Status of equine viral arteritis in Kentucky, 1985

Clinical cases of equine arteritis virus infection have not been diagnosed in Kentucky since 1984, and there has been no indication that any of the horses involved in the 1984 epizootic have since been responsible for spread of the disease to horses in other states or other countries. Cases of abortion caused by naturally acquired infection with this virus have not been confirmed in 1984 or 1985. Neither field nor vaccine strains of equine arteritis virus have been shown to induce teratologic abnormalities or the carrier state in foals born to infected or vaccinated mares. The carrier stallion appears to have played a major epidemiologic role in the dissemination and perpetuation of the virus. A commercial modified live equine viral arteritis vaccine was found to be safe and efficacious for stallions and mares. The disease can be controlled by immunizing the stallion population and by restricting the breeding of equine arteritis virus-shedding stallions to vaccinated or seropositive mares, followed by an appropriate period of isolation from other nonvaccinated Equidae.

[Factors in the spread of diseases caused by nonagglutinating vibrios studied by using the data from strain serotyping]

The method of the serotyping of strains was used for the epidemiological evaluation of the role of different factors in the transfer of infective agents in 147 cases of diseases and carrier state, caused by NAG vibrios, in Karakalpakia. Out of 150 NAG vibrio strains, 136 strains were serotyped and classified with 26 serovars. The strains were found to belong mostly to serovars 47, 37, 5 and 6 (42.0%). Most of the infected persons (58.5%) used water from open water bodies for household purposes. The role of water factor in the spread of infection was confirmed by a wide spectrum of serologic variants, a low index of the focal outbreaks (1.02), and sporadic pattern of infection. No group morbidity or toxinfection-type outbreaks were recorded.

The carrier food-handler and non-typhoid salmonellosis

The number of reported cases of food poisoning and food-borne disease continues to increase in most countries. The published figures are recognized as being only a small fraction of the true total and the problem is clearly both very large and international.

Of the variety of micro-organisms responsible for outbreaks, Salmonella spp. are by far the most frequently incriminated and in the United Kingdom these organisms cause over 90% of cases (Epidemiology, 1986). The almost universal presence of these organisms in certain common foods, their ability to grow in a wide variety of foodstuffs over a substantial temperature range, the ease with which dissemination occurs from person to person and the prolonged period of excretion following recovery are the properties which, taken together, distinguish Salmonella spp. from other food-poisoning organisms. It is because of these characteristics that salmonellas are really the only food-poisoning organisms in which human beings as carriers pose potential problems as sources of outbreaks. This review is, therefore, confined to a consideration of the practical significance of the faecal carriage of salmonellas by asymptomatic food handlers, to an evaluation of the degree of risk, if any, that such a person may pose and to an assessment as to whether the time and money devoted to the investigation and exclusion of such persons is well spent.

Detection of hepatitis B virus DNA in spermatozoa, urine, saliva and leucocytes, of chronic HBsAg carriers. A lack of relationship with serum markers of replication

Urine, saliva and semen from 18 chronic HBsAg carriers, material that might be concerned in the transmission of hepatitis B virus infection, was examined for the presence of HBV-DNA using molecular hybridisation. HBV-DNA was detected in samples from 14 patients: semen was positive in all of these, saliva in 12 and urine in 10. Autoradiographic studies indicated that HBV-DNA was present in the free form in all cases and in 10, higher molecular weight bands were also observed. While the latter suggested integration of HBV-DNA into host chromosome, resolution to 3.2 Kb following digestion with Eco RI in every case was more consistent with the HBV-DNA being free. In a further group of patients peripheral blood leucocytes were also found to contain HBV-DNA and were the likely source of HBV-DNA in saliva and urine, while in semen both spermatozoa and mononuclear cells contained HBV-DNA. Moreover, free HBV-DNA was identified in the semen of patients without markers of viral replication in serum indicating that sexual transmission could still occur and this is of importance in relation to current vaccination policies.

[Combined passive and active immunization for preventing the development of the infantile carrier state in hepatitis B virus vertical transmission]

By applying hepatitis B (HB) immunoglobulin (HBIG) and HB vaccine (vaccine) to 43 infants born to HB e antigen (HBeAg)-positive HB surface antigen (HBsAg) carrier women intramuscularly, and sub-and/or intra-cutaneously, respectively, the clinical usefulness of combined passive and active immunization in preventing infantile development of the carrier state was evaluated. The results obtained in this study are summarised as follows: Of the 43 infants, 5 (11.6%) developed the carrier state and 38(88.4%) were persistent HBsAb-positive. This carrier-rate was found to be significantly lower than that of 78 non-treated infants (73.1%) born to HBeAg-positive carrier women (control). Four of 15 infants (26.7%), who received HBIG every 4 months, developed carrier state, while only one case (3.6%) fell into carrier state in 28 infants who received HBIG every 3 months. In 30 infants whose vaccination was started at 2 or 4 months of age, 93.3% of the cases became persistent HBsAb-positive within 12 months, while 76.9% of 13 infants who underwent the first vaccination at 12 months of age became persistent HBsAb-positive. No adverse effects of HBIG and HB vaccine were observed in this study. In addition, the mean values for serum glutamic pyruvic transaminase (SGPT) were 35 and 69mu/ml in the treated and control groups, respectively. Thus, the present study demonstrates that the infantile development of HBsAg carrier state by HB virus-vertical transmission could be safely, economically and easily prevented by early initiation of vaccination and re-administration of HBIG within 3 months.

[Morphology of a natural focus of Pomona leptospirosis in a steppe area]

The natural focus of Leptospira pomona infection has been found to include areas of the forest-meadow flood plain where the circulation of leptospires is constantly maintained among small mammals (the nucleus of the focus). A high level of Leptospira carriership (17.7%) among the animals has been registered in the central part of the flood plain and near the terraces, these areas having the most favorable conditions for the development of epizootic leptospirosis.

The epidemiology of pediatric acquired immunodeficiency syndrome

HTLV III infection of children exhibits a relatively narrow spectrum in which the majority of patients develop clinical manifestations before the age of 2 years. In most instances the disease is transmitted in utero, whereby 35-65% of HTLV III-positive women give birth to an infected child. Discordant infection in twins is described. In fewer cases the disease is acquired through blood transfusions. In exceptional cases transmission via sexual abuse or use of needles may occur in young children. We have no evidence of intrafamilial horizontal disease transmission from child to child. The number of children with the disease may increase sharply. Around 2000 pregnancies in HTLV III-infected women are projected in New York City in the next year. Should all these pregnancies be completed, several hundred additional cases of pediatric AIDS may be expected in 1986.

Risk of hepatitis B in a ward for mentally retarded HBsAg carriers

A screening of 615 mentally retarded residents in a Finnish institution revealed 22 HBsAg-positive asymptomatic carriers in 1972. Thirteen of them were placed in a special ward and followed up for 12 years. Only one patient had hepatitis eight years later. During the years all 52 staff members of the ward and the laboratory had been HBsAg-negative, but one laboratory nurse and two ward nurses showed antibody production. The seroconversion rate was one per 33 person-years among the staff. The results suggest that the risk of transmitting hepatitis B still exists, even in special wards in such institutions, and isolation of the carriers alone cannot guarantee full protection for hepatitis B infections.

[Persistent HBsAg antigenemia in newborn infants following intrauterine HBV infection. Cause for the failure of the prevention of perinatal HBV transmission]

In areas with high carrier rates for hepatitis B the combination of hepatitis B immune globulin and hepatitis B vaccine prevent perinatal infection in 90-95% of the newborn infants. Since 1979 the failure of perinatal prevention of hepatitis B infection was observed in only two cases. Evidence of intrauterine infection is presented in these two cases.

Efficacy of hepatitis-B immunoglobulin and hepatitis-B vaccine in prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg

Combined prophylaxis of perinatal transmission of hepatitis B virus (HBV) with hepatitis-B immunoglobulin (HBIG) and hepatitis-B vaccine was investigated in 40 infants born to HBeAg positive carrier mothers. The efficacy of two combined prophylaxis schedules was compared to 78 similar infants in the control group receiving no treatment, by following the HBV markers at regular intervals up to one year of age. In both schedules, the HBIG and HBV vaccine were given at birth, followed by HBV vaccine given at 30 days and 60 days (group I) or 180 days (group II) of age. The incidence of persistent HBsAg carrier in infants born to HBeAg positive carrier mothers was significantly reduced from 92.6 percent at one year of age in the control group to zero percent (group I) and 11.5 percent (group II) in the treated groups. There was no statistical significant difference in the efficacy of these two combined prophylaxis schedules. HBIG given at birth did not interfere with infant immune response to the hepatitis B vaccine. At twelve months of age, anti-HBs could be detected in 77.8 percent of infants in group I and 89.5 percent in group II with mean titre of 621.4 and 1148.0 in group I and group II respectively. It was concluded that combined prophylaxis with HBIG and hepatitis-B vaccine immediately after birth is the best method for prevention of HBV perinatal transmission from HBeAg positive carrier mothers to their infants.

[Pathogenic microorganisms on the pharyngeal swabs from hospital personnel]

After a survey of the literature concerning nosocomial infections, 593 healthy human subjects belonging to the "Ospedale S. Croce Cuneo" staff, have been investigated for the presence of Staphylococcus aureus and other pathogenic bacteria in their oropharyngeal secretions.

A note on the experimental uptake and clearance of Candida albicans in a young captive gull (Larus sp.)

An immature gull (Larus sp.) was placed in captivity after having been kept as a pet for several weeks and allowed to roam freely. On day one of captivity, bird feces showed the presence of Candida albicans but the yeast was absent for the next 16 days. The gull was fed only yeast-free water and fish. On day 17 only, the bird was fed fish containing C. albicans which had been isolated from a wild gull. The yeast was present in all fecal samples (2-4 per day) for the next 13 days. Beginning on day 26 and irregularly thereafter the bird was fed fish containing 100-200 mg of ketoconazole. Feces continued to show the presence of C. albicans but only sporadically because the bird continued to reinfect itself, probably by contaminating the water supply via feet or feces. After protecting the water, yeast presence in feces decreased. The gull was released on day 57; feces that day were negative for C. albicans. During the experimental period the bird displayed no clinical symptoms of candidiasis. The observations indicated that one exposure to C. albicans was sufficient to establish the carrier state and that the possibility exists for shedding a potentially dangerous microorganism over a large geographical area.