Assessment of a recombinant protein from Leishmania infantum as a novel tool for Visceral Leishmaniasis (VL) diagnosis in VL/HIV co-infection cases

Visceral Leishmaniasis and HIV-AIDS coinfection (VL/HIV) is considered a life-threatening pathology when undiagnosed and untreated, due to the immunosuppression caused by both diseases. Serological tests largely used for the VL diagnosis include the direct agglutination test (DAT), ELISA and immunochromatographic (ICT) assays. For VL diagnosis in HIV infections, different studies have shown that the use of the DAT assay facilitates the VL diagnosis in co-infected patients, since the performance of the most widely used ELISA and ICT tests, based on the recombinant protein rK39, are much less efficient in HIV co-infections. In this scenario, alternative recombinant antigens may help the development of new serological diagnostic methods which may improve the VL diagnosis for the co-infection cases. This work aimed to evaluate the use of the recombinant Lci2 antigen, related to, but antigenically more diverse than rK39, for VL diagnosis in co-infected sera through ELISA assays. A direct comparison between recombinant Lci2 and rK39 was thus carried out. The two proteins were first tested using indirect ELISA with sera from VL afflicted individuals and healthy controls, with similar performances. They were then tested with two different sets of VL/HIV co-infected cases and a significant drop in performance, for one of these groups, was observed for rK39 (32% sensitivity), but not for Lci2 (98% sensitivity). In fact, an almost perfect agreement (Kappa: 0.93) between the Lci2 ELISA and DAT was observed for the coinfected VL/HIV patients. Lci2 then has the potential to be used as a new tool for the VL diagnosis of VL/HIV co-infections.

Isolation and characterisation of Leishmania donovani protein antigens from urine of visceral leishmaniasis patients

Diagnosis of visceral leishmaniasis (VL) relies on invasive and risky aspirate procedures, and confirmation of cure after treatment is unreliable. Detection of Leishmania donovani antigens in urine has the potential to provide both a non-invasive diagnostic and a test of cure. We searched for L. donovani antigens in urine of VL patients from India and Sudan to contribute to the development of urine antigen capture immunoassays. VL urine samples were incubated with immobilised anti-L. donovani polyclonal antibodies and captured material was eluted. Sudanese eluted material and concentrated VL urine were analysed by western blot. Immunocaptured and immunoreactive material from Indian and Sudanese urine was submitted to mass spectrometry for protein identification. We identified six L. donovani proteins from VL urine. Named proteins were 40S ribosomal protein S9, kinases, and others were hypothetical. Thirty-three epitope regions were predicted with high specificity in the 6 proteins. Of these, 20 were highly specific to Leishmania spp. and are highly suitable for raising antibodies for the subsequent development of an antigen capture assay. We present all the identified proteins and analysed epitope regions in full so that they may contribute to the development of non-invasive immunoassays for this deadly disease.

Purification of Antibodies Against Entamoeba histolytica MIF and Their Use in Analyzing Human and Mouse Samples

Macrophage migration inhibitory factor (MIF) is a proinflammatory and proproliferative cytokine expressed in humans. MIF homologs also exist in many pathogenic protozoans, including Entamoeba, Plasmodium, Toxoplasma, and Leishmania. Production of antibodies against parasite proteins allows for the generation of assays to measure and visualize parasite infection within hosts. In this chapter, we describe how to specifically purify antibodies against Entamoeba histolytica MIF (EhMIF), and subsequently use anti-EhMIF antibodies for ELISA on mouse and human samples and for immunohistochemistry on human tissue. These methods can be applied to any protein for high-quality antibody purification.

Avian antibodies (IgY) against Trypanosoma cruzi: Purification and characterization studies

Trypanosoma cruzi is a flagellated protozoan belonging to the Trypanosomatidae family, the etiologic agent of Chagas disease. Currently, there is neither a licensed vaccine nor effective treatment, characterizing an unmet clinical need. The IgY refers to the egg yolk immunoglobulin (Y=yolk) and its production and use are subjects of many studies due to the diversity of its diagnostic and therapeutic applications. Several researchers have shown that the use of specific IgY may prevent and/or control infectious and parasitic diseases. Based on these evidences, the aim of this study was to immunize chickens with trypomastigotes of T. cruzi in order to produce highly effective and pure antibodies (IgY), as well as extract, characterize, quantify, and verify cytotoxic effects of IgY anti-T. cruzi. After the induction of IgY production by chickens, the eggs were collected and the IgY was extracted by method of precipitation of polyethylene glycol 6000. The IgY anti-T. cruzi characterization was performed using polyacrylamide gel electrophoresis (SDS-PAGE), western-blot and enzyme-linked immunosorbent assay (ELISA). Moreover, the cytotoxic or proliferative effects of IgY anti-T. cruzi was verified by MTT assay. The concentration of IgY in yolk was 8.41±1.47mg/mL. The characterization of IgY reveled bands of stained peptides with molecular weight between 75 and 50kDa and 37 and 25kDa. In the ELISA test was observed that there was antigen-antibody reaction throughout the sample period. The concentrations of 1, 5 and 10mg/mL of IgY anti-T. cruzi presented no cytotoxic of proliferative effects in mononuclear and VERO cells in vitro. The results indicated that T. cruzi is able to generate a high production of specific immunoglobulins in chickens, it did not cause damage to the cell membrane and no proliferative effect.

Production of a conjugate between the rK346 antigen from Leishmania infantum and the horseradish peroxidase C for the detection of rK346 antibodies

It was designed and characterized a reporter system to be captured by an- tibodies bound to ELISA plates. The system was designed with the rK346 from Leishmania infantum, a highly antigenic and specific protein. The rK346 was coupled to the horseradish peroxidase C (HRPc) from Armoracia rusticana using glutaraldehyde or sulfo-SMCC. Gluta- raldehyde conjugation was performed in two steps. Separation of conjugates was carried out using a Sepharose S-200 in size exclusion chromatography (SEC); fractions were analyzed via HRPc activity and through ELISA plates sensitized with polyclonal anti-rK346 IgG puri- fied from rabbit serum. A heterogeneous population of conjugates rK346-HRPc was obtained with molecular weights ranging between 109.7 ± 16.5 to 67.6 ± 10.1 kDa; with rK346-HRPe stoichiometries of 1:2; 2:1; 3:1; and 2:2. Conjugation using sulfo-SMCC was carried out first by introducing -SH groups onto the HRPc using the SATA reagent and the antigen was modi- fied with sulfo-SMCC during 45 min. Separation and analysis of conjugates was performed similarly as with glutaraldehyde, resulting in a heterogeneous population of conjugates rK346- HRPc with molecular weights between 150.5 ± 22.6 to 80.0 ± 12.0 kDa; with rK346-HRPC stoichiometries of 2:1; 1:2; 2:2; and 1:3, with an increased conjugation efficiency in compari- son with glutaraldehyde. This enables sulfo-SMCC to be used as a potential reagent for cou- pling the antigen to the HRPc, to design an economic, specific and easy method to apply as a reporter system, available to assess individuals at risk and/or at early and late stages of visceral leishmaniasis.

Fast track antibody V-gene rescue, recombinant expression in plants and characterization of a PfMSP4-specific antibody

BACKGROUND

Monoclonal antibodies (mAbs) are essential tools in biological research, diagnosis and therapy, and are conventionally produced in murine hybridoma cell lines. Professional applications of mAbs depend on the steady supply of material. Because hybridoma cultures can stop producing the antibody or even die, preservation of the unique epitope specificity of mAbs by rescue of the sequences encoding the antibody variable domains (V regions) is important. The availability of these sequences enables not only the recombinant expression of the original antibody for further applications, but opens the road for antibody engineering towards innovative diagnostic or therapeutic applications. A time- and cost-efficient production system enabling the detailed analysis of the antibodies is an essential requirement in this context.

METHODS

Sequences were rescued from three hybridoma cell lines, subjected to sequence analysis, subcloned into binary expression vectors and recombinantly expressed as chimeric mAb (constant regions of human IgG1:k1) in Nicotiana benthamiana plants. The properties of the recombinant and the murine mAbs were compared using competition enzyme-linked immunosorbent assay (ELISA) and surface plasmon resonance (SPR) spectroscopy. The recognition of native PfMSP4 by the recombinant mAb was analysed by immunofluorescence staining of Pf 3D7A schizonts and by western blot analysis of merozoite extract.

RESULTS

The rescued sequences of all three hybridoma cell lines were identical. The recombinant mAb was successfully expressed as IgG in plants at moderate levels (45 mg/kg fresh leaf weight). Preservation of the original epitope was demonstrated in a competition ELISA, using recombinant mAb and the three murine mAbs. EGF_PfMSP4-specific affinities were determined by SPR spectroscopy to 8 nM and 10 nM for the murine or recombinant mAb, respectively. Binding to parasite PfMSP4 was confirmed in an immunofluorescence assay showing a characteristic staining pattern and by western blot analysis using merozoite extract.

CONCLUSIONS

As demonstrated by the example of an EGF_PfMSP4-specific antibody, the described combination of a simple and efficient hybridoma antibody cloning approach with the flexible, robust and cost-efficient transient expression system suitable to rapidly produce mg-amounts of functional recombinant antibodies provides an attractive method for the generation of mAbs and their derivatives as research tool, novel therapeutics or diagnostics.

Comparative serology techniques for the diagnosis of Trypanosoma cruzi infection in a rural population from the state of Querétaro, Mexico

Immunological diagnostic methods for Trypanosoma cruzi depend specifically on the presence of antibodies and parasitological methods lack sensitivity during the chronic and "indeterminate" stages of the disease. This study performed a serological survey of 1,033 subjects from 52 rural communities in 12 of the 18 municipalities in the state of Querétaro, Mexico. We detected anti-T. cruzi antibodies using the following tests: indirect haemagglutination assay (IHA), indirect immunofluorescence assay (IFA), ELISA and recombinant ELISA (rELISA). We also performed Western blot (WB) analysis using iron superoxide dismutase (FeSOD), a detoxifying enzyme excreted by the parasite, as the antigen. Positive test results were distributed as follows: ELISA 8%, rELISA 6.2%, IFA and IHA 5.4% in both cases and FeSOD 8%. A comparative study of the five tests was undertaken. Sensitivity levels, specificity, positive and negative predictive values, concordance percentage and kappa index were considered. Living with animals, trips to other communities, gender, age, type of housing and symptomatology at the time of the survey were statistically analysed using SPSS software v.11.5. Detection of the FeSOD enzyme that was secreted by the parasite and used as an antigenic fraction in WBs showed a 100% correlation with traditional ELISA tests.

Unusual multiple large abscesses of the liver: interest of the radiological features and the real-time PCR to distinguish between bacterial and amebic etiologies

We report a rare case of amebiasis generating 19 large liver abscesses. Such a quantity of abscesses is rare, especially when occurring in a young casual traveler without any immunodeficiency disorders. A possible co-infection was excluded. By contrast, the amebic etiology was confirmed by means of serology and real-time PCR.

Toxocariasis in waste pickers: a case control seroprevalence study

BACKGROUND

The epidemiology of Toxocara infection in humans in Mexico has been poorly explored. There is a lack of information about Toxocara infection in waste pickers.

AIMS

Determine the seroepidemiology of Toxocara infection in waste pickers.

METHODS

Through a case control study design, the presence of anti-Toxocara IgG antibodies was determined in 90 waste pickers and 90 age- and gender-matched controls using an enzyme-linked immunoassay. Associations of Toxocara exposure with socio-demographic, work, clinical, and behavioral data of the waste pickers were also evaluated.

RESULTS

The seroprevalence of anti-Toxocara IgG antibodies was significantly higher in waste pickers (12/90: 13%) than in control subjects (1/90: 1%) (OR = 14; 95% CI: 2-288). The seroprevalence was not influenced by socio-demographic or work characteristics. In contrast, increased seroprevalence was found in waste pickers suffering from gastritis, and reflex and visual impairments. Multivariate analysis showed that Toxocara exposure was associated with a low frequency of eating out of home (OR = 26; 95% CI: 2-363) and negatively associated with consumption of chicken meat (OR = 0.03; 95% CI: 0.003-0.59). Other behavioral characteristics such as animal contacts or exposure to soil were not associated with Toxocara seropositivity.

CONCLUSIONS

1) Waste pickers are a risk group for Toxocara infection. 2) Toxocara is impacting the health of waste pickers. This is the first report of Toxocara exposure in waste pickers and of associations of gastritis and reflex impairment with Toxocara seropositivity. Results warrant for further research.

[Expression of aldolase of Toxoplasma gondii and preparation of the polyclonal antibodies against this protein]

AIM

To produce the aldolase protein and its polyclonal antibody.

METHODS

Aldolase gene was obtained from cDNA library by PCR amplification and subcloned to vector pET30a. The recombinant protein aldolase-His(6); was expressed in E.coli upon IPTG induction and then purified with affinity chromatography. The purified protein mixed with adjuvant was used to immunize SD rats to produce the polyclonal antibodies.

RESULTS

The recombinant plasmid aldolase/pET30a was constructed successfully and expressed as a fusion protein aldolase-His(6);; Polyclonal antibody against aldolase-His(6); was obtained from rat, and antibody titer was 1:4 000.

CONCLUSION

The purified protein aldolase-His(6); and its polyclonal antibodies were obtained, which may provide the foundation for the further studies on the function of aldolase.

Anti-peptide antibodies differentiate between plasmodial lactate dehydrogenases

Malaria lactate dehydrogenase, a glycolytic enzyme, is a malaria diagnostic target in lateral flow immunochromatographic rapid diagnostic tests. Recombinant Plasmodium yoelii LDH was cloned into the pET-28a vector, expressed and the expressed protein purified from a Ni-NTA affinity matrix. A pan-malarial LDH antibody directed against a common malaria LDH peptide (APGKSDKEWNRDDLL) and two anti-peptide antibodies, each targeting a unique Plasmodium falciparum (LISDAELEAIFDC) and Plasmodium vivax (KITDEEVEGIFDC) LDH peptide were raised in chickens. The antibodies were affinity purified with the appropriate peptide affinity matrix. The affinity purified anti-peptide antibodies detected recombinant P. falciparum, P. vivax and P. yoelii LDH and native P. falciparum and P. yoelii LDH in western blots and immunofluorescence studies. The pan-malarial antibody detected LDH from the three malaria species in western blots. The species-specific anti-peptide antibodies differentiated between P. falciparum and P. vivax LDH. Affinity purified chicken antibodies against recombinant PfLDH, PvLDH and PyLDH proteins each detected the parent and orthologous proteins with similar titers in an ELISA. The study supports an anti-peptide antibody approach to the development of diagnostic reagents.

Seroepidemiology of giardiasis in Mexico

Prevalence of antibodies against Giardia duodenalis was determined by enzyme-linked immunosorbent assay in serum samples from a national serologic survey of Mexico that included all geographic areas and socioeconomic and demographic data for each person sampled. The country was divided into four regions on the basis of development (high, medium high, medium low, and low). Of 3,461 serum samples tested, 1,914 (55.3%) were positive for IgG antibodies against Giardia duodenalis. Seropositivity was age-specific; the probability of seropositivity increased 4.9-fold (95% confidence interval [CI] = 3.16-7.64) in adolescents 10-19 years of age, 8.0-fold (95% CI = 5.19-12.53) in young adults 20-39 years of age, and 12.6-fold (95% CI = 7.93-20.28) in adults more than 40 years of age. Giardia duodenalis seropositivity was associated with male sex (odds ratio = 1.40, 95% CI = 1.22-1.61). No association was found between seropositivity and socioeconomic variables or regional development status.

[Evaluation on malaria situation in areas along Yellow River and Huaihe River by indirect fluorescent antibody test]

OBJECTIVE

To evaluate malaria situation by indirect fluorescent antibody test (IFAT) in 12 villages of six counties along Yellow River and Huihe River in Anhui, Henan and Hubei Provinces.

METHODS

Cross sectional seroepidemiologic survey was conducted through IFAT in Anopheles sinensis area and A. anthropophagus plus A. sinensis area respectively in 2006 and 2007. The blood-filter papers collected from residents were tested by IFAT to calculate malaria antibody positive rate (APR) and positive GMRT in different age groups. The predictive infection probability was evaluated by reversible catalytic model based on antibody positive rate in the group of less than 20 year-old and compared to the annual parasite incidence.

RESULTS

In 2006 and 2007, the average antibody positive rate in the investigated villages was 6.1% and 12.0% respectively. In An. sinensis areas, the APR in 2007 (12.0%) was significantly higher than that in 2006 (4.1%) (chi2 = 69.9, P < 0.01) while in An. anthropophagus plus An. sinensis areas there was no significant difference in 2006 (10.3%) and 2007 (12.1%) (chi2 = 0.17, P > 0.05). The average positive GMRT of the 12 villages was 26.2 in 2007, slightly higher than that in 2006. In both An. sinensis area and An. anthropophagus plus An. sinensis area, the predictive infection probabilities were higher than the annual parasite incidence with an average 117.3 and 17.20 times higher than the latter respectively. 87.8% of the antibody positive cases were asymptomatic, indicating that there were potential infection sources with symptomatic parasitaemia in the areas.

CONCLUSION

Malaria is still prevalent in areas along Yellow River and Huihe River and the actual number of malaria cases are underestimated by the case report system. Malaria reemergence may occur in An. sinensis area but relatively stable in An. anthropophagus plus An. sinensis area.

Spatial analysis of Neospora caninum distribution in dairy cattle from Sweden

The national herd prevalence and spatial distribution of Neospora caninum infected dairy herds in Sweden were investigated. The study was based on a bulk milk survey comprising samples from 2,978 herds. Test-positive herds were found in all parts of Sweden and the overall prevalence of test-positive herds was 8.3% (95% confidence interval = 7.3-9.3%). The presence of spatial autocorrelation was tested using the Moran's I test. Possible clusters of test-positive herds were identified by applying the local indicator of spatial association (LISA) test statistic and the spatial scan statistic. Analysis based on data aggregated by postal code areas as well as analysis based on exact coordinates identified significant clusters of high prevalence in the middle parts of Sweden and low prevalence in the south. This was not expected considering the results from other European studies of N. caninum in cattle. However, the findings are supported by the distribution of previously known case herds.

Hydrodynamic flow-mediated protein sorting on the cell surface of trypanosomes

The unicellular parasite Trypanosoma brucei rapidly removes host-derived immunoglobulin (Ig) from its cell surface, which is dominated by a single type of glycosylphosphatidylinositol-anchored variant surface glycoprotein (VSG). We have determined the mechanism of antibody clearance and found that Ig-VSG immune complexes are passively sorted to the posterior cell pole, where they are endocytosed. The backward movement of immune complexes requires forward cellular motility but is independent of endocytosis and of actin function. We suggest that the hydrodynamic flow acting on swimming trypanosomes causes directional movement of Ig-VSG immune complexes in the plane of the plasma membrane, that is, immunoglobulins attached to VSG function as molecular sails. Protein sorting by hydrodynamic forces helps to protect trypanosomes against complement-mediated immune destruction in culture and possibly in infected mammals but likewise may be of functional significance at the surface of other cell types such as epithelial cells lining blood vessels.

The importance of human FcgammaRI in mediating protection to malaria

The success of passive immunization suggests that antibody-based therapies will be effective at controlling malaria. We describe the development of fully human antibodies specific for Plasmodium falciparum by antibody repertoire cloning from phage display libraries generated from immune Gambian adults. Although these novel reagents bind with strong affinity to malaria parasites, it remains unclear if in vitro assays are predictive of functional immunity in humans, due to the lack of suitable animal models permissive for P. falciparum. A potentially useful solution described herein allows the antimalarial efficacy of human antibodies to be determined using rodent malaria parasites transgenic for P. falciparum antigens in mice also transgenic for human Fc-receptors. These human IgG1s cured animals of an otherwise lethal malaria infection, and protection was crucially dependent on human FcγRI. This important finding documents the capacity of FcγRI to mediate potent antimalaria immunity and supports the development of FcγRI-directed therapy for human malaria.

Malaria rivals HIV and tuberculosis as the world's most deadly infection killing a child every 30 seconds. Antibodies and their receptors (Fc-receptors) have been shown to be vital for the development of protective immunity, and as such they act as correlates of protection in studies aimed at defining the best antigens to incorporate into current vaccines. Understanding antibody types and Fc-receptors that optimally induce immunity is therefore vital to developing the best vaccines. Surrogate markers of antibody efficacy currently rely on in vitro assays that are laborious and difficult to reproduce. It remains unclear if such in vitro assays are predictive of functional immunity in humans due to the lack of suitable animal models permissive for Plasmodium falciparum. Here, we create a transgenic in vivo mouse model that has significant advantage over the use of new world primates, the only other model for human malaria. We demonstrate that this model defines an Fc-dependent mechanism of parasite destruction that cannot be assessed in current in vitro assays. The model provides both a test for therapeutic antibody efficacy prior to clinical trials in humans and an important tool in malaria vaccine development.

Preparation and characterization of a monoclonal antibody specific to Plasmodium falciparum TATA binding protein

PfTBP is a transcriptional factor required by all three types of RNA polymerases in eukaryotic cells. In order to obtain a specific monoclonal antibody (MAb) against PfTBP, a DNA fragment of 684 base pairs (bp) that contained the complete PfTBP gene was amplified by polymerase chain reaction (PCR) and inserted into the pGEX prokaryotic expression vector. The recombinant protein (GST-PfTBP) was expressed in Escherichia coli, purified, and used as antigen to immunize mice. MAbs against PfTBP were obtained and hybridomas were screened by enzyme-linked immunosorbent assay (ELISA). Western blotting and immunofluorescence assays showed that MAb Pf.r1 recognized the PfTBP protein in nuclear extracts from Plasmodium falciparum as well as a native protein in the nuclei of this parasite. This MAb will be a helpful tool for the identification of the TBP associated factors (TAFs), which are apparently highly divergent with other eukaryotes. This information could help to identify new candidate gene products to develop novel drugs or vaccines.

Field evaluation of four novel enzyme immunoassays for Chagas' disease in Venezuela blood banks: comparison of assays using fixed-epimastigotes, fixed-trypomastigotes or trypomastigote excreted?secreted antigens from two Trypanosoma cruzi strains

Many serological tests have been developed for the diagnosis of Chagas' disease, but few have been subjected to a rigorous field evaluation. We have recently described several novel enzyme immunoassays (EIAs) based on fixed-whole organisms or trypomastigote excretory-secretory antigens (TESA) from different Trypanosoma cruzi strains (Tulahuen or Brazil). This study evaluated the most promising of these novel assays (e.g. fixed-epimastigotes, fixed-trypomastigotes, TESA Brazil and TESA Tulahuen antigens) in a field study of Venezuelan blood bank specimens. The assays were tested in an operator-blinded fashion using 2038 blood bank samples obtained from low and high T.cruzi prevalence regions of Venezuela (n= 1050 and n= 988 from Bolivar and Portuguesa states, respectively). Based on National Laboratory for Chagas Immunodiagnosis (NLCI) 'gold standard' results, all novel EIAs were superior to the commercial kit currently used in Venezuela, achieving 100% sensitivity and >99% specificity at optimal cut-off values. The novel assays identified seven false-negative samples compared with the routine screening performed by the Venezuelan blood bank although two samples were also misclassified as positive. Minor differences in the performance of the four novel assays were observed at lower arbitrary cut-off values. This study confirms the potential utility of both the fixed-organism and the TESA-based assays in the diagnosis of T.cruzi infection.

Presence of Neospora caninum specific antibodies in three dairy farms in Georgia and two in Texas

Neospora caninum is known to cause abortion in cattle. This study demonstrated the presence of specific IgG to Neospora in milk and serum samples obtained from three dairy farms in Georgia and two in Texas. Samples from four hundred fourteen dairy cows were examined using a western blot assay of which 362 were milk and 87 were serum. Samples with antibodies to Neospora were identified in 32.1% (105/327) of the examined animals in Georgia, whereas in Texas it was identified in 10.3% (9/87). Positive Georgia samples were found in 24.4% from farm A (28/115), 21.6% from farm B (30/139), and 64.4% from farm C (47/73). In Texas, 13.5% (7/52) of animals in farm D and 5.71% (2/35) from farm E also had specific antibodies to Neospora. The number of animals from Georgia dairy farms with antibodies to Neospora was significantly higher than the Texas dairy farms. This may be related to the age of the animals examined in this study (more than 2 years old). Antibodies present in sera had excellent agreement with the antibodies present in milk. Collection of milk samples for serological testing is easier and less invasive than obtaining bovine sera, therefore offering an alternative for animal testing.

Identification of a tryptophan-like epitope borne by the variable surface glycoprotein (VSG) of African trypanosomes

Antibodies (Ab) directed against a tryptophan-like epitope (WE) were previously detected in patients with human African trypanosomiasis (HAT). We investigated whether or not these Ab resulted from immunization against trypanosome antigen(s) expressing a WE. By Western blotting, we identified an antigen having an apparent molecular weight ranging from 60 to 65 kDa, recognized by purified rabbit anti-WE Ab. This antigen, present in trypomastigote forms, was absent in procyclic forms and Trypanosoma cruzi trypomastigotes. Using purified variable surface glycoproteins (VSG) from various trypanosomes, we showed that VSG was the parasite antigen recognized by these rabbit Ab. Anti-WE and anti-VSG Ab were purified from HAT sera by affinity chromatography. Immunoreactivity of purified antibodies eluted from affinity columns and of depleted fractions showed that WE was one of the epitopes borne by VSG. These data underline the existence of an invariant WE in the structure of VSG from several species of African trypanosomes.

Prevalence of anti-toxoplasma Gondii antibodies in Turkish blood donors

OBJECTIVE

Toxoplasmosis is caused by an obligate intracellular protozoan parasite, Toxoplasma gondii. Most of these infections are asymptomatic or benign, but may cause severe or fatal consequences in immunodeficient patients, transplant recipients, and in the fetus. Transmission may occur by eating uncooked meat, contaminated vegetables, blood transfusion, organ transplantation, and across the placenta from the mother to the fetus. IgG antibodies to T. gondii may persist in the serum at high titers for years. In the present study, our aim was to determine prevalence of anti- T. gondii IgG and IgM antibodies in Turkish blood donors.

METHODS

A total samples from 385 healthy blood donors from Kayseri, Turkey were examined for anti- T. gondii antibodies by indirect fluorescent antibody test (IFAT) and enzyme-linked immunosorbent assay (ELISA).

RESULTS

The seroprevalence of the anti- T. gondii IgG and IgM antibodies was 19.5%, 2.33% respectively by IFAT and 20.25%, 2.33% by ELISA.

CONCLUSION

It is suggested that all blood donors should be screened for toxoplasmosis before transfusion

Evaluation of three Pichia pastoris-expressed Plasmodium falciparum merozoite proteins as a combination vaccine against infection with blood-stage parasites

Because invasion of erythrocytes by Plasmodium falciparum merozoites involves multiple receptor-ligand interactions, it may be necessary to develop a multivalent malaria vaccine that is comprised of distinct parasite ligands. PfAMA-1, PfMSP1, and PfEBA-175 are merozoite proteins that play important roles in invasion. We have constructed a PfCP-2.9 chimeric protein consisting of PfAMA-1 and PfMSP1 and tested it for immunogenicity in animal models and humans. The F2 subdomain of PfEBA-175 (PfEBA-175II F2) was identified as the binding domain for glycophorin A on erythrocytes. In this study, we used the codon frequencies of the yeast Pichia pastoris to redesign and synthesize a gene encoding the F2 domain. We found that the codon-optimized gene was expressed at a high level in P. pastoris as a soluble protein with a yield of about 300 mg/liter. The expressed protein was able to bind normal erythrocytes but not those treated with neuraminidase or trypsin. Moreover, the protein was recognized by the sera of malaria patients and was highly immunogenic in mice, rabbits, and rhesus monkeys. Immunoglobulin G isolated from both immunized rabbits and monkeys inhibited in vitro parasite growth. Immunization of animals with a combination of PfEBA-175II F2 and PfCP-2.9 did not result in antigen (Ag) competition in animals. Moreover, antibodies to both PfEBA-175II F2 and PfCP-2.9, isolated from rabbits immunized with both constructs, inhibited parasite growth in vitro. The combination of high yield, functional folding, antibody inhibition, and lack of Ag competition provides support for inclusion of these merozoite proteins in a combination vaccine against infection with blood-stage parasites.

Variation in the relationship between anti-MSP-1(19) antibody response and age in children infected with Plasmodium falciparum during the dry and rainy seasons

Malaria remains a major parasitic disease in Africa, with 300-500 million new infections each year. There is therefore an urgent need for the development of new effective measures, including vaccines. Plasmodium falciparum merozoite surface protein-1(19) (MSP-1(19)) is a prime candidate for a blood-stage malaria vaccine. Blood samples were collected from children aged 10 days to 15 years in the months of January-March (N = 351) and October-November (N = 369) corresponding to the dry and rainy seasons, respectively. P. falciparum infection was determined by microscopy and enzyme linked immunosorbent assay (ELISA) was used to determine the total IgG and IgG subclasses. There was a significant increase in the mean anti-MSP-1(19) antibody titre in the dry season (p < 0.05), compared to the rainy season. A significantly positive correlation between the anti-MSP-1(19) antibody titre and parasite density (p < 0.01, r = 0.138) was observed. In the rainy season, unlike in the dry season, P. falciparum positive children had higher anti-MSP-1(19) antibody titres than P. falciparum negative children and this difference was significant (p < 0.05). When all individuals were grouped together, the anti-MSP-1(19) antibody titre increased with age in both seasons (r = 0.186 and 0.002), this increase was more apparent in the dry season. However, when the study population was divided into P. falciparum positive and negative groups, it was observed that in the rainy season, there was a negative correlation between anti-MSP-1(19) titre and age in P. falciparum positive individuals, while those who were P. falciparum negative had a positive correlation between anti-MSP-1(19) titre and age. Analysis of anti-MSP-1(19) IgG subclass showed that IgG1 and IgG3 mean titres were highest in both the dry and rainy seasons with an increase in the mean antibody titres for IgG1, IgG2 and IgG3 in the rainy season. In the dry season there was a positive correlation between IgG1, IgG2, and IgG3 titres with age, while IgG4 was negative, whereas in the rainy season there was a positive correlation between IgG2 and IgG4 (non-cytophilic antibodies) with age and a negative correlation for IgG1 and IgG3 (cytophilic antibodies) with age. Seasonal differences in the level of MSP-1(19) IgG subclass titres were observed for P. falciparum negative and positive individuals. Only samples, which were positive for IgG2 and IgG4, showed positive correlation between parasitemia and total IgG. The incidence of P. falciparum infection, which increases during the rainy season, might be an important determinant of anti-MSP-1(19) antibody levels in children living in Igbo-Ora and the results point to the fact that non-cytophilic antibodies to MSP-1(19) in children might be associated with an increase in total IgG and parasitemia.

Antibodies Directed againstO‐Acetylated Sialoglycoconjugates Accelerate Complement Activation inLeishmania donovaniPromastigotes

BACKGROUND

An enhanced presence of 9-O-acetylated sialoglycoconjugates (9-O-AcSGs) triggers the alternate pathway (AP) in Indian visceral leishmaniasis (VL). Antibodies directed against these epitopes are present in high titers. The biological relevance of these antibodies, with regard to activation of the classical pathway (CP), was investigated.

METHODS

Complement activators were affinity purified, complement activation via the CP, AP, and lectin-mediated complement pathway was measured by use of an anti-C3 radio-binding assay, and the number of C3 molecules was quantitated by Scatchard analysis. Cell death induced via the complement pathways was measured by use of MTT (tetrazolium salt 3- [4, 5-dimethylthiazol-2-yl] -2, 5-diphenyltetrazolium bromide) assay, and uptake of propidium iodide (PI) was measured by flow cytometry.

RESULTS

Anti-O-AcSGs from both healthy donors and patients with VL elicited C3 deposition as early as 3 min, which triggered parasite lysis, as demonstrated by use of MTT assay and corroborated by the high rate of uptake of PI. Analysis of complement activation by mannan-binding lectin and C-reactive protein demonstrated their negligible contribution during the 3-min time frame.

CONCLUSIONS

Anti-O-AcSGs were identified as an important source of CP activation under normal physiological conditions, suggesting that they play a role in conferring host protection against parasite infection.

Detection of IgA anti-Entamoeba histolytica in the patients' saliva

E. histolytica is a protozoan parasite with worldwide distribution. The diagnosis of this parasite still depends on the microscopic examination. Determination of the sIgA in the different body fluid proves to be of diagnostic value in many pathogens. To find out the potentials of salivary sIgA in diagnosis of intestinal amoebiasis, 30 patients with parasitologic proved E. histolytica and 30 cross-matched negative controls were selected for levels of salivary sIgA using radial immunodiffuion technique. The result showed a high significant increase in the mean concentration of salivary sIgA in patients rather controls. However, six negative controls gave positive sIgA. So, salivary IgA concentration has a predictive diagnostic values of intestinal amoebiasis, when the stool examination is practically impossible as well as in tissue amoebiasis.

The risk for Chagas' disease in the Midwestern United States organ donor population is low

PURPOSE

Several recent publications have increased awareness that transplanted organs can transmit infectious diseases. In light of the recent report describing the transmission of Trypanosoma cruzi infection by an organ donor in the United States (MMWR 2002: 51: 210), we have tested archived serum samples from our Organ Procurement Organization's (OPO's) deceased organ donors and live donors from 23 October 1995 through 1 March 2002.

METHODS

A total of 1117 serum samples from 558 locally recovered deceased donors, 178 imported deceased donors, and 212 live donors were tested (several duplicates were included). Samples were screened for antibodies to T. cruzi, the protozoan parasite that causes Chagas' disease, with a passive particle agglutination assay (Fujirebio, Inc., Tokyo, Japan). Indeterminate samples (those agglutinating both sensitized and control particles) were absorbed with control antigen and re-tested. Inconclusive samples (those not yielding clearly negative or positive results) were re-tested using the original test format, and if persistently inconclusive, were assayed by radio-immune precipitation (RIPA).

RESULTS

Of the 770 local OPO donors (deceased and live donor) and the 178 imported donors tested, 52 (5.5%) were indeterminate, but following absorption, all were negative. Forty-four samples (4.6%) were inconclusive and after re-testing 34 were negative while 10 remained inconclusive. Those 10 samples were found to be negative by RIPA.

CONCLUSIONS

The risk of transmission of Chagas' disease by organ transplantation in the Midwestern United States is low because during a 6.5 year period, none of our deceased or live donors tested positive for antibodies to T. cruzi. Although the passive particle agglutination test is simple to perform, easy to interpret and rapid enough to be used in screening organ donors, because of the rate of false positive results, it should only be utilized when the donor population is at high risk for previous exposure to T. cruzi.

Preparation, crystallization and preliminary X-ray analysis of a complex between the Plasmodium vivax sexual stage 25 kDa protein Pvs25 and a malaria transmission-blocking antibody Fab fragment

The Plasmodium vivax sexual stage 25 kDa protein Pvs25, located on the surface of the ookinete form of the parasite, is a vaccine candidate designed to elicit immunity that blocks the transmission of malaria by mosquitoes. The 2A8 murine monoclonal antibody directed against recombinant Pvs25 prevents the formation of P. vivax oocysts in mosquitoes fed in the laboratory. The complex between recombinant Pvs25 and the Fab fragment of 2A8 forms crystals that diffract X-rays to 3.5 A. Two native data sets, A and B, have been collected from crystals of the Pvs25-Fab complex. Both crystals belong to space group P2(1), with unit-cell parameters of a = 86.3, b = 61.7, c = 142.7 A, beta = 101.7 degrees for data set A and a = 86.8, b = 61.0, c = 149.3 A, beta = 104.3 degrees for data set B, and contain two complex molecules per asymmetric unit. Efforts are under way to reveal the structure of the Pvs25-Fab complex by molecular replacement. The three-dimensional structure of the Pvs25-Fab complex will provide an understanding of the interaction between Pvs25 and the 2A8 antibody that inhibits ookinete development in the mosquito and should aid in the development of transmission-blocking vaccines against P. vivax malaria.

Potential diagnosis of Giardia lamblia infection through specific antibody detection in saliva

Thirty six patients presenting with gastrointestinal symptoms were studied for the presence of specific anti-Giardia lamblia salivary IgA antibodies. Stool samples were examined for parasites especially G. lamblia by direct smear. Duodenal aspirate was examined for the parasite. Saliva samples were collected from each patient and examined by ELISA technique for the specific anti-Giardia lamblia IgA antibodies. 94.4% of positive cases for G. laimblia by stool analysis had positive anti-Giardia salivary IgA antibodies. 33.3% of stool negative cases were positive for anti-Giardia salivary IgA antibodies. All Giardia negative cases by duodenal aspirate examination were negative for anti-Giardia salivary IgA antibodies. Detection of antiGiardia salivary IgA antibodies was an excellent tool for screening G. lamblia in patients with long standing symptoms of more than one month duration.

Secretory IgA antibody responses in Venezuelan children infected with Giardia duodenalis

We standardized and evaluated an ELISA technique for the detection of total and specific anti-Giardia duodenalis secretory IgA antibodies (sIgA). Samples of saliva and serum of 161 Venezuelan schoolchildren were analysed. After stool examination, 66 children were diagnosed to be infected with Giardia duodenalis, 22 with other protozoa, and 73 non-parasitized. The mean (+ 2 SD) values of secretory IgA in the non-parasitized group was considered as the criterion of positivity. The levels of total and specific anti-Giardia sIgA were significantly higher in children with Giardia compared with the group with other protozoa (p < 0.01) and the non-parasitized group (p < 0.001). The ELISA technique developed showed values of sensitivity and specificity of 74 and 94 per cent, respectively, a predictive value of 92 per cent for positive samples and 80 per cent for negative samples. Specific anti-Giardia IgA serum levels showed a low sensitivity (57 per cent) and a predictive value for negative samples (53 per cent). Our results suggest that secretory anti-Giardia IgA levels measured in saliva samples may reflect local intestinal IgA responses elicited by these parasites. Thus, determinations of the levels of sIgA anti-Giardia could be a useful diagnostic tool for giardiasis in children.

Serodiagnosis of toxoplasmosis. The impact of measurement of IgG avidity

The development of IgG avidity assays has revolutionised serological diagnosis of Toxoplasma infections. The measurement of IgG avidity has shown its power in various clinical settings, especially in situations where timing and differentiation of primary and secondary infections is crucial. However, no laboratory test performed alone is self-sustained, whereby the diagnostic strategy of choice is sequential (or combinatorial) use of high-quality IgG, IgM, IgA and IgG-avidity assays. The impact of IgG avidity measurement will be discussed in five clinical scenarios: acute acquired infection, primary infection during pregnancy, congenital toxoplasmosis, ocular toxoplasmosis and Toxoplasma infection in immunocompromised patients. All in all in toxoplasmosis, superior diagnostic performance is achieved by appropriate combinations of serological, culture-based and PCR techniques.

Specific anti-Toxoplasma gondii antibodies produced in inbred mice differring in their natural resistance to toxoplasmosis

The laboratory diagnostics of T. gondii infections both in humans and animals relies mainly upon detection of specific antibodies. We studied the influence of the host genetic factors on the level and repertoire of antibodies produced in Toxoplasma infection employing as an experimental model two inbred mouse strains with different innate susceptibility to toxoplasmosis. Using polyvalent antigen preparations in ELISA and microagglutination we found no differences in the antibody levels in both strains. By comparison of the antibody profiles in immunoblot we determined mouse strain-specific and common toxoplasmosis markers.

Impact of stage differentiation on diagnosis of toxoplasmosis

Within its intermediate host, such as man, the protozoan parasite Toxoplasma gondii interconverts between tachyzoites and bradyzoites. The replicative tachyzoite stage is thought to be responsible for acute/active infection and expresses immunodominant antigens thereby inducing a strong cellular immune response, which vice versa triggers the differentiation process into dormant and immunologically weak cyst stages. The immunodominance of tachyzoites is also responsible for the induction of a strong humoral immune response leading to the formation of antibodies specifically directed against tachyzoite antigens. In contrast, the bradyzoite stage which is associated with inactive/chronic infection, seems not to be a strong inducer of specific antibodies. However, since the humoral antibody response is also directed against antigens that are expressed in both stages, serodiagnosis cannot always adequately discriminate between active and inactive/chronic infection. This short review focuses on the impact of stage differentiation and discusses the potential of stage-specifically expressed antigens that might be useful in a recombinant form in order to improve future serodiagnostical approaches.

A long-term study of Neospora caninum infection in a Swedish dairy herd

A longitudinal study was performed in a Swedish dairy herd where Neospora caninum had been isolated from a stillborn calf. Starting in autumn 1994, blood samples from all female animals in the herd were collected once yearly until 1999. The sera were analysed for presence of IgG1 antibodies to N. caninum by the iscom ELISA, and by an avidity ELISA to establish the timing of infection. In addition, data on reproductive performance were compiled. During the study the percentage of seropositive female animals increased from 63% to 87%. In 1994 a large number of young animals tested seropositive although their dams were seronegative, indicating that a transmission of the parasite other than the vertical had recently occurred. Low avidity values supported this assumption. The annual abortion rate increased from a mean of 2% before the initiation of the study to 9% in 1994-1998. During the same time, as judged by the avidity data, a large proportion of the animals shifted from being recently to being chronically infected. The source of the external infection in the herd could not be identified.

Survey of Neospora caninum antibodies in dairy and beef cattle from five regions of the United States

Serum samples from 4,907 cows from 93 dairy and five beef herds were analyzed for antibodies to Neospora caninum by commercially available ELISA. The herds were recruited from 20 states and the territory of Puerto Rico. A questionnaire assessed the herd's abortion history and exposure risks to N. caninum. Results showed that 788 (16%) cows tested positive for antibodies to N. caninum. At least one positive animal was detected in 90% of the herds tested. The prevalence of cows seropositive to N. caninum varied from 2% to 65% among herds. Abortion rates ranging from 2% to 19% were reported. The epidemiologic data collected from the questionnaire suggested that the presence of farm dogs does not increase the risk of exposure of cows to N. caninum.

Polyclonal Fab phage display libraries with a high percentage of diverse clones to Cryptosporidium parvum glycoproteins

The protozoan parasite Cryptosporidium parvum is regarded as a major public health problem world-wide, especially for immunocompromised individuals. Although no effective therapy is presently available, specific immune responses prevent or terminate cryptosporidiosis and passively administered antibodies have been found to reduce the severity of infection. Therefore, as an immunotherapeutic approach against cryptosporidiosis, we set out to develop C. parvum-specific polyclonal antibody libraries, standardised, perpetual mixtures of polyclonal antibodies, for which the genes are available. A combinatorial Fab phage display library was generated from the antibody variable region gene repertoire of mice immunised with C. parvum surface and apical complex glycoproteins which are believed to be involved in mediating C. parvum attachment and invasion. The variable region genes used to construct this starting library were shown to be diverse by nucleotide sequencing. The library was subjected to one round of antigen selection on C. parvum glycoproteins or a C. parvum oocyst/sporozoite preparation. The two selected libraries showed specific reactivity to the glycoproteins as well as to the oocyst/sporozoite preparation, with 50-73% antigen-reactive members. Fingerprint analysis of individual clones from the two antigen-selected libraries showed high diversity, confirming the polyclonality of the selected libraries. Furthermore, immunoblot analysis on the oocyst/sporozoite and glycoprotein preparations with selected library phage showed reactivity to multiple bands, indicating diversity at the antigen level. These C. parvum-specific polyclonal Fab phage display libraries will be converted to libraries of polyclonal full-length antibodies by mass transfer of the selected heavy and light chain variable region gene pairs to a mammalian expression vector. Such polyclonal antibody libraries would be expected to mediate effector functions and provide optimal passive immunity against cryptosporidiosis.

Survey of Theileria lestoquardi antibodies among Sudanese sheep

The prevalence of Theileria lestoquardi antibodies in Sudanese sheep from nine geographical areas in Sudan was determined using indirect fluorescent antibody "IFA" test. Out of 315 samples examined, 51 (16.2%) were found positive and ranged between 23.4% in River Nile State and 10% in Kasala and Darfour Provinces with an overall prevalence of 16.2% indicating widespread distribution of the infection. We also report on presence of antibodies reactive to Theileria annulata in sheep sera.

A herd-level analysis of risk factors for antibodies to Sarcocystis neurona in Michigan equids

Equine protozoal myeloencephalitis (EPM) is a neurological disease of horses and ponies caused by infection of the central nervous system with the protozoan parasite Sarcocystis neurona. A herd-level analysis of a cross-sectional study of serum antibodies to S. neurona in Michigan equids was conducted, using data collected in 1997 for study that included 1121 equids from 98 Michigan horse farms. Our objective was to identify specific herd-level risk factors associated with seropositivity. We tested associations between herd seroprevalence and various farm-management practices (including feed-storage methods and wildlife control). Multivariable models were developed for three strata based on relative opossum abundance (opossum districts). Herd seroprevalence ranged from 0 to 100% (median=57%). No risk factor was significantly associated with herd seroprevalence at P< or = 0.05 in all opossum districts. Our results suggest that equids living in areas with large opossum populations might be infected with S. neurona from multiple sources.

Cutaneous leishmaniosis in a horse in southern Germany caused by Leishmania infantum

This report describes a case of cutaneous leishmaniosis in a horse in southern Germany. Diagnosis is based on histopathology, immunohistochemistry and electron microscopy. The protozoan was identified as Leishmania infantum via PCR and restriction fragment length polymorphism. The horse did not show specific Leishmania antibodies. The lesions healed completely within 6 months without any specific treatment. Since neither the infected horse nor its dam had ever left their rural area, autochthonous infection in Germany cannot be excluded. Factors possibly influencing the epidemiological situation are discussed.

Neospora caninum: oocyst challenge of pregnant cows

Three pregnant cows were each orally challenged at 10 weeks of gestation with 600 sporulated oocysts of Neospora caninum. The number of oocysts was limited by those available. In concurrent bioassays, one oocyst per os infected each of two gerbils. Challenged cattle developed Neospora-specific antibody, cell proliferation and gamma-interferon responses. N. caninum specific PCR demonstrated persisting infection in the brains of cows 4 months after calving. Abortion was not induced and there was no evidence of transplacental infection in the healthy calves born at full-term. This experiment suggests that the dose threshold for induction of abortion exceeds 600 oocysts.

The application of latent class analysis for diagnostic test validation of chronic Trypanosoma cruzi infection in blood donors

The main strategy to prevent transfusion-associated Chagas disease is the identification of T. cruzi-infected blood donors by serological screening tests, however there is no perfect serological gold standard. We evaluated an enzyme immunoassay (EIA), an indirect hemaglutination (IHA), and an indirect immunofluorescence (IIF) test for detecting T. cruzi antibodies in Brazilian blood donors. The results were submitted to latent class analysis, and a radioimmunopreciptation (RIPA) test was performed on repeatedly positive samples. Among 1951 donors, 11 (0.56%) were positive by EIA, 6 (0.31%) by IHA and 16 (0.82%) by IIF. Six samples were positive with all tests, while 4 reacted with EIA and IIF. The RIPA was positive in 6 (75.0%), 7 (66.6%), and 4 (54.0%) samples reacting by the EIA, IHA and IIF tests, respectively. The latent class model detected a high sensitivity rate (100%) for the EIA and IIF, and a specificity rate of 99.95% and 99.69% for the EIA and IIF tests, respectively. The probability of being case according to the model was 99.92% when both EIA and IIF were positive, and 100% for the association of EIA, IIF, and IHA.

Entomologic and serologic evidence of zoonotic transmission of Babesia microti, eastern Switzerland

We evaluated human risk for infection with Babesia microti at a site in eastern Switzerland where several B. microti-infected nymphal Ixodes ricinus ticks had been found. DNA from pooled nymphal ticks amplified by polymerase chain reaction was highly homologous to published B. microti sequences. More ticks carried babesial infection in the lower portion of the rectangular 0.7-ha grid than in the upper (11% vs. 0.8%). In addition, we measured seroprevalence of immunoglobulin (Ig) G antibodies against B. microti antigen in nearby residents. Serum from 1.5% of the 396 human residents of the region reacted to B. microti antigen (>1:64), as determined by indirect immunofluorescence assay (IgG). These observations constitute the first report demonstrating B. microti in a human-biting vector, associated with evidence of human exposure to this agent in a European site.

The burden of Leishmania chagasi infection during an urban outbreak of visceral leishmaniasis in Brazil

First noted in the city of Teresina in 1981, the last decades have witnessed a remarkable increase in urban transmission of American visceral leishmaniasis (VL) in many Brazilian cities. Teresina, the site of this study, has faced two large outbreaks of VL. The first occurred from 1981-1985 when almost 1000 new cases were reported. The second started in the 1990s, and between 1993 and 1996 more than 1200 new cases were detected. This report describes the prevalence of infection with Leishmania chagasi in Teresina at the end of the second outbreak and gives estimates of the number of people who became infected during the epidemic. Between June 1995 and May 1996, 200 households were chosen at random from a list of addresses covering about 93% of Teresina's urban households. In each household, one person over the age of 1 year was screened for Leishmania antibodies and skin-tested. Nearly 50% of persons had a positive leishmanin reaction, but only 13.9% had detectable antibodies to L. chagasi. While prevalence estimates based on the leishmanin skin-test increased with age (P<0.001), those based on serological tests showed a lesser, and non significant, variation with age (P=0.31). Using a geometric growth equation, and assuming that the annual distribution of clinical cases may serve as an approximation to what would have been the distribution of infections by year, we estimated that over 320000 persons were infected during the epidemic. Little is known about the epidemiology of VL in urban areas, where social networks, population density, and relationships of housing with the natural environment are more varied and complex than in the rural scene. In those areas, control interventions have failed to eliminate transmission of the parasite and prevent new epidemics. Further epidemiological studies of VL in urban areas might be needed to inform control actions.

Serological evidence for remarkably variable prevalence rates of Toxoplasma gondii in children of major residential areas in United Arab Emirates

The major objective of this study was to determine the seroprevalence rate of Toxoplasma gondii in children citizens of United Arab Emirates (UAE) main residential areas. Questionnaire information, clinical data and blood samples were obtained from 1006 primary school children residence of seven out of nine districts of UAE. ELISA was used for detection of antibodies against the immunodominant surface antigen (SAG1) of T. gondii. The sensitivity and specificity of the employed ELISA were 98.4 and 99.1%, respectively using 'Eiken' latex agglutination test as a reference test. The seroprevalence rates were remarkably variable in different residential areas and ranged between 3.5% for Dubai and 34.6% for Sharjah, with an overall prevalence of 12.5% for the seven districts. Rear of ruminants at home and consumption of raw milk associated significantly (P<0.05) with exposure to T. gondii. UAE children exposed to T. gondii infection had a significantly higher hepatomegaly rate (P<0.05) and complained more of various symptoms at the time of sampling (P<0.01) compared to unexposed children. This study urges for more population studies to further elucidate the prevalence rates of toxoplasmosis in UAE in relation to age, gender, place of residence and risk factors.

The 1999-2000 avian influenza (H7N1) epidemic in Italy: veterinary and human health implications

From the end of March to the beginning of December 1999, 199 outbreaks of low pathogenicity avian influenza (LPAI) were diagnosed in the Veneto and Lombardia regions, which are located in the northern part of Italy. The virus responsible for the epidemic was characterized as a type A influenza virus of the H7N1 subtype of low pathogenicity. On the 17th of December, highly pathogenic avian influenza (HPAI) was diagnosed in a meat turkey flock in which 100% mortality was observed in 72 h. The infection spread to the industrial poultry population of northern Italy including chickens, guinea-fowl, quail, pheasants, ducks and ostriches for a total of 413 outbreaks. Over 13 million birds were affected by the epidemic, which caused dramatic economic losses to the Italian poultry industry with severe social and economic implications. The possibility of H7 virus transmission to humans in close contact with the outbreaks was evaluated through a serological survey. Seven hundred and fifty nine sera were collected and tested for the detection of anti-H7 antibodies by means of the micro-neutralization (MN) and single radial haemolysis (SRH) tests. All samples resulted negative. A limited number of clinical samples were also collected for attempted virus isolation with negative results. Current European legislation considers LPAI and HPAI as two completely distinct diseases, not contemplating any compulsory eradication policy for LPAI and requiring eradication for HPAI. Evidence collected during the Italian 1999-2000 epidemic indicates that LPAI due to viruses of the H7 subtype may mutate to HPAI, and, therefore, LPAI caused by viruses of the H5 or H7 subtypes must be controlled to avoid the emergence of HPAI. A reconsideration of the current definition of avian influenza adopted by the EU, could possibly be an aid to avoiding devastating epidemics for the poultry industry in Member States.

Risk of infection with Leishmania spp. in the canine population in the Netherlands

The dog is the main reservoir of Leishmania infantum, the causative agent of visceral leishmaniasis (VL) in humans in Southern Europe. In order to identify the risk of dogs from a Leishmania non-endemic area traveling to a Leishmania-endemic area becoming infected and the risk of transmitting infection to humans in non-endemic areas an investigation was performed, in which the results of a questionnaire were combined with the results of a serologic survey. The questionnaire was sent to 1478 at random chosen families in the Netherlands. Of the 59.0% responders 28.0% had one or more dogs and 4.8% of these dogs had visited Southern Europe during the summer period of that year. On a total population of 1,200,000 dogs in the Netherlands, this means that each year some 58,000 dogs are at risk of being exposed to a Leishmania infection in Southern Europe. During the period 1990-1992 blood was collected for serology in 1911 dogs presented to the Utrecht University Clinic because of clinical problems not related to leishmaniasis, of which 434 had been in Southern Europe in the foregoing years. None was serologically positive. From these data it can be deduced that the highest chance to obtain leishmaniasis during a vacation in Southern Europe is mathematically less than 1/434 or less than 0.23%. Serology was also performed during the period 1989-1993 in 597 dogs that had been in Southern Europe and were suspected of leishmaniasis. Titers were positive in 145 of these samples. Sixty-four of these dogs were born in the Mediterranean and had been imported into the Netherlands. Excluding these imported dogs, it was calculated that at least 0.027% of the 58,000 dogs yearly taken to Southern Europe during holidays become infected with Leishmania. In order to establish the risk of disease transmission for people in close contact with an infected dog, serum samples of owners and house mates of 37 dogs with leishmaniasis were tested. All 112 sera tested negative. It was concluded that the risk to get leishmaniasis was between 0.027% and 0.23% for the dog when taken to Southern Europe during vacation, and that the risk for owners in non-endemic areas to get leishmaniasis from an infected dog is minimal.