compared to the Architect Syphilis TP assay at low antibody titer, except that it is suitable for adaptation on diverse automated chemistry analyzers.
Izadi, S; Mokhtari-Azad, T; Zahraei, S M
Discrepancies often exist between recorded immunization coverage and the real immunity level in a community. To estimate the vaccination coverage against measles in south-east Islamic Republic of Iran, a crosssectional study was conducted in 3 districts during summer 2011. Using probability proportional to size cluster sampling, 1368 children aged 30-54 months were selected. Serum samples of 663 who had received 2 injections of mumpsmeasles- rubella (MMR) vaccine were checked for anti-measles IgG. Vaccination coverage for the second dose of MMR vaccine was 93.7%. The prevalence of anti-measles IgG in those who had received at least 2 MMR vaccine doses was 94.6%. There was a statistically significant association between the serological results and variables that reflected poor accessibility to health services. Combining serological results with coverage data, the proportion of the community protected against measles was estimated as 88.6%, which was below the limits defined for the measles elimination goals.
Kennedy, Richard B; Ovsyannikova, Inna G; Haralambieva, Iana H; O'Byrne, Megan M; Jacobson, Robert M; Pankratz, V Shane; Poland, Gregory A
Measles infection and vaccine response are complex biological processes that involve both viral and host genetic factors. We have previously investigated the influence of genetic polymorphisms on vaccine immune response, including measles vaccines, and have shown that polymorphisms in HLA, cytokine, cytokine receptor, and innate immune response genes are associated with variation in vaccine response but do not account for all of the inter-individual variance seen in vaccinated populations. In the current study we report the findings of a multigenic analysis of measles vaccine immunity, indicating a role for the measles virus receptor CD46, innate pattern-recognition receptors (DDX58, TLR2, 4, 5, 7 and 8) and intracellular signaling intermediates (MAP3K7, NFKBIA), and key antiviral molecules (VISA, OAS2, MX1, PKR) as well as cytokines (IFNA1, IL4, IL6, IL8, IL12B) and cytokine receptor genes (IL2RB, IL6R, IL8RA) in the genetic control of both humoral and cellular immune responses. This multivariate approach provided additional insights into the genetic control of measles vaccine responses over and above the information gained by our previous univariate SNP association analyses.
Ducrotoy, M; Bertu, W J; Matope, G; Cadmus, S; Conde-Álvarez, R; Gusi, A M; Welburn, S; Ocholi, R; Blasco, J M; Moriyón, I
Brucellosis is a highly contagious zoonosis caused by bacteria of the genus Brucella and affecting domestic and wild mammals. In this paper, the bacteriological and serological evidence of brucellosis in Sub-Saharan Africa (SSA) and its epidemiological characteristics are discussed. The tools available for the diagnosis and treatment of human brucellosis and for the diagnosis and control of animal brucellosis and their applicability in the context of SSA are presented and gaps identified. These gaps concern mostly the need for simpler and more affordable antimicrobial treatments against human brucellosis, the development of a B. melitensis vaccine that could circumvent the drawbacks of the currently available Rev 1 vaccine, and the investigation of serological diagnostic tests for camel brucellosis and wildlife. Strategies for the implementation of animal vaccination are also discussed.
García, Patricia J.; Cárcamo, César P.; Chiappe, Marina; Valderrama, Maria; La Rosa, Sayda; Holmes, King K.; Mabey, David C. W.; Peeling, Rosanna W.
Objectives Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT) offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening. Methods The study was implemented from September 2009–November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability. Results Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the “two for one strategy”, offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%. Conclusions Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1) engaging the authorities; (2) dissipating tensions between providers and identifying champions; (3) training according to the needs; (4) providing monitoring, supervision, support and recognition; (5) sharing results and discussing actions together; (6) consulting and obtaining feedback from users; and (7) integrating with other services such as with rapid HIV
Patricia J García
Full Text Available Untreated maternal syphilis leads to adverse pregnancy outcomes. The use of point of care tests (POCT offers an opportunity to improve screening coverage for syphilis and other aspects of health systems. Our objective is to present the experience of the introduction of POCT for syphilis in Peru and describe how new technology can catalyze health system strengthening.The study was implemented from September 2009-November 2010 to assess the feasibility of the use of a POCT for syphilis for screening pregnant women in Lima, Peru. Outcomes measured included access to syphilis screening, treatment coverage, partner treatment, effect on patient flow and service efficiency, acceptability among providers and patients, and sustainability.Before the introduction of POCT, a pregnant woman needed 6 visits to the health center in 27 days before she received her syphilis result. We trained 604 health providers and implemented the POCT for syphilis as the "two for one strategy", offering with one finger stick both syphilis and HIV testing. Implementation of the POCT resulted in testing and treatment on the first visit. Screening and treatment coverages for syphilis improved significantly compared with the previous year. Implementation of POCT has been scaled up nationally since the study ended, and coverages for screening, treatment and partner treatment have remained over 92%.Implementation of POCT for syphilis proved feasible and acceptable, and led to improvement in several aspects of health services. For the process to be effective we highlight the importance of: (1 engaging the authorities; (2 dissipating tensions between providers and identifying champions; (3 training according to the needs; (4 providing monitoring, supervision, support and recognition; (5 sharing results and discussing actions together; (6 consulting and obtaining feedback from users; and (7 integrating with other services such as with rapid HIV testing.
Haile, R W; Visscher, B R; Detels, R; Valdiviezo, N L; Sever, J L; Madden, D L
Recently published studies of formal linkage analyses strongly suggest that a multiple sclerosis susceptibility (MSS) gene is linked to the HLA region of the sixth chromosome. The objective of this analysis was to investigate whether or not the gene has any demonstrable relationship to the immune status with regard to measles within members of multiple-case MS families. Family members were HLA-typed, and levels of antibodies to measles were determined using the hemagglutination inhibition assay. Since a specific, HLA-defined haplotype within each family is presumably a marker for the MSS gene, family members were characterized as either carrying [(+) controls] or not carrying [(-) controls] the MSS gene by the presence of this specific haplotype. Twenty families were entered into the analyses. Results revealed that the mean titer to measles was not different between (+) and (-) controls, and that MS cases had significantly higher titers than both control groups combined.
In 2005, the World Health Organization (WHO) Regional Committee for the Western Pacific Region (WPR) resolved that WPR should aim to eliminate measles by 2012. The recommended measles elimination strategies in WPR include 1) achieving and maintaining high (≥95%) coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services and by implementing supplementary immunization activities (SIAs), when required; 2) conducting high-quality, case-based measles surveillance; 3) ensuring high-quality laboratory surveillance, with timely and accurate testing of specimens to confirm or discard suspected cases and detect measles virus for genotyping and molecular analysis; and 4) establishing and maintaining measles outbreak preparedness for rapid response and ensuring appropriate case management. This report updates the previous report and describes progress toward eliminating measles in WPR during 2009-2012. During this period, measles incidence reached a historic low, decreasing by 83%, from 34.0 to 5.9 cases per million population. However, to achieve measles elimination in WPR, additional efforts are needed to strengthen routine immunization services in countries and areas with measles-susceptible populations in countries and areas that have ongoing measles virus transmission.
Leuridan, E; Sabbe, M; Van Damme, P
As women vaccinated against measles transfer low amounts of antibodies, an increasing number of infants lack early protection through maternal antibodies until being immunised themselves. This paper reviews the literature on disease burden of measles in the population too young to be immunized according to the respective national recommendations during recent outbreaks in EU and EEA/EFTA countries. In addition, specific control strategies adopted to protect this young population are reviewed. Pubmed, Unbound Medline, Web of Knowledge and the Eurosurveillance database were searched using MESH terms: measles and epidemiology, measles and infants, prevalence of measles, measles and outbreaks and measles and epidemic. Additionally, data from Euvac.net and ECDC were consulted. Databases were searched from January 2001 to September 2011. Fifty-three papers were included in the analysis. The percentage of all measles cases during outbreaks affecting young infants ranged from 0.25% to 83.0%. Specific control strategies were adopted: e.g. administration of the first or second vaccine dose earlier than recommended. Infants younger than 12 months are often involved in measles outbreaks, and advancing the first vaccine dose could reduce the burden of disease. However, immunization before 9 months of age is not systematically recommended because of dysmature humoral immune responses of infants. High coverage and timely administration of the recommended series of vaccines are the most important measures to decrease measles incidence and measles circulation and protect vulnerable infants from infection.
Kamadjeu, Raoul; Assegid, Kebede; Naouri, Boubker; Mirza, Imran Raza; Hirsi, Abdurazak; Mohammed, Abdurahman; Omer, Mohammed; Dualle, Abdi Hassan; Mulugeta, Abraham
Despite enormous challenges, Somalia has been successfully implementing accelerated measles control activities since 2005. Through innovative strategies and with the support of local and international partners, the country has shown potentials of implementing measles mortality reduction activities in complex emergencies. Measles incidence has been reduced by >80% after the measles catch-up campaigns of 2005-2007, and national reported measles routine immunization coverage with first dose measles containing vaccine has reached 59% for the first time in 2009. However, the near collapse of the health care system and the ongoing insecurity continue to hamper the implementation of recommended measles control and elimination strategies in some parts of the country, making these achievements fragile. Somalia exemplifies the challenges in meeting measles elimination goals in the World Health Organization Eastern Mediterranean region. As the region is entering its 2010 measles elimination goals, it appears necessary to establish realistic and flexible interim goals for measles control in Somalia that will take into consideration the specificities of the country. Maintaining flexibility in conducting field operations, securing financial resources, multiplying opportunities for measles vaccination, and improving disease monitoring systems will remain vital to sustain and improve current achievements.
Full Text Available Splenic infarction is an extremely rare and unique presentation of brucellosis. Only few cases have been reported worldwide. We here report a case of a young man, presenting with acute onset of fever, left hypochondial pain, and vomiting. Further evaluation revealed multiple splenic infarcts and positive blood culture for brucellosis despite negative transesophageal echocardiography for endocarditis. Significant improvement in clinical symptoms and splenic lesions was achieved after six weeks of combination therapy against brucellosis.
OF.TUBERCULOSIS AND BRUCELLOSIS ■ - East Germany - ’ ; \\ ’ ■ ’-] [Following is the translation of an article by G. Seidel in Das Deutsche...of our contribution to preventive medicine lies in the field of meat hygiene. Since today tuberculosis and brucellosis are prominent diseases in...the case we shall propose changes. The prevailing ,;■•’ measures for the control of brucellosis and tuberculosis in animals, and the changes
Mukhtar Salihu Anka; Latiffah Hassan; Siti Khairani-Bejo; Mohamed Abidin Zainal; Ramlan Bin Mohamad; Annas Salleh; Azri Adzhar
Bovine brucellosis was first reported in Peninsular Malaysia in 1950. A subsequent survey conducted in the country revealed that the disease was widespread. Current knowledge on the potential risk factors for brucellosis occurrence on cattle farms in Malaysia is lacking. Therefore, we conducted a case-control study to identify the potential herd-level risk factors for bovine brucellosis occurrence in four states in the country, namely Kelantan, Pahang, Selangor and Negeri Sembilan. Thirty-fiv...
Kanık-Yüksek, Saliha; Gülhan, Belgin; Ozkaya-Parlakay, Aslınur; Tezer, Hasan
Brucellosis is a common zoonotic infection worldwide caused by Brucella species. Central nervous system involvement is a serious complication of brucellosis, and the clinical presentation is quite heterogeneous. The genitourinary system may be affected. Epididymo-orchitis is the most common type of urinary tract involvement, which can cause serious complications. Herein, we present a case of brucellosis in a child with a rare combination of epididymo-orchitis and neurobrucellosis not encountered previously in the literature.
Serdar Olt; Hasan Ergenç; Seyyid Bilal Açıkgöz
Here we wanted to investigate predictive value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in the diagnosis of brucellosis. Thirty-two brucellosis patients diagnosed with positive serum agglutination test and thirty-two randomized healthy subjects were enrolled in this study retrospectively. Result with ROC analyzes the baseline NLR and hemoglobin values were found to be significantly associated with brucellosis (P=0.01, P=0.01, resp.). Herein we demonstrated for ...
Olt, Serdar; Ergenç, Hasan; Açıkgöz, Seyyid Bilal
Here we wanted to investigate predictive value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in the diagnosis of brucellosis. Thirty-two brucellosis patients diagnosed with positive serum agglutination test and thirty-two randomized healthy subjects were enrolled in this study retrospectively. Result with ROC analyzes the baseline NLR and hemoglobin values were found to be significantly associated with brucellosis (P = 0.01, P = 0.01, resp.). Herein we demonstrated ...
Ellular immunity was studied in patients with acute, subacute, primary and secondary chronic forms of brucellosis was studied before and after therapy including domestic preparation “Immunе-5” and in healthy persons (as a control group). Effect was not observed in the treatment of acute and subacute brucellosis, but positive immunologic and clinical dynamics was observed in patients with chronic forms of brucellosis.
Mina, Michael J; Metcalf, C Jessica E; de Swart, Rik L; Osterhaus, A D M E; Grenfell, Bryan T
Immunosuppression after measles is known to predispose people to opportunistic infections for a period of several weeks to months. Using population-level data, we show that measles has a more prolonged effect on host resistance, extending over 2 to 3 years. We find that nonmeasles infectious disease mortality in high-income countries is tightly coupled to measles incidence at this lag, in both the pre- and post-vaccine eras. We conclude that long-term immunologic sequelae of measles drive interannual fluctuations in nonmeasles deaths. This is consistent with recent experimental work that attributes the immunosuppressive effects of measles to depletion of B and T lymphocytes. Our data provide an explanation for the long-term benefits of measles vaccination in preventing all-cause infectious disease. By preventing measles-associated immune memory loss, vaccination protects polymicrobial herd immunity.
Aaby, Peter; Jensen, T G; Hansen, H L
In a randomised study of 558 children in an urban African community, the protective effect of the Edmonston-Zagreb (EZ) measles vaccine given in a dose of 40,000 plaque forming units from the age of 4 months was compared with the effects of a standard dose (6000 tissue culture infectious units......) of Schwarz measles vaccine given from the age of 9 months. During two years of follow-up, all 14 clinical cases of measles occurred in the Schwarz group; 10 of the children contracted measles before vaccination and 4 after measles vaccination. Thus the EZ vaccine provided significant protection against...... measles both before and after the usual age of vaccination. Among the children who were exposed to measles at home, those given EZ vaccine were better protected than either unvaccinated children or those given the Schwarz vaccine....
Go, H; Hashimoto, K; Imamura, T; Sato, M; Kawasaki, Y; Momoi, N; Hosoya, M
The incidence of measles epidemics has decreased recently owing to the development and widespread use of measles vaccine in the United States of America and Europe. However, repeated measles epidemics have been reported in Japan. Here, the authors report a case of an extremely low body weight infant (ELBWI) whose mother had a measles virus infection. Real-time PCR was performed on the infant's blood and urine samples and skin, nasal secretion, and anal swabs, as well as on the mother's breast milk, blood samples and throat swabs. The infant was found to be positive for measles virus by PCR, but not immunoglobulin M positive. An earlier report showed that there were no such cases in which the patient was found to be positive for measles virus by real-time PCR but was not infected by the measles virus.
Vânia de Carvalho
Full Text Available Patients with AIDS have a high incidence of skin problems due to the immunosuppression and malnourishment that are inherent to the progression of this disease. Clinical manifestation of these skin lesions and their severity are different in AIDS patients. We made a prospective study of five cases of measles in children with HIV infection during a community outbreak, and there were typical as well as atypical forms of the disease, including one case with negative serology. There were pulmonary complications, but none of the patients died. The anti-retroviral treatment may have contributed to the decrease in measles morbidity in these pediatric AIDS patients.
Delpiano, Luis; Astroza, Leonor; Toro, Jorge
Measles, one of most important inmuno-preventable diseases, remains as a worldwide concern issue with an important morbidity and mortality. Particularly in the America region declared free of measles in 2010 by WHO, they still appear imported cases that origin outbreaks of variable magnitude in susceptible subjects usually none vaccinated which is the current situation in Santiago, the capital city of Chile. In this review we present characteristics of the etiological agent, the disease, epidemiological aspects with national historical focus, impact of immunization programs and outbreaks in Chile, in order to contribute to knowledge and management of this always present public health problem.
The measles incidence record for Copenhagen 1880-1966 shows that the date of admission of new pupils has major impact on the structure of the epidemics, suggesting that measles transmission should be modelled in a way that accounts for the pulsed influx of new pupils. Assuming that the school year...... is long enough to allow for the epidemic to reach its final size, I derive an age-structured model reflecting the school sytructure and discuss its properties. If disease transmission is independent of age there exists a stable equilibrium in the sense that the epidemics of the same size will arise...
Full Text Available This study was conducted in 1985-86 amongst non-hospitalized children of jaipur city in33 investigative units having 3791 families with 6183 children in the 0-9 years age group. Measles vaccine coverage was only 21.7% Measles developed in 189 cases. Maximum incidence occurred in the 1-2 years olds and during the first half of the years (January to June. Complication developed in 50 (26.5% children. The most frequent was diarrohea (14.3% followed by respiratory infection (6.9%. No case fatality was reported.
Choe, Young June; Eom, Hye Suk; Bae, Geun-Ryang
As the incidence of measles decreases, cases reported as suspected measles will increasingly involve rash associated with measles vaccination itself. In this study, we assessed vaccine-associated measles cases reported in Korea between 2002 and 2012 using a standardized assessment and following by the World Health Organization case definition criteria. We retrospectively analyzed data regarding (i) wild-type measles and (ii) vaccine-associated measles in patients aged 12-23 months. The presence or absence of fever, rash, cough, coryza, conjunctivitis, and Koplik spots were reviewed. Males were more likely to be reported with vaccine-associated measles than with wild-type measles (68% vs. 47%, P measles peaked between April and July, whereas that of patients with vaccine-associated measles remained relatively constant throughout the year. However, after excluding the cases reported during the 2007 outbreak in Korea, the trend was similar between the two groups. Cough, coryza, and conjunctivitis were more likely to be present in patients with wild-type measles (32-61% vs. 10-43%, P vaccine-associated measles. We therefore conclude that cough, coryza, and conjunctivitis may be useful as key positive findings to distinguish between wild-type measles and vaccine-associated measles infection among 12-23-month-old patients in a country with a low incidence of measles.
Lou, Pengwei; Wang, Lei; Zhang, Xueliang; Xu, Jiabo; Wang, Kai
Brucellosis is one of the severe public health problems; the cumulative number of new human brucellosis cases reached 211515 from 2010 to 2014 in China. Bayingolin Mongol Autonomous Prefecture is situated in the southeast of Xinjiang, where brucellosis infection occurs every year. Based on the reported data of newly acute human brucellosis cases for each season in Bayingolin Mongol Autonomous Prefecture, we proposed a susceptible, exposed, infected, and vaccinated (SEIV) model with periodic transmission rates to investigate the seasonal brucellosis transmission dynamics among sheep/cattle and from sheep/cattle to humans. Compared with the criteria of MAPE and RMSPE, the model simulations agree to the data on newly acute human brucellosis. We predict that the number of newly acute human brucellosis is increasing and will peak 15325 [95% CI: 11920-18242] around the summer of 2023. We also estimate the basic reproduction number R0 = 2.5524 [95% CI: 2.5129-2.6225] and perform some sensitivity analysis of the newly acute human brucellosis cases and the basic reproduction number R0 in terms of model parameters. Our study demonstrates that reducing the birth number of sheep/cattle, raising the slaughter rate of infected sheep/cattle, increasing the vaccination rate of susceptible sheep/cattle, and decreasing the loss rate of vaccination are effective strategies to control brucellosis epidemic.
Li, Mingtao; Sun, Guiquan; Zhang, Juan; Jin, Zhen; Sun, Xiangdong; Wang, Youming; Huang, Baoxu; Zheng, Yaohui
Brucellosis is one of the major infectious and contagious bacterial diseases in Hinggan League of Inner Mongolia, China. The number of newly infected human brucellosis data in this area has increased dramatically in the last 10 years. In this study, in order to explore effective control and prevention measures we propose a deterministic model to investigate the transmission dynamics of brucellosis in Hinggan League. The model describes the spread of brucellosis among sheep and from sheep to humans. The model simulations agree with newly infected human brucellosis data from 2001 to 2011, and the trend of newly infected human brucellosis cases is given. We estimate that the control reproduction number Rc is about 1.9789 for the brucellosis transmission in Hinggan League and compare the effect of existing mixed cross infection between basic ewes and other sheep or not for newly infected human brucellosis cases. Our study demonstrates that combination of prohibiting mixed feeding between basic ewes and other sheep, vaccination, detection and elimination are useful strategies in controlling human brucellosis in Hinggan League.
Zhan, B D; Wang, S Q; Lai, S M; Lu, Y; Shi, X G; Cao, G P; Hu, X L; Zheng, C J; Yu, Z Y; Zhang, J M; Fang, C F; Gong, Z Y
Brucellosis is an occupational disease affecting workers in butcher shops, the milking and dairy product industry, causing more than 500 000 new cases around the world. As a national statutory B infectious disease in China, morbidity of brucellosis is rapidly increasing in recent years. We report an occupational outbreak of brucellosis infection in a pharmaceutical factory. Exposure was a result of manual operation in the process line, close contact with sheep placentas, insufficient disinfection and repeated using of protective suits and infected by aerosol dissemination. Improved preventive methods, appropriate public health measures and spread of health education would be helpful to prevent the occupational outbreak of brucellosis in future.
Bala, Keziban Asli; Doğan, Murat; Kaba, Sultan; Akbayram, Sinan; Aslan, Oktay; Kocaman, Selami; Bayhan, Gülsüm İclal; Üstyol, Lokman; Demir, Nihat
Background Our study aimed to demonstrate the frequency of the syndrome of inappropriate ADH secretion (SIADH) and associated factors during the course of brucellosis in children and adolescents. Material/Methods The study included children and adolescents aged 0–18 years old diagnosed with brucellosis between 2012 and 2014. The data were collected from patient charts. The diagnosis of brucellosis was made based on titrations >1:160 in standard Wright tube agglutination tests and/or positive culture tests. SIADH diagnosis was made based on the following criteria: euvolemic hyponatremia, serum Na+ 25 mmol/L with normal dietary salt intake), low uric acid (brucellosis. PMID:27590789
Lou, Pengwei; Wang, Lei; Zhang, Xueliang; Xu, Jiabo
Brucellosis is one of the severe public health problems; the cumulative number of new human brucellosis cases reached 211515 from 2010 to 2014 in China. Bayingolin Mongol Autonomous Prefecture is situated in the southeast of Xinjiang, where brucellosis infection occurs every year. Based on the reported data of newly acute human brucellosis cases for each season in Bayingolin Mongol Autonomous Prefecture, we proposed a susceptible, exposed, infected, and vaccinated (SEIV) model with periodic transmission rates to investigate the seasonal brucellosis transmission dynamics among sheep/cattle and from sheep/cattle to humans. Compared with the criteria of MAPE and RMSPE, the model simulations agree to the data on newly acute human brucellosis. We predict that the number of newly acute human brucellosis is increasing and will peak 15325 [95% CI: 11920–18242] around the summer of 2023. We also estimate the basic reproduction number R0 = 2.5524 [95% CI: 2.5129–2.6225] and perform some sensitivity analysis of the newly acute human brucellosis cases and the basic reproduction number R0 in terms of model parameters. Our study demonstrates that reducing the birth number of sheep/cattle, raising the slaughter rate of infected sheep/cattle, increasing the vaccination rate of susceptible sheep/cattle, and decreasing the loss rate of vaccination are effective strategies to control brucellosis epidemic. PMID:27872852
Selmin Dirgen Çaylak
Full Text Available Brucellosis is a systemic disease in which all kind of tissues and organs can be affected. Brucellosis may present with different symptoms and symptoms are non-specific. A broad spectrum of clinical manifestations can be seen, therefore diagnosis can be difficult. Cutaneous complications and febrile neutropenia have been rarely reported. Here, a rare brucellosis case was reported that he applied with fever, skin eruption and neutropenia. We emphasized that especially in endemic areas brucellosis should always be kept on mind in the differential diagnosis of patient with skin eruption and febril neutropenia.J Microbiol Infect Dis 2014;4(1: 39-41
Morgan Oliver WC
Full Text Available Abstract Background Although an effective measles vaccine has been available for almost 40 years, in 2000 there were about 30 million measles infections worldwide and 777,000 measles-related deaths. The history of smallpox suggests that achieving measles eradication depends on several factors; the biological characteristics of the organism; vaccine technology; surveillance and laboratory identification; effective delivery of vaccination programmes and international commitment to eradication. Discussion Like smallpox, measles virus has several biological characteristics that favour eradication. Humans are the only reservoir for the virus, which causes a visible illness and infection leading to life-long immunity. As the measles virus has only one genetic serotype which is relatively stable over time, the same basic vaccine can be used world-wide. Vaccination provides protection against measles infection for at least 15 years, although efficacy may be reduced due to host factors such as nutritional status. Measles vaccination may also confer other non-specific health benefits leading to reduced mortality. Accurate laboratory identification of measles cases enables enhanced surveillance to support elimination programmes. The "catch-up, keep-up, follow-up" vaccination programme implemented in the Americas has shown that measles elimination is possible using existing technologies. On 17th October 2003 the "Cape Town Measles Declaration" by the World Health Organisation and the United Nations Childrens Fund called on governments to intensify efforts to reduce measles mortality by supporting universal vaccination coverage and the development of more effective vaccination. Summary Although more difficult than for smallpox, recent experience in the Americas suggests that measles eradication is technically feasible. Growing international support to deliver these programmes means that measles, like smallpox, may very well become a curiosity of history.
Kofoed, Kristian; Gerstoft, Jan; Mathiesen, Lars Reinhardt;
OBJECTIVES: To assess the effect of human immunodeficiency virus (HIV)-1 and syphilis coinfection on HIV-ribonucleic acid (RNA) viral load, CD4 cell count, and the response in rapid plasmin reagin (RPR) to treatment of the syphilis infection. STUDY DESIGN: Cases of syphilis diagnosed during 1 yea...... treated with doxycycline were the same. CONCLUSION: Syphilis was associated with a decrease in CD4 cell counts and an increase in HIV-RNA levels that both improved after treatment of syphilis....
Full Text Available The dissemination of cattle brucellosis in Zhejiang province of China can be attributed to the transport of cattle between cities within the province． In this paper，an n-patch dynamical model is proposed to study the effect of cattle dispersal on brucellosis spread． Theoretically，we analyze the dynamical behavior of the muti-patch model． For the 2-patch submodel，sensitivity analyses of the basic reproduction number Ｒ0 and the number of the infectious cattle in term of model parameters are carried out． By numerical analysis，it is obtained that the dispersal of susceptible cattle between patches and the centralization of infected cattle to the large scale patch can alleviate the epidemic and are in favor of the control of disease in the whole region．
Full Text Available Brucellosis has remained a great problem of health in most of countries, which have failed in control of zoonosis infections. This disease is caused by species of Brucella and usually is transferred from animals to humans. The purpose of this study was to investigate the seroprevalence of brucellosis among animal farmers of Yazd province. In this descriptive study, 933 animal farmers were investigated by serological tests and blood culture method. Then the data were analyzed by SPPS statistical program. The results showed that the frequency distribution of seropositive cases by MAT and STAT were 35 (3.2%; 25 (2.7% males and 10 (1.1% females. The highest and lowest incidences of seropositive cases were among age group of 21-30 (1% and more than 60 (0.3% years old, respectively. Of the 35 seropositive cases, 2MET positive were 5 (0.5%, while all blood cultures were negative.
Kakchapati, Sampurna; Singh, Dipendra Raman; Rawal, Bir Bahadhur; Lim, Apiradee
Purpose Female sex workers (FSWs) are a key-affected population susceptible to acquiring HIV and sexually transmitted infections (STIs), as well as transmitting the virus to others. The aim of the study was to assess HIV and syphilis prevalence among FSWs in Nepal and to examine factors associated with it. Materials and methods The study was based on Integrated Biological and Behavioral Surveillance (IBBS) surveys among FSWs in Nepal from 2004 to 2015. Statistical analysis used chi-squared test to assess statistically significant risk factors for HIV and syphilis. Logistic regression models were used to identify the most important determinants for each outcome. Results A total of 5,958 FSWs were tested, and among them, 100 (1.7%) were HIV positive and 230 (3.9%) were syphilis positive. The multivariate analysis revealed that syphilis was higher among those street-based, aged ≥35 years, illiterate, and with a duration of sex work of >3 years. HIV was higher among those aged ≥35 years, illiterate, street-based, and with a duration of sex work >3 years. Syphilis was strongly correlated with HIV. Conclusion HIV epidemic among FSWs in Nepal appears in the stagnant trend, whereas STI epidemic has increased in recent years. The high influencing factors for HIV and syphilis prevalence were advanced age, street-based, lower education, and longer duration of sex work. Urgent efforts, as part of routine HIV/STI prevention and intervention, are required to reduce the high burden of syphilis among FSWs.
Cengiz Demir; Mustafa Kasim Karahocagil; Ramazan Esen; Murat Atmaca; Hayriye G(o)nüllü; Hayrettin Akdeniz
Background Brucellosis can mimic various multisytem diseases,showing wide clinical polymorphism that frequently leads to misdiagnosis and treatment delay,further increasing the complication rates.In this study,we aimed to examine bone marrow biopsy findings in brucellosis cases presenting with hematologic abnormalities.Methods Forty-eight brucellosis cases were prospectively investigated.Complaints and physical examination findings of patients were recorded.Patients' complete blood count,routine biochemical tests,erythrocyte sedimentation rate,C-reactive protein and serological screenings were performed.Bone marrow biopsy and aspiration was performed in patients with cytopenia,for bone marrow examination and brucella culture,in accordance with the standard procedures from spina iliaca posterior superior region of pelvic bone.Results Of the 48 patients,35 (73％) were female and 13 (27％) were male.Mean age was (34.8±15.4) years (age range:15-70 years).Anemia,leukopenia,thrombocytopenia and pancytopenia were found in 39 (81％),28 (58％),22 (46％) and 10 patients (21％),respectively.In the examination of bone marrow,hypercellularity was found In 35 (73％) patients.Increased megacariocytic,erythroid and granulocytic series were found in 28 (58％),15 (31％) and 5 (10％) patients,respectively.In addition,hemophagocytosis was observed in 15 (31％) patients,granuloma observed in 12 (25％) and increased eosinophil and plasma cells observed in 9 (19％) patients.Conclusion According to the results of our series,hemophagocytosis,microgranuloma formation and hypersplenism may be responsible for hematologic complications of brucellosis.
Introduction Human brucellosis has been attributed to B. abortus, B. melitensis, B. suis, and B. canis and more recently to strains resembling Brucella isolated from marine mammals. Brucella has been isolated from human tissue samples, blood, urine, cerebrospinal fluid which are suitable for analysis by PCR. Brucella species are highly monomorphic with minimal genetic variation among species. Brucella genome consists of two circular hromosomes, has been completely sequenced for B. ...
Nicholas X Tan
Full Text Available BACKGROUND: Syphilis is a major public health problem in many regions of China, with increases in congenital syphilis (CS cases causing concern. The Chinese Ministry of Health recently announced a comprehensive 10-y national syphilis control plan focusing on averting CS. The decision analytic model presented here quantifies the impact of the planned strategies to determine whether they are likely to meet the goals laid out in the control plan. METHODS AND FINDINGS: Our model incorporated data on age-stratified fertility, female adult syphilis cases, and empirical syphilis transmission rates to estimate the number of CS cases associated with prenatal syphilis infection on a yearly basis. Guangdong Province was the focus of this analysis because of the availability of high-quality demographic and public health data. Each model outcome was simulated 1,000 times to incorporate uncertainty in model inputs. The model was validated using data from a CS intervention program among 477,656 women in China. Sensitivity analyses were performed to identify which variables are likely to be most influential in achieving Chinese and international policy goals. Increasing prenatal screening coverage was the single most effective strategy for reducing CS cases. An incremental increase in prenatal screening from the base case of 57% coverage to 95% coverage was associated with 106 (95% CI: 101, 111 CS cases averted per 100,000 live births (58% decrease. The policy strategies laid out in the national plan led to an outcome that fell short of the target, while a four-pronged comprehensive syphilis control strategy consisting of increased prenatal screening coverage, increased treatment completion, earlier prenatal screening, and improved syphilis test characteristics was associated with 157 (95% CI: 154, 160 CS cases averted per 100,000 live births (85% decrease. CONCLUSIONS: The Chinese national plan provides a strong foundation for syphilis control, but more
Zhang, Shao-Hui; Liu, Shu-Jun; Hu, Ling-Ling; Li, Jie-Fang; Liu, Li-Hua; Wei, Ning
Bisexual men (men who have sex with men and women) are potential epidemiological bridges responsible for the spread of HIV and other sexually transmitted infections from men who have sex with men only to the heterosexual population. We aimed to estimate the prevalence of syphilis and HIV and the factors associated with syphilis infection among men who have sex with men and women and men who have sex with men only from Shijiazhuang, China. In 2011-2013, a cross-sectional cohort of 427 men who have sex with men was recruited by a snowball sampling method and tested for syphilis and HIV. Chi square and logistic regression were performed to identify syphilis risk factors. Among the 427 men who have sex with men, 71 (16.6%) cases were syphilis-positive and 16 cases (3.7%) were HIV-positive. The proportions of men who have sex with men and women and men who have sex with men only in the total sample were 31.4% and 68.6%, respectively. Men who have sex with men and women exhibited double the syphilis prevalence of men who have sex with men only and were more likely to practice insertive anal sex. Higher education level, being married, having more male partners, and both receptive and insertive anal sex roles were associated with syphilis among men who have sex with men and women. Residing in suburban areas, being married, being HIV positive, and an absence of desire to change sexual orientation were associated with syphilis among men who have sex with men only. Therefore, men who have sex with men and women represent an important sub-group in the syphilis epidemic and further interventions should be developed to reduce risk among different sub-sets of men who have sex with men.
Jacquier, N; Dos Santos, L; Deschutter, J D; Duarte, B; Rodriguez Fermepin, M; Martinelli, M; de Torres, R A
During three months (April to June 1997) 1,238 consecutive pregnant women were studied at the time of delivery at the Madariaga public Hospital. Syphilis was confirmed in 26 (2.1%) women, and 15 cases (57.7%) of congenital syphilis were demonstrated in newborns one of whom was a stillborn. Of the syphilitic women 61.5% were 20 years old (average), 65.4% were single, 19.2% had a stable partner and 15.4% were married; 70% of them had finished elementary school (seven years), but despite this discrete level of instruction and that they were benefited with free health attention, 73% of them had not started or completed the pregnancy control. None of these women acted as sexual workers or were drug users; 57.7% were unemployed and the remainder worked as domestic servants or were still going to school. Menarca started at 13 (average) and the age of the first sexual activity was 15 (average). The distribution of the cases of syphilis within the city area shows four clusters that coincide with the lower income population, but not with marginal groups. The failure to submit to medical control during pregnancy among syphilitic women is directly linked with an increased risk for congenital syphilis. The specific prevalence of syphilis in women (20 years old or less) pregnant or not, shows an alarming hidden epidemic situation. An interinstitutional and communitary program, with direct interventions within the detected population clusters, is now underway in order to control syphilis. Undesired pregnancy and syphilis seem to be associated with adolescent unsafe sex conducts. A coordinated program between Public Health Service and National Misiones University is operating, visiting home by home, in order to decrease or eliminate congenital syphilis and is considered a priority health problem. Unfortunately, if sexual conducts do not undergo changes in the near future, at least by the correct use of condoms, HIV will replace syphilis.
Nielsen, K; Gall, D; Lin, M; Massangill, C; Samartino, L; Perez, B; Coats, M; Hennager, S; Dajer, A; Nicoletti, P; Thomas, F
To evaluate the fluorescence polarization assay (FPA) for the serological diagnosis of bovine brucellosis, 118 sera from cattle which were culture positive for Brucella abortus, 1751 sera from cattle from premises containing cattle infected with B. abortus, 1222 sera from cattle vaccinated with B. abortus strain 19 and 1199 sera from cattle with no evidence of brucellosis were tested in Argentina, Chile, Mexico and in the American states of Iowa, Missouri and Texas. Initial determination of serological positivity and negativity was based upon reactivity in currently used serological tests, consisting of a rapid screening test, the rose-bengal or the buffered plate antigen tests, followed by a second serological test, the complement fixation test. Sensitivity of the FPA (sera from culture positive animals) ranged from 87.5% to 100%. Serological positivity of cattle from infected premises ranged from 65.5% to 99.0% while the % negative cattle in herds without evidence of brucellosis was between 94.9 and 100%. Of B. abortus strain 19 vaccinated cattle which were positive in at least one in-use serological tests, 88.2% were negative in the FPA. In contrast, previous Canadian studies, sensitivity values were 99.0% and 100% and the specificity in both cases was 100%. This discrepancy was probably due to the use of less well characterized sera in the current study.
Full Text Available Purpose. Acute scrotal pain as the first symptom of brucellosis is rarely observed. We aimed to evaluate the data of male patients with brucellosis and epididymoorchitis as the initial diagnosis. Material and Methods. The data of seven patients presented with testicular pain, hyperemia, swelling, and increased fever were reviewed. Concomitant focal diseases as well as clinical, laboratory, and radiological findings were retrospectively evaluated. Results. The mean age of the patients was 22.28 ± 7.78 (16–35 years. All patients presented with scrotal pain, swelling, and increased sweating. Additional findings included fever, asthenia, arthralgia, dysuria, shiver and rash, weight loss, and vomiting in 6, 5, 4, 4, 3, 2, and 1 patient, respectively. In all of 7 patients, the agglutination tests of Rose-Bengal and Wright were positive. Coombs test was positive only in 3 patients. The patients underwent antibiotic and conservative treatment. No relapse was observed following the treatment. Conclusion. In endemic regions, epididymoorchitis caused by brucellosis should be considered in the differential diagnosis of patients presenting with acute scrotal pain. Clinical and serological findings are sufficient for the diagnosis. Conservative management combined with antibiotic therapy is adequate for managing brucellar epididymoorchitis.
Full Text Available Abstract Introduction Measles is on the rise in the United Kingdom and must be considered in the differential diagnosis of any patient presenting with fever and rash. As a highly infectious disease, identified patients must be isolated in the hospital setting. Case presentation A 28-year-old Polish woman presented ill to the accident and emergency department of a district general hospital. She had painful genital ulceration, oral soreness, fever, and a facial rash. She became hypoxic within 24 hours of presentation and began to tire, thus requiring noninvasive ventilation. Her respiratory symptoms were out of proportion to the findings of her chest radiograph, which remained virtually normal. Human immunodeficiency virus seroconversion syndrome complicated by Pneumocystis carinii pneumonia was high among the differential diagnoses. She was given cotrimoxazole, high-dose steroids, broad spectrum antibiotics, and anti fungal cover. Human immunodeficiency virus polymerase chain reaction came back as negative and her symptoms resolved within 10 days of presentation. She was taken off all treatment and discharged home feeling well. Serological measles was confirmed as part of a viral screen, but its clinical suspicion was low. Conclusion The presentation of measles in this patient was unique and atypical. With its incidence rising in the United Kingdom, measles must be increasingly considered as a differential diagnosis in patients presenting with fever and rash.
A.D.M.E. Osterhaus (Albert); P. de Vries (Petra)
textabstractSeveral viruses may cause more or less severe acute respiratory infections in man, some of which are followed by systemic infection. Only for influenza and measles are licensed vaccines available at present. The protection induced by influenza vaccines, which are based on inactivated who
S. M. Kharit
Full Text Available Abstract. One hundred and seven children (45 girls and 62 boys in the age of 20 months — 14 years old (mean 9,62±0,37 suffered from acute lymphoblast leukosis and solid tumors in history have been examined in the clinic of Research Institute of children infections of FMBA. The vaccination history was studied in all children and the titers of specific antibodies to measles and mumps viruses as well as immune status were determined. 83,8% and 85,4% of studied children had no protection against measles and mumps respectively or had low titers of antibodies. Immunological examination of these children conducted within 4 months after finishing of therapy revealed absence of immunodeficiency. It gave opportunities to vaccinate or revaccinate these children against mentioned infections. Fifty three children were immunized against measles and 47 — against mumps. Application of live vaccines was safe because majority of vaccinated against measles (81,1% and mumps (82,9% children had mild vaccination process. It was established that to increase immunological efficacy of vaccination using of polyoxidony during 5 days before vaccination and 5 days after vaccination is reasonable.
Veasey, John Verrinder; Lellis, Rute Facchini; Boin, Maria Fernanda Feitosa de Camargo; Porto, Pedro Loureiro; Chen, Jessica Chia Sin
Syphilis is a sexually transmitted disease caused by Treponema pallidum and divided into three stages according to the duration of the disease: primary, secondary and tertiary. Secondary syphilis has diverse clinical presentations, such as papular-nodular lesions. This presentation is rare, with 15 cases reported in the literature over the past 20 years. We report a case of secondary syphilis with papular-nodular lesions in a healthy 63-year-old patient, who has presented treponema in immunohistochemical examination of the skin lesions. PMID:27192520
Full Text Available Purpose: HIV-infected patients treated for syphilis may be at increased risk for serological failure and serofast state. Our aim was to analyse serological response to treatment in HIV-infected patients diagnosed with syphilis, and factors associated with serological cure and serofast state. Methods: Open-label, no controlled study of a series of HIV-patients diagnosed with syphilis during 2004–2011. Patients were categorized by rapid plasma reagin titer (RPR into success (4-fold decrease in RPR by 12 or 24 months after treatment of early or late syphilis, serofast (success with persistently stable reactive RPR, and failure/re-infection (failure to decrease 4-fold in RPR by 12 or 24 months after treatment or sustained 4-fold increase in RPR after treatment response. Results: 141 HIV-patients were diagnosed with syphilis during the study period (104 early syphilis, 36 late or indeterminate latent syphilis. The mean age was 36.3 years, 98.5% were male, and 87.2% homosexual men. In 46 (32.6% cases, HIV and syphilis infection diagnosis were coincident (mean CD4 457/mm3 and HIV-VL 4.72 log10. Among patients with prior known HIV infection, 65 were on antiretroviral therapy (ART at syphilis diagnosis (mean CD4 469/mm3, 76.9% undetectable HIV-VL. 116 patients satisfied criteria for serological response analysis (89 early, 24 late/indeterminate. At 12 months of early syphilis treatment (89.2% penicillin there were 16 (18% failures, and at 24 months of late/indeterminate syphilis (91.7% penicillin there were 5 (18.5% failures. Overall, 36 (31.0% patients presented serofast state. Treatment failure was related with lower CD4 count (295 vs 510/mL; p=0.045 only in patients with coincident diagnosis. Serofast state was related with older age (41 vs 36 years; p=0.024, and lower CD4 count (391 vs 513/mm3; p=0.026. Conclusions: In this series of HIV-infected patients, with many patients on ART and with good immunological and virological parameters, serological
Saito, Kumiko; Tagawa, Masayo; Hasegawa, Atsuhiko
Since the RPR (rapid plasma regain) test was found to be useful for the diagnosis of rabbit syphilis, serological survey by this test has been carried out in Japanese companion rabbits. A hundred virgin household rabbits kept alone and without signs and history of syphilis were examined by RPR test from April 2001 to March 2002, in Tokyo, Japan. The test was positive in 35 cases and negative in 65 cases. RPR negative rabbits should be selected for breeding to prevent the spread of rabbit syphilis in companion rabbits in Japan.
Full Text Available Abstract Background A large measles outbreak occurred in Italy in 2002–2003. This study evaluates the health burden and economic impact of measles-related hospitalizations in Italy during the specified period. Methods Hospital discharge abstract data for measles hospitalizations in Italy during 2002–2003 were analysed to obtain information regarding number and rates of measles hospitalizations by geographical area and age group, length of hospital stay, and complications. Hospitalization costs were estimated on the basis of Diagnosis-Related Groups. Results A total of 5,154 hospitalizations were identified, 3,478 (67% of which occurred in children Conclusion The nationwide health burden associated with measles during the 2002–2003 outbreak was substantial and a high cost was incurred by the Italian National Health Service for the thousands of measles-related hospitalizations which occurred. By assuming that hospital costs represent 40–50% of the direct costs of measles cases, direct costs of measles for the two years combined were estimated to be between €17.6 – 22.0 million, which equates to the vaccination of 1.5–1.9 million children (3–4 birth cohorts with one dose of MMR. The high cost of measles and the severity of its complications fully justify the commitment required to reach measles elimination.
Before licensure of a measles vaccine in 1963, more than 500,000 measles cases on average were reported in the United States each year during 1951-1962. By 1993, through measles vaccination and control efforts, only 312 cases were reported nationwide. In 2000, the last year in which an outbreak had occurred in Utah, measles was declared "not endemic in the United States," but measles importations continue to occur, leading to outbreaks, especially among unvaccinated persons. Many U.S. health-care personnel have never seen a measles patient, which might hamper diagnosis and delay reporting. During March-June 2011, local health departments collaborated with the state health department in Utah to investigate two measles outbreaks comprising 13 confirmed cases. The first outbreak, with seven confirmed cases, was associated with an unvaccinated U.S. resident who traveled internationally; the second, with six confirmed cases, had an undetermined source. The genotype D4 sequences obtained from these two outbreaks differed by a single nucleotide, suggesting two separate importations. Health-care providers should remind their patients of the importance of being current with measles, mumps, and rubella (MMR) vaccination; this is especially important before international travel. Measles should be considered in the differential diagnosis of febrile rash illness, especially in unvaccinated persons with recent international travel. Reporting a confirmed or suspected case immediately to public health authorities is critical to limit the spread of measles.
Full Text Available Context: Measles imparts high morbidity and mortality in low-income countries with weak health infrastructure. The coverage of measles vaccination in Kerala which is best performing state of India in indicators of health has also not reached the elimination level and outbreaks of measles continue to occur. Aim: The aim of the paper was to study the profile of measles outbreaks in Kerala during the years 2007-2008. Settings and Designs: The study design was cross-sectional and data of the measles surveillance project of Kerala were analyzed . Results: The total number of clinically suspected measles outbreaks in Kerala during the 2-year period of 2007 and 2008 was 29. But only 15(53.6% were found to be ′measles only′ outbreak. The total number of epidemiologically linked measles cases was 718 (314 in 2007 and 404 in 2008. The cases that were immunized but developed the disease were 187 (28.6%, the number of cases that were not immunized was 355 (54.3% and those whose immunization status was unknown were 112 (17.1%. The mean age of occurrence of disease was higher in the vaccinated group as compared to not vaccinated group. Two deaths were recorded in the study. Conclusions: Significant morbidity and mortality due to measles do occur in the most developed state of India. The epidemics were clustered in some districts. The study indicated an age shift in occurrence of measles cases among who received the vaccination.
Al-Qayoudhi, Abdullah; Al-Kindi, Hanan; Meki, Nabil; Al-Maani, Amal
The introduction of measles vaccination programs and broad coverage worldwide has meant this infection a rare encounter for pediatricians. In Oman, with almost 100% measles vaccination coverage for children, this infection disappeared from the list of fever and rash differential diagnoses. Encephalitis is a well-known complication of measles infection and sometimes can be the only manifestation especially in adults. We report a seven-year-old Syrian immigrant who was admitted to the Royal Hospital, Muscat, with acute encephalitis secondary to wild measles infection. Although she had a classical presentation of measle infection, the diagnosis was missed in the private and regional hospital she attended before getting referred to Royal Hospital. She was later identified to be exposed to an outbreak of the infection in an unvaccinated population. Magnetic resonance imaging showed high signal intensity of both basal ganglia suggestive of measles encephalitis. The diagnosis was confirmed by detection of measles virus from her urine and blood, and a throat swab. The isolated measles virus was D8 serotype, which was prevalent in Syria around the same time. The child was treated with steroids and vitamin A. She achieved full recovery despite her severe presentation. A high degree of suspicion for measles infection should be maintained in unvaccinated children with a compatible presentation of the infection or its complications. There might be a role for steroid use in cases of acute measles encephalitis.
Full Text Available The introduction of measles vaccination programs and broad coverage worldwide has meant this infection a rare encounter for pediatricians. In Oman, with almost 100% measles vaccination coverage for children, this infection disappeared from the list of fever and rash differential diagnoses. Encephalitis is a well-known complication of measles infection and sometimes can be the only manifestation especially in adults. We report a seven-year-old Syrian immigrant who was admitted to the Royal Hospital, Muscat, with acute encephalitis secondary to wild measles infection. Although she had a classical presentation of measle infection, the diagnosis was missed in the private and regional hospital she attended before getting referred to Royal Hospital. She was later identified to be exposed to an outbreak of the infection in an unvaccinated population. Magnetic resonance imaging showed high signal intensity of both basal ganglia suggestive of measles encephalitis. The diagnosis was confirmed by detection of measles virus from her urine and blood, and a throat swab. The isolated measles virus was D8 serotype, which was prevalent in Syria around the same time. The child was treated with steroids and vitamin A. She achieved full recovery despite her severe presentation. A high degree of suspicion for measles infection should be maintained in unvaccinated children with a compatible presentation of the infection or its complications. There might be a role for steroid use in cases of acute measles encephalitis.
Martins, C.L.; Garly, May-Lill; Bale, C.
-Bissau. Intervention Measles vaccination using standard titre Edmonston-Zagreb vaccine at 4.5 months of age. Main outcome measures Vaccine efficacy against measles infection, admission to hospital for measles, and measles mortality before standard vaccination at 9 months of age. Results 28% of the children tested at 4...... children developed measles; 19% of unvaccinated children had measles before 9 months of age. The monthly incidence of measles among the 441 children enrolled in the treatment arm was 0.7% and among the 892 enrolled in the control arm was 3.1%. Early vaccination with the Edmonston-Zagreb measles vaccine...... prevented infection; vaccine efficacy for children with serologically confirmed measles and definite clinical measles was 94% (95% confidence interval 77% to 99%), for admissions to hospital for measles was 100% (46% to 100%), and for measles mortality was 100% (-42% to 100%). The number needed to treat...
Full Text Available Abstract Background The health needs of children and adolescents in humanitarian emergencies are critical to the success of relief efforts and reduction in mortality. Measles has been one of the major causes of child deaths in humanitarian emergencies and further contributes to mortality by exacerbating malnutrition and vitamin A deficiency. Here, we review measles vaccination activities in humanitarian emergencies as documented in published literature. Our main interest was to review the available evidence focusing on the target age range for mass vaccination campaigns either in response to a humanitarian emergency or in response to an outbreak of measles in a humanitarian context to determine whether the current guidance required revision based on recent experience. Methods We searched the published literature for articles published from January 1, 1998 to January 1, 2010 reporting on measles in emergencies. As definitions and concepts of emergencies vary and have changed over time, we chose to consider any context where an application for either a Consolidated Appeals Process or a Flash Appeal to the UN Central Emergency Revolving Fund (CERF occurred during the period examined. We included publications from countries irrespective of their progress in measles control as humanitarian emergencies may occur in any of these contexts and as such, guidance applies irrespective of measles control goals. Results Of the few well-documented epidemic descriptions in humanitarian emergencies, the age range of cases is not limited to under 5 year olds. Combining all data, both from preventive and outbreak response interventions, about 59% of cases in reports with sufficient data reviewed here remain in children under 5, 18% in 5-15 and 2% above 15 years. In instances where interventions targeted a reduced age range, several reports concluded that the age range should have been extended to 15 years, given that a significant proportion of cases occurred
Full Text Available Infection with Brucella spp. continues to pose a human health risk globally despite strides in eradicating the disease from domestic animals. Brucellosis has been an emerging disease since the discovery of Brucella melitensis by Sir David Bruce in 1887. Although many countries have eradicated B. abortus from cattle, in some areas B. melitensis and B. suis have emerged as causes of this infection in cattle, leading to human infections. Currently B. melitensis remains the principal cause of human brucellosis worldwide including India. The recent isolation of distinct strains of Brucella from marine mammals as well as humans is an indicator of an emerging zoonotic disease. Brucellosis in endemic and non-endemic regions remains a diagnostic puzzle due to misleading non-specific manifestations and increasing unusual presentations. Fewer than 10% of human cases of brucellosis may be clinically recognized and treated or reported. Routine serological surveillance is not practiced even in Brucella - endemic countries and we suggest that this should be a part of laboratory testing coupled with a high index of clinical suspicion to improve the level of case detection. The screening of family members of index cases of acute brucellosis in an endemic area should be undertaken to pick up additional unrecognised cases. Rapid and reliable, sensitive and specific, easy to perform and automated detection systems for Brucella spp. are urgently needed to allow early diagnosis and adequate antibiotic therapy in time to decrease morbidity / mortality. The history of travel to endemic countries along with exposure to animals and exotic foods are usually critical to making the clinical diagnosis. Laboratory testing is indispensable for diagnosis. Therefore alertness of clinician and close collaboration with microbiologist are essential even in endemic areas to correctly diagnose and treat this protean human infection. Existing treatment options, largely based on
Hale Turan Ozden
Full Text Available Purpose: Brucellosis is a systemic disease that can affect many organs and tissues. Musculoskeletal system is one of the most commonly affected systems. Disease may present itself with sacroiliitis, peripheral arthritis, spondylitis, paraspinal abscess, bursitis or osteomyelitis. The objective of the present study was to determine the frequency, types and clinical features of osteoarticular involvement among cases with brucellosis in Konya city and to establish the differences between patients with and without osteoarticular involvement. Material and Methods: Three hundred and sixteen patients with Brucellosis who presented between June 2003 and June 2014 were included in the study. Brucellosis was diagnosed by positive Brucella Standard Agglutination Test ( and #61619;1/160 titer and/or growth of Brucella spp. in blood culture in addition to the presence of clinical signs and findings. Diagnosis of osteoarticular system complications was established by physical examination and radiological findings obtained by diagnostic imaging tools. Magnetic resonance images of the thoracic, lumbar or sacral vertebrae were acquired in patients with back pain, low back pain and sacro-iliac joint pain. Results: Osteoarticular involvement was noted in 129 patients (40.8% (females: 52% and males: 48%. The most common route of transmission was employment in farming and/or consumption of un-pasteurized milk or dairy products, especially fresh cheese, in 97 (75% cases. Mean age was 46 and #61617;18 years. Sacroiliitis was the most frequent osteoarticular involvement (n: 68, 52.7%, 70.5% of which were bilateral. Sacroiliitis was followed by spondylodiscitis in 35 (38.7%, peripheral arthritis in 20 (15.5%, bursitis in 1 (0.8% cases. Patients with osteoarticular involvement received medical treatment for at least three months. Discussion: Ratio and anatomical region of osteoarticular involvement in brucellosis shows variability among areas. In the present study, we
Van Der Maas, Nicoline A T; Woudenberg, T.; Hahń, S. J M; De Melker, H. E.
Background. In 2013–2014, a measles outbreak spread through the Netherlands. To protect young infants, measles-mumps-rubella (MMR) vaccination was offered to those aged 6–14 months in municipalities with routine first-dose MMR vaccine coverage of <90%. We assessed the tolerability of this early admi
Smith, Graegar; Michelson, Joshua; Singh, Rohit; Dabbagh, Alya; Hoekstra, Edward; van den Ent, Maya; Mallya, Apoorva
Responding to regional advancements in combating measles, the World Health Organization in May 2008 called for an assessment of the feasibility of measles eradication, including whether sufficient vaccine supply exists. Interviews with international health officials and vaccine-makers provided data for a detailed model of worldwide demand and supply for measles-containing vaccine (MCV). The study projected global MCV demand through 2025 with and without a global eradication goal. The study found that 5.2 billion MCV doses must be administered during 2010-2025 to maintain current measles programs, and 5.9 billion doses would likely be needed with a 2020 eradication goal; in the most intensive scenario, demand could increase to 7.5 billion doses. These volumes are within existing and planned MCV-manufacturing capacity, although there are risks. In some markets, capacity is concentrated: Supply-chain disruptions could reduce supply or increase prices. Mitigation strategies could include stockpiling, long-term contracts, and further coordination with manufacturers.
McHale, P; Keenan, A; Ghebrehewet, S
Uptake rates for the combined measles, mumps and rubella (MMR) vaccine have been below the required 95% in the UK since a retracted and discredited article linking the MMR vaccine with autism and inflammatory bowel disease was released in 1998. This study undertook semi-structured telephone interviews among parents or carers of 47 unvaccinated measles cases who were aged between 13 months and 9 years, during a large measles outbreak in Merseyside. Results showed that concerns over the specific links with autism remain an important cause of refusal to vaccinate, with over half of respondents stating this as a reason. A quarter stated child illness during scheduled vaccination time, while other reasons included general safety concerns and access issues. Over half of respondents felt that more information or a discussion with a health professional would help the decision-making process, while a third stated improved access. There was clear support for vaccination among respondents when asked about current opinions regarding MMR vaccine. The findings support the hypothesis that safety concerns remain a major barrier to MMR vaccination, and also support previous evidence that experience of measles is an important determinant in the decision to vaccinate.
Lobanova, Liubov M; Eng, Nelson F; Satkunarajah, Malathy; Mutwiri, George K; Rini, James M; Zakhartchouk, Alexander N
Despite the availability of live attenuated measles virus (MV) vaccines, a large number of measles-associated deaths occur among infants in developing countries. The development of a measles subunit vaccine may circumvent the limitations associated with the current live attenuated vaccines and eventually contribute to global measles eradication. Therefore, the goal of this study was to test the feasibility of producing the recombinant globular head domain of the MV hemagglutinin (H) protein by stably transfected human cells and to examine the ability of this recombinant protein to elicit MV-specific immune responses. The recombinant protein was purified from the culture supernatant of stably transfected HEK293T cells secreting a tagged version of the protein. Two subcutaneous immunizations with the purified recombinant protein alone resulted in the production of MV-specific serum IgG and neutralizing antibodies in mice. Formulation of the protein with adjuvants (polyphosphazene or alum) further enhanced the humoral immune response and in addition resulted in the induction of cell-mediated immunity as measured by the production of MV H-specific interferon gamma (IFN-γ) and interleukin 5 (IL-5) by in vitro re-stimulated splenocytes. Furthermore, the inclusion of polyphosphazene into the vaccine formulation induced a mixed Th1/Th2-type immune response. In addition, the purified recombinant protein retained its immunogenicity even after storage at 37°C for 2 weeks.
Germeraad, Eveline A.; Hogerwerf, Lenny; Faye-Joof, Tisbeh; Goossens, Bart; Van Hoek, Wim Der; Jeng, Momodou; Lamin, Modou; Manneh, Ismaila L.; Nwakanma, Davis; Roest, Hendrik I J; Secka, Arss; Stegeman, Arjan; Wegmüller, Rita; Van Der Sande, Marianne A B; Secka, Ousman
BACKGROUND: Brucellosis is a worldwide zoonosis with significant impact on rural livelihoods and a potentially underestimated contributor to febrile illnesses. The aim of this study was to estimate the seroprevalence of brucellosis in humans and small ruminants in The Gambia. METHODS: The study was
Germeraad, Eveline A.; Hogerwerf, Lenny; Faye-Joof, Tisbeh; Roest, Hendrik-Jan
Background Brucellosis is a worldwide zoonosis with significant impact on rural livelihoods and a potentially underestimated contributor to febrile illnesses. The aim of this study was to estimate the seroprevalence of brucellosis in humans and small ruminants in The Gambia. Methods The study was
Nell, A.J.; Vugt, van F.
This is the report of the first mission to Egypt for the project: Impact of brucellosis and tuberculosis on animal production and public health (BO-10-009-118). The objective of this mission was: to make an assessment of the current needs and problems in Egypt related to brucellosis and tuberculosis
Regulatory programs for brucellosis in domestic livestock have been active in the United States for almost 80 years. Wildlife reservoirs of brucellosis include bison (Bison bison) and elk (Cervus elaphus nelsonii) for B. abortus whereas B. suis is the predominant species infecting feral swine. The...
Germeraad, Eveline A; Hogerwerf, Lenny; Faye-Joof, Tisbeh; Goossens, Bart; van der Hoek, Wim; Jeng, Momodou; Lamin, Modou; Manneh, Ismaila L; Nwakanma, Davis; Roest, Hendrik I J; Secka, Arss; Stegeman, Arjan; Wegmüller, Rita; van der Sande, Marianne A B; Secka, Ousman
BACKGROUND: Brucellosis is a worldwide zoonosis with significant impact on rural livelihoods and a potentially underestimated contributor to febrile illnesses. The aim of this study was to estimate the seroprevalence of brucellosis in humans and small ruminants in The Gambia. METHODS: The study was
Oseguera Montiel, D.; Bruce, M.; Frankena, K.; Udo, H.M.J.; Zijpp, van der A.J.; Rushton, J.
Brucellosis is an endemic disease in small-scale goat husbandry systems in Mexico. It is a zoonosis and the economic consequences can be large, although estimates are not available for the Mexican goat sector. Our objective was to conduct a financial analysis of brucellosis control in a prominent da
Chen, Shouyi; Zhang, Hao; Liu, Xiaoning; Wang, Wenjing; Hou, Shuiping; Li, Tingting; Zhao, Shuoxian; Yang,Zhicong; Li, Chengyao
Cases of brucellosis were diagnosed in 3-month-old twins and their mother. An epidemiologic survey suggested that raw sheep or goat meat might be the source of Brucella melitensis infection. This finding implies that the increasing threat of brucellosis might affect low-risk persons in urban settings in China.
Full Text Available Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae.
Shilaih, Mohaned; Marzel, Alex; Braun, Dominique L.; Scherrer, Alexandra U.; Kovari, Helen; Young, Jim; Calmy, Alexandra; Darling, Katharine; Battegay, Manuel; Hoffmann, Matthias; Bernasconi, Enos; Thurnheer, Maria C.; Günthard, Huldrych F.; Kouyos, Roger D.
Abstract After several years of steady decline, syphilis is reemerging globally as a public health hazard, especially among people living with human immunodeficiency virus (HIV). Syphilis resurgence is observed mainly in men who have sex with men (MSM), yet other transmission groups are affected too. In this manuscript, we study the factors associated with syphilis incidence in the Swiss HIV cohort study in the era of highly effective antiretrovirals. Using parametric interval censored models with fixed and time-varying covariates, we studied the immunological, behavioral, and treatment-related elements associated with syphilis incidence in 3 transmission groups: MSM, heterosexuals, and intravenous drug users. Syphilis incidence has been increasing annually since 2005, with up to 74 incident cases per 1000 person-years in 2013, with MSM being the population with the highest burden (92% of cases). While antiretroviral treatment (ART) in general did not affect syphilis incidence, nevirapine (NVP) was associated with a lower hazard of syphilis incidence (multivariable hazard ratio 0.5, 95% confidence interval 0.2–1.0). We observed that condomless sex and younger age were associated with higher syphilis incidence. Moreover, time-updated CD4, nadir CD4, and CD8 cell counts were not associated with syphilis incidence. Finally, testing frequency higher than the recommended once a year routine testing was associated with a 2-fold higher risk of acquiring syphilis. Condomless sex is the main driver of syphilis resurgence in the Swiss HIV Cohort study; ART and immune reconstitution provide no protection against syphilis. This entails targeted interventions and frequent screening of high-risk populations. There is no known effect of NVP on syphilis; therefore, further clinical, epidemiological, and microbiological investigation is necessary to validate our observation. PMID:28079818
Solomon, Marc M.; Mayer, Kenneth H.; Glidden, David V.; Liu, Albert Y.; McMahan, Vanessa M.; Guanira, Juan V.; Chariyalertsak, Suwat; Fernandez, Telmo; Grant, Robert M.; Bekker, Linda-Gail; Buchbinder, Susan; Casapia, Martin; Chariyalertsak, Suwat; Guanira, Juan; Kallas, Esper; Lama, Javier; Mayer, Kenneth; Montoya, Orlando; Schechter, Mauro; Veloso, Valdiléa
Background. Syphilis infection may potentiate transmission of human immunodeficiency virus (HIV). We sought to determine the extent to which HIV acquisition was associated with syphilis infection within an HIV preexposure prophylaxis (PrEP) trial and whether emtricitabine/tenofovir (FTC/TDF) modified that association. Methods. The Preexposure Prophylaxis Initiative (iPrEx) study randomly assigned 2499 HIV-seronegative men and transgender women who have sex with men (MSM) to receive oral daily FTC/TDF or placebo. Syphilis prevalence at screening and incidence during follow-up were measured. Hazard ratios for the effect of incident syphilis on HIV acquisition were calculated. The effect of FTC/TDF on incident syphilis and HIV acquisition was assessed. Results. Of 2499 individuals, 360 (14.4%) had a positive rapid plasma reagin test at screening; 333 (92.5%) had a positive confirmatory test, which did not differ between the arms (FTC/TDF vs placebo, P = .81). The overall syphilis incidence during the trial was 7.3 cases per 100 person-years. There was no difference in syphilis incidence between the study arms (7.8 cases per 100 person-years for FTC/TDF vs 6.8 cases per 100 person-years for placebo, P = .304). HIV incidence varied by incident syphilis (2.8 cases per 100 person-years for no syphilis vs 8.0 cases per 100 person-years for incident syphilis), reflecting a hazard ratio of 2.6 (95% confidence interval, 1.6–4.4; P < .001). There was no evidence for interaction between randomization to the FTC/TDF arm and incident syphilis on HIV incidence. Conclusions. In HIV-seronegative MSM, syphilis infection was associated with HIV acquisition in this PrEP trial; a syphilis diagnosis should prompt providers to offer PrEP unless otherwise contraindicated. PMID:24928295
Yoo, Jeong Rae; Heo, Sang Taek; Lee, Keun Hwa; Kim, Young Ree; Yoo, Seung Jin
Since the first reported case of human brucellosis in 2002 in South Korea, its incidence has been increasing nationally. However, bovine brucellosis has not been present from 2005 to date on Jeju Island. Despite Jeju Island being considered a clean area for bovine brucellosis, we experienced an outbreak of human brucellosis between 2012 and 2013. Herein, we report cases with human brucellosis after ingestion of raw materials of fetal calf at a restaurant. Patients were identified by isolation of the Brucella abortus in their blood and joint tissue. Because all patients developed zoonosis by a faulty folk remedy, we emphasize the importance of educational programs to increase the awareness of zoonosis, and the need for active surveillance and detection of illegal distribution channels of the infected animal. After the outbreak, we took control of the involved restaurant and its illegal distribution channel, and there have been no further outbreaks.
Gül, Serdar; Satilmiş, Ozgun Kiriş; Ozturk, Baris; Gökçe, Mehmet Ilker; Kuscu, Ferit
Brucellosis is an important public-health problem in Turkey. Children may constitute 20 to 30% of all brucellosis cases in the world, especially in the endemic regions. Data on the seroprevalence of brucellosis in childhood are very limited. In this study, we aimed to evaluate the seroprevalence of brucellosis among a child population. One thousand one hundred and ten subjects were included in the study. Blood samples were collected and tested with Rose Bengal (RB) and standard tube agglutination test (SAT). RB test results were positive for 6 patients, and SAT was negative for all patients. Our findings suggest that seroprevalence of brucellosis is decreasing in Middle Anatolia due to a new cattle vaccination and eradication programme which was initiated in 2009.
Nicole Dalton Wheeler
Full Text Available Human cases of brucellosis are rare in the United States and difficult to diagnose. We report a case of a young female who underwent a diagnostic investigation of fever of unknown origin, which included a lymph node biopsy. The biopsy was consistent with Kikuchis Disease, or histiocytic necrotizing lymphadenitis, an entity where the major differential diagnosis is systemic lupus erythematosus. Interestingly, serologic studies supported the diagnosis of brucellosis. Brucellosis has rarely been associated with histiocytic necrotizing lymphadenitis. This association has never been reported in the United States, thus suggesting that brucellosis should be considered in the differential for histiocytic necrotizing lymphadenitis, along with lupus-like autoimmune disease. As the prognosis and treatment of histiocytic necrotizing lymphadenitis, brucellosis, and systemic lupus erythematosus are distinct, it is important to differentiate these entities. [J Interdiscipl Histopathol 2013; 1(5.000: 274-279
CHU He-Ling; YANG Fei-Fei; HUANG Yu-Xian; JIN Jia-Lin; ZHANG Wen-Hong; WENG Xin-Hua
Brucellosis is a zoonosis caused by Brucella ,with an acute or chronic clinical infection .Clinical manifestations of brucellosis are various or atypical ,and it is easily misdiagnosed and miss-diagnosed .The case we have reported had an onset of fever and abdominal pain ,associated with arthralgia ,headache and rashes during the course , and was initially misdiagnosed as “acute cholangitis , associated with biliary pancreatitis” . According to epidemiologic survey , radiological evidence , as well as blood culture and agglutination test showing Brucella positive ,the diagnosis of brucellosis associated with splenic infarction and multi-systemic involvement including lungs , skin and brain was made . After regular anti-brucellosis treatment , the patient’s symptoms were significantly improved . Brucellosis associated with splenic infarction is rare ,which is possibly due to vasculitis resulting from Brucella infection .
Full Text Available Human brucellosis is considered a great example of the complexity of clinical manifestations possibly affecting multiple organs or systems. Renal manifestations of human brucellosis have been documented in few case reports and one case series. Herein, we present a case of Nephrotic syndrome (NS due to minimal change disease in the course of acute brucellosis. A 53-year-old male farmer was admitted to our department with acute brucellosis and NS. Renal biopsy revealed minimal change disease. Combined treatment with prednisone (1 mg/kg, rifampicin (600 mg/day, and doxycycline (200 mg/day was initiated. Complete remission of NS was achieved at the end of the fourth week. One year later, the patient remained in complete remission of NS without any sign of relapse of brucellosis.
Sabanis, Nikolaos; Gavriilaki, Eleni; Paschou, Eleni; Tsotsiou, Eleni; Kalaitzoglou, Asterios; Kavlakoudis, Christos; Vasileiou, Sotirios
Human brucellosis is considered a great example of the complexity of clinical manifestations possibly affecting multiple organs or systems. Renal manifestations of human brucellosis have been documented in few case reports and one case series. Herein, we present a case of Nephrotic syndrome (NS) due to minimal change disease in the course of acute brucellosis. A 53-year-old male farmer was admitted to our department with acute brucellosis and NS. Renal biopsy revealed minimal change disease. Combined treatment with prednisone (1 mg/kg), rifampicin (600 mg/day), and doxycycline (200 mg/day) was initiated. Complete remission of NS was achieved at the end of the fourth week. One year later, the patient remained in complete remission of NS without any sign of relapse of brucellosis.
Esen, Ramazan; Aslan, Mehmet; Kucukoglu, Mehmet Emin; Cıkman, Aytekin; Yakan, Umit; Sunnetcioglu, Mahmut; Selek, Sahbettin
It is well known that paraoxonase-1 (PON1) activity may decrease during the course of infection and inflammation. The aim of this study was to investigate serum PON1 activity, oxidative status, and thiols levels in patients with acute brucellosis. In addition, we investigated the PON1 phenotype in patients with acute brucellosis. Thirty patients with acute brucellosis and 35 healthy controls were enrolled. Serum paraoxonase and arylesterase activities, thiols levels, lipid hydroperoxide levels, total antioxidant capacity (TAC), total oxidant status (TOS) and oxidative stress index (OSI) were determined. Serum basal and salt-stimulated paraoxonase-arylesterase activities, TAC levels and thiols levels were significantly lower in patients with acute brucellosis than controls (for all, p brucellosis. These results indicate that lower PON1 activity is associated with oxidant-antioxidant imbalance.
Salado-Rasmussen, Kirsten; Hoffmann, Steen; Cowan, Susan;
Serological response to treatment of syphilis with orally administered doxycycline or intramuscularly administered penicillin was assessed in patients with concurrent HIV. All HIV-infected individuals diagnosed with syphilis attending 3 hospitals in Copenhagen, Denmark were included. Odds ratios...... (ORs) with 95% confidence intervals (CI) associated with serological outcome were modelled using propensity-score-adjusted logistic regression analysis. In total, 202 cases were treated with doxycycline or intramuscular penicillin. At 12 months, serological failure was observed in 12 cases (15......%) treated with doxycycline and in 8 cases (17%) treated with penicillin (OR 0.78 (95% CI 0.16-3.88), p = 0.76). The serological cure rate at 12 months was highest in patients with primary syphilis (100%), followed by patients with secondary (89%), early latent (71%) and late latent (67%) syphilis (p = 0...
Salado-Rasmussen, Kirsten; Cowan, Susan; Gerstoft, Jan; Larsen, Helle Kiellberg; Hoffmann, Steen; Knudsen, Troels Bygum; Katzenstein, Terese Lea; Jensen, Jørgen Skov
The aim of this nationwide study is to determine the strain type diversity among patients diagnosed with syphilis by PCR during a 4-year period in Denmark. Epidemiological data, including HIV status, for all patients were obtained from the Danish national syphilis registration system. Molecular strain typing was based on characterization of 3 variable treponemal genes, arp, tpr and tp0548. A total of 278 specimens from 269 patients were included. Among the fully typeable specimens (n = 197), 22 strain types were identified, with 1 type, 14d/g, accounting for 54%. The majority (93%) of the patients reported acquiring syphilis in Denmark. Among patients with concurrent HIV, 9 full strain types were identified and no difference in strain type was found by HIV status (p = 0.197). In conclusion, the majority of patients were infected in Denmark and the HIV-infected syphilis patients were diagnosed with a wide spectrum of different strain types of Treponema pallidum.
Smajs, David; Norris, Steven J; Weinstock, George M
Pathogenic uncultivable treponemes, similar to syphilis-causing Treponema pallidum subspecies pallidum, include T. pallidum ssp. pertenue, T. pallidum ssp. endemicum and Treponema carateum, which cause yaws, bejel and pinta, respectively. Genetic analyses of these pathogens revealed striking similarity among these bacteria and also a high degree of similarity to the rabbit pathogen, Treponema paraluiscuniculi, a treponeme not infectious to humans. Genome comparisons between pallidum and non-pallidum treponemes revealed genes with potential involvement in human infectivity, whereas comparisons between pallidum and pertenue treponemes identified genes possibly involved in the high invasivity of syphilis treponemes. Genetic variability within syphilis strains is considered as the basis of syphilis molecular epidemiology with potential to detect more virulent strains, whereas genetic variability within a single strain is related to its ability to elude the immune system of the host. Genome analyses also shed light on treponemal evolution and on chromosomal targets for molecular diagnostics of treponemal infections.
Lithgow, Karen V.; Hof, Rebecca; Wetherell, Charmaine; Phillips, Drew; Houston, Simon; Cameron, Caroline E.
Syphilis is a prominent disease in low- and middle-income countries, and a re-emerging public health threat in high-income countries. Syphilis elimination will require development of an effective vaccine that has thus far remained elusive. Here we assess the vaccine potential of Tp0751, a vascular adhesin from the causative agent of syphilis, Treponema pallidum subsp. pallidum. Tp0751-immunized animals exhibit a significantly reduced bacterial organ burden upon T. pallidum challenge compared with unimmunized animals. Introduction of lymph nodes from Tp0751-immunized, T. pallidum-challenged animals to naive animals fails to induce infection, confirming sterile protection. These findings provide evidence that Tp0751 is a promising syphilis vaccine candidate. PMID:28145405
The studies included in this PhD thesis examined the interactions of syphilis, which is caused by Treponema pallidum, and HIV. Syphilis reemerged worldwide in the late 1990s and hereafter increasing rates of early syphilis were also reported in Denmark. The proportion of patients with concurrent HIV has been substantial, ranging from one third to almost two thirds of patients diagnosed with syphilis some years. Given that syphilis facilitates transmission and acquisition of HIV the two sexually transmitted diseases are of major public health concern. Further, syphilis has a negative impact on HIV infection, resulting in increasing viral loads and decreasing CD4 cell counts during syphilis infection. Likewise, HIV has an impact on the clinical course of syphilis; patients with concurrent HIV are thought to be at increased risk of neurological complications and treatment failure. Almost ten per cent of Danish men with syphilis acquired HIV infection within five years after they were diagnosed with syphilis during an 11-year study period. Interestingly, the risk of HIV declined during the later part of the period. Moreover, HIV-infected men had a substantial increased risk of re-infection with syphilis compared to HIV-uninfected men. As one third of the HIV-infected patients had viral loads >1,000 copies/ml, our conclusion supported the initiation of cART in more HIV-infected MSM to reduce HIV transmission. During a five-year study period, including the majority of HIV-infected patients from the Copenhagen area, we observed that syphilis was diagnosed in the primary, secondary, early and late latent stage. These patients were treated with either doxycycline or penicillin and the rate of treatment failure was similar in the two groups, indicating that doxycycline can be used as a treatment alternative - at least in an HIV-infected population. During a four-year study period, the T. pallidum strain type distribution was investigated among patients diagnosed by PCR
Hagen, Catherine E; Kamionek, Michal; McKinsey, David S; Misdraji, Joseph
Syphilis, a sexually transmitted infection caused by the spirochete Treponema pallidum, has seen a resurgence since 2001, particularly in men who have sex with men. Syphilis can affect the liver during the secondary stage as syphilitic hepatitis and during the tertiary stage as gummas. We describe 3 cases of syphilis in human immunodeficiency virus-positive homosexual men that presented as hepatic mass lesions clinically suspected of being malignant tumors. Histologically, 2 of the 3 cases showed a plump spindle cell proliferation, mixed inflammatory infiltrate with numerous neutrophils, and abscesses, whereas the third case showed granulomas and pericholangitis/cholangitis. Immunohistochemical staining for T. pallidum showed innumerable organisms in 2 of the cases. Pathologists must be aware of the possibility of syphilis causing hepatic inflammatory masses in human immunodeficiency virus-positive men who have sex with men in order to avoid misdiagnosis or delayed treatment.
Full Text Available Introduction: The aim of this study was to determine factors associated with lack of serological response (LSR to treatment of syphilis among HIV-infected subjects. Materials and Methods: Retrospective, longitudinal study on HIV-infected subjects diagnosed and treated for syphilis and with an assessable serological response between 1 January 2004 and 15 September 2013. LSR was defined as a <4-fold decline of rapid plasma reagin (RPR titer or a failed reversion to nonreactive (if RPR ≤1:4 at diagnosis after one year since treatment. Diagnoses of syphilis were staged in early syphilis (primary, secondary and early latent or late syphilis (tertiary and late latent according to clinical examination and patient's history. Syphilis was classified in new infections [NI: positive RPR and TPHA (Treponema pallidum Haemagglutination assay titers in subjects without previous history of syphilis] or re-infections [ReI: a ≥4-fold increase of RPR titer in subjects previously successfully treated for syphilis]. Syphilis treatment was prescribed according to CDC guidelines. The crude incidence rates (IRs of LSR were calculated per 1000-person months of follow-up (PMFU as the total number of LSR episodes divided by the cumulative time contributed by all subjects (interval time since each syphilis diagnosis and the date of ascertainment of response. Results are described as median (IQR or frequency (%. Results: 565 diagnoses of syphilis with an assessable serological response in 421 patients; 458 (81% were early syphilis, 189 (33% were NI, 376 (67% were ReI. At first, diagnosis of syphilis median age was 41 (36–47 years, 419 (99.5% males, 391 (93% MSM, HIV-infected since 7.7 (3.5–12.9 years, 75 (18% HCV or HBV co-infected, 56 (13% with a previous AIDS diagnosis, 82 (19% antiretroviral treatment naïve, 102 (24% with HIV-RNA ≥50 cp/mL, CD4+=576 (437–749 cells/mm3, nadir CD4+=308 (194–406 cells/mm3. LSRs were observed in 70/565 (12.4% treated syphilis
施辛; 吴锦昌; 刘增礼; 唐军; 苏玉华
Objective To injvestigate the cerebral blood flow of patients with early syphilis. Methods 99Tcm-ECD as brain perfusion imaging agent was used in single photon emission computed tomography (SPECT) for 32 patients with early syphilis and 15 controls. Visual analyses were made on every BSPECT image. Results The 32 patients with early syphilis had general, patchy hypoperfusion of cerebral blood flow. Fourteen of the 32 patients had 48 episodes of marked patchy hypoperfusion of rCBF. The responsible areas of hypoperfusion in a patchy distribution involved the left frontal lobe (6 episodes), right frontal lobe (3), left parietal lobe (7), right parietal lobe (6), left temporal lobe (11), right temporal lobe (5), left occipital lobe (3), left basal ganglia (3), cerebellum (1), and nerve nuceus (1). No abnormality was found in the control group.Conclusions Cerebral blood flow abnormalities exist in patients with early syphilis. General patchy hypoperfusion on SPECT imaging is common.
张秀英; 陈懿德; 庞玉森; 张景生; 严静丽
Objective: To investigate the roles of interleukin-2 (IL-2) and interleukin-10 (IL-10) in pathogenesis of early syphilis.Methods: The serum levels of IL-2 and IL-10 in 48 patients with early syphilis were detected by ABC-ELISA.Results: (1) The level of IL-2 in the patients with early syphilis was significantly higher than that in healthy controls, while that of IL-10 was lower (P0.05), as well as between dif-ferent RPR titers (P>0.05). (3) After therapy, the level of IL-2 decreased markedly (P0.05). (4) A significant correlation was found between the serum levels of IL-2 and IL-10 (r=0.5385 P<0.05).Conclusions: Th1 up-regulation occurs in patients with early syphilis, and plays an active role in fighting against TP infection.
Full Text Available Aims: analysis of dynamics and pattern of syphilis incidence in 2011-2015 years in Saratov region. Materials and methods. The article provides analysis of the state statistical supervision forms from 2011-2015. Results. The analysis of the data obtained from the state statistical supervision forms during 2011-2015 years has shown the decreasing tendency of syphilis incidence. However, an unfavorable situation still remains in number of territories of Saratov region. The indicators of morbidity caused by late syphilis and neurosyphilis have increased. Conclusion. High incidence of syphilis has negative effect on the reproductive health of the general population. The fast spread of disease is generating special interest in conditions of demographic crisis.
Adriana R Cruz
Full Text Available Venereal syphilis is a multi-stage, sexually transmitted disease caused by the spirochetal bacterium Treponema pallidum (Tp. Herein we describe a cohort of 57 patients (age 18-68 years with secondary syphilis (SS identified through a network of public sector primary health care providers in Cali, Colombia. To be eligible for participation, study subjects were required to have cutaneous lesions consistent with SS, a reactive Rapid Plasma Reagin test (RPR-titer > or = 1 : 4, and a confirmatory treponemal test (Fluorescent Treponemal Antibody Absorption test- FTA-ABS. Most subjects enrolled were women (64.9%, predominantly Afro-Colombian (38.6% or mestizo (56.1%, and all were of low socio-economic status. Three (5.3% subjects were newly diagnosed with HIV infection at study entry. The duration of signs and symptoms in most patients (53.6% was less than 30 days; however, some patients reported being symptomatic for several months (range 5-240 days. The typical palmar and plantar exanthem of SS was the most common dermal manifestation (63%, followed by diffuse hypo- or hyperpigmented macules and papules on the trunk, abdomen and extremities. Three patients had patchy alopecia. Whole blood (WB samples and punch biopsy material from a subset of SS patients were assayed for the presence of Tp DNA polymerase I gene (polA target by real-time qualitative and quantitative PCR methods. Twelve (46% of the 26 WB samples studied had quantifiable Tp DNA (ranging between 194.9 and 1954.2 Tp polA copies/ml blood and seven (64% were positive when WB DNA was extracted within 24 hours of collection. Tp DNA was also present in 8/12 (66% skin biopsies available for testing. Strain typing analysis was attempted in all skin and WB samples with detectable Tp DNA. Using arp repeat size analysis and tpr RFLP patterns four different strain types were identified (14d, 16d, 13d and 22a. None of the WB samples had sufficient DNA for typing. The clinical and microbiologic
Thomas, D.D.; Baseman, J.B.; Alderete, J.F.
The syphilis bacterium, Treponema pallidum, parasitizes host cells through recognition of fibronectin (Fn) on cell surfaces. The active site of the Fn molecule has been identified as a four-amino acid sequence, arg-gly-asp-ser (RGDS), located on each monomer of the cell-binding domain. The synthetic heptapeptide gly-arg-gly-asp-ser-pro-cys (GRGDSPC), with the active site sequence RGDS, specifically competed with SVI-labeled cell-binding domain acquisition by T. pallidum. Additionally, the same heptapeptide with the RGDS sequence diminished treponemal attachment to HEp-2 and HT1080 cell monolayers. Related heptapeptides altered in one key amino acid within the RGDS sequence failed to inhibit Fn cell-binding domain acquisition or parasitism of host cells by T. pallidum. The data support the view that T. pallidum cytadherence of host cells is through recognition of the RGDS sequence also important for eukaryotic cell-Fn binding.
Owen, Benjamin D.; Balavenkataraman, Arvind; Weinstein, Mitchell R.
An uncommon variant in the pre-AIDS era, lues maligna is a nodular-ulcerative form of secondary syphilis. We present a case of a 41-year-old man with HIV infection who developed fever, chills, nausea, vomiting, right upper quadrant abdominal pain, weight loss, watery diarrhea, and a painless, nonpruritic rash. He had diffuse nodular-ulcerative lesions in various stages of development. He was found to have a CD4 count of 101 cells/mm3 (22%), an HIV viral load of 2,735,060 copies/mL, and a positive rapid plasma reagin at 1:64. He was started on emtricitabine, tenofovir, and dolutegravir, as well as doxycycline. He was given benzathine penicillin 2.4 million units intramuscularly and within hours developed a Jarisch-Herxheimer reaction. Skin lesions showed signs of healing, and constitutional symptoms improved 48 hours later. PMID:28127144
Rasmussen, Lasse Dam; Fonager, Jannik; Knudsen, Lisbet Krause;
an outbreak. The majority of the cases were unvaccinated (n = 27) or recipients of one dose of measles-mumps-rubella (MMR) vaccine (n = 7). In addition, two fully vaccinated adult cases were reported in 2014. We demonstrate the transmission of measles virus in a population in which the two-dose MMR......Despite the introduction of safe, effective vaccines decades ago and joint global public health efforts to eliminate measles, this vaccine-preventable disease continues to pose threats to children's health worldwide. During 2013 and 2014, measles virus was introduced into Denmark through several...... independent importations. This resulted in a number of secondary cases (n = 7), with two clusters in 2013 and one in 2014. In total, there were 44 cases of measles. Most cases (n = 41) were laboratory confirmed by detection of measles virus genome by real-time reverse transcription (RT)-PCR and IgM antibodies...
Hegazy, Y M; Ridler, A L; Guitian, F J
Brucellosis is an important zoonosis in Middle Eastern countries. In this study we assessed the extent of the application of planned official brucellosis control programmes in Kafr El Sheikh governorate, Egypt and we used a stochastic simulation model to assess the probable impact of changes to the official control strategy on the dynamics of small-ruminant brucellosis. Our results show that brucellosis. Given our assumptions, the intensity with which infected animals are removed under the actual levels of implementation of test-and-slaughter programmes would permit brucellosis to remain endemic at a level >8% of the sheep and goat population.
Rahman, A K M Anisur; Dirk, Berkvens; Fretin, David; Saegerman, Claude; Ahmed, Muzahed Uddin; Muhammad, Noor; Hossain, Akram; Abatih, Emmanuel
Brucellosis is an occupational hazard of livestock farmers, dairy workers, veterinarians, slaughterhouse workers, and laboratory personnel, all of whom are considered to belong to the high-risk occupational group (HROG). A study was undertaken to determine the seroprevalence of brucellosis, identify risk factors associated with brucellosis seropositivity, and detect Brucella at genus level using real-time polymerase chain reaction (PCR) among people in the HROG in the Dhaka division of Bangladesh. A sample of 500 individuals from the HROG was collected from three districts of Dhaka division of Bangladesh. A multiple random effects logistic regression model was used to identify potential risk factors. Two types of real-time PCR methods were applied to detect Brucella genus-specific DNA using serum from seropositive patients. The prevalence of brucellosis based on the three tests was observed to be 4.4% based on a parallel interpretation. The results of the multiple random effects logistic regression analysis with random intercept for district revealed that the odds of brucellosis seropositivity among individuals who had been in contact with livestock for more than 26 years was about 14 times higher as compared to those who had less than 5 years of contact with livestock. In addition, when the contact was with goats, the odds of brucellosis seropositivity were about 60 times higher as compared to when contact was with cattle only. Noticeable variation in brucellosis seropositivity among humans within the three districts was noted. All of the 13 individuals who tested positive for the serological tests were also positive in two types of real-time PCR using the same serum samples. Livestock farmers of brucellosis positive herds had a significantly higher probability to be seropositive for brucellosis. The study emphasized that contact with livestock, especially goats, is a significant risk factor for the transmission of brucellosis among individuals in the HROG.
Full Text Available Abstract Background Caused by intracellular Gram-negative bacteria Brucella spp., brucellosis is the most common bacterial zoonotic disease. Extensive studies in brucellosis have yielded a large number of publications and data covering various topics ranging from basic Brucella genetic study to vaccine clinical trials. To support data interoperability and reasoning, a community-based brucellosis-specific biomedical ontology is needed. Results The Brucellosis Ontology (IDOBRU: http://sourceforge.net/projects/idobru, a biomedical ontology in the brucellosis domain, is an extension ontology of the core Infectious Disease Ontology (IDO-core and follows OBO Foundry principles. Currently IDOBRU contains 1503 ontology terms, which includes 739 Brucella-specific terms, 414 IDO-core terms, and 350 terms imported from 10 existing ontologies. IDOBRU has been used to model different aspects of brucellosis, including host infection, zoonotic disease transmission, symptoms, virulence factors and pathogenesis, diagnosis, intentional release, vaccine prevention, and treatment. Case studies are typically used in our IDOBRU modeling. For example, diurnal temperature variation in Brucella patients, a Brucella-specific PCR method, and a WHO-recommended brucellosis treatment were selected as use cases to model brucellosis symptom, diagnosis, and treatment, respectively. Developed using OWL, IDOBRU supports OWL-based ontological reasoning. For example, by performing a Description Logic (DL query in the OWL editor Protégé 4 or a SPARQL query in an IDOBRU SPARQL server, a check of Brucella virulence factors showed that eight of them are known protective antigens based on the biological knowledge captured within the ontology. Conclusions IDOBRU is the first reported bacterial infectious disease ontology developed to represent different disease aspects in a formal logical format. It serves as a brucellosis knowledgebase and supports brucellosis data integration and
Ron-Román, Jorge; Ron-Garrido, Lenin; Abatih, Emmanuel; Celi-Erazo, Maritza; Vizcaíno-Ordóñez, Laura; Calva-Pacheco, Jaime; González-Andrade, Pablo; Berkvens, Dirk; Benítez-Ortíz, Washington; Brandt, Jef; Fretin, David; Saegerman, Claude
Human brucellosis in Ecuador is underreported and based only on passive surveillance. Since 2008, brucellosis was removed from the list of communicable diseases in the country. Until now, the true human brucellosis picture has not yet been determined. The aim of this study was to determine the seroprevalence of the disease, identify risk factors associated with brucellosis seropositivity in humans, and isolate circulating strains of Brucella spp. in the northwestern part of Ecuador. Between 2006 and 2008, a large transect survey was conducted, based on blood sampling of people from the northwestern part of Ecuador (n=3733) together with an epidemiological inquiry. On the basis of three diagnostic tests used in parallel, the overall seroprevalence was estimated as 1.88% (95% confidence interval [CI] 1.48-2.38). Based on a multivariable random effects logistic regression analysis, the main risk factors associated with human brucellosis seropositivity were contact with livestock (odds ratio [OR]=3.0; CI 1.25-7.08), consumption of fetus and placenta (OR=2.5; CI 1.18-5.22), and involvement in activities at risk for brucellosis infection (OR=1.8; CI 1.00-3.35). Noticeable variation in brucellosis seropositivity among humans within cantons was observed. The circulating strain was Brucella abortus biotype 4. This study emphasized that contact with livestock, consumption of fetus and placenta, and occupational hazard group were all significant risk factors for the transmission of brucellosis among individuals in the northwestern part of Ecuador. Alongside encouraging the launching of educational campaigns against brucellosis, especially in rural areas where 36% of the population lives, controlling this zoonotic disease in animals will directly benefit its prevention in humans, especially because there is no safe and efficacious vaccine against brucellosis in humans.
Full Text Available Syphilis is one of the most fascinating diseases of humans. Widespread use of antibiotics now has reduced the incidence of early syphilis and recognized new cases of late syphilis have decreased. Serological tests are the basis for the diagnosis of latent syphilis. They vary in their sensitivity and specificity. While non-treponemal tests (VDRL and RPR are most frequently used as screening procedures, treponemal tests (FTA-ABS and TPHA are considered to be highly sensitive and specific. MATERIALS AND METHODS In this study 100 serum samples collected from the patients attending STD Department, King George Hospital, Visakhapatnam. Samples were subjected to VDRL, RPR and Micro-TPHA tests to evaluate the sensitivity and specificity of Micro-TPHA test in patients with various stages of syphilis and to evaluate the efficacy of Micro-TPHA to confirm the diagnosis of syphilis and to rule out biological false positive reactions or false negative reactions of VDRL tests. RESULTS Three tests (VDRL, RPR and Micro-TPHA were applied to all 100 patients. Among them 85 were VDRL reactive, 84 were RPR positive and 89 were TPHA positive. In them males were more in number, in 3 tests with respect to age, (21-30 age group patients showed predominance. Out of 100 patients, 81 sera were positive for all three tests and one serum sample was VDRL reactive, but RPR and TPHA were non-reactive. This may be a false positive reaction. The following tables showed the sensitivity and specificity of each test and also the sensitivity of each test in various stages of syphilis. CONCLUSION It is concluded as by performing TPHA test, false positive reactivity of VDRL test could be detected. Even in the cases of treated primary and secondary syphilis, TPHA was reactive. The lipoidal antigen tests primarily reflect disease activity and serial quantitative performance of these tests used to measure the treatment response.
Pines, Heather A; Rusch, Melanie L; Vera, Alicia; Rangel, Gudelia; Magis-Rodriguez, Carlos; Strathdee, Steffanie A
Given that syphilis is associated with HIV infection among people who inject drugs (PWID), we examined syphilis incidence among PWID in Tijuana, Mexico. From 2006 to 2007, 940 PWID (142 women and 798 men) were recruited via respondent-driven sampling and followed for 18 months. At semi-annual visits, participants were tested for syphilis and completed surveys, which collected information on socio-demographics, sexual behaviours, substance use and injection behaviours. Poisson regression was used to estimate syphilis incidence rates (IRs), incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Twenty-one participants acquired syphilis during follow-up (IR = 1.57 per 100 person-years, 95% CI: 1.02-2.41). In a multivariate analysis, syphilis incidence was higher among women (IRR = 3.90, 95% CI: 1.37-11.09), HIV-positive participants (IRR = 4.60, 95% CI: 1.58-13.39) and those who reported ever exchanging sex for drugs, money, or other goods (IRR = 2.74, 95% CI: 0.97-7.76), while syphilis incidence was lower among those living in Tijuana for a longer duration (IRR = 0.95 per year, 95% CI: 0.91-1.00) and those reporting at least daily injection drug use (past 6 months) (IRR = 0.22, 95% CI: 0.09-0.54). Our findings suggest interventions that address the destabilising conditions associated with migration and integrate sexual and drug-related risk reduction strategies may help reduce syphilis incidence among PWID along the Mexico-US border.