title: Antibiotic Prophylaxis in Gynaecologic Procedures

text: OBJECTIVE: To review the evidence and provide recommendations on antibiotic prophylaxis for gynaecologic procedures. OUTCOMES: Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in gynaecologic procedures. EVIDENCE: Medline and The Cochrane Library were searched for articles published between January 1978 and January 2011 on the topic of antibiotic prophylaxis in gynaecologic procedures. Results were restricted to systematic reviews, randomized control trials/ controlled clinical trials, and observational studies. Searches were updated on a regular basis and incorporated in the guideline to June 2011. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. VALUES: The quality of evidence obtained was rated using the criteria described in the Report of the Canadian Task Force on Preventative Health Care (Table 1). BENEFITS, HARMS, AND COSTS: Guideline implementation should result in a reduction of cost and related harm of administering antibiotics when not required and a reduction of infection and related morbidities when antibiotics have demonstrated a proven benefit. RECOMMENDATIONS: 1. All women undergoing an abdominal or vaginal hysterectomy should receive antibiotic prophylaxis. (I-A); 2. All women undergoing laparoscopic hysterectomy or laparoscopically assisted vaginal hysterectomy should receive prophylactic antibiotics. (III-B); 3. The choice of antibiotic for hysterectomy should be a single dose of a first-generation cephalosporin. If patients are allergic to cephalosporin, then clindamycin, erythromycin, or metronidazole should be used. (I-A); 4. Prophylactic antibiotics should be administered 15 to 60 minutes prior to skin incision. No additional doses are recommended. (I-A); 5. If an open abdominal procedure is lengthy (e.g., > 3 hours), or if the estimated blood loss is > 1500 mL, an additional dose of the prophylactic antibiotic may be given 3 to 4 hours after the initial dose. (III-C); 6. Antibiotic prophylaxis is not recommended for laparoscopic procedures that involve no direct access from the abdominal cavity to the uterine cavity or vagina. (l-E); 7. All women undergoing surgery for pelvic organ prolapse and/or stress urinary incontinence should receive a single dose of firstgeneration cephalosporin. (III-B); 8. Antibiotic prophylaxis is not recommended for hysteroscopic surgery. (II-2D); 9. All women undergoing an induced (therapeutic) surgical abortion should receive prophylactic antibiotics to reduce the risk of postabortal infection. (I-A); 10. Prophylactic antibiotics are not suggested to reduce infectious morbidity following surgery for a missed or incomplete abortion. (I-E); 11. Antibiotic prophylaxis is not recommended for insertion of an intrauterine device. (I-E) However, health care professionals could consider screening for sexually transmitted infections in high-risk populations. (III-C); 12. There is insufficient evidence to support the use of antibiotic prophylaxis for an endometrial biopsy. (III-L); 13. The best method to prevent infection after hysterosalpingography is unknown. Women with dilated tubes found at the time of hysterosalpingography are at highest risk, and prophylactic antibiotics (e.g., doxycycline) should be given. (II-3B); 14. Antibiotic prophylaxis is not recommended for urodynamic studies in women at low risk, unless the incidence of urinary tract infection post-urodynamics is > 10%. (1-E); 15. In patients with morbid obesity (BMI > 35 kg/m(2)), doubling the antibiotic dose may be considered. (III-B); 16.. Administration of antibiotics solely to prevent endocarditis is not recommended for patients who undergo a genitourinary procedure. (III-E).


Zika virus and the 2016 Olympic Games


Giving identity to the faceless threat of antibiotic resistance


Neglected zoonoses: forgotten infections among disregarded populations


title: Diagnosis and treatment of group a streptococcal pharyngitis

text: Pharyngitis caused by the group A streptococcus requires accurate diagnosis and timely treatment to prevent acute rheumatic fever. Clinical signs and symptoms often do not distinguish pharyngitis caused by group A streptococci from pharyngitis caused by other microorganisms. Rapid antigen detection or throat culture are recommended for diagnosis except when viral signs and symptoms are prominent. Therapy with penicillin, the drug of choice, is associated with prevention of rheumatic fever, more rapid clinical improvement, and prompt loss of contagiousness. Bacteriologic treatment failure occurs despite universal sensitivity of group A streptococci to penicillin. The cause of treatment failure (and of chronic carriage) remain to be determined. Newer, more expensive antibiotics do not substantially enhance treatment success and need not be prescribed for most patients.


MERS – A cautionary tale


title: Impact of bacterial colonization on the severity, and accompanying airway inflammation, of virus-induced wheezing in children

text: It is reported that bacterial colonization of the airway in neonates affects the likelihood and severity of subsequent wheezing in childhood. This study aimed to explore the impact of bacterial colonization on the severity of virus-induced wheezing, and accompanying airway inflammation. Nasopharyngeal aspirates (NPAs) from 68 hospitalized children with bronchiolitis and 85 children with recurrent wheezing were obtained. Eleven common respiratory viruses were sought by PCR and/or direct fluorescence assay. Bacteria were isolated from NPAs by routine culture methods. Cell numbers and concentrations of cytokines/chemokines in the NPAs were measured, and nucleated cells were characterized. The frequency of bacterial colonization in children with recurrent wheezing was significantly higher than in children with an initial attack of bronchiolitis. Bacterial colonization accompanying virus infection had no effect on clinical manifestations, duration of hospitalization, concentrations of cytokines/chemokines (except interleukin-10 (IL-10)) or cellularity in the children with bronchiolitis; however, among the children with recurrent wheezing, those who had coexistent non-invasive bacterial colonization and virus infection presented more frequent cyanosis, longer duration of hospitalization, a higher concentration of IL-10 and a higher percentage of neutrophils in NPAs than those with virus infection but without bacterial colonization. Bacterial colonization was common in children with virus-induced wheezing, particularly in the situation of recurrent wheezing. To some extent, bacterial colonization accompanying virus infection may contribute to the severity of the wheezing because of its impact on airway inflammation.


Editorial overview: Engineering for viral resistance


Obituary—John (Jack) Payne Woodall


title: The aetiology of pharyngotonsillitis in adolescents and adults – Fusobacterium necrophorum is commonly found

text: Sore throat is common in primary healthcare. Aetiological studies have focused on the presence of a limited number of pathogens. The aim of the present study was to investigate the presence of a wide range of bacteria and viruses, including Fusobacterium necrophorum, in patients with pharyngotonsillitis and in asymptomatic controls. A prospective case control study was performed in primary healthcare in Kronoberg County, Sweden. Patients (n = 220) aged 15 to 45 years with a suspected acute pharyngotonsillitis, and controls (n = 128), were included. Nasopharyngeal and throat swabs were analysed for β-hemolytic streptococci, F. necrophorum, Mycoplasma pneumoniae, and Chlamydophila pneumoniae, and 13 respiratory viruses. Serum samples were analysed for antibodies to Epstein-Barr virus. The patient history and symptoms, including Centor score, were analysed in relation to pathogens. In 155/220 (70.5%) of the patients, as compared to 26/128 (20.3%) of the controls (p <0.001), at least one microorganism was found. Group A streptococci, F. necrophorum, and influenza B virus were the three most common findings, and all significantly more common in patients than in controls (p <0.001, p 0.001, and p 0.002, respectively). Patients with F. necrophorum only (n = 14) displayed a lower Centor score than patients with Group A streptococcus only (n = 46), but a higher score than patients with influenza B, other viruses, or no potential pathogen (Kruskal-Wallis p <0.001). A pathogen was detected in 70% of the patients, displaying a wide range of pathogens contributing to the aetiology of pharyngotonsillitis. This study supports F. necrophorum as one of the pathogens to be considered in the aetiology of pharyngotonsillitis.


Be vigilant: New MERS-CoV outbreaks can occur in the Kingdom of Saudi Arabia


The epidemiology of MERS-CoV


title: Pathways of protein sorting and membrane traffic between the rough endoplasmic reticulum and the Golgi complex

text: Recent results have provided increasing evidence for the existence of an intermediate membrane compartment between the rough endoplasmic reticulum and the Golgi complex which seems to function in protein sorting and the regulation of membrane traffic in the early part of the exocytic pathway. Localization of resident marker proteins has shown that this compartment consists of both peripheral and central elements. The aim of the present review is to combine the data on the pre-Golgi compartment with previous ideas of membrane traffic at the ER-Golgi interface. We propose a model which describes how mobile, endosome-like elements of the pre-Golgi compartment function in the generation of the compositional and functional boundary between the widely distributed ER and the more centrally located Golgi stacks.


From Hajj services to Mass Gathering Medicine: Saudi Arabia formalizes a novel discipline


title: Virus-like particles: Passport to immune recognition

text: Virus-like particles (VLPs) are formed by the self-assembly of envelope and/or capsid proteins from many viruses. In many cases such VLPs have structural characteristics and antigenicity similar to the parental virus, and some have already proven successful as vaccines against the cognate virus infection. The structural components of some VLPs have also proven amenable to the insertion or fusion of foreign antigenic sequences, allowing the production of chimeric VLPs exposing the foreign antigen on their surface. Other VLPs have been used as carriers for foreign antigens, including non-protein antigens, via chemical conjugation. This review outlines some of the advantages, disadvantages, and technical considerations for the use of a wide range of VLP systems in vaccine development.


title: Nonneoplastic disorders of the brain

text: Computed tomography (CT) and magnetic resonance imaging (MRI) are helpful in the diagnosis of many nonneoplastic brain disorders in the dog and cat. The ability of CT and MRI to depict normal and abnormal anatomy facilitates the identification of developmental anomalies, including hydrocephalus, Chiari malformations, arachnoid cysts, and cerebellar hypoplasia. These imaging modalities also allow the detection of hemorrhage and infarction and are therefore useful in the evaluation of spontaneous cerebrovascular disorders and head trauma. Finally, many inflammatory diseases, such as encephalitis, brain abscess, and parasite migration, cause abnormalities detectable by CT and MRI. Although more research on the imaging features of specific nonneoplastic brain disorders is needed, current information indicates that CT and MRI are useful in the management of these disorders.


Proceedings of the Middle East Respiratory Syndrome (MERS) Coronavirus research initiative workshop, September 9–10 2015 in Riyadh, KSA


What Has SARS Taught Us About Infection Control in Nursing Homes?


Travel medicine research in the new millennium: A bibliometric analysis of articles published in Travel Medicine and Infectious Disease, 2003–2019


15 years of the ECDC


title: Nonstreptococcal pharyngitis

text: Pharyngitis is the third most common illness diagnosed by pediatricians in the United States. Group A ß-hemolytic streptococci account for only approximately 30% of episodes of symptomatic pharyngitis. A broad list of other pathogens, including both bacteria and viruses, as well as Toxoplasma gondii and Candida species, are suggested frequently as the pathogens responsible for the remaining 70% of cases. This article reviews the evidence for a causative role of ß-hemolytic streptococci other than Streptococcus pyogenes and other bacteria and viruses in outbreaks and sporadic cases of pharyngitis. Recommendations for the diagnosis and management of pharyngitis caused by pathogens other than S pyogenes are offered.


title: Veterinary Vaccines and Their Importance to Animal Health and Public Health

text: Veterinary vaccines have had, and continue to have, a major role in protecting animal health and public health, reducing animal suffering, enabling efficient production of food animals to feed the burgeoning human population, and greatly reducing the need for antibiotics to treat food and companion animals. Prominent examples include rabies vaccines and rinderpest vaccines. Rabies vaccines for domestic animals and wildlife have nearly eliminated human rabies in developed countries. Thanks to the Global Rinderpest Eradication Program which involves vaccination, trade restrictions, and surveillance, rinderpest may soon become only the second disease (after smallpox) to be globally eradicated. Successful examples of new technology animal vaccines that are licensed for use, include gene-deleted marker vaccines, virus-like-particle vaccines, recombinant modified live virus vaccines, chimeric vaccines, and DNA vaccines. Animal vaccines also use a wide variety of novel adjuvants that are not yet approved for use in human vaccines. Animal vaccines can be developed and licensed much more quickly than human vaccines. The West Nile virus was discovered in the United States in August 1999. By August 2001, an Equine vaccine for West Nile virus was conditionally licensed. For animal vaccines to effectively protect animal and public health they must be widely used, which means they must be affordable. The regulatory process must meet the need for assuring safety and efficacy without increasing the cost of licensing and production to the point where they are not affordable to the end user.


Re-emergence of porcine epidemic diarrhea virus in the global pig population


Treatment and Outcome of a Patient With Lung Cancer Infected With Severe Acute Respiratory Syndrome Coronavirus-2


title: RNA pseudoknots downstream of the frameshift sites of retroviruses

text: RNA pseudoknot structural motifs could have implications for a wide range of biological processes of RNAs. In this study, the potential RNA pseudoknots just downstream from the known and suspected retroviral frameshift sites were predicted in the Rous sarcoma virus, primate immunodeficiency viruses (HIV-1, HIV-2, and SIV), equine infectious anemia virus, visna virus, bovine leukemia virus, human T-cell leukemia virus (types I and II), mouse mammary tumor virus, Mason-Pfizer monkey virus, and simian SRV-1 type-D retrovirus. Also, the putative RNA pseudoknots were detected in the gag-pol overlaps of two retrotransposons of Drosophila, 17.6 and gypsy, and the mouse intracisternal A particle. For each sequence, the thermodynamic stability and statistical significance of the secondary structure involved in the predicted tertiary structure were assessed and compared. Our results show that the stem-loop structures in the pseudoknots are both thermodynamically highly stable and statistically significant relative to other such configurations that potentially occur in the gag-pool or gag-pro and pro-pol junction domains of these viruses (300 nucleotides upstream and downstream from the possible frameshift sites are included). Moreover, the structural features of the predicted pseudoknots following the frameshift site of propol overlaps of the HTLV-1 and HTLV-2 retroviruses are structurally well conserved. The occurence of eight compensatory base changes in the tertiary interaction of the two related sequences allow the conservation of their tertiary structures in spite of the sequence divergence. The results support the possible control mechanism for frameshifting proposed by Brierley et al. [1] and Jacks et al. [2, 3].


SARS treatment: who will lead the way forward?


title: Rapid viral quasispecies evolution: implications for vaccine and drug strategies

text: High mutation rates occurring during replication allow RNA viruses to evolve rapidly and adapt continuously to new environments. This poses an enormous challenge to vaccine and drug development which, to be effective, must consid RNA virus variability and follow approaches that minimize the probability of escape or resistant mutants arising.


FOCIS abstract supplement


Infectious diseases upsurge in Mongolia


Pink pages 3 & 4: The Winn Foundation


title: Placental Extract Improves Hippocampal Neuronal Loss and Fear Memory Impairment Resulting From Chronic Restraint Stress in Ovariectomized Mice

text: We have recently found that combination of ovariectomy (OVX) and chronic restraint stress causes cognitive dysfunction and reduces hippocampal CA3 neurons in female rats and mice and that estrogen replacement and chronic treatment with Ginkgo biloba extract EGb 761 suppress the OVX/stress-induced behavioral and morphological changes. In this study, we examined the effect of placental extract on the memory impairment and neuromorphological change in OVX/stress-subjected mice. Female Slc:ICR strain mice were randomly divided into four groups: vehicle-treated OVX, porcine placental extract (120 and 2160 mg/kg)-treated OVX, and sham-operated control groups. Two weeks after surgical operation, OVX mice underwent restraint stress for 21 days (6 h/day), and all animals were then subjected to a contextual fear conditioning test followed by morphological examination by Nissl staining. Placental extract was orally administered once daily until the behavioral analysis was carried out. Chronic treatment with both doses of placental extract improved the OVX/stress-induced fear memory impairment and Nissl-positive cell loss of the hippocampal CA3 region, although it did not affect the loss of bone mineral density and increase in body weight after OVX. These results have important implications for the neuroprotective and cognition-enhancing effects of placental extract in postmenopausal women.


Taming the beast: Hospital management of a nosocomial middle east respiratory syndrome outbreak


Beyond Ebola: lessons to mitigate future pandemics


Trade in wild animals: a disaster ignored


Marc Struelens-President of the European Society of Clinical Microbiology and Infectious Diseases


Infectious diseases high on agenda under new WHO leadership


Clinical research networks and assessing pandemic severity


title: Documentary Research of Human Respiratory Droplet Characteristics()

text: Respiratory droplet characteristics are key to determine the droplet-borne pathogen transmission, which provide scientific basis for formulating the disease prevention from droplet transmission and control measures. Through studying the data information from existing documents, this paper gives the respiratory droplet characteristics, like size, concentration, velocity, etc. Meanwhile, droplet evaporation, droplet-borne pathogen activity and their transmission are discussed. The droplet size is no significant difference with human health level, gender and age. The size of droplets produced by health people is between 0.1 and 10 μm, it produced by patients is between 0.05 and 10 μm, and the patients’ droplet concentration is higher. The coughed droplet concentrations change with the size into a peak rule. The velocity of the cough droplets is the biggest, the range of 10 to 25m/s, the transmission distance is more than 2m.


Imported cases of Middle East respiratory syndrome: An update


Editorial overview: Viral immunology: Generating immunity to diverse viral pathogens


A Case of a Patient with Idiopathic Pulmonary Fibrosis with Lung Squamous Cell Carcinoma Treated with Nivolumab


Wild animals could be source of SARS


AACR cancels annual meeting because of SARS


title: Fimbriae assisted bacterial surface display of heterologous peptides

text: The display of peptide segments on the surface of bacteria offers many new and exciting applications in biotechnology and medical research. Fimbria-assisted display of heterologous sequences is a paradigm for chimeric organelle display on bacteria. Fimbriae are particularly attractive candidates for epitope display for several reasons: (1) they are present in extremely high numbers at the cell surface, (2) they are strong immunogens, (3) they possess inherent adhesive properties, and (4) they can be easily purified. The majority of work dealing with fimbria-assisted peptide display has been focused on the development of recombinant vaccines. A number of different fimbrial types have been used to display immune-relevant sectors of various foreign proteins. Chimeric fimbrial vaccines can be used in the context of purified proteins, however the potential also exists to exploit this technology for the development of live recombinant vaccines. Work has also been performed demonstrating the amenability of fimbriae towards the powerful technology of random peptide display. This review summarises the current state of research in this field.


Environment: the neglected component of the One Health triad


Pandemic avian influenza


Meeting report(): Part II. Notes from the Twentieth Annual Clinical Virology Symposium


Addressing the global health security agenda


Highlights from the second ICPIC


Known unknowns and unknown unknowns


title: Molecular diagnostic techniques

text: Molecular diagnostic techniques will continue to transform clinical microbiology. They provide more rapid and sensitive testing that impacts directly on clinical management of infected patients. Molecular diagnostic tests arose from the need to detect micro-organisms that are slow or difficult to grow, or that are present in only small numbers. Nucleic acid amplification techniques (e.g. polymerase chain reaction, PCR) can detect DNA or RNA specific to certain micro-organisms and do not rely on either the recovery of the pathogen or an immune response in the infected patient. Alternative nucleic acid amplification methods have emerged recently because of increasing commercial interest in infectious disease diagnostics and the comprehensive patient protection of PCR technology. Such techniques are gaining widespread acceptance, and have displaced more conventional gold-standard testing in some areas of infectious disease (e.g. viral load testing in HIV-1 infected patients, diagnosis of Chlamydia trachomatis infection). Genetic characterization techniques are increasingly used to determine the relatedness of micro-organisms in the clinical setting. These methods are useful in establishing routes or sources of infection in outbreaks of disease, and are powerful epidemiological tools in large-scale clinical investigations. Recently, there has been a move towards pathogen characterization techniques based on direct nucleotide sequencing (e.g. single nucleotide polymorphism analysis, multi-locus sequence typing). These techniques offer unambiguous, portable data that can be exchanged via the Internet, strengthening collaborative efforts in the field of infectious disease research.


Abstracts cont.


Hajj, Umrah, and other mass gatherings: Which pathogens do you expect? Beware of the tree that hides the forest!


Análisis de las coinfecciones detectadas entre los subtipos del virus respiratorio sincitial y otros virus respiratorios


title: Differential diagnosis of pandemic (H1N1) 2009 infection by detection of haemagglutinin with an enzyme-linked immunoassay

text: A sensitive and convenient immunoassay that can directly differentiate pandemic (H1N1) 2009 (pH1N1) virus from seasonal influenza virus can play an important role in the clinic. In the presented study, a double-sandwich ELISA (pH1N1 ELISA), based on two monoclonal antibodies against haemagglutinin (HA) of the pH1N1 virus, was developed. After laboratory determination of the sensitivity and specificity characteristics, the performance of this assay was evaluated in a cohort of 904 patients with influenza-like illness. All seven strains of pH1N1 virus tested were positive by pH1N1 ELISA, with an average lower detection limit of 10(3.0 ± 0.4) tissue culture infective dose (TCID)(50)/mL (or 0.009 ± 0.005 HA titre). Cross-reaction of the assay with seasonal influenza virus and other common respiratory pathogens was rare. In pH1N1-infected patients, the sensitivity of the pH1N1 ELISA was 92.3% (84/91, 95% CI 84.8–96.9%), which is significantly higher than that of the BD Directigen EZ Flu A + B test (70.3%, p <0.01). The specificity of pH1N1 ELISA in seasonal influenza A patients was 100.0% (171/171, 95% CI 97.9–100.0%), similar to that in non-influenza A patients (640/642, 99.7%, 95% CI 98.9–100.0%). The positive predictive value for pH1N1 ELISA was 97.7% and the negative predictive value was 99.1% in this study population with a pH1N1 prevalence of 10.1%. In conclusion, detection of HA of pH1N1 virus by immunoassay appears to be a convenient and reliable method for the differential diagnosis of pH1N1 from other respiratory pathogens, including seasonal influenza virus.


Editorial overview: Antivirals and resistance: Advances and challenges ahead


Self-assessment/CPD


Rhinovirus genetic diversity among immunosuppressed and immunocompetent patients presenting with a severe respiratory infection


Origins of MERS-CoV, and lessons for 2019-nCoV


Influenza vaccine for Hajj and Umrah pilgrims


Calling the shots


Emerging respiratory viral infections: MERS-CoV and influenza


Watch your bats


Are you ready for the next influenza pandemic?


Guest editorial


Joseph Malik Peiris–on the trail of pneumonia in Hong Kong


Transmission risk and predictability of invasive meningococcal disease


SARS—lessons learned so far


The duty to treat


USA reworks its case definition for SARS


title: Short-term Follow-up Results of Drug-eluting Stenting in Premature Coronary Artery Disease Patients with Multiple Atherosclerotic Risk Factors

text: BACKGROUND: Premature coronary artery disease (CAD) is a special entity with a strong link to familial hypercholesterolemia, family history of premature CAD, or multiple coexistent atherosclerotic risk factors. Drug-eluting stenting (DES), including paclitaxel-eluting stenting (PES) and sirolimus-eluting stenting (SES), has been proven to have a lower restenotic rate. However, to date, few studies have investigated the clinical and angiographic results of DES in premature CAD patients. METHODS: Between February 2004 and October 2005, premature CAD patients, defined as those younger than 50 years ofage, who were treated with DES in our medical center were all retrospectively enrolled. Their baseline clinical characteristics, clinical outcome and angiographic follow-up results were analyzed. RESULTS: A total of 26 patients (M/F: 23/3) were enrolled, with a mean age of 44 ±6 years (range, 24–50 years). Conventional atherosclerotic risk factors were prevalent in this study group, including diabetes mellitus (35%), hypertension (35%), hyperlipidemia (54%) and smoking (73%). Moreover, there was 1 homozygous and 1 heterozygous familial hypercholesterolemia case in our study group. In terms of angiographic results, there were 40 target lesions in 34 target vessels. Forty DES (39 PES, 1 SES) were implanted with a median stent diameter of 3 mm and median length of 24 mm. The clinical follow-up was counted up to May 2006, with a mean follow-up duration of 540 ±168 days; 11 (42%) patients had a second angiogram during the follow-up period (200 ±98 days after DES). None of the patients had target lesion revascularization (TLR). In addition, there was no difference in TLR or stent thrombosis between patients with or without acute coronary syndrome. CONCLUSION: Based on our single-center experience, DES had good short-term follow-up results for a premature CAD group with diverse and multiple atherosclerotic risk factors.


South Asia today: William Osler's world with antibiotics


Vaccine hesitancy in Japan: Is the country well prepared for Tokyo 2020?


Not such an innocent cough


Editorial overview: Antiviral strategies: Antiviral drug design: creating new ideas against old and new bugs


The use of vaccines to control disease is not a simple matter


Enterovirus D68 nosocomial outbreak in elderly people, France, 2014


Emerging viruses of zoonotic and veterinary importance


title: Preparing for an influenza pandemic: healthcare workers’ opinions on working during a pandemic

text: The aim of this study was to solicit opinions from healthcare workers (HCWs) as to their attitude to working during a pandemic. A cross-sectional survey of HCWs using a self-administered, anonymous survey was conducted between February 2007 and April 2007. The setting was a large Victorian metropolitan health service, employing over 10 000 staff. Sixty-seven percent of HCWs stated they would be available to work during a pandemic, 26% stated they would stay at home to care for their children, whereas 10% admitted they would stay away because of fear of catching influenza. The majority of employees expected to be provided with personal protective equipment, antivirals and vaccine (92%, 90% and 89%, respectively). HCWs also believed that family members should be supplied with antivirals and vaccine (64% and 63%, respectively), 20% believed they needed a place of residence while working, 45% were prepared to be relocated to another site, and 36% were prepared to change to another duty. The survey highlights several areas that need attention in preparing for a pandemic. Targeted education is required now for all those HCWs who will be expected to work during a pandemic. How we cope with the next inevitable pandemic depends on the depth of our preparation.


title: Feline epilepsy

text: The diagnosis and management of seizures in the cat require an understanding of the more common diseases that predispose to feline epilepsy. Feline seizures may occur secondary to intracranial or extracranial disease. Intracranial causes include inflammatory, neoplastic, vascular, and traumatic disorders. Extracranial causes include various metabolic and toxic insults. Previous brain insults that are no longer active may leave “seizure foci.” Idiopathic epilepsy is uncommon in the cat relative to the dog but should be considered if no cause can be found. Regardless of the etiology, ictal events in cats can manifest themselves in multiple forms and levels of severity. Therapy should be directed at controlling seizure frequency and treating the underlying cause. An aggressive diagnostic and therapeutic approach to feline epilepsy may improve prognosis and lead to a favorable outcome.


Crossing the minefield of disease names


title: SUMO fusion technology for difficult-to-express proteins

text: The demands of structural and functional genomics for large quantities of soluble, properly folded proteins in heterologous hosts have been aided by advancements in the field of protein production and purification. Escherichia coli, the preferred host for recombinant protein expression, presents many challenges which must be surmounted in order to over-express heterologous proteins. These challenges include the proteolytic degradation of target proteins, protein misfolding, poor solubility, and the necessity for good purification methodologies. Gene fusion technologies have been able to improve heterologous expression by overcoming many of these challenges. The ability of gene fusions to improve expression, solubility, purification, and decrease proteolytic degradation will be discussed in this review. The main disadvantage, cleaving the protein fusion, will also be addressed. Focus will be given to the newly described SUMO fusion system and the improvements that this technology has advanced over traditional gene fusion systems.


title: A history of the Pan American Society for Clinical Virology

text: [Figure: see text]


Identification of MERS-CoV in dromedary camels


title: Cell biology of viruses that assemble along the biosynthetic pathway

text: In this review we discuss five groups of viruses that bud into, or assemble from, different compartments along the biosynthetic pathway. These are herpes-, rota-, corona-, bunya- and poxviruses. Our main emphasis will be on the virally-encoded membrane glycoproteins that are responsible for determining the site of virus assembly. In a number of cases these proteins have been well characterized and appear to serve as resident markers of the budding compartments. The assembly and dissemination of these viruses raises many questions of cell biological interest.


Finding Information by “Design”: Search Strategies for Cardiothoracic and Vascular Anesthesia Literature


Middle East respiratory syndrome in the shadow of Ebola


title: Alternative Methods to Reduce, Refine, and Replace the Use of Animals In the Development and Testing of Veterinary Biologics in The United States; a Strategic Priority

text: The Virus-Serum-Toxin Act of 1913 provides the legal basis for the regulation of veterinary biological products in the United States, and the USDA's Center for Veterinary Biologics (CVB) has the authority to issue licenses and permits for such products. The law was intended to establish standards and control the importation of products into the United States as well as the domestic distribution of products, assuring the purity, safety, potency, and efficacy of veterinary biological products. Prelicensing data evaluation procedures are designed to assess the quality of each product and support product label claims. Under the standard licensing process, this spectrum of evaluation includes complete characterization of seed material and ingredients, and laboratory- and host-animal safety and efficacy studies. Post-license testing includes batch tests for purity, safety, and potency. As part of the production and testing of regulated products, procedures involving animals are used to validate product requirements for safety, potency, and efficacy. Incorporating alternative methods to reduce, refine, and replace the use of animals in the development and testing of veterinary biological products has been a strategic goal for the CVB for several decades, and current licensing processes and policies are designed to support and encourage the shift from animal-based methods to alternative practices while ensuring that regulated products continue to be safe and effective.


MERS—an uncertain future


Camels, MERS-CoV, and other emerging infections in east Africa


title: Antisense Inhibition of Virus Infections

text: This chapter summarizes the new approaches to identify novel antiviral drug targets and to develop novel antiviral strategies. The chapter also reviews genetic pharmacology as it relates to antiviral antisense research and drug development. Antisense oligonucleotides are selective compounds by virtue of their interaction with specific segments of RNA. For potential antivirals, identification of appropriate target RNA sequences for antisense oligonucleotides is performed at two levels: the optimal gene within the virus, and the optimal sequence within the RNA. The importance of these oligonucleotide modifications in designing effective drugs is just now being evaluated, both in animal model systems and in the clinic. The first generation of widely used antisense oligonucleotides has been the phosphorothioate (PS) compounds and a body of data on biodistribution, pharmacokinetics, and metabolism in animals and in humans is now available. Since the identification and sequencing of human immunodeficiency virus (HIV), there has been a strong interest in identifying a potent oligonucleotide inhibitor that would have the potential for development as a therapy for acquired immunodeficiency syndrome (AIDS). Numerous phosphorothioate oligonucleotides, with no apparent antisense sequence specificity, can have an anti-herpes simplex virus (HSV) effect. Oligonucleotides can be effective anti-influenza agents in cell culture assays. Hepatitis B virus (HBV) X protein that is a transactivator has been also reported to be targeted successfully by antisense oligonucleotides in vivo. Several of picornaviruses have been targets for antisense oligonucleotide inhibition, and the studies demonstrate the versatility of the antisense approach. However, the fact that oligonucleotides may contribute numerous mechanisms toward the antiviral activity, in addition to the antisense mechanism, may in some cases be an asset in the pursuit of clinically useful antiviral drugs.


ECMO in severe acute respiratory distress syndrome


title: Role of micro-organisms in necrotizing enterocolitis

text: The frequency with which necrotizing enterocolitis occurs in outbreaks makes it likely that the illness can have an infective origin. Immunological and non-immunological defences of the gastrointestinal are impaired in early life. Consequently the gut of the preterm infant is predisposed to bacterial overgrowth. A wide range of pathogenic bacteria and viruses have been isolated from infants with necrotizing enterocolitis or detected histologically. The presence of bacterial metabolites in the breath, intestinal bullae (hydrogen) and urine (D-lactate) during the course of the illness is further confirmatory evidence. The presence of bacteria or bacterial products (such as exo- and endotoxin) in the circulation will lead to ischaemia of the intestine and other organs either directly or via mediators such as cytokines or platelet activating factor. Future studies in necrotizing enterocolitis should be directed to understanding and modulating inflammatory mediators in necrotizing enterocolitis and preventing the disease with breast milk and nutritional supplements (glutamine, short chain fatty acids), chemoprophylaxis, and antibodies.


SARS: at least and at last, are we learning from the worst?


Predicting global death patterns not an easy task


The interface of animal and human vaccines


Correction to Lancet Respir Med 2020; 8: 420–22


Building the Capacity of Schools to Improve the Health of Nations


title: Role of toll-like receptors in respiratory diseases

text: There has been growing interest in the last 10 years in the study of innate immunity, in particular because of the possible role that toll-like receptors (TLR) may play in the pathogenesis of some respiratory diseases including, asthma, chronic obstructive pulmonary disease, and infections. TLR are a family of type 1 transmembrane proteins, responsible for recognising molecular patterns associated with pathogens (PAMP, pathogen-associated molecular patterns), and expressed by a broad spectrum of infectious agents. This recognition leads to a quick production of cytokines and chemokines which provides a long-lasting adaptive response to the pathogen. At present, it is considered //It is currently considered that the administration of drugs which modulate the activity of these receptors upwards or downwards may represent major therapeutic progress for handling these diseases. The aim of this review is to describe the different TLS, define their possible role in the pathogenesis of the main respiratory diseases and finally, speculate over the therapeutic possibilities which their modulation, agonist or antagonist, offers as possible therapeutic targets.


Oral presentations


title: Management of exacerbations of COPD

text: Exacerbations of chronic obstructive pulmonary disease (COPD) are an important cause of morbidity and mortality in the condition, and their incidence increases with its severity. Some patients suffer frequent exacerbations leading to hospital admission, with considerable impact on their quality of life and activities of daily living. COPD exacerbations are associated with considerable physiological deterioration and increased airway inflammatory changes caused by factors such as viruses, bacteria and, possibly, common pollutants. Current evidence suggests that appropriate management and prevention of exacerbations may modify the long-term course of COPD.


title: A study of risk factors for cat mortality in adoption centres of a UK cat charity

text: A case–control study was used to identify variables associated with the risk of mortality in cats housed at adoption centres. Multivariable logistic regression, based on retrospective data collected for 194 cases (cats that died or were euthanased) and 320 controls (cats that did not die) revealed an increased risk of mortality for cats admitted to adoption centres unneutered, in fair/poor health and cats born at adoption centres. Cats aged 7 weeks or less and cats aged over 7 years had an increased risk of mortality compared with cats of other ages. The risk of mortality decreased as the time in the adoption centre increased. Cats with disabilities (eg, blindness) had a higher mortality risk than cats without disabilities. Knowledge of these risk factors can inform intervention strategies aimed at reducing the risk of cat mortality at adoption centres.


Measles returns to the Gaza Strip


10 years on, the world still learns from SARS


Autochthonous hepatitis E: a common and fatal but neglected emerging disease in France


Deadly “paleoviruses”: a bioweapon Pandora's box?


Emerging and re-emerging infectious diseases: Review of general contributing factors and of West Nile virus


title: Mask-wearing and respiratory infection in healthcare workers in Beijing, China

text: OBJECTIVES: The aim of the study was to determine rates of mask-wearing, of respiratory infection and the factors associated with mask-wearing and of respiratory infection in healthcare workers (HCWs) in Beijing during the winter of 2007/2008. METHODS: We conducted a survey of 400 HCWs working in eight hospitals in Beijing by face to face interview using a standardized questionnaire. RESULTS: We found that 280/400 (70.0%) of HCWs were compliant with mask-wearing while in contact with patients. Respiratory infection occurred in 238/400 (59.5%) subjects from November, 2007 through February, 2008. Respiratory infection was higher among females (odds ratio [OR], 2.00 [95% confidence interval {CI}, 1.16-3.49]) and staff working in larger hospitals (OR, 1.72 [95% CI, 1.09-2.72]), but was lower among subjects with seasonal influenza vaccination (OR, 0.46 [95% CI, 0.28-0.76]), wearing medical masks (reference: cotton-yarn; OR, 0.60 [95% CI, 0.39-0.91]) or with good mask-wearing adherence (OR, 0.60 [95% CI, 0.37-0.98]). The risk of respiratory infection of HCWs working in low risk areas was similar to that of HCWs in high risk area. CONCLUSION: Our data suggest that female HCWs and staffs working in larger hospitals are the focus of prevention and control of respiratory infection in Beijing hospitals. Mask-wearing and seasonal influenza vaccination are protective for respiratory infection in HCWs; the protective efficacy of medical masks is better than that of cotton yarn ones; respiratory infection of HCWs working in low risk areas should also be given attention.


Challenge accepted!


Zika in India and the need for transparent reporting


Infections of the nervous system


Comparison of self-collected nasal swabs with oral washes for sequential viral load monitoring in lung transplant recipients with respiratory virus infection


Inharmonious coexistence


Corrections


The fifth hurricane: Florida’s crisis of access to medical care


The challenges of cholera at the 2017 Hajj pilgrimage


Are we living in an antibiotic resistance nightmare?


Human rhinovirus infection and cirrhosis: A potential fatal complication


Geography, global pandemics & air travel: Faster, fuller, further & more frequent


Title Index


New opportunity for an old technique


Lassa fever and global health security


Antibacterial resistance deemed a public-health crisis


The etiology of idiopathic parkinsonism


Infections in symptomatic travelers returning from the Arabian peninsula to France: A retrospective cross-sectional study


Fear and Worrying About Health


title: Aspergillus PCR in serum for the diagnosis, follow-up and prognosis of invasive aspergillosis in neutropenic and nonneutropenic patients()

text: We evaluated the usefulness of a serum Aspergillus PCR assay for the diagnosis and prognosis of invasive aspergillosis in a study involving 941 patients for a total of 5146 serum samples. Fifty-one patients had proven/probable aspergillosis. We compared galactomannan (GM), PCR and mycologic analysis of pulmonary samples in both neutropenic and nonneutropenic patients. PCR performed in serum yielded 66.7% sensitivity, 98.7% specificity, 75.6% positive predictive value and 98.0% negative predictive value, while the GM index yielded 78.4% sensitivity, 87.5% specificity, 27% positive predictive value and 98.6% negative predictive value. The inclusion of PCR in the European Organization for Research and Treatment of Cancer (EORTC) and the Mycosis Study Group (MSG) mycologic criteria permitted the reclassification of nine other cases from possible to probable aspergillosis and increased the sensitivity to 71.7%. Combining the GM index with serum PCR increased the detection rate of invasive aspergillosis with 88.2% sensitivity. PCR was systematically negative in 16 patients with noninvasive forms of aspergillosis (namely aspergilloma and chronic aspergillosis). Remaining PCR positive after a period of 14 to 20 days of treatment was related to poor outcome at 30 and 90 days. Our results also indicate that, unlike the determination of the GM index, the initial fungus load as determined by PCR was highly predictive of 90-day mortality, with the rate of the latter being 15.8% for patients with <150 copies/mL vs. 73.2% for patients at or above that cutoff (p <0.0001). Therefore, PCR appears to be a powerful and interesting tool for the identification of patients with invasive aspergillosis who might benefit from more intense care.


“Healthy Hajj 2019” –– what you need to know, before you go


Re: 'Syndromic panels or “panel syndrome”? A perspective through the lens of respiratory-tract infections' by Zanella et al


title: Informed Consent in the (Mis) Information Age

text: Recent studies suggest that large numbers of healthcare consumers are turning to the Internet as a source of health information. This article considers the potential impact of on-line health information on women’s health-care decisions, and the role of physicians relating to their patients’ use of the Internet as an information source. In particular, the article examines the effect of on-line health information on the informed consent process. Physicians’ disclosure obligations (their legal duty to provide information to patients) and the law of informed consent are briefly described. The article then considers the Internet as a source of health information, and instances and types of misinformation. Finally, the article suggests steps physicians may take to help their patients benefit from Internet health information and to become critical consumers who do not fall victim to inaccurate or misleading information. The article concludes by suggesting that physicians make a practice of asking their patients about alternate sources of information they may have accessed, in order to help ensure that patients’ health-care decisions are based on current accurate and complete information.


Author index volume 5, 2004


Infections in cystic fibrosis


Clinical research in the context of rapidly emerging public health threats


title: Time Trends of Th1 and Th2 Cytokines in Induced Sputum of Asthmatic Subjects During Acute Upper Respiratory Viral Infections

text: FUNDAMENTALS: Many asthma exacerbations are caused by respiratory viral infections that induce the interplay between Th1 and Th2 immune responses. However, the time trends for Th1 and Th2 immune responses during these phenomena have not been well studied. OBJECTIVE: To identify possible mechanisms underlying the link between respiratory viral infections and asthma exacerbations. PATIENTS AND METHODS: We recruited 40 adults aged 21-58 years for 4 groups. A. Healthy, B. Healthy with viral infection, C. Mild to moderate asthma and D. Same as C, but with viral infection. Th1 and Th2 cytokines in induced sputum samples during the course of acute upper respiratory viral infections in otherwise healthy and asthmatic individuals were monitored. IL-4, IL-5 and IFN-γ were assayed by ELISA. Viral infection symptoms and asthma severity scores were monitored. Time trends were analyzed using linear mixed models. RESULTS: IL-4 and IL-5 levels in groups C and D were higher than in groups A and B. IFN-γ levels and viral infection symptoms scores in group B spiked by day 2 and rapidly declined by day 7, while in group D, IFN-γ and symptoms scores for viral infection and asthma peaked much later (days 3-5) and slowly declined. The ratios of IL-4 and IL-5 to IFN-γ in group D were significantly higher than in group C. CONCLUSIONS: Infection-induced asthma exacerbations may be due to impaired anti-viral Th1-immune responses. There appears to be a critical window of 3-5 days for therapeutic intervention.


Potential and challenges of serotherapy for severe influenza


Revue de presse


The cost and challenge of vaccine development for emerging and emergent infectious diseases


A chance to implement One Health in the Middle East and north Africa


title: Direct pathogen detection from swab samples using a new high-throughput sequencing technology

text: The detection of emerging infectious diseases has been a continuing concern, especially with the novel influenza A (H1N1) viral pandemic of 2009. In the present study, we validated a ‘second-generation’ parallel sequencing platform for viral detection in swab samples collected during recent influenza virus infections in Beijing. This operation yielded millions of valid reads per sample and resulted in an almost complete spectrum of nucleotide information. Importantly, novel A (H1N1) and seasonal A (H3N2) influenza virus-derived sequences were detected without prior knowledge or use of genetic information in advance, suggesting that this approach could be a valuable tool for diagnosing emerging infectious diseases.


Canine infectious respiratory disease: Tackling the unknown unknowns


Index to Volume 9, 2007


Proteomics in infectious diseases


A new public health world order


Revising the International Health Regulations: call for a 2017 review conference


Health conditions for travellers to Saudi Arabia for the Umra and pilgrimage to Mecca (Hajj) – 2014()


Highlights from the 6(th) International Meeting on Emerging Diseases and Surveillance (IMED 2016) Vienna, Austria from Nov 3 to 7, 2016


Europe set to tackle zoonotic infections


title: A new Amaryllidaceae alkaloid from the bulbs of Lycoris radiata

text: AIM: To study the Amaryllidaceae alkaloids of the bulbs of Lycoris radiata. METHODS: The chemical constituents were isolated and purified by various chromatographic techniques, and the chemical structures were elucidated on the basis of spectroscopic methods. In addition, the antiviral activities of alkaloids 1–10 were evaluated using flu virus A. RESULTS: One new homolycorine-type alkaloid 2α-methoxy-6-O-ethyloduline (1), together with nine known alkaloids 2α-methoxy-6-O-methyloduline (2), trispherine (3), 8-O-demethylhomolycorine (4), homolycorine (5), 9-O-demethylhomolycorine (6), oduline (7), lycorenine (8), 6α-O-methyllycorenine (9) and O-ethyllycorenine (10) were obtained. CONCLUSION: Alkaloid 1 is a new compound, and 1–3 were major alkaloids in this plant. Alkaloids 1–3 showed weak antiviral activities against flu virus A with IC50 values of 2.06, 0.69, and 2.71 μg·mL-1 and CC50 values of 14.37, 4.79, and 80.12 μg·mL-1, respectively.


Summary of WHO measures related to international travel23 May 2003


Viral and atypical pathogens as causes of type 1 acute exacerbations of chronic bronchitis


Severe acute respiratory syndrome in developing countries


Canine parvovirus post-vaccination shedding: Interference with diagnostic assays and correlation with host immune status


Measles transmission during commercial air travel in Brazil


A case of imported Monkeypox in Singapore


Cross-species transmission resulted in the emergence and establishment of circovirus in pig


Health-care associate transmission of Middle East Respiratory Syndrome Corona virus, MERS-CoV, in the Kingdom of Saudi Arabia


Avian influenza should be ruffling our feathers


A call to respond, not to react


SARS: an amalgam of avian and mammalian viruses?


Arguments Against Corticosteroids in Community Acquired Pneumonia


Redesign proposed for UK infrastructure to fight infection


Exploring the Breadth of Supportive Cancer Care Issues


How respiratory viruses overcome mucosal defenses and exploit the unique environment of the respiratory tract


Hajj: preparations underway


Combating the emerging viral infectious diseases


The search for therapeutic options for Middle East Respiratory Syndrome (MERS)


title: Analysis of Synonymous Codon Usage in Aeropyrum pernix K1 and Other Crenarchaeota Microorganisms

text: In this study, a comparative analysis of the codon usage bias was performed in Aeropyrum pernix K1 and two other phylogenetically related Crenarchaeota microorganisms (i.e., Pyrobaculum aerophilum str. IM2 and Sulfolobus acidocaldarius DSM 639). The results indicated that the synonymous codon usage in A. pernix K1 was less biased, which was highly correlated with the GC(3S) value. The codon usage patterns were phylogenetically conserved among these Crenarchaeota microorganisms. Comparatively, it is the species function rather than the gene function that determines their gene codon usage patterns. A. pernix K1, P. aerophilum str. IM2, and S. acidocaldarius DSM 639 live in differently extreme conditions. It is presumed that the living environment played an important role in determining the codon usage pattern of these microorganisms. Besides, there was no strain-specific codon usage among these microorganisms. The extent of codon bias in A. pernix K1 and S. acidocaldarius DSM 639 were highly correlated with the gene expression level, but no such association was detected in P. aerophilum str. IM2 genomes.


Influencia de los factores meteorológicos y contaminantes del aire en casos de bronquiolitis grave en el área metropolitana de Barcelona: estudio piloto


The medical literature and the discipline of infection control


First US SARS trial launches


Human polyomavirus KI and WU in adults with community acquired pneumonia in The Netherlands, 2008–2009


SARS returns to China


Achievements and highlights for Infection, Disease and Health


title: Sustainable development strategy of tourism resources offered by regional advantage: Exploring the feasibility of developing an ‘exotic culture’ resource for Weihai City of China

text: Tourism resources are the prerequisite and basis for urban tourism development. Unlike mineral products and oil, tourism resources are renewable. How to find, create, manage, and maintain urban tourism resources will determine if they can be used sustainably. As the traditional coastal tourist city of China, Weihai does not have obvious advantages compared with other areas, so Weihai should develop a new tourism resource, an ‘exotic culture’ resource, offered by regional advantage. The paper will explore the feasibility of developing an ‘exotic culture’ resource for Weihai tourism in order to fulfil the sustainable utilization and development of tourism resources.


Editorial overview: Emerging viruses: Interspecies transmission


The emergence of a new corona virus—MERS-CoV: Hind sight is always 20/20


Meeting Report: Part I. Notes from the Molecular Virology Workshop 23–24 April, 2004, Clearwater Beach, Florida, USA


Scott Hammer—integrating research with politics, public policy, and international collaborations


Case fatality ratio of pandemic influenza


Is it the end of the nervous breakdown on avian influenza?


Fighting back against chikungunya


title: Brain abscess in seven cats due to a bite wound: MRI findings, surgical management and outcome

text: PRESENTATION AND LESION LOCALISATION: Seven adult domestic shorthair cats were presented with a 1- to 6-day history of progressive neurological signs. A focal skin puncture and subcutaneous swelling over the dorsal part of the head were detected on physical examination. Neurological examination indicated lesion(s) in the right forebrain in four cats, multifocal forebrain in one cat, left forebrain in one cat, and multifocal forebrain and brainstem in the remaining cat. In all cats, magnetic resonance imaging revealed a space-occupying forebrain lesion causing a severe mass effect on adjacent brain parenchyma. CLINICAL APPROACH AND OUTCOME: All cats were managed with a combination of medical and surgical treatment. At surgery a small penetrating calvarial fracture was detected in all cats, and a tooth fragment was found within the content of the abscess in two cats. The combination of surgical intervention, intensive care and intravenous antimicrobials led to a return to normal neurological function in five cats. PRACTICAL RELEVANCE: As this series of cases indicates, successful resolution of a brain abscess due to a bite injury depends on early recognition and combined used of antimicrobials and surgical intervention. A particular aim of surgery is to remove any skull and foreign body (tooth) fragments that may represent a continuing focus of infection.


Pat Troop-Chief Executive of the UK Health Protection Agency


Establishment of a mass gathering department within health service systems


Preparing for the first influenza pandemic of the 21st century


Getting out into the field, and forest


Caracterización clínica y etiológica de los casos de parotiditis en un servicio de urgencias


WHA acts on health regulations and intellectual property


The concept of commensal viruses almost 20 years later: redefining borders in clinical virology


title: Lead, a major environmental pollutant, is immunomodulatory by its differential effects on CD4(+) T cell subsets

text: Studies were undertaken to address the necessity of B-T cell contact for the enhancement of B cell differentiation caused by the heavy metal lead (Pb). Membrane segregated cultures were used so that the influences of direct B-T cell contact and T cell factors on B cell differentiation could be independently evaluated. B-T cell contact was not absolutely required for Pb's enhancement of B cell maturation to antibody forming cells (AFCs); however, enhancement of the AFC response by Pb was optimal when B-T cell interactions were allowed. These results were corroborated by use of anti-L3T4 (mouse CD4) to block CD4(+) T cell-B cell interaction. Blockade of B-T cell contact with anti-L3T4 did not inhibit the enhancement of the AFC response by Pb. Additional experimentation showed that Pb enhanced the AFC response and Ig production in the presence of antigen-specific T cell help, suggesting that Pb enhances B cell differentiation by augmenting cognate help rather than by inducing a response to Pb-altered-self. In studies employing antigen-specific T cell clones, Pb was found to differentially modulate antigen presentation to T(H1) versus T(H2) T cell clones, in that T(H1) activation was inhibited and T(H2) activation was enhanced by Pb.


title: Tumour necrosis factor causes an increase in axonal transport of protein and demyelination in the mouse optic nerve

text: An increase in fast axonal transport of protein by the optic nerve was found in mice following a single combined injection of human recombinant tumour necrosis factor alpha (rTNF) and [(3)H]proline into the vitreous chamber. Demyelination was observed in optic nerve fibres arising from the eyes of mice which received a single rTNF injection. No such changes were detected when heat-inactivated rTNF was injected with the label. The effects of intravitreal injection of rTNF on the pathophysiology of mouse optic nerve resembled those found in mice infected with Semliki Forest virus (SFV), an animal model of multiple sclerosis. We suggest that TNF could mediate at lease some of the pathophysiological changes found in SFV-infected mice and may provide a clue concerning the disease mechanism in multiple sclerosis.


title: The pathogenesis of multiple sclerosis: Additional considerations

text: Multiple sclerosis (MS) is acquired as a systemic “trait” by individuals who are genetically susceptible. This condition does not involve the central nervous system (CNS) and is characterized by a state of hyperactive immunocompetent responsiveness. It develops as the result of an antigenic challenge by a viral protein, either from a viral infection or a vaccination. In order for MS to become a disease affecting the CNS, it is necessary for the blood-brain barrier's (BBB) impermeability to be altered. This is now a fully recognized fact. As a result of this change, the MS lesion, which consists of edema and inflammation occurs. It may but need not lead to demyelination. Several mechanisms can cause this increased permeability of the BBB. The role of the immune system, and in particular of T lymphocytes in initiating and continuing the process of lesion formation remains extremely controversial. In fact, there are unanswered questions regarding the actual target of MS: is it the myelin sheath itself or its forming cell, the oligodendrocyte, or is it the BBB itself leading to bystander demyelination? The role of mild, concussional trauma to the CNS in producing the alteration of the BBB and therefore acting as a trigger or facilitator in the development or enlargement of MS lesions in the CNS, is based on considerable clinical, neuropathological and experimental evidence. Along with another viral infection, it must be one of the commonest causes of progression of MS, and quite often leads to the onset of the clinical manifestations of an hitherto asymptomatic condition.


Hong Kong’s gloom and doom


DEPENDING ON VACCINES


title: Cryptosporidiosis in Perspective

text: This chapter focuses on cryptosporidiosis in perspective. The significance of cryptosporidiosis in humans, however, depends on the severity of the disease it produces and the incidence in population, both of which are unknown. The frequency of cryptosporidiosis is highest in children aged between six months and three years. The chapter discusses these epidemiological observations and more accurate information regarding the morphology and the life-cycle of Cryptosporidium. Detailed studies on the life-cycle and the ultrastructure have provided a better understanding of the biology of the parasite and have highlighted its unique characteristics. Of these, the existence of sporulated, thin-walled oocysts, and their independence of reducing conditions for excystation are of major importance and may explain the occurrence of autoinfection and persistent infection. Cryptosporidium has numerous characteristics that set it apart from the rest of that subclass. The parasite's ability to maintain persistent infection in certain individuals and its astonishingly stubborn resistance to chemotherapy are serious medical problems that need to be addressed in the future.


title: The oligomeric structure of renal aminopeptidase N from bovine brush-border membrane vesicles

text: Bovine renal brush-border membrane vesicle aminopeptidase N at various stages of purity was treated with two bifunctional cross-linking agents. A pattern of emergence of higher molecular weight forms was observed. By using a cleavable cross-linker, aminopeptidase N was shown to cross-link both to itself and to its breakdown products as well as to dipeptidyl peptidase IV. Using this technique it was possible to identify three of the breakdown products as 45 kDa, 66 kDa and 95 kDa peptides. N-terminal amino acid sequence analysis was used to define the precise cleavage points for the bovine renal aminopeptidase N breakdown products. The short amino acid sequences obtained show strong sequence similarity with the human intestinal and rat kidney aminopeptidase N.


title: Studies on the mechanism of protection from acute viral encephalomyelitis by delayed-type hypersensitivity inducer T cell clones

text: Previous studies have shown that mice can be protected from a lethal infection with the neurotropic JHM strain of mouse hepatitis virus (JHMV) by the adoptive transfer of delayed-type hypersensitivity (DTH)-inducer T cell clones specific for the virus. Protection does not involve the suppression of virus replication in the central nervous system (CNS) or via augmentation of the antiviral antibody response. In the present report we have compared the CNS lesions induced by JHMV in lethally infected and T cell clone protected mice. The presence of virus-specific T cell clones induced a transient increase in mononuclear cell infiltration into the parenchyma of the brains of protected mice, consistent with previous data suggesting that a DTH response was responsible for protection. Immunohistochemical studies suggested further that virus was not replicating in the ependyma or cellular infiltrate, but that the presence of the T cell clone prevented neuronal infection. While the mechanism of effectively altering the in vivo cellular tropism is unknown, survival is accompanied by increased specific destruction of target tissues with fulminant CNS demyelination and an increased incidence of persistent infection.


title: The malaria-infected red blood cell: Structural and functional changes

text: The asexual stage of malaria parasites of the genus Plasmodium invade red blood cells of various species including humans. After parasite invasion, red blood cells progressively acquire a new set of properties and are converted into more typical, although still simpler, eukaryotic cells by the appearance of new structures in the red blood cell cytoplasm, and new proteins at the red blood cell membrane skeleton. The red blood cell undergoes striking morphological alterations and its rheological properties are considerably altered, manifesting as red blood cells with increased membrane rigidity, reduced deformability and increased adhesiveness for a number of other cells including the vascular endothelium. Elucidation of the structural changes in the red blood cell induced by parasite invasion and maturation and an understanding of the accompanying functional alterations have the ability to considerably extend our knowledge of structure-function relationships in the normal red blood cell. Furthermore, interference with these interactions may lead to previously unsuspected means of reducing parasite virulence and may lead to the development of novel antimalarial therapeutics.


Ribavarin Should Be Tested in Clinical Trials in Combination With Other Antiviral Agents for Severe Acute Respiratory Syndrome


title: Diarrhoea in the dog and cat I. Acute diarrhoea

text: Faeces are not always uniform in consistency. Many owners believe that variations in faecal consistency are abnormal, but consistency may vary during one evacuation, i.e. initially firm but latterly soft, or over the day, e.g. the initial morning faeces are frequently firmer than those passed later in the day. It is normal for a dog to defaecate more than twice daily. The accepted range of normality for the dog and cat is one to four times daily although this depends on the diet. The faecal output of a dog fed on a dry, complete diet may be twice that on a meat-based diet. The addition of dog biscuit to the meat has little effect upon faecal bulk as most biscuit is low in fibre.


SARS, Pneumothorax, and Our Response to Epidemics


title: Prevalence of antibodies to IBR and BVD viruses in dairy cows with reproductive disorders

text: We determined the prevalence of antibodies to infectious bovine rhinotracheitis virus (IBRV) and bovine viral diarrhea virus (BVDV) in sera of dairy cows on 4 different farms in the Republic of Croatia. A high percentage (60.8%) of cows had various reproductive disorders. The results showed that seroprevalence of infectious bovine rhinotracheitis (IBR) was 85.8% and that of bovine viral diarrhea (BVD) was 79.2% in tested cows. Antibodies to both viruses were found in 80.8% of cows with reproductive disorders but in only 46.8% of cows without reproductive disorders. This difference was statistically significant (P<0.01), and indicated a connection between reproductive disorders and simultaneous infections with IBR and BVD viruses in dairy cows.


Safe treatment of health-care workers with Ebola


A winter of windborne spread


title: Central nervous system myelin: structure, function, and pathology

text: Multiple sclerosis (MS) and a number of related distinctive diseases are characterized by the active degradation of central nervous system (CNS) myelin, an axonal sheath comprised essentially of proteins and lipids. These demyelinating diseases appear to arise from complex interactions of genetic, immunological, infective, and biochemical mechanisms. While circumstances of MS etiology remain hypothetical, one persistent theme involves recognition by the immune system of myelin-specific antigens derived from myelin basic protein (MBP), the most abundant extrinsic myelin membrane protein, and/or another equally susceptible myelin protein or lipid component. Knowledge of the biochemical and physical—chemical properties of myelin proteins and lipids, particularly their composition, organization, structure, and accessibility with respect to the compacted myelin multilayers, thus becomes central to the understanding of how and why these antigens become selected during the development of MS. This review focuses on current understanding of the molecular basis underlying demyelinating disease as it may relate to the impact of the various protein and lipid components on myelin morphology; the precise molecular architecture of this membrane as dictated by protein—lipid and lipid—lipid interactions; and the relationship, if any, between the protein/lipid components and the destruction of myelin in pathological situations.


title: Transmissible Gastroenteritis: Mucosal ion transport in acute viral enteritis

text: Ion transport in the jejunal mucosa of 14- to 16-day-old piglets with severe diarrhea 40hr after infection with transmissible gastroenteritis (TGE) virus was studied. In infected pigs Na(+) transport failed to. respond normally to glucose when studied either in Ussing short-circuited chambers or in suspensions of enterocytes isolated selectively from jejunal villi. Theophylline, 10 mm, added to the chambers produced the same brisk electrical responses and increments in net Cl(−) secretion in tissue from both infected and control groups. A defect in glucose-stimulated Na(+) absorption in the acute stage of a viral enteritis has been identified which probably contributes to the impaired lumen-to-extracellular fluid flux of Na(+) found previously in the jejunum of intact TGE-infected pigs. The mechanisms causing diarrhea in this invasive viral enteritis differ from those causing toxigenic diarrhea.


title: Identification of an aprotinin antiviral domain

text: Digestion of the proteinase inhibitor aprotinin, by clostripain, a cysteine proteinase, yielded five oligopeptide fragments. Two fragments exhibited both antiviral and antibacterial activities, two fragments only antiviral activity, and one fragment showed no antimicrobial activity. One of the former oligopeptides showed antiviral activity against human herpes simplex virus type 1 and bovine parainfluenza virus type 3. It consisted of the hexapeptide Y-F-Y-N-A-K corresponding to amino acids 21–26 of intact aprotinin. An identical synthetic peptide had the same antiviral spectrum as the natural hexapeptide, exhibited no antibacterial activity, and was also devoid of trypsin inhibiting activity. Intact aprotinin, in contrast, is ineffective against human herpes simplex virus 1 and bovine parainfluenza virus 3 but possesses antibacterial properties against several bacterial species [(1992) J. Appl. Bact. 72, 180–187].


Treatment of Severe Acute Respiratory Syndrome


title: The use of Arsenicum album 30c to complement conventional treatment of neonatal diarrhoea (‘scours’) in calves

text: In a pilot double blind study carried out in Scotland, the effect of supplementing a conventional treatment plan with homoeopathic Arsenicum album was studied. In the management of neonatal calf scour it appeared that more animals recovered after one day in the group that had received active medicine, than in the placebo group. These results are encouraging.


Response


Economically significant enteric infections in domestic animals in Australia


Subject Index to Volumes 86-95


title: Analogous amino acid sequences in myelin proteolipid and viral proteins

text: Computer analysis of the intrinsic membrane protein, myelin proteolipid, shows strong sequence similarities between the putative extramembrane segments of the proteolipid protein and a number of viral proteins, several of which infect humans. These similarities are even more striking than those reported previously between viral proteins and the encephalitogenic myelin basic protein (MBP). These findings, along with other reports of molecular mimicry by viruses, suggest that immunological cross‐reactions between virus‐induced antibodies or T‐cells and analogous antigenic determinants (epitopes) in myelin proteolipid could be involved in the pathophysiology of multiple sclerosis or post‐infectious demyelinating syndromes.


title: Chapter 1 Viruses as Model Systems in Cell Biology

text: This chapter focuses on the contributions that studies with viruses have made to current concepts in cell biology. Among the important advantages that viruses provide in such studies is their structural and genetic simplicity. The chapter describes the methods for growth, assay, and purification of viruses and infection of cells by several viruses that have been widely utilized for studies of cellular processes. Most investigations of virus replication at the cellular level are carried out using animal cells in culture. For the events in individual cells to occur with a high level of synchrony, single cycle growth conditions are used. Cells are infected using a high multiplicity of infectious virus particles in a low volume of medium to enhance the efficiency of virus adsorption to cell surfaces. After the adsorption period, the residual inoculum is removed and replaced with an appropriate culture medium. During further incubation, each individual cell in the culture is at a similar temporal stage in the viral replication process. Therefore, experimental procedures carried out on the entire culture reflect the replicative events occurring within an individual cell. The length of a single cycle of virus growth can range from a few hours to several days, depending on the virus type.


Novel coronavirus associated with SARS outbreak


title: Immunolabelling of fish host molecules on the tegumental surface of Ligula intestinalis (Cestoda: Ppseudophyllidea)

text: Immunoblotting, SDS-PAGE and western biotting procedures were used to demonstrate cross-reactivity of a polyclonal anti-carp IgM antibody with components of roach serum. The polyclonal antibody labelled 2 major bands in both immune and normal roach sera corresponding to molecular mannes of approximately 90 and 65 kDa. One of these bands (65 kDa) was considered to be the heavy chain of fish immunoglobulin whilst the identity of the other remains uncertain. This cross-reaction has been exploited in immunofluorescence and immunogold labelling studies to localize fish host molecules on the tegumental membrane of Ligula intestinalis freshly removed from roach fry. Immunogold studies revealed a low level of host molecules to be associated mainly with the microthrix spines of the tegament with less gold labelling being observed on the microthrix shafts.


SARS, Cough, and Fever—or Is It SARS, Fever, and Cough?


title: Mycotoxicosis produced in rats by cultural products of an isolate of aspergillus ochraceus

text: The toxicity of an isolate of Aspergillus ochraceus was examined in weanling male Sprague-Dawley rats fed diets containing a rice culture or fungal mat of the organism for 5 wk. The ground rice culture was mixed with a commercial purified diet at concentrations of 5, 7·5 and 10% and the fungal mat at concentrations of 1, 2 and 3%. In groups fed the rice-culture diets, weight gains were reduced and all the rats in the group fed the 10% diet died. Rats fed fungal-mat diets showed a marked reduction in weight gain, and the death rate was high (about 83%) in groups fed the 2 or 3% diet. Gross lesions found in groups fed either type of diet included focal necrosis in the liver, greenish discoloration of the kidneys, gastric ulceration, ulceration of the scrotal epidermis and corneal opacity. Histological changes in the liver included necrosis of the epithelium of biliary ducts, periductal oedema, pericholangitis, periductal fibrosis and disseminated focal hepatocellular necrosis. Necrosis of epithelium occurred also in the extraheptic ducts and was accompanied by an interstitial pancreatitis in certain rats. Foci of leucocytes and macrophages were found in the dermis of the scrotum and in the epididymal adipose connective tissue. Ulceration of the epidermis occurred late in the sequence of scrotal changes. Ocular lesions comprised corneal oedema, interstitital keratitis, iridocyclitis and hypopyon. Renal lesions consisted of tubular necrosis and hyaline and biliary casts within convoluted tubules.


title: Detection of porcine reproductive and respiratory syndrome virus and Mycoplasma hyorhinis antigens in pulmonary lesions of pigs suffering from respiratory distress

text: Eleven field cases of a disease characterized by severe dyspnoea or abdominal breathing were examined post mortem. The affected pigs had antibody against porcine reproductive and respiratory syndrome virus (PRRSV). The predominant lung lesions were severe proliferative and interstitial pneumonia, and slight suppurative bronchopneumonia. The lesions were closely associated with the sites at which PRRSV and Mycoplasma hyorhinis antigens were detected. Four of five pigs inoculated with PRRSV developed slight pneumonitis. The fifth animal, which died of severe pneumonitis, yielded a heavy culture of M. hyorhinis. These findings demonstrate that dual infection with M. hyorhinis and PRRSV caused severe pulmonary lesions.


Equine exercise physiology—New horizons


PRRS: Trans-Atlantic Cooperation and new ideas


title: Molecular and immunodiagnostic investigations on bovine neosporosis in Switzerland

text: Neospora caninum has gained considerable attention through its role in the aetiology of bovine abortion. Due to its close phylogenetic relationship with Toxoplasma gondii, respective unequivocal differential diagnosis deserves special consideration. In order to evaluate the diagnostic performance of molecular and immunodiagnostic techniques and to provide insights into the epidemiological significance of bovine neosporosis in Switzerland, we conducted a study on 83 cases of bovine abortion: of these, 24 (29%) foetal brains were positive by Neospora-PCR, six of these foetuses were simultaneously seropositive in Neospora-IFAT and/or somatic antigen-ELISA. Conversely, four (5%) foetal brains were considered positive by Toxoplasma-PCR, two of which were also seropositive in the Toxoplasma-P30-ELISA and/or direct agglutination test. The seroprevalence in 1689 cattle sera obtained from 113 dairy farms was 11.5% (95% confidence interval: 9.2–13.8) by Neospora-somatic antigen-ELISA and 10.7% (95% confidence interval: 8.3–12.6) by Toxoplasma-P30-ELISA. From the same samples, 1.1%, less than statistically expected, were positive in both ELISA. Within selected groups of cow-calf farms, the seroprevalence determined using the Neospora-somatic antigen-ELISA was 14% (95% confidence interval: 5.0–23.0) for dams and 15% (95% confidence interval: 3.0–28.0) for offspring calves. Seroprevalences determined by Toxoplasma-P30-ELISA were 8% (95% confidence interval: 4.0–12.0) for dams and 3% (95% confidence interval: 0.3–6.0) for calves. None of the sera gave a positive reaction in both ELISA. Our data indicated that prenatal neosporosis appears as an important cause of bovine abortion in Switzerland.


title: Acidic pH induces fusion of cells infected with baculovirus to form syncytia

text: The enveloped baculovirus⧹insect cell system has been used extensively for expression of recombinant proteins. including viral fusion proteins. We tested wild‐type baculovirus for endogenous fusion protein activity. Syncytia formation, dye transfer, and capacitance changes were observed after incubating infected Spodoptera frugiperda cells in acidic media, consistent with fusion protein activity. Only a short acidic pulse or 10 s is needed to trigger syncytia formation. Identical results were obtained with recombinant baculovirus. This new system convenient for studying pH activated cell‐cell fusion. However, using this enveloped virus to study the mechanism of recombinant fusion proteins requires caution.


Causation of Crohn's disease: The impact of clusters


Animal disease research


Could human bocavirus be a causative agent of parotitis in children?


title: Pathological, immunocytochemical and microbiological findings in calf pneumonias associated with Haemophilus somnus infection

text: Pathological, immunocytochemical and microbiological findings in 32 cases of calf pneumonia associated with Haemophilus somnus infection are described. The majority of cases were "found dead" or died after a sudden onset pneumonia of less than 24 h duration. Lesions of exudative bronchopneumonia were present and the cases could be divided into two main groups on the basis of histopathological and immunocytochemical features. In group A, cases were dominated by necrotizing bronchiolitis, degeneration and necrosis of airway and alveolar exudates, severe alveolitis with accumulations of degenerate basophilic cells, interstitial inflammatory changes and the widespread distribution of H. somnus antigen in airways and alveoli. In Group B, necrotizing and degenerative changes were much less extensive and less severe and the overall appearance was of suppurative bronchopneumonia with H. somnus antigen much less widespread within the lungs. Alveolar oedema, hyaline membrane formation and alveolar epithelial hyperplasia were present in caudodorsal lung areas of several calves. No major differences were seen between the histopathology of lungs where H. somnus was the sole isolate and that of lungs where H. somnus was isolated along with other bacterial pathogens.


title: Relationship between onset of puberty and establishment of persistent infection with equine arteritis virus in the experimentally infected colt

text: The relationship between stage of reproductive tract maturity and susceptibility to the experimental establishment of persistent infection with equine arteritis virus, (EAV) was investigated in 21 prepubertal and 15 peripubertal colts. Five of six prepubertal colts inoculated intranasally remained infected in the reproductive tract from post-challenge day 28 to 93 and two of six from post-challenge day 120 to 180. No virus was detected in five of these animals killed on post-challenge day 210. Each of two peripubertal colts remained infected in the reproductive tract at post-challenge day 60 and one of nine was found to be persistently infected with EAV 15 months after challenge. These findings confirm that the virus can replicate in the reproductive tract of a significant proportion of colts for a variable period of time after clinical recovery in the absence of circulating concentrations of testosterone equivalent to those found in sexually mature stallions. Long-term persistent infection with EAV does not appear to occur in colts exposed to the virus before the onset of peripubertal development. We suggest that colts should be vaccinated at approximately 6 months of age, before peripubertal development but after the disappearance of maternally acquired antibodies.


title: Blood biochemical reference ranges for sows under modern management conditions

text: Published reference ranges for blood biochemistry in swine generally do not relate to sows in modern breeding units, and results were often obtained by methods that are now outdated. The ranges widely used in clinical practice reflect these inappropriate sources. The data presented here were obtained using modern methods of analysis on blood samples from healthy, conventionally managed sows from six breeding herds of known disease status in eastern England, and thus represent appropriate ranges for this class of swine. The values differ from earlier reports principally in higher values for total bilirubin, creatine kinase, and more particularly of total plasma and serum proteins. The latter are shown to be due to higher immunoglobulin concentrations than those previously reported.


A study of infective and other factors in exacerbations of chronic bronchitis


Unusual nosocomial infections


Protagonismo de los virus en la etiología de cuadros respiratorios


Reduce, reuse, and recycle: Shedding light on shedding cells


Can We Diagnose Amebiasis?


title: Rotavirus infection in calves, piglets, lambs and goat kids in trinidad

text: Faecal samples from diarrhoeic and non-diarrhoeic calves, piglets, lambs and goat kids were collected and screened by a latex agglutination test to detect the presence of group A rotavirus antigen. Of a total of 470 animals screened, 138 (29.4%) had faecal samples positive for rotavirus antigen. The prevalences of infection were 27.7% (73/264) in calves, 27.8% (45/162) in piglets, 48.6% (18/37) in lambs and 28.6% (2/7) in goat kids. Rotavirus antigen was not detected in calves and lambs <1 week old and in piglets <2 weeks old. The highest prevalence was found in calves between the ages 1–6 weeks (72.6%); piglets, 2–8 weeks (91.1%) and in lambs 1–8 weeks (88.9%). The overall prevalence of infection was 39.9% for diarrhoeic and 13.4% for non-diarrhoeic animals and the difference was statistically significant (P⩽0.001; X(2)). Differences among husbandry systems in relation to the prevalence of rotavirus infection were not statistically significant (P⩾0.05; X(2)). The relatively high prevalence of rotavirus infection in the young animals tested, coupled with the detected significantly higher infection rates in diarrhoeic animals, indicate that rotavirus may be important in livestock diarrhoea in Trinidad.


title: Abnormalities of serum and plasma components in patients with multiple sclerosis

text: Qualitative and quantitative abnormalities in protein and non-protein components of serum and plasma in patients with multiple sclerosis have been the subjects of numerous reports. In this review many of the more recent observations are documented and evaluated. It is concluded that at present the welter of information that has been gathered does not contribute in any major, coherent way to our understanding of the etiology or pathogenesis of the disorder. Several of the abnormalities that have been observed may be future candidates for biochemical markers for multiple sclerosis; at present none is sufficiently reliable, distinctive or easily performed to warrant the status of a useful diagnostic or prognostic test.


title: Neurotropism of mouse-adapted haemagglutinating encephalomyelitis virus

text: The propagation of a mouse-adapted strain, (67N) of haemagglutinating encephalomyelitis virus in infected mice and murine cells was examined by viral re-isolation and immunostaining. Viral propagation was strictly limited to the neurons and to an established line of neuroblastoma cells in in-vivo and in-vitro experiments. These results provide adequate evidence that this virus is neurotropic.


Recent Advances in Viral Gastroenteritis


title: The Mucosal Lesion in Viral Enteritis: Extent and Dynamics of the Epithelial Response to Virus Invasion in Transmissible Gastroenteritis of Piglets

text: In transmissible gastroenteritis (TGE) of piglets, an infection closely resembling human rotavirus enteritis, we studied the timing and extent of epithelial viral invasion along the small intestine after a single oral inoculum of virus; we related these findings to measured alterations in mucosal structure, kinetics, and differentiation, and to previously documented abnormalities of ion transport that occurred at the height of diarrhea. Six and twelve hours after inoculation, before diarrhea, extensive specific viral immunofluorescence and viral particles on electron microscopy were seen in villus but not crypt enterocytes in jejunum, mid-intestine, and ileum. At 24 and 40 hr, when diarrhea was most severe, immunofluorescence was patchy; villus blunting (P < 0.001) and increased crypt depth (P < 0.001) were observed by light microscopy in all segments; radioautographically labeled enterocytes showed accelerated migration and shortened life span; and cells on villi were deficient in sucrose activity (P < 0.001) and rich in thymidine kinase activity (P < 0.005), suggesting relative immaturity. Villus structure recovered by 72 and 144 hr, although deeper crypts (P < 0.001) and accelerated migration still persisted. We conclude that extensive, almost simultaneous direct viral invasion of villus enterocytes can occur along the entire length of the small intestine after a single exposure to virus, and thus can cause shedding of mature villus cells and proliferation and accelerated migration of cells from the crypts. At the height of diarrhea, when enterocyte turnover is maximal, the epithelium consists predominantly of immature virus-free cells which have migrated to the villi in a relatively undifferentiated state.


Uncertainty, risk analysis and change for Ebola personal protective equipment guidelines


Highlights of international conference of immunogenomics and immunomics, October 8–12, 2006 Budapest, Hungary


title: Detection of nucleic acids of porcine reproductive and respiratory syndrome virus in the lungs of naturally infected piglets as determined by in-situ hybridization

text: Replication of porcine reproductive and respiratory syndrome virus (PRRSV) was studied in formalin-fixed paraffin wax-embedded lung tissues from seven naturally infected piglets by in-situ hybridization with a non-radioactive digoxigenin-labelled probe. A 433 base pair cDNA probe for the viral RNA encoding the nucleocapsid proteins of a Korean PRRSV isolate was generated by the polymerase chain reaction. All seven piglets infected with PRRSV showed a distinct, positive signal, scattered throughout the alveolar septa and spaces. Positive cells typically exhibited dark brown staining deposits in the cytoplasm without background staining. In-situ hybridization demonstrated that PRRSV replicated primarily in interstitial and alveolar macrophages, and occasionally in type 2 pneumocytes. The bronchial or bronchiolar epithelium did not exhibit a hybridization signal for PRRSV nucleic acids. The anterior and middle lobes of the lung were more reliable than the caudal or accessory lobes for the detection of PRRSV nucleic acids. The in-situ hybridization technique used was rapid, specific and sensitive, and may prove useful for the diagnosis of PRRSV infection in routinely fixed and processed tissues.


title: Generalized intravascular proliferation in two cats: Endotheliosis or intravascular pseudoangiosarcoma?

text: Two cats had unusual occlusive vascular endothelial proliferations in several organs. The newly formed cells were strictly intraluminal and of endothelial origin, as shown by positive immunohistochemical staining with factor VIII-related antigen.


title: Enterotoxic effect of stool supernatant of Cryptosporidium-infected calves on human jejunum

text: BACKGROUND/AIMS: The clinical pattern of cryptosporidial diarrhea suggests an enterotoxic mechanism. No evidence for this mechanism has been reported thus far. This study aimed to look for enterotoxic effect elaborated by Cryptosporidium. METHODS: The effects on human intestinal transport of stool supernatant of diarrheal calves infected with Cryptosporidium parvum were examined. Aliquots of centrifuged and filtered stools were added to the mucosal or serosal side of human jejunum obtained from patients undergoing surgery and mounted in Ussing chambers. Electrical parameters were recorded. Stool supernatants of uninfected calves served as a control. RESULTS: The mucosal addition of 2.5 mg protein of fecal supernatant from diarrheal calves induced a prompt and significant increase in short circuit current with no effects on tissue conductance. The serosal addition of this material and the addition of control supernatant to either side did not induce modifications of electrical parameters. The enterotoxic effect was dose-dependent and saturable. It was reversible by withdrawing the supernatant from the incubation medium. The electrical effect was chloride- and calcium-dependent and was sensitive to heating. CONCLUSIONS: An enterotoxic activity is present in the stools of Cryptosporidium-infected calves. This activity may be responsible for secretory diarrhea in humans.


Primum Non Nocere


Keeping the Workplace Safe in Troubled Times


title: Pathology of equine respiratory disease occurring in association with transport

text: Eight young thoroughbred horses, taken 1858 km by road (travelling time, 41 h), were exmanined toassess the pathological nature of respiratory disease associated with transport. Three of the horses showed clinical abnormalities including pyrexia, coughing, leucocytosis and neutrophilia after the first 20 h of transportation. Endoscopical examination of the trachea revealed exacerbation of airway inflammation as a result of transport in two of the three affected horses. A consistent finding in the affected horses was focal serous neutrophilic pneumonia affecting the cranio-ventral portion of the caudal lung lobe with a propensity to affect the right lung. Streptococcus equi subspecies zooepidemicus was isolated from the pneumonic areas, in which corresponding bacterial antigens were identified immunohistochemically. Viral cultures from the pneumonic lesions proved negative for respiratory viruses. It is suggested that transport predisposes the upper respiratory tract and the lower airways to invasion by the bacterium, with episodic pyrexia and acute pneumonia.


title: Altered Jejunal Permeability to Macromolecules During Viral Enteritis in the Piglet

text: We studied the macromolecular permeability of segments of jejunum from 2-wk-old piglets after the animals had been experimentally infected with an invasive enteric virus, transmissible gastroenteritis virus. Jejunal segments were mounted in Ussing chambers at stages of the infection, and permeability was measured using three probe molecules of differing molecular weights. In control tissue, permeability to horseradish peroxidase was 2.6 times higher across segments with Peyer's patches than across segments without Peyer's patches, whereas polyethylene glycol 4000 and mannitol permeabilities were the same in patch and nonpatch segments. Twelve hours after infection, when virus had invaded the mucosa causing a structural lesion, and before diarrhea had begun, horseradish peroxidase permeability increased in non-patch-containing segments to equal that across patch-containing tissue. At this early 12-h stage, polyethylene glycol 4000 and mannitol permeation were unchanged in patchcontaining segments compared with controls. Ninety-six hours after transmissible gastroenteritis infection, when diarrhea was severe, horseradish peroxidase permeability in patch-free segments had returned to normal and patch-containing tissue permeability was diminished below control levels. Increased macromolecular permeability appears to occur only in the very early invasive stage of this viral enteritis and only in patch-free segments. Any consideration of the immunologic relevance of these complex phenomena must take into account the specialized function of the Peyer's patch regions of the small intestine.


title: Characterization of an influenza A (H3N2) virus isolated from pigs in England in 1987

text: This study describes the isolation and characterization of an influenza virus subtype H3N2 designated A/Swine/Weybridge/163266/87. The virus was isolated from a severe outbreak of respiratory disease in East Anglia. Haemagglutinin and neuraminidase characterization showed the virus to be very similar to H3N2 strains circulating in the human population during the years 1972–1975, and to H3N2 strains recently isolated from pigs in Belgium and France. A serological survey showed antibodies to the virus to be present in 31% of pigs tested, and reactors were detected on 43% of farms sampled.


SELECTED EPIDEMICS & EMERGING PATHOGENS – CONCLUSION


title: Overexpression of TGN38/41 leads to mislocalisation of γ‐adaptin

text: TGN38 and TGN41 are isoforms of a monotopic integral membrane protein which recycles between the trans Golgi network (TGN) and the cell surface, but which, at steady state, is predominantly located in the TGN. Full‐length and truncated versions of rat TGN38/41 have been expressed in monkey (COS) and human (Heb7a) cells under the control of the heavy metal inducible Metallothionein IIA promoter. This has allowed the regulated expression of TGN38/41 protein constructs to different levels in the transfected cells. These studies show that (i) controlled overexpression of TGN38/41 results in mislocalisation to parts of the endocytic pathway, (ii) a truncated version of TGN38/41, lacking the cytoplasmic domain, remains in the TGN, and (iii) there is a direct or indirect interaction between the cytoplasmic domain of TGN38/41 and γ‐adaptin.