... occur many years after the original, untreated infection. Congenital syphilis Babies born to women who have syphilis can ... the placenta or during birth. Most newborns with congenital syphilis have no symptoms, although some experience a rash ...
... active person can get syphilis through unprotected vaginal, anal, or oral sex. Have an honest and open talk with your health care provider and ask whether you should be tested for syphilis or other STDs. • All pregnant women should be tested for syphilis at their first ...
Rota, Paul A; Moss, William J; Takeda, Makoto; de Swart, Rik L; Thompson, Kimberly M; Goodson, James L
Measles is an infectious disease in humans caused by the measles virus (MeV). Before the introduction of an effective measles vaccine, virtually everyone experienced measles during childhood. Symptoms of measles include fever and maculopapular skin rash accompanied by cough, coryza and/or conjunctivitis. MeV causes immunosuppression, and severe sequelae of measles include pneumonia, gastroenteritis, blindness, measles inclusion body encephalitis and subacute sclerosing panencephalitis. Case confirmation depends on clinical presentation and results of laboratory tests, including the detection of anti-MeV IgM antibodies and/or viral RNA. All current measles vaccines contain a live attenuated strain of MeV, and great progress has been made to increase global vaccination coverage to drive down the incidence of measles. However, endemic transmission continues in many parts of the world. Measles remains a considerable cause of childhood mortality worldwide, with estimates that >100,000 fatal cases occur each year. Case fatality ratio estimates vary from 5% in developing countries. All six WHO regions have set goals to eliminate endemic transmission of MeV by achieving and maintaining high levels of vaccination coverage accompanied by a sensitive surveillance system. Because of the availability of a highly effective and relatively inexpensive vaccine, the monotypic nature of the virus and the lack of an animal reservoir, measles is considered a candidate for eradication.
Syphilis is a sexually transmitted disease caused by bacteria. It infects the genital area, lips, mouth, or anus of both men and women. You usually get syphilis from sexual contact with someone who has it. It can also pass from mother to ...
Syphilis is back since the beginning of this century. The epidemic affects mainly men having sex with men with a high proportion of HIV-infected patients. The classification of syphilis distinguishes early syphilis where patients are contagious (primary, secondary and early latent of less than one year) and late syphilis where patients are not (or less) contagious (late latent of more than one year and tertiary). The clinical presentation of syphilis has not changed. However, we must insist on the early forms of neurosyphilis, notably ophthalmic syphilis often under-diagnosed, as it affects the treatment. Serologic tests may be improved but are very helpful for the positive diagnosis and the follow-up after treatment. Treatment of early syphilis is based on one injection of benzathine benzyl penicillin G. Patients who have had syphilis must be regularly followed-up after treatment, as re-infections are common and are often asymptomatic. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.
... as other STIs such as gonorrhea and chlamydial, hepatitis B, and HIV infections. If necessary, his partner(s) should be treated. All pregnant women should receive a blood test for syphilis early ...
... or whose immune systems have been weakened by HIV/AIDS or other diseases. In populations with high levels of malnutrition, particularly vitamin A deficiency, and a lack of adequate health care, about 3â6%, of measles cases result in death, and in displaced groups, up to 30% of ...
... been eliminated in the United States. However, unvaccinated people who travel to other countries where measles is common have brought the disease back to the United States. This has led to ... groups of people who are unvaccinated. Some parents DO NOT let ...
... their newborn (congenital syphilis). Syphilis has three stages: Primary syphilis Secondary syphilis Tertiary syphilis (the late phase ... screening, and treatment. Symptoms The incubation period for primary syphilis is 14 to 21 days. Symptoms of ...
Franco, María Pía; Mulder, Maximilian; Gilman, Robert H.; Smits, Henk L.
Human brucellosis still presents scientists and clinicians with several challenges, such as the understanding of pathogenic mechanisms of Brucella spp, the identification of markers for disease severity, progression, and treatment response, and the development of improved treatment regimens.
Full Text Available The article provides comprehensive review of different aspects of measles. Definition of disease, historical overview, measles in the world epidemiology and in the countries bordering Ukraine over the recent years, particularities of measles epidemiology in Ukraine are given in details. Etiology of measles virus including known genomic structure and viral proteins list, genetic changeability of the virus. Particularities of measles epidemiological process are discussed, criteria of determination of morbidity level and contagiosity of the given disease are outlined. Detailed pathogenesis of measles in different periods of disease is provided, reciprocal influence of the disease and vitamin A metabolism is given. Particularities of humoral and cellular immunological response, including those in early-aged and in patients with immune deficiency are described. Possibility of development of subacute sclerosing panencephalitis is pointed out; currently accepted causes of this complication development, its immunological and virological particularities are summarized. Pathogenetic mechanisms of rash development, complications as well as morphological changes in different organs and systems are given. The article gives both international and different clinical classifications of measles. Clinical manifestations of typical and atypical measles course are described in details by syndromes and according to disease periods. Particularities of measles course at different premorbid conditions are described. The article provides colored photos which illustrate clinical mani¬festations of measles manifestation on the skin and mucosa at different disease periods.
... Home > Complications & Loss > Pregnancy complications > Syphilis in pregnancy Syphilis in pregnancy E-mail to a friend Please ... if he doesn’t get treatment. What is syphilis? Syphilis is a sexually transmitted disease (also called ...
... on the anus and outer vagina Joint swelling Refusal to move a painful arm or leg Saber ... Call your health care provider if your baby has signs or symptoms of this condition. If you think that you may have syphilis ...
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...
... Education & Events Advocacy For Patients About ACOG Chlamydia, Gonorrhea, and Syphilis Home For Patients Search FAQs Chlamydia, ... and Syphilis FAQ071, December 2016 PDF Format Chlamydia, Gonorrhea, and Syphilis Gynecologic Problems What is a sexually ...
... Staying Safe Videos for Educators Search English Español Syphilis KidsHealth / For Parents / Syphilis What's in this article? ... there can be different symptoms in each. Primary Syphilis The symptoms of the first stage of the ...
... a Glance Adolescent Vaccination Recommendation: MMR About Measles Facts about Measles for Adults What is measles? Measles ... are pregnant or severely immunosuppressed. Disease and vaccine facts FACT: Measles can be prevented with a safe ...
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%)
Wendel, G D
The frequency of congenital syphilis continues to increase throughout the United States during the 1980s. Untreated maternal infection can lead to stillbirth, premature labor, congenital infection, and neonatal death. Preventive measures, based on control of early syphilis in women, prenatal care, improved diagnosis and diligent followup, can help to decrease the incidence of congenital syphilis. The clinical presentation and recommended regimens for therapy of the gravida with syphilis and neonates with suspected congenital syphilis are reviewed.
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.)
Lü, J; Huang, C; Zeng, Y
To investigate obstetric treatment and pregnancy outcomes of syphilis infection during pregnancy. 64 pregnant women diagnosed with syphilis by serological assays were divided into treated group and untreated group according to whether they accepted full-dose treatment against syphilis or not. Patients in the treated group accepted benzathine penicillin(2.4 million units once per week) intramuscular injection for three weeks. The outcome of pregnan after treatment was observed and compared between the two groups. There were 5 cases of primary syphilis (7.8%), 29 cases of secondary syphilis (45.3%), and 30 cases of latent syphilis (46.9%) among the 64 cases. The occurrences of premature birth, fetal intrauterine death, and stillbirth were 0, and 3 cases of congenital syphilis in total 13 cases who carried pregnancy to term in the treated group; while 4, 11, 3, and 10 in the untreated group respectively. In treated group, the 3 babies with congenital syphilis were born from 10 mothers received treatment after 24 gestational weeks, while no congenital syphilis in the 3 women started treatment before 24 weeks. Pregnant syphilis is prone to be misdiagnosed because of its slight symptom, so it is especially important to screen syphilis as a routine among high risk pregnant women. Premature, fetal death and congenital syphilis can be well controlled through regular and early treatment during pregnancy, yet congenital syphilis can not be avoided completely.
Godfroid, J; Garin-Bastuji, B; Saegerman, C; Blasco, J M
The epidemiological link between brucellosis in wildlife and brucellosis in livestock and people is widely recognised. When studying brucellosis in wildlife, three questions arise: (i) Is this the result of a spillover from livestock or a sustainable infection in one or more host species of wildlife? (ii) Does wildlife brucellosis represent a reservoir of Brucella strains for livestock? (iii) Is it of zoonotic concern? Despite their different host preferences, B. abortus and B. suis have been isolated from a variety of wildlife species, whereas B. melitensis is rarely reported in wildlife. The pathogenesis of Brucella spp. in wildlife reservoirs is not yet fully defined. The prevalence of brucellosis in some wildlife species is very low and thus the behaviour of individual animals, and interactions between wildlife and livestock, may be the most important drivers for transmission. Since signs of the disease are non-pathognomonic, definitive diagnosis depends on laboratory testing, including indirect tests that can be applied to blood or milk, as well as direct tests (classical bacteriology and methods based on the polymerase chain reaction [PCR]). However, serological tests cannot determine which Brucella species has induced anti-Brucella antibodies in the host. Only the isolation of Brucella spp. (or specific DNA detection by PCR) allows a definitive diagnosis, using classical or molecular techniques to identify and type specific strains. There is as yet no brucellosis vaccine that demonstrates satisfactory safety and efficacy in wildlife. Therefore, controlling brucellosis in wildlife should be based on good management practices. At present, transmission of Brucella spp. from wildlife to humans seems to be linked to the butchering of meat and dressing of infected wild or feral pig carcasses in thedeveloped world, and infected African buffalo in the developing world. In the Arctic, the traditional consumption of raw bone marrow and the internal organs of freshly
... 20 million people get measles each year. When people with measles travel into the United States, they can spread the disease to unvaccinated people including children too young to be vaccinated. The ...
... Preteen cold, ice Cold, Ice, and Snow Safety Rubella (German Measles) KidsHealth > For Parents > Rubella (German Measles) ... to Call the Doctor en español Rubéola About Rubella Rubella — commonly known as German measles or 3- ...
Lithgow, Karen V; Cameron, Caroline E
Syphilis, caused by the spirochete Treponema pallidum subspecies pallidum, continues to be a globally prevalent disease despite remaining susceptible to penicillin treatment. Syphilis vaccine development is a viable preventative approach that will serve to complement public health-oriented syphilis prevention, screening and treatment initiatives to deliver a two-pronged approach to stemming disease spread worldwide. Areas covered: This article provides an overview of the need for development of a syphilis vaccine, summarizes significant information that has been garnered from prior syphilis vaccine studies, discusses the critical aspects of infection that would have to be targeted by a syphilis vaccine, and presents the current understanding within the field of the correlates of protection needed to be achieved through vaccination. Expert commentary: Syphilis vaccine development should be considered a priority by industry, regulatory and funding agencies, and should be appropriately promoted and supported.
100000) and Guillain-Barre syndrome(12, 14). There have also been some suggestions of an association between measles vaccination and'Crohn's disease and autism, but the evidence is unconvincing and has been refuted by a large volume of strong research(12,15). Currently the diagnosis of measles is largely clinical,.
Pollock, K; Potts, A; Love, J; Steedman, N; Donaghy, M
In 2013, Wales and England experienced large outbreaks of measles, a disease that has been targeted by the World Health Organisation for European elimination by 2015. Unfortunately, measles-mumps-rubella vaccine uptake declined to less than 80% in Wales and England after the Wakefield publicity and this resulted in increased population susceptibility to measles. In Scotland, measles-mumps-rubella vaccine uptake dropped to 87% in 2003. Scottish public health efforts in response to this decline aimed to maximise uptake of MMR1 by two years; ensure at least 95% uptake of one dose of measles-mumps-rubella before starting school at age five; and maximise uptake of the second dose of measles-mumps-rubella by age six. Although Scotland has not had any large outbreaks reported to date, transmission of measles from healthcare workers to patients has occurred and reiterates the importance of all healthcare workers accurately knowing their immune status and, when needed, to be fully immunised.
Yi Li; Bernard Gonik
Detroit has recently been distinguished as having the highest congenital syphilis rate in the United States (250.3 cases per 100 000 live births in Detroit versus 10.3 in the US). However, depending on each health department's followup and CDC reporting, these data may not accurately reflect the true congenital syphilis rate. This study examines the reported cases over a three-year time period with focus on the criteria used for diagnosis. All local health department congenital syphilis C...
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. Copyright Â© 2016 Elsevier B.V. All rights reserved.
Full Text Available Detroit has recently been distinguished as having the highest congenital syphilis rate in the United States (250.3 cases per 100 000 live births in Detroit versus 10.3 in the US. However, depending on each health department's followup and CDC reporting, these data may not accurately reflect the true congenital syphilis rate. This study examines the reported cases over a three-year time period with focus on the criteria used for diagnosis. All local health department congenital syphilis CDC collection forms (form 73.126 were reviewed for the years in question. The reported congenital syphilis cases in the year 2002–2004 in Detroit were reviewed. No cases met confirmed case criteria and few probable cases were based on neonatal evaluations. The majority of “congenital syphilis” cases were established based on incomplete maternal data such as missing followup serologic titers in the absence of complete neonatal information. In conclusion, although the reported congenital syphilis rate in Detroit is alarmingly high, the true occurrence of congenital syphilis is likely to have been overstated. A health department reporting program that includes more diligent neonatal followup would allow for a more accurate representation of this public health concern.
Eduardo Chaida Sonda; Felipe Farias Richter; Graziela Boschetti; Marcela Pase Casasola; Candice Franke Krumel; Cristiane Pimentel Hernandes Machado
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 ...
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
Aug 5, 1989 ... The prevalence of syphilis (or positive serology) in pregnant mothers delivering at Baragwanath Hospital, Johannesburg, was assessed in order to try to establish the prevalence of congenital syphilis and possibly to identify a specific popula- tion at risk. From August 1985 to January 1986 all mothers.
Melina G.S. Sousa
Full Text Available ABSTRACT: The domestication of water buffaloes (Bubalus bubalis originated in India and China and spread throughout the world and represents an important source of food of high biological value. Given the importance and relevance of brucellosis for buffalo production, this article reviews the history, etiopathogenesis, epidemiology, clinical signs, anatomopathological findings, diagnosis and control of the disease, focusing on data from studies on water buffaloes performed in different countries and the Brazilian Amazon biome.
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.
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.
Lee, Tiffany; Bell, Stephanie; Scimeme, Jason; Maraqa, Nizar
As of late, the incidence of congenital syphilis in the United States is increasing. Each new case represents a failure of preventing, diagnosing, and treating syphilis in pregnant women. Pediatricians should confirm that all women have received adequate screening for and management of syphilis during pregnancy. Congenital syphilis is easily treatable but may be a diagnostic challenge with high morbidity and mortality.
Prior to the emergence of venereal syphilis, treponema disease was widespread in Africa either in the form of yaws or in the form of endemic, i.e., non-venerally transmitted syphilis. In much of Africa, venereal syphilis started to increase following the highly successful yaws eradication campaigns of the 1950s and the 1960s. One prospective study reported no increase in CNS infection by Treponema pallidum in syphilis patients with HIV compared to those without HIV. However, HIV infection may modulate the clinical expressions of syphilis, in particular, making cutaneous manifestations more florid (luens maligna, giant primary chancre, early appearance of gumma) and neurosyphilis and eye complications (uveitis, papillitis, vitreitis, optic neuritis) more common. Thus, serological tests may give false positives or false negatives in HIV-infected individuals. WHO guidelines for the management of syphilis advocate the use of a single dose of benzathine penicillin for primary and secondary syphilis and syphilis in pregnancy, and 10-day courses of crystalline or procaine penicillin for congenital syphilis. In Lusaka, Zambia, 12.5% of 202 antenatal clinic attenders were RPR and TPHA positive. 42% of women delivering stillbirths were positive and 6.5% of 469 infants delivered in a hospital were positive. 8.6% of children admitted to a hospital aged more than 3 months were positive. Mortality was 54% in 65 cases aged more than 4 weeks. For treatment, a 2nd test later in pregnancy or administration of penicillin to all mothers in the final trimester and again to all newborns has been suggested. In addition, the results of testing ought to be made available to women attending clinics on the day of attendance so that testing and treatment are carried out on the same day. Syphilis can be transmitted by blood transfusion, but storing blood for 5 days at 4 degrees Celsius assures safety.
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
de Vries, Rory D.; Mesman, Annelies W.; Geijtenbeek, Teunis B. H.; Duprex, W. Paul; de Swart, Rik L.
Measles is an important cause of childhood morbidity and mortality in developing countries. Measles virus (MV) is transmitted via the respiratory route and causes systemic disease. Over the last decade, identification of new cellular receptors and studies in animal models have challenged the
T. I. Zlobina
Full Text Available Joint involvement in syphilis has been considered as casuistry in recent years. At the same time, the high incidence of primary syphilis and the notified cases of late neurosyphilis may suggest that joint involvement in this disease is by no means always verified. Traditionally there are two forms of syphilitic arthritis: primary synovial (involving the articular membranes and sac and primary bone (involving the articular bones and cartilages ones. The paper describes the authors' clinical case of the primary bone form of articular syphilis in a 34-year-old man.
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.
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.
Gwida, Mayada; Al Dahouk, Sascha; Melzer, Falk; Rösler, Uwe; Neubauer, Heinrich; Tomaso, Herbert
To gain deeper insight into the seroprevalence of brucellosis, which remains a zoonotic disease of worldwide public health concern, by reviewing studies from countries including North Africa, the Middle East, and India...
Rajat Gupta; Vora, Rita V.
Congenital syphilis is a potentially serious pathology affecting newborns of infected mothers. Even one case of congenital syphilis is a sentinel public health event, since timely diagnosis and treatment of syphilis infected pregnant woman should prevent transmission almost entirely. Here, we are reporting a case of early symptomatic congenital syphilis presented with severe desquamating papulosquamous lesions over multiple body parts along with erosive lesions around oral cavity and nostrils.
A. Notowicz (Alfred)
textabstractApart from identification of the causative microorganism, serological blood testing is still the principal aid in the diagnosis of venereal syphilis. In latent syphilis it is in fact the only diagnostic aid. In the diagnosis of late symptomatic syphilis, additional organ-specific
V; Chawla; Pandit, P B; Nkrumah, F K
We studied 53 newborn babies with congenital syphilis. The common clinical features seen were low birth weight, hepatosplenomegaly, anaemia, jaundice, and symmetrical superficial desquamation of the skin affecting palms and soles. The presence of these clinical signs is highly suggestive of early congenital syphilis. Hydrops fetalis without rhesus or ABO isoimmunisation should always arouse the suspicion of congenital syphilis.
... Inspection Service 9 CFR Part 78 Brucellosis in Swine; Add Texas to List of Validated Brucellosis- Free... comments. SUMMARY: We are amending the brucellosis regulations concerning the interstate movement of swine by adding Texas to the list of validated brucellosis-free States. We have determined that Texas meets...
Objective: This study was carried out to assess the impact of the supplemental measles vaccinations on the cases of measles admitted ... Methods: Weretrospectivelylooked at therecords of cases of measles in children admitted to the Wesley Guild Hospital, Ile- sa over a ..... Byrne J.P Encyclopedia of Pestilence, Pandemics,.
Sheffield, Jeanne S; Sánchez, Pablo J; Morris, George; Maberry, Mark; Zeray, Fiker; McIntire, Donald D; Wendel, George D
The purpose of this study was to characterize pregnancies that were complicated by maternal syphilis that had been treated before delivery in which the newborn infant was diagnosed with congenital syphilis. Prospective surveillance from January 1, 1982, to December 31, 1998, involved women who received antenatal treatment for syphilis. Infants who were born with congenital syphilis were identified by clinical or laboratory criteria. Antepartum factors such as gestational age, time to delivery and VDRL titers were then analyzed and compared with those of women who had been treated and who were delivered of an uninfected infant. The 1:1 match was based on the stage of syphilis and the gestational age at treatment. Forty-three women who received antepartum therapy for syphilis were delivered of an infant with congenital syphilis. Most of the women had been treated for early syphilis; the mean gestational age at treatment was 30.3 weeks. Thirty-five percent of the women were treated >30 days before delivery. Fifty-six percent of the infants were preterm. The 1:1 match revealed that treatment and delivery high VDRL titers, prematurity, and a short interval from treatment to delivery were significantly different in those infants who were diagnosed with congenital syphilis. High VDRL titers at treatment and delivery, earlier maternal stage of syphilis, the interval from treatment to delivery, and delivery of an infant at gestation are associated with the delivery of a congenitally infected neonate after adequate treatment for maternal syphilis.
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.
Chowdhary, Nagalakshmi; Rani, Bs Kavya; Mukunda, K S; Kiran, N K
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.
Hamid Reza Nouri
Full Text Available Context: Brucellosis represents a zoonotic bacterial disease, caused by a gram negative bacterium called Brucella. Between the diverses pecies of this bacteria, B. melitensis, B. abortus, B. suis and B. canis consist the main causes of the disease in humans.More than half a million new cases of Brucellosis are reported annually. Consequently, brucellosis is a remarkable threat for the health of society. Because of the multiple nonspecific clinical signs of this infection, such as fever (60% of cases, night sweating, insomnia and anorexia, which are similar to other diseases, the detection of brucellosis is time-consuming and needs more scrutiny. Evidence Acquisition: Blood culture is considered the gold standard for the detection of brucellosis and the sensitivity of this test in the acute form is high. However, for the chronic type of disease, it is remarkably low, in addition, in some cases, it needs long reaction times. Nevertheless, today, some kinds of tests like automatic culturing system and serological methods, such as Rose Bengal (RB test, serum agglutination test (SAT, 2-mercaptoethanol (2ME and coombs, which are operated based on agglutination, are useful for the problems mentioned earlier. Conclusion: Although serological methods are common for the diagnosis of brucellosis, false results are observable for several methods, such as the SAT method. Tests like the enzyme-linked immunosorbent assay (ELISA, for the screening of specific traits, although confirmed, have their advantages and defects. The lateral flow assay (LFA shows promising evidence to be effective in the diagnosis of brucellosis. The polymerase chain reaction (PCR is more prevalent than other common tests, according to sensitivity and fast answering potency in case of molecular diagnosis. Also, PCR is proper for patients' follow-up during the period of treatment and crimination of relapse by this method is easier compared to others.
Sunil K Gupta
Full Text Available A 28-year-old male patient presented to Skin, V.D. and Leprosy outpatient with a single gray white plaque on the left side of the lower lip for last 8 months and multiple papulosquamous lesions all over the body for last 6 months. There was history of blood transfusion for anemia 1 year back. Histopathology of lip lesion and reactive VDRL and TPHA tests confirmed the diagnosis as syphilis. We report this rare case of Syphilis d′ emblee.
... 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 are...
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.
White, Sarah J; Boldt, Kristi L; Holditch, Sara J; Poland, Gregory A; Jacobson, Robert M
Measles, mumps, and rubella are viral diseases that may adversely affect nonimmune pregnant women and their fetuses/neonates. Prevention of these diseases and their complications can be achieved through measles-mumps-rubella (MMR) vaccination before pregnancy. The vaccine is contraindicated during pregnancy, because it contains live, attenuated viruses that pose a theoretical risk to the fetus. However, accidental receipt of MMR vaccination is not known to cause maternal/fetal complications. MMR immunization is recommended to nonimmune obstetric patients upon completion or termination of pregnancy.
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
Rota, P A; Featherstone, D A; Bellini, W J
Genetic characterization of wild-type measles viruses provides a means to study the transmission pathways of the virus and is an essential component of laboratory-based surveillance. Laboratory-based surveillance for measles and rubella, including genetic characterization of wild-type viruses, is performed throughout the world by the WHO Measles and Rubella Laboratory Network, which serves 166 countries in all WHO regions. In particular, the genetic data can help confirm the sources of virus or suggest a source for unknown-source cases as well as to establish links, or lack thereof, between various cases and outbreaks. Virologic surveillance has helped to document the interruption of transmission of endemic measles in some regions. Thus, molecular characterization of measles viruses has provided a valuable tool for measuring the effectiveness of measles control programs, and virologic surveillance needs to be expanded in all areas of the world and conducted during all phases of measles control.
Sheffield, Jeanne S; Sánchez, Pablo J; Wendel, George D; Fong, David W I; Margraf, Linda R; Zeray, Fiker; McIntire, Donald D; Barton Rogers, Beverly
To evaluate the contribution of placental histopathology to the diagnosis of congenital syphilis. From January 1, 1986, through December 31, 1998, all pregnant women presenting to a large, urban Dallas County labor and delivery unit with untreated syphilis at delivery and who had placental evaluation performed were identified. Women were clinically staged, and the infants were evaluated for congenital syphilis using a standard protocol. Each placenta was evaluated by two independent pathologists. Histologic characteristics of the placenta related to congenital syphilis in live-born and stillborn infants were then analyzed. Sixty-seven women met the study criteria: 33 (49%) stillborn and 18 (27%) live-born infants with congenital syphilis, 15 (22%) uninfected live-born infants, and one uninfected stillborn fetus diagnosed by current criteria. There were no differences between the groups with regard to demographic characteristics, prenatal care, or stage of syphilis. Stillborn infants were more likely to deliver preterm (P gestational age, histopathology revealed necrotizing funisitis, villous enlargement, and acute villitis associated with congenital syphilis. Erythroblastosis was more common in stillborn infants with congenital syphilis than all live-born infants (odds ratio 16, 95% confidence interval 1, 370). The addition of histologic evaluation to conventional diagnostic evaluations improved the detection rate for congenital syphilis from 67% to 89% in live-born infants, and 91% to 97% in stillborn infants. Our results show that histopathologic examination of the placenta is a valuable adjunct to the contemporary diagnostic criteria used to diagnose congenital syphilis.
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…
... STD STD on Twitter STD on Facebook Archive Syphilis Recommend on Facebook Tweet Share Compartir This web ... Table 36B ). Interpreting Rates of Reported Cases of Syphilis Left untreated, infection with syphilis can span decades. ...
Berman, Stuart M.
Despite the long history of medical interest in syphilis and its effects on pregnancy outcome, many fundamental questions about the pathophysiology and treatment of syphilis during pregnancy remain unanswered. However, understanding has been advanced by recent scientific reports such as those which delineate the complete sequence of the genome of the syphilis spirochaete, provide a more precise description of fetal and neonate infection by use of rabbit infectivity tests and describe the gest...
Chacon, Anna H
Syphilis has extremely variable manifestations that produce an extremely broad differential diagnosis. Care must be taken to consider syphilis in dermatologic and other systemic disorders as is relevant.
Lasfargue, M; Thümmler, S; Perelman, S; de Ricaud, D
Syphilis is a re-emerging infectious disease in Western Europe. Congenital syphilis is a potentially serious pathology affecting newborns of infected mothers. This disease is easily curable by a simple antibiotic treatment. Because of systematic antenatal screening it should no longer exist in industrialized countries. Nevertheless, we report a case of a six-week-old infant with a delayed diagnosis of congenital syphilis. Physicians, especially gynaecologists, obstetricians and paediatricians, have to be vigilant in order to allow for early diagnosis and appropriate treatment of congenital syphilis.
Bellini, William J; Rota, Paul A
Because of the success of global measles control programs, the World Health Organization (WHO), along with its partner agencies, is once again considering the possibility of setting a target date for measles eradication. Measles would be the fourth viral agent to be eradicated joining the successful programs to eradicate smallpox and rinderpest virus, and the continuing effort to eradicate polio virus. A description of the recent progress toward measles eradication was recently published as a supplement in the Journal of Infectious Diseases (15 July, 2011, 204 (Suppl. 1)) and the reader is referred to this document for a detailed summary of the global status of measles control. This review will focus on the biologic and virologic aspects of measles eradication. Published by Elsevier B.V.
Krishna Prasad Acharya
Full Text Available OBJECTIVES The aim of this paper is to evaluate the current status of the disease, the mechanism of infection, and pathogenesis, its zoonotic potential, diagnostic advances, treatment regimens, and the preventive measures that can be adopted in managing human brucellosis in under-developed countries such as Nepal. METHODS We performed a systematic review of all the available literture through Google Scholar, PubMed, Gideon Informatics, World Health Organization and other legitimate sources. Other secondary informations were collected from the government agencies such as department of livestock services and Ministry of Health. The obtained information was then re-analysed and summarized. RESULTS Few publications have addressed brucellosis in Nepal and most of those publications have focused on bovine brucellosis with sparse information available on brucellosis in humans and small ruminants. Brucella abortus is the most predominant causative agent followed by B. suis. B. abortus is predominant in cattle accounting for a substantial portion of bovine abortion in the country. Lack of awareness, unhealthy food habit, traditional husbandry practices, and a lack of surveillance and immunization have been the major factors in maintaining a vicious cycle of propagation of the disease in human and animals. Unfortunately, nothing has been done to identify the species of Brucella at the biovar level. CONCLUSIONS Although brucellosis has been reported to be endemic in Nepal, neither the distribution nor the economic and public health impact of this disease is well characterized. Robust and well-designed nationwide survey is warranted to assess the prevalence and distribution of disease in livestock and humans. Such data would facilitate the design of appropriate control programmes.
Acharya, Krishna Prasad; Niroula, Nirajan; Kaphle, Krishna
OBJECTIVES The aim of this paper is to evaluate the current status of the disease, the mechanism of infection, and pathogenesis, its zoonotic potential, diagnostic advances, treatment regimens, and the preventive measures that can be adopted in managing human brucellosis in under-developed countries such as Nepal. METHODS We performed a systematic review of all the available literture through Google Scholar, PubMed, Gideon Informatics, World Health Organization and other legitimate sources. Other secondary informations were collected from the government agencies such as department of livestock services and Ministry of Health. The obtained information was then re-analysed and summarized. RESULTS Few publications have addressed brucellosis in Nepal and most of those publications have focused on bovine brucellosis with sparse information available on brucellosis in humans and small ruminants. Brucella abortus is the most predominant causative agent followed by B. suis. B. abortus is predominant in cattle accounting for a substantial portion of bovine abortion in the country. Lack of awareness, unhealthy food habit, traditional husbandry practices, and a lack of surveillance and immunization have been the major factors in maintaining a vicious cycle of propagation of the disease in human and animals. Unfortunately, nothing has been done to identify the species of Brucella at the biovar level. CONCLUSIONS Although brucellosis has been reported to be endemic in Nepal, neither the distribution nor the economic and public health impact of this disease is well characterized. Robust and well-designed nationwide survey is warranted to assess the prevalence and distribution of disease in livestock and humans. Such data would facilitate the design of appropriate control programmes. PMID:27703129
... Animal and Plant Health Inspection Service 9 CFR Part 78 Brucellosis in Swine; Add Texas to List of Validated Brucellosis- Free States AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION... interim rule that amended the brucellosis regulations concerning the interstate movement of swine by...
Szyfres, Boris; Centro Panamericano de Zoonosis, Azul, Argentina; Blood, Benjamín D.; Centro Panamericano de Zoonosis, Azul, Argentina; Moya, Víctor; Centro Panamericano de Zoonosis, Azul, Argentina
The authors have summarized the information available to them regarding the problem of human and animal brucellosis in Latin America. Animal brucellosis in Latin American countries is a widespread infection. In cattle attacked in preference to animal milk which reaches its highest prevalence. The suina and caprine brucellosis is second in magnitude. In beef cattle, the infection is lower than in the previous groups, and in sheep there is a small percentage of reactants significant title, ther...
Rota, Paul A; Brown, Kevin; Mankertz, Annette; Santibanez, Sabine; Shulga, Sergey; Muller, Claude P; Hübschen, Judith M; Siqueira, Marilda; Beirnes, Jennifer; Ahmed, Hinda; Triki, Henda; Al-Busaidy, Suleiman; Dosseh, Annick; Byabamazima, Charles; Smit, Sheilagh; Akoua-Koffi, Chantal; Bwogi, Josephine; Bukenya, Henry; Wairagkar, Niteen; Ramamurty, Nalini; Incomserb, Patcha; Pattamadilok, Sirima; Jee, Youngmee; Lim, Wilina; Xu, Wenbo; Komase, Katsuhiro; Takeda, Makoto; Tran, Thomas; Castillo-Solorzano, Carlos; Chenoweth, Paul; Brown, David; Mulders, Mick N; Bellini, William J; Featherstone, David
A critical component of laboratory surveillance for measles is the genetic characterization of circulating wild-type viruses. The World Health Organization (WHO) Measles and Rubella Laboratory Network (LabNet), provides for standardized testing in 183 countries and supports genetic characterization of currently circulating strains of measles viruses. The goal of this report is to describe the lessons learned from nearly 20 years of virologic surveillance for measles, to describe the global databases for measles sequences, and to provide regional updates about measles genotypes detected by recent surveillance activities. Virologic surveillance for measles is now well established in all of the WHO regions, and most countries have conducted at least some baseline surveillance. The WHO Global Genotype Database contains >7000 genotype reports, and the Measles Nucleotide Surveillance (MeaNS) contains >4000 entries. This sequence information has proven to be extremely useful for tracking global transmission patterns and for documenting the interruption of transmission in some countries. The future challenges will be to develop quality control programs for molecular methods and to continue to expand virologic surveillance activities in all regions. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2011.
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.
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
Blair, S.; Shave, N; McKay, J.
Two hundred and one parents attending three child health clinics were questioned about both measles and immunisation against measles. Most parents were unaware of the symptoms and possible complications of measles and did not believe immunisation to be effective in preventing measles. They did not remember having talked to health professionals about immunisation.
Kurtaran, Behice; Akyildiz, Ozay; Candevir Ulu, Aslihan; Inal, Seza Ayse; Komur, Suheyla; Seydaoglu, Gulsah; Arslan, Yusuf Kemal; Yaman, Akgun; Kibar, Filiz; Aksu, Hasan Salih Zeki; Tasova, Yesim
This study was aimed to determine the relationship between vitamin D and soluble vitamin D receptor (VDR) levels and brucellosis, a common infection in Turkey, in which the cellular immune system is important in the course of the disease. Patients who had been followed up in the Department of Infectious Diseases and Clinical Microbiology of Cukurova University Medical Faculty, having been diagnosed with brucellosis and who had no brucellosis treatment before, were enrolled in the study along with healthy controls. The participants' vitamin D and soluble VDR values were recorded. Laboratory parameters of patients and controls, clinical findings, and disease course of brucellosis patients were also noted. The mean age of the 86 brucellosis patients, of whom 38 (44.2%) were males and 48 (55.8%) were females, was 40.9 ± 18.4 years. Complicated course of brucellosis rate was found to be 29.1%. Vitamin D and VDR levels were lower in brucellosis patients at the time of diagnosis compared to control group. For males, vitamin D and VDR levels were higher in the control group than in the patient group. In males, VDR levels were higher than in females. A significant difference was not found between clinical forms of the disease and vitamin D and VDR levels. Vitamin D and VDR levels were shown to be significantly lower in brucellosis patients before treatment compared to the control group. These results suggest that vitamin D could be involved in the pathogenesis of the disease.
... season recorded the highest prevalence of 15.07% among the seasons. Since brucellosis is a zoonotic disease, it is important to include camels in vaccination programs against the disease. Keywords: Sero-prevalence; brucellosis; Camels; Zoonotic; Brucella abortus; Nigeria Animal Production Research Advances Vol.
... 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. (a...
... 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. (a...
... 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, Alaska...
... 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. (a...
... 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. (a...
... 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 bison...
... 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 cattle...
Berman, Stuart M
Despite the long history of medical interest in syphilis and its effects on pregnancy outcome, many fundamental questions about the pathophysiology and treatment of syphilis during pregnancy remain unanswered. However, understanding has been advanced by recent scientific reports such as those which delineate the complete sequence of the genome of the syphilis spirochaete, provide a more precise description of fetal and neonate infection by use of rabbit infectivity tests and describe the gestational age distribution of fetal death secondary to syphilis. It appears that fetal syphilitic involvement progresses in a rather predictable fashion, and although there is disagreement about the optimal prenatal treatment regimen, programmatic efforts to prevent fetal death must provide seropositive pregnant women with a recommended treatment early in pregnancy, and certainly before the third trimester.
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.
Kazak, Esra; Akalın, Halis; Yılmaz, Emel; Heper, Yasemin; Mıstık, Reşit; Sınırtaş, Melda; Özakın, Cüneyt; Göral, Güher; Helvacı, Safiye
Brucellosis is a public health problem that is prevalent in several developing countries. The clinical and laboratory characteristics of 164 cases of brucellosis in Bursa, Turkey, were retrospectively evaluated. The ages of the 164 patients ranged from 15-85 years. All of the patients underwent the Rose Bengal test and 163 (99.4%) patients tested positive. 122 (74.4%) patients were diagnosed with acute brucellosis, 31 (18.9%) with subacute brucellosis and 11 (6.7%) with chronic brucellosis. Focal involvement was found in 101 (61.6%) patients. Although patients with focal involvement had a higher white blood cell count (p = 0.002), those without focal involvement had higher aspartate transaminase and alanine transaminase values, and lower platelet values (p = 0.005, 0.007 and 0.039, respectively). Spondylodiscitis was observed on imaging in 58 (66.7%) of the 87 patients who presented with back pain. Among the 118 patients who were examined within the first month of treatment, 79 (66.9%) responded to treatment. The relapse rate was 11.6% among all 164 patients. Brucellosis should be considered as a differential diagnosis among patients who present with fever, and joint or back pain. Focal involvement should be investigated in the presence of leucocytosis, and subacute or chronic forms of brucellosis. To identify cases of spondylodiscitis, radiography should be performed in patients who present with back pain.
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 pidemiology 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, cl...
Bakri, Faris G; Al-Bsoul, Nazzal M; Magableh, Ahmad Y; Shehabi, Asem; Tarawneh, Musleh; Al-Hadidy, Azmy M; Abu-Fara, Mohammed A; Awidi, Abdallah S
We describe the case of a 29-year-old woman who presented with pancytopenia and myelofibrosis. Brucella melitensis was identified in her blood. The patient recovered completely with doxycycline and rifampin. A repeat bone marrow biopsy showed hypercellularity without myelofibrosis. Bone marrow findings in cases of pancytopenia due to brucellosis reveal normocellularity, hypercellularity, hemophagocytosis, or granuloma. To our knowledge this is the first report of brucellosis causing myelofibrosis. Brucellosis should be considered as a possible cause of myelofibrosis in endemic areas. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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.
Conover, C S; Rend, C A; Miller, G B; Schmid, G P
BACKGROUND: Although congenital syphilis usually occurs as a result of a failure to detect and treat syphilis in pregnant women, failures of the currently recommended regimen to prevent congenital syphilis have been reported. CASE: This report describes an infant with congenital syphilis despite maternal treatment with a regimen exceeding current CDC guidelines. CONCLUSION: Regardless of the regimen used to treat syphilis during pregnancy, clinicians should recognize the possibility of occasi...
Craig S. Conover; Rend, Charles A.; Grayson B. Miller; Schmid, George P
Background: Although congenital syphilis usually occurs as a result of a failure to detect and treat syphilis in pregnant women, failures of the currently recommended regimen to prevent congenital syphilis have been reported.Case: This report describes an infant with congenital syphilis despite maternal treatment with a regimen exceeding current CDC guidelines .Conclusion: Regardless of the regimen used to treat syphilis during pregnancy, clinicians should recognize the possibility of occasio...
Full Text Available This case concerns a premature infant with typical signs of congenital syphilis born to an untreated foreign mother. Syphilis prevalence in pregnant women has been rising in Italy since the beginning of the 21st century, mainly due to immigration. A correct antenatal syphilis screening and consequent adequate therapy of pregnant woman are fundamental to prevent the neonatal infection.
... 42 Public Health 5 2010-10-01 2010-10-01 false Syphilis serology. 493.923 Section 493.923 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.923 Syphilis serology. (a) Program content and frequency of challenge. To be approved for proficiency testing in syphilis serology, a program...
Lane, G K; Oates, R K
Thirty-three cases of congenital syphilis that were seen at The Children's Hospital, Camperdown, over a 34-year period were reviewed. Twenty-nine cases were examples of early congenital syphilis, as the patients developed clinical features in the first two years of life, and the other four cases were examples of late congenital syphilis, with the clinical features developing between two years and nine months of age and 10 years of age. Twenty-five patients were symptomatic at the time of admission to hospital. The most common clinical feature on the patient's presentation to hospital was a maculopapular or vesiculobullous skin eruption which occurred in 13 of the infants. Hepatic and splenic enlargement were present in 12 cases, and nine children had the "snuffles". Five of the children died. Patient follow-up occurred in fewer than 40% of cases and three of the children who were followed-up suffer from developmental delay. Congenital syphilis can occur in all social groups but is most common in infants who are premature or are small for gestational age and are born to young, unmarried mothers of low socioeconomic status. The treatment of congenital syphilis is simple and effective although the patients may need to be linked with community-health facilities to assist in their compliance with follow-up appointments.
Solera, Javier; Solís García Del Pozo, Julián
Pulmonary involvement is a rare, focal complication of human brucellosis. The aim of this review is to describe clinical and radiologic features, treatment administered and clinical course of these patients. Areas covered: We conducted a systematic search of scientific reports of brucellosis with pulmonary involvement published from January 1985 to July 2016. Four main patterns of disease were observed: pneumonia, pleural effusion, nodules and interstitial pattern. Cough and fever were the most common symptoms. Brucella spp. culture was obtained from blood (50%) or pleural fluid. Treatment is based on the same antibiotics and combinations of antibiotics as for patients with acute no complicated brucellosis. The most frequent antimicrobial combination was doxycycline and rifampin for six weeks. The clinical course was favorable in most reports, and mortality was remarkably low (Brucellosis from other pulmonary infections, such as tuberculosis, sometimes posed an added diagnostic challenge.
de Vries, Rory D; Stittelaar, Koert J; Osterhaus, Albert D M E; de Swart, Rik L
Measles is a highly contagious viral disease. With 1 million deaths reported in 1996, measles was the leading cause of vaccine-preventable deaths. However, in recent years, significant progress has been made in measles control, reducing deaths attributed to measles to 454,000 in 2004 and 242,000 in 2006. The main strategy behind this reduction has been the improvement of vaccination coverage and implementation of a second opportunity for immunization with the live-attenuated measles vaccine. The Measles Initiative, a partnership between the American Red Cross, CDC, UNICEF, WHO and UN Foundation, has had a significant role in this achievement. Here, we provide an overview of old and new vaccination strategies, and discuss changes in the route of administration of the existing live-attenuated vaccine, the development of new-generation nonreplicating measles virus vaccine candidates and attempts to use recombinant measles virus as a vector for vaccination against other pathogens.
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.
Ogawa, Yoshihiko; Imai, Yuichiro; Yoshihara, Shingo; Fujikura, Hiroyuki; Hirai, Nobuyasu; Sato, Masatoshi; Ogawa, Taku; Uno, Kenji; Kasahara, Kei; Yano, Hisakazu; Mikasa, Keiichi
Pulmonary involvement in secondary syphilis is considered a rare occurrence; however, the number of cases has increased in the 2000s. This is likely due to the increased use of computed tomography scans and molecular diagnostic testing. We report a case of an HIV-positive man with pleural chest pain and bilateral subpleural nodules on chest computed tomography. His rapid plasma reagin and Treponema pallidum hemagglutination tests were positive, and the specimen of one of the pulmonary nodules obtained by transthoracic biopsy was positive for the polA gene of Treponema pallidum. Since clinical manifestations of syphilis are highly variable, clinicians should bear in mind that pleural chest pain with bilateral subpleural nodules can be caused by pulmonary syphilis.
Bell, Carrie; Taxy, Jerome
Congenital syphilis remains a public health concern in the United States. Infants whose mothers are treated in the third trimester without adequate prenatal care have an increased risk of morbidity and mortality in the immediate perinatal period. The identification of Treponema pallidum in tissue is definitive confirmation of infection. We report the case of a 32-week gestational age infant born to a mother treated for syphilis 7 days prior to delivery. The infant died 12.5 hours after birth. At autopsy, there was extensive acute hyaline membrane disease. In addition, there were bilateral pulmonary abscesses with spirochetes. The onset of maternal disease was unknown, but was probably early in or prior to the pregnancy. This is an unusual case of pulmonary involvement in congenital syphilis.
Leunbach, Tina Lund; Koppelhus, Uffe; Bender, Lars
A pregnant Caucasian woman with newly diagnosed syphilis in the secondary stage was hospitalized for observation while being treated with penicillin. After one dose of penicillin the foetus was delivered by a caesarean section at gestational age 28 weeks + five days due to a reduced blood flow in arteria cerebri media. He was small for gestational age with birth weight 1,320 g. He received intensive care for eight weeks and intravenously administered benzyl penicillin 80.000 IE × 2 in 15 days. At corrected age one year he was developmentally normal. The incidence of syphilis is increasing and this case illustrates that screening and awareness of syphilis in the Western world is important.
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
... 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... for preparing the production seed virus for vaccine production. All serials of vaccine shall be...
Apr 20, 1991 ... Taylor WR, Ruti-Kalisa, Ma-disa M, Weinman JM. Measles control efforts in urban Africa complicated by high incidence of measles in the first year of life. Am J Epidemiol 1988; 127: 788-794. 12. Fisher SA. Measles and poverty in Port Elizabeth. Paper presented at the. Second Carnegie Inquiry into Poverty ...
Tridapalli, Elisabetta; Capretti, Maria Grazia; Reggiani, Maria Letizia Bacchi; Stronati, Mauro; Faldella, Giacomo
To study the prevalence of congenital syphilis and its risk factors in Italy. Prospective study from 1 July 2006 to 30 June 2007. Data on mother-child pairs were collected for every syphilis seropositive mother. Maternal syphilis seroprevalence at delivery was 0.17%. 207 infants were born to 203 syphilis seropositive mothers. In 25 newborns it was possible to diagnose congenital syphilis (20/100,000 live births). Maternal risk factors included age syphilis seropositive mothers were foreign born but the risk of an infected newborn was not higher in foreign-born than in Italian seropositive women. The significant factors were lack of antenatal screening and inadequate maternal treatment. Syphilis is a re-emerging infection in Italy. Prevention strategies should include antenatal serological tests for all pregnant women and treatment for infected mothers.
... are most commonly infected include sheep, cattle, goats, pigs, and dogs, among others. Transmission How do people ... Worldwide Areas at Greatest Risk For Veterinarians For Laboratory Personnel For Clinicians For Consumers Travelers Expecting Mothers ...
Full Text Available Acute disseminated encephalomyelitis is an inflammatory demyelinating illness usually associated with infections or antecedent immunization. Due to control of most vaccine preventable diseases in developed countries, most cases of acute disseminated encephalomyelitis occur in developing countries and are seen secondary to nonspecific upper respiratory tract infections. We report a case of acute disseminated encephalomyelitis associated with measles in a 2½-year-old male child despite having measles vaccination in infancy. The diagnosis was based on clinical findings and CT scan of brain. The patient was managed with high dose corticosteroids along with supportive measures. He recovered completely and follow-up for six months revealed no neurological deterioration.
Godfroid, Jacques; Nielsen, Klaus; Saegerman, Claude
Aim To describe and discuss the merits of various direct and indirect methods applied in vitro (mainly on blood or milk) or in vivo (allergic test) for the diagnosis of brucellosis in animals. Methods The recent literature on brucellosis diagnostic tests was reviewed. These diagnostic tests are applied with different goals, such as national screening, confirmatory diagnosis, certification, and international trade. The validation of such diagnostic tests is still an issue, particularly in wildlife. The choice of the testing strategy depends on the prevailing brucellosis epidemiological situation and the goal of testing. Results Measuring the kinetics of antibody production after Brucella spp. infection is essential for analyzing serological results correctly and may help to predict abortion. Indirect ELISAs help to discriminate 1) between false positive serological reactions and true brucellosis and 2) between vaccination and infection. Biotyping of Brucella spp. provides valuable epidemiological information that allows tracing an infection back to the sources in instances where several biotypes of a given Brucella species are circulating. Polymerase chain reaction and new molecular methods are likely to be used as routine typing and fingerprinting methods in the coming years. Conclusion The diagnosis of brucellosis in livestock and wildlife is complex and serological results need to be carefully analyzed. The B. abortus S19 and B. melitensis Rev. 1 vaccines are the cornerstones of control programs in cattle and small ruminants, respectively. There is no vaccine available for pigs or for wildlife. In the absence of a human brucellosis vaccine, prevention of human brucellosis depends on the control of the disease in animals. PMID:20718082
East African Medical Journal Vol. 80 No. 12 December 2003. CONGENITAL SYPHILIS IN IMMUNOCOMPROMISED NEONATE: CASE REPORT. A. M. O., Shonubi, MBBS, FMCS, FWACS. Consultant Paediatric Surgeon; Queen Elizabeth II Hospital, Maseru, Kingdom of Lesotho, B. A., Salami, MBBS,. FMCS. Consultant ...
Araújo, E C; Moura, E F; Ramos, F L; Holanda, V G
OBJECTIVE: To determine the incidence of congenital syphilis among newborns at the maternity of a public hospital. METHODS: The study was conducted at the maternity of Fundação Santa Casa de Misericórdia do Pará, from May to September 1996; 361 mothers were interviewed, and physical examination was performed in their newborns. Serum samples from both, mothers and neonates, were tested using three methods: VDRL, FTA - Abs, ELISA IgM. The diagnosis of congenital syphilis was established according to the criteria defined by Ministério da Saúde in 1993. RESULTS: The rate of congenital syphilis was of 9.1% (33); in 14 cases, there were one or more signs of the disease: prematurity, hepatomegaly, stillbirth, splenomegaly, perinatal death, abdominal distention, nasal stuffiness, jaundice, newborn small for gestational age. The majority of the infected mothers belonged to the age group of 20-35 years (81.8%); 60.6% were married; 63.6% received prenatal care; 48.5% reported previous spontaneous abortion, and 12.1% previous stillbirth. The rate of bisexuality among fathers was of 9.1%. CONCLUSION: The syphilis control measures and the prenatal care, have not been sufficient to prevent the high rate of the disease.
Background: Measles is a highly contagious vaccine-preventable infection which continues to be a significant cause of childhood morbidity and mortality in developing countries particularly those with poor routine immunisation coverage. Supplemental immunisation activities (SIAs) were thus introduced to improve vaccine ...
5 Namibia Country Office, Center for Global Health, US Centers for Disease Control and Prevention, Windhoek, Namibia. 6 World Health Organization Field ... The wide age distribution of cases indicated measles-susceptible individuals accumulated over several decades prior to the start of the outbreak. S Afr Med J 2016 ...
Featherstone, David; Brown, David; Sanders, Ray
The routine reporting of suspected measles cases and laboratory testing of samples from these cases is the backbone of measles surveillance. The Global Measles Laboratory Network (GMLN) has developed standards for laboratory confirmation of measles and provides training resources for staff of network laboratories, reference materials and expertise for the development and quality control of testing procedures, and accurate information for the Measles Mortality Reduction and Regional Elimination Initiative. The GMLN was developed along the lines of the successful Global Polio Laboratory Network, and much of the polio laboratory infrastructure was utilized for measles. The GMLN has developed as countries focus on measles control activities following successful eradication of polio. Currently more than 100 laboratories are part of the global network and follow standardized testing and reporting procedures. A comprehensive laboratory accreditation process will be introduced in 2002 with six quality assurance and performance indicators.
Fábio Lopes Pedro
Full Text Available Pericarditis is a rare manifestation during the course of brucellosis. This paper describes a case of pericarditis associated with brucellosis in a 31-year-old veterinary physician with a past medical history of testicular tumor and reviews the cases of pericarditis associated with brucellosis in medical English literature.
... 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 meetings...
...; ] 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 partnering...
Moline, Heather R; Smith, James F
Syphilis in pregnancy continues to be a worldwide threat to mothers and their fetuses, and in recent years has been increasing in prevalence. The purpose of this short review is to address current issues in the diagnosis and management of syphilis complicating pregnancies. Maternal syphilis infections and congenital syphilis appear to be increasing in both high and low resource settings. Treponema pallidum ssp. pallidum, the causative spirochete of syphilis, remains one of the few human infectious pathogens that has not been successfully cultured, making identification difficult and research in targeted antimicrobial therapies challenging. Fortunately, syphilis remains sensitive to penicillin, which remains the foundational therapy for this infection. Patients with syphilis and significant penicillin allergies remain a specific challenge in treatment. Of concern is the emergence of T. pallidum resistant to macrolides such as azithromycin. This will limit options in patients with penicillin allergies, and potentially contribute to suboptimal treatment. During pregnancy, penicillin is the only known effective treatment for congenital syphilis, and pregnant patients with penicillin allergy should be desensitized and treated with penicillin. Research focusing on protein expression of the genome of T. pallidum may lead to more accurate screening and diagnosis and development of novel antibiotic therapies. Obstetric and pediatric providers, public health organizations, and governments should recognize the re-emergence of syphilis globally and in their local healthcare environments. Screening of all pregnant patients with robust treatment and follow-up represents the most effective method to reduce congenital syphilis currently available.
Aypak, Adalet; Aypak, Cenk; Bayram, Yasemin
Brucellosis produces a variety of non-specific hematological abnormalities. The aim of the present study was to evaluate the hematological findings in childhood brucellosis. Medical records of children with brucellosis admitted to a tertiary hospital in a 1 year period, were analyzed retrospectively. Sixty-nine patients (mean age, 14.5 ± 3.3 years) were diagnosed with brucellosis. The most common hematological finding was thrombocytopenia (n = 11, 15.9%). Thrombocytosis was detected in five patients (7.3%), leukopenia in four (5.8%), anemia in three (4.3%), and bicytopenia in three (4.3%). None of the patients had pancytopenia. Blood culture was positive for Brucella spp. in 41 patients (59.4%). Among those patients with positive blood culture, six (14.6%) had serum agglutination test titer ≤1/80. Platelet (PLT) count was significantly lower in the bacteremia-positive group. The OR (95%CI) of bacteremia for PLT cut-off 200,000/mm(3) was 0.148 (95%CI: 0.031-0.718) and relative risk was 1.718 (95%CI: 1.244-2.372; P = 0.010). Brucellosis should be kept in mind in the differential diagnosis of isolated thrombocytopenia in pediatric patients from endemic areas. © 2015 Japan Pediatric Society.
... 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, classification...
... 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... amending the brucellosis regulations to reduce the amount of testing required to maintain Class Free status...
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.
Full Text Available Autophagy is a biological process that helps cells to recycle obsolete cellular components and which greatly contributes to maintaining cellular integrity in response to environmental stress factors. Autophagy is also among the first lines of cellular defense against invading microorganisms, including viruses. The autophagic destruction of invading pathogens, a process referred to as xenophagy, involves cytosolic autophagy receptors, such as p62/SQSTM1 (Sequestosome 1 or NDP52/CALCOCO2 (Nuclear Dot 52 KDa Protein/Calcium Binding And Coiled-Coil Domain 2, which bind to microbial components and target them towards growing autophagosomes for degradation. However, most, if not all, infectious viruses have evolved molecular tricks to escape from xenophagy. Many viruses even use autophagy, part of the autophagy pathway or some autophagy-associated proteins, to improve their infectious potential. In this regard, the measles virus, responsible for epidemic measles, has a unique interface with autophagy as the virus can induce multiple rounds of autophagy in the course of infection. These successive waves of autophagy result from distinct molecular pathways and seem associated with anti- and/or pro-measles virus consequences. In this review, we describe what the autophagy–measles virus interplay has taught us about both the biology of the virus and the mechanistic orchestration of autophagy.
Dr. Shelley Deeks, chief of communicable diseases at Public Health Ontario, discusses a measles outbreak in Canada. Created: 8/24/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 8/24/2017.
... the Field: Measles Outbreak at a United States Immigration and Customs Enforcement Facility — Arizona, May–June 2016 MMWR. May 26, ... May 25, 2016, a detainee at a U.S. Immigration and Customs Enforcement (ICE) detention center in Arizona who had been ...
Saraceni, Valéria; Miranda, Angélica Espinosa
This paper aimed to correlate syphilis in pregnancy and congenital syphilis with coverage of the Family Health Strategy (FHS), based on available data in the national health information systems. The syphilis notification estimates were calculated according to the Sentinel Childbirth Study for 2004 under the Ministry of Health and the data were obtained from the websites of the Health Surveillance Secretariat and Healthcare Secretariat, for the year 2008. The ratios between observed and estimated gestational syphilis and congenital syphilis were not statistically correlated with population coverage by the FHS (r = -0.28 and r = -0.40, respectively). The FHS is a privileged area for prenatal care and logically a source of compulsory notification of syphilis in pregnancy. By combining diagnosis with adequate treatment of syphilis in pregnant women and their partners, the FHS becomes a prime instrument for eliminating congenital syphilis in Brazil. Expanding the FHS coverage and quality of care are essential for achieving this goal.
Suvanbekov, Akbar; Kitarova, Gulzhan; Reyer, Joshua A; Hamajima, Nobuyuki
Measles is one of the most severe infectious diseases of childhood, and one of the major causes of mortali-ty, especially in developing countries. Despite rare measles outbreaks in recent years, Kyrgyzstan seeks to show its commitment towards the global anti-measles campaign. The aim of this article is to summarize the scattered information on the recent status of measles, valid surveillance system, and measles elimination strategies in Kyrgyzstan, based on sources that include non-confidential but usually inaccessible governmental data. Infor-mation was extracted from the reports to the Ministry of Health and documents on the national surveillance system, in addition to outbreak cases extracted from the Republican Infectious Diseases Hospital's archive. To tackle the worsening measles situation in Kyrgyzstan, the Ministry of Health established the Republican Center for Immunoprophylaxis in 1994. Measles related death, which was rampant up until 1992, has not been registered since 2000 due to improved routine vaccination coverage, increasing from 88% in 1994 to 97% and over in 1997. The national surveillance system was modernized thanks to the World Health Organization, helping to detect measles cases and prevent major outbreaks. The system identified 222 cases in the outbreak of 2011, and the case cards in the hospital provided the findings of 69 admitted cases (42 infants, 22 children aged 1 to 14 years, and 5 aged 15 years or over), including 32 severe cases. This article provides a whole view on measles in Kyrgyzstan, which would be useful to control measles worldwide.
Full Text Available Syphilis is a sexually transmitted disease caused by spiral-shaped bacterium, Treponema pallidum The disease has been known under many names during history, and has had a prominent role in history and literature for the last several hundred years. Since its recognition in 15th-century Europe as a new disease, syphilis has been the subject of great mystery and legend. there are three main theories. These are the Columbian theory, the Pre-Columbian theory and the Evolutionary theory. The Columbian theory is most accepted. Syphilis exist nowadays, the World Health Organization estimats that 12 million new cases of syphilis occur each year. While syphilis eradication seems a biologically plausible goal, the major political, cultural, and logistic difficulties involved make it unlikely. Regrettably, rather than become an infection of historical significance, syphilis in the era of HIV continues to challenge researchers and clinicians.
Maatouk, Ismael; Moutran, Roy
The origin of syphilis is a matter of debate and two "historical" hypotheses explain its emergence. We present here a review about syphilis history. A review of literature about syphilis history using the following keywords: "syphilis," "history," and "treponema." The Columbian opinion is that syphilis came from the New World (America) with the crews of Christopher Columbus's fleet. As Naples fell before the invading army of Charles the VIII in 1495, a plague broke out among the French leader's troops. When the army disbanded shortly after the campaign, the troops, composed largely of mercenaries, returned to their homes and disseminated the disease across Europe. Indeed, there were reports that indigenous peoples of the New World suffered from a similar condition. Regardless of the Columbian and the Pre-Columbian theories, syphilis remains an international disease, growing nowadays with HIV infection. Despite history, politics, paleopathology and molecular approaches, the origin of the disease remains an enigma. © 2013 International Society for Sexual Medicine.
Vaidya, Sunil R; Kamble, Madhukar B; Chowdhury, Deepika T; Kumbhar, Neelakshi S
Under the outbreak-based measles surveillance in Maharashtra State the National Institute of Virology at Pune receives 3-5 serum samples from each outbreak and samples from the local hospitals in Pune for laboratory diagnosis. This report describes one year data on the measles and rubella serology, virus isolation and genotyping. Maharashtra State Health Agencies investigated 98 suspected outbreaks between January-December 2013 in the 20 districts. Altogether, 491 serum samples were received from 20 districts and 126 suspected cases from local hospitals. Samples were tested for the measles and rubella IgM antibodies by commercial enzyme immunoassay (EIA). To understand the diagnostic utility, a subset of serum samples (n=53) was tested by measles focus reduction neutralization test (FRNT). Further, 37 throat swabs and 32 urine specimens were tested by measles reverse transcription (RT)-PCR and positive products were sequenced. Virus isolation was performed in Vero hSLAM cells. Of the 98 suspected measles outbreaks, 61 were confirmed as measles, 12 as rubella and 21 confirmed as the mixed outbreaks. Four outbreaks remained unconfirmed. Of the 126 cases from the local hospitals, 91 were confirmed for measles and three for rubella. Overall, 93.6 per cent (383/409) confirmed measles cases were in the age group of 0-15 yr. Measles virus was detected in 18 of 38 specimens obtained from the suspected cases. Sequencing of PCR products revealed circulation of D4 (n=9) and D8 (n=9) strains. Four measles viruses (three D4 & one D8) were isolated. 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.
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. Copyright © 2016 Elsevier Inc. All rights reserved.
Ornelas, Jennifer; Agbai, Oma N; Kiuru, Maija; Sivamani, Raja K
Alopecia can be one of the many symptoms of secondary syphilis and the clinical presentations include essential syphilitic alopecia or symptomatic syphilitic alopecia. In this report, we present a case of a patient with essential syphilitic alopecia whose sole presenting symptom of syphilis was alopecia. Despite an initial negative rapid plasma reagin (RPR) test, he was ultimately found to have syphilis on scalp biopsy. His alopecia improved following treatment with benzathine penicillin. This presentation serves as a reminder to clinicians to be cognizant of alopecia as a presenting sign of syphilis. A review of the specificity and sensitivity of the typical tests used for the diagnosis is presented.
Archana, B R; Prasad, S R; Beena, P M; Okade, R; Sheela, S R; Beeregowda, Y C
Screening women for syphilis during pregnancy and providing proper treatment are the cornerstones of congenital syphilis prevention. During 2008-2011, 6,221 pregnant women were screened for syphilis using the Rapid Plasma Reagin (RPR) and Treponema Pallidum Hemagglutination (TPHA) tests at R.L. Jalappa Hospital, Kolar, Karnataka, India. The seroprevalence of syphilis during pregnancy ranged from 0.57% to 0.78% during the study. Of the 35 women with a positive test, 26 (74.28%) were detected at the time of labor and 9 (25.71%) were detected during antenatal care. None of the women detected at the time of labor received penicillin therapy for syphilis. Adverse fetal outcomes due to untreated syphilis during pregnancy were seen in many of the cases. During the study 26 infants (3.69/1,000) were diagnosed with congenital syphilis. Our findings show detection and treatment of syphilis during pregnancy needs to be strengthened in the study area to reduce the incidence of congenital syphilis.
R V Koranne
Full Text Available A study of 36 untreated patients with early syphilis revealed atypical variations namely; long incubation period of 101 days in I patient, more than 3 chancres in 1, undermined margin of the chancre along with tenderness in 1 and moderate to severe tenderness of the ulcers in 2 cases. In 3 patients there was no indurations of the ulcers. Three patients with primary syphilis had unilateral lymphadenitis, and in I case the lymph nodes were not only tender but showed tendency towardsmatingawell. Insecondarysyphilis, 11 out of 16 patients having condylomata lata had no other muco-cutaneous lesions. Concomitant presence of other venereal disease to account for the atypical manifestations was discounted- by appropriate laboratory tests, response to therapeutic agents and follow up.
Rogalska, J; Santibanez, S; Mankertz, A; Makowka, A; Szenborn, L; Stefanoff, P
The objective of this study was to describe transmission chains of measles observed in Poland during 2008-2009. A decade ago, the incidence of measles in Poland declined and approached one case per million inhabitants one of the World Health Organization's criteria for measles elimination. Following a period of very few reported measles cases (2003 to 2005), an increase in incidence was observed in 2006. Since then, the incidence has constantly exceeded one case per million inhabitants. Of 214 measles cases reported in 2008 and 2009 in Poland, 164 (77%) were linked to 19 distinct outbreaks, with 79% of cases belonging to the Roma ethnic group. Outbreaks in the non-Roma Polish population had different dynamics compared to those in the Roma population. On average, measles outbreaks in Roma communities involved 10 individuals, seven of whom were unvaccinated, while outbreaks in the non-Roma Polish population involved five individuals, half of whom were incompletely vaccinated. The majority of outbreaks in Roma communities were related to importation of virus from the United Kingdom. In six outbreaks, the epidemiologic investigation was confirmed by identification of genotype D4 closely related to measles viruses detected in the United Kingdom and Germany. Our data indicate that Poland is approaching measles elimination, but measles virus circulation is still sustained in a vulnerable population. More efforts are needed to integrate the Roma ethnic group into the Polish healthcare system and innovative measures to reach vulnerable groups should be explored.
Garcés-Sánchez, María; Renales-Toboso, María; Bóveda-García, María; Díez-Domingo, Javier
Measles is a rash illness of moderate severity and high risk of serious complications, with recovery in several weeks. It is a viral disease caused by one of the most infectious and contagious pathogens that exists, whose only known reservoir is human. In 1998, the European Region of the WHO set a target of eliminating measles by 2010. This goal has not been achieved. Furthermore, it has been observed the resurgence of the disease in some parts of Europe. We review the disease and its vaccines as well as the epidemiological and social factors that have so far prevented the total control of the disease. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.
Yri, Hanne; Wegener, Marianne; Jensen, Rigmor
Idiopathic intracranial hypertension (IIH) is a condition of yet unknown aetiology affecting predominantly obese females of childbearing age. IIH is a diagnosis of exclusion as raised cerebrospinal fluid pressure may occur secondary to numerous other medical conditions. An atypical phenotype or a...... antibiotic treatment, signs and symptoms of elevated intracranial pressure resolved completely. Syphilis is a rare, but very important, differential diagnosis that in this case was clinically indistinguishable from IIH....
Background. Low measles vaccine coverage has been a characteristic of child health indices in Uganda. A countrywide mass measles vaccination of children from 6 months to 15 years old was undertaken in October 2003 and again in October 2006. Objective. To describe the effect of mass measles vaccination on the ...
Measles is an exanthem, caused by an RNA virus of the genus. Morbillivirus and the family Paramyxovirus.1 Measles is one of the oldest childhood diseases; the first written record goes back to the 10th century.2 The introduction of an effective vaccine has brought measles under reasonable control in the many countries ...
Fox, Annette; Than Manh Hung; Wertheim, Heiman; Le Nguyen Minh Hoa; Vincent, Angela; Lang, Bethan; Waters, Patrick; Nguyen Hong Ha; Nguyen Vu Trung; Farrar, Jeremy; Nguyen Van Kinh; Horby, Peter
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. Stand...
Jan 1, 2014 ... Whey agglutination test. This test has been an important test in detecting sero- logically negative or suspect animals with udder infection. These animals usually are chronically or recently infected animals in herds, from which it has been difficult to eradicate brucellosis (Stiles et al., 1958; Cameron, 1959;.
human population stand at a greater risk of acquiring zoonotic diseases including brucellosis. The disease has an added importance in countries like India, where conditions are conducive for wide-spread human infection on account of unhygienic conditions and poverty. Species of main concern in India are B. melitensis, ...
Hubálek, Zdeněk; Scholz, H.; Sedláček, I.; Melzer, F.; Sanogo, Yibayiri Osée; Nesvadbová, Jiřina
Roč. 7, č. 4 (2007), s. 679-688 ISSN 1530-3667 Institutional research plan: CEZ:AV0Z60930519 Keywords : common vole * brucellosis Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 1.919, year: 2007
Background: Several zoonotic diseases are known to constitute great impediment to livestock management and production worldwide, especially in developing countries where control measures are largely non-existent. This study sets out to investigate the occurrence of toxoplasmosis, neosporosis and brucellosis among ...
Jan 12, 2015 ... Aim: This study investigated the seroprevalence, complications and risk factors of Brucella infection in rural areas of. Sivas, Turkey. Materials and Methods: The study was conducted in three hyperendemic counties for brucellosis known as Gurun,. Altinyayla and Kangal in Sivas between April and October ...
Aim: This study investigated the seroprevalence, complications and risk factors of Brucella infection in rural areas of Sivas, Turkey. Materials and Methods: The study was conducted in three hyperendemic counties for brucellosis known as Gurun, Altinyayla and Kangal in Sivas between April and October in 2011. A total of ...
The prevalence of bovine brucellosis was measured in cross sectional study in Jimma zone, Western Ethiopia using Rose Bengal Plate Test (RBT) and CFT from October 2003 to April 2004. The study animals consisted of 1305 local breed found in extensive system in five districts of in the zone. The overall individual animal ...
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.
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.)
Back ground: Human brucellosis is a major debilitating zoonotic disease. It is caused by bacteria of the genus Brucella Methods: The serum antibody titres to Brucella melitensis and Brucella abortus of one thousand febrile patients, randomly selected from Khartoum, Khartoum North and Omdurman Teaching Hospitals, ...
Rubach, Matthew P.; Halliday, Jo E.B.; Cleaveland, Sarah; Crump, John A.
Purpose of review Human brucellosis is a neglected, underrecognized infection of widespread geographic distribution. It causes acute febrile illness and a potentially debilitating chronic infection in humans, and livestock infection has substantial socioeconomic impact. This review describes new information regarding the epidemiology of brucellosis in the developing world and advances in diagnosis and treatment. Recent findings The highest recorded incidence of human brucellosis occurs in the Middle East and Central Asia. Fever etiology studies demonstrate brucellosis as a cause of undifferentiated febrile illness in the developing world. Brucellosis is a rare cause of fever among returning travelers, but is more common among travelers returning from the Middle East and North Africa. Sensitive and specific rapid diagnostic tests appropriate for resource-limited settings have been validated. Randomized controlled trials demonstrate that optimal treatment for human brucellosis consists of doxycycline and an aminoglycoside. Decreasing the burden of human brucellosis requires control of animal brucellosis, but evidence to inform the design of control programs in the developing world is needed. Summary Brucellosis causes substantial morbidity in human and animal populations. While improvements in diagnostic options for resource-limited settings and stronger evidence for optimal therapy should enhance identification and treatment of human brucellosis, prevention of human disease through control in animals remains paramount. PMID:23963260
... 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 Remote...
Anis, Emilia; Leventhal, Alex; Grotto, Itamar; Gandacu, Dan; Warshavsky, Bruce; Shimshony, Arnon; Israeli, Avi
The majority of human brucellosis cases in Israel are caused by the ingestion of unpasteurized dairy foods produced from unlicensed family-owned flocks whose products are sold door-to-door at low prices. Exposure to infected farm animals is another major cause of infection. To determine, by examining recent incidence data and brucellosis control programs, whether a reduction in the incidence of human brucellosis in Israel can be sustained. Case information is reported to the Health Ministry and national data are compiled and analyzed by the Division of Epidemiology. The current study focuses on data from 1998 through 2009 and discusses several of the major prevention and health education programs that have been implemented. An incidence decline of almost 70% during the period 1998-2002 was followed by a return to previously existing levels, although the incidence has remained consistently lower than in past decades. The disease is mostly limited to certain sectors of the rural Arab population. In 2009 the incidence rate per 100,000 population was 7.0 among Arabs compared with 0.2 among Jews. Between 1998 and 2009, 63% of cases were from the Beer Sheva and Acre health districts, which together comprise 15.5% of the Israeli population. Control programs--including efforts to combat brucellosis in animals and to discourage the sale of unpasteurized homemade dairy products--have met with partial success. Without routine vaccination of all family-owned flocks, more effective restraints on the market for unpasteurized dairy foods and improved regional cooperation, human brucellosis will continue to be a contained, but persistent, health problem in Israel due to cultural behavior, socioeconomic factors, and the regional political environment.
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.
Lomotey, Chaylah J; Lewis, Judy; Gebrian, Bette; Bourdeau, Royneld; Dieckhaus, Kevin; Salazar, Juan C
A study was conducted to assess the prevalence of maternal syphilis and estimate the rate of congenital syphilis in five rural villages surrounding Jeremie, Haiti. This research was a retrospective observational study. Data were extracted from the Haitian Health Foundation's public health database and verified through original clinical paper records, death certificates, midwife reports, and discussions with community health workers. Data were analyzed by chi-square analysis, bivariate correlations, and two-tailed t-test for independent samples. Of the 410 women tested for syphilis, 31 (7.6%) were sero-reactive. Average gestation at time of testing was 25 weeks, which correlated with entry into prenatal care at an average of 23 weeks. Women who tested positive during pregnancy were more likely to have had a negative pregnancy outcome than those who did not (chi square = 16.4; P congenital syphilis in the region was 767 per 100,000 live births. Maternal syphilis is prevalent in rural Haiti. This prevalence combined with late entry into prenatal care contributes to adverse pregnancy outcomes and a high estimated rate of congenital syphilis. More research is needed on congenital syphilis and prenatal-careseeking practices of rural Haitian women in order to understand the impact of maternal syphilis in the region and improve pregnancy outcomes.
S.N. Naicker, J. Moodley, A. Van Middelkoop, R.C. Cooper. Abstract. Three different serological screening tests for syphilis were performed at the 'booking' visit of 500 antenatal patients at the King Edward VIII Hospital, Durban. The prevalence of ... The TPHA test is therefore advocated for screening patients for syphilis.
de la Calle, María; Cruceyra, Mireia; de Haro, Mar; Magdaleno, Fernando; Montero, María Dolores; Aracil, Javier; González, Antonio
To study the epidemiology, diagnosis, treatment strategies and perinatal outcomes of gestational syphilis. We performed a retrospective study of 94 pregnant women with syphilis whose gestation and delivery were monitored in a Department of Obstetrics from 2002 to 2010 among a total of 85,806 births of women without syphilis in the same period. The prevalence of gestational syphilis was 0.11%. Most of the women were foreign and the most prevalent type was late latent syphilis. Only 57 patients underwent right treatment despite adequate prescription. Maternal complications were confirmed in 31 pregnant women and 16 cases had fetal complications. We diagnosed 4 cases of neonatal syphilis, 3 of them with syphilitic meningitis, whose mothers had not completed the treatment correctly. The implementation of a mandatory syphilis serology in the pregnancy has enabled us to diagnose many cases of late latent syphilis. The successful completion of treatment must be ensured to prevent vertical transmission. Copyright © 2012 Elsevier España, S.L. All rights reserved.
years (± 5.34) and the mean gestational age 26.4 weeks. (±6.36). The modal parity was 0. Only three patients were found to be reactive for syphilis giving a prevalence of 0.13%. Conclusion: The sero- prevalence value in this study is quite low and may justify the call to discontinue routine antena- tal syphilis screening.
Syphilis is a notifiable and preventable disease, congenital syphilis more so. Consequently, attention has been recently focused on prenatal diagnosis of foetal syphilis by the use of ultrasonography apart from the conventional serologic screening. Congenital syphilis has not been reported from the Kingdom of Lesotho.
Full Text Available Brucellosis is a zoonotic disease with widespread prevalence. It presents with in various range and often with the presence of non-specific clinical signs and symptoms. Brucellosis also may cause different manifestations in eyes such as uveitis, keratitis, conjunctivitis and neuro-ophthalmic defects. Ocular brucellosis is rare among children. Herein, we present a 7-year-old girl with systemic and ocular brucellosis. After treatment with systemic steroid and antibiotics, her signs and symptoms disappeared. Since early treatment is important in preventing permanent visual loss and the other complications of ocular brucellosis, examination of the eyes in brucellosis patients must always be noticed by clinicians working in this field.
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. Copyright © 2014 Elsevier B.V. All rights reserved.
Owens, S.; Harper, G.; Amuasi, J.; Offei-Larbi, G.; Ordi, J.; Brabin, B. J.
The efficiency of transplacental transfer of measles specific antibody was assessed in relation to placental malaria. Infection at delivery was associated with a 30% decrease in expected cord measles antibody titres. Uninfected women who received anti-malarial drugs during pregnancy transmitted 30%
B.M. Laksono (Brigitta); R.D. de Vries (Rory); 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
Of those serologically confirmed to have measles (N=38), 26.3% (95% CI 11.6 - 40.9%) conformed to the 'classic' dermatological picture. Therefore, a significant majority of these patients presented with what was considered in this study to be a 'non-classic' dermatological picture.Conclusions. Measles infection in a ...
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.
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
Bouley, Andrew J.; Biggs, Holly M.; Stoddard, Robyn A.; Morrissey, Anne B.; Bartlett, John A.; Afwamba, Isaac A.; Maro, Venance P.; Kinabo, Grace D.; Saganda, Wilbrod; Cleaveland, Sarah; Crump, John A.
Acute and convalescent serum samples were collected from febrile inpatients identified at two hospitals in Moshi, Tanzania. Confirmed brucellosis was defined as a positive blood culture or a ≥ 4-fold increase in microagglutination test titer, and probable brucellosis was defined as a single reciprocal titer ≥ 160. Among 870 participants enrolled in the study, 455 (52.3%) had paired sera available. Of these, 16 (3.5%) met criteria for confirmed brucellosis. Of 830 participants with ≥ 1 serum sample, 4 (0.5%) met criteria for probable brucellosis. Brucellosis was associated with increased median age (P = 0.024), leukopenia (odds ratio [OR] 7.8, P = 0.005), thrombocytopenia (OR 3.9, P = 0.018), and evidence of other zoonoses (OR 3.2, P = 0.026). Brucellosis was never diagnosed clinically, and although all participants with brucellosis received antibacterials or antimalarials in the hospital, no participant received standard brucellosis treatment. Brucellosis is an underdiagnosed and untreated cause of febrile disease among hospitalized adult and pediatric patients in northern Tanzania. PMID:23091197
Chen, Zhe; Zhang, Yu-Xue; Fu, Dong-Wei; Gao, Qing-Feng; Ge, Feng-Xia; Liu, Wei-Hua
Brucellosis is associated with inflammation and the oxidative stress response. Heme oxygenase-1 (HO-1) is a cytoprotective stress-responsive enzyme that has anti-inflammatory and anti-oxidant effects. Nevertheless, the role of HO-1 in human brucellosis has not yet been studied. The aim of this study was to examine the plasma levels of HO-1 in patients with brucellosis and to evaluate the ability of plasma HO-1 levels as an auxiliary diagnosis, a severity predictor, and a monitor for brucellosis treatments. A total of 75 patients with brucellosis were divided into the acute, subacute, chronic active, and chronic stable groups. An additional 20 volunteers were included as the healthy control group. The plasma HO-1 levels and other laboratory parameters were measured in all groups. Furthermore, the plasma levels of HO-1 in the acute group were compared before and after treatment. The plasma HO-1 levels were considerably increased in the acute (4.97 ± 3.55), subacute (4.98 ± 3.23), and chronic active groups (4.43 ± 3.00) with brucellosis compared to the healthy control group (1.03 ± 0.63) (p brucellosis (r = 0.707, p brucellosis status and may be used as a supplementary plasma marker for diagnosing brucellosis and monitoring its treatment.
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.
Méndez-Lozano, Meztli; Rodríguez-Reyes, Erika Judith; Sánchez-Zamorano, Luisa María
To determinate the relationship of human brucellosis incidence in Mexico during 2000-2011 in relation with domestic ruminant brucellosis. An ecological time series study was analyzed using multilevel poisson multiple regression, the incidence of human brucellosis during 2000-2011 and incidence in ruminants and human development index. The high incidence of bovine brucellosis increased 19% the incidence of human brucellosis. The high incidence of caprine brucellosis increase 17% the incidence of human brucellosis. The presence of new cases of ovine brucellosis increased 13% the incidence rates of human brucellosis. Brucellosis is a public health problem in Mexico, the presence of brucellosis in domestic ruminants and the level of disease control in them affects the presence of the disease in humans.
Untreated syphilis during pregnancy, especially early syphilis, can lead to stillbirth, neonatal death, or infant disorders such as deafness, neurologic impairment, and bone deformities. Congenital syphilis (CS) can be prevented by early detection of maternal infection and treatment at least 30 days before delivery. Changes in the population incidence of primary and secondary (P&S) syphilis among women usually are followed by similar changes in the incidence of CS. To assess recent trends in CS rates, CDC analyzed national surveillance data from the period 2003--2008. This report summarizes the results of that analysis, which indicated that, after declining for 14 years, the CS rate among infants aged syphilis rate among females aged >or=10 years from 2004 to 2007. During 2005-2008, CS rates increased primarily in the South (from 9.6 per 100,000 live births to 15.7) and among infants born to black mothers (from 26.6 per 100,000 live births to 34.6). Reversing the upward trend in CS rates will require collaboration among health-care providers, health departments, health insurers, policymakers, and the public to reduce syphilis among women and to increase early prenatal care access and syphilis screening during pregnancy.
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.
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.
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
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 and 33000 ya, 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. PMID:24860561
Guzmán-Verri, Caterina; González-Barrientos, Rocío; Hernández-Mora, Gabriela; Morales, Juan-Alberto; Baquero-Calvo, Elías; Chaves-Olarte, Esteban; Moreno, Edgardo
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. PMID:22919595
Full Text Available Buffalo’s production represents an important option as input source in livestock systems located in areas with little profitability by cattle. In mostly farms, cattle and buffalos are breeding together, due that in Argentina, to carry out buffalo’s production is in an extensive way, with the aim to produce meat – mostly- milk – for this production nutritional supplements are used- and leathers. Brucellosis is zoonic illnesses from bacteria belong to Brucella which caused human human health problems by contaminated food ingestion or to those who are in touch with cattle. In Argentina, exist the National Control an Elimination Program for cattle Brucellosis, which include buffalos also, there is inclosed female vaccination and serologic segregation of positive reactants. Diagnosis techniques ruled for cattle brucellosis are BPA (Buffered Plate Agglutination, Tube seroaglutination and 2MercaptoEthanol. International reference test is Complement Fixation. By means of this present work, we pretend to evaluate the serologic diagnosis utility, ruled to the buffalos and compare obtained results by BPA, SAT and 2ME with Complement Fixation Test. In the present communication are presented results from the use of diagnosis techniques recommended by SENASA (National Service of Sanity and Quality Agro-Food to buffalo’s serums which belong to nine farms from NE Corrientes State. Obtained results show that association o BPA as Screening Test and SAT and 2ME as Confirmated Test has a valid correlation for the detection of positive animals with the reference technique Complement Fixation.
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
Brigitta M. Laksono
Full Text Available Measles 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 conjunctivitis. A hallmark of measles is the transient immune suppression, leading to increased susceptibility to opportunistic infections. At the same time, the disease is paradoxically associated with induction of a robust virus-specific immune response, resulting in lifelong immunity to measles. Identification of CD150 and nectin-4 as cellular receptors for measles virus has led to new perspectives on tropism and pathogenesis. In vivo studies in non-human primates have shown that the virus initially infects CD150+ lymphocytes and dendritic cells, both in circulation and in lymphoid tissues, followed by virus transmission to nectin-4 expressing epithelial cells. The abilities of the virus to cause systemic infection, to transmit to numerous new hosts via droplets or aerosols and to suppress the host immune response for several months or even years after infection make measles a remarkable disease. This review briefly highlights current topics in studies of measles virus host invasion and pathogenesis.
Ogbuanu, Ikechukwu U; Muroua, Clementine; Allies, Martiena; Chitala, Kennedy; Gerber, Sue; Shilunga, Primus; Mhata, Petrus; Kriss, Jennifer L; Caparos, Lucille; Smit, Sheilagh B; De Wee, Roselina J; Goodson, James L
The World Health Organization, African Region, set the goal of achieving measles elimination by 2020. Namibia was one of seven African countries to implement an accelerated measles control strategy beginning in 1996. Following implementation of this strategy, measles incidence decreased; however, between 2009 and 2011 a major outbreak occurred in Namibia. Measles vaccination coverage data were analysed and a descriptive epidemiological analysis of the measles outbreak was conducted using measles case-based surveillance and laboratory data. During 1989 - 2008, MCV1 (the first routine dose of measles vaccine) coverage increased from 56% to 73% and five supplementary immunisation activities were implemented. During the outbreak (August 2009 - February 2011), 4 605 suspected measles cases were reported; of these, 3 256 were confirmed by laboratory testing or epidemiological linkage. Opuwo, a largely rural district in north-western Namibia with nomadic populations, had the highest confirmed measles incidence (16 427 cases per million). Infants aged ≤11 months had the highest cumulative age-specific incidence (9 252 cases per million) and comprised 22% of all confirmed cases; however, cases occurred across a wide age range, including adults aged ≥30 years. Among confirmed cases, 85% were unvaccinated or had unknown vaccination history. The predominantly detected measles virus genotype was B3, circulating in concurrent outbreaks in southern Africa, and B2, previously detected in Angola. A large-scale measles outbreak with sustained transmission over 18 months occurred in Namibia, probably caused by importation. The wide age distribution of cases indicated measles-susceptible individuals accumulated over several decades prior to the start of the outbreak.
Zou, Yaming; Liao, Yu; Liu, Fengying; Chen, Lei; Shen, Hongcheng; Huang, Shujie; Zheng, Heping; Yang, Bin; Hao, Yuantao
Syphilis has continuously posed a great challenge to China. However, very little data existed regarding the cost of syphilis. Taking Guangdong Initiative for Comprehensive Control of Syphilis area as the research site, we aimed to comprehensively measure the annual economic burden of syphilis from a societal perspective. Newly diagnosed and follow-up outpatient cases were investigated by questionnaire. Reported tertiary syphilis cases and medical institutions cost were both collected. The direct economic burden was measured by the bottom-up approach, the productivity cost by the human capital method, and the intangible burden by the contingency valuation method. Three hundred five valid early syphilis cases and 13 valid tertiary syphilis cases were collected in the investigation to estimate the personal average cost. The total economic burden of syphilis was US $729,096.85 in Guangdong Initiative for Comprehensive Control of Syphilis sites in the year of 2014, with medical institutions cost accounting for 73.23% of the total. Household average direct cost of early syphilis was US $23.74. Average hospitalization cost of tertiary syphilis was US $2,749.93. Of the cost to medical institutions, screening and testing comprised the largest proportion (26%), followed by intervention and case management (22%) and operational cost (21%). Household average productivity cost of early syphilis was US $61.19. Household intangible cost of syphilis was US $15,810.54. Syphilis caused a substantial economic burden on patients, their families, and society in Guangdong. Household productivity and intangible costs both shared positive relationships with local economic levels. Strengthening the prevention and effective treatment of early syphilis could greatly help to lower the economic burden of syphilis.
Conway, S.P.; Phillips, R R
Parents of 99 children who were admitted to hospital with whooping cough or measles, and of 50 children with whooping cough or measles who were nursed at home, were interviewed to determine the extent of morbidity and its effects on the family. Children admitted with whooping cough or measles spent a mean of 12.6 and 5.8 days in hospital, respectively. Time to full recovery was 13.7 and 2.1 weeks, respectively. Over a third of the children who were admitted were emotionally upset during the a...
Loutan, L; Paillard, S
A serological survey was conducted among Tuareg nomads to determine their level of immunity to measles. More than half (57.9%) of the children under 10 years of age did not have detectable antibodies to measles, suggesting that transmission of the disease is low in this mobile population. Mothers' reports of their children's history of measles were accurate (positive predictive value 93.9% for under-5-year-olds). Nomads are a reservoir of susceptible individuals who require immunization strategies adapted to their particular life-styles. These can be implemented at relatively low cost.
Raghavendra D Kulkarni
Full Text Available Measles, a highly infectious viral disease is the next target for eradication following poliovirus. Decades of experience with highly effective vaccination has invigorated us to take on this virus. The task is not only Titanic but is laced with intricate issues. Recently, an outbreak of fever with rash occurred on a tertiary care teaching hospital campus and was confirmed serologically as measles outbreak by IgMELISA. Therefore, we searched the literature related to outbreaks, transmission of the measles virus, age groups involved, vaccination strategies, vaccination failure and epidemiological features of the disease and reviewed the possible reasons for such outbreaks and problems in the global eradication of the virus.
Campana, F; Carvelli, J; Fricain, J C; Vergier, B; Boralevi, F; Kaplanski, G
Syphilis is a sexually transmitted infection (STI) related to Treponema pallidum. Secondary syphilis is the blood-borne systemic spread of Treponema. We report the case of secondary syphilis in a patient without risk of STIs factor. The clinical picture began with a genital affection followed by oral erosions and ulcers and an anterior and then posterior uveitis. Serology established the diagnosis and intravenous penicillin G treatment allowed for healing. Called the "great pretender" because of its clinical polymorphism, secondary syphilis can lead to formidable neurological and ophthalmological complications. Serological diagnosis is based on the use of treponemal and a nontreponemal tests. Penicillin G remains the treatment of choice and must be adapted according to the clinical damage. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Follett, Tara; Clarke, Denise F
Despite comprehensive antenatal screening recommendations and inexpensive treatment, congenital syphilis has long been and continues to be a public health concern, causing substantial morbidity and adverse outcomes. The following article reviews syphilis etiology and presentation, clinical disease, laboratory diagnosis, and treatment of congenital syphilis. A case will be presented describing a 31-week male infant exposed to infectious syphilis in utero. The neonate presented with classic signs of infection at birth. After initial serology testing of the infant, appropriate treatment was commenced. The infant received crystalline penicillin G for a period of ten days in consultation with pediatric infectious disease specialists. As expected, the infant's rapid plasma reagin (RPR) titers declined by three and six months of age. An interdisciplinary approach provided safe and optimal care for this infant. He was discharged, stable, and thriving at 38 weeks corrected age. Long-term multidisciplinary management and follow-up were arranged.
Navas, Rosa M; Parra, Reinaldo; Pacheco, Maivelys; Gomez, Jimena; Bermudez, Iris; Rodriguez-Morales, Alfonso J
Congenital microphthalmos and anophthalmos are currently considered rare conditions. Many infectious agents have been previously associated with these pathologies, but rarely Treponema pallidum. We report a case of bilateral microphthalmos in which her mother presented gestational syphilis.
A cross-sectional survey was carried out in Karatu and Ngorongoro districts in Arusha region and Babati, Hanang and Mbulu districts in Manyara region involving 20 agro-pastoral and 9 pastoral villages, to establish the magnitude of human brucellosis in relation to livestock brucellosis. A multistage random sampling was ...
Background: Brucellosis, a zoonotic infection, was most widely diagnosed by the Brucella standard serum agglutination test (SAT). No previous publication has demonstrated a correlation between the degree of Brucella SAT agglutination positivity and the severity of brucellosis infection. Objective: To contribute to the ...
Introduction: Brucellosis is a neglected zoonosis of public health importance. This study was conducted to determine the prevalence and risk factors of brucellosis among slaughtered cattle as well as challenges to the protection of abattoir workers in Nigeria. Methods: A slaughterhouse study was conducted in a major ...
Brucellosis presents with many clinical manifestation that make its diagnosis a difficult task. Ever since the report of the first serologic test for brucellosis, a definitive diagnostic technique has been actively pursued. The most widely used methods of diagnosis are based on serology, which measures the ability of the serum ...
Bovine brucellosis is a contagious disease of cattle causing reproductive failure, loss of milk production and zoonosis worldwide. A cross-sectional epidemiological study was conducted on 816 dairy cattle (449 were cows) from 60 dairy farms to determine the seroprevalence and associated risk factors of bovine brucellosis ...
Brucellosis is among the neglected zoonotic disease which mostly affects the pastoral and agro-pastoral communities because they are exposed to many risk factors for the infection. A four-year (2013–2016) retrospective study was carried out to determine the sero-prevalence of human brucellosis in patients at Wasso and ...
Brucellosis is an acute to chronic zoonotic disease which is endemic in some tropical developing countries with profound impact on infected animals and people. The study examined some of the risk factors for brucellosis following outbreak of the disease in Anseba, a region in Eritrea. Twenty three patients from Dekemhare ...
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...
Hernández-Mora, Gabriela; Bonilla-Montoya, Roberto; Barrantes-Granados, Osvaldo; Esquivel-Suárez, Andrea; Montero-Caballero, Danilo; González-Barrientos, Rocío; Fallas-Monge, Zeanne; Palacios-Alfaro, José David; Baldi, Mario; Campos, Elena; Chanto, Grettel; Barquero-Calvo, Elías; Chacón-Díaz, Carlos; Chaves-Olarte, Esteban; Guzmán Verri, Caterina; Romero-Zúñiga, Juan-José; Moreno, Edgardo
Brucellosis has been an endemic disease of cattle and humans in Costa Rica since the beginning of XX century. However, brucellosis in sheep, goats, pigs, water buffaloes, horses and cetaceans, has not been reported in the country. We have performed a brucellosis survey in these host mammal species, from 1999-2016. In addition, we have documented the number of human brucellosis reported cases, from 2003-2016. The brucellosis seroprevalence in goat and sheep herds was 0.98% and 0.7% respectively, with no Brucella isolation. Antibodies against Brucella were not detected in feral or domestic pigs. Likewise, brucellosis seroprevalence in horse and water buffalo farms was estimated in 6.5% and 21.7%, respectively, with no Brucella isolation. Six cetacean species showed positive reactions against Brucella antigens, and B. ceti was isolated in 70% (n = 29) of striped dolphins (Stenella coeruleoalba). A steady increase in the diagnosis of human brucellosis cases was observed. Taking into account the prevalence of brucellosis in the various host mammals of Costa Rica, different measures are recommended.
Purpose: Brucellosis is responsible for considerable public health issues involving economic losses due to abortion, loss of milk production and infertility in adult males. The purpose of this study was to determine the sero-prevalence of brucellosis in Jazan Province, Saudi Arabia and assess the possible risk factors.
Bovine brucellosis is a contagious bacterial disease of cattle, elk, and bison which occurs in the U.S., primarily in the greater Yellowstone area (GYA) of Wyoming, Montana, and Idaho. Brucellosis commonly causes infected pregnant animals to abort their calves. It can result in significant productio...
Hernández-Mora, Gabriela; Bonilla-Montoya, Roberto; Barrantes-Granados, Osvaldo; Esquivel-Suárez, Andrea; Montero-Caballero, Danilo; González-Barrientos, Rocío; Fallas-Monge, Zeanne; Palacios-Alfaro, José David; Baldi, Mario; Campos, Elena; Chanto, Grettel; Barquero-Calvo, Elías; Chacón-Díaz, Carlos; Chaves-Olarte, Esteban; Guzmán Verri, Caterina; Romero-Zúñiga, Juan-José
Brucellosis has been an endemic disease of cattle and humans in Costa Rica since the beginning of XX century. However, brucellosis in sheep, goats, pigs, water buffaloes, horses and cetaceans, has not been reported in the country. We have performed a brucellosis survey in these host mammal species, from 1999–2016. In addition, we have documented the number of human brucellosis reported cases, from 2003–2016. The brucellosis seroprevalence in goat and sheep herds was 0.98% and 0.7% respectively, with no Brucella isolation. Antibodies against Brucella were not detected in feral or domestic pigs. Likewise, brucellosis seroprevalence in horse and water buffalo farms was estimated in 6.5% and 21.7%, respectively, with no Brucella isolation. Six cetacean species showed positive reactions against Brucella antigens, and B. ceti was isolated in 70% (n = 29) of striped dolphins (Stenella coeruleoalba). A steady increase in the diagnosis of human brucellosis cases was observed. Taking into account the prevalence of brucellosis in the various host mammals of Costa Rica, different measures are recommended. PMID:28793352
Full Text Available Brucellosis has been an endemic disease of cattle and humans in Costa Rica since the beginning of XX century. However, brucellosis in sheep, goats, pigs, water buffaloes, horses and cetaceans, has not been reported in the country. We have performed a brucellosis survey in these host mammal species, from 1999-2016. In addition, we have documented the number of human brucellosis reported cases, from 2003-2016. The brucellosis seroprevalence in goat and sheep herds was 0.98% and 0.7% respectively, with no Brucella isolation. Antibodies against Brucella were not detected in feral or domestic pigs. Likewise, brucellosis seroprevalence in horse and water buffalo farms was estimated in 6.5% and 21.7%, respectively, with no Brucella isolation. Six cetacean species showed positive reactions against Brucella antigens, and B. ceti was isolated in 70% (n = 29 of striped dolphins (Stenella coeruleoalba. A steady increase in the diagnosis of human brucellosis cases was observed. Taking into account the prevalence of brucellosis in the various host mammals of Costa Rica, different measures are recommended.
... 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, VS...
Full Text Available A middle aged woman with secondary syphilis-diagnosed clinically and serologically was prescribed oral tetracyline. She did not complete the course of treatment. Recurrent mucosal erosions in the mouth she developed subsequently as manifestation of relapsing secondary syphilis were wrongly diagnosed as ′aphthous stomatitis′ and were treated with betamethasone gargling. The erosions progressed to ulcerations and finally resulted in perforation of the soft palate.
Kotsafti, Ourania; Paparizos, Vassilios; Kourkounti, Sofia; Chatziioannou, Argiro; Nicolaidou, Electra; Kapsimali, Violetta; Antoniou, Christina
The objective of this study was to investigate if early syphilis infection affects markers of HIV infection; CD4 T cells and viral load (VL). A retrospective study was performed on 160 HIV-positive patients (111 receiving antiretroviral therapy [ART] and 49 without ART). Early syphilis diagnosis was made in HIV patients during their follow-up at the HIV/AIDS Unit at a Greek Dermatology and Venereology Unit. The patients' blood tests were available at the time of diagnosis, as well as before and 12 weeks after early syphilis diagnosis. CD4 T cell counts and VL levels were measured. It was found that syphilis infection had a negative impact on the CD4 T cell counts in both groups, with reduced CD4 T cell counts observed in 84.6% (99/111) and 79.5% (39/49) of patients receiving and not receiving ART, respectively. After treatment for syphilis, CD4 T cell counts returned to pre-treatment levels in most patients, especially those receiving ART. There was a slight and transient VL increase. Patients receiving ART had a 27% increase in VL, compared to 71.4% among patients not receiving ART. Although the VL increase was slight (41-14,000 copies/ml) in the group under treatment, 4-5% (5/111) patients did not return to pre-treatment levels. Moreover, viral mutations associated with treatment resistance were identified in these patients. Early syphilis accelerates and complicates the progression of HIV infection. Early diagnosis and treatment of syphilis may prevent infection-associated complications in most instances. Consequently, prevention of syphilis and other sexually transmitted infections is of great importance for patients infected with HIV. © The Author(s) 2016.
Martins, Cesario; Bale, Carlitos; Garly, May-Lill
BACKGROUND: Previous studies have suggested that girls may have lower maternal measles antibody levels than boys. Girls might therefore be more likely to contract measles infection before the normal age of measles vaccination at 9 months of age. METHODS: In connection with a clinical trial...... of different measles vaccination strategies, we collected pre-measles vaccination blood samples at 4.5 months of age from two subgroups of children. Samples from these children were used to assess possible differences in maternal antibody levels for boys and girls. At 9 months of age another subgroup...... of children was sampled before the normal measles vaccination; these samples were used to assess the frequency of subclinical measles infection among boys and girls. RESULTS: We determined measles-specific antibody levels for 812 children at 4.5 months of age and for 896 children at 9 months of age. At 4...
The historical process of brucellosis extends back to humankind's first contact with animals. Although brucellosis is a sporadic disease observed in animals in certain regions of the world, it is an important disease in humans that can affect many organs and systems due to the consumption of contaminated milk or milk products. Studies have shown that the presence of Brucella dates back to 60 million years ago. In 450 BC, Hippocrates described a disease similar to brucellosis. Since Hippocrates' time, brucellosis has been characterized by fever. Our aim is to investigate selfless work undertaken by scientists on the epidemiology, diagnosis and clinical findings of brucellosis until today, and to gain a historical perspective about the disease that is as old as human history, still has importance today, causes economic losses in treated animals and harms human health.
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.
Chang, Y K; Chao, S L; Huang, L W
From September 1987 to April 1991, 19 pregnant women (0.97%) with syphilis were detected out of 1,955 pregnant women who received prenatal serologic screening at the Buddhist Tz'u-Chi General Hospital. The ages ranged from 17 to 34 years (average, 26). Three cases had recurrent gestational syphilis. The time of diagnosis was: the third trimester, 11 cases; the second trimester, six cases; and the first trimester, two cases. The reasons for late (third trimester) diagnosis were: delay of prenatal care, four cases; failure to screen syphilis in the pregnancy, four cases; and negative first test and late infection, three cases. Late diagnosis and treatment often resulted in poor fetal outcome: syphilitic stillbirth, two cases; probable and possible congenital syphilis, seven cases; and normal infant, two cases. Patients (delivered, five; undelivered, two; abortion, one) who had been diagnosed before the third trimester had a better fetal outcome: possible congenital syphilis, one case; and normal infant, four cases. The perinatal mortality and morbidity were significantly higher in the late diagnosis group (9/11) than in the early diagnosis group (1/5). Pregnant women should be screened in early pregnancy by a serologic test for syphilis. In areas of high prevalence, or in patients at high risk, screening should be repeated in the third trimester and again at delivery.
Byberg, S.; Thysen, S. M.; Rodrigues, A.
.15 (0.04–0.63)). Conclusions We found indications of strong beneficial non-specific effects of receiving measles vaccine during the 2012 campaign, especially for girls and children with previous routine measles vaccination. Measles vaccination campaigns may be an effective way of improving child......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...
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... jerking and staring), brain damage, and death. Mumps:Mumps virus causes fever, headache, muscle pain, loss of appetite, ... ovaries, and rarely sterility. Rubella (German Measles):Rubella virus causes rash, ... mumps, and rubella (MMR) vaccine can protect children (and ...
Cavalcante, Patrícia Alves de Mendonça; Pereira, Ruth Bernardes de Lima; Castro, José Gerley Diaz
to describe the epidemiological profile of reported cases of syphilis in pregnant women and congenital syphilis in the period 2007-2014 in Palmas-TO, Brazil. this is a descriptive study with data from the Information System for Notifiable Diseases (Sinan). 171 pregnant women with syphilis (4.7/1,000 live births [LB]) and 204 cases of congenital syphilis (5.6/1,000 LB) were identified; most women were brown-skinned (71.3%), had low education level (48.0%) and received late diagnosis during prenatal care (71.9%); the incidence of congenital syphilis varied from 2.9 to 8.1/1,000 LB in the period; the predominant maternal characteristics were age from 20 to 34 years (73.5%), having up to complete high school (85.3%), attending prenatal care (81.4%), diagnosis of syphilis during prenatal care (48.0%), and untreated partners of mothers who attended prenatal care (83.0%), reaching almost 80% of live births with congenital syphilis. it is necessary to adopt new strategies for the effectiveness of the prenatal care provided, and, consequently, to reduce the incidence of congenital syphilis.
Soeiro, Claudia Marques de Oliveira; Miranda, Angélica Espinosa; Saraceni, Valeria; Santos, Marcelo Cordeiro dos; Talhari, Sinesio; Ferreira, Luiz Carlos de Lima
This study analyzes notification of syphilis in pregnancy and congenital syphilis in Amazo- nas State, Brazil, from 2007 to 2009 and verifies underreporting in databases in the National Information System on Diseases of Notification (SINAN) and the occurrence of perinatal deaths associated with congenital syphilis and not reported in the Mortality Information System (SIM). This was a cross-sectional study with probabilistic record linkage between the SINAN and SIM. There were 666 reports of syphilis in pregnant women, including 224 in 2007 (3.8/1,000), 244(4.5/1,000) in 2008, and 198(4.0/1,000) in 2009. The study found 486 cases of congenital syphilis, of which 153 in 2007 (2.1/1,000), 193 in 2008 (2.6/1,000), and 140 in 2009 (2.0/1,000). After linkage of the SINAN databases, 237 pregnant women (35.6%) had cases of congenital syphilis reported. The SIM recorded 4,905 perinatal deaths, of which 57.8% were stillbirths. Probabilistic record linkage between SIM and SINAN-Congenital Syphilis yielded 13 matched records. The use of SINAN and SIM may not reflect the total magnitude of syphilis, but provide the basis for monitoring and analyzing this health problem, with a view towards planning and management.
Full Text Available 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.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.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 corticosteroids and IVIG is common practice, and should be
Meyer Sauteur, Patrick M; Trück, Johannes; Bosshard, Philipp P; Tomaske, Maren; Morán Cadenas, Francisca; Lautenschlager, Stephan; Goetschel, Philippe
Acquired syphilis has re-emerged in many Western European countries. In contrast to international guidelines, screening for syphilis in pregnancy is not generally recommended in Switzerland. There has been an increase in the incidence of laboratory syphilis notifications in recent years, regardless of gender and age. We conducted a retrospective study, evaluating the total numbers of pregnant women with positive syphilis serology (Treponema pallidum Particle Agglutination assay, TPPA) from 2000 to 2009, and evaluated the clinical management and outcome of their offspring. In addition, we sought to determine cases of infectious syphilis (primary, secondary, and early latent syphilis) reported to the Swiss Federal Office of Public Health in women of childbearing age, which has previously been shown to precede changes in the incidence of congenital syphilis within a population. Out of 13,833 women who gave birth at our institution, positive syphilis serology was found in 9 pregnant women during the 10 years studied. A total of 6 pregnant women were diagnosed having syphilis infection during pregnancy. Regarding their offspring, 8 of the 9 newborns were tested serologically. One neonate experienced congenital syphilis because the adequately treated mother developed re-infection after treatment. Within the Swiss population, infectious syphilis cases in women of childbearing age increased substantially from 2006 to 2009. The epidemiologic data suggest that congenital syphilis could become a medical problem in Switzerland due to the rise of infectious syphilis cases in women of childbearing age that have been shown to be followed by changes in the congenital syphilis incidence. The persistence of congenital syphilis in Switzerland along with this rise of infectious syphilis in women of childbearing age suggests a potential for improvement of prenatal care and syphilis control programmes.
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
Jankowski, M.A.; Gut, W.; Kantoch, M. (Department of Virology, National Institute of Hygiene, Warsaw (Poland))
A sensitive radioimmunoassay (RIA) was introduced for detecting measles virus IgG and IgM antibodies. The hyperimmune response to the measles virus could be demonstrated more accurately by RIA than by haemagglutination inhibition (HI). The ratio between RIA and HI antibody titres was decidedly higher in sera and cerebrospinal fluids of patients with subacute sclerosing panencephalitis than in those of other groups tested.
Buckle, Kelly; Roe, Wendi D; Howe, Laryssa; Michael, Sarah; Duignan, Padraig J; Burrows, E; Ha, Hye Jeong; Humphrey, Sharon; McDonald, Wendy L
Brucella spp infections of marine mammals are often asymptomatic but have been associated with reproductive losses and deaths. Zoonotic infections originating from marine isolates have also been described. Hector's dolphins (Cephalorhynchus hectori) are an endangered species with a declining population, and the role of infectious disease in population dynamics is not fully understood. In this study, 27 Hector's dolphins found dead around the New Zealand coastline between November 2006 and October 2010 were evaluated for lesions previously associated with cetacean brucellosis. Tissues were examined using histological, immunohistochemical, and molecular (polymerase chain reaction [PCR]) techniques. Seven of 27 dolphins (26%) had at least 1 tissue that was positive on PCR for Brucella spp. Lesions consistent with brucellosis were present in 10 of 27 (37%) dolphins, but in 8 of these dolphins Brucella infection could not be demonstrated in lesional tissues. Two dolphins (7%) were diagnosed with active brucellosis: 1 female with placentitis and metritis, and 1 stillborn male fetus. Brucella identified in these 2 dolphins had genetic similarity (99%) to Brucella pinnipedialis. The omp2a gene amplicon from the uterus of the female had 100% homology with ST27 genotype isolates from a human in New Zealand and a bottlenose dolphin of Pacific origin. The remaining 5 PCR-positive dolphins were assessed as having asymptomatic or latent infection. While most Brucella infections identified in this study appeared to be subclinical, the finding of 2 dolphins with reproductive disease due to Brucella infection suggests that this disease has the potential to affect reproductive success in this species.
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
Rosenlund, H.; Bergstrom, A.; Alm, J.; Swartz, J.; Scheynius, A.; van Hage, M.; Johansen, K.; Brunekreef, B.|info:eu-repo/dai/nl/067548180; 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
... Twitter STD on Facebook Sexually Transmitted Diseases (STDs) Syphilis & MSM (Men Who Have Sex With Men) - CDC ... Share Compartir Once nearly eliminated in the U.S., syphilis is increasing, especially among gay, bisexual, and other ...
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...
Surender Nikhil Gupta
Full Text Available Introduction: In outbreak settings, more than one virus may be infecting the given population. In twin or triple outbreak of measles, German measles (rubella, and varicella in highly immunized hilly areas, maximal number of the case patients in all the hilly villages belonged to the older age group. It suggested an obvious shift to the higher age group, warranting second dose opportunity in such case scenario. The clinical presentations of viral diseases are too similar to differentiate. The aim is to clearly categorize the case patients of modified measles, rubella, and atypical measles in outbreak settings. Results: Four outbreaks are listed. In the first one, sixty case patients were identified from 1026 people in 5 villages. Of these, 41 were diagnosed by clinically, 8 were laboratory confirmed as measles and 11 were epidemiologically linked German measles case patients. Seventy percent of the cases were vaccinated for measles. In second case, we identified 29/35 measles and 6/35 were confirmed as epidemiologically linked unvaccinated chickenpox case patients. In third one, we identified 116 cases in eight villages (112/116 clinically and 04/116 laboratory confirmed. Majority of cases were immunized against measles, but only minor cases for rubella. In fourth case, we identified 505 case patients from mixed outbreaks of varicella, measles and rubella (30/505 clinically, 467/505 epidemiologically linked and 8/505 laboratory confirmed case patients from a study population of 3280. In all the four outbreaks, prima facie, the clinical presentations of both rubella and modified measles were difficult to differentiate. Discussion: On the basis of outbreak investigation and analytical inference, it has been observed that the symtomatology of modified measles and laboratory confirmed rubella case patients/epidemiologically linked cases are so similar placed that many a time, it becomes much difficult to line list the cases in one section of modified
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.
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.
Zhou, Yanhua; Zuo, Shunwu; Yao, Yingbo; Yang, Rusong; Wang, Shukun
To investigate the epidemic status of brucellosis in the occupational population in Yuxi, China, and to develop effective prevention and control strategies. Serological test was performed for 2320 employees involved in breeding, slaughtering, meat and dairy product processing, veterinary medicine, and sales in counties and districts where brucellosis was detected from 2008 to 2014 in Yuxi; pathogenic detection was performed for those in the occupational population who were suspected of brucellosis. The results of serological test showed that the infection rate of brucellosis reached 3.32% , and 15 cases of brucellosis had clinical symptoms. The employees involved in breeding had the highest infection rate (4.89%) (χ2=25.75, Pbrucellosis was 0.37%~4.93% and tended to increase; 67.85% of the occupational population did not take personal protective measures and had a significantly higher infection rate than those who took personal protective measures (4.45% vs 0.94%; χ2=19.42, Pbrucellosis, 42 cases were diagnosed as current brucellosis confirmed by laboratory pathogenic detection. The infection rate of brucellosis and the number of newly diagnosed cases tend to increase in the occupational population in Yuxi, and the employees involved in breeding are the major infected population.
Tsend, Selenge; Baljinnyam, Zolzaya; Suuri, Bujinlkham; Dashbal, Enkhbayar; Oidov, Baatarkhuu; Roth, Felix; Zinstag, Jakob; Schelling, Esther; Dambadarjaa, Davaalkham
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. 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. 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). 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.
Ali, Shahzad; Akhter, Shamim; Neubauer, Heinrich; Scherag, André; Kesselmeier, Miriam; Melzer, Falk; Khan, Iahtasham; El-Adawy, Hosny; Azam, Asima; Qadeer, Saima; Ali, Qurban
Brucella species occasionally cause spontaneous human abortion. Brucella can be transmitted commonly through the ingestion of raw milk or milk products. The objective of this study was to determine the sero-prevalence of and to identify potential risk factors for brucellosis in pregnant women from Rawalpindi, Pakistan. We conducted a cross-sectional study at the Gynecology Outdoor Patient department of the Benazir Bhutto Hospital, Rawalpindi, Pakistan from March to June 2013. Data related to potential risk factors and clinical history was collected by individual interviews on the blood sampling day. The 429 serum samples collected were initially screened by Rose Bengal Plate Agglutination test for the detection of Brucella antibodies. We applied standard descriptive statistics and logistic regression analyses. Twenty five (5.8 %; 95 % confidence interval (CI): 3.8 % -8.5 %) serum samples were found to be seropositive. Brucellosis-related clinical symptoms were recorded in various seropositive cases. Animal contact, raw milk consumption, having an abortion history and the experience of an intrauterine fetal death were associated with seropositivity for brucellosis in univariate analyses (all p Brucellosis is a serious threat for pregnant women and their unborn children in Pakistan. Pregnant women having brucellosis-related symptoms or previous history of abortions, miscarriages, intrauterine fetal death and other brucellosis-related manifestations should be screened for brucellosis - especially those exposed to animals given the increased risk - and medication should be administered according to state of the art.
Kolgelier, Servet; Ergin, Merve; Demir, Lutfi Saltuk; Inkaya, Ahmet Cagkan; Aktug Demir, Nazlim; Alisik, Murat; Erel, Ozcan
The objective of this study was to examine a novel profile: thiol-disulfide homeostasis in acute brucellosis. The study included 90 patients with acute brucellosis, and 27 healthy controls. Thiol-disulfide profile tests were analyzed by a recently developed method, and ceruloplasmin levels were determined. Native thiol levels were 256.72 ± 48.20 μmol/L in the acute brucellosis group and 461.13 ± 45.37 μmol/L in the healthy group, and total thiol levels were 298.58 ± 51.78 μmol/L in the acute brucellosis group and 504.83 ± 51.05 μmol/L in the healthy group (p brucellosis than in the healthy controls (p brucellosis. The strong associations between thiol-disulfide parameters and a positive acute-phase reactant reflected the disruption of the balance between the antioxidant and oxidant systems. Since thiol groups act as anti-inflammatory mediators, the alteration in the thiol-disulfide homeostasis may be involved in brucellosis.
Full Text Available Abstract Background: Brucella is an intracellular bacterium that causes chronic infection in humans and domestic animals. The underlying mechanisms that cause prolonged illness are complex and not fully understood. Immune responses may have an important role in the chronicity of infection. Here, we evaluated the lymphocyte proliferation responses in patients with chronic and acute brucellosis. Materials and Methods: This descriptive - analytical study was performed on 22 patients with acute brucellosis, 21 patients with chronic brucellosis and 21 healthy people with the similar age, sex and genetic background as control group. Peripheral lymphocytes were isolated using Ficoll and the cellular proliferation was quantified in presence of antigen and phytohemaglutinin-A by MTT method. Results: The brucella antigen-specific stimulation index in patients with chronic brucellosis was significantly lower than the acute brucellosis patients (p=0.001. Also, stimulating the lymphocytes with phytohemaglutinin-A has shown that proliferative response in patients with chronic brucellosis was lower than the other groups (p=0.04. Conclusion: The results indicated that chronic brucellosis inhibits lymphocyte proliferation. This inhibition of lymphocyte proliferation may be due to the induction of anergy.
Clarissa Prieto Herman Reinehr
Full Text Available Summary Syphilis is an infection caused by Treponema pallidum, mainly transmitted by sexual contact. Since 2001, primary and secondary syphilis rates started to rise, with an epidemic resurgence. The authors describe an exuberant case of secondary syphilis, presenting with annular and lichen planus-like lesions, as well as one mucocutaneous lesion. Physicians must be aware of syphilis in daily practice, since the vast spectrum of its cutaneous manifestations is rising worldwide.
Stamm, Lola V.
Syphilis is caused by infection with Treponema pallidum subsp. pallidum, a not-yet-cultivable spiral-shaped bacterium that is usually transmitted by sexual contact with an infected partner or by an infected pregnant woman to her fetus. There is no vaccine to prevent syphilis. Diagnosis and treatment of infected individuals and their contacts is key to syphilis control programs that also include sex education and promotion of condom use to prevent infection. Untreated syphilis can progress thr...
Reinehr, Clarissa Prieto Herman; Kalil, Célia Luiza Petersen Vitello; Reinehr, Vinícius Prieto Herman
Syphilis is an infection caused by Treponema pallidum, mainly transmitted by sexual contact. Since 2001, primary and secondary syphilis rates started to rise, with an epidemic resurgence. The authors describe an exuberant case of secondary syphilis, presenting with annular and lichen planus-like lesions, as well as one mucocutaneous lesion. Physicians must be aware of syphilis in daily practice, since the vast spectrum of its cutaneous manifestations is rising worldwide.
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.
... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Syphilis serology. 493.1207 Section 493.1207 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES....1207 Condition: Syphilis serology. If the laboratory provides services in the subspecialty of Syphilis...
Koekenbier, Rik H.; Davidovich, Udi; van Leent, Edwin J. M.; Thiesbrummel, Harold F. J.; Fennema, Han S. A.
Objectives: To determine the feasibility and efficacy of an online-mediated syphilis screening among men who have sex with men. Methods: We developed a Web site that offered information about syphilis and motivated users to download a referral letter with which they could test for syphilis in a
Introduction: Syphilis remains a major public health problem in sub-Saharan Africa, including Burkina Faso. However, few published data are available on the prevalence of syphilis in the population. This study had two main objectives: to determine the seroprevalence of syphilis in a cohort of 37,210 first time blood donors ...
Tikhonova, L.; Salakhov, E; Southwick, K; Shakarishvili, A; Ryan, C.; Hillis, S
Objectives: Reported cases of congenital syphilis in the Russian Federation increased 26-fold from 1991–9. Our objectives were to describe the frequency, risk factors, and consequences of delivering an infant with congenital syphilis among pregnant women with active syphilis.
Conclusion: Syphilis can be presented initially as ocular uveitis without obvious systemic manifestation. Ophthalmologists play an important role in the early diagnosis and treatment of syphilis. If treated early enough, the response is good, even if the patient is allergic to penicillin. Awareness of the multiple manifestations of ocular syphilis is the key to early detection of the disease.
Full Text Available Brucella endocarditis (BE is a rare but life threatening complication of brucellosis. We present a case report of a patient with relapsing brucellosis complicated with aortic valve endocarditis. The patient underwent valve replacement and required prolonged antibiotic treatment because of rupture of the noncoronary leaflet and development of congestive heart failure. Since the onset of endocarditis in patients with brucellosis is not known, proper follow-up is required in order to identify any late onset complications, especially in endemic areas.
To provide an up-to-date overview on the role of Brucella as a possible biological (B-) agent to be used in biological warfare, biological crimes and biological terrorism (with special respect to agroterrorism) scenarios. An analysis of current literature and of Internet-based sources was made. Brucella spp. have always been in the focus of military decision. The main reason for military research on Brucella was driven by the finding that the organism can easily be transmitted via aerosols. Confronted with the new challenge of global terrorism in the last decades of the 20th century, experts tried to evaluate the risk that Brucella spp. are used against the civilian population. Based on criteria concerning public health demands brucellosis was rated to have only a lower medical and public impact. Nevertheless, small-scale outbreaks in humans will pose problems in all those countries where first responders are usually not aware of the clinical syndrome. Countries which have eradicated brucellosis from their livestock successfully may face another severe threat: agroterrorism. Brucella spp. might be introduced intentionally into livestock (cattle, small ruminants, pigs). Undeterminable losses for a state's economy may be the result of such an attack. The world has become safer in the last decades due to the intensive efforts of the global community to effectively ban the use of weapons of mass destruction. However, bio- and agroterrorism especially an attack against the agricultural infrastructure is considered to be a permanent danger.
Muhammed Emin Akkoyunlu
Full Text Available A 68 years old male farmer referred with cough, expectorating sputum, intermittant fever, night sweats, fatigue and anorexia persisting for two weeks. There was a history of 80 packs each year of smoking and he was still an active smoker. Pneumonectomy was performed because of pulmonary epidermoid cancer and he received chemotherapy. He was diagnosed lung tuberculosis and using anti-tuberculous treatment for 4 months. He had a weight loss of 8 kg in last month. His body tempereature was 38.5 °C. Heart rate was 100/min. ESR was 51mm/h and CRP was 5.6 mg/ dL. There was no proliferation in blood and sputum cultures. Three sputum specimens were examined and AFB wasn’t detected. Fibronodular infiltration was seen in right lower zone of chest X-ray. In thorax CT, fibronodular densities were seen in lower lobe anterior and posterior segments. Brucella melitensis was isolated in blood culture. Second bronchoscopy was performed with suspect of brucellosis pneumonia. Brucella tube agglutination test was positive at titer 1/320 in the bronchial lavage fluid and 1/640 in concurrent serum sample. In cases with chronic cough or pneumonia which is irresponsive to nonspecific antibiotherapy, respiratory brucellosis must be rememberred in endemic areas.
... cases and outbreaks. Q: What does “measles elimination” mean? A: CDC defines measles elimination as the absence ... Respiratory Diseases , Division of Viral Diseases Email Recommend Tweet YouTube Instagram Listen Watch RSS ABOUT About CDC ...
Tipples, Graham A; Gray, Michael; Garbutt, Michael; Rota, Paul A
Genotyping is an important component of measles surveillance. In this study, we report the genotypes of 30 measles viruses from cases in Canada; 6 of these were collected between 1979 and 1996 and 24 were collected from 1997 through 2002. Many measles virus genotypes were found (C1, C2, D3, D4, D5, D6, D7, D8, E, and H1). These data indicate that the predominant measles virus genotypes detected from 1979 to 1997 in Canada are no longer commonly found. Since the implementation of a routine second dose of measles vaccine and catch-up campaigns in 1996-1997, the wide variety of measles virus genotypes found supports epidemiological data showing that importation of measles is the source of current measles cases in Canada.
... of NLM NLM Grantee's "HealthMap" Helps Uncover Measles Vaccination Gap Inadequate vaccine coverage is likely a driving ... stop this and future measles outbreaks is through vaccination." The research indicates that vaccine coverage among the ...
Kirkcaldy, Robert D; Su, John R; Taylor, Melanie M; Koumans, Emilia; Mickey, Tom; Winscott, Michelle; Kenney, Kerry; Weinstock, Hillard S
We investigated factors associated with high rates of congenital syphilis among Hispanic infants in Maricopa County, AZ. Using 2004-2008 syphilis case report data from the state and county health departments, we examined characteristics of pregnant and nonpregnant women with syphilis and their male partners. During 2004-2008, 970 women were reported to have syphilis: 49% were Hispanic (of whom 49% were non-US citizens), 27% were white, 13% were black, and 8% were American Indian/Alaskan Native. Although 16% of Hispanic noncitizens reported drug use or high-risk sexual behaviors, 64% of these women had a male sex partner who reported drug use or anonymous sex. Hispanic women with syphilis were more likely to be pregnant (37%) than white (15%) or black women (13%) (P syphilis. Pregnant Hispanic noncitizens were treated later than pregnant Hispanic citizens (median 28 weeks gestation vs. 21 weeks, P = 0.01). Innovative congenital syphilis prevention strategies that are relevant to Hispanic women are warranted. Strategies should address the reproductive health and prenatal care needs of Hispanic women, and may include interventions for their male partners.
Lai, Kuan; Pinto-Sander, Nicolas; Richardson, Daniel; Wei, Shanshan; Zeng, Kang
Awareness of the spectrum of clinical manifestations of syphilis, especially uncommon changes, is essential for diagnosis and effective management of patients. A 48-year-old Han businessman presented to the ear, nose and throat surgeons with an eight-week history of epigastric pain, a four-week history of a widespread non-itchy rash including the scrotal skin and a one-week history of tinnitus and dizziness. On examination, he was afebrile with widespread lymphadenopathy and a maculopapular rash affecting his trunk and scrotum. His abdomen was soft but tender in the epigastrium. The Treponema pallidum particle agglutination assay result was positive, and the rapid plasma reagin was 1:2. Gastroscopy showed ulcers in the gastric antrum and pylorus. Histopathological examination of gastric mucosa lesions showed a large amount of lymphoplasmacytic infiltrate detected in the lamina propria of the gastric mucosa. The T. pallidum Liferiver real time polymerase chain reaction kit assay performed on specimens from skin lesions and gastric mucosal tissue were positive. The patient was treated with intravenous sodium penicillin followed by intramuscular benzathine penicillin. On the fourth day of the treatment, the rash, epigastric pain and lymphadenopathy subsided. Two weeks after treatment, the tinnitus alleviated and vertigo disappeared.
Aaby, P; Whittle, H; Cisse, B; Samb, B; Jensen, H; Simondon, F
It has been suggested that measles infection mainly kills frail children who are likely to die anyhow of other infections. If that were true, the proportion of frail children should increase after the introduction of measles vaccination and post-measles mortality compared with mortality in uninfected children should increase when the case fatality declines and frail children are no longer dying of measles. The latter deduction was investigated in Niakhar, Senegal, where the measles case fatality has declined markedly. Measles has been studied in Niakhar during 12 years from 1983 to 1994. We compared long-term mortality after measles infection in periods with both high and low case fatality. The acute measles case fatality rate (CFR) declined from 6.5% in 1983-1986 to 1.5% in 1987-1994, an age-adjusted decline of 66% (RR=0.34 (0.19-0.58)). Between 1983-1986 and 1987-1994, mortality in the first year after measles infection declined by 35% (RR=0.65 (0.37-1.16)), the pattern being the same in the second and third year after infection (RR=0.63 (0.33-1.21)). This reduction could not be related to introduction of immunization, treatment of measles with Vitamin A, or prophylactic use of antibiotics. Controlling for age, immunization, and season, the decline in post-measles mortality was similar to the fall in non-measles-related mortality between the two periods (mortality rate ratio=0.72 (0.64-0.80)). Since the mortality decline in survivors of measles was as large as the decline in mortality among uninfected children, reduction in acute measles mortality did not lead to accumulation of frail children. We doubt measles infection ever eliminated mainly weak children; it always killed a broad spectrum of children, most of whom were "fit to survive". Hence, it seems unlikely that measles vaccination has contributed to the survival of more frail children.
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.
Rodríguez-Cerdeira, C; Silami-Lopes, V G
While the prevalence of congenital syphilis continues to be low throughout most of the developed world, there has been a slight resurgence of the disease in several European countries, including Spain. In this context, we need to become more familiar with the signs and symptoms of this disease and consider its diagnosis in patients with only mild clinical manifestations. A definitive diagnosis may be difficult or even impossible in patients whose diagnostic tests reveal low positive titers or inconsistent results. The cornerstone of congenital syphilis control is prenatal screening and the treatment of infected mothers with penicillin, an effective and economical intervention. Based on a review of the literature supplemented by data from our own clinical experience, this article provides a detailed description of the clinical manifestations of congenital syphilis as well as the various diagnostic methods and treatments available. Copyright © 2011 Elsevier España, S.L. y AEDV. All rights reserved.
Basu, Sriparna; Kumar, Ashok
In spite of availability of cost-effective preventive measures and treatment, a resurgence of congenital syphilis has currently been noted. During the past 4 years, we came across five low birth weight neonates with unusual symptoms, which subsequently proved to be manifestations of early congenital syphilis. All the mothers had apparently uneventful antenatal period. No investigation was done during pregnancy. They were unaware about their disease and were found to be positive for syphilis by Venereal Disease Research Laboratory Test and fluorescent treponemal antibody (absorbed) IgM test only after childbirth. Screening for other congenital infections was negative. All the neonates were positive for Venereal Disease Research Laboratory Test. They were treated with intravenous crystalline penicillin G for 10 days. Recovery was uneventful. We reemphasize the importance of raising public awareness, routine antenatal screening and treatment for all pregnant mothers to avoid such a potentially treatable condition.
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.
Introduction: Despite accelerated measles control efforts, a massive measles resurgence occurred in the Democratic Republic of the Congo (DRC) starting in mid-2010, prompting an investigation into likely causes. Methods: We conducted a descriptive epidemiological analysis using measles immunization and surveillance ...
Background: According to the World Health Organization (WHO), African region accounts for 36% of deaths caused by measles worldwide. Nigeria has, over the years, recorded the highest average annual measles incidence per 100,000 populations in Africa. Measles epidemics have consistently been reported in northern ...
Introduction: Efforts at immunizing children against measles was intensified in Nigeria with nation-wide measles vaccination campaigns in 2005 - 2006, 2008 and 2011 targeting children between 9 and 59 months. However, there were measles outbreaks in 2010 and 2011in Abia state Nigeria. This study seeks to find out if ...
Background: Measles is still a major cause of childhood morbidity and mortality in Nigeria despite the availability of safe and effective vaccines. The burden of measles using length of hospital stay as a result of complications in hospitalised children with measles is reported. Methods: We carried out a two year retrospective ...
Objectives: To determine morbidity and mortality from measles and to estimate measles vaccine effectiveness among children hospitalised with measles in two hospitals in Nairobi. Design: A review of hospital records (index cards). Setting: Kenyatta National Hospital and Mbagathi District Hospitals covering the years ...
The 1990 national mass measles immunisation campaign resulted in a marked reduction in measles incidence in Natal/KwaZulu in the first 6 months after the campaign. Data from the measles ward admissions book at Clairwood Hospital were collated for the period 1 January 1989 to 31 May 1992 to assess the ...
Introduction: To estimate the post-campaign level of measles vaccination coverage in Guinea. Method: Interview of parents and observation of measles vaccination cards of children aged 9 to 59 months during the mass measles campaign. A nationwide cluster randomized sample under health District stratification. Results: ...
Liu, Wei-Liang; He, Zhi-Xu; Li, Fang; He, Dian; Ai, Rong
1 patient with SSPE at 4 y. He had had measles and measles encephalitis at 7.5 months. In China, the first and the second measles immunizations are recommended at 8 months and at 18-24 months, respectively. We recommend above immunizations should be given separately at 6 months and at 12-15 months.
District measles coverage was highly positively correlated with diphtheria, pertussis and tetanus (DPT3) coverage (r = 0.960, P = 0.000). There was a strong negative correlation between ranked measles campaign coverage and routine measles immunisation coverage. Obstacles to immunisation accounted· for nearly half ...
Bhakta R Giri
Full Text Available Background: Bhutan has attained universal child immunization since 1991. Since then, immunization coverage is maintained at high level through routine immunization, periodic National Immunization Days, and mop up campaigns. Despite high immunization coverage, every year, significant numbers of clinically suspected measles cases were reported. Objective: To assess the cause of continuing high "suspected measles cases" and take appropriate public health measures. Materials and Methods: Febrile rash outbreaks occurred in several districts in 2003. These episodes were investigated. Simultaneously, a retrospective data search revealed evidence of congenital rubella syndrome (CRS in the country. Results: Thirty five percent of the tested samples were positive for rubella but none for measles. There were evidences of the presence of CRS. This was discussed in the annual health conference 2004, amongst health policy makers and district heads who recommended that a possibility of inclusion of rubella as an antigen be looked into. A nationwide measles and rubella immunization campaign was conducted in 2006 followed by introduction of rubella vaccine in the immunization schedule. Conclusion: Febrile rash can be caused by a host of viral infections. Following universal measles immunization, it is pertinent that febrile rash be looked in the light of rubella infections. Following the introduction of rubella vaccination in the national immunization schedule, there has been significant reduction of febrile rash episodes, cases of rubella, and congenital rubella syndrome.
Vilchez, Gustavo; Espinoza, Miguel; D'Onadio, Guery; Saona, Pedro; Gotuzzo, Eduardo
Brucellosis is a zoonosis with high morbidity in humans. This disease has gained interest recently due to its re-emergence and potential for weaponization. Pregnant women with this disease can develop severe complications. Its association with adverse obstetric outcomes is not clearly understood. The objective of this study was to describe the obstetric outcomes of brucellosis in pregnancy. Cases of pregnant women with active brucellosis seen at the Hospital Nacional Cayetano Heredia from 1970 to 2012 were reviewed. Diagnostic criteria were a positive agglutination test and/or positive blood/bone marrow culture. Presentation and outcomes data were collected. The Chi-square test was used for nominal variables. A p-value of 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. Copyright © 2015. Published by Elsevier Ltd.
Investigation into the prevalence of bovine brucellosis and the risk factors that predispose human to infection among urban dairy and non-dairy farming households in Dagoretti Division, Nairobi, Kenya.
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...
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.
Rahman, AKM Anisur
Background Brucellosis is an ancient and one of the world’s most widespread zoonotic diseases affecting both, public health and animal production. It is endemic in many developing countries of Asia, Africa and Latin America including Bangladesh. Since the first report in 1970, a lot of brucellosis seroprevalence reports are available in cattle, goats, sheep and humans in Bangladesh. Most of the previously reported prevalence studies were based on non-random samples, which may not give a tr...
Rahman, Akm Anisur; Berkvens, Dirk; Saegerman, Claude; Fretin, David; Muhammad, Noor; Hossain, Akram; Abatih, Emmanuel
This study describes the seroprevalence of human brucellosis among pyretic patients and detection of Brucella abortus DNA from seropositive pyretic patients using real-time polymerase chain reaction (rtPCR) for the first time in Bangladesh. Blood samples were collected from 300 pyretic patients from October 2007 to May 2008 and subjected to three serological tests: Rose-Bengal plate test (RBT), standard tube agglutination test (STAT), and indirect enzyme-linked immunosorbent assay (iELISA). Risk factors were identified by multivariate Firth's logistic regression analysis. Brucella genus (BCSP31) and species-specific (IS711) rtPCR were applied to six human sera samples. The seroprevalence of brucellosis among pyretic patients was estimated to be 2.0% (95% confidence interval [CI]: 0.74-4.30). The odds of brucellosis seropositivity were 8.9 (95% CI: 1.26-63.0) times higher in pyretic patients who handled goats than those who handled only cattle, whereas the odds of brucellosis seropositivity were 9.7 (95% CI: 1.28-73.68) times higher in pyretic patients who had backache compared to those without backache. B. abortus DNA was amplified from all six human sera that tested positive by RBT, STAT, and iELISA. As the agreement between the tests was very strong, RBT is recommended as a screening test for the diagnosis of human brucellosis in Bangladesh because it is easier to use, cheaper, and faster. Brucellosis among pyretic patients is common, and B. abortus is responsible for brucellosis in such patients. Pyretic patients who handle goats and those with backaches should be screened for brucellosis.
De Santis, Marco; De Luca, Carmen; Mappa, Ilenia; Spagnuolo, Terryann; Licameli, Angelo; Straface, Gianluca; Scambia, Giovanni
Congenital syphilis is still a cause of perinatal morbidity and mortality. Untreated maternal infection leads to adverse pregnancy outcomes, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death, and congenital disease among newborns. Clinical manifestations of congenital syphilis are influenced by gestational age, stage of maternal syphilis, maternal treatment, and immunological response of the fetus. It has been traditionally classified in early congenital syphilis and late congenital syphilis. Diagnosis of maternal infection is based on clinical findings, serological tests, and direct identification of treponemes in clinical specimens. Adequate treatment of maternal infection is effective for preventing maternal transmission to the fetus and for treating fetal infection. Prenatal diagnosis of congenital syphilis includes noninvasive and invasive diagnosis. Serological screening during pregnancy and during preconception period should be performed to reduce the incidence of congenital syphilis. PMID:22829747
Peterman, Thomas A; Su, John; Bernstein, Kyle T; Weinstock, Hillard
Syphilis rates and trends vary by population subgroup. Among men who have sex with men (MSM), rates of primary and secondary (P&S) syphilis are high throughout the USA (228.8 per 100,000 in 2013). P&S syphilis among women is much less common (0.9 per 100,000 in 2013) and occurs in isolated outbreaks plus in a few counties with persistent low levels of infection. Congenital syphilis trends closely follow P&S trends among women. These trends have implications for prevention. Routine screening among MSM can prevent tertiary syphilis, but despite interventions, rates of infection continue to rise among MSM and will soon approach those last seen in 1982 (estimate: 340.7 per 100,000). Control of syphilis among women is possible and important because it often leads to congenital syphilis. Outbreaks among heterosexuals can be halted by intensive screening, treatment and partner notification.
Marco De Santis
Full Text Available Congenital syphilis is still a cause of perinatal morbidity and mortality. Untreated maternal infection leads to adverse pregnancy outcomes, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death, and congenital disease among newborns. Clinical manifestations of congenital syphilis are influenced by gestational age, stage of maternal syphilis, maternal treatment, and immunological response of the fetus. It has been traditionally classified in early congenital syphilis and late congenital syphilis. Diagnosis of maternal infection is based on clinical findings, serological tests, and direct identification of treponemes in clinical specimens. Adequate treatment of maternal infection is effective for preventing maternal transmission to the fetus and for treating fetal infection. Prenatal diagnosis of congenital syphilis includes noninvasive and invasive diagnosis. Serological screening during pregnancy and during preconception period should be performed to reduce the incidence of congenital syphilis.
De Santis, Marco; De Luca, Carmen; Mappa, Ilenia; Spagnuolo, Terryann; Licameli, Angelo; Straface, Gianluca; Scambia, Giovanni
Congenital syphilis is still a cause of perinatal morbidity and mortality. Untreated maternal infection leads to adverse pregnancy outcomes, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death, and congenital disease among newborns. Clinical manifestations of congenital syphilis are influenced by gestational age, stage of maternal syphilis, maternal treatment, and immunological response of the fetus. It has been traditionally classified in early congenital syphilis and late congenital syphilis. Diagnosis of maternal infection is based on clinical findings, serological tests, and direct identification of treponemes in clinical specimens. Adequate treatment of maternal infection is effective for preventing maternal transmission to the fetus and for treating fetal infection. Prenatal diagnosis of congenital syphilis includes noninvasive and invasive diagnosis. Serological screening during pregnancy and during preconception period should be performed to reduce the incidence of congenital syphilis.
Hussey, J; Mitchell, L; Hew, Y; Foster, K; Waldram, A
Genitourinary case records of 42 pregnant women with syphilis were reviewed as part of a regional audit following the re-emergence of congenital syphilis in the north east of England. National standards, from the British Association of Sexual Health and HIV guidelines on managing syphilis in pregnancy, were met in the majority of cases with 69% being treated according to national guidance and all cases completing treatment. Locally developed standards on multidisciplinary working and communication were met less well, with particular issues regarding the documentation of pregnancy outcomes in GUM records and communication between specialities being highlighted. A regional good practice guide has been developed and implemented to address standards not met, reduce adverse outcomes and prevent future cases of congenital syphilis.
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
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.
Bréhin, C; Ray, S; Honorat, R; Prère, M-F; Bicart-See, A; Claudet, I; Grouteau, E
Brucellosis is an overlooked infection of widespread geographic distribution. This disease is rarely evoked when assessing unexplained pediatric fever, and only 20-30 cases (children and adults) are confirmed per year. Risk factors for contracting brucellosis are exposure to bodily fluids and consumption of unpasteurized dairy products from infected animals. Most cases of brucellosis are associated with traveling to or importing contaminated goods from endemic areas. Here, we report a case of brucellosis in a 16-month-old patient hospitalized for an acute febrile illness in a French general pediatric ward. An antibiotic regimen of rifampicin and co-trimoxazole given over 6 weeks led to successful cure without relapse. The child had eaten a cake made from unpasteurized goat's milk and imported from Oran, a region in Algeria. His mother had consumed the same cake and was hospitalized for brucellosis 15 days later. Clinicians should suspect brucellosis when encountering febrile patients who have traveled to endemic areas, been exposed to body fluids or products of abortion of farm animals, or consumed unpasteurized products. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Norman, Francesca F; Monge-Maillo, Begoña; Chamorro-Tojeiro, Sandra; Pérez-Molina, Jose-Antonio; López-Vélez, Rogelio
Brucellosis is one of the main neglected zoonotic diseases. Several factors may contribute to the epidemiology of brucellosis. Imported cases, mainly in travellers but also in recently arrived immigrants, and cases associated with imported products, appear to be infrequently reported. Cases of brucellosis diagnosed at a referral unit for imported diseases in Europe were described and a review of the literature on imported cases and cases associated with contaminated imported products was performed. Most imported cases were associated with traditional risk factors such as travel/consumption of unpasteurized dairy products in endemic countries. Cases associated with importation of food products or infected animals also occurred. Although a lower disease incidence of brucellosis has been reported in developed countries, a higher incidence may still occur in specific populations, as illustrated by cases in Hispanic patients in the USA and in Turkish immigrants in Germany. Imported brucellosis appears to present with similar protean manifestations and both classical and infrequent modes of acquisition are described, leading on occasions to mis-diagnoses and diagnostic delays. Importation of Brucella spp. especially into non-endemic areas, or areas which have achieved recent control of both animal and human brucellosis, may have public health repercussions and timely recognition is essential. Copyright © 2016 Elsevier Ltd. All rights reserved.
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.
Domingues, Rosa Maria Soares Madeira; Szwarcwald, Celia Landmann; Souza, Paulo Roberto Borges; Leal, Maria do Carmo
OBJECTIVE Determine the coverage rate of syphilis testing during prenatal care and the prevalence of syphilis in pregnant women in Brazil. METHODS This is a national hospital-based cohort study conducted in Brazil with 23,894 postpartum women between 2011 and 2012. Data were obtained using interviews with postpartum women, hospital records, and prenatal care cards. All postpartum women with a reactive serological test result recorded in the prenatal care card or syphilis diagnosis during hospitalization for childbirth were considered cases of syphilis in pregnancy. The Chi-square test was used for determining the disease prevalence and testing coverage rate by region of residence, self-reported skin color, maternal age, and type of prenatal and child delivery care units. RESULTS Prenatal care covered 98.7% postpartum women. Syphilis testing coverage rate was 89.1% (one test) and 41.2% (two tests), and syphilis prevalence in pregnancy was 1.02% (95%CI 0.84;1.25). A lower prenatal coverage rate was observed among women in the North region, indigenous women, those with less education, and those who received prenatal care in public health care units. A lower testing coverage rate was observed among residents in the North, Northeast, and Midwest regions, among younger and non-white skin-color women, among those with lower education, and those who received prenatal care in public health care units. An increased prevalence of syphilis was observed among women with social inequalities in access to health care units, coupled with other gaps in health assistance, have led to the persistence of congenital syphilis as a major public health problem in Brazil. PMID:25372167
Zhang, Xiao-min; Zhang, Rong-na; Lin, Shu-qin; Chen, Shui-xian; Zheng, Li-ying
To investigate the clinical characteristics of pregnant women with syphilis, their pregnant outcomes, perinatal and neonatal prognosis and the incidence of congenital syphilis. One hundred and ninety-two pregnant women with syphilis by serological assays were divided into two groups, group A (n = 93): treated with a full course anti-syphilis therapy and group B (n = 99): untreated group. Meanwhile, they were divided into groups C and D according to maternal serum rapid plasma reagin (RPR) test: RPR titer or = 1:16 (group D). The pregnant outcomes and congenital syphilis were compared between two groups. (1) Perinatal outcomes: Term delivery reached 93.6% (87/93) in group A and only 28.3% (28/99) in group B; the rate of premature birth and fetal intrauterine death were 5.4% (5/93) and 1.1% (1/93) in group A, obviously lower than 28.3% (28/99) and 32.3% (32/99) in group B (P syphilis and neonatal death in group A were significantly lower than those in group B (P syphilis, perinatal death and neonatal death in group C were lower than those in group D (P Gestational week and drug treatment: The earlier the treatment started during pregnancy, the lower the rate of congenital syphilis was (P syphilis were similar between penicillin and dibenzyl penicillin groups (P syphilis therapy is the key to improving the outcomes of pregnancy with syphilis, prognosis of neonates and reducing incidence of congenital syphilis. (2) Maternal serum RPR titer, the starting time of anti-syphilis treatment as well as the choice of therapeutical drugs are important influence factors on the outcomes of pregnancy with syphilis.
Abstract A review of the notification of congenital syphilis at Johannesburg Hospital from 1 May 1991 to 30. April 1992 was conducted to evaluate the effect of the recently introduced notification programme. A total of209 Wassermann reaction (WR)-positive mothers were delivered during this time; 12 preg- nancies (5,7%) ...
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.
Apr 2, 1983 ... 3. Holder WR, Knox JM. Syphilis in pregnancy. Med C1in North Am 1972; 56: 1151-1160. REFERENCES mothers, whose average gestational age was 29 weeks at the time of diagnosis, 15 ofthe 32 babies who had diagnostic tests had an active infection. Holder and Knox3 have shown that although.
associated PPHN and superimposed intra-uterine hypoxia, illustrating the varying spectrum of clinical circumstances in which congenital syphilis should be a diagnostic consideration. Case history. The patient, a male infant weighing 2 520 g, was the product of 38 weeks' gestation in a 34-year-old gravida 9, para 8 woman.
Sehgal, Virendra N; Verma, Prashant; Chatterjee, Kingshuk; Chaudhuri, Anita; Chatterjee, Gautam; Rasool, Farhan
The venereal form of treponematosis, caused by the spirochete Treponema pallidum, plagued every major city in the preantibiotic era. "Civilization means syphilization," was an idea touted by Richard von Krafft-Ebing in the late 19th, and early 20th centuries that the effects of modern life make men more susceptible to syphilis and other diseases. Christopher Columbus was thought of as an importer of syphilis to Europe. Because his serendipitous voyages to the New World initiated the process of Spanish colonization, which foreshadowed general European colonization of the New World, it is difficult to rule out the cultural and political animosity created by Columbus and his men. These recent revelations are intriguing and may create dialogue that may subsequently challenge the age-old theory of "East to West" spread of venereal syphilis. This contribution warrants the continuation of study in this direction, taking into account skeletal studies that utilized radiocarbon dating technique and the phylogenetic analysis of the bacterial strains, offering a possible consensus on the origin and evolution of syphilis.
Aaby, Peter; Martins, Cesário L; Garly, May-Lill
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...... 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...... 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...
Daoud, M; Duca, Elena; Onofriescu, M; Petrescu, Zenaida
The Romanian program for the management and screening of syphilis includes the recording, follow-up, and antenatal care of pregnant women. It aims at testing all pregnant women for syphilis with the help of VDLR (Venereal Disease Research Laboratory) or RPR (Rapid Plasma Reagin) tests, and in the women with positive tests to confirm the results by treponemal tests (treponemal antibodies): THPA (Treponema Pallidum Hemagglutination), FTA-Abs (Fluorescent Treponemal Antibody with Absorption), ELISA-Captia-IgM, and Western Blotting-IgM. In the pregnant women with positive tests two doses of 2.4 million units of penicillin G benzathine were administered at 5 days interval. These pregnant women are in the evidence of a specialist (obstetrician, dermatologist), and District Department of Public Health, and required to come for another serology test in 3 months. In case they still test positive, the same treatment is applied at the beginning of the third trimester of pregnancy. To assess the outcome of congenital syphilis prevention programs in lasi, Romania. In the interval 2005-2011, in the Iasi town, 84 RPR positive pregnant women were recorded. There was no significant difference in the number of pregnant women residing in urban as compared to rural areas. Most of these women were from poor social environments and had a low level of education. The diagnosis of acquired syphilis was made by serological tests as most pregnant women presented in the period of syphilis latency, being asymptomatic. All pregnant women followed the treatment, and were tested periodically. Ultrasound examination was normal in all women (no changes suggestive of fetal malformations). Free clinical, laboratory, and ultrasound investigations, history taking, psychological assessment, sex education, rapid identification of contacts of known patients, follow-up of the interaction between health care providers and syphilitic pregnant women, booklets, and leaflets altogether made that in the last 3
... 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 Vaccination...
Tanyel, Esra; Taşdelen Fişgin, Nuriye; Sarikaya Genç, Hanife; Tülek, Necla
Hepatitis is a rare clinical manifestation of syphilis. In this report a 50 years old male patient who was diagnosed as secondary syphilis presenting with hepatitis has been discussed. The patient was admitted to the hospital with high fever and skin rash, and his history revealed a suspected sexual contact. He indicated that he had been admitted to a health center eight months ago because of the presence of a penile wound, however VDRL (Venereal Disease Research Laboratory) test was negative at that time. Fever (39.5 degrees C), jaundice in skin and sclera, generalized macular and maculopapular skin rash including palms and soles, lymphadenopathy and hepatosplenomegaly were detected in physical examination. Laboratory tests yielded elevated erythrocyte sedimantation rate, high CRP levels and elevated liver enzyme levels, however viral hepatitis markers together with VDRL and TPHA (Treponema pallidum hemagglutination) tests were found negative. Ceftriaxone therapy was initiated because of the presence of high fever (40 degrees C) and 30 leukocyte/mm3 in urine, and the absence of bacteria in Gram staining of urine sample. However, the antibiotic therapy was discontinued since fever persisted. As the clinical signs and symptoms strongly indicated syphilis, the serological tests were repeated and VDRL positivity at 1/8 and TPHA positivity at 1/1280 titers were detected. Ceftriaxone therapy was restarted and continued for 14 days with complete cure. Since the spouse of the patient was also found VDRL and TPHA positive, she was treated with penicilin. The presentation of this case emphasized the importance of repeating the serological tests for syphilis since they might be negative in the early stages of infection. The case also indicates that syphilis should be considered in the differential diagnosis of hepatitis.
Liu, G; Liao, Z; Xu, X; Liang, Y; Xiong, Y; Ni, J
The validity of parent-reported measles-containing vaccination history in children with measles has not been assessed. This study evaluated the accuracy of parental recall of measles-containing vaccination histories in Shenzhen, China. A retrospective study was performed to compare the data from the electronic records with parental recall. The electronic records were regarded as accurate data about the children's measles-containing vaccination status. We collected data from the National Notifiable Diseases Surveillance System and the Immunization Program Information Management System in Shenzhen city, China. Between 2009 and 2014, there were 163 children with measles who had electronic vaccination records; the vaccination status of these cases was reported by the parents in the field epidemiological investigation. We validated parental recall with electronic records. The agreement between parental recall and electronic records was 78.7%. The kappa value was 0.57. The parent-reported measles-containing vaccination rate was higher than the electronic record (48.5% vs 41.7%, χ2 = 53.64, P vaccination rate, and the vaccination status recalled by parents was in moderate agreement with the electronic record. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Mina, Michael J
The measles virus is among the most transmissible viruses known to infect humans. Prior to measles vaccination programs, measles infected over 95% of all children and was responsible for over 4 million deaths each year. Measles vaccination programs have been among the greatest public health achievements reducing, eliminating endemic measles in the whole of the Americas and across much of the globe. Where measles vaccines are introduced, unexpectedly large reductions in all-cause childhood mortality have been observed. These gains appear to derive in part from direct heterologous benefits of measles vaccines that enhance innate and adaptive immune responses. Additionally, by preventing measles infections, vaccination prevents measles-associated short- and long-term immunomodulating effects. Before vaccination, these invisible hallmarks of measles infections increased vulnerability to non-measles infections in nearly all children for weeks, months, or years following acute infections. By depleting measles incidence, vaccination has had important indirect benefits to reduce non-measles mortality. Delineating the relative importance of these two modes of survival benefits following measles vaccine introduction is of critical public health importance. While both support continued unwavering global commitments to measles vaccination programs until measles eradication is complete, direct heterologous benefits of measles vaccination further support continued commitment to measles vaccination programs indefinitely. We discuss what is known about direct and indirect nonspecific measles vaccine benefits, and their implications for continued measles vaccination programs. © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Matthias, James M; Rahman, Mohammad M; Newman, Daniel R; Peterman, Thomas A
From 2012 to 2014, rates of congenital syphilis increased in Louisiana and Florida. We evaluated the effectiveness of early (first or second) and third trimester syphilis screening for the prevention of congenital syphilis in these high-morbidity states. Reported syphilis cases among pregnant women in Louisiana and Florida during January 1, 2013, to December 31, 2014, were reviewed for documented screening for syphilis in the first 2 trimesters and third trimester. Pregnant women with syphilis were linked to congenital syphilis records and stratified by whether the pregnancy led to a reported congenital syphilis case. Seven hundred ten pregnant women with syphilis in Louisiana and Florida were linked to 155 congenital syphilis cases. Three hundred seventy (52%) pregnant women with syphilis were staged as early syphilis (n = 270) or high-titer late or unknown duration-latent syphilis (n = 100), and 109 (70% of the total) were linked to congenital syphilis cases. Screening in the first 2 trimesters identified 513 pregnant women who tested positive for syphilis, and 470 (92%) potential congenital syphilis were averted. One hundred nine pregnant women tested positive for syphilis in the third trimester, and 85 (78%) had babies without congenital syphilis. During their pregnancy, 85 (12%) women tested negative at least once, and 55 (65%) had babies with congenital syphilis. Thirty-nine women had no reported syphilis screening 30 days or longer before delivery. Screening for syphilis both early and in the third trimester prevented many pregnant women with syphilis from having a baby with congenital syphilis. Preventing all congenital syphilis would likely require preventing all syphilis among women.
Full Text Available Aims: Brucellosis is one of the important infectious factors in most areas of Iran and other developing countries. Brucellosis has different clinical manifestations and should be considered in the differential diagnosis of infectious and noninfectious diseases. The aims of this study was to determine the epidemiological, clinical findings of the brucellosis in patients based on blood culture and serological tests. Materials and Methods: In this cross-sectional study, 190 brucellosis patients admitted in Isfahan Hospital in 2016–2017 that were studied based on positive immunological tests such as Wright, 2-mercaptoethanol (2ME, and enzyme-linked immunosorbent assay. Samples of blood were cultured (BACTEC and incubated at 37°C for 5 days and then on Brucella agar. In addition, clinical and laboratory characteristics of brucellosis were done. The patients who had brucellosis (Coombs test ≥1/80 and 2ME ≥1/40 were selected. Data were analyzed using SPSS statistical package. Results: About 62.5% of patients were female with mean age of 37.5% years. 54.8% of cases were living in urban and 45.2% in rural areas. The most contagious seasons were spring. The most common transmission way was consuming of contaminated dairy products (59.3%; however, some of the patients had a history of animal contacts. The most common symptoms were fever (65.2%, arthralgia (68.1%, sweating (32%, malaise and fatigue (37.2%. The most common clinical signs were fever and peripheral arthritis. High leukocytosis and elevated erythrocyte sedimentation rate (>20 mm/h were reported in all of the cases. Elevated C-reactive protein was detected in 72.1% of patients. Conclusion: Brucellosis should be considered in the differential diagnosis of patients with prolonged fever, spondylitis, or peripheral arthritis in endemic areas.
Background A retrospective case-control study was undertaken to examine the spatial risk factors for human brucellosis in Kampala, Uganda. Methods Information on age, sex and month of diagnosis was derived from records from plate agglutination tests undertaken at Mulago Hospital, Kampala. Information on Parishes (LC2s) where patients reside was sourced from the outpatient registration book. In-patient fracture cases were selected for use as controls using 1:1 matching based on the age, sex and month of diagnosis. The locations of cases and controls were obtained by calculating Cartesian coordinates of the centroids of Parish level (LC2) polygons and a spatial scan statistic was applied to test for disease clustering. Parishes were classified according to the level of urbanization as urban, peri-urban or rural. Results Significantly more females than males were found to show sero-positivity for brucellosis when compared with the sex ratio of total outpatients, in addition female brucellosis patients were found to be significantly older than the male patients. Spatial clustering of brucellosis cases was observed including around Mulago Hospital (radius = 6.8 km, p = 0.001). The influence of proximity to the hospital that was observed for brucellosis cases was not significantly different from that observed in the controls. The disease cluster was confounded by the different catchment areas between cases and controls. The level of urbanization was not associated with the incidence of brucellosis but living in a slum area was a significant risk factor among urban dwellers (odds ratio 1.97, 95% CI: 1.10-3.61). Conclusions Being female was observed to be a risk factor for brucellosis sero-positvity and among urban dwellers, living in slum areas was also a risk factor although the overall risk was not different among urban, peri-urban and rural areas of the Kampala economic zone. PMID:21962176
Karli, Arzu; Sensoy, Gulnar; Albayrak, Canan; Koken, Ozlem; Cıraklı, Sevgi; Belet, Nursen; Albayrak, Davut
Presenting with severe thrombocytopenia and pancytopenia is rare in children with brucellosis, and at the beginning it can be misdiagnosed as a hematological or a viral hemorrhagic disease. The follow-ups of 52 patients diagnosed with brucellosis from January, 2008, to December, 2013, in our clinic have shown the following results. Eleven out of these 52 patients revealed the fact that they had pancytopenia at the admission phase. Anemia and leukopenia were defined as hemoglobin levels and leukocyte counts below the standard values in terms of ages, thrombocytopenia as thrombocyte counts below 150,000/mm(3), and severe thrombocytopenia as thrombocyte counts below 20,000/mm(3). The most frequent admission symptoms and findings of the patients with pancytopenia were fever (75%), fatigue (50%), splenomegaly (75%), and hepatomegaly (41%). Laboratory results were hemoglobin 9.3±0.96 gram/dL, white blood cell count 2226±735.9/mm(3), and thrombocyte count 70,090±47,961/mm(3). The standard tube agglutination test was positive for all patients, and Brucellosis spp. were isolated in the blood cultures of six (54%) patients. Three of the 11 patients had severe thrombocytopenia, and they were admitted with complaints of epistaxis, gingival bleeding, petechiae, and purpura. At the beginning, two of three cases were misdiagnosed as Crimean-Congo hemorrhagic fever (CCHF), another zoonotic endemic disease in Turkey. Pancytopenia improved with treatment of brucellosis on all patients. In conclusion, brucellosis can show great similarity with hematologic and zoonotic diseases like CCHF. Brucellosis should be considered in the differential diagnosis of pancytopenia, treatment-resistant immune thrombocytopenia, and viral hemorrhagic disease, especially in countries where brucellosis is endemic.
Eskandari-Nasab, Ebrahim; Moghadampour, Mehdi; Sepanj-Nia, Adel
Brucella abortus is an intracellular bacterium that affects humans and domestic animals. Tumor necrosis factor-alpha (TNF-α) has been shown as a key player in the induction of cell-mediated resistance against Brucella infection. We aimed to evaluate the possible influence of the TNF-α promoter polymorphisms (-308 G/A, -238 G/A, and -863 C/A) on the susceptibility of human brucellosis. A total of 153 patients with active brucellosis and 128 healthy individuals were recruited. All subjects were genotyped for the polymorphisms in the TNF-α gene by Allele-Specific polymerase chain reaction analysis. Our results showed that the TNF-α -308 GG genotype was significantly more frequently present in controls than in brucellosis patients (91% vs. 75%), thus was a protective factor against developing brucellosis (OR=0.313, p=0.001). In contrast, the -308 GA genotype (OR=3.026, p=0.002) and minor allele (A) (OR=3.058, p=0.001) as well as AAG haplotype (OR=4.014, p=0.001) conferred an increased risk of brucellosis. However, the -238 G/A and -863 C/A polymorphisms were not associated with the risk of brucellosis at both allelic and genotypic levels (p>0.05). Our study revealed that the TNF-α -308 A allele or GA heterozygosity or AAG haplotype were associated with an increased risk of brucellosis in our population. Copyright © 2015 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.
Cortina, María E; Balzano, Rodrigo E; Rey Serantes, Diego A; Caillava, Ana J; Elena, Sebastián; Ferreira, A C; Nicola, Ana M; Ugalde, Juan E; Comerci, Diego J; Ciocchini, Andrés E
Brucellosis is a highly zoonotic disease that affects animals and human beings. Brucella suis is the etiological agent of porcine brucellosis and one of the major human brucellosis pathogens. Laboratory diagnosis of porcine brucellosis mainly relies on serological tests, and it has been widely demonstrated that serological assays based on the detection of anti O-polysaccharide antibodies are the most sensitive tests. Here, we validate a recombinant glycoprotein antigen, an N-formylperosamine O-polysaccharide-protein conjugate (OAg-AcrA), for diagnosis of porcine brucellosis. An indirect immunoassay based on the detection of anti-O-polysaccharide IgG antibodies was developed coupling OAg-AcrA to enzyme-linked immunosorbent assay plates (glyco-iELISA). To validate the assay, 563 serum samples obtained from experimentally infected and immunized pigs, as well as animals naturally infected with B. suis biovar 1 or 2, were tested. A receiver operating characteristic (ROC) analysis was performed, and based on this analysis, the optimum cutoff value was 0.56 (relative reactivity), which resulted in a diagnostic sensitivity and specificity of 100% and 99.7%, respectively. A cutoff value of 0.78 resulted in a test sensitivity of 98.4% and a test specificity of 100%. Overall, our results demonstrate that the glyco-iELISA is highly accurate for diagnosis of porcine brucellosis, improving the diagnostic performance of current serological tests. The recombinant glycoprotein OAg-AcrA can be produced in large homogeneous batches in a standardized way, making it an ideal candidate for further validation as a universal antigen for diagnosis of "smooth" brucellosis in animals and humans. Copyright © 2016, American Society for Microbiology. All Rights Reserved.
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,
Recent events have led to an increased interest in emerging infectious diseases. This article applies various deterministic models to the SARS epidemic of 2003 and a measles outbreak in the Netherlands in 1999-2000. We take a historical approach beginning with the well-known logistic curve and a lesser-known extension popularized by Pearl and Reed…
... been reported in Europe. And 35 people across Europe have died from the highly contagious infection in the past year, the World Health Organization says. "Most measles cases in the United States are the result of international travel," said Dr. Gary Brunette, chief of the CDC's ...
Smit, Pieter W; van der Vlis, Thomas; Mabey, David; Changalucha, John; Mngara, Julius; Clark, Benjamin D; Andreasen, Aura; Todd, Jim; Urassa, Mark; Zaba, Basia; Peeling, Rosanna W
Syphilis causes up to 1,500,000 congenital syphilis cases annually. These could be prevented if all pregnant women were screened, and those with syphilis treated with a single dose of penicillin before 28 weeks gestation...
H.J.H. Engelkens (Herman)
textabstractTreponemal diseases important to mankind are sexually transmitted syphilis and the endemic nonvenereally transmitted treponematoses (yaws, pinta, and endemic syphilis). Historically, the most important disease caused by treponemes is syphilis. During the last few decades, yaws, endemic
... 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 review...
... 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, but...
Njeru, John; 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.
... 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 for...
Young, H; Pryde, J; Duncan, L; Dave, J
To determine the sensitivity and specificity of the Architect Syphilis Chemiluminescence Assay (CLIA): a new highly automated screening test for syphilis. To establish the sensitivity of the Architect Syphilis assay we tested 129 stored sera from serologically characterised cases of untreated syphilis. The sera were selected to contain a disproportionately high number of primary infections. There were 79 primary infections, 29 secondary infections, 9 early latent infections and 12 latent syphilis of unknown duration. To establish the specificity of the assay we tested 1107 sera that had been submitted for routine syphilis serology. The Architect CLIA and the Treponema pallidum particle agglutination test (TPPA) were in total agreement for all untreated infection with sensitivity of 98.4%. This was significantly higher than the sensitivity of the Murex immune capture enzyme (ICE) immunoassay (86%, pArchitect and ICE assays was entirely due to primary stage syphilis (97.5% vs 77.2%, pArchitect CLIA was very high (99.1%, 1049/1059) it was significantly lower (p = 0.016) than that of the Murex ICE assay (99.9%). The Architect CLIA is significantly more sensitive than the Murex ICE screening assay in detecting primary syphilis but it is significantly less specific. Given the relatively high levels of early syphilis, we consider a small increase in the number of confirmatory tests required to exclude false-positive results is worthwhile to increase the detection of primary syphilis by 20%.
Carlson, J. Andrew; Dabiri, Ganary; Cribier, Bernard; Sell, Stewart
Syphilis has plagued mankind for centuries and is currently resurgent in the Western hemisphere. While there has been a significant reduction of tertiary disease, and recognition of facilitative interactions with HIV infection, the natural history of syphilis has remained largely unchanged; thus, new strategies are required to more effectively combat this pathogen. The immunopathologic features of experimental syphilis in the rabbit; the course, stages, and pathology of human syphilis; and a comparison of human syphilis with leprosy suggest that the clinical course of syphilis and its tissue manifestations are determined by the balance between delayed type hypersensitivity (DTH) and humoral immunity to the causative agent, Treponema pallidum. A strong DTH response is associated with clearance of the infecting organisms in a well-developed chancre, whereas a cytotoxic T-cell response or strong humoral antibody response is associated with prolonged infection and progression to tertiary disease. Many of the protean symptoms/appearances of secondary and tertiary human syphilis are manifestations of immune reactions that fail to clear the organism, due to a lack of recruitment and more importantly, activation of macrophages by sensitized CD4 T-cells. The Bacillus Calmette Guerin (BCG) vaccination can enhance DTH and has been shown to produce a low, but measurable beneficial effect in the prevention of leprosy, a disease that shows a disease spectrum with characteristics in common with syphilis. In the prevention of syphilis, a potential vaccine protective against syphilis should be designed to augment the DTH response. PMID:21694502
Hong, Fu-Chang; Wu, Xiao-Bing; Yang, Fan; Lan, Li-Na; Guan, Yang; Zhang, Chun-Lai; Feng, Tie-Jian; Yang, Ying-Zhou; Yin, Yue-Ping; Yu, Wei-Ye; Chen, Xiang-Sheng
Early screening for syphilis among pregnant women and the effective treatment of maternal syphilis is fundamental to prevent congenital syphilis (CS). We obtained data from the Shenzhen Program for Prevention of CS (SPPCS) and estimated incidence rates of CS among infants born to syphilis-seropositive women treated with different regimens or untreated for maternal syphilis. A total of 4746 matched cases of syphilis-seropositive mothers and their infants were included for analyses, and 162 infants were diagnosed with CS, providing an overall incidence of 3.41% (95% confidence interval [CI], 2.91%-3.98%). Among infants born to syphilis-seropositive women who had syphilis and were adequately treated before pregnancy, the incidence was 0.22% (95% CI, .05%-.66%). There were 159 cases of CS occurring in 3519 infants born to women who were syphilis-seropositive during their pregnancies, for an incidence of 4.52% (95% CI, 3.84%-5.28%). The incidence of CS was 1.82%-11.90% lower among infants born to the women treated with early benzathine penicillin G (BPG) compared with those treated with late BPG (adjusted odds ratio [aOR], 8.06 [95% CI, 2.93-22.21]; P syphilis-seropositive pregnant women with 1 course of intramuscular BPG before 28 gestational weeks is critical for prevention of CS.
Seruyange, Eric; Gahutu, Jean-Bosco; Mambo Muvunyi, Claude; Uwimana, Zena G; Gatera, Maurice; Twagirumugabe, Theogene; Katare, Swaibu; Karenzi, Ben; Bergström, Tomas
Measles outbreaks are reported after insufficient vaccine coverage, especially in countries recovering from natural disaster or conflict. We compared seroprevalence to measles in blood donors in Rwanda and Sweden and explored distribution of active cases of measles and vaccine coverage in Rwanda. 516 Rwandan and 215 Swedish blood donors were assayed for measles-specific immunoglobulin G (IgG) by enzyme-linked immunosorbent assay (ELISA). Data on vaccine coverage and acute cases in Rwanda from 1980 to 2014 were collected, and IgM on serum samples and polymerase chain reaction (PCR) on nasopharyngeal (NPH) swabs from suspected measles cases during 2010-2011 were analysed. The seroprevalence of measles IgG was significantly higher in Swedish blood donors (92.6%; 95% CI: 89.1-96.1%) compared to Rwandan subjects (71.5%; 95% CI: 67.6-75.4%) and more pronounced Rwandan blood donors as compared to Swedish subjects (p genocide. 76/544 serum samples were IgM positive and 21/31 NPH swabs were PCR positive for measles, determined by sequencing to be of genotype B3. Measles seroprevalence was lower in Rwandan blood donors compared to Swedish subjects. Despite this, the number of reported measles cases in Rwanda rapidly decreased during the study period, concomitant with increased vaccine coverage. Taken together, the circulation of measles was limited in Rwanda and vaccine coverage was favourable, but seroprevalence and IgG levels were low especially in younger age groups.
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.
Carmen Lucia Muricy
Full Text Available INTRODUCTION: This study aimed to describe the epidemiology of congenital and maternal syphilis in the Brazilian Federal District in 2010. METHODS: A retrospective descriptive study was conducted on the basis of the cases recorded in the System of Notifiable Disease Information. RESULTS: The study population comprised 133 cases of congenital syphilis; of these, 116 (52.6% mothers received prenatal care, and 70 (60.4% were diagnosed with syphilis during pregnancy. Only 1 mother was adequately treated, and 100 (75.2% of the pregnant women's partners did not undergo treatment for syphilis. CONCLUSIONS: Although mothers attended prenatal care, not all were diagnosed during pregnancy or received adequate treatment for syphilis, as their partners did not undergo treatment for syphilis.
Muricy, Carmen Lucia; Pinto Júnior, Vitor Laerte
This study aimed to describe the epidemiology of congenital and maternal syphilis in the Brazilian Federal District in 2010. A retrospective descriptive study was conducted on the basis of the cases recorded in the System of Notifiable Disease Information. The study population comprised 133 cases of congenital syphilis; of these, 116 (52.6%) mothers received prenatal care, and 70 (60.4%) were diagnosed with syphilis during pregnancy. Only 1 mother was adequately treated, and 100 (75.2%) of the pregnant women's partners did not undergo treatment for syphilis. Although mothers attended prenatal care, not all were diagnosed during pregnancy or received adequate treatment for syphilis, as their partners did not undergo treatment for syphilis.
Rosa Maria Soares Madeira Domingues
Full Text Available OBJECTIVE Determine the coverage rate of syphilis testing during prenatal care and the prevalence of syphilis in pregnant women in Brazil. METHODS This is a national hospital-based cohort study conducted in Brazil with 23,894 postpartum women between 2011 and 2012. Data were obtained using interviews with postpartum women, hospital records, and prenatal care cards. All postpartum women with a reactive serological test result recorded in the prenatal care card or syphilis diagnosis during hospitalization for childbirth were considered cases of syphilis in pregnancy. The Chi-square test was used for determining the disease prevalence and testing coverage rate by region of residence, self-reported skin color, maternal age, and type of prenatal and child delivery care units. RESULTS Prenatal care covered 98.7% postpartum women. Syphilis testing coverage rate was 89.1% (one test and 41.2% (two tests, and syphilis prevalence in pregnancy was 1.02% (95%CI 0.84;1.25. A lower prenatal coverage rate was observed among women in the North region, indigenous women, those with less education, and those who received prenatal care in public health care units. A lower testing coverage rate was observed among residents in the North, Northeast, and Midwest regions, among younger and non-white skin-color women, among those with lower education, and those who received prenatal care in public health care units. An increased prevalence of syphilis was observed among women with < 8 years of education (1.74%, who self-reported as black (1.8% or mixed (1.2%, those who did not receive prenatal care (2.5%, and those attending public (1.37% or mixed (0.93% health care units. CONCLUSIONS The estimated prevalence of syphilis in pregnancy was similar to that reported in the last sentinel surveillance study conducted in 2006. There was an improvement in prenatal care and testing coverage rate, and the goals suggested by the World Health Organization were achieved in two regions
Smita S. Mangalgi
Full Text Available Background: Brucellosis is an important but ignored zoonotic disease in India, with high prevalence among livestock and humans. It is of particular concern among veterinarians as they come in contact with infected animals in their day to day work. Aim and Objectives: The present study was carried out to determine the prevalence of antibrucellar antibodies and assess the Knowledge, Attitude and Practice (KAP levels with regards to brucellosis among the veterinarians. Material and Methods:The serum samples of 1084 veterinarians were evaluated using the Rose Bengal Plate agglutination Test (RBPT, Serum Agglutination Test (SAT and 2-Mercaptoethanol Test (2-ME test. All the participants were interviewed with a pre-designed questionnaire. Results: Prevalence of antibrucellar antibodies among the veterinarians was 9.31% by RBPT. Clinical symptoms relating to brucellosis were seen in 4.33% individuals. Of the 1084 subjects screened for KAP, awareness was highest among the veterinary officers and students, while other veterinary workers were ignorant. Though most of the veterinary officers had adequate knowledge and positive attitude the regular preventive practices were not sound. Conclusion:Significantly higher seroprevalence of brucellosis was noted among veterinarians. High 2-ME titres were a better correlate of an active infection. Awareness regarding brucellosis among assisting staff was low. Training and health education programs to raise the KAP standard are necessary.
Suchandan Sikder*, AKM Anisur Rahman1, Mohammad Rayhan Faruque, Mohammad Abdul Alim2, Shubhagata Das2, Aungshuman Das Gupta3, Bhajan Chandra Das, Mohammad Inkeyas Uddin4 and Mohammad Abdul Matin Prodhan
Full Text Available An epidemiological survey was conducted to identify probable risk factors and prevalence of brucellosis in commercial and backyard dairy cows at Chittagong, Bangladesh. A total of 500 milk samples were collected (250 commercial and 250 backyards for Milk Ring Test (MRT. The MRT positive cows were subjected to sera collection and Rose Bengal Plate Test (RBPT and indirect ELISA were done for confirmatory diagnosis. The overall seroprevalence of brucellosis in cattle was 5% (7.6% in commercial and 2.4% in backyard. Significantly higher (P<0.05 prevalence was found in the zero grazing (5.74%, pregnant cows (7.53% and cows with history of retained placenta (7.89% or abortion (5.88% or both (11.76% than non-pregnant (2.68% and without any reproductive disorder (4.44%. A total of 420 farm attendants and owners were interviewed where 93.55 and 99.08% commercial and backyard personnel were found to have no knowledge of brucellosis and 9.67 and 87.77% consumed raw milk and yogurt respectively were highly vulnerable to zoonotic brucellosis. The results showed that brucellosis is widely distributed locally, underscoring the need for further studies including biovar determination.
Singh, B B; Dhand, N K; Gill, J P S
Brucellosis is a serious public health issue in India. Estimation of economic losses occurring due to brucellosis is required to help formulate prevention and control strategies, but has not been done in India. We estimated economic losses due to brucellosis by sourcing prevalence data from epidemiological surveys conducted in India. Data for livestock populations were obtained from official records. Probability distributions were used for many of the input parameters to account for uncertainty and variability. The analysis revealed that brucellosis in livestock is responsible for a median loss of US $ 3.4 billion (5th-95th percentile 2.8-4.2 billion). The disease in cattle and buffalo accounted for 95.6% of the total losses occurring due to brucellosis in livestock populations. The disease is responsible for a loss of US $ 6.8 per cattle, US$18.2 per buffalo, US $ 0.7 per sheep, US $ 0.5 per goat and US $ 0.6 per pig. These losses are additional to the economic and social consequences of the disease in humans. The results suggest that the disease causes significant economic losses in the country and should be controlled on a priority basis. Copyright © 2015 Elsevier B.V. All rights reserved.
... Collection; Brucellosis in Sheep, Goats, and Horses; Payment of Indemnity AGENCY: Animal and Plant Health... destroyed because of brucellosis. DATES: We will consider all comments that we receive on or before November... for sheep, goats, and horses destroyed because of brucellosis, contact Dr. Debra Donch, Brucellosis...
... Approval of an Information Collection; Brucellosis in Sheep, Goats, and Horses; Payment of Indemnity AGENCY..., and horses destroyed because of brucellosis. DATES: We will consider all comments that we receive on... for sheep, goats, and horses destroyed because of brucellosis, contact Dr. Debra Donch, Brucellosis...
...; Brucellosis First Point Testing of Cattle and Bison; Brucellosis Standard Card Test AGENCY: Animal and Plant...-Federal Brucellosis Eradication Program. DATES: We will consider all comments that we receive on or before... (202) 690-2817 before coming. FOR FURTHER INFORMATION CONTACT: For information on brucellosis first...
Introcaso, Camille E; Gruber, DeAnn; Bradley, Heather; Peterman, Thomas A; Ewell, Joy; Wendell, Debbie; Foxhood, Joseph; Su, John R; Weinstock, Hillard S; Markowitz, Lauri E
Congenital syphilis is a serious, preventable, and nationally notifiable disease. Despite the existence of a surveillance case definition, congenital syphilis is sometimes classified differently using an algorithm on the Centers for Disease Control and Prevention's case reporting form. We reviewed Louisiana's congenital syphilis electronic reporting system for investigations of infants born from January 2010 to October 2011, abstracted data required for classification, and applied the surveillance definition and the algorithm. We calculated the sensitivities and specificities of the algorithm and Louisiana's classification using the surveillance definition as the surveillance gold standard. Among 349 congenital syphilis investigations, the surveillance definition identified 62 cases. The algorithm had a sensitivity of 91.9% and a specificity of 64.1%. Louisiana's classification had a sensitivity of 50% and a specificity of 91.3% compared with the surveillance definition. The differences between the algorithm and the surveillance definition led to misclassification of congenital syphilis cases. The algorithm should match the surveillance definition. Other state and local health departments should assure that their reported cases meet the surveillance definition.
Samb, B; Aaby, P; Whittle, H; Seck, A M; Simondon, F
The epidemiology of measles has been investigated in Niakhar, a rural area of Senegal, during two periods, 1983-1986 and 1987-1990. Following a major increase in immunization coverage beginning in 1987, the case fatality ratio for all ages declined fourfold from the first to the second period (relative risk (RR) = 0.24, 95% confidence interval (CI) 0.13-0.46). The measles incidence for children under 10 years of age declined by 69% (95% CI 65-72) and the risk of dying of measles by 91% (95% CI 82-95). Vaccinated children who contracted measles had significantly lower case fatality ratio than unvaccinated children with measles (p = 0.038). Children infected by an immunized case tended to have lower case fatality ratio than those infected by an unimmunized index case (p = 0.104) and immunized index cases generated fewer secondary cases than unimmunized index cases (p < 0.001). Respiratory complications were more common in secondary cases infected by an index case with respiratory complications than by an index case without such complications (RR = 1.60, 95% CI 1.08-2.37), which suggests that severe cases give rise to further severe cases. As expected, there was a significant increase in the proportion of vaccinated cases in the second period (RR = 1.41, 95% CI 1.00-1.98). Mean age at infection increased from 4 to 7 years between the two periods and the change in age structure accounted for 20% of the decline in case fatality ratio. Measles immunization may contribute to lower mortality directly through reduced incidence and indirectly through increases in age at infection, less severe infection for immunized cases and changes in transmission patterns leading to reduced severity of measles.
Cameron, Caroline E; Lukehart, Sheila A
Syphilis is a multistage disease caused by the invasive spirochete Treponema pallidum subsp. pallidum. Despite inexpensive and effective antibiotic therapy, syphilis remains a prevalent disease in developing countries and has re-emerged as a public health threat in developed nations. In addition to the medical burden imparted by infectious syphilis, congenital syphilis is considered the most significant infectious disease affecting fetuses and newborns worldwide, and individuals afflicted with syphilis have an enhanced risk for HIV transmission and acquisition. The global disease burden of syphilis and failure of decades of public health efforts to stem the incidence of disease highlight the need for an effective syphilis vaccine. Although challenges associated with T. pallidum research have impeded understanding of this pathogen, the existence of a relevant animal model has enabled insight into the correlates of disease protection. Complete protection against infection has been achieved in the animal model using an extended immunization regimen of γ-irradiated T. pallidum, demonstrating the importance of treponemal surface components in generation of protective immunity and the feasibility of syphilis vaccine development. Syphilis is a prime candidate for development of a successful vaccine due to the (1) research community's accumulated knowledge of immune correlates of protection; (2) existence of a relevant animal model that enables effective pre-clinical analyses; (3) universal penicillin susceptibility of T. pallidum which enhances the attractiveness of clinical vaccine trials; and (4) significant public health benefit a vaccine would have on reduction of infectious/congenital syphilis and HIV rates. Critical personnel, research and market gaps need to be addressed before the goal of a syphilis vaccine can be realized, including recruitment of additional researchers to the T. pallidum research field with a proportional increase in research funding
Shinha, Takashi; Weaver, Bree A.
The ocular manifestations of syphilis are varied. Ocular syphilis can occur during any stage of infection and involve virtually any part of the eye. In immunocompetent individuals, the most common etiologies include syphilitic uveitis. Although the clinical presentation of ocular syphilis in HIV-infected patients is also widespread, posterior segment involvement has been more commonly described particularly in patients with AIDS. The diagnosis of syphilitic retinitis is challenging since its ...
Dou, Lixia; Wang, Xiaoyan; Wang, Fang; Wang, Qian; Qiao, Yaping; Su, Min; Jin, Xi; Qiu, Jie; Song, Li; Wang, Ailing
Objective. The aim of this study was to investigate the epidemiological characteristics and adverse pregnancy outcomes of pregnant women with syphilis infection in China. Methods. Data were from China's Information System of Prevention of Mother-to-Child Transmission of Syphilis Management. Women who were registered in the system and delivered in 2013 were included in the analysis. Results. A total of 15884 pregnant women with syphilis infection delivered in China in 2013. 79.1% of infected w...
De Santis, Marco; De Luca, Carmen; Mappa, Ilenia; Spagnuolo, Terryann; Licameli, Angelo; Straface, Gianluca; Scambia, Giovanni
Congenital syphilis is still a cause of perinatal morbidity and mortality. Untreated maternal infection leads to adverse pregnancy outcomes, including early fetal loss, stillbirth, prematurity, low birth weight, neonatal and infant death, and congenital disease among newborns. Clinical manifestations of congenital syphilis are influenced by gestational age, stage of maternal syphilis, maternal treatment, and immunological response of the fetus. It has been traditionally classified in early co...
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.
Sarkodie, Francis; Owusu-Dabo, Ellis; Hassall, Oliver
Objective:To describe the recalled medical history, clinical manifestations, and treatment of yaws and syphilis by syphilis seroreactive blood donors in Kumasi, Ghana. Methods: Of the blood donors at Komfo Anokye Teaching Hospital, Kumasi, Ghana tested with the syphilis rapid diagnostic test (RDT......) 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...
Gomes, Natália Carolina Rodrigues Colombo; Meier, Denise Andrade Pereira; Pieri, Flávia Meneguetti; Alves, Elaine; Albanese, Silvia Paulino Ribeiro; Lentine, Edvilson Cristiano; Arcêncio, Ricardo Alexandre; Dessunti, Elma Mathias
The implementation of the rapid test (RT) for syphilis increases access of vulnerable populations to early diagnosis and treatment, impacting the outcomes of infection. We aimed to assess the prevalence of and factors associated with syphilis in a Center for Testing and Counseling (CTC). We conducted a cross-sectional study at a Reference Center for sexually transmitted disease (STD) and acquired immune deficiency syndrome in Londrina, Northern Paraná State, Southern Brazil. Data regarding the 5,509 individuals who underwent RT from June 2012 to December 2014 were collected from patient records and the CTC Information System and served as the basis to check associations of syphilis cases (346) and cases without syphilis (5,163). Nine patients' records were not found. OpenEpi was used to perform a prevalence analysis and determine odds ratios to assess the associations between sociodemographic and behavioral variables (independent variables) and cases of syphilis (dependent variable). An alpha value syphilis was 6.3%; higher in males (7.5%) than in females (4.3%, p Syphilis was associated with an age of 25-34 years, little education, and single marital status. The main associated behavioral factors were men who have sex with men, drug users, STD patients, and those presenting with an STD in the last year. The use of alcohol, marijuana, cocaine, and crack was significantly associated with syphilis. Strategies for prevention and control of syphilis should be intensified, especially in populations identified as most vulnerable.
Rac, Martha W F; Bryant, Stefanie N; McIntire, Donald D; Cantey, Joseph B; Twickler, Diane M; Wendel, George D; Sheffield, Jeanne S
The purpose of this study was to evaluate ultrasound findings of fetal syphilis and to describe their progression after maternal treatment. This was a retrospective cohort study from September 1981 to June 2011 of seropositive women after 18 weeks of gestation who had an ultrasound before treatment to evaluate for fetal syphilis. Only those women who received treatment after the initial ultrasound scan, but before delivery, were included. If the initial ultrasound scan was abnormal, serial sonography was performed until resolution of the abnormality or delivery. Patient demographics, ultrasound findings, stage of syphilis, delivery, and infant outcomes were recorded. Standard statistical analyses were performed. Kaplan-Meier estimates were constructed to estimate time to resolution. Two hundred thirty-five women met the inclusion criteria; 73 of them (30%) had evidence of fetal syphilis on initial ultrasound scan. Abnormalities included hepatomegaly (79%), placentomegaly (27%), polyhydramnios (12%), ascites (10%) and abnormal middle cerebral arterial Doppler assessment (33%). After treatment, middle cerebral arterial Doppler assessment abnormalities, ascites, and polyhydramnios resolved first, followed by placentomegaly and finally hepatomegaly. Infant outcomes were available for 173 deliveries; of these, 32 infants (18%) were diagnosed with congenital syphilis. Congenital syphilis was more common when antenatal ultrasound abnormalities were present (39% vs 12%; P congenital syphilis, hepatomegaly was the most frequent abnormality found, regardless of antenatal ultrasound findings. Sonographic signs of fetal syphilis confer a higher risk of congenital syphilis at delivery for all maternal stages. Hepatomegaly develops early and resolves last after antepartum treatment. Copyright © 2014 Elsevier Inc. All rights reserved.
Pessoa, Larissa; Galvão, Virgilio
Congenital syphilis is an infectious disease caused by Treponema pallidum transmitted by infected mother to her baby during pregnancy. Late congenital syphilis is recognised with 2 or more years after birth. One of the main aspects is observed with the triad of Hutchinson, characterised by the presence of interstitial keratitis, eighth nerve deafness and Hutchinson's teeth. This manuscript reports a case of late congenital syphilis presenting with Hutchinson's triad at an age of 7 years. These clinical features are related to syphilis present during pregnancy and at birth, however they commonly become apparent after 5-years of age.
Gallouj, S; Bendahhou, K; Baybay, H; Benchat, L; Meziane, M; El Fakir, S; Mikou, O; Nejjari, C; Mernissi, F Z
A prospective study of syphilis cases over a period of 2 years (January 2008 to September 2009) was carried out in the Department of Dermatology of the Hassan II University Hospital Center in Fes, Morocco. A total of 57 cases were identified. The M/F sex ratio was 0.89. Mean patient age was 40.5 years (range, 22-80). Risk factors included unprotected sex in 96.5% of cases and multiple partners in 42.1%. Nine patients had a history of sexually transmitted infection. No patient had received blood transfusion. Clinical picture was late latent syphilis in 70.2% of cases (n = 41). Only one case was associated with human immunodeficiency virus. The mainstay treatment was intramuscular benzathine benzylpenicillin. Outcome was favorable in 48 cases.
Fisker, Ane Bærent; Rodrigues, Amabelia; Martins, Cesario
BACKGROUND: Randomised trials have shown that measles vaccine (MV) prevents non-measles deaths. MV-campaigns are conducted to eliminate measles infection.The overall mortality effect of MV-campaigns has not been studied. METHODS: Bandim Health Project (BHP) surveys children aged 0-4 years in rural...... by prevention of measles deaths. If MV-campaigns reduce non-measles related mortality the policies for measles vaccination should take this into account....
Tannous, Leen Khader; Barlow, Gavin; Metcalfe, Neil H
Major epidemics of measles are again in the news across the UK because of our failure to maintain population herd immunity. This situation has occurred primarily because of a loss of public confidence in the measles, mumps and rubella (MMR) vaccine, which was never restored following the Wakefield debacle, and a lack of awareness of the potential morbidity and mortality associated with measles. This article provides healthcare professionals with a succinct overview of important clinical aspects of measles and also describes the history of measles vaccination in the UK. Restoration of herd immunity will require higher public acceptance of the MMR vaccine in the context of recognition that measles remains an important infection. While achievement of this appears to be challenging, recent UK-based research suggests that it can be ascertained.
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.
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.
Jama'ayah, M Z; Heu, J Y; Norazah, A
Brucellosis is a zoonotic disease which can be transmitted by direct or indirect contact with infected animal or their products. It is an important public health problem but little is known on brucellosis in the Malaysian population. The aim of this study was to determine the presence of Brucella antibodies using commercial Brucella IgG and IgM ELISA kits (Vircell, SL, Barcelona Spain). A total of 184 sera from suspected patients were received from 16 hospitals in Malaysia over the years 2004 to 2009. Only 10 serum samples (5.4%) were positive for Brucella antibodies in which 5 showed the presence of both IgM and IgG. Most of the positive patients were occupationally involved with animals. This study suggests the seroprevalance of brucellosis among individuals who have contact with infected animals in Malaysia is low.
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
Trinh, Thuy T; Kamb, Mary L; Luu, Minh; Ham, D Cal; Perez, Freddy
To present the findings of the Pan American Health Organization's 2014 survey on syphilis testing policies and practices in the Americas. Representatives of national/regional reference and large, lower-level laboratories from 35 member states were invited to participate. A semi-structured, electronically administered questionnaire collected data on syphilis tests, algorithms, equipment/commodities, challenges faced and basic quality assurance (QA) strategies employed (i.e. daily controls, standard operating procedures, technician training, participating in external QA programmes, on-site evaluations). The 69 participating laboratories from 30 (86%) member states included 41 (59%) national/regional reference and 28 (41%) lower-level laboratories. Common syphilis tests conducted were the rapid plasma reagin (RPR) (62% of surveyed laboratories), venereal disease research laboratory (VDRL) (54%), fluorescent treponemal antibody absorption (FTA-ABS) (41%) and Treponema pallidum haemagglutination assay (TPHA) (32%). Only three facilities reported using direct detection methods, and 28 (41% overall, 32% of lower-level facilities) used rapid tests. Most laboratories (62%) used only traditional testing algorithms (non-treponemal screening and treponemal confirmatory testing); however, 12% used only a reverse sequence algorithm (treponemal test first), and 14% employed both algorithms. Another nine (12%) laboratories conducted only one type of serologic test. Although most reference (97%) and lower-level (89%) laboratories used at least one QA strategy, only 16% reported using all five basic strategies. Commonly reported challenges were stock-outs of essential reagents or commodities (46%), limited staff training (73%) and insufficient equipment (39%). Many reference and clinical laboratories in the Americas face challenges in conducting appropriate syphilis testing and in ensuring quality of testing. © 2017 John Wiley & Sons Ltd The Pan-American Health Organization retains
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.
Magalhães, Daniela Mendes dos Santos; Kawaguchi, Inês Aparecida Laudares; Dias, Adriano; Calderon, Iracema de Mattos Paranhos
This descriptive study collected socio-demographic, obstetric, and diagnostic and treatment-related data from pregnant and postpartum women and their partners, for the 67 pregnant or postpartum women reported with syphilis to the National System of Diseases of Notification, users of public maternity hospitals in the Federal District of Brazil from 2009 to 2010. Data on clinical and laboratory follow-up of the newborn were obtained from the hospital patient charts, compulsory notification forms, and Infant Health Cards. Of the pregnant women, 41.8% were adequately treated; the main reason for inadequate treatment was the absence (83.6%) or inadequate treatment of the partner (88.1%). More than a third required repeat treatment at the maternity hospital due to lack of documentation of treatment during the prenatal period. Of the newborns diagnosed with congenital syphilis, 48% received radiographic investigation, 42% received a spinal tap, and 36% failed to receive any kind of intervention. Thus, the quality of prenatal care was insufficient to guarantee the control of congenital syphilis and achieve the goal of reducing incidence of the disease.
Rivera-López, María Rebeca F; Arenas-Esqueda, Alfonso; Ambriz-Fernández, Raúl
A syphilis test is performed in blood donors because the national transfusion law makes it mandatory, nevertheless the blood has not been found as an important vehicle of transmission for Treponema pallidum infection. Our objective was to know the prevalence of syphilis in blood donors. we reviewed tests from blood donors of the "Banco Central de Sangre del Centro Médico Nacional Siglo XXI" in two periods, the first from July 2001 to April 2003, and the second from March 2005 to June 2006. Both groups went through screening tests, such as VDRL or USR. and a second test for confirmation, FTA-ABS for the first group and TPHA for the second group. in the first group 111 030 blood donors were included. In this group the positive results from VDRL or USR tests were 471 (0.42 %). One hundred and ninety six were confirmed (0.17 %) with FTA-ABS. In the second group results from 80 578 blood donors were included; the positive results from VDRL or USR tests were 279 (0.34 %). In this group, only 0.08 % were confirmed for a syphilis infection.
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.
Vaidya, Sunil R; Chowdhury, Deepika T
The Government of India is accepted to participate in the measles elimination and rubella control goal 2020, hence genetic characterization of measles viruses (MeV) becomes essential. At National Reference Laboratory (National Institute of Virology, Pune), the throat swabs/urine specimens (n = 380) or PCR products (n = 219) obtained from the suspected measles cases were referred for the molecular testing and subsequently, MeV nucleoprotein (N) gene sequencing/genotyping. In addition, 2,449 suspected measles cases, mainly from the Maharashtra state were referred for the laboratory diagnosis. A detailed study was performed on N gene sequences obtained during last two decades. Indian MeV sequences obtained during 2011-2015 were compared with 1996-2010 sequences and genetic divergence was studied. Circulation of measles genotypes B3 (n = 3), D4 (n = 49), and D8 (n = 351) strains were observed in 19 States and three Union Territories of India. In addition, 64 measles viruses were isolated from 253 throat swab or urine specimens obtained from the suspected measles cases. During 2011-2015, 67.9% (1,663/2,449) suspected measles cases were laboratory confirmed. Molecular studies showed circulation of measles genotype B3 in India along with prominently circulating genotypes D4 and D8 except D7 strains. The genetic diversion within Indian B3, D4, and D8 genotypes was 0.3%, 1.1%, and 2.1%, respectively. The genetic divergence of Indian B3, D4, and D8 measles strains with the WHO reference sequences was 2.5%, 2.6%, and 1.8%, respectively. It is crucial data for national immunization program. More measles/rubella genotyping studies are necessary to track transmission and to support measles elimination and rubella control. J. Med. Virol. 89:753-758, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Botelho-Nevers, E; Cassir, N; Minodier, P; Laporte, R; Gautret, P; Badiaga, S; Thiberville, D J; Ninove, L; Charrel, R; Brouqui, P
We report here 14 cases of measles among healthcare workers (HCWs) in Public Hospitals of Marseilles, France that occurred between April and November 2010. All cases but one were under 30 years of age. Following the identification of these cases, we checked the immune status among 154 HCWs who volunteered to take part in the study and showed that 93% and 88% were immune against measles and mumps respectively. HCWs non-immunised against measles were all under 30 years of age.
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.
Smith, Nichole; Dhillon, Sonu; Cotter, John G; Ahmed, Zohair
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.
Rourk, Angela R; Nolte, Frederick S; Litwin, Christine M
With the recent introduction of automated treponemal tests, a new reverse syphilis algorithm has been proposed and now used by many clinical laboratories. We analyzed the impact of instituting the reverse screening syphilis algorithm in a laboratory that serves a geographic area with a moderately high prevalence of syphilis infection. Serum samples sent for syphilis testing were tested using a treponemal enzyme immunoassay (EIA) as the screening assay. EIA reactive samples were tested by rapid plasma reagin (RPR) and titered to end point if reactive. RPR nonreactive samples were analyzed by the Treponema pallidum particle agglutination test (TP-PA). Pertinent medical records were reviewed for false-reactive screens and samples with evidence of past syphilis infection. Among 10,060 patients tested, 502 (5%) were reactive on the initial EIA screen. The RPR was reactive in 150 (1.5%). TP-PA testing determined that 103 (1.0%) were falsely reactive on initial EIA screen. The reverse screening algorithm, however, identified 242 (2.4%) with evidence of latent, secondary, or past syphilis, 21 of whom had no or unknown prior treatment with antibiotics. Despite a 1.0% false-reactive rate, the reverse syphilis algorithm detected 21 patients with possible latent syphilis that may have gone undetected by traditional syphilis screening.
Singh, Ameeta E; Levett, Paul N; Fonseca, Kevin; Jayaraman, Gayatri C; Lee, Bonita E
Despite universal access to screening for syphilis in all pregnant women in Canada, cases of congenital syphilis have been reported in recent years in areas experiencing a resurgence of infectious syphilis in heterosexual partnerships. Antenatal screening in the first trimester continues to be important and should be repeated at 28 to 32 weeks and again at delivery in women at high risk of acquiring syphilis. The diagnosis of congenital syphilis is complex and is based on a combination of maternal history and clinical and laboratory criteria in both mother and infant. Serologic tests for syphilis remain important in the diagnosis of congenital syphilis and are complicated by the passive transfer of maternal antibodies which can affect the interpretation of reactive serologic tests in the infant. All infants born to mothers with reactive syphilis tests should have nontreponemal tests (NTT) and treponemal tests (TT) performed in parallel with the mother's tests. A fourfold or higher titre in the NTT in the infant at delivery is strongly suggestive of congenital infection but the absence of a fourfold or greater NTT titre does not exclude congenital infection. IgM tests for syphilis are not currently available in Canada and are not recommended due to poor performance. Other evaluation in the newborn infant may include long bone radiographs and cerebrospinal fluid tests but all suspect cases should be managed in conjunction with sexually transmitted infection and/or pediatric experts.
Zhang, Junhui; Yin, Fei; Zhang, Tao; Yang, Chao; Zhang, Xingyu; Feng, Zijian; Li, Xiaosong
Objectives China has experienced a sharply increasing rate of human brucellosis in recent years. Effective spatial monitoring of human brucellosis incidence is very important for successful implementation of control and prevention programmes. The purpose of this paper is to apply exploratory spatial data analysis (ESDA) methods and the empirical Bayes (EB) smoothing technique to monitor county-level incidence rates for human brucellosis in mainland China from 2004 to 2010 by examining spatial patterns. Methods ESDA methods were used to characterise spatial patterns of EB smoothed incidence rates for human brucellosis based on county-level data obtained from the China Information System for Disease Control and Prevention (CISDCP) in mainland China from 2004 to 2010. Results EB smoothed incidence rates for human brucellosis were spatially dependent during 2004–2010. The local Moran test identified significantly high-risk clusters of human brucellosis (all p values brucellosis incidence. PMID:24713215
Lola V. Stamm
Full Text Available Syphilis is caused by infection with Treponema pallidum subsp. pallidum, a not-yet-cultivable spiral-shaped bacterium that is usually transmitted by sexual contact with an infected partner or by an infected pregnant woman to her fetus. There is no vaccine to prevent syphilis. Diagnosis and treatment of infected individuals and their contacts is key to syphilis control programs that also include sex education and promotion of condom use to prevent infection. Untreated syphilis can progress through four stages: primary (chancre, regional lymphadenopathy, secondary (disseminated skin eruptions, generalized lymphadenopathy, latent (decreased re-occurrence of secondary stage manifestations, absence of symptoms, and tertiary (gummas, cardiovascular syphilis and late neurological symptoms. The primary and secondary stages are the most infectious. WHO estimates that each year 11 million new cases of syphilis occur globally among adults aged 15-49 years. Syphilis has re-emerged in several regions including North America, Western Europe, China and Australia. Host-associated factors that drive the re-emergence and spread of syphilis include high-risk sexual activity, migration and travel, and economic and social changes that limit access to health care. Early, uncomplicated syphilis is curable with a single intramuscular injection of benzathine penicillin G (BPG, the first line drug for all stages of syphilis. Emergence of macrolide-resistant T. pallidum has essentially precluded the empirical use of azithromycin as a second-line drug for treatment of syphilis. Virulence attributes of T. pallidum are poorly understood. Genomic and proteomic studies have provided some new information concerning how this spirochete may evade host defense mechanisms to persist for long periods in the host.
Dai, Ting; Qu, Rui; Liu, Jinfen; Zhou, Pingyu; Wang, Qianqiu
Doxycycline is an alternative antibiotic drug for the treatment of syphilis, but data on its efficacy, especially data on its efficacy against late latent syphilis, are limited. A retrospective study was conducted to evaluate the effectiveness of doxycycline for the treatment of patients with different stages of syphilis. Patients who received doxycycline treatment between June 2011 and June 2014 were involved. The serological response to doxycycline was defined as either a negative toluidine red unheated serum test (TRUST) result or a ≥4-fold decrease in titer at 12 months following the treatment. Univariate and multivariate logistic regression analyses were performed to identify factors associated with the serological response. During the study period, a total of 163 syphilis patients were treated with doxycycline, and 118 patients completed doxycycline treatment and the 12-month follow-up. Among the 118 patients, the serological response rate at 12 months was 100.0% (7/7) in patients with primary syphilis, 96.9% (62/64) in patients with secondary syphilis, 91.3% (21/23) in patients with early latent syphilis, and 79.2% (19/24) in patients with late latent syphilis. The total serological response rates were 92.4% (109/118) for preprotocol (PP) patients and 66.9% (109/163) for all intention-to-treat (ITT) patients. In multivariate analysis, patients who serologically responded at 12 months following treatment were positively associated with a higher baseline TRUST titer and an earlier syphilis stage than nonresponders. Our study showed excellent treatment outcomes in patients with different stages of syphilis. Our data, along with those from other reports, support the usage of doxycycline as a good alternative therapeutic option in the treatment of syphilis. Copyright © 2016 American Society for Microbiology.
Smock, Laura; Caten, Evan; Hsu, Katherine; DeMaria, Alfred
We used area-level indicators of poverty to describe economic disparities in the incidence rate of infectious syphilis in Massachusetts to (1) determine whether methods developed in earlier AIDS analyses in Massachusetts could be applied to syphilis and (2) characterize syphilis trends during a time of increased rates of syphilis incidence. Using census tract data and population counts from the US Census Bureau and Massachusetts data on syphilis, we analyzed the incidence rate of syphilis infection from 2001 to 2013 by the poverty level of the census tract in which people with syphilis resided, stratified by age, sex, and race/ethnicity. The syphilis incidence rate increased in all census tract groups in Massachusetts from 2001 to 2013, and disparities in incidence rates by area poverty level persisted over time. The overall incidence rate of syphilis increased 6.9-fold from 2001 to 2013 in all census tract poverty-level groupings (from 1.5 to 10.3 per 100 000 population), but the rise in rate was especially high in the poorest census tracts (from 5.6 to 31.0 per 100 000 population) and among men (from 2.2 to 19.4 per 100 000 population). The highest syphilis incidence rate was among non-Hispanic black people. The largest changes in incidence rate occurred after 2010. One region had a disproportionate increase in incidence rates and a disproportionate impact on the statewide trend. Census tract poverty analyses can inform the targeting of interventions that make progress toward reducing disparities in rates of syphilis incidence possible.
The evidence that Adolf Hitler may have suffered from incapacitating syphilis is reviewed. Rumours 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 ...
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.
Apr 4, 2000 ... the serious sequel of syphilis, especially in areas where the first generation of sexually transmitted disease are rampant and have not been controlled. Syphilis is a multifaceted disease with serious implications for the pregnant women and the unborn foetus. According to Colombian theory, the disease was.
Background: One of the greatest values of serological test for syphilis is as a surrogate marker for lifestyle known to be associated with high risk of HIV and HCV infections. This study was designed to determine the prevalence of syphilis among blood donors in Ilorin and also the relationship between seropositivity and ...
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....
Background: Sexually transmitted diseases are widespread in the developing countries and constitute a major public health problem in Sub-Saharan Africa. More recently, there has been a resurgence of syphilis. The aim of this study was to determine the seroprevalence rate of syphilis among newly recruited senior cadres ...
Objective. To determine the validity, predictive value and accuracy of the rapid plasma reagin card test performed on site to diagnose active syphilis in pregnant women so that immediate treatment can be offered to prevent congenital syphilis. Design. Open, descriptive study. Setting. Antenatal clinic, Mamelodi Hospital, ...
... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Syphilis serology. 493.835 Section 493.835 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.835 Standard; Syphilis serology. (a) Failure to attain an overall testing event score...
The prevalence of syphilis (or positive serology) in pregnant mothers delivering at Baragwanath Hospital, Johannesburg, was assessed in order to try to establish the prevalence of congenital syphilis and possibly to identify a specific population at risk. From August 1985 to January 1986 all mothers admitted to the major ...
Champredon, D; Cameron, C E; Smieja, M; Dushoff, J
Despite the availability of inexpensive antimicrobial treatment, syphilis remains prevalent worldwide, affecting millions of individuals. Furthermore, syphilis infection is suspected of increasing both susceptibility to, and tendency to transmit, HIV. Development of a syphilis vaccine would be a potentially promising step towards control, but the value of dedicating resources to vaccine development should be evaluated in the context of the anticipated benefits. Here, we use a detailed mathematical model to explore the potential impact of rolling out a hypothetical syphilis vaccine on morbidity from both syphilis and HIV and compare it to the impact of expanded 'screen and treat' programmes using existing treatments. Our results suggest that an efficacious vaccine has the potential to sharply reduce syphilis prevalence under a wide range of scenarios, while expanded treatment interventions are likely to be substantially less effective. Our modelled interventions in our simulated study populations are expected to have little effect on HIV, and in some scenarios lead to small increases in HIV incidence, suggesting that interventions against syphilis should be accompanied with interventions against other sexually transmitted infections to prevent the possibility that lower morbidity or lower perceived risk from syphilis could lead to increases in other sexually transmitted diseases.
Full Text Available A case of secondary syphilis in HIV infection is being reported. The patient presented with skin rash only. VDRL was found to be negative and HIV testing was positive. He was treated for secondary syphilis with clinical response. Blood VDRL test was subsequently reported as reactive.
years (± 5.34) and the mean gestational age 26.4 weeks (±6.36). The modal parity was 0. Only three patients were found to be reactive for syphilis giving a prevalence of 0.13%. Conclusion: The sero- prevalence value in this study is quite low and may justify the call to discontinue routine antenatal syphilis screening.
Lago, E G; Garcia, P C
OBJECTIVE: To highlight to the fact that some newborns are not identified as having congenital syphilis, and will present to an emergency room within a few months with a severe disease. METHOD: Review of the charts concerning 3 patients with congenital syphilis, as well as review of the literature using Medline and Lilacs databases, covering the period from 1988 to 1999. RESULTS: We describe the case of 3 infants whose diagnosis of congenital syphilis was only established after the neonatal period, when they presented to the emergency room and were admitted to the pediatric intensive care unit. The first patient had neurosyphilis and nephrotic syndrome, the second had neurosyphilis, and the third had hepatitis. We discuss the clinical aspects of the cases, and comment on other clinical manifestations of congenital syphilis that should be within the purview of pediatric emergency medicine. We analyze the reasons for the failure to diagnose syphilis at birth, and describe some risk factors for gestational syphilis. CONCLUSIONS: Considering the rising incidence of syphilis in Brazil, and the possibility that the congenital infections are not recognized at birth, emergency physicians must keep a high degree of suspicion and an awareness of maternal risk factors, prenatal serology pitfalls, as well as of the several clinical presentations of congenital syphilis that can develop in the first months of life.
Arnesen, Lauren; Martínez, Gerardo; Mainero, Luis; Serruya, Suzanne; Durán, Pablo
To measure the association between gestational syphilis and stillbirth in Latin America and the Caribbean. In a retrospective study, data on stillbirth and gestational syphilis extracted from the Sistema Informático Perinatal database were analyzed for deliveries in 11 countries between January 1, 2009, and December 31, 2012. Potential confounders were examined, and binary logistic regression analysis was performed to assess the association between gestational syphilis and stillbirth. Among 368 151 deliveries, 3875 (1.1%) were by women with a positive syphilis test, and 1461 (0.4%) were stillbirths. Among the stillbirths, 29 (2.0%) were delivered by women with a positive syphilis test. After controlling for country, congenital anomalies, gestational age at labor, maternal age, and previous stillbirth, gestational syphilis was significantly associated with stillbirth (odds ratio 1.88, 95% confidence interval 1.25-2.83; P=0.002). Gestational syphilis contributes to stillbirth in Latin America and the Caribbean. Interventions targeting gestational syphilis are highly cost-effective and should be implemented across the region. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Young, Sean D; Mercer, Neil; Weiss, Robert E; Torrone, Elizabeth A; Aral, Sevgi O
Syphilis rates have been rapidly rising in the United States. New technologies, such as social media, might be used to anticipate and prevent the spread of disease. Because social media data collection is easy and inexpensive, integration of social media data into syphilis surveillance may be a cost-effective surveillance strategy, especially in low-resource regions. People are increasingly using social media to discuss health-related issues, such as sexual risk behaviors, allowing social media to be a potential tool for public health and medical research. This study mined Twitter data to assess whether social media could be used to predict syphilis cases in 2013 based on 2012 data. We collected 2012 and 2013 county-level primary and secondary (P&S) and early latent syphilis cases reported to the Center for Disease Control and Prevention, along with >8500 geolocated tweets in the United States that were filtered to include sexual risk-related keywords, including colloquial terms for intercourse. We assessed the relationship between syphilis-related tweets and actual case reports by county, controlling for socioeconomic indicators and prior year syphilis cases. We found a significant positive relationship between tweets and cases of P&S and early latent syphilis. This study shows that social media may be an additional tool to enhance syphilis prediction and surveillance. Copyright © 2017 Elsevier Inc. All rights reserved.
Tsuzuki, Masako; Hirose, Kaoru; Masui, Tsuneo; Minagawa, Hiroko
Under the Japanese Infectious Disease Prevention Law, measles was monitored by the national epidemiological surveillance system through reports from sentinel clinical institutions until December 2007. In order to obtain rapid and precise information on measles outbreaks and take necessary actions, a case-surveillance system was introduced in Aichi Prefecture in February 2007. In this report, measles cases reported through the case-surveillance system were examined for characteristics of infection and the utility of the system. The case-surveillance system for measles started in Aichi in February 2007, all local medical institutions being requested to provide a set of information on every measles case immediately after the clinical diagnosis was made. Reported data were processed by ourselves and real-time surveillance results were shown in our web site. Data were analyzed and compared with measles data from the national epidemiological surveillance system, reported by the sentinel clinical institutions in Aichi. A total of 212 cases were registered through the case-surveillance from February to December 2007, including 123 (58.0%) adult cases (over 15 years old of age). In contrast, only 56 cases were registered in Aichi by the national epidemiological surveillance in 2007 including 11 adult cases (19.6%), indicating considerable under-representation of adult measles cases by the sentinel survey. Of the case-surveillance cases, 56 (26.4%) had an immunization history, 88 (41.5%) were without a history, and 68 (32.1%) were unknown, indicating that primary and/or secondary vaccine failure occurred in at least 26.4%. The results of the case-surveillance of measles in Aichi provided useful information on characteristics of measles infection and proved to be effective in detecting the occurrence of measles rapidly and accurately. In order to achieve the Japanese target of measles elimination by 2012, it will be necessary to further strengthen the monitoring system and
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.
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...... of 58 (48%) transfusion facilities tested donors for syphilis, with an estimated 3.7% seroprevalence (95% confidence interval 3.6-3.8%). A total of 62782 out of 91386 (68.7%) donations were tested with assays that are not recommended. The estimated syphilis seroprevalence in voluntary donations was 2...... blood donations for syphilis. These data show a considerable mismatch between recommendations and practice, with serious consequences for blood safety and public health....
They called bovine brucellosis (Bakkale) and described it as a cattle disease characterized by standing hair coat, fever, loss of appetite, swollen joints, and abortion and transmitted by ingestion and contact. The high prevalence observed calls for urgent government intervention towards public health enlightenment of ...
A serological survey of brucellosis in livestock animals and workers was conducted in Ibadan, Southwestern Nigeria between May and August 2004. A total of 1,210 cattle, 54 sheep, 496 goats, 200 pigs and 21 humans (i.e. butchers and herdsmen) were screened using the Rose Bengal test (RBT).From the results ...
associated with the disease and the management of the disease. ... whom were admitted with confirmed diagnosis of brucellosis in Orotta National Referral Medical and Surgical. Hospital in Asmara ... of the animals in the area were sick but less than 20% received veterinary consultations with half of them testing positive for ...
Brucellosis is an emerging zoonotic disease that poses a threat to both livestock and public health in east Africa. There are several reports of occurrence of the disease in livestock populations especially in Tanzania and Kenya, suggesting chances of increased spread to humans, and the disease being misdiagnosed for ...
A sero-epidemiological survey of bovine brucellosis in two selected was conducted from November 2007 to April 2008 in North Gondar Zone. Sera from 780 cattle (571) local and (209) cross breed were screened using Rose Bengal Plate Test (RBPT) and RBPT positive reactors were further confirmed by Complement ...
A cross-sectional study was carried out from October 2008- March 2009 to determine the sero-prevalence of bovine brucellosis in four districts of Jijjiga Zone, eastern Ethiopia. Purposive sampling technique was employed to select the four districts and nine peasant associations (PAs). A total of 435 blood samples were ...
Brucellosis is one of the most prevalent and yet most under-diagnosed zoonotic diseases in equal measure, with profound human and animal economic adversity2. The pathogenic types of this intracellular organism are brucella melitensis, brucella suis, and brucella arbotus presenting major diagnostic challenges because ...
Jan 28, 2014 ... Abstract. A serological survey of brucellosis was carried out in three selected local government areas of Taraba state to determine the current status of the disease in the field, especially in the nomadic Fulani breeding herds. A test using the Brucella abortus Rose Bengal Plate Test antigen to test the sera of ...
Bacteriological investigations of sheep and goats brucellosis were carried out in Northern Nigeria. Seven government or quasi-government farms were investigated. A total of 418 sheep and goats milk samples were examined culturally. Investigation revealed a 34.75 per cent and 15.88 per cent rate of infection in goats and ...
A limited study was conducted to determine prevalence of brucellosis in domestic ruminants kept in a free range grazing system in Ngorongoro Conservation Area (NCA) which is a world heritage site in which pastoralists communities have been living harmoniously with wildlife for decades. Blood samples from 200 cattle, ...
A serological survey of brucellosis was carried out in three selected local government areas of Taraba state to determine the current status of the disease in the field, especially in the nomadic Fulani breeding herds. A test using the Brucella abortus Rose Bengal Plate Test antigen to test the sera of bovine, ovine and caprine ...
A retrospective study covering 10 years (1995 – 2004) was conducted to investigate brucellosis seroprevalence and patterns in commercial and smallholder mixed dairy-beef cattle in Zimbabwe using surveillance data from the Central Veterinary Laboratory at Harare. Positive cases were analysed according to farming ...
A random survey to study the seroprevalence of ovine and caprine brucellosis was carried out between July 2008 and January 2009 in three main districts of arid and semiarid rearing regions of Somaliland. A total of 1938 sheep, and 1344 goats' blood sera were randomly collected from 42 herd/flock of accessible ...
A cross sectional study was carried on bovine brucellosis from November 2008 to March 2009 to determine the sero-prevalence and distribution of bovine brucel osis in selected sites of Jimma zone, Southwestern Ethiopia. A total of 950 animals (541 female and 409 male) were examined serologically by using RBPT as ...
Background: Brucellosis in animals has been identified as a common cause of miscarriage. It is the most common zoonotic disease that leads to considerable morbidity in humans. It is rarely diagnosed in hospitals in Nigeria, and debate exists as to whether it is a more common cause of miscarriage in humans compared to ...
AbstRACt background: Brucellosis in animals has been identified as a common cause of miscarriage. It is the most common zoonotic disease that leads to considerable morbidity in humans. It is rarely diagnosed in hospitals in Nigeria, and debate exists as to whether it is a more common cause of miscarriage in humans ...
Objectives: To identify factors associated with Brucellosis in patients attending Terekeka Health Facility, Terekeka County, Central Equatoria State, Southern Sudan and to evaluate the utility of the rapid test kit Euracil®. Design: A facility based case-control study. Setting: Terekeka Health Facility, Terekeka County, Central ...
A cross sectional study was carried out from October 2008 to April 2009 to determine the sero-prevalence of brucellosis in small ruminants in and around Bahir Dar, northwest Ethiopia. The sampling method used was purposive sampling technique for districts and simple random for the study animals. A total of 500 serum ...
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.
Olivares, Roberto; Vidal, Pamela; Sotomayor, Camila; Norambuena, Mackarenna; Luppi, Mario; Silva, Francisco; Cifuentes, Marcela
Brucellosis is a zoonosis caused by Brucella spp. It may be acquired by consuming unpasteurized dairy products. Brucellosis has a low incidence in Chile, thus, we have a scarce data. To report and to characterize the first series of clinical cases of adult patients diagnosed with brucellosis in Chile. We describe a series of 13 clinical cases in patients diagnosed between 2000 and 2016 in three different centers in the Metropolitan Region, Chile. A retrospective analysis was performed on clinical presentation, laboratory, antibiotic treatment, morbidity and mortality. The mean age was 50 years old. Eight cases had a record of consumption of unpasteurized dairy products. The most frequently reported complaints were fever. The most frequent focal point involved was the spine. Only one patient had a positive blood culture, while the diagnosis was made using serological techniques in the other part of the group. The most indicated antibiotic regimens were doxycycline-rifampicin and doxycycline-gentamicin. The hospital stay was 20 days approximately as an average. Clinical cure was achieved in all cases. Brucellosis is an infrequent zoonosis in Chile, and it produces a nonspecific clinical picture, so it is necessary to have high suspicion to make the diagnosis based in the antecedent of consumption of unpasteurized dairy or raw meat.
Sidama Zone, Southern Ethiopia. Eth. Vet. J ., 11(2), 59-68. Bekele, A, 1999. Bovine brucellosis sero-epidemiological study in selected farms and ranches in Southeastern Ethiopia. DVM Thesis, Faculty of Veterinary Medicine,. Addis Ababa University, Debre Zeit, Ethiopia. Bekele, A., Molla, B., Asfaw, Y., and Yirgu, L., 2000.
LMA (Livestock Marketing Authority) 2001. Brief Baseline Information on Ethiopian. Livestock Resource Base and Its Trade. Livestock Marketing Authority. Addis. Ababa, Ethiopia. Muhie, Y. 2005. A Sero-prevalence Study of Small Ruminant Brucellosis in Selected Sites of the Afar and Somali Regions, Ethiopia. DVM Thesis ...
Full Text Available Clinical human brucellosis is quite rare in Malaysia although seroconverters are relatively more. This report describes a case of clinical human brucellosis in Malaysia. This case involved a 29-year-old research assistant in a veterinary microbiology laboratory. She complained of intermittent fever, anorexia, profuse sweating, malaise, headache, normotensive (110/60 mm Hg, muscle pain, and arthralgia for 3 d. Blood tests against dengue and malaria were negative thus she was prescribed vitamin C, paracetamol and cough syrup for common flu. The complaints, however, persisted on and off for the next 1 month. She eventually developed anemia and hypotension (90/50 mm Hg and started to show reduced body weight. Abdominal palpations revealed hepatomegaly and splenomegaly with pain. Thus, brucellosis was suspected before the Rose-Bengal plate test was performed, which revealed the presence of high level of antibody against Brucella. The same test was repeated after 14 d and the results confirmed the presence of high antibody level against Brucella. Following serum agglutination test, a diagnosis of brucellosis was made and she was eventually prescribed rifampicine p.o. once a day combined with doxycycline p.o. twice a day for 6 consecutive weeks before she made a full recovery.
Records 700 - 1600 ... There are several reports of occurrence of the disease in livestock populations especially in Tanzania and Kenya, suggesting chances ... of this study was to determine brucellosis prevalence in livestock and incidence in humans among pastoralists and .... The advice targeted to control further spread of ...
Čekanac, Radovan; Mladenović, Jovan; Ristanović, Elizabeta; Lazić, Srđan
Aim To analyze the epidemiological characteristics of human brucellosis in Serbia from 1980 to 2008 and the most important factors affecting its emergence and spread. Methods Public sources of data on brucellosis were used, including official reports of infectious diseases and epidemics, as well as monthly and annual reports of the Serbia and Vojvodina Institutes of Public Health. Results From 1980 through 2008, there were 1521 human brucellosis cases in Serbia. The annual number ranged from 2 in 2000 to 324 in 1991. Infections occurred more often in men (67% of cases) than in women (odds ratio, 2.17; 95% confidence interval, 1.57-3.00; χ2 = 24.52, P Serbia was recorded from June to September (310 of 623 cases, 50%). The disease was most prevalent among people aged 30-49 years, accounting for 81 of 177 (46%) of the cases in Serbia from 1999 to 2008. Conclusion Brucellosis has been a significant public health concern in Serbia. This problem may be solved by joint efforts of all relevant factors, first of all human and veterinary medical services. PMID:20718087
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
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
Smits, H. L.
The traditional lifestyle and beliefs of pastoralists and small-scale farmers with confined livestock, together with certain farming environments, create favourable conditions for the spread and transmission of brucellosis. The risks associated with these practices are difficult to control because
Rüegger, Kristina; Tarr, Philip; Karatolios, Konstantinos; Humburg, Jörg; Hügli, Rolf; Jeanneret, Christina
We describe the case of a 23-year old woman with a newly diagnosed thrombosis of the inferior vena cava associated with a Brucella melitensis infection. We suggest possible mechanisms leading to brucellosis-associated venous thrombosis and review 14 previously reported cases. .
Bertu, Wilson J.; Gusi, Amahyel M.; Hassan, Moses; Mwankon, Esther; Ocholi, Reuben A.; Ior, Daniel D.; Husseini, Bakari A.; Ibrahim, Gideon; Abdoel, Theresia H.; Smits, Henk L.
Purpose Nigeria is the largest cattle-rearing nation in Africa with most animals kept under traditional husbandry practices. While bovine brucellosis does not receive much attention, a relatively high seroprevalence is found in samples submitted for laboratory testing. The aim of the study was to
Franco, María Pía; Mulder, Maximilian; Smits, Henk L.
Treatment failure and relapse are major problems in the management of brucellosis. In developing countries, treatment with the oral combination doxycycline/rifampicin is preferred because of its convenience. However, its efficacy is lower than that of the doxycycline/streptomycin regimen and is
Abdoel, Theresia H.; Smits, Henk L.
We developed and evaluated a user-friendly latex agglutination assay for the serodiagnosis of human brucellosis. The assay was obtained by coating colored latex beads with Brucella lipopolysaccharides and drying of the activated beads onto white agglutination cards. Individual cards were sealed in a
Background. Syphilis research has neglected the prevalence of the disease among psychiatric patients, and traditional syphilis screening has been reported as inadequate. Objectives. (i) To assess the syphilis prevalence among psychiatric patients; (ii) to compare psychiatric diagnoses of syphilis-infected and -uninfected ...
Chew Ng, Rilene A.; Katz, Kenneth A.; Bernstein, Kyle T.; Samuel, Michael C.; Kerndt, Peter R.; Bolan, Gail
Objectives. We examined rates of and risk factors for repeat syphilis infection among men who have sex with men (MSM) in California. Methods. We analyzed 2002 to 2006 California syphilis surveillance system data. Results. During the study period, a mean of 5.9% (range: 4.9%–7.1% per year) of MSM had a repeat primary or secondary (PS) syphilis infection within 2 years of an initial infection. There was no significant increase in the annual proportion of MSM with a repeat syphilis infection (P = .42). In a multivariable model, factors associated with repeat syphilis infection were HIV infection (odds ratio [OR] = 1.65; 95% confidence interval [CI] = 1.14, 2.37), Black race (OR = 1.84; 95% CI = 1.12, 3.04), and 10 or more recent sex partners (OR = 1.99; 95% CI = 1.12, 3.50). Conclusions. Approximately 6% of MSM in California have a repeat PS syphilis infection within 2 years of an initial infection. HIV infection, Black race, and having multiple sex partners are associated with increased odds of repeat infection. Syphilis elimination efforts should include messages about the risk for repeat infection and the importance of follow-up testing. Public health attention to individuals repeatedly infected with syphilis may help reduce local disease burdens. PMID:22095364
Sarkodie, Francis; Owusu-Dabo, Ellis; Hassall, Oliver; Bates, Imelda; Bygbjerg, Ib C; Ullum, Henrik
To describe the recalled medical history, clinical manifestations, and treatment of yaws and syphilis by syphilis seroreactive blood donors in Kumasi, Ghana. Of the blood donors at Komfo Anokye Teaching Hospital, Kumasi, Ghana tested with the syphilis rapid diagnostic test (RDT) 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. 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 the age of 15 years. 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. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.
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.
Domingues, Rosa Maria Soares Madeira; Saracen, Valeria; Hartz, Zulmira Maria de Araújo; Leal, Maria do Carmo
To evaluate antenatal care in reducing the vertical transmission of syphilis. A cross-sectional study was designed to be representative of low-risk pregnancies in women cared for at the Brazilian Unified Health System (SUS) network in the city of Rio de Janeiro, from November 2007 to July 2008. Pregnant women diagnosed with syphilis were identified through interviews, checking their antenatal care card and searching for reported cases in the public health information systems. Cases of congenital syphilis were sought at the disease reporting system (Sinan), the Mortality Information System (SIM) and the SUS's Hospital Information System (SIH). Syphilis was identified in 46 of the pregnancies, and 16 cases of congenital syphilis were identified, resulting in a prevalence of 1.9% (95%CI 1.3;2.6) of syphilis in pregnancy and an incidence of 6/1,000 (95%CI 3;12/1,000) of congenital syphilis. The vertical transmission rate was 34.8% with three cases resulting in death (1 abortion, 1 stillborn and 1 neonatal death) and high proportions of prematurity and low birth weight. The healthcare pathway of those women revealed flaws in the care they received, such as late entry to antenatal care, syphilis remaining undiagnosed during pregnancy and lack of treatment for the partner. Innovative strategies are needed to improve the outcomes of syphilis in pregnancy, including improving the laboratory network, the quality of care delivered to the pregnant women and their sexual partners and, most important of all, investigating every case of congenital syphilis as a sentinel event in the quality of antenatal care.
Introduction: Measles is a public health problem especially in South Asia and Africa. Nylon Health District has experienced two measles outbreaks over a period of three years. We hereby describe the epidemiology and clinical characteristics of the outbreak of February 2011. Methods: A retrospective descriptive cross ...
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
Oct 20, 2015 ... Abstract. Measles is a highly contagious viral infection and still a leading cause of vaccine-preventable deaths in Africa; especially in unvaccinated populations. We reviewed the medical reports of the measles outbreak that occurred in Misaje, in the North west region of Cameroon from. 11/03/2015 to ...
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...
Measles is one of the most infectious diseases known to affect man. It spreads rapidly from an index case to many susceptible individuals resulting in cycles of epidemics in different parts of the world especially in the African continent. The contribution of measles to childhood mortality and morbidity remains high because it ...
The global disease burden from measles as a vaccine preventable disease remains high despite decades of interventions by various organs and agencies. To determine the prevalence and outcome of childhood cases of measles admitted into the children's emergency ward of the National hospital and highlight the ...
Comparative Analysis of Measles Morbidigf and. Mortalityin Calabar during the Eaqaanded Programme. ' on Immunization and the National Programme on. Immunization Eras. IS Etuk*, EE Ekanem'h", JJ Udo*. Summary. Etuk IS, Ekanem EE, UdoJJ. Comparative Analysis of Measles Morbidity and Mortality in Calabar ...
Conclusions: Our results likely reflect the highly contagious nature of measles, indicating that Japan is at risk of observing multiple generations of measles transmission given imported cases. Considering that importation events may continue in the future, supplementary vaccination of adults needs to be considered.
Jun 27, 2009 ... Background: Recently measles outbreaks have been occurring in several areas of Ethiopia. ... The Ethiopian Ministry of Health (MOH) has started .... Ethiopia; 2004. 12. Talley L, Salama P. Assessing field vaccine efficacy for measles in famine affected rural Ethiopia. Am J. Trop med Hyg 2003;68: 545 546.
Nov 26, 2012 ... Abstract. Introduction. Measles is a public health problem especially in South Asia and Africa. Nylon Health District has experienced two measles outbreaks over a period of three years. We hereby describe the epidemiology and clinical characteristics of the outbreak of February 2011. Methods.
with a transmissible latent virus, (c) only one serotype, and (d) availability of an effective vaccine. In spite of these, measles eradication seems elusive for now. It does appear that the dissimilarities between measles and smallpox, which tend to favour poor control of the former, play a more influential role in our environment.
... the power to protect their children with MMR vaccine. Protect Your Child from Measles Infographic highlights CDC’s routine measles vaccine ... and answers about vaccinating infants and young children Vaccines When Your Child Is Sick [2 pages] Explains that a child’s ...
Pakistan's immunization program is already a topic of much interest. Measles is a highly contagious disease, mostly found in children, which was highly prevalent in the world until the introduction of its vaccine. Epidemics of measles have become relatively uncommon since the introduction of its vaccine in the ...
Feb 8, 2013 ... Abstract Background: Despite a global decline in mortality and morbidity from measles in the last decade, outbreaks continue to occur in some parts of the world including Nigeria. Objective: To determine antibody response to routine measles vacci- nation in Nigerian children and evaluate vaccine potency.
A study of seroconversion of 115 children between 9 months to 5 years vaccinated against measles was conducted in Oriowon local government area of Edo State. This has to establish the immune status of the children against measles after immunisation. Haemagglutination inhibition technique was used. Prevaccination ...
Adamo, G; Sturabotti, G; D'Andrea, E; Baccolini, V; Romano, F; Iannazzo, S; Marzuillo, C; Villari, P
Despite substantial progress towards measles and rubella control, outbreaks continue to threaten elimination goals worldwide. This paper aims to document progress towards the global eradication of measles and rubella. In particular, it investigates the major challenges faced by Italy in reaching the elimination goals. A review of the most important literature was carried out. Furthermore, a systematic review of the scientific literature on measles and rubella in the Italian setting was performed for the period 2000-2016. In the National Plan 2010-2015, Italy renewed its commitment to eliminate measles and rubella by 2015. However, Italy recently experienced a high measles burden (2,205 cases in 2013, 1,694 in 2014). Between June 2015 and May 2016, 515 cases were reported, accounting for 28% all cases in Europe. Immunization coverage decreased in recent years, with no Region reaching the 95% target. The systematic review included a total of 175 papers, with an upward trend in the number of published articles, which demonstrates an increasing interest in the field of measles and rubella. The review highlights the need to improve the commitment of the Italian Regions to the elimination goals; to promote Supplementary Immunization Activities (SIAs); to improve the communication skills of health care workers; to improve the health literacy of citizens; and to enhance integrated measles and rubella surveillance. Elimination of measles and rubella in Italy will require a substantial improvement in both commitment of the 21 Regions and activity of the whole country towards the WHO goals.
INTRODUCTION. Measles outbreaks pose a continuing public health problem in Africa and other developing nations of the world1. Measles case fatality has been estimated to be between 3 to 5% in developing countries and may be as high as 10% during epidemics2. Despite the efforts made at increasing immunization, ...
Background: Despite a global decline in mortality and morbidity from measles in the last decade, outbreaks continue to occur in some parts of the world including Nigeria. Objective: To determine antibody response to routine measles vaccination in Nigerian children and evaluate vaccine potency. Methods: A prospective ...
The recent outbreak of measles in different areas of Pakistan has raised questions over its immunization program once again. The number of cases of measles in 2012 was reported to be. 14,000 with 210 patients dying of it. Unfortunately, due to a lack of proper surveillance infrastructure, the demographic statistics ...
Aznar, M N; Samartino, L E; Humblet, M-F; Saegerman, C
Bovine brucellosis is a zoonotic disease spread worldwide. The infection in cattle is predominantly caused by Brucella abortus and is usually detected in pregnant females through abortions. The disease is endemic in Argentina; however, infection in humans is underestimated and often not reported. The prevalence of bovine brucellosis in countries bordering Argentina is quite variable: 0.04% in Uruguay, 10.20% in the north and 0.06% in the south of Brazil, 0.2% in Chile, 3.15% in Paraguay and 2.27% in Bolivia. In 1999, the Argentine National Control and Eradication Program was implemented. Its strategies include identification of vaccinated animals, compulsory vaccination with B. abortus S19 of 100% of 3- to 8-month-old females, negative serological tests before animal movements and categorization of farms in terms of their brucellosis status. The epidemiological surveillance in milk is performed through the milk ring test and the indirect ELISA. The result of a national brucellosis survey performed in 2004 indicates that 12.4% (95% CI: 10.89-14.0) of Argentine beef farms are seropositive to Brucella and that the apparent prevalence in cattle is 2.10% (95% CI: 1.90-2.40). The official serological diagnostic tests are as follows: buffered plate antigen test, as screening, serum agglutination test, 2-mercaptoethanol and fluorescence polarization assay, competitive ELISA, as confirmatory tests, and complement fixation test, as definitive test. Santa Fe and a district in Córdoba have 'Outstanding Plans'. Tierra del Fuego is a 'Zone free from bovine brucellosis'. One question arising when studying the Argentine situation is why the disease remains endemic if good regulations exist to control and eradicate it. In future, some different aspects might be evaluated to understand it, and further studies should be performed to prioritize, select and refine control strategies. © 2012 Blackwell Verlag GmbH.
Earhart, Kenneth; Vafakolov, Sadulla; Yarmohamedova, Nargiza; Michael, Atef; Tjaden, Jeffrey; Soliman, Atef
This study was conducted to identify the potential risk factors for human brucellosis infection in Samarqand, Uzbekistan. Clinically identified cases admitted to different hospitals during 2004-2006 (N=144), and age-, sex- and residence-matched control patients (N=288) with other unrelated conditions, were included in this study. Structured questionnaires were completed and consent forms signed. Patients and controls were tested on site for Brucella infection by standard tube agglutination test and culture. Statistical analyses were performed with Stata software for univariate and multivariate analysis. Among the 144 patients with confirmed brucellosis, 137 (95.1%) owned farm animals, 135 (93.8%) were from rural areas, and 119 (82.6%) were enrolled during the animal breeding season. Multivariate analysis indicated that brucellosis was highly associated with contact with aborted animals (adjusted matched odds ratio (AMOR) 87.19, 95% confidence interval (CI) 9.36-911.85; p<0.001), slaughtering/butchering animals (AMOR 35.35, 95% CI 6.25-199.77; p<0.001) in the household, consumption of raw milk (AMOR 54.13, 95% CI 1.98-1476.13; p=0.018), and being in a family that had brucellosis sharing the same exposure (AMOR 15.93, 95% CI 1.37-184.97; p=0.027). To reduce the burden of brucellosis in Samarqand Oblast, veterinary services should be improved. Also public health education programs should be increased. Implementing these measures will minimize exposure to infected farm animals and reduce the risk of infection.
Russo, Ana M; Mancebo, Orlando A; Monzón, Carlos M; Gait, Juan J; Casco, Rubén D; Torioni de Echaide, Susana M
An epidemiological study of brucellosis was carried out in 516 goats and mixed flocks (goat/sheep) from the three agro-ecological regions of Formosa province, Argentina. Serum samples from a total of 25401 goats and 2453 sheeps were analyzed using buffered plate agglutination test (BPAT) and complement fixation test (CFT). Bacteriological and PCR analyses on milk samples from goats in three flocks with a history of brucellosis and recent abortions were also performed. Brucellosis was detected in four of the nine departments of the province with an overall prevalence of 2% and an intra-flock prevalence ranging between 1% and 40%. The proportion of infected flocks was 3.6%, 12% and 36% for the eastern, central and western regions, respectively. Brucella melitensis bv. 1 was isolated efrom goats for the first time in the province. The expected fragments of 827bp from the omp2ab gene (Brucella spp.) and 731bp from the insert IS711 (B. melitensis) were amplified by PCR. Detection of antibodies by BPAT and FCT in sheep cohabiting with goats suggests that infections could have been caused by B. melitensis, posing an additional risk to public health. Control and eradication programs for brucellosis should consider mixed flocks as a single epidemiological unit. The results indicate that brucellosis by B. melitensis bv1 is highly endemic in the central and western regions of Formosa province. Copyright © 2015 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.
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.
Rawls, W E; Rawls, M L; Chernesky, M A
A measles epidemic occurred in the Greensville (Ont.) Unit schools during January and February 1975. There were 47 cases of measles in 403 students: 26 (55%) of the children had a history of being vaccinated and 18 (38%) had not been vaccinated. Among children known to have been vaccinated at less than 1 year of age 7 of 13 contracted measles, while among the 48 children who had not been vaccinated 18 contracted measles. The attack rate among vaccinees increased with increasing time since vaccination. The observations of this study as well as those of similar studies suggest that vaccine failures contributed to the genesis of the epidemic. It is recommended that all children initially vaccinated at less than 1 year of age should be revaccinated with live attenuated measles virus vaccine.
Zhu, Liping; Qin, Min; Du, Li; Xie, Ri-hua; Wong, Tom; Wen, Shi Wu
To assess the trends and determinants of maternal and congenital syphilis in Shanghai, China. We conducted a prospective cohort study of maternal and congenital syphilis from 2002 to 2006 in Shanghai, China. We presented the trends of maternal syphilis and congenital syphilis rates and compared outcomes in infants born to mothers with complete versus incomplete treatment for maternal syphilis. We also assessed the determinants of compliance to treatment of maternal syphilis and examined the associations of initial maternal RPR antibody level and gestational age at initiation of treatment with occurrence of congenital syphilis. A total of 535 537 pregnant women were included in the analysis. During this period of time, 1471 maternal syphilis cases (298.7 per 100 000 live births) and 334 congenital syphilis cases (62.4 per 100 000 live births) were identified. Both maternal and congenital syphilis rates increased from 2002 until 2005, with a slight decrease in 2006. The rate of maternal syphilis was 156.2 per 100 000 live births in Shanghai residents and 371.7 per 100 000 live births in the migrating population (psyphilis was poorer in women with a lower level of education. The rate of congenital syphilis in infants born to mothers with incomplete treatment (50.8%) was much higher than in infants born to mothers with complete treatment (12.5%). Rates of fetal death, neonatal death, and major birth defects were 30.4%, 11.0%, and 3.8%, respectively, in the incomplete treatment group; the corresponding figures were 5.5%, 0.56%, and 0.46%, respectively, in the complete treatment group. Infant outcome was also affected by initial maternal RPR antibody level and time of treatment, with much better outcomes in mothers with low antibody levels and earlier treatment. There has been a resurgence of congenital syphilis in Shanghai, China, especially in the migrating population and other populations with a lower socioeconomic status. Copyright © 2010 International Society
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.
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.
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, Shuai; Wang, Qi; Liu, Han; Sun, Siqiao; Sun, Xiwei; Zhang, Yang; Wang, Zhongying; Cheng, Zhihua
Arterial damage is a known complication of brucellosis, but the occurrence of a thoracic aortic pseudoaneurysm secondary to brucellosis has not been previously reported. A 65-year-old Chinese man presented with a pseudoaneurysm in the descending segment of the thoracic aorta that caused symptoms of chest pain and intermittent fever. He was diagnosed with a thoracic aortic pseudoaneurysm secondary to brucellosis based on a positive brucella serology test (standard-tube agglutination test) and imaging examination (computed tomography angiography). Anti-brucellosis treatment and covered stent graft implantation were attempted to eliminate the brucellosis and pseudoaneurysm, respectively, and were ultimately successful, with no symptoms after 6 months of follow-up. Endovascular repair may be effective and safe for treating a thoracic aortic pseudoaneurysm resulting from brucellosis.
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. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.
Dou, Lixia; Wang, Xiaoyan; Wang, Fang; Wang, Qian; Qiao, Yaping; Su, Min; Jin, Xi; Qiu, Jie; Song, Li; Wang, Ailing
Objective. The aim of this study was to investigate the epidemiological characteristics and adverse pregnancy outcomes of pregnant women with syphilis infection in China. Methods. Data were from China's Information System of Prevention of Mother-to-Child Transmission of Syphilis Management. Women who were registered in the system and delivered in 2013 were included in the analysis. Results. A total of 15884 pregnant women with syphilis infection delivered in China in 2013. 79.1% of infected women attended antenatal care at or before 37 gestational weeks; however, 55.4% received no treatment or initiated the treatment after 37 gestational weeks. 14.0% of women suffered serious adverse pregnancy outcomes including stillbirth/neonatal death, preterm delivery/low birth weight, or congenital syphilis in newborns. High maternal titer (≥1 : 64) and late treatment (>37 gestational weeks)/nontreatment were significantly associated with increased risk of congenital syphilis and the adjusted ORs were 1.88 (95% CI 1.27 to 2.80) and 3.70 (95% CI 2.36 to 5.80), respectively. Conclusion. Syphilis affects a great number of pregnant women in China. Large proportions of women are not detected and treated at an early pregnancy stage. Burden of adverse pregnancy outcomes is high among infected women. Comprehensive interventions still need to be strengthened to improve uptake of screening and treatment for maternal syphilis. PMID:26981537
Dou, Lixia; Wang, Xiaoyan; Wang, Fang; Wang, Qian; Qiao, Yaping; Su, Min; Jin, Xi; Qiu, Jie; Song, Li; Wang, Ailing
The aim of this study was to investigate the epidemiological characteristics and adverse pregnancy outcomes of pregnant women with syphilis infection in China. Data were from China's Information System of Prevention of Mother-to-Child Transmission of Syphilis Management. Women who were registered in the system and delivered in 2013 were included in the analysis. A total of 15884 pregnant women with syphilis infection delivered in China in 2013. 79.1% of infected women attended antenatal care at or before 37 gestational weeks; however, 55.4% received no treatment or initiated the treatment after 37 gestational weeks. 14.0% of women suffered serious adverse pregnancy outcomes including stillbirth/neonatal death, preterm delivery/low birth weight, or congenital syphilis in newborns. High maternal titer (≥1 : 64) and late treatment (>37 gestational weeks)/nontreatment were significantly associated with increased risk of congenital syphilis and the adjusted ORs were 1.88 (95% CI 1.27 to 2.80) and 3.70 (95% CI 2.36 to 5.80), respectively. Syphilis affects a great number of pregnant women in China. Large proportions of women are not detected and treated at an early pregnancy stage. Burden of adverse pregnancy outcomes is high among infected women. Comprehensive interventions still need to be strengthened to improve uptake of screening and treatment for maternal syphilis.
Full Text Available Objective. The aim of this study was to investigate the epidemiological characteristics and adverse pregnancy outcomes of pregnant women with syphilis infection in China. Methods. Data were from China’s Information System of Prevention of Mother-to-Child Transmission of Syphilis Management. Women who were registered in the system and delivered in 2013 were included in the analysis. Results. A total of 15884 pregnant women with syphilis infection delivered in China in 2013. 79.1% of infected women attended antenatal care at or before 37 gestational weeks; however, 55.4% received no treatment or initiated the treatment after 37 gestational weeks. 14.0% of women suffered serious adverse pregnancy outcomes including stillbirth/neonatal death, preterm delivery/low birth weight, or congenital syphilis in newborns. High maternal titer (≥1 : 64 and late treatment (>37 gestational weeks/nontreatment were significantly associated with increased risk of congenital syphilis and the adjusted ORs were 1.88 (95% CI 1.27 to 2.80 and 3.70 (95% CI 2.36 to 5.80, respectively. Conclusion. Syphilis affects a great number of pregnant women in China. Large proportions of women are not detected and treated at an early pregnancy stage. Burden of adverse pregnancy outcomes is high among infected women. Comprehensive interventions still need to be strengthened to improve uptake of screening and treatment for maternal syphilis.
Nardone, Raffaele; Golaszewski, Stefan; Trinka, Eugen; Tezzon, Frediano; Zuccoli, Giulio
We report a case of acute disseminated encephalomyelitis preceding measles virus infection. Brain magnetic resonance imaging revealed signal intensity abnormalities in the basal ganglia and cortex consistent with acute disseminated encephalomyelitis. Fever and the first Koplik spots appeared 8 and 10 days later, respectively. This case supports the hypothesis that the immune-mediated demyelinating process may occur before the symptomatic phase of a viral infection. Therefore, children without history of infectious disorders should also have acute disseminated encephalomyelitis included in the differential considerations.
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.
Natália Carolina Rodrigues Colombo Gomes
Full Text Available Abstract INTRODUCTION: The implementation of the rapid test (RT for syphilis increases access of vulnerable populations to early diagnosis and treatment, impacting the outcomes of infection. We aimed to assess the prevalence of and factors associated with syphilis in a Center for Testing and Counseling (CTC. METHODS: We conducted a cross-sectional study at a Reference Center for sexually transmitted disease (STD and acquired immune deficiency syndrome in Londrina, Northern Paraná State, Southern Brazil. Data regarding the 5,509 individuals who underwent RT from June 2012 to December 2014 were collected from patient records and the CTC Information System and served as the basis to check associations of syphilis cases (346 and cases without syphilis (5,163. Nine patients’ records were not found. OpenEpi was used to perform a prevalence analysis and determine odds ratios to assess the associations between sociodemographic and behavioral variables (independent variables and cases of syphilis (dependent variable. An alpha value <0.05 was considered statistically significant. RESULTS: The prevalence of syphilis was 6.3%; higher in males (7.5% than in females (4.3%, p <0.001. Syphilis was associated with an age of 25-34 years, little education, and single marital status. The main associated behavioral factors were men who have sex with men, drug users, STD patients, and those presenting with an STD in the last year. The use of alcohol, marijuana, cocaine, and crack was significantly associated with syphilis. CONCLUSIONS: Strategies for prevention and control of syphilis should be intensified, especially in populations identified as most vulnerable.
N.A. Norouzi; B. Talebi; H. Erfani; A Karimi; S.J. Bathaie; A.R. Moradi; Moradi , A. (MSc)
Introduction & Objective: Brucellosis is an important zoonosis considered a serious hazard to public health . Human brucellosis is caused by one of the four species of the brucella genus: B. melitensis is principally found in goats and sheep, B. abortus in cattle, B. suis in swine and B. canis in dogs. Vaccination of young animals, is a strategy to decrease the incidence rate of brucellosis in humans. The objective of this study is to give an estimate of vaccination coverage in animals (sheep...
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.
Yan-Ling Ge; Xiao-Wen Zhai; Yan-Feng Zhu; Xiang-Shi Wang; Ai-Mei Xia; Yue-Fang Li; Mei Zeng
Background: Despite substantial progress toward measles control are making in China, measles outbreaks in immunocompromised population still pose a challenge to interrupt endemic transmission. This study aimed to investigate the features of measles in pediatric hematology and oncology patients and explore the reasons behind the outbreak. Methods: We collected demographic, epidemiological, and clinical data of immunocompromised measles children. All suspected measles cases were laboratory-conf...
Full Text Available Background Brucellosis is a common zoonotic disease of the Middle Eastern countries. Acute cases of brucellosis are often treated as cases of Pyrexia of unknown origin. Aims The main aim of this study is to compare the epidemiological, clinical and laboratory findings of the 42 culture positive cases of Brucella. Methods Forty two culture positive cases of Brucella were obtained from both in -patients and outpatients with a history of pyrexia over a period of two years (Nov 2014-Nov 2016. The patients' files were examined retrospectively for the history, clinical features, and lab findings. Results The prevalence of brucellosis was calculated to be 11.1 per cent as 42 cases were positive for brucellosis out of 377 of PUO cases Of the 42 cultures positive patients the percentage of males (57.1 per cent were almost equal to the females(42.8 per cent. The mean±S.D age was 28.5±13.65. 28.5 per cent had a history of livestock associations (Chi-square 3.8889, a p-value of 0.048607 which was statistically significant. 26.2 per cent had a history of raw milk and dairy produce intake (Chi-Square 2.6276, p-value of 0.105023 this was not statistically significant. 9.5 per cent had a family history of brucellosis; this association was not statistically significant as well (chi-square statistic 1.8651, p-value of 0.172034. 61.9 per cent presented as acute cases, 30.9 per cent of sub-acute cases and 7.1 per cent as chronic cases respectively. The pre- dominant clinical symptom was Fever (100 per cent with the commonest clinical signs being the osteoarticular signs (30.9 per cent. Raised ESR and CRP positives were seen in 34 cases (80.9 per cent and 23 cases (55 per cent respectively followed by Anaemia in 22 cases (52.3 per cent. Forty two cases were blood culture positive. All the cases were sensitive to the recommended regimen of Doxycycline and streptomycin. Conclusion Brucellosis is still a major health problem in the Middle Eastern countries especially
Full Text Available Abstract In 2013 a cross-sectional study was carried out that revealed 28 cases of active syphilis amongst female inmates in a prison of Cochabamba, Bolivia. A search was conducted for congenital syphilis amongst the children that lived with the infected mothers. It is important to note the prevention of perinatal transmission of syphilis by systematic screening of pregnant women and appropriate treatment given by trained professionals within the prison environment, which represents a key population for controlling this disease, which is responsible for causing severe complications.
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.
Kaplan, Robert M
Syphilis has changed the course of history, shaped the path of medicine and had more influence on psychiatry than any other illness. This paper, part two of a two-part series, investigates the historical, social and cultural aspects of the interaction of syphilis and psychiatry. By the end of the 19th century, social changes such as population growth, mass migration from Eastern Europe and technological developments led to a great rise in syphilis. By 1900, it was estimated that 5-20% of the population of Europe and the USA had, or would have, syphilis. By 1914, there were over 100,00 new cases and 3 million cases of syphilis in Great Britain. There was a constant interaction between syphilis, prostitution and sexual crime; it was the likely motivation for the Jack the Ripper murders, if not many in the next century. The idea of hereditary syphilis fitted perfectly into the theory of degeneration and coursed through psychiatry and caught the attention of Adolf Hitler, facilitating his antisemitic paranoia. Psychiatric progress passed to the German school, led by Kraepelin who did his first research into the symptoms and course of neurosyphilis. In 1906, Wasserman's serological test for syphilis showed that latent lesions could be present. Any doubt about the cause of syphilis was finally eliminated when Noguchi and Moore demonstrated the presence of treponema pallidum in paretic brains in 1913. German academic psychiatry defined psychiatric practice for the next century but malariotherapy, the first physical treatment in psychiatry, was announced by Julius Wagner-Juarreg in Vienna in 1917, bringing hope to the incurable and destroying the climate of therapeutic nihilism that haunted psychiatry. The first trial of malariotherapy in Australia was done by Reginald Ellery at Mont Park Hospital In 1927 in Melbourne. The discovery of penicillin was a caesura, ending malariotherapy and leading many to regard syphilis as a night-extinct illness, but this turned out to be
Bala, Keziban Aslı; 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 AND 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.
Full Text Available 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.
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 R 0 = 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 R 0 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
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 R 0 = 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 R 0 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.
Rosa Maria Soares Madeira Domingues; Maria do Carmo Leal; Ana Paula Esteves Pereira; Barbara Ayres; Alexandra Roma Sánchez; Bernard Larouzé
International audience; This study aimed to estimate the prevalence of syphilis and HIV infection during pregnancy, the mother to child transmission of syphilis and the incidence of congenital syphilis in incarcerated women in Brazil; to compare these rates to those observed in pregnant women outside of jail; and to verify the maternal factors associated with syphilis infection during pregnancy in free and incarcerated women. We used data from two nationwide studies conducted during the perio...
Interpretation & conclusions: Most HEI lacked measles antibodies at six months age and were, therefore, more vulnerable to measles than HUnI. Seroconversion in response to a single dose of measles vaccine administered at six months age was low in these infants, signifying the need of additional dose(s of measles/measles-containing vaccine.
Tipples, Graham; Hiebert, Joanne
Measles, mumps, and rubella are infections caused by RNA viruses of the same name and are vaccine preventable. The vaccines are frequently administered in a trivalent form. Laboratory diagnostic methods can include indirect detection via antibody (IgM and IgG) detection methods and direct detection by viral culture or viral genome detection. There are challenges for the laboratory in areas with low prevalence due to high vaccine uptake. In those areas, routine serological methods such as IgM detection may have a reduced positive predictive value and thus require confirmation by other methods. Direct detection of viral genomic material using reverse transcription polymerase chain reaction (RT-PCR) methodologies can play an important role for laboratory confirmation of acute infections. Furthermore, genotyping of these three viruses provides useful molecular epidemiological data for differentiating vaccine from wild-type strains, linking cases and outbreaks, and tracking geographic spread and elimination. The purpose of this chapter is to provide guidance for the laboratory diagnosis of measles, mumps, and rubella virus infections. Where assays are commercially available or previously published, the appropriate references are provided as well as brief comments on the interpretation of results. Detailed protocols are provided for the molecular assays which have been developed and more commonly applied in recent years.
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. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2011.
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.
Fievez, L C R; Wong, A; Ruijs, W L M; Meerstadt-Rombach, F S; Timen, A
This study examined adherence to national recommendations on measles pre- and postexposure measures, including immunization of health care workers (HCWs) in Dutch hospitals, during a national outbreak of measles in The Netherlands. This study also investigated which hospital characteristics and
Stephenson, J.R.; Meulen, V. ter (Wuerzburg Univ. (Germany, F.R.))
Isolates from two cases of acute measles, one case of acute measles encephalitis and three patients with subacute sclerosing panencephalitis were compared. This comparison was based upon the electrophoretic analysis of T/sub 1/ oligonucleotides from single-stranded, full-length RNA isolated from cytoplasmic nucleocapsids. Although all viruses have oligonucleotides in common, each isolate generated a unique pattern of oligonucleotides. However, no group of oligonucleotides was observed which would allow differentiation between viruses isolated from acute infections and those isolated from CNS diseases; indicating that probably all measles viruses differ in their nucleotide sequence, regardless of origin.
V. Bhanu Rekha
Full Text Available Aim: To assess the status of bovine brucellosis in an organized dairy with a past history of Brucella abortions and where Brucella control measures including test and removal, calf-hood vaccination (already present adult animals were not vaccinated, use of semen obtained from a screened bull and general hygienic measures helps in the control of brucellosis in the farm have been implemented for the past four years.Materials and Methods: A total of 195 samples including 89 blood samples, 89 serum samples and 17 milk samples were collected and analysed by isolation and identification, Polymerase chain Reaction (PCR, Milk Ring Test (MRT, Rose Bengal Plate Test (RBPT, Standard Tube Agglutination Test (STAT and Enzyme Linked Immnuno-Sorbent assay ELISA.Results: On analysis, all the 89 blood and 17 milk samples turned out to be negative for culture and PCR. MRT and ELISA tests on all the 17 milk samples and STAT on all the 89 serum samples were also negative. The percent positives for Brucella antibodies in serum samples were 4.5 and 6.7 by RBPT and ELISA, respectively. Of the 17 vaccinated animals, 14 were negative by all the Brucella antigen and antibody diagnostic tests employed. Amongst the three vaccinated animals, one animal was positive by RBPTand I-ELISAand, two animals were positive by I-ELISAalone. On the other hand, of the 72 nonvaccinated animals, 65 were negative by all the diagnostic tests employed, three animals were positive by RBPTand 4 animals were positive by I-ELISA. Conclusion: The results of our study indicated that a combination of RBPT and I-ELISA can be successfully used for screening for brucellosis when the prevalence is low. Implementation of control measures including test and removal of the affected, calf-hood vaccination, use of semen obtained from a screened bull and general hygienic measures help in the control of brucellosis in the farm.
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 - 2015.In this Table, provisional cases of selected notifiable diseases (â¥1,000 cases reported during the...
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...
Macé, Guillaume; Castaigne, Vanina; Trabbia, Aurore; Guigue, Virginie; Cynober, Evelyne; Cortey, Anne; Lalande, Valérie; Carbonne, Bruno
An upsurge in syphilis has been observed almost everywhere over the past decade. The mother's clinical presentation is often uninformative. The diagnosis of maternal syphilis infection is most often based on serologic tests that allow early Extencilline treatment. Syphilis ultrasound findings are non-specific, and delay before treatment can be decisive for prognosis. Fetal anemia is a physiological consequence of severe infection. We confirmed that syphilis can be suggested non-invasively by MCA-PSV measurements in a context of ascitis or atypical hydrops in the absence of usual causes. It is therefore important to perform maternal TPHA/VDRL serology if fetal anemia is suspected. In association with Extencilline treatment, intra uterine transfusion can limit consequences of infection. Reduced fetal movements and non-reactive fetal heart rate may prefigure acute perinatal complications or stillbirth.
Rashid, Usman; Yaqoob, Usman; Bibi, Nazia; Bari, Attia
Congenital syphilis is a severe, disabling infection often with grave consequences seen in infants. It occurs due to the transmission of the disease from an infected mother to the unborn infant through the placenta. Congenital syphilis can involve any organ system and present with various symptoms. However, early diagnosis of congenital syphilis is difficult because more than half of the affected infants are asymptomatic, and the signs in symptomatic infants may be subtle and nonspecific. The continuing prevalence of this disease reveals the failure of control measures established for its prevention. Here we report a case of a one-month infant who presented with skin rash. The report stresses upon the importance of implementing the World Health Organization's recommendation that all pregnant women should be screened for syphilis in the first antenatal visit in the first trimester and again in the late pregnancy.
Miguel E Cervera-Hernández
Full Text Available Objective. To describe the seroprevalence and associated factors for brucellosis among dairy farm workers. Materials and methods. We performed a secondary analysis of a data set and sera from a previous cross-sectional study in a dairy farm. Sera were tested for Brucella spp. antibodies by the slide agglutination test. Seropositivity was defined as a titer ≥1:40; recent infection was titers ≥1:160. Results. We tested 331 human sera. Seroprevalence of brucellosis was 18.1% (60/331; 95% CI 14.1-22.7; 13.3% of them (8/60; 95% CI 5.9 - 24.5 corresponded to recent infection. Highexposure occupation (calf caretaker; OR 3.3; 95%CI 1.1 – 9.7, daily hours in contact with cows (OR 1.1; 95%CI 1.03 – 1.2, and living on-site (OR 2.2; 95% CI 1.1 – 4.4 remained inde- pendently associated with seropositivity. Conclusions. We found a high seroprevalence of brucellosis among dairy farm workers, as well as a significant association among those with prolonged and close contact with cattle.
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.
Mojtaba Kamali Aghdam
Full Text Available 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.
López, Gustavo E; Peña, Sabrina; Escobar, Gabriela I; Hasan, Déborah B; Lucero, Nidia E
Ovine cattle was introduced into America during the Spanish conquest with the second journey of Columbus to the Antilles and was disseminated throughout the region. In 1587, sheep were introduced into Argentina, later developing into the "Creole" breed. We selected 486 animals from different Argentine provinces with the aim of determining the serological status of brucellosis caused by Brucella melitensis and Brucella ovis. For the detection of antibodies against smooth Brucella spp., the Rose Bengal test (RBT) was performed as screening test while the serum agglutination test (SAT) and 2 mercapto-ethanol (2ME) were run as a confirmatory technique. Moreover, for the detection of antibodies against rough Brucella spp., we used the rapid slide agglutination test (RSAT) for screening and an indirect ELISA (IELISA) as confirmatory assay. This study showed that the total positive percentage of brucellosis due to B. ovis was 2.9%. Excluding the animals mixed with the Suffolk breed; seropositivity would be 0.6%. All animals tested negative for brucellosis caused by B. melitensis. Copyright © 2017 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.
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 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.
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.
Luciane Rodrigues Pedreira de Cerqueira
Full Text Available ABSTRACT Introduction: In 2013, the World Health Organization (WHO reported that 1.9 million pregnant women were infected with syphilis worldwide, of which 66.5% had adverse fetal effects in cases of untreated syphilis. Congenital syphilis contributes significantly to infant mortality, accounting for 305,000 perinatal deaths worldwide annually. Aim: To estimate the prevalence of syphilis in parturients, the incidence of congenital syphilis and the vertical transmission rate. Material and methods: a cross-sectional study with data collected from 2041 parturients who had undergone treatment between 2012 and 2014 in the maternity section of the Pedro Ernesto Hospital of the State University of Rio de Janeiro, in the metropolitan area of Rio de Janeiro. The inclusion criterion was positive VDRL and treponemal test in a hospital environment. Results: the prevalence of syphilis in pregnant women was 4.1% in 2012, 3.1% in 2013 and 5% in 2014, with official reporting of 15.6%, 25.0% and 48.1%, respectively. The incidence of congenital syphilis (CS was 22/1,000 in live births (LB in 2012; 17/1,000 LB in 2013 and 44.8/1,000 LB in 2014. CS underreporting during the period was 6.7%. Vertical transmission occurred in 65.8% of infants from infected mothers. It was concluded that, in 34.6% of the CS cases, maternal VDRL titers were = 1/4. Conclusion: Results demonstrate the magnitude of the disease, fragility of the reporting system in the assessment of the actual prevalence, impact on perinatal outcomes, and they are a warning about the real situation of syphilis, which is still underestimated in the State.
Parker, Lucy Anne; Deschutter, Enrique Jorge; Bornay-Llinares, Fernando Jorge; Hernandez-Aguado, Ildefonso; Silva, Gustavo; Piragine, Rosa Del Carmen; Lumbreras, Blanca
To explore clinical and socioeconomic factors related to congenital syphilis in Posadas, Argentina. Data were collected from 102 mothers who had given birth to an infant with congenital syphilis at Dr. Ramón Madariaga Central Hospital (2005-2007) and 306 control mothers. Clinical and demographic information were collected from clinical records, and socioeconomic details were obtained by interview. Multivariable logistic regression was used to explore the relationships between congenital syphilis and clinical and socioeconomic factors. Receiving the recommended number of prenatal health checks had a clear protective effect on congenital syphilis in the univariate analysis (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.31-0.86), as did being in a stable relationship (OR 0.23, 95% CI 0.14-0.38). Furthermore, women with secondary education or above were over four-times less likely to have a child with congenital syphilis compared to women who had not completed primary school education, even after controlling for the number of prenatal health checks and other factors (adjusted OR 0.24, 95% CI 0.08-0.72). In addition, women with previous stillborn births were over three-times more likely to have a baby with congenital syphilis after controlling for education and prenatal care (adjusted OR 3.37, 95% CI 1.24-9.16). There is a clear opportunity for reducing the burden of congenital syphilis by promoting syphilis screening and treatment in women with previous stillborn births. In addition, the potential impact of more general policies addressing social determinants of health, such as those improving education, must not be overlooked. Copyright Â© 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
de Cerqueira, Luciane Rodrigues Pedreira; Monteiro, Denise L. M.; Taquette, Stella R.; Rodrigues, Nádia C. P.; Trajano, Alexandre J. B.; de Souza, Flavio Monteiro; Araújo, Bianca De Melo
ABSTRACT Introduction: In 2013, the World Health Organization (WHO) reported that 1.9 million pregnant women were infected with syphilis worldwide, of which 66.5% had adverse fetal effects in cases of untreated syphilis. Congenital syphilis contributes significantly to infant mortality, accounting for 305,000 perinatal deaths worldwide annually. Aim: To estimate the prevalence of syphilis in parturients, the incidence of congenital syphilis and the vertical transmission rate. Material and methods: a cross-sectional study with data collected from 2041 parturients who had undergone treatment between 2012 and 2014 in the maternity section of the Pedro Ernesto Hospital of the State University of Rio de Janeiro, in the metropolitan area of Rio de Janeiro. The inclusion criterion was positive VDRL and treponemal test in a hospital environment. Results: the prevalence of syphilis in pregnant women was 4.1% in 2012, 3.1% in 2013 and 5% in 2014, with official reporting of 15.6%, 25.0% and 48.1%, respectively. The incidence of congenital syphilis (CS) was 22/1,000 in live births (LB) in 2012; 17/1,000 LB in 2013 and 44.8/1,000 LB in 2014. CS underreporting during the period was 6.7%. Vertical transmission occurred in 65.8% of infants from infected mothers. It was concluded that, in 34.6% of the CS cases, maternal VDRL titers were = 1/4. Conclusion: Results demonstrate the magnitude of the disease, fragility of the reporting system in the assessment of the actual prevalence, impact on perinatal outcomes, and they are a warning about the real situation of syphilis, which is still underestimated in the State. PMID:29267586
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.
Emek, M; Islek, D; Atasoylu, G; Ozbek, O A; Ceylan, A; Acikgoz, A; Tay, Z; Demiral, Y; Oktem, M A; Unal, B
Despite an ongoing measles elimination programme, a measles outbreak occurred in 2013 in Turkey. Population-based seroprevalence studies are needed to determine seronegativity and explore the reasons for this outbreak. This study aimed to explore the seroprevalence of measles and its association with various social determinants in a provincial population in Turkey in the year following a measles outbreak. Cross-sectional study. This study was conducted in Manisa Province in 2014 in a sample of 1740 people aged >2 years. The dependent variable was the seroprevalence of measles. Independent variables were sex, age, migration, household size, household density, income, education level, existence of chronic disease and occupational class. Blood samples were collected from participants at family health centres. The presence of specific measles antibodies in serum samples was determined using an anti-measles virus IgG enzyme-linked immunosorbent assay test. Chi-squared test and logistic regression analysis were performed. Overall, data from 1250 people were analysed. The seroprevalence of measles in the whole study population was 82.2% (95% confidence interval 80.0-84.2). Seroprevalence was 55.4% among subjects aged 2-9 years, 48.7% among subjects aged 10-19 years, 74.1% among subjects aged 20-29 years and 93.6% among subjects aged 30-39 years (P 40 years was >95%. The lowest seroprevalence was found in primary school children (40.2%), followed by those below the age for primary education (69.8%) and secondary school graduates (75.1%). The prevalence of measles seronegativity was not associated with any of the social determinants when adjusted for age. The seroprevalence of measles was lower than expected in the study population and was particularly low in subjects aged <30 years of age despite previous vaccination. Seroprevalence was not associated with social determinants of health that confirmed either an even distribution of virus exposure or fair access to
Full Text Available We present the first reported case of papulonodular secondary syphilis in an HIV-positive transgender female. Syphilis is classified into primary, secondary, latent, and tertiary stages, with secondary syphilis having notably diverse cutaneous manifestations. Our patient presented with diverse lesions throughout her body, all pathologically consistent with papulonodular secondary syphilis. Proper identification of the multiple presentations of syphilis is crucial to early diagnosis and treatment. This report seeks to broaden the scope of dermatological manifestations that arise secondary to papulonodular syphilis in HIV-positive patients.
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.
Saad-Roy, C M; Shuai, Zhisheng; van den Driessche, P
Syphilis is caused by the bacterium Treponema pallidum subspecies pallidum, and is a sexually transmitted disease with multiple stages. A model of transmission of syphilis in an MSM population (there has recently been a resurgence of syphilis in such populations) that includes infection stages and treatment is formulated as a system of ordinary differential equations. The control reproduction number is calculated, and it is proved that if this threshold parameter is below one, syphilis dies out; otherwise, if it is greater than one, it is shown that there exists a unique endemic equilibrium and that for certain special cases, this equilibrium is globally asymptotically stable. Using data from the literature on MSM populations, numerical methods are used to determine the variation and robustness of the control reproduction number with respect to the model parameters, and to determine adequate treatment rates for syphilis eradication. By assuming a closed population and no return to susceptibility, an epidemic model is obtained. Final outbreak sizes are numerically determined for various parameter values, and its variation and robustness to parameter value changes is also investigated. Results quantify the importance of early treatment for syphilis control. Copyright © 2016 Elsevier Inc. All rights reserved.
Lafetá, Kátia Regina Gandra; Martelli Júnior, Hercílio; Silveira, Marise Fagundes; Paranaíba, Lívia Máris Ribeiro
To identify and to describe cases of congenital and maternal syphilis reported and not reported in a Brazilian medium-sized city. This is a descriptive and retrospective study, which evaluated 214 medical records of pregnant women and newborns. It began with the identification of epidemiological notification records, followed by active search in maternity evaluating all records that did show positive nontreponemal serology and records of the reference service in infectious diseases in Montes Claros, Minas Gerais, from 2007 to 2013. The case definitions followed the Ministry of Health recommendations in Brazil and the variables were described using absolute and relative frequencies. This study was approved by the Ethics in Research Committee (University State of Montes Claros). Of the 214 medical records, we identified 93 cases of maternal syphilis and 54 cases of congenital. The women studied were predominantly mulatto, with Secundary/Higher, aged between 21 and 30 years and single marital status. Considering the prenatal care of pregnant women with syphilis, it was observed predominance of late diagnosis, after parturition or curettage, and all of their treatments were considered inadequate according the Ministry of Health. The newborns of pregnant women with syphilis, most were not referenced for pediatric follow-up. Only 6.5% of syphilis in pregnant women was notified, and in congenital syphilis, 24.1%. Persisting vertical transmission, there are signs that the quality of prenatal and neonatal care should be restructured.
Conclusion: Decline of the incidence of human brucellosis is one of the major indicators for successfully implemented new control programs and strategies for prevention and eradication of brucellosis in sheep and goats. Vaccination was good measure to control brucellosis in the 3 regions.
Park, J Y; Han, G H; Kwon, D Y; Hong, H R; Seol, H J
Congenital syphilis is preventable and curable if maternal infection is detected early, and pregnant women in Korea are screened routinely for this disease. Nevertheless, the incidence of congenital syphilis is not decreasing. Prenatal diagnosis of congenital syphilis is difficult and treatment is usually based on maternal syphilis serology. Prenatal ultrasonographic examination may sometimes reveal abnormal features suggesting congenital infection. The authors report a case of congenital syphilis that was diagnosed in both fetus and asymptomatic mother following detection on prenatal ultrasonography of transient fetal pleural effusion. The case is noteworthy for its sonographic presentation as fetal pleural effusion rapidly resolved spontaneously.
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.
... Emails Measles: Make Sure Your Child is Fully Immunized Language: English (US) Español (Spanish) Recommend on Facebook ... his or her healthcare provider, or Visit the immunization scheduler for newborn to 6-year-old children. ...
Zhang, Yan; Ding, Zhengrong; Wang, Huiling; Li, Liqun; Pang, Yankun; Brown, Kevin E; Xu, Songtao; Zhu, Zhen; Rota, Paul A; Featherstone, David; Xu, Wenbo
To determine the origin of the virus associated with a measles outbreak in Menglian County, Yunnan Province, People's Republic of China, in 2009, we conducted genetic analyses. Phylogenetic analyses based on nucleoprotein (N) and hemagglutinin (H) gene sequences showed that these Menglian viruses were not closely related to sequences of any World Health Organization (WHO) reference strains representing the 23 currently recognized genotypes. The minimum nucleotide divergence between the Menglian viruses and the most closely related reference strain, genotype D7, was 3.3% for the N gene and 3.0% for the H gene. A search of the databases of GenBank, WHO, and the Health Protection Agency Measles Nucleotide Surveillance showed that the Menglian viruses, together with the 2 older non-Menglian viruses, could be members of a new proposed measles genotype, d11. The new genotype designation will allow for better description of measles transmission patterns, especially in the Southeast Asian and Western Pacific regions.
Rota, Paul A; Brown, Kevin E; Hübschen, Judith M; Muller, Claude P; Icenogle, Joseph; Chen, Min-Hsin; Bankamp, Bettina; Kessler, Julia R; Brown, David W; Bellini, William J; Featherstone, David
An important aspect of laboratory surveillance for measles and rubella is the genetic characterization of circulating wild-type viruses to support molecular epidemiologic studies and to track transmission pathways. Virologic surveillance that is sufficient to document the interruption of transmission of measles and rubella viruses will be an essential criterion for verification of elimination. Laboratories in the World Health Organization (WHO) Measles and Rubella Laboratory Network have worked to improve and expand virologic surveillance as many regions move toward elimination of measles and rubella/congenital rubella syndrome. As countries approach elimination, it will be necessary to obtain genetic information from as many chains of transmission as possible. In addition, baseline virologic surveillance, especially for rubella, needs to be improved in many countries. This report contains a summary of recent improvements to the methods used for virologic surveillance. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2011.
The estimated level of population immunity needed to prevent measles outbreaks is ..... transfer fewer antibodies than mothers whose immunity followed wild-type .... Scott S, et al. HIV type 1 infection is a risk factor for mortality in hospitalized.
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
Wichmann, Ole; Rieck, Thorsten; Matysiak-Klose, Dorothea
Abstract Objective We aimed to quantify progress towards measles elimination in Germany from 2007 to 2011 and to estimate any potential underreporting over this period. Methods We determined the annual incidence of notified cases of measles – for each year – in northern, western, eastern and southern Germany and across the whole country. We then used measles-related health insurance claims to estimate the corresponding incidence. Findings In each year between 2007 and 2011, there were 6.9–19.6 (mean: 10.8) notified cases of measles per million population. Incidence decreased with age and showed geographical variation, with highest mean incidence – 20.3 cases per million – in southern Germany. Over the study period, incidence decreased by 10% (incidence rate ratio, IRR: 0.90; 95% confidence interval, CI: 0.85–0.95) per year in western Germany but increased by 77% (IRR: 1.77; 95% CI: 1.62–1.93) per year in eastern Germany. Although the estimated incidence of measles based on insurance claims showed similar trends, these estimates were 2.0- to 4.8-fold higher than the incidence of notified cases. Comparisons between the data sets indicated that the underreporting increased with age and was generally less in years when measles incidence was high than in low-incidence years. Conclusion Germany is still far from achieving measles elimination. There is substantial regional variation in measles epidemiology and, therefore, a need for region-specific interventions. Our analysis indicates underreporting in the routine surveillance system between 2007 and 2011, especially among adults. PMID:25378728