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Waterborne non-A, non-B hepatitis.

Waterborne non-A, non-B hepatitis (NANB) is responsible for outbreaks of hepatitis with a predilection for young adults. The disease is usually mild, except in pregnant women, who have a high case-fatality rate from fulminant hepatic failure. Diagnosis is largely based on the epidemiological findings of faecal contamination of drinking water and serological exclusion of hepatitis A and B virus infection. Histological features of liver biopsy specimens are characteristic and virus-like particles in the stool are aggregated by antibody present in acute and convalescent phase sera of the test subject. NANB is widespread in India and several countries of South-East Asia; it is increasingly recognised in Africa and may occur in Latin America. Control measures include provision of clean water supplies, safe disposal of human excreta, and sound personal and food hygiene practices. Passive immunisation with immunoglobulin derived from healthy donors resident in the countries affected by the disease may protect vulnerable groups.

Adolescent

An outbreak of streptococcal infection in a chicken factory.

A large outbreak of streptococcal skin infection occurred late in the summer of 1978 in a factory which undertakes the slaughter, preparation and packing of chickens. In all, 103 episodes of infection occurred in 82 workers from a total factory establishment of 347. The highest incidence of infection was in the packing department where there was an attack rate of 44%. The routes of introduction of infection into and spread within the factory remain mostly unknown. Following the identification of cases and carriers and the institution of appropriate treatment and control measures the outbreak quickly declined. The responsible organism in the outbreak was Streptococcus pyogenes T-type 3/13/B3264, provisional M-type 'R78/55'. This is the first poultry factory outbreak in England to be reported.

Animals

Emergence of a Bundibugyo virus variant in the 2026 outbreak in the Democratic Republic of the Congo and Uganda.

In May 2026, an outbreak of Ebola disease caused by Bundibugyo virus (BDBV, species Orthoebolavirus bundibugyoense) was declared in the Democratic Republic of the Congo (DRC), with cases originating from DRC and locally transmitted cases reported in Uganda. Bundibugyo virus disease (BVD) outbreaks were previously recorded in 2007-2008 in Bundibugyo District, Uganda, and in 2012 in Isiro, DRC. Here, we generated 22 genomes from samples obtained from individuals with BVD in DRC and Uganda. These genomes form a well-supported phylogenetic cluster separate from BDBV variants associated with the 2007 and 2012 outbreaks, together with evidence for sustained human transmission. This is consistent with the emergence of a new zoonotic spillover event rather than resurgence from previously reported variants. Besides ongoing efforts in strengthening surveillance systems, community engagement, establishing Ebola treatment centers, and developing targeted medical countermeasures; our report advocates to specifically increase decentralized laboratory diagnostics capacity, with pan-Orthoebolavirus assays, including genomic sequencing capacity, for limiting further outbreak expansion, timely detection and control of future outbreaks.

Journal Article

Triacylglycerol metabolism is a novel target to combat West Nile virus infection.

West Nile virus (WNV) is a zoonotic Orthoflavivirus transmitted by mosquitoes that is responsible for outbreaks of meningitis and encephalitis worldwide. Driven by climate change, WNV has expanded as a global public health concern, particularly in temperate regions. However, there are still no specific approved therapies, reinforcing the need for antiviral development. Previous works have documented that WNV multiplication strictly depends on certain cellular lipids. To identify novel lipid-related therapeutic targets, we analyzed the infection driven alterations in the CNS lipidome, the primary tissue supporting WNV replication. Our results indicated that the major alterations in the brain lipid content of WNV-infected mice corresponded to triacylglycerols (TAGs). Moreover, transcriptomic analysis showed that infected brains underwent changes in the expression of TAG metabolism. Supplementation with exogenous fatty acids increased lipid droplets (LD) content and promoted viral replication in cell culture models. On the contrary, pharmacological intervention in TAG metabolism using diacylglycerol acyltransferase inhibitors (DGATi) suppressed WNV multiplication in cell culture models. As a proof-of-concept of the therapeutic potential of DGATi, treatment of mice with A922500 reduced viral burden in the brain and proinflammatory cytokine production. Overall, our results unveil the importance of LDs and glycerolipid metabolism for WNV and highlight the potential of therapeutic interventions targeting this pathway to control viral replication and neuroinflammation.

West Nile virus; lipid

Elimination of indigenous measles from the United States.

In October 1978, a nationwide initiative to eliminate indigenous measles from the United States by October 1, 1982, was announced. The measles elimination program has three major elements: attaining and maintaining high immunization levels, aggressive and effective surveillance, and vigorous response to cases. In 1980, immunization levels in children entering school for the first time were 96%, indicating that the necessary levels have been attained in the age group. Mechanisms are in place to assure maintenance of these levels; these rely heavily on the use of immunization requirements for school attendance in each state. Aggressive surveillance systems have been developed for each state to detect suspected measles cases as soon as possible after they occur and to investigate them within 24 hr of notification. The clinical definition of measles used is fever of greater than or equal to 101 F (38.3 C); rash of three or more days duration; and cough, coryza, or conjunctivitis. The response to outbreaks involves identifying persons in the area who are at risk of contracting measles, determining those who are possibly susceptible, and ensuring that these persons are vaccinated. In school outbreaks, susceptible students are vaccinated or excluded from school until the outbreak is over. During 1981, measles morbidity reached a record low level of only 3,032 reported cases (provisional total). Epidemic measles occurred in only a few outbreaks of limited size and duration, and endemic cases were restricted to a small number. Imported cases averaged slightly more than two per week, occasionally producing limited outbreaks, but more often resulting in no secondary spread. Transmission of measles has been interrupted in most of the United States. With continued vigorous implementation of the current strategy and with additional measures to lessen the risk of importations, it appears likely that the goal to eliminate indigenous measles transmission will be attained by October 1982.

Adolescent

Analysis of increasing antibiotic resistance of Klebsiella pneumoniae relative to changes in chemotherapy.

Three antibiotic-resistant strains of Klebsiella pneumoniae responsible for outbreaks of systemic infection in a hospital nursery were analyzed. Each organism emerged after prolonged use of a drug to which it was resistant. The first strain (RO16) produced neomycin phosphotransferase and contained three plasmids with molecular weights of 24, 25, and 30 X 10(6) daltons, respectively. Resistance to ampicillin, carbenicillin, neomycin, and kanamycin was transferred by conjugation at a frequency of 10(-6). The second strain of K. pneumoniae (RO106) produced gentamicin adenyltransferase and maintained aminoglycoside resistance only when propagated in antibiotic-containing medium. DNA analyses revealed eight species of plasmid DNA: one species with a molecular weight of 70 X 10(6) daltons apparently accounted for conjugal transfer of resistance to ampicillin, carbenicillin, chloramphenicol, and streptomycin. The third strain (RO180) was resistant primarily to colistin and lacked plasmids. Control of the outbreak due to this strain was achieved by aminoglycoside therapy.

Aminoglycosides

Non-O group 1 Vibrio cholerae: a look at the epidemiology of an occasional pathogen.

Non-O1 V. cholerae is a ubiquitous environmental isolate. It is a common contaminant of shellfish, and in the developing world, it is frequently isolated from food and water. Asymptomatic carriage rates approaching 4 percent have been described among persons involved in high-risk activities, such as eating oysters in New Orleans or going on pilgrimage to Mecca. The actual occurrence of disease appears to be much less common. This is an "occupational" pathogen which may be responsible for outbreaks or a high frequency of isolation in certain areas at specific times but which generally ranks as a minor cause of diarrheal disease. While host susceptibility and infectious dose may help explain the relatively infrequent occurrence of non-O1 V. cholerae-associated disease, it also appears likely that only a small minority of strains carry the necessary virulence factors to cause gastroenteritis. Unfortunately, there does not appear to be a single mechanism by which these organisms cause diarrhea; it is likely that we will find a heterogeneous pattern of virulence mechanisms, similar to the heterogeneity seen among diarrheagenic E. coli. As our understanding of these pathogenic mechanisms improves, there should be a corresponding refinement in our understanding of the epidemiology of these widely distributed organisms.

Adult

Microbe Profile: Salmonella Typhimurium: the master of the art of adaptation.

Salmonella Typhimurium is a major Salmonella serovar that is found globally. It is responsible for outbreaks of self-limiting gastroenteritis that are broadly linked to the industrialization of food production. S. Typhimurium is a pathogen with a broad host range and remarkable metabolic versatility. The ∼5 Mb genome includes the pSLT virulence plasmid and has a characteristic prophage repertoire. The major virulence determinants are encoded by a variety of pathogenicity islands. Emerging multidrug-resistant lineages of epidemics of S. Typhimurium are currently causing bloodstream infections in sub-Saharan Africa. The versatility and adaptability of S. Typhimurium pose an important public health challenge.

Salmonella typhimurium

Differential plating medium for quantitative detection of histamine-producing bacteria.

A histidine-containing agar medium has been devised for quantitative detection of histamine-producing bacteria that are alleged to be associated with scombroid fish poisoning outbreaks. The responsible bacteria produce a marked pH change in the agar, with attendant color change of pH indicator adjacent to the colonies, thus facilitating their recognition. Proteus morganii and Klebsiella pneumoniae were the two most common histidine-decarboxylating species isolated from scombroid fish and mahi mahi.

Animals

Comparison of Vibrio cholerae O139 with V. cholerae O1 classical and El Tor biotypes.

Vibrio cholerae O139 is a recently identified non-O1 V. cholerae strain responsible for outbreaks of epidemic cholera in India, Bangladesh, and Thailand in the past 2 years. Other workers have demonstrated the presence of the cholera toxin genetic element in V. cholerae O139, unlike the situation for other non-O1 V. cholerae strains. We sought to compare further this strain with strains of V. cholerae O1, classical and El Tor biotypes, by classic microbiologic methods, Southern blot analysis for restriction fragment length polymorphisms with probes for iron-regulated genes of V. cholerae O1, and comparisons of outer membrane protein profiles. Our results were similar for V. cholerae O139 and the El Tor biotype of V. cholerae O1, with the exception of the constitutive expression in V. cholerae O139 of OmpS, an outer membrane protein that was maltose inducible in comparison strains of V. cholerae O1.

Bacterial Outer Membrane Proteins

Equine infectious respiratory disease.

During the past 20 years the equine population of Great Britain and Ireland has increased with the result that the practising veterinary surgeon is more frequently called upon to advise on equine problems. A significant portion of this advice is concerned with the examination of horses showing signs of this advice is concerned with the examination of horses showing signs of respiratory disease. Numerous pathogens, which include viruses, bacteria, parasites and moulds invade the respiratory tract causing similar signs of illness. It is therefore difficult to provide an aetiological diagnosis based on a clinical examination. Field studies supported by laboratory investigations have established that influenza and herpes viruses are frequently responsible for outbreaks of disease. Epidemiological studies suggest that other factors including the immune state of the equine population influence the distribution and severity of respiratory disease. The aetiology, diagnosis, treatment and control of equine infectious respiratory disease are discussed below.

Abortion, Veterinary

Recovery of hepatitis A virus from a water supply responsible for a common source outbreak of hepatitis A.

An outbreak of hepatitis A occurred in a north Georgia trailer park served by a private well. Of 18 residents who were serosusceptible to hepatitis A virus (HAV), 16 (89%) developed hepatitis A. Well water samples were collected 3 months after illness onset in the index case and 28 days after illness onset in the last trailer park resident. Hepatitis A virus antigen (HAVAg) was detected in the samples by enzyme immunoassay from three of the five cell lines following two 30-day passages and from a fourth cell line following a third passage of 21 days.

Adult

Human West Nile virus lineage 2 neuroinvasive infection as a cause of fatal Guillain-Barré syndrome.

BACKGROUND: West Nile virus (WNV) is now endemic in Europe and continues to spread to several countries, with strains 1 and 2 primarily responsible for outbreaks. According to the European Centre for Disease Prevention and Control (ECDC), Italy accounts for the majority of locally acquired cases and West Nile neuroinvasive disease (WNND). CASE REPORT: We present the first case described in Italy and Europe of WNND-related Guillain-Barré syndrome (GBS). Phylogenetic analysis showed that the genome belonged to the WNV-2, sublineage 2a, clustering within sequences from genomes originating mainly from Hungarian 578/10 strain, a particularly virulent strain. CONCLUSION: The first case of GBS as a presentation of WNND in a European patient is reported, along with a review of all previously published cases of GBS related to WNND. The United States Centers for Diseases Control and Prevention (CDC) documented 13% of WNV infections manifest as GBS, with a gradual and slow improvement, often with residual neurologic deficits of varying severity. Physicians should be aware that the presentation of a patient to an emergency department with GBS, during a certain epidemiological period of the year, should raise the clinical suspicion that the GBS may be related to a WNND.

Humans

[Arnozán-Dubreuilh depilating folliculitis].

Male patient, aged twenty-six years. Having an eight-and-a-half-year- old dermatosis of localized evolution on scalp, under arms, thighs, pubis and legs, characterized by inflammatory papules and follicular and extra-adnexial pustules, tiny scars and lack of hair in the affected areas. The authors present a representative case of "depilating folliculitis" of (Arnozán and Dubreuilh) stressing the following: Uncommon frequency in our country but frequent in warmer climates where it is observed mainly among peasants and sugar-cane workers. Wide-depilated areas principally in folds. Seasonal outbreak. Good response to treatment. A revision of the theme is made emphasizing the histopathologic pathogenesis.

Adult

The virtual elimination of rubella and mumps from the United States and the use of combined measles, mumps and rubella vaccines (MMR) to eliminate measles.

The measles elimination effort, which began in 1978, has made dramatic contributions to the virtual elimination of rubella and congenital rubella syndrome (CRS) and the control of mumps in the USA. The use of combined MMR vaccine has resulted in immunization levels at school entry in excess of 95% against each of these diseases. As a result, record low levels of rubella, CRS, and mumps were reported in 1984. Continued use of MMR, along with improved surveillance and aggressive response to outbreaks, can be expected to eliminate rubella and mumps as well as measles.

Cost-Benefit Analysis

Water supply as a source of Pseudomonas aeruginosa in a hospital for hematological malignancies.

This report details of an investigation on a significant increase in nosocomial bacteremias due to multiply-resistant Pseudomonas aeruginosa strains which occurred in a hematological ward. Serotyping according to Habs method showed a high frequence of the serotype 12. Control cultures identified in the hospital building water reservoirs the presence of the organism. After disinfection of these water reservoirs, the frequence of nosocomial septicemias caused by serotype 12 Pseudomonas aeruginosa strains on the overall bacteremic episodes declined immediately and showed a declining trend in the following 13 months period. To conclude serotyping of Pseudomonas aeruginosa is a useful epidemiological marker and allows to discover from where the diffusion of the organism responsible of outbreaks starts.

Cancer Care Facilities

Epidemiological evaluation of influenza in Italy.

A statistical study of the mortality from all causes and from respiratory diseases was carried out in an evaluation of the influenza epidemics in Italy from 1956 to 1973. Type A influenzaviruses were responsible for outbreaks every 2-3 years. Type B influenzavirus appeared every 4 years and accounted for a single noteworthy epidemic in 1962-63. From the analysis of data on both general mortality and respiratory mortality a better evaluation of the extent of the influenza outbreaks could be made.

Disease Outbreaks