bluuebunny/crossref_metadata_2025 huggingface dataset:
Modification of the clinical course of intestinal microsporidiosis in acquired immunodeficiency syndrome patients by immune status and anti-human immunodeficiency virus therapy.
Authors: Conteas C N , Berlin O G , Speck C E , Pandhumas S S , Lariviere M J , Fu C
Published: May 2017

The clinical course of 37 Enterocytozoon bieneusi-infected acquired immunodeficiency syndrome patients with diarrhea was studied. Parasite clearance was seen in 15 patients (40.5%). Clearance of E. bieneusi resulted in a 25-100% reduction in episodes of diarrhea, suggesting that microsporidia are true pathogens. Univariate and multivariate proportional hazards analyses revealed that peripheral blood CD4 cell counts > or = 100/mm3, the use of two or more antiretroviral medications, and use of a protease inhibitor were statistically associated with decreased time to clearance of E. bieneusi. Specific anti-microsporidial therapy (albendazole) was not associated with parasite eradication. Factors related to immunocompetence and human immunodeficiency virus suppression appeared to be important in the clearance of E. bieneusi.
Examination of the prevalence and seasonal variation of intestinal microsporidiosis in the stools of persons with chronic diarrhea and human immunodeficiency virus infection.
Authors: Conteas C N , Berlin O G , Lariviere M J , Pandhumas S S , Speck C E , Porschen R , Nakaya T
Published: May 2017

The epidemiology of human microsporidiosis is poorly understood and environmental factors affecting transmission of the organism have not been fully elucidated. Temporal variation in the prevalence of microsporidia in the stool of patients with human immunodeficiency virus (HIV) infection and diarrhea was studied to evaluate the role of water-borne transmission. From January 1993 to December 1996, 8,439 stools from HIV-infected individuals were examined for microsporidia spores in southern California. Yearly positivity rates were 8.8% in 1993, 9.7% in 1994, 6.6% in 1995, and 2.9% in 1996. An analysis for linear trend showed a statistically significant decrease in stool positivity rates over time (chi2 = 81.9, P = 0.001). No significant seasonal variation in the prevalence of microsporidiosis was seen over that time period. These results suggest the constant presence of microsporidia in the environment, rather than a seasonal association with recreational water use or seasonal contamination of the water supply, and a real decrease in yearly prevalence of microsporidia related diarrhea. Factors related to a progressive decrease in prevalence are subjects of future investigation.
Estimation of vector infectivity rates for plague by means of a standard curve-based competitive polymerase chain reaction method to quantify Yersinia pestis in fleas.
Authors: Hinnebusch B J , Gage K L , Schwan T G
Published: May 2017

The prevalence of infectivity within a vector population is a critical factor in arthropod-borne disease epidemiology but it is difficult to estimate. In the case of bubonic plague, infective flea vectors contain large numbers of Yersinia pestis within a bacterial mass that blocks the flea's foregut, and only such blocked fleas are important for biologic transmission. A bacterial quantitation method could therefore be used to assess the prevalence of plague-infective (blocked) fleas in a population. We developed a standard, curve-based, competitive polymerase chain reaction (PCR) procedure to quantitate Y. pestis in individual fleas. The quantitative PCR (Q-PCR) method equaled a colony count reference method in accuracy and precision when evaluated using mock samples and laboratory-infected fleas. The Q-PCR was more reliable than colony count, however, for field-collected fleas and for blocked fleas collected after their death. In a sample of fleas collected from a prairie dog colony in the aftermath of a plague epizootic, 48% were infected but less than 2% contained numbers of Y. pestis indicative of blockage. The method provides a means to monitor plague epizootics and associated risks of flea-borne transmission to humans, and is applicable to the study of other vector-borne diseases.
Monitoring of dengue viruses in field-caught Aedes aegypti and Aedes albopictus mosquitoes by a type-specific polymerase chain reaction and cycle sequencing.
Authors: Chow V T , Chan Y C , Yong R , Lee K M , Lim L K , Chung Y K , Lam-Phua S G , Tan B T
Published: May 2017

Virologic surveillance for dengue through the detection of the prevalent serotype(s) circulating in the human population during inter- and intra-epidemic periods constitutes a reliable sentinel system for dengue outbreaks. We have applied a rapid and sensitive, semi-nested, reverse transcription-polymerase chain reaction (RT-PCR) assay using nonstructural protein 3 gene primers for the type-specific-detection of dengue viruses in artificially infected and in field-caught adult Aedes mosquitoes. In laboratory experiments, the assay was sensitive enough to detect one virus-infected mosquito head in pools of up to 59 uninfected heads. In a prospective field study conducted from April 1995 to July 1996, female adult Ae. aegypti and Ae. albopictus mosquitoes were caught from selected dengue-sensitive areas in Singapore and assayed by RT-PCR. Approximately 20% of 309 mosquito pools were positive for dengue viruses. Of the 23 RT-PCR-positive Ae. aegypti pools (containing 1-17 mosquitoes each), 18 pools (78.3%) were positive for dengue 1 virus. There were 40 RT-PCR-positive Ae. albopictus pools (containing 1-33 mosquitoes each) of which 31 (77.5%) were positive for dengue 1 virus. The predominant virus type responsible for the current dengue epidemic since 1995 was also dengue 1. The geographic locations of the virus-infected mosquitoes correlated with the residences or workplaces of patients within dengue outbreak areas. A total of 43.5% of the positive Ae. aegypti pools and 25.0% of the positive Ae. albopictus pools contained only a single mosquito. Both Aedes species showed similar overall minimum infection rates of 57.6 and 50 per 1,000 mosquitoes. Infected Ae. aegypti were detected as early as six weeks before the start of the dengue outbreaks in 1995 and 1996. However, infected Ae. albopictus appeared later, when the number of cases was increasing. Virologic surveillance by RT-PCR for detecting dengue virus-infected Aedes mosquitoes in the field may serve as an early warning monitoring system for dengue outbreaks.
Current status of onchocerciasis in Colombia.
Authors: Corredor A , Nicholls R S , Duque S , Munoz de Hoyos P , Alvarez C A , Guderian R H , Lopez H H , Palma G I
Published: May 2017

To assess the current epidemiologic status of onchocerciasis in Colombia two surveys were undertaken in 1995 in a suspected new focus on the border between Colombia and Ecuador and in the known focus located on the Micay River. No new focus was found along the Colombia-Ecuador border. In the known focus, communities along the upper Micay River and its tributaries were surveyed; 655 adults underwent physical examinations and skin biopsies. Infected individuals were found almost exclusively in the community of Naiciona, where prevalence of infection was 40% (36 of 91). Polymerase chain reaction detection of onchocercal DNA in skin snips correlated with the skin-snip biopsy results. The prevalence of punctate keratitis, the only ocular manifestation found, was 33%. A rapid entomologic assessment demonstrated Simulium exiguum infected with Onchocerca volvulus. This is the first finding in Colombia of naturally infected black flies and confirms S. exiguum as a vector species. These data will be used for implementing a control program using periodic ivermectin distribution.
Prevalence of and risk factors for anemia in young children in southern Cameroon.
Authors: Cornet M , Le Hesran J Y , Fievet N , Cot M , Personne P , Gounoue R , Beyeme M , Deloron P
Published: May 2017

Anemia during childhood remains a major public health challenge in sub-Saharan Africa. To determine the prevalence of and the main risk factors for anemia in young children, we conducted a longitudinal survey in Ebolowa in southern Cameroon. Children were enrolled in two cohorts and followed during a three-year period: the first cohort was composed of 122 children from 0 to 36 months of age and the second cohort was composed of 84 children from 24 to 60 months of age. The two cohorts were followed weekly for symptomatic malaria, monthly for both symptomatic and asymptomatic malaria, and every six months for hematologic data; the children were grouped into six-month age groups. The prevalence of anemia (hemoglobin [Hb] level < 11 g/dl) was the highest in the six-month-old age group (47%) and the age-related evolution clearly showed a decrease in the prevalence from three years of age. Thus, 42% of the children less than three years of age were anemic, while 21% of the children between three and five years of age were anemic. The lowest mean +/- SD Hb content (10.7 +/- 2.1 g/dl) was observed in the six-month-old children and a regular improvement in the Hb level occurred from six months to three years of age. A stabilization was observed at a level of approximately 12 g/dl. At any age, there was no difference in mean Hb levels between children with AS and AA Hb genotypes. Hookworm infection was diagnosed in two children in the study population. Results of a multivariate analysis showed that placental malaria infection was the strongest risk factor for anemia in the six-month-old children (odds ratio [OR] = 3.6; 95% confidence interval [CI] = 1.1-12.3) and was independent of the frequency of parasitemia, parasitemia at the time of Hb measurement, or microcytosis. In the one-year-old age group, microcytosis was a significant factor related to anemia (OR = 2.8, 95% CI = 1-7.8) pointing out the role of iron deficiency at this age. Parasitemia at the time of Hb measurement was significantly associated with anemia in all age groups (except in 54- and 60-month-old groups). Strategies to decrease the prevalence of anemia in young children in southern Cameroon should include chemoprophylaxis for pregnant women, prevention of acquired malaria infection in both pregnancy and infancy, and prevention of nutritional iron deficiency.
Follow-up of the susceptibility of Plasmodium falciparum to antimalarials in Gabon.
Authors: Philipps J , Radloff P D , Wernsdorfer W , Kremsner P G
Published: May 2017

The sensitivity of Plasmodium falciparum to chloroquine, mefloquine, quinine, quinidine, halofantrine, artemisinin, and sulfadoxine/pyrimethamine was investigated in Lambarene, Gabon in 1994. The development of in vitro susceptibility has been traced from 1983 or 1992 to 1994 for chloroquine, mefloquine, halofantrine, and quinine. Standard in vitro microtests according to World Health Organization methodology were performed. Of 33 isolates tested for susceptibility to chloroquine, 31 were resistant, one was borderline, and one isolate was sensitive (mean 50% effective concentration [EC50] = 1.38 micromol/L of blood). With mefloquine, all isolates were fully inhibited below the threshold of resistance (mean EC50 = 0.51 micrmol/L of blood). Of 32 isolates tested with quinine, six had borderline resistance (mean EC50 = 0.54 micromol/L of blood medium mixture). Susceptibility to quinidine was higher with a mean EC50 of 0.15 micromol/L of blood medium mixture. With halofantrine, 26 of 32 isolates matured at 3 nmol/L of blood medium mixture (mean EC50 = 1.64 nmol/L of blood medium mixture), indicating a steep decrease in susceptibility in comparison with 1992. For artemisinin, the mean EC50 was 97.92 nmol/L of blood medium mixture. Sulfadoxine/pyrimethamine showed five of 16 resistant isolates with a mean EC50 of 2.46 nmol/L of blood medium mixture. Whereas chloroquine resistance remained stable with a tendency to decrease, susceptibility to mefloquine and quinine was slightly decreased. A significant increase in the mean EC50 and EC90 in comparison with our previous data from Gabon was found for halofantrine.
Malaria chemotherapy trial at a minimal effective dose of mefloquine/sulfadoxine/pyrimethamine compared with equivalent doses of sulfadoxine/pyrimethamine or mefloquine alone.
Authors: Lell B , Lehman L G , Schmidt-Ott J R , Sturchler D , Handschin J , Kremsner P G
Published: May 2017

In murine malaria the addition of mefloquine to sulfadoxine/pyrimethamine has been shown to exert an additive effect and to significantly slow the emergence of resistance to the individual components. In a pilot study carried out in Gabon, a reduced dosage of the triple combination with a mean of 1 mg/kg of mefloquine/2 mg/kg of sulfadoxine/0.1 mg/kg of pyrimethamine (Fansimef; Roche, Basel, Switzerland) had previously been shown to achieve high cure rates in Plasmodium falciparum malaria. To evaluate the additive effect, a randomized, double-blind trial in school children with mild P. falciparum malaria was performed in Gabon. Two hundred thirty-one patients evaluated received a single dose of either the triple combination with a mean of 1.07 mg/kg of mefloquine/2.14 mg/kg of sulfadoxine/0.11 mg/kg of pyrimethamine (group MSP), or 1.07 mg/kg of mefloquine alone (group M), or 2.14 mg/kg of sulfadoxine/0.11 mg/kg of pyrimethamine alone (group SP). In the MSP group and the SP group, 67% and 69% of the patients were parasitologically cured, respectively, compared with only 13% in the M group (P < 0.001). A significantly higher parasitemia was found in the M group compared with the MSP group or the SP group on days 2 and 3 after the start of treatment. The high efficacy of the low dose sulfadoxine/pyrimethamine regimen was the most surprising finding of this study.
First-time-in-humans safety and pharmacokinetics of WR 238605, a new antimalarial.
Authors: Brueckner R P , Lasseter K C , Lin E T , Schuster B G
Published: May 2017

WR 238605 is an 8-aminoquinoline drug currently under development for prophylaxis and treatment of malaria. Preclinical studies have demonstrated that it has greater efficacy and less toxicity compared with primaquine. In this first-time-in-human randomized, double-blind, placebo-controlled study designed to evaluate the safety, tolerance and pharmacokinetics, WR 238605 was administered to 48 men in single oral doses ranging from four to 600 mg (base). It was well tolerated, with gastrointestinal disturbances as possible side effects. Linear kinetics were demonstrated at these doses. WR 238605 has a long absorption phase and is slowly metabolized, with a tmax of 12 hr and an elimination half-life of 14 days. These safety, efficacy and pharmacokinetic properties make this drug an excellent candidate for further testing as a prophylactic, radical curative, and terminal eradication drug.
A population-based seroprevalence study in South Africa as a tool in the polio eradication initiative.
Authors: Schoub B D , McAnerney J M , van Middelkoop A , Blackburn N K , Labadarios D
Published: May 2017

A seroprevalence study for poliomyelitis was carried out on a sample of sera from a serum bank used for a vitamin A study. Vaccination coverage was satisfactory (80% or more) in five of nine provinces, although a prevalence of antibody to polio of 80% or more was found in all provinces. Serologic immunity (i.e., the prevalence of neutralizing antibodies) exceeded vaccination coverage, suggesting secondary spread of vaccine virus. However, whether or not water was supplied through a piped system was not associated with secondary spread of vaccine virus to nonvaccinated children. Seroprevalence studies are a valuable adjunct to acute flaccid paralysis surveillance, which is the standard surveillance instrument for the poliomyelitis eradication initiative. The use of available and suitable serum banks for seroprevalence investigations is a relatively cheap monitoring option that can yield very valuable information for the eradication initiative.
Engineered resistance in Aedes aegypti to a West African and a South American strain of yellow fever virus.
Authors: Higgs S , Rayner J O , Olson K E , Davis B S , Beaty B J , Blair C D
Published: May 2017

Double subgenomic Sindbis (dsSIN) viruses were engineered to transduce mosquito cells with antisense RNA derived either from the premembrane (prM) or polymerase (NS5) coding regions of the 17D vaccine strain of yellow fever virus (YFV). Aedes albopictus C6/36 cells were infected at high multiplicities of infection (MOI) with each dsSIN virus. Forty-eight hours later, the transduced cells were challenged with an MOI of 0.1 of the Asibi strain of YFV. At 72-hr postchallenge, the cells were assayed by immunofluorescence for the presence of YFV antigen. Cells transduced with prM or NS5 antisense RNAs derived from the YFV genome displayed no YFV-specific antigens. In contrast, cells infected with control dsSIN viruses that expressed no antisense RNA or dengue virus-derived antisense RNAs were permissive for the challenge virus. To analyze resistance in the mosquito, five log10 50% tissue culture infective doses (TCID50) of each dsSIN virus and three log10TCID50 of either a West African (BA-55) or South American (1899/81) strain of wild-type YFV were coinoculated into Ae. aegypti. Mosquitoes transduced with effector RNAs targeting the prM or NS5 gene regions did not transmit West African YFV and poorly transmitted the South American strain of YFV.
Short report: A case of ectopic schistosomiasis in Puerto Rico with some observations on the biology of the parasite.
Authors: File S , Francheschini A B , Fernandez-Santiago A
Published: May 2017

A recently acquired Schistosoma mansoni infection that resulted in a cervical polyp containing a pair of adult worms is reported in a Puerto Rican woman. Active schistosome transmission is not commonly reported in Puerto Rico at the present time and the ectopic location of the worms is rare in very light infections. Observations on the biology of the parasite recovered from the patient are described.
Association of elevated lymph node cell release of histamine and tumor necrosis factor with genetic predisposition to limb edema formation in dogs infected with Brugia pahangi.
Authors: Orton S , Weinstock D , Hammerberg B
Published: May 2017

Brugia pahangi infection in the canine rear limb results in marked lymphatic duct and popliteal lymph node pathologic changes. Limb edema is variably associated with infection and does not correlate well with duct or node lesions. To understand the mechanisms of limb edema, lymph node cells were collected by sequential biopsy following infection and examined for production of inflammatory mediators. Lymph node cells from a litter of dogs selectively bred with a high incidence of edema formation (82%) demonstrated spontaneously released histamine and prostaglandin E2 levels higher than those of closely related nonedema-forming dogs (0-20%) and/or control dogs. These edema-forming dogs also showed elevated release of tumor necrosis factor-alpha when cells were cultured with Brugia antigen. Toluidine blue staining of infected lymph node sections revealed that the edema-forming dogs had higher numbers of mast cells than infected lymph nodes of nonedema-forming dogs.
Linkage analysis of blood Plasmodium falciparum levels: interest of the 5q31-q33 chromosome region.
Authors: Garcia A , Marquet S , Bucheton B , Hillaire D , Cot M , Fievet N , Dessein A J , Abel L
Published: May 2017

There is accumulating evidence for the involvement of genetic factors in the human response to malaria infection, mostly based on results obtained in studies of severe clinical malaria. The role of major gene(s) controlling blood parasitemia levels in human malaria has also been detected by means of segregation analysis. To confirm and to localize such gene(s), we performed a sib-pair linkage analysis investigating the role of five candidate chromosomal regions: 6p21 (HLA-tumor necrosis factor region), 2q13-q21 (genes coding for interleukin-1 alpha and beta), 14q11 (locus coding for the alpha chain of T cell antigen receptor), 7q35 (gene cluster for the beta subunit of T cell receptor), and 5q31-q33, which includes several candidate genes and was recently linked to a locus controlling infection levels by Schistosoma mansoni, denoted as SM1. The analysis was carried out on nine families from a southern Cameroon village, and the phenotype under study was blood infection levels with Plasmodium falciparum. No linkage was found with any of the four markers outside the 5q31-q33 region. A trend in favor of linkage was observed in the distal part of the 5q31-q33 region, especially with the marker D5S636 (P < 0.05 using the Monte Carlo P value), which was the marker that provided the highest evidence for linkage with SM1. These results suggest that a locus influencing P. falciparum levels in malaria could be located in the same genetic region as that containing SM1, indicating that the 5q31-q33 region may be critical in the control of different parasite infections.
Behavior in a mouse model of isolates of Leishmania donovani sensu lato cultured from the blood of patients with chronic cutaneous lesions.
Authors: Nuwayri-Salti N , Matta M , Shbaklo Z , Lakkis M , Kabbani Z E
Published: May 2017

Our objective was to characterize biologically in an animal model two isolates of Leishmania parasites unexpectedly encountered in the circulating blood of two patients with chronic cutaneous leishmaniasis. Both isolates were classified by cellulose acetate electrophoresis as belonging to the L. donovani senso lato complex. We elected to use BALB/c mice, an inbred strain that has been proven to be very sensitive to the dermotropic parasite L. major. This study demonstrated that for the same number of parasites, the course of infection with the L. donovani strain was different from that developed in similar animals that received the L. major strain. After a protracted incubation period, L. donovani produced scanty cutaneous lesions and mainly a systemic disease. This is in contrast to the rapidly spreading skin lesion that kills L. major-infected animals within a few months. It is concluded that BALB/c mice are an adequate animal model for the L. donovani strain, which had an unusual clinical presentation in humans. The prolonged incubation period, such as observed here, may lead to erroneous conclusions of host resistance if the experiment were terminated based on L. major activity in the same model. Finally, the unusual behavior in humans and mice of certain strains (such as the one encountered in these patients) must reflect peculiar intrinsic features of the parasite, which are best understood using animal models in the laboratory.
Clinicopathologic characteristics of the lungs of patients with human T cell lymphotropic virus type 1-associated myelopathy.
Authors: Sugisaki K , Tsuda T , Kumamoto T , Akizuki S
Published: May 2017

Lung autopsy specimens were evaluated histologically in the six patients with human T cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy (HAM). The results revealed two histologic changes. First, lymphoid infiltrates were distributed widely in peribronchiolar and perivascular regions, subpleural regions, and the alveolus. Lymphoid infiltrates were also observed in bronchial mucosal glands in relatively large bronchi, in which the acinar epithelium was sometimes degenerated. Second, chronic inflammatory changes, such as smooth muscle hypertrophy, fibrosis, or squamous cell metaplasia, were increased significantly in the membranous bronchioles of HAM patients compared with specimens from lung cancer control patients. Such histologic changes were subclinical in most cases, but one case had an abnormal chest shadow, and two cases had recurrent pneumonia. In HAM patients, high levels of HTLV-1-specific cytotoxic T lymphocytes are believed to attack the HTLV-1-bearing cells in the lung, resulting in inflammatory reactions.
Short report: Decrease in seroprevalence of antibodies to hantavirus in rodents from 1993-1994 hantavirus pulmonary syndrome case sites.
Authors: Engelthaler D M , Levy C E , Fink T M , Tanda D , Davis T
Published: May 2017

Rodent trapping was conducted at seven hantavirus pulmonary syndrome (HPS) case sites from June 1993 to March 1994 during the HPS outbreak in the southwestern United States. To determine if there were changes in the rodent population or the hantavirus seroprevalence in rodents since the HPS outbreak, rodents were trapped at the same sites three years later using the same trapping protocol. The trap success decreased from the numbers trapped during the outbreak, however, the number of Peromyscus, as a percentage of the total rodents captured, did not noticeably decrease. In addition, the seroprevalence of hantavirus antibodies in Peromyscus decreased significantly (P < 0.0001).
An interstate outbreak of tick-borne relapsing fever among vacationers at a Rocky Mountain cabin.
Authors: Trevejo R T , Schriefer M E , Gage K L , Safranek T J , Orloski K A , Pape W J , Montenieri J A , Campbell G L
Published: May 2017

In July 1995, an outbreak of acute febrile illness affected 11 (48%) of 23 family members from Nebraska and Kansas who had vacationed at a Colorado cabin in June. Similar symptoms were identified among five (17%) of 30 additional persons from Nebraska, Kansas, Florida, and Texas who had vacationed at the same cabin. Symptoms suggested tick-borne relapsing fever (TBRF). Although no spirochetes were detected in available blood smears from five case-patients, Borrelia hermsii was cultured from the blood of one case-patient and two chipmunks trapped near the cabin. Case-patients were more likely than non-ill cabin visitors to have slept on the floor (odds ratio [OR] = 28.0, 95% confidence interval [CI] = 3.0-258) or in the top bunk bed (OR = 5.2, 95% CI = 1.1-25.1). Tick-borne relapsing fever should considered in the differential diagnosis of fever in patients who have stayed overnight in mountain cabins in the western United States.
Neurocysticercosis in CearÃ¡ State, northeastern Brazil: a review of 119 cases.
Authors: Sousa A Q , Sa H L , Queiroz T R , Horta W G , Pearson R D
Published: May 2017

Relatively little is known about the occurrence of neurocysticercosis in northeastern Brazil. There have been no published reports from the state of CearÃ¡, but a review of the records at the Hospital SÃ£o JosÃ© in Fortaleza, Brazil identified 119 patients with neurocysticercosis diagnosed between January 1988 and April 1994. Patients came from 43 municipalities in CearÃ¡. Their ages ranged from five to 74 years; the greatest number of cases were in persons 10-40 years of age; 63% were males. Seizures were the presenting complaint in 64% of the patients and headache in 22%. Two patients, each with several hundred intracranial lesions, presented with mental status changes; one was initially given the clinical diagnosis of viral meningoencephalitis. Computed tomography scans showed that 44% of the patients had five or more lesions. Cysts were found throughout the brain. The parietal lobe was the most frequent site of involvement; 85% of patients had one or more lesions there. The brain stem was involved in 8%. There was no consistent association between the severity of the clinical abnormalities and the radiologic findings. Computed tomography of the thighs was done in 10 persons; cysts were identified in nine.
Immune response and lack of immune response to Plasmodium falciparum P126 antigen and its amino-terminal repeat in malaria-infected humans.
Authors: Banic D M , de Oliveira-Ferreira J , Pratt-Riccio L R , Conseil V , GonÃ§alves D , Fialho R R , Gras-Masse H , Daniel-Ribeiro C T , Camus D
Published: May 2017

A parasitophorous vacuole protein of Plasmodium falciparum, p126, is a potential candidate for a malaria vaccine. Its N-terminal region, composed of six repeats of eight amino acids, appears to be involved in the induction of protective immunity against P. falciparum challenge in monkeys. This study evaluated the immune response to p126 and to its N-terminal region (Nt47) in patients (n = 45) living in a malaria-endemic area of Brazil (Colina, Porto Velho, Rondonia). Cellular proliferative responses against Nt47 were low and infrequent. The study of the humoral immune response demonstrated that 95% of the patients had detectable anti-p126 antibodies and 77% had anti-Nt47 antibodies. Analysis of the antibody isotypes specific for Nt47 revealed that all four IgG subclasses were present and individuals with higher levels of anti-Nt47 cytophilic IgG antibody (IgG1 + IgG3/IgG2 + IgG4) had significantly lower parasitemia levels, suggesting that antibodies to the N-terminal region of the p126 protein may contribute to acquisition of immunity to P. falciparum malaria.
Laboratory evaluation of a dot-blot enzyme immunoassay for serologic confirmation of illness due to Rickettsia conorii.
Authors: Broadhurst L E , Kelly D J , Chan C T , Smoak B L , Brundage J F , McClain J B , Miller R N
Published: May 2017

Of the 169 United States Army soldiers who deployed on a field training exercise to a remote area of Botswana for two weeks in January 1992, more than 30% developed a febrile illness within five days of their return. A diagnosis of South African tick typhus was suggested by soldiers' exposure to ticks, as well as the presence of eschars and vesicles at the site of tick bites, and tender regional lymphadenopathies. This high attack rate, experienced during such a short exposure period, emphasizes the hazard of illness due to Rickettsia conorii to persons visiting endemic areas. A rapid, diagnostic, semiquantitative enzyme immunoassay (DS) for detection of IgG and IgM antibodies to R. conorii was performed on 209 acute and convalescent sera from soldiers in the outbreak and on 75 control sera. For the acute sera from soldiers meeting the probable case definition of having both regional lymphadenopathy and tick bite eschar, as judged by an IgG indirect fluorescent antibody (IFA) test, the resulting sensitivity and specificity of the DS test were 100% and 48%, respectively. In the analysis of the acute sera, the DS test identified as reactive more of the probable cases (62%) than either the IgG (16%) or IgM (55%) IFAs. This simple and rapid diagnostic test could be useful in establishing a preliminary diagnosis of R. conorii rickettsiosis in remote settings when immediate confirmation by IFA is impossible.
Short report: An imported case of cystic echinococcosis in Japan diagnosed by imaging and serology with confirmation of Echinococcus granulosus-specific DNA sequences.
Authors: Ito A , Okamoto M , Ishiguro T , Ma L , Suzuki H , Yasui A , Shigeta H , Matsuura T , Hosokawa T , Chai J J
Published: May 2017

We report one case of cystic echinococcosis (CE) in Japan in a native of Nepal. Ultrasonography and computed tomography scan of the liver revealed unique cystic lesions with or without daughter cysts of Echinococcus granulosus. Immunoblot analysis using crude antigens of E. multilocularis and cyst fluid of E. granulosus, without reference to these image analyses, strongly suggested this was a case of CE. We found protoscoleces in surgically removed hepatic lesions and analyzed the mitochondrial cytochrome c oxidase subunit I (COI) gene by the polymerase chain reaction. Based on the similarity in DNA sequences of the COI gene of this Echinococcus spp. with that of previously reported sheep-dog strain (GI), the parasite was considered to be the so-called common sheep strain of E. granulosus.
Activity of anticancer compounds against Trypanosoma cruzi-infected mice.
Authors: Kinnamon K E , Poon B T , Hanson W L , Waits V B
Published: May 2017

Chagas' disease, which is caused by Trypanosoma cruzi, remains essentially incurable. Due principally to a lack of profit incentive, the pharmaceutical industry has had limited interest in developing new antichagasic drugs. Thus, a search for agents that exhibit activity against T. cruzi, although medicaments have been developed for the treatment of other diseases, seems justifiable. Responding to evidence that the principal biochemical differences between mammalian cells and African trypanosomes apply equally to T. cruzi, our evaluations were conducted. Previous work showed the effectiveness of anticancer agents against T. rhodesiense. In the present studies, 76 anticancer compounds were assessed for their ability to suppress the trypomastigotes of T. cruzi- infected mice. Five compounds were found to be active. The most effective was cycloheximide, which was more than six times as effective as the standard, nifurtimox.
Excessive fibrinolysis: the coagulopathy following Merrem's hump-nosed viper (Hypnale hypnale) bites.
Authors: Premawardena A P , Seneviratne S L , Gunatilake S B , de Silva H J
Published: May 2017

In 56 patients with proven hump-nosed viper (Hypnale hypnale) bites, 12 (21.4%) developed continued oozing of blood from the site of the bite and a prolonged clotting time. Further investigations showed low fibrinogen levels and increased fibrinogen degradation products in plamsa. The bleeding time, platelet count, prothrombin time, and partial thromboplastin time with kaolin were normal. The bite of this snake can be complicated with a coagulopathy in which excessive fibrinolysis seems to be the main abnormality.
Evaluation of N,N-diethyl-m-toluamide (DEET) as a topical agent for preventing skin penetration by cercariae of Schistosoma mansoni.
Authors: Salafsky B , Ramaswamy K , He Y X , Anderson G L , Nowicki D K , Shibuya T
Published: May 2017

The effect of skin application of N,N-diethyl-m-toluamide (DEET) on the penetration and migration behavior of cercariae of Schistosoma mansoni was evaluated in vitro and in vivo in a mouse model. These studies showed that DEET at concentrations of 7.5% or higher was 100% effective in immobilizing and killing cercariae of S. mansoni in vitro. Ultrastructural studies on such DEET-exposed cercariae showed transformative and degenerative changes involving both tegument and deeper parenchymal structures. Fatal tissue lesions were evident as early as 5 min postexposure to DEET, and became more extensive with increasing exposure time. Cutaneous application of DEET (as a pure chemical in isopropanol or as a commercial insect repellent preparation) was more than 99% effective in preventing entry of S. mansoni cercariae into the mouse tail skin. Radiolabeling and tracer studies confirmed that 7.5% DEET applied to the skin prior to infection was highly effective in preventing schistosomular migration to the lungs.
Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus.
Authors: Germani Y , Minssart P , Vohito M , Yassibanda S , Glaziou P , Hocquet D , BerthÃ©lÃ©my P , Morvan J
Published: May 2017

A study of the etiologies of diarrhea in adults in relation to their human immunodeficiency virus (HIV) serostatus and number of CD4+ cells was carried out in the Central African Republic. In cases and controls, multi-parasitism was observed. Salmonella spp. were identified mainly during acute diarrhea, with 50% of the S. enteritidis isolated during the study being responsible for septicemia and/or urinary tract infection in immunodeficient patients. Enteroaggregative Escherichia coli (EAggEC) were the most frequently identified agent in HIV+ patients with persistent diarrhea; 42.8% of the patients with EAggEC as sole pathogens had bloody diarrhea, and these strains were negative for the presence of a virulence plasmid. Coccidia were found in those with acute and persistent diarrhea. Blood was observed in 53.3% of infections involving coccidia as the sole pathogen. Microsporidium spp. and Blastocystis hominis were found only in HIV+ patients with persistent diarrhea. Shigella spp., Campylobacter spp., and Entamoeba histolytica were found in HIV+ and HIV- dysenteric patients; bacteria resembling spirochetes that could not be cultivated were identified only in HIV+ cases with dysentery. Shiga-like toxin-producing E. coli O157:H- was isolated from two cases with hemolytic-uremic syndrome. Fungi were identified as the sole pathogen in 6.4% of the HIV+ patients with persistent diarrhea. Most of enteropathogenic bacteria identified were resistant to ampicillin and trimethoprim-sulfamethoxazole, remained susceptible to ampicillin plus clavulanic acid, and were susceptible to amikacin, gentamicin, and ciprofloxacin.
Re-emergence of yellow fever in Senegal in 1995.
Authors: Thonnon J , Fontenille D , Tall A , Diallo M , Renaudineau Y , Baudez B , Raphenon G
Published: May 2017

An outbreak of yellow fever (YF) occurred in the central part of Senegal during October 1995. Thirty-one probable cases were detected and 79 cases were confirmed either by IgM ELISA or by virus isolation (30 strains isolated). The case fatality rate was 18.9%. Incidence of the infection was evaluated by a serosurvey in the area. Males 10-29 years old belonging to the Peul ethnic group were more affected. Moreover, 28 YF virus strains were isolated from mosquitoes and larvae pools and vertical transmission of YF virus by Aedes aegypti was also demonstrated for the first time in the field. This outbreak occurred after the major amplification of the wild cycle of YF virus in 1993 in West Africa. This epidemic represented a typical example of intermediate transmission of YF: both humans and wild vertebrates are involved in the virus cycle through wild mosquitoes with semidomestic habits, mainly Ae. furcifer, Ae. luteocephalus, and domestic vector Ae. aegypti. It was controlled by a prompt immunization campaign. The impact of inclusion of YF vaccine in the Expanded Program of Immunization, which has been conducted in Senegal for eight years, is discussed.
Frequency of the Asn-108 and Thr-108 point mutations in the dihydrofolate reductase gene in Plasmodium falciparum from southwest Colombia.
Authors: Giraldo L E , Acosta M C , Labrada L A , Praba A , Montenegro-James S , Saravia N G , Krogstad D J
Published: May 2017

Several point mutations in the dihydrofolate reductase (DHFR) gene of Plasmodium falciparum have been correlated with in vitro anti-folate drug resistance of laboratory and field isolates. Furthermore, two different point mutations that generate amino acid substitutions at the same position of the enzyme have been observed in all the isolates studied to date. These point mutations change a serine (Ser-108) in the wild type to an asparagine (Asn-108 mutation) or to a threonine (Thr-108 mutation). Using the polymerase chain reaction (PCR), it is possible to identify isolates that present these mutations. We used a mutation-specific PCR to screen 71 samples from several geographic locations of Colombia for the Asn-108 mutation (pyrimethamine resistance). In this initial screening 53 of 71 yielded amplification product with the DHFR mutation-specific primers. We further analyzed the 18 samples that did not amplify using a mutation-specific nested PCR. Of those 18 samples, seven amplified with primers specific for the Thr-108 mutation (proguanil resistance), one with the wild type (Ser-108), and 10 did not amplify. Of these 10 samples, three were identified as P. falciparum using a species-specific diagnostic nested PCR base on sequences from the small ribosomal RNA subunit gene. Overall, 51.6% of the samples amplified for the Asn-108 mutation, 10.9% for the Thr-108 mutation, 35.9% with the wild type specific primer, and 4.8% did not amplify with any of the DHFR primers. We observed variability in the frequency of the mutation between the different geographic location. The frequency of the Asn-108 and Thr-108 mutations in the state of Narifio was 25% each, while in Valle del Cauca the frequencies were 59% and 11%, respectively. These results contrast with observations in Brazil in which the Asn-108 mutation was found in 90% of the blood samples screened.
Monitoring for mefloquine-resistant Plasmodium falciparum in Africa: implications for travelers' health.
Authors: Lobel H O , Varma J K , Miani M , Green M , Todd G D , Grady K , Barber A M
Published: May 2017

The effectiveness of mefloquine to prevent malaria caused by Plasmodium falciparum is influenced by the sensitivity of the malaria parasites to this drug. Concern has been raised that resistance to mefloquine may develop in sub-Saharan Africa as has been observed in Southeast Asia. Case reports, along with blood smears to confirm the diagnosis and blood samples to determine the mefloquine concentration, were provided on any Peace Corps volunteer serving in sub-Saharan Africa who was diagnosed with malaria. We defined prophylaxis failures probably due to mefloquine resistance as patients with P. falciparum malaria confirmed at the Centers for Disease Control and Prevention, reported compliance with prophylaxis, no ingestion of mefloquine between date of illness onset and date of blood drawing, and a mefloquine level > or = 620 ng/ml in blood drawn within five days of onset of illness. Between January 1, 1991 and September 6, 1996, 44 (31%) of 140 volunteers with confirmed P. falciparum had blood drawn within five days of onset of illness. Twenty-nine (66%) had not fully complied with prophylaxis. Five of 15 prophylaxis failures in four countries had mefloquine levels > or = 620 ng/ml. Failure of mefloquine prophylaxis is primarily due to noncompliance. Evidence of probable resistance to mefloquine among strains of P. falciparum was found in five Peace Corps volunteers in sub-Saharan Africa. Clusters of well-documented prophylaxis failures need to be followed-up by therapeutic in vivo studies to document parasite resistance to mefloquine. Reduced sensitivity to mefloquine does not (yet) appear to be a significant problem in sub-Saharan Africa.
Human occult loiasis: improvement in diagnostic sensitivity by the use of a nested polymerase chain reaction.
Authors: TourÃ© F S , Kassambara L , Williams T , Millet P , Bain O , Georges A J , Egwang T G
Published: May 2017

The development of control strategies for loiasis is of crucial importance in endemic areas and depends heavily on the accurate identification of occult-infected individuals. A polymerase chain reaction (PCR) and nested polymerase chain reaction (nested PCR) were developed and based on sequences of the repeat 3 region (15r3) of the gene encoding a Loa loa 15-kD protein. The assays was performed on 20 blood samples from occult-infected subjects and 30 from field-collected amicrofilaremic individuals. The size of the initial PCR product was 396 basepairs (bp). When this initial amplification using primers 15r3(1) and 15r3(2) was carried out for 30 cycles, the PCR products from three of the 20 occult-infected and five of the 30 amicrofilaremic individuals were visualized after electrophoresis by staining the gel with ethidium bromide. Subsequent Southern blotting and hybridization with the specific probe revealed hybridization in 19 of 20 occult-infected and 23 of 30 amicrofilaremic samples but only after two days of exposure of the blot to the x-ray film. When the nested PCR was carried out (product size = 366 bp, primers 15r3(3) and 15r3(4)), 19 of 20 occult-infected and 23 of 30 amicrofilaremic samples that were positive by Southern hybridization of the initial PCR products were strongly positive by staining with ethidium bromide. Qualitative Southern blotting of the nested PCR products using the same probe previously described confirmed the ethidium bromide staining results after a very short exposure time of 4 hr. These results demonstrate that the nested PCR amplification product is specific and that its sensitivity in detecting occult loiasis is 95%. This approach has significant promise for the screening of large human populations for active loiasis without the requirement for blotting and hybridization of the PCR products.
Relationships of malaria morbidity with exposure to Plasmodium falciparum in young children in a highly endemic area.
Authors: Smith T , Charlwood J D , Kitua A Y , Masanja H , Mwankusye S , Alonso P L , Tanner M
Published: May 2017

To study incidence of clinical Plasmodium falciparum malaria in relation to exposure to parasites, attendance of children less than eighteen months old at a village dispensary in a highly endemic area of Tanzania was recorded. Entomologic inoculation rates (EIRs), estimated as a function of time period and place of residence, exceeded one sporozoite positive bite per adult per night in some village neighborhoods during the wet season. Incidence of clinical P. falciparum malaria, defined either as fever with parasitemia or as fever with hyperparasitemia, increased with the EIR over the whole range of exposures. Each 10-fold increase in the EIR corresponded to a 1.6-fold increase in incidence of fever plus parasitemia (95% confidence interval = 1.4-2.0). Therefore reduction of human-vector contacts will probably reduce morbidity incidence even at very high exposures. Incidence showed little relationship to estimated cumulative numbers of inoculations since birth, but decreased steeply with estimated cumulative time infected with trophozoites. This suggests that clinical immunity depends mainly on the extent of exposure to blood-stage antigens, not on the diversity of inocula seen, and thus temporary reductions in human-vector contacts are unlikely to result in subsequent increases in morbidity.
Laboratory diagnosis of acute dengue fever during the United Nations Mission in Haiti, 1995-1996.
Authors: Rossi C A , Drabick J J , Gambel J M , Sun W , Lewis T E , Henchal E A
Published: May 2017

We evaluated laboratory methods to confirm a clinical diagnosis of dengue. Acute sera were collected from personnel (n = 414) supporting the United Nations Mission in Haiti and presenting with febrile illness consistent with dengue fever or no apparent underlying cause. Dengue virus was recovered from 161 of 379 acute sera by inoculation into C6/36 cell culture. While 93 of 414 acute sera had detectable IgM antibodies, the IgM capture ELISA (MAC ELISA) had a sensitivity of only 13% compared with the virus isolation gold standard. If presumptive dengue fever cases were identified by both virus isolation and the presence of IgM, virus isolation and the MAC ELISA had clinical sensitivities of 69% and 40%, respectively. This study suggests that a combination of laboratory methods that target virus or subviral components as well as anti-viral IgM antibodies may be necessary for sensitive laboratory diagnosis with acute sera.
Salvador II strain of Plasmodium vivax in Aotus monkeys and mosquitoes for transmission-blocking vaccine trials.
Authors: Collins W E , Richardson B B , Morris C L , Sullivan J S , Galland G G
Published: May 2017

Infections with the Salvador II strain of Plasmodium vivax in Aotus lemurinus griseimambra monkeys were fed upon by Anopheles freeborni mosquitoes. Periods of mosquito infectivity were determined to establish a model system for the testing of transmission-blocking vaccines. The highest levels of mosquito infection were associated with the ascending asexual parasitemia after reaching 1,000/microl, and before the peak asexual parasite count. Sporozoite-induced infections were more infectious than were trophozoite-induced infections. Secondary episodes of parasitemia were also infectious, indicating the lack of development of naturally developing transmission-blocking immunity to this strain of P. vivax in splenectomized Aotus monkeys following single infections.