Karababa Ali O
Full Text Available Abstract Background According to the surveillance system in Turkey, most diseases are notified only by clinicians, without involving laboratory notification. It is assumed that a considerable inadequacy in notifications exists; however, this has not been quantified by any researcher. Our aim was to evaluate the completeness of communicable disease surveillance in the province of Izmir, Turkey for the year of 2003 by means of estimating the incidences of diseases. Methods Data on positive laboratory results for the notifiable and serologically detectable diseases hepatitis A, B, C, brucellosis, syphilis, measles and HIV detected in 2003 in Izmir (population 3.5 million were collected from serology laboratories according to WHO surveillance standards and compared to the notifications received by the Provincial Health Directorate. Data were checked for duplicates and matched. Incidences were estimated with the capture-recapture method. Sensitivities of both notifications and laboratory data were calculated according to these estimates. Results Among laboratories performing serologic tests (n = 158 in Izmir, 84.2% accepted to participate, from which 23,515 positive results were collected. Following the elimination of duplicate results as well as of cases residing outside of Izmir, the total number was 11,402. The total number of notifications was 1802. Notification rates of cases found in laboratories were 31.6% for hepatitis A, 12.1% for acute hepatitis B, 31.8% for brucellosis, 25.9% for syphilis and 100% for HIV confirmation. Conclusions It was discovered that for hepatitis A, B, C, brucellosis and syphilis, there is a considerable under-notification by clinicians and that laboratory data has the potential of contributing greatly to their surveillance. The inclusion of laboratories in the surveillance system of these diseases could help to achieve completeness of reporting.
Full Text Available Brucellosis and fascioliasis are zoonoses which induce different type of cell-mediated immune responses and rarely cause hepatitis with together. Brucellosis induces T helper type 1 (Th1 immune response whereas Fasciola hepatica induces T helper type 2 (Th2 immune. It may be speculated that chronic fascioliasis can predispose to brucellosis by suppression of Th1 response against brucellosis. In this paper, we present a patient who was diagnosed with brucellosis as well as chronic fasciolasis on the basis of parasite that was seen incidentally during the abdomen ultrasonography. To our knowledge, this case is one of the few cases in the literature that showing the co-infection of the liver by both fascioliasis and brucellosis.
... risk of contracting syphilis, but only if the condom covers the syphilis sores. Avoid recreational drugs. Excessive use of alcohol or other drugs can cloud your judgment and lead to unsafe sexual practices. Screening for pregnant women People can be ...
Syphilis is a sexually transmitted disease caused by bacteria. It infects the genital area, lips, mouth, or ... of both men and women. You usually get syphilis from sexual contact with someone who has it. ...
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.
Salado-Rasmussen, Kirsten; Knudsen, Andreas; Krarup, Henrik Bygum
BACKGROUND: Treponema pallidum, the causative agent of syphilis, elicits a vigorous immune response in the infected host. This study sought to describe the impact of syphilis infection on hepatitis C virus (HCV) RNA levels in patients with HIV and chronic HCV infection. METHODS: Patients......-α), interferon gamma (IFN-γ), and IFN-γ-inducible protein 10 kDa (IP-10). RESULTS: Undetectable HCV RNA at the time of early latent syphilis infection was observed in 2 patients with HIV and chronic HCV infection. After treatment of the syphilis infection, HCV RNA levels increased again in patient 1, whereas...... patient 2 initiated HCV therapy and remained HCV RNA-negative. Available plasma samples obtained before and after the episode with undetectable HCV RNA were phylogenetically identical, making the possibility of spontaneous clearance and HCV reinfection less likely. The IL-10, TNF-α, and IP-10 levels...
Mavenyengwa, Rooyen T; Mukesi, Munyaradzi; Chipare, Israel; Shoombe, Esra
Transfusion Transmissible Infections (TTIs) such as Human Immunodeficiency Virus (HIV), syphilis, hepatitis B virus (HBV) and hepatitis C virus (HCV) are infections which are common in some communities in Southern Africa. It is important to screen blood donations for these infections. This is a retrospective study which involved reviewing of previous blood donation records for the year 2012 in Namibia. The records were analyzed to determine the prevalence of HIV, syphilis, Hepatitis B and C among blood donations with regard to gender, age and geographical region of the donors. The findings indicated a significantly low prevalence of HIV, syphilis, HBsAg and anti-Hepatitis C among the blood donations. A low infection rate of 1.3% by any of the four tested TTIs was found among the blood donations given by the donor population in Namibia in 2012. The blood donations given by the donor population in Namibia has a low infection rate with the HIV, syphilis, HBsAg and anti-HCV. A strict screening regime must continue to be used as the infections are still present albeit in small numbers.
Swati Dhirajlal Jethava
Full Text Available BACKGROUND This study was conducted to assess the extent of seropositivity of hepatitis B, hepatitis C, syphilis and HIV in pregnant women at tertiary care hospitals in Gujarat from December 2015 to June 2016 and to re-evaluate the need for routine antenatal care screening for these infections among obstetric patients. MATERIALS AND METHODS Patients were enrolled for study after taking informed consent. All samples were tested to detect HbsAg by Enzyme-Linked Immunosorbent Assay (ELISA, anti-HCV by ELISA, samples were also tested for antibodies to Treponema pallidum by Rapid Plasma Regain (RPR, samples were tested for antibodies to HIV by three different methods as per strategy III of the National AIDS Control Organisation by using different systems of testing to establish a diagnosis of HIV. RESULTS Total 1000 samples were tested. Out of this, seropositivity of hepatitis B was (0.6%, hepatitis C was (0.2%, syphilis was (0.0% and HIV was 0.1%. Out of the 1000 samples, no coinfection was found between hepatitis B, hepatitis C, syphilis or HIV. CONCLUSION This study can help the health professionals to efficiently treat antenatal patients. Early diagnosis of disease in antenatal period is helpful for proper management and initiation of treatment to prevent transmission to newborn.
Padovese, V; Egidi, A M; Melillo, T Fenech; Farrugia, B; Carabot, P; Didero, D; Costanzo, G; Mirisola, C
In the last few years, Malta has witnessed increasing immigration flows from the Libyan coasts. Public health policies are focused on screening migrants for tuberculosis, whereas no systematic actions against STIs are implemented. The aim of this study is to define the epidemiological profile of asylum seekers in Malta as regards syphilis, hepatitis B, C and latent tuberculosis, thus supporting screening policies. Five hundred migrants living in open centres were screened between December 2010 and June 2011. 83.2% of people was from Somalia, 81.2% males, average age 26.5 years. The tuberculin skin test (TST) was positive in 225 migrants (45%). Latent syphilis was diagnosed in 11 migrants, hepatitis C in 3 and 31 migrants were HBsAg positive. Systematic screening for asymptomatic migrants in Malta is not recommended for hepatitis C and syphilis, given the low prevalence observed. On the contrary, it should be considered for hepatitis B. TST could be indicated as the first step of a two step screening for migrants from countries with high TB incidence. Efficacy and cost-effectiveness could be achieved by further targeting screening to specific subgroups at higher risk of reactivation, such as people living with HIV and subjects affected by chronic diseases.
B N Joshi
Full Text Available In some cases of Hepatitis B antigen positive hepatitis, a history of previous blood transfusion or any parenteral therapy is lacking and evidence for other routes of infections have to be sought. Sexual contact has been suggested as one of the methods of transmission of this infection. To approach the problem from this angle we studied 480 serawhich werepositive for syphilis serology for the presence of HB antigen and antibody by discontinuous counter immune electrophoresis method. It was found to be prevalent to the extentof 5.Z-per centagainst 1.4 per cent found in voluntary blood donors. Our observation agrees with that of other workers that HB antigen/antibody is seen more frequently in patients with positive syphilis serol-ogy.
Deme, Chala; Edao, Beyene; Jaya, Gemedi; Tisiano, Gebre; Fano, Hayi; Alegria, Iñaki; Reyes, Francisco; Gorgolas, Miguel; Ramos, José M
Antenatal care (ANC) is provided to prevent, diagnose early and treat pregnant women for a variety of diseases. The objective of this study was to determine the seroprevalences of syphilis, human immunodeficiency virus (HIV) and hepatitis B virus (HVB) and asymptomatic urinary tract infections and the prevalence of hypertension and anemia among pregnant women attending the antenatal clinic at Gambo Rural Hospital in southern Ethiopia. The following tests were conducted among study subjects: hemoglobin (Hgb) level, rapid plasma reagin (RPR) for syphilis, anti-HIV antibodies, hepatitis B surface antigen (HBsAg) and urine analysis. A total of 574 pregnant women were included in this study. The mean age of the participants was 25.7 (SD: 4.8) years old; 88.2% were living in urban areas and 11.8% in rural areas. Sixty-seven point two percent of participants began their attended care during the second trimester of their pregnancy. Overall, anemia (Hgb urinary tract infection (having ≥10 white blood cells /high power field in the urine) was present in 12.7% of participants (95% CI: 10.0-15.5). The RPR test was positive in two patients (0.3%; 95% CI: 0.1-1.3). The prevalences of positive test for HBsAg and HIV-1 were 2.3% (95% CI: 1.3-3.8) and 0.2% (95% CI: 0.03-0.9), respectively. No HIV-2 cases were detected. Our data show relatively low prevalences of anemia, hypertension, urinary tract infection, syphilis, HIV, and hepatitis B virus infections among study subjects at a rural antenatal clinic in southern Ethiopia.
Dehghan Manshadi, Seyed Ali; Rezahosseini, Omid; Abdi Liaei, Zahra
The brucellosis with multi-organ involvement in a patient with a history of the composite aortic graft (Bentall procedure) and Hepatitis B infection is rare. A 35-year-old man presented to us with fever and loss of consciousness. Four years ago, he was IDU and underwent cardiac surgery because of endocarditis. Recently lumbar spondylodiscitis was diagnosed. The Wright (1/320) and Coombs Wright tests (1/640) were positive. After CNS imaging, lumbar puncture was done. The CSF pleocytosis was lymphocyte dominant. In cardiac echocardiography, large vegetation on prosthetic aortic valve leaflets was seen. The brain MRI was reported abnormal. Treatment of brucellosis started with Ceftriaxone, Doxycycline, Rifampin and Gentamycin. After 4 days, he became oriented, and fever was disappeared then we continued the treatment for 16 days. The patient discharged and followed by daily phone calls. As symptoms of abdominal pain and jaundice were presented on the fifth day, he re-admitted. The patient expired because of hepatorenal and cardiac insufficiency. Drug side effects, activation of Hepatitis B and embolism of cardiac vegetation to other organs were suspected causes of death. We do not suggest medical therapy without cardiac surgery in such cases. When combination therapy is necessary for brucellosis in an HBsAg-positive patient, hepatitis virus activity should be assess by HBV-DNA PCR and the dose of drugs with known hepatotoxic effects such as rifampin and co-trimoxazole should be adjust. Combination therapy with quinolones instead of hepatoxic drugs is one of our suggustions.
Mutagoma, Mwumvaneza; Nyirazinyoye, Laetitia; Sebuhoro, Dieudonné; Riedel, David J; Ntaganira, Joseph
Human Immunodeficiency Virus (HIV), syphilis, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are sexually transmitted infections (STIs) and share modes of transmission. These infections are generally more prevalent among female sex workers (FSWs). This is a cross-sectional study conducted among female sex workers (FSWs) in Rwanda in 2015. Venue-Day-Time (VDT) sampling method was used in recruiting participants. HIV, syphilis, HBV, and HCV testing were performed. Descriptive analyses and logistic regression models were computed. In total, 1978 FSWs were recruited. The majority (58.5%) was aged between 20 and 29 years old. Up to 63.9% of FSWs were single, 62.3% attained primary school, and 68.0% had no additional occupation beside sex work. Almost all FSWs (81.2%) had children. The majority of FSWs (68.4%) were venue-based, and most (53.5%) had spent less than five years in sex work. The overall prevalence of syphilis was 51.1%; it was 2.5% for HBV, 1.4% for HCV, 42.9% for HIV and 27.4% for syphilis/HIV co-infection. The prevalence of syphilis, HIV, and syphilis + HIV co-infection was increasing with age and decreasing with the level of education. A positive association with syphilis/HIV co-infection was found in: 25 years and older (aOR = 1.82 [95% CI:1.33-2.50]), having had a genital sore in the last 12 months (aOR = 1.34 [95% CI:1.05-1.71]), and having HBsAg-positive test (aOR = 2.09 [1.08-4.08]). The prevalence of HIV and syphilis infections and HIV/syphilis co-infection are very high among FSWs in Rwanda. A strong, specific prevention program for FSWs and to avert HIV infection and other STIs transmission to their clients is needed.
Full Text Available Brucellosis is a zoonotic disease of worldwide distribution. Despite its control in many developing countries the disease remains endemic in Iran. The symptoms, signs and laboratory results are variable and nonspecific. This case series study was conducted to determine the liver complications of Brucellosis in Iran"nMaterials and Methods: We studied 188 patients (108 males and 80 females with Brucellosis, fulfilled the diagnostic criteria, aged 1-79 years (mean 34.8 years were registered in Imam Khomeini Hospital, a referral center in Tehran, during the six years (1995-2001."nResults: Thirty-four of 188 cases (18.08 percent had elevated liver enzyme (elevated SGOT only, 6 patients; elevated SGPT only 1 patient; elevation of both transaminases, 27 patients. The prominent symptoms included anorexia (74 cases, weight loss (62 cases, right upper quadrant pain (32 cases, epigastric pain (25 cases and nausea and vomiting (23 cases. Among the gastrointestinal signs were found in these patients, hepatomegaly was seen in 28 patients. Jaundice and ascitis were present in only 7 and 3 patients, respectively. Other laboratory results showed elevated alkaline phosphatase in 28 cases and abnormal bilirubin in 10 cases. Fifty-seven patients had a focal illness, representing 30.32 percent of all patients. Osteoarticular complications were the most frequent focal forms, being present in 34 cases. Twelve male patients had genitourinary Brucellosis, representing 10.53 percent of focal forms. Also, 5 patients had neurologic complications."nConclusion: In conclusion liver involvement is frequent in Brucellosis, although the rate of this complication in our study was lower than other studies. So, in patients with evidence of overt clinical or laboratory findings compatible with liver disturbance etiologies other than brucellosis should be considered in Iran."n"n"n
Full Text Available Every year, an estimated 180 000 babies in the Western Pacific Region are infected by hepatitis B, 13 000 by syphilis and 1400 by HIV through mother-to-child transmission.1 These infections can be largely prevented by antenatal screening, treatment and timely vaccination for newborns. Despite challenges in controlling each disease, major achievements have been made. National immunization programmes have reduced the regional hepatitis B prevalence from over 8% in 1990 to 0.93% among children born in 2012. In addition, HIV testing and treatment have helped keep the regional prevalence of HIV infections at 0.1%. In contrast, the number of maternal syphilis cases is still high in the Western Pacific Region, with an estimated 45 million cases in 2012. Elimination of mother-to-child transmission of these infections cannot be achieved through vertically applied programming and require using and augmenting to the shared Maternal, Newborn and Child Health platform to coordinate, integrate and enable cost efficiencies for these elimination efforts. The Regional Framework for Triple Elimination of Mother-to-Child Transmission of HIV, Hepatitis B and Syphilis in Asia and the Pacific 2018–2030 offers such a coordinated approach towards achieving the triple elimination of mother-to-child transmission of HIV, hepatitis B and syphilis and provides guidance for decision-makers, managers and health professionals working in programmes addressing maternal, newborn and child health, HIV, hepatitis, sexually transmitted infections and immunization.
María I Camejo
Full Text Available OBJETIVO: En Venezuela las trabajadoras sexuales reciben un control sanitario para la sífilis y el virus de inmunodeficiencia humana (VIH. Sin embargo, otras importantes infecciones de transmisión sexual no son evaluadas. Así, se realizó este estudio con el objetivo de determinar el nivel socio-cultural de un grupo de trabajadores sexuales y su relación con la sero-presencia de marcadores de Hepatitis C y Hepatitis B, en adición a la evaluación de rutina. MÉTODOS: Se evaluaron 212 trabajadoras sexuales, que acudieron al control sanitario en el servicio de infecciones de transmisión sexual, de la ciudad de Los Teques, Venezuela. Fueron entrevistadas en cuanto a edad, nivel educativo, uso de anticonceptivos y del condón. Se les tomó una muestra de sangre para determinar sífilis, antígeno de superficie de hepatitis B (HBsAg y la presencia de anticuerpos contra el core de hepatitis B (anti-HBc, virus de hepatitis C (anti-HC y VIH. Los datos fueron evaluados estadísticamente por Chi-cuadrado y correlación de Pearson. RESULTADOS: La prevalencia fue de 2,4% para sífilis, 0,5% para anti-HC, 3,8% para HBsAg y 13,8% para anti-HBc. Un aumento en la prevalencia de marcadores de hepatitis B se correlacionó con un bajo nivel educativo (pOBJECTIVE: In Venezuela, female sex workers are submitted to a preventive control of syphilis and human immunodeficiency virus (HIV. However, other very important sexually transmitted infections are not evaluated. A study was carried out to identify the sociocultural background of a group of sex workers and its association with the seroprevalence of hepatitis B and C markers, in addition to routine evaluation. METHOD: A total of 212 female sex workers who attended the control center of sexually transmitted infections (STI in the city of Los Teques, Venezuela, were evaluated. Women were asked their age, educational background, use of contraceptive methods and condoms. Blood was drawn to determine the prevalence
Bhattar, Sonali; Aggarwal, Prabhav; Sahani, Satyendra Kumar; Bhalla, Preena
HIV, syphilis, hepatitis B and C (HBV & HCV) infections modify the epidemiology and presentation of each other. This study aimed to estimate the seroprevalence of these infections and their co-infections in sexually transmitted infections (STI) clinic attendees in New Delhi, India. A retrospective study including 220 patients was conducted during May 2014 through December 2014. Serodiagnosis of HIV was performed as per Strategy III of NACO guidelines; syphilis by VDRL followed by TPHA; HBV and HCV by rapid immuno-chromatographic test followed by ELISA. Male subjects were slightly more in number as compared to females (56.36% vs. 43.63%). Twelve (5.45%), 14 (6.36%), three (1.36 %) and one (0.45%) were reactive for HIV, VDRL, HBV and HCV, respectively. Three were both HIV and syphilis positive and one was both HIV and HBV positive; no co-infections of HBV/HCV, HIV/HBV/HCV and HIV/HBV/HCV/syphilis coexisted. High prevalence of HIV, HBV, HCV and syphilis in STI clinic attendees mandate routine screening to detect co-infections and follow prompt therapy in order to minimize their sequelae.
Pallawela, Sns; Bradshaw, D; Hodson, L; Rehill, K; Wong, F; Rockwood, N; Gedela, K; Hardie, J; Price, H; Alexander, S; McLean, K; Dean, G; Smith, A; Sullivan, A K
Patients diagnosed with lymphogranuloma venereum have high rates of co-infection with HIV, syphilis and hepatitis C. The aim of this enhanced surveillance was to screen all men who have sex with men (MSM) newly diagnosed with HIV, syphilis or hepatitis C for co-infection with asymptomatic lymphogranuloma venereum as part of the recommended sexual health screen. Of the 145 patients screened, 21 patients were diagnosed with rectal Chlamydia trachomatis, one with both rectal and urethral chlamydia and six with urethral chlamydia. One rectal chlamydia-positive sample, when tested, was equivocal for lymphogranuloma venereum. Our data suggested that there was not a pool of asymptomatic lymphogranuloma venereum infection in MSM recently diagnosed with HIV, hepatitis C and syphilis. However, there have been recent reports of an increased incidence of asymptomatic lymphogranuloma venereum, raising the question whether lymphogranuloma venereum should be screened for in high risk asymptomatic MSM. The prevalence of asymptomatic rectal chlamydia infections was 19%. © The Author(s) 2015.
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.
Ormaeche, Melvy; Whittembury, Alvaro; Pun, Mónica; Suárez-Ognio, Luis
To assess the seroprevalence of hepatitis B virus (HBV), syphilis, and HIV and associated risk factors in pregnant women and their male partners from six indigenous populations of the Peruvian Amazon Basin. A cross-sectional study was performed in six indigenous populations from the Peruvian Amazon Basin. Blood samples were obtained and tested for HBV (antibodies to the hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg)), for syphilis (rapid plasma reagin and microhemagglutination assay for Treponema pallidum antibodies), and for HIV (ELISA and indirect immunofluorescence test). A survey was also performed to identify associated risk factors. One thousand two hundred and fifty-one pregnant women and 778 male partners were enrolled in the study. The seroprevalence of anti-HBc in pregnant women was 42.06% (95% confidence interval (CI) 39.28-44.85%) and in their male partners was 54.09% (95% CI 50.32-57.86%). The seroprevalence of HBsAg in pregnant women was 2.11% (95% CI 0.78-3.44%) and in their male partners was 3.98% (95% CI 1.87-6.08%). The seroprevalence of syphilis in pregnant women was 1.60% (95% CI 0.86-2.33%) and in their male partners was 2.44% (95% CI 1.22-3.66%). HIV seroprevalence in pregnant women was 0.16% (95% CI 0.02-0.58%) and in their male partners was 0.29% (95% CI 0.04-1.03%). Sexual risk factors were strongly related to blood markers of syphilis and HBV. Hepatitis B was found to be hyperendemic and strongly related to sexual factors, suggesting an important sexual component in the transmission of the disease in the populations studied. Syphilis was found to have an endemicity in pregnant women above the national level and this may be indicative of high mother-to-child transmission. HIV has started to show its presence in indigenous populations of the Amazon Basin and the results suggest the epidemic is concentrated. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights
Coul, E.L.M. op de; Hahné, S.; Weert, Y.M. van; Oomen, P.; Smit, S.; Ploeg, C.P.B. van der; Notermans, D.W.; Boer, K.; Sande1, M.A.B. van der
A screening programme for pregnant women has been in place since the 1950s in the Netherlands. In 2004 universal HIV screening according to opting out was implemented. Here, we describe the evaluation of the effectiveness of antenatal screening in the Netherlands for 2006-2008 for HIV, hepatitis B
Lyamuya Eligius F
Full Text Available Abstract Background According to the latest Tanzanian National AIDS Control Programme (NACP report a total of 147,271 individuals donated blood during the year 2002. However, blood safety remains an issue of major concern in transfusion medicine in Tanzania where national blood transfusion services and policies, appropriate infrastructure, trained personnel and financial resources are inadequate. Most of the donated blood is screened for HIV alone. Methods We determined among blood donors at Muhimbili National Hospital (MNH, the seroprevalence of human immunodeficiency virus (HIV, hepatitis C virus (HCV, hepatitis B surface antigen (HBsAg and syphilis by donor type, sex and age and to determine association, if any, in the occurrence of the pathogens. The sample included 1599 consecutive donors, 1424(89.1% males and 175 (10.9% females, who donated blood between April 2004 and May, 2005. Most of them 1125 (70.4% were replacement donors and a few 474 (29.6% voluntary donors. Their age (in years ranged from 16 to 69, and most (72.2% were between 20–39 years. Results Two hundred and fifty four (15.9% of the donated blood had serological evidence of infection with at least one pathogen and 28 (1.8% had multiple infections. The current seroprevalence of HIV, HBsAg, HCV and syphilis among blood donors at MNH in Dar es Salaam was found to be 3.8%, 8.8%, 1.5% and 4.7%, respectively. Respective seroprevalences among HIV seronegative blood donors were 8.7% for HBV, 1.6% for HCV and 4.6% for syphilis. The differences in the prevalence of HIV and syphilis infections between replacement and voluntary donors were statistically significant (P 2 = 58.5 df = 5, P Conclusion The high (15.9% seroprevalence of blood-borne infections in blood donated at MNH calls for routine screening of blood donors for HBV, HCV, HIV and syphilis and for strict selection criteria of donors, with emphasis on getting young voluntary donors and for establishment of strict guidelines
A new strategy to improve the cost-effectiveness of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis testing of blood donations in sub-Saharan Africa: a pilot study in Burkina Faso.
Kania, Dramane; Sangaré, Lassana; Sakandé, Jean; Koanda, Abdoulaye; Nébié, Yacouba Kompingnin; Zerbo, Oumarou; Combasséré, Alain Wilfried; Guissou, Innocent Pierre; Rouet, François
In Africa where blood-borne agents are highly prevalent, cheaper and feasible alternative strategies for blood donations testing are specifically required. From May to August 2002, 500 blood donations from Burkina Faso were tested for hepatitis B surface antigen (HBsAg), human immunodeficiency virus (HIV), syphilis, and hepatitis C virus (HCV) according to two distinct strategies. The first strategy was a conventional simultaneous screening of these four blood-borne infectious agents on each blood donation by using single-marker assays. The second strategy was a sequential screening starting by HBsAg. HBsAg-nonreactive blood donations were then further tested for HIV. If nonreactive, they were further tested for syphilis. If nonreactive, they were finally assessed for HCV antibodies. The accuracy and cost-effectiveness of the two strategies were compared. By using the simultaneous strategy, the seroprevalences of HBsAg, HIV, syphilis, and HCV among blood donors in Ouagadougou were estimated to be 19.2, 9.8, 1.6, and 5.2%. No significant difference of HIV, syphilis, and HCV prevalence rates was observed by using the sequential strategy (9.2, 1.9, and 4.7%, respectively). Whatever the strategy used, 157 blood donations (31.4%) were found to be reactive for at least one transfusion-transmissible agent and were thus discarded. The sequential strategy allowed a cost decrease of euro 908.6, compared to the simultaneous strategy. Given that approximately there are 50,000 blood donations annually in Burkina Faso, the money savings reached potentially euro 90,860. In resource-limited settings, the implementation of a sequential strategy appears as a pragmatic solution to promote safe blood supply and ensure sustainability of the system.
Serwin, Agnieszka Beata; Koper, Marta; Unemo, Magnus
We describe the first case of lymphogranuloma venereum (LGV) in Poland, with inguino-femoral lymphadenopathy, diagnosed and successfully treated according to the 2013 European LGV guideline. Chlamydia trachomatis genovar L2b, mainly responsible for the ongoing LGV epidemics among men who have sex with men (MSM) in Western European countries, was confirmed. The case also verified that co-infections with other sexually transmitted infections (syphilis and hepatitis C virus) are frequent in MSM LGV patients, as well as the very large difficulties with contact tracing for these patients. LGV needs to be considered in the diagnosis of inguinal lymph nodes inflammation or proctitis, especially in MSM. It is also crucial to have access to appropriate laboratory diagnostic methods in order to screen for and confirm all LGV cases by typing C. trachomatis genovars.
Shan, Duo; Wang, Juan; Sun, Jiangping; Duan, Song; Guo, Yunsong
To demonstrate the effectiveness of prevention of mother-to-child HIV, syphilis, and hepatitis B transmission among pregnant women in Dehong prefecture, Yunnan province, China from 2011 to 2013. Data were collected mainly from the continuous HIV surveillance system and prevention of mother-to-child transmission (PMTCT) reporting system of Dehong prefecture, and supplemented by annual reported data on HIV, syphilis, and hepatitis B PMTCT to know the general demographic characteristics, HIV testing and counseling service, PMTCT service, and other medical services. Data were presented as absolute numbers and proportions. From 2011 to 2013, the number of pregnant women participating in HIV, syphilis, and hepatitis B testing in Dehong prefecture increased and the HIV testing rates were 99.2% (18 694/18 854), 99.9% (22 047/22 060) and 99.9% (21 751/21 756), the syphilis testing rates were 56.0% (10 550/18 854), 99.6% (21 980/22 060) and 99.9% (21 751/21 756), and the hepatitis B testing rates were 60.2% (11 358/18 854), 99.6% (21 974/22 060) and 99.9% (21 751/21 756). From 2011 to 2013, the HIV positive rates were 0.87% (327/37 787),0.82% (319/38 817) and 0.85% (315/37 261), the syphilis positive rates were 0.05% (10/18 520),0.12% (43/36 817) and 0.11% (40/35 888), the hepatitis B positive rates were 2.46% (456/18 520), 2.23% (794/35 547) and 2.14% (739/34 468), respectively. The rates of HIV-positive pregnant women giving birth in hospitals were 99.2% (128/129), 100.0% (141/141) and 100.0% (141/141). From 2011 to 2013, the proportions of HIV-positive pregnant women receiving antiretroviral therapy were 99.2% (128/129), 99.3% (140/141) and 99.3% (140/141), respectively. And the treatment rate of syphilis-positive pregnant women were 71% (5/7), 89% (16/18) and 97% (32/33). The rates of hepatitis B immunoglobulin injection among new-borns of hepatitis B-positive pregnant women were 92.9% (263/283), 99.7% (612/614) and 99.4% (629/633). The estimated rates of mother
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...
Fielding, Cory M; Angulo, Paul
To describe the etiology of hepatitis and identify occult hepatitis B virus (HBV) infection. A 40-year-old man presented with severe abdominal pain and jaundice, a history of acute HBV infection that had cleared as well as the use of acetaminophen, methamphetamine, buprenorphine and marijuana. He admitted to having had unprotected sex with multiple partners of both genders. A thorough skin examination revealed papulosquamous lesions on his penis, scrotum, upper and lower extremities and feet. Transaminases and bilirubin were elevated. His rapid plasma reagin was reactive, and hepatitis serologies showed occult HBV. Liver biopsy showed severe hepatitis, but the stains for hepatitis B surface antigen and hepatitis B core antigen were negative. The pathological findings were highly indicative of drug-induced hepatitis without evidence of chronic hepatitis, reactivation of HBV or syphilitic hepatitis. With supportive management and abstinence from drugs, his condition improved. This case describes a patient with multiple potential causes for hepatitis and highlights the importance of obtaining a detailed social history. Further, one should consider the presence of occult HBV and recognize the serologic pattern. © 2014 S. Karger AG, Basel.
Miranda, Angelica Espinosa; Figueiredo, Nínive Camilo; Schmidt, Renylena; Page-Shafer, Kimberly
Objective To estimate the prevalence of HIV, hepatitis B (HBV) and C (HCV) and syphilis infections and associated risk exposures in a population-based sample of young women in Vitória, Brazil. Methods From March to December 2006, a cross-sectional sample of women aged 18 to 29 years was recruited into a single stage, population-based study. Serological markers of HIV, HBV, HCV, and syphilis infections and associated risk exposures were assessed. Results Of 1,200 eligible women, 1,029 (85.8%) enrolled. Median age was 23 (interquartile range [IQR] 20, 26) years; 32.2% had ≤ 8 years of education. The survey weighted prevalence estimates were: HIV, 0.6% (95% CI), 0.1%, 1.1%); anti-HBc, 4.2% (3.0%, 5.4%); HBsAg, 0.9% (0.4%, 1.6%); anti-HCV, 0.6% (0.1%, 1.1%) and syphilis 1.2% (0.5%, 1.9%). Overall, 6.1% had at least one positive serological marker for any of the tested infection. A majority (87.9%) was sexually active, of whom 12.1% reported a previously diagnosed sexually transmitted infection (STI) and 1.4% a history of commercial sex work. Variables independently associated with any positive serological test included: older age (≥25 vs. 4× minimum wage), previously diagnosed STI, ≥ 1 sexual partner, and any illicit drug use. Conclusions These are the first population-based estimates of the prevalence of exposure to these infectious diseases and related risks in young women, a population for whom there is a scarcity of data in Brazil. PMID:18401700
Comparison of seropositivity of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis among Hospital Cornea Retrieval Programme-Donors versus voluntary cornea donors at a large eye bank in Eastern India.
Basak, Soham; Basak, Samar K; Biswas, Bani
To compare the serology profile of donors from Hospital Cornea Retrieval Programme-donors (HCRP-D) and voluntary cornea donors (VC-D) from a large eye bank in Eastern India. This is a retrospective analysis of donor details from January 2011 to December 2016. Donor demographics, cause of death, and serology reports were compiled. Postmortem blood was tested for human immunodeficiency virus 1 and 2 (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis using government-approved kits as per the National Programme for Control of Blindness Standards of Eye Banking. Donors for whom serology was not possible were excluded. A total of 4300 of 4353 donors were included of which 74.3% were hospital donors and 25.7% were voluntary donors. A total of 93 (2.2%) donors with 94 seropositive reports were noted: 79 (84.9%) from HCRP-D and 14 (15.1%) from VC-D which was statistically significantly higher (P = 0.02). Among seropositive reports, HIV, HBV, HCV, and syphilis accounted for 12 (12.8%), 38 (40.4%), 36 (38.3%), and eight (8.5%), respectively. There was no correlation between the cause of death and seropositivity. A statistically significant decreasing trend in seroprevalence among hospital donors was observed over the years (5.3% in 2011 to 1.4% in 2016; P = 0.004). Two (0.47%) of 421 hospital donors with prior negative serology were found to be seropositive. Seropositive rates are significantly higher among hospital donors in spite of medical prescreening compared to nonscreened voluntary donors. Serology should be repeated even when prior reports are available.
Comparison of seropositivity of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis among Hospital Cornea Retrieval Programme-Donors versus voluntary cornea donors at a large eye bank in Eastern India
Full Text Available Purpose: To compare the serology profile of donors from Hospital Cornea Retrieval Programme-donors (HCRP-D and voluntary cornea donors (VC-D from a large eye bank in Eastern India. Methods: This is a retrospective analysis of donor details from January 2011 to December 2016. Donor demographics, cause of death, and serology reports were compiled. Postmortem blood was tested for human immunodeficiency virus 1 and 2 (HIV, hepatitis B virus (HBV, hepatitis C virus (HCV, and syphilis using government-approved kits as per the National Programme for Control of Blindness Standards of Eye Banking. Donors for whom serology was not possible were excluded. Results: A total of 4300 of 4353 donors were included of which 74.3% were hospital donors and 25.7% were voluntary donors. A total of 93 (2.2% donors with 94 seropositive reports were noted: 79 (84.9% from HCRP-D and 14 (15.1% from VC-D which was statistically significantly higher (P = 0.02. Among seropositive reports, HIV, HBV, HCV, and syphilis accounted for 12 (12.8%, 38 (40.4%, 36 (38.3%, and eight (8.5%, respectively. There was no correlation between the cause of death and seropositivity. A statistically significant decreasing trend in seroprevalence among hospital donors was observed over the years (5.3% in 2011 to 1.4% in 2016; P = 0.004. Two (0.47% of 421 hospital donors with prior negative serology were found to be seropositive. Conclusion: Seropositive rates are significantly higher among hospital donors in spite of medical prescreening compared to nonscreened voluntary donors. Serology should be repeated even when prior reports are available.
... 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 ...
Lee, Sang Wook; Kim, Kyung Soo; Hur, Don
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%)
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.)
Chelli Bouaziz, Mouna; Ladeb, Mohamed Fethi; Chakroun, Mohamed; Chaabane, Skander
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.)
Nielsen, K; Yu, W L
To present a review and to describe the most widely used laboratory tests for serology diagnosis of brucellosis along with their pros and cons. Review the recent literature on brucellosis serology diagnostic tests. The choice of the testing strategy depends on the prevailing brucellosis epidemiological situation and the goal of testing. The 'gold standard' for the diagnosis of brucellosis is isolation and identification of the causative bacterium, a member of Brucella sp. Isolation of Brucella sp. requires high security laboratory facilities (biological containment level 3), highly skilled personnel, an extended turnaround time for results and it is considered a hazardous procedure. Hence brucellosis is generally diagnosed by detection of an elevated level of antibody in serum or other body fluid. This is a presumptive diagnosis as other microorganisms and perhaps environmental factors can also cause increased antibody levels. A large number of serological tests for brucellosis have been devised over the 100+ years since its initial isolation, starting with a simple agglutination test and progressing to sophisticated primary binding assays available today. However, no test devised to date is 100% accurate so generally serological diagnosis consists of testing sera by several tests, usually a screening test of high sensitivity, followed by a confirmatory test of high specificity.
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.
Purpose: This study aimed to determine the frequency rates of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis among blood donors. Methods: Physically fit persons aged 18 – 48 years who came for blood donation at the blood bank unit of the military hospital in Hodeidah, ...
Full Text Available SC Olsen, FM Tatum Infectious Bacterial Diseases of Livestock Research Unit, National Animal Disease Center, Agricultural Research Service, United States Department of Agriculture, Ames, IA, USA Abstract: Brucella suis is a significant zoonotic species 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 livestock, preventing human infection is the primary reason for its emphasis in disease control programs. Although disease prevalence varies worldwide, in areas outside of Europe, swine brucellosis is predominantly caused by B. suis biovars 1 and 3. In Europe, swine are predominantly infected with biovar 2 which is much less pathogenic in humans. In many areas worldwide, feral or wild populations of swine are important reservoir hosts. Like other Brucella spp. in their natural host, B. suis has developed mechanisms to survive in an intracellular environment and evade immune detection. Limitations in sensitivity and specificity of current diagnostics require use at a herd level, rather for individual animals. There is currently no commercial vaccine approved for preventing brucellosis in swine. Although not feasible in all situations, whole-herd depopulation is the most effective regulatory mechanism to control swine brucellosis. Keywords: livestock, transmission, pathogenicity, vaccine, host, infection
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...
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
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.
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.
To briefly report on the large increase in cases of syphilis managed at Auckland Regional Sexual Health Service (ARSHS) in 2015. To raise awareness of syphilis as an emerging significant public health issue in Auckland. A search was conducted of the electronic patient management system at ARSHS for cases of syphilis diagnosed between 1st of January 2015 and 31st of December 2015. Those that fitted the Institute of Environmental Science and Research Ltd (ESR) case definitions for infectious syphilis were included and demographic, clinical and behavioural characteristics were described. One hundred and fifty-two cases of infectious syphilis were managed at ARSHS in 2015, which was a 78% increase from the previous year. The crude incidence rate was 9.5 cases per 100,000 head of population. As in previous years, the majority of cases were male (92%) and most of these were gay or bisexual men (GBM). Thirty-nine percent of cases were asymptomatic and 22% of cases were diagnosed with another STI. Twenty-eight percent of GBM were co-infected with HIV. While the overall number of heterosexual cases was small (n=35); there was a 3.8-fold increase from the numbers diagnosed in 2014 (n=9). The largest number of syphilis cases in recent decades was managed by the Auckland Regional Sexual Health Service in 2015. The increase in numbers is concerning as syphilis can enhance transmission and acquisition of HIV. Furthermore, other countries have noted increases in congenital syphilis cases when incidence in females has increased. It is important that all persons at risk of STI are tested for syphilis and that sexually active GBM in particular are tested regularly. Health professionals need to be made aware of who and when to test, and to refer or discuss any suspected cases with a specialist service as management of syphilis requires significant expertise.
van Rijckevorsel, Gini G. C.; Sonder, Gerard J. B.; Bovée, Lian P. M. J.; Thiesbrummel, Harold F. J.; Geskus, Ronald B.; van den Hoek, Anneke
Background: Since the mid-1990s, sexually transmitted infections (STIs) among men who have sex with men (MSM) have increased and appear to be related to more risky sexual behavior. We compare trends in hepatitis A, acute hepatitis B, and shigellosis with the trends of gonorrhea and infectious
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.
Hasanjani-Roushan Mohammad Reza
Full Text Available Objective: Brucellosis is considered as an important zoonotic and worldwide infection with more than half of million human cases, which it occurs more and more in animals like as wild and live stocks. Sheep, cattle, and goats are animal samples that listed. Symptoms of this disease in human are consisted of: undulant fever, back pains, faint, spondylitis, arthritis and orchitis. This infection causes abortion in livestock, and this point is one of the important economic losses. Reduction in milk production is another problem in this disease too. Materials and Methods: This study is conducted by reviewing of the literatures, which are related to this concern, and also visiting PubMed, ISI and other websites. Results: We must pay heed that most zoonoses are maintained in the animal reservoir. These diseases, such as leptospirosis, Q-fever, brucellosis etc. which among them brucellosis can transfer to human via close contact with infected animals or consumption of unpasteurized dairy. Therefore, eradication of this infection in human population is depended on omission of that in possible methods among animals reservoir. Such methods are like test-slaughter and vaccination of livestock. Hence, vaccination is not alone method for controlling, but it is probably economic one. Conclusion: Nowadays a vaccine which is effective for this disease control in human is not available. Of course presented some different vaccines for this infection in livestock that cleave live attenuated, killed bacteria and sub unit. Therefore, for eradication of this disease some vaccines with more effectiveness protection mid fewer side effects are necessary.
... most common types of viral hepatitis. What Is Hepatitis A? For kids, hep A is the most common ... they recover, it does not come back. Can Hepatitis A Be Prevented? The following will help keep people ...
Ceylan, Abdullah; Köstü, Murat; Tuncer, Oğuz; Peker, Erdal; Kırımi, Ercan
In this case report the authors present an extremely low birth weight premature infant with neonatal brucellosis whose mother had been treated for brucellosis during pregnancy. Infant developed mild respiratory distress syndrome soon after birth. At 2nd wk of postnatal age findings of bronchopulmonary dysplasia were evident and she and her mother were diagnosed to have brucellosis at the same time. After commencement of antibrucellosis therapy and nonspesific treatment for bronchopulmonary dysplasia, infant was completely cured of the symptoms related to both brucellosis and bronchopulmonary dysplasia. The results of the present case and a review of the literature have let to conclude that Brucella might have role in development of prematurity and bronchoplumonary dysplasia. Since discovery of brucella bacilli in early periods of 20th century, fetotoxicity of brucella bacilli seems to increase gradually suggesting an increasing virulance of the bacilli or vanishing host defense of human beings.
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.
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 diagnostic procedures are indispensable. Interpretation of the results of serological syphilis tests often poses problems in actual practice. Apart from possibly inadequate knowledge of the natural histor...
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
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.
Tolaj, Ilir; Mehmeti, Murat; Ramadani, Hamdi; Tolaj, Jasmina; Dedushi, Kreshnike; Fejza, Hajrullah
Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg.
Full Text Available Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg.
Tolaj, Ilir; Mehmeti, Murat; Ramadani, Hamdi; Tolaj, Jasmina; Dedushi, Kreshnike; Fejza, Hajrullah
Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left leg. PMID:25568754
Tolaj, Ilir; Mehmeti, Murat; Ramadani, Hamdi; Tolaj, Jasmina; Dedushi, Kreshnike; Fejza, Hajrullah
Over the past 10 years more than 700 cases of brucellosis have been reported in Kosovo, which is heavily oriented towards agriculture and animal husbandry. Here, brucellosis is still endemic and represents an uncontrolled public health problem. Human brucellosis may present with a broad spectrum of clinical manifestations; among them, vascular complications are uncommon. Hereby we describe the case of a 37-year-old male patient with brucellosis complicated by deep vein thrombosis on his left ...
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.
... 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...
Full Text Available Abstract Background Brucellosis is a multi-system disease that may present with a broad spectrum of clinical manifestations. While hepatic involvement in brucellosis is not rare, it may rarely involve the kidney or display with cardiac manifestations. Central nervous system involvement in brucellosis sometimes can cause demyelinating syndromes. Here we present a case of brucella hepatitis, myocarditis, acute disseminated encephalomyelitis, and renal failure. Case presentation A 26-year-old man presented with fever, ataxia, and dysarthria. He was a shepherd and gave a history of low grade fever, chilly sensation, cold sweating, loss of appetite, arthralgia and 10 Kg weight loss during the previous 3 months. He had a body temperature of 39°C at the time of admission. On laboratory tests he had elevated level of liver enzymes, blood urea nitrogen, Creatinine, Creatine phosphokinase (MB, and moderate proteinuria. He also had abnormal echocardiography and brain MRI. Enzyme-linked immunosorbent assay for IgG and IgM was negative. Standard tube agglutination test (STAT and 2-mercaptoethanol (2-ME titers were 1:80 and 1:40 respectively. Finally he was diagnosed with brucellosis by positive blood culture and the polymerase chain reaction for Brucella mellitensis. Conclusion In endemic areas clinicians should consider brucellosis in any unusual presentation involving multiple organ systems, even if serology is inconclusive. In endemic areas low STAT and 2-ME titers should be considered as an indication of brucellosis and in these cases additional testing is recommended to rule out brucellosis.
Full Text Available Syphilis in pregnancy still remains a challenge despite the availability of adequate diagnostic tests for serological screening and penicillin therapy. We report a case of 2 month old female infant who presented with runny nose, papulosquamous lesions over both palms and soles and perianal erosions since 1 month after birth. Cutaneous examination revealed moist eroded areas in the perianal region and fine scaly lesions over palms and soles. Radiograph of both upper limbs and limbs revealed early periosteal changes in lower end of humerus and lower end of tibia. Diagnosis of early pre-natal syphilis was confirmed by Child′s Serum Rapid Plasma Reagin Antibody test [S.RPR] being positive with 1:64 dilution while that of mother was 1:8.
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
Bari, A.U.; Mehmood, T.; Khan, B.; Malik, N.; Malik, K.Z.; Sukhera, A.M.
Syphilis is a chronic, systemic and sexually transmitted infectious disease affecting most of the organs in the body. A young African man presented with vertigo, unsteadiness of gait and a skin rash suggestive of secondary syphilis. Diagnosis was confirmed on serology and was treated with two shots of long-acting penicillin, following which his symptoms settled. (author)
Mohsenpour, Behzad; Hajibagheri, Katayon; Afrasiabian, Shahla; Ghaderi, Ebrahim; Ghasembegloo, Saeideh
The relationship between blood groups and some infections such as norovirus, cholera, and malaria has been reported. Despite the importance of brucellosis, there is a lack of data on the relationship between blood groups and brucellosis. Thus, in this study, we examined the relationship between blood groups and brucellosis. In this case-control study, the blood groups of 100 patients with brucellosis and 200 healthy individuals were studied. Exclusion criteria for the control group consisted of a positive Coombs Wright test or a history of brucellosis. The chi-square test was used to compare qualitative variables between the two groups. The variables that met inclusion criteria for the regression model were entered into the logistic regression model. A total of 43% patients were female and 57% male; 27% were urban and 73% rural. Regression analysis showed that the likelihood of brucellosis infection was 6.26 times more in people with blood group AB than in those with blood group O (Pblood group and brucellosis. People with blood group AB were susceptible to brucellosis, but no difference was observed for brucellosis infection in terms of blood Rh type.
Full Text Available Brucellosis is primarily an animal disease, and in them it passes as an asymptomatic chronic infection. In humans, brucellosis can be acute, sub-acute and/or chronic disease, but its geographical distribution follows the pattern found in animals. After the last war, the first Brucella cases in Bosnia and Herzegovina were reported in 2000, in returnees, owners of donated livestock. The objective of this paper was to address an increased public health problem regarding brucellosis in Bosnia and Herzegovina and to initiate better cooperation among epidemiologists, veterinarians, microbiologists and infectologists and responsible authorities toward elimination and eradication of this severe disease. Retrospective analysis of Brucella case histories and treatment protocols of all the cases hospitalized in Clinic for Infectious Diseases, University of Sarajevo Clinics Center (CCUS was conducted. All the patients hospitalized between 1 January 2000 and 1 July 2005 were included. The diagnoses were confirmed by laboratory tests, chemo culture or serologically. The Rose Bengal agglutination and ELISA tests were used as laboratory confirmation methods. The number of hospitalized cases over the last 5 years was compared with total number of reported cases in the first 6 months of 2005. The results of this study showed that Brucella infections in humans, compared to other zoonoses, was represented with 11.8%. Brucellosis was the second zoonose in a ranking of zoonotic diseases cases with steady increase in the number of reported cases each year. The number of cases treated in the first 6 months of 2005 already exceeded half of the total number of cases treated in the last 5 years. Human brucellosis is an increasing public health problem in Bosnia and Herzegovina, and it reflects spreading of the same disease in animals. The applied prevention measures have been insufficient, so it is necessary to mobilize all the available resources of human and veterinary
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Brucellosis reactor cattle. 78.7... Restrictions on Interstate Movement of Cattle Because of Brucellosis § 78.7 Brucellosis reactor cattle. (a) Destination. Brucellosis reactor cattle may be moved interstate only for immediate slaughter as follows: (1...
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Brucellosis exposed cattle. 78.8... Restrictions on Interstate Movement of Cattle Because of Brucellosis § 78.8 Brucellosis exposed cattle. Brucellosis exposed cattle may be moved interstate only as follows: (a) Movement to recognized slaughtering...
... 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 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 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 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...
Human Brucellosis in Khartoum State: A Commonly Underdiagnosed Disease. AAA Mustafa, HS Hassan. Abstract. 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 ...
Jan 1, 2014 ... 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.
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.
Prieto, Paula; Imaz, Arkaitz; Calatayud, Laura; García, Olga; Saumoy, María; Podzamczer, Daniel
We describe a series of cases of syphilis with atypical extracutaneous clinical presentation diagnosed in HIV-infected patients. Retrospective observational study. All cases of syphilis diagnosed in HIV-infected patients during the period between June 2013 and June 2016 in a tertiary hospital of the Barcelona metropolitan area were analysed. A total of 71 cases of syphilis were diagnosed, 32 of them presenting with clinical signs or symptoms. Seven of these cases (9.8% of the total and 21.8% of the symptomatic cases) had atypical presentations with extracutaneous involvement: ocular (4), gastric (1), multiple hepatic abscesses (1) and generalised adenopathies (1). Patients were treated with intramuscular or intravenous penicillin and the clinical and serological evolution was good in all of them. Extracutaneous atypical clinical presentations were observed in 21.8% of symptomatic cases of syphilis in HIV+ patients with ocular involvement being the most freqent. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Friedly, G; Zartarian, M V; Wood, J C; Floyd, C M; Peterson, E M; de la Maza, L M
Sera from 290 hospital patients were tested to compare the sensitivity, specificity, and reproducibility of the hemagglutination treponemal test for syphilis (HATTS) with the fluorescent treponemal antibody absorption test (FTA-ABS). Complete agreement was obtained between the methods when 142 syphilitic sera from patients with various stages of syphilis were tested. By using clinical histories, the specificity with 148 nonsyphilitic sera was determined to be 100% for the HATTS and 96.6% (143...
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. Copyright: © Singapore Medical Association
Buçaj, Emine; Puca, Edmond; Namani, Sadie; Bajrami, Muharem; Krasniqi, Valbon; Berisha, Lindita; Jakupi, Xhevat; Halili, Bahrie; Kraja, Dhimiter
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...
Human immunodeficiency virus (HIV), hepatitis B virus (HBV) and Syphilis share similar transmission routes including sexual, blood to blood contact, injecting drug usage and vertical transmission. Infections in pregnancy can result in adverse outcomes including vertical transmission and neonatal death. This study was ...
McPhee, Stephen J.
Reports of cases of primary and secondary syphilis are increasing in the United States, particularly in urban areas and among homosexual men. While primary syphilis poses little diagnostic difficulty, many physicians are unfamiliar with the multisystem nature of secondary lues. Patients who have secondary syphilis commonly present with systemic signs, skin rash, mucous membrane lesions and generalized adenopathy. Less commonly, secondary syphilis may occur as acute meningitis, sensorineural h...
... 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...
Ong, Daini; Bhardwaj, Gaurav; Ong, Jason; Chen, Marcus; Lim, Lyndell L
The objective of this article was to alert general practitioners (GPs) to the increase in ocular syphilis in the context of a worsening epidemic of syphilis among men who have sex with men (MSM). This study used a retrospective case review of ocular syphilis cases that presented to the Royal Victorian Eye and Ear Hospital from January 2015 to August 2016. Twelve patients (19 eyes) were identified, including 11 males. The mean age was 35 years, and seven men were identified as MSM. Two men were diagnosed with human immunodeficiency virus (HIV) infection at presentation. Blurred vision (n = 10) and/or floaters (n = 9) were the most common presenting symptoms. All patients had uveitis as the manifestation of the ocular involvement; however, redness and pain were not universally reported. GPs should be alert to the possibility of ocular syphilis at the time of syphilis diagnosis, particularly among MSM. Urgent ophthalmic referral is required if the patient is found to have new onset visual symptoms.
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.
Full Text Available Introduction. The incidence of syphilis continues to rise in the United States over the past 15 years. This disease process is classified into stages and may present with a coinfection of Human Immunodeficiency Virus (HIV. Case Report. We present a case of a 32-year-old African American male who presented with cutaneous manifestations of secondary syphilis and transaminitis. A workup revealed that the transaminitis was secondary to underlying syphilitic hepatitis in the presence of HIV coinfection. The patient had a reactive rapid plasma reagin (RPR of 1 : 64 TU and reactive Treponema pallidum particle agglutination assay (TPPA. Lab findings showed alkaline phosphate (ALP of 648 unit/L, aspartate aminotransferase (AST of 251 unit/L, and alanine aminotransferase (ALT of 409 unit/L. Conclusion. Syphilitic hepatitis is a recognized entity in the medical literature. It is a manifestation of secondary syphilis and it is more commonly seen in coinfected patients with both syphilis and HIV. Therefore, primary care physicians should keep infectious etiologies (e.g., syphilis and HIV in the differential diagnosis of patients who present with unexplained liver dysfunction in a cholestatic pattern.
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.
Ivars Lleó, M; Clavo Escribano, P; Menéndez Prieto, B
Although the diversity of the clinical manifestations of syphilis is well-known, atypical presentations can also occur. Such atypical presentations are associated with a high risk of transmission as a result of diagnostic confusion and treatment delays owing to the disease's ability to mimic other common skin diseases, deviate from classic clinical presentations, and adopt unique forms. Cases of atypical syphilis have been described most frequently in patients with concomitant human immunodeficiency virus (HIV) infection. Because the incidence of syphilis has been growing over recent years -particularly in patients with HIV co-infection- dermatologists need to be familiar with the less well-known clinical presentations of this venereal disease. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.
Pedersen, Anders Elm; Knudsen, Troels Bygum; Sand, Carsten
Syphilis is still a serious disease with diagnostic difficulties. In the present clinical case a patient had a routine serology screen for syphilis and HIV at a venerology clinic. He had previously presented with anogenital tumors, but the diagnosis was uncertain. A polymerase chain reaction (PCR) analysis was performed in addition to serology, and the diagnosis of syphilis in the secondary stage was confirmed. This case demonstrates how PCR technology can assist in the diagnosis of syphilis at early stages and underlines the importance of syphilis screening in homosexual men presenting with anogenital complaints.
... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service 9 CFR Part 78 [Docket No. APHIS-2011-0005] Brucellosis in Swine; Add Texas to List of Validated Brucellosis- Free States AGENCY... or birth of weak offspring, reduced milk production, and infertility. There is no economically...
ifiable risk factors for the infection in humans in post conflict Northern Uganda. Methods: The study ... human brucellosis control. Keywords: Brucellosis, human, fever, prevalence, Uganda, zoonosis. ..... lution and taxonomy. Vet Microbiol. 2002 ...
Brucella can infect cattle, goats, camels, dogs, and pigs. The bacteria can spread to humans if you come in contact with infected meat or the placenta of infected animals, or if you eat or drink unpasteurized milk ...
Six patients were seen with primary syphilitic chancres on their fingers between 1965 and 1980. Of these, two had bipolar chancres on their fingers and genitals resulting from sexual foreplay. Because syphilis is rarely suspected in such cases diagnostic errors are common.
Dar, N.R.; Ali, L.; Nawaz, M.A.
This case report describes a male patient who presented with generalized, centrally-ulcerated papules with crusts and hypopigmented macules. Initially, differential diagnostic considerations included pityriasis lichenoides but the serology for syphilis was positive and there was a rapid response to penicillin with clearing of the lesions at the end of three weeks treatment. (author)
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
...] Bovine Tuberculosis and Brucellosis; Program Framework AGENCY: Animal and Plant Health Inspection Service... framework being developed for the bovine tuberculosis and brucellosis programs in the United States. This... proposed revisions to its programs regarding bovine tuberculosis (TB) and bovine brucellosis in the United...
... Inspection Service [Docket No. APHIS-2011-0044] Bovine Tuberculosis and Brucellosis; Public Meetings AGENCY... bovine tuberculosis and brucellosis programs in the United States. The meetings are being organized by... tuberculosis (TB) and bovine brucellosis in the United States. In keeping with its commitment to partnering...
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.
Guzmán-Hernández, Rosa Lilia; Contreras-Rodríguez, Araceli; Ávila-Calderón, Eric Daniel; Morales-García, M Rosario
Brucellosis is one of the most frequent zoonosis in most parts of the world. This zoonosis remains a great problem to public health in developing countries, although developed countries have successfully controlled it. Mexico still shows a high annual brucellosis incidence in humans; thus, the country is considered around the world as an endemic brucellosis country. To describe the connection/association between this zoonosis and the current epidemiological situation in the Mexican population. Perusal of research reports, epidemiological studies and veterinarian reviews performed in Mexico, using data bases such as PubMed, Thompson Reuters, Mesh research. The risk of infection by Brucella in Mexico is associated with the consumption of unpasteurized dairy products, mainly fresh cheeses.
Hira, S K; Hira, R S
Painless swelling of the parotid salivary gland was observed in a patient presenting with secondary syphilis. This case is of special interest to venereologists and surgeons as parotitis associated with syphilis may be mistaken for common tumours of the parotid glands. A diagnosis of syphilitic parotitis should be considered in patients presenting with swollen parotid salivary glands in countries where syphilis is prevalent. PMID:6704695
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.
ROMAO, Elen A.; BOLELLA, Valdes R.; NARDIN, Maria Estela P.; HABIB-SIMAO, Maria Lucia; FURTADO, João Marcelo; MOYSES-NETO, Miguel
We present a case of ocular syphilis after a renal transplantation involving progressive vision loss without clinically identifiable ocular disease. Electroretinography showed signs of ischemia, especially in the internal retina. A serological test was positive for syphilis. Lumbar puncture revealed lymphocytic meningitis and a positive serologic test for syphilis in the cerebrospinal fluid. The patient was treated with penicillin, and had a quick vision improvement. In the case of transplant recipients, clinicians should always consider the diagnosis of ocular syphilis in cases with unexplained visual acuity decrement, as this condition may cause serious complications if not treated. PMID:27253748
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.
... chronic conditions, including arthritis. Humans can be treated for brucellosis with antibiotics. The... good cause under 5 U.S.C. 553 for making this action effective less than 30 days after publication in...
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....
Tafesse, Tadesse Bekele; Gebru, Addis Adera; Gobalee, Semgne; Belay, Gosaye Degu; Belew, Molla Teferi; Ataro, Demelash; Ebrahim, Belay Ali; Shebeshi, Getachew Mekonnon; Yimam, Yonas
Blood transfusion is one of the most important therapeutic options of life-saving intervention for recipients who are in diseased or non-diseased conditions with severe blood loss. However, it is associated with certain risks which can lead to adverse consequences that may cause acute or delayed complications and bring the risk of transfusion-transmissible infections including HIV, Hepatitis B & C and Syphilis. So, there might be a fatal risk instead of life saving. This paper aims to provide a comprehensive and reliable tabulation of available data on seroprevalence and diagnosis of HIV, HBV, HCV and Syphilis infections among blood donors. We searched studies reporting the prevalence rate of HIV, HBV, HCV and Syphilis infections among blood donors that were published between October 2009 and June 2016, using databases of PubMed, Scopus, MEDLINE, Elsevier, ScienceDirect, EBSCO, Google Scholar, EMBASE, and Web of Science with keywords: ``Hepatitis C Virus'', ``Hepatitis B Virus'', ``HIV'', ``Syphilis'', ``Seroprevalence'', and ``blood donor''. The seroprevalence of HBV and HCV was highest in African countries as compared to others continents, predominantly the West African region with a range of 10.0% to 14.96% and 1.5% to 8.69%, respectively, while the overall seropositivity of HIV and syphilis infection show a significant declining pattern through successive years globally, even though relatively higher prevalence rate was observed among older age and those with low level of education. There is a problem during selection, diagnoses and screening process in developing nations primarily due to shortage of sensitive screening test kits, highly qualified human resource and lack of proper standard operating procedures and hence, the safety of blood and blood products are the primary threats in the region. Proper clinical diagnosis and screening method should be applied during blood donation and therefore, all the donated blood should be screened properly for
This study sets out to investigate the occurrence of toxoplasmosis, neosporosis and brucellosis among cattle herds in Oyo State, southwest Nigeria. Materials and Methods: A cross-sectional survey to screen for antibodies to Toxoplasma gondii, Neospora caninum and Brucella abortus was conducted among 174 cattle in 17 ...
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.)
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
Piampiano, P.; McLeary, M.; Young, L.W.; Janner, D.
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.)
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 ...
... DEPARTMENT OF THE INTERIOR National Park Service Bison Brucellosis Remote Vaccination, Draft... Brucellosis Remote Vaccination Program, Yellowstone National Park. SUMMARY: Pursuant to the National... the Bison Brucellosis Remote Vaccination Draft Environmental Impact Statement (EIS) for Yellowstone...
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
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.
Aseem K Tiwari
Full Text Available Context: Syphilis is a transfusion transmissible infections and it is mandatory to do serological test for syphilis (STS on all donor blood samples. STS is usually based on detection of antibodies against the cardiolipin-lecithin antigen or against the Treponema-specific antigen. STS with good sensitivity and specificity helps enhance blood safety and consolidation of STS along with other transfusion transmittable infections such as human immunodeficiency virus, hepatitis-C virus, and hepatitis-B virus helps in reducing the errors and enhances efficiency. Aims: This study was designed to evaluate the performance of newly introduced VITROS ® syphilis Treponema pallidum agglutination (TPA assay based on enhanced chemiluminescence principle for its analytical performance for use as a STS on donor blood samples at a tertiary care health center in National Capital Region, India. Materials and Methods: A total of 108 random blood units collected from the donors (both voluntary and replacement donors and 28 known syphilis sero-reactive samples stored at −20°C, were used to evaluate the performance of VITROS ® syphilis TPA assay based on enhanced chemiluminescence assay on VITROS ® ECiQ immunodiagnostics system along with its analytical performance in terms of its sensitivity, precision, cross-reactivity and interference studies. Results: VITROS ® syphilis TPA showed 100% sensitivity and specificity with precision (20 days study of <10% co-efficient of variation. There was no cross-reactivity with other viral and auto-immune antibodies. No interference was observed from endogenous interfering substances like free hemoglobin or fats. Conclusions: Performance of the VITROS ® syphilis TPA assay meets the requirements for its use as STS in blood bank, thus allowing consolidation with other transfusion transmittable infections screening assay on chemiluminescence platform, which is highly valuable for optimizing workflow and efficiency.
Tiwari, Aseem K; Pandey, Prashant K; Dara, Ravi C; Rawat, Ganesh S; Raina, Vimarsh; Bhargava, Richa
Syphilis is a transfusion transmissible infections and it is mandatory to do serological test for syphilis (STS) on all donor blood samples. STS is usually based on detection of antibodies against the cardiolipin-lecithin antigen or against the Treponema-specific antigen. STS with good sensitivity and specificity helps enhance blood safety and consolidation of STS along with other transfusion transmittable infections such as human immunodeficiency virus, hepatitis-C virus, and hepatitis-B virus helps in reducing the errors and enhances efficiency. This study was designed to evaluate the performance of newly introduced VITROS(®) syphilis Treponema pallidum agglutination (TPA) assay based on enhanced chemiluminescence principle for its analytical performance for use as a STS on donor blood samples at a tertiary care health center in National Capital Region, India. A total of 108 random blood units collected from the donors (both voluntary and replacement donors) and 28 known syphilis sero-reactive samples stored at -20°C, were used to evaluate the performance of VITROS(®) syphilis TPA assay based on enhanced chemiluminescence assay on VITROS(®) ECiQ immunodiagnostics system along with its analytical performance in terms of its sensitivity, precision, cross-reactivity and interference studies. VITROS(®) syphilis TPA showed 100% sensitivity and specificity with precision (20 days study) of endogenous interfering substances like free hemoglobin or fats. Performance of the VITROS(®) syphilis TPA assay meets the requirements for its use as STS in blood bank, thus allowing consolidation with other transfusion transmittable infections screening assay on chemiluminescence platform, which is highly valuable for optimizing workflow and efficiency.
John, Kunda; Fitzpatrick, Julie; French, Nigel; Kazwala, Rudovick; Kambarage, Dominic; Mfinanga, Godfrey S; MacMillan, Alastair; Cleaveland, Sarah
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. 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. 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 livestock to humans. These can be achieved
Full Text Available 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.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.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 livestock to humans. These can be
Breast abscess caused by human brucellosis is extremely rare. A 46-year-old woman received the diagnosis of brucellosis with positive serologic tests. Two weeks after the onset of symptoms, the case was complicated by vertebral (L5-S1) abscess which was treated by surgical drainage. One month after the diagnosis of brucellosis, the patient noticed a mass in her left breast. Breast palpation revealed a painless, mobile, round mass that was hypoechoic on ultrasound imaging. Purulent material was obtained by needle aspiration. Besides treatment of the breast abscess by needle aspiration, brucellosis was successfully controlled by prolonged antimicrobial treatment.
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.
Background. Human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis remain major infections around the world. In Angola, about 166 000 individuals are living with HIV, representing a prevalence of 1.98% in adults between 15 and 49 years of age. In a 2003 study in Luanda, 4.5% ...
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.
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
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.
Wyatt, H V
The disease we now know as brucellosis was first discovered in the 1850s in Malta. It came to the attention of British medical officers serving on the island after the Crimean War. It was easy to eliminate the disease in British servicemen, but very difficult to reach Maltese citizens. Over the decades, more and more Maltese were infected asthe control measures introduced were half-hearted and were often not even enforced. The work of Dr Themistocles Zammit showed that infected goats transmitted brucellosis and that banning use of their milk would be effective. Pasteurisation was not introduced onto the island until the 1930s, when the production of cheap, small sterile containers became possible. Transmission was also possible through sexual contact and by inhalation when people were crowded in hot airless conditions. Success in controlling the disease requires sensible, strict control of animals and the elimination of infected ones, but will fail without an educated public willing to help. In Malta, failure to control rogue flocks and small flocks kept for family use led to an epidemic caused by the sale of cheeselets (small cheeses). In 2005, nearly a century after Zammit's discovery, Malta was finally free of brucellosis.
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
Deveci, Özcan; Aslan, Emel; Tekin, Alicem; Toka Özer, Türkan; Tekin, Recep; Bozkurt, Fatma; Çetinçakmak, Mehmet Guli
Brucellosis is a zoonotic infectious disease that can affect many organs and systems and leads to very different clinical circumstances. Brucellosis is rare in association with various infectious agents. Fascioliasis is a zoonotic disease caused by Fasciola hepatica, popularly referred to as a large leaf-shaped liver fluke. This case is a 39-year-old male patient, and his complaints began a week ago, which were chills, fever, abdominal pain, nausea, vomiting, weakness, sweating, and widespread pain. The patient was considered brucellosis in the preliminary diagnosis. Rose Bengal test and Wright test (1/640) were detected as positive. Due to patients having elevated liver enzymes, abdominal ultrasound was taken. A liver lesion was seen with abdominal ultrasound. So, abdominal computed tomography (CT) was taken. The CT result report came in the form that at the left lobe of the liver segment 2, largely necrosis that showed no contrast enhancement, approximately 61x63 mm in size (compatible with fascioliasis) is viewed. The patient's IHA test results, required for fascioliasis, were detected as 1/320 positive. Especially for zoonotic diseases in areas with high endemicity, it should be considered that more than one infectious agent can be present together in high-risk patients.
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
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.
Cokca, F.; Yilmaz-Bozkurt, G.; Azap, A.; Memikoglu, O.; Takeli, E.
A complicated case of brucellosis with some rare features is reported. Brucellosis is a multisystematic disease. However, disseminated brucellosis with cerebral, pulmonary, hematopoietic and splenic involvement in an otherwise healthy patient is a rare event. In this article, we report a case of disseminated brucellosis who was initially diagnosed as myeldoplastic syndrome (MDS) and meningoencephalitis, pulmonary symptoms, and splenic abscess formation occurred thereafter. (author)
... but has not been validated for standard laboratory use. This paper highlights useful samples and, especially the different conventional to more sophisticated molecular techniques for the diagnosis of brucellosis. Keywords: Brucellosis, diagnosis, techniques. African Journal of Biotechnology, Vol. 13(1), pp. 1-10, 1 January, ...
Jan 28, 2014 ... common vole and species isolated from red fox in. 2009 is yet to be officially described (Hofer, 2009). Prevalence of bovine brucellosis varies widely across. Nigeria, and between herds in the same area (Mai et al., 2012). RBPT and MRT were used as screening tests for brucellosis (Samuel, 2002; Cadmus ...
A four-year (2013–2016) retrospective study was carried out to determine the sero-prevalence of human brucellosis in patients at Wasso and Endulen hospitals in Ngorongoro district, Tanzania. Hospitalization records were reviewed and serological positive cases of brucellosis were classified according to: year recorded, ...
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.
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Brucellosis-reactor goats. 309.14 Section 309.14 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... INSPECTION AND CERTIFICATION ANTE-MORTEM INSPECTION § 309.14 Brucellosis-reactor goats. Goats which have...
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 ...
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 ...
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...
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...
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 ...
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.
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.
Full Text Available ... Disease Type 1 (von Gierke) Hemochromatosis Hepatic Encephalopathy Hepatitis A Hepatitis B Hepatitis C Intrahepatic Cholestasis of Pregnancy ( ... Disease Type 1 (von Gierke) Hemochromatosis Hepatic Encephalopathy Hepatitis A Hepatitis B Hepatitis C Intrahepatic Cholestasis of Pregnancy ( ...
... Relations Cyber Infrastructure Computational Biology Equal Employment Opportunity Ethics Global Research Office of Mission Integration and Financial Management Strategic Planning Workforce Effectiveness Workplace Solutions Technology Transfer Intellectual Property Division of AIDS ...
surface antigen (HBsAg), syphilis and HCV from the antenatal records. The data were extracted by two trained assistants. Hepatitis B surface antigen and antibodies to HCV were determined using Clinotech diagnostic enzyme linked immunosorbent assay (ELISA) test kits (Clinotech Laboratories,. USA; batch/lot no. for ...
... reclassification of any Class Free State or area to a lower status if two or more herds are found to have.... APHIS-2009-0083] RIN 0579-AD22 Brucellosis Class Free States and Certified Brucellosis-Free Herds... Class Free States. This action will allow interested persons additional time to prepare and submit...
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
Chow, Eric P F; Callander, Denton; Fairley, Christopher K; Zhang, Lei; Donovan, Basil; Guy, Rebecca; Lewis, David A; Hellard, Margaret; Read, Phillip; Ward, Alison; Chen, Marcus Y
Syphilis rates have increased markedly among men who have sex with men (MSM) internationally. We examined trends in syphilis testing and detection of early syphilis among MSM in Australia. Serial cross-sectional analyses on syphilis testing and diagnoses among MSM attending a national sentinel network of 46 clinics in Australia between 2007 and 2014. 359313 clinic visits were included. The proportion of MSM serologically tested for syphilis annually increased in HIV-negative (48% to 91%; Ptrend syphilis cases were detected in HIV-negative and HIV-positive MSM, respectively. Among HIV-negative MSM, the proportion of infections that were early latent increased from 27% to 44% (Ptrend syphilis correlated with increasing testing coverage (r = -0.87; P = .005) or frequency (r = -0.93; P = .001). Increases in syphilis screening were associated with increased detection of asymptomatic infectious syphilis and relative falls in secondary syphilis for both HIV-positive and HIV-negative MSM nationally, suggesting interruption of syphilis progression. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: email@example.com.
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...
... STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy HIV / AIDS Find an STD testing site near you. ... STDs & Pregnancy Syphilis Trichomoniasis Other STDs See Also Pregnancy HIV / AIDS Find an STD testing site near you. ...
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.
Full Text Available Hepatitis being first manifestation of secondary syphilis is rare. Here in we report a case of 39 years old male who was being treated for hepatitis and presented to us subsequently with itchy maculopapular rash. Venereal disease research laboratory (VDRL titre was 1:16. Treponema pallidum hemagglutination assay (TPHA was positive. He was treated with intramuscular Benzathine Penicillin. His hepatitis improved rapidly.
Full Text Available AIM: We evaluated retrospectively laboratory test results of 520 patient who has brucellosis suspect between 2002-2004 years. METHOD: We use to Rose-Bengal test, Wright agglutination test and the other laboratory results and demographic properties for diagnosis. RESULTS: Rose-Bengal test was positive in 39 patients (11.3 % sera. Wright agglutination test was found positive for 1/160 or higher titers in 18 (3.4% sera. CONCLUSION: Wright agglutination test gave higher positive results in summer and autumn months. [TAF Prev Med Bull 2009; 8(6.000: 485-488
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.
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.
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.
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.
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.
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.
Freqüência das infecções pelo HIV-1, rubéola, sífilis, toxoplasmose, citomegalovírus, herpes simples, hepatite B, hepatite C, doença de Chagas e HTLV I/II em gestantes, do Estado de Mato Grosso do Sul Frequency of HIV-1, rubella, syphilis, toxoplasmosis, cytomegalovirus, simple herpes virus, hepatitis B, hepatitis C, Chagas’ disease and HTLV I/II infection in pregnant women of State of Mato Grosso do Sul
Ernesto Antonio Figueiró-Filho
Full Text Available Objetivou-se avaliar a freqüência das infecções por sífilis, rubéola, hepatite B, hepatite C, toxoplasmose, doença de Chagas, HTLV I/II, herpes simples, HIV-1 e citomegalovírus em gestantes e relacionar a faixa etária das pacientes com a freqüência das infecções. Estudo transversal de 32.512 gestantes submetidas à triagem pré-natal no período de novembro de 2002 a outubro de 2003. As freqüências encontradas foram de 0,2% para infecção pelo vírus HIV-1, 0,03% para rubéola, 0,8% para sífilis, 0,4% para toxoplasmose, 0,05% para infecção aguda pelo citomegalovírus, 0,02% pelo vírus herpes simples, 0,3% para hepatite B (HBsAg, 0,1% para hepatite C, 0,1% para HTLV I/II e 0,1% para doença de Chagas. Houve associação significativa entre faixa etária e infecções por rubéola, citomegalovírus, doença de Chagas e herpes vírus. As freqüências de rubéola, sífilis, toxoplasmose, doença de Chagas e citomegalovírus nas gestantes encontram-se abaixo dos valores descritos na literatura.It was aimed to estimate the frequency of syphilis, rubella, hepatitis B, hepatitis C, toxoplasmosis, Chagas’ disease, HTLV I/II, simple herpes virus, HIV-1 and cytomegalovirus in pregnant women and to evaluate the relationship between age and the frequency of the infections studied. A transversal study of 32,512 pregnant women submitted to pre-natal sreening in the period of November 2002 to October 2003. The frequency of the tried infections among the pregnant women were 0.2% of HIV-1, 0.03% of rubella, 0.8% of syphilis, 0.4% of toxoplasmosis, 0.05% of cytomegalovirus, 0.02% of simple herpes virus, 0.3% of HBsAg, 0.1% of hepatitis C, 0.1% of HTLV and 0.1% of Chagas’ disease. There was significative statistical association between age and prenatal infection of rubella, cytomegalovirus, Chagas’ disease and herpes virus. The rates of frequency of rubella, syphilis, toxoplasmosis, Chagas’ disease and cytomegalovirus in pregnant women
Kassem, Ahmed M; Bartschi, Jared; Carter, Kris K
During 2011-2015 in Idaho, 14 (7%) of 193 persons with early syphilis had repeat syphilis. Persons with repeat infections were more likely to have had secondary or early latent syphilis (P = 0.037) and be infected with HIV (P < 0.001) compared with those having one infection.
Wasley, G D
The importance of syphilis serological tests demands that laboratory reports are reliable. Internal quality control applied to the organisation of a syphilis serology service improves laboratory bench performance and reporting. Described here are internal quality control procedures of a department that serves a genitourinary medicine clinic and conducts 70 000 tests a year to investigate for syphilis.
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 ...
... 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...
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.
Kanmaz, Lutfi; Karakeçili, Faruk; Çıkman, Aytekin; Özçiçek, Fatih; Karavaş, Erdal
Brucellosis is a common zoonotic infection caused by Brucella bacteria. Brucella infections are usually presented with various clinical manifestations, and often accompanied by multiple organ involvements. In this article, we present a case of brucellosis with suppurative parotitis involvement accompanied by parotid abscess and fistula in a 60-year-old male patient. According to the literature review we conducted regarding complications of brucellosis, our case is the first case reported in the literature. Significant improvement in patient's suppurative parotitis and clinical findings was observed at the fifth week of combination antibiotic therapy. Patient's complaints resolved completely after eight weeks of treatment.
Kujat, C.; Neidl, K.; Mueller-Leisse, C.; Berg, D.
As shown in the case reports, bone scintigraphy plays an important part considering the diagnosis of chronic brucellosis, an infectious disease which occurs rarely in Germany. To establish the diagnosis knowledge of symptoms and signs of the disease is necessary. Chronic brucellosis may occur in each organ, ionvolving especially bones and joints. The disease may manifest as spondilytis (especially of the lumbar spine) or arthritis of large joints, sacroiliacal joints or costotransverse joints. Chronic brucellosis has to be considered if a bone scan reveals a typical pattern even without a typical history. (orig.) [de
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.
Akkoyunlu, Muhammed Emin; Akkoyunlu, Yasemin; Hakyemez, Ismail Necati; Erboy, Fatma; Arvas, Gulhan; Aslan, Turan
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.
Qolohle, D C; Hoosen, A A; Moodley, J; Smith, A N; Mlisana, K P
OBJECTIVE--The aim of this study was to assess the prevalence of syphilis, human immunodeficiency virus (HIV), and hepatitis B virus (HBV) infections in women at the time of delivery, and to determine the seroconversion rates for syphilis and HIV infections from initial booking visit to delivery. SETTING--The labour ward of a typical tertiary hospital in a developing country and serving an indigent African population. METHOD--Four hundred and eighteen women presenting in labour were randomly selected and informed consent obtained for serological testing for syphilis and HBV infections in umbilical cord blood samples. The specimens were then given a study number, the gestational ages recorded and anonymously tested for HIV infection. RESULTS--Of the 191 women who had antenatal care, 13 (6.8%) were HIV antibody positive at the initial "booking" visit. An additional 4 were found to be HIV antibody positive at the time of delivery resulting in a seroconversion rate of 2.2%. The seroconversion rate for syphilis at the time of delivery was 2.7%. Hepatitis B surface antigens were detected in only 2 women, one of whom was antigen positive. CONCLUSION--The high seroconversion rates for both syphilis and HIV infection in pregnancy justifies re-screening for these conditions in endemic areas such as ours. PMID:7744414
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.
this study was to determine the sero-prevalence of brucellosis in Jazan Province, Saudi Arabia and assess the ... Conclusion: These results indicate the need for a vaccination program in Jazan Province and for public .... from blue to yellow.
Serefhanoglu, Kivanc; Taskin, Abdullah; Turan, Hale; Timurkaynak, Funda Ergin; Arslan, Hande; Erel, Ozcan
Oxidative stress can be defined as an increase in oxidants and/or a decrease in antioxidant capacity. We aimed to determine total antioxidant capacity (TAC), total peroxide, malondialdehyde and catalase levels in plasma samples, and calculation of oxidative stress index (OSI) in patients with brucellosis to evaluate their oxidative status using a novel automated method. Sixty-nine patients with brucellosis and 69 healthy control subjects were included in the present study. Plasma levels of total peroxide and malondialdehyde were significantly increased in patients as compared with healthy controls (p0.05). OSI level was significantly increased in patients as compared with healthy controls (pantioxidants were decreased in patients with brucellosis. Oxidative stress was increased in patients with brucellosis.
Full Text Available Oxidative stress can be defined as an increase in oxidants and/or a decrease in antioxidant capacity. We aimed to determine total antioxidant capacity (TAC, total peroxide, malondialdehyde and catalase levels in plasma samples, and calculation of oxidative stress index (OSI in patients with brucellosis to evaluate their oxidative status using a novel automated method. Sixty-nine patients with brucellosis and 69 healthy control subjects were included in the present study. Plasma levels of total peroxide and malondialdehyde were significantly increased in patients as compared with healthy controls (p0.05. OSI level was significantly increased in patients as compared with healthy controls (p<0.001. In conclusion, oxidants were increased and antioxidants were decreased in patients with brucellosis. Oxidative stress was increased in patients with brucellosis.
Diarra, A; Kouriba, B; Baby, M; Murphy, E; Lefrere, J-J
Good data on background seroprevalence of major transfusion transmitted infections is lacking in Mali. We gathered data on the rate of positive donations of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) and syphilis among blood donations in Mali for calendar year 2007. Donations with repeatedly reactive results on screening enzyme immunoassay (EIA) were considered to be seropositive. Rate of positive donations per blood unit collected was 2.6% for HIV, 3.3% for HCV, 13.9% for hepatitis B surface antigen (HBsAg) and 0.3% for syphilis. For HIV, HBsAg and syphilis, rate of positive donations was significantly (pdonations from replacement donors than those from volunteer donors, while HCV rate of positive donations was similar in the two groups. Rate of positive donations was also significantly (p<0.0001) lower in blood units from regular than from first-time donors. These data reinforce WHO recommendations for increasing the number of regular, volunteer blood donors in Africa.
Smita S. Mangalgi
Full Text Available Brucellar chorea is a rare and unusual presentation of brucellosis. We would hereby like to report a case of Brucellar chorea. The purpose of reporting this case is to create awareness about the neuropsychiatric manifestations of brucellosis. Neurobrucellosis should be considered as one of the differential diagnoses in patients having long-standing fever with neurological manifestations, especially in endemic zones like India.
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.
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.
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.
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 brucellosis in 6.4%. The most common treatment was aminoglycosides plus rifampicin (42.2% of cases). Complication rates decreased if treatment was started within 2 weeks of presentation (p brucellosis in pregnancy reported in the literature. Brucella presents adverse obstetric outcomes including fetal and maternal/neonatal death. Cases with unexplained spontaneous abortion should be investigated for brucellosis. Prompt treatment is paramount to decrease the devastating outcomes. Copyright © 2015. Published by Elsevier Ltd.
Oseguera Montiel, David; Frankena, Klaas; Udo, Henk; Keilbach Baer, Nícola Maria; van der Zijpp, Akke
Brucellosis is a major constraint for small-scale goat farming systems in Mexico. This study estimated the prevalence of testing positive to brucellosis and identified and quantified risk factors in goats from small-scale farms of Michoacán that had participated in a brucellosis campaign (i.e. vaccination, serological testing, culling and awareness) and of Jalisco that had negligible brucellosis campaign participation. A cross-sectional serological survey was conducted among 1,713 goats of 83 flocks. The prevalence of testing positive to brucellosis was higher (38%) in Jalisco than in Michoacán (11%). Logistic regression analysis indicated that goats from Michoacán had lower odds to test positive for brucellosis (odds ratio (OR) = 0.32, 95% confidence interval (CI) 0.21-0.48) compared to goats from Jalisco. Goats in zero-grazing systems had lower odds than goats in grazing systems (OR = 0.22, 95% CI 0.09-0.57). When goats were kept in pens with low density (0.002 to 0.22 goat/m(2)), odds was lower (OR = 0.44, 95% CI 0.28-0.67) compared to goats kept in pens with higher density (0.23 to 1 goat/m(2)). Odds was higher for testing positive when farmers bought goats from goat traders (OR = 1.82, 95% CI 1.15-2.87) compared to farmers who did not. If scavenger poultry had access to goat pens, the odds was half (OR = 0.52, 95% CI 0.33-0.83) of those where poultry had no access. Regular disinfection of the pen reduced the odds (OR = 0.66, 95% CI 0.44-0.99) compared to where disinfection was not regular. The brucellosis control campaign was effective in reducing brucellosis seropositivity.
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.
booking' visit of 500 antenatal patients at the King Edward VIII Hospital,. Durban. The prevalence of active.syphilis was 7,4%. T.he ra.pid plasma reagent test not only had a high biological false-positive rate at 11,8%, but also ...
INTRODUCTION. Syphilis, caused by infection with Treponema pallidum, is a muco-cutaneous sexually transmitted infection (STI) with high infectivity in the early stages. It may also be passed transplacentally from the ninth week of gesta- tion onwards1. The basic pathology in all stages is vas- culitis2.Untreated maternal ...
in incomplete abortions, and there were 2 (0,96%) ... Congenital syphilis is a significant health problem in South ... and the effectiveness of the programme in terms of ... Subjects and methods ... may be that the admitting staff failed adequately to ... Population Development No notifications were received from areas not merr.
Yang, Li-Gang; Tucker, Joseph D; Yang, Bin; Shen, Song-Ying; Sun, Xi-Feng; Chen, Yong-Feng; Chen, Xiang-Sheng
Syphilis cases have risen in many parts of China, with developed regions reporting the greatest share of cases. Since syphilis increases in these areas are likely driven by both increased screening and changes in sexual behaviours, distinguishing between these two factors is important. Examining municipal-level primary syphilis cases with spatial analysis allows a more direct understanding of changing sexual behaviours at a more policy-relevant level. In this study we examined all reported primary syphilis cases from Guangdong Province, a southern province in China, since the disease was first incorporated into the mandatory reporting system in 1995. Spatial autocorrelation statistics were used to correlate municipal-level clustering of reported primary syphilis cases and gross domestic product (GDP). A total of 52,036 primary syphilis cases were reported over the period 1995-2008, and the primary syphilis cases increased from 0.88 per 100,000 population in 1995 to 7.61 per 100,000 in 2008. The Pearl River Delta region has a disproportionate share (44.7%) of syphilis cases compared to other regions. Syphilis cases were spatially clustered (p = 0.01) and Moran's I analysis found that syphilis cases were clustered in municipalities with higher GDP (p = 0.004). Primary syphilis cases continue to increase in Guangdong Province, especially in the Pearl River Delta region. Considering the economic impact of syphilis and its tendency to spatially cluster, expanded syphilis testing in specific municipalities and further investigating the costs and benefits of syphilis screening are critical next steps.
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... DEPARTMENT OF THE INTERIOR National Park Service Bison Brucellosis Remote Vaccination, Draft Environmental Impact Statement, Yellowstone National Park, Wyoming ACTION: Reopening of public comment period... Brucellosis Remote Vaccination Draft Environmental Impact Statement. The original comment period was from 28...
Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua
Abstract Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs). We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40–49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time. By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P HIV prevalence increased for older age clients (1.3%–2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%–0.8%, P sex with men or intravenous drug use. Clients preferred LTFSWs, especially older clients (81.9%). Our results suggest that HIV and syphilis infections are increasing in older clients who prefer LTFSWs. HIV and syphilis are likely increasing in Guangxi Province through heterosexual transmission
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.
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.
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.
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
Melzer, Falk; Wareth, Gamal; El-Adawy, Hosny; Henning, Klaus; Pletz, Mathias W.; Heller, Regine; Kariuki, Samuel; Fèvre, Eric; Neubauer, Heinrich
During 2014–2015, patients in northeastern Kenya were assessed for brucellosis and characteristics that might help clinicians identify brucellosis. Among 146 confirmed brucellosis patients, 29 (20%) had negative serologic tests. No clinical feature was a good indicator of infection, which was associated with animal contact and drinking raw milk. PMID:27662463
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...
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.
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
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.
Full Text Available Background: Crimean-Congo hemorrhagic fever (CCHF is a fatal zoonotic viral disease caused by infection with a tick-borne virus of the genus Nairovirus. In this study, we investigated the incidence of brucellosis in patients diagnosed with CCHF.Methods: Overall, 169 patients hospitalized with an initial diagnosis of CCHF were included in 2011 in Tokat/ Turkey. Immunoglobulin M (IgM antibodies and/or PCR results were used in the laboratory diagnosis of CCHF, while plate and standard tube agglutination (STA tests were used to diagnose brucellosis.Results: Overall, 120 patients (79% with positive PCR tests were diagnosed with CCHF. Five (4.16% were also diagnosed with brucellosis based on the positive plate and STA test results. Four patients (2.36% had negative CCHF PCR and positive STA test results.Conclusion: Brucellosis and CCHF can mimic each other and that all patients with CCHF or brucellosis should be screened for both conditions.
Scythes, John B; Jones, Colman M
This review argues that syphilis has been underdiagnosed and undertreated, a problem that goes back to the beginning of the Wassermann era, and indeed long before. Non-treponemal tests do not detect the larger pool of persons with latent syphilis, the immunological consequences of which have not been systematically investigated in the context of HIV infection and progression to AIDS. Recent efforts to confirm the prevalence of syphilis in high-risk patients by reverse sequence screening, i.e. using a treponemal test first, as the screening test, have revealed untreated syphilis at higher rates than expected. Further testing using PCR discovered even more previously undetected cases. We suggest that latent syphilis is a chronic active immunological condition that drives the AIDS process and cannot be managed with the older Wassermann-based algorithm, and that non-treponemal tests have failed to associate syphilis with immune suppression since this screening concept was developed in 1906. In light of the overwhelming association between a past history of syphilis and HIV seroconversion, more sensitive tools, including recombinant antigen-based immunological tests and direct detection (PCR) technology, are needed to adequately assess the role of latent syphilis in persons with HIV/AIDS. Repeating older syphilis reinoculation studies may help establish a successful animal model for AIDS, and resolve many paradoxes in HIV science.
Olt, Serdar; Ergenç, Hasan; Açıkgöz, Seyyid Bilal
Here we wanted to investigate predictive value of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in the diagnosis of brucellosis. Thirty-two brucellosis patients diagnosed with positive serum agglutination test and thirty-two randomized healthy subjects were enrolled in this study retrospectively. Result with ROC analyzes the baseline NLR and hemoglobin values were found to be significantly associated with brucellosis (P = 0.01, P = 0.01, resp.). Herein we demonstrated for the first time that NLR values were significantly associated with brucellosis. This situation can help clinicians during diagnosis of brucellosis.
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.
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
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Full Text Available ... Hemochromatosis Hepatic Encephalopathy Hepatitis A Hepatitis B Hepatitis C Intrahepatic Cholestasis of Pregnancy (ICP) Jaundice In Newborns ... are the common causes of cirrhosis? Hepatitis B & C Alcohol-related Liver Disease Non-alcoholic Fatty Liver ...
Sandvik, Anniken; Lie, Anne Kveim
In the period from 1891 - 1910, around 2000 patients with syphilis were admitted to the Department of Dermatology, Oslo University Hospital, Rikshospitalet. The head of the department, Cæsar Boeck (1845 - 1917), believed in allowing the disease to take its natural course and withheld treatment. He made detailed notes of the diagnosis and the clinical course of the disease for all his patients. Boeck's material is unique, and forms the basis for our current knowledge about the prognosis and course of syphilis infections. In 1928, the patients were scrutinised by Boeck's successor in the Department of Dermatology, Edvin Bruusgaard (1869 - 1934), and later by Trygve Gjestland (1911 - 1993). Gjestland's doctoral thesis from 1955 has remained as «The Oslo study of untreated syphilis.» This article presents a medical historical background for the study. Bruusgaard's and Gjestland's research was important for the Tuskegee Study in the USA, and the Oslo study gave implicit support to this research project, which posterity has emphatically condemned as ethically unacceptable.
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
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.
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. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org
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
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.
Full Text Available Abstract Background Prisons are known to be high-risk environments for the spread of bloodborne and sexually transmitted infections. Prison officers are considered to have an intermittent exposure potential to bloodborne infectious diseases on the job, however there has been no studies on the prevalence of these infections in prison officers in Ghana. Methods A national multicenter cross-sectional study was undertaken on correlates of human immunodeficiency virus (HIV, hepatitis B virus (HBV, hepatitis C virus (HCV, and syphilis infections in sample of prison inmates and officers from eight of ten regional central prisons in Ghana. A total of 1366 inmates and 445 officers were enrolled between May 2004 and December 2005. Subjects completed personal risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for presence of antibodies to HIV, HCV and Treponema pallidum; and surface antigen of HBV (HBsAg. These data were analyzed using both univariate and multivariate techniques. Results Almost 18% (1336 of 7652 eligible inmates and 21% (445 of 2139 eligible officers in eight study prisons took part. Median ages of inmates and officers were 36.5 years (range 16–84 and 38.1 years (range 25–59, respectively. Among inmates, HIV seroprevalence was 5.9%, syphilis seroprevalence was 16.5%, and 25.5% had HBsAg. Among officers tested, HIV seroprevalence was 4.9%, HCV seroprevalence was 18.7%, syphilis seroprevalence was 7.9%, and 11.7% had HBsAg. Independent determinants for HIV, HBV and syphilis infections among inmates were age between 17–46, being unmarried, being illiterate, female gender, being incarcerated for longer than median time served of 36 months, history of homosexuality, history of intravenous drug use, history of sharing syringes and drug paraphernalia, history of participation in paid sexual activity, and history of sexually transmitted diseases. Independent determinants for HIV, HBV, HCV and syphilis
Full Text Available OBJECTIVE: The goal of this study was to understand the knowledge about AIDS, identify the correlates and determine the prevalence of HIV infection, syphilis, HCV among migrant workers in Zhejiang, China. METHODS: A cross-sectional study using face-to-face anonymous questionnaire interviews was conducted and blood samples were collected for HIV, syphilis and Hepatitis C infection screening. RESULTS: 17,377 (92.8% of 18,730 migrant workers approached were interviewed. Among 17,377 participants, the HIV/AIDS knowledge rate was 66.2%. A total of 12,694 (73% of the participants reported having ever had sexual intercourse, with 30.1% of single participants reporting having had sexual intercourse. Among those respondents with sexual experiences, 7.5% admitted they had two or more sexual partners and 4.9% reported having had sex with casual (unpaid partners in the previous 12 months, whilst 3.7% had paid for sex. More than half of those who had paid for sex (59.4% had not used a condom every time in their sexual acts with the sex workers. Multiple logistic regression analysis indicated that high risk sexual behavior (defined as sex with a casual or commercial sex partner without using a condom consistently was associated with being divorced or widowed (P<0.05 for single; male gender; shorter duration of stay in Zhejiang; working in factory, market or domestic service (P<0.05 for odd job; having a province of origin inside Zhejiang; and drug use. The prevalence of HIV and HCV infections were 0.02% (95% CI: 0.01%-0.06% and 0.40% (95%CI: 0.31%-0.51%, respectively. The prevalence of syphilis among those who were sexually active was 0.55% (95% CI: 0.43%-0.70%. Risk factors for syphilis included shorter duration of stay in Zhejiang, ethnic minority status, being divorced or widowed and having had multiple sex partners. CONCLUSIONS: Much greater efforts are needed to promote safer sex, and programs for the control of syphilis need to be tailored for migrant
Kenyon, Chris; Tsoumanis, Achilleas; Osbak, Kara; Van Esbroeck, Marjan; Florence, Eric; Crucitti, Tania; Kestens, Luc
We aimed to asses if there are differences in the clinical presentation and immune response of repeat as compared with initial syphilis. Prospective study: we prospectively recruited all patients with a new diagnosis of syphilis and tested their plasma for a range of cytochemokines and rapid plasma reagin (RPR) at baseline pretreatment and 6 months following therapy. Retrospective study: we compared RPR assay response kinetics between initial and repeat syphilis in persons attending our HIV/STI clinic from 1993 to 2016. Prospective study: a total of 91 individuals, 36 with initial syphilis and 55 with repeat syphilis, were included in the study. At baseline visit, those with initial syphilis were more likely to be symptomatic and have higher levels of interleukin-10 than repeaters. At baseline, median RPR titres were higher in the repeat than the initial infection groups. Repeaters were less likely than those with initial infections to serorevert to a negative RPR and be serofast (<4-fold RPR titre decline) at 6 months.Retrospective study: syphilis was diagnosed in 1027/43 870 individuals tested. At diagnosis, repeaters had higher RPR titres and a stepwise increase in RPR titre with number of syphilis episodes. They had a different RPR test response kinetic: they were less likely to be serofast and to serorevert than initial syphilis at 6 and 12 months. No individuals with four or more previous episodes of syphilis seroreverted. Repeat syphilis has a different clinical presentation and immunological response to initial infection. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
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.
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....
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 a...
Syphilis and HIV infections among pregnant women attending antenatal clinics in Republic of Congo. ... Introduction: HIV and syphilis during pregnancy remain a public health concern especially in developing countries. Pregnant women ... Marital status and sentinel site location were a risk factor associated with. HIV and ...
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.
Kenyon, Chris Richard; Tsoumanis, Achilleas
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: R 2 = 0.54, P < 0.001; 2008: R 2 = 0.41, P < 0.001 and 40–44-year-olds: 1990–99: R 2 = 0.42, P < 0.001; 2008: R 2 = 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. PMID:27069710
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 ...
Apr 4, 2000 ... Objective: To assess the extent of syphilis seropositivity in pregnant women, identify the risk factors associated with it and re-evaluate the need for routine antenatal care screening for syphilis. Design: Prospective cross-sectional study. Setting: Three teaching hospitals of Addis Ababa University Faculty of ...
Mar 1, 2014 ... Introduction. Sexually transmitted infections (STIs) are a serious public health problem in developing countries, including. Ethiopia (1). Syphilis is STIs caused by the spirochete. Treponema pallidum and constitutes a major public health problem worldwide (2). Syphilis is an important cause of morbidity and ...
... 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 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 ...
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.
Background: Untreated maternal syphilis is strongly associated with adverse birth outcomes, especially in women with high titre syphilis. The WHO recommends routine serological screening in pregnancy. Some workers have advised a reappraisal of this practice, having demonstrated low sero-prevalence in their antenatal ...
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 ...
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 ...
Knudsen, Andreas; Benfield, Thomas; Kofoed, Kristian
BACKGROUND: Little is known about cytokine responses to syphilis infection in HIV-1-infected individuals. METHODS: We retrospectively identified patients with HIV-1 and Treponema pallidum coinfection. Plasma samples from before, during, and after coinfection were analyzed for interleukin (IL)-2, IL......-4, IL-6, IL-8, IL-10, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha. RESULTS: Thirty-six patients were included. IL-10 levels increased significantly in patients with primary or secondary stage syphilis from a median of 12.8 pg/mL [interquartile range (IQR), 11.0-27.8] before...... infection to 46.7 pg/mL (IQR, 28.4-78.9) at the time of diagnosis (P = 0.027) and decreased to 13.0 pg/mL (IQR, 6.2-19.4) after treatment of syphilis (P syphilis in patients with primary or secondary stage syphilis (median 3.9 pg...
Yang Cheng; Yang Xinghui; Wang Man
Objective: To investigate the CT features of the central nervous system in congenital syphilis infant. Methods: CT findings of central nervous system in 11 infants with clinically proved congenital syphilis were analyzed retrospectively. Results: CT findings in 10 syphilis neonates were diffuse hypodense lesions in the white matter, with subarachnoid and intra-encephalic hemorrhage in 3 and 1 cases, respectively. One 2-month-old syphilis infant case and 5 cases of follow-up after 45 days to 6 months of treatment demonstrated bilateral widened sulci and cistern with enlarged ventricles in 3 of them. Conclusion: CT findings of the central nervous system in congenital syphilis infant are similar to those of hypoxic-ischemic encephalopathy in neonates, and extra-encephalic hydrocephalus or brain hypogenesis ensues later on. (authors)
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 ...
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.
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.
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.
the sero-prevalence of bovine brucellosis in four districts of Jijjiga Zone, eastern. Ethiopia. ... animals and herds given the extensive production system prevailing in the area which may allow contact ... due to abortion, infertility and reduction in milk production. In addition, the ..... Epidemiology and surveillance. In: Nielsen, K.
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 ...
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 ...
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.
This document is a travel report of a three-week mission (from October 13 to November 1, 1991) to Indonesia within the framework of ''The implementation of ELISA technology for the sero-diagnosis of important livestock diseases''. The mission evaluated the implementation of ELISA technology at the Regional Laboratories and its role in the surveillance and control of bovine brucellosis
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
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
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
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
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 ...
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
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; Yu, Hongjie
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.
Brucellosis caused by Brucella species is a disease of economic and public health importance worldwide. Although present in Nigeria, there is a paucity of information regarding the occurrence of the disease in small ruminants in Nasarawa State. A cross-sectional study was therefore carried out to determine the ...
Abstract. 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 ...
Brucellosis is a zoonotic infection mainly affecting farm animals ... and although it is a notifiable disease in South Africa (SA), as in many .... laboratory workers were followed up by ... livestock, and having adequate protocols in ... Map of SA indicating outbreaks of Brucella abortus in animals, 2010 - 2014 (courtesy of the.
Fouskis, Ioannis; Sandalakis, Vassilios; Christidou, Athanasia; Tsatsaris, Andreas; Tzanakis, Nikos; Tselentis, Yannis; Psaroulaki, Anna
Brucellosis remains a disease that is very difficult to control and eradicate in Greece. Information exchange between the responsible authorities is crucial in order to support public health infrastructure in the sense of the 'One-Health' strategy model. The data for 2007-2012 were retrieved from the notifiable diseases system and analysed statistically for correlations between human brucellosis cases and the disease in small ruminants. Disease-related risk factors were also estimated with parallel exploitation mapping software. In Greece the dominant strain for brucellosis is Brucella melitensis. The average incidence in Greece was estimated to be 1.43/100,000. The majority of human cases were males (67.60%). The age distribution of brucellosis patients differs significantly between men and women. Brucellosis in male patients was related to high risk jobs and animal contact, while brucellosis in females was related to recent consumption of dairy products. Seasonality of the disease was different in relation to the European countries an observation attributed to the traditional customs. There was a statistically significant difference in human brucellosis incidence between the eradication and vaccination zones. The updated information on brucellosis in Greece revealed differences in seasonality and transmission patterns. A more active cooperation between the involved public health-related sectors should be followed in order to effectively fight brucellosis as there are still foci of brucellosis in Greece.
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.
F. WADOOD, M. AHMAD, A. KHAN1, S. T. GUL1 AND N. REHMAN
Full Text Available Rose Bengal Plate test (RBPT and Serum Agglutination test (SAT were used to monitor the seroprevalence of brucellosis in horses in and around Faisalabad, Pakistan. Sera were screened by RBPT and positive or doubtful sera were further processed by SAT for confirmation. The overall seroprevalence of brucellosis in horses was 20.7 and 17.7% by RBPT and SAT, respectively. Source wise seroprevalence of brucellosis was 19.8, 25.5, 2.9 and 0% in horses of Remount Area Faisalabad, Remount Area Toba Tek Singh, private and Livestock Management Department University of Agriculture Faisalabad, respectively. Sex wise seroprevalence in horses was 9.67 and 17.7% in male and female, respectively. In relation to age, seroprevalence was 12.9, 16.5, 14.8 and 20.6%, in horses of 1-5, 6-10, 11-15 and above 15 years of age, respectively. Highest seroprevalence was recorded in horses of above 15 years of age. Depending upon the body condition, the seroprevalence was 9.7, 13, and 20% in poor fair, and good body conditioned horses, respectively. Seroprevalence of brucellosis on the basis of parity was 19.2, 20.9, 18.7, 16.6, and 21.1% in 0, 1, 2, 3 and above 3 foaling females, respectively. Prevalence of brucellosis in different breeds of horses was 22.4, 17.1, 25.7 and 0.0% in Desi, Thoroughbred, Crossbred and Arabian horses, respectively. However, statistically, in relation to various factors like source, sex, body condition, parity and breed of horses, a non significant difference was observed among various groups. Statistically a significant difference (P<0.001 in seroprevalence was observed with respect to age, only.
Full Text Available A comparative analysis of the sensitivity and specificity of immunoblotting against other non-treponemal and treponemal reactions was carried out in 215 patients with early forms of syphilis. A high diagnostic efficiency of immunoblotting in patients with early latent syphilis was established. It was found that only in case of primary syphilis, immunoblotting is inferior to Immunofluorescence reaction; this test can be used for differential diagnosis between hidden syphilis and false positive reactions to syphilis.
Dmitrieva, S.D.; Gurova, S.V.; Kovalenko, S.F.; Popova, G.N.; Legostaev, V.M.
The possibilities of roentgenoendoscopic diagnostics of stomach syphilis are demonstrated by disease cases. Three forms of the stomach syphilis: tumor-like, infiltration and ulcerous ones are identified both roentgenological and endoscopic. Any infiltration process in the stomach of a young patient determined roentgenological should be reasoned as a sign of alterness relative to the syphilis. To perform endoscopic diagnosis of the stomach syphilis is easier than roentgenological one. The final syphilis diagnosis is impossible without blood test [ru
..., it causes loss of young through spontaneous abortion or birth of weak offspring, reduced milk production, and infertility. There is no economically feasible treatment for brucellosis in livestock. In... for classifying States or portions of States according to the rate of Brucella abortus (B. abortus...
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.
Full Text Available ... A Hepatitis B Hepatitis C Intrahepatic Cholestasis of Pregnancy (ICP) Jaundice In Newborns Diseases of the Liver ... A Hepatitis B Hepatitis C Intrahepatic Cholestasis of Pregnancy (ICP) Jaundice In Newborns Diseases of the Liver ...
... Home A-Z Health Topics Viral hepatitis Viral hepatitis > A-Z Health Topics Viral hepatitis (PDF, 90 ... liver. Source: National Cancer Institute Learn more about hepatitis Watch a video. Learn who is at risk ...
... B Entire Lesson Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For Veterans and the Public Veterans ... in their blood (sometimes referred to as the hepatitis B viral load) and an unusually high level of a ...
Verghese, Valsan P; Hendson, Leonora; Singh, Ameeta; Guenette, Tamara; Gratrix, Jennifer; Robinson, Joan L
There are minimal neurodevelopmental follow-up data for infants exposed to syphilis in utero. This is an inception cohort study of infants exposed to syphilis in utero. We reviewed women with reactive syphilis serology in pregnancy or at delivery in Edmonton (Canada), 2002 through 2010 and describe the neurodevelopmental outcomes of children with and without congenital syphilis. There were 39 births to women with reactive syphilis serology, 9 of whom had late latent syphilis (n = 4), stillbirths (n = 2) or early neonatal deaths (n = 3), leaving 30 survivors of which 11 with and 7 without congenital syphilis had neurodevelopmental assessment. Those with congenital syphilis were all born to women with inadequate syphilis treatment before delivery. Neurodevelopmental impairment was documented in 3 of 11 (27%) infants with congenital syphilis and one of 7 (14%) without congenital syphilis with speech language delays in 4 of 11 (36%) with congenital syphilis and 3 of 7 (42%) without congenital syphilis. Infants born to mothers with reactive syphilis serology during pregnancy are at high risk for neurodevelopmental impairment, whether or not they have congenital syphilis, so should all be offered neurodevelopmental assessments and early referral for services as required.
Full Text Available The purpose of this study was to study the change in the content of the most active cytokines (interleukins 6 and 10 during the formation of the immune response in patients with latent early syphilis, as well as to study the possible relationship between the concentrations of these cytokines and the duration of the disease. In 50 patients with early latent syphilis, the concentration of interleukins 6 and 10 in serum was studied. The serum level of interleukins was studied by the enzyme immunoassay. A statistically significant increase in the concentration of interleukin 6 in the blood of patients with latent syphilis and decrease in the interleukin 10 concentration in comparison with healthy people was established. At the same time, in patients with latent syphilis with term of infection for more than 1 year, interleukin 10 has been expressed, as compared with healthy people and, especially, with patients with syphilis with a duration of infection of up to 1 year. Along with this, a lower degree of increase in the concentration of interleukin 6 in patients with latent syphilis with a duration of infection over 1 year has been established, as compared with patients with latent syphilis with a term of infection up to 1 year, against the background of its increased concentration as compared with a group of healthy individuals.
Full Text Available Serological tests represent a valuable tool for the diagnosis and monitoring the syphilis treatment. Non-treponemal antibodies are nonspecific to detect the infection, but antibody titers are used to monitor the effects of syphilis treatment. A definitive diagnosis of syphilis is made using treponemal tests, because they detect specific antibodies to the treponemal strains or treponemal fragments, which cause syphilis. These tests may remain reactive for years, sometimes for life, regardless of the therapy outcome. Even after successful treatment, approximately 85% of patients remain positive for treponemal antibodies for the rest of their lives. However, treponemal tests cannot differentiate past infections from a current infection. Therefore, we use a combination of specific and non-specific tests, the two most frequently used diagnostic algorithms. The traditional algorithm begins with a non-treponemal assay, and if it is positive, the treponemal test is done. A positive treponemal test indicates syphilis. The reverse serology algorithm detects early, primary, and treated syphilis that may be missed with traditional screening. However, non-treponemal test is necessary to detect patients with active syphilis.
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
Reekie, Ian; Reddy, Yaviche
Ocular syphilis has become rare in the developed world, but is a common presentation to ophthalmology departments in South Africa. We investigated the proportion of patients diagnosed with ocular syphilis who went on to receive lumbar punctures, and determined the fraction of these who had cerebrospinal fluid findings suggestive of neurosyphilis. We aimed to determine whether the use of lumbar punctures in ocular syphilis patients was beneficial in picking up cases of neurosyphilis. Retrospective study of case notes of patients admitted to two district hospitals in Durban, South Africa, with ocular syphilis over a 20-month period. A total of 31 of 68 ocular syphilis patients underwent lumbar puncture, and of these, eight (25.8%) had findings suggestive of neurosyphilis. Lumbar puncture in ocular syphilis patients should continue to be a routine part of the investigation of these patients; a large proportion of ocular syphilis patients show cerebrospinal fluid findings suggestive of neurosyphilis, are at risk of the complications of neurosyphilis, and should be managed accordingly.
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.
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.
Angelini, Lauretta; Guidi, Enrica; Contini, Carlo
In this article the authors highlight the behaviour of government authorities in the nineteenth century in Italy and especially in Ferrara to implement those measures deemed necessary to stem the spread of syphilis in epidemic form through the control of prostitution. Albeit discontinuously and until 1865, corrupted and infected women in Ferrara were assisted and treated by charitable institutions (Congregation of Charity, the Congregation of the Ladies of St. Vincent and the Sisters of Charity at the complex St. Mary of Consolation) since the Ferrara public hospital (Arcispedale S. Anna) could not accept or treat infected prostitutes for economic reasons and lack of beds. Subsequently, the hospital only treated prostitutes free of charge if they bore a certificate of poverty. The other infected prostitutes were sent to the sifilicomio in Modena. The authors also study mortality from syphilis in Ferrara from 1813 to 1899 in order to detect any significant differences according to age, sex and professional status and attempt to identify the stage of the disease (primary, secondary and tertiary), according to the terminology used by the doctors of that time.
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.
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.
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
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 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.
Selmin Dirgen Çaylak
Full Text Available Brucellosis is a systemic disease in which all kind of tissues and organs can be affected. Brucellosis may present with different symptoms and symptoms are non-specific. A broad spectrum of clinical manifestations can be seen, therefore diagnosis can be difficult. Cutaneous complications and febrile neutropenia have been rarely reported. Here, a rare brucellosis case was reported that he applied with fever, skin eruption and neutropenia. We emphasized that especially in endemic areas brucellosis should always be kept on mind in the differential diagnosis of patient with skin eruption and febril neutropenia.J Microbiol Infect Dis 2014;4(1: 39-41
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
Bissessor, Melanie; Fairley, Christopher K; Leslie, David; Howley, Kerri; Chen, Marcus Y
Syphilis continues to be a significant public health problem among HIV-positive men who have sex with men (MSM) internationally. This study aimed to determine whether the routine inclusion of syphilis serology with every blood test performed as part of HIV monitoring increases the detection of early asymptomatic syphilis among HIV-positive MSM. We examined the effect of this intervention, implemented in January 2007, on the detection of early asymptomatic syphilis among HIV-positive MSM attending the Melbourne Sexual Health Centre, Australia, and compared this with the previous clinic policy of annual syphilis screening. In the 18 months before and after the intervention, the median number of syphilis tests performed per man per year was 1 and 2, respectively. The proportion of MSM diagnosed with early syphilis who were asymptomatic was 21% (3 of 14) and 85% (41 of 48) for the 2 respective periods (P = 0.006). The time between the midpoint since last syphilis serology and diagnosis of syphilis was a median of 107 days (range 9-362) and 45 days (range 23-325) for the 2 periods, respectively (P = 0.018). The inclusion of routine syphilis serology with every blood test performed as part of HIV monitoring in HIV-positive MSM resulted in a large increase in the proportion of men diagnosed with early asymptomatic syphilis. This simple intervention probably also decreased the duration of infectiousness, enhancing syphilis control while also reducing morbidity.
Sarkodie, Francis; Owusu-Dabo, Ellis; Hassall, Oliver
the age of 15 years. 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......) 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...
Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua
Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs).We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40-49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time.By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P HIV prevalence increased for older age clients (1.3%-2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%-0.8%, P sex with men or intravenous drug use. Clients preferred LTFSWs, especially older clients (81.9%).Our results suggest that HIV and syphilis infections are increasing in older clients who prefer LTFSWs. HIV and syphilis are likely increasing in Guangxi Province through heterosexual transmission.
Su, Shu; Mao, Limin; Zhao, Jinxian; Chen, Liang; Jing, Jun; Cheng, Feng; Zhang, Lei
The number of poly-drug users who mix use heroin and synthetic drugs (SD) is increasing worldwide. The objective of this study is to measure the risk factors for being infected with hepatitis C (HCV), human immunodeficiency virus (HIV) and syphilis among SD-only users, heroin-only users and poly-drug users. A cross-sectional study was conducted in 2015 from a national HIV surveillance site in Southwest China, 447 poly-drug, 526 SD-only and 318 heroin-only users were recruited. Poly-drug users have higher drug-use frequency, higher rates of drug-sharing and unsafe sexual acts than other users (p users experienced sexual arousal due to drug effects, which is higher than the rate among other drug users. Poly-drug users had the highest prevalence of HIV (10.5%) and syphilis (3.6%), but heroin-only users had the highest prevalence of HCV (66.0%) (all p users, having sex following drug consumption and using drugs ≥1/day were the major risk factors for both HIV (Adjusted odds ratio (AOR) = 2.4, 95% CI [1.8-3.4]; 2.3, [1.6-3.1]) and syphilis infection (AOR = 4.1, [2.1-6.9]; 3.9, [1.8-5.4]). Elevated risk of both HIV and syphilis infection have been established among poly-drug users.
Sebastian Dybeck Udd
Full Text Available Syphilis is a rare but increasing disease. Due to changing sexual habits, presentation of oral manifestations may rise. Since syphilis may mimic other oral manifestations, diagnoses can be difficult. Clinicians need to be aware that ambiguous oral manifestations may in fact be caused by oral syphilis. Here, we present a case of extended diagnostic delay highlighting the importance of consulting an expert in infectious diseases in case of obscure oral lesions not responding to standard treatment. Despite seven visits to six different medical doctors, a patient who presented with oral syphilis was continuously misdiagnosed. After 6 months of increasing complaints and deteriorating severity of disease, the patient was referred to an oral and maxillofacial surgeon where the correct diagnosis was determined and proper treatment initiated.
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 (≥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...
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 (≥1,000 cases reported during the...
U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2016. In this Table, provisional* cases of selected† notifiable diseases (≥1,000 cases reported during...
Full Text Available Presently, the diagnosis of syphilis is dependent mainly on serological tests. The most widely used screening tests for syphilis are the VDRL and the rapid plasma reagin (RPR and for confirmation, the fluorescent treponemal antibody (FTA and the treponema pallidum hemagglutination (TPHA tests. The four alternative modes for diagnosis of syphilis can be a VDRL + FTA, b VDRL + TPHA, c RPR + FTA and d RPR + TPHA. Here the author reports an evaluation of cost utility of these tests in medical practice. It is shown that the cost per accurate diagnosis with VDRL + TPH is the least expensive choice. Therefore, this alternative is the best method for serological diagnosis for syphilis, based on medical laboratory economics principles
Ji Yaping; Zhuge Moyi
Objective: To explore the method of radiological diagnosis of early attacking congenital syphilis. Methods: Seven cases of early attacking congenital syphilis of bone were retrospectively analyzed, diagnosed serologically, and were taken X-rays of the long bones. Results: Bone radiographs abnormalities were identified in 6 of 7 cases. Five cases suffered periotities, six cases metaphysitis, and three cases combined with diaphysitis. Seven cases had swollen soft tissue. The vertebraes, craniums and epiphysitis were not found abnormal in 7 cases. Diffusion, multiple and symmetric metaphysitis, periosteitis and osteitis were the radiological characters of congenital syphilis of bone. Conclusion: Radiography can affirm the diagnose of early attacking congenital syphilis and definite the arrange and depth. Radiographs of the extremities should be routinely taken in suspected infants. (authors)
Roberts, William Clifford; Lensing, Forrester Dubus; Kourlis, Harry; Ko, Jong Mi; Newberry, Jonathan Warren; Smerud, Michael John; Burton, Elizabeth C; Hebeler, Robert Frederick
The investigators report the case of a 44-year-old man who presented acutely and was found to have saccular aneurysm of the innominate artery, narrowed or totally occluded aortic arch arteries, and marked thickening of the thoracic aorta except for the wall behind the sinuses of Valsalva. The abdominal aorta was entirely normal. Results of the serologic test for syphilis were strongly positive. Because cardiovascular syphilis appears to be a disease that affects the vasa vasora and because these channels are limited to the thoracic aorta, the abdominal aorta is uninvolved, as demonstrated so nicely in the patient described in this case report. Because most patients with cardiovascular syphilis are much older than the patient described, it is unusual to see a perfectly normal abdominal aorta, as in the present patient. In conclusion, syphilis producing aneurysm of the innominate artery is unusual but is always associated with syphilitic involvement of the thoracic aorta.
Arnow, P M; Smaron, M; Ormiste, V
An epidemiologic investigation, initiated when Brucella melitensis infection was detected in a high school student, identified five unrecognized cases in classmates. Before the investigation, four infected students had symptoms of brucellosis for one to ten weeks, made nine visits to physicians, and were confined to the school infirmary or hospitals for 27 days. The other two students were asymptomatic when Brucella agglutination testing demonstrated elevated titers, and treatment was quickly instituted when symptoms occurred. Travel to Spain was implicated because cases were clustered in six of 27 travelers compared with none of 23 control students. Food-history questionnaires showed more frequent consumption of cheese by infected than noninfected travelers. This cluster of cases demonstrates the risk of brucellosis in travelers to endemic areas and illustrates the value of an epidemiologic investigation of cases.
Full Text Available Background/Aim. Despite the fact that brucellosis occurs sporadically in the epidemic form, this disease is still one of the world's most widespread zoonoses. Methods. Data from the register of infectious diseases of the Institute of Public Health of Vojvodina and Scientific Veterinary Institute in Novi Sad were used in this study. Using descriptive statistics, data were analyzed for the period 2000 to 2014. Results. In the observed period in Vojvodina 102 cases of brucellosis were registered with different frequency of notification cases by districts of province. Most frequent modes of transmission of brucellosis were consumption of contaminated food (especially sheep cheese or direct contact with domestic animals. In 70.2% of the patients, occupational exposures to the agent or direct daily contact with animals were noted. The dominant source of infection in the urban area was food, whereas a direct contact with sick animals was dominant mode of transmission in the rural area. Overall, 14 epidemic outbreaks of brucella were registered with direct contact as dominant mode of transmission. The predominant age-range of patients with brucella confirmed infections was 30–59 years (50.0 male %, and 2.5 times more males than females were affected. Seasonal distribution was highest during spring, with 50.0% of all confirmed cases. During the period 2004–2005, prevalence of serum positive patients in the South Bačka District coincided with the highest number of laboratory confirmed serum samples among animals. Conclusion. Although the incidence of brucellosis shows a declining trend, education and improving of surveillance of disease of all relevant institutions seems as necessary for better recognition and notification of the disease.
Andrea Pisani Ceretti
Full Text Available Rectal syphilis is a rare expression of the widely recognised sexual transmitted disease, also known as the great imitator for its peculiarity of being confused with mild anorectal diseases because of its vague symptoms or believed rectal malignancy, with the concrete risk of overtreatment. We present the case of a male patient with primary rectal syphilis, firstly diagnosed as rectal cancer; the medical, radiological, and endoscopic features are discussed below.
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.
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.
Cerqueira, Luciane Rodrigues Pedreira de; Monteiro, Denise L M; Taquette, Stella R; Rodrigues, Nádia C P; Trajano, Alexandre J B; Souza, Flavio Monteiro de; Araújo, Bianca De Melo
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. To estimate the prevalence of syphilis in parturients, the incidence of congenital syphilis and the vertical transmission rate. 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. 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. 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.
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.
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.
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.
Nyangoma, E N; Olson, C K; Painter, J A; Posey, D L; Stauffer, W M; Naughton, M; Zhou, W; Kamb, M; Benoit, S R
U.S. immigration regulations require clinical and serologic screening for syphilis for all U.S.-bound refugees 15 years of age and older. We reviewed syphilis screening results for all U.S.-bound refugees from January 1, 2009 through December 31, 2013. We calculated age-adjusted prevalence by region and nationality and assessed factors associated with syphilis seropositivity using multivariable log binomial regression models. Among 233,446 refugees, we identified 874 syphilis cases (373 cases per 100,000 refugees). The highest overall age-adjusted prevalence rates of syphilis seropositivity were observed among refugees from Africa (1340 cases per 100,000), followed by East Asia and the Pacific (397 cases per 100,000). In most regions, male sex, increasing age, and living in non-refugee camp settings were associated with syphilis seropositivity. Future analysis of test results, stage of infection, and treatment delivery overseas is warranted in order to determine the extent of transmission risk and benefits of the screening program.
Full Text Available ... 1 (von Gierke) Hemochromatosis Hepatic Encephalopathy Hepatitis A Hepatitis B Hepatitis C Intrahepatic Cholestasis of Pregnancy (ICP) Jaundice ... diseases. What are the common causes of cirrhosis? Hepatitis B & C Alcohol-related Liver Disease Non-alcoholic Fatty ...
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
Samoff, Erika; Cope, Anna B; Maxwell, Jason; Thomas, Francina; Mobley, Victoria L
Compare syphilis investigation yield among patient groups using number needed to interview. To increase investigation efficiency. Retrospective review of North Carolina 2015 syphilis investigations, using the number of cases needed to interview (NNTI) and the total number of cases and contacts needed to interview (TNTI) to compare yield of new syphilis and human immunodeficiency virus diagnoses between patient groups. We reviewed 1646 early syphilis cases and 2181 contacts; these yielded 241 new syphilis cases (NNTI, 6.9; TNTI, 16.4) and 38 new human immunodeficiency virus cases (NNTI, 43). Interviews of women (prevalence difference [PD] = 6%, 95% confidence interval [CI], 12-16), patients 1:16 (PD = 5%, 95% CI, 1-9) yielded more new syphilis cases in our adjusted model; no other patient factors increased investigation yield. The NNTI and TNTI are useful measures of efficiency. Prioritizing early syphilis investigation by gender, rapid plasmin reagin titer, and age provides small increases in efficiency; no other factors increased efficiency.
Objectives: This study aimed to determine the sero-prevalence of transfusion transmitted infections (TTIs), namely immunodeficiency virus, hepatitis B and C and syphilis among blood donors. Setting: The study was carried in the blood bank at ElObeid Teaching Hospital. Material and methods: The study included 260 blood ...
Full Text Available Brucellosis is a zoonotic disease widely seen in endemic regions and that can lead to systemic involvement. The musculoskeletal system is frequently affected, and the disease can exhibit clinical involvements such as arthritis, spondylitis, spondylodiscitis, osteomyelitis, tenosynovitis and bursitis. Spondylitis and spondylodiscitis, common complications of brucellosis, predominantly affect the lumbar and thoracic vertebrae.
Oseguera Montiel, D.; Bruce, M.; Frankena, K.; Udo, H.M.J.; Zijpp, van der A.J.; Rushton, J.
Brucellosis is an endemic disease in small-scale goat husbandry systems in Mexico. It is a zoonosis and the economic consequences can be large, although estimates are not available for the Mexican goat sector. Our objective was to conduct a financial analysis of brucellosis control in a prominent
Mendoza-Núñez, Marjorie; Mulder, Maximilian; Franco, María Pía; Maas, Kathlène S. J. S. M.; Castañeda, Maria L.; Bonifacio, Nilo; Chacaltana, Jesús; Yagui, Elena; Gilman, Robert H.; Espinosa, Benjamin; Blazes, David; Hall, Eric; Abdoel, Theresia H.; Smits, Henk L.; Castañeda-Castañeda, Laura; Manrique, Jenny; Cordova, Nancy; Tuesta, Pilar; Osorio, Pilar; Yausen, Zósimo; Méndez, Melissa; Zavaleta, Milagros
During home visits and using a point-of-care test for brucellosis, we screened the household members of adult patients found to have brucellosis by investigation at the Hospital Nacional Daniel Alcides Carrión in Callao, Peru. A total of 206 household members of 43 patients were screened, and 15
Altuglu, Imre; Zeytinoğlu, Aysin; Bilgic, Altinay; Kamcioglu, Saniye; Karakartal, Guney; Smits, Henk
The diagnostic value of the dipstick assay was evaluated by comparison with Rose Bengal (RB), serum aglutination tests (SAT) and 2 mercaptoethanol test (2-ME) on consecutive serum samples submitted because of suspicion of brucellosis. Serum samples of 232 patients with suspected brucellosis that
Regulatory programs for brucellosis in domestic livestock have been active in the United States for almost 80 years. Wildlife reservoirs of brucellosis include bison (Bison bison) and elk (Cervus elaphus nelsonii) for B. abortus whereas B. suis is the predominant species infecting feral swine. The...
Smits, H. L.; Basahi, M. A.; Díaz, R.; Marrodan, T.; Douglas, J. T.; Rocha, A.; Veerman, J.; Zheludkov, M. M.; Witte, O. W.; de Jong, J.; Gussenhoven, G. C.; Goris, M. G.; van der Hoorn, M. A.
A dipstick assay for the detection of brucella-specific immunoglobulin M antibodies was evaluated with 707 sera from 247 laboratory-confirmed brucellosis patients and 342 control sera from brucellosis-free individuals. These sera were collected from six different countries. The assay was found to be
Brucellosis is of serious economic importance in livestock and in humans. There are batteries of serological tests developed and in use for the diagnosis of brucellosis in human and livestock Brief history, merits and demerits of some of these test are enumerated in this review. The purpose of the review is to bring together in ...
Yin, Dehui; Li, Li; Song, Xiuling; Li, Han; Wang, Juan; Ju, Wen; Qu, Xiaofeng; Song, Dandan; Liu, Yushen; Meng, Xiangjun; Cao, Hongqian; Song, Weiyi; Meng, Rizeng; Liu, Jinhua; Li, Juan; Xu, Kun
In epidemic regions of the world, brucellosis is a reemerging zoonosis with minimal mortality but is a serious public hygiene problem. Currently, there are various methods for brucellosis diagnosis, however few of them are available to be used to diagnose, especially for serious cross-reaction with other bacteria. To overcome this disadvantage, we explored a novel multi-epitope recombinant protein as human brucellosis diagnostic antigen. We established an indirect enzyme-linked immunosorbent assay (ELISA) based on this recombinant protein. 248 sera obtained from three different groups including patients with brucellosis (146 samples), non-brucellosis patients (82 samples), and healthy individuals (20 samples) were tested by indirect ELISA. To evaluate the assay, a receiver-operating characteristic (ROC) analysis and immunoblotting were carried out using these characterized serum samples. For this test, the area under the ROC curve was 0.9409 (95 % confidence interval, 0.9108 to 0.9709), and a sensitivity of 88.89 % and a specificity of 85.54 % was given with a cutoff value of 0.3865 from this ROC analysis. The Western blot results indicate that it is feasible to differentiate human brucellosis and non-brucellosis with the newly established method based on this recombinant protein. Our results obtained high diagnostic accuracy of the ELISA assay which encourage the use of this novel recombinant protein as diagnostic antigen to implement serological diagnosis of brucellosis.
Full Text Available A recombinant-antigen enzyme immunoassay (EIA, BioSCREEN TM anti-Treponema pallidum, was compared favorably with the T. pallidum hemagglutination test, in the detection of specific antibodies in different groups of sera from patients with primary (n = 38, secondary (n = 10, early latent (n = 28 and congenital syphilis (n = 2, patients with leptospirosis ( n= 8, infectious mononucleosis (n = 7, hepatitis (n = 9, diabetes mellitus (n = 11, rheumatoid arthritis (n = 13, leprosy (n = 11, tuberculosis (n = 9, HIV/Aids ( n= 12, systemic lupus erythematosus (n = 4, rheumatic fever (n = 3, old-persons (n = 9, pregnant women (n = 29 and blood donors (n = 164. The coincidence between them was 95.1%. The sensitivity and specificity of the EIA were 93.3% and 95.5%, respectively. Fifteen serum specimens belonging to old-persons, pregnant women, blood donors, and patients with human leptospirosis, hepatitis, diabetes mellitus, tuberculosis and rheumatic fever gave false-positive results by Venereal Disease Research Laboratory and/or Rapid Plasma Reagin. The EIA can be used as alternative method for the serological confirmation of syphilis.
Full Text Available Abstract Background Recent epidemiological data show an increased trend of official estimates for syphilis infection in the general population. Many of the infected cases remain undetected leaving an underestimation of the true prevalence of syphilis in the general population, but also among subpopulations such as illicit drug users. There is limited epidemiological data published on the proportion and risk factors of syphilis infections associated with illicit drug abuse. Methods Illicit drug addicts (n = 1223 in inpatients units in Germany were screened (2000–01 for syphilis and interviewed regarding patterns of drug use and sexual behaviour. TPHA-test for initial screening and FTA-ABS-IgM test in TPHA-positive patients were used. Results In total, TPHA-tests were positive in 39 (3.3% and 7 patients (0.6% were IgM positive. The prevalence rate for syphilis in males was 1.9% and for women it was 8.5%. Female patients were 4.56 (CI 95% 2.37–8.78 times more likely to have a positive TPHA test than males. Sexual behaviours such as high number of sexual partners, sex for drugs/money, sex on the first day were associated with syphilis infection only in women. Females with frequent sex for drugs or money had 4.31 (CI 95% 2.32–8.52 times more likely a reactive TPHA test than remaining patients. Neither the sociodemographic factors nor sexual behaviour were statistically significant associated with syphilis infection among men at all. Conclusion Our data suggest the need for screening for syphilis among these illicit drug users in inpatient settings, in particular among sexual active women. This conclusion is corroborated by the finding of increasing numbers of syphilis infections in the general population. The identification of syphilis cases among drug addicts would give treatment options to these individuals and would help to reduce the spread of infection in this population, but also a spread into heterosexual populations related to
Gul, S.T.; Khan, A.; Ahmad, M.
The aim of this study was to determine the seroprevalence and hemato-biochemical manifestations of brucellosis in horses. Serum samples were screened for Brucella antibodies by Rose Bengal plate test (RBPT) and serum agglutination test (SAT). Blood samples were evaluated for hemato-biochemical parameters following standard procedures. Results indicated seroprevalence of brucellosis 20.13 and 16.23% in horses by RBPT and SAT, respectively. Brucellosis does not lead to any significant change in hematological and biochemical parameters in relation to age, sex, body condition and lactation except few parameters. The values of erythrocyte sedimentation rate, neutrophil, basophil and alkaline phosphatase significantly decreased in brucellosis positive animals as compared to healthy animals whereas lymphocytes and alanine aminotransferase were in opposite order. It was concluded from the results that prevalence of brucellosis in horse population is of concern; therefore, control measures should be opted so that its zoonotic threat is curtailed. (author)
Ogholikhan, Sina; Schwarz, Kathleen B.
Viral hepatitis is a serious health problem all over the world. However, the reduction of the morbidity and mortality due to vaccinations against hepatitis A and hepatitis B has been a major component in the overall reduction in vaccine preventable diseases. We will discuss the epidemiology, vaccine development, and post-vaccination effects of the hepatitis A and B virus. In addition, we discuss attempts to provide hepatitis D vaccine for the 350 million individuals infected with hepatitis B ...
Rovira-López, Roger; Bertolín-Colilla, Marta; Martín-Ezquerra, Gemma; Pujol, Ramon M
The typical finding in secondary syphilis stage is a generalized non-pruritic maculopapular eruption. We report a case of secondary syphilis in an HIV-infected patient presenting with pruritic crusted nodules showing numerous eosinophils on the histopathological examination.
Morshed, Muhammad G; Singh, Ameeta E
Complexities in the diagnosis of syphilis continue to challenge clinicians. While direct tests (e.g., microscopy or PCR) are helpful in early syphilis, the mainstay of diagnosis remains serologic tests. The traditional algorithm using a nontreponemal test (NTT) followed by a treponemal test (TT) remains the standard in many parts of the world. More recently, the ability to automate the TT has led to the increasingly widespread use of reverse algorithms using treponemal enzyme immunoassays (EIAs). Rapid, point-of-care TTs are in widespread use in developing countries because of low cost, ease of use, and reasonable performance. However, none of the current diagnostic algorithms are able to distinguish current from previously treated infections. In addition, the reversal of traditional syphilis algorithms has led to uncertainty in the clinical management of patients. The interpretation of syphilis tests is further complicated by the lack of a reliable gold standard for syphilis diagnostics, and the newer tests can result in false-positive reactions similar to those seen with older tests. Little progress has been made in the area of serologic diagnostics for congenital syphilis, which requires assessment of maternal treatment and serologic response as well as clinical and laboratory investigation of the neonate for appropriate management. The diagnosis of neurosyphilis continues to require the collection of cerebrospinal fluid for a combination of NTT and TT, and, while newer treponemal EIAs look promising, more studies are needed to confirm their utility. This article reviews current tests and discusses current controversies in syphilis diagnosis, with a focus on serologic tests. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
Young, Sean D; Torrone, Elizabeth A; Urata, John; Aral, Sevgi O
Researchers have suggested that social media and online search data might be used to monitor and predict syphilis and other sexually transmitted diseases. Because people at risk for syphilis might seek sexual health and risk-related information on the internet, we investigated associations between internet state-level search query data (e.g., Google Trends) and reported weekly syphilis cases. We obtained weekly counts of reported primary and secondary syphilis for 50 states from 2012 to 2014 from the US Centers for Disease Control and Prevention. We collected weekly internet search query data regarding 25 risk-related keywords from 2012 to 2014 for 50 states using Google Trends. We joined 155 weeks of Google Trends data with 1-week lag to weekly syphilis data for a total of 7750 data points. Using the least absolute shrinkage and selection operator, we trained three linear mixed models on the first 10 weeks of each year. We validated models for 2012 and 2014 for the following 52 weeks and the 2014 model for the following 42 weeks. The models, consisting of different sets of keyword predictors for each year, accurately predicted 144 weeks of primary and secondary syphilis counts for each state, with an overall average R of 0.9 and overall average root mean squared error of 4.9. We used Google Trends search data from the prior week to predict cases of syphilis in the following weeks for each state. Further research could explore how search data could be integrated into public health monitoring systems.
Singh, Ameeta E.
Complexities in the diagnosis of syphilis continue to challenge clinicians. While direct tests (e.g., microscopy or PCR) are helpful in early syphilis, the mainstay of diagnosis remains serologic tests. The traditional algorithm using a nontreponemal test (NTT) followed by a treponemal test (TT) remains the standard in many parts of the world. More recently, the ability to automate the TT has led to the increasingly widespread use of reverse algorithms using treponemal enzyme immunoassays (EIAs). Rapid, point-of-care TTs are in widespread use in developing countries because of low cost, ease of use, and reasonable performance. However, none of the current diagnostic algorithms are able to distinguish current from previously treated infections. In addition, the reversal of traditional syphilis algorithms has led to uncertainty in the clinical management of patients. The interpretation of syphilis tests is further complicated by the lack of a reliable gold standard for syphilis diagnostics, and the newer tests can result in false-positive reactions similar to those seen with older tests. Little progress has been made in the area of serologic diagnostics for congenital syphilis, which requires assessment of maternal treatment and serologic response as well as clinical and laboratory investigation of the neonate for appropriate management. The diagnosis of neurosyphilis continues to require the collection of cerebrospinal fluid for a combination of NTT and TT, and, while newer treponemal EIAs look promising, more studies are needed to confirm their utility. This article reviews current tests and discusses current controversies in syphilis diagnosis, with a focus on serologic tests. PMID:25428245
Ron-Román, Jorge; Ron-Garrido, Lenin; Abatih, Emmanuel; Celi-Erazo, Maritza; Vizcaíno-Ordóñez, Laura; Calva-Pacheco, Jaime; González-Andrade, Pablo; Berkvens, Dirk; Benítez-Ortíz, Washington; Brandt, Jef; Fretin, David; Saegerman, Claude
Human brucellosis in Ecuador is underreported and based only on passive surveillance. Since 2008, brucellosis was removed from the list of communicable diseases in the country. Until now, the true human brucellosis picture has not yet been determined. The aim of this study was to determine the seroprevalence of the disease, identify risk factors associated with brucellosis seropositivity in humans, and isolate circulating strains of Brucella spp. in the northwestern part of Ecuador. Between 2006 and 2008, a large transect survey was conducted, based on blood sampling of people from the northwestern part of Ecuador (n=3733) together with an epidemiological inquiry. On the basis of three diagnostic tests used in parallel, the overall seroprevalence was estimated as 1.88% (95% confidence interval [CI] 1.48-2.38). Based on a multivariable random effects logistic regression analysis, the main risk factors associated with human brucellosis seropositivity were contact with livestock (odds ratio [OR]=3.0; CI 1.25-7.08), consumption of fetus and placenta (OR=2.5; CI 1.18-5.22), and involvement in activities at risk for brucellosis infection (OR=1.8; CI 1.00-3.35). Noticeable variation in brucellosis seropositivity among humans within cantons was observed. The circulating strain was Brucella abortus biotype 4. This study emphasized that contact with livestock, consumption of fetus and placenta, and occupational hazard group were all significant risk factors for the transmission of brucellosis among individuals in the northwestern part of Ecuador. Alongside encouraging the launching of educational campaigns against brucellosis, especially in rural areas where 36% of the population lives, controlling this zoonotic disease in animals will directly benefit its prevention in humans, especially because there is no safe and efficacious vaccine against brucellosis in humans.
Full Text Available ... Donate Today Enroll in 123 What is Hepatic Encephalopathy? Hepatic Encephalopathy, sometimes referred to as portosystemic encephalopathy or PSE, is a condition that causes temporary ...
Jafari, S; Ashrafizadeh, S-G; Zeinoddini, A; Rasoulinejad, M; Entezari, P; Seddighi, S; Akhondzadeh, S
Depression is a debilitating complication of brucellosis and how best to treat this is a matter of debate. Inflammatory processes are involved in the pathogenesis of both brucellosis and depression. Therefore, we hypothesized that celecoxib could be beneficial for the treatment of depression due to brucellosis. Forty outpatients with depression due to brucellosis with a Hamilton Depression Rating Scale score (HDRS) brucellosis when compared with placebo. © 2015 John Wiley & Sons Ltd.
Zakharov, S. V.
A comparative analysis of the sensitivity and specificity of immunoblotting against other non-treponemal and treponemal reactions was carried out in 215 patients with early forms of syphilis. A high diagnostic efficiency of immunoblotting in patients with early latent syphilis was established. It was found that only in case of primary syphilis, immunoblotting is inferior to Immunofluorescence reaction; this test can be used for differential diagnosis between hidden syphilis and false positive...
An, Jingna; Chen, Qixia; Liu, Qianqian; Rao, Chenli; Li, Dongdong; Wang, Tingting; Tao, Chuanmin; Wang, Lanlan
The resurgence of syphilis in recent years has become a serious threat to public health worldwide, and the serological detection of specific antibodies against Treponema pallidum remains the most reliable method for laboratory diagnosis of syphilis. This study examined the performance of the recently launched HISCL anti-Treponema pallidum (anti-TP) assay as a screening test for syphilis in a high-volume laboratory. The HISCL anti-TP assay was tested in 300 preselected syphilis-positive sample...
Jiang, Chuanhao; Xiao, Jinhong; Xie, Yafeng; Xiao, Yongjian; Wang, Chuan; Kuang, Xingxing; Xu, Man; Li, Ranhui; Zeng, Tiebing; Liu, Shuanquan; Yu, Jian; Zhao, Feijun; Wu, Yimou
Syphilis is a multistage disease caused by the invasive spirochete Treponema pallidum subsp. pallidum, and accurate diagnosis is important for the prevention and treatment of syphilis. Here, to identify appropriate diagnostic antigens for serodiagnosis of syphilis, 6 recombinant proteins were expressed in Escherichia coli and purified, including flagellins (FlaB1 [Tp0868], FlaB2 [Tp0792], and FlaB3 [Tp0870]), Tp0463, Tp0751, and Tp1038. The sensitivities were determined by screening sera from individuals with primary (n=82), secondary (n=115), latent (n=105), and congenital (n=65) syphilis. The specificities were determined by screening sera from uninfected controls (n=30) and potentially cross-reactive infections including Lyme disease (n=30), leptospirosis (n=5), and hepatitis B (n=30). Our data showed that FlaB1, FlaB2, FlaB3, Tp0463, and Tp1038 exhibited higher overall sensitivities and specificities for detecting IgG antibody, with 95.4% and 98.9%, 92.6% and 95.8%, 95.1% and 95.8%, 92.6% and 97.9%, and 95.9% and 98.9%, respectively. In contrast, Tp0751 demonstrated only an overall sensitivity of 39.2%. For comparison, the sensitivity and specificity of Architect Syphilis TP were determined to be 98.1% and 93.7%, respectively. In addition, FlaB1, FlaB2, FlaB3, and Tp0463 demonstrated excellent performance for detecting IgM antibody in primary and congenital syphilis, with sensitivities of 76.8% and 83.1%, 72.0% and 87.7%, 74.4% and 89.2%, and 64.6% and 75.3%, respectively. These results indicate that FlaB1, FlaB2, FlaB3, and Tp0463 could be as novel diagnostic candidates for serodiagnosis of syphilis. Copyright © 2016 Elsevier Inc. All rights reserved.
Kenyon, Chris Richard; Osbak, Kara; Tsoumanis, Achilleas
Background How can we explain the uneven decline of syphilis around the world following the introduction of penicillin? In this paper we use antenatal syphilis prevalence (ASP) to investigate how syphilis prevalence varied worldwide in the past century, and what risk factors correlate with this variance. Methods 1) A systematic review using PubMed and Google Scholar was conducted to identify countries with published data relating to ASP estimates from before 1952 until the present. Eleven countries were identified (Canada, Denmark, Finland, India, Japan, Norway, Singapore, South Africa, United States of America (USA), United Kingdom (UK) and Zimbabwe). The ASP epidemic curve for each population was depicted graphically. In South Africa and the USA, results are reported separately for the black and white populations. 2) National antenatal syphilis prevalence estimates for 1990 to 1999 and 2008 were taken from an Institute for Health Metrics and Evaluation database on the prevalence of syphilis in low risk populations compiled for the Global Burden of Diseases study and from a recent review paper respectively. National ASPs were depicted graphically and regional median ASPs were calculated for both time periods. 3) Linear regression was used to test for an association between ASP in 1990–1999 and 2008 and four risk factors (efficacy of syphilis screening/treatment, health expenditure, GDP per capita and circumcision prevalence). WHO world regions were included as potential explanatory variables. Results In most populations, ASP dropped to under 1% before 1960. In Zimbabwe and black South Africans, ASP was high in the pre-penicillin period, dropped in the post-penicillin period, but then plateaued at around 6% until the end of the 20th century when ASP dropped to just above 1%. In black Americans, ASP declined in the post penicillin period, but plateaued at 3–5% thereafter. ASP was statistically significantly higher in sub-Saharan Africa in 1990–1999 and 2008
Branger, Judith; van der Meer, Jan T. M.; van Ketel, Ruud J.; Jurriaans, Suzanne; Prins, Jan M.
Background: Recently, the incidence of syphilis has risen, mainly among men having sex with men (MSM), many of whom are coinfected with HIV. Current guidelines recommend at least yearly syphilis testing in this group. In this study, we assessed the yield of routine syphilis screening in outpatient
Marks, Michael; Mabey, David Cw
Syphilis remains an important and preventable cause of stillbirth and neonatal mortality. About 1 million women with active syphilis become pregnant each year. Without treatment, 25% of them will deliver a stillborn baby and 33% a low birth weight baby with an increased chance of dying in the first month of life. Adverse pregnancy outcomes due to syphilis can be prevented by screening pregnant women, and treating those who test positive with a single dose of penicillin before 28 weeks' gestation. Areas covered: This manuscript covers the impact of syphilis on pregnancy outcome, the diagnosis of syphilis, with a special focus on point of care (POC) tests, and challenges to the introduction of POC tests, and their potential impact on the control and prevention of syphilis in resource limited settings. Expert commentary: POC tests for syphilis are available which meet the ASSURED criteria, and could make syphilis screening accessible to all women anywhere in the world who attend an antenatal clinic. High quality dual POC tests for HIV and syphilis could ensure that well-funded programmes for the prevention of mother to child transmission of HIV can contribute towards increased coverage of antenatal syphilis screening, and prevent more than 300,000 adverse pregnancy outcomes due to syphilis annually. Alongside investment to increase availability of syphilis POC tests, operational research is needed to understand how best to improve screening of pregnant women and to translate test availability into improved pregnancy outcomes.
Siqueira, C S; Saturno, J L; de Sousa, S C O M; da Silveira, F R X
Awareness of the increased prevalence of syphilis is essential for early diagnosis and treatment, and to prevent the spread of the disease. Although serological studies are the primary tool used to confirm the diagnosis of secondary syphilis, biopsy of unsuspected oral lesions is not uncommon in the routine oral pathology laboratory. In these cases, histopathological characteristics are likely to indicate the possibility of syphilis, and an immunohistochemical reaction can confirm it. The aim of the present study was to highlight the histological features and test the efficacy of immunohistochemistry in the detection of Treponema pallidum in oral lesions biopsied with the assumption of a non-syphilitic disease. Thirty-nine tissue samples from patients for whom the possibility of syphilis was suggested on the basis of histopathological findings, were retrieved from the surgical oral pathology service files and submitted to immunohistochemical staining for T. pallidum. The study was approved by the institutional ethics committee. Eighteen of the tissue samples were positive for T. pallidum. Following this, the contributing clinicians were contacted to check whether they had asked for serological examinations when the diagnostic report was received; for all 18 positive cases, the clinicians confirmed that the patients had tested positive at that time. This study shows the importance of clinical-pathological correlation and the value of immunohistochemistry in the diagnosis of unsuspected syphilis. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Shaw, Souradet Y; Ross, Craig; Nowicki, Deborah L; Marshall, Shelley; Stephen, Sandy; Davies, Christina; Riddell, Jennifer; Bailey, Kim; Elliott, Lawrence J; Reimer, Joss N; Plourde, Pierre J
The aim of this study was to examine trends in infectious syphilis epidemiology among women in Winnipeg, Canada. A descriptive study of syphilis among Winnipeg residents between 2003 and 30 June 2015 was undertaken. Adjusted rate ratios (ARR) and 95% confidence intervals (95%CI) from Poisson regression analyses are reported. Characteristics of men and women were compared using logistic regression, with adjusted odds ratios (AOR) reported. Between 2014 and 2015, the rate of syphilis was 1.7/100,000, representing a five-fold increase since 2006-2013. All cases have been heterosexual, 90% 20-39 years of age, and 59% living in Winnipeg's inner core. Approximately 24% were pregnant at diagnosis; no cases of congenital syphilis have been reported. Compared to men, women were more likely to report alcohol use (AOR: 3.8, 95% CI: 1.2-11.9) and co-infection with chlamydia (AOR: 5.0, 95% CI: 1.1-22.9). In conclusion, the rates of infectious syphilis are increasing among women. Prenatal screening and education for inner-core women and the health care providers serving them should be prioritized.
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Full Text Available Brucellosis infection is a multisystem disease, with a broad spectrum of symptoms. We investigated the existence of clusters of infected patients according to their clinical presentation. Using national surveillance data from the Electronic-Integrated Disease Surveillance System, we applied a latent class cluster (LCC analysis on symptoms to determine clusters of brucellosis cases. A total of 454 cases reported between July 2011 and July 2013 were analyzed. LCC identified a two-cluster model and the Vuong-Lo-Mendell-Rubin likelihood ratio supported the cluster model. Brucellosis cases in the second cluster (19% reported higher percentages of poly-lymphadenopathy, hepatomegaly, arthritis, myositis, and neuritis and changes in liver function tests compared to cases of the first cluster. Patients in the second cluster had a severe brucellosis disease course and were associated with longer delay in seeking medical attention. Moreover, most of them were from Beylagan, a region focused on sheep and goat livestock production in south-central Azerbaijan. Patients in cluster 2 accounted for one-quarter of brucellosis cases and had a more severe clinical presentation. Delay in seeking medical care may explain severe illness. Future work needs to determine the factors that influence brucellosis case seeking and identify brucellosis species, particularly among cases from Beylagan.
Namanda, Augustine Taban; Kakai, Rose; Otsyula, Mary
Brucellosis is a zoonotic disease that continues to infect many people worldwide. Though its mortality rate is low, long convalescent periods associated with brucellosis translate into reduced socio-economic capacity of the people affected. Human brucellosis is mostly transmitted from animals. In Kenya, the prevalence of the disease has increased recently, along with the increased hawking of unpasteurized milk. The extent of the risk such raw milk poses to human health with respect to brucellosis is unknown. This study investigates the possibility of brucellosis being transmitted through unprocessed milk sold by hawkers in Eldoret municipality. In this cross-sectional study, 130 samples of unpasteurized pooled milk from hawkers and 14 pasteurized milk samples were collected from shops in selected estates using cluster and simple random sampling techniques. All samples were subjected to the Brucella Milk Ring Test (MRT) for screening. A milk consumption questionnaire was administered to households in the selected estates to establish their milk sources and consumption patterns. Data analysis involved comparing computed percentages of different variables. A high proportion of households (77.5%) consume unpasteurized milk from hawkers. However, no antibody to Brucella was detected in any of the milk samples collected. We find no evidence that hawked milk in Eldoret is responsible for transmitting brucellosis to consumers. More research in the potential transmission of brucellosis through milk consumption is recommended.
Patricia Lopez Guarnizo
Full Text Available This research aims to conduct a descriptive study of the occurrence of human brucellosis in Colombia between 2000 and 2012, and, based on previous studies, to determine the prevalence and incidence of the disease, and the limitations for its timely diagnosis and recognition by the Colombian labor system. The research consisted of searching for and analyzing articles on human brucellosis published between 2000 and 2012 in Colombia. It included a phase of information gathering and unstructured interviews with representatives of brucellosis control programs and experienced professionals. We analyzed 17 studies of human brucellosis cases in personnel at risk in slaughterhouses, retailers and vaccinators for animal brucellosis programs: 10 of them reported prevalences between 0.14% and 10.4%, and seven evidenced seropositivity. Information revealed the limitations of the diagnosis, and it demonstrated the little knowledge of the medical community about this disease. In Colombia, there is no clear policy regarding this occupational zoonosis. Brucellosis is mentioned only in Decree 2566 of 2009, in which the new table of occupational diseases is established. The paper concludes that human brucellosis in Colombia is an underdiagnosed, and therefore underreported, disease since there is no mandatory reporting system on the subject.
Patil, D P; Ajantha, G S; Shubhada, C; Jain, P A; Kalabhavi, A; Shetty, P C; Hosamani, M; Appannanavar, S; Kulkarni, R D
Brucellosis is an important zoonotic disease. India having a major agrarian population is expected to have a higher prevalence. However, due to lack of laboratory facility or awareness among clinicians, the disease is largely underreported. The aim of this study was to know the prevalence and trend of human brucellosis over a decade, in patients attending a teaching hospital in North Karnataka, and to understand their geographical distribution. The study was conducted from January 2006 to December 2015 at a tertiary care teaching hospital in North Karnataka. A total of 3610 serum samples were evaluated from suspected cases of brucellosis. All serum samples were initially screened by Rose Bengal plate test, and positive samples were further analysed by Serum agglutination test (SAT) using standard Brucella abortus antigen from Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India. A titre above or equal to 1:80 IU/ml was considered as positive. Demographic data such as age, sex and native place of these patients were also analysed. We observed that human brucellosis is present in North Karnataka. The overall seropositivity of brucellosis in suspected cases was 5.1%. The positive titres ranged from 1:80 to 163,840 IU/ml. The majority of the patients were from Gadag, Koppal and Haveri districts of North Karnataka. Our study confirms the presence of human brucellosis in the northern part of Karnataka. Further studies to understand the prevalence of animal brucellosis in these areas will help in implementing prevention measures.
Al Shehhi, Nawal; Aziz, Faisal; Al Hosani, Farida; Aden, Bashir; Blair, Iain
Worldwide, human brucellosis remains an important and widespread infection. In the past, there were limited data on the occurrence of human brucellosis in the United Arab Emirates and the reported incidence appeared to be low compared with similar areas. In 2009, a new web-based infectious disease surveillance system was introduced in the Emirate of Abu Dhabi. This paper reports data from this new system on human brucellosis for the 6 years 2010 to 2015. A dataset was extracted for each case of human brucellosis reported to the notification system for the 6 year period January 2010 to December 2015. Annual brucellosis rates by age-group, gender, nationality and, geographical region were calculated and compared. A total of 480 cases of brucellosis were reported. The overall crude notification rate was 3 · 3 per 100,000 population but higher rates were seen in certain population subgroups notably expatriate males of working age in the Eastern Region (approximately 10 per 100,000) and UAE nationals of all ages and both genders in Abu Dhabi (between 4 -- 24 per 100,000). These findings reflect environmental and behavioral factors linked to occupation and leisure time activities associated with the large number of small non-commercial livestock farms in Abu Dhabi. Controlling human brucellosis in these circumstances will be challenging.
Kingston, M; French, P; Higgins, S; McQuillan, O; Sukthankar, A; Stott, C; McBrien, B; Tipple, C; Turner, A; Sullivan, A K; Radcliffe, Keith; Cousins, Darren; FitzGerald, Mark; Fisher, Martin; Grover, Deepa; Higgins, Stephen; Kingston, Margaret; Rayment, Michael; Sullivan, Ann
These guidelines are an update for 2015 of the 2008 UK guidelines for the management of syphilis. The writing group have piloted the new BASHH guideline methodology, notably using the GRADE system for assessing evidence and making recommendations. We have made significant changes to the recommendations for screening infants born to mothers with positive syphilis serology and to facilitate accurate and timely communication between the teams caring for mother and baby we have developed a birth plan. Procaine penicillin is now an alternative, not preferred treatment, for all stages of syphilis except neurosyphilis, but the length of treatment for this is shortened. Other changes are summarised at the start of the guideline. © The Author(s) 2016.
Eyer-Silva, Walter de Araujo; Martins, Carlos José; Silva, Guilherme Almeida Rosa da; Acakpovi, Giresse; Pinto, Jorge Francisco da Cunha
Leucoderma syphiliticum (LS), originally described as syphilide pigmentaire, encompasses a spectrum of dyschromic lesions that emerge during the course of secondary syphilis. Very few case reports are available in modern biomedical databases. We present the case of a 57-year-old HIV-infected male patient who presented with several round to oval, non-scaling, slightly raised and well-demarcated hypochromic lesions scattered over the trunk, abdomen, dorsum, and arms. Prior non-treponemal tests were negative for syphilis, but novel studies yielded positive results at high titers. Skin lesions slowly regressed and the hypochromic areas repigmented a few weeks after benzathine penicillin G treatment. This is the first report of LS in an HIV-infected patient. A review of modern and ancient literature was performed. The present case report emphasizes the need for clinicians to have a heightened awareness of the varied and unusual clinical phenotypes of syphilis.
Miller, R; Nakavuma, J L; Ssajjakambwe, P; Vudriko, P; Musisi, N; Kaneene, J B
A cross-sectional study was conducted to determine the presence of brucellosis in cattle, goats and humans in farms from south-western Uganda and identify risk factors associated with brucellosis in these three host groups. Data and serum samples were collected from 768 cattle, 315 goats and 236 humans, with 635 samples of bovine milk, from 70 farms in two different study areas in south-western Uganda. Sera from livestock were tested with the Rose Bengal Plate test, using B. abortus and B. melitensis antigens, and human sera were tested with a commercial IgG/IgM lateral flow assay. Milk samples were tested using the OIE-approved milk ring test. Screening tests for brucellosis were positive in 14% of cattle serum, 29% of bovine milk, 17% of goat serum and 11% of human serum samples. There were significant differences in the test prevalence of brucellosis by study site, with levels higher in the study area near Lake Mburo National Park than in the study area near Queen Elizabeth National Park. Multivariable regression models identified risk factors associated with increasing test positivity at the individual and farm levels for cattle, goats and humans. Positive associations were seen between increasing seropositivity of brucellosis in goats, cattle and humans. Results of multivariable analyses suggest that improvements in farm biosecurity and hygiene may reduce the risk of brucellosis on the farm and suggest a role for ticks in bovine brucellosis. Although cattle are the focus of brucellosis control in Uganda, the significant associations between seropositivity in humans and seropositivity in goats suggest that brucellosis in goats may be an important contributor to the epidemiology of the disease on the farm. © 2015 Blackwell Verlag GmbH.
Marvez-Valls, E; Weiss, S J; Ernst, A A; Johnson, W D
To estimate the rates of syphilis infection in inner-city patients managed by prehospital providers, a convenience sampling of prehospital patients who had intravenous lines initiated was screened for syphilis over a nine-month study period from February 1992 through October 1992. In a university-affiliated inner-city emergency department served by a city ambulance company, patients 18 years of age or older transported via ambulance who had had intravenous lines initiated at the scene or en route had a Venereal Disease Research Laboratory (VDRL) and microhemagglutination-Treponema pallidum (MHA-TP) drawn and performed by the state laboratory as a routine serological test. If the results were reactive with no previous history of syphilis recorded in the state registry, the state health department and/or one of the authors of this study contacted the patient for follow-up treatment. Age, race, sex, and diagnostic category (medical, surgical/obstetric, or neuropsychiatric) were recorded. Results were checked with the state syphilis registry. Latent syphilis was defined as a reactive VDRL and MHA-TP with no prior history of infection or record of infection in the state syphilis registry. Chi-squared test was used in statistical analysis for comparisons among ages, races, and sexes, with P > .05 considered significant. Three hundred two subjects 18 years of age and older consenting to a screening VDRL and MHA-TP had serum drawn. Two hundred seventy-nine patients were enrolled in the study after 23 patients were excluded because of improper data collection or insufficient serum collection. There were 174 men (63%) and 105 women (37%), with 73 white (26%) and 199 African-Americans (71%).(ABSTRACT TRUNCATED AT 250 WORDS)
Cruz, Adriana R; Castrillón, Maria Alejandra; Minotta, Alba Yadira; Rubiano, Luisa C; Castaño, Martha C; Salazar, Juan C
Congenital syphilis (CS) is a major global public health problem. Buenaventura, a socioeconomically deprived municipality in the Colombian Pacific Coast, accounts for 6.6% of all CS cases in Colombia. To begin to understand the main reasons for the high rates of the disease in Buenaventura, we conducted a retrospective electronic health record analysis of all infants admitted with CS during the first 7 months of 2011 to the Hospital Departamental de Buenaventura, the city's main birthing hospital. The diagnosis of gestational syphilis and CS was based on a predefined Colombian public health service algorithm. Clinical, laboratory, and sociodemographic parameters for all infants studied, including maternal access to prenatal care, syphilis serologic diagnosis, and adequacy of penicillin treatment, were abstracted and analyzed. A total of 89 infants met the case definition for CS. Most mothers (80%) were affiliated with government-regulated or private health care insurance plans. While 64 (70%) of 92 attended at least 1 antenatal care visit and 59 of these 64 (84%) were screened for syphilis, only 5 (8%) of 59 received appropriate antibiotic therapy. Although most infants were asymptomatic at birth, prematurity (15/82) was common. Two infants died in the neonatal period, and 5 pregnancies ended in stillbirth. Our findings confirm that Buenaventura has a very high incidence of CS and demonstrate that existing antenatal care gestational syphilis programs are flawed. Prevention strategies should emphasize enhanced early syphilis screening in pregnancy, preferably through the implementation of point-of-care testing in the community and same-day treatment with at least 1 dose of penicillin.
R. A. Agaev
Full Text Available In 1996–2009, the incidence of syphilis in the North-West region of Russia has declined and changed its structure. The frequency of neurosyphilis and latent forms increased, especially of late and unspecified latent syphilis. Differences in the structure of syphilis between the Leningrad region and St. Petersburg have been identified, which consisted in the reduction of primary syphilis and an increase in early latent syphilis in comparison with the city.
You, Ji Hong; Cho, Ki Won; Cha, Yoon Jin; Park, Hyo Jin
Syphilis is a rare disease in the rectum. It is difficult to diagnose because the characteristics of the rectal syphilis rectal lesion are highly varied. The endoscopic findings of rectal syphilis are proctitis, ulcers, and masses. If rectal syphilis is suspected to be the cause for rectal lesions, it is important for physicians to consider the sexual history and sexual orientation of the patient. We report a case of incidental rectal syphilis in a 41-year-old man diagnosed during a regular medical check-up.
V. D. Zavadovskaya
Full Text Available A peculiarity of the congenital syphilis of recent years is an increase of the number of cases of latent forms of the disease, marked with osteopathy. With the help of an examination of 50 children with early congenital syphilis, the following ultrasonic signs of a musculoskeletal system lesion were revealed: osteochondritis 90%, osteosclerosis 80%, and periostitis 30%.The comparison of the nature of a musculoskeletal system lesion with serological data of the specific process activity showed that complex manifestations of lesions with periostitis being a component were of the greatest clinical significance.
Ho, Emily L.; Lukehart, Sheila A.
Syphilis is a fascinating and perplexing infection, with protean clinical manifestations and both diagnostic and management ambiguities. Treponema pallidum subsp. pallidum, the agent of syphilis, is challenging to study in part because it cannot be cultured or genetically manipulated. Here, we review recent progress in the application of modern molecular techniques to understanding the biological basis of this multistage disease and to the development of new tools for diagnosis, for predicting efficacy of treatment with alternative antibiotics, and for studying the transmission of infection through population networks. PMID:22133883
Mutagoma, Mwumvaneza; Balisanga, Helene; Remera, Eric; Gupta, Neil; Malamba, Samuel S; Riedel, David J; Nsanzimana, Sabin
Syphilis can be transmitted by pregnant women to their children and is a public health problem in Africa. A cross-sectional survey was conducted in 24 antenatal clinics from 2002 to 2003 and increased to 30 sites from 2005 to 2011. Participants were tested for syphilis and HIV. Multi-variate logistic regression was performed to identify risks associated with syphilis and its co-infection with HIV. Results showed that syphilis decreased from 3.8% in 2002 to 2.0% in 2011. Syphilis in the HIV-infected participants increased from 6.0% in 2002 to 10.8% in 2011, but decreased from 3.7% to 1.7% in the HIV-negative participants. In 2011, syphilis in urban participants was 2.7% and 1.4% in rural ones. HIV-infected participants screened positive for syphilis more frequently in both rural (aOR = 3.64 [95% CI: 1.56%-8.51%]) and urban areas (aOR = 7.26 [95% CI: 5.04%-10.46%]). Older participants (25-49 years) residing in urban areas (aOR = 0.43[95% CI: 0.32%-0.58%]) and women with secondary or high education (aOR = 0.35[95% CI: 0.20%-0.62%]) were less likely to screen positive for syphilis. HIV-syphilis co-infection was more likely in women residing in urban areas (aOR = 8.32[95% CI: 3.54%-19.56%]), but less likely in women with secondary/high education (aOR = 0.11[95% CI: 0.01%-0.77%]). In conclusion, syphilis increased in HIV-positive pregnant women, but decreased in HIV-negative women. Positive HIV status and young age were associated risks for syphilis. HIV-syphilis co-infection was associated with a lower level of education and urban residence.
Wong, Ngai Sze; Huang, Shujie; Zheng, Heping; Chen, Lei; Zhao, Peizhen; Tucker, Joseph D; Yang, Li Gang; Goh, Beng Tin; Yang, Bin
Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015) accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21), adjusted for age at diagnosis and gender. Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.
Zhang, Xingyu; Zhang, Tao; Pei, Jiao; Liu, Yuanyuan; Li, Xiaosong; Medrano-Gracia, Pau
The infection rate of syphilis in China has increased dramatically in recent decades, becoming a serious public health concern. Early prediction of syphilis is therefore of great importance for heath planning and management. In this paper, we analyzed surveillance time series data for primary, secondary, tertiary, congenital and latent syphilis in mainland China from 2005 to 2012. Seasonality and long-term trend were explored with decomposition methods. Autoregressive integrated moving average (ARIMA) was used to fit a univariate time series model of syphilis incidence. A separate multi-variable time series for each syphilis type was also tested using an autoregressive integrated moving average model with exogenous variables (ARIMAX). The syphilis incidence rates have increased three-fold from 2005 to 2012. All syphilis time series showed strong seasonality and increasing long-term trend. Both ARIMA and ARIMAX models fitted and estimated syphilis incidence well. All univariate time series showed highest goodness-of-fit results with the ARIMA(0,0,1)×(0,1,1) model. Time series analysis was an effective tool for modelling the historical and future incidence of syphilis in China. The ARIMAX model showed superior performance than the ARIMA model for the modelling of syphilis incidence. Time series correlations existed between the models for primary, secondary, tertiary, congenital and latent syphilis.
Zhang, Xingyu; Zhang, Tao; Pei, Jiao; Liu, Yuanyuan; Li, Xiaosong; Medrano-Gracia, Pau
Background The infection rate of syphilis in China has increased dramatically in recent decades, becoming a serious public health concern. Early prediction of syphilis is therefore of great importance for heath planning and management. Methods In this paper, we analyzed surveillance time series data for primary, secondary, tertiary, congenital and latent syphilis in mainland China from 2005 to 2012. Seasonality and long-term trend were explored with decomposition methods. Autoregressive integrated moving average (ARIMA) was used to fit a univariate time series model of syphilis incidence. A separate multi-variable time series for each syphilis type was also tested using an autoregressive integrated moving average model with exogenous variables (ARIMAX). Results The syphilis incidence rates have increased three-fold from 2005 to 2012. All syphilis time series showed strong seasonality and increasing long-term trend. Both ARIMA and ARIMAX models fitted and estimated syphilis incidence well. All univariate time series showed highest goodness-of-fit results with the ARIMA(0,0,1)×(0,1,1) model. Conclusion Time series analysis was an effective tool for modelling the historical and future incidence of syphilis in China. The ARIMAX model showed superior performance than the ARIMA model for the modelling of syphilis incidence. Time series correlations existed between the models for primary, secondary, tertiary, congenital and latent syphilis. PMID:26901682
Full Text Available Abstract Introduction Myositis is a rare bacterial muscle infection. Involvement of the piriformis muscle has been rarely reported in the literature. In this report we describe a case of piriformis myositis due to Brucella melitensis, which to the best of our knowledge is the first such case presented in the literature. Case presentation We report the case of a 19-year-old Caucasian man who presented to our institution with fever and right hip pain. Brucellosis was suspected, but the clinical suspicion was for spondylodiscitis. A pelvic magnetic resonance imaging scan allowed prompt diagnosis of inflammatory involvement of the right piriformis muscle. Blood culture results were positive for B. melitensis. Our patient was treated with antibiotics, and follow-up magnetic resonance imaging scans showed resolution of the inflammation. Conclusion Brucellosis can present as piriformis myositis. The clinical diagnosis of piriformis myositis is difficult, as it can mimic other common entities such as referred back pain from spondylodiscitis. Magnetic resonance imaging is the method of choice for establishing the diagnosis in the early stages of the disease, as late diagnosis can lead to abscess formation and the need for drainage.
Full Text Available Abstract Background Globally syphilis is an important yet preventable cause of stillbirth, neonatal mortality and morbidity. Objectives This review sought to estimate the effect of detection and treatment of active syphilis in pregnancy with at least 2.4MU benzathine penicillin (or equivalent on syphilis-related stillbirths and neonatal mortality. Methods We conducted a systematic literature review of multiple databases to identify relevant studies. Data were abstracted into standardised tables and the quality of evidence was assessed using adapted GRADE criteria. Where appropriate, meta-analyses were undertaken. Results Moderate quality evidence (3 studies supports a reduction in the incidence of clinical congenital syphilis of 97% (95% c.i 93 – 98% with detection and treatment of women with active syphilis in pregnancy with at least 2.4MU penicillin. The results of meta-analyses suggest that treatment with penicillin is associated with an 82% reduction in stillbirth (95% c.i. 67 – 90% (8 studies, a 64% reduction in preterm delivery (95% c.i. 53 – 73% (7 studies and an 80% reduction in neonatal deaths (95% c.i. 68 – 87% (5 studies. Although these effect estimates were large and remarkably consistent across studies, few of the studies adjusted for potential confounding factors and thus the overall quality of the evidence was considered low. However, given these large observed effects and a clear biological mechanism for effectiveness the GRADE recommendation is strong. Conclusion Detection and appropriate, timely penicillin treatment is a highly effective intervention to reduce adverse syphilis-related pregnancy outcomes. More research is required to identify the most cost-effective strategies for achieving maximum coverage of screening for all pregnant women, and access to treatment if required.
Background Globally syphilis is an important yet preventable cause of stillbirth, neonatal mortality and morbidity. Objectives This review sought to estimate the effect of detection and treatment of active syphilis in pregnancy with at least 2.4MU benzathine penicillin (or equivalent) on syphilis-related stillbirths and neonatal mortality. Methods We conducted a systematic literature review of multiple databases to identify relevant studies. Data were abstracted into standardised tables and the quality of evidence was assessed using adapted GRADE criteria. Where appropriate, meta-analyses were undertaken. Results Moderate quality evidence (3 studies) supports a reduction in the incidence of clinical congenital syphilis of 97% (95% c.i 93 – 98%) with detection and treatment of women with active syphilis in pregnancy with at least 2.4MU penicillin. The results of meta-analyses suggest that treatment with penicillin is associated with an 82% reduction in stillbirth (95% c.i. 67 – 90%) (8 studies), a 64% reduction in preterm delivery (95% c.i. 53 – 73%) (7 studies) and an 80% reduction in neonatal deaths (95% c.i. 68 – 87%) (5 studies). Although these effect estimates were large and remarkably consistent across studies, few of the studies adjusted for potential confounding factors and thus the overall quality of the evidence was considered low. However, given these large observed effects and a clear biological mechanism for effectiveness the GRADE recommendation is strong. Conclusion Detection and appropriate, timely penicillin treatment is a highly effective intervention to reduce adverse syphilis-related pregnancy outcomes. More research is required to identify the most cost-effective strategies for achieving maximum coverage of screening for all pregnant women, and access to treatment if required. PMID:21501460
Meng, Fanjie; Pan, Xiangpo; Tong, Wenzhen
Brucellosis is a zoonotic disease with a high morbidity in developing countries, but there the optimal treatment is not yet determined. Therefore, the development of a simple and effective treatment is important. The aim of this study was to summarize the available evidences and compare rifampicin with streptomycin in human brucellosis with doxycycline as background regimen. We systematically searched PubMed, EmBase, and the Cochrane Library from their inception up through December 2016. We included studies with a randomized controlled design that evaluated the effect of streptomycin compared with rifampicin in human brucellosis patients who received doxycycline therapy as background regimen. The overall failure and relapse were summarized using random-effects model. Our meta-analysis included 1,383 patients with brucellosis from 14 trials. We found that patients who received rifampicin therapy had a higher risk of overall failure (RR: 2.36; 95% CI: 1.72-3.23; Pbrucellosis receiving streptomycin therapy.
Zhan, B D; Wang, S Q; Lai, S M; Lu, Y; Shi, X G; Cao, G P; Hu, X L; Zheng, C J; Yu, Z Y; Zhang, J M; Fang, C F; Gong, Z Y
Brucellosis is an occupational disease affecting workers in butcher shops, the milking and dairy product industry, causing more than 500 000 new cases around the world. As a national statutory B infectious disease in China, morbidity of brucellosis is rapidly increasing in recent years. We report an occupational outbreak of brucellosis infection in a pharmaceutical factory. Exposure was a result of manual operation in the process line, close contact with sheep placentas, insufficient disinfection and repeated using of protective suits and infected by aerosol dissemination. Improved preventive methods, appropriate public health measures and spread of health education would be helpful to prevent the occupational outbreak of brucellosis in future. © 2016 Blackwell Verlag GmbH.
Conclusions: Despite international and national recommendations, more than half of the studied health facilities that provide blood transfusions in Ghana are not screening blood donations for syphilis. These data show a considerable mismatch between recommendations and practice, with serious consequences for blood safety and public health.
Crevel, R. van; Grefte, J.M.M.; Doorninck, D. van; Sturm, P.D.J.
Two young adult brothers, with no apparent risk for sexually transmitted infections (STI), presented with unilateral cervical lymphadenitis. Syphilis was diagnosed by fine-needle aspiration cytology in one case, and subsequent serology and revision of a resected lymph node in the second case.
Sixty one patients with early syphilis were treated with benzathine penicillin under guide of serological analysis, the results showed that benzathine penicilline was able to cure indurated chancre and skin rashes in a month, flat condyloma in one and a half month, and PRP were all negative in 18 month
Naaber, Paul; Makoid, Ene; Aus, Anneli; Loivukene, Krista; Poder, Airi
Laboratory diagnosis of syphilis is usually accomplished by serology. There are currently a large number of different commercial treponemal tests available that vary in format, sensitivity and specificity. To evaluate the ID-PaGIA Syphilis Antibody Test as an alternative to other specific treponemal tests for primary screening or confirmation of diagnosis. Serum samples from healthy adults (n = 100) were used for detection of specificity of ID-PaGIA. To evaluate sensitivity of ID-PaGIA serum samples (n = 101) from patients with confirmed or suspected syphilis were tested for syphilis antibodies with FTA-Abs IgM, ID-PaGIA, ELISA IgM and TPHA tests. No false-positive results were found with ID-PaGIA. Sensitivity of various treponemal tests was the following: FTA-Abs IgM: 95.5%, ID-PaGIA and ELISA IgM: 94%, and TPHA 75%. The positive and negative predictive values of ID-PaGIA were 100 and 89.5%, respectively. Compared with other treponemal tests ID-PaGIA has excellent sensitivity and specificity.
of 1932 in the US, the Guatemala experiments on prisoners, prostitutes and infidels of 1946 .... violated in the Tuskegee Study, with a view to contributing to a more secure future. ... fields of medicine, psychology, civil rights, law, ethics and religion. ..... The Tuskegee Syphilis study has left us with unpleasant memories of how ...
BACKGROUND: Syphilis is one of the mandatory transfusion transmissible infections to be tested for in any unit of blood for homologous transfusion. The paucity of voluntary blood donors in Nigeria has compelled health care providers to rely on paid and family replacement donors for blood. AIMS: This study was carried ...
Objectives: We aimed to evaluate socio-demographic factors associated with HIV and syphilis seroreactivity in pregnant Malawians presenting for antenatal care in late third trimester of pregnancy. Methods: Between December 2000 and March 2004 at Queen Elizabeth Central Hospital Blantyre, Malawi, we collected ...
Erasmus, Syphilis and the abuse of stigma. C Whitty. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...
Abstract. Background: In general,the risk of transfusion transmitted infections has been greatly reduced today. However, blood borne bacterial, viral as well as parasitic infections and emerging infections transmitted through transfusion are an area of increasing concern. More recently, there has been a resurgence of syphilis ...
Wang, Lu; Tang, Weiming; Wang, Lan; Qian, Shasha; Li, Yin-Ge; Xing, Jiannan; Li, Dongmin; Ding, Zhengwei; Babu, Giridhara R; Wang, Ning
Studies on the transmission of human immunodeficiency virus (HIV) and sexually transmitted diseases in female sex workers (FSWs) have been limited primarily to inferences drawn by focusing on defined geographical areas. This serial cross-sectional study was conducted in mainland China from 2008 through 2012. Data for 827 079 participants was analyzed. We classified venues such as karaoke bars and hotels as high tier and venues such as hair salons and barbershops, massage parlors, and other public outdoor venues as low tier based on the participants' socioeconomic status. FSWs who worked at the venues and those who were present on the days of the survey were recruited. The prevalence of HIV decreased from 0.6% in 2008 to 0.3% in 2012, the syphilis prevalence ranged from 2.4% to 3.2% between 2008 and 2012, and hepatitis C virus (HCV) prevalence decreased from 0.9% in 2008 to 0.8% in 2012. Further, we found that HIV, syphilis, and HCV prevalence proportions were high in FSWs from low tiers. HIV, syphilis, and HCV prevalence among FSWs in our study decreased during the study period. Comprehensive intervention strategies, particularly those that focus on low-tier and older FSWs, are needed in order to decrease the disease burden in this population. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: email@example.com.
Full Text Available Abstract Background Brucellosis is known to cause debilitating conditions if not promptly treated. In some rural areas of Tanzania however, practitioners give evidence of seeing brucellosis cases with symptoms of long duration. The purpose of this study was to establish health-seeking behaviour of human brucellosis cases in rural Tanzania and explore the most feasible ways to improve it. Methods This was designed as a longitudinal study. Socio-demographic, clinical and laboratory data were collected from patients who reported to selected hospitals in rural northern Tanzania between June 2002 and April 2003. All patients with conditions suspicious of brucellosis on the basis of preliminary clinical examination and history were enrolled into the study as brucellosis suspects. Blood samples were taken and tested for brucellosis using the Rose-Bengal Plate Test (RBPT and other agglutination tests available at the health facilities and the competitive ELISA (c-ELISA test at the Veterinary Laboratory Agencies (VLA in the UK. All suspects who tested positive with the c-ELISA test were regarded as brucellosis cases. A follow-up of 49 cases was made to collect data on health-seeking behaviour of human brucellosis cases. Results The majority of cases 87.7% gave a history of going to hospital as the first point of care, 10.2% purchased drugs from a nearby drug shop before going to hospital and 2% went to a local traditional healer first. Brucellosis cases delayed going to hospital with a median delay time of 90 days, and with 20% of the cases presenting to hospitals more than a year after the onset of symptoms. Distance to the hospital, keeping animals and knowledge of brucellosis were significantly associated with patient delay to present to hospital. Conclusion More efforts need to be put on improving the accessibility of health facilities to the rural poor people who succumb to most of the diseases including zoonoses. Health education on brucellosis in
Background Brucellosis is one of the most common zoonotic infections globally. Lack of knowledge about brucellosis may affect the health-seeking behavior of patients, thus leading to sustained transmission in these communities. Our study assessed knowledge and perceptions of brucellosis among pastoral communities adjacent to Lake Mburo National Park (LMNP), Kiruhura District, Uganda. Methods A community cross-sectional questionnaire survey involving 371 randomly selected household heads from three sub-counties neighboring LMNP were interviewed between June and August 2012. Data collected included communities’ knowledge on causes, symptoms, transmission, treatment, prevention and risk factors of brucellosis. Multivariable logistic regression analysis was performed to explore strength of association between overall knowledge of brucellosis and various individual factors using odds ratios and 95% confidence intervals. Results Only 70 (19%) knew the symptoms of brucellosis in animals, and three quarters (279, 75.5%) mentioned joint and muscle pain as a common symptom in humans. Almost all participants (370, 99.3%) had ever heard about brucellosis, majority (311, 84.7%) believed it affects all sexes and two thirds (67.7%) of the respondents believed close proximity to wildlife contributes to the presence of the disease. Almost all (352, 95.4%) knew that brucellosis in humans could be treatable using modern drugs. The main routes of infection in humans such as consumption of unpasteurized dairy products were known by 97% (360/371); eating of half-cooked meat by 91.4% and eating contaminated pasture in animals by 97.4%. There was moderate overall knowledge of brucellosis 197 (53.1%). Factors associated with higher overall knowledge were being agro-pastoralists (aOR: 2.08, CI: 1.17-3.71) compared to pure pastoralists while those who reported that the disease was a health problem (aOR: 0.18, CI: 0.06-0.56) compared to those who said it was not were less likely to be
Workalemahu, Bereket; Sewunet, Tsegaye; Astatkie, Ayalew
Human brucellosis is neglected in southern Ethiopia. Although traditional food processing practices and animal husbandry which increase the risk of brucellosis are common, it has not been properly studied yet. This study was conducted to determine the seroepidemiology of brucellosis among apparently healthy individuals in southern Ethiopia. In the study, blood samples were collected to screen for serum agglutinins reactive to stained antigen of Brucella abortus Standard tube titration was performed for reactive serum to determine the titer of the agglutinin. A structured questionnaire was used to collect data on possible risk factors for brucellosis. The seroprevalence of human brucellosis in this study was found to be 10.6% (95% confidence interval = 7.0, 14.0). Possession of domestic ruminant animals, contact with ruminant animals, and husbandry practices at home were associated with seropositivity. The higher seroprevalence of human brucellosis in the study area needs attention and additional confirmatory investigation. © The American Society of Tropical Medicine and Hygiene.
Zhao, Zhi Jun; Li, Qiang; Zhou, Xin; Ma, Li; Xu, Li Qing; Yang, Pei Zhen; Meng, Xian Ya; Yu, Hui Zhen; Xu, Xiao Qing; Cao, Jian Ying
Brucellosis is one of the most widespread zoonotic diseases, with the most frequent complication being osteoarticular changes. The aim of this study was to assess the changes of C-terminal telopeptide of type II collagen (CTX-II) in patients infected with brucellosis. A total of 84 brucellosis patients and 43 volunteers were selected and divided into brucellosis vs. control groups. Serum samples were subjected to serological tests for brucellosis, and CTX-II levels in all samples were measured simultaneously with ELISA. The results showed that serum CTX-II levels in human brucellosis were higher than those of healthy controls, without a statistically significant difference, but serum CTX-II levels in male patients were significantly higher than those of female patients (Pbrucellosis. Copyright © 2016 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.
Kichieva, B N; Chernysheva, M I; Zheludkov, M M; Musaeva, N B
The data on the IgA, IgM and IgG levels in the sera of 89 patients with chronic brucellosis lasting for 1-10 years and longer are presented. The chronic form of brucellosis is characterized by the normal or low level of immunoglobulins. No correlation between the levels of IgG, IgM and the titer of specific antibodies has been established.
Brawley, Otis W.
Purpose: The participation of minorities in clinical studies is the subject of much discussion and has even become the subject of Federal law. The project known as the Tuskegee Syphilis Study and officially titled 'The Tuskegee Study of Untreated Syphilis in the Negro Male', is one of the great debacles of American medicine and a national shame. Despite the fact that its existence is well known, many do not know the historical facts of the study nor the context of the study. My purpose here is to recount the facts of the study and its historical context. Methods: The history recounted here is taken from documents gathered during a U.S. Senate investigation of the study, original papers located in National Library of Medicine, and books about the trial. Results: The trial began in 1931 as a survey of the natural history of untreated tertiary syphilis in Black men. This study enrolled 399 men with syphilis and 201 uninfected men to serve as controls. All were at least 25 years old at enrollment. The men were told they were in a study, but never educated about the implications. Later, men were not informed that there was a treatment for effective treatment for their disease - a treatment that was being withheld from them. This trial continued till 1972. Conclusion: Many of the issues that led to the study and caused it to continue for 40 years still exist. The lessons of the Public Health Study of Untreated Syphilis in the Untreated Negro include the dangers of paternalism, arrogance, blind loyalty, and misuse of science. 'Those who do not appreciate history are condemned to repeat it' (Alfred North Whitehead)
Vilma Costa de Macêdo
Full Text Available ABSTRACT OBJECTIVE To determine the sociodemographic, behavioral, and health care factors related to the occurrence of syphilis in women treated at public maternity hospitals. METHODS This is a case-control study (239 cases and 322 controls with women admitted to seven maternity hospitals in the municipality of Recife, Brazil, from July 2013 to July 2014. Eligible women were recruited after the result of the VDRL (Venereal Disease Research Laboratory under any titration. The selection of cases and controls was based on the result of the serology for syphilis using ELISA (enzyme-linked immunosorbent assay. The independent variables were grouped into: sociodemographic, behavioral, clinical and obstetric history, and health care in prenatal care and maternity hospital. Information was obtained by interview, during hospitalization, with the application of a questionnaire. Odds ratios and 95% confidence intervals were estimated using logistic regression to identify the predicting factors of the variable to be explained. RESULTS The logistic regression analysis identified as determinant factors for gestational syphilis: education level of incomplete basic education or illiterate (OR = 2.02, lack of access to telephone (OR = 2.4, catholic religion (OR = 1.70 , four or more pregnancies (OR = 2.2, three or more sexual partners in the last year (OR = 3.1, use of illicit drugs before the age of 18 (OR = 3.0, and use of illicit drugs by the current partner (OR = 1.7. Only one to three prenatal appointments (OR = 3.5 and a previous history of sexually transmitted infection (OR = 9.7 were also identified as determinant factors. CONCLUSIONS Sociodemographic, behavioral, and health care factors are associated with the occurrence of syphilis in women and should be taken into account in the elaboration of universal strategies aimed at the prevention and control of syphilis, but with a focus on situations of greater vulnerability.
de Macêdo, Vilma Costa; de Lira, Pedro Israel Cabral; de Frias, Paulo Germano; Romaguera, Luciana Maria Delgado; Caires, Silvana de Fátima Ferreira; Ximenes, Ricardo Arraes de Alencar
ABSTRACT OBJECTIVE To determine the sociodemographic, behavioral, and health care factors related to the occurrence of syphilis in women treated at public maternity hospitals. METHODS This is a case-control study (239 cases and 322 controls) with women admitted to seven maternity hospitals in the municipality of Recife, Brazil, from July 2013 to July 2014. Eligible women were recruited after the result of the VDRL (Venereal Disease Research Laboratory) under any titration. The selection of cases and controls was based on the result of the serology for syphilis using ELISA (enzyme-linked immunosorbent assay). The independent variables were grouped into: sociodemographic, behavioral, clinical and obstetric history, and health care in prenatal care and maternity hospital. Information was obtained by interview, during hospitalization, with the application of a questionnaire. Odds ratios and 95% confidence intervals were estimated using logistic regression to identify the predicting factors of the variable to be explained. RESULTS The logistic regression analysis identified as determinant factors for gestational syphilis: education level of incomplete basic education or illiterate (OR = 2.02), lack of access to telephone (OR = 2.4), catholic religion (OR = 1.70 ), four or more pregnancies (OR = 2.2), three or more sexual partners in the last year (OR = 3.1), use of illicit drugs before the age of 18 (OR = 3.0), and use of illicit drugs by the current partner (OR = 1.7). Only one to three prenatal appointments (OR = 3.5) and a previous history of sexually transmitted infection (OR = 9.7) were also identified as determinant factors. CONCLUSIONS Sociodemographic, behavioral, and health care factors are associated with the occurrence of syphilis in women and should be taken into account in the elaboration of universal strategies aimed at the prevention and control of syphilis, but with a focus on situations of greater vulnerability. PMID:28832758
G. L. Katunin
Full Text Available Goal. To conduct a comparative assessment of the results of regulated serological tests obtained as a result of blood tests in patients suffering from latent syphilis. Materials and methods. The authors examined 187 patient medical records with newly diagnosed latent syphilis in FGBU GNTsDK (State Research Center for Dermatology, Venereology and Cosmetology, Health Ministry of the Russian Federation, in 2006-2015. The results of patient blood tests were analyzed with the use of non-treponemal (microprecipitation test/RPR and treponemal (passive hemagglutination test, immune-enzyme assay (IgA, IgM, IgG, IFabs, immunofluorescence test and Treponema pallidum immobilization test serology tests. Results. According to the results of blood tests of latent syphilis patients, the largest number of positive results was obtained as a result of treponemal serology tests such as immune-enzyme assay (100%, passive hemagglutination test (100% and IFabs (100%. The greatest number of negative results was observed in non-treponemal (microprecipitation test/RPR serology tests: in 136 (72.7% patients; evidently positive results (4+ test results were obtained in 8 (4.3% patients only. According to the results of a comparative analysis of blood tests in patients suffering from latent syphilis obtained with the use of treponemal serology tests, the greatest number of evidently positive results (4+ was noted for the passive hemagglutination test (67.9%. Negative treponemal test results were obtained with the use of the immunofluorescence test and Treponema pallidum immobilization test (21.9% and 11.8% of cases, respectively. Moreover, weakly positive results prevailed for the immunofluorescence test: in 65 (34.7% patients. Conclusion. These data confirm that the following treponemal tests belong to the most reliable ones for revealing patients suffering from latent syphilis: immune-enzyme assay, passive hemagglutination test and IFabs.
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Beauvais, Wendy; Coker, Richard; Nurtazina, Gulzhan; Guitian, Javier
Brucellosis is a considerable public health and economic burden in many areas of the world including sub-Saharan Africa, the Middle East and former USSR countries. The collapse of the USSR has been cited as a driver for re-emergence of diseases including brucellosis, and human incidence rates in the former Soviet republics have been estimated as high as 88 per 100,000 per year. The aim of this paper is to examine the historical trends in brucellosis in Kazakhstan and to explore how livestock systems, veterinary services and control policies may have influenced them. In conclusion, a brucellosis epidemic most likely began before the collapse of the USSR and high livestock densities may have played an important role. Changes to the livestock systems in Kazakhstan, as well as other factors, are likely to have an impact on the success of brucellosis policies in the future. Incentives and practicalities of different policies in smallholder settings should be considered. However, the lack of reliable estimates of brucellosis prevalence and difficulties in understanding exactly how policy is being applied in Kazakhstan, which is a vast country with low population density, prevent firm conclusions from being drawn.
N. I. Kovalevich
Full Text Available The purpose of the study was to determine the level of proinflammatory cytokines: IL-12, IL-8 and IFNγ, neopterin and lipopolysaccharide-binding protein in the serum of patients with acute brucellosis before and after antibiotic therapy. The clinical data from 32 patients with laboratory-confirmed diagnosis — “acute brucellosis” admitted to the diagnosis, treatment and examination of occupational diseases brucellosis GBUZ SC “City Clinical Hospital No. 2”, the city of Stavropol were used in the study. The concentrations IL-12, IL-8, IFNγ cytokines and acute-phase proteins in serum was determined by ELISA. In the acute phase of brucellosis infection (before treatment had high levels of pro-inflammatory cytokines IL-8 and IFNγ, but despite holding a course of antibiotic treatment in the serum of patients with preserved high levels of IL-8, indicative of active inflammation in the absence of clinical manifestations. IL-12 level, a key cytokine in the initiation of lymphocyte-dependent immune response was lower than in the control group. Evaluation of the cytokine status (IL-8, IL-12, IL-18 and proteins of acute inflammation phase (neopterin and lipopolysaccharide-binding protein will provide valuable information for monitoring the effect of pharmacotherapy of acute brucellosis. Indicators of lipopolysaccharide-binding protein and neopterin in the serum of patients with brucellosis should be considered as a marker of inflammatory activity and as a predictor of outcome of acute brucellosis.
J. B. Muma
Full Text Available A study was performed in 2008 to estimate the prevalence of tuberculosis and brucellosis in traditionally reared cattle of Southern Province in Zambia in four districts. The single comparative intradermal tuberculin test (SCITT was used to identify TB reactors, and the Rose Bengal test (RBT, followed by confirmation with competitive enzyme-linked immunosorbent assay (c-ELISA, was used to test for brucellosis. A total of 459 animals were tested for tuberculosis and 395 for brucellosis. The overall prevalence of BTB based on the 4 mm and 3 mm cutoff criteria was 4.8% (95% CI: 2.6–7.0% and 6.3% (95% CI: 3.8–8.8%, respectively. Change in skin thickness on SCITT was influenced by initial skin-fold thickness at the inoculation site, where animals with thinner skin had a tendency to give a larger tuberculin response. Brucellosis seroprevalence was estimated at 20.7% (95% CI: 17.0–24.4%. Comparison between results from RBT and c-ELISA showed good agreement (84.1% and revealed subjectivity in RBT test results. Differences in brucellosis and tuberculosis prevalence across districts were attributed to type of husbandry practices and ecological factors. High prevalence of tuberculosis and brucellosis suggests that control control programmes are necessary for improved cattle productivity and reduced public health risk.
Al-Griw, Huda H; Kraim, Elfurgani Salem; Farhat, Milad E; Perrett, Lorraine L; Whatmore, Adrian M
Animal brucellosis is thought to be present in small ruminants, cattle, and camels in Libya, particularly in the west coastal strip. Before the system collapsed due to political unrest in 2011, prevalence of the disease did not exceed 0.2% in cattle, 0.1% in camels, 8.3% in sheep, and 14.8% in goats. The aim of this study was to highlight outbreaks of disease that took place during the 18-month period from November 2014 to April 2016. A total of 1612 serum samples, collected opportunistically from 29 herds in 12 different localities in the northwest region of Libya, were investigated for brucellosis. The samples were screened for Brucella antibodies using the Rose Bengal test, and confirmed with either indirect enzyme linked immunosorbent assay in the case of sheep, and/or a serum agglutination test, followed with a complement fixation test, in the case of cattle and camels. Our results showed the highest rates of brucellosis seropositivity in goats (33.4%) and sheep (9.2%). The overall percentage of brucellosis seropositivity was 21%. The high level of brucellosis identified by this study, particularly in small ruminants, strongly suggests re-emergence of the disease in the region. Re-evaluation of intervention measures applied to the control of brucellosis is highly recommended. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.
Çiftdoğan, Dilek Yılmaz; Aslan, Selda
Brucellosis is an infectious, contagious and zoonotic disease that occurs worldwide. The family members of an index case of brucellosis may be especially susceptible, due to sharing the same source of infection and similar risk factors for brucellosis. In this study, we propose to screen pediatric and adult family members of brucellosis index cases for detecting additional unrecognized infected family members. 114 family members of 41 pediatric patients with brucellosis were evaluated. All family members completed a brief questionnaire and were tested by a standard tube agglutination test (STA). The majority of family members (n=96, 84.2%) were children. Among the 114 family members, 42 (36.8%) were seropositive, and 15 (35.7%) were symptomatic. The majority of the symptomatic seropositive family members (n=12, 80%) had STA titers (≥1:640) higher than asymptomatic seropositive family members (n=9, 33%; p=0.004). The routine screening of both pediatric and adult family members of index cases is a priority in endemic areas. Using this screening approach, unrecognized family members who are seropositive for brucellosis will be identified earlier and be able to receive prompt treatment. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.
Mailles, A; Garin-Bastuji, B; Lavigne, J P; Jay, M; Sotto, A; Maurin, M; Pelloux, I; O'Callaghan, D; Mick, V; Vaillant, V; De Valk, H
Brucellosis is a bacterial zoonotic disease mainly transmitted to humans by ruminants. In France, brucellosis has disappeared from ruminants herds. Human brucellosis surveillance is performed through mandatory notification and the national reference center. We report the results of human brucellosis surveillance from 2004 to 2013 with regards to epidemiological, clinical and microbiological data. A total of 250 cases were notified, making an annual incidence of 0.3 cases per million inhabitants. Brucella melitensis biovar 3 was the most frequently identified bacterium (79% of isolated strains). In total, 213 (85%) cases had been contaminated abroad in endemic countries. In 2012, an episode of re-emergence of brucellosis in cattle occurred in Haute-Savoie, in the French Alps, and was responsible for 2 human cases. Brucellosis has become a disease of travelers in France. However, maintaining a stringent epidemiological surveillance is necessary to be able to early detect any local re-emergence in humans or animals. The multidisciplinary surveillance was implemented in France years ago and is a successful example of the One Health Concept. Copyright Â© 2016 Elsevier Masson SAS. All rights reserved.
Li, Ming-Tao; Sun, Gui-Quan; Zhang, Wen-Yi; Jin, Zhen
Brucellosis, the most common zoonotic disease worldwide, represents a great threat to animal husbandry with the potential to cause enormous economic losses. Brucellosis has become a major public health problem in China, and the number of human brucellosis cases has increased dramatically in recent years. In order to evaluate different intervention strategies to curb brucellosis transmission in China, a novel mathematical model with a general indirect transmission incidence rate was presented. By comparing the results of three models using national human disease data and 11 provinces with high case numbers, the best fitted model with standard incidence was used to investigate the potential for future outbreaks. Estimated basic reproduction numbers were highly heterogeneous, varying widely among provinces. The local basic reproduction numbers of provinces with an obvious increase in incidence were much larger than the average for the country as a whole, suggesting that environment-to-individual transmission was more common than individual-to-individual transmission. We concluded that brucellosis can be controlled through increasing animal vaccination rates, environment disinfection frequency, or elimination rates of infected animals. Our finding suggests that a combination of animal vaccination, environment disinfection, and elimination of infected animals will be necessary to ensure cost-effective control for brucellosis.
Kayabas, Uner [Department of Infectious Disease and Clinical Microbiology, Inonu University, Medical Faculty, TR-44280 Malatya (Turkey)], E-mail: firstname.lastname@example.org; Alkan, Alpay; Firat, Ahmet Kemal; Karakas, Hakki Muammer [Department of Radiology, Inonu University, Medical Faculty, TR-44280 Malatya (Turkey); Bayindir, Yasar; Yetkin, Funda [Department of Infectious Disease and Clinical Microbiology, Inonu University, Medical Faculty, TR-44280 Malatya (Turkey)
We aimed to evaluate whether the subtle metabolic cerebral changes are present in normal-appearing white matter on conventional MRI, in patients with acute brucellosis, by using MR spectroscopy (MRS). Sixteen patients with acute brucellosis and 13 healthy control subjects were investigated with conventional MRI and single-voxel MRS. Voxels were placed in normal-appearing parietal white matter (NAPWM). N-Acetyl aspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios were calculated. There was no significant difference between the study subjects and the control group in NAA/Cr ratios obtained from NAPWM. However, the Cho/Cr ratios were significantly higher in patients with acute brucellosis compared to controls (p = 0.01). MRS revealed metabolic changes in normal-appearing white matter of patients with brucellosis. Brucellosis may cause subtle cerebral alterations, which may only be discernible with MRS. Increased Cho/Cr ratio possibly represents an initial phase of inflammation and/or demyelination process of brucellosis.
Serrano, E.; Cross, P.C.; Beneria, M.; Ficapal, A.; Curia, J.; Marco, X.; Lavin, S.; Marco, I.
When a pathogen infects a number of different hosts, the process of determining the relative importance of each host species to the persistence of the pathogen is often complex. Removal of a host species is a potential but rarely possible way of discovering the importance of that species to the dynamics of the disease. This study presents the results of a 12-year programme aimed at controlling brucellosis in cattle, sheep and goats and the cascading impacts on brucellosis in a sympatric population of red deer (Cervus elaphus) in the Boumort National Game Reserve (BNGR; NE Spain). From February 1998 to December 2009, local veterinary agencies tested over 36 180 individual blood samples from cattle, 296 482 from sheep and goats and 1047 from red deer in the study area. All seropositive livestock were removed annually. From 2006 to 2009 brucellosis was not detected in cattle and in 2009 only one of 97 red deer tested was found to be positive. The surveillance and removal of positive domestic animals coincided with a significant decrease in the prevalence of brucellosis in red deer. Our results suggest that red deer may not be able to maintain brucellosis in this region independently of cattle, sheep or goats, and that continued efforts to control disease in livestock may lead to the eventual eradication of brucellosis in red deer in the area.
Kayabas, Uner; Alkan, Alpay; Firat, Ahmet Kemal; Karakas, Hakki Muammer; Bayindir, Yasar; Yetkin, Funda
We aimed to evaluate whether the subtle metabolic cerebral changes are present in normal-appearing white matter on conventional MRI, in patients with acute brucellosis, by using MR spectroscopy (MRS). Sixteen patients with acute brucellosis and 13 healthy control subjects were investigated with conventional MRI and single-voxel MRS. Voxels were placed in normal-appearing parietal white matter (NAPWM). N-Acetyl aspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios were calculated. There was no significant difference between the study subjects and the control group in NAA/Cr ratios obtained from NAPWM. However, the Cho/Cr ratios were significantly higher in patients with acute brucellosis compared to controls (p = 0.01). MRS revealed metabolic changes in normal-appearing white matter of patients with brucellosis. Brucellosis may cause subtle cerebral alterations, which may only be discernible with MRS. Increased Cho/Cr ratio possibly represents an initial phase of inflammation and/or demyelination process of brucellosis
Yousefali Abedini; Nahideh Mohammadi; Koorosh Kamali; Mohsen Ahadnejad; Mehdi Azari
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 win...
Nematollahi, Shahrzad; Ayubi, Erfan; Karami, Manoochehr; Khazaei, Salman; Shojaeian, Masoud; Zamani, Reza; Mansori, Kamyar; Gholamaliee, Behzad
Human brucellosis and recurrent brucellosis is an ever-increasing public health concern, especially in endemic areas like Iran. Nevertheless, little is known regarding the epidemiology and determinants of recurrent brucellosis. Therefore, the objective of this study was to investigate epidemiological patterns and potential determinants of recurrent brucellosis in Hamadan Province during the years 2009-2015. Data on reported cases of new and recurrent brucellosis from 2009 to 2015 were obtained from the provincial Notifiable Diseases Surveillance System at Hamadan University of Medical Sciences. Incidence rates per 100000 were estimated at the county level. Binary logistic regression was used to estimate the effects of background characteristics and recurrent brucellosis. The power of discrimination of the model for recurrent brucellosis was assessed using the area under the curve (AUC). Among 7318 brucellosis cases, the total frequency (%) of recurrent cases was 472 (6.45%). The rate of recurrent brucellosis was higher in females, people aged 50 years and over, people with a history of consuming unpasteurized dairy products with no history of contact with animals, and in the winter season. Multivariable logistic regression analysis showed that female sex (adjusted odds ratio (AOR) 1.36, 95% confidence interval (CI) 1.13-1.65), age ≥55 years (AOR 4.15, 95% CI 2.32-7.42), consumption of unpasteurized dairy products (AOR 1.16, 95% CI 0.96-1.40), and winter season (AOR 1.32, 95% CI 1.03-1.71) are potential risk factors for recurrent brucellosis. The final model that involved all the determinants showed moderate discrimination (AUC 0.61). Female sex, older age, and winter months were found to be significant determinants of recurrent human brucellosis. Enhanced surveillance systems with an emphasis on these population characteristics will allow effective preventive and protective measures to be implemented and might alleviate the recurrence of brucellosis in the
Enders, Martin; Hunjet, Andrea; Gleich, Michael; Imdahl, Roland; Mühlbacher, Annelies; Schennach, Harald; Chaiwong, Kriangsak; Sakuldamrongpanich, Tasanee; Turhan, Ajda; Sertöz, Rüchan; Wolf, Eva; Mayer, Wolfgang; Tao, Chuanmin; Wang, Lan Lan; Semprini, Simona; Sambri, Vittorio
Syphilis is a health problem of increasing incidence in recent years that may have severe complications if not diagnosed and treated at an early stage. There are many diagnostic tests available for syphilis, but there is no gold standard, and diagnosis therefore usually relies upon a combination of tests. In this multicenter study, we evaluated the treponemal Elecsys syphilis assay for use in the diagnosis of syphilis in routine samples, i.e., when syphilis is suspected or during antenatal or blood donation screening. The sensitivity and specificity of the Elecsys syphilis assay were compared head to head with those of other treponemal assays used in routine clinical practice and were assessed in potentially cross-reactive samples from patients with Epstein-Barr virus, HIV, and Lyme disease. In a total of 8,063 syphilis-negative samples collected from routine diagnostic requests and blood donations, the Elecsys syphilis assay had a specificity of 99.88%. In 928 samples previously identified as syphilis positive, the sensitivity was 99.57 to 100% (the result is presented as a range depending on whether four initially indeterminate samples are included in the assessment). The specificity of the Elecsys syphilis assay in patients with other infections was 100%; no false-positive samples were identified. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
Enders, Martin; Hunjet, Andrea; Gleich, Michael; Imdahl, Roland; Mühlbacher, Annelies; Schennach, Harald; Chaiwong, Kriangsak; Sakuldamrongpanich, Tasanee; Turhan, Ajda; Sertöz, Rüchan; Wolf, Eva; Mayer, Wolfgang; Tao, Chuanmin; Wang, Lan Lan; Semprini, Simona
Syphilis is a health problem of increasing incidence in recent years that may have severe complications if not diagnosed and treated at an early stage. There are many diagnostic tests available for syphilis, but there is no gold standard, and diagnosis therefore usually relies upon a combination of tests. In this multicenter study, we evaluated the treponemal Elecsys syphilis assay for use in the diagnosis of syphilis in routine samples, i.e., when syphilis is suspected or during antenatal or blood donation screening. The sensitivity and specificity of the Elecsys syphilis assay were compared head to head with those of other treponemal assays used in routine clinical practice and were assessed in potentially cross-reactive samples from patients with Epstein-Barr virus, HIV, and Lyme disease. In a total of 8,063 syphilis-negative samples collected from routine diagnostic requests and blood donations, the Elecsys syphilis assay had a specificity of 99.88%. In 928 samples previously identified as syphilis positive, the sensitivity was 99.57 to 100% (the result is presented as a range depending on whether four initially indeterminate samples are included in the assessment). The specificity of the Elecsys syphilis assay in patients with other infections was 100%; no false-positive samples were identified. PMID:25355799
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Salado-Rasmussen, Kirsten; Katzenstein, Terese Lea; Gerstoft, Jan
in men diagnosed with one of these sexually transmitted diseases indicate a high frequency of unsafe sex in the Danish MSM population. As one-third of the HIV-infected persons diagnosed with syphilis had high viral loads, our data support initiation of antiretroviral therapy in all HIV-infected MSM...... to reduce HIV transmission....
Chris Richard Kenyon
Full Text Available How can we explain the uneven decline of syphilis around the world following the introduction of penicillin? In this paper we use antenatal syphilis prevalence (ASP to investigate how syphilis prevalence varied worldwide in the past century, and what risk factors correlate with this variance.1 A systematic review using PubMed and Google Scholar was conducted to identify countries with published data relating to ASP estimates from before 1952 until the present. Eleven countries were identified (Canada, Denmark, Finland, India, Japan, Norway, Singapore, South Africa, United States of America (USA, United Kingdom (UK and Zimbabwe. The ASP epidemic curve for each population was depicted graphically. In South Africa and the USA, results are reported separately for the black and white populations. 2 National antenatal syphilis prevalence estimates for 1990 to 1999 and 2008 were taken from an Institute for Health Metrics and Evaluation database on the prevalence of syphilis in low risk populations compiled for the Global Burden of Diseases study and from a recent review paper respectively. National ASPs were depicted graphically and regional median ASPs were calculated for both time periods. 3 Linear regression was used to test for an association between ASP in 1990-1999 and 2008 and four risk factors (efficacy of syphilis screening/treatment, health expenditure, GDP per capita and circumcision prevalence. WHO world regions were included as potential explanatory variables.In most populations, ASP dropped to under 1% before 1960. In Zimbabwe and black South Africans, ASP was high in the pre-penicillin period, dropped in the post-penicillin period, but then plateaued at around 6% until the end of the 20th century when ASP dropped to just above 1%. In black Americans, ASP declined in the post penicillin period, but plateaued at 3-5% thereafter. ASP was statistically significantly higher in sub-Saharan Africa in 1990-1999 and 2008 than in the other world
... an inflammation of the liver. One type, hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with ... childbirth. Most people who are infected with hepatitis C don't have any symptoms for years. If ...
Full Text Available ... Caregiver Support Caregiver Stories Home › What is Hepatic Encephalopathy? Why Your Liver is Important The Connection Between HE and Liver ... Why it’s Important to Treat HE Symptoms of Liver Failure Glossary of terms ... is Hepatic Encephalopathy? Hepatic Encephalopathy, sometimes referred to as portosystemic encephalopathy ...
... Caregiver Support Caregiver Stories Home › What is Hepatic Encephalopathy? Why Your Liver is Important The Connection Between HE and Liver ... Why it’s Important to Treat HE Symptoms of Liver Failure Glossary of terms ... is Hepatic Encephalopathy? Hepatic Encephalopathy, sometimes referred to as portosystemic encephalopathy ...
... is an inflammation of the liver. One type, hepatitis A, is caused by the hepatitis A virus (HAV). The disease spreads through contact with ... suggest medicines to help relieve your symptoms. The hepatitis A vaccine can prevent HAV. Good hygiene can also ...
Zeng, L J; Yang, W W; Tie, P; Liu, X R; Gao, X R; Li, Z Y; Hou, P; Zhi, Y; Bai, Y F; Geng, M J; Chen, Q L; Cui, B Y; Li, Z J; Wang, L P
Objective: To evaluate the accuracy of human brucellosis diagnosis and reporting in medical institutions in Shanxi province, and understand the performance of clinical doctors to diagnose human brucellosis according to diagnostic criteria. Methods: Field investigation was conducted in 6 medical institutions in the key areas of human brucellosis in Shanxi province. The diagnosis data of the reported brucellosis cases in 2015 were collected and reviewed retrospectively for the evaluation of the diagnosis accuracy with systematic sampling method. The database was established with Excel 2010 and the descriptive analysis and statistical test were conducted with software R 3.3.2. Results: The diagnosis consistent rate of the 377 brucellosis cases reviewed was 70.8% (267/377), the diagnosis consistent rates in medical institutions at city-level and country-level were 77.0% (127/165) and 66.0% (140/212) respectively, the differences had significance ( χ (2)=5.4, P =0.02). Among the reviewed cases, the diagnosis consistent rate of laboratory diagnosis and clinical diagnosis were 87.1% (256/294) and 13.3% (11/83) respectively, and the differences had significance ( χ (2)=170.7, P brucellosis cases within 24 hours after diagnosis. Conclusion: The accuracy of human brucellosis diagnosis in key areas of human brucellosis in Shanxi was low, and the performance of the clinical doctors to diagnose human brucellosis according to diagnostic and case classification criteria was unsatisfied.
Musa, M T; Eisa, M Z M; El Sanousi, E M; Abdel Wahab, M B; Perrett, L
In a field outbreak of brucellosis in 21 camels mixed with cattle, sheep and goats, five camels, three of which showed clinical signs, were serologically positive. In a subsequent abattoir survey of apparently healthy camels, six animals were seropositive, albeit with titres that tended to be lower than those found in the field outbreak. Of the six seropositive slaughtered camels, five were shown to have lymph nodes (prescapular and supramammary) infected with brucellae (Brucella melitensis biovar 3, two camels; Brucella abortus biovar 6, three camels). Infection of camels with B. abortus biovar 6 had not previously been reported. Infection of the supramammary lymph nodes presents a potential hazard to those who consume raw camels' milk, a common practice in nomadic camel owners.
Nepomuceno, Erivelton G.; Barbosa, Alípio M.; Silva, Marcos X.; Perc, Matjaž
We present a theoretical approach to control bovine brucellosis. We have used individual-based modelling, which is a network-type alternative to compartmental models. Our model thus considers heterogeneous populations, and spatial aspects such as migration among herds and control actions described as pulse interventions are also easily implemented. We show that individual-based modelling reproduces the mean field behaviour of an equivalent compartmental model. Details of this process, as well as flowcharts, are provided to facilitate the reproduction of the presented results. We further investigate three numerical examples using real parameters of herds in the São Paulo state of Brazil, in scenarios which explore eradication, continuous and pulsed vaccination and meta-population effects. The obtained results are in good agreement with the expected behaviour of this disease, which ultimately showcases the effectiveness of our theory.
Peraza, C.; Valdes, O.; Fonseca, N.; Garcia, M.; Alvarez, M.; Izquierdo, D.L.
Four immunoassays (two indirect and two competitive ones) were evaluated by samples from areas free of disease, free by vaccination and affected areas using as reference techniques the Bengal Rose Tests, the Antigen in Buffered Plate Tests and the Complement Fixation Reaction Test. The evaluated samples demonstrated that the competitive assays (ELISAC-1 and ELISAC-2) detected less false positives than the indirect ones (ELISAI-1 and ELISAI-2). Of the competitive ELISAS, version 2 presented better sensitivity and specificity results in affected areas for 95% confidence: 80.9 - 96.9% and 97.5 - 99.4% respectively with positive predictive value in the range of 76 to 94% and negative predictive one between 98.1 and 99.7%. It was concluded that this assay can be used for brucellosis control because it gives higher assurance than the other evaluated immunoassays and it can discriminate infected from vaccinated animals. (author)
Mufinda, Franco Cazembe; Boinas, Fernando; Nunes, Carla
The objective of this study is to estimate the seroprevalence of human brucellosis in livestock professionals and analyze the factors associated with brucellosis focusing on sociodemographic variables and the variables of knowledge and practices related to the characteristics of the activities carried out in livestock. This is a cross-sectional seroepidemiological study with a population of 131 workers of butchers, slaughter rooms, and slaughterhouse and 192 breeders sampled randomly in Namibe province, Angola. The data were obtained from the collection of blood and use of questionnaires. The laboratory tests used were rose bengal and slow agglutination. The questionnaire allowed us to collect sociodemographic information and, specifically on brucellosis, it incorporated questions about knowledge, attitudes, and behaviors of livestock professionals. In addition to the descriptive statistical approach, we used the Chi-square test of independence, Fisher's test, and logistic regression models, using a significance level of 10%. The general weighted prevalence of brucellosis was 15.6% (95%CI 13.61-17.50), being it 5.3% in workers and 16.7% (95%CI 11.39-21.93) in breeders. The statistical significance was observed between human seroprevalence and category (worker and breeder) (p brucellosis in professionals was the professional category (OR = 3.54; 95%CI 1.57-8.30, related to breeders in relation to workers). Human brucellosis in livestock professionals is prevalent in Namibe province (15.6%), where the professional category was the most important factor. The seroprevalence levels detected are high when compared with those found in similar studies. Estimar a seroprevalência da brucelose humana em profissionais da pecuária e analisar os factores associados à brucelose com foco em variáveis sociodemográficas, de conhecimento e práticas relativas às características das actividades desenvolvidas na pecuária. Estudo transversal seroepidemiológico em população de
Amadid, Hanan; Schiødt, Frank Vinholt
Hypoxic hepatitis (HH), also known as ischaemic hepatitis or shock liver, is an acute liver injury caused by hepatic hypoxia. Cardiac failure, respiratory failure and septic shock are the main underlying conditions. In each of these conditions, several haemodynamic mechanisms lead to hepatic...... hypoxia. A shock state is observed in only 50% of cases. Thus, shock liver and ischaemic hepatitis are misnomers. HH can be a diagnostic pitfall but the diagnosis can be established when three criteria are met. Prognosis is poor and prompt identification and treatment of the underlying conditions...
Marangoni, Antonella; Nardini, Paola; Foschi, Claudio; Moroni, Alessandra; D'Antuono, Antonietta; Bacchi Reggiani, Letizia; Cevenini, Roberto
Despite recent technological advances, the diagnosis of syphilis remains a challenging enterprise. Actually, most high-volume laboratories have adopted the "reverse algorithm" due several factors, including the potential to automate testing. Recently, immunoassays processed on random-access systems have been proposed as screening tests. The purpose of this study was to evaluate diagnostic performances of BioPlex 2200 Syphilis IgG and BioPlex 2200 Syphilis IgM, tests based on Multiplex Flow technology, in comparison with the performance of Architect Syphilis TP, a chemiluminescent immunoassay for the detection of IgG and/or IgM anti-Treponema pallidum antibodies. A retrospective study was performed with a panel of 100 blood donor sera, a panel of 350 clinical and laboratory-characterized syphilitic sera, and 170 samples obtained from subjects with potentially interfering conditions. Moreover, 200 unselected samples submitted to the Microbiology Laboratory of St. Orsola Hospital in Bologna for routine screening for syphilis were evaluated. As confirmatory tests, T. pallidum hemagglutination and Western blot assays were used. Considering the IgG Western blot (WB) assay to be the gold standard method, BioPlex 2200 Syphilis IgG specificity was far higher than Architect Syphilis TP specificity (89.7% versus 78.4%, respectively), whereas the sensitivity was 100% for both automated methods. Compared to the IgM WB assay, BioPlex 2200 Syphilis IgM performed with a specificity of 94.9%, whereas the sensitivity was 84.8%. Considering the excellent ease of use and automation, the high sample throughput and its valuable analytical performances, BioPlex Syphilis 2200 IgG could represent a suitable choice for high-volume laboratories. BioPlex Syphilis 2200 IgM could be considered a good addition to IgG testing for uncovering active infections.
Full Text Available The recombinant protein technology considerably promoted the development of rapid and accurate treponema-specific laboratory diagnostics of syphilis infection. For the last ten years, the immunodominant recombinant inner membrane lipoproteins are proved to be sensitive and specific antigens for syphilis screening. However, the development of an enlarged T. pallidum antigen panel for diagnostics of early and late syphilis and differentiation of syphilis stages or cured syphilis remains as actual goal of multidisciplinary expertise. Current review revealed novel recombinant antigens: surface-exposed proteins, adhesins, and periplasmic and flagellar proteins, which are promising candidates for the improved syphilis serological diagnostics. The opportunities and limitations of diagnostic usage of these antigens are discussed and the criteria for selection of optimal antigens panel summarized.
Kubanov, Aleksey; Runina, Anastassia; Deryabin, Dmitry
The recombinant protein technology considerably promoted the development of rapid and accurate treponema-specific laboratory diagnostics of syphilis infection. For the last ten years, the immunodominant recombinant inner membrane lipoproteins are proved to be sensitive and specific antigens for syphilis screening. However, the development of an enlarged T. pallidum antigen panel for diagnostics of early and late syphilis and differentiation of syphilis stages or cured syphilis remains as actual goal of multidisciplinary expertise. Current review revealed novel recombinant antigens: surface-exposed proteins, adhesins, and periplasmic and flagellar proteins, which are promising candidates for the improved syphilis serological diagnostics. The opportunities and limitations of diagnostic usage of these antigens are discussed and the criteria for selection of optimal antigens panel summarized.
Roberts, Chelsea P; Klausner, Jeffrey D
Syphilis and human immunodeficiency virus (HIV) coinfection disproportionately affects men who have sex with men (MSM), and the rate of coinfection has been increasing over the last decade. HIV and syphilis coinfection is particularly challenging because the infections interact synergistically thereby increasing the risk of acquisition and transmission as well as accelerating disease progression. Areas covered: This paper reviews and summarizes the epidemiology, pathogenesis, diagnosis, clinical management and prevention of HIV and syphilis coinfection among MSM. Expert commentary: Research does not support a different syphilis treatment for coinfected individuals; however, coinfection may warrant a recommendation for antiretroviral therapy. In order to reverse the epidemic of syphilis and HIV coinfection, there needs to be greater awareness, improved cultural sensitivity among health care providers, improved access to preventative services and increased screening for syphilis and HIV.
Caswell, Rachel J; Hathorn, Emma; Manavi, Kaveh
The Treponemal test algorithm for syphilis screening is widely used. A diagnostic challenge between identifying early syphilis versus a false positive signal occurs in cases where the treponemal enzyme immunoassay (EIA) is reactive and confirmatory T. pallidum particle agglutination assay is negative. We investigated the diagnostic outcome of isolated reactive EIA in patients attending a sexual health clinic. Results of syphilis serology tests carried out at Birmingham Whittall Street Clinic between August 10, 2010, and November 31, 2014, were reviewed. Cases with isolated EIA were routinely invited for repeat syphilis serology. Outcomes of patients with isolated EIA were reviewed and the proportion with confirmed positive syphilis serology on their repeat test identified. The number of isolated EIA cases needed to retest to identify 1 case of early syphilis was calculated. A total of 121,724 syphilis screening tests were performed. Among the 1561 individual patients with reactive EIA sera, 316 (20% of total reactive tests) had isolated reactive EIA. Repeat syphilis serology results of 163 patients were reviewed; 106 patients remained with isolated reactive EIA, 50 had negative EIA test and 7 (4.3%) had confirmed reactive EIA. Of the 7 patients, 2 had evidence of early syphilis infection. The number of isolated EIA needed to retest to identify 1 case of early syphilis was 81.5 (95% confidence interval, 22.9-671.4). Routine recall of patients with isolated EIA sera is not warranted. Risk of acquisition or presence of early syphilis should be assessed independently and irrespective of a negative syphilis screening test or isolated EIA.
Kremastinou, J; Polymerou, V; Lavranos, D; Aranda Arrufat, A; Harwood, J; Martínez Lorenzo, M J; Ng, K P; Queiros, L; Vereb, I; Cusini, M
Treponema pallidum infections can have severe complications if not diagnosed and treated at an early stage. Screening and diagnosis of syphilis require assays with high specificity and sensitivity. The Elecsys Syphilis assay is an automated treponemal immunoassay for the detection of antibodies against T. pallidum The performance of this assay was investigated previously in a multicenter study. The current study expands on that evaluation in a variety of diagnostic settings and patient populations, at seven independent laboratories. The samples included routine diagnostic samples, blood donation samples, samples from patients with confirmed HIV infections, samples from living organ or bone marrow donors, and banked samples, including samples previously confirmed as syphilis positive. This study also investigated the seroconversion sensitivity of the assay. With a total of 1,965 syphilis-negative routine diagnostic samples and 5,792 syphilis-negative samples collected from blood donations, the Elecsys Syphilis assay had specificity values of 99.85% and 99.86%, respectively. With 333 samples previously identified as syphilis positive, the sensitivity was 100% regardless of disease stage. The assay also showed 100% sensitivity and specificity with samples from 69 patients coinfected with HIV. The Elecsys Syphilis assay detected infection in the same bleed or earlier, compared with comparator assays, in a set of sequential samples from a patient with primary syphilis. In archived serial blood samples collected from 14 patients with direct diagnoses of primary syphilis, the Elecsys Syphilis assay detected T. pallidum antibodies for 3 patients for whom antibodies were not detected with the Architect Syphilis TP assay, indicating a trend for earlier detection of infection, which may have the potential to shorten the time between infection and reactive screening test results. Copyright © 2016 Kremastinou et al.
Full Text Available Abstract Background Syphilis is a growing public health problem among men who have sex with men (MSM globally. Rapid and accurate detection of syphilis is vital to ensure patients and their contacts receive timely treatment and reduce ongoing transmission. Methods We evaluated a PCR assay for the diagnosis of Treponema pallidum using swabs of suspected early syphilis lesions in longitudinally assessed MSM. Results We tested 260 MSM for T pallidum by PCR on 288 occasions: 77 (26.7% had early syphilis that was serologically confirmed at baseline or within six weeks, and 211 (73.3% remained seronegative for syphilis. Of 55 men with primary syphilis, 49 were PCR positive, giving a sensitivity of 89.1% (95% CI: 77.8%-95.9% and a specificity of 99.1% (95% CI: 96.5%-99.9%. Of 22 men with secondary syphilis, 11 were PCR positive, giving a sensitivity of 50% (95% CI: 28.2%-71.8% and a specificity of 100% (95% CI: 66.4%-71.8%. Of the 77 syphilis cases, 43 (56% were HIV positive and the sensitivity and specificity of the PCR test did not vary by HIV status. The PCR test was able to detect up to five (10% primary infections that were initially seronegative, including one HIV positive man with delayed seroconversion to syphilis (72 to 140 days and one HIV positive man who did not seroconvert to syphilis over 14 months follow-up. Both men had been treated for syphilis within a week of the PCR test. Conclusions T pallidum PCR is a potentially powerful tool for the early diagnosis of primary syphilis, particularly where a serological response has yet to develop.
Full Text Available Syphilis in the United States during the 1800s and 1900s had a high prevalence rate causing great concern to health officials. Various measures were taken to control its spread. Mercuric treatments were used up until the introduction of penicillin. The aim of this paper is to determine whether dental abnormalities related to congenital syphilis in individuals who died of syphilis or syphilis-related causes, in the Hamman Todd Osteological Collection, occur and whether mercurial treatment was effective. Hutchinson, Moon and Fournier’s works were analyzed to determine dental abnormalities associated with congenital syphilis and its treatments and used as criteria. Hillson et al. (AJPA,107:25-40 standardized method of description of dental changes was used. In the Hamman Todd Osteological Collection in Cleveland, Ohio, 102 individuals had cause of death recorded in the catalogue as syphilis or lues, and 69 had causes of death relating to syphilis which included paresis (53, aortic insufficiency (15 and pericarditis (1. Thus altogether 171 individuals were studied. Dentition was examined to determine if dental abnormalities associated with congenital syphilis and its treatments were present in individuals not recorded as having congenital syphilis. Crania were examined for any osteological changes. One individual (2266 demonstrated dental malformations possibly related to the congenital disease itself, while three demonstrated dental abnormalities associated with mercuric treatments in childhood (2118, 2263 and 3097. No remarkable bone pathologies were evident on any skull. The use of pre-penicillin treatment of congenital syphilis may have been effective to maintain health into adulthood but not always in eradicating the infection. Effects of mercury on enamel formation and bone changes, need to be considered when making a differential diagnosis of syphilis/congenital syphilis.
Kremastinou, J.; Polymerou, V.; Lavranos, D.; Aranda Arrufat, A.; Harwood, J.; Martínez Lorenzo, M. J.; Ng, K. P.; Queiros, L.; Vereb, I.
Treponema pallidum infections can have severe complications if not diagnosed and treated at an early stage. Screening and diagnosis of syphilis require assays with high specificity and sensitivity. The Elecsys Syphilis assay is an automated treponemal immunoassay for the detection of antibodies against T. pallidum. The performance of this assay was investigated previously in a multicenter study. The current study expands on that evaluation in a variety of diagnostic settings and patient populations, at seven independent laboratories. The samples included routine diagnostic samples, blood donation samples, samples from patients with confirmed HIV infections, samples from living organ or bone marrow donors, and banked samples, including samples previously confirmed as syphilis positive. This study also investigated the seroconversion sensitivity of the assay. With a total of 1,965 syphilis-negative routine diagnostic samples and 5,792 syphilis-negative samples collected from blood donations, the Elecsys Syphilis assay had specificity values of 99.85% and 99.86%, respectively. With 333 samples previously identified as syphilis positive, the sensitivity was 100% regardless of disease stage. The assay also showed 100% sensitivity and specificity with samples from 69 patients coinfected with HIV. The Elecsys Syphilis assay detected infection in the same bleed or earlier, compared with comparator assays, in a set of sequential samples from a patient with primary syphilis. In archived serial blood samples collected from 14 patients with direct diagnoses of primary syphilis, the Elecsys Syphilis assay detected T. pallidum antibodies for 3 patients for whom antibodies were not detected with the Architect Syphilis TP assay, indicating a trend for earlier detection of infection, which may have the potential to shorten the time between infection and reactive screening test results. PMID:27358468
Dassah, Edward Tieru; Adu-Sarkodie, Yaw; Mayaud, Philippe
Use of treponemal tests to screen for syphilis (caused by Treponema pallidum pallidum) poses challenges with infection status classification, especially in settings where other treponemal infections are endemic. This study aimed to determine the validity of the syphilis surveillance testing strategy implemented since 2004 using two treponemal tests, and estimate the seroprevalence of active syphilis infection in Ghana where yaws (caused by Treponema pallidum pertenue) is endemic. We retested sera from the 2007 HIV sentinel survey (HSS) using a traditional algorithm, quantitative rapid plasma reagin test followed by qualitative Treponema pallidum haemagglutination assay. The adjusted seroprevalence of active syphilis was calculated by applying the proportions of active syphilis within identified categories of HSS samples during the retesting, to the entire population of HSS samples. The 95% confidence intervals (CIs) were calculated for each proportion, and the t-test was used to assess differences in proportions. Of 2,214 samples that were retested, 203 (9.2%) had active syphilis infection, 21 (0.9%) were biological false reactions, 640 (28.9%) were past or treated syphilis infections, and 1,350 (61%) were uninfected. The current syphilis testing strategy overestimated the seroprevalence of active syphilis infection by a third (HSS versus traditional algorithm: 6.0% (95% CI: 5.6-6.3) vs. 4.5% (95% CI: 4.2-4.8); p syphilis infection. More than half (51.9%) of HSS syphilis positive cases were actually past/treated treponemal infections, possibly previous exposure to yaws. There is an urgent need to review the current syphilis sentinel surveillance testing strategy in Ghana in the context of concurrent endemic treponematoses, to better inform policy.
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Ducrotoy, Marie J; Bertu, Wilson J; Ocholi, Reuben A; Gusi, Amahyel M; Bryssinckx, Ward; Welburn, Sue; Moriyón, Ignacio
Nigeria is the most populous country in Africa, has a large proportion of the world's poor livestock keepers, and is a hotspot for neglected zoonoses. A review of the 127 accessible publications on brucellosis in Nigeria reveals only scant and fragmented evidence on its spatial and temporal distribution in different epidemiological contexts. The few bacteriological studies conducted demonstrate the existence of Brucella abortus in cattle and sheep, but evidence for B. melitensis in small ruminants is dated and unclear. The bulk of the evidence consists of seroprevalence studies, but test standardization and validation are not always adequately described, and misinterpretations exist with regard to sensitivity and/or specificity and ability to identify the infecting Brucella species. Despite this, early studies suggest that although brucellosis was endemic in extensive nomadic systems, seroprevalence was low, and brucellosis was not perceived as a real burden; recent studies, however, may reflect a changing trend. Concerning human brucellosis, no studies have identified the Brucella species and most reports provide only serological evidence of contact with Brucella in the classical risk groups; some suggest brucellosis misdiagnoses as malaria or other febrile conditions. The investigation of a severe outbreak that occurred in the late 1970s describes the emergence of animal and human disease caused by the settling of previously nomadic populations during the Sahelian drought. There appears to be an increasing risk of re-emergence of brucellosis in sub-Saharan Africa, as a result of the co-existence of pastoralist movements and the increase of intensive management resulting from growing urbanization and food demand. Highly contagious zoonoses like brucellosis pose a threat with far-reaching social and political consequences.
Saleh Mohammed Jajere
Full Text Available Aim: A cross-sectional study was conducted to determine the seroprevalence of bovine brucellosis among cattle slaughtered at three municipal abattoirs of Gombe State, Nigeria. Materials and Methods: A total of 200 blood samples collected from slaughtered cattle of different breeds (Sokoto Gudali - 50, White Fulani - 102, Red bororo – 34, and Crossbreeds - 14, sex (males - 19 and females - 181, and from different locations (Billiri - 30, Yamaltu Deba – 50, and Gombe - 120 were screened for brucellosis using rose bengal plate test (RBPT, serum agglutination test (SAT, and microtiter agglutination test (MAT. Results: Of the 200 serum samples analyzed, 7 (3.5%, 10 (5.0% and 18 (9.0% were positive by RBPT, SAT and MAT, respectively. The results showed no statistically significant association between sex and seropositivity to bovine brucellosis. However, seropositivity of bovine brucellosis was higher in females than in males. Similarly, no statistically significant association was observed between breed and occurrence of bovine brucellosis. Moreover, the prevalence of brucellosis was higher in Sokoto Gudali as compared with the other breeds. Based on the study locations, higher seroprevalence was observed in animals screened from Billiri as compared with those from other locations (p<0.05. Conclusion: The presence of Brucella abortus antigen in the sera of slaughtered cattle in Gombe state poses a significant public health risk. Therefore, it is important to carry out further epidemiological studies on fulani herdsmen and cattle herds in the study area, in order to explore the risk factors associated with the occurrence and perpetuation of brucellosis among cattle herds, ascertain the prevalence and status of the disease among both farms and nomadic herds.
Mirnejad, Reza; Jazi, Faramarz Masjedian; Mostafaei, Shayan; Sedighi, Mansour
Brucellosis is still one of the most challenging issues for health and the economy in many developing countries such as Iran. Considering the high prevalence of brucellosis, the aim of the current study was to systematically review published data about the annual incidence rate of this infection from different parts of Iran and provide an overall relative frequency (RF) for Iran using meta-analysis. We searched several databases including PubMed, ISI Web of Science, Scopus, google scholar, IranMedex and Iranian Scientific Information Database (SID) by using the following keywords: "Brucella", "Brucellosis", "Malta fever", "Mediterranean fever", "undulant fever", "zoonosis" and "Iran" in Title/Abstract/Keywords fields. Articles/Abstracts, which used clinical specimens and reported the incidence of brucellosis, were included in this review. Quality of studies was assessed by STROB and PRISMA forms. All statistical analyses were performed using STATA 11.0 (STATA Corp, College Station, TX) and P-values under 0.05 were considered statistically significant. Out of the 8326 results, we found 34 articles suitable, according to inclusion and exlusion criteria, for inclusion in this systematic review and meta-analysis. The pooled incidence of brucellosis was estimated 0.001% (95% confidence interval (CI) = 0.0005-0.0015%) annually. Relative frequency of brucellosis in different studies varied from 7.0/100000 to 276.41/100000 in Qom and Kermanshah provinces, respectively. This systematic-review and meta-analysis study showed that the highest incidences of brucellosis are occurred in west and northwest regions of Iran. Totally, the incidence of the disease in Iran is in the high range. Copyright © 2017 Elsevier Ltd. All rights reserved.
Shevtsova, Elena; Shevtsov, Alexandr; Mukanov, Kasim; Filipenko, Maxim; Kamalova, Dinara; Sytnik, Igor; Syzdykov, Marat; Kuznetsov, Andrey; Akhmetova, Assel; Zharova, Mira; Karibaev, Talgat; Tarlykov, Pavel; Ramanculov, Erlan
Brucellosis is a major zoonotic infection in Kazakhstan. However, there is limited data on its incidence in humans and animals, and the genetic diversity of prevalent strains is virtually unstudied. Additionally, there is no detailed overview of Kazakhstan brucellosis control and eradication programs. Here, we analyzed brucellosis epidemiological data, and assessed the effectiveness of eradication strategies employed over the past 70 years to counteract this infection. We also conducted multiple loci variable-number tandem repeat analysis (MLVA) of Brucella abortus strains found in Kazakhstan. We analyzed official data on the incidence of animal brucellosis in Kazakhstan. The records span more than 70 years of anti-brucellosis campaigns, and contain a brief description of the applied control strategies, their effectiveness, and their impact on the incidence in humans. The MLVA-16 method was used to type 94 strains of B. abortus and serial passages of B. abortus 82, a strain used in vaccines. MLVA-8 and MLVA-11 analyses clustered strains into a total of four and seven genotypes, respectively; it is the first time that four of these genotypes have been described. MLVA-16 analysis divided strains into 28 distinct genotypes having genetic similarity coefficient that varies from 60 to100% and a Hunter & Gaston diversity index of 0.871. MST analysis reconstruction revealed clustering into "Kazakhstani-Chinese (Central Asian)", "European" and "American" lines. Detection of multiple genotypes in a single outbreak confirms that poorly controlled trade of livestock plays a crucial role in the spread of infection. Notably, the MLVA-16 profile of the B. abortus 82 strain was unique and did not change during 33 serial passages. MLVA genotyping may thus be useful for epidemiological monitoring of brucellosis, and for tracking the source(s) of infection. We suggest that countrywide application of MLVA genotyping would improve the control of brucellosis in Kazakhstan.
D P Patil
Full Text Available Background: Brucellosis is an important zoonotic disease. India having a major agrarian population is expected to have a higher prevalence. However, due to lack of laboratory facility or awareness among clinicians, the disease is largely underreported. The aim of this study was to know the prevalence and trend of human brucellosis over a decade, in patients attending a teaching hospital in North Karnataka, and to understand their geographical distribution. Materials and Methods: The study was conducted from January 2006 to December 2015 at a tertiary care teaching hospital in North Karnataka. A total of 3610 serum samples were evaluated from suspected cases of brucellosis. All serum samples were initially screened by Rose Bengal plate test, and positive samples were further analysed by Serum agglutination test (SAT using standard Brucella abortus antigen from Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India. A titre above or equal to 1:80 IU/ml was considered as positive. Demographic data such as age, sex and native place of these patients were also analysed. Results: We observed that human brucellosis is present in North Karnataka. The overall seropositivity of brucellosis in suspected cases was 5.1%. The positive titres ranged from 1:80 to 163,840 IU/ml. The majority of the patients were from Gadag, Koppal and Haveri districts of North Karnataka. Conclusion: Our study confirms the presence of human brucellosis in the northern part of Karnataka. Further studies to understand the prevalence of animal brucellosis in these areas will help in implementing prevention measures.
H. K. Sharma
Full Text Available Aim: Brucellosis is a disease of zoonotic importance as it affects both human as well as animal’s health, and therefore, directly affects animal productivity and human efficiency. Therefore, a study was conducted to estimate the seroprevalence of brucellosis in humans in Jammu and surrounding areas. Materials and Methods: A total of 121 sera samples from humans occupied with professional related to animals were collected and tested for anti-Brucella antibodies by Rose Bengal plate test (RBPT, modified RBPT (mRBPT, standard tube agglutination test (STAT, and indirect enzyme-linked immunosorbent assay (I-ELISA. Sampling was done keeping in view with the occupation, sex, and age. Results: The overall seroprevalence of brucellosis recorded was 4.96%. The test-wise seroprevalence was 9.91% by RBPT, 9.91% by mRBPT, 9.09% by STAT, and 16.52% by I-ELISA. The prevalence of brucellosis was higher in >35-50 years age group compared to >20-35 years and >50-65 years. Sex-wise seroprevalence was higher in males than females. Taking I-ELISA as standard, the relative sensitivities of mRBPT, RBPT, and I-ELISA were in the order of mRBPT=RBPT>STAT. All the tests revealed high specificity values; however, among different serological tests, I-ELISA detected a maximum number of positive sera samples. Conclusions: The prevalence of brucellosis was found to be approximately 5%. The adult (>35-50 years age male group was most vulnerable. The routine diagnosis of brucellosis involved the conventional serological tests, viz., RBPT and STAT, but each was associated with drawbacks which could give either false-positive or false-negative interpretation. Therefore, it is always recommended to use a battery of tests in the diagnosis of brucellosis.
Ducrotoy, Marie J.; Bertu, Wilson J.; Ocholi, Reuben A.; Gusi, Amahyel M.; Bryssinckx, Ward; Welburn, Sue; Moriyón, Ignacio
Nigeria is the most populous country in Africa, has a large proportion of the world's poor livestock keepers, and is a hotspot for neglected zoonoses. A review of the 127 accessible publications on brucellosis in Nigeria reveals only scant and fragmented evidence on its spatial and temporal distribution in different epidemiological contexts. The few bacteriological studies conducted demonstrate the existence of Brucella abortus in cattle and sheep, but evidence for B. melitensis in small ruminants is dated and unclear. The bulk of the evidence consists of seroprevalence studies, but test standardization and validation are not always adequately described, and misinterpretations exist with regard to sensitivity and/or specificity and ability to identify the infecting Brucella species. Despite this, early studies suggest that although brucellosis was endemic in extensive nomadic systems, seroprevalence was low, and brucellosis was not perceived as a real burden; recent studies, however, may reflect a changing trend. Concerning human brucellosis, no studies have identified the Brucella species and most reports provide only serological evidence of contact with Brucella in the classical risk groups; some suggest brucellosis misdiagnoses as malaria or other febrile conditions. The investigation of a severe outbreak that occurred in the late 1970s describes the emergence of animal and human disease caused by the settling of previously nomadic populations during the Sahelian drought. There appears to be an increasing risk of re-emergence of brucellosis in sub-Saharan Africa, as a result of the co-existence of pastoralist movements and the increase of intensive management resulting from growing urbanization and food demand. Highly contagious zoonoses like brucellosis pose a threat with far-reaching social and political consequences. PMID:25058178
Parlak, Mehmet; Akbayram, Sinan; Doğan, Murat; Tuncer, Oğuz; Bayram, Yasemin; Ceylan, Nesrin; Özlük, Suat; Akbayram, Hatice Tuba; Öner, Abdurrahman
Brucellosis is the most common zoonotic disease worldwide and remains an important human disease especially in developing countries. The aim of the present study was to evaluate clinical manifestations and laboratory findings of childhood brucellosis in Van province of Eastern Turkey. To our knowledge, this is the largest series of childhood brucellosis reported in the literature. In this retrospective study, 496 children with brucellosis were assessed for the clinical manifestations and laboratory findings from July 2009 through December 2013. The diagnosis of brucellosis was based on clinical findings and a standard tube agglutination test (titer ≥ 1:160). Data were analyzed using Minitab version 16. The study included 496 children (boys, 60.5%) with a mean age of 10.0 ± 3.95 years (range, 1-16 years). The most frequent clinical symptoms were arthralgia (46.2%), fever (32.1%), and abdominal pain (17.1%) and the most common clinical signs were peripheral arthritis (10.1%), splenomegaly (2.2%) and hepatomegaly (1.8%). The most contagious seasons were summer and autumn (63.3%). Elevated lactate dehydrogenase and C-reactive protein and erythrocyte sedimentation rate were reported in 63.1%, 58.7%, and 55.2% of the patients, respectively. Anemia (20.4%), thrombocytopenia (15.5%), and leukopenia (12.1%) were the most common hematologic findings. Brucellosis remains a serious public health problem in Turkey. The clinical and laboratory characteristics of childhood brucellosis have been described in order to assist clinicians in diagnosing and monitoring the disease. © 2015 Japan Pediatric Society.
Tschopp, Rea; Bekele, Shiferaw; Moti, Tesfaye; Young, Douglas; Aseffa, Abraham
This cross-sectional study investigated the prevalence of brucellosis and bovine tuberculosis (BTB) in local cattle and goat breeds of Oromo and Afar pastoralist communities living in two distinct parts around the Awash National Park. A questionnaire survey was carried out to assess information on husbandry, milk consumption habits, and on knowledge-attitude-practice regarding both diseases. Among a total of 771 animals from all sites tested by comparative intradermal tuberculin test (CIDT) none were BTB reactors with the >4mm cut-off. Using the >2mm cut-off, individual apparent prevalence was 0.9% (95%CI: 0.23-3.56%) in cattle and 0.7% (95%CI: 0.12-3.45%) in goats. Herd prevalence in Oromia and Afar sites was 0% and 66.7% respectively in goats and 16.7% and 50% in cattle. Among the 327 animals tested by enzyme linked immunoassay for brucellosis, 4.8% (95%CI: 1.2-17.1%) of cattle and 22.8% (95%CI: 5.98-29.5%) of goats were reactors. Highest individual prevalence of both diseases was found in Afar settlements with brucellosis being as high as 50%. Respondent ethnicity was the only risk factor for brucellosis positivity in goats in the univariable risk factor analysis. Knowledge about the diseases was poor. Raw goat milk was regularly consumed by women and children, putting them at risk for brucellosis. This study highlighted an increased prevalence gradient of BTB and brucellosis from West to East along the study sites with high brucellosis individual prevalence and abortion rates among Afar settlements in particular. Copyright © 2015 Elsevier B.V. All rights reserved.
Sepanjnia, Adel; Eskandari-Nasab, Ebrahim; Moghadampour, Mehdi; Tahmasebi, Arezoo; Dahmardeh, Fatemeh
Cytokines play a critical role in the regulation of the immune response against brucellosis infection, and mediate production of many pro- and anti-inflammatory signals. Transforming growth factor-beta 1 (TGFβ1), a powerful suppressive cytokine, inhibits macrophage activation and modulates T-cell function, and plays crucial roles in regulation of microbial replication and host responses to brucella. The association of three polymorphisms in the TGFβ1 gene (-509 C/T [rs1800469], + 868 C/T [rs1800470], and + 913 G/C [rs1800471]) in promoter, codons 10 and 25, respectively, with brucellosis infection was evaluated. This case-control study was performed on a total of 281 Iranian subjects including 153 patients with active brucellosis and 128 age- and sex-matched healthy individuals as controls. Genotyping for the TGFβ1 -509 C/T and + 868 C/T variants was performed using tetra amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR). Also, the + 913 G/C polymorphism was genotyped using an allele-specific PCR. The results demonstrated that the TGFβ1 + 868 C/T mutant homozygote genotype (TT vs CC), was a risk factor for developing brucellosis in the co-dominant and recessive models (odds ratio (OR) = 2.60, p = 0.023; OR = 2.602, p = 0.014, respectively). Additionally, the diplotype analyses revealed that TGFβ1 codon 10 and 25 diplotype, TT/GG, was associated with an increased risk of brucellosis (OR = 2.49, p = 0.038). Other TGFβ1 variants did not increase the risk of brucellosis infection. Our findings propose that TGFβ1 + 868 TT genotype and TT/GG diplotype may confer increased risk of brucellosis in the examined population.
Okoroiwu, Henshaw Uchechi; Okafor, Ifeyinwa Maryann; Asemota, Enosakhare Aiyudubie; Okpokam, Dorathy Chioma
Provision of constant and safe blood has been a public health challenge in Sub-Saharan Africa with high prevalence of transfusion-transmissible infections (TTIs). This study was aimed at determining the trend and seroprevalence of HBV, HCV, syphilis and HIV across the years within study among prospective blood donors at blood bank in University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. A retrospective analysis of blood donor data from January 2005 to December 2016 was conducted in Blood Bank/Donor Clinic of University of Calabar Teaching Hospital, Calabar, Nigeria. Sera samples were screened for hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (HCV), human immunodeficiency virus (HIV) 1 and 2 and Treponema pallidum using commercially available immunochromatic based kits. Out of the 24,979 screened prospective donors in the 2005-2016 study period, 3739 (14.96%) were infected with at least one infective agent. The overall prevalence of HBV, HCV, syphilis and HIV were 4.1, 3.6, 3.1 and 4.2%, respectively. During the period of study, the percentage of all transfusion-transmissible infections declined significantly with remarkable decline in HIV. The study showed male dominated donor pool (98.7%) with higher prevalence (4.2%) of transfusion-transmissible infections than in female donors (0.0%). Commercial donors constituted majority (62.0%) of the donors and as well had the highest prevalence of transfusion-transmissible infections. Majority (62.9%) of the donors were repeat donors. HBV, HCV, syphilis and HIV have remained a big threat to safe blood transfusion in Nigeria and Sub-Saharan Africa at large. Strict adherence to selection criteria and algorithm of donor screening are recommended.
Lomholt, Hans; Poulsen, Asmus; Brandrup, Flemming
The optimal dosage and duration of penicillin treatment for the various stages of syphilis are not known. We present data on 20 patients with syphilis (primary, secondary or latent) treated with high-dose, short-time penicillin infusion therapy. Patients were given 10 MIU of penicillin G intraven......The optimal dosage and duration of penicillin treatment for the various stages of syphilis are not known. We present data on 20 patients with syphilis (primary, secondary or latent) treated with high-dose, short-time penicillin infusion therapy. Patients were given 10 MIU of penicillin G...
Drago, Francesco; Ciccarese, Giulia; Tomasini, Carlo F; Calamaro, Paola; Boggio, Maurizio; Rebora, Alfredo; Parodi, Aurora
We describe herein a woman who developed subcutaneous gummas in her trochanteric regions, bilaterally, although she had been treated for syphilis two decades earlier. Evidence of Treponema pallidum latent late infection was the presence of IgG antibodies against T. pallidum and the positive non-treponemal and treponemal tests. Moreover, immunohistochemical staining for T. pallidum detected some spirochetes close to the atrophic adipocytes allowing the diagnosis of lypo-atrophic panniculitis tertiary syphilis. This is the first case of tertiary syphilis presenting as panniculitis in an immunocompetent patient, demonstrating that subcutaneous fat may be another organ infected in tertiary syphilis.
Full Text Available To analyze the midterm evaluation data from the National Syphilis Prevention and Control Plan (2010-2020 and evaluate the current status of syphilis prevention and control in Jiangsu province, China.We collected data via (1 field surveys conducted in 2015 and (2 data recorded in existing syphilis surveillance systems. We conducted descriptive statistical analysis to evaluate the current landscape of syphilis control initiatives and their potential effect in syphilis control.The incidence of all cases of syphilis decreased from 2010 (32.3 per 100,000 to 2015 (30.1 per 100,000, with an annual growth of -1.17% (x2trend = -7.52, P<0.001 in Jiangsu province. The incidence of primary and secondary syphilis and congenital syphilis both decreased significantly from 2010 to 2015. The average awareness rate of syphilis knowledge among professional personnel was 95.4% (3781/3963. Rural residents had the lowest awareness rate (83.5%, 1875/2245 and commercial sex workers had the highest awareness rate (92.1%, 7804/8474 in 2015. Only 47.8% (33908/70894 of patients received provider-initiated syphilis counseling and testing (PISTC services in sexually transmitted disease (STD clinics, but 94.5% (87927/93020 of all syphilis patients received free testing for syphilis. Overall, 97.2% (9378/9648 of syphilis reported cases of syphilis at medical institutions were confirmed to be accurate, and 92.2% (5850/6345 of patients diagnosed with syphilis at medical institutions received treatment with penicillin.The syphilis incidence rate in Jiangsu has decreased in recent years, but remains at a high level. It is essential to promote PISTC services to improve knowledge of syphilis and rates of testing and treatment in Jiangsu province.
Muflihanah, Hanah; Hatta, Mochammad; Rood, Ente; Scheelbeek, Pauline; Abdoel, Theresia H.; Smits, Henk L.
Brucellosis is a major cause of infertility and reproductive failure in livestock. While cattle in the Eastern Indonesian archipelago suffers from reproductive problems information on bovine brucellosis in the region is fragmentary. The control of brucellosis requires a major and prolonged effort
Full Text Available Viral hepatitis is a serious health problem all over the world. However, the reduction of the morbidity and mortality due to vaccinations against hepatitis A and hepatitis B has been a major component in the overall reduction in vaccine preventable diseases. We will discuss the epidemiology, vaccine development, and post-vaccination effects of the hepatitis A and B virus. In addition, we discuss attempts to provide hepatitis D vaccine for the 350 million individuals infected with hepatitis B globally. Given the lack of a hepatitis C vaccine, the many challenges facing the production of a hepatitis C vaccine will be shown, along with current and former vaccination trials. As there is no current FDA-approved hepatitis E vaccine, we will present vaccination data that is available in the rest of the world. Finally, we will discuss the existing challenges and questions facing future endeavors for each of the hepatitis viruses, with efforts continuing to focus on dramatically reducing the morbidity and mortality associated with these serious infections of the liver.
Ogholikhan, Sina; Schwarz, Kathleen B.
Viral hepatitis is a serious health problem all over the world. However, the reduction of the morbidity and mortality due to vaccinations against hepatitis A and hepatitis B has been a major component in the overall reduction in vaccine preventable diseases. We will discuss the epidemiology, vaccine development, and post-vaccination effects of the hepatitis A and B virus. In addition, we discuss attempts to provide hepatitis D vaccine for the 350 million individuals infected with hepatitis B globally. Given the lack of a hepatitis C vaccine, the many challenges facing the production of a hepatitis C vaccine will be shown, along with current and former vaccination trials. As there is no current FDA-approved hepatitis E vaccine, we will present vaccination data that is available in the rest of the world. Finally, we will discuss the existing challenges and questions facing future endeavors for each of the hepatitis viruses, with efforts continuing to focus on dramatically reducing the morbidity and mortality associated with these serious infections of the liver. PMID:26978406
Mounia Lakhdar Idrissi
Full Text Available Alors qu�elle est actuellement oubliee dans les pays developpes, la syphilis congenitale se voit encore chez nous faute du depistage antenatal. Ses formes cliniques sont polymorphes et orientent a tord vers d�autres pathologies surtout en periode neonatale. Le diagnostic n�est donc pas toujours facile. La revelation d�une syphilis congenitale par une fracture spontanee est exceptionnellement decrite. Nous rapportons dans ce travail le cas d�un nourrisson de 2 mois ramene en consultation pour limitation douloureuse des mouvements du bras droit. Le diagnostic est evoque sur les donnees radiologiques et confirme par la serologie syphilitique. Le traitement a repose essentiellement sur l�administration de la penicilline G avec une bonne evolution clinique.
Full Text Available Syphilis is a venereal disease. Morocco has witnessed syphilis since the fifteenth century and the treatment of this disease remained archaic until the Protectorate was established.With the establishment of the colonial system in Morocco, the phenomenon of prostitution spread. Protectorate authorities designated a particular place in Casablanca for such activity that developed: Bousbir district. The authorities’ efforts failed to regulate and organize such activity because of the development of clandestine prostitution in relation to urban growth and the increase of employed, poor and downgraded urban population, especially among women who practice prostitution, and due to lack of a real social policy of the Protectorate concerning the policy of land-use planning or control that were a priority.
Irmak, Hasan; Buzgan, Turan; Evirgen, Omer; Akdeniz, Hayrettin; Demiroz, A. Pekcan; Abdoel, Theresia H.; Smits, Henk L.
The clinical utility of two complementary tests for brucellosis, the Brucella IgM and IgG flow assays, was evaluated in a hospital in eastern Turkey. The results show that the flow assays are convenient diagnostic tests for use in endemic areas. A positive result in the flow assays was obtained in
Al-Qudah, A A; Mostratos, A
Using an ultrasonicate of the Reiter treponeme as antigen the Reiter haemagglutination test (RHA) was evaluated as a serological test for syphilis. Comparison of the results of the cardiolipin Wassermann reaction, Reiter protein complement-fixation test, the fluorescent treponemal antibody-absorbed (FTA-ABS) test, the Treponema pallidum haemagglutination test (TPHA) (at dilutions of 1/16 and 1/80), and the Venereal Disease Research Laboratory test with those of the RHA showed that the RHA was...
Renan Albert Mendonça Rodrigues
Full Text Available Here we report the occurrence of pale yellowish perivascular preretinal dots in 12 patients with ocular syphilis. A case series of these patients was examined between March and October 2012 at the Uveitis Sector of Universidade Federal de São Paulo. After diagnostic confirmation of syphilis, fundus photographs and optical coherence tomography (OCT were performed to verify the localization of the dots, and patients were treated with IV crystalline penicillin for 14 days. The study comprised 11 men (91.6%, 19 eyes, median presentation age of 38.1 years, and panuveitis as the main clinical manifestation (seven patients, 58.3%, being bilateral in four. Ten patients were taking oral prednisone (83.3%. Serum panels performed by the Venereal Disease Research Laboratory (VDRL showed positive results in eight patients (66.7%, whereas VDRL cerebrospinal fluid (CSF tests were negative in seven of nine collected (77.8%. However, serum FTA-Abs was positive in 100% of patients, and eight patients (66.7% had HIV infection. The best corrected visual acuity (BCVA presented after treatment improved in 10 eyes (55.6%, did not change in seven eyes (38.9%, and worsened in one eye (5.6%. Although not yet acknowledged in the literature as a typical manifestation of ocular syphilis, these are very common findings in clinical practice. We believe that preretinal dots are due to perivasculitis secondary to treponema infection. It is important recognize them and remember that syphilis can present in several forms, including the one presented in this study.
Godt, P.; Stoeppler, L.; Wischer, U.; Schroeder, H.H.
The computed tomographic findings of three patients with cerebral syphilis, including cerebral gumma, which regressed completely under penicillin therapy, syphilitic angiitis with cerebral infarction, and syphilitic cerebral atrophy, are reported CT is unable to provide specific diagnostic data for these conditions. The etiology can be clarified only by taking into consideration the clinical findings and course, the serological results, and the result of therapy. (orig.) [de
Simčič, Saša; Potočnik, Marko
Serological tests' limitations in syphilis diagnosis as well as numerous test interpretations mean that patients with discordant serology results can present diagnostic and treatment challenges for clinicians. We analyzed three common diagnostic algorithms for detecting suspected syphilis in high-prevalence populations in Slovenia. The prospective study included a total of 437 clinical serum samples from adults throughout Slovenia tested with Rapid Plasma Reagin (RPR), Treponema pallidum hemagglutination (TPHA), and an automated chemiluminescence immunoassay (CIA) according to the manufacturer's instructions. In addition to percent agreement, kappa coefficients were calculated as a secondary measure of agreement between the three algorithms. Overall, of 183 subjects that had seroreactive results, 180 were seroreactive in both the reverse sequence and the European Centre for Disease Prevention and Control (ECDC) algorithm. The traditional algorithm had a missed serodiagnosis rate of 30.0%, the overall percent agreement between the traditional and the reverse algorithm (or the ECDC algorithm) was 87.6%, and the kappa value was 0.733. However, the reverse and ECDC algorithm failed to detect three subjects with positive serodiagnosis determined by additional confirmative treponemal assays. Our results supported the ECDC algorithm in the serodiagnosis of syphilis in high-prevalence populations and the use of nontreponemal serology to monitor the response to treatment.
Bai, Yang; Niu, Feng; Liu, Lidi; Sha, Hui; Wang, Yimei; Zhao, Song
The incidence of tertiary syphilis involvement in the spinal column with destructive bone lesions is very rare. It is difficult to establish the correct diagnosis from radiographs and histological examination alone. Limited data are available on surgical treatment to tertiary syphilitic spinal lesions. In this article, we report a case of tertiary syphilis in the lumbar spine with osteolytic lesions causing cauda equina compression. A 44-year-old man who suffered with low back pain for 6 months and progressive radiating pain at lower extremity for 1 week. Radiologic findings showed osteolytic lesion and new bone formation in the parts of the bodies of L4 and L5. Serum treponema pallidum hemagglutination (TPHA) test was positive. A surgery of posterior debridement, interbody and posterolateral allograft bone fusion with instrumentation from L3 to S1 was performed. The low back pain and numbness abated after operation. But the follow-up radiographs showed absorption of the bone grafts and failure of instrumentation. A Charcot's arthropathy was formed between L4 and L5. It is challenging to diagnose the tertiary syphilis in the spine. Surgery is a reasonable auxiliary method to antibiotic therapy for patients who suffered with neuropathy. Charcot's arthropathy should be considered as an operative complication.
Evaluation of two automated chemiluminescence immunoassays, the LIAISON Treponema Screen and the ARCHITECT Syphilis TP, and the Treponema pallidum particle agglutination test for laboratory diagnosis of syphilis.
Wellinghausen, Nele; Dietenberger, Hanna
Automated Treponema pallidum-specific chemi-luminescence immunoassays (CLIA) run on random-access analyzers allow for rapid diagnosis of syphilis infection. We evaluated the LIAISON Treponema Screen (LIA) and the ARCHITECT Syphilis TP (ARCH) in comparison to the Treponema pallidum particle agglutination (TPPA) test, as a screening test for syphilis. We performed a prospective study using 577 sera submitted for diagnosis of syphilis, including 318 samples from pregnant women. In addition, 42 stored sera from 32 patients with clinically and serologically characterized syphilis infection were investigated. In the prospective study, the sensitivity and specificity of LIA, ARCH, and TPPA were 100% (18/18), 100% (17/17), and 100% (18/18), and 100% (558/558), 99.8% (552/553), and 99.6% (556/558), respectively. In pregnant women, the specificity of LIA and ARCH was 100% (317/317) and of TPPA 99.7% (316/317). One sample from a child with assumed exposure to maternal antitreponemal antibodies was omitted from analysis. LIA, ARCH, and TPPA were also positive in all investigated sera from patients with known syphilis. Both automated CLIA demonstrated excellent diagnostic sensitivity and specificity when evaluated as a screening test for syphilis under routine conditions of a diagnostic laboratory. Thus, these may be used independently as an alternative to the manual TPPA screen.
Ulianova, Onega V.; Ulyanov, Sergey
Testing of prototypes of vaccines against extremely dangerous diseases, such as tularemia and brucellosis has been performed using speckle-microscopy. Changes of microcirculation caused by effect of toxins at applications of suspension of photoinactivated bacteria have been studied. Toxic properties of prototypes of vaccines against tularemia and brucellosis have been analyzed.
Brucellosis, caused by bacteria of the genus Brucella, is a contagious disease that causes economic loss to owners of domestic animals due to loss of progeny and milk yield. Because cattle, sheep, goats, and to a lesser extent pigs are considered to be the source of human brucellosis, serological
Full Text Available Introduction. Undiagnosed and untreated syphilis in pregnancy may result in subsequent complications: early fetal loss, stillbirth, low birth weight of infants and newborns with congenital syphilis. Objective. To analyze diagnostic and therapeutic dilemmas of positive results of serological tests for syphilis (STS in pregnancy. Case reports. We present two cases of pregnant women, hospitalized in our department due to positive results of serological tests for syphilis, performed during the antenatal visit. On the basis of patients' history, physical examination and STS results, early latent syphilis was diagnosed in the first patient; biological false positive reactions were considered in the second one. Both patients received procaine penicillin treatment. Conclusions. Screening for syphilis in pregnancy as a part of antenatal care and appropriate treatment with penicillin are the most effective interventions to prevent complications of syphilis in pregnancy. It is also important to adapt modern European Guidelines for management of syphilis to Polish conditions.
Hari Mohan Saxena
Full Text Available Brucellosis is an important zoonotic disease causing huge economic losses worldwide. Currently no effective immunotherapy for Brucellosis or any biomarker to monitor the efficacy of therapy is available. Treatment is ineffective and animals remain carrier lifelong. S19 and RB51 are live attenuated vaccine strains of Brucella abortus. However, S19 induces only antibody, ineffective for intracellular pathogen. RB51 induces cell mediated immunity (CMI but it is Rifampicin resistant. Both organisms are secreted in milk and can infect humans and cause abortions in animals. Phage lysed bacteria (lysates retain maximum immunogenicity as opposed to killing by heat or chemicals. We report here the successful immunotherapy of bovine Brucellosis by phage lysates of RB51 (RL and S19 (SL. The SL induced strong antibody response and RL stimulated CMI. In vitro restimulation of leukocytes from RL immunized cattle induced interferon gamma production. A single subcutaneous dose of 2 ml of cocktail lysate (both RL and SL, eliminated live virulent Brucella from Brucellosis affected cattle with plasma level of Brucella specific 223 bp amplicon undetectable by RT-PCR and blood negative for live Brucella by culture in 3 months post-immunization. This is the first report on minimally invasive monitoring of the efficacy of antibacterial therapy employing plasma RNA specific for live bacteria as a biomarker as well as on the use of RB51 phage lysate for successful immunotherapy of Brucellosis in cattle.
Full Text Available Introduction: Brucellosis is a common zoonotic disease which has a wide spectrum of clinical manifestations and complications in humans. Brucellosis is an endemic disease in Iran, and vein thrombosis is a rare complication of acute brucellosis. Case Report: A 58-year old woman admitted to the infectious diseases ward in Farshchian hospital had fever and severe headache beginning 15 days before admission. Moreover, she complained from fatigue, malaise, anorexia, skin lesions around the nose and cervical lym-phadenopathy. Sonogarphy of cervical soft tissues of the patient showed right internal jugu-lar vein thrombosis and numerous cervical lymphadenopathy in the right posteriocervical tri-angle. Doppler sonography of the cervical vessels of the patient showed thrombosis of the middle right internal jugular vein. The blood culture isolates were small gram-negative aero-bic coccobacilli in two separate cultures. Serologic tests of Wright, 2ME and IgG ELISA were positive in the patient. The patient was treated with doxycycline, rifampin and warfarin, and she improved completely after a 5 month follow-up. Conclusion: We should consider brucellosis in the patients with rare manifestations of brucel-losis such as vascular thrombosis in endemic areas because early diagnosis and treatment of the patients can decrease its complications and mortality rate. (Sci J Hamadan Univ Med Sci 2014; 21 (2:161-166
Gavazzi, G; Prigent, D; Baudet, J M; Banoita, S; Daoud, W
Brucellosis is an ubiquitous anthropozoonoses in the Republic of Djibouti, but it has only been studied in the City of Djibouti. This retrospective study of 42 cases of human brucellosis diagnosed between April 1993 and April 1995 was carried out at the Peltier Hospital in Djibouti to obtain epidemiological data concerning brucellosis in the Republic of Djibouti. Diagnosis was based on clinical symptoms and positive immunologic tests (Rose Bengal test > 100 UI and Wright serology > 1/80). The following information was obtained for each patient: nationality, ethnic origin, place of residence, age, sex, and risk factors for exposure to infected animals or products. There were 30 men and 12 women including 38 Djiboutis, 3 Somalis, and 1 Ethiopian. Ethnic origin was Afar in 32 cases, Somali in 6 cases, and undetermined in 4 cases. Mean age was 31.6 years. Of the 38 Djiboutis, 15 lived in the district of Djibouti, 17 in the district of Tadjourah, 3 in the district of Obock, and none in districts located in the Southern part of the country. In 18 cases brucellosis involved cattle raisers from the Northern part of the country. In five cases no risk factor could be identified. The incidence of brucellosis in the Republic of Djibouti appears to be comparable to that observed in other highly endemic countries. Further study is needed to determine the exact incidence in man and animals and ascertain the need and feasibility of preventive measures.
Anka, Mukhtar Salihu; Hassan, Latiffah; Khairani-Bejo, Siti; Zainal, Mohamed Abidin; Mohamad, Ramlan Bin; Salleh, Annas; Adzhar, Azri
Bovine brucellosis was first reported in Peninsular Malaysia in 1950. A subsequent survey conducted in the country revealed that the disease was widespread. Current knowledge on the potential risk factors for brucellosis occurrence on cattle farms in Malaysia is lacking. Therefore, we conducted a case-control study to identify the potential herd-level risk factors for bovine brucellosis occurrence in four states in the country, namely Kelantan, Pahang, Selangor and Negeri Sembilan. Thirty-five cases and 36 controls of herds were selected where data on farm management, biosecurity, medical history and public health were collected. Multivariable logistic regression identified that Brucella seropositive herds were more likely to; have some interaction with wildlife (OR 8.9, 95% CI = 1.59-50.05); originated from farms where multiple species such as buffalo/others (OR 41.8, 95% CI = 3.94-443.19) and goat/sheep (OR 8.9, 95%Cl = 1.10-71.83) were reared, practice extensive production system (OR 13.6, 95% CI 1.31-140.24) and have had episodes of abortion in the past (OR 51.8, 95% CI = 4.54-590.90) when compared to seronegative herds. Considering the lack of information on the epidemiology of bovine brucellosis in peninsular Malaysia and absence of information on preventing the inception or spread of the disease, this report could contribute to the on-going area-wise national brucellosis eradication program.
Hegazy, Yamen; Elmonir, Walid; Abdel-Hamid, Nour Hosny; Elbauomy, Essam Mohamed
Between February and July 2014, a cross-sectional study to estimate the seroprevalence of brucellosis in sheep in the Kafrelsheikh district of Egypt was carried out, together with a survey of knowledge, attitudes and practices (KAPs) among local shepherds. A total of 273 serum samples were collected from 28 sheep flocks in 10 villages within the study area. These samples were analysed by the Rose Bengal Plate test (RBPT) test, with all positive samples being confirmed by complement fixation test (CFT). True seroprevalence was 20 % (95 % CI 15.3-24.7 %) with the prevalence of villages with at least one seropositive sheep estimated at 95.5 % (95 % CI 92.2-100 %); village flock seroprevalence ranged from 0 to 46.8 %. Results of the KAPs survey demonstrated that despite good knowledge regarding brucellosis being potentially present within their flocks, shepherds lacked knowledge regarding routes of livestock to humans disease transmission and the symptoms of brucellosis in humans. This lack of knowledge regarding disease transmission resulted in high-risk practices being widespread-practices such as assisting parturition without protective measures, throwing aborted material into water canals and a reluctance to remove animals that had aborted from the flock. This study proposes potential measures to reduce seroprevalence of brucellosis in sheep and reduce public health risks from brucellosis such as culling aborted livestock and educational campaigns among shepherds regarding disease risks and modes of transmission.
Budak, Ferah; Bal, S. Haldun; Tezcan, Gulcin; Guvenc, Furkan; Akalin, E. Halis; Goral, Guher; Deniz, Gunnur
Although our knowledge about Brucella virulence factors and the host response increase rapidly, the mechanisms of immune evasion by the pathogen and causes of chronic disease are still unknown. Here, we aimed to investigate the immunological factors which belong to CD8+ T cells and their roles in the transition of brucellosis from acute to chronic infection. Using miRNA microarray, more than 2000 miRNAs were screened in CD8+ T cells of patients with acute or chronic brucellosis and healthy controls that were sorted from peripheral blood with flow cytometry and validated through qRT-PCR. Findings were evaluated using GeneSpring GX (Agilent) 13.0 software and KEGG pathway analysis. Expression of two miRNAs were determined to display a significant fold change in chronic group when compared with acute or control groups. Both miRNAs (miR-126-5p and miR-4753-3p) were decreased (p 2). These miRNAs have the potential to be the regulators of CD8+ T cell-related marker genes for chronic brucellosis infections. The differentially expressed miRNAs and their predicted target genes are involved in MAPK signaling pathway, cytokine-cytokine receptor interactions, endocytosis, regulation of actin cytoskeleton, and focal adhesion indicating their potential roles in chronic brucellosis and its progression. It is the first study of miRNA expression analysis of human CD8+ T cells to clarify the mechanism of inveteracy in brucellosis. PMID:27824867
Garofolo, Giuliano; Fasanella, Antonio; Di Giannatale, Elisabetta; Platone, Ilenia; Sacchini, Lorena; Persiani, Tiziana; Boskani, Talar; Rizzardi, Kristina; Wahab, Tara
Human brucellosis cases are still reported each year in Sweden despite eradication of the disease in animals. Epidemiological investigation has never been conducted to trace back the source of human infection in the country. The purpose of the study was to identify the source of infection for 16 human brucellosis cases that occurred in Sweden, during the period 2008-2012. The isolates were identified as Brucella melitensis and MLVA-16 genotyping revealed 14 different genotypes of East Mediterranean and Africa lineages. We also reported one case of laboratory-acquired brucellosis (LAB) that was shown to be epidemiological linked to one of the cases in the current study. Brucella melitensis was the only species diagnosed, confirming its highest zoonotic potential in the genus Brucella, and MLVA-16 results demonstrated that the cases of brucellosis in Sweden herein investigated, are imported and linked to travel in the Middle East and Africa. Due to its zoonotic concerns, any acute febrile illness linked to recent travel within those regions should be investigated for brucellosis and samples should be processed according to biosafety level 3 regulations.
Torkaman Asadi, Fatemeh; Hashemi, Seyyed Hamid; Alikhani, Mohammad Yousef; Moghimbeigi, Abbas; Naseri, Zahra
Current drug regimens for brucellosis are associated with relatively high rates of therapeutic failure or relapse. Reduced antimicrobial susceptibility of Brucella spp. has been proposed recently as a potential cause of therapeutic failure. The aim of this study was to evaluate the antibiotic resistance pattern of Brucella melitensis clinical isolates by E-test method in Hamadan, west of Iran. In a 15-month period, all patients with suspected brucellosis were enrolled. Blood specimens were collected for diagnosis of brucellosis by BACTEC system and serological tests. Antimicrobial susceptibility of clinical isolates to 7 antibiotics was assessed by the E-test method. One hundred forty-nine patients with brucellosis were evaluated. 38.3% of cultures of clinical samples were positive for BACTEC system, of which 91.2% were associated with a positive serological test result. No significant associations were found between serology and the culture method. All Brucella isolates were susceptible to doxycycline, streptomycin, gentamicin, ciprofloxacin, and moxifloxacin. However, decreased sensitivity to rifampin and trimethoprim-sulfamethoxazole was found in 35.1% and 3.5% of isolates, respectively. Because of the high rates of intermediate sensitivity to rifampin among Brucella isolates, this drug should be prescribed with caution. We recommend restricting the use of rifampin for treatment of brucellosis except as an alternative drug for special situations.
Liu, Qianhong; Wei, Jie; Sun, Qingsong; Wang, Ben; Wang, Yuting; Hu, Ying; Wu, Wenrong
Brucellosis (Brucella bovis) in sika deer ( Cervus nippon ) can cause enormous losses to stag breeding, especially in areas in which stag breeding has become an important industry. It also poses a threat to humans because it is a zoonotic disease. Use of the loop-mediated isothermal amplification (LAMP) assay has been poorly described in the diagnosis of brucellosis in deer. We developed a LAMP assay targeting the omp25 gene sequence to detect brucellosis in sika deer. The reaction can be completed in 60 min at 63 C and, with a detection limit of 17 pg, it was more sensitive than conventional PCR, with its detection limit of 1.7 ng. No cross-reactivity was observed with four bacteria: Escherichia coli , Salmonella enterica subsp. enterica, Clostridium pasteurianum , and Pseudomonas aeruginosa . We used 263 samples of blood to evaluate the reaction. The percentage of agreement between LAMP and PCR reached 91%; relative specificity reached 87%, and relative sensitivity reached 100%. The results indicate LAMP can be a simple and rapid diagnostic tool for detecting brucellosis in sika deer, particularly in the field, where it is essential to control brucellosis in deer with a rapid and accurate diagnosis for removal of positive animals.
Moon, Oun-Kyong; Lee, Soo-Han; Lee, Won-Chang; Her, Moon; Jeong, Wooseog; Jung, Suk-Chan; Kim, Do-Soon
In the present study, the outbreak patterns of bovine brucellosis in Korea from 2000 to 2011 were analyzed to understand the epidemiological evolution of this disease in the country. A total of 85,521 brucella reactor animals were identified during 14,215 outbreaks over the 12-year study period. The number of bovine brucellosis cases increased after 2003 and peaked in 2006 before decreasing thereafter. The majority of the bovine brucellosis cases were Korean native cattle, Han Woo. The numbers of human brucellosis cases and cattle outbreaks increased and decreased in the same pattern. The correlation coefficient for human and bovine cases per year was 0.96 (95% confidence interval = 0.86~0.99; p brucellosis appeared to be affected by the intensity of eradication programs that mainly involved a test-and-slaughter policy. Findings from the present study were based on freely available statistics from web pages maintained by government agencies. This unlimited access to information demonstrates the usefulness of government statistics for continually monitoring the health of animal populations. PMID:25234321
Dirar, Bashahun Gebremichael; Nasinyama, George William; Gelalcha, Benti Deresa
A cross-sectional study was carried out in Jimma town and Chora Botor district of Jimma zone from February 2014 to May 2014 to determine seroprevalence and risk factors of brucellosis in cattle. A total of 348 blood samples (174 each from zebu and crossbreed) were collected. The sera were separated and screened by Rose Bengal plate test (RBPT), and positive sera were retested by complement fixation test (CFT) for confirmation. The overall seroprevalence of bovine brucellosis was 1.4 and 0.3 % as tested by RBPT and CFT, respectively. The seroprevalence of bovine brucellosis in indigenous and crossbreed cattle was 1.1 and 0.6 % and 1.7 and 0 % using RBPT and CFT, respectively. Retained fetal membrane was the only risk factor found to be significantly associated with seropositivity of brucellosis in this study (p = 0.019). The overall seroprevalence of brucellosis was very low. However, due to the zoonotic and economic importance of the disease, prevention and control measures are required to stop further spread of the disease. To effectively implement this, the One Health (OH) is the most constructive approach we recommend.
O'Brien, Michael P; Beja-Pereira, Albano; Anderson, Neil; Ceballos, Ruben M; Edwards, William H; Harris, Beth; Wallen, Rick L; Costa, Vânia
The wildlife of the Greater Yellowstone Ecosystem carries brucellosis, which was first introduced to the area by cattle in the 19th century. Brucellosis transmission between wildlife and livestock has been difficult to study due to challenges in culturing the causative agent, Brucella abortus . We examined B. abortus transmission between American bison ( Bison bison ), Rocky Mountain elk ( Cervus elaphus nelsoni), and cattle ( Bos taurus ) using variable number tandem repeat (VNTR) markers on DNA from 98 B. abortus isolates recovered from populations in Idaho, Montana, and Wyoming, US. Our analyses reveal interspecies transmission. Two outbreaks (2007, 2008) in Montana cattle had B. abortus genotypes similar to isolates from both bison and elk. Nevertheless, similarity in elk and cattle isolates from the 2008 outbreak suggest that elk are the likely source of brucellosis transmission to cattle in Montana and Wyoming. Brucella abortus isolates from sampling in Montana appear to be divided in two clusters: one found in local Montana elk, cattle, and bison; and another found mainly in elk and a bison from Wyoming, which is consistent with brucellosis having entered Montana via migration of infected elk from Wyoming. Our findings illustrate complex patterns of brucellosis transmission among elk, bison, and cattle as well as the utility of VNTRs to infer the wildlife species of origin for disease outbreaks in livestock.
Corrente, Marialaura; Desario, Costantina; Parisi, Antonio; Grandolfo, Erika; Scaltrito, Domenico; Vesco, Gesualdo; Colao, Valeriana; Buonavoglia, Domenico
Bovine brucellosis is diagnosed by official tests, such as Rose Bengal plate test (RBPT) and Complement Fixation test (CFT). Both tests detect antibodies directed against the lipolysaccharide (LPS) of Brucella cell wall. Despite their good sensitivity, those tests do not discriminate between true positive and false positive serological reactions (FPSR), the latter being generated by animals infected with other Gram negative microorganisms that share components of Brucella LPS. In this study, an antigenic extract from whole Brucella melitensis B115 strain was used to set up an ELISA assay for the serological diagnosis of bovine brucellosis. A total of 148 serum samples from five different groups of animals were tested: Group A: 28 samples from two calves experimentally infected with Yersinia enterocolitica O:9; Group B: 30 samples from bovines infected with Brucella abortus; Group C: 50 samples from brucellosis-free herds; Group D: 20 samples RBPT positive and CFT negative; Group E: 20 samples both RBPT and CFT positive. Group D and Group E serum samples were from brucellosis-free herds. Positive reactions were detected only by RBPT and CFT in calves immunized with Y. enterocolitica O:9. Sera from Group B animals tested positive also in the ELISA assay, whereas sera from the remaining groups were all negative. The results obtained encourage the use of the ELISA assay to implement the serological diagnosis of brucellosis. Copyright © 2015 Elsevier B.V. All rights reserved.
The objectives of this study were to assess the heterogeneities of estimates and to estimate the seroprevalence of brucellosis in animals and humans in Ethiopia. Data from 70 studies covering 75879 animals and 2223 humans were extracted. Rose Bengal Plate Test (RBPT) and Complement Fixation Test (CFT) in series were the most frequently used serological tests. A random effects model was used to calculate pooled prevalence estimates. The overall True Prevalence of brucellosis seropositivity in goats and sheep were estimated at 5.3% (95%CI = 3.5, 7.5) and 2.7% (95%CI = 1.8, 3.4), respectively, and 2.9% for each of camels and cattle. The prevalence was higher in post-pubertal than in pre-pubertal animals (OR = 3.1, 95% CI = 2.6, 3.7) and in the pastoral than in the mixed crop-livestock production system (OR = 2.8, 95%CI = 2.5, 3.2). The incidence rates of brucellosis in humans of pastoral and sedentary system origins were estimated at 160 and 28 per 100 000 person years, respectively. The seroprevalence of brucellosis is higher in goats than in other species. Its occurrence is evocative of its importance in the country in general and in the pastoral system in particular. Public awareness creation could reduce the transmission of Brucella spp. from animals to humans and the potential of livestock vaccination as a means of control of brucellosis needs to be assessed.
Abulizi, Yakefu; Liang, Wei-Dong; Muheremu, Aikeremujiang; Maimaiti, Maierdan; Sheng, Wei-Bin
Spinal brucellosis is a less commonly reported infectious spinal pathology. There are few reports regarding the surgical treatment of spinal brucellosis in existing literature. This retrospective study was conducted to determine the effectiveness of single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral spinal brucellosis. From February 2012 to April 2015, 32 consecutive patients (19 males and 13 females, mean age 53.7 ± 8.7) with lumbosacral brucellosis treated by transforaminal decompression, debridement, interbody fusion, and posterior instrumentation were enrolled. Medical records, imaging studies, laboratory data were collected and summarized. Surgical outcomes were evaluated based on visual analogue scale (VAS), Oswestry Disability Index (ODI) and Japanese Orthopaedic Association (JOA) scale. The changes in C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), clinical symptoms and complications were investigated. Graft fusion was evaluated using Bridwell grading criteria. The mean follow-up period was 24.9 ± 8.2 months. Back pain and radiating leg pain was relieved significantly in all patients after operation. No implant failures were observed in any patients. Wound infection was observed in two patients and sinus formation was observed in one patient. Solid bony fusion was achieved in 30 patients and the fusion rate was 93.8%. The levels of ESR and CRP were returned to normal by the end of three months' follow-up. VAS and ODI scores were significantly improved (P brucellosis.
Sanjuan-Jimenez, Rocio; Colmenero, Juan D; Morata, Pilar
Brucellosis remains an emerging and re-emerging zoonosis worldwide causing high human morbidity. It usually affects persons who are permanently exposed to fastidious microorganisms of the Brucella genus and has a nonspecific clinical picture. Thus, diagnosis of brucellosis can sometimes be difficult. Molecular techniques have recently been found very useful in the diagnosis of brucellosis together with its common and very diverse focal complications. We herein review all the lessons learned by our group concerning the molecular diagnosis of human brucellosis over the last twenty years. The results, initially using one-step conventional PCR, later PCR-ELISA and more recently real-time PCR, using both fluorescent intercalating reagents (SYBR-Green I) and specific probes (Taqman), have shown that these techniques are all much more sensitive than bacteriological methods and more specific than the usual serological techniques for the diagnosis of primary infection, the post-treatment control of the disease, early detection of relapse and the diagnosis of focal complications. Optimization of the technique and improvements introduced over the years show that molecular methods, currently accessible for most clinical laboratories, enable easy rapid diagnosis of brucellosis at the same time as they avoid any risk to laboratory personnel while handling live Brucella spp. Copyright © 2017 Elsevier B.V. All rights reserved.
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Domingues, Rosa Maria Soares Madeira; Leal, Maria do Carmo; Pereira, Ana Paula Esteves; Ayres, Barbara; Sánchez, Alexandra Roma; Larouzé, Bernard
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 period 2011-2014. The Birth in Brazil study included 23,894 free women cared for in 266 hospitals. The Maternal and Infant Health in Prisons study included 495 incarcerated pregnant women or mothers living with their children, according to a census conducted in 33 female prisons. The same case definitions and data collection methods were used in both studies. The chi-square test was used to compare the characteristics of incarcerated and free women with a significance of 0.05. For incarcerated women, the estimated prevalence of syphilis during pregnancy was 8.7% (95%CI: 5.7-13.1) and for HIV infection 3.3% (95%CI: 1.7-6.6); the estimated mother to child transmission of syphilis was 66.7% (95%CI: 44.7-83.2) and the incidence of congenital syphilis was 58.1 per 1,000 living newborns (95%CI: 40.4-82.8). Incarcerated women had a greater prevalence of syphilis and HIV infection during pregnancy, lower quality of antenatal care and higher levels of social vulnerability. Syphilis infection showed to be an indicator of social vulnerability in free women, but not in incarcerated women. Health initiatives in prison are necessary to reduce healthcare inequalities and should include adequate antenatal and birth care.
Rosa Maria Soares Madeira Domingues
Full Text Available Abstract: 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 period 2011-2014. The Birth in Brazil study included 23,894 free women cared for in 266 hospitals. The Maternal and Infant Health in Prisons study included 495 incarcerated pregnant women or mothers living with their children, according to a census conducted in 33 female prisons. The same case definitions and data collection methods were used in both studies. The chi-square test was used to compare the characteristics of incarcerated and free women with a significance of 0.05. For incarcerated women, the estimated prevalence of syphilis during pregnancy was 8.7% (95%CI: 5.7-13.1 and for HIV infection 3.3% (95%CI: 1.7-6.6; the estimated mother to child transmission of syphilis was 66.7% (95%CI: 44.7-83.2 and the incidence of congenital syphilis was 58.1 per 1,000 living newborns (95%CI: 40.4-82.8. Incarcerated women had a greater prevalence of syphilis and HIV infection during pregnancy, lower quality of antenatal care and higher levels of social vulnerability. Syphilis infection showed to be an indicator of social vulnerability in free women, but not in incarcerated women. Health initiatives in prison are necessary to reduce healthcare inequalities and should include adequate antenatal and birth care.
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Valéria Correa de Almeida
Full Text Available ABSTRACT OBJECTIVE We aim to analyze trend of syphilis and factors associated with recurrent episodes of syphilis among adults and adolescents attended in a STI/AIDS reference centers in Campinas, state of São Paulo, 2004 to 2012. METHODS Medical records, pharmacy data, and notification database were accessed to analyze trends of syphilis and sociodemographic, epidemiological and clinical variables associated with reinfection of syphilis. After univariate analysis, a hierarchical logistic regression model was adjusted to analyze variables associated with more than one episode of syphilis (dependent variable. First step (sex, age, and years of schooling were tested and in the second, epidemiological and clinical variables. RESULTS A total of 1,009 episodes of syphilis were identified among 860 adolescents and adults, 117 individuals (13.6% presented with more than one episode of syphilis. Factors associated with more than one episode of syphilis were sex (male (OR = 4.28; 95%CI 1.31–14.0, age (OR = 1.02; 95%CI 1.00–1.04, homosexual/bisexual orientation (OR = 2.29; 95%CI 1.22–4.32, HIV coinfection (OR = 3.54; 95%CI 2.22–5.63, and absence of STI symptoms at the time of syphilis diagnostic (OR = 1.70; 95%CI 1.03–2.80. CONCLUSIONS The number of cases of syphilis and proportion in relation to STI increased in recent years in a specific population attended in a STI/AIDS reference centers in Campinas. Association with HIV, homosexual/bisexual orientation and the silent clinical characteristic of cases confirm the necessity to implement more aggressive strategies to prevent the occurrence of syphilis and other STI in specific populations with higher disease risk.
Ngai Sze Wong
Full Text Available Abstract Background Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. Methods In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015 accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21, adjusted for age at diagnosis and gender. Results Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. Conclusions To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.
Mireille B. Kalou
Full Text Available Background: Use of rapid diagnostic tests for HIV and syphilis has increased remarkably in the last decade. As new rapid diagnostic tests become available, there is a continuous need to assess their performance and operational characteristics prior to use in clinical settings. Objectives: In this study, we evaluated the performance of the Chembio Dual Path Platform (DPP® HIV–Syphilis Assay to accurately diagnose HIV, syphilis, and HIV/syphilis co-infection. Method: In 2013, 990 serum samples from the Georgia Public Health Laboratory in Atlanta, Georgia, United States were characterised for HIV and syphilis and used to evaluate the platform. HIV reference testing combined third-generation Enzyme Immunoassay and Western Blot, whereas reference testing for syphilis was conducted by the Treponema pallidum passive particle agglutination method and the TrepSure assay. We assessed the sensitivity and specificity of the DPP assay on this panel by comparing results with the HIV and syphilis reference testing algorithms. Results: For HIV, sensitivity was 99.8% and specificity was 98.4%; for syphilis, sensitivity was 98.8% and specificity was 99.4%. Of the 348 co-infected sera, 344 (98.9% were detected accurately by the DPP assay, but 11 specimens had false-positive results (9 HIV and 2 syphilis due to weak reactivity. Conclusion: In this evaluation, the Chembio DPP HIV–Syphilis Assay had high sensitivity and specificity for detecting both HIV and treponemal antibodies. Our results indicate that this assay could have a significant impact on the simultaneous screening of HIV and syphilis using a single test device for high-risk populations or pregnant women needing timely care and treatment.
Bjekić, Milan; Šipetić-Grujičić, Sandra; Begović-Vuksanović, Biljana; Rafailović, Nevena; Vlajinac, Hristina
A worldwide syphilis incidence increase was recorded at the beginning of the new millennium, occurring primarily among men who have sex with men (MSM). The aim of this study was to analyse the epidemiological situation of syphilis in the Belgrade population between 2005 and 2014 and to examine the characteristics of an early syphilis outbreak among MSM in Belgrade in 2014. Reporting of syphilis is compulsory in Serbia. Routinely reported data were analysed along with data collected from patients' charts. During the period observed, syphilis incidence increased from 1.07 per 100,000 in 2005 to 4.1 per 100,000 in 2014 (383.2%). From 2005 to 2009, syphilis rates in Belgrade were low, around 1 case per 100,000 people. The first outbreak was registered in 2010. The new incidence increase happened in 2012, and again in 2014 when it was the highest. These incidence changes were registered mainly in men, where the frequency of syphilis was much higher than in women. In 2014, primary syphilis was diagnosed in 20 cases, secondary syphilis in 42, and early latent syphilis in 9 patients. Fifty-seven were MSM, 10 were heterosexual men and 4 were women. Twenty-four cases, all MSM were co-infected with HIV. Majority of patients acquired infection in Belgrade, while in 42/71 cases oral sex was the only risk factor. In comparison with HIV negative, HIV positive syphilis patients were older, more frequently unemployed and MSM. They also more frequently had sex with unknown partners and were diagnosed in the secondary stage of infection. Study results underline the need for coordinated and expeditious surveillance, partner services, enhanced screening of population at risk, health education, as well as early diagnosis and treatment. Copyright© by the National Institute of Public Health, Prague 2017
Almeida, Valéria Correa de; Donalisio, Maria Rita; Cordeiro, Ricardo
We aim to analyze trend of syphilis and factors associated with recurrent episodes of syphilis among adults and adolescents attended in a STI/AIDS reference centers in Campinas, state of São Paulo, 2004 to 2012. Medical records, pharmacy data, and notification database were accessed to analyze trends of syphilis and sociodemographic, epidemiological and clinical variables associated with reinfection of syphilis. After univariate analysis, a hierarchical logistic regression model was adjusted to analyze variables associated with more than one episode of syphilis (dependent variable). First step (sex, age, and years of schooling) were tested and in the second, epidemiological and clinical variables. A total of 1,009 episodes of syphilis were identified among 860 adolescents and adults, 117 individuals (13.6%) presented with more than one episode of syphilis. Factors associated with more than one episode of syphilis were sex (male) (OR = 4.28; 95%CI 1.31-14.0), age (OR = 1.02; 95%CI 1.00-1.04), homosexual/bisexual orientation (OR = 2.29; 95%CI 1.22-4.32), HIV coinfection (OR = 3.54; 95%CI 2.22-5.63), and absence of STI symptoms at the time of syphilis diagnostic (OR = 1.70; 95%CI 1.03-2.80). The number of cases of syphilis and proportion in relation to STI increased in recent years in a specific population attended in a STI/AIDS reference centers in Campinas. Association with HIV, homosexual/bisexual orientation and the silent clinical characteristic of cases confirm the necessity to implement more aggressive strategies to prevent the occurrence of syphilis and other STI in specific populations with higher disease risk.
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Mizanbayeva, Sulushash; Smits, Henk L; Zhalilova, Katya; Abdoel, Theresia H; Kozakov, Stanislaw; Ospanov, Kenes S; Elzer, Philip H; Douglas, James T
Serum samples from all patients with culture-confirmed brucellosis including those with chronic disease from Kazakhstan tested positive in the serum agglutination test for titers > or = 1:25 and reacted in the Brucella immunoglobulin M/immunoglobulin G lateral flow assay (LFA) confirming the high sensitivity of these assays. The strong reactivity in the LFA observed for the majority (92.1%) of the samples from the patients with culture-confirmed brucellosis together with the user-friendliness of the assay procedure makes the LFA ideal for the confirmation of brucellosis in endemic areas in Kazakhstan. The Rose Bengal test lacked sensitivity in particular for patients with chronic brucellosis therefore limiting its value as a quick screening assay. The study emphasizes the importance of the LFA as a useful, rapid, and easy-to-perform tool in the diagnostic testing of brucellosis.
Nah, Byung Sik; Chung, Ung Ki
Congenital syphilis is transmitted through the placenta by the infected mother after 16 weeks of gestation. Since the incidence of syphilis is again on the increase, syphilis remains at the present time a public problem of major and increasing proportions. Recently, congenital syphilis has different formas of presentation. The authors observed clinically and radiologically 27 cases of congenital syphilis in the neonates and infants treated at the pediatric ward of Chonnam National University Hospital from Jan. 1977 to Mar. 1982. The results are as follows: 1. The number of observed patients was 27 cases, 22 cases in male, 5 cases in female. 2. Onset of first clinical symptoms and signs was within the 4th week life in 14 cases (52%), 1-2 months in 6 cases (22%), 2-3 months in 4 cases (15%), 3-4 months in 3 cases (11%). All cases was within 6 months. 3. The order of the frequency of common clinical manifestations was hepatomegaly (96%), splenomegaly (78%), skin lesion (63%), anemia (63%), nasal snuffle (56%). 4. Of 11 cases with known birth weight, 10 cases were low birth weight. 5. The serologic test (VDRL slide test) of 27 tested caes revealed reactive response in 26 cases, non-reactive response in 1 case, and that of syphilitic mothers except one revealed reactive in 23 cases, non- reactive in 3 cases. 6. Roentgenographic syphilitic bony changes were detected in 26 cases (96%), of 27 studied cases, osteochondritis was present in 24 cases (89%), periostitis in 21 case (78%), osteomyelitis in 11 cases (41%). 7. The most common sites affected were as follows. Radius and ulna were the most frequently affected, the next were in order of tibia and fibula. Considering osteochondiritis only, the distal end of radius and ulna (78% respectively) and proximal end of tibra (67%) were the most frequently affected sites, the proximal end of femur (33%) was least frequently affected site. 8. On chest films of 27 case, osseous changes (mainly periostitis) of clavicle were noted
Marta Koper; Agnieszka B. Serwin; Anna Baran; Iwona Flisiak
Introduction. Undiagnosed and untreated syphilis in pregnancy may result in subsequent complications: early fetal loss, stillbirth, low birth weight of infants and newborns with congenital syphilis. Objective. To analyze diagnostic and therapeutic dilemmas of positive results of serological tests for syphilis (STS) in pregnancy. Case reports. We present two cases of pregnant women, hospitalized in our department due to positive results of serological tests for syphilis, pe...
S. V. Koshkin
Full Text Available Sixty patients with different clinical symptoms of secondary syphilis (ulcer chancres, pustular syphilis, hypertrophic papules, widespread leukoderma and alopecia were examined in order to study the distribution pattern of histocompatibility antigens of the first class in patients with secondary syphilis of the skin and mucous membranes. As a result of the study, the presence of an associative relationship between the distribution pattern of histocompatibility antigens of the first class and various clinical manifestations in patients with secondary syphilis was established.
Chen, Yuan-Fang; Ding, Jian-Ping; Yan, Hong-Jing; Lu, Jing; Ding, Ping; Chen, Guo-Hong; Li, Jian-Jun; Huan, Xi-Ping; Yang, Hai-Tao; Tang, Wei-Ming; Fu, Geng-Feng
To analyze the midterm evaluation data from the National Syphilis Prevention and Control Plan (2010-2020) and evaluate the current status of syphilis prevention and control in Jiangsu province, China. We collected data via (1) field surveys conducted in 2015 and (2) data recorded in existing syphilis surveillance systems. We conducted descriptive statistical analysis to evaluate the current landscape of syphilis control initiatives and their potential effect in syphilis control. The incidence of all cases of syphilis decreased from 2010 (32.3 per 100,000) to 2015 (30.1 per 100,000), with an annual growth of -1.17% (x2trend = -7.52, Psyphilis and congenital syphilis both decreased significantly from 2010 to 2015. The average awareness rate of syphilis knowledge among professional personnel was 95.4% (3781/3963). Rural residents had the lowest awareness rate (83.5%, 1875/2245) and commercial sex workers had the highest awareness rate (92.1%, 7804/8474) in 2015. Only 47.8% (33908/70894) of patients received provider-initiated syphilis counseling and testing (PISTC) services in sexually transmitted disease (STD) clinics, but 94.5% (87927/93020) of all syphilis patients received free testing for syphilis. Overall, 97.2% (9378/9648) of syphilis reported cases of syphilis at medical institutions were confirmed to be accurate, and 92.2% (5850/6345) of patients diagnosed with syphilis at medical institutions received treatment with penicillin. The syphilis incidence rate in Jiangsu has decreased in recent years, but remains at a high level. It is essential to promote PISTC services to improve knowledge of syphilis and rates of testing and treatment in Jiangsu province.
Bryan, J P; Reyes, L; Hakre, S; Gloria, R; Kishore, G M; Tillett, W; Engle, R; Tsarev, S; Cruess, D; Purcell, R H
Hepatitis is common in the Stann Creek District of southern Belize. To determine the etiologies, incidence, and potential risk factors for acute jaundice, we conducted active surveillance for cases. Cases of jaundice diagnosed by a physician within the previous 6 weeks were enrolled. Evaluation included a questionnaire and laboratory tests for hepatitis A, B, C, D, and E, a blood film for malaria, and a serologic test for syphilis. Etiologies of jaundice among 62 evaluable patients included acute hepatitis A, 6 (9.7%), acute hepatitis B, 49 (79.0%), hepatitis non-A-E, 2 (3.2%), and malaria, 5 (8.1%). There were no cases of acute hepatitis E. One patient each with antibody to hepatitis C and D were detected. The annualized incidence of hepatitis A was 0.26 per 1,000. All cases of hepatitis A were in children 4-16 years of age. The annualized incidence of hepatitis B, 2.17 per 1,000, was highest in adults aged 15-44 years (4.4 per 1,000) and was higher in men (36 cases; 3.09 per 1,000) than women (13 cases; 1.19 per 1,000). Four (31%) of the women with hepatitis B were pregnant. The annualized incidence was significantly higher in Mestizo (6.18 per 1000) and Maya (6.79 per 1,000) than Garifuna (0.38 per 1,000) or Creole (0.36 per 1,000). Persons with hepatitis B were significantly more likely to be born outside of Belize (82%), had been in Belize or = 14 years of age with hepatitis B, only 36% were married. Few persons admitted to transfusions, tattoos, IV drug use, multiple sexual partners, visiting prostitutes, or sexually transmitted diseases. Only 1 of 49 had a reactive test for syphilis. Six patients were hospitalized (including 3 with acute hepatitis B and one with hepatitis A), and none to our knowledge died. Acute hepatitis B is the most common cause of viral hepatitis in the Stann Creek District, but the modes of transmission remain obscure. Infants, women attending prenatal clinics, and new workers are potential targets for immunization with hepatitis B
Wang, Cuini; Cheng, Yuanyuan; Liu, Biao; Wang, Yuanyuan; Gong, Weiming; Qian, Yihong; Guan, Zhifang; Lu, Haikong; Gu, Xin; Shi, Mei; Zhou, Pingyu
The aim of this work was to investigate the application of the nested PCR assay for the detection of Treponema pallidum (TP) DNA from the blood of patients with different stages of syphilis. In this study, a nested PCR method targeting the Tpp47 and polA genes (Tpp47-Tp-PCR and polA-Tp-PCR) was developed to detect TP-DNA in whole blood samples collected from 262 patients with different stages of syphilis (84 primary syphilis, 97 secondary syphilis, and 81 latent syphilis patients). The PCR assay detected T. pallidum DNA in 53.6% and 62.9% of the patients with primary and secondary syphilis, respectively, which was much higher than the detection levels in patients with latent syphilis (7.4%) (both p PCR in the early phase of the latent infection. Thus, blood RPR titers were correlated with the blood T. pallidum burden, but the correlations varied with primary and secondary syphilis. The results indicate that nested PCR is a sensitive method for detecting blood TP-DNA and is especially useful for detecting early syphilis including primary syphilis and secondary syphilis. The findings also suggest that the PCR assay may be used to complement other methods to enhance the diagnosis of syphilis.
Poulsen, Keith P.; Hutchins, Frank T.; McNulty, Chase M.; Tremblay, Marlène; Zabala, Carmen; Barragan, Veronica; Lopez, Luis; Trueba, Gabriel; Bethel, Jeffrey W.
The purpose of this study was to conduct a convenience study for brucellosis prevalence in dairy-producing animals in northern Ecuador. In total, 2,561 cows and 301 goats were tested. Cattle sera were tested using the Rose Bengal card antigen test (RBCT), yielding an overall apparent prevalence of 5.5% (95% confidence interval [95% CI] = 4.7–6.5%) and true prevalence of 7.2% (95% CI = 6.0–8.5%). Prevalence varied by herd size and was highest in larger commercial herds. Polymerase chain reaction was used to test goat milk and lymph nodes, resulting in 9% and 8% positivity, respectively. The RBCTs from goat sera yielded an adjusted true prevalence of 17.8% (95% CI = 6.2–44.2%). Our findings are similar to other overall prevalence estimates for dairy herds but show higher prevalence in commercial herds compared with small groups (less than five animals). We also identify urban milking goats living in metropolitan Quito as a potential source of zoonosis. PMID:24591429
Silva, M.; Muller, G.; Errico, F.; Dilave, M.
Sera from 600 cattle on Rio Negro Island, known to be free of brucellosis, and 400 sera from vaccinated cattle but known to be negative in the Rose-Bengal test were selected for validation of the FAO/IAEA test kit for detection of antibody to Brucella abortus. Two conjugates, one a polyclonal antiserum and the other a monoclonal antibody, were evaluated. When evaluated for reproducibility using the sera from uninfected cattle, the average coefficient of variation for duplicate samples was 7.1%±5.5. The serum control samples did not exceed OD limits as established for the kit, for any of the 15 plates evaluated. When evaluated by regression analysis, the control sera had an average correlation coefficient of 0.996, indicating a high degree of agreement between the observed OD values of controls on each plate vs the expected values for those controls. Specificity in the assay was >98% as calculated by the PP or regression methods. Comparison of the monoclonal and polyclonal conjugates using sera from vaccinated cattle indicated that many of the cattle must have been vaccinated as adults because of high antibody levels detected by both conjugates. Before this assay can be used on vaccinated animals, the kit will have to be evaluated using sera from animals of known age of vaccination. (author)
Comerci, D.J.; Ugalde, J.E.; Ugalde, R.A.
Brucella abortus S19 is the most commonly used attenuated live vaccine to prevent bovine brucellosis. In spite of its advantages, S19 has several drawbacks: it is abortive for pregnant cattle, is virulent for humans, and re-vaccination is not advised due to the persistence of anti-lipopolysaccharide (LPS) antibodies that hamper the immunoscreening procedures. For these reasons, there is a continuous search for new bovine vaccine candidates. We have previously characterized the phenotype of the phosphoglucomutase (pgm) gene disruption in Brucella abortus S2308, as well as the possible role for the smooth LPS in virulence and intracellular multiplication. Here we evaluate the vaccine properties of an unmarked deletion mutant of pgm. Western blot analysis of purified lipopolysaccharide and whole-cell extract from Δpgm indicate that it synthesizes O-antigen but is incapable of assembling a complete LPS. In consequence Δpgm has a rough phenotype. Experimental infections of mice indicate that Δpgm is avirulent. Vaccination with Δpgm induces protection levels comparable to those induced by S19, and generates a splenocyte proliferative response and cytokines profile typical of a Th-1 response. The ability of the mutant to generate a strong cellular Th-1 response without eliciting specific O-antigen antibodies highlights the potential use of this mutant as a new live vaccine for cattle. (author)
Neiland, K A
Antibodies against rangiferine brucellosis, Brucella suis type 4, are commonly found in the serum of various domestic and wild alaskian carnivores which feed on caribou, Rangifer tarandus granti, arctic Alaska. Sled dogs from five native villages on the range of the Artic caribou herd, but not from two villages on the the range of the Porcupine caribou herd, are commonly infected. Wolves (Canis lupus) and red foxes (Vulpes fulva) are less commonly infected. About 90% of the grizzly bears (Ursus arctos horribilis) associated with the Artic caribou herd and 30% of those associated with the porcupine caribou herd show serologic signs of exposure to Brucella, presumalby the enzootic strain present in Alaska caribou. This is the first evidence of natural Brucella infection in bears. It is concluded that infection of predators by enzootic strains of Brucella present in prey species (e.g., ruminants) is common to many areas of the world. Evidence from the literature and unpublished experimental data suggest that such infections may intefere with reproduction in wild species, but additional study is needed to clearly resolve this question.
Chisi, Songelwayo L; Schmidt, Tracy; Akol, George W; Van Heerden, Henriette
Serology is primarily used in the diagnosis of bovine brucellosis. Bacterial culture and isolation is the gold standard in diagnosing brucellosis but, like serology, it does not offer complete (100%) diagnostic sensitivity and specificity. Polymerase chain reaction (PCR) has been suggested to offer better specificity and sensitivity. In this study, we evaluated the performance of Brucella abortus species specific (BaSS) PCR directly from different samples in the diagnosis of bovine brucellosis in naturally infected cattle in KwaZulu-Natal province of South Africa with known infectious status from culture. The BaSS PCR had a low diagnostic sensitivity (DSe) of 70%, but was able to identify vaccine strains using abomasal fluid from aborted foetuses and detect Brucella DNA from decomposing samples. The best sample for the BaSS PCR was abomasal fluid.
Godfroid, Jacques; Al Dahouk, Sascha; Pappas, Georgios; Roth, Felix; Matope, Gift; Muma, John; Marcotty, Tanguy; Pfeiffer, Dirk; Skjerve, Eystein
Although a "One Health" approach has been successfully implemented for emerging infectious zoonotic diseases with pandemic potential, we still lack a conceptual framework to address enzootic diseases like brucellosis. The vast majority of published brucellosis studies in the developing world rely solely on serology. An important shortcoming of brucellosis serology is the impossibility to infer which (smooth) Brucella spp. induced antibodies in the host. In this respect, mixed farming and especially raising small ruminants along with cattle, a common practice in the developing world, is reported to be a risk factor and a central question that has to be answered is whether cattle are infected with B. melitensis or with B. abortus or with both Brucella species. Therefore the isolation, identification and molecular characterization of Brucella spp. in human and the different livestock species needs to be undertaken to define a sound conceptual framework, identify the source of infection and plan appropriate control measures. Copyright © 2012 Elsevier Ltd. All rights reserved.
Palmer, Mitchell V; Olsen, Steve C
Hepatic lipidosis, a hallmark lesion of lipid mobilization disorders in ruminants, was noted in four 3-year-old, pregnant bison (Bison bison) after periods of anorexia that progressed to recumbency and death. The affected bison were part of a herd at the National Animal Disease Center (NADC) that was used for brucellosis vaccine research. Microscopically, the liver contained swollen hepatocytes with numerous, variably sized, round, smoothly contoured vacuoles that displaced cytoplasmic structures. Hepatocytes in all zones of the lobule were affected equally. Hypoglycemia, decreased total carbon dioxide, elevated gamma-glutamyltransferase, elevated alkaline phosphatase, and increased nonesterified fatty acid levels were noted. As in the case of cattle, altered nutritional demands of late gestation combined with management factors such as obesity, nutrition, stress, and concomitant disease may be critical in the pathophysiology of lipid mobilization disorders in bison. Additionally, stressors unique to this research herd likely contributed to fatal hepatic lipidosis.
... yellow color. Confusion, drowsiness and slurred speech (hepatic encephalopathy). A damaged liver has trouble removing toxins from your body. The ... of toxins can damage your brain. Severe hepatic encephalopathy can result in ... of the liver frequently leads to liver failure. Kidney failure. A ...
Sabid?, Meritxell; Benzaken, Adele S.; de Andrade Rodrigues, ?nio Jos?; Mayaud, Philippe
: We assessed the acceptability and operational suitability of a rapid point-of-care syphilis test and identified barriers to testing among high-risk groups and healthcare professionals in a sexually transmitted infections clinic in Manaus, Brazil. Use of this test could considerably alleviate the impact of syphilis in hard-to-reach populations in the Amazon region of Brazil.
Stephens, Sally C; Bernstein, Kyle T; McCright, Jacqueline E; Klausner, Jeffrey D
To promote regular syphilis testing among men who have sex with men in San Francisco, a social marketing campaign, Dogs Are Talking, was created. An evaluation of the campaign found no difference in syphilis testing among men who recalled the campaign and those that did not. A significant difference was seen among HIV-infected men.
Katanami, Yuichi; Hashimoto, Takehiro; Takaya, Saho; Yamamoto, Kei; Kutsuna, Satoshi; Takeshita, Nozomi; Hayakawa, Kayoko; Kanagawa, Shuzo; Ohmagari, Norio
There is no proven alternative to penicillin for treatment of maternal syphilis. We report 2 case-patients with maternal syphilis who were successfully treated without penicillin. We used amoxicillin and probenecid for the first case-patient and amoxicillin, probenecid, and ceftriaxone for the second case-patient.
Meier, J L; Mollet, E
Acute periostitis affecting the long bones is a characteristic but uncommon manifestation of syphilis in the adult with an early acquired infection. This report describes the history of a jogger who developed acute localized periostitis of the shaft of both tibiae during the early stage of acquired syphilis. Symptomatology was initially attributed to the medial tibial stress syndrome.
Chris Richard Kenyon
Conclusions: AIDS mortality may have played an important role in the decline in syphilis in this region. Consequently, with AIDS deaths declining in Sub-Saharan Africa, vigilant surveillance of syphilis prevalence will be necessary to detect a potential re-emergence, as has occurred in high-income countries, and to render a timely public health response.