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By exclusion of other possible aetiological agents, strong circumstantial evidence is presented of Trypanosoma evansi infection being the cause of late gestation abortion and stillbirth in buffaloes.
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OBJECTIVE: This study was undertaken to evaluate the pregnancy and perinatal outcomes of pregnant women with severe acute respiratory syndrome (SARS). STUDY DESIGN: All pregnant women (12) who presented with SARS in Hong Kong between February 1 and July 31, 2003, were included. The pregnancy and perinatal outcomes were collected. Evidence of perinatal transmission of virus was assessed with the SARS-associated coronavirus reverse-transcriptase polymerase chain reaction on cord blood, placenta tissue, and subsequent follow-up of the neonate on serology. RESULTS: Three deaths occurred among the 12 patients, giving a case fatality rate of 25%. Four of the 7 patients (57%) who presented in the first trimester had spontaneous miscarriage. Four of the 5 patients who presented after 24 weeks were delivered preterm. Two mothers recovered without delivery, but their ongoing pregnancies were complicated by intrauterine growth restriction. No newborn infant had clinical SARS and all investigations were negative for SARS. CONCLUSION: SARS during pregnancy is associated with high incidences of spontaneous miscarriage, preterm delivery, and intrauterine growth restriction. There is no evidence of perinatal SARS infection among infants born to these mothers.
A report in May 2005 from the Centers for Disease Control and Prevention describing a cluster of lymphocytic choriomeningitis virus (LCMV) infections among 4 solid organ recipients has increased awareness of and clinical interest in this pathogen. Human infection with LCMV results from direct or indirect contact with rodents. LCMV has particular relevance to obstetrics, as it is likely an under-recognized abortifacient and fetal teratogen. There have been 54 cases of congenital LCMV reported since 1955, with 34 of the cases diagnosed since 1993. Chorioretinitis and hydrocephalus are the predominant characteristics among children diagnosed with congenital LCMV infection. Obstetricians should educate their pregnant patients about the risks of exposure to laboratory, pet, and wild rodents.
Neospora caninum is a recently recognized protozoan parasite of animals, which until 1988 was misidentified as Toxoplasma gondii. Its life cycle is unknown. Transplacental transmission is the only recognized mode of transmission. It has a wide host range, but its zoonotic potential is unknown. Neosporosis is a major cause of abortion in cattle in many countries. It is also an important cause of neuromuscular paralysis in dogs. This paper reviews information on parasite structure, life cycle, biology, clinical signs, diagnosis, treatment and control.
Chlamydophila abortus (formerly Chlamydia psittaci) is one of the most important causes of reproductive failure in sheep and goats, especially in intensively managed flocks. The disease is usually manifested as abortion in the last 2 to 3 weeks of gestation, regardless of when the animal was infected. Ewes that abort are resistant to future reproductive failure due to C. abortus, but they become inapparent carriers and persistently shed the organism from their reproductive tracts during estrus. Chlamydophila pecorum is the other member of the genus that affects small ruminants, and it is recognized as a primary cause of keratoconjunctivitis in sheep and goats and of polyarthritis in sheep.
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By subcutaneous inoculation of SHIV(KU-2) in the hands of macaques, we developed a model of human immunodeficiency virus type-1 (HIV-1) occupational infection due to needle-stick injury and used the model to determine whether neutralizing serum to SHIV administered before or after virus inoculation could either prevent or abort infection, respectively. Six rhesus macaques were given 15 ml/kg pooled anti-SHIV plasma and challenged 24 hr later with approximately 300 animal infectious doses of SHIV(KU-2), subcutaneously. Three of the six macaques completely resisted infection with SHIV(KU-2). A fourth animal failed to yield infectious virus, but DNA extracted from its peripheral blood mononuclear cells (PBMC) and lymph nodes had viral sequences. Partial resistance was noted in the other two animals because virus recovery was delayed compared with the control animals. In contrast, six of six macaques given the same dose of anti-SHIV plasma 18 hr after exposure to virus became infected, as did two of two macaques given anti-SHIV plasma only 2 hr after exposure to virus. Our results suggest that neutralizing antibodies may have a prophylactic but not a therapeutic role in HIV-1 infections.
We report the case of a pregnant woman with leptospirosis who gave birth to a healthy baby. We also review 15 previously reported cases of leptospirosis in pregnancy. Of these 15 cases, eight women had abortions, two delivered healthy babies, and four delivered babies who had signs of active leptospirosis; in one case, the fate of the fetus was not stated. It appears that women are more likely to spontaneously abort if leptospirosis occurs in the early months of pregnancy. Since congenital infection is rare, leptospirosis should not necessarily be considered an indication to terminate pregnancy. Increased awareness of the possibility of leptospirosis for pregnant women who live in areas where the disease is endemic is of utmost importance for early detection and treatment of the disease and, thus, for the safety of the fetus.
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A pregnant woman contracted toxoplasmosis from exposure to oocysts shed by cats. She underwent amniocentesis for a therapeutic abortion, and Toxoplasma gondii was isolated from the amniotic fluid and placenta. This method may be useful in determining whether the fetus is infected in cases of toxoplasmosis acquired during pregnancy.
The immune response to foot-and-mouth disease virus (FMDV) elicited by infection or immunization with inactivated virus in adult mice was examined. A model of adoptive transfer of immunocompetent cells was used for this purpose. The results presented here indicate that both short- and long-term secondary immune responses elicited by high doses of inactivated virus are indistinguishable, at the humoral or cellular level, from that observed after infection. The responses to inactivated or infectious virus were both efficiently mediated by B cells. However, immunization with low doses of inactivated virus induced a response which, although effective in aborting infection, was fully dependent on FMDV-specific T cell cooperation. These findings suggest that the different immune responses observed after infection and immunization are mainly the result of the different viral mass presented to the immune system in each case.
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OBJECTIVE: To determine the prevalence of HIV among pregnant women, in particular those whose behaviour or that of their partners put them at "low risk" of infection. DESIGN: Voluntary named or anonymous HIV testing of pregnant women during 21 months (November 1988 to July 1990). SUBJECTS AND SETTING: All women who planned to continue their pregnancy and attended clinics serving the antenatal populations of Edinburgh and Dundee. All women admitted for termination of pregnancy to gynaecology wards serving the pregnant populations of Dundee and outlying rural areas. MAIN OUTCOME MEASURES: Period prevalence of HIV antibody positivity. RESULTS: 91% of antenatal clinic attenders and 97% of women having termination of pregnancy agreed to HIV testing on a named or anonymous basis. HIV period prevalences for antenatal clinic attenders and women having termination of pregnancy tested in Dundee were 0.13% and 0.85% respectively, and for antenatal clinic attenders tested in Edinburgh 0.26%. For those at "low risk" rates for antenatal clinic attenders and women having termination of pregnancy in Dundee were 0.11% and 0.13%, and for antenatal clinic attenders in Edinburgh 0.02%. In Dundee HIV prevalence among women having a termination of pregnancy (0.85%) was significantly greater than that among antenatal clinic attenders (0.13%). CONCLUSIONS: HIV infection is undoubtedly occurring among women at "low risk," and it is clear that a policy of selective testing of those at only "high risk" is inadequate for pregnant women living in areas of high prevalence such as Edinburgh and Dundee. Moreover, when studying pregnant populations in such areas there is the need to include those having a termination of pregnancy.
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Thirty-five Scottish blackface gimmers in mid or late pregnancy were infected with Toxoplasma gondii by subcutaneous injection of 2000 tissue cysts. Approximately half the gimmers developed a mild febrile response between eight and 10 days after infection but were otherwise unaffected until lambing. Only seven gimmers lambed without loss; in the remainder abortions and neonatal deaths accounted for 27 of the 31 lambs born. These losses occurred predominantly among gimmers which had been infected in mid pregnancy. Antibody titres in the toxoplasma indirect haemagglutination test rose sharply after the 10th day post infection and remained high for over 200 days. The majority of abortions and neonatal deaths occurred after the 40th day post infection by which time mean indirect haemagglutination titres had exceeded 1/320.