bluuebunny/crossref_metadata_2025 huggingface dataset:
EPIDEMIOLOGY AND CLINICAL ASPECTS OF ENTERIC FEVER IN ISRAEL
Authors: MELTZER EYAL , YOSSEPOWITCH ORIT , SADIK CHANTAL , DAN MICHAEL , SCHWARTZ ELI
Published: September 2018

Enteric fever decreased in Israel in the last 50 years, but its current epidemiology is unknown. In a nationwide study, we evaluated all cases of enteric fever from 1995 to 2003. On hundred thirty-six cases met the case definition. During the period studied, the incidence of enteric fever decreased from 0.42 to 0.23/100,000. A total of 57.4% of the cases were acquired abroad. The incidence of endemic enteric fever was 2.7 times higher in Arabs than in Jews. In Arabs, Salmonella Typhi was the causative agent in all cases, and almost all cases were endemic. In Jews, most cases were imported, with a decrease in imported S. typhi, cases and an increase in imported S. Paratyphi A cases. Salmonella Paratyphi B was endemic, and restricted to the Jewish population. The reasons for the difference in causative agents along ethnic lines need further evaluation. A more efficient vaccine for travelers that includes S. Paratyphi A is needed.
POLYMERASE CHAIN REACTION AND MOLECULAR GENOTYPING TO MONITOR PARASITOLOGICAL RESPONSE TO ANTI-MALARIAL CHEMOTHERAPY IN THE PERUVIAN AMAZON
Authors: AYALA EVERICK , LESCANO ANDRÉS G. , GILMAN ROBERT H. , CALDERÓN MARITZA , PINEDO VIVIANA V. , TERRY HILJA , CABRERA LILIA , VINETZ JOSEPH M.
Published: September 2018

Over the past decade, anti-malarial drug resistance has rapidly become a major public health problem in the Peruvian Amazon. This study compared polymerase chain reaction (PCR) to light microscopy for diagnosing and monitoring the parasitological response of malaria patients to anti-malarial chemotherapy in the Peruvian Amazon region of Iquitos. Typing of P. falciparum using MSP1, MSP2, and glutamine-rich protein distinguished among infecting parasites. Most (73%) P. falciparum patients were parasitologically resistant to sulfadoxine-pyrimethamine (RI = 10, RII = 1). Sensitivity of microscopy was lower than PCR (69% for P. vivax and 78% for P. falciparum), but parasite clearance times were comparable between microscopy and PCR. PCR sensitively and specifically detected mixed infections and low-level parasitemia indicative of drug resistance, making this approach of practical use for the control of malaria at the public health level. Genotyping malaria parasites will be useful to distinguish drug failure from new infections in clinical trials of anti-malarial drugs in the Peruvian Amazon region.
ASSOCIATION OF FCγ RECEPTOR IIA (CD32) POLYMORPHISM WITH MALARIAL ANEMIA AND HIGH-DENSITY PARASITEMIA IN INFANTS AND YOUNG CHILDREN
Authors: OUMA COLLINS , KELLER CHRISTOPHER C. , OPONDO DOROTHY A. , WERE TOM , OTIENO RICHARD O. , OTIENO MICHAEL F. , ORAGO ALLOYS S. S. , ONG’ECHA JOHN M. , VULULE JOHN M. , FERRELL ROBERT E. , PERKINS DOUGLAS J.
Published: September 2018

Protective immunity against Plasmodium falciparum is partially mediated through binding of malaria-specific IgG antibodies to Fcγ receptors. Polymorphic variability in Fcγ RIIa (H/R-131) is associated with differential binding of IgG subtypes and malaria disease outcomes. However, the role of Fcγ RIIa-131 variability in conditioning susceptibility to severe malarial anemia, the primary manifestation of severe malaria in holoendemic P. falciparum transmission areas, is largely undefined. Thus, Fcγ RIIa-H131R polymorphism was investigated in 493 children who came to a hospital with acute malaria. Variation in Fcγ RIIa-131 was not significantly associated with severe malarial anemia (hemoglobin [Hb] < 6.0 g/dL) or malaria anemia (Hb < 8.0 g/dL). However, relative to the heterozygous genotype, homozygotes for the R131 alleles were protected against high-density parasitemia (≥ 10,000 parasites/μL; odds ratio [OR] = 0.58, 95% confidence interval [CI] = 0.37–0.92, P = 0.02), while homozygotes for the H131 alleles were mildly protective (OR = 0.71, 95% CI = 0.45–1.13, P = 0.14). Additional multivariate analyses showed that infection with human immunodeficiency virus type 1 did not influence the associations between FcγRIIa-H131R polymorphism and malaria disease outcomes. Genotypic results presented here parallel data illustrating that parasite density is unrelated to the severity of anemia in children with acute malaria. Thus, although homozygosity for the R131 allele protects against high-density parasitemia, FcγRIIa-131 polymorphism does not protect against malaria anemia.
VARICELLA ZOSTER VIRUS MENINGITIS COMPLICATING SODIUM STIBOGLUCONATE TREATMENT FOR CUTANEOUS LEISHMANIASIS
Authors: HARTZELL JOSHUA D. , ARONSON NAOMI E. , NAGARAJA SUDHIR , WHITMAN TIM , HAWKES CLIFTON A. , WORTMANN GLENN
Published: September 2018

Sodium stibogluconate (Pentostam®; GlaxoSmithKline) is a pentavalent antimonial compound used in the treatment of leishmaniasis, which has an association with reactivation of varicella zoster virus (VZV). We report the first known case of an immunocompetent adult who developed VZV aseptic meningitis and dermatomal herpes zoster during treatment with sodium stibogluconate.
ASSOCIATION BETWEEN TUBERCULOSIS AND DIABETES IN THE MEXICAN BORDER AND NON-BORDER REGIONS OF TEXAS
Authors: PÉREZ ADRIANA , BROWN H. SHELTON , RESTREPO BLANCA I.
Published: September 2018

The association between tuberculosis and underlying risk factors was evaluated in Texas patients hospitalized in the 15 counties along the Mexico border within the remaining non-border counties. A case control analysis of the hospital discharge dataset from the Texas Health Care Information Council was performed for the years 1999–2001. A discharge diagnosis of tuberculosis identified cases (N = 4,915). Deep venous thrombosis, pulmonary embolism, and acute appendicitis conditions identified controls (N = 70,808). Risk factors associated with tuberculosis were identified by logistic regression. Diabetes patients were almost twice as likely to have tuberculosis after adjusting by sex, age, and race/ethnicity. The association was strong for the population in the Texas border region, where there are higher incidence rates of tuberculosis (odds ratio [OR]adj = 1.82; 95% CI = 1.57–2.12) compared with non-border counties (ORadj = 1.51; 95% CI = 1.36–1.67).
CAGE TRIALS USING AN ENDOGENOUS MEIOTIC DRIVE GENE IN THE MOSQUITO AEDES AEGYPTI TO PROMOTE POPULATION REPLACEMENT
Authors: CHA SUNG-JAE , MORI AKIO , CHADEE DAVE D. , SEVERSON DAVID W.
Published: September 2018

Control of arthropod-borne diseases based on population replacement with genetically modified non-competent vectors has been proposed as a promising alternative to conventional control strategies. Due to likely fitness costs associated with vectors manipulated to carry anti-pathogen effector genes, the effector genes will need to be coupled with a strong drive system to rapidly sweep them into natural populations. Endogenous meiotic drive systems have strong and stable population replacement potential, and have previously been reported in two mosquito species: Aedes aegypti and Culex pipiens. To investigate the influence of an endogenous meiotic drive gene on Ae. aegypti population dynamics, we established three experimental population types that were initiated with 100%, 10%, and 1% male mosquitoes carrying a strong meiotic driver (T37 strain) and 100% sensitive females (RED strain), respectively. Among the 100% and 10% populations, early generations were highly male biased, which reflected the effects of the meiotic driver, and remained more than 60% male by the F15. A genetic marker tightly linked with the meiotic driver on chromosome 1 showed strong selection for the T37 strain-specific allele. Similar but reduced effects of the meiotic driver were also observed in the 1% populations. These results suggest that release of Ae. aegypti males carrying a strong meiotic driver into drive sensitive populations can be an effective tool for population replacement, and provide a foundation for additional studies including both experimental populations and simulations by mathematical modeling.
A NEW HIGH-PERFORMANCE PCR DIAGNOSTIC FOR THE DETECTION OF PYRETHROID KNOCKDOWN RESISTANCE KDR IN ANOPHELES GAMBIAE
Authors: TRIPET FREDERIC , WRIGHT JENNIFER , LANZARO GREG
Published: September 2018

Monitoring the spread of the knockdown resistance allele kdr in areas of extensive pyrethroid use is critical to vector-control projects. Currently available methods for detecting kdr from DNA samples are characterized by poor amplification, time-consuming steps, and primers that exhibit frequent null alleles. We describe a new PCR diagnostic that uses fluorescent primers based on conserved priming sites and enables simple detection of the kdr allele on a sequencer. Using samples from a West African Anopheles gambiae population, we show that the new PCR yielded significantly higher rates of amplification and more accurate estimates of kdr frequency. The method works equally well for the leucine to phenylalanine substitution found in West Africa and the East African leucine to serine substitution.
MOLECULAR EPIDEMIOLOGY OF HUMAN IMMUNODEFICIENCY VIRUS–INFECTED INDIVIDUALS IN MEDELLIN, COLOMBIA
Authors: SANCHEZ GLORIA I. , BAUTISTA CHRISTIAN T. , EYZAGUIRRE LINDSAY , CARRION GLADYS , ARIAS SONIA , SATEREN WARREN B. , NEGRETE MONICA , MONTANO SILVIA M. , SANCHEZ JOSE L. , CARR JEAN K.
Published: September 2018

To study the molecular epidemiology of human immunodeficiency virus type 1 (HIV-1) strains in Medellín, Colombia, 115 HIV-1-positive individuals who were recruited from an HIV outpatient hospital (Universitario San Vicente de Paul) during the period from July 2001 to January 2002 were genotyped. All samples were analyzed by envelope heteroduplex mobility assay and found to be subtype B. Twenty-four samples were randomly selected for sequencing of the protease and the reverse transcriptase regions; all isolates were found to be subtype B. Phylogenetic analysis of seven nearly full-length genomes showed that all samples were subtype B. This study shows that the HIV epidemic in Colombia continues to be dominated by the subtype B virus. The predominance of subtype B genotypes of HIV-1 strains in Medellín resembles what is seen in the nearby countries of Peru, Ecuador, and Venezuela.
SEVERE CUTANEOUS REACTIONS TO SULFADOXINE-PYRIMETHAMINE AND TRIMETHOPRIM-SULFAMETHOXAZOLE IN BLANTYRE DISTRICT, MALAWI
Authors: GIMNIG JOHN E. , MacARTHUR JOHN R. , M’BANG’OMBE MAURICE , KRAMER MICHAEL H. , CHIZANI NYSON , STERN ROBERT S. , MKANDALA CHRIS , NEWMAN ROBERT D. , STEKETEE RICHARD W. , CAMPBELL CARL H.
Published: September 2018

We estimated the frequency of clinically diagnosed Stevens-Johnson syndrome and toxic epidermal necrolysis associated with sulfadoxine-pyrimethamine (SP) and trimethoprim-sulfamethoxazole (CTX) in Blantyre District, Malawi. Cases were detected by passive surveillance at 22 health centers from March 2001 through September 2002. Denominators were estimated from the Malawi national census for Blantyre District and the frequency of SP and CTX use reported in five household surveys. Crude rates of adverse reactions were estimated to be 1.2 per 100,000 exposures for SP and 1.5 per 100,000 exposures for CTX. Rates were higher in adults (1.7 cases per 100,000 SP exposures and 2.6 cases per 100,000 CTX exposures) and in persons positive for human immunodeficiency virus (4.9 cases per 100,000 SP exposures and 8.4 cases per 100,000 CTX exposures). Infrequent treatment doses with SP are associated with a low risk of an adverse cutaneous reaction, and SP can be recommended for treatment of malaria in areas where P. falciparum is susceptible.
MEFLOQUINE USE AND HOSPITALIZATIONS AMONG US SERVICE MEMBERS, 2002–2004
Authors: WELLS TIMOTHY S. , SMITH TYLER C. , SMITH BESA , WANG LINDA Z. , HANSEN CHRISTIAN J. , REED ROBERT J. , GOLDFINGER WENDY E. , CORBEIL THOMAS E. , SPOONER CHRISTINA N. , RYAN MARGARET A.K.
Published: September 2018

The safety of mefloquine has not been well described in military populations. This study used standard military databases for mefloquine prescriptions and hospitalizations to investigate mefloquine safety among US service members from 2002 through 2004. Mefloquine-prescribed and deployed personnel (N = 8,858) were compared with two reference groups. The reference groups comprised US service members who were not prescribed mefloquine and resided in Europe or Japan (N = 156,203) or had been otherwise deployed (N = 232,381). In comparison with active-duty US service members residing in Europe or Japan, mefloquine-prescribed service members were at statistically significant decreased hazard for any-cause hospitalization, as well as diseases of the respiratory and digestive systems, musculoskeletal system and connective tissue diseases, injuries and poisonings, ill-defined conditions, and mood disorders. These results suggest there is no association between mefloquine prescriptions and severe health effects, as measured by hospitalizations, across a wide range of outcomes.
A CASE OF HEMOLYSIS RESULTING FROM CONTACT WITH A LONOMIA CATERPILLAR IN SOUTHERN BRAZIL
Authors: MALAQUE CEILA M. S. , ANDRADE LÚCIA , MADALOSSO GERALDINE , TOMY SANDRA , TAVARES FLÁVIO L. , SEGURO ANTONIO C.
Published: September 2018

Contact with a caterpillar of the genus Lonomia can result in a hemorrhagic syndrome. Lonomia obliqua venom activates prothrombin and factor X and promotes fibrinogenolytic activity. Although crude L. obliqua bristle extract can induce hemolytic activity in human and rat erythrocytes, there have been no reports of hemolysis in the cases of human contact. We report a confirmed human case of Lonomia venom-induced hemolysis.
A REAL-TIME PCR-BASED ASSAY FOR DETECTION OF WUCHERERIA BANCROFTI DNA IN BLOOD AND MOSQUITOES
Authors: RAO RAMAKRISHNA U. , ATKINSON LAURA J. , RAMZY REDA M. R. , HELMY HANAN , FARID HODA A. , BOCKARIE MOSES. J. , SUSAPU MELINDA , LANEY SANDRA J. , WILLIAMS STEVEN A. , WEIL GARY J.
Published: September 2018

We developed and evaluated real-time polymerase chain reaction (PCR) assays for detecting Wuchereria bancrofti DNA in human blood and in mosquitoes. An assay based on detection of the W. bancrofti “LDR” repeat DNA sequence was more sensitive than an assay for Wolbachia 16S rDNA. The LDR-based assay was sensitive for detecting microfilarial DNA on dried membrane filters or on filter paper. We also compared real-time PCR with conventional PCR (C-PCR) for detecting W. bancrofti DNA in mosquito samples collected in endemic areas in Egypt and Papua New Guinea. Although the two methods had comparable sensitivity for detecting filarial DNA in reference samples, real-time PCR was more sensitive than C-PCR in practice with field samples. Other advantages of real-time PCR include its high-throughput capacity and decreased risk of cross-contamination between test samples. We believe that real-time PCR has great potential as a tool for monitoring progress in large-scale filariasis elimination programs.
SOCIOECONOMIC AND BEHAVIOR RISK FACTORS OF HUMAN ALVEOLAR ECHINOCOCCOSIS IN TIBETAN COMMUNITIES IN SICHUAN, PEOPLE’S REPUBLIC OF CHINA
Authors: WANG QIAN , QIU JIAMIN , YANG WEN , SCHANTZ PETER M. , RAOUL FRANCIS , CRAIG PHILIP S. , GIRAUDOUX PATRICK , VUITTON DOMINIQUE A.
Published: September 2018

Data from two cross-sectional investigations on 7,138 subjects were used to explore risk factors of human alveolar echinococcosis (AE) in Tibetan communities. The overall human AE prevalence was 3.1% (223 of 7,138), females had a higher prevalence (3.6%, 132 of 3,713) than males (2.7%, 91 of 3,425; P = 0.011), and herdsmen had a higher prevalence (5.2%, 154 of 2,955) than farmers (1.8%, 12 of 661; P < 0.001) and urban populations (2.1%, 49 of 2,360; P < 0.001). Age in all populations, number of dogs kept, fox skin ownership in farmers, not preventing flies from landing on food in herdsmen, using open streams as drinking water sources, and playing with dogs in urban populations were statistically significant risk factors. The results suggest that AE is highly endemic in the eastern Tibetan plateau, in Sichuan Province, the role of the dog is important for human infection, and other factors associated with environmental contamination may vary according to structure and practices of communities.
HIVCORPS: USING VOLUNTEERS TO RAPIDLY EXPAND HIV HEALTH SERVICES ACROSS ZAMBIA
Authors: CHI BENJAMIN H. , FUSCO HARMONY , GOMA FASTONE M. , ZULU ISAAC , SIMMERS ERIN , STRINGER JEFFREY S. A.
Published: September 2018

In 2004, we created HIVCorps, an international volunteer program to involve pre-medical, medical, and public health students in the scale-up of HIV care and prevention services in Zambia. In our first year, we used 27 American and Zambian volunteers to assist with the administrative and logistical aspects of program implementation. Ten volunteers were based in the capital Lusaka; the remaining 17 were stationed across five rural districts. Supervision was provided by local health care providers, district officials, and hospital administrators. In our setting, the use of volunteers has proven feasible and effective for program support. Depending on a program’s immediate needs, use of many basic field personnel may be more beneficial than employment of one to two trained clinicians. Formal volunteer programs like HIVCorps should be developed alongside initiatives focused on deploying more specialized, experienced healthcare workers aboard.
RISK FACTORS FOR HTLV-II INFECTION IN PERUVIAN MEN WHO HAVE SEX WITH MEN
Authors: ZUNT JOSEPH R. , LA ROSA ALBERTO M. , PEINADO JESÚS , LAMA JAVIER R. , SUAREZ LUIS , PUN MONICA , CABEZAS CESAR , SANCHEZ JORGE
Published: September 2018

Human T-cell lymphotropic virus type-II (HTLV-II) infection is endemic in indigenous groups in the Americas and injection drug users (IDUs) worldwide. In Peru, HTLV-II infection was previously identified in two indigenous Amazonians. We examined risk factors for HTLV-II infection in 2,703 Peruvian men who have sex with men (MSM): 35 (1.3%) were HTLV-II positive. HTLV-II infection was associated with syphilis, HSV-2 infection, unprotected receptive anal intercourse, and older age. This is the first report of HTLV-II in a non-indigenous non-IDU population in Peru. Additional studies are needed to determine if HTLV-II is a sexually transmitted infection in this and other sexually active populations.
SEROEPIDEMIOLOGY OF STRONGYLOIDIASIS IN THE PERUVIAN AMAZON
Authors: YORI PABLO P. , KOSEK MARGARET , GILMAN ROBERT H. , CORDOVA JULIANNA , BERN CARYN , CHAVEZ CESAR BANDA , OLORTEGUI MARIBEL PAREDES , MONTALVAN CARMEN , SANCHEZ GRACIELA MEZA , WORTHEN BEVELLE , WORTHEN JAMES , LEUNG FAY , ORÉ CARLOS VIDAL
Published: September 2018

A stool and serosurvey for Strongyloides stercoralis was conducted in a community in the Peruvian Amazon region. Strongyloidiasis stercoralis was identified in the stool of 69 (8.7%) of 792 participants. Six hundred nine sera were tested using by an enzyme-linked immunosorbent assay (ELISA), which had a sensitivity of 92% and a specificity of 94%; 442 (72%) were positive. In multivariable logistic regression models, having S. stercoralis in stool was associated with hookworm in the same specimen (odds ratio [OR] = 4.44, 95% confidence interval [CI] = 2.02–9.79), occasionally or never wearing shoes (OR = 1.89, 95% CI = 1.10–3.27), and increasing age (OR = 1.012 for each one-year increase, 95% CI = 1.00–1.03). Similarly, occasionally or never wearing shoes (OR = 1.54, 95% CI = 1.01–2.37) and increasing age (OR = 1.04 for each one-year increase, 95% CI = 1.02–1.06) were associated with an increased risk of a positive S. stercoralis ELISA result. The ELISA had a negative predictive value of 98% and is an excellent screening test for strongyloidiasis.
CATACAMAS VIRUS, A HANTAVIRAL SPECIES NATURALLY ASSOCIATED WITH ORYZOMYS COUESI (COUES’ ORYZOMYS) IN HONDURAS
Authors: MILAZZO MARY L. , CAJIMAT MARIA N. B. , HANSON J. DELTON , BRADLEY ROBERT D. , QUINTANA MIGUEL , SHERMAN CATALINA , VELÁSQUEZ REINA T. , FULHORST CHARLES F.
Published: September 2018

The primary objective of this study was to extend our knowledge of the geographical distribution, genetic diversity, and natural host associations of the hantaviruses indigenous to North America. Antibody to a hantavirus was found in 5 (20.8%) of 24 Coues’ oryzomys (Oryzomys couesi) and none of 41 other rodents captured near the town of Catacamas in eastern Honduras, and a hantavirus was isolated from one of the antibody-positive Coues’ oryzomys. Analyses of nucleotide and amino acid sequence data indicated that the viral isolate is a strain of a novel hantaviral species (proposed species name “Catacamas virus”) that is phylogenetically most closely related to Bayou virus, a hantaviral species that is principally associated with Oryzomys palustris (marsh oryzomys) in the southeastern United States. Catacamas virus is the first evidence for the occurrence of a hantaviral species in Honduras and the first evidence that a hantaviral species is naturally associated with an Oryzomys species other than O. palustris.
TUBERCULOSIS MORTALITY, DRUG RESISTANCE, AND INFECTIOUSNESS IN PATIENTS WITH AND WITHOUT HIV INFECTION IN PERU
Authors: KAWAI VIVIAN , SOTO GISELLE , GILMAN ROBERT H. , BAUTISTA CHRISTIAN T. , CAVIEDES LUZ , HUAROTO LUZ , TICONA EDUARDO , ORTIZ JAIME , TOVAR MARCO , CHAVEZ VICTOR , RODRIGUEZ RICHARD , ESCOMBE A. RODERICK , EVANS CARLTON A.
Published: September 2018

The effects of HIV co-infection and multi-drug resistant tuberculosis (MDRTB) on tuberculosis prognosis are poorly defined. Therefore, we studied infectiousness and mortality of 287 tuberculosis patients treated with standard, directly observed, short-course therapy in the Peruvian community. During 6–17 months of treatment, 49 (18%) of patients died, of whom 48 (98%) had AIDS and 28 (57%) had MDRTB; 17/31 (55%) of MDRTB-patients with AIDS died within 2 months of diagnosis, before traditional susceptibility testing would have identified their MDRTB. Most non-MDRTB became smear- and culture-negative within 6 weeks of therapy, whereas most MDRTB remained sputum-culture-positive until death or treatment completion. HIV-negative patients with non-MDRTB had good outcomes. However, MDRTB was associated with prolonged infectiousness and HIV co-infection with early mortality, indicating a need for greater access to anti-retroviral therapy. Furthermore, early and rapid tuberculosis drug-susceptibility testing and infection control are required so that MDRTB can be appropriately treated early enough to reduce mortality and transmission.
SPATIAL AND TEMPORAL VARIATIONS IN LOCAL TRANSMISSION OF SCHISTOSOMA HAEMATOBIUM IN MSAMBWENI, KENYA
Authors: CLENNON JULIE A. , MUNGAI PETER L. , MUCHIRI ERIC M. , KING CHARLES H. , KITRON URIEL
Published: September 2018

As part of an extensive study of the eco-epidemiology of urinary schistosomiasis along the southern coast of Kenya, spatial and temporal transmission patterns were associated with various ponds infested with Bulinus snails. The household-level spatial pattern of infection for children of various age groups in 2000 was contrasted with historical data from 1984. Significant local clustering of high and low infection levels among school age children was detected, and the spatial extent of clusters and their direction from specific water sources were measured. High infection levels were clustered around ponds known to contain Bulinus nasutus snails that shed Schistosoma haematobium cercariae, and low infection levels were concentrated near a river where intermediate host snails were rarely found. The spatial patterns of infection varied between 2000 and 1984 and between age groups. High levels of infection were clustered around different transmission foci in the two study periods, and, for younger children in 2000, were clustered nearer to the transmission foci than for the older children. Simultaneous consideration of the effects of different foci on transmission will allow for targeted application of control measures aimed at interrupting S. haematobium transmission at a local level.
RELAPSE OF NEW WORLD DIFFUSE CUTANEOUS LEISHMANIASIS CAUSED BY LEISHMANIA (LEISHMANIA) MEXICANA AFTER MILTEFOSINE TREATMENT
Authors: CALVOPINA MANUEL , GOMEZ EDUARDO A. , SINDERMANN HERBERT , COOPER PHILIP J. , HASHIGUCHI YOSHIHISA
Published: September 2018

A 35-year-old man with a 19-year history of slowly evolving diffuse cutaneous leishmaniasis was treated with oral miltefosine, 50 mg three times a day. The patient responded after four months of miltefosine treatment with clearance of all nodular lesions and plaques from the entire body surface and had negative slit-skin smears and cultures for Leishmania. However, two months after stopping miltefosine, skin lesions reappeared and parasites were observed in samples. The relapsed lesions did not respond to an additional two-month course of miltefosine. No laboratory or clinical adverse events to miltefosine were observed. Parasites from skin lesions were cultured and identified as Leishmania (Leishmania) mexicana by isoenzyme electrophoresis.
REINFECTION AND RELAPSE IN EARLY LYME DISEASE
Authors: KRAUSE PETER J. , FOLEY DANIEL T. , BURKE GEORGINE S. , CHRISTIANSON DIANE , CLOSTER LINDA , SPIELMAN ANDREW , _ _
Published: September 2018

To determine whether recurrent episodes of appropriately treated Lyme disease are caused by reinfection or relapse, we monitored pertinent clinical manifestations and serology of residents of an endemic site each year for 14 years. Of 253 episodes of early Lyme disease recorded among 213 residents, we observed 40 recurrent episodes. Virtually all included an erythema migrans (EM) rash that appeared at body sites that differed from those of the initial rash, no subjects produced detectable levels of specific antibody between sequential episodes, all episodes occurred a year or more after the initial EM episode, and all occurred during late spring and early summer. People experiencing recurrent episodes tended to have frequent contact with vector ticks. Prompt administration of standard antibiotic therapy for early Lyme disease reliably eliminates persistent infection and prevents relapse.
DIFFERENT FECAL SHEDDING PATTERNS OF TWO COMMON STRAINS OF HEPATITIS E VIRUS AT THREE JAPANESE SWINE FARMS
Authors: NAKAI IZUMI , KATO KANAKO , MIYAZAKI AYAKO , YOSHII MASAAKI , LI TIAN-CHENG , TAKEDA NAOKAZU , TSUNEMITSU HIROSHI , IKEDA HIDETOSHI
Published: September 2018

Zoonotic infections caused by eating the meat of deer, wild boar, and pig have been suggested in Japan, a country that is not epidemic for hepatitis E caused by hepatitis E virus (HEV). This virus is widely spread in domestic pigs in both epidemic and non-epidemic countries. We studied fecal HEV shedding patterns on three Japanese farms that had two common genotype III HEV strains. Two of the three farms had high shedding peaks (75% and 100%) in pigs 1–3 months of age, suggesting that these animals had the highest risk of spreading HEV through feces. Another farm had a low shedding rate in animals six months of age and a low prevalence of the IgG antibody to HEV. Fecal IgA antibody to HEV was found in sucking pigs < 13 days of age on farms that had high and low shedding patterns. A small fraction of pigs (3 of 43 [7%]) at the finishing stage (5–6 months of age) still shed HEV on the three farms.
MYOCARDITIS IN WEST NILE VIRUS INFECTION
Authors: PERGAM STEVEN A. , DELONG CHRISTINE E. , ECHEVARRIA LEONOR , SCULLY GAIL , GOADE DIANE E.
Published: September 2018

West Nile virus (WNV) myocarditis has been documented pathologically in birds and mammals but has rarely been reported in human clinical syndromes. We describe myocarditis associated with WNV.
EFFICACY AND SAFETY OF β-ARTEETHER AND α/β-ARTEETHER FOR TREATMENT OF ACUTE PLASMODIUM FALCIPARUM MALARIA
Authors: PAREEK ANIL , NANDY AMITABHA , KOCHAR DHANPAT , PATEL K. H. , MISHRA S. K. , MATHUR P. C.
Published: September 2018

One hundred thirty-eight adult patients with acute Plasmodium falciparum malaria were randomized to receive either β-arteether or α/β-arteether. The drugs were administered in the dose of 150 mg once a day intramuscularly for three consecutive days in hospitalized patients. After one week of hospitalization, patients were followed-up for three weeks after release from the hospital. There was no statistically significant difference between cure rates, mean fever clearance time (FCT), mean parasite clearance time (PCT), and occurrence of side effects in either group. The cure rate was 97.14% for β-arteether and 97.01 for α/β-arteether (P = 0.9660). The mean PCT was 38.49 hours for β-arteether and 36.90 hours for α/β-arteether (P = 0.6054), and the mean FCT was 37.27 hours for β-arteether and 37.9 hours for α/β-arteether (P = 0.8718). Both arteether formulations were safe and efficacious in reducing the clinical symptoms of acute falciparum malaria. There was also rapid clearance of parasitemia with both formulations. Thus, either β-arteether or α/β-arteether can be used in the treatment of acute falciparum malaria.
PARASITIC CO-INFECTIONS: DOES ASCARIS LUMBRICOIDES PROTECT AGAINST PLASMODIUM FALCIPARUM INFECTION?
Authors: BRUTUS LAURENT , WATIER LAURENCE , BRIAND VALÉRIE , HANITRASOAMAMPIONONA VIRGINIE , RAZANATSOARILALA HÉLÈNE , COT MICHEL
Published: September 2018

A controlled randomized trial of antihelminthic treatment was undertaken in 1996–1997 in a rural area of Madagascar where populations were simultaneously infected with Ascaris lumbricoides and Plasmodium falciparum. Levamisole was administered bimonthly to 164 subjects, randomized on a family basis, whereas 186 were controls. While levamisole proved to be highly effective in reducing Ascaris egg loads in the treated group (P < 10−3 at all bimonthly visits), subjects more than 5 years of age, treated with levamisole had a significant increase in their P. falciparum densities compared with controls (P = 0.02), whereas there was no effect of anti-helminthic treatment on children 6 months to 4 years of age. The demonstration of a clear negative interaction between Ascaris infection and malaria parasite density has important implications. Single community therapy programs to deliver treatments against several parasitic infections could avoid an increase of malaria attacks after mass treatment of ascariasis.
PLANT-BORNE HUMAN CONTAMINATION BY FASCIOLIASIS
Authors: ASHRAFI KEYHAN , VALERO MARIA ADELA , MASSOUD JAFAR , SOBHANI ABDOLRASOUL , SOLAYMANI-MOHAMMADI SHAHRAM , CONDE PATRICIA , KHOUBBANE MESSAUD , BARGUES MARIA DOLORES , MAS-COMA SANTIAGO
Published: September 2018

Contamination by fasciolids takes place through ingestion of metacercariae attached to vegetables. Experimental studies were performed with plant-made foods suggesting a role in human contamination in Iran and on the usefulness of potassium permanganate as a preventive tool for killing metacercariae attached to vegetables used in salads in Egypt. In the foods assayed, although viability decreases with time, a high percentage of the metacercariae were still alive 2 and 4 weeks after preparation. Infection of laboratory animals proved that metacercariae kept their infectivity. The 5-minute tests of potassium permanganate effects showed that metacercarial viability was not affected even at the very high doses of 300, 600, and 1,200 mg/L. Careful, subsequent washing of leaves and vegetables with water is therefore needed after its application. A review on similar studies performed with metacercariae belonging to fasciolid and other trematode species affecting humans is included.
IS THE HUMAN-INFECTING DIPHYLLOBOTHRIUM PACIFICUM A VALID SPECIES OR JUST A SOUTH AMERICAN POPULATION OF THE HOLARCTIC FISH BROAD TAPEWORM, D. LATUM?
Authors: ŠKEŘÍKOVÁ ANDREA , BRABEC JAN , KUCHTA ROMAN , JIMÉNEZ JUAN A. , GARCÍA HECTOR H. , SCHOLZ TOMÁŠ
Published: September 2018

Using ITS2 gene sequences, the validity of the tapeworm Diphyllobothrium pacificum (Nybelin, 1931), infecting humans on the Pacific coast of South America and in Japan, was assessed. ITS2 sequences of this cestode differed markedly (sequence similarity 79.0–80.2%) from those of the most common human-infecting cestode, the broad fish tapeworm Diphyllobothrium latum (L.), as well as other four species of Diphyllobothrium, including potential human parasites (D. cordatum, D. dendriticum, and D. lanceolatum) and two species of Spirometra (sequence similarity 77.5–81.9%). Interspecific sequence similarity between all but one (D. pacificum) species was 86.1–99.6%, whereas individual isolates of D. dendriticum and D. ditremum exhibited intraspecific sequence similarity of 97.0–98.0% and 98.2–99.9%, respectively. Phylogenetic trees constructed from ITS2 sequences show a markedly distant position of D. pacificum from other species analyzed and also indicate the possible paraphyly of Spirometra.
EFFECTS OF IMMUNOSUPPRESSION ON WEST NILE VIRUS INFECTION IN HAMSTERS
Authors: MATEO ROSA , XIAO SHU-YUAN , GUZMAN HILDA , LEI HAO , DA ROSA AMELIA P. A. TRAVASSOS , TESH ROBERT B.
Published: September 2018

A research study, comparing the pathogenesis of experimental West Nile virus (WNV) infection in immunocompetent and immunosuppressed golden hamsters, is described. Cyclophosphamide was used to immunosuppress the animals. The immunosuppressed hamsters had a prolonged period of viremia, depressed humoral immune response, more extensive and severe pathology, and higher fatality rate than the untreated immunocompetent animals. Histopathological and immunohistochemical studies of tissues from the two groups showed that pathologic changes in the untreated infected animals were confined to the brain and spinal cord, whereas the histopathological changes and WNV antigen distribution in the immunosuppressed animals were much more extensive and diffuse, involving the adrenal, kidney, heart and lung, and brain and spinal cord. Results of this study in the hamster model provide insight into the increased severity of WNV infection observed in immunosuppressed people.
THROMBOCYTOPENIA IN FALCIPARUM MALARIA IS ASSOCIATED WITH HIGH CONCENTRATIONS OF IL-10
Authors: CASALS-PASCUAL CLIMENT , KAI OSCAR , NEWTON CHARLES R. J. C. , PESHU NORBERT , ROBERTS DAVID J.
Published: September 2018

Over the last decade, a number of observations have suggested that platelets may play a role in the pathophysiology of severe malaria. However, somewhat paradoxically, thrombocytopenia is not associated clearly with outcome. We studied the relationship between thrombocytopenia and cytokines in Kenyan children with severe malaria and showed that thrombocytopenia (platelet count < 150 × 109/L) strongly correlates with high levels of interleukin (IL)-10. Several studies have shown that high levels of IL-10 are associated with a favorable outcome in severe malaria. Taken together, these data suggest why thrombocytopenia has a complex relationship with severe disease and suggest one mechanism whereby IL-10 may modify the outcome of severe disease.
PREVIOUS INFECTION WITH WEST NILE OR ST. LOUIS ENCEPHALITIS VIRUSES PROVIDES CROSS PROTECTION DURING REINFECTION IN HOUSE FINCHES
Authors: FANG YING , REISEN WILLIAM K.
Published: September 2018

House finches are competent hosts for both West Nile and St. Louis encephalitis viruses and frequently become infected during outbreaks. In the current study, House finches were infected initially with either West Nile or St. Louis encephalitis viruses and then challenged 6 weeks post infection with either homologous or heterologous viruses. Although mortality rates were high during initial infection with West Nile virus, prior infection with either virus prevented mortality upon challenge with West Nile virus. Prior infection with West Nile virus provided sterilizing immunity against both viruses, whereas prior infection with St. Louis encephalitis virus prevented viremia from St. Louis encephalitis virus, but only reduced West Nile virus viremia titers. Immunologic responses were measured by enzyme immunoassay and plaque reduction neutralization tests. Heterologous challenge with West Nile virus in birds previously infected with St. Louis encephalitis virus produced the greatest immunologic response, markedly boosting antibody levels against St. Louis encephalitis virus. Our data have broad implications for free-ranging avian serological diagnostics and possibly for the recent disappearance of St. Louis encephalitis virus from California.
ENTEROPATHOGENIC ESCHERICHIA COLI O157 IN BANGUI AND N’GOILA, CENTRAL AFRICAN REPUBLIC: A BRIEF REPORT
Authors: TUYET DINH THI N. , YASSIBANDA SIMON , NGUYEN THI PHUONG L. , KOYENEDE MARCEL R. , GOUALI MALIKA , BÉKONDI CLAUDINE , MAZZI JEAN , GERMANI YVES
Published: September 2018

Escherichia coli O157:H7 producing Shiga like toxins is a food-borne pathogen frequently isolated in Bangui from patients with hemorrhagic colitis (HC). This survey provides comprehensive data on the high prevalence of E. coli O157:H7 infection in Bangui: carriage of E. coli O157:H7 by zebu (Bos indicus) and fish, contamination of the fields at N’Goila where the butchers kill the zebus, and contamination of the field surface water along the M’Poko River upstream of the Oubangui River where fish are caught, appear to be important contributory factors. We also describe novel strains of serogroup O157:NM isolated from zebu and from fish; a variety of assays indicate that these strains belong to the enteropathogenic pathotype, though they lack certain genetic elements thought to be diagnostic for this pathotype.
A GROWING DEGREE-DAYS BASED TIME-SERIES ANALYSIS FOR PREDICTION OF SCHISTOSOMA JAPONICUM TRANSMISSION IN JIANGSU PROVINCE, CHINA
Authors: YANG GUO-JING , GEMPERLI ARMIN , VOUNATSOU PENELOPE , TANNER MARCEL , ZHOU XIAO-NONG , UTZINGER JÜRG
Published: September 2018

It has been suggested that global warming may alter the frequency and transmission dynamics of vector-borne diseases. To test this claim for schistosomiasis, we conducted a time-series analysis from 1972–2002 for 39 of the 70 counties of Jiangsu province, eastern China, where Schistosoma japonicum is partially endemic. We used a modeling approach to estimate the annual growing degree-days (AGDD), employing a lower temperature threshold of 15.3°C. Our final model included both temporal and spatial components, the former consisting of second order polynomials in time plus a seasonality component, whereas the spatial trend was formed by second order polynomials of the coordinates plus the thin-plate smoothing splines. We found that temperature increased over the past 30 years in all observing stations. There were distinct temporal trends with seasonality and periodicities of 12, 6, and 3 months, whereas only marginal spatial variation was observed. The predicted AGDDs for 2006 and 2003 showed increases for the entire Jiangsu province, with the AGDDs difference between these two time points exhibiting an increase from north to south. Our data suggest that changes in temperature will alter the extent and level of schistosomiasis transmission, which is relevant for the control of S. japonicum in a future warmer China.
IMMUNE CORRELATES OF ACUTE MYCOBACTERIUM TUBERCULOSIS INFECTION IN HOUSEHOLD CONTACTS IN KAMPALA, UGANDA
Authors: WHALEN CHRISTOPHER C. , CHIUNDA ALLAN , ZALWANGO SARAH , NSHUTI LORNA , JONES-LOPEZ EDWARD , OKWERA ALPHONSE , HIRSCH CHRISTINA , PETERS PIERRE , BOOM W. HENRY , MUGERWA ROY D.
Published: September 2018

To determine immunologic and epidemiologic correlates of acute Mycobacterium tuberculosis infection in household contacts of infectious tuberculosis cases, we performed a prospective, community-based cohort study of index cases and their household contacts in Kampala, Uganda. Contacts were evaluated for tuberculin skin test (TST) conversion over two years. Interferon-γ expression was measured using a whole blood assay after stimulating with M. tuberculosis culture-filtrate. In 222 contacts with a TST less than 5 mm at baseline, the one-year rate of TST conversion was 27%. The TST conversion was associated with the infectiousness of the index case and proximity of contact. Interferon-γ levels at baseline were greater among TST converters compared with those who did not convert. The risk of TST conversion increased four-fold as the baseline interferon-γ increased 10-fold, but only in contacts with BCG vaccination. In household contacts of tuberculosis, interferon-γ responses to non-specific mycobacterial antigens may be used to make an early diagnosis of tuberculosis infection, especially in resource-limited settings where bacille Calmette-Guérin vaccination is commonly used.
USE OF AREA UNDER THE CURVE TO CHARACTERIZE TRANSMISSION POTENTIAL AFTER ANTIMALARIAL TREATMENT
Authors: MÉNDEZ FABIÁN , MUÑOZ ÁLVARO , PLOWE CHRISTOPHER V.
Published: September 2018

To evaluate transmission potential of Plasmodium falciparum, we use the area under the curve (AUC) of gametocyte levels after treatment as an approach to combine their duration and magnitude. Analysis of determinants of AUC was based on two main exposures: parasite clearance time (PCT) and presence of dihydrofolate reductase and dihydropteroate synthase mutations associated with sulfadoxine-pyrimethamine (SP) resistance in vitro. Exposures were determined based on the first three days after treatment with SP of 96 individuals who had malaria, cleared parasitemia by days 1–3, and were followed-up for 21 days. Using regression methods, we characterized both the heterogeneity of the presence of gametocytes (AUC > 0) and the magnitude of the AUC among those with an AUC > 0. A PCT of two or three days was associated with a substantial and highly significant odds ratio for presence of gametocytes. Among those who developed gametocytes, if their clearance time was 3 days or if they had any mutations (1 or 2) the magnitude of gametocytemia was ≥ 3-fold. Methods presented are applicable to both observational studies and clinical trials assessing the effect of therapies on transmission potential.
DISRUPTION OF THE SALIVARY PROTEIN 14 IN IXODES SCAPULARIS NYMPHS AND IMPACT ON PATHOGEN ACQUISITION
Authors: PEDRA JOAO H. F. , NARASIMHAN SUKANYA , DEPONTE KATHLEEN , MARCANTONIO NANCY , KANTOR FRED S. , FIKRIG EROL
Published: September 2018

We previously examined the physiological role of the anticoagulant salivary protein 14 (salp14) in adult Ixodes scapularis and showed that Salp14 played a role in tick feeding and engorgement. We now analyze whether the disruption of the salp14 family expression by RNA interference affects tick weight in naïve nymph I. scapularis. Salp14 expression after dsRNA injection was significantly reduced, as shown by mRNA and protein analysis. However, nymph engorgement weight was not altered in salp9pac (salp14 paralog) dsRNA-injected ticks. We also determined Borrelia burgdorferi and Anaplasma phagocytophilum acquisition in I. scapularis nymphs that had reduced Salp14 expression. B. burgdorferi and A. phagocytophilum acquisition was not affected 72 hours after feeding. Our results suggest that different mechanisms govern nymph and adult feeding in I. scapularis.
WEST NILE VIRUS INFECTION OF PRIMARY MOUSE NEURONAL AND NEUROGLIAL CELLS: THE ROLE OF ASTROCYTES IN CHRONIC INFECTION
Authors: DINIZ JOSE A. P. , DA ROSA AMELIA P. A. TRAVASSOS , GUZMAN HILDA , XU FANGLING , XIAO SHU-YUAN , POPOV VSEVOLOD L. , VASCONCELOS PEDRO F. C. , TESH ROBERT B.
Published: September 2018

Primary cultures of embryonic murine neurons and newborn mouse astrocytes were inoculated with West Nile virus (WNV) strain NY385-99 to compare the pathogenesis of WNV infection in these types of CNS cells. Two different outcomes were observed. WNV infection in the neurons was rapidly progressive and destructive; within 5 days, all of the neurons were destroyed through apoptosis. WNV infection in the astrocytes evolved more slowly and did not seem to be highly lethal to the cells. The infected astrocytes continued to produce infectious virus (104.6–106.5 PFU/mL) for 114 days, in a permissive, persistent infection. During this period, WNV antigen could be shown in the cytoplasm of the infected astrocytes by immunocytochemical assay, transmission electron microscopy of ultrathin sections, and in the cell culture medium by complement fixation test. Our results with this in vitro experimental murine cell model indicate that astrocytes can develop chronic or persistent infection with WNV, suggesting that these cells may play a role in the maintenance of WNV in the CNS.
VALIDATION OF MICROSATELLITE MARKERS FOR USE IN GENOTYPING POLYCLONAL PLASMODIUM FALCIPARUM INFECTIONS
Authors: GREENHOUSE BRYAN , MYRICK ALISSA , DOKOMAJILAR CHRISTIAN , WOO JONATHAN M. , CARLSON ELAINE J. , ROSENTHAL PHILIP J. , DORSEY GRANT
Published: September 2018

Genotyping methods for Plasmodium falciparum drug efficacy trials have not been standardized and may fail to accurately distinguish recrudescence from new infection, especially in high transmission areas where polyclonal infections are common. We developed a simple method for genotyping using previously identified microsatellites and capillary electrophoresis, validated this method using mixtures of laboratory clones, and applied the method to field samples. Two microsatellite markers produced accurate results for single-clone but not polyclonal samples. Four other microsatellite markers were as sensitive as, and more specific than, commonly used genotyping techniques based on merozoite surface proteins 1 and 2. When applied to samples from 15 patients in Burkina Faso with recurrent parasitemia after treatment with sulphadoxine-pyrimethamine, the addition of these four microsatellite markers to msp1 and msp2 genotyping resulted in a reclassification of outcomes that strengthened the association between dhfr 59R, an anti-folate resistance mutation, and recrudescence (P = 0.31 versus P = 0.03). Four microsatellite markers performed well on polyclonal samples and may provide a valuable addition to genotyping for clinical drug efficacy studies in high transmission areas.
HUMAN TRYPANOSOMIASIS CAUSED BY TRYPANOSOMA EVANSI IN A VILLAGE IN INDIA: PRELIMINARY SEROLOGIC SURVEY OF THE LOCAL POPULATION
Authors: SHEGOKAR VIJAY R. , POWAR RAJARAM M. , JOSHI PRASHANT P. , BHARGAVA ARADHANA , DANI VIBHAWARI S. , KATTI RAVINDRA , ZARE VASANT R. , KHANANDE VITHHALRAO D. , JANNIN JEAN , TRUC PHILIPPE
Published: September 2018

After discovery of the first recorded case of human infection with Trypanosoma evansi, serologic screening of 1,806 persons from the village of origin of the patient in India was performed using the card agglutination test for trypanosomiasis and T. evansi. A total of 410 (22.7%) people were positive by whole blood, but only 81 were confirmed positive by serum. However, no trypanosomes were detected in the blood of 60 people who were positive at a high serum dilution. The results probably indicate frequent exposure of the human population to T. evansi in the study area, which suggests frequent vector transmission of parasites to humans. Although T. evansi is not infective for humans, a follow-up of seropositive persons is required to observe the evolution of human infection with this parasite.
EVIDENCE AND POTENTIAL FOR TRANSMISSION OF HUMAN AND SWINE TAENIA SOLIUM CYSTICERCOSIS IN THE PIRACURUCA REGION, PIAUÍ, BRAZIL
Authors: SATO MARCELLO OTAKE , CAVALCANTE TÂNIA VASCONCELOS , SAKO YASUHITO , NAKAO MINORU , YAMASAKI HIROSHI , YATSUDA ANA PATRÍCIA , NAKAYA KAZUHIRO , ITO AKIRA
Published: September 2018

The study conducted in the Cocal dos Alves municipality, located in the Piracuruca region of Piauí State, Brazil in November of 2003 was based on both a socio-behavioral survey and analysis of serum antibodies and parasitic materials. Pig raising is the main economic activity with 91.4% using extensive farming. On the studied population, 54.3% of people did not apply any sanitary measures to wastewater, 45.7% used septic tanks, and 69.1% consumed water without treatment. The data collected indicated the occurrence and active transmission of the taeniasis-cysticercosis complex in the region. One of seven voluntary persons was positive in antibody-ELISA tests using both native and recombinant antigens. Multiplex PCR and DNA sequencing of cyst samples obtained from a pig revealed the presence of the Afro-American genotype of Taenia solium. This study revealed the occurrence of human and porcine cysticercosis in the Piracuruca region of Piauí State, middle-north of Brazil.