Surveillance for Ross River virus infection using blood donors

The number of clinical Ross River virus (RRV) infections (epidemic polyarthritis) each year in Australia continues to grow despite extensive vector control programs. There is a need, therefore, for a surveillance program that can give sufficient warning of outbreaks of the disease so that highly focused preventative measures may be undertaken. The ability of a surveillance program, based on voluntary Red Cross blood donations, to predict outbreaks of epidemic polyarthritis was evaluated. Anti-RRV IgM antibody was detected in significant numbers of blood donors from throughout the state of Queensland 6-9 weeks prior to an increase in the number of notified cases of epidemic polyarthritis. At a local level, significant numbers of anti-RRV IgM blood donors were detected in Brisbane in 1996 four weeks prior to an increase in the number of notified cases of epidemic polyarthritis. This system of surveillance is technically simple, rapid (results are obtained in 2-3 days), it samples the human population from throughout the state, and it gives timely warning of outbreaks of epidemic polyarthritis.

Breast feeding in neonatal alloimmune thrombocytopenia

Infants with neonatal alloimmune thrombocytopenia are at risk of severe intracranial haemorrhage. Placental transfer of maternal immunoglobulin G (IgG) directed against fetal platelet antigens is known to be the underlying mechanism. Since breast milk contains IgG it is theoretically possible that breast feeding of these infants could cause thrombocytopenia. The following case report shows that an infant with neonatal alloimmune thrombocytopenia may be safely breast fed, even when the breast milk contains the platelet specific antibody (HPA-1a).

The thrombin receptor

1. The thrombin receptor has now been cloned and found to be a member of the G-protein-coupled seven-transmembrane domain receptor family. 2. The receptor has been detected directly in platelets, endothelial cells and smooth muscle cells and studies using receptor-derived peptides have demonstrated that this receptor may be the one responsible for many of the actions of thrombin in platelets, endothelial cells, smooth muscle cells, fibroblasts, mesangial cells and neural cells. 3. The receptor appears to be activated by the novel mechanism of cleavage by thrombin to yield a new N-terminus which then interacts with the receptor as a tethered ligand to initiate cell activation.