Serological and demographic survey of Epstein-Barr virus infection in Ethiopia

Expression of EBV encoded nuclear small non-polyadenylated RNA (EBER) molecules in 32 cases of childhood Burkitt's lymphoma from Israel

We have analyzed paraffin sections from 32 children with histologically confirmed Burkitt's Lymphoma (BL) for the presence of EBV using in situ hybridization to detect expression of the EBV-encoded early RNAs (EBERs). EBV was present in the tumors of 11 patients (34%). Sixty nine percent of the children presented with abdominal disease, 19% had bone marrow infiltration and only one child had jaw involvement. There was no statistically significant difference between EBV positive and EBV negative children with regard to age, gender, origin, primary site at presentation, or clinical stage of disease. However, there was a trend for younger age in the children with EBV positive BL with a median age of 4, compared to 7 years in children with EBV negative BL. None of the 7 children of Ashkenazi Jewish origin had EBER positive disease. There was no difference in the treatment outcome between the EBV positive patients (estimated survival at 24 months of 82%) and EBV negative children (estimated survival rate of 71% (p=0.58)). In conclusion, although this is only a small series it seems that childhood BL in Israel has the clinical characteristics of sporadic, non-African type with 34% EBV association and a low incidence of jaw tumors. Our data suggest that Ashkenazi Jewish children with BL are less likely to have EBV positive tumors than other ethnic groups. However, more patients will need to be studied in order to assess the validity of this observation.

Seroepidemiological study of Epstein-Barr virus infection in Bangladesh

A seroepidemiological study was carried out on 502 sera to determine the prevalence of EBV infection in a group of Bangladeshi people (age range: 15 days-90 years). All sera were tested for IgG antibody to the EBV viral capsid antigen (VCA) by a commercially available enzyme linked immunosorbent assay (ELISA) and the negative sera were checked subsequently by indirect immunofluorescence (IF) methods. The prevalence of EBV infection in the study group was 81.27%. 42.37% of infants had antibodies to EBV by the age of 1 year. A significant rise in the percentage of seropositives between 0-1- and 1-2-year-old children was demonstrated, indicating a high rate of primary infection at these ages. The prevalence of IgG antibody to VCA was 87.93% in the 2-10 years age group and was sustained at over 85% thereafter. Higher ELISA values were more common both in the 0-2- and > 25-year age groups, the latter being statistically significant (P < 0.025). Similar higher values were also observed in females as compared to males (P = 0.05). Eighteen out of 109 negative sera and two equivocal sera by ELISA were found to be positive by indirect IF, indicating a negative predictive value of 82% for ELISA. The concordance between the two methods was 97% with ELISA proving to be less sensitive than indirect IF. It is concluded that the prevalence of EBV infection in Bangladeshi population is similar to that observed in other developing countries and that ELISA can be used for seroepidemiological surveys; however, the sera negative by ELISA should be checked routinely by indirect IF.

Outbreak of acute hepatitis E virus infection among military personnel in northern Ethiopia

An outbreak of acute hepatitis E virus (HEV) infection occurred from October 1988 to March 1989 in military camps in northern Ethiopia. The epidemic was waterborne and entirely confined to military men, of whom 423 hospitalized, icteric patients were studied. The clinical course was mild and short, without any fulminant hepatitis or death. All sera tested for anti-HAV-IgM were negative and among 54 (13%) patients who were positive for HBsAg, 7 (2%) were positive for anti-HBc IgM. On the other hand, 28 of 30 (93%) patients had antibodies against hepatitis E virus (anti-HEV) in contrast to 1 of 29 (3%) asymptomatic controls (P less than .01). The need for an easily available, inexpensive serologic test for HEV infection, protection of water supplies from fecal contamination, adequate chlorination and/or boiling of drinking water, and health education about personal and environmental hygiene, especially in communities at high risk, is emphasized.