An unusual case of Streptococcus agalactiae meningitis in a patient with sys-temic lupus erythematosus

BACKGROUND

Streptococcus agalactiae (group B Streptococcus) is a major cause of sepsis and meningitis in neonates and an important cause of invasive disease in adults.

CASE DESCRIPTION

We describe an unusual case of fatal bacterial meningitis caused by Streptococcus agalactiae in a young man suffering from systemic lupus erythematosus for over 20 years. The young man was transferred intubated in AHEPA University Hospital in a coma; twenty-four hours upon arrival and despite intense invasive treatment, he died from multiple organ failure.

CONCLUSION

The risk of serious infections in patients with systemic lupus erythematosus even under treatment with moderate doses of corticosteroids is high. Hippokratia 2015; 19 (4):372-373.

Chemokine CXCL-1: activity in the vitreous during proliferative vitreoretinopathy

The aim of this study was to investigate CXCL-1 chemokine levels in the vitreous during rhegmatogenous retinal detachment (RRD) with and without proliferative vitreoretinopathy (PVR) and identify possible correlations with clinical parameters (extent and duration or RRD and PVR grade). Vitreous samples from patients with primary RRD with or without PVR were collected and assayed using a double antibody enzyme-linked immunosorbent assay (ELISA). Eleven vitreous samples from organ donors were employed as a control group. CXCL-1 levels were measured in 35 vitreous samples from 35 RRD patients. Mean CXCL-1 levels (64·82 ± 6·47 pg/ml) were significantly higher (P = 0·048) compared to controls. There was a significant positive correlation between CXCL-1 levels and the extent of the detachment (r = 0·794, P = 0·006). Peak CXCL-1 levels coincided with 3+ quadrant RRD, an interim of 29-60 days' duration and PVR grade B. Increased CXCL-1 levels may be indicative of mild inflammation in the detached retina and the adjacent vitreous. The results of the present study may provide novel insight into the complex interactions taking place during the early and late stages of RRD complicated by PVR.

Detection and typing of human papillomaviruses (HPV) in malignant, dysplastic, nondysplastic and normal oral epithelium by nested polymerase chain reaction, immunohistochemistry and transitional electron microscopy in patients of northern Greece

OBJECTIVES

To evaluate the role of HPV in oral carcinogenesis, we examined the prevalence of HPV in malignant, potentially malignant and normal oral epithelium and studied the relation of HPV prevalence with other factors obtained from the patient's records.

MATERIALS AND METHODS

Our material consisted of 291 tissue specimens from 258 individuals. From every individual formalin fixed and paraffin embedded tissues were examined by nested Polymerase Chain Reaction (NPCR) for the detection of HPV DNA and by immunohistochemistry (IHC) for the in situ detection of HPV L1 protein. Positive PCR products were sequenced in order to type HPVs. Also 33 fresh tissues were obtained, fixed and used to detect HPV particles by transitional electron microscopy (TEM).

RESULTS

HPV was detected in 32.9% of the tissue specimens by NPCR, in 4.7% by immunohistochemistry and in 28.1% by TEM. In detail, by nested PCR HPV L1 DNA was detected in 40% of normal tissues, 40% of fibromas, 35.8% of non-dysplastic leukoplakias, 31.6% of dysplastic leukoplakias and 22.2% of oral squamous cell carcinomas. The HPV viral load of 96.5% of the samples was very low (1 viral copy per 10(2)-10(4) cells). HPV16 prevails in all histological groups in 89-100%.

CONCLUSION

We conclude that HPV does not seem, from the specific sample examined, to play a substantial role in oral carcinogenesis. However, it cannot be excluded that HPV could be involved in oral carcinogenesis only in cases with high viral load or at early stages of carcinogenesis possibly through the hit-and-run mechanism.

Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum in asymptomatic women in Northern Greece

AIM

This study attends to determine the prevalence and the antimicrobial susceptibility of Ureaplasma urealyticum in asymptomatic women in Northern Greece.

MATERIALS-METHODS

A total of 347 cervical smears were divided into 5 groups according to age. Samples were cultured, Ureaplasma urealyticum isolation was confirmed by the detection of the urease gene and the antimicrobial susceptibility of the isolates to 9 commercially available antibiotics was determined.

RESULTS

Fifty-six (16.13%) samples were found positive. Women >60 years old were rarely infected. Only 9 (16.07%) isolates were susceptible to all antimicrobials tested. Thirteen isolates were resistant and 34 intermediately resistant to ciprofloxacin, two resistant and 29 intermediately resistant to ofloxacin, three intermediately resistant to macrolides, while all were susceptible to tetracyclines.

CONCLUSIONS

In Northern Greece, 16.13% of asymptomatic women seem to be carriers of Ureaplasma urealyticum mostly in reproductive ages. Almost no resistance to macrolides and tetracyclines has been noticed, while most of the isolates present resistance or moderate sensitivity to quinolones.

Mechanisms responsible for the emergence of carbapenem resistance in Pseudomonas aeruginosa

Pseudomonas aeruginosa (P. aeruginosa) is an opportunistic pathogen associated with a range of nosocomial infections. This microorganism is noted for its intrinsic resistance to antibiotics and for its ability to acquire genes encoding resistance determinants. Among the beta-lactam antibiotics, carbapenems with antipseudomonal activity are important agents for the therapy of infections due to P. aeruginosa. The development of carbapenem resistance among P. aeruginosa strains is multifactorial. Plasmid or integron-mediated carbapenemases, increased expression of efflux systems, reduced porin expression and increased chromosomal cephalosporinase activity have all been defined as contributory factors. Phenotypic tests and molecular techniques are used for the characterization of the resistance determinants. The isolation of carbapenem resistant strains is alarming and requires the implementation of strict infection control measures in order to prevent the spread of carbapenemase encoding genes to unrelated clones or to other bacterial species.

Epidemiological and clinical characteristics of human parvovirus B19 infections during 2006-2009 in Northern Greece

Background. Parvovirus B19 infects children and adults, often causing erythema infectiosum, polyarthritis, but also aplastic crisis in patients with chronic haemolytic anaemia, rash, fever and fetal hydrops or fetal death. This study aims at the detection of acute parvovirus B19 infections during 2006-2009 in northern Greece on epidemiological and clinical aspect.Material and methods. Specimens were obtained from 63 patients, who addressed to hospitals, suspected for acute parvovirus B19 infection (17 in 2006, 29 in 2007, 10 in 2008 and 7 in 2009). Thirty (47.6%) were children (one day - 15 years old) and 33 (52.4%) were adults (16-65 years old). The infection was shown by PCR in whole blood and/or pleural fluid and supported by detection of specific IgM antibodies in the patients' blood serum, which was performed by ELISA.Results. Twenty (31.7%) out of the 63 specimens were found to be positive: 3/17 (17.6 %) in 2006, 16/29 (55.2 %) in 2007, none in 2008 and 1/7 (14.3%) in 2009, p=0.0002. Positive children were found 10/30 (33.3%) and positive adults 10/33 (30.3%). Specific IgM antibodies were detected in all 20 positive patients. Children developed hematological disorders, mainly types of anemia (6 cases), hydrothorax/ascites (2 cases), arthritis (1 case), and liver transplant rejection (1 case). Adults were presented with pregnancy complications (2 cases), arthralgia/arthritis (4 cases), febrile syndromes (3 cases) and atypical rash (1 case).Conclusions. In conclusion, an annual variation in the circulation of parvovirus B19 was noticed, presenting an increase of acute infections in northern Greece during 2007. Regarding serious cases, although children and adults seemed equally affected, differences in clinical manifestations were observed between them, with hematological dysfunctions predominant in childhood.

Mycoplasma pneumoniae respiratory tract infections among Greek children

BACKGROUND

M. pneumoniae is a common cause of respiratory tract infections (RTIs) of variable severity especially in children. New diagnostic techniques offered more reliable information about the epidemiology of infection by this pathogen.

AIM

The aim of this study was to investigate the prevalence and epidemiology of acute M. pneumoniae infections among Greek children hospitalized for RTIs using more advanced techniques.

MATERIAL AND METHODS

The study included 225 Greek children hospitalized for RTIs during a 15-month period. Throat swab specimens were tested by PCR for the detection of M. pneumoniae, while IgG and IgM antibodies were determined by ELISA and, in certain cases, also by western-blot. In parallel, specimens were tested for the presence of additional respiratory pathogens.

RESULTS

M. pneumoniae infection was diagnosed as the only pathogen in 25 (11.1%) cases, being the second (after respiratory syncytial virus- RSV) most often detected pathogen. The proportion of cases with M. pneumoniae infection in age group 8-14 years (23.3%) was significantly higher than that in <3 years age group.

CONCLUSION

During our study period, M. pneumoniae was the second causative agent of RTIs after RSV. The proportion of children with M. pneumoniae RTIs increased with age, while most cases were reported during summer and autumn.

Hematopoietic cell transplantation and emerging viral infections

Viral infections remain important causes of morbidity and mortality in hematopoietic cell transplant recipients. More recent developments in preparative regimens and graft manipulations, as well as the control of well-recognized post-transplant infections by the introduction of prophylaxis and preemptive strategies, have influenced the timing and the epidemiology of infections. As new pathogens, such as human metapneumovirus (HMPV), human bocavirus, human coronaviruses HCoV-NL63 and HCoV-HKU1, human herpesviruses HHV-6 and HHV-7, and polyomaviruses, have emerged, it is fundamental to determine the significance of the newly discovered viruses and their role in the transplantation field. This article summarizes recent data on epidemiology and laboratory diagnosis of new pathogens, as well as clinical features and management of the associated infectious complications. J. Med. Virol. 82:528-538, 2010. (c) 2010 Wiley-Liss, Inc.

Seroepidemiology of Chlamydia Pneumoniae in Northern Greece

The prevalence of IgG and IgA antibodies to Chlamydia pneumoniae was evaluated in a group of an apparently healthy population in northern Greece. Serum samples were obtained over a period of one year (June 2006 to May 2007) from 530 individuals (300 males and 230 females, aged from 1 month to 90 years). The sera were tested for specific antibodies to C. pneumoniae by two commercial methods, an ELISA and a micro-IF assay based on the principles of MIF. The prevalence of IgG and IgA antibodies to C. pneumoniae was 53.2% and 45.9%, respectively, and was found to be unrelated to gender, even in the elderly >61 years old. The IgG antibody prevalence was low in children under 5 years old (7.7%), sharply increased by the age of 20 (40%) and continued to increase, gradually, to reach 80.1% in the elderly. IgA antibodies also increased with similar kinetics to IgG, although at a lower level (3.8–66.1%). Our results show that infection with C. pneumoniae is common in northern Greece. The high prevalence of IgA specific antibodies reported in the present study is due to primary infection at a young age, while in the elderly is probably due to infection or reinfection, although the option of persistence cannot be excluded.

Cluster of new influenza A(H1N1) cases in travellers returning from Scotland to Greece - community transmission within the European Union?

On 26 and 27 May, the Hellenic Centre for Disease Control and Prevention in Greece reported two confirmed cases of new influenza A(H1N1) virus infection in travellers returning from Scotland. The two cases had no apparent traceable links to an infectious source. Herein we report details of the two cases and potential public health implications.

Antiviral resistance of influenza A (H3N2) strains isolated in northern Greece between 2004 and 2007

The prevention and control of influenza with vaccines and antiviral drugs is of great importance. M2 inhibitors, amantadine and rimantadine have been extensively used in some countries. The next generation of antiviral drugs, neuraminidase (NA) inhibitors oseltamivir and zanamivir, are being stockpiled for a potential influenza pandemic. The emergence of resistant strains is thus an important issue. The purpose of this study was to examine the sensitivity to M2 and NA inhibitors of Greek influenza A(H3N2) strains isolated during three influenza seasons between 2004 and 2008 and to determine the phylogenetic clades of those strains. M2 and NA sequences of 34 patient isolates were checked for known resistance mutations. In addition, haemagglutinin (HA) sequences were used to determine the phylogenetic relationship between resistant and sensitive strains. All influenza A(H3N2) strains isolated during the season 2004-5 were found susceptible to adamantanes, bearing the S31N mutation, compared to 88% of the strains isolated in 2005-6 and 75% of the strains isolated in 2006-7. Molecular analysis of the HA gene showed a correlation of the mutants with specific phylogenetic clades. No known mutations in the NA or HA gene that have been implicated in resistance to NA inhibitors were found in the A(H3N2) strains isolated in the three influenza seasons. Despite the fact that amantadine is the only drug approved for prophylaxis in Greece, it has not been extensively used. So it seems that resistant strains circulating in the area after 2005 followed the global trend of replacement of susceptible strains by resistant ones. Oseltamivir and zanamivir are currently approved only for therapeutic use in Greece and has not been extensively used either.

Antiviral resistance of influenza A (H3N2) strains isolated in northern Greece between 2004 and 2007

The prevention and control of influenza with vaccines and antiviral drugs is of great importance. M2 inhibitors, amantadine and rimantadine have been extensively used in some countries. The next generation of antiviral drugs, neuraminidase (NA) inhibitors oseltamivir and zanamivir, are being stockpiled for a potential influenza pandemic. The emergence of resistant strains is thus an important issue. The purpose of this study was to examine the sensitivity to M2 and NA inhibitors of Greek influenza A(H3N2) strains isolated during three influenza seasons between 2004 and 2008 and to determine the phylogenetic clades of those strains. M2 and NA sequences of 34 patient isolates were checked for known resistance mutations. In addition, haemagglutinin (HA) sequences were used to determine the phylogenetic relationship between resistant and sensitive strains. All influenza A(H3N2) strains isolated during the season 2004-5 were found susceptible to adamantanes, bearing the S31N mutation, compared to 88% of the strains isolated in 2005-6 and 75% of the strains isolated in 2006-7. Molecular analysis of the HA gene showed a correlation of the mutants with specific phylogenetic clades. No known mutations in the NA or HA gene that have been implicated in resistance to NA inhibitors were found in the A(H3N2) strains isolated in the three influenza seasons. Despite the fact that amantadine is the only drug approved for prophylaxis in Greece, it has not been extensively used. So it seems that resistant strains circulating in the area after 2005 followed the global trend of replacement of susceptible strains by resistant ones. Oseltamivir and zanamivir are currently approved only for therapeutic use in Greece and has not been extensively used either.

Inflammatory cytokines in insulin-treated patients with type 2 diabetes

OBJECTIVE

An association between type 2 diabetes mellitus and inflammation has been described in several studies. The aim of this study was to search for the presence of low-grade inflammation in a special group of insulin-treated patients with type 2 diabetes, and to investigate a possible correlation between inflammation and obesity, glucose homeostasis and insulin requirement (IU insulin/kg body weight, BW).

METHODS

We studied 85 subjects with type 2 diabetes that were receiving insulin treatment (group A) and 32 receiving sulfonylurea treatment (group B), and 57 subjects without diabetes (group C). Interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha), and the soluble TNF-alpha receptors sTNFR-60 and sTNFR-80 were measured in serum samples taken from all patients.

RESULTS

The mean serum cytokine levels in group A vs. group B were: IL-6, 8.54+/-11 vs. 2.71+/-1.9 pg/ml (p=0.000); TNF-alpha, 14.33+/-24 vs. 5.12+/-15 pg/ml (p=0.016); sTNFR60, 3.9+/-2.8 vs. 2.36+/-1.4 ng/ml (p=0.000); and sTNFR80, 11.9+/-7 vs. 9.4+/-6 ng/ml (p=0.080). The mean serum cytokine levels in group A vs. group C were: IL-6, 8.54+/-11 vs. 4.74+/-7 pg/ml (p=0.017); TNF-alpha, 14.33+/-24 vs. 5.94+/-3.4 pg/ml (p=0.003); sTNFR60, 3.9+/-2.8 vs. 2.54+/-1.4 ng/ml (p=0.000); and sTNFR80, 11.9+/-7 vs. 10.85+/-8 ng/ml (p=0.470). A positive association between waist circumference and IL-6 (r=0.165, p=0.030) and sTNFR-60 (r=0.276, p=0.000) was detected. A significant correlation coefficient was observed between haemoglobin A1c (HbA1c) and both IL-6 (r=0.278, p=0.000) and sTNFR-60 (r=0.293, p=0.000), when the groups were studied as one. No correlation between inflammation and units of insulin/kg BW was found. In conclusion, low-grade chronic inflammation, as estimated by the relative levels of inflammatory cytokines, was present in patients with type 2 diabetes that were receiving insulin treatment, with significantly higher cytokine levels recorded compared to sulfonylurea-treated patients. In addition, an association between inflammation and both obesity and glucose homeostasis was detected.

Toxoplasmosis during pregnancy: a case report and review of the literature

Although toxoplasmosis is considered harmless for a non-pregnant woman, it is potentially harmful during pregnancy, especially at first trimester. The aim of this study is to increase our alertness and monitoring in case of toxoplasmosis during pregnancy, given that when diagnosed it can be effectively treated.We present a case of a healthy 26 years old adult woman, found with toxoplasmosis during the 13th week of pregnancy. The role of frequent maternal and fetus immunological tests, PCR-tests of the amniotic fluid and ultrasound screening of the fetus throughout pregnancy was of great value. The patient was treated with spiramycin (1 grx3) from the 16th week of pregnancy. The patient was subjected to cesarean delivery at the 36th week of pregnancy due to preterm contractions and history of previous cesarean delivery. The newborn was a healthy girl with a birth weight of 2880 gr. A two-year follow up of the baby revealed no medical condition. Maternal infections are a serious medical condition during pregnancy. Toxoplasmosis when diagnosed on time and treated properly can lead to healthy offspring.

Seroprevalence of Toxoplasma gondii in northern Greece during the last 20 years

The seroprevalence of Toxoplasma gondii in the northern Greek population was determined in 1984, 1994 and 2004, and changes during this period were investigated. In total, 1014, 812 and 958 sera from individuals aged 1 day to 70 years were examined in 1984, 1994 and 2004, respectively, for IgG and IgM anti-Toxoplasma antibodies with the standard immunofluorescence assay (IFA) and microparticle enzyme immunoassay (MEIA). In individuals positive for IgM-specific antibodies, primary infection with Toxoplasma was diagnosed on the basis of the Toxoplasma serological profile (IFA, MEIA, conventional IgM and IgA ELISAs, immunosorbent agglutination assay and IgG avidity test). The prevalence of IgG-specific antibodies in the general population was 37%, 29.9% and 24.1% in 1984, 1994 and 2004, respectively, and was 35.6%, 25.6% and 20%, respectively, in women of reproductive age (15-39 years). The incidence of Toxoplasma infection, based on cases of primary infection and the annual seroconversion rate for the general population, was estimated to be 1.25% and 1.1% in 1984, 1.05% and 0.93% in 1994, and 0.85% and 0.8% in 2004. The significant decline in prevalence, and the shift towards an older age group, observed during this period could be explained by the improved socio-economic situation. The high (80%) proportion of women of reproductive age susceptible to Toxoplasma infection, with an estimated 90-200 neonates infected in utero annually, seems to present a potential risk to public health. Education of the public and prophylactic measures may become increasingly important.

A seroprevalence study of poliovirus antibody in the population of northern Greece

This study assessed immunity to poliomyelitis in a representative sample of 1064 persons living in northern Greece. Antibody prevalences in the individuals tested were 91.1% (95% confidence interval (CI): 89.4-92.8), 92.1% (95% CI: 90.5-93.7) and 83.1% (95% CI: 80.8-85.4) for poliovirus types 1, 2 and 3, respectively. For poliovirus type 3, a gap in immunity was found in individuals aged 10-29 years. Re-vaccination of adolescents living in northern Greece is suggested to ensure herd immunity and to minimise the risk of importation of wild poliovirus from endemic countries.

Occurrence of Bartonella henselae and Bartonella quintana in a healthy Greek population

The purpose of this study was to determine the prevalence of IgM and IgG antibodies against Bartonella henselae and B. quintana in a healthy Greek population using a commercially available immunofluorescent test (Focus test). Five hundred healthy individuals were divided by sex into four age groups and three groups according to contact with cats. IgM antibodies were not detected in any of the subjects examined, while 99 (19.8%) and 75 (15%) were IgG seropositive to B. henselae and to B. quintana, respectively. No statistical difference in the seropositivity was observed among these groups. The IgG antibody titers ranged from 1/64 to 1/256 for B. henselae and from 1/64 to 1/512 for B. quintana. A high percentage (12.4%) of cross-reactivity between the two species was observed. Our data show that the prevalence of both Bartonella species in Greece is high. However, low IgG antibody levels are not sufficient evidence of active infection.

Effects of interleukin-13 on antifungal activity of human monocytes against Candida albicans

We investigated the effects of human interleukin-13 (IL-13) on human monocytes' (MNC) activities against Candida albicans, an important human pathogen. Increased phagocytosis of blastoconidia was observed after incubation with 50 U ml(-1) of IL-13 for 4 h or 48 h in the presence or absence of serum. The latter effect was inhibited by anti-IL-13 monoclonal antibody or mannose. Incubation of MNC with 50 U ml(-1) of IL-13 for 2 h significantly enhanced superoxide anion production in response to phorbol myristate acetate. IL-13 did not, however, alter the damage caused by MNC to hyphae, whereas it suppressed killing of blastoconidia. IL-13 has variable effects on MNC activities and may play an important immunoregulatory role against C. albicans.

Human parvovirus B19: immunity of Greek females and prenatal investigation of hydrops fetalis

Sera from 308 healthy Greek females of reproductive age were examined for specific IgG antibodies to human parvovirus B19 by recombinant-Elisa to determine the immunity rates of this part of population to parvovirus B19. Also paired maternal sera and amniotic fluids from nine pregnancies with hydrops fetalis were investigated for specific IgG and IgM antibodies and parvovirus DNA by polymerase chain reaction and southern hybridization analysis. The latter study was conducted to find out the participation of parvovirus B19 infection in hydrops fetalis cases in Greece. The overall prevalence of IgG antibodies in healthy Greek females was at a rate of 57.8% rising with age. One case of hydrops fetalis out of the nine examined, was diagnosed prenatally as parvovirus B19 maternal-fetal infection. It was a twin pregnancy with one fetus hydropic and the other growth retarded. Premature birth of liveborn infants was followed by neonatal death, 48 h after delivery. The contribution of parvovirus B19 in cases of non-immune hydrops fetalis was at 11% in this part of the world.

Serological survey on the immunity to diphtheria of the northern Greek population

The recent outbreak of diphtheria in the Newly Independent States (NIS) of the former USSR and the immigration from these high risk areas to Greece prompted us to determine the diphtheria antitoxin levels by enzyme-linked immunosorbent assays (ELISA) in 509 healthy individuals (307 males and 202 females) from northern Greece. The population under study was divided in ten age groups from 1 day to > 60 years old. Diphtheria antitoxin levels of > or = 0.1 IU/ml were considered as protective ones. 44.6% of the examined people were found susceptible. The children up to their twenties seem to be immune to diphtheria in a high proportion (86-88.4%). The diphtheria antitoxin levels declined sharply above this age (17.6% in the age group 21-30 years old). The level of protection in adults appeared to be higher in the oldest group (49%). According to these results, the adults are not properly protected. Booster doses of vaccine for them are recommended to improve the resistance of the northern Greek population from possible infection by toxigenic stains of Corynebacterium diphtheriae, imported or endogenous.

Prenatal diagnosis of fetal cytomegalovirus infection in seropositive pregnant women

Thirty two pregnant women, immune to human cytomegalovirus (HCMV) before conception, were examined with a combination of amniocentesis, and blood sampling for fetal HCMV infection. The pregnant women had no history of recurrent infection and they all had normal ultrasonographic findings. Maternal sera and amniotic fluids were examined for anti-HCMV antibodies and viral DNA by enzyme immunoassay and polymerase chain reaction (PCR). All maternal sera were negative for viral DNA and IgM anti-HCMV antibodies. However, HCMV DNA was detected in the amniotic fluid of four pregnant women. These four cases were considered as fetal HCMV infections. Three of them were followed up after birth. The three neonates appeared clinically normal at birth, but HCMV DNA was detected in their urine specimens and in two of them in the cord blood sera. Although the neonates were asymptomatic at birth, the possibility of developing sequelae later on, cannot be excluded. The results show that HCMV recurrent maternal infection is silent and difficult to be suspected and diagnosed. They also show that fetal HCMV infection is not rare among pre-immune pregnant women.

Influenza surveillance in N. Greece during 1983-1993

Following the WHO programme to monitor influenza, the National Influenza Centre for N. Greece presents the results of a laboratory surveillance during 1983-93. Influenza viruses were isolated every year except for 1986-87 and 1987-88 seasons. Type A viruses predominated in 1983-84, 1985-86, 1988-89 and 1989-90. Type B viruses were prevalent in 1990-91 and 1992-93. Both types of A and B viruses circulated concurrently in the community during the winters of 1984-85 and 1991-92. Seroconversions (CF tests) occurred each year against A, B or both types of influenza viruses. In 1986-87 and 1987-88 when no viruses were recovered, there were seroconversions to B viruses, suggesting influenza B activity in the area. Serological surveys by haemagglutination inhibition (HI) tests were also conducted in 1986-87 and 1988-89. The patterns of the isolated strains were similar to those recorded worldwide at the same time. There have been however differences in the virulence of the viruses and the duration of influenza seasons in this part of the world during 1983-93.

Chlamydia trachomatis in infertile Greek women. A serologic and laparoscopic study

This study investigates the prevalence of antichlamydial antibodies in infertile women, who underwent diagnostic laparoscopy. The patients were divided into two groups based on the presence or absence of damage of the fallopian tubes. Antichlamydial IgG antibodies were found in 22 of 27 (81.5%) infertile women with damaged fallopian tubes and 10 of 23 (43.5%) women with normal tubes. Mean geometric IgG titres for C. trachomatis were significantly higher in the patients with damaged tubes (187.4 vs. 39.39). C. trachomatis was not isolated from the peritoneal fluids. Only two chlamydial cultures of cervical specimens were positive, one in each group. These findings confirm that C. trachomatis may be a major cause of tubal damage with resultant infertility.