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PubMedDate not supplied

[Isolation of highly pathogenic avian influenza (HPAI) A/5H5N1 strains from wild birds in the epizootic outbreak on the Ubsu-Nur Lake (June 2006) and their incorporation to the Russian Federation State Collection of viruses (July 3, 2006)].

Virological and molecular genetic studies of the field material collected in the epicenter of epizooty with high mortality rates among the wild birds on the coast of the Ubsu-Nur lake (Republic of Tyva, 51 degrees NL, 93 degrees EL, June 2006) revealed the etiological role of highly pathogenic avian influenza (HPAI) H5N1. Seven HPAI/H5N1 strains were isolated from the tracheal/cloacal swabs of clinically healthy, ill and recently dead great-crested grebes (Podiceps cristatus), cormorants (Phalacrocorax carbo), balt-coots (Fulica atra), and common terns (Sterna hirundo) collected on June 24, 2006, and incorporated to the RF State Collection of Viruses (with the July 3, 2006 priority). Full-length genome nucleotide sequences were incorporated to the GenBank (with the July 23, 2006 priority) (DQ852600-DQ852607). Comparative analysis of molecular genetic characteristics showed their belonging to the Qinghai-Siberian genotype. The strains were sensitive to rimantadine.

Animals↗

PubMed2005

[The role of the Federal Government in the prevention and control of infectious diseases. Organizational structures, responsibilities and duties--an overview].

Health policy is faced today with the challenge of keeping the health care system up to a high standard and affordable at the same time. A comprehensive health protection system that is efficient and readily accessible to all is required. Although it is to a great extent the responsibility of every citizen to promote and sustain their own health, it is the duty of the Federal Government to provide for risks that can emanate from pathogens, products or environmental factors. Protection against all known risks should be improved, new health threats have to be countered and new scientific findings must be considered. Prevention, health promotion and health protection are important key factors to improve health in the general population and to reduce health care costs. The prevention of and protection from infectious diseases are high priority tasks in the further development of an effective health care system in Germany. In order to accomplish these tasks in the control of infectious diseases close collaboration between a number of federal agencies and federal institutes under the responsibility of the Ministry of Health and Social Security as well as the Ministry of Consumer Protection, Food and Agriculture has to be ensured.

Communicable Disease Control↗

PubMed2004

[Pathogenicity basis in medical and social strategies in preventive health services].

Pathogenetic processes inherent in the social reform course pre-conditioning an extra high and extra young mortality of population and the worsened physical development of children were analyzed. Four main factors, which confirm that the below processes are involved in the above phenomenon, are defined; they are: CNS (dynamic stereotype of the higher nervous activity) neuroendocrinal regulation (stress), free radical oxidation (phenoptosis) and population gene pool (heterozygosity). Social (deliberate labor motivation) and medical (individual prevention) priorities are substantiated to improve the health state in Russia.

Child↗

PubMed2005

[Complementary to notification required by the national Protection against Infection Act. State-specific mandatory infectious disease notification in Saxony-Anhalt].

In May 1991 a decree supplementing the federal Epidemic Law concerning the mandatory notification of communicable diseases was implemented by the Ministry of Health in Saxony-Anhalt. This was updated and newly implemented in 1997. With implementation of the national Protection against Infection Act in 2001 further amendment of the state regulation (published in April 2005) be came necessary. The following diseases or laboratory evidence of the underlying pathogens, respectively, will now be notifiable with inclusion of the affected individual's name: aseptic meningitis, mumps, rubella, varicella, epidemickera to conjunctivitis, pertussis, and pneumococcal meningitis. The possibility of preventing further spread of the pathogen to others though immediate implementation of preventive measures by the public health service justifies notification of the individual's name. Furthermore, the epidemiological situation is to be monitored and evaluated. This also applies to Lyme disease, which will be anonymously notifiable. Particular emphasis is placed on vaccine-preventable diseases in the state regulation for mandatory notification in Saxony-Anhalt, since priority is placed on attaining the health goal "age-appropriate vaccination status in over 90% of the population". The state-specific notification regulation of Saxony-Anhalt has worked well in preventing and controlling communicable diseases. It is a source of reliable data, which may be helpful in the discussion regarding the amendment of the Protection against Infection Act. Non-anonymous notification should be enforced nationally at least for all vaccine-preventable diseases for which a post-exposure vaccination is recommended by the Standing Committee on Vaccination (STIKO).

Communicable Disease Control↗

PubMed2006

Transcriptional and translational expression patterns associated with immobilized growth of Campylobacter jejuni.

Although Campylobacter jejuni is a leading cause of food-borne illness, little is known about the mechanisms by which this pathogen mediates prolonged environmental survival or host cell virulence. Although these behaviours represent distinct phenotypes, they share a common requirement of an immobilized state. In order to understand the cellular mechanisms that facilitate a surface-associated lifestyle, transcriptional and translational expression profiles were determined for sessile and planktonic C. jejuni. These investigations indicate that the immobilized bacteria undergo a shift in cellular priorities away from metabolic, motility and protein synthesis capabilities towards emphasis on iron uptake, oxidative stress defence and membrane transport. This pattern of expression partially overlaps those reported for Campylobacter during host colonization, as well as for other species of bacteria involved in biofilms, highlighting common adaptive responses to the conserved challenges within each of these phenotypes. The adaptation of Campylobacter to immobilized growth may represent a quasi-differentiated state that functions as a foundation for further specialization towards phenotypes such as biofilm formation or host cell virulence.

Bacterial Adhesion↗

PubMed2003

[The role of lipopolysaccharide in toxicity of Francisella genus bacteria].

It was demonstrated that the lipopolysaccharides (LPS) preparations, which were isolated from all representatives of Francisella Genus bacteria, i.e. F. tularensis, F. novicida, F. novicida-like and F. philomiragia by using the method of R.P. Darveau, R.E. Hancock (1983), were not toxic for white rats and white mice. A comparative study of toxicity of live F. tularensis bacteria (both wild and LPS-defective strains) made it possible to establish a direct correlation between the toxicity of microbes and LPS chemotype. It was found that only typical strains, which synthesize the wild-type S-LPS, caused the death of white rats and white mice in 24 hours after intraperitoneal contamination (10(9), 10(10) CFU/animal). Live bacteria of F tularensis R-mutants were not able to induce a lethal infection of rats and retained only residual virulence for mice. Other representatives of Francissela genus possessed less pronounced pathogenic properties. Thus, the toxic effect was registered, in case of white rats, only for F. novicida but not for F. novicida-like or F. philomiragia. At the same time, the two last mentioned species displayed a certain degree of virulence at high challenge doses (10(9), 10(10) CFU/animal) in respect to white mice. F. philomiragia, which generated lipoolygosaccharide (LOS) with an unusual structure, was found to be least pathogenic (25-75% of dead mice). The toxicity of bacteria, killed experimentally by different means (heating, UV-light, chloroform, acetone and formalin), was studied to define the role of bacterial proteins in the realisation of F. tularensis toxic potential in vivo. No lethal effect was exerted on experimental animals by killed microbes or purified LPS preparations. Finally, the study results show a priority role of the LPS molecule in the toxic effect of F. tularensis, which is possible in vivo only if structurally valuable molecules of live bacterial cells are available.

Animals↗

PubMed2001

Antibiotic resistance in hospital pathogens--acquisition or spread?

Hospital resistant pathogens are a problem of hospital use allowing acquisition of multi-resistant strains. The use of antibiotics in the community and on the farm has little impact on hospital infection rates and prevalence of resistance in hospital bacteria. Once acquisition occurs the main problem is spread of clones to highly vulnerable patients. Attention to protective methods for such patients ought to be a priority in hospital infection control.

Animals↗

PubMed2004

Risk and management in hospital water systems for Legionella pneumophila: a case study in Rio de Janeiro-Brazil.

This article analyses the water used at hospitals in Rio de Janeiro, Brazil. The research, based on microbiological and physical-chemical aspects, suggests subsidies for normalization of hospital potable water systems and makes recommendations for standardization of operational procedures for inspection for Legionella pneumophila. A total of 16 hospitals were inspected and positive results for the presence of L. pneumophila were found at five hospitals. These hospitals were integrated in a research project aiming at the detection and quantification of this pathogen. During 10 consecutive weeks, four collections representing a total of 200 analyses were done at the five researched hospitals. In this way seven physical-chemical parameters and three microbiological parameters were observed to evaluate the quality of water in each hospital. The results showed that routine surveillance for a hospital water distribution system is fundamental for public health and must include, as a priority, monitoring of L. pneumophila. The water quality varies in accordance with the hospital water system involved. It is important and necessary to implement environmental culturing in order to minimize hospital infection, in particular, pneumonia data and also to provide the basis for disinfection of the water system.

Brazil↗

PubMed1999

Defense mechanisms against infections.

Respiratory infections remain common and may be more difficult to treat because new microbes have been identified; commensal flora can become pathogens; and antibiotic resistance is developing, especially to Streptococcus pneumoniae. Contributing to the severity of pneumonia is the increasing number of more susceptible hosts--immunodeficient patients, created as a by-product of modern medical therapy or from infection with HIV, and elderly patients who have associated illnesses. Better strategies to replete immunocompromised hosts are required. Vaccination to modify infection with S. pneumoniae must be given higher priority by health care providers. New means to immunize the respiratory mucosal surface are needed. Research approaches to consider involve 1) targeting (carrying) relevant antigens to appropriate antigen-processing cells in the airways, eg, dendritic cells; and 2) coupling the immunomodulatory effects of cytokines, eg, interleukin-12. Interleukin-12, for example, can stimulate mucosal antibody responses producing S-IgA and IgG and cause T lymphocytes to produce interferon-gamma that can enhance microbial killing by macrophages.

Bacterial Infections↗

PubMedDate not supplied

[Isolation of influenza A/H5N1 virus strains from poultry and wild birds in West Siberia during epizooty (July 2005) and their depositing to the state collection of viruses (August 8, 2005)].

Six strains of influenza AH5N1 virus were isolated, by using PS and MDCK continuous cell lines from poultry and wild birds, which were collected on July 28, 2005 in the samples taken from 5 examines species of wild birds in the Novosibirsk region during the epizootic outbreak with a high mortality. The strains were identified by means of HIT, RT-PCR, and microchip-based techniques. Two strains, A/Grebe/Novosibirsk/29/05 (H5N1) and A/Duck/Novosibirsk/56/05 (H5N1), were deposited to the Russian State Collection of Viruses (Registration Nos. 2372 and 2371, respectively) with the priority date 08.08.2005. Positive results in RT-PCR for influenza A/H5N1 virus detec- tion were obtained in 100% of the samples from dead and sick poultry; 93% from the clinically healthy poultry kept together with sick one; positive results ranged from 0 to 36%. Sequencing established the identity of genetic characteristics of strains isolated for wild birds and poultry as well as their affiliation to high pathogenic avian influenza (HPAI). Phylogenetic analysis revealed a high homology of hemagglutining of West-Siberian strains and strains isoolated from bar-headed gooses (Eulabeia indica) on the Qinghai Lake (Western China) in the 2005 spring.

Animals↗

PubMed1995

The hemolytic uremic syndrome.

HUS is the most common cause of acute renal failure in infants and young children and follows a diarrheal prodrome about 90% of the time. Persuasive evidence shows that virtually all of postdiarrheal cases are caused by EHEC infections, and that the great majority of cases in the United States are caused by the EHEC serotype O157:H7. Mortality is approximately 5%, and approximately 10% of survivors are left with severe sequelae. A much larger number (30%-50%) experience mild chronic renal damage. Public health strategies, including zero tolerance for fecal contamination in slaughter houses and additional public education on proper food handling and cooking, does much to decrease the prevalence of the syndrome. Efforts to further dissect the postdiarrheal pathogenic cascade should continue, and an animal model needs to be developed. Only then will researchers be positioned to develop effective intervention strategies. Preventing life-threatening extrarenal complications, especially of the CNS, is a major challenge. Idiopathic nondiarrheal HUS accounts for approximately 10% of cases and comprises a poorly understood composite of HUS subsets. Research directed toward a better understanding of these mysterious variants also is a priority for the years ahead.

Child↗

PubMed2000

Domestic hygiene and diarrhoea - pinpointing the problem.

Improving domestic hygiene practices is potentially one of the most effective means of reducing the global burden of diarrhoeal diseases in children. However, encouraging behaviour change is a complex and uncertain business. If hygiene promotion is to succeed, it needs to identify and target only those few hygiene practices which are the major source of risk in any setting. Using biological reasoning, we hypothesize that any behaviours which prevent stools from getting into the domestic arena, the child's main habitat, are likely to have a greater impact on health than those practices which prevent pathogens in the environment from being ingested. Hence safe stool disposal, a primary barrier to transmission, may be more important than hand-washing before eating, which constitutes a secondary barrier, for example. We review the epidemiological evidence for the effect of primary and secondary barrier behaviours and suggest that it supports this conclusion. In the absence of local evidence to the contrary, hygiene promotion programmes should give priority to the safe disposal of faecal material and the adequate washing of hands after contact with adult and child stools.

Animals↗

PubMed2004

Manipulation of immunity to and pathology of respiratory infections.

Respiratory infections are the third leading cause of death worldwide and are a priority for vaccine development. Immune defence mechanisms are critical in recovery from most respiratory infections but the role of the immune system in causing bystander lung injury is not as well understood, and will be the focus of this review. Immune-mediated injury results from physical occlusion of the airways or the ensuing 'cytokine storm', which may spill over into the systemic circulation and cause devastating consequences. Respiratory pathogens employ numerous strategies to avoid detection by the immune system. One of these, the alteration of key surface determinants, makes the design of rational vaccines problematic. In the following review the immune compartments responsible for clinical lung disease are discussed, and current and novel strategies to reduce their potency are overviewed.

Anti-Infective Agents↗

PubMed2002

[Immune response to live influenza vaccine].

Priority data on the induction, by using a Russian live cold-adapted reassortant influenza vaccine (LIV), of the cellular and humoral immunity with regard for attenuation and genetic reassortment of vaccine stains as well as with regard for the age of vaccinated persons and the production of Th1 (IFNY, IL-2) and Th2 (IL-4) cytokine markers in vitro are presented. It was demonstrated in vivo that a pathogenic virus of the A group by far more actively induced the lymphocyte apoptosis as compared with attenuated genetically reassorted stains. Unlike the influenza pathogenic virus, the genetically attenuated and reassorted strain did not produce any negative effects on the induction of cellular immunity. A comparative study of the LIV immunogenic properties in vaccinated persons showed an advantage of LIV over inactivated influenza vaccine (IIV) in stimulating the cellular and local immunity in the elderly. Unlike IIV, LIV induced an active and balanced immune response developing due to Th1 and Th2 activation. LIV was found to stimulate well enough the production of IFN and IL-2 in both young and old persons.

Adolescent↗

PubMed1988

Bacteremia complicating acute leukemia with special reference to its incidence and changing etiological patterns.

Over the 15-yr period, 1972-1986, 194 episodes of bacteremia occurred in 132 patients with acute leukemia at the Third Department of Medicine, Kanazawa University Hospital, giving an incidence of 478 episodes per 1,000 hospital admissions. This incidence was at least twice as high as that in patients with chronic leukemia, malignant lymphoma, multiple myeloma or aplastic anemia, and about 40-fold higher than that in patients with all other internal diseases. The rate of occurrence of bacteremia, whether unimicrobial or polymicrobial, remained almost unchanged throughout the study period. The frequency of gram-negative bacilli decreased significantly, however, from 81% of the total isolates for the first 10-yr period to 50% for the second 5-yr period. Escherichia coli and Klebsiella pneumoniae were isolated in markedly decreasing frequency, but Pseudomonas aeruginosa and Enterobacter cloacae in relatively constant frequency. The majority of P. aeruginosa isolates belonged to a limited number of O-antigen groups, suggesting the possibility of nosocomial infection. On the other hand, the frequency of gram-positive cocci increased from 9 to 36%. Staphylococcus epidermidis, Enterococcus species, and Staphylococcus aureus emerged as important pathogens. Such a change in the spectrum of organisms was considered to coincide with the common use of the so-called second- and third-generation cephalosporins and central venous catheters. It is thus suggested that vancomycin be added to empiric antibiotic therapy, especially when gram-positive infections are clinically or microbiologically suspected, and that reducing the acquisition of P. aeruginosa from the hospital environment remains a priority in infection prevention.

Acute Disease↗

PubMed2005

Strategies for containing an emerging influenza pandemic in Southeast Asia.

Highly pathogenic H5N1 influenza A viruses are now endemic in avian populations in Southeast Asia, and human cases continue to accumulate. Although currently incapable of sustained human-to-human transmission, H5N1 represents a serious pandemic threat owing to the risk of a mutation or reassortment generating a virus with increased transmissibility. Identifying public health interventions that might be able to halt a pandemic in its earliest stages is therefore a priority. Here we use a simulation model of influenza transmission in Southeast Asia to evaluate the potential effectiveness of targeted mass prophylactic use of antiviral drugs as a containment strategy. Other interventions aimed at reducing population contact rates are also examined as reinforcements to an antiviral-based containment policy. We show that elimination of a nascent pandemic may be feasible using a combination of geographically targeted prophylaxis and social distancing measures, if the basic reproduction number of the new virus is below 1.8. We predict that a stockpile of 3 million courses of antiviral drugs should be sufficient for elimination. Policy effectiveness depends critically on how quickly clinical cases are diagnosed and the speed with which antiviral drugs can be distributed.

Age Distribution↗

PubMed1998

Clinical implications of antibiotic resistance for management of acute otitis media.

Antibiotic resistance to available antimicrobial agents has been constant since the introduction of the sulfonamides in the 1930s. Multidrug-resistant Streptococcus pneumoniae and beta-lactamase-producing Haemophilus influenzae are a concern now because of the importance of these pathogens in infections of the respiratory tract in infants and children. Amoxicillin remains the drug of choice for initial episodes of acute otitis media (AOM) although increase of the dosage schedule to 80 mg/kg/day has been recommended by some investigators. There are 15 additional antimicrobial agents approved by the Food and Drug Administration for the indication of AOM. All approved drugs are clinically effective but some have been suggested to have priority for patients who fail amoxicillin: amoxicillin-clavulanate; an oral cephalosporin such as cefuroxime axetil; and intramuscular ceftriaxone. Management of the child with severe and recurrent disease should include antibiotic prophylaxis but the increased incidence of resistance requires selective use. Prevention of infection may be achieved by innovative techniques for interference with attachment of bacteria to the nasal mucosa such as administration of oligosaccharides in a nasal spray. The currently available polysaccharide pneumococcal vaccines have limited immunogenicity in infants, but the vaccine is useful in children 2 years of age and older who still have recurrent AOM. Children with frequent AOM during the prior respiratory season are candidates also for influenza virus vaccine. If medical management fails to prevent new episodes of AOM in children with severe and recurrent disease, placement of tympanostomy tubes and possible adenoidectomy should be considered.

Acute Disease↗

PubMed2004

Immune restoration disease after antiretroviral therapy.

Suppression of HIV replication by highly active antiretroviral therapy (HAART) often restores protective pathogen-specific immune responses, but in some patients the restored immune response is immunopathological and causes disease [immune restoration disease (IRD)]. Infections by mycobacteria, cryptococci, herpesviruses, hepatitis B and C virus, and JC virus are the most common pathogens associated with infectious IRD. Sarcoid IRD and autoimmune IRD occur less commonly. Infectious IRD presenting during the first 3 months of therapy appears to reflect an immune response against an active (often quiescent) infection by opportunistic pathogens whereas late IRD may result from an immune response against the antigens of non-viable pathogens. Data on the immunopathogenesis of IRD is limited but it suggests that immunopathogenic mechanisms are determined by the pathogen. For example, mycobacterial IRD is associated with delayed-type hypersensitivity responses to mycobacterial antigens whereas there is evidence of a CD8 T-cell response in herpesvirus IRD. Furthermore, the association of different cytokine gene polymorphisms with mycobacterial or herpesvirus IRD provides evidence of different pathogenic mechanisms as well as indicating a genetic susceptibility to IRD. Differentiation of IRD from an opportunistic infection is important because IRD indicates a successful, albeit undesirable, effect of HAART. It is also important to differentiate IRD from drug toxicity to avoid unnecessary cessation of HAART. The management of IRD often requires the use of anti-microbial and/or anti-inflammatory therapy. Investigation of strategies to prevent IRD is a priority, particularly in developing countries, and requires the development of risk assessment methods and diagnostic criteria.

Antiretroviral Therapy, Highly Active↗