bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECTS OF MATERNAL VITAMIN SUPPLEMENTS ON MALARIA IN CHILDREN BORN TO HIV-INFECTED WOMEN
Authors: VILLAMOR EDUARDO , MSAMANGA GERNARD , SAATHOFF ELMAR , FATAKI MAULIDI , MANJI KARIM , FAWZI WAFAIE W.
Published: September 2018

Vitamin deficiencies are frequent in children suffering from malaria. The effects of maternal multivitamin supplementation on the risk of malaria in children are unknown. We examined the impact of providing multivitamins or vitamin A/β-carotene supplements during pregnancy and lactation to HIV-infected women on their children’s risk of malaria up to 2 years of age, in a randomized, placebo-controlled trial. Tanzanian women (N = 829) received one of four daily oral regimens during pregnancy and after delivery: 1) vitamins B, C, and E (multivitamins); 2) vitamin A and β-carotene (VA/BC); 3) multivitamins including VA/BC; or 4) placebo. After 6 months of age, all children received 6-monthly oral vitamin A supplements irrespective of treatment arm. The incidence of childhood malaria was assessed through three-monthly blood smears and at monthly and interim clinic visits from birth to 24 months of age. Compared with placebo, multivitamins excluding VA/BC reduced the incidence of clinical malaria by 71% (95% CI = 11–91%; P = 0.02), whereas VA/BC alone resulted in a nonsignificant 63% reduction (95% CI = −4% to 87%; P = 0.06). Multivitamins including VA/BC significantly reduced the incidence of high parasitemia by 43% (95% CI = 2–67%; P = 0.04). The effects did not vary according to the children’s HIV status. Supplementation of pregnant and lactating HIV-infected women with vitamins B, C, and E might be a useful, inexpensive intervention to decrease the burden of malaria in children born to HIV-infected women in sub-Saharan Africa.
GENETIC CONTROL OF MALARIA PARASITE TRANSMISSION: THRESHOLD LEVELS FOR INFECTION IN AN AVIAN MODEL SYSTEM
Authors: JASINSKIENE NIJOLE , COLEMAN JUDY , ASHIKYAN AURORA , SALAMPESSY MICHAEL , MARINOTTI OSVALDO , JAMES ANTHONY A.
Published: September 2018

Genetic strategies for controlling malaria transmission based on engineering pathogen resistance in Anopheles mosquitoes are being tested in a number of animal models. A key component is the effector molecule and the efficiency with which it reduces parasite transmission. Single-chain antibodies (scFvs) that bind the circumsporozoite protein of the avian parasite, Plasmodium gallinaceum, can reduce mean intensities of sporozoite infection of salivary glands by two to four orders of magnitude in transgenic Aedes aegypti. Significantly, mosquitoes with as few as 20 sporozoites in their salivary glands are infectious for a vertebrate host, Gallus gallus. Although scFvs hold promise as effector molecules, they will have to reduce mean intensities of infection to zero to prevent parasite transmission and disease. We conclude that similar endpoints must be reached with human pathogens if we are to expect an effect on disease transmission.
POSITIVE BLOOD CULTURE WITH PLASMODIUM FALCIPARUM: CASE REPORT
Authors: DE VRIES JUTTE J.C. , VAN ASSEN SANDER , MULDER ANDRÉ B. , KAMPINGA GREETJE A.
Published: September 2018

An adult traveler presented with fever and malaise after returning from Sierra Leone. Young trophozoites of Plasmodium falciparum were seen in a blood smear, with parasitemia being 10%. Moreover, blood cultures drawn on admission signaled as “positive” after 1 day of incubation, but no bacteria were seen in the Gram stain or were subcultured. A Giemsa-stained smear from the positive bottle contents yielded numerous pigmented, mature trophozoites of P. falciparum. This case indicates that, in patients with malaria, the growth of P. falciparum in blood cultures can result in “false”-positive blood cultures.
FACTORS ASSOCIATED WITH E. COLI CONTAMINATION OF HOUSEHOLD DRINKING WATER AMONG TSUNAMI AND EARTHQUAKE SURVIVORS, INDONESIA
Authors: GUPTA SUNDEEP K. , SUANTIO ASTRID , GRAY ALICIA , WIDYASTUTI ENDANG , JAIN NEENA , ROLOS REINEKE , HOEKSTRA ROBERT M. , QUICK ROB
Published: September 2018

The December 2004 tsunami in Sumatra, Indonesia, destroyed drinking water infrastructure, placing over 500,000 displaced persons at increased risk of waterborne disease. In June 2005, we assessed the relationship of water handling behaviors to household water quality in three districts: Aceh Besar, Simeulue, and Nias. We surveyed 1,127 households from 21 communities and tested stored drinking water. Factors associated with a reduced likelihood of having contaminated stored drinking water included obtaining water from improved sources (Aceh Besar, adjusted odds ratio (aOR) 0.41, P < 0.01; Simeulue, aOR 0.48, P = 0.02), using chlorine solution (Simeulue, aOR 0.41, P < 0.01), and having free chlorine in stored water (Aceh Besar, aOR 0.42, P < 0.01; Nias, aOR 0.28, P < 0.01). Reported boiling, even among those who could describe correct practice, was not associated with improved water quality. Water source improvement and household water chlorination appear to be useful strategies to improve household stored drinking water quality in post-disaster situations.
ANTIGENIC AND GENETIC RELATIONSHIPS AMONG RIFT VALLEY FEVER VIRUS AND OTHER SELECTED MEMBERS OF THE GENUS PHLEBOVIRUS (BUNYAVIRIDAE)
Authors: XU FANGLING , LIU DONGYING , NUNES MARCIO R. T. , DA ROSA AMELIA P. A. TRAVASSOS , TESH ROBERT B. , XIAO SHU-YUAN
Published: September 2018

Preliminary serologic data indicated that two South American phleboviruses (Belterra virus [BELTV] and Icoaraci virus [ICOV]) may be related to Rift Valley fever virus (RVFV), an African phlebovirus that causes severe hepatitis and hemorrhagic fever in humans. To further define this relationship and to investigate the underlying genetic basis, comparative serologic and genetic sequence analyses were performed with RVFV and five other New World phleboviruses (ICOV, BELTV, Salobo virus, Joa virus, and Frijoles virus). Serologically, a one-way cross reaction was confirmed between antibodies against these New World viruses and RVFV antigen. In contrast, phylogenetic analysis demonstrated clear separation of these viruses from RVFV, into distinct phylogenies, based on sequences of the small, medium, and large RNA segments.
COMPARATIVE PATHOLOGY OF NORTH AMERICAN AND CENTRAL AFRICAN STRAINS OF MONKEYPOX VIRUS IN A GROUND SQUIRREL MODEL OF THE DISEASE
Authors: SBRANA ELENA , XIAO SHU-YUAN , NEWMAN PATRICK C. , TESH ROBERT B.
Published: September 2018

The first human cases of monkeypox (MPX) were recognized in central Africa in 1970. Since then, sporadic outbreaks of the disease have occurred in central and west Africa. In 2003, an outbreak of human MPX occurred in the United States after importation of infected rodents from west Africa. Clinical features of the 2003 outbreak were less severe than accounts of the disease among people in central Africa. The reasons for this observed difference are unknown. In this study, the clinical and pathologic characteristics of experimental infection with representative central African and North American MPX virus strains were compared in a ground squirrel model of the disease. The results indicate that the US 2003 virus, which phylogenetically is a member of the west African MPX virus clade, was less virulent than central African MPX virus strains.
INFECTION WITH HEPATITIS C VIRUS AMONG HEALTH CARE WORKERS IN THE BRAZILIAN WESTERN AMAZON REGION (RIO BRANCO, STATE OF ACRE)
Authors: PARANÁ RAYMUNDO , PAIVA TIAGO , LEITE MÁRCIO RIOS , OLIVEIRA FABRIZIO NEY , KALI NARDINO , LOBATO CIRLEY , DANTAS THOR , NETO JOSÉ TAVARES
Published: September 2018

Clinical and epidemiologic studies on the hepatitis C virus (HCV) in the western Brazilian Amazon region are scarce. However, reports of clinical cases of hepatitis or pathologies associated to the HCV infection are frequent. In the state of Acre, there have been no studies on the population with the greatest exposure to parenteral transmission of virus infection. The objective of this study was to determine the prevalence of HCV infection among health care workers (HCWs) in this region. Of 2,338 HCWs, 646 were randomly selected for this study. The presence of antibody to HCV was determined. If these persons were antibody positive, they were tested for HCV RNA and the viral genotype was determined. The seroprevalence of antibody to HCV was 4.8% (31 of 646), and 3.7% (24 of 646) of those tested had detectable HCV RNA. Among these 24 viremic cases, HCV genotype 1 was most common (n = 16), followed by genotypes 3 (n = 6), 2 (n = 1), and an unidentified genotype. Infection with HCV (identified by a polymerase chain reaction) was more frequent among those with lower educational levels and lower incomes, those who lived for a longer period in the city of Rio Branco, those who reported intravenous use of vitamin complexes, those with a history of dental treatment, those with alcoholism, and women with history of caesarian parturition. The high prevalence of patients with HCV observed among HCWs in the city of Rio Branco and risk factors indicate the need for prevention and control programs, in addition to assistance programs, because this region is also hyperendemic for hepatitis B virus and hepatitis D virus.
SPECTRUM OF DERMATOSES IN 165 TRAVELERS RETURNING FROM THE TROPICS WITH SKIN DISEASES
Authors: ANSART SÉVERINE , PEREZ LUCIA , JAUREGUIBERRY STÉPHANE , DANIS MARTIN , BRICAIRE FRANÇOIS , CAUMES ERIC
Published: September 2018

The spectrum of dermatoses occurring in travelers returning from tropical areas is poorly documented. We analyzed the relative frequency of travel-associated dermatoses and their possible relationships to travel characteristics in all persons who came to our hospital between November 2002 and May 2003 for a cutaneous disorder related to travel in a tropical country. One hundred sixty-five travelers were included. The main dermatoses identified were infectious cellulitis (12.7%), scabies (10.3%), and pruritus of unknown origin (PUO) (9.1%). Tropical dermatoses accounted for 33.9% of the cutaneous disorders. Univariate analysis showed statistically significant correlations of infectious cellulitis with females, PUO with older age and immigrant status, pyoderma with expatriate status, scabies with tourism and travel to Africa, myiasis with tourism and travel to Africa and America, filariasis with travel to Africa and immigrant status, and cutaneous larva migrans with tourism. Dermatoses diagnosed in travelers returning from the tropics seemed to be influenced by traveler status and region visited.
REDUCTION OF PARASITE LEVELS IN PATIENTS WITH UNCOMPLICATED MALARIA BY TREATMENT WITH HE2000
Authors: FRINCKE JAMES M. , STICKNEY DWIGHT R. , ONIZUKA-HANDA NANETTE , GARSD ARMANDO , READING CHRISTOPHER , KRUDSOOD SRIVICHA , WILAIRATANA POLRAT , LOOAREESUWAN SORNCHAI
Published: September 2018

16α-Bromoepiandrosterone (HE2000) is a synthetic androstane steroid that has immune effects in pre-clinical models of malaria, tuberculosis, and infection with human immunodeficiency virus. In pilot studies, 42 patients with confirmed uncomplicated Plasmodium falciparum malaria were treated with a seven-day course of HE2000 by either buccal administration or intramuscular injection. Of the 42 patients, 41 showed a 50% reduction in blood levels of parasites, the primary endpoint of the study. Of these, 32 (76%) cleared malaria parasites below detectable levels. All febrile patients became afebrile by the end of treatment. There was no reduction in gametocyte forms. Adverse events were transient and mild to moderate in intensity. The anti-malarial response was generally similar with either the intramuscular or buccal routes of administration. HE2000 shows a safety profile and pharmacologic activity worthy of further investigation to understand its role in the treatment of malaria, perhaps in combination with anti-malarial agents.
SUSTAINED USE OF INSECTICIDE-TREATED CURTAINS IS NOT ASSOCIATED WITH GREATER CIRCULATION OF DRUG-RESISTANT MALARIA PARASITES, OR WITH HIGHER RISK OF TREATMENT FAILURE AMONG CHILDREN WITH UNCOMPLICATED MALARIA IN BURKINA FASO
Authors: DIALLO DIADIER A. , SUTHERLAND COLIN , NEBIÉ ISSA , KONATÉ AMADOU T. , ORD ROSALYNN , POTA HIRVA , ROPER CALLY , ILBOUDO-SANOGO EDITH , GREENWOOD BRIAN M. , COUSENS SIMON N.
Published: September 2018

The impact of vector control measures on the evolution of antimalarial drug resistance is an important issue for malaria control programs. We investigated whether the in vivo efficacy of chloroquine (CQ) in children aged 6–59 months with uncomplicated malaria differed in 9 villages that had benefited from long-term use of insecticide-treated curtains (ITCs) and in 9 nearby non-ITC villages. We also compared the prevalence of genetic markers of resistance to CQ and sulfadoxine-pyrimethamine (SP) between the two groups of villages. The study enrolled 1,035 children with uncomplicated malaria and 231 infected but asymptomatic children. After taking account of re-infections, the proportions of children who experienced clinical failure after treatment with CQ were 14% and 19% in ITC and non-ITC villages, respectively (OR = 0.68; 95% CI: 0.39, 1.18). Parasitologic failure was observed in 49% of children in ITC villages and 58% of children in non-ITC villages (OR = 0.71 95%CI: 0.44, 1.13). The proportion of symptomatic children who harbored parasites carrying the pfcrt-76T allele was 43% in ITC villages and 40% in non-ITC villages (OR = 1.09; 95%CI: 0.80, 1.50). The pfmdr1-86Y allele was detected in 31% and 29% of children in the two groups of villages (OR = 1.14; 95%CI: 0.75, 1.72). Triple mutations in the dhfr gene were observed in 12% of children in both groups. No double mutations in the dhps gene were observed. Similar results were observed in asymptomatic children. In this setting, ITC use was not associated with increased circulation of parasites resistant to standard antimalarial drugs, or with a greater risk of treatment failure among children less than 5 years of age.
IN VITRO ANTIMALARIAL DRUG SUSCEPTIBILITY AND PFCRT MUTATION AMONG FRESH PLASMODIUM FALCIPARUM ISOLATES FROM THE LAO PDR (LAOS)
Authors: MAYXAY MAYFONG , BARENDS MARION , BROCKMAN ALAN , JAIDEE ANCHALEE , NAIR SHALINI , SUDIMACK DAN , PONGVONGSA TIENGKHAM , PHOMPIDA SAMLANE , PHETSOUVANH RATTANAXAY , ANDERSON TIM , WHITE NICHOLAS J. , NEWTON PAUL N.
Published: September 2018

Recent drug trials in Laos have shown high levels of Plasmodium falciparum resistance to chloroquine, but there are no published data on in vitro antimalarial drug susceptibility. We used the double-site enzyme-linked pLDH immunodetection (DELI) assay to estimate the in vitro antimalarial drug susceptibility of 108 fresh P. falciparum isolates from southern Laos. The geometric mean (95% confidence interval) 50% inhibitory concentration values (nmol/L) were 152.4 (123.8–187.6) for chloroquine, 679.8 (533.8–863.0) for quinine, 45.9 (37.9–55.7) for mefloquine, 5.0 (4.4–6.4) for artesunate, 6.3 (4.5–8.9) for dihydroartemisinin, and 59.1 (46.4–75.3) for lumefantrine. The proportion of isolates defined as resistant were 65%, 40%, and 8% for chloroquine, quinine, and mefloquine, respectively. Of 53 isolates genotyped for the pfcrt T76K chloroquine-resistance mutation, 48 (91%) were mutants. P. falciparum in Laos is multi-drug resistant; antimalarial immunity resulting from the use of ineffective chloroquine before 2005 probably contributes significantly to the therapeutic responses in clinical trials.
HUMAN EASTERN EQUINE ENCEPHALITIS IN MASSACHUSETTS: PREDICTIVE INDICATORS FROM MOSQUITOES COLLECTED AT 10 LONG-TERM TRAP SITES, 1979–2004
Authors: HACHIYA MASAHIKO , OSBORNE MATTHEW , STINSON CYNTHIA , WERNER BARBARA G.
Published: September 2018

Human eastern equine encephalitis (EEE) is a life-threatening mosquito-borne disease. To determine whether mosquito abundance and EEE virus infection rates are associated with human EEE disease, we evaluated retrospectively a total of 592,637 mosquitoes and onset dates for 20 confirmed human cases over 26 years in Massachusetts. Annual Culiseta melanura populations at 10 defined sites decreased over the study period (P = 0.002). Weekly infection rates and number of infected Culiseta melanura captured per trap night were positively associated EEE cases (P < 0.023 and P < 0.001, respectively), whereas abundance was not (P = 0.077). The infection rate for Culiseta melanura of 0.39 per 1,000 tested mosquitoes identified human cases with a sensitivity of 0.87, a specificity of 0.82, a positive predictive value of 0.14, and a negative predictive value of 0.995. Timely mosquito testing and infection rate calculation are critical for disease risk estimation and outbreak control efforts.
CHRONIC ST. LOUIS ENCEPHALITIS VIRUS INFECTION IN THE GOLDEN HAMSTER (MESOCRICETUS AURATUS)
Authors: SIIRIN MARINA T. , DUAN TAO , LEI HAO , GUZMAN HILDA , DA ROSA AMELIA P. A. TRAVASSOS , WATTS DOUGLAS M. , XIAO SHU-YUAN , TESH ROBERT B.
Published: September 2018

To further study the phenomenon of flavivirus persistent infection, golden hamsters (Mesocricetus auratus) were inoculated intraperitoneally with a low pathogenicity strain of St. Louis encephalitis virus (SLEV). After inoculation, the animals remained asymptomatic and developed high levels of specific neutralizing antibodies in their sera. However, about one half of the hamsters continued to shed infectious SLEV in their urine for prolonged periods of time. By co-cultivation, SLEV was recovered from selected tissues (kidney, lung, and brain) of some of the animals for up to 185 days after initial infection. Although no specific histopathologic changes were observed in these tissues, SLEV antigen was shown by immunohistochemistry in the interstitium and tubular epithelium of the renal cortex and in a few large neurons of the cerebral cortex. Seventeen SLEV isolates from urine and tissues of the chronically infected hamsters were sequenced. In comparison with the infecting parent SLEV strain, two common mutations and amino acid substitutions were observed in all of the hamster isolates. The findings of this study were very similar to previous descriptions of chronic West Nile, Modoc, and tick-borne encephalitis virus infections in mammals, and they re-emphasize the potential importance of persistent flavivirus infection in vertebrates.
MOLECULAR KARYOTYPING OF THE 2LA INVERSION IN ANOPHELES GAMBIAE
Authors: WHITE BRADLEY J. , SANTOLAMAZZA FEDERICA , KAMAU LUNA , POMBI MARCO , GRUSHKO OLGA , MOULINE KARINE , BRENGUES CECILE , GUELBEOGO WAMDAOGO , COULIBALY MAMADOU , KAYONDO JONATHAN K. , SHARAKHOV IGOR , SIMARD FREDERIC , PETRARCA VINCENZO , DELLA TORRE ALESSANDRA , BESANSKY NORA J.
Published: September 2018

The African malaria vector Anopheles gambiae is polymorphic for alternative arrangements on the left arm of chromosome 2 (2La and 2L+a) that are non-randomly distributed with respect to degree of aridity. Detailed studies on the ecological role of inversion 2La have been hindered by the technical demands of traditional karyotype analysis and by sex- and stage-specific limitations on the availability of polytene chromosomes favorable for analysis. Recent molecular characterization of both inversion breakpoints presented the opportunity to develop a polymerase chain reaction (PCR)-based method for karyotype analysis. Here we report the development of this molecular diagnostic assay and the results of extensive field validation. When tested on 765 An. gambiae specimens sampled across Africa, the molecular approach compared favorably with traditional cytologic methods, correctly scoring > 94% of these specimens. By providing ready access to the 2La karyotype, this tool lays groundwork for future studies of the ecological genomics of this medically important species.
SWINE CYSTICERCOSIS HOTSPOTS SURROUNDING TAENIA SOLIUM TAPEWORM CARRIERS
Authors: LESCANO ANDRES G. , GARCIA HECTOR H. , GILMAN ROBERT H. , GUEZALA M. CLAUDIA , TSANG VICTOR C. W. , GAVIDIA CESAR M. , RODRIGUEZ SILVIA , MOULTON LAWRENCE H. , GREEN JUSTIN A. , GONZALEZ ARMANDO E. , _ _
Published: September 2018

We estimated the Taenia solium swine cysticercosis risk gradient surrounding tapeworm carriers in seven rural communities in Peru. At baseline, the prevalences of taeniasis by microscopy and swine cysticercosis by serology were 1.2% (11 of 898) and 30.8% (280 of 908), respectively. The four-month cumulative seroincidence was 9.8% (30 of 307). The unadjusted swine seroprevalence and seroincidence rates increased exponentially by 12.0% (95% confidence [CI] = 9.7–14.3%) and 32.8% (95% CI = 25.0–41.0%), respectively when distance to carriers decreased by half. Swine seroprevalence was 18.4% at > 500 meters from a carrier, 36.5% between 51 and 500 meters, and 68.9% within 50 meters (P < 0.001). Swine seroincidence also displayed a strong gradient near tapeworm carriers (3.8%, 12.2%, and 44.0%; P < 0.001). Within 50 meters, swine seroprevalence appeared unaffected if the owners harbored tapeworms, although pigs owned by a tapeworm carrier had a four times higher seroincidence compared with other pigs (P = 0.005). In rural areas, swine cysticercosis occurs in high-risk hotspots around carriers where control interventions could be delivered.
THERAPEUTIC EFFICACY OF ARTEMETHER-LUMEFANTRINE FOR THE TREATMENT OF UNCOMPLICATED PLASMODIUM FALCIPARUM MALARIA IN BANGLADESH
Authors: HAQUE RASHIDUL , THRIEMER KAMALA , WANG ZHUXI , SATO KIMI , WAGATSUMA YUKIKO , SALAM MOHAMMED ABDUS , AKTHER SELIM , AKTER JASMIN , FUKUDA MARK , MILLER R. SCOTT , NOEDL HARALD
Published: September 2018

Bangladesh faces increasing levels of chloroquine resistance, and drug sensitivity to sulfadoxine-pyremethamine is already compromised. Therefore, the Ministry of Health recently changed the national treatment guidelines to artemisinin-based combination therapies. The purpose of this study was to determine the baseline therapeutic efficacy of artemether-lumefantrine used as a six-dose regimen for the treatment of uncomplicated Plasmodium falciparum malaria. Sixty-seven patients were enrolled in the study; the cure rate in a 42-day follow-up after an adjustment by polymerase chain reaction was 94.3%. The treatment led to rapid fever (mean ± SD = 25.82 ± 12.14 hours) and parasite (30.36 ± 19.43 hours) clearance. These data suggest that artemether-lumefantrine is a highly efficacious and well-tolerated treatment for uncomplicated P. falciparum malaria in Bangladesh.
COMPARISON OF IVERMECTIN AND BENZYL BENZOATE LOTION FOR SCABIES IN NIGERIAN PATIENTS
Authors: SULE HALIMA M. , THACHER TOM D.
Published: September 2018

Few studies have compared ivermectin directly with topical agents in developing countries. We compared the effectiveness of oral ivermectin (200 μg/kg) with topical 25% benzyl benzoate and monosulfiram soap in 210 subjects of age 5 to 65 years with scabies. Subjects with persistent lesions after 2 weeks received a second course of treatment. All lesions had resolved after 2 weeks in 77 of 98 (79%) subjects treated with ivermectin and in 60 of 102 (59%) subjects treated topically (P = 0.003). The improvement in severity score was greater in the ivermectin group than in the topical treatment group (P < 0.001). The overall cure rate after 4 weeks was 95% in the ivermectin group and 86% in the topical treatment group (P = 0.04). Compared with topical benzyl benzoate and monosulfiram in the treatment of scabies, ivermectin was at least as effective and led to more rapid improvement.
GENETIC ANALYSIS OF SOUTH AMERICAN EASTERN EQUINE ENCEPHALOMYELITIS VIRUSES ISOLATED FROM MOSQUITOES COLLECTED IN THE AMAZON BASIN REGION OF PERU
Authors: KONDIG JOHN P. , TURELL MICHAEL J. , LEE JOHN S. , O’GUINN MONICA L. , WASIELOSKI LEONARD P.
Published: September 2018

Identifying viral isolates from field-collected mosquitoes can be difficult and time-consuming, particularly in regions of the world where numerous closely related viruses are co-circulating (e.g., the Amazon Basin region of Peru). The use of molecular techniques may provide rapid and efficient methods for identifying these viruses in the laboratory. Therefore, we determined the complete nucleotide sequence of two South American eastern equine encephalomyelitis viruses (EEEVs): one member from the Peru-Brazil (Lineage II) clade and one member from the Argentina-Panama (Lineage III) clade. In addition, we determined the nucleotide sequence for the nonstructural P3 protein (nsP3) and envelope 2 (E2) protein genes of 36 additional isolates of EEEV from mosquitoes captured in Peru between 1996 and 2001. The 38 isolates were evenly distributed between lineages II and III virus groupings. However, analysis of the nsP3 gene for lineage III strongly suggested that the 19 isolates from this lineage could be divided into two sub-clades, designated as lineages III and IIIA. Compared with North American EEEV (lineage I, GA97 strain), we found that the length of the nsP3 gene was shorter in the strains isolated from South America. A total of 60 nucleotides was deleted in lineage II, 69 in lineage III, and 72 in lineage IIIA. On the basis of the sequences we determined for South American EEEVs and those for other viruses detected in the same area, we developed a series of primers for characterizing these viruses.
NONVIREMIC TRANSMISSION OF WEST NILE VIRUS: EVALUATION OF THE EFFECTS OF SPACE, TIME, AND MOSQUITO SPECIES
Authors: McGEE CHARLES E. , SCHNEIDER BRADLEY S. , GIRARD YVETTE A. , VANLANDINGHAM DANA L. , HIGGS STEPHEN
Published: September 2018

To evaluate the potential for nonviremic transmission (NVT) of West Nile virus (WNV) to occur in nature, we examined the effect of increasing spatial and temporal separation between co-feeding mosquitoes on the efficiency of nonviremic transmission and the potential of a West Nile virus bridge vector species, Aedes albopictus, to be infected via nonviremic transmission. West Nile virus-infected (donor) Culex pipiens quinquefasciatus were allowed to feed on a mouse for 5 minutes followed by non-infected (recipient) mosquitoes with increasing spatial (0, 10, 20, 30, 40, or 50 mm) or temporal (0, 15, 30, 45, or 60 min) separation from the site or time of donor feeding, respectively. Recipients became infected when feeding up to 40 mm from the donor and up to 45 minutes after donor feeding. Additionally, nonviremic transmission of West Nile virus from Cx. p. quinquefasciatus to Ae. albopictus was observed.
AVIAN MORTALITY SURVEILLANCE FOR WEST NILE VIRUS IN COLORADO
Authors: NEMETH NICOLE M. , BECKETT SUSAN , EDWARDS ERIC , KLENK KACI , KOMAR NICHOLAS
Published: September 2018

We tested 1,549 avian carcasses of 104 species to identify targets for West Nile virus (WNV) surveillance in Colorado, determine species affected by WNV, compare virus isolation versus RNA detection applied to hearts and oral swabs from carcasses, and compare the VecTest WNV Antigen Assay (VecTest) to standard assays. Forty-two species tested positive. From June to September 2003, 86% of corvids, 34% of non-corvid passerines, and 37% of raptors tested positive. We developed the Target Species Index, which identified American crows as the most important avian indicator species. However, testing multiple species maximizes detection, which may be important early and late in the transmission season. This index may benefit surveillance for other zoonotic pathogens, such as highly pathogenic avian influenza H5N1 virus. VecTest using oral swabs was most sensitive for American crow, black-billed magpie, house finch, house sparrow, and American kestrel. Wildlife rehabilitation centers should be recruited to enhance WNV surveillance.
TWO CASES OF HANTAVIRUS PULMONARY SYNDROME IN RANDOLPH COUNTY, WEST VIRGINIA: A COINCIDENCE OF TIME AND PLACE?
Authors: SINCLAIR JULIE R. , CARROLL DARIN S. , MONTGOMERY JOEL M. , PAVLIN BORIS , MCCOMBS KATHERINE , MILLS JAMES N. , COMER JAMES A. , KSIAZEK THOMAS G. , ROLLIN PIERRE E. , NICHOL STUART T. , SANCHEZ ANGELA J. , HUTSON CHRISTINA L. , BELL MICHAEL , ROONEY JANE A.
Published: September 2018

Hantavirus pulmonary syndrome (HPS) is caused by an infection with viruses of the genus Hantavirus in the western hemisphere. Rodent hosts of hantaviruses are present throughout the United States. In July 2004, two HPS case-patients were identified in Randolph County, WV: a wildlife science graduate student working locally and a Randolph County resident. We interviewed family members and colleagues, reviewed medical records, and conducted environmental studies at likely exposure sites. Small mammals were trapped, and blood, urine, and tissue samples were submitted to the Centers for Disease Control and Prevention for laboratory analyses. These analyses confirmed that both patients were infected with Monongahela virus, a Sin Nombre hantavirus variant hosted by the Cloudland deer mouse, Peromyscus maniculatus nubiterrae. Other than one retrospectively diagnosed case in 1981, these are the first HPS cases reported in West Virginia. These cases emphasize the need to educate the public throughout the United States regarding risks and prevention measures for hantavirus infection.
IMPACT OF DEFORESTATION AND AGRICULTURAL DEVELOPMENT ON ANOPHELINE ECOLOGY AND MALARIA EPIDEMIOLOGY
Authors: YASUOKA JUNKO , LEVINS RICHARD
Published: September 2018

To clarify mechanisms linking deforestation, anopheline ecology, and malaria epidemiology, this study draws together 60 examples of changes in anopheline ecology and malaria incidence as a consequence of deforestation and agricultural development. The deforestation projects were classified based on subsequent land use and were reviewed in terms of their impact on anopheline density and malaria incidence. To further examine different anopheline responses to land transformation, two major ecological characteristics of 31 anopheline species were tested for their associations with changes in their densities and malaria incidence. Although niche width of anopheline species was not associated with density changes, sun preference was significantly associated with an increase in density. This study suggests the possibility of predicting potential impacts of future deforestation on vector density by using information on types of planned agricultural development and the ecology of local anopheline species.
MALARIA VECTOR INCRIMINATION IN THREE RURAL RIVERINE VILLAGES IN THE BRAZILIAN AMAZON
Authors: GALARDO ALLAN KARDEC RIBEIRO , ARRUDA MERCIA , COUTO ALVARO A. R. D’ALMEIDA , WIRTZ ROBERT , LOUNIBOS L. PHILIP , ZIMMERMAN ROBERT H.
Published: September 2018

Vector incrimination studies were conducted from April 2003 to February 2005 at three riverine villages 1.5 km to 7.0 km apart, along the Matapi River, Amapa State, Brazil. A total of 113,117 mosquitoes were collected and placed in pools of ≤ 7 mosquitoes (19,883 pools) and tested for species-specific circumsporozoite protein (CSP) of P. falciparum, P. vivax VK210, and P. vivax VK247 using the enzyme-linked immunoabsorbent assay (ELISA). A subset of 63,330 mosquitoes (12,191 pools) was tested for P. malariae. Anopheles darlingi and An. marajoara had the highest proportion of circumsporozoite protein positives for human malaria parasites compared with An. nuneztovari, An. triannulatus, and An. intermedius. Anopheles darlingi and An. marajoara had the highest entomological inoculation rates (EIR) and were considered to be the most important malaria vectors in the study. Anopheles nuneztovari was also an important vector. Differences in entomological inoculation rates were more dependent on mosquito abundance than on sporozoite rates.
HEALING OF OLD WORLD CUTANEOUS LEISHMANIASIS IN TRAVELERS TREATED WITH FLUCONAZOLE: DRUG EFFECT OR SPONTANEOUS EVOLUTION?
Authors: MORIZOT GLORIA , DELGIUDICE PASCAL , CAUMES ERIC , LAFFITTE EMMANUEL , MARTY PIERRE , DUPUY ALAIN , SARFATI CLAUDINE , HADJ-RABIA SMAIN , DARIE HERVE , LE GUERN ANNE-SOPHIE , SALAH AFIF BEN , PRATLONG FRANCINE , DEDET JEAN-PIERRE , GRÖGL MAX , BUFFET PIERRE A.
Published: September 2018

The efficacy of fluconazole was evaluated in 35 travelers with parasitologically proven imported Old World cutaneous leishmaniasis (CL). Leishmania major (mainly MON-25) was identified in 15 patients and strongly suspected given the transmission area in 12 of these patients. Daily oral fluconazole (200 mg/day for adults and 2.5 mg/kg/day for children) was prescribed for six weeks. Outcome definition was based on re-epithelialization rate at day 50. Of the 27 L. major-infected patients, 12 (44.4%) were cured. This cure rate is similar to the placebo cure rate from trials in L. major CL in which, as in the present report, the definition of outcome relied exclusively on re-epithelialization. These data question the assumption that oral fluconazole is consistently effective for treatment of CL caused by L. major.
LOW-LEVEL MALARIA INFECTIONS DETECTED BY A SENSITIVE POLYMERASE CHAIN REACTION ASSAY AND USE OF THIS TECHNIQUE IN THE EVALUATION OF MALARIA VACCINES IN AN ENDEMIC AREA
Authors: IMOUKHUEDE EGERUAN B. , ANDREWS LAURA , MILLIGAN PAUL , BERTHOUD TAMARA , BOJANG KALIFA , NWAKANMA DAVIS , ISMAILI JAMILA , BUCKEE CAROLINE , NJIE FANTA , KEITA SAIKOU , SOWE MAIMUNA , LANG TRUDIE , GILBERT SARAH C. , GREENWOOD BRIAN M. , HILL ADRIAN V. S.
Published: September 2018

The feasibility of using a sensitive polymerase chain reaction (PCR) to evaluate malaria vaccines in small group sizes was tested in 102 adult Gambian volunteers who received either the malaria vaccine regimen FP9 ME-TRAP/MVA ME-TRAP or rabies vaccine. All volunteers received the antimalarial drugs primaquine and Lapdap plus artesunate to eliminate malaria parasites. Volunteers in a further group received an additional single treatment with sulfadoxine-pyrimethamine (SP) to prevent new infections. There was substantially lower T-cell immunogenicity than in previous trials with this vaccine regimen and no protection against infection in the malaria vaccine group. Using the primary endpoint of 20 parasites per mL, no difference was found in the prevalence of low-level infections in volunteers who received SP compared with those who did not, indicating that SP did not reduce the incidence of very low-density infection. However, SP markedly reduced the incidence of higher density infections. These findings support the feasibility and potential of this approach to screen pre-erythrocytic vaccines for efficacy against infection in small numbers of vaccinees in endemic areas.
MULTIPLE HYBRID GENOTYPES OF LEISHMANIA (VIANNIA) IN A FOCUS OF MUCOCUTANEOUS LEISHMANIASIS
Authors: NOLDER DEBBIE , RONCAL NORMA , DAVIES CLIVE R. , LLANOS-CUENTAS ALEJANDRO , MILES MICHAEL A.
Published: September 2018

The principal agent of mucocutaneous leishmaniasis (MCL) is the South American protozoan parasite Leishmania (Viannia) braziliensis. This organism is generally considered to be clonal, that is, it does not to undergo genetic exchange. Nevertheless, apparent hybrids between several Leishmania species have been reported in the New World and the Old World. When we characterized isolates of Leishmania (Viannia) from a single focus of cutaneous leishmaniasis (CL) and MCL, we found a remarkable phenotypic and genotypic diversity, with 12 zymodemes and 20 microsatellite genotypes. Furthermore, 26 of the 59 isolates were L. braziliensis/L. peruviana phenotypic hybrids that displayed 7 different microsatellite genotypes. A hybrid genotype was the only organism isolated from 4 patients with MCL. Thus hybrids must be included among the potential agents of MCL. Despite the propensity for clonality, hybrids are also an important feature of Leishmania (Viannia) and may give rise to epidemiologically important emergent genotypes.
SPECIFIC TREATMENT FOR TRYPANOSOMA CRUZI: LACK OF EFFICACY OF ALLOPURINOL IN THE HUMAN CHRONIC PHASE OF CHAGAS DISEASE
Authors: RASSI ANIS , LUQUETTI ALEJANDRO OSTERMAYER , RASSI ANIS , RASSI GUSTAVO GABRIEL , RASSI SERGIO GABRIEL , DA SILVA IONIZETE GARCIA , RASSI ALEXANDRE GABRIEL
Published: September 2018

Thirty-five individuals from endemic areas of Central Brazil (age range, 18–64 years; 19 women) in the chronic phase of Chagas disease, with positive serology and presence of circulating parasites detected by one or more recent positive xenodiagnosis, were selected for this study. Allopurinol (900 mg/d) or placebo was administered in a double-blind clinical trial for 60 days. After codes were broken, 23 had been allocated to the intervention group and 12 to the placebo group. Side effects were observed in 11 patients in the intervention group and in 1 in the placebo group. Seventeen patients in the intervention group and 10 in the placebo group completed the trial. Follow-up was performed by monthly xenodiagnosis and serologic tests every 3 months during the first year and at the end of the trial. Xenodi-agnosis remained positive in all 17 of the treated group and in all 10 of the placebo group. Serologic tests were persistently positive in both groups after treatment. We concluded that, at the doses used, allopurinol was not effective to clear, in our region, Trypanosoma cruzi from peripheral blood of infected individuals.
USE OF BIOMASS FUEL IS ASSOCIATED WITH INFANT MORTALITY AND CHILD HEALTH IN TREND ANALYSIS
Authors: RINNE SEPPO T. , RODAS EDGAR J. , RINNE MIKAEL L. , SIMPSON JOSHUA M. , GLICKMAN LARRY T.
Published: September 2018

Biomass fuel used for cooking results in widespread exposure to indoor air pollution (IAP), affecting nearly 3 billion people throughout the world. Few studies, however, have tested for an exposure–response relationship between biomass fuel and health outcomes. The aim of this study was to explore the relationship between biomass fuel, infant mortality, and children’s respiratory symptoms. Eighty households in a rural community in Ecuador were selected based on their use of biomass fuel and questioned regarding a history of infant mortality and children’s respiratory symptoms. Carbon monoxide (CO) and particulate matter (PM) were measured in a subset of these homes to confirm the relationship between biomass fuel use and IAP. Results showed a significant trend for higher infant mortality among households that cooked with a greater proportion of biomass fuel (P = 0.008). Similar trends were noted for history of cough (P = 0.02) and earache (P < 0.001) among children living in these households.
FURUNCULAR MYIASIS CAUSED BY DERMATOBIA HOMINIS IN A RETURNING TRAVELER
Authors: BHANDARI RAMANATH , JANOS DAVID P. , SINNIS PHOTINI
Published: September 2018

Furuncular myiasis caused by Dermatobia hominis is endemic throughout Central and South America. We report a case of furuncular myiasis in a traveler returned from Costa Rica. The case is unique because the primary care physician obtained magnetic resonance images. The images, however, do not show any characteristic features that assist in diagnosis.
A CASE OF ANAPHYLACTIC REACTION TO PRAZIQUANTEL TREATMENT
Authors: SHEN CHENGHUA , CHOI MIN-HO , BAE YOUNG MEE , YU GUI , WANG SHUHUA , HONG SUNG-TAE
Published: September 2018

A 35-year-old Chinese man was administered praziquantel for clonorchiasis, and 30 minutes later he experienced a sudden onset of itching urticaria over his entire body with dyspnea, palpitation, and dizziness. The patient had no recent medication history except for the praziquantel. He was diagnosed as having an anaphylactic reaction with skin eruptions induced by praziquantel. His symptoms subsided after a stomach wash and the administration of anti-anaphylactic medication in emergency department of a regional hospital in the People’s Republic of China. The immediate type of hypersensitive reaction to praziquantel is plausible, and this reaction should be considered for praziquantel therapy.
SULFADOXINE–PYRIMETHAMINE EFFICACY AND SELECTION OF PLASMODIUM FALCIPARUM DHFR MUTATIONS IN BURKINA FASO BEFORE ITS INTRODUCTION AS INTERMITTENT PREVENTIVE TREATMENT FOR PREGNANT WOMEN
Authors: TINTO HALIDOU , OUÉDRAOGO JEAN BOSCO , ZONGO ISSAKA , VAN OVERMEIR CHANTAL , VAN MARCK ERIC , GUIGUEMDÉ TINGA ROBERT , D’ALESSANDRO UMBERTO
Published: September 2018

Sulfadoxine-pyrimethamine efficacy was determined with a 28-day follow-up in 97 children between 6 months and 15 years of age. The polymerase chain reaction (PCR)-corrected treatment failure was 8.2% and the uncorrected was 21.6%. The presence of the dihydrofolate reductase (DHFR) and dihydropteroate synthetase (DHPS) mutations linked to sulfadoxine-pyrimethamine resistance before and after treatment was determined by PCR-restriction fragment length polymorphism (RFLP) and by a fluorogenic PCR assay. Before treatment, the prevalence of the triple DHFR mutations was higher among the patients having had a recurrent parasitemia (either recrudescence or new infection; 28.6% versus 9.3%), although the difference was not significant (P = 0.1). The double mutation Ala-436/Gly-437 was observed in 67% of samples, whereas no Glu-540 mutation was found. After treatment, the triple DHFR mutation was found in 76.2% of patients with recurrent parasitemia, recrudescence, and new infection alike. Such high prevalence of mutant parasites indicates that sulfadoxine-pyrimethamine should not be used as monotherapy.
PFMDR1 AND IN VIVO RESISTANCE TO ARTESUNATE-MEFLOQUINE IN FALCIPARUM MALARIA ON THE CAMBODIAN–THAI BORDER
Authors: ALKER ALISA P. , LIM PHARATH , SEM RITHY , SHAH NAMAN K. , YI PORAVUTH , BOUTH DENIS MEY , TSUYUOKA REIKO , MAGUIRE JASON D. , FANDEUR THIERRY , ARIEY FREDERIC , WONGSRICHANALAI CHANSUDA , MESHNICK STEVEN R.
Published: September 2018

Artemisinin combination therapies (ACTs) have recently been adopted as first-line therapy for Plasmodium falciparum infections in most malaria-endemic countries. In this study, we estimated the association between artesunate-mefloquine therapy failure and genetic changes in the putative transporter, pfmdr1. Blood samples were acquired from 80 patients enrolled in an 2004 in vivo efficacy study in Pailin, Cambodia, and genotyped for pfmdr1 copy number and haplotype. Having parasites with three or more copies of pfmdr1 before treatment was strongly associated with recrudescence (hazard ratio [HR] = 8.30; 95% CI: 2.60–26.43). This relationship was maintained when controlling for initial parasite density and hematocrit (HR = 7.91; 95% CI: 2.38–26.29). Artesunate-mefloquine treatment selected for increased pfmdr1 copy number, because isolates from recurrent episodes had higher copy numbers than the paired enrollment samples (Wilcoxon rank test, P = 0.040). pfmdr1 copy number should be evaluated further as a surveillance tool for artesunate-mefloquine resistance in Cambodia.
DISSEMINATED INTRAVASCULAR COAGULATION COMPLICATED BY PERIPHERAL GANGRENE IN A RHESUS MACAQUE (MACACA MULATTA) EXPERIMENTALLY INFECTED WITH PLASMODIUM COATNEYI
Authors: MORENO ALBERTO , GARCÍA ANAPATRICIA , CABRERA-MORA MÓNICA , STROBERT ELIZABETH , GALINSKI MARY R.
Published: September 2018

We report the first case of disseminated intravascular coagulation (DIC) complicated by peripheral gangrene induced by Plasmodium coatneyi in rhesus monkeys. Ten days after experimental challenge, numerous petechiae were noted over the trunk and extremities, with polychromasia, severe anemia, thrombocytopenia, and moderate parasitemia. These changes were accompanied by elevated serum activity of blood urea nitrogen, creatinine, transaminases, and creatinine phosphokinase. The animal received intravenous fluid support, artemether, and blood transfusion. Three days after treatment, the platelet counts returned to normal, and parasitemia was abated. However, several areas of skin discoloration with gangrenous tissue in the hands and the tail were observed. Coagulation profile showed elevated D-dimers and elevated levels of fibrinogen/fibrin degradation products with low levels of protein S functional activity. DIC with peripheral gangrene is very rare in Plasmodium-infected individuals. Our results indicate that the experimental model of P. coatneyi infection of rhesus monkeys is important for studies of malarial anemia and coagulopathy.
EFFICACY OF ATOVAQUONE-PROGUANIL FOR TREATMENT OF ACUTE MULTIDRUG-RESISTANT PLASMODIUM FALCIPARUM MALARIA IN THAILAND
Authors: KRUDSOOD SRIVICHA , PATEL SAMIR N. , TANGPUKDEE NOPADDON , THANACHARTWET WIPA , LEOWATTANA WATTANA , PORNPININWORAKIJ KARNCHANA , BOGGILD ANDREA K. , LOOAREESUWAN SORNCHAI , KAIN KEVIN C.
Published: September 2018

A combination of atovaquone-proguanil (Malarone®; GlaxoSmithKline, Research Triangle Park, NC) was previously shown to be highly effective in the treatment of uncomplicated Plasmodium falciparum malaria. However, there are only limited recent efficacy data, particularly from regions of multidrug resistance. In this study, we examined the efficacy of atovaquone-proguanil for the treatment of uncomplicated P. falciparum malaria on the Thailand-Myanmar border. Patients were given directly observed atovaquone-proguanil (1,000 mg/400 mg) once a day for three days and followed-up for four weeks in a non-transmission area. Of 140 eligible patients enrolled in this open-label study, 97.8% (95% confidence interval = 95.4–100%) responded to therapy and remained clear of parasitemia at follow-up. Mean parasite clearance time was 41.9 hours and mean fever clearance time was 37.1 hours. On the basis of genotyping, three cases of treatment failure were identified (1 RIII and 2 RI). These data indicate that atovaquone-proguanil remains highly efficacious for the treatment of multidrug-resistant P. falciparum malaria in Thailand.
DAILY SURVIVAL RATES AND DISPERSAL OF AEDES AEGYPTI FEMALES IN RIO DE JANEIRO, BRAZIL
Authors: MACIEL-DE-FREITAS RAFAEL , CODEÇO CLAUDIA TORRES , LOURENÇO-DE-OLIVEIRA RICARDO
Published: September 2018

Daily survival rates, life expectancy, dispersal, and parity are important components of vectorial capacity of Aedes aegypti. These parameters were estimated for mosquito populations from a slum and a suburban district in Rio de Janeiro, during the wet and dry seasons in 2005. In each mark-release-recapture experiment, three cohorts of dust-marked Ae. aegypti females were released. Recaptures were carried out daily in randomly selected houses, using backpack aspirators, adult traps, and sticky ovitraps. Recapture varied between 6.81% and 14.26%. Daily survival was estimated by fitting two alternative models: exponential and nonlinear models with correction for the removal of individuals. Slum area presented higher survival and parity rates (68.5%). Dispersal rates were higher in the suburban area, where a maximum dispersal of 363 m was observed. Results suggest intense risk of dengue epidemic, particularly in the urban area.
INFESTATION OF WISTAR RATS WITH TUNGA PENETRANS IN DIFFERENT MICROENVIRONMENTS
Authors: WITT LARS , HEUKELBACH JÖRG , SCHWALFENBERG STEFAN , RIBEIRO RONALDO A. , HARMS GUNDEL , FELDMEIER HERMANN
Published: September 2018

Tungiasis is a zoonotic ectoparasitosis that causes considerable morbidity in affected populations. The type of microenvironment that facilitates infestation of hosts by Tunga penetrans has not been investigated. In this study, we exposed 30 laboratory-raised Wistar rats, a suitable model for the infestation, at six different places characterized by different microenvironments in a hyperendemic fishing village in northeastern Brazil. During a period of two weeks, the animals were monitored and the number of embedded fleas was documented. The number of lesions varied considerably according to the microenvironment and was highest in a cage placed at the far end of a compound of a household affected by tungiasis. No penetration was observed inside houses. Results indicate that in this endemic area transmission of T. penetrans seems to occur mainly outdoors.