bluuebunny/crossref_metadata_2025 huggingface dataset:
PREPARATION OF RECOMBINANT ANTIGEN OF O. TSUTSUGAMUSHI PTAN STRAIN AND DEVELOPMENT OF RAPID DIAGNOSTIC REAGENT FOR SCRUB TYPHUS
Authors: CAO MIN , GUO HENGBIN , TANG TANG , WANG CHANGJUN , LI XIANFU , PAN XIUZHEN , JIN ZHU , TANG JIAQI
Published: September 2018

Spring scrub typhus has frequently occurred in Pingtan Island, China, since 2000. In this study, we amplified a 1352-bp DNA fragment encoding a truncated 56-kDa outer membrane protein of the Ptan strain, which was isolated from a serum sample of a patient with spring scrub typhus, and cloned it into the pET28a vector for expression. The expression product was a recombinant polypeptide containing a His-tag to facilitate purification on a Ni2+ chromatography column. The recombinant protein was further identified by Western blotting and enzyme-linked immunosorbent assay (ELISA) and appeared to be a good diagnostic antigen candidate. A rapid colloidal gold immunochromatographic assay (CIA) for detecting serum total antibodies, IgG and IgM, which are anti-Orientia tsutsugamushi, was developed, using a mixture of the r56 of the Gilliam and Ptan strains as the diagnostic antigen. CIA performance was tested on a panel of 112 control sera from confirmed cases of scrub typhus. The detection sensitivities of CIA against anti-O. tsutsugamushi total antibodies, IgM, and IgG were 98.2%, 81.2%, and 94.6%, respectively, while that of IFA (using the lysate of the O. tsutsugamushi Gilliam-infected chicken yolk sac as the antigen) against IgG was 85.7%. One hundred five serum samples from healthy individuals and patients with other febrile diseases were tested with CIA as negative controls. Specificities of CIA against anti-O. tsutsugamushi total antibodies, IgM, and IgG were 98.1%, 100%, and 98.9%, respectively, while the specificity of IFA against IgG was 98.9%. These results indicated that CIA was a good assay and could substitute for conventional immunofluorescence assays for diagnosis of scrub typhus.
UNUSUAL PATTERN OF PLASMODIUM FALCIPARUM DRUG RESISTANCE IN THE NORTHWESTERN PERUVIAN AMAZON REGION
Authors: DURAND SALOMÓN , MARQUIÑO WILMER , CABEZAS CESAR , UTZ GREGORY , FIESTAS VICTOR , CAIRO JAVIER , PURAY MARITZA , LUCAS CARMEN , SALAS CAROLA , GUTIERREZ SONIA , ARROSPIDE NANCY , BACON DAVID J. , RUEBUSH TRENTON K.
Published: September 2018

High levels of Plasmodium falciparum resistance to both chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) have been documented throughout the Amazon Basin of South America. Because of reports about the persistent efficacy of both of these drugs in the northwestern Peruvian Amazon region, we carried out an evaluation of the therapeutic efficacy of chloroquine (25 mg/kg) and SP (25 mg/kg of the sulfadoxine component) for the treatment of uncomplicated P. falciparum infections at two sites: Ullpayacu and Pampa Hermoza/Alianza. A total of 111 patients were enrolled. Only 5 (14.3%) of the 35 patients who received CQ had an adequate clinical and parasitologic response (ACPR). Six subjects (17%) had early treatment failure, 1 (2.9%) had late clinical failure, and 23 (65.7%) had late parasitologic failure (LPF). Of the subjects treated with SP, 92.3% had ACPR and 7.7% had LPF. Based on these findings, it is clear that there are at least limited areas within the Peruvian Amazon region where P. falciparum strains continue to be sensitive to SP.
CHARACTERIZATION OF NATURAL ANTIMONY RESISTANCE IN LEISHMANIA DONOVANI ISOLATES
Authors: MITTAL MUKUL K. , RAI SMITA , ASHUTOSH  , RAVINDER  , GUPTA SUMAN , SUNDAR SHYAM , GOYAL NEENA
Published: September 2018

Clinical resistance to pentavalent antimonial compounds has long been recognized as a major problem in the treatment of visceral leishmaniasis in India. However, mechanisms of natural resistance are unclear. In this study, we observed that Leishmania donovani clinical isolates not responsive to sodium stibogluconate showed resistance to antimony treatment in both in vitro and in vivo laboratory conditions. The resistant isolates have increased levels of intracellular thiols. This increase in thiol levels was not mediated by the amplification of γ-glutamylcysteine synthetase, but was accompanied by amplification of trypanothione reductase and an intracellular ATP-binding cassette transporter gene MRPA. The resistance of parasites to antimony could be reversed by the glutathione biosynthesis-specific inhibitor, buthionine sulfoximine, which resulted in increased drug susceptibility. These results suggest the possible role of thiols and MRPA in antimony resistance in field isolates.
MOLECULAR EVIDENCE OF BABESIA EQUI TRANSMISSION IN HAEMAPHYSALIS LONGICORNIS
Authors: IKADAI HIROMI , SASAKI MIZUKI , ISHIDA HIDEKAZU , MATSUU AYA , IGARASHI IKUO , FUJISAKI KOZO , OYAMADA TAKASHI
Published: September 2018

We studied the tick, Haemaphysalis longicornis, to determine the possibility of both transovarial and transstadial transmission of Babesia equi. We also studied the usefulness of the needle injection method for pathogenic tick-transmitted organisms including Babesia parasites. Erythrocytes infected with B. equi were injected into the midgut of engorged adults or nymphs using a hypodermic needle passed through the integument. DNA of B. equi in ticks was detected using nested polymerase chain reaction (PCR). B. equi DNA was present in adults, eggs, and larvae, indicating that transovarial transmission occurred. B. equi DNA was present in adults that developed from infected nymphs, and the B. equi antigen was present in their salivary glands, indicating that transstadial transmission occurred. These findings suggest that H. longicornis may play a role in the transmission of B. equi.
INDUCTION OF BIVALENT IMMUNE RESPONSES BY EXPRESSION OF DENGUE VIRUS TYPE 1 AND TYPE 2 ANTIGENS FROM A SINGLE COMPLEX ADENOVIRAL VECTOR
Authors: RAJA NICHOLAS U. , HOLMAN DAVID H. , WANG DANHER , RAVIPRAKASH KANAKATTE , JUOMPAN LAURE Y. , DEITZ STEPHEN B. , LUO MIN , ZHANG JIANGHUI , PORTER KEVIN R. , DONG JOHN Y.
Published: September 2018

There are approximately 100 million new cases of dengue (DEN) virus infection each year. Infection can result in illness ranging from a mild fever to hemorrhaging, shock, or even death. There are four serotypes of dengue virus (DEN1–4), and immunity to one serotype does not cross protect from infection with other serotypes. Currently there are no approved vaccines for dengue fever. In this report, we describe the construction of a bivalent dengue virus vaccine using a complex recombinant adenovirus approach to express multiple genes of DEN1 and DEN2 serotypes. In vaccinated mice, this vector induced humoral immune responses against all four dengue serotypes as measured by enzyme-linked immunosorbent assay. However, the neutralizing antibody responses were specific for DEN1 and DEN2 serotypes. Expansion of this vaccine development platform towards the DEN3 and DEN4 serotypes can lead towards the development of an adenovirus-based tetravalent dengue vaccine.
SPECTRUM OF RIFT VALLEY FEVER VIRUS TRANSMISSION IN KENYA: INSIGHTS FROM THREE DISTINCT REGIONS
Authors: LABEAUD A. DESIREE , OCHIAI YOSHITSUGU , PETERS C.J. , MUCHIRI ERIC M. , KING CHARLES H.
Published: September 2018

Rift Valley fever virus (RVFV) is an emerging pathogen that maintains high biodefense priority based on its threat to livestock, its ability to cause human hemorrhagic fever, and its potential for aerosol spread. To define the range of human transmission during inter-epidemic and epidemic periods in Kenya, we tested archived sera from defined populations (N = 1,263) for anti-RVFV IgG by ELISA and plaque reduction neutralization testing. RVFV seroprevalence was 10.8% overall and varied significantly by location, sex, and age. In NW Kenya, high seroprevalence among those born before 1980 indicates that an undetected epidemic may have occurred then. Seroconversion documented in highland areas suggests previously unsuspected inter-epidemic transmission. RVFV seroprevalence is strikingly high in certain Kenyan areas, suggesting endemic transmission patterns that may preclude accurate estimation of regional acute outbreak incidence. The extent of both epidemic and inter-epidemic RVFV transmission in Kenya is greater than previously documented.
KEY DIFFERENTIATING FEATURES BETWEEN SCRUB TYPHUS AND HEMORRHAGIC FEVER WITH RENAL SYNDROME IN NORTHERN CHINA
Authors: LIU YUN-XI , FENG DAN , ZHANG QIAN , JIA NA , ZHAO ZHONG-TANG , DE VLAS SAKE J. , LI JIAN , ZHANG PAN-HE , YANG HONG , MIN JING-SI , FENG PEI-TIAN , MA SHU-BIN , CAO WU-CHUN
Published: September 2018

Both scrub typhus and hemorrhagic fever with renal syndrome (HFRS) are severely epidemic in northern China and often present with acute undifferentiated fever. To correctly distinguish the two diseases at an early stage, we collected and compared clinical and routine laboratory data of 46 patients with confirmed scrub typhus and 49 patients with confirmed HFRS presenting to the outpatient departments of three town hospitals in northern China. Most patients with HFRS but none of the patients with scrub typhus had hemorrhagic manifestations. Retro-orbital pain, lumbar back pain, flank tenderness, proteinuria, and occult blood in urine often occurred in patients with HFRS. However, skin eschar, regional lymphadenopathy, and maculopapular rash were more commonly found in patients with scrub typhus. In addition, platelet counts in patients with HFRS were significantly lower than in patients with scrub typhus. These findings will be useful for physicians to distinguish scrub typhus from HFRS.
DISTRIBUTION OF ESCHARS ON THE BODY OF SCRUB TYPHUS PATIENTS: A PROSPECTIVE STUDY
Authors: KIM DONG-MIN , WON KYUNG JUN , PARK CHI YOUNG , YU KI DONG , KIM HYONG SUN , YANG TAE YOUNG , LEE JI HYUN , KIM HYUN KUK , SONG HYEON-JE , LEE SEUNG-HYUN , SHIN HO
Published: September 2018

Eschar is an important finding for the diagnosis of scrub typhus. The IFA test for possible scrub typhus was performed. The presence or absence of eschar was thoroughly examined. Among the 176 scrub typhus cases confirmed by IFA, 162 (92.0%) cases had eschar; 128 patients (79.5%) had eschars on the front of the body. Eschars were primarily detected in males within 30 cm below the umbilicus (19 patients, 35.8%). Distributions on the lower extremities and the front chest above the umbilicus were 22.6% (12 patients) and 20.8% (11 patients), respectively. A different pattern was seen in females. The most prevalent area was the front chest above the umbilicus, which accounted for 40.7% (44 patients) of all the detected eschars. Our study is the first report of a schematic diagram that shows the differences between the males and females with respect to eschar location in scrub typhus patients.
PRODUCTION OF RECOMBINANT KINESIN-RELATED PROTEIN OF LEISHMANIA DONOVANI AND ITS APPLICATION IN THE SERODIAGNOSIS OF VISCERAL LEISHMANIASIS
Authors: TAKAGI HIDEKAZU , ISLAM MOHAMMAD ZAHIDUL , ITOH MAKOTO , ISLAM ANWAR UL , SAIFUDDIN EKRAM A. R. M. , HUSSAIN SULTANA MONIRA , HASHIGUCHI YOSHIHISA , KIMURA EISAKU
Published: September 2018

To detect IgG antibody in the serodiagnosis of visceral leishmaniasis (VL), a recombinant antigen rK39, which is part of a Leishmania chagasi kinesin-related protein, has been used successfully and showed high sensitivity and specificity. We report production of a recombinant protein rKRP42, which is part of an L. donovani kinesin-related protein and a homolog of rK39, and its application in an enzyme-linked immunosorbent assay (ELISA) for the diagnosis of VL. When rKRP42 and rK39 were compared, amino acid sequence analysis showed 89.3% identity and 98.7% homology, with rKRP42 having 39 more amino acids than rK39. The ELISA using rKRP42 showed a sensitivity of 94.6% (70 positive samples among 74 from VL patients) and a specificity of 99.3% (148 negative samples among 149 samples from Japanese controls), whereas the sensitivity of the commercial rK39 dipstick test was 93.2% (69 positive samples among 74 from patients with VL). The rKRP42 is a promising new antigen in developing immunodiagnostic methods for VL.
DIAGNOSIS OF CUTANEOUS LEISHMANIASIS IN GUATEMALA USING A REAL-TIME POLYMERASE CHAIN REACTION ASSAY AND THE SMARTCYCLER®
Authors: WORTMANN GLENN , HOCHBERG LISA P. , ARANA BYRON A. , RIZZO NIDIA R. , ARANA FLORA , RYAN JEFFREY R.
Published: September 2018

The polymerase chain reaction (PCR) assay has been reported for the diagnosis of cutaneous leishmaniasis (CL). Real-time (RT) PCR offers several advantages over traditional PCR, including faster processing time and decreased risk of contamination. Enhanced portability is another benefit that expands the applicability of the assay. A portable RT-PCR assay was transported from the United States to Guatemala for comparison with traditional diagnostic modalities. With the clinical diagnosis of CL as the gold standard, RT-PCR was positive in 86% (37 of 43) versus 53% (20 of 38) for microscopy and 72% (28 of 39) for culture. Negative RT-PCR samples (6) were also negative by traditional diagnostic methods (although subsequently determined to be positive by a nested kDNA PCR). Sixty-four percent (9 of 14) of cases tested and negative by microscopy and/or culture were positive by RT-PCR. This study demonstrates that a RT-PCR assay can be successfully deployed to offer enhanced sensitivity for the diagnosis of CL.
DIAGNOSTIC POTENTIAL OF A CONSERVED GENOMIC REARRANGEMENT IN THE TRYPANOSOMA BRUCEI GAMBIENSE-SPECIFIC TGSGP LOCUS
Authors: FELU CECILE , PASTURE JULIE , PAYS ETIENNE , PÉREZ-MORGA DAVID
Published: September 2018

We have previously identified TGSGP as a gene specific to the Trypanosoma brucei gambiense subspecies. TGSGP is a truncated VSG-like telomeric gene transcribed by RNA polymerase II. The TGSGP protein localizes to the flagellar pocket, and exhibits features compatible with a role as surface receptor. Here we show that TGSGP is physically linked to a truncation of a gene homologous to yeast AUT1 (APG3), a gene involved in internal vesicular formation. Further analysis indicated that T. b. gambiense is heterozygous for AUT1 (AUT1/aut1), with each allele located on independent chromosome II homologues. In 18 T. b. gambiense isolates from distinct geographical origins and different hosts, this genomic rearrangement was conserved. The size of the intergenic region between TGSGP and truncated aut1 varied among isolates but was similar in isolates of the same geographical area, and this observation may be used in epidemiology to trace the geographical origin of T. b. gambiense isolates.
A HUMAN CASE OF OTOACARIASIS INVOLVING A HISTIOSTOMATID MITE (ACARI: HISTIOSTOMATIDAE)
Authors: AL-ARFAJ AHMED M. , MULLEN GARY R. , RASHAD RAFIAA , ABDEL-HAMEED AHMED , OCONNOR BARRY M. , ALKHALIFE IBRAHIM S. , DUTE ROLAND R.
Published: September 2018

A 31-year-old Saudi man was seen at an ear, nose, and throat clinic at Riyadh, Saudi Arabia, with bilateral itching in the external auditory canal. On otoscopic examination, the skin lining the ear canal was thickened with whitish sheets of sloughed cells and thick discharge. Large numbers of mites of an undescribed species closely related to members of the genus Loxanoetus (Histiostomatidae) were present. The patient underwent successive washings of the ear canal with saline and 70% ethanol at intervals of 2–3 months and was treated with antibiotics. Treatment with Eurax® (crotamiton) ear drops for one week cleared the mite infestation. This represents the first reported case of human otoacariasis involving a histiostomatid mite. Based on the known biology of histiostomatid mites and the associated hosts of Loxanoetus and related genera, there is reason to speculate that the patient acquired the infestation while swimming in a lake or pond where this mite was present.
THE RISK OF MALARIAL INFECTIONS AND DISEASE IN PAPUA NEW GUINEAN CHILDREN
Authors: MICHON PASCAL , COLE-TOBIAN JENNIFER L. , DABOD ELIJAH , SCHOEPFLIN SONJA , IGU JENNIFER , SUSAPU MELINDA , TARONGKA NANDAO , ZIMMERMAN PETER A. , REEDER JOHN C. , BEESON JAMES G. , SCHOFIELD LOUIS , KING CHRISTOPHER L. , MUELLER IVO
Published: September 2018

In a treatment re-infection study of 206 Papua New Guinean school children, we examined risk of reinfection and symptomatic malaria caused by different Plasmodium species. Although children acquired a similar number of polymerase chain reaction–detectable Plasmodium falciparum and P. vivax infections in six months of active follow-up (P. falciparum = 5.00, P. vivax = 5.28), they were 21 times more likely to develop symptomatic P. falciparum malaria (1.17/year) than P. vivax malaria (0.06/year). Children greater than nine years of age had a reduced risk of acquiring P. vivax infections of low-to-moderate (>150/μL) density (adjusted hazard rate [AHR] = 0.65 and 0.42), whereas similar reductions in risk with age of P. falciparum infection was only seen for parasitemias > 5,000/μL (AHR = 0.49) and symptomatic episodes (AHR = 0.51). Infection and symptomatic episodes with P. malariae and P. ovale were rare. By nine years of age, children have thus acquired almost complete clinical immunity to P. vivax characterized by a very tight control of parasite density, whereas the acquisition of immunity to symptomatic P. falciparum malaria remained incomplete. These observations suggest that different mechanisms of immunity may be important for protection from these malaria species.
Flavivirus Serology by Western Blot Analysis
Authors: Oceguera Leopoldo F. , Patiris Peter J. , Chiles Robert E. , Busch Michael P. , Tobler Leslie H. , Hanson Carl V.
Published: September 2018

The spread of West Nile virus (WNV) across the United States into areas with endemic flavivirus activity has complicated serologic surveillance of seasonal virus activity and diagnosis of infected individuals. Here we describe preliminary results from a comparison of serologic assays for flaviviruses: the reference plaque reduction neutralization test (PRNT), enzyme immunoassay (EIA), and a Western blot (WB) in which crude viral lysates were electrophoresed and blotted onto nitrocellulose. Human and chicken sera were tested and compared by each method against WNV and St. Louis encephalitis virus (SLEV). Antibody binding to three viral proteins determined WB interpretation: non-structural protein 1 (NS1), envelope (E), and pre-membrane (prM). WB results for a group of serially collected human plasma samples from WNV seroconverting blood donors were also correlated with transcription mediated amplification (TMA) and polymerase chain reaction (RT-PCR) results. Reactivity with NS1 appeared to be the most useful differentiating marker of WNV and SLEV infection in humans and chickens. Envelope protein was highly cross-reactive and, as indicated by additional results from dengue virus (DENV)-positive human sera, is perhaps useful serologically as a flavivirus group antigen.
New Interventions for Malaria: Mining the Human and Parasite Genomes
Authors: Ntoumi Francine , Kwiatkowski Dominic P. , Diakité Mahamadou , Mutabingwa Theonest K. , Duffy Patrick E.
Published: September 2018

Malaria has been the greatest scourge of humankind for many millennia, and as a consequence has had more impact than any other pathogen in shaping the human genome. The sequencing of the human genome provides a new opportunity to determine the genetic traits that confer resistance to infection or disease. The identification of these traits can reveal immune responses, or host–parasite interactions, which may be useful for designing vaccines or new drugs. Similarly, the parasite genome sequence is being exploited to accelerate the development of new antimalarial interventions, for example by identifying parasite metabolic pathways that may be targeted by drugs. The malaria parasites are well known for their ability to undergo antigenic variation, and in parallel to cause a diverse array of disease syndromes, including the severe syndromes that commonly cause death. Genome-based technologies are being harnessed to relate gene and protein expression levels, or genetic variation, to the parasite forms that are targets of protective immunity. Well-conducted clinical studies are required to relate host or parasite diversity with disease. However, genomics studies of human populations raise important ethical issues, such as the disposition of data related to disease susceptibility or paternity, and the ability of communities to understand the nature of the research.
Methods for Determining Vaccine Efficacy and Effectiveness and the Main Barriers to Developing a Fully Deployable Malaria Vaccine
Authors: Guinovart Caterina , Alonso Pedro L.
Published: September 2018

The past few years have witnessed the appearance of public-private partnerships and a significant increase of resources devoted to the development of malaria vaccines. Lessons have been learned on different approaches to the clinical development plan for a vaccine candidate, including different clinical trial phases and endpoints and methods to conduct them. Improved understanding of mechanisms underlying naturally acquired immunity, definitions of surrogate markers of protection, including improved in vitro assays and animal models, and strengthened capacity in malaria-endemic countries to conduct clinical trials would accelerate the development of malaria vaccines. We are closer to having a first-generation vaccine being registered. The impact of this vaccine and subsequent products will need to be evaluated under program conditions in the context of comprehensive malaria control activities. Deployment of a safe and effective malaria vaccine administered in early childhood could become a major public health tool, particularly in sub-Saharan Africa.
Analysis of the Population Genetic Structure of the Malaria Vector Anopheles sinensis in South Korea Based on Mitochondrial Sequences
Authors: Jung Jongwoo , Jung Yunjung , Min Gi-Sik , Kim Won
Published: September 2018

The population genetics of Anopheles sinensis, a major malaria vector in South Korea, was studied based on the nucleotide sequences of a 238-bp variable region of the mitochondrial control region. Three features of genetic variance were observed. First, the Taebaek and Sobaek mountain ranges may function as genetic barriers between the Northern Group (NG) and the Southern Group (SG). These mountain ranges are associated with the subdivision of the population, and significant and unique population differentiation was observed in the examined area. Second, the genetic cohesiveness observed within each group may have been caused by a recent expansion in the population rather than recurrent gene flow. Third, a marked dissimilarity in the genetic diversity between the two groups may also have resulted from several factors that caused a difference in the effective population sizes.
Advocacy for Malaria Prevention, Control, and Research in the Twenty-First Century
Authors: Bates Nicole , Herrington James
Published: September 2018

Until recent years, public interest and political investment in malaria prevention, control, and research have been stagnant. The global malaria agenda is now experiencing an unprecedented time of public and political will and momentum. At the heart of this favorable period lies a nascent, but increasingly sophisticated, global advocacy effort that has contributed to new and expanded malaria funding, programs, and technology. This paper reviews the elements of malaria’s rise to political and public prominence, tracks the increase in funding and policy commitments to malaria over the past decade, and comments on an evolving policymaking progress, increasing transparency and accountability in program governance, and the impact of philanthropic investments in malaria advocacy. In addition, the principles of sound advocacy are described along with the mechanisms that will underlie sustained pro-political momentum for malaria research, resources, and results.

“Today, we have begun to write the final chapter in the history of malaria. We have raised hopes and expectations of our people—we must not let them down. We cannot afford to let them down.”

—His Excellency Olusegan Obasanjo, President of Nigeria, Abuja Summit 2000
Establishment of a Mass Screening Method of Sand Fly Vectors for Leishmania Infection by Molecular Biological Methods
Authors: Kato Hirotomo , Uezato Hiroshi , Gomez Eduardo A. , Terayama Yoshimi , Calvopiña Manuel , Iwata Hiroyuki , Hashiguchi Yoshihisa
Published: September 2018

Surveillance of the prevalence of Leishmania and its vector, sand fly species, in endemic and surrounding areas is important for prediction of the risk and expansion of leishmaniasis. In this study, a method for the mass screening of sand flies for Leishmania infection was established. This method was applied to 319 field-captured specimens, and 5 positive sand flies were detected. Sand fly species were identified by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) of the18S rRNA gene, and all the positive flies were Lu. hartmanni. Furthermore, cytochrome b (Cyt b) gene sequence analyses identified all the parasites as Endotrypanum species including a probable novel species. Because the method requires minimum effort and can process a large number of samples at once, it will be a powerful tool for studying the epidemiology of leishmaniasis.
Serologic Evidence of West Nile Virus Infections in Wild Birds Captured in Germany
Authors: Linke Sonja , Niedrig Matthias , Kaiser Andreas , Ellerbrok Heinz , Müller Kerstin , Müller Thomas , Conraths Franz Josef , Mühle Ralf-Udo , Schmidt Daniel , Köppen Ulrich , Bairlein Franz , Berthold Peter , Pauli Georg
Published: September 2018

To assess the risk of acquiring a West Nile virus (WNV) infection in Germany, we investigated samples from migrating and from resident birds. Because of their stay in or migration through WNV-endemic regions, these birds are at risk to become infected with WNV. Blood samples from 3,399 birds, representing 87 bird species, were collected in Germany in 2000 and in 2002–2005. Overall, 53 birds belonging to 5 species had WNV-neutralizing antibodies. Fifty-nine birds belonging to 9 species were reactive by WNV immunofluorescence assay, and 8 birds had neutralizing antibodies against Usutu virus. Because of maternal antibody transfer via egg yolk, WNV-antibody titers in white stork nestlings were generally lower than those in adults. Despite a relatively high percentage of stork nestlings with antibodies, no viral genomes were detectable by polymerase chain reaction. In Germany, the prevalence of antibodies to WNV in migrating birds wintering in Africa or southern Europe is comparatively low.
Malaria Burden Among Pregnant Women Living in the Rural District of Boromo, Burkina Faso
Authors: Coulibaly Sheick Oumar , Gies Sabine , D’Alessandro Umberto
Published: September 2018

In two cross-sectional surveys carried out in the rural health district of Boromo, Burkina Faso, malaria infection was evaluated in 295 pregnant women in May 2003 and 288 pregnant women in December 2003. Malaria prevalence, all P. falciparum infection, was higher in December (32.2%) than in May (11.9%) (P < 0.0001). In both surveys primigravidae had a significantly higher risk of infection than multigravidae (P < 0.0001). Such risk decreased significantly and progressively with gestational age, the highest risk being during the first trimester. Women who had not attended the antenatal clinic had also a significantly higher risk of malaria infection. Despite the high antenatal clinic attendance and the use (or misuse) of chloroquine chemoprophylaxis, malaria remains an important problem for pregnant women living in the rural district of Boromo. This requires a major effort by the health authorities to guarantee all pregnant women have access to and use preventive measures.
Bartonella Strains in Small Mammals from Dhaka, Bangladesh, Related to Bartonella in America and Europe
Authors: Bai Ying , Montgomery Susan P. , Sheff Kelly W. , Chowdhury Manjur A. , Breiman Robert F. , Kabeya Hidenori , Kosoy Michael Y.
Published: September 2018

Ecological and bacteriologic observations of small mammals captured in Dhaka, Bangladesh, indicated that Bartonella infections occurred in high prevalence among lesser bandicoot rats (Bandicota bengalensis), black rats (Rattus rattus), and house shrews (Suncus murinus). Sequence analysis of the citrate synthase gene of Bartonella isolates showed that small mammals in Bangladesh harbored a diverse assemblage of strains. Some cultures were genetically related to Bartonella elizabethae, a species identified from a human patient in the United States. Sequences of some other cultures from Bandicota and Rattus rats were identical to sequences of cultures from domestic rats in France, Portugal, and the United States. The finding of Bartonella species in a high proportion of the mammalian samples from Dhaka suggests the need to study whether these agents might be responsible for human cases of febrile illness of unknown etiology in Bangladesh and elsewhere in south Asia.
Two Cases of Plasmodium vivax Malaria with the Clinical Picture Resembling Toxic Shock
Authors: Song Joon Young , Park Cheong Won , Jo You Mee , Kim Jeong Yun , Kim Jeong Hyun , Yoon Hyo Joong , Kim Chi Hoon , Lim Chae Seung , Cheong Hee Jin , Kim Woo Joo
Published: September 2018

Fatal complications of Plasmodium falciparum malaria have been reported. However, complicated P. vivax malaria is rare. We observed two unusual cases of P. vivax malaria who presented with clinical pictures of toxic shock. Both showed disseminated intravascular coagulation with marked thrombocytopenia, oliguric renal failure, and pulmonary edema. Examination of initial blood smears showed a P. vivax parasitemia of 2,352/μL and 12,376/μL, respectively. The patients were treated with hydroxychloroquine and primaquine without an antibacterial agent. These cases emphasize the importance of considering the possibility of P. vivax malarial infection in patients with a clinical picture resembling toxic shock if they have a travel history to malaria-endemic areas.
Use of kDNA-based Polymerase Chain Reaction as a Sensitive and Differentially Diagnostic Method of American Tegumentary Leishmaniasis in Disease-Endemic Areas of Northern Argentina
Authors: Barrio Alejandra , Mora María C. , Ramos Federico , Moreno Sonia , Samson Ruth , Basombrío Miguel A.
Published: September 2018

We evaluated the polymerase chain reaction (PCR) for the diagnosis of endemic American Tegumentary Leishmaniasis in Salta, Argentina. Diverse Leishmania species, coexistence of mycotic and varicose ulcers, and high endemicity T. cruzi, represent diagnostic challenges in the region. We performed a simplified PCR using sensitive, generic primers on samples obtained by a non-invasive method. We tested different culture types and clinical specimens with other microorganisms that induce leishmaniasis-like lesions. The PCR had a sensitivity and specificity of 100%. Forty-five patients with presumptive leishmaniasis were compared to the PCR, smears, and the Montenegro skin test (MST). In the same population, the PCR had an increased sensitivity, detecting 25 of 45 cases compared with 16 of 45 for smears and had a higher sensitivity in detecting mucocutaneous lesions. Diagnosis by PCR was supported by clinical presentation, positive MST results, compatible epidemiology, and in some cases histopathologic results or isolation of parasites by culture. These findings indicate the convenience of incorporating this PCR into diagnostic strategies for detecting leishmaniasis in northern Argentina.
Burden of Malaria in India: Retrospective and Prospective View
Authors: Kumar Ashwani , Valecha Neena , Jain Tanu , Dash Aditya P.
Published: September 2018

In India, nine Anopheline vectors are involved in transmitting malaria in diverse geo-ecological paradigms. About 2 million confirmed malaria cases and 1,000 deaths are reported annually, although 15 million cases and 20,000 deaths are estimated by WHO South East Asia Regional Office. India contributes 77% of the total malaria in Southeast Asia. Multi-organ involvement/dysfunction is reported in both Plasmodium falciparum and P. vivax cases. Most of the malaria burden is borne by economically productive ages. The states inhabited by ethnic tribes are entrenched with stable malaria, particularly P. falciparum with growing drug resistance. The profound impact of complicated malaria in pregnancy includes anemia, abortions, low birth weight in neonates, still births, and maternal mortality. Retrospective analysis of burden of malaria showed that disability adjusted life years lost due to malaria were 1.86 million years. Cost–benefit analysis suggests that each Rupee invested by the National Malaria Control Program pays a rich dividend of 19.7 Rupees.
Severe Myalgia of the Lower Extremities as the First Clinical Feature of Meningococcal Purpura Fulminans
Authors: de Souza Alexandre Leite , Sztajnbok Jaques , Salgado Maristela Marques , Romano Carla C. , Alkmin Maria das Graças Adelino , Duarte Alberto J. S. , Seguro Antonio Carlos
Published: September 2018

In patients with meningococcal infection, devastating presentations, such as purpura fulminans, which can progress to extensive tissue necrosis of the limbs and digits, have a significant social impact. The case presented herein illustrates such a phenomenon in a patient who developed bilateral necrosis of the lower extremities as a result of infection with Neisseria meningitis. We emphasize that severe myalgia was the first clinical manifestation of meningococcal purpura fulminans in our case. However, myalgia has typically been overlooked and undervalued as an early clinical feature of meningococcal sepsis. Early recognition and prompt initial antibiotic therapy continue to be the cornerstones of the successful management of this dramatic disease, reducing morbidity and mortality.
Monitoring of Larval Habitats and Mosquito Densities in the Sudan Savanna of Mali: Implications for Malaria Vector Control
Authors: Sogoba Nafomon , Doumbia Seydou , Vounatsou Penelope , Baber Ibrahima , Keita Moussa , Maiga Mamoudou , Traoré Sékou F. , Touré Abdoulaye , Dolo Guimogo , Smith Thomas , Ribeiro José M. C.
Published: September 2018

In Mali, anopheline mosquito populations increase sharply during the rainy season, but are barely detectable in the dry season. This study attempted to identify the dry season mosquito breeding population in and near the village of Bancoumana, Mali, and in a fishing hamlet 5 km from this village and adjacent to the Niger River. In Bancoumana, most larval habitats were human made, and dried out in January–February. In contrast, in the fishing hamlet, productive larval habitats were numerous and found mainly during the dry season (January–May) as the natural result of drying riverbeds. Adult mosquitoes were abundant during the dry season in the fishermen hamlet and rare in Bancoumana. To the extent that the fishermen hamlet mosquito population seeds Bancoumana with the advent of the rainy season, vector control in this small hamlet may be a cost-effective way to ameliorate malaria transmission in the 40-times larger village.
High Proportion of Isosporiasis among HIV-Infected Patients with Diarrhea in Southern India
Authors: Vignesh R. , Balakrishnan P. , Shankar E. M. , Murugavel K. G. , Hanas S. , Cecelia A. J. , Thyagarajan S. P. , Solomon Suniti , Kumarasamy N.
Published: September 2018

We investigated 245 diarrheal stool specimens from HIV-positive subjects between January 2003 and December 2006 to determine the etiological role of coproparasites. Parasitic etiology was observed in 91 (37.1%) cases. Isospora belli (26.1%) was the most common parasite followed by Entameba histolytica/dispar (3.3%), Cryptosporidium spp. (2.9%), Giardia intestinalis (1.6%), and Strongyloides stercoralis (1.2%). Interesting trends of significant increase in the number of cases of I. belli and decline in Cryptosporidium spp. were observed during the study period.
Laboratory-based Dengue Surveillance in Taiwan, 2005: A Molecular Epidemiologic Study
Authors: Huang Jyh-Hsiung , Liao Tsai-Ling , Chang Shu-Fen , Su Chien-Ling , Chien Li-Jung , Kuo Yu-Chung , Yang Cheng-Fen , Lin Chien-Chou , Shu Pei-Yun
Published: September 2018

We present the results of laboratory-based dengue surveillance in Taiwan for 2005. A phylogenetic study showed that multiple dengue epidemics were caused by three different imported dengue virus (DENV) strains. A strain of DENV-3 (genotype I) imported from the Philippines first appeared in the southern part of Kaohsiung City and later spread to Kaohsiung County from August to December, which resulted in 77 cases of dengue. Another strain of DENV-3 (genotype II) imported from Vietnam first appeared in the central part of Kaohsiung City and later spread to Kaohsiung County from September to December, which resulted in 35 cases of dengue. A strain of DENV-2 (American/ Asian genotype) imported from Vietnam first appeared in Tainan City and later spread to Kaohsiung City/County from October to December, which resulted in 60 cases of dengue. This study provides molecular epidemiologic evidence that most dengue in Taiwan is caused by imported strains of the virus.
Low Efficacy of Amodiaquine or Chloroquine Plus Sulfadoxine-Pyrimethamine against Plasmodium falciparum and P. vivax Malaria in Papua New Guinea
Authors: Marfurt Jutta , Müeller Ivo , Sie Albert , Maku Peter , Goroti Mary , Reeder John C. , Beck Hans-Peter , Genton Blaise
Published: September 2018

Because of increasing resistance to 4-aminoquinolines in Papua New Guinea, combination therapy of amodiaquine (AQ) or chloroquine (CQ) plus sulfadoxine-pyrimethamine (SP) was introduced as first-line treatment against uncomplicated malaria in 2000. The purpose of this study was to monitor in vivo efficacy of the current standard combination therapy against Plasmodium falciparum and P. vivax malaria. Studies were conducted between 2003 and 2005 in the Simbu, East Sepik, and Madang Provinces in Papaua New Guinea according to the revised protocol of the World Health Organization (WHO) for assessment of antimalarial drug efficacy. Children between six months and seven years of age with clinically overt and parasitologically confirmed P. falciparum or P. vivax malaria were treated according to the new policy guidelines (i.e., AQ plus SP given to patients weighing < 14 kg and CQ plus SP given to patients weighing < 14 kg). Children were monitored up to day 28 and classified according to clinical and parasitological outcome as adequate clinical and parasitological response (ACPR), early treatment failure (ETF), late clinical failure (LCF), or late parasitological failure (LPF). For P. falciparum malaria, polymerase chain reaction (PCR)–corrected treatment failure rates up to day 28 ranged between 10.3% and 28.8% for AQ plus SP and between 5.6% and 28.6% for CQ plus SP, depending on the region and the year of assessment. Overall treatment failure rate with AQ or CQ plus SP for P. vivax malaria was 12%. Our results suggest that the current first-line treatment in Papua New Guinea is not sufficiently effective. According to the new WHO guidelines for the treatment of malaria, a rate of parasitological resistance greater than 10% in the two dominant malaria species in the country justifies a change in treatment policy.
Neonatal Respiratory Tract Involvement by Trichomonas vaginalis: A Case Report and Review of the Literature
Authors: Carter J. Elliot , Whithaus Kenneth C.
Published: September 2018

Only occasional cases of Trichomonas spp. infection have been reported in neonates, and these usually represent vaginal infections with Trichomonas vaginalis acquired during passage down the birth canal. We report the case of a 2-week-old girl who was brought by her mother to the Children’s Emergency Clinic at our institution for symptoms of lethargy and poor appetite. The neonate was subsequently diagnosed with herpetic encephalitis and developed increasing respiratory difficulty, requiring intubation. Routine viral culture of a nasopharyngeal wash showed no viral organisms, but trichomonads were abundant microscopically on the viral culture medium. Molecular studies identified the organism as T. vaginalis. The significance of this organism as a neonatal respiratory pathogen and its contribution to neonatal respiratory distress are discussed.
Multiple Modes of Transmission of Giardiasis in Primary Schoolchildren of a Rural Community, Thailand
Authors: Ratanapo Supawat , Mungthin Mathirut , Soontrapa Suthipong , Faithed Chakri , Siripattanapipong Suradej , Rangsin Ram , Naaglor Tawee , Piyaraj Phunlerd , Taamasri Paanjit , Leelayoova Saovanee
Published: September 2018

In February 2005, we conducted a cross-sectional study to determine the prevalence and the risk factors of giardiasis in 531 primary schoolchildren of a rural community, Chacheongsao province, Thailand. Using both sedimentation and flotation techniques to detect Giardia duodenalis, the prevalence of giardiasis was 6.2%. Assemblage A, subgenotype II and assemblage B, subgenotype IV were identified by PCR-RFLP of glutamate dehydrogenase gene. Our data might indicate that, in this population, only assemblage A, subgenotype II of G. duodenalis was transmitted via water. Using multivariate analysis, significant risk factors for giardiasis were children of age 5–9 years, households with ≥ 3 children under the age of 12 years, low parental educational level, drinking bottled water, and living in close contact with dogs. Washing hands before meals had a protective effect. From these significant risk factors, multiple modes of transmission of G. duodenalis were suggested in this population.
Cryptosporidium muris in a Texas Canine Population
Authors: Lupo Philip J. , Langer-Curry Rebecca C. , Robinson Mary , Okhuysen Pablo C. , Chappell Cynthia L.
Published: September 2018

Molecular technology has led to the discovery of previously unrecognized Cryptosporidium species in new hosts, such as C. canis in humans. The notion that dogs may transmit Cryptosporidium species to humans has significant public health implications, and additional studies are merited. The purpose of this study was to examine a group of kenneled dogs to determine the prevalence of Cryptosporidium species infection and to identify parasite species. Prevalence of active infection was 71%. Six positive samples were analyzed by polymerase chain reaction amplification of the 18S ribosomal RNA gene followed by restriction fragment length polymorphism analysis to identify the Cryptosporidium species. Restriction digest patterns identified C. muris as the infecting species in all six dogs; species identity was confirmed by genetic sequencing. To our knowledge, this is the first report of a naturally occurring C. muris infection in a canine host. The finding of C. muris in asymptomatic canines supports the notion of dogs as potential sources of human infection.
An Envelope Domain III–based Chimeric Antigen Produced in Pichia pastoris Elicits Neutralizing Antibodies Against All Four Dengue Virus Serotypes
Authors: Etemad Behzad , Batra Gaurav , Raut Rajendra , Dahiya Satinder , Khanam Saima , Swaminathan Sathyamangalam , Khanna Navin
Published: September 2018

There is currently no vaccine to prevent dengue (DEN) virus infection, which is caused by any one of four closely related serotypes, DEN-1, DEN-2, DEN-3, or DEN-4. A DEN vaccine must be tetravalent, because immunity to a single serotype does not offer cross-protection against the other serotypes. We have developed a novel tetravalent chimeric protein by fusing the receptor-binding envelope domain III (EDIII) of the four DEN virus serotypes. This protein was expressed in the yeast, Pichia pastoris, and purified to near homogeneity in high yields. Antibodies induced in mice by the tetravalent protein, formulated in different adjuvants, neutralized the infectivity of all four serotypes. This, coupled with the high expression potential of the P. pastoris system and easy one-step purification, makes the EDIII-based recombinant protein a potentially promising candidate for the development of a safe, efficacious, and inexpensive, tetravalent DEN vaccine.
Isolation of Leishmania tropica from a Patient with Visceral Leishmaniasis and Disseminated Cutaneous Leishmaniasis, Southern Iran
Authors: Alborzi Abdolvahab , Pouladfar Gholam R. , Fakhar Mahdi , Motazedian Mohammad H. , Hatam Gholam R. , Kadivar Mohammad R.
Published: September 2018

We report a case visceral leishmaniasis with disseminated cutaneous leishmaniasis caused by Leishmania tropica in southern Iran. Typing of this parasite was performed by a species-specific polymerase chain reaction and isoenzyme electrophoresis.
Malaria on the Amazonian Frontier: Transmission Dynamics, Risk Factors, Spatial Distribution, and Prospects for Control
Authors: da Silva-Nunes Mônica , Codeço Cláudia T. , Malafronte Rosely S. , da Silva Natal S. , Juncansen Camila , Muniz Pascoal T. , Ferreira Marcelo U.
Published: September 2018

Little follow-up data on malaria transmission in communities originating from frontier settlements in Amazonia are available. Here we describe a cohort study in a frontier settlement in Acre, Brazil, where 509 subjects contributed 489.7 person-years of follow-up. The association between malaria morbidity during the follow-up and individual, household, and spatial covariates was explored with mixed-effects logistic regression models and spatial analysis. Incidence rates for Plasmodium vivax and Plasmodium falciparum malaria were 30.0/100 and 16.3/100 person-years at risk, respectively. Malaria morbidity was strongly associated with land clearing and farming, and decreased after five years of residence in the area, suggesting that clinical immunity develops among subjects exposed to low malaria endemicity. Significant spatial clustering of malaria was observed in the areas of most recent occupation, indicating that the continuous influx of nonimmune settlers to forest-fringe areas perpetuates the cycle of environmental change and colonization that favors malaria transmission in rural Amazonia.
Size Alters Susceptibility of Vectors to Dengue Virus Infection and Dissemination
Authors: Alto Barry W. , Reiskind Michael H. , Lounibos L. Philip
Published: September 2018

The size of arthropod vectors may affect their ability to transmit pathogens. Here we test the hypothesis that body size alters the susceptibility of Aedes aegypti and Aedes albopictus mosquitoes to dengue virus (DENV) infection and subsequent dissemination throughout the body of the mosquito. After feeding on blood containing known quantities of virus, smaller-sized females were significantly more likely to become infected and to disseminate virus than larger individuals. The effects of size were stronger for Ae. aegypti and independent of rearing conditions. Ae. albopictus was more susceptible to DENV infection and had higher virus titer in the body than Ae. aegypti, yet infected Ae. aegypti disseminated DENV more readily than infected Ae. albopictus. These results are consistent with the concept that Ae. aegypti is a more competent vector of DENV and emphasize the importance of body size in determining adult infection parameters.
The Role of Case Containment Centers in the Eradication of Dracunculiasis in Togo and Ghana
Authors: Hochberg Natasha , Ruiz-Tiben Ernesto , Downs Philip , Fagan Jennifer , Maguire James H.
Published: September 2018

As part of the global effort to eradicate dracunculiasis (Guinea worm disease), several endemic countries established case containment centers to provide treatment and support to patients with emerging Guinea worms to keep them from contaminating water sources. To assess the functioning, effectiveness, and public perception of this intervention, we visited eight centers and conducted surveys in 32 villages in Togo and Ghana. In the areas served by these centers, incidence dropped by 71% in Togo and 42% in Ghana from 2003 to 2004. Among persons with emerging worms, admission to the centers was associated with younger age (P value = 0.04) after controlling for occupation and gender. Overall, the centers functioned well and were regarded favorably: 99% of the 152 center-attendees expressed satisfaction with their stay. Strategically-located case containment centers in conjunction with other interventions appear to play an important role in the final effort to eradicate dracunculiasis.