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Sample records for acute gastroenteritis worldwide

  1. Acute gastroenteritis.

    PubMed

    Graves, Nancy S

    2013-09-01

    Acute gastroenteritis is a common infectious disease syndrome, causing a combination of nausea, vomiting, diarrhea, and abdominal pain. There are more than 350 million cases of acute gastroenteritis in the United States annually and 48 million of these cases are caused by foodborne bacteria. Traveler's diarrhea affects more than half of people traveling from developed countries to developing countries. In adult and pediatric patients, the prevalence of Clostridium difficile is increasing. Contact precautions, public health education, and prudent use of antibiotics are necessary goals in decreasing the prevalence of Clostridium difficle. Preventing dehydration or providing appropriate rehydration is the primary supportive treatment of acute gastroenteritis.

  2. Mucosal Immunity and acute viral gastroenteritis.

    PubMed

    Rose, Markus A

    2014-01-01

    Acute gastroenteritis is a major killer of the very young worldwide. Rotavirus is the most common intestinal virus, causing acute gastroenteritis and extra-intestinal complications especially in young and chronically ill subjects. As early as 1991, the WHO recommended as high priority the development of a vaccine against rotavirus, the major pathogen causing enteric infections. Since the introduction of rotavirus vaccines for infant immunization programmes in different parts of the world in 2006, vaccination against rotavirus has resulted in substantial declines in severe gastroenteritis. The oral rotavirus vaccines RotaTeq(®) and Rotarix(®) are excellent examples for their unique features and principles of mucosal immunization. We elaborate on rotavirus immunity and the success of rotavirus vaccination and aspects also beyond infants' acute gastroenteritis.

  3. Therapy of acute gastroenteritis: role of antibiotics.

    PubMed

    Zollner-Schwetz, I; Krause, R

    2015-08-01

    Acute infectious diarrhoea remains a very common health problem, even in the industrialized world. One of the dilemmas in assessing patients with acute diarrhoea is deciding when to test for aetiological agents and when to initiate antimicrobial therapy. The management and therapy of acute gastroenteritis is discussed in two epidemiological settings: community-acquired diarrhoea and travellers' diarrhoea. Antibiotic therapy is not required in most patients with acute gastroenteritis, because the illness is usually self-limiting. Antimicrobial therapy can also lead to adverse events, and unnecessary treatments add to resistance development. Nevertheless, empirical antimicrobial therapy can be necessary in certain situations, such as patients with febrile diarrhoeal illness, with fever and bloody diarrhoea, symptoms persisting for >1 week, or immunocompromised status.

  4. [The mode of differential diagnostic of and acute alcoholic gastroenteritis].

    PubMed

    Makarov, V K; Makarov, P V

    2014-12-01

    The study was carried out to develop mode of differential diagnostic of salmonella and acute alcoholic gastroenteritis on the basis of phospholipid specter of blood serum. The indicators of phospholipid fractions of blood serum were analyzed in 50 healthy persons, 50 patients with acute alcoholic gastroenteritis and 50 patients with salmonella gastroenteritis were analyzed. The relative content of following fractions of whole phospholipids were analyzed--total lysophospholipids, sphyngomiyelin, phosphatidcholine, phosphatidyletanolamin. The phospholipid spectrum of blood serum can be applied in differential diagnostic of salmonella gastroenteritis and acute alcoholic gastroenteritis. The disorders of metabolism of lipids under given pathological conditions have a multidirectional character. The salmonella gastroenteritis is characterized by decreasing of relative content of total lysophospholipids and increasing of phosphatidcholine as compared with standard conditions. The acute alcoholic gastroenteritis is characterized by increasing of relative content of total lysophospholipids and phosphatidcholine and decreasing of level of phosphatidcholine. The content of total Iysophospholipids in blood serum is lower on 35% or 30.0 mg% permits diagnosing acute alcoholic gastroenteritis. The content of phosphaltidcholine in blood serum higher than 40% or 50 mg% permits diagnosing salmonella gastroenteritis.

  5. Molecular surveillance of non-polio enterovirus infections in patients with acute gastroenteritis in Western India: 2004-2009.

    PubMed

    Patil, Pooja R; Chitambar, Shobha D; Gopalkrishna, V

    2015-01-01

    Acute gastroenteritis is a major cause of childhood morbidity and mortality worldwide. Rotavirus (RV) and Norovirus (NoV) are the leading cause of the disease. Despite the use of improved diagnostic methods a significant proportion of gastroenteritis cases remained undiagnosed. Though nonpolio enteroviruses (NPEVs) have been reported frequently in children with acute gastroenteritis, their etiologic role has not been established. To investigate the epidemiology of NPEVs in gastroenteritis cases which remained negative for leading causative agents, 955 RV and NoV negative stool specimens from children hospitalized for acute gastroenteritis were included in the study. A case control study was conducted which includes stool specimens from 450 children with gastroenteritis and 162 asymptomatic control subjects to determine the association of NPEVs with the disease. NPEV detection and typing was carried out by RT-PCR and sequencing. Presence of RV, NoV, Adenovirus, and Astrovirus was confirmed by ELISA or PCR/RT-PCR. Overall 14% NPEV prevalence was noted. The percentage of children with NPEV infection differed significantly between gastroenteritis and non-gastroenteritis patients (13.7% vs. 4.9%). NPEV was more prevalent among patients with gastroenteritis of undetectable etiology as compared to those detected positive for other viruses (17.9% vs. 7%) (P < 0.01). Genotyping of NPEV identified predominance of EV-B species (56.5%) followed by EV-C (16.7%), EV-A (13.8%) species and mixed NPEV infections (13%). These data support the association of NPEVs with acute gastroenteritis and highlights the clinical and epidemiological features of NPEV infections in patients with acute gastroenteritis from western India.

  6. Gastroenteritis

    MedlinePlus

    ... the "stomach flu?" What you probably had was gastroenteritis - not a type of flu at all. Gastroenteritis is an inflammation of the lining of the ... caused by a virus, bacteria or parasites. Viral gastroenteritis is the second most common illness in the ...

  7. Acute Gastroenteritis on Cruise Ships - United States, 2008-2014.

    PubMed

    Freeland, Amy L; Vaughan, George H; Banerjee, Shailendra N

    2016-01-15

    From 1990 to 2004, the reported rates of diarrheal disease (three or more loose stools or a greater than normal frequency in a 24-hour period) on cruise ships decreased 2.4%, from 29.2 cases per 100,000 travel days to 28.5 cases (1,2). Increased rates of acute gastroenteritis illness (diarrhea or vomiting that is associated with loose stools, bloody stools, abdominal cramps, headache, muscle aches, or fever) occurred in years that novel strains of norovirus, the most common etiologic agent in cruise ship outbreaks, emerged (3). To determine recent rates of acute gastroenteritis on cruise ships, CDC analyzed combined data for the period 2008-2014 that were submitted by cruise ships sailing in U.S. jurisdiction (defined as passenger vessels carrying ≥13 passengers and within 15 days of arriving in the United States) (4). CDC also reviewed laboratory data to ascertain the causes of acute gastroenteritis outbreaks and examined trends over time. During the study period, the rates of acute gastroenteritis per 100,000 travel days decreased among passengers from 27.2 cases in 2008 to 22.3 in 2014. Rates for crew members remained essentially unchanged (21.3 cases in 2008 and 21.6 in 2014). However, the rate of acute gastroenteritis was significantly higher in 2012 than in 2011 or 2013 for both passengers and crew members, likely related to the emergence of a novel strain of norovirus, GII.4 Sydney (5). During 2008-2014, a total of 133 cruise ship acute gastroenteritis outbreaks were reported, 95 (71%) of which had specimens available for testing. Among these, 92 (97%) were caused by norovirus, and among 80 norovirus specimens for which a genotype was identified, 59 (73.8%) were GII.4 strains. Cruise ship travelers experiencing diarrhea or vomiting should report to the ship medical center promptly so that symptoms can be assessed, proper treatment provided, and control measures implemented.

  8. Acute Gastroenteritis on Cruise Ships - United States, 2008-2014.

    PubMed

    Freeland, Amy L; Vaughan, George H; Banerjee, Shailendra N

    2016-01-01

    From 1990 to 2004, the reported rates of diarrheal disease (three or more loose stools or a greater than normal frequency in a 24-hour period) on cruise ships decreased 2.4%, from 29.2 cases per 100,000 travel days to 28.5 cases (1,2). Increased rates of acute gastroenteritis illness (diarrhea or vomiting that is associated with loose stools, bloody stools, abdominal cramps, headache, muscle aches, or fever) occurred in years that novel strains of norovirus, the most common etiologic agent in cruise ship outbreaks, emerged (3). To determine recent rates of acute gastroenteritis on cruise ships, CDC analyzed combined data for the period 2008-2014 that were submitted by cruise ships sailing in U.S. jurisdiction (defined as passenger vessels carrying ≥13 passengers and within 15 days of arriving in the United States) (4). CDC also reviewed laboratory data to ascertain the causes of acute gastroenteritis outbreaks and examined trends over time. During the study period, the rates of acute gastroenteritis per 100,000 travel days decreased among passengers from 27.2 cases in 2008 to 22.3 in 2014. Rates for crew members remained essentially unchanged (21.3 cases in 2008 and 21.6 in 2014). However, the rate of acute gastroenteritis was significantly higher in 2012 than in 2011 or 2013 for both passengers and crew members, likely related to the emergence of a novel strain of norovirus, GII.4 Sydney (5). During 2008-2014, a total of 133 cruise ship acute gastroenteritis outbreaks were reported, 95 (71%) of which had specimens available for testing. Among these, 92 (97%) were caused by norovirus, and among 80 norovirus specimens for which a genotype was identified, 59 (73.8%) were GII.4 strains. Cruise ship travelers experiencing diarrhea or vomiting should report to the ship medical center promptly so that symptoms can be assessed, proper treatment provided, and control measures implemented. PMID:26766396

  9. Hypernatraemic dehydration and acute gastro-enteritis in children.

    PubMed

    Abu-Ekteish, F; Zahraa, J

    2002-09-01

    A prospective study was conducted over a 2-year period to detect the effect of feeding practice, in particular the role of artificial milk formulae, in children admitted with hypernatraemic dehydration (serum sodium > or = 150 mmol/L) caused by acute gastro-enteritis, and to record morbidity and mortality in these patients. A control group was selected from infants and children admitted with gastro-enteritis but normal sodium levels. Sixty-seven children aged 18 days to 18 months (mean 6.9 months) were studied and represented 4.6% of all children admitted during the study with acute gastro-enteritis. Their mean serum sodium level was 161 mmol/L, the highest being 194 mmol/L. Twenty-four infants (36%) with hypernatraemic dehydration were on evaporated cow's milk powder compared with ten (15%) in the control group (p < 0.01). Five hypernatraemic infants (7.5%) were breastfed compared with 40 (60%) isonatraemic controls (p < 0.00001). Six children from the hypernatraemic group developed convulsions and two died. Hypernatraemic dehydration remains an important and serious complication in infants with gastro-enteritis in our area. Artificial milk feeding, particularly the use of evaporated cow's milk powder, is a predisposing factor for hypernatraemia in infantile gastro-enteritis. This study emphasises the importance of breast-feeding and the need to educate mothers to avoid giving evaporated cow's milk formulae to babies under 1 year of age if breast-feeding is not possible.

  10. Human bocavirus in acute gastroenteritis in children in Brazil.

    PubMed

    Campos, Gubio Soares; Silva Sampaio, Madina Lyve; Menezes, Aline Dorea Luz; Tigre, Dellane Martins; Moura Costa, Lilia Ferreira; Chinalia, Fabio Alexandre; Sardi, Silvia Ines

    2016-01-01

    Epidemiological surveillance for Human Bocavirus (HBoV) was conducted on 105 fecal specimens from children with acute gastroenteritis in Bahia, Brazil. Among of a total 105 stool samples, 44 samples were positive for HBoV as detected by nested-PCR. Of the 44 positive samples, co-infections with other enteric viruses (Norovirus, Adenovirus, and Rotavirus) were found in 12 pediatric patients. Mixed infections among HBoV with Norovirus were frequently observed in this population. The phylogenetic analysis identified the presence of HBoV-1, and HBoV 2A species. This study shows that HBoV is another viral pathogen in the etiology of acute gastroenteritis in children in Bahia, Brazil.

  11. [Etiology of acute infantile gastroenteritis in Gabon].

    PubMed

    Gendrel, D; Sitbon, M; Richard-Lenoble, D; Galliot, A; Kombila, M; Ivanoff, B; Nardou, M; Gendrel, C; Kani, F

    1985-01-01

    Rotaviruses are the main etiology of acute diarrhoeas in gabonese children (11 to 30% according to age). Salmonellae (11.4%), Shigellae (7.1%) and E. histolytica (7.1%), isolated or associated with enterobacteria, E. coli (3%), Giardia and Strongyloides stercoralis (1.4%), Yersinia enterocolitica (1%) and Balantidium coli (0.5%) were also found, without cholera. PMID:2863005

  12. [THE ROLE OF BIOLOGICAL MEMBRANES IN DIFFERENTIAL DIAGNOSTICS OF SALMONELLA AND ACUTE ALCOHOL GASTROENTERITIS].

    PubMed

    Makarov, V K; Makarov, P V

    2015-01-01

    We evaluated the influence of Salmonella infection and alcohol on biological membranes from the content of serum phospholipid fraction known to be a component ofenterocyte membranes. Any change of membrane phospholipid content leads to a change of their blood level. The study included 50 patients with acute alcohol gastroenteritis, 50 ones with salmonella gastroenteritis, and 50 healthy subjects. Both salmonellosis and alcohol caused differently directed changes in biological membranes. The mechanism of diarrhea in patients with salmonella and acute alcohol gastroenteritis is different. Diarrhea associated with alcohol gastroenteritis is due to enhanced viscosity of biomembranes that decreases in salmonella gastroenteritis. It suggests different approaches to the treatment of these conditions. The membrane destruction coefficient below 2 is an additional proof of alcoholic etiology of gastroenteritis whereas its value above 3 confirms the involvement of salmonellosis in pathogenesis of gastroenteritis.

  13. Efficacy and safety of gelatine tannate for the treatment of acute gastroenteritis in children: protocol of a randomised controlled trial

    PubMed Central

    Michałek, Dorota; Kołodziej, Maciej; Konarska, Zofia; Szajewska, Hania

    2016-01-01

    Introduction Worldwide, acute gastroenteritis in children, usually caused by viruses, leads to considerable morbidity and mortality. The treatment is aimed at preventing and treating dehydration, promoting weight gain after rehydration, and reducing the duration and severity of diarrhoea. Effective and inexpensive interventions that could add to the effect of oral rehydration therapy are of interest. Recently, in many European countries, gelatine tannate is being widely marketed for treating acute gastroenteritis. Gelatine tannate is a complex of tannic acid, which possesses astringent and anti-inflammatory properties, and a protective gelatine. Currently, there is no evidence to support the use of gelatine tannate for treating acute gastroenteritis in children and only scant evidence to support the use of gelatine tannate in adults. We aim to assess the efficacy of gelatine tannate for the treatment of acute gastroenteritis in children. Methods and analysis This will be a blind, placebo-controlled, randomised trial. Children younger than 5 years of age with acute gastroenteritis defined as a change in stool consistency to loose or liquid form (according to the Bristol Stool Form scale or Amsterdam Stool Form scale) and/or an increase in the frequency of evacuations (typically ≥3 in 24 h), lasting for no longer than 5 days, will be recruited. A total of 158 children will be randomised to receive either gelatine tannate (children younger than 3 years of age will receive 250 mg, 4 times/day, and those older than 3 years of age will receive 500 mg, 4 times/day) or matching placebo for 5 days. The primary outcome measure is the duration of diarrhoea. Ethics and dissemination The Bioethics Committee approved the study protocol. The findings of this trial will be submitted to a peer-reviewed paediatric journal. Abstracts will be submitted to relevant national and international conferences. Trial registration number NCT02280759; Pre-results. PMID

  14. Acute Nonbacterial Gastroenteritis in Hospitalized Children: A Cross Sectional Study

    PubMed Central

    Shokrollahi, Mohammad Reza; Noorbakhsh, Samileh; Monavari, Hamid Reza; Ghavidel Darestani, Sahar; Vosoughi Motlagh, Ahmad; Javadi Nia, Shima

    2014-01-01

    Background: Viral acute gastroenteritis (AGE) is a major cause of morbidity in childhood and leads to hospitalization in developed countries, such as Iran. Objectives: The aim of this study was to determine the prevalence and viral types (rotavirus, adenovirus, human parechoviruses-1, and human bocavirus) of acute nonbacterial gastroenteritis in hospitalized children. Patients and Materials: This was a across-sectional prospective study performed at the Pediatric Department of Rasoul Hospital, Tehran, Iran (2009-2011) on 80 hospitalized children with viral AGE. All Stool samples were collected on viral transport media. Human bocavirus (HBoV) was detected using the Real-time PCR TaqMan method. Molecular detection of human parechovirus type 1 (HPeV-1) RNA in stool samples was done using a specific nested reverse transcription PCR (RT-PCR). Rota and adeno virus antigens were sought by rapid chromatographic tests. P values less than 0.05 were considered statistically significant. Results: Fever was determined in 47.5% of cases (38), nausea and vomiting in 42.5% (34), respiratory symptoms in 16.3% (13), abdominal pain in 76%. Duration of diarrhea was 1-30 days (mean = 6.3 + 4.3 days). No dehydration was observed in 43.5% of subjects, mild dehydration in 33.8%, moderate dehydration in 17.5% and severe dehydration in 5% of cases. Positive rotavirus was found in 48.8% of cases (39), adenovirus in 20% (16), HBoV in 8% (6) and HPeV-1 in 23.2% (19), and adeno and rotaviruses co-infection in 6% (4). The frequency of positive HBoV was significantly lower than adeno and rotaviruses infection (P value = 0.0001). Rotavirus was more frequent in males (P value = 0.003) and in young children (17.49 months vs. 21.44 months) [P value = 0.03, CI = -13.4, 5.5]. Rotavirus infection was related to the degree of dehydration (P value = 0.001) but was not related to the presence of vomiting or fever (P value > 0.5). Conclusions: This study indicates that viral agents, especially rotavirus (48

  15. Etiology of Sporadic Cases of Pediatric Acute Gastroenteritis in Asturias, Spain, and Genotyping and Characterization of Norovirus Strains Involved

    PubMed Central

    Boga, José Antonio; Melón, Santiago; Nicieza, Inés; de Diego, Isabel; Villar, Mercedes; Parra, Francisco; de Oña, María

    2004-01-01

    From November 2000 to October 2001, a reverse transcription-PCR using primers directed to the norovirus RNA polymerase coding region was included in a viral and bacterial routine screening to diagnose sporadic cases of acute gastroenteritis among children in Asturias, Spain. The role of noroviruses (8.6% of the positively diagnosed cases) as the cause of sporadic pediatric gastroenteritis was evaluated with respect to the detection rates of other gastroenteritis-associated viruses and bacteria. The results indicated that noroviruses were less common than rotaviruses (36.9%), Campylobacter spp. (28.8%), and Salmonella spp. (18.4%) but more frequent than astroviruses (4.3%), adenoviruses (3.8%), and Yersinia spp. (2.2%). Mixed infections involving noroviruses were rarely observed (0.5%). The presence of a norovirus-associated pediatric gastroenteritis peak in summer, as well as the complete absence of norovirus-associated cases in colder months, challenges the view that norovirus infections exclusively have wintertime seasonality. On the other hand, phylogenetic analysis of the amplified fragments showed that the norovirus strains responsible were closely related. A further study using the full-length capsid region showed that these strains could be included into genogroup II, Bristol/Lorsdale cluster, and were closely related to the 1995 and 1996 U.S. subset of strains associated with outbreaks recorded worldwide between 1995 and 1996. PMID:15184450

  16. Etiology and Risk Factors of Acute Gastroenteritis in a Taipei Emergency Department: Clinical Features for Bacterial Gastroenteritis

    PubMed Central

    Lai, Chao-Chih; Ji, Dar-Der; Wu, Fang-Tzy; Mu, Jung-Jung; Yang, Ji-Rong; Jiang, Donald Dah-Shyong; Lin, Wen-Yun; Chen, Wei-Ting; Yen, Muh-Yong; Wu, Ho-Sheng; Chen, Tony Hsiu-Hsi

    2016-01-01

    Background The causative pathogen is rarely identified in the emergency department (ED), since the results of cultures are usually unavailable. As a result, antimicrobial treatment may be overused. The aim of our study was to investigate the pathogens, risk factors of acute gastroenteritis, and predictors of acute bacterial gastroenteritis in the ED. Methods We conducted a matched case-control study of 627 stool samples and 612 matched pairs. Results Viruses (41.3%) were the leading cause of gastroenteritis, with noroviruses (32.2%) being the most prevalent, followed by bacteria (26.8%) and Giardia lamblia (12.4%). Taking antacids (adjusted odds ratio [aOR] 4.10; 95% confidence interval [CI], 2.57–6.53), household members/classmates with gastroenteritis (aOR 4.69; 95% CI, 2.76–7.96), attending a banquet (aOR 2.29; 95% CI, 1.64–3.20), dining out (aOR 1.70; 95% CI, 1.13–2.54), and eating raw oysters (aOR 3.10; 95% CI, 1.61–5.94) were highly associated with gastroenteritis. Elders (aOR 1.04; 05% CI, 1.02–1.05), those with CRP >10 mg/L (aOR 2.04; 95% CI, 1.15–3.62), or those who were positive for fecal leukocytes (aOR 2.04; 95% CI, 1.15–3.62) or fecal occult blood (aOR 1.97; 95% CI, 1.03–3.77) were more likely to be hospitalized in ED. In addition, presence of fecal leukocytes (time ratio [TR] 1.22; 95% CI, 1.06–1.41), abdominal pain (TR 1.20; 95% CI, 1.07–1.41), and frequency of vomiting (TR 0.79; 95% CI, 0.64–0.98) were significantly associated with the duration of acute gastroenteritis. Presence of fecal leukocytes (aOR 2.08; 95% CI, 1.42–3.05), winter season (aOR 0.45; 95% CI, 0.28–0.74), frequency of diarrhea (aOR 1.69; 95% CI, 1.01–2.83), and eating shrimp or crab (aOR 1.53; 95% CI, 1.05–2.23) were highly associated with bacterial gastroenteritis. The area under the receiver operating characteristic curve of the final model was 0.68 (95% CI, 0.55–0.63). Conclusions Acute bacterial gastroenteritis was highly associated with season

  17. Clinical and molecular epidemiology of norovirus infection in adults with acute gastroenteritis in Ji'nan, China.

    PubMed

    Sai, Lintao; Wang, Gang; Shao, Lihua; Liu, Haihong; Zhang, Yajun; Qu, Chunmei; Ma, Lixian

    2013-11-01

    Acute gastroenteritis caused by human noroviruses (NoVs) has become an important public health problem worldwide. This study was carried out to investigate the rates of NoV infections and the genetic characteristics of NoVs in adult outpatients with acute gastroenteritis in Ji'nan, a large eastern city in China. A total of 480 fecal samples were collected from outpatients at the Shandong University Qilu Hospital between June 2010 and May 2011. Of the collected samples, 42 (42/480, 8.75 %) were positive for NoVs by RT-PCR, and seven different genotypes were identified: GI-1, GI-4, GII-1, GII-3, GII-4, GII-6 and GII-13, of which GII-4 was the most prevalent (29/42, 69.0 %). Phylogenetic and Simplot analyses showed that three recombinant strains were detected: two GII-4 polymerase/GII-3 capsid recombinants and one GII-6 polymerase/GII-4 capsid recombinant. This study indicated that NoV was a common causative agent of sporadic acute gastroenteritis in adults in Ji'nan, China, and that NoV GII-4 was the predominant strain during this period. Three recombinant strains were identified in which GII-6 polymerase/GII-4 capsid was detected for the first time in China.

  18. Estimating the Contribution of Acute Gastroenteritis to the Overall Prevalence of Irritable Bowel Syndrome

    PubMed Central

    Shah, Eric D; Riddle, Mark S; Chang, Christopher

    2012-01-01

    Background/Aims Recent studies reveal that acute gastroenteritis can precipitate irritable bowel syndrome (IBS) symptoms leading to the concept of post-infectious IBS. However, the overall contribution of gastroenteritis to the total IBS prevalence is unknown. In this exercise we try to estimate the contribution of gastroenteritis in IBS using the published literature and a longitudinal approach. Methods Existing literature was reviewed to determine the incidence of IBS after gastroenteritis, the rate of remission over time, data on rates of gastroenteritis in a given population and any patterns of resistance to these effects in human populations. This produced 3 models. The first assumed all humans were susceptible to gastroenteritis and its ability to produce IBS. The second assumed (using meta-analysis data) that 90% of humans in a given outbreak would be resistant to this effect. The third model used a high gastroenteritis exposure rate as might be seen in military deployment. Results In model 1, the prevalence was unrealistically high with an eventual steady state of 43.6% of the population affected by IBS. In a very conservative approach (model 2), steady state was achieved after 10 years to an overall prevalence of 8.9%. Interestingly, based on a high 1 year exposure rate such as military deployment, the maximum prevalence (steady state) was reached before 1 year suggesting high risk. Conclusions Although hypothetical in approach, based on conservative estimates in existing literature the contribution of gastroenteritis to the overall prevalence of IBS is substantial. PMID:22523730

  19. Fecal contamination of drinking water supplies in and around Chandigarh and correlation with acute gastroenteritis.

    PubMed

    Neelam, Taneja; Malkit, Singh; Pooja, Rao; Manisha, Biswal; Shiva, Priya; Ram, Chander; Meera, Sharma

    2012-12-01

    Acute gastroenteritis due to Vibrio cholerae and Enterotoxigenic E. coli is a common problem faced in the hot and humid summer months in north India. The study was undertaken to evaluate drinking water supplies for fecal coliforms, V. cholerae and Enterotoxigenic E. coli in urban, semiurban and rural areas in and around Chandigarh and correlate with occurrence of acute gastroenteritis occurring from the same region. Drinking water sample were collected from various sources from April to October 2004 from a defined area. Samples were tested for fecal coliforms and E. coli count. E. coli were screened for heat labile toxin (LT) also. Stool samples from cases of acute gastroenteritis from the same region and time were collected and processed for V. cholerae, Enterotoxigenic E. coli (ETEC) and others like Salmonella, Shigella and Aeromonas spp. A total of 364 water samples were collected, (251 semi urban, 41 rural and 72 from urban areas). 116 (31.8%) samples were contaminated with fecal coliforms (58.5% rural, 33.4% semiurban and 11.1% of samples from urban areas). E. coli were grown from 58 samples. Ninety two isolates of E. coli were tested for enterotoxins of which 8 and 24 were positive for LT and ST respectively. V. cholerae were isolated from 2 samples during the outbreak investigation. Stored water samples showed a significantly higher level of contamination and most of Enterotoxigenic E. coli were isolated from stored water samples. A total of 780 acute gastroenteritis cases occurred; 445 from semiurban, 265 rural and 70 from urban areas. Out of 189 stool samples submitted, ETEC were the commonest (30%) followed by V. cholerae (19%), Shigellae (8.4%), Salmonellae (2.1%) and Aeromonas (2.6%). ST-ETEC (40/57) were commoner than LT-ETEC (17/57). In the present study, high levels of contamination of drinking water supplies (32.1%) correlated well with cases of acute gastroenteritis. Majority of cases of acute gastroenteritis occurred in the semi urban

  20. Enteropathogenic Escherichia coli (EPEC) infection in association with acute gastroenteritis in 7 dogs from Saskatchewan.

    PubMed

    Kjaergaard, Astrid B; Carr, Anthony P; Gaunt, M Casey

    2016-09-01

    Seven dogs diagnosed with enteropathogenic Escherichia coli (EPEC) infection in association with acute gastroenteritis are described. Disease severity ranged from mild in adults to fatal disease in young dogs. Enteropathogenic E. coli infection should be considered as a possible differential diagnosis in dogs with diarrhea. PMID:27587889

  1. Fecal contamination of drinking water supplies in and around Chandigarh and correlation with acute gastroenteritis.

    PubMed

    Taneja, Neelam; Singh, Malkit; Rao, Pooja; Biswal, Manisha; Priya, Shiva; Chander, Ram; Sharma, Meera

    2011-09-01

    The study evaluated drinking water from localities in and around Chandigarh for fecal coliforms, V. cholerae and Enterotoxigenic E. coli and correlate with occurrence of acute gastroenteritis occurring from the same region. Drinking water sample were collected from various sources from the defined area. Samples were tested for fecal coliforms and E. coli count by multiple tube method and pathogens by membrane filtration technique. E. coli were screened for heat labile toxin (LT) by the reverse passive agglutination method and heat stable toxin (ST) by ELISA. Stool samples from cases of acute gastroenteritis from the same region and time were collected and processed for V. cholerae, Enterotoxigenic E coli (ETEC) and others like Salmonella, Shigella and Aeromonas spp. Of 364 water samples examined, 116 (31.8%) samples were contaminated with fecal coliforms (58.5% rural, 33.4% semi-urban and 11.1% from urban areas). E. coli were grown from 58 samples. Ninety-two isolates of E. coli were tested for enterotoxins of which 8 and 24 were positive for LT and ST respectively. V. cholerae were isolated from 2 samples during the outbreak investigation. Stored water samples showed a significantly higher level of contamination and most of Enterotoxigenic E. coli were isolated from stored water samples. A total of 780 acute gastroenteritis cases occurred; 445 from semi-urban, 265 rural and 70 from urban areas. Out of 189 stool samples submitted, ETEC were the commonest (30%) followed by V. cholerae (19%), Shigellae (8.4%), Salmonellae (2.1%) and Aeromonas (2.6%). ST-ETEC (40/57) were commoner than LT- ETEC(17/57). In the present study, high levels of contamination of drinking water supplies (32.1%) correlated well with cases of acute gastroenteritis. Majority of cases of acute gastroenteritis occurred in the semi-urban area corresponding with high level of contamination (33.4%/). The highest level of water contamination was seen in rural areas (58.5%) but the number of acute

  2. The effectiveness of rotavirus vaccine in preventing acute gastroenteritis during rotavirus seasons among Polish children

    PubMed Central

    Kieltyka, Agnieszka; Majewska, Renata; Augustyniak, Malgorzata

    2016-01-01

    Introduction Rotavirus is the main etiological cause of intestinal infections in children. Voluntary rotavirus vaccines were included in the Polish vaccination schedule in 2007. The aim of this study was to assess the effectiveness of a completed rotavirus vaccination course in preventing acute gastroenteritis in Polish infants during their first five years of life. Material and methods This was a retrospective cohort study conducted in Lesser Poland (Malopolska Province). The sample population included a group of 303 children who received the completed rotavirus vaccination course and 303 children not vaccinated against rotavirus. The date of the child's acute gastroenteritis diagnosis and his or her vaccination history were extracted from the physicians’ records. Each kind of diagnosed acute gastroenteritis during winter-spring rotavirus seasons was treated as the endpoint. The relative risk of having gastrointestinal infection was assessed using the hazard ratio from the Cox proportional hazards regression model. Results In the examined group, 96 (15.8%) children had winter-spring gastrointestinal infections. In the non-vaccinated children, the cumulative incidence of these infections in the first 5 years of life was 20.8%, whereas in the children vaccinated with Rotarix it was only 10.9%. Those who were vaccinated with Rotarix had a 44% reduction in the risk of a winter-spring acute gastroenteritis infection compared to those not vaccinated with Rotarix (p = 0.005). Birth weight less than 2500 g increased the risk of the infection twofold and also reached statistical significance (p = 0.044). Conclusions The results showed that Rotarix is effective in preventing acute gastroenteritis in Polish children during rotavirus seasons. PMID:27279856

  3. Salivirus in Children and Its Association with Childhood Acute Gastroenteritis: A Paired Case-Control Study.

    PubMed

    Yu, Jie-Mei; Ao, Yuan-Yun; Liu, Na; Li, Li-Li; Duan, Zhao-Jun

    2015-01-01

    Salivirus was recently discovered in children with gastroenteritis and in sewage. Though a causative role for salivirus in childhood gastroenteritis was suggested in the previous study, the relationship between salivirus and acute gastroenteritis has not yet been clearly clarified. The sewage strain reported by Ng, although represented by incomplete genome sequencing data, was distinct from previously reported saliviruses, and had not previously been detected in humans. A case-control study examining 461 paired stool samples from children with diarrhea and healthy controls (1:1) was conducted in this study. Also, common diarrheal viruses were detected and complete genome of a salivirus was determined. Results showed that salivirus was detected in 16 (3.5%) and 13 (2.8%) of the case and control samples, respectively; no differences in detection rates (p=0.571) or mean values of viral loads (p=0.400) were observed between the groups. Multivariate Cox regression revealed no association between salivirus and gastroenteritis (p=0.774). The data also demonstrated that salivirus infection did not exacerbate clinical symptoms of gastroenteritis in children. Furthermore, complete genome sequence of a salivirus recovered from the feces of a child with diarrhea (i.e., SaliV-FHB) shared a 99% nucleotide identity with the sewage strain. In conclusion, a paired case-control study did not support a causative role for salivirus strains detected in this study with pediatric gastroenteritis. This study also demonstrated that all known saliviruses can be detected in the feces of children with or without gastroenteritis.

  4. Impact of genotype-specific herd immunity on the circulatory dynamism of norovirus: a 10-year longitudinal study of viral acute gastroenteritis.

    PubMed

    Sakon, Naomi; Yamazaki, Kenji; Nakata, Keiko; Kanbayashi, Daiki; Yoda, Tomoko; Mantani, Masanobu; Kase, Tetsuo; Takahashi, Kazuo; Komano, Jun

    2015-03-15

    Human norovirus is a major cause of viral acute gastroenteritis worldwide. However, the transition of endemic norovirus genotypes remains poorly understood. The characteristics of natural immunity against norovirus are unclear because few studies have been performed in the natural infection setting. This prospective 10-year surveillance study of acute gastroenteritis in the province of Osaka, Japan, revealed that norovirus spread shows temporal, geographic, and age group-specific features in the humans. Genogroup II genotype 4 (GII.4) was detected in most sporadic pediatric cases, as well as in foodborne and nursing home outbreaks, respectively. The dominant genotypes in outbreaks at childcare facilities and schools shifted every season and involved GI, GII.2, GII.3, GII.4, and GII.6. Evidence at both the facility and individual levels indicated that genotype-specific herd immunity lasted long enough to influence the endemic norovirus genotype in the next season. Thus, norovirus circulates through human populations in a uniquely dynamic fashion.

  5. Prevalence of Rotavirus, Adenovirus, and Astrovirus Infections among Patients with Acute Gastroenteritis in, Northern Iran

    PubMed Central

    Hamkar, R; Yahyapour, Y; Noroozi, M; Nourijelyani, K; Jalilvand, S; Adibi, L; Vaziri, S; Poor-Babaei, AA; Pakfetrat, A; Savad-Koohi, R

    2010-01-01

    Background: The aim of the study was to determine the incidence of non-bacterial acute gastroenteritis associated with diarrheal diseases in Mazandaran Province, northern Iran. Methods: A total of 400 symptomatic cases from patients with acute gastroenteritis from Mazandaran Province in Iran were screened using EIA method for the presence of rotavirus, adenovirus and astrovirus during 2005–2006. Chi-square tests were used for testing relationships between different variables. Results: Rotavirus, adenovirus and astrovirus were detected in 62%, 2.3%, and 3% of samples, respectively. The maximum rate of rotaviruses was detected in the <1-year-old age group, while minimum rate was found in the 10 years and older age group. Astrovirus and adenovirus were detected predominantly in the 2–5-year-old age group of children, with a prevalence of 8.3% and 3.5% respectively. All studied viral gastroenteritis peaked in the winter, and minimum rate were found in summer. Conclusion: Our statistical analyzes indicated that viral gastroenteritis, especially Rota-viral, had the highest number of occurrences in colder seasons notably in winter and more frequently were observed among younger children. PMID:23113006

  6. Ulcerative colitis presenting as acute infectious gastroenteritis with a paralytic ileus

    PubMed Central

    Schoenmaker, Suzanne Gerdien; Tjon a Ten, Walther E

    2012-01-01

    A 15-year-old girl who presented with signs of acute infectious gastroenteritis, just as two members of her family is described. As the patient did not improve, a sigmoidoscopy was performed and the diagnosis of ulcerative colitis (UC) was made. Our hypothesis is that an infection triggered the development of UC. Her paralytic ileus was probably triggered by the increased nitric oxide produced in the macrophages and smooth muscles of the inflamed bowel. PMID:22605860

  7. Acute gastroenteritis outbreaks associated with ground-waterborne norovirus in South Korea during 2008-2012.

    PubMed

    Cho, H G; Lee, S G; Kim, W H; Lee, J S; Park, P H; Cheon, D S; Jheong, W H; Jho, E H; Lee, J B; Paik, S Y

    2014-12-01

    Epidemiological and virological studies indicate that noroviruses-contaminated groundwater was the primary source of four acute gastroenteritis outbreaks in South Korea between 2008 and 2012. Furthermore, cabbage kimchi was first identified as the vehicle of transmission between groundwater and infected patients in an outbreak in 2011. The proper treatment of groundwater sources prior to use for drinking or in food preparation is necessary to prevent further outbreaks. PMID:24534556

  8. Recent viral pathogen in acute gastroenteritis: a retrospective study at a tertiary hospital for 1 year

    PubMed Central

    Jin, Hye Il; Lee, Yoo Mi; Choi, You Jin

    2016-01-01

    Purpose Viral gastroenteritis among children is mainly caused by rotavirus, norovirus, astrovirus, or adenovirus strains. However, changing socioeconomic conditions and a rotavirus vaccination program may be affecting the prevalence of these viral infections. Therefore, we aimed to elucidate the season-specific trends in viral infections for facilitating prophylaxis and surveillance in our region. Methods We evaluated 345 pediatric patients (203 males, 142 females; age, 1 month to 16 years) who visited the CHA Bundang Medical Center because of gastroenteric symptoms between June 2014 and May 2015. The specimens were simultaneously tested for norovirus, rotavirus, astrovirus, and adenovirus via multiplex reverse transcription polymerase chain reaction. Clinical characteristics of patients were analyzed retrospectively. Results The most common virus was norovirus, followed by rotavirus, adenovirus, and astrovirus. Of all viral infections, 45.2% occurred mainly between 6 and 24 months of age; in particular, norovirus infection mostly occurred in all age groups except those below 6 months of age, when rotavirus was most prevalent. In addition, seasonal variation was observed, such as norovirus infection from December to February, rotavirus infection from February to April, and adenovirus infection from July to October. Conclusion Our results showed that the most common cause of acute pediatric viral gastroenteritis had changed from rotavirus to norovirus in our patients, because of effective rotaviral vaccination. We recommend the management of food and personal hygiene in accordance with age or seasons as well as active vaccination for preventing viral gastroenteritis. PMID:27186218

  9. Xyloglucan for the Treatment of Acute Gastroenteritis in Children: Results of a Randomized, Controlled, Clinical Trial

    PubMed Central

    Pleșea Condratovici, Cătălin; Bacarea, Vladimir; Piqué, Núria

    2016-01-01

    Background. Xyloglucan, a film-forming agent, improves intestinal mucosa resistance to pathologic damage. The efficacy, safety, and time of onset of the antidiarrheal effect of xyloglucan were assessed in children with acute gastroenteritis receiving oral rehydration solution (ORS). Methods. This randomized, controlled, open-label, parallel-group, multicenter, clinical trial included children (3 months–12 years) with acute gastroenteritis of infectious origin. Children were randomized to xyloglucan and ORS, or ORS only, for 5 days. Diarrheal symptoms, including stool number/characteristics, and safety were assessed at baseline and after 2 and 5 days and by fulfillment of a parent diary card. Results. Thirty-six patients (58.33% girls) were included (n = 18/group). Patients receiving xyloglucan and ORS had better symptom evolution than ORS-only recipients, with a faster onset of action. At 6 hours, xyloglucan produced a significantly greater decrease in the number of type 7 stools (0.11 versus 0.44; P = 0.027). At days 3 and 5, xyloglucan also produced a significantly greater reduction in types 6 and 7 stools compared with ORS alone. Xyloglucan plus ORS was safe and well tolerated. Conclusions. Xyloglucan is an efficacious and safe option for the treatment of acute gastroenteritis in children, with a rapid onset of action in reducing diarrheal symptoms. This study is registered with ISRCTN number 65893282. PMID:27212943

  10. Hyperuricemia in acute gastroenteritis is caused by decreased urate excretion via ABCG2

    PubMed Central

    Matsuo, Hirotaka; Tsunoda, Tomoyuki; Ooyama, Keiko; Sakiyama, Masayuki; Sogo, Tsuyoshi; Takada, Tappei; Nakashima, Akio; Nakayama, Akiyoshi; Kawaguchi, Makoto; Higashino, Toshihide; Wakai, Kenji; Ooyama, Hiroshi; Hokari, Ryota; Suzuki, Hiroshi; Ichida, Kimiyoshi; Inui, Ayano; Fujimori, Shin; Shinomiya, Nariyoshi

    2016-01-01

    To clarify the physiological and pathophysiological roles of intestinal urate excretion via ABCG2 in humans, we genotyped ABCG2 dysfunctional common variants, Q126X (rs72552713) and Q141K (rs2231142), in end-stage renal disease (hemodialysis) and acute gastroenteritis patients, respectively. ABCG2 dysfunction markedly increased serum uric acid (SUA) levels in 106 hemodialysis patients (P = 1.1 × 10−4), which demonstrated the physiological role of ABCG2 for intestinal urate excretion because their urate excretion almost depends on intestinal excretion via ABCG2. Also, ABCG2 dysfunction significantly elevated SUA in 67 acute gastroenteritis patients (P = 6.3 × 10−3) regardless of the degree of dehydration, which demonstrated the pathophysiological role of ABCG2 in acute gastroenteritis. These findings for the first time show ABCG2-mediated intestinal urate excretion in humans, and indicates the physiological and pathophysiological importance of intestinal epithelium as an excretion pathway besides an absorption pathway. Furthermore, increased SUA could be a useful marker not only for dehydration but also epithelial impairment of intestine. PMID:27571712

  11. Hyperuricemia in acute gastroenteritis is caused by decreased urate excretion via ABCG2.

    PubMed

    Matsuo, Hirotaka; Tsunoda, Tomoyuki; Ooyama, Keiko; Sakiyama, Masayuki; Sogo, Tsuyoshi; Takada, Tappei; Nakashima, Akio; Nakayama, Akiyoshi; Kawaguchi, Makoto; Higashino, Toshihide; Wakai, Kenji; Ooyama, Hiroshi; Hokari, Ryota; Suzuki, Hiroshi; Ichida, Kimiyoshi; Inui, Ayano; Fujimori, Shin; Shinomiya, Nariyoshi

    2016-01-01

    To clarify the physiological and pathophysiological roles of intestinal urate excretion via ABCG2 in humans, we genotyped ABCG2 dysfunctional common variants, Q126X (rs72552713) and Q141K (rs2231142), in end-stage renal disease (hemodialysis) and acute gastroenteritis patients, respectively. ABCG2 dysfunction markedly increased serum uric acid (SUA) levels in 106 hemodialysis patients (P = 1.1 × 10(-4)), which demonstrated the physiological role of ABCG2 for intestinal urate excretion because their urate excretion almost depends on intestinal excretion via ABCG2. Also, ABCG2 dysfunction significantly elevated SUA in 67 acute gastroenteritis patients (P = 6.3 × 10(-3)) regardless of the degree of dehydration, which demonstrated the pathophysiological role of ABCG2 in acute gastroenteritis. These findings for the first time show ABCG2-mediated intestinal urate excretion in humans, and indicates the physiological and pathophysiological importance of intestinal epithelium as an excretion pathway besides an absorption pathway. Furthermore, increased SUA could be a useful marker not only for dehydration but also epithelial impairment of intestine. PMID:27571712

  12. Human bocavirus in hospitalized children with acute gastroenteritis in Russia from 2010 to 2012.

    PubMed

    Tymentsev, Alexander; Tikunov, Artem; Zhirakovskaia, Elena; Kurilschikov, Alexander; Babkin, Igor; Klemesheva, Vera; Netesov, Sergei; Tikunova, Nina

    2016-01-01

    Human bocavirus (HBoV) can cause respiratory diseases and is detectable in the stool samples of patients with gastroenteritis. To assess the prevalence of HBoV in children hospitalized with acute gastroenteritis in Novosibirsk, Russia, as well as its genetic diversity and the potential role in the etiology of gastroenteritis in this region, a total of 5502 stool samples from children hospitalized with gastroenteritis from 2010 to 2012, n=5250, and healthy children, n=252, were assayed for the presence of HBoV DNA by semi-nested PCR. The HBoV DNA was found in 1.2% of stool samples from children, with gastroenteritis varying from 0.5% in 2012 to 1.7% in 2011. The prevalence of HBoV in healthy children was 0.3%. HBoV strains were detected throughout the year with an increase in the fall-winter season. In 87% of cases, HBoV was detected in children before 1 year of age. All known HBoV genetic variants have been detected in Novosibirsk, although with different prevalences: HBoV2>HBoV1>HBoV4>HBoV3. At the beginning of 2011, HBoV2 replaced HBoV1 as the most prevalent variant. The median age of children with detected HBoV1 was 8.3months, and that with HBoV2 was 8.0 months. All HBoV-positive samples were assayed for the presence of the rotaviruses A and C, norovirus GII, astrovirus, enterovirus, adenovirus F, Salmonella spp., Campylobacter spp., Shigella spp., and EIEC. HBoV1 and HBoV2 as single agents were found in 45.8% and 60% samples, respectively, although this difference was not statistically significant. In the case of co-infections, HBoV was most frequently recorded with rotavirus A and norovirus GII. This study demonstrated that the detection rate of HBoV in stool samples from children with gastroenteritis was low, although both HBoV1 and HBoV2 could be found as the sole agents in children with gastroenteritis in Novosibirsk.

  13. Early Detection of Epidemic GII-4 Norovirus Strains in UK and Malawi: Role of Surveillance of Sporadic Acute Gastroenteritis in Anticipating Global Epidemics.

    PubMed

    Allen, David J; Trainor, Eamonn; Callaghan, Anna; O'Brien, Sarah J; Cunliffe, Nigel A; Iturriza-Gómara, Miren

    2016-01-01

    Noroviruses are endemic in the human population, and are recognised as a leading cause of acute gastroenteritis worldwide. Although they are a highly diverse group of viruses, genogroup-II genotype-4 (GII-4) noroviruses are the most frequently identified strains worldwide. The predominance of GII-4 norovirus strains is driven by the periodic emergence of antigenic variants capable of evading herd protection. The global molecular epidemiology of emerging GII-4 strains is largely based on data from outbreak surveillance programmes, but the epidemiology of GII-4 strains among sporadic or community cases is far less well studied. To understand the distribution of GII-4 norovirus strains associated with gastroenteritis in the wider population, we characterised the GII-4 norovirus strains detected during studies of sporadic cases of infectious gastroenteritis collected in the UK and Malawi between 1993 and 2009. Our data shows that GII-4 norovirus strains that have emerged as strains of global epidemic importance have circulated in the community up to 18 years before their recognition as pandemic strains associated with increases in outbreaks. These data may suggest that more comprehensive surveillance programmes that incorporate strains associated with sporadic cases may provide a way for early detection of emerging strains with pandemic potential. This may be of particular relevance as vaccines become available.

  14. Early Detection of Epidemic GII-4 Norovirus Strains in UK and Malawi: Role of Surveillance of Sporadic Acute Gastroenteritis in Anticipating Global Epidemics

    PubMed Central

    Callaghan, Anna; O’Brien, Sarah J.; Cunliffe, Nigel A.; Iturriza-Gómara, Miren

    2016-01-01

    Noroviruses are endemic in the human population, and are recognised as a leading cause of acute gastroenteritis worldwide. Although they are a highly diverse group of viruses, genogroup-II genotype-4 (GII-4) noroviruses are the most frequently identified strains worldwide. The predominance of GII-4 norovirus strains is driven by the periodic emergence of antigenic variants capable of evading herd protection. The global molecular epidemiology of emerging GII-4 strains is largely based on data from outbreak surveillance programmes, but the epidemiology of GII-4 strains among sporadic or community cases is far less well studied. To understand the distribution of GII-4 norovirus strains associated with gastroenteritis in the wider population, we characterised the GII-4 norovirus strains detected during studies of sporadic cases of infectious gastroenteritis collected in the UK and Malawi between 1993 and 2009. Our data shows that GII-4 norovirus strains that have emerged as strains of global epidemic importance have circulated in the community up to 18 years before their recognition as pandemic strains associated with increases in outbreaks. These data may suggest that more comprehensive surveillance programmes that incorporate strains associated with sporadic cases may provide a way for early detection of emerging strains with pandemic potential. This may be of particular relevance as vaccines become available. PMID:27115152

  15. [Acute renal failure due to obstructive ureteral stone associated with norovirus gastroenteritis in an infant with congenital solitary kidney].

    PubMed

    Kato, Taiki; Hamano, Atsushi; Kawamura, Hideki

    2014-10-01

    We report a 35 month-old boy with acute renal failure caused by an obstructive ureteral stone associated with norovirus gastroenteritis. He visited his family physician because of fever, abdominal pain and vomiting. He was diagnosed as acute gastroenteritis. The symptoms relieved once, but abdominal pain and vomiting recurred two days after the visit and the volume of urine decreased. He was diagnosed as norovirus gastoenteritis and acute renal failure which was unresponsive to fluid replacement. Ultrasound study of the abdomen showed a solitary kidney with mild hydronephrosis. He was then admitted to our hospital. He was finally diagnosed as acute postrenal failure due to obstructive ureteral stone with left solitary kidney by abdominal computer tomography (CT). We performed transurethral catheterization immediately. The creatinine and blood urea nitrogen returned to normal level in 2 days. The CT performed on the 28th day post operation showed disappearance of the stone after uric alkalization. Recently, some cases of postrenal failure due to bilateral obstructive ureteral stones, mainly ammonium acid urate stones, associated with viral gastroenteritis were reported. As clinical features, they are common in boys three years or younger after an episode of rotavirus gastroenteritis with high uric acid concentration. By far, the most common cause of acute renal failure in patients with severe gastroenteritis is prerenal failure resulting from hypovolemia. But postrenal cause due to bilateral obstructive stones should be taken in a consideration.

  16. Genetic Diversity of Human Adenovirus in Children with Acute Gastroenteritis, Albania, 2013-2015.

    PubMed

    La Rosa, G; Della Libera, S; Petricca, S; Iaconelli, M; Donia, D; Saccucci, P; Cenko, F; Xhelilaj, G; Divizia, M

    2015-01-01

    The objectives of the present study were to assess the occurrence of human adenoviruses (HAdVs) in paediatric patients with gastroenteritis in Albania and to characterize HAdV strains. Faecal specimens from children admitted with acute gastroenteritis to the Paediatric Hospital in Tirana were screened for HAdV, using broad-range primers targeting the hexon gene, in combination with species-specific primers targeting the fiber gene. Phylogenetic analysis was then performed to assess the genetic relationships among the different sequences and between the sequences of the samples and those of the prototype strains. Adenovirus DNA was detected in 33/142 samples (23.2%); 14 belonged to species F (13 HAdV-41 and 1 HAdV-40), 13 to species C (1 HAdV-1, 8 HAdV-2, and 4 HAdV-5), 5 to species B (HAdV-3), and 1 to species A (HAdV-12). Rotavirus coinfection was present in 9/33 (27.2%) positive samples. In the remaining 24 positive samples (12 enteric--F species; 12 nonenteric--A, B, or C species), HAdVs were detected as unique viral pathogens, suggesting that HAdV may be an important cause of diarrhoea in children requiring hospitalization. This is the first study investigating the presence of human adenoviruses (species A-G) as etiologic agents of viral gastroenteritis in children in Albania. PMID:26339589

  17. Genetic Diversity of Human Adenovirus in Children with Acute Gastroenteritis, Albania, 2013-2015.

    PubMed

    La Rosa, G; Della Libera, S; Petricca, S; Iaconelli, M; Donia, D; Saccucci, P; Cenko, F; Xhelilaj, G; Divizia, M

    2015-01-01

    The objectives of the present study were to assess the occurrence of human adenoviruses (HAdVs) in paediatric patients with gastroenteritis in Albania and to characterize HAdV strains. Faecal specimens from children admitted with acute gastroenteritis to the Paediatric Hospital in Tirana were screened for HAdV, using broad-range primers targeting the hexon gene, in combination with species-specific primers targeting the fiber gene. Phylogenetic analysis was then performed to assess the genetic relationships among the different sequences and between the sequences of the samples and those of the prototype strains. Adenovirus DNA was detected in 33/142 samples (23.2%); 14 belonged to species F (13 HAdV-41 and 1 HAdV-40), 13 to species C (1 HAdV-1, 8 HAdV-2, and 4 HAdV-5), 5 to species B (HAdV-3), and 1 to species A (HAdV-12). Rotavirus coinfection was present in 9/33 (27.2%) positive samples. In the remaining 24 positive samples (12 enteric--F species; 12 nonenteric--A, B, or C species), HAdVs were detected as unique viral pathogens, suggesting that HAdV may be an important cause of diarrhoea in children requiring hospitalization. This is the first study investigating the presence of human adenoviruses (species A-G) as etiologic agents of viral gastroenteritis in children in Albania.

  18. Domperidone with ORT in the treatment of pediatric acute gastroenteritis in Japan: a multicenter, randomized controlled trial.

    PubMed

    Kita, Fumiyo; Hinotsu, Shiro; Yorifuji, Tohru; Urushihara, Hisashi; Shimakawa, Tetsuro; Kishida, Kenji; Wakazono, Yoshihiro; Yamauchi, Eiko; Sasaki, Hiroshi; Nakahata, Tatsutoshi; Kawakami, Koji

    2015-03-01

    Domperidone is an antiemetic that is often prescribed for children with acute gastroenteritis in Japan. In this study, the authors assessed the efficacy of domperidone prescription in combination with oral rehydration treatment (ORT) in the treatment of vomiting during acute gastroenteritis in children during the early period. They performed a prospective multicenter randomized trial in Japan. Patients received either ORT or ORT and domperidone prescription. The primary outcome was the proportion of patients who had vomiting during the first 2 hours after randomization. A total of 56 children were eligible; 24 received ORT alone, and 32 received ORT and prescribed domperidone suppository. Results showed that 27.3% of children in the ORT group vomited as compared with 20.7% of children in the ORT and domperidone group (P = .41). In this study, it appears that domperidone in combination with ORT in the treatment of acute gastroenteritis does not reduce vomiting in the early period.

  19. Importance of rotavirus and adenovirus types 40 and 41 in acute gastroenteritis in Korean children.

    PubMed Central

    Kim, K H; Yang, J M; Joo, S I; Cho, Y G; Glass, R I; Cho, Y J

    1990-01-01

    To examine the role of rotavirus (Rv) and adenovirus types 40 and 41 (Ad40/41) in Korean children with acute gastroenteritis, we evaluated 345 children with acute gastroenteritis and 90 children without acute gastroenteritis in Seoul, Korea, during a 29-month period. Stools were tested for group A Rv antigen and for Ad40/41 by using monoclonal antibody (MAb)-based assays. Rv was found in 68% of the ill children and 19% of the controls (P less than 0.001), whereas Ad40/41 was detected in 9% of the ill children and 2% of the controls (P less than 0.05). Also, 6% of the ill children and 0.01% of the controls excreted Rv and Ad40/41 simultaneously. Among the ill children, 96% of children with Rv and 94% of those with Ad40/41 were younger than 24 months. Although a peak of Rv infection was detected in early winter in both years of the study, there was no apparent seasonal trend with Ad40/41. Diarrhea with more than 10 stools per day, vomiting, or fever was most strongly associated with Rv shedding, whereas the first two manifestations were associated with coinfection of Rv and Ad40/41. To investigate the genetic and serotypic diversity of Rv strains, we tested 195 and 144 fecal Rv specimens isolated from the gastroenteritis cases, respectively, by polyacrylamide gel electrophoresis of the segmented RNA genome and by an enzyme-linked immunosorbent assay with serotype-specific MAbs. Of the 195 specimens, 154 yielded RNA patterns characteristic of group A Rv: 18% had short electrophoretic migration patterns, 81% had long patterns, and 1% had a mixture of short and long patterns. Of the 144 specimens, serotype specificity was determined in 51%: 89% were serotype 1, 10% were serotype 2, and 1% were serotype 3. Analysis of the specimens for which electropherotypes and serotypes were available indicated that a given RNA pattern corresponded to a particular serotype, except in one strain that showed short patterns but serotype 1. We suggest that Rv and Ad40/41 in stools be

  20. Aetiology of acute paediatric gastroenteritis in Bulgaria during summer months: prevalence of viral infections.

    PubMed

    Mladenova, Zornitsa; Steyer, Andrej; Steyer, Adela Fratnik; Ganesh, Balasubramanian; Petrov, Petar; Tchervenjakova, Tanja; Iturriza-Gomara, Miren

    2015-03-01

    Paediatric acute gastroenteritis is a global public health problem. Comprehensive laboratory investigation for viral, bacterial and parasitic agents is helpful for improving management of acute gastroenteritis in health care settings and for monitoring and controlling the spread of these infections. Our study aimed to investigate the role of various pathogens in infantile diarrhoea in Bulgaria outside the classical winter epidemics of rotavirus and norovirus. Stool samples from 115 hospitalized children aged 0-3 years collected during summer months were tested for presence of 14 infectious agents - group A rotavirus, astrovirus, Giardia, Cryptosporidium and Entamoeba using ELISAs; norovirus by real-time RT-PCR; picobirnavirus and sapovirus by RT-PCR; adenovirus using PCR, and Salmonella, Shigella, Escherichia coli, Yersinia and Campylobacter using standard bacterial cultures. Infectious origin was established in a total of 92 cases and 23 samples remained negative. A single pathogen was found in 67 stools, of which rotaviruses were the most prevalent (56.7 %), followed by noroviruses (19.4 %), enteric adenoviruses (7.5 %), astroviruses (6.0 %), bacteria and parasites (4.5 % each) and sapoviruses (1.4 %). Rotavirus predominant genotypes were G4P[8] (46.3 %) and G2P[4] (21.4 %); for astroviruses, type 1a was the most common, while the GII.4/2006b variant was the most prevalent among noroviruses. Bacteria were observed in five cases, with Salmonella sp. as the most prevalent, while parasites were found in ten stool samples, with Giardia intestinalis in five cases. The results demonstrated high morbidity associated with viral infections and that rotavirus and norovirus remain the most common pathogens associated with severe gastroenteritis during summer months in Bulgaria, a country with a temperate climate, and significant molecular diversity among circulating virus strains.

  1. Human bocavirus 1 and 3 infection in children with acute gastroenteritis in Brazil.

    PubMed

    Sousa, Teresinha Teixeira de; Souza, Menira; Fiaccadori, Fabíola Souza; Borges, Ana Maria Tavares; Costa, Paulo Sucasas da; Cardoso, Divina das Dôres de Paula

    2012-09-01

    To determine the positivity rate of human bocavirus (HBoV) 1 and 3 among children who presented with acute gastroenteritis symptoms during the period of 1994-2004 in the Central-West Region of Brazil, 762 faecal samples were tested using polymerase chain reaction (PCR) for the detection of HBoV DNA. Primers for a segment of the non-structural viral protein 1 (NS1) gene of HBoV-1 and HBoV-3 were used. Twelve HBoV-positive samples were further characterised via genomic sequencing and phylogenetic analysis. Of the samples tested, 5.8% (n = 44) were positive for HBoV-1 or HBoV-3 and co-infection was observed in 14 (31.8%) of the 44 HBoV-positive samples. Nine of the 14 samples were also positive for Rotavirus A and five were positive for Aichi virus. The genomic sequencing of the NS1 partial sequence of 12 HBoV-samples showed that 11 samples were characterised as HBoV-1 and that one was characterised as HBoV-3. The phylogenetic analysis showed that the HBoV-1 samples had a high sequence homology to others previously identified in China, Sweden and Brazil. This is the first study conducted in the Central-West Region of Brazil to detect HBoV-1 and HBoV-3 in faecal samples from children with acute gastroenteritis. Further studies are required to define the role of HBoVs as aetiological agents of gastroenteritis.

  2. Acute Infectious Gastroenteritis Potentiates a Crohn's Disease Pathobiont to Fuel Ongoing Inflammation in the Post-Infectious Period

    PubMed Central

    Small, Cherrie L.; Xing, Lydia; Law, Hong T.

    2016-01-01

    Crohn’s disease (CD) is a chronic inflammatory condition of diverse etiology. Exposure to foodborne pathogens causing acute gastroenteritis produces a long-term risk of CD well into the post-infectious period but the mechanistic basis for this ongoing relationship to disease onset is unknown. We developed two novel models to study the comorbidity of acute gastroenteritis caused by Salmonella Typhimurium or Citrobacter rodentium in mice colonized with adherent-invasive Escherichia coli (AIEC), a bacterial pathobiont linked to CD. Here, we show that disease activity in the post-infectious period after gastroenteritis is driven by the tissue-associated expansion of the resident AIEC pathobiont, with an attendant increase in immunopathology, barrier defects, and delays in mucosal restitution following pathogen clearance. These features required AIEC resistance to host defense peptides and a fulminant inflammatory response to the enteric pathogen. Our results suggest that individuals colonized by AIEC at the time of acute infectious gastroenteritis may be at greater risk for CD onset. Importantly, our data identify AIEC as a tractable disease modifier, a finding that could be exploited in the development of therapeutic interventions following infectious gastroenteritis in at-risk individuals. PMID:27711220

  3. Diapers in war zones: ethnomedical factors in acute childhood gastroenteritis in Peshawar, Pakistan.

    PubMed

    Zaidi, Saira H; Smith-Morris, Carolyn

    2015-01-01

    This article considers ethnomedical knowledge and practices among parents related to contraction of acute gastroenteritis among children in Peshawar, Pakistan. Research methods included analysis of the Emergency Pediatric Services' admission register, a structured interview administered to 47 parents of patients seen in the Khyber Medical College Teaching Hospital, semi-structured interviews of 12 staff, and four home visits among families with children treated at the hospital. The use of native research assistants and participant observation contributed to the reliability of the findings, though the ethnographic, home-visit sample is small. Our research indicated that infection rates are exacerbated in homes through two culturally salient practices and one socioeconomic condition. Various misconceptions propagate the recurrence or perserverance of acute gastroenteritis including assumptions about teething leading to poor knowledge of disease etiology, rehydration solutions leading to increased severity of disease, and diaper usage leading to the spread of disease. In our Discussion, we suggest how hospital structures of authority and gender hierarchy may impact hospital interactions, the flow of information, and its respective importance to the patient's parents leading to possible propagation of disease. These ethnographic data offer a relatively brief but targeted course of action to improve the effectiveness of prevention and treatment efforts.

  4. Diapers in War Zones: Ethnomedical Factors in Acute Childhood Gastroenteritis in Peshawar, Pakistan

    PubMed Central

    Zaidi, Saira H.; Smith-Morris, Carolyn

    2015-01-01

    This article considers ethnomedical knowledge and practices among parents related to contraction of acute gastroenteritis among children in Peshawar, Pakistan. Research methods included analysis of the Emergency Pediatric Services’ admission register, a structured interview administered to 47 parents of patients seen in the Khyber Medical College Teaching Hospital, semi-structured interviews of 12 staff, and four home visits among families with children treated at the hospital. The use of native research assistants and participant observation contributed to the reliability of the findings, though the ethnographic, home-visit sample is small. Our research indicated that infection rates are exacerbated in homes through two culturally salient practices and one socioeconomic condition. Various misconceptions propagate the recurrence or perserverance of acute gastroenteritis including assumptions about teething leading to poor knowledge of disease etiology, rehydration solutions leading to increased severity of disease, and diaper usage leading to the spread of disease. In our Discussion, we suggest how hospital structures of authority and gender hierarchy may impact hospital interactions, the flow of information, and its respective importance to the patient’s parents leading to possible propagation of disease. These ethnographic data offer a relatively brief but targeted course of action to improve the effectiveness of prevention and treatment efforts. PMID:25768117

  5. Diapers in war zones: ethnomedical factors in acute childhood gastroenteritis in Peshawar, Pakistan.

    PubMed

    Zaidi, Saira H; Smith-Morris, Carolyn

    2015-01-01

    This article considers ethnomedical knowledge and practices among parents related to contraction of acute gastroenteritis among children in Peshawar, Pakistan. Research methods included analysis of the Emergency Pediatric Services' admission register, a structured interview administered to 47 parents of patients seen in the Khyber Medical College Teaching Hospital, semi-structured interviews of 12 staff, and four home visits among families with children treated at the hospital. The use of native research assistants and participant observation contributed to the reliability of the findings, though the ethnographic, home-visit sample is small. Our research indicated that infection rates are exacerbated in homes through two culturally salient practices and one socioeconomic condition. Various misconceptions propagate the recurrence or perserverance of acute gastroenteritis including assumptions about teething leading to poor knowledge of disease etiology, rehydration solutions leading to increased severity of disease, and diaper usage leading to the spread of disease. In our Discussion, we suggest how hospital structures of authority and gender hierarchy may impact hospital interactions, the flow of information, and its respective importance to the patient's parents leading to possible propagation of disease. These ethnographic data offer a relatively brief but targeted course of action to improve the effectiveness of prevention and treatment efforts. PMID:25768117

  6. Cases of acute gastroenteritis due to calicivirus in outbreaks: clinical differences by age and aetiological agent.

    PubMed

    Sala, M R; Broner, S; Moreno, A; Arias, C; Godoy, P; Minguell, S; Martínez, A; Torner, N; Bartolomé, R; de Simón, M; Guix, S; Domínguez, A

    2014-08-01

    The Caliciviridae family includes norovirus and sapovirus, which both cause acute gastroenteritis (AGE). Currently, norovirus is the most common cause of AGE in all age groups in many countries. We analysed clinical differences in reported cases of acute gastroenteritis caused by caliciviruses (AGC) by age group and agent involved. We conducted a descriptive study of AGE outbreaks reported to the Public Health Agency of Catalonia (Spain) in 2010 and 2011. The odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated to estimate the association between clinical symptoms and age. Clinical differences between the <15 years and ≥15 years age groups were statistically significant: children more frequently presented with vomiting (OR, 3.25; 95% CI, 2.56-4.13), abdominal pain (OR, 3.27; 95% CI, 2.60-4.12), fever (OR, 1.51; 95% CI, 1.17-1.96) and nausea (OR, 1.49; 95% CI, 1.19-1.85). Comparing clinical manifestations of sapovirus and norovirus infection in children aged <15 years, cases caused by norovirus more frequently presented with vomiting and fever (p <0.001), and cases caused by sapovirus more frequently presented with diarrhoea (p 0.013). Determination of the clinical differences associated with cases in outbreaks according to the age of the majority of cases and the symptoms most frequently detected may aid decision making and guide aetiological investigations and the adoption of prevention and control measures.

  7. [Oral rehydration in acute gastroenteritis in infants and children--advantages of a standardized protocol].

    PubMed

    Weizman, Z; Weizman, A; Alsheikh, A; Herzog, L; Tal, A; Gorodischer, R

    2000-11-01

    Oral rehydration (OR) for acute gastroenteritis in infants and children has been shown to be as effective as IV therapy, with less discomfort and lower costs. In this retrospective study we compared 2 pediatric wards, in 1 of which only a standardized, simplified, bedside protocol, based on American Academy of Pediatrics guidelines, was used. There were no significant clinical characteristics in the 208 patients. In the ward which used the above protocol, OR utilization was significantly more frequent than in the other ward (48% versus 15%), thus saving equipment costs of nearly $1,000/3 months. There were no significant differences in outcome between the wards. We conclude that introducing a standardized management protocol may increase OR utilization in hospitalized children with acute diarrhea. PMID:11341212

  8. Burden of acute gastroenteritis, norovirus and rotavirus in a managed care population.

    PubMed

    Karve, Sudeep; Krishnarajah, Girishanthy; Korsnes, Jennifer S; Cassidy, Adrian; Candrilli, Sean D

    2014-01-01

    This study assessed and described the episode rate, duration of illness, and health care utilization and costs associated with acute gastroenteritis (AGE), norovirus gastroenteritis (NVGE), and rotavirus gastroenteritis (RVGE) in physician office, emergency department (ED), and inpatient care settings in the United States (US). The retrospective analysis was conducted using an administrative insurance claims database (2006-2011). AGE episode rates were assessed using medical (ICD-9-CM) codes for AGE; whereas a previously published "indirect" method was used in assessing estimated episode rates of NVGE and RVGE. We calculated per-patient, per-episode and total costs incurred in three care settings for the three diseases over five seasons. For each season, we extrapolated the total economic burden associated with the diseases to the US population. The overall AGE episode rate in the physician office care setting declined by 15% during the study period; whereas the AGE episode rate remained stable in the inpatient care setting. AGE-related total costs (inflation-adjusted) per 100 000 plan members increased by 28% during the 2010-2011 season, compared with the 2006-2007 season ($832,849 vs. $1 068 116) primarily due to increase in AGE-related inpatient costs. On average, the duration of illness for NVGE and RVGE was 1 day longer than the duration of illness for AGE (mean: 2 days). Nationally, the average AGE-related estimated total cost was $3.88 billion; NVGE and RVGE each accounted for 7% of this total. The episodes of RVGE among pediatric populations have declined; however, NVGE, RVGE and AGE continue to pose a substantial burden among managed care enrollees. In conclusion, the study further reaffirms that RVGE has continued to decline in pediatric population post-launch of the rotavirus vaccination program and provides RVGE- and NVGE-related costs and utilization estimates which can serve as a resource for researchers and policy makers to conduct cost

  9. Acute gastroenteritis and video camera surveillance: a cruise ship case report.

    PubMed

    Diskin, Arthur L; Caro, Gina M; Dahl, Eilif

    2014-01-01

    A 'faecal accident' was discovered in front of a passenger cabin of a cruise ship. After proper cleaning of the area the passenger was approached, but denied having any gastrointestinal symptoms. However, when confronted with surveillance camera evidence, she admitted having the accident and even bringing the towel stained with diarrhoea back to the pool towels bin. She was isolated until the next port where she was disembarked. Acute gastroenteritis (AGE) caused by Norovirus is very contagious and easily transmitted from person to person on cruise ships. The main purpose of isolation is to avoid public vomiting and faecal accidents. To quickly identify and isolate contagious passengers and crew and ensure their compliance are key elements in outbreak prevention and control, but this is difficult if ill persons deny symptoms. All passenger ships visiting US ports now have surveillance video cameras, which under certain circumstances can assist in finding potential index cases for AGE outbreaks.

  10. Enteropathogenic and enteroaggregative E. coli in stools of children with acute gastroenteritis in Davidson County, Tennessee.

    PubMed

    Foster, Monique A; Iqbal, Junaid; Zhang, Chengxian; McHenry, Rendie; Cleveland, Brent E; Romero-Herazo, Yesenia; Fonnesbeck, Chris; Payne, Daniel C; Chappell, James D; Halasa, Natasha; Gómez-Duarte, Oscar G

    2015-11-01

    This prospective acute gastroenteritis (AGE) surveillance was conducted in the inpatient and emergency room settings at a referral pediatric hospital to determine the prevalence of diarrheagenic Escherichia coli (DEC) in children <12years of age with AGE in Davidson County, Tennessee. Subjects 15 days to 11 years of age, who presented with diarrhea and/or vomiting, were enrolled. Stool specimens were processed for detection of DEC using multiplex polymerase chain reaction. From December 1, 2011, to June 30, 2012, a total of 79 (38%) out of 206 stool specimens from children with AGE tested positive for E. coli. A total of 12 (5.8%) out of 206 stool specimens from children with AGE were positive for a DEC. Eight (67%) out of these 12 were positive for enteropathogenic E. coli, and the remaining 4 were positive for enteroaggregative E. coli. DEC clinical isolates clustered with known E. coli enteropathogens according to multilocus sequencing typing.

  11. Burden and impact of acute gastroenteritis and foodborne pathogens in Trinidad and Tobago.

    PubMed

    Lakhan, Carelene; Badrie, Neela; Ramsubhag, Adash; Sundaraneedi, Kumar; Indar, Lisa

    2013-12-01

    Objectives of this study were to determine the burden and impact of acute gastroenteritis (AGE) and foodborne pathogens in Trinidad and Tobago. A retrospective, cross-sectional population survey, based on self-reported cases of AGE, was conducted in November-December 2008 and May-June 2009 (high- and low-AGE season respectively) by face-to-face interviews. From 2,145 households selected to be interviewed, the response rate was 99.9%. Of those interviewed, 5.1% (n = 110; 95% CI 4.3-6.2) reported having AGE (3 or more loose watery stools in 24 hours) in the 28 days prior to the interview (0.67 episodes/person-year). Monthly prevalence of AGE was the highest among children aged < 5 years (1.3 episodes/year). Eighteen (16%) persons with AGE sought medical care (4 treated with oral rehydration salts and 6 with antibiotics), and 66% reported restricted activity [range 1-16 day(s)]. The mean duration of diarrhoea was 2.3 days (range 2-10 days). One case submitted a stool sample, and another was hospitalized. Overall, 56 (10%) AGE specimens tested positive for foodbome pathogens. It was estimated that 135,820 AGE cases occurred in 2009 (84% underreporting), and for every 1 AGE case reported, an additional 6.17 cases occurred in the community. The estimated economic cost of AGE ranged from US$ 27,331 to 19,736,344. Acute gastroenteritis, thus, poses a huge health and economic burden on Trinidad and Tobago.

  12. Gastroenteritis exhumed.

    PubMed

    Shah, Mian Mujahid; Jan, Adil; Munawwar, Anjum Zia; Arif, Muhammad; Ahmed, Riaz

    2008-01-01

    Nature of presenting symptoms and even signs of disease can lead to a diagnosis that seems routine but is in fact erroneous because a sufficient index of suspicion is not generated in the mind of the physician dealing with the case. A young girl of about 16 years was brought to the Casualty Department, DHQ Hospital Bannu on 12 Sep 2004 with complains of severe vomiting and diarrhoea; the casualty medical officer diagnosed her as a case of acute gastroenteritis.

  13. Clinical characteristics and genetic diversity of noroviruses in adults with acute gastroenteritis in Beijing, China in 2008-2009.

    PubMed

    Tian, Geng; Jin, Miao; Li, Huiying; Li, Quanrui; Wang, Jing; Duan, Zhao-jun

    2014-07-01

    Norovirus (NoV) infections that cause acute gastroenteritis are commonly observed during colder months. This study was conducted to investigate the clinical features and molecular epidemiology of NoVs in adult outpatients with acute gastroenteritis in Beijing, China from August 2008 to July 2009. Five hundred nineteen patients were enrolled, their stool specimens were collected, and 136 (26.2%) were positive for NoV. The elderly were found to be more susceptible to NoVs than other age groups. The greatest number of gastroenteritis cases associated with occurred in October. Six GI and eleven GII NoV genotypes were isolated; among these, the GII.4 genotype was most prevalent (70/140 and 50% were the 2006b variant). The elderly were more susceptible to the GII.4 genotype than to other genotypes. Greater numbers of neutrophils in the peripheral blood were observed in the NoV infected group than in uninfected control group. However, the levels of neutrophils and leukocytes in the non-GII.4 patients infected with NoV were higher than those of the GII.4-infected patients. The data highlight the role of NoV as a primary agent responsible for gastroenteritis in adults in Beijing, China.

  14. Permeability of the small intestine to (/sup 51/Cr)EDTA in children with acute gastroenteritis or eczema

    SciTech Connect

    Forget, P.; Sodoyez-Goffaux, F.; Zappitelli, A.

    1985-06-01

    Increased gut permeability to macromolecules is thought to be an important factor in the development of food hypersensitivity. The latter can develop in the course of acute gastroenteritis and could play a role in infantile eczema. The authors studied gut permeability in 10 normal adults, 11 control children, 7 children with acute gastroenteritis, and 8 patients with infantile eczema, making use of (/sup 51/Cr)EDTA as probe molecule. (/sup 51/Cr)EDTA was given orally (50-100 microCi); 24-h urinary excretion of (/sup 51/Cr)EDTA was measured and expressed as a percentage of the oral dose. Mean and standard error were 2.35 +/- 0.24, 2.51 +/- 0.21, 9.96 +/- 3.44, and 10.90 +/- 2.05 in normal adults, control children, and gastroenteritis and eczema patients, respectively. Differences between controls and either gastroenteritis (p less than 0.001) or eczema (p less than 0.001) patients are significant. The results support the hypothesis that increased gut permeability could play a role in food hypersensitivity.

  15. Detection of rotavirus and other enteropathogens in children hospitalized with acute gastroenteritis in Havana, Cuba.

    PubMed

    Ribas, María de Los Angeles; Tejero, Yahisel; Cordero, Yanislet; de Los Angeles León, María; Rodriguez, Misladys; Perez-Lastre, Jorge; Triana, Thelma; Guerra, Mabel; Ayllón, Lucía; Escalante, Gladys; Hadad, Jorge

    2015-08-01

    The aim of the study was to diagnose infections with rotavirus and other enteric pathogens in children under five years old with acute gastroenteritis and to identify the most common epidemiological and clinical characteristics of these pathogens. The study was conducted using 110 stool samples from the same number of children under five years old who were inpatients at three paediatric hospitals in Havana, Cuba, between October and December 2011. The samples were tested for rotavirus and other enteric pathogens using traditional and molecular microbiological methods. Pathogens were detected in 85 (77.3 %) of the children. Rotavirus was the most commonly found, appearing in 54.5 % of the children, followed by bacteria (29 %) and parasites (10.9 %). Other viral pathogens detected included adenovirus (6.4 %) and astrovirus (3.6 %). In rotavirus-positives cases, at least one other pathogen was detected, usually a bacterium (26.6 %). More than three episodes of watery diarrhea in 24 hours were observed in 78.3 % of the cases. Dehydration was found in 30 (50 %) rotavirus-positive children, of whom seven (11.6 %) were transferred to an intensive care unit due to complications of metabolic acidosis. Rotavirus was most commonly observed among children under 12 months old (65 %). The highest incidence of infection occurred in children who were under the care of a relative at home (78.3 %), had not been breastfed (65 %), or had been breastfed for less than six months (28.3 %). The genotype combinations most frequently found were G9P8 (28.3 %) and G1P8 (10 %). This study demonstrates the presence of rotavirus and other enteric pathogens as causes of gastroenteritis in hospitalized infants and young children in Cuba.

  16. Prevalence and genetic diversity of noroviruses in adults with acute gastroenteritis in Huzhou, China, 2013-2014.

    PubMed

    Wu, Xiaofang; Han, Jiankang; Chen, Liping; Xu, Deshun; Shen, Yuehua; Zha, Yunfeng; Zhu, Xiaojuan; Ji, Lei

    2015-07-01

    Norovirus (NoV) infection is the most common cause of nonbacterial acute gastroenteritis, which affects both adults and children. However, the molecular epidemiology of NoV in adults with acute gastroenteritis in China has not been investigated extensively. In this study, we investigated the occurrence of NoV infections and analyzed the genetic diversity of NoV in adults with acute gastroenteritis in Huzhou, China. A total of 796 fecal samples were collected from outpatients (≥16 years of age) between March 2013 and February 2014. Real-time RT-PCR was performed to detect NoV genogroups I (GI) and II (GII). For genotyping, the capsid and RNA-dependent RNA polymerase (RdRp) genes were partially amplified and sequenced for phylogenetic analysis. NoVs were detected in 26.51% (211/796) of the specimens, with GII being predominant, representing 96.20% of the NoV infections. At least nine genotypes were identified among GI and GII specimens, including GI.P2/GI.2, GI.P3/GI.3, GI.P4/GI.4, GII.Pe/GII.4 Sydney_2012, GII.P12/GII.3, GII.P7/GII.6, GII.P16/GII.13, GII.Pe, and GII.Pg (RdRp only). This is the first report of a GII.P16/GII.13 recombinant virus in adults in China. GII.Pe/GII.4 Sydney_2012 was the most prevalent genotype and the only GII.4 variant identified during the study period. Our findings suggested that NoV was a common causative agent of acute gastroenteritis in adults in Huzhou, China. During the study period, the NoVs circulating in adults in Huzhou were predominantly GII.4 Sydney_2012 variants and GII NoV recombinants.

  17. What is new on the term probiotics and the role of probiotics for the management of acute gastroenteritis.

    PubMed

    Szajewska, H

    2015-01-01

    There is an increasing interest in probiotics, and evidence of the effectiveness of probiotics in preventing or treating diarrhoeal diseases is also advancing. The purpose of this short opinion paper is to summarise two aspects of current development in regard to probiotics. First, it discusses what is new with regard to some key questions related to the term 'probiotic'. Second, recent, evidence-based, clinical practice guidelines on the use of probiotics for the management of acute gastroenteritis in children are presented.

  18. Prevalence of adenovirus and rotavirus infection in immunocompromised patients with acute gastroenteritis in Portugal

    PubMed Central

    Ribeiro, Joana; Ferreira, Delfim; Arrabalde, Célia; Almeida, Sandra; Baldaque, Inês; Sousa, Hugo

    2015-01-01

    AIM: To characterize the prevalence of rotavirus (RV) and adenovirus (AdV) infections in immunocompromised patients with acute gastroenteritis. METHODS: The presence of RV and AdV (serotypes 40 and 41) was evaluated in 509 stool samples obtained between January 2009 and December 2010 from 200 immunocompromised patients (83 females and 117 males; median age 21 years old, range 0-72. The diagnosis of infection was performed as a routine procedure and the presence of RV and AdV (serotypes 40 and 41) was determined by immunochromatography using the RIDA® Quick Rota-Adeno-Kombi kit (r-Biopharm, Darmstadt, Germany). The data analysis and description of seasonal frequencies were performed using computer software IBM® SPSS® (Statistical Package for Social Sciences) Statistics version 20.0 for Mac. The frequencies of infection were compared into different age and gender groups by χ2 test. RESULTS: The study revealed 12.4% AdV positive samples and 0.8% RV positive samples, which correspond to a prevalence of 6.5% and 1.5%, respectively. AdV was more frequent between October 2009 and April 2010, while RV was identified in April 2010 and July 2010. The stool analysis revealed that from the 509 samples, 63 (12.4%) were positive for AdV and 4 (0.8%) positive for RV, which by resuming the information of each patient, lead to an overall prevalence of AdV and RV of 6.5% (13/200 patients) and 1.5% (3/200 patients), respectively. The stratification of the analysis regarding age groups showed a tendency to an increased prevalence of infection in paediatric patients between 0-10 years old. Considering the seasonal distribution of these infections, our study revealed that AdV infection was more frequent between October 2009 and April 2010, while RV infection was characterized by two distinct peaks (April 2010 and July 2010). CONCLUSION: The overall prevalence of AdV and RV infection in immunocompromised patients with acute gastroenteritis was 8% and AdV was the most prevalent agent

  19. Prospective evaluation of indirect costs due to acute rotavirus gastroenteritis in Spain: the ROTACOST study

    PubMed Central

    2011-01-01

    Background The effect of rotavirus in developed countries is mainly economic. This study aimed to assess the indirect costs induced by rotavirus acute gastroenteritis (RVAGE) in Spain. Methods A prospective observational study was conducted from October 2008 to June 2009. It included 682 children up to 5 years of age with acute gastroenteritis (AGE) who attended primary care (n = 18) and emergency room/hospital settings (n = 10), covering the regions of Galicia and Asturias (North-west Spain). All non-medical expenses incurred throughout the episode were recorded in detail using personal interviews and telephone contact. Results Among the 682 enrolled children, 207 (30.4%) were rotavirus positive and 170 (25%) had received at least one dose of rotavirus vaccine. The mean (standard deviation) indirect cost caused by an episode of AGE was estimated at 135.17 (182.70) Euros. Costs were 1.74-fold higher when AGE was caused by rotavirus compared with other etiologies: 192.7 (219.8) Euros vs. 111.6 (163.5) Euros (p < .001). The costs for absenteeism were the most substantial with a mean of 91.41 (134.76) Euros per family, resulting in a loss of 2.45 (3.17) days of work. In RVAGE patients, the absenteeism cost was 120.4 (154) Euros compared with 75.8 (123) for the other etiologies (p = .002), because of loss of 3.5 (3.6) vs 1.9 (2.9) days of work (p < .001). Meals costs were 2-fold-higher (48.5 (55) vs 24.3 (46) Euros, p < .001) and travel costs were 2.6-fold-higher (32 (92) vs 12.5 (21.1) Euros, p = .005) in RVAGE patients compared with those with other etiologies. There were no differences between RVAGE and other etiologies groups regarding costs of hiring of caregivers or purchase of material. Patients with RVAGE were admitted to hospital more frequently than those with other etiologies (47.8% vs 14%, p < .001). Conclusions Rotavirus generates a significant indirect economic burden. Our data should be considered in the decision-making process of the eventual inclusion

  20. No increase in drug dispensing for acute gastroenteritis after Storm Klaus, France 2009.

    PubMed

    Pirard, P; Goria, S; Nguengang Wakap, S; Galey, C; Motreff, Y; Guillet, A; Le Tertre, A; Corso, M; Beaudeau, P

    2015-09-01

    During the night of 23-24 January 2009, Storm Klaus hit south-western France and caused power outages affecting 1,700,000 homes and stopping numerous pumping and drinking water disinfection systems. In France, medicalized acute gastroenteritis (MAGE) outbreaks are monitored by analysing the daily amount of reimbursements of medical prescriptions, registered in the French National Health Insurance database, at the 'commune' administrative level. As AGE is suspected to be associated with perturbations to water supply systems as well as power outages, Storm Klaus provided an opportunity to test its influence on the incidence of MAGE in the communes of three affected French departments (administrative areas larger than communes). The geographical exposure indicator was built by using the mapping of the water distribution zones, the reported distribution/production stoppages and their duration. Irrespective of exposure class, a relative risk of MAGE of 0.86 (95% confidence 0.84-0.88) was estimated compared with the 'unexposed' reference level. Although these results must be considered with caution because of a potential marked decrease in global medical consultation probably due to impassable roads, they do not suggest a major public health impact of Klaus in terms of increased MAGE incidence. PMID:26322759

  1. No increase in drug dispensing for acute gastroenteritis after Storm Klaus, France 2009.

    PubMed

    Pirard, P; Goria, S; Nguengang Wakap, S; Galey, C; Motreff, Y; Guillet, A; Le Tertre, A; Corso, M; Beaudeau, P

    2015-09-01

    During the night of 23-24 January 2009, Storm Klaus hit south-western France and caused power outages affecting 1,700,000 homes and stopping numerous pumping and drinking water disinfection systems. In France, medicalized acute gastroenteritis (MAGE) outbreaks are monitored by analysing the daily amount of reimbursements of medical prescriptions, registered in the French National Health Insurance database, at the 'commune' administrative level. As AGE is suspected to be associated with perturbations to water supply systems as well as power outages, Storm Klaus provided an opportunity to test its influence on the incidence of MAGE in the communes of three affected French departments (administrative areas larger than communes). The geographical exposure indicator was built by using the mapping of the water distribution zones, the reported distribution/production stoppages and their duration. Irrespective of exposure class, a relative risk of MAGE of 0.86 (95% confidence 0.84-0.88) was estimated compared with the 'unexposed' reference level. Although these results must be considered with caution because of a potential marked decrease in global medical consultation probably due to impassable roads, they do not suggest a major public health impact of Klaus in terms of increased MAGE incidence.

  2. Detection of Rotavirus in children with acute gastroenteritis in Zagazig University Hospitals in Egypt

    PubMed Central

    Ibrahim, Salwa Badrelsabbah; El-Bialy, Abdallah Abdelkader; Mohammed, Mervat Soliman; El-Sheikh, Azza Omar; Elhewala, Ahmed; Bahgat, Shereen

    2015-01-01

    Introduction: Rotavirus is the major cause of acute gastroenteritis (AGE) in infants and young children all over the world. The objective of the study was to compare different methods for detecting rotavirus and to assess the burden of rotavirus as a causative agent for AGE in children younger than five. Methods: This case control study included 65 children with AGE and 35 healthy control children. They were chosen from the Pediatric Department of Zagazig University Hospitals from October 2014 to March 2015. Stool samples were obtained and assayed for rotavirus by the immunochromatography test (ICT), enzyme linked immunosorbent assay (ELISA) and quantitative real time RT-PCR (qr RT-PCR). Results: Fifty out of the 65 patients (76.9%) were positive for qr RT-PCR. Forty-five (69.2%) and 44 (67.7%) were positive for ICT and ELISA, respectively. There was a significant association between the severity of the disease as determined by the Vesikari score and rotavirus infection. Conclusion: This study demonstrated that ICT is a useful method for the rapid screening of group A rotavirus in fecal specimens, because it is rapid, inexpensive, easy to perform, and requires very little equipment. In addition, this study highlights the substantial health burden of rotavirus AGE among children less than five. PMID:26435821

  3. Outbreaks of acute gastroenteritis associated with Norwalk-like viruses in campus settings.

    PubMed

    Moe, C L; Christmas, W A; Echols, L J; Miller, S E

    2001-09-01

    Norwalk-like viruses (NLVs) are transmitted by fecally contaminated food, water, fomites, and person-to-person contact. They are a leading cause of acute gastroenteritis epidemics in industrialized countries. NLV outbreaks are characterized by a 12- to 48-hour incubation period; nausea, vomiting, and diarrhea for 24 to 72 hours; and high secondary attack rates. NLV infections spread rapidly on college and university campuses because of close living quarters, shared bathrooms and common rooms, many food handlers, popular self-service salad bars in dining halls, and person-to-person contact through sports and recreational activities. The illness is generally mild and self-limited but an outbreak can strain the resources of campus health services and cause high absenteeism among both students and staff. Treatment is primarily through antiemetic medication and oral rehydration. Prevention and control of NLV outbreaks rests on promoting hand washing; enforcement of strict hygiene in all food preparation areas; and prompt, rigorous cleaning of potentially contaminated areas where someone has been ill.

  4. The impact of childhood acute rotavirus gastroenteritis on the parents’ quality of life: prospective observational study in European primary care medical practices

    PubMed Central

    2012-01-01

    Background Rotavirus (RV) is the commonest cause of acute gastroenteritis in infants and young children worldwide. A Quality of Life study was conducted in primary care in three European countries as part of a larger epidemiological study (SPRIK) to investigate the impact of paediatric rotavirus gastroenteritis (RVGE) on affected children and their parents. Methods A self-administered questionnaire was linguistically validated in Spanish, Italian and Polish. The questionnaire was included in an observational multicentre prospective study of 302 children aged <5 years presenting to a general practitioner or paediatrician for RVGE at centres in Spain, Italy or Poland. RV infection was confirmed by polymerase chain reaction (PCR) testing (n = 264). The questionnaire was validated and used to assess the emotional impact of paediatric RVGE on the parents. Results Questionnaire responses showed that acute RVGE in a child adversely affects the parents’ daily life as well as the child. Parents of children with RVGE experience worry, distress and impact on their daily activities. RVGE of greater clinical severity (assessed by the Vesikari scale) was associated with higher parental worries due to symptoms and greater changes in the child’s behaviour, and a trend to higher impact on parents’ daily activities and higher parental distress, together with a higher score on the symptom severity scale of the questionnaire. Conclusions Parents of a child with acute RVGE presenting to primary care experience worry, distress and disruptions to daily life as a result of the child’s illness. Prevention of this disease through prophylactic vaccination will improve the daily lives of parents and children. PMID:22650611

  5. Distribution, burden, and impact of acute gastroenteritis in Dominica, 2009-2010.

    PubMed

    Ahmed, Shalauddin; Ricketts, Paul; Bergeron, Marc; Jones, Walter; Indar, Lisa

    2013-12-01

    Acute gastroenteritis (AGE) is an important public-health issue in Dominica. To determine the burden of AGE in Dominica, a retrospective, cross-sectional population survey was conducted in March-April 2009 and October 2010 (low- and-high-AGE seasons) and a laboratory survey from April 2009 to March 2010. The overall monthly prevalence of self-reported AGE was 8.6 % (95% CI 7.0-10.6); the incidence rate was 1.1 episodes/person-year and 79,157.1 episodes of AGE for the total population/year. Monthly prevalence of AGE was the highest in the 1-4 year(s) age-group (25.0%), higher in females (10.8%) and also varied by health district, with the highest monthly prevalence of AGE being reported in the Portsmouth district (13.1%). This difference in gender and across the health region was statistically significant. The estimated underreporting of syndromic AGE to the Ministry of Health was 83.3%. Furthermore, for every reported laboratory-confirmed case of AGE and foodbome disease (FBD), there was an estimated underreporting factor of 280. Overall, 47% of AGE specimens tested were positive for FBD pathogens. The predominant pathogens isolated were norovirus, followed by Giardia, Salmonella, and Shigella. The total annual estimated cost of AGE was US$ 1,371,852.92, and the total cost per capita due to AGE was US$ 19.06, indicating an economic burden of AGE-related illness on a small island of Dominica.

  6. Societal Burden and Correlates of Acute Gastroenteritis in Families with Preschool Children

    PubMed Central

    Mughini-Gras, Lapo; Pijnacker, Roan; Heusinkveld, Moniek; Enserink, Remko; Zuidema, Rody; Duizer, Erwin; Kortbeek, Titia; van Pelt, Wilfrid

    2016-01-01

    Gastrointestinal infection morbidity remains high amongst preschool children in developed countries. We investigated the societal burden (incidence, healthcare utilization, and productivity loss) and correlates of acute gastroenteritis (AGE) in families with preschoolers. Monthly for 25 months, 2000 families reported AGE symptoms and related care, productivity loss, and risk exposures for one preschooler and one parent. Amongst 8768 child-parent pairs enrolled, 7.3% parents and 17.4% children experienced AGE (0.95 episodes/parent-year and 2.25 episodes/child-year). Healthcare utilization was 18.3% (children) and 8.6% (parents), with 1.6% children hospitalized. Work absenteeism was 55.6% (median 1.5 days) and day-care absenteeism was 26.2% (median 1 day). Besides chronic enteropathies, antacid use, non-breastfeeding, and toddling age, risk factors for childhood AGE were having developmental disabilities, parental occupation in healthcare, multiple siblings, single-parent families, and ≤12-month day-care attendance. Risk factors for parental AGE were female gender, having multiple or developmentally-disabled day-care-attending children, antimicrobial use, and poor food-handling practices. Parents of AGE-affected children had a concurrent 4-fold increased AGE risk. We concluded that AGE-causing agents spread widely in families with preschool children, causing high healthcare-seeking behaviours and productivity losses. Modifiable risk factors provide targets for AGE-reducing initiatives. Children may acquire some immunity to AGE after one year of day-care attendance. PMID:26917406

  7. A microbiological investigation of acute summer gastroenteritis in Black South African infants

    PubMed Central

    Schoub, Barry D.; Greeff, A. S.; Lecatsas, G.; Prozesky, O. W.; Hay, I. T.; Prinsloo, J. G.; Ballard, R. C.

    1977-01-01

    A microbiological investigation of Black infants suffering from severe acute summer gastroenteritis revealed enteropathogenic agents in 30 out of 37 patients (81%). Enterotoxigenic bacteria were isolated from 15 patients (41%). A total of 16 enterotoxigenic strains were isolated, comprising 9 enterotoxigenic Escherichia coli strains secreting labile and stable toxin on their own and in combination, and labile-toxin secreting strains of Klebsiella pneumoniae (4), Enterobacter cloacae (2) and Proteus vulgaris (1). In the case of the latter three species, however, 6 out of the 7 strains were isolated from patients who were excreting other enteric pathogens, whereas only 2 out of 9 enterotoxigenic E. coli patients had concomitant infections with other pathogens. No invasive bacteria were isolated except for 2 shigella strains. Salmonella and shigella strains were found in four patients. No correlation was found between the enteropathogenicity of E. coli and its serotype. Rotavirus was observed by negative staining electron microscopy in only two patients (6%) but using a reverse complement fixation test rotavirus antigen was detected in the stool of 17 out of 35 patients (49%). The low EM detection rate may well be due to the patients being admitted for treatment late in the course of their illness when the degree of viral shedding has decreased below EM detectability. No significant difference in clinical presentation was noted between the various aetiological agents. Only one patient was being solely breast-fed compared to 16% of control non-diarrhoeic infants. Evidence of malnutrition was noted in over half of our patients. PMID:325127

  8. Emergence of Norovirus GII.17 Variants among Children with Acute Gastroenteritis in South Korea

    PubMed Central

    Dang Thanh, Hien; Than, Van Thai; Nguyen, Tinh Huu; Lim, Inseok; Kim, Wonyong

    2016-01-01

    Of 1,050 fecal specimens collected from January 2013 to August 2015 from children with acute gastroenteritis, 149 (14.2%) were found to be positive for norovirus. Norovirus GII was the most predominant genogroup (98.65%; 147 of 149). The genotypes detected in this study were GI (2; 1.3%), GII.Pe-GII.4 (109; 73.1%), GII.P17-GII.17 (16; 10.7%), GII.P12-GII.3 (8; 5.4%), GII.P12-GII.12 (8; 5.4%), GII.P4-GII.4 (5; 3.4%), and the recombinant GII.Pe-GII.17 (1; 0.7%). Of these, the novel GII.17 strain was the second most predominant, and the number of affected children appeared to continuously increase over time (2013 [2; 4.4%], 2014 [4; 9.3%], and 2015 [10; 16.4%]). Phylogenetic analysis of the full genome and ORF1, ORF2, and ORF3 nucleotide sequences showed that GII.17 was grouped in cluster III with other strains isolated from 2013 to 2015 and had a different evolutionary history from strains collected in 1978 to 2002 and 2005 to 2009 formed clusters I and II. However, the phylogenetic trees also showed that cluster III was divided into subclusters IIIa (CAU-55 and CAU-85) and IIIb (Kawasaki 2014) (CAU-193, CAU-265, CAU-267, CAU-283, and CAU-289). Comparative analysis of the VP1 capsid protein using 15 complete amino acid sequences from noroviruses isolated from 1978 to 2015 showed 99 amino acid changes. These results could be helpful for epidemiological studies to understand circulating norovirus genotypes in population. PMID:27148739

  9. Acute Gastroenteritis and Campylobacteriosis in Swiss Primary Care: The Viewpoint of General Practitioners.

    PubMed

    Bless, Philipp J; Muela Ribera, Joan; Schmutz, Claudia; Zeller, Andreas; Mäusezahl, Daniel

    2016-01-01

    Acute gastroenteritis (AG) is frequently caused by infectious intestinal diseases (IID) including food- and waterborne pathogens of public health importance. Among these pathogens, Campylobacter spp. plays a major role. Many European countries monitor selected IIDs within disease surveillance systems. In Switzerland, the information on IIDs is restricted to limited surveillance data, while no data is available for AG. We conducted a qualitative study among Swiss general practitioners (GPs) to investigate the case management of AG and campylobacteriosis patients, the associated disease burden and the determinants leading to registration in the National Notification System for Infectious Diseases (NNSID). Interviews were conducted with a semi-structured questionnaire and underwent inductive content analysis based on Grounded Theory. The questionnaire was repeatedly adapted to capture emerging themes until the point of theoretical saturation. GPs perceived AG and campylobacteriosis of little relevance to their daily work and public health in general. According to GP self-estimates each consults about two cases of AG per week and diagnoses a median of five campylobacteriosis cases per year. A large proportion of AG cases receives telephone consultations only and gets medical advice from the practice nurse. Antibiotic therapy is considered useful and stool diagnostics are performed for about a fifth of consulting AG patients. Stool diagnostics ("test") and antibiotic therapy ("treat") are interrelated and follow four strategies: "Wait & See", "Treat & See", "Treat & Test", and "Test & See". AG case management is diverse and includes different triage steps. A small proportion of AG patients have stool diagnostics performed and only positive tested patients are reported to the NNSID. As a result severe cases and cases with a history of travel abroad are overrepresented in the NNSID. The use of multiplex PCR panels in routine diagnostics likely leads to improved case

  10. Acute Gastroenteritis and Campylobacteriosis in Swiss Primary Care: The Viewpoint of General Practitioners

    PubMed Central

    Bless, Philipp J.; Muela Ribera, Joan; Schmutz, Claudia; Zeller, Andreas; Mäusezahl, Daniel

    2016-01-01

    Acute gastroenteritis (AG) is frequently caused by infectious intestinal diseases (IID) including food- and waterborne pathogens of public health importance. Among these pathogens, Campylobacter spp. plays a major role. Many European countries monitor selected IIDs within disease surveillance systems. In Switzerland, the information on IIDs is restricted to limited surveillance data, while no data is available for AG. We conducted a qualitative study among Swiss general practitioners (GPs) to investigate the case management of AG and campylobacteriosis patients, the associated disease burden and the determinants leading to registration in the National Notification System for Infectious Diseases (NNSID). Interviews were conducted with a semi-structured questionnaire and underwent inductive content analysis based on Grounded Theory. The questionnaire was repeatedly adapted to capture emerging themes until the point of theoretical saturation. GPs perceived AG and campylobacteriosis of little relevance to their daily work and public health in general. According to GP self-estimates each consults about two cases of AG per week and diagnoses a median of five campylobacteriosis cases per year. A large proportion of AG cases receives telephone consultations only and gets medical advice from the practice nurse. Antibiotic therapy is considered useful and stool diagnostics are performed for about a fifth of consulting AG patients. Stool diagnostics (“test”) and antibiotic therapy (“treat”) are interrelated and follow four strategies: “Wait & See”, “Treat & See”, “Treat & Test”, and “Test & See”. AG case management is diverse and includes different triage steps. A small proportion of AG patients have stool diagnostics performed and only positive tested patients are reported to the NNSID. As a result severe cases and cases with a history of travel abroad are overrepresented in the NNSID. The use of multiplex PCR panels in routine diagnostics likely

  11. Societal Burden and Correlates of Acute Gastroenteritis in Families with Preschool Children.

    PubMed

    Mughini-Gras, Lapo; Pijnacker, Roan; Heusinkveld, Moniek; Enserink, Remko; Zuidema, Rody; Duizer, Erwin; Kortbeek, Titia; van Pelt, Wilfrid

    2016-01-01

    Gastrointestinal infection morbidity remains high amongst preschool children in developed countries. We investigated the societal burden (incidence, healthcare utilization, and productivity loss) and correlates of acute gastroenteritis (AGE) in families with preschoolers. Monthly for 25 months, 2000 families reported AGE symptoms and related care, productivity loss, and risk exposures for one preschooler and one parent. Amongst 8768 child-parent pairs enrolled, 7.3% parents and 17.4% children experienced AGE (0.95 episodes/parent-year and 2.25 episodes/child-year). Healthcare utilization was 18.3% (children) and 8.6% (parents), with 1.6% children hospitalized. Work absenteeism was 55.6% (median 1.5 days) and day-care absenteeism was 26.2% (median 1 day). Besides chronic enteropathies, antacid use, non-breastfeeding, and toddling age, risk factors for childhood AGE were having developmental disabilities, parental occupation in healthcare, multiple siblings, single-parent families, and ≤ 12-month day-care attendance. Risk factors for parental AGE were female gender, having multiple or developmentally-disabled day-care-attending children, antimicrobial use, and poor food-handling practices. Parents of AGE-affected children had a concurrent 4-fold increased AGE risk. We concluded that AGE-causing agents spread widely in families with preschool children, causing high healthcare-seeking behaviours and productivity losses. Modifiable risk factors provide targets for AGE-reducing initiatives. Children may acquire some immunity to AGE after one year of day-care attendance. PMID:26917406

  12. The impact of acute gastroenteritis on haematological markers used for the athletes biological passport - report of 5 cases.

    PubMed

    Schumacher, Y O; Pottgiesser, T

    2011-02-01

    The haematological module of the "Athletes Biological Passport" (ABP) is used to detect blood doping through the longitudinal variation of blood variables, such as haemoglobin concentration (Hb). Sporting federations have opened disciplinary procedures against athletes based on ABP results. Suspicious athletes try to explain the variations in their blood values with dehydration caused by gastrointestinal (GI) problems. The aim of the present report is to describe haemoglobin concentration, a key variable of the ABP, during acute gastroenteritis in athletes. 5 athletes with severe gastroenteritis were studied in retrospective. Blood test results (Hb, white blood cell count (WBC) and differential, CRP) obtained on hospital admission for GI problems were compared to data obtained from the same athletes in states of good health on previous occasions. During GI problems, athletes displayed marked inflammatory constellations with increased CRP and typical WBC shifts. Hb was not affected and remained mostly unchanged. This is in line with basic physiologic fluid regulation, where plasma volume is kept constant, even under conditions of severe dehydration. It is therefore unlikely that fluid loss associated with gastroenteritis will cause athletes blood data to reach levels of abnormality that will be suspicious of blood doping.

  13. Impact of vaccination uptake on hospitalizations due to rotavirus acute gastroenteritis in 2 different socioeconomic areas of Spain.

    PubMed

    Giménez Sánchez, Francisco; Nogueira, Esperanza Jiménez; Sánchez Forte, Miguel; Ibáñez Alcalde, Mercedes; Cobo, Elvira; Angulo, Raquel; Garrido Fernández, Pablo

    2016-04-01

    Rotavirus is the leading cause of hospitalization due to acute gastroenteritis (AGE) in infants and toddlers. However, rotavirus vaccination has been associated with a decline in hospitalization rates due to rotavirus AGE. A descriptive retrospective study was conducted to analyze the impact of rotavirus vaccination on the rate of hospitalizations due to AGE among children ≤2 years old in 2 areas of the province of Almería, Spain. After eight years of rotavirus vaccination, rates of hospitalizations due to rotavirus AGE are diminished. This decline is closely related to vaccine coverage in the studied areas.

  14. Incidence of Norwalk-like viruses, rotavirus and adenovirus infection in patients with acute gastroenteritis in Jakarta, Indonesia.

    PubMed

    Subekti, D; Lesmana, M; Tjaniadi, P; Safari, N; Frazier, E; Simanjuntak, C; Komalarini, S; Taslim, J; Campbell, J R; Oyofo, B A

    2002-03-25

    Norwalk-like viruses (NLVs), rotavirus and adenovirus are reportedly responsible from 4 to 42% of non-bacterial acute sporadic gastroenteritis. The incidence of NLVs, adenovirus and rotavirus infections in Indonesia is unclear. A total of 402 symptomatic cases from Indonesian patients with acute gastroenteritis and 102 asymptomatic controls that tested negative for bacteria and parasites were screened for the presence of NLVs, rotavirus and adenovirus using the reverse transcriptase-polymerase chain reaction (RT-PCR), Rotaclone kits and Adenoclone kits. Specific prototype probes were used to ascertain which NLV prototypes were present in the area. NLVs were detected in 45/218 (21%), rotavirus was detected in 170/402 (42%) and adenovirus was detected in 11/273 (4%) samples examined. Genetic analysis of the RT-PCR products using specific prototype probes for NLVs indicated that the prototypes were 42% Taunton agent and 58% Hawaii/Snow Mountain agent. Comparative data on patients showed that the incidence of rotavirus infections was two times greater than the NLVs infections, and that adenovirus infections were the least prevalent. All of the control samples tested were negative for NLVs and adenoviruses, however 8/70 (11%) of the samples were positive for rotaviruses. The high incidence of enteric viral-related infections is a threat among acute diarrheic patients in Jakarta, Indonesia. PMID:11985965

  15. Norovirus gastroenteritis.

    PubMed

    Goodgame, Richard

    2006-10-01

    Recent epidemiologic studies have shown that norovirus is one of the most frequent causes of acute nonbacterial gastroenteritis. Reverse-transcription polymerase chain reaction and nucleotide sequencing are the means by which the hundreds of norovirus strains have been identified, named, and classified into genogroups and genetic clusters. They are also the means by which a particular strain is traced from the source of an outbreak throughout its spread. These molecular techniques have been combined with classic epidemiology to investigate norovirus outbreaks in diverse settings, including hospitals, nursing homes, dining locations, schools, daycare centers, and vacation venues. Outbreaks are difficult to control because of the apparent ease of transmission through food, water, person-to-person contact, and environmental surfaces. Almost all patients with norovirus gastroenteritis recover completely, but hospital and nursing home outbreaks have been associated with morbidity and mortality. The diagnostic and management approach to an individual patient is to use clinical and epidemiologic findings to rule out "not norovirus." At the first sign that there is an outbreak, strict compliance with cleaning, disinfection, and work release guidelines is important to prevent further spread.

  16. Acute Gastroenteritis and Recreational Water: Highest Burden Among Young US Children

    EPA Science Inventory

    OBJECT I VES : To provide summary estimates of gastroenteritis risks and illness burden associated with recreational water exposure and determine whether children have higher risks and burden.METHODS: We combined individual participant data from 13 prospective cohorts at marine a...

  17. Canine-origin G3P[3] rotavirus strain in child with acute gastroenteritis.

    PubMed

    De Grazia, Simona; Martella, Vito; Giammanco, Giovanni M; Gòmara, Miren Iturriza; Ramirez, Stefania; Cascio, Antonio; Colomba, Claudia; Arista, Serenella

    2007-07-01

    Infection by an animal-like strain of rotavirus (PA260/97) was diagnosed in a child with gastroenteritis in Palermo, Italy, in 1997. Sequence analysis of VP7, VP4, VP6, and NSP4 genes showed resemblance to a G3P[3] canine strain identified in Italy in 1996. Dogs are a potential source of human viral pathogens. PMID:18214189

  18. Molecular characterization of norovirus GII.17 detected in healthy adult, intussusception patient, and acute gastroenteritis children in Thailand.

    PubMed

    Khamrin, Pattara; Kumthip, Kattareeya; Yodmeeklin, Arpaporn; Supadej, Kanittapon; Ukarapol, Nuthapong; Thongprachum, Aksara; Okitsu, Shoko; Hayakawa, Satoshi; Ushijima, Hiroshi; Maneekarn, Niwat

    2016-10-01

    Noroviruses (NoVs) have been recognized as a leading cause of sporadic cases and outbreaks of acute gastroenteritis in all age groups. During the surveillance of NoVs in Chiang Mai, Thailand, four cases of the novel GII.17 NoVs were sporadically detected by RT-PCR in 2014-2015. The first case of GII.17 was detected in a healthy adult who worked for a restaurant. The second case was found in a pediatric patient who admitted to the hospital with intussusception. The third and fourth cases were found in acute gastroenteritis children. Phylogenetic analysis clearly demonstrated that GII.17 NoVs detected in this study were genetically closely related with the novel GII.17 Kawasaki reference strains. These four GII.17 NoV positive specimens were also tested by two immunochromatographic test kits in order to evaluate the sensitivity for GII.17 NoV detection. The viral loads in those specimens were determined by real-time RT-PCR. The sensitivity of GII.17 NoV detection varies by individual test kits and also depending on the amount of the viruses contained in the fecal specimens. In summary, our study reported the detection of novel GII.17 NoVs in a wide range of subjects with and without diarrhea. Therefore, continued comprehensive screening and genetic molecular characterization of NoV strains circulating in this area need to be further investigated. PMID:27469026

  19. A Study on the Epidemiology and Aetiology of Acute Gastroenteritis in Adult Patients Presenting at the Infectious Diseases Hospital in Tirana, Albania

    PubMed Central

    Stroni, Gentian P.; Dhimolea, Majlinda M.; Pipero, Pëllumb S.; Kraja, Dhimiter V.; Sallavaci, Suela Y.; Bino, Silva F.

    2014-01-01

    Background: Acute gastroenteritis remains a common cause of hospital emergency room visits in Albania. However, the aetiology of severe gastroenteritis leading to hospitalization in adults frequently remains unclear. Aims: Our objective was to study the epidemiology and causes of community-acquired, acute gastroenteritis in adult patients presenting to hospital. Study Design: Cross sectional study. Methods: A prospective study was conducted from January 2010 to January 2012, among patients ≥15 years old with community-acquired gastroenteritis presenting to the emergency room of the University Hospital “Mother Theresa” in Tirana, Albania. Stool samples and rectal swabs were collected from the patients for microbiological testing. Results: The median age of the study patients was 33 (15–88) years and 577 (58%) were females. The median age of males was 35 (15–87) years. The vast majority of cases occurred in urban area (849, 85%), p<0.01. Patients were admitted throughout the year with peak admissions for patients infected by bacterial pathogens in summer and those affected by viral pathogens in autumn. A total of 917 (91.7%) patients underwent a laboratory examination. The overall isolation rate was 51%. Bacterial pathogens were found in 29%, viral pathogens in 19% and protozoal pathogens in 2.5% of patients. No aetiological agent or other cause of acute diarrhoea was found in 449 (49%) patients. Twenty-nine (3.2%) patients were hospitalized. Conclusion: Despite extensive laboratory investigations, enteropathogens were detected in only 51% of adult patients who presented to the hospital ER with acute gastroenteritis. Viral infections ranked as the second most common cause of gastroenteritis in adults. PMID:25625016

  20. Update: Outbreak of severe acute respiratory syndrome--worldwide, 2003.

    PubMed

    2003-03-28

    CDC continues to support the World Health Organization (WHO) in the investigation of a multicountry outbreak of unexplained atypical pneumonia referred to as severe acute respiratory syndrome (SARS). This report includes summaries of the epidemiologic investigations and public health responses in several affected locations where CDC is collaborating with international and national health authorities. This report also describes an unusual cluster of cases associated with a hotel in Hong Kong and identifies the potential etiologic agent of SARS. Epidemiologic and laboratory investigations of SAPS are ongoing. PMID:12680518

  1. Acute Gastroenteritis and Recreational Water: Highest Burden Among Young US Children

    PubMed Central

    Wade, Timothy J.; Benjamin-Chung, Jade; Schiff, Kenneth C.; Griffith, John F.; Dufour, Alfred P.; Weisberg, Stephen B.; Colford, John M.

    2016-01-01

    Objectives. To provide summary estimates of gastroenteritis risks and illness burden associated with recreational water exposure and determine whether children have higher risks and burden. Methods. We combined individual participant data from 13 prospective cohorts at marine and freshwater beaches throughout the United States (n = 84 411). We measured incident outcomes within 10 days of exposure: diarrhea, gastrointestinal illness, missed daily activity (work, school, vacation), and medical visits. We estimated the relationship between outcomes and 2 exposures: body immersion swimming and Enterococcus spp. fecal indicator bacteria levels in the water. We also estimated the population-attributable risk associated with these exposures. Results. Water exposure accounted for 21% of diarrhea episodes and 9% of missed daily activities but was unassociated with gastroenteritis leading to medical consultation. Children aged 0 to 4 and 5 to 10 years had the most water exposure, exhibited stronger associations between levels of water quality and illness, and accounted for the largest attributable illness burden. Conclusions. The higher gastroenteritis risk and associated burden in young children presents important new information to inform future recreational water quality guidelines designed to protect public health. PMID:27459461

  2. Epidemiology of Rotavirus-Norovirus Co-Infection and Determination of Norovirus Genogrouping among Children with Acute Gastroenteritis in Tehran, Iran

    PubMed Central

    Nasab, Seyed Dawood Mousavi; Sabahi, Farzaneh; Makvandi, Manoochehr; Samiee, Siamak Mirab; Nadji, Seyed Alireza; Ravanshad, Mehrdad

    2016-01-01

    Background: Enteric viruses, particularly human rotavirus and norovirus, have been shown to replace bacteria and parasites, as the most common pathogens responsible for acute diarrhea. However, there are still few epidemiological data on the simultaneous occurrence of these viruses in Iran. In this regard, the aim of this study was to assess the useful epidemiological data on the gastroenteritis associated with rotavirus-norovirus mixed infection and to examine the prevalence of norovirus genogrouping among children aged less than five years old in Iran. Methods: A total of 170 stool samples were collected from children under five years of age with the clinical signs and symptoms of acute gastroenteritis, from May 2013 to May 2014. For the detection of both rotavirus and norovirus, total RNA was extracted from all samples, followed by reverse transcription polymerase chain reaction (RT-PCR). For both detected rotaviruses and noroviruses, genogrouping was performed. Results: Of 170 samples, 49 (28.8%) and 15 (8.8%) samples were found to be positive for rotavirus and norovirus infections by RT-PCR. Interestingly, 6 (3.5%) patients were positive for both infections. Among the 15 norovirus-positive patients, 13 (86.6%) and 2 (13.3%) belonged to genogroups GII and GI. Conclusion: The norovirus genogroup GII and rotavirus lead to the serious infections in children with acute gastroenteritis. However, more well-designed studies are needed to further elucidate the role of other enteric viruses in acute gastroenteritis PMID:27137790

  3. Determining the community prevalence of acute gastrointestinal illness and gaps in surveillance of acute gastroenteritis and foodborne diseases in Guyana.

    PubMed

    Persuad, Shamdeo; Mohamed-Rambaran, Pheona; Wilson, Alexis; James, Colin; Indar, Lisa

    2013-12-01

    Guyana is an English-speaking country in South America and, culturally, it is part of the Caribbean. Objective of this study was to determine the community prevalence and true burden and economic impact of acute gastroenteritis (AGE) and foodborne diseases (FBDs) in Guyana. A cross-sectional population-based survey was conducted in 7 of the 10 regions in Guyana during August and November 2009 to capture the high- and low-AGE season respectively. Overall, 1,254 individual surveys were administered at a response rate of 96.5%. The overall monthly prevalence of self-reported cases of AGE was 7.7% (97 cases) (95% CI 6.3-9.3), and the yearly incidence was 1.0 episodes per person-year. The highest monthly prevalence of AGE was observed in region 4 (8.9%) and in children aged 1-4 year(s) (12.7%). Of the 97 AGE cases, 23% sought medical care; 65% reported spending time at home due to their illness [range 1-20 day(s), mean 2.7 days], of whom 51% required other individuals to look after them while ill. The maximum number of stools per 24 hours ranged from 3 to 9 (mean 4.5), and number of days an individual suffered from AGE ranged from 1 to 21 day(s) (mean 2.7 days). The burden of syndromic AGE cases in the population for 2009 was estimated to be 131,012 cases compared to the reported 30,468 cases (76.7% underreporting), which implies that, for every syndromic case of AGE reported, there were additional 4.3 cases occurring in the community. For every laboratory-confirmed case of FBD/AGE pathogen reported, it was estimated that approximately 2,881 more cases were occurring in the population. Giardia was the most common foodborne pathogen isolated. The minimum estimated annual cost associated with the treatment for AGE was US$ 2,358,233.2, showing that AGE and FBD pose a huge economic burden on Guyana. Underreporting of AGE and foodbome pathogens, stool collection, and laboratory capacity were major gaps, affecting the surveillance of AGE in Guyana.

  4. Eosinophilic Gastroenteritis With Malabsorption, Acute Intestinal Obstruction, Ascites and Pleural Effusion: A Case Report and Review of Literature

    PubMed Central

    de Matos Brasil, Aloisio Antonio Gomes; Bezerra, Luiza Neves Pinheiro; Bruno, Estela Lucena Alcantara; Carvalho, Danyelle Rolim; de Oliveira, Paulo Levi Pereira; Leite, Roana Lacerda Tavares

    2013-01-01

    We report a case of a 49-year-old male patient with abdominal distension and diffuse stomach cramps associated with peripheral eosinophilia. Treatment for eosinophilic parasitosis was not effective. After a few weeks, the patient developed acute obstructive abdomen with ascites, which was atypically improved with the use of antispasmodics and analgesics. Upper digestive endoscopy, colonoscopy and histopathologic examination of the gastric and intestinal mucosa did not show any significant changes. Video laparoscopic biopsy of the mesenteric lymph node and peritoneum revealed a nonspecific chronic inflammatory process with intense diffuse tissue eosinophilia. Complementary tests revealed right-sided pleural effusion and increased serum immunoglobulin E levels, with altered D-xylose absorption test results. The patient was treated with a hypoallergenic diet and an oral corticosteroid; the symptoms resolved and the laboratory test results improved. Eosinophilic gastroenteritis is a rare inflammatory disease characterized by eosinophilic infiltration in the wall of the gastrointestinal tract. The clinical presentation varies according to the affected site and the depth and extent of digestive tract involvement. This case report, which presents the rare simultaneous involvement of the mucosal, muscular and serosal layers, aims to describe and discuss the clinical and therapeutic aspects of eosinophilic gastroenteritis as well as its progression.

  5. Anaphylactoid Purpura Manifested after Acute Gastroenteritis with Severe Dehydration in an 8-Year-Old Male Child: A Case Report.

    PubMed

    Thakkar, Umang G; Vanikar, Aruna V; Trivedi, Hargovind L

    2015-12-01

    Anaphylactoid purpura, also known as Henoch-Schönleinpurpura (HSP), is an IgA-mediated vasculitis that tends to be a benign disease of childhood. Up to 50% of cases are preceded by an upper tract respiratory infection caused by group-A beta-hemolytic streptococcus and present with the common tetrad of abdominal pain, arthritis, purpuric rash, and renal involvement. The majority of patients recover completely. Here we document a rare case of anaphylactoid purpura which manifested with skin lesions in the form of palpable purpura following about of acute gastroenteritis with severe dehydration; it was treated with a short regimen of steroid therapy, which resulted in the complete remission of the disease. We conclude that prompt diagnosis and multidisciplinary intervention will lead to appropriate management-consisting of the installation of early short-course steroid therapy and thus, prevent further complications and the recurrence of the disease. PMID:26602584

  6. Comparison of Enzyme-Linked Immunosorbent Assay and Immunochromatography for Rotavirus Detection in Children Below Five Years with Acute Gastroenteritis

    PubMed Central

    Devi, Bimla; Singh, Karnail; Devi, Pushpa

    2015-01-01

    Background Group-A rotaviruses are responsible for 30 to 60% of severe watery diarrhea cases in young children. Timely diagnosis of rotavirus infection helps to determine appropriate treatment and prevents unnecessary use of antibiotics. Aim To compare Immunochromatography (ICG) with standard ELISA test for diagnosis of and to determine incidence, clinical socio-epidemiological profile and possible risk factors associated with rotavirus infection in children below five years with acute gastroenteritis. Settings and Design A prospective study performed from February 2013 to April 2014 in Microbiology and Paediatrics Departments, Government Medical College, Amritsar, Punjab, India. Materials and Methods Hundred stool samples from children below five years diagnosed with acute gastroenteritis were taken and tested by ICG and standard ELISA test. Statistical analysis Performed using the SPSS software for Windows, version 17.0. P-values calculated using χ2 test for categorical variables. A p < 0.05 was considered significant. Results Maximum cases with ICG showed a sensitivity of 95.24% and specificity of 97.47% when compared to ELISA. Incidence of rotavirus diarrhea was 21% using ELISA and 23% using ICG. With ELISA rotavirus infection was highest in age group 6 months to 24 months (83.3%) and in male (90.47%). The infection was maximum during November to April and presented with triad of diarrhea, vomiting, fever (76.2%). Majority of cases had watery diarrhea in high percentage (90.47%). Severe dehydration (76.19%), respiratory symptoms (38.09%), bottle feeding (52.38%), malnourished children (47.61%), children playing with toys (47.6%) and submersible water pump (61.95%) as a source of drinking water associated with rotavirus infection were found to statistically significant. Conclusion: ICG shows a good agreement with ELISA and has the advantage of being a quicker, cost-effective and useful for testing single specimen, convenient, not requiring additional equipment

  7. Epidemiology of gastroenteritis viruses in Japan: Prevalence, seasonality, and outbreak.

    PubMed

    Thongprachum, Aksara; Khamrin, Pattara; Maneekarn, Niwat; Hayakawa, Satoshi; Ushijima, Hiroshi

    2016-04-01

    Acute gastroenteritis has been recognized as one of the most common diseases in humans and continues to be a major public health problem worldwide. Several groups of viruses have been reported as the causative agents of acute gastroenteritis, including rotavirus, norovirus, sapovirus, human astrovirus, adenovirus, and an increasing number of others which have been reported more recently. The epidemiology, prevalence, seasonality, and outbreaks of these viruses have been reviewed in a number of studies conducted in Japan over three decades. Rotavirus and norovirus were the two most common viruses detected almost equally in children under 5 years of age who were suffering from acute gastroenteritis. Like many other countries, the main rotavirus strains circulating in pediatric patients in Japan are G1P[8], G2P[4], G3P[8], and G9P[8]. Norovirus GII.4 was involved in most outbreaks in Japan and found to be associated with the emergence of new variants Sydney_2012. The classic human astrovirus, MLB, and VA clades astroviruses were also commonly found in pediatric patients with acute diarrhea. The sapovirus and adenovirus have been identified as the minor viral causative agents for acute gastroenteritis in Japan.

  8. Characterization of GII.4 noroviruses circulating among children with acute gastroenteritis in Pune, India: 2005-2013.

    PubMed

    Kulkarni, Ruta; Patel, Amit; Bhalla, Shilpa; Chhabra, Preeti; Cherian, Sarah; Chitambar, Shobha D

    2016-01-01

    Genogroup II genotype 4 noroviruses (GII.4 NoVs), an important cause of sporadic childhood gastroenteritis worldwide, undergo continuous evolution leading to the periodic emergence of novel variants. The present study was undertaken for surveillance of GII.4 NoVs and identification and characterization of GII.4 variants circulating among children with sporadic gastroenteritis in Pune, India during 2005-2013. Among the 12 GII genotypes detected in the study, GII.4 was predominant. Sequencing and phylogenetic analysis of ORF2 (major capsid protein VP1 gene) of the GII.4 NoVs revealed circulation of seven GII.4 variants, Hunter_2004 (2005-2007), Yerseke_2006a (2006), DenHaag_2006b (2007), Osaka_2007 (2007-2009), Apeldoorn_2007 (2008), New Orleans_2009 (2008-2012) and Sydney_2012 (2013), with the Pune strains grouping with the contemporary global reference strains. The Hunter_2004, Osaka_2007 and New Orleans_2009 variants showed prolonged circulation, with the Hunter_2004 and New Orleans_2009 variants differentiating into temporally separated sub-clusters. Analysis of VP1 sequences and predicted structures of the GII.4 variants identified variant specific amino acid positions, particularly in and near (within 8A(°)) the epitopes A-E, displaying differences in the sequence and physicochemical characteristics of the different variants. Comparison with the reference strains of each of the GII.4 variants revealed up to 11 amino acid substitutions at the variant specific positions in the GII.4 strains from Pune. Amino acid variations were also noted among the strains of the same GII.4 variant in Pune. The strains of different sub-clusters identified in the Hunter_2004 and New Orleans_2009 variants showed differences in sequence and physicochemical properties of either or all of the epitopes A, C and E. The study thus describes the temporal variations and diversity of the GII.4 strains in Pune and emphasizes continuous monitoring and analysis of the GII.4 variants.

  9. An examination of co-infection in acute gastroenteritis and histo-blood group antigens leading to viral infection susceptibility

    PubMed Central

    FURUYA, KENTA; NAKAJIMA, HITOSHI; SASAKI, YOUSUKE; URITA, YOSHIHISA

    2016-01-01

    The aim of the present study was to evaluate co-infection in the gastrointestinal tract in terms of viruses, bacteria and the ABO blood group. We hypothesized that a combination of norovirus (NV) and bacteria in the gastrointestinal tract could affect the likelihood of an individual to contracting NV. Histo-blood group antigens (HBGAs) are considered to act as receptors that can lead to NV susceptibility. In addition to genetics, co-infection in the gastrointestinal tract may be associated with this mechanism. A total of 370 patients with acute gastroenteritis presenting with diarrhea (14–89 years) were recruited. The male/female ratio was 20/17. Single infection (bacteria or virus), co-infection with two viruses, and co-infection with one virus and one bacterium were statistically analyzed. In total, 88 of the 376 subjects (23.4%) were positive for one virus, and 50 (13.3%) were positive for one bacterium. Co-transfection with bacteria and a virus were detected in 46 (47.9%) of the 96 bacterial gastroenteritis cases. Statistical analysis revealed that co-infection of bacteria and NV was not significant in all viral infections (P=0.768). In terms of the ABO histo-blood group type and NV infection, the frequency in the O type was not significantly increased (P=0.052). Co-infection of bacteria and a virus occurred frequently in the gastrointestinal tract. The ABO blood phenotype expression was not a significant factor in NV infection in the present case series and the results did not suggest an affinity of NV for specific bacteria. PMID:26998270

  10. [Incidence and symptoms of cow's milk protein intolerance following acute gastroenteritis in young infants. Effect of a hypoallergenic diet].

    PubMed

    Wolf, A; Leupold, D; Bürgin-Wolff, A; Kohne, E

    1989-11-01

    In a prospective randomized study we investigated in 28 mainly bottle-fed infants younger than 60 days whether in acute gastroenteritis a hypoallergenic formula could prevent the development of cow's milk protein intolerance. Group 1 (14 infants) was fed with a formula adapted to human milk, Group 2 (14 infants) got a semi-elementary formula (Alfaré). After 3 months group II was exposed to cow's milk protein with a standardized challenge and the incidence of CMPI in both groups was calculated. All cases with the acute form of CMPI occurred in group II (5/12) whereas in group I only one infant suffered from the protracted mild form of the disease. Inspite of the relatively small number of probands we conclude from our results that in infants who are not totally breast-fed in the post-enteritic period feeding with a formula adapted to human milk is preferable to hypoallergenic semi-elementary preparations. An allergen free period of 3 months seems to induce symptoms of cow's milk intolerance, probably as a booster-effect to early sensibilisation.

  11. Transmissible Gastroenteritis MECHANISMS RESPONSIBLE FOR DIARRHEA IN AN ACUTE VIRAL ENTERITIS IN PIGLETS

    PubMed Central

    Butler, D. G.; Gali, D. G.; Kelly, M. H.; Hamilton, J. R.

    1974-01-01

    We studied 3-wk-old piglets 40 h after experimental infection with transmissible gastroenteritis (TGE) virus to identify the mechanisms of diarrhea in this disease and to better understand infectious diarrhea in humans. Using continuous segmental marker perfusion in four regions along the gut, we found significant increases in net intraluminal accumulation of water and electrolytes only in the proximal jejunum, the region infected by the virus. In this jejunal segment studied in vivo, unidirectional sodium flux, extracellular fluid (ECF) to lumen, significantly increased, lumen to ECF significantly decreased, compared with matchfed littermates. The standard perfusate rendered hypertonic by adding mannitol (450 mosmol/kg), in the same segment of normal pigs, caused only an increase in ECF to lumen flux of sodium. TGE did not alter gross villous structure or intraluminal bacteria, bile salts, lactate, pH, or osmolality. Epithelial cell migration was accelerated in the jejunum of infected pigs. Isolated in suspension, these cells from TGE pigs exhibited increased active and passive sodium efflux, cells from mannitol-perfused pigs exhibited only increased active sodium efflux. In this viral enteritis, altered sodium transport occurring in the jejunum, the region of the intestine infected appears to be associated with defective epithelial cell function. The precise nature of the abnormalities in sodium transport, their relationship to disturbances of transport of other solutes, and to virus epithelial cell interaction remain to be defined. Images PMID:4825228

  12. Phylogenetic analysis of probable non-human genes of group A rotaviruses isolated from children with acute gastroenteritis in Belém, Brazil.

    PubMed

    Maestri, Régis Piloni; Kaiano, Jane Haruko Lima; Neri, Darivaldo Luz; Soares, Luana da Silva; Guerra, Sylvia de Fatima Dos Santos; Oliveira, Darleise de Souza; Farias, Yasmin Nascimento; Gabbay, Yvone Benchimol; Leite, José Paulo Gagliardi; Linhares, Alexandre da Costa; Mascarenhas, Joana D'Arc Pereira

    2012-12-01

    Rotaviruses (RVs) are the main cause of acute viral gastroenteritis in both humans and young animals of various species such as calves, horses, pigs, dogs, cats, and birds. The genetic diversity of RVs is related to a variety of evolutionary mechanisms, including point mutation, and genome reassortment. The objective of this study was to characterize molecularly genes that encode structural and nonstructural proteins in unusual RV strains. The clinical specimens selected for this study were obtained from children and newborn with RV gastroenteritis, who participated in research projects on viral gastroenteritis conducted at the Evandro Chagas Institute. Structural (VP1-VP4, VP6, and VP7) and nonstructural (NSP1-NSP6) genes were amplified from stool samples by the polymerase chain reaction and subsequently sequenced. Eight unusual RV strains isolated from children and newborn with gastroenteritis were studied. Reassortment between genes of animal origin were observed in 5/8 (62.5%) strains analyzed. These results demonstrate that, although rare, interspecies (animal-human) transmission of RVs occurs in nature, as observed in the present study in strains NB150, HSP034, HSP180, HST327, and RV10109. This study is the first to be conducted in the Amazon region and supports previous data showing a close relationship between genes of human and animal origin, representing a challenge to the large-scale introduction of RV vaccines in national immunization programs. PMID:23080508

  13. Vaccines for viral and bacterial pathogens causing acute gastroenteritis: Part I: Overview, vaccines for enteric viruses and Vibrio cholerae

    PubMed Central

    O’Ryan, Miguel; Vidal, Roberto; del Canto, Felipe; Salazar, Juan Carlos; Montero, David

    2015-01-01

    Efforts to develop vaccines for prevention of acute diarrhea have been going on for more than 40 y with partial success. The myriad of pathogens, more than 20, that have been identified as a cause of acute diarrhea throughout the years pose a significant challenge for selecting and further developing the most relevant vaccine candidates. Based on pathogen distribution as identified in epidemiological studies performed mostly in low-resource countries, rotavirus, Cryptosporidium, Shigella, diarrheogenic E. coli and V. cholerae are predominant, and thus the main targets for vaccine development and implementation. Vaccination against norovirus is most relevant in middle/high-income countries and possibly in resource-deprived countries, pending a more precise characterization of disease impact. Only a few licensed vaccines are currently available, of which rotavirus vaccines have been the most outstanding in demonstrating a significant impact in a short time period. This is a comprehensive review, divided into 2 articles, of nearly 50 vaccine candidates against the most relevant viral and bacterial pathogens that cause acute gastroenteritis. In order to facilitate reading, sections for each pathogen are organized as follows: i) a discussion of the main epidemiological and pathogenic features; and ii) a discussion of vaccines based on their stage of development, moving from current licensed vaccines to vaccines in advanced stage of development (in phase IIb or III trials) to vaccines in early stages of clinical development (in phase I/II) or preclinical development in animal models. In this first article we discuss rotavirus, norovirus and Vibrio cholerae. In the following article we will discuss Shigella, Salmonella (non-typhoidal), diarrheogenic E. coli (enterotoxigenic and enterohemorragic), and Campylobacter jejuni. PMID:25715048

  14. Vaccines for viral and bacterial pathogens causing acute gastroenteritis: Part I: Overview, vaccines for enteric viruses and Vibrio cholerae.

    PubMed

    O'Ryan, Miguel; Vidal, Roberto; del Canto, Felipe; Salazar, Juan Carlos; Montero, David

    2015-01-01

    Efforts to develop vaccines for prevention of acute diarrhea have been going on for more than 40 y with partial success. The myriad of pathogens, more than 20, that have been identified as a cause of acute diarrhea throughout the years pose a significant challenge for selecting and further developing the most relevant vaccine candidates. Based on pathogen distribution as identified in epidemiological studies performed mostly in low-resource countries, rotavirus, Cryptosporidium, Shigella, diarrheogenic E. coli and V. cholerae are predominant, and thus the main targets for vaccine development and implementation. Vaccination against norovirus is most relevant in middle/high-income countries and possibly in resource-deprived countries, pending a more precise characterization of disease impact. Only a few licensed vaccines are currently available, of which rotavirus vaccines have been the most outstanding in demonstrating a significant impact in a short time period. This is a comprehensive review, divided into 2 articles, of nearly 50 vaccine candidates against the most relevant viral and bacterial pathogens that cause acute gastroenteritis. In order to facilitate reading, sections for each pathogen are organized as follows: i) a discussion of the main epidemiological and pathogenic features; and ii) a discussion of vaccines based on their stage of development, moving from current licensed vaccines to vaccines in advanced stage of development (in phase IIb or III trials) to vaccines in early stages of clinical development (in phase I/II) or preclinical development in animal models. In this first article we discuss rotavirus, norovirus and Vibrio cholerae. In the following article we will discuss Shigella, Salmonella (non-typhoidal), diarrheogenic E. coli (enterotoxigenic and enterohemorragic), and Campylobacter jejuni.

  15. Vaccines for viral and bacterial pathogens causing acute gastroenteritis: Part I: Overview, vaccines for enteric viruses and Vibrio cholerae.

    PubMed

    O'Ryan, Miguel; Vidal, Roberto; del Canto, Felipe; Salazar, Juan Carlos; Montero, David

    2015-01-01

    Efforts to develop vaccines for prevention of acute diarrhea have been going on for more than 40 y with partial success. The myriad of pathogens, more than 20, that have been identified as a cause of acute diarrhea throughout the years pose a significant challenge for selecting and further developing the most relevant vaccine candidates. Based on pathogen distribution as identified in epidemiological studies performed mostly in low-resource countries, rotavirus, Cryptosporidium, Shigella, diarrheogenic E. coli and V. cholerae are predominant, and thus the main targets for vaccine development and implementation. Vaccination against norovirus is most relevant in middle/high-income countries and possibly in resource-deprived countries, pending a more precise characterization of disease impact. Only a few licensed vaccines are currently available, of which rotavirus vaccines have been the most outstanding in demonstrating a significant impact in a short time period. This is a comprehensive review, divided into 2 articles, of nearly 50 vaccine candidates against the most relevant viral and bacterial pathogens that cause acute gastroenteritis. In order to facilitate reading, sections for each pathogen are organized as follows: i) a discussion of the main epidemiological and pathogenic features; and ii) a discussion of vaccines based on their stage of development, moving from current licensed vaccines to vaccines in advanced stage of development (in phase IIb or III trials) to vaccines in early stages of clinical development (in phase I/II) or preclinical development in animal models. In this first article we discuss rotavirus, norovirus and Vibrio cholerae. In the following article we will discuss Shigella, Salmonella (non-typhoidal), diarrheogenic E. coli (enterotoxigenic and enterohemorragic), and Campylobacter jejuni. PMID:25715048

  16. Viral Gastroenteritis

    MedlinePlus

    ... stomach, small intestine, and large intestine. Several different viruses can cause viral gastroenteritis, which is highly contagious ... and last for 1 to 3 days. Some viruses cause symptoms that last longer. [ Top ] What are ...

  17. Molecular characterization of hepatitis A virus isolated from acute gastroenteritis patients in the Seoul region of Korea.

    PubMed

    Park, S-H; Kim, E-J; Lee, J-H; Choi, S-S; Kim, M-S; Jung, S-S; Han, G-Y; Yun, H-S; Chun, D-S; Oh, S-S; Kim, H-S

    2009-10-01

    Hepatitis A virus (HAV) is a major public health problem throughout the world. As a result of declining HAV endemic in Korea, an increasing number of children and adolescents have become susceptible to HAV infection. HAV is related with sanitation conditions of the environment and is transmitted via the fecal-oral route, either through person-to-person contact or by contaminated water and food. The present study has been carried out to determine the phylogenetic analysis and circulating patterns of HAV strains detected from hospitalized patients with acute gastroenteritis (AGE) in the Seoul region of Korea. In total, 2,782 stool specimens from hospitalized patients with AGE collected in October 2006 to September 2007 in Seoul were tested for HAV. A pair comparison of the nucleic acid sequence of a 159-bp base region at the putative VP1/2A junction of 85 Seoul isolates revealed that the most common HAV strain circulating in the region during 2006-2007 was subgenotype IA. HAV phylogenetic studies can provide important information on the genetic characteristics of HAV from AGE patients who may subsequently become the source of infection in Korea.

  18. Diarrhoeagenic microbes by real-time PCR in Rwandan children under 5 years of age with acute gastroenteritis.

    PubMed

    Kabayiza, J-C; Andersson, M E; Nilsson, S; Baribwira, C; Muhirwa, G; Bergström, T; Lindh, M

    2014-12-01

    Acute gastroenteritis is a main cause of disease and death among children in low-income countries. The causality rates and pathogenic characteristics of putative aetiological agents remain insufficiently known. We used real-time PCR targeting 16 diarrhoeagenic agents to analyse stool samples from children ≤5.0 years old with acute diarrhoea in Rwanda. Among the 880 children (median age 14.2 months; 41% female) at least one pathogen was detected in 92% and two or more agents in 63% of cases. Rotavirus was detected in 36.9%, adenovirus in 39.7%, enterotoxigenic Escherichia coli (ETEC) with genes for labile (eltB) or stable (estA) toxin in 31.3% and 19.0%, E. coli with eae or bfpA genes in 25.2% and 14.2%, Shigella in 17.5% and Cryptosporidium in 7.8%. Rotavirus and ETEC-estA were associated with more severe dehydration than diarrhoea due to other causes. Shigella was associated with bloody stools and higher CRP. Microbial loads (Ct values) of rotavirus, ETEC-estA and Shigella were associated with severity of symptoms. Rotavirus, ETEC-estA and E. coli with bfpA were associated with younger age, Shigella with older age. Antibiotic treatment was given to 42% and was associated with dehydration, fever and CRP, but not with pathogen. We conclude that rotavirus and ETEC-estA were the most important causes of diarrhoea with dehydration, that Shigella caused bloody diarrhoea but less severe dehydration, that microbial loads of rotavirus, ETEC-estA and Shigella were associated with severity of symptoms, and that antibiotic use was frequent and in poor agreement with microbiological findings.

  19. Diarrhoeagenic microbes by real-time PCR in Rwandan children under 5 years of age with acute gastroenteritis.

    PubMed

    Kabayiza, J-C; Andersson, M E; Nilsson, S; Baribwira, C; Muhirwa, G; Bergström, T; Lindh, M

    2014-12-01

    Acute gastroenteritis is a main cause of disease and death among children in low-income countries. The causality rates and pathogenic characteristics of putative aetiological agents remain insufficiently known. We used real-time PCR targeting 16 diarrhoeagenic agents to analyse stool samples from children ≤5.0 years old with acute diarrhoea in Rwanda. Among the 880 children (median age 14.2 months; 41% female) at least one pathogen was detected in 92% and two or more agents in 63% of cases. Rotavirus was detected in 36.9%, adenovirus in 39.7%, enterotoxigenic Escherichia coli (ETEC) with genes for labile (eltB) or stable (estA) toxin in 31.3% and 19.0%, E. coli with eae or bfpA genes in 25.2% and 14.2%, Shigella in 17.5% and Cryptosporidium in 7.8%. Rotavirus and ETEC-estA were associated with more severe dehydration than diarrhoea due to other causes. Shigella was associated with bloody stools and higher CRP. Microbial loads (Ct values) of rotavirus, ETEC-estA and Shigella were associated with severity of symptoms. Rotavirus, ETEC-estA and E. coli with bfpA were associated with younger age, Shigella with older age. Antibiotic treatment was given to 42% and was associated with dehydration, fever and CRP, but not with pathogen. We conclude that rotavirus and ETEC-estA were the most important causes of diarrhoea with dehydration, that Shigella caused bloody diarrhoea but less severe dehydration, that microbial loads of rotavirus, ETEC-estA and Shigella were associated with severity of symptoms, and that antibiotic use was frequent and in poor agreement with microbiological findings. PMID:24890572

  20. Cytosolic phosphoenolpyruvate carboxykinase deficiency presenting with acute liver failure following gastroenteritis.

    PubMed

    Santra, Saikat; Cameron, Jessie M; Shyr, Casper; Zhang, Linhua; Drögemöller, Britt; Ross, Colin J; Wasserman, Wyeth W; Wevers, Ron A; Rodenburg, Richard J; Gupte, Girish; Preece, Mary Anne; van Karnebeek, Clara D

    2016-05-01

    We report a patient from a consanguineous family who presented with transient acute liver failure and biochemical patterns suggestive of disturbed urea cycle and mitochondrial function, for whom conventional genetic and metabolic investigations for acute liver failure failed to yield a diagnosis. Whole exome sequencing revealed a homozygous 12-bp deletion in PCK1 (MIM 614168) encoding cytosolic phosphoenolpyruvate carboxykinase (PEPCK); enzymatic studies subsequently confirmed its pathogenic nature. We propose that PEPCK deficiency should be considered in the young child with unexplained liver failure, especially where there are marked, accumulations of TCA cycle metabolites on urine organic acid analysis and/or an amino acid profile with hyperammonaemia suggestive of a proximal urea cycle defect during the acute episode. If suspected, intravenous administration of dextrose should be initiated. Long-term management comprising avoidance of fasting with the provision of a glucose polymer emergency regimen for illness management may be sufficient to prevent future episodes of liver failure. This case report provides further insights into the (patho-)physiology of energy metabolism, confirming the power of genomic analysis of unexplained biochemical phenotypes.

  1. Cytosolic phosphoenolpyruvate carboxykinase deficiency presenting with acute liver failure following gastroenteritis.

    PubMed

    Santra, Saikat; Cameron, Jessie M; Shyr, Casper; Zhang, Linhua; Drögemöller, Britt; Ross, Colin J; Wasserman, Wyeth W; Wevers, Ron A; Rodenburg, Richard J; Gupte, Girish; Preece, Mary Anne; van Karnebeek, Clara D

    2016-05-01

    We report a patient from a consanguineous family who presented with transient acute liver failure and biochemical patterns suggestive of disturbed urea cycle and mitochondrial function, for whom conventional genetic and metabolic investigations for acute liver failure failed to yield a diagnosis. Whole exome sequencing revealed a homozygous 12-bp deletion in PCK1 (MIM 614168) encoding cytosolic phosphoenolpyruvate carboxykinase (PEPCK); enzymatic studies subsequently confirmed its pathogenic nature. We propose that PEPCK deficiency should be considered in the young child with unexplained liver failure, especially where there are marked, accumulations of TCA cycle metabolites on urine organic acid analysis and/or an amino acid profile with hyperammonaemia suggestive of a proximal urea cycle defect during the acute episode. If suspected, intravenous administration of dextrose should be initiated. Long-term management comprising avoidance of fasting with the provision of a glucose polymer emergency regimen for illness management may be sufficient to prevent future episodes of liver failure. This case report provides further insights into the (patho-)physiology of energy metabolism, confirming the power of genomic analysis of unexplained biochemical phenotypes. PMID:26971250

  2. Management strategies in the treatment of neonatal and pediatric gastroenteritis

    PubMed Central

    Ciccarelli, Simona; Stolfi, Ilaria; Caramia, Giuseppe

    2013-01-01

    Acute gastroenteritis, characterized by the onset of diarrhea with or without vomiting, continues to be a major cause of morbidity and mortality in children in mostly resource-constrained nations. Although generally a mild and self-limiting disease, gastroenteritis is one of the most common causes of hospitalization and is associated with a substantial disease burden. Worldwide, up to 40% of children aged less than 5 years with diarrhea are hospitalized with rotavirus. Also, some microorganisms have been found predominantly in resource-constrained nations, including Shigella spp, Vibrio cholerae, and the protozoan infections. Prevention remains essential, and the rotavirus vaccines have demonstrated good safety and efficacy profiles in large clinical trials. Because dehydration is the major complication associated with gastroenteritis, appropriate fluid management (oral or intravenous) is an effective and safe strategy for rehydration. Continuation of breastfeeding is strongly recommended. New treatments such as antiemetics (ondansetron), some antidiarrheal agents (racecadotril), and chemotherapeutic agents are often proposed, but not yet universally recommended. Probiotics, also known as “food supplement,” seem to improve intestinal microbial balance, reducing the duration and the severity of acute infectious diarrhea. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the European Society of Paediatric Infectious Diseases guidelines make a stronger recommendation for the use of probiotics for the management of acute gastroenteritis, particularly those with documented efficacy such as Lactobacillus rhamnosus GG, Lactobacillus reuteri, and Saccharomyces boulardii. To date, the management of acute gastroenteritis has been based on the option of “doing the least”: oral rehydration-solution administration, early refeeding, no testing, no unnecessary drugs. PMID:24194646

  3. The Usefulness of Clinical and Laboratory Parameters for Predicting Severity of Dehydration in Children with Acute Gastroenteritis

    PubMed Central

    Hoxha, Teuta Faik; Azemi, Mehmedali; Avdiu, Muharrem; Ismaili-jaha, Vlora; Grajqevci, Violeta; Petrela, Ela

    2014-01-01

    ABSTRACT Background: An accurate assessment of the degree of dehydration in infants and children is important for proper decision-making and treatment. This emphasizes the need for laboratory tests to improve the accuracy of clinical assessment of dehydration. The aim of this study was to assess the relationship between clinical and laboratory parameters in the assessment of dehydration. Methods: We evaluated prospectively 200 children aged 1 month to 5 years who presented with diarrhea, vomiting or both. Dehydration assessment was done following a known clinical scheme. Results: We enrolled in the study 200 children (57.5% were male). The mean age was 15.62±9.03 months, with more than half those studied being under 24 months old. Overall, 46.5% (93) had mild dehydration, 34% (68) had moderate dehydration, 5.5% (11) had severe dehydration whereas, 14% (28) had no dehydration. Patients historical clinical variables in all dehydration groups did not differ significantly regarding age, sex, fever, frequency of vomiting, duration of diarrhea and vomiting, while there was a trend toward severe dehydration in children with more frequent diarrhea (p=0.004). Serum urea and creatinine cannot discriminate between mild and moderate dehydration but they showed a good specificity for severe dehydration of 99% and 100% respectively. Serum bicarbonates and base excess decreased significantly with a degree of dehydration and can discriminate between all dehydration groups (P<0.001). Conclusion: Blood gases were useful to diagnose the degree of dehydration status among children presenting with acute gastroenteritis. Serum urea and creatinine were the most specific tests for severe dehydration diagnosis. Historical clinical patterns apart from frequency of diarrhea did not correlate with dehydration status. Further studies are needed to validate our results. PMID:25568559

  4. Meta-analysis: Lactobacillus reuteri strain DSM 17938 (and the original strain ATCC 55730) for treating acute gastroenteritis in children.

    PubMed

    Szajewska, H; Urbańska, M; Chmielewska, A; Weizman, Z; Shamir, R

    2014-09-01

    Lactobacillus reuteri ATCC 55730 has been shown to provide a moderate clinical effect in the treatment of acute gastroenteritis (AGE) in children. However, as the L. reuteri ATCC 55730 strain was found to carry potentially transferable resistance traits for tetracycline and lincomycin, it was replaced by a new strain, L. reuteri DSM 17938, without unwanted plasmid-borne antibiotic resistance. Bioequivalence of the two strains has been suggested. We aimed to systematically evaluate data on the effectiveness of L. reuteri DSM 17938 and the original strain, L. reuteri ATCC 55730, in the treatment of AGE in children. The Cochrane Library, MEDLINE, and EMBASE databases, reference lists, and abstract books of major scientific meetings were searched in August 2013, with no language restrictions, for relevant randomised controlled trials (RCTs). Two RCTs (n=196) that evaluated L. reuteri DSM 17938 and three RCTs (n=156) that evaluated L. reuteri ATCC 55730, which involved hospitalised children aged 3 to 60 months, met the inclusion criteria. Compared with placebo or no treatment, DSM 17938 significantly reduced the duration of diarrhoea (mean difference -32 h, 95% confidence interval (CI): -41 to -24) and increased the chance of cure on day 3 (relative risk: 3.5, 95% CI: 1.2 to 10.8, random effects model). Similar results were obtained with the original strain, L. reuteri ATCC 55730. In conclusion, in hospitalised children, use of both strains of L. reuteri reduced the duration of diarrhoea, and more children were cured within 3 days. Data from outpatients and countryspecific cost-effectiveness analyses are needed. Given the limited data and the methodological limitations of the included trials, the evidence should be viewed with caution.

  5. The Impact of E-Learning on Adherence to Guidelines for Acute Gastroenteritis: A Single-Arm Intervention Study

    PubMed Central

    Nicastro, Emanuele; Lo Vecchio, Andrea; Liguoro, Ilaria; Chmielewska, Anna; De Bruyn, Caroline; Dolinsek, Jernej; Doroshina, Elena; Fessatou, Smaragdi; Pop, Tudor Lucian; Prell, Christine; Tabbers, Merit Monique; Tavares, Marta; Urenden-Elicin, Pinar; Bruzzese, Dario; Zakharova, Irina; Sandhu, Bhupinder; Guarino, Alfredo

    2015-01-01

    Objective E-learning is a candidate tool for clinical practice guidelines (CPG) implementation due to its versatility, universal access and low costs. We aimed to assess the impact of a five-module e-learning course about CPG for acute gastroenteritis (AGE) on physicians’ knowledge and clinical practice. Study design This work was conceived as a pre/post single-arm intervention study. Physicians from 11 European countries registered for the online course. Personal data, pre- and post-course questionnaires and clinical data about 3 to 5 children with AGE managed by each physician before and after the course were collected. Primary outcome measures included the proportion of participants fully adherent to CPG and number of patients managed with full adherence. Results Among the 149 physicians who signed up for the e-learning course, 59 took the course and reported on their case management of 519 children <5 years of age who were referred to their practice because of AGE (281 and 264 children seen before and after the course, respectively). The course improved knowledge scores (pre-course 8.6 ± 2.7 versus post-course 12.8 ± 2.1, P < 0.001), average adherence (from 87.0 ± 7.7% to 90.6 ± 7.1%, P = 0.001) and the number of patients managed in full adherence with the guidelines (from 33.6 ± 31.7% to 43.9 ± 36.1%, P = 0.037). Conclusions E-learning is effective in increasing knowledge and improving clinical practice in paediatric AGE and is an effective tool for implementing clinical practice guidelines. PMID:26148301

  6. Fever without apparent source on clinical examination, lower respiratory infections in children, other infectious diseases, and acute gastroenteritis and diarrhea of infancy and early childhood.

    PubMed

    McCarthy, P L; Klig, J E; Shapiro, E D; Baron, M A

    1996-02-01

    This section focuses on issues in infectious disease that are commonly encountered in pediatric office practice. Paul McCarthy discusses recent literature regarding the evaluation and management of acute fevers without apparent source on clinical examination in infants and children and the evaluation of children with prolonged fevers of unknown origin. Jean Klig reviews recent literature about lower respiratory tract infection in children. Eugene Shapiro discusses recent developments in the literature concerning several infectious diseases commonly facing practitioners in the office. Michael Baron reviews recent literature about gastroenteritis and diarrhea of infancy and early childhood.

  7. Fever without apparent source on clinical examination, lower respiratory infections in children, other infectious diseases, and acute gastroenteritis and diarrhea of infancy and early childhood.

    PubMed

    McCarthy, P L; Klig, J E; Kahn, J S; Shapiro, E D; Baron, M A

    1997-02-01

    This section focuses on issues in infectious disease that are commonly encountered in pediatric office practice. Paul McCarthy discusses recent literature regarding the evaluation and management of acute fevers without apparent source on clinical examination in infants and children and the evaluation of children with prolonged fevers of unknown origin. Jean Klig reviews recent literature about lower respiratory tract infection in children. Jeffrey Kahn and Eugene Shapiro discuss literature concerning several infectious diseases commonly seen in office settings and concerning which recent developments are of interest. Michael Baron reviews recent literature about gastroenteritis and diarrhea of infancy and early childhood.

  8. Performance of Clinical Signs in the Diagnosis of Dehydration in Children with Acute Gastroenteritis

    PubMed Central

    Hoxha, Teuta; Xhelili, Luan; Azemi, Mehmedali; Avdiu, Muharrem; Ismaili-Jaha, Vlora; Efendija-Beqa, Urata; Grajcevci-Uka, Violeta

    2015-01-01

    Background: Acute evaluation and treatment of children presenting with dehydration represent one of the most common situation in the pediatric emergency department. To identify dehydration in infants and children before treatment, a number of symptoms and clinical signs have been evaluated. The aim of the study was to describe the performance of clinical signs in detecting dehydration in children. Methods: Two hundred children aged 1 month to 5 year were involved in our prospective study. The clinical assessment consisted of the ten clinical signs of dehydration, including those recommended by WHO (World Health Organization), heart rate, and capillary refill time. Results: Two hundred patients with diarrhea were enrolled in the study. The mean age was 15.62±9.03 months and 57.5% were male. Of these 121 had a fluid deficit of < 5%, 68 had a deficit of 5 to 9% and 11(5.5%) had a deficit of 10% or more. Patients classified as having no or mild, moderate, and severe dehydration were found to have the following respective gains in percent weight at the end of illness: 2.44±0.3, 6.05± 1.01 and, 10.66± 0.28, respectively. All clinical signs were found more frequently with increasing amounts of dehydration(p<0.001, One–way ANOVA). The median number of findings among subjects with no or mild dehydration (deficit <5%) was 3; among those with moderate dehydration (deficit 5% to 9%) was 6.5 and among those with severe dehydration (deficit >10%) the median was 9 (p<0.0001, Kruskal-Wallis test). Using stepwise linear regression and a p value of <0.05 for entry into the model, a four-variable model including sunken eyes, skin elasticity, week radial pulse, and general appearance was derived. Conclusion: None of the 10 findings studied, is sufficiently accurate to be used in isolation. When considered together, sunken eyes, decreased skin turgor, weak pulse and general appearance provide the best explanatory power of the physical signs considered. PMID:25870468

  9. Human viral gastroenteritis.

    PubMed Central

    Christensen, M L

    1989-01-01

    During the last 15 years, several different groups of fastidious viruses that are responsible for a large proportion of acute viral gastroenteritis cases have been discovered by the electron microscopic examination of stool specimens. This disease is one of the most prevalent and serious clinical syndromes seen around the world, especially in children. Rotaviruses, in the family Reoviridae, and fastidious fecal adenoviruses account for much of the viral gastroenteritis in infants and young children, whereas the small caliciviruses and unclassified astroviruses, and possibly enteric coronaviruses, are responsible for significantly fewer cases overall. In addition to electron microscopy, enzyme immunoassays and other rapid antigen detection systems have been developed to detect rotaviruses and fastidious fecal adenoviruses in the stool specimens of both nonhospitalized patients and those hospitalized for dehydration and electrolyte imbalance. Experimental rotavirus vaccines have also been developed, due to the prevalence and seriousness of rotavirus infection. The small, unclassified Norwalk virus and morphologically similar viruses are responsible for large and small outbreaks of acute gastroenteritis in older children, adolescents, and adults. Hospitalization of older patients infected with these viruses is usually not required, and their laboratory diagnoses have been limited primarily to research laboratories. Images PMID:2644024

  10. Immune Response and Intestinal Permeability in Children With Acute Gastroenteritis Treated With Lactobacillus rhamnosus GG: A Randomized, Double-Blind, Placebo-Controlled Trial

    PubMed Central

    Sindhu, Kulandaipalayam N. C.; Sowmyanarayanan, Thuppal V.; Paul, Anu; Babji, Sudhir; Ajjampur, Sitara S. R.; Priyadarshini, Sophia; Sarkar, Rajiv; Balasubramanian, K. A.; Wanke, Christine A.; Ward, Honorine D.; Kang, Gagandeep

    2014-01-01

    Background. Probiotics have a possible role in the treatment of pediatric acute gastroenteritis. We report the effect of the probiotic Lactobacillus rhamnosus GG (LGG) on intestinal function, immune response, and clinical outcomes in Indian children with cryptosporidial or rotavirus diarrhea. Methods. Children with gastroenteritis aged 6 months to 5 years, testing positive for either rotavirus or Cryptosporidium species in stool (coinfections were excluded), were randomized to LGG (ATCC 53103) or placebo, once daily for 4 weeks. Baseline demographic and clinical details were obtained. Sera were tested for immunoglobulin G (IgG) and immunoglobulin A (IgA) antibodies to Cryptosporidium and rotavirus, and the lactulose to mannitol ratio for intestinal permeability was determined at baseline and at the end of follow-up. Results. Of the 124 children enrolled, 82 and 42 had rotavirus and cryptosporidial diarrhea, respectively. Median diarrheal duration was 4 days; one-third of the children had severe diarrhea. Baseline and clinical parameters were comparable between children receiving LGG and placebo. At the end of follow-up, fewer children with rotavirus diarrhea on LGG had repeated diarrheal episodes (25% vs 46%; P = .048) and impaired intestinal function (48% vs 72%; P = .027). Significant increase in IgG levels postintervention (456 vs 2215 EU; P = .003) was observed in children with rotavirus diarrhea receiving LGG. Among children with cryptosporidial diarrhea, those receiving LGG showed significant improvement in intestinal permeability. Conclusions. LGG has a positive immunomodulatory effect and may be useful in decreasing repeated episodes of rotavirus diarrhea. Improvement in intestinal function in children with rotavirus and cryptosporidial gastroenteritis emphasizes the role of probiotics in treating intestinal impairment after infection. Clinical Trials Registration. CTRI/2010/091/000339. PMID:24501384

  11. The Role of Human Coronaviruses in Children Hospitalized for Acute Bronchiolitis, Acute Gastroenteritis, and Febrile Seizures: A 2-Year Prospective Study

    PubMed Central

    Jevšnik, Monika; Steyer, Andrej; Pokorn, Marko; Mrvič, Tatjana; Grosek, Štefan; Strle, Franc; Lusa, Lara; Petrovec, Miroslav

    2016-01-01

    Human coronaviruses (HCoVs) are associated with a variety of clinical presentations in children, but their role in disease remains uncertain. The objective of our prospective study was to investigate HCoVs associations with various clinical presentations in hospitalized children up to 6 years of age. Children hospitalized with acute bronchiolitis (AB), acute gastroenteritis (AGE), or febrile seizures (FS), and children admitted for elective surgical procedures (healthy controls) were included in the study. In patients with AB, AGE, and FS, a nasopharyngeal (NP) swab and blood sample were obtained upon admission and the follow-up visit 14 days later, whereas in children with AGE a stool sample was also acquired upon admission; in healthy controls a NP swab and stool sample were taken upon admission. Amplification of polymerase 1b gene was used to detect HCoVs in the specimens. HCoVs-positive specimens were also examined for the presence of several other viruses. HCoVs were most often detected in children with FS (19/192, 9.9%, 95% CI: 6–15%), followed by children with AGE (19/218, 8.7%, 95% CI: 5.3–13.3%) and AB (20/308, 6.5%, 95% CI: 4.0–9.8%). The presence of other viruses was a common finding, most frequent in the group of children with AB (19/20, 95%, 95% CI: 75.1–99.8%), followed by FS (10/19, 52.6%, 95% CI: 28.9–75.6%) and AGE (7/19, 36.8%, 95% CI: 16.3–61.6%). In healthy control children HCoVs were detected in 3/156 (1.9%, 95% CI: 0.4–5.5%) NP swabs and 1/150 (0.7%, 95% CI: 0.02–3.3%) stool samples. It seems that an etiological role of HCoVs is most likely in children with FS, considering that they had a higher proportion of positive HCoVs results than patients with AB and those with AGE, and had the highest viral load; however, the co-detection of other viruses was 52.6%. Trial Registration: ClinicalTrials.gov NCT00987519 PMID:27171141

  12. Clinical presentation and management of acute gastro-enteritis in in-patient children at King Khalid University Hospital, Riyadh, Saudi Arabia.

    PubMed

    Abdullah, A M

    1990-01-01

    In a retrospective survey, case notes of all children with acute gastro-enteritis (AGE) admitted to our hospital between 1984 and 1988 were reviewed. The total number of cases was 300. The mean age was 14 months (range 1-60 mths): 67% of cases were boys and 33% girls. Eleven per cent were exclusively breastfed. The clinical presentation was diarrhoea and vomiting in 81%, diarrhoea alone in 15%, and vomiting primarily in 4%. All children had good nutritional status, i.e. both their height and weight were between the 5th and 90th percentile for their age and none showed signs of marasmus or kwashiorkor. Forty-six per cent of the children had AGE without dehydration. Mild, moderate and severe dehydration was present in 41%, 10% and 3% of cases, respectively. Isotonic, hypotonic and hypernatraemic dehydration was present in 95%, 3% and 2% of cases of dehydration, respectively. Sixty-five per cent of cases were given intravenous (IV) fluids. The mean duration of IV administration was 1 day, with a range of 1-7 days. Twenty-two per cent of the children were given oral rehydration solution (ORS) initially, and 13% were given IV plus ORS. None of the children died of gastro-enteritis. It is concluded that there was excessive use of IV fluids, and that there is an urgent need to encourage the use of ORS.

  13. Fever without apparent source on clinical examination, lower respiratory infections in children, bacterial infections, and acute gastroenteritis and diarrhea of infancy and early childhood.

    PubMed

    McCarthy, P L; Bachman, D T; Shapiro, E D; Baron, M A

    1995-02-01

    This section focuses on issues in infectious disease that are commonly encountered in pediatric office practice. Paul McCarthy discusses recent literature regarding the evaluation and management of acute fevers without apparent source on clinical examination in infants and children and the evaluation of children with prolonged fevers of unknown origin. David Bachman reviews recent literature about lower respiratory tract infection in children and focuses on community-acquired lower respiratory infections and respiratory syncytial virus. Eugene Shapiro discusses literature concerning several infectious diseases commonly seen in office settings and concerning which recent developments are of interest: the hemolytic-uremic syndrome and enterohemorrhagic Escherichia coli. Streptococcus pneumoniae resistant to penicillin, infections in day care centers, and new antimicrobial drugs. Michael Baron reviews recent literature about gastroenteritis and diarrhea of infancy and early childhood and discusses diagnosis, complications, pathogenesis and physiology, epidemiology, and treatment.

  14. Management of acute urinary retention: a worldwide survey of 6074 men with benign prostatic hyperplasia

    PubMed Central

    Fitzpatrick, John M; Desgrandchamps, François; Adjali, Kamel; Guerra, Lauro Gomez; Hong, Sung Joon; Khalid, Salman El; Ratana-Olarn, Krisada

    2012-01-01

    OBJECTIVES To evaluate the management of acute urinary retention (AUR) associated with benign prostatic hyperplasia (BPH) in real-life practice. To identify predictors of successful trial without catheter (TWOC). MATERIALS AND METHODS In all, 6074 men catheterized for painful AUR were enrolled in a prospective, cross-sectional survey conducted in public and private urology practices in France, Asia, Latin America, Algeria and the Middle East. Patient clinical characteristics, type of AUR and its management (type of catheterization, hospitalization, TWOC, use of α1-blockers, immediate or elective surgery) and adverse events observed during the catheterization period were recorded. Predictors of TWOC success were also analysed by multivariate regression analysis with stepwise procedure. RESULTS Of the 6074 men, 4289 (71%) had a spontaneous AUR and 1785 (29%) had a precipitated AUR, mainly as the result of loco-regional/general anaesthesia (28.5%) and excessive alcohol intake (18.2%). Presence of BPH was revealed by AUR in 44% of men. Hospitalization for AUR varied between countries, ranging from 1.7% in Algeria to 100% in France. A urethral catheter was inserted in most cases (89.8%) usually followed by a TWOC (78.0%) after a median of 5 days. Overall TWOC success rate was 61%. Most men (86%) received an α1-blocker (mainly alfuzosin) before catheter removal with consistently higher TWOC success rates, regardless of age and type of AUR. Multivariate regression analysis confirmed that α1-blocker before TWOC doubled the chances of success (odds ratio 1.92, 95% CI 1.52–2.42, P < 0.001). Age ≥70 years, prostate size ≥50 g, severe lower urinary tract symptoms, drained volume at catheterization ≥1000 mL and spontaneous AUR favoured TWOC failure. Catheterization >3 days did not influence TWOC success but was associated with increased morbidity and prolonged hospitalization for adverse events. In the case of TWOC failure, 49% of men were recatheterized and had BPH

  15. The prevalence of norovirus, astrovirus and adenovirus infections among hospitalised children with acute gastroenteritis in Porto Velho, state of Rondônia, western Brazilian Amazon

    PubMed Central

    Amaral, Maria Sandra Costa; Estevam, Grecy Kelli; Penatti, Marilene; Lafontaine, Roger; Lima, Ian Carlos Gomes; Spada, Paula Katharine Pontes; Gabbay, Yvone Benchimol; Matos, Najla Benevides

    2015-01-01

    Although viruses are well-established causes of acute gastroenteritis, few data on the circulation of these pathogens in Porto Velho, state of Rondônia, Brazil, are available. Thus, faecal samples from hospitalised diarrhoeic children, under six years of age, were collected and tested for the presence of norovirus (NoV), adenovirus (AdV) and astrovirus (AstV) from February 2010-February 2012. Specimens were screened by reverse-transcription polymerase chain reaction and viruses were found in 10.7% (63/591) of the cases. NoV, AdV and AstV were detected in 7.8%, 2% and 0.8% of the samples, respectively. NoV infection was observed at all ages and was most prevalent in zero-18-month-old children (84.7%; p = 0.002). A higher incidence of NoV was detected from February-April 2010, when it was found in 52.2% of the cases. Co-infections involving these viruses, rotavirus and enteropathogenic bacteria were detected in 44.4% (28/63) of the children with viral diarrhoea. Nosocomial infections were demonstrated in 28.6% (18/63) of the cases in which viruses were detected. The present paper reports, for the first time, the circulation of NoV and AstV among the paediatric population of Porto Velho and it contributes to our understanding of the roles of these pathogens in gastrointestinal infections. PMID:25946245

  16. [Noroviruses: leading cause of gastroenteritis].

    PubMed

    Delacour, H; Dubrous, P; Koeck, J L

    2010-04-01

    Although noroviruses were the first viral agents to be linked to gastrointestinal disease, they were long considered a secondary cause far behind rotaviruses. Development of molecular-based diagnostic techniques has provided clearer insight into the epidemiological impact of noroviruses that are now recognized not only as the leading cause of non-bacterial gastroenteritis outbreaks but also as an important cause of sporadic gastroenteritis in both children and adults. Norovirus infection is generally characterized by mild acute vomiting and diarrhea usually lasting for only a few days, but it can lead to more severe and potentially life-threatening symptoms in high-risk groups such as young children, elderly, and immunodeficient persons. It has been demonstrated that they are present in tropical countries. Molecular epidemiological studies have documented the great genetic diversity of noroviruses with regular emergence of variants. Since no vaccine is available, prevention on norovirus infection depends mainly on strict personal and community hygiene measures.

  17. CMV - gastroenteritis/colitis

    MedlinePlus

    Colitis - cytomegalovirus; Gastroenteritis - cytomegalovirus; Gastrointestinal CMV disease ... or after bone marrow or organ transplant Ulcerative colitis or Crohn disease Rarely, serious CMV infection involving ...

  18. Epidemiology of Acute Gastroenteritis Outbreaks Caused by Human Calicivirus (Norovirus and Sapovirus) in Catalonia: A Two Year Prospective Study, 2010-2011

    PubMed Central

    Martinez, Ana; Moreno, Antonio; Camps, Neus

    2016-01-01

    Background The epidemiology of cases of acute gastroenteritis (AGE) of viral etiology is a relevant public health issue. Due to underreporting, the study of outbreaks is an accepted approach to investigate their epidemiology. The objective of this study was to investigate the epidemiological characteristics of AGE outbreaks due to norovirus (NoV) and sapovirus (SV) in Catalonia. Material and Methods Prospective study of AGE outbreaks of possible viral etiology notified during two years in Catalonia. NoV and SV were detected by real time reverse transcription polymerase (RT-PCR). Results A total of 101 outbreaks were registered affecting a total of 2756 persons and 12 hospitalizations (hospitalization rate: 0.8x1,000,000 persons-year); 49.5% of outbreaks were foodborne, 45.5% person to person and 5% waterborne. The distribution of outbreaks according to the setting showed a predominance of catering services (39.6%), nursing homes and long term care facilities (26.8%) and schools (11.9%). The median number of cases per outbreak was 17 (range 2–191). The total Incidence rate (IR) was 18.3 per 100,000 persons-years (95%CI: 17.6–19.0). The highest IR was in persons aged ≥65 years (43.6x100,000 (95% CI: 41.0–46.2)) (p<0.001). A total of 1065 samples were analyzed with a positivity rate of 60.8%. 98% of positive samples were NoV (GII 56.3%; GI 4.2%; GII+GI 4.2%; non- typable 33.0%). SV was identified in two person-to-person transmission outbreaks in children. Conclusions These results confirm the relevance of viral AGE outbreaks, both foodborne and person-to-person, especially in institutionalized persons. SV should be taken into account when investigating viral AGE outbreaks. PMID:27120472

  19. The control of rotavirus gastroenteritis in the United States.

    PubMed

    Glass, Roger I; Parashar, Umesh; Patel, Manish; Tate, Jacqueline; Jiang, Baoming; Gentsch, Jon

    2012-01-01

    Since 2006, two new vaccines have been licensed to prevent rotavirus, the cause of 20% to 50% of severe acute gastroenteritis in young children worldwide. These vaccines have been implemented in national immunization programs in about 30 high- and middle-income countries, including the United States, and vaccine use has led to substantial decreases in diarrhea-related health care visits. In addition to reductions in diarrhea burden in vaccinated children, decreases have been observed in older, unvaccinated age groups in many settings, suggesting indirect benefits (i.e., herd immunity) from vaccination. Although the efficacy of these oral rotavirus vaccines is expectedly lower in developing countries in Asia and Africa, the public health benefits of vaccination in these settings, where more than 90% of the estimated 453,000 annual deaths from rotavirus occur, are likely to be substantial. Efforts continue to develop alternative rotavirus vaccines that could have a better efficacy and safety profile and may be less expensive.

  20. Campylobacter concisus pathotypes are present at significant levels in patients with gastroenteritis.

    PubMed

    Underwood, Alexander P; Kaakoush, Nadeem O; Sodhi, Nidhi; Merif, Juan; Seah Lee, Way; Riordan, Stephen M; Rawlinson, William D; Mitchell, Hazel M

    2016-03-01

    Given that Campylobacter jejuni is recognized as the most common cause of bacterial gastroenteritis worldwide, recent findings showing comparable levels of Campylobacter concisus in patients with gastroenteritis would suggest that this bacterium is clinically important. The prevalence and abundance of Campylobacter concisus in stool samples collected from patients with acute gastroenteritis was examined using quantitative real-time PCR. The associated virulence determinants exotoxin 9 and zonula occludens toxin DNA were detected for Campylobacter concisus-infected samples using real-time PCR. Campylobacter concisus was detected at high prevalence in patients with gastroenteritis (49.7 %), higher than that observed for Campylobacter jejuni (∼5 %). The levels of Campylobacter concisus were putatively classified into clinically relevant and potentially transient subgroups based on a threshold developed using Campylobacter jejuni levels, as the highly sensitive real-time PCR probably detected transient passage of the bacterium from the oral cavity. A total of 18 % of patients were found to have clinically relevant levels of Campylobacter concisus, a significant number of which also had high levels of one of the virulence determinants. Of these patients, 78 % were found to have no other gastrointestinal pathogen identified in the stool, which strongly suggests a role for Campylobacter concisus in the aetiology of gastroenteritis in these patients. These results emphasize the need for diagnostic laboratories to employ identification protocols for emerging Campylobacter species. Clinical follow-up in patients presenting with high levels of Campylobacter concisus in the intestinal tract is needed, given that it has been associated with more chronic sequelae. PMID:26698172

  1. Campylobacter concisus pathotypes are present at significant levels in patients with gastroenteritis.

    PubMed

    Underwood, Alexander P; Kaakoush, Nadeem O; Sodhi, Nidhi; Merif, Juan; Seah Lee, Way; Riordan, Stephen M; Rawlinson, William D; Mitchell, Hazel M

    2016-03-01

    Given that Campylobacter jejuni is recognized as the most common cause of bacterial gastroenteritis worldwide, recent findings showing comparable levels of Campylobacter concisus in patients with gastroenteritis would suggest that this bacterium is clinically important. The prevalence and abundance of Campylobacter concisus in stool samples collected from patients with acute gastroenteritis was examined using quantitative real-time PCR. The associated virulence determinants exotoxin 9 and zonula occludens toxin DNA were detected for Campylobacter concisus-infected samples using real-time PCR. Campylobacter concisus was detected at high prevalence in patients with gastroenteritis (49.7 %), higher than that observed for Campylobacter jejuni (∼5 %). The levels of Campylobacter concisus were putatively classified into clinically relevant and potentially transient subgroups based on a threshold developed using Campylobacter jejuni levels, as the highly sensitive real-time PCR probably detected transient passage of the bacterium from the oral cavity. A total of 18 % of patients were found to have clinically relevant levels of Campylobacter concisus, a significant number of which also had high levels of one of the virulence determinants. Of these patients, 78 % were found to have no other gastrointestinal pathogen identified in the stool, which strongly suggests a role for Campylobacter concisus in the aetiology of gastroenteritis in these patients. These results emphasize the need for diagnostic laboratories to employ identification protocols for emerging Campylobacter species. Clinical follow-up in patients presenting with high levels of Campylobacter concisus in the intestinal tract is needed, given that it has been associated with more chronic sequelae.

  2. Incidence of Norovirus and Other Viral Pathogens That Cause Acute Gastroenteritis (AGE) among Kaiser Permanente Member Populations in the United States, 2012-2013.

    PubMed

    Grytdal, Scott P; DeBess, Emilio; Lee, Lore E; Blythe, David; Ryan, Patricia; Biggs, Christianne; Cameron, Miriam; Schmidt, Mark; Parashar, Umesh D; Hall, Aron J

    2016-01-01

    Noroviruses and other viral pathogens are increasingly recognized as frequent causes of acute gastroenteritis (AGE). However, few laboratory-based data are available on the incidence of AGE caused by viral pathogens in the U.S. This study examined stool specimens submitted for routine clinical diagnostics from patients enrolled in Kaiser Permanente (KP) health plans in metro Portland, OR, and the Maryland, District of Columbia, and northern Virginia geographic areas to estimate the incidence of viral enteropathogens in these populations. Over a one-year study period, participating laboratories randomly selected stools submitted for routine clinical diagnostics for inclusion in the study along with accompanying demographic and clinical data. Selected stools were tested for norovirus, rotavirus, sapovirus, and astrovirus using standardized real-time RT-PCR protocols. Each KP site provided administrative data which were used in conjunction with previously published data on healthcare utilization to extrapolate pathogen detection rates into population-based incidence rates. A total of 1,099 specimens collected during August 2012 to September 2013 were included. Mean age of patients providing stool specimens was 46 years (range: 0-98 years). Noroviruses were the most common viral pathogen identified among patients with AGE (n = 63 specimens, 6% of specimens tested). In addition, 22 (2%) of specimens were positive for rotavirus; 19 (2%) were positive for sapovirus; and 7 (1%) were positive for astrovirus. Incidence of norovirus-associated outpatient visits was 5.6 per 1,000 person-years; incidence of norovirus disease in the community was estimated to be 69.5 per 1,000 person-years. Norovirus incidence was highest among children <5 years of age (outpatient incidence = 25.6 per 1,000 person-years; community incidence = 152.2 per 1,000 person-years), followed by older adults aged >65 years (outpatient incidence = 7.8 per 1,000 person-years; community incidence = 75.8 per 1

  3. [Gastroenteritis eosinofílica].

    PubMed

    Garibay-Vargas, Ondina Marlene; Soto-Candía, Diego; Coria-Ramírez, Erika; Castrejón-Vázquez, María Isabel; Vargas-Camaño, María Eugenia; Ramos-Acosta, Gabriel; Salamanca-García, Moisés; Guido-Bayardo, Ricardo Leopoldo

    2014-01-01

    The eosinophilic gastroenteritis is a disease of unknown etiopathogenesis and rare presentation, with several clinical symptoms, ranging from mild episodes until nonspecific abdominal acute episodes of intestinal obstruction, which some times make it necessary urgent surgical treatment. This wide symptomatic range seems to be conditioned by the degree of eosinophilic infiltration of the intestinal wall and the number of layers involved. This paper reports the case of a patient who, due to the diagnosis difficulties, illustrates in a single patient the intestinal and respiratory anatomo-clinical diversity and the evolution of the eosinophilia both intestinal and peripheral. Patient was sent to our service with diagnoses of bronchial asthma, chronic allergic rhinitis and chronic anemia.

  4. Norovirus Gastroenteritis Successfully Treated with Nitazoxanide

    PubMed Central

    Siddiq, Danish M.; Koo, Hoonmo L.; Adachi, Javier A.; Viola, George M.

    2012-01-01

    Infectious and non-infectious diarrhea is a common occurrence in the immunosuppressed population. We present a 43-year-old individual with large-volume stool output Norovirus acute gastroenteritis in the setting of relapsed refractory acute myelogenous leukemia, hematopoietic stem cell transplantation, and biopsy-proven cutaneous and pulmonary graft-versus-host disease. Therapeutic options such as intravenous immunoglobulin or reduction of oral immunosuppressants were not a feasible choice. A prompt clinical cure was achieved with nitazoxanide, a broad spectrum antimicrobial agent. Nitazoxanide may be a safe therapeutic alternative, in which a reduction in immunosuppression is not a viable option. PMID:21839773

  5. Norwalk-like viral gastroenteritis outbreak in U.S. Army trainees.

    PubMed Central

    Arness, M. K.; Feighner, B. H.; Canham, M. L.; Taylor, D. N.; Monroe, S. S.; Cieslak, T. J.; Hoedebecke, E. L.; Polyak, C. S.; Cuthie, J. C.; Fankhauser, R. L.; Humphrey, C. D.; Barker, T. L.; Jenkins, C. D.; Skillman, D. R.

    2000-01-01

    An outbreak of acute gastroenteritis hospitalized 99 (12%) of 835 U. S. Army trainees at Fort Bliss, El Paso, Texas, from August 27 to September 1, 1998. Reverse transcriptase polymerase chain reaction tests for Norwalk-like virus were positive for genogroup 2. Gastroenteritis was associated with one post dining facility and with soft drinks. PMID:10756159

  6. Eosinophilic Gastroenteritis with Eosinophilic Dermatitis

    PubMed Central

    Lee, Joung Il; Joo, Kwang Ro; Shin, Hyun Phil

    2010-01-01

    Eosinophilic gastroenteritis (EG) is characterized by eosinophilic infiltration of the bowel wall and variable gastrointestinal manifestations. Clinicians should have a high index of suspicion for EG when faced with gastrointestinal symptoms and peripheral eosinophilia to avoid incorrect diagnosis and inappropriate treatments. A 24-year-old woman was admitted to our hospital complaining of acute right lower quadrant abdominal pain and a laparoscopic appendectomy performed for a presumed diagnosis of an acute appendicitis. However, the procedure revealed bowel edema and a moderate amount of ascites without evidence of a suppurative appendicitis. Postoperatively, she showed persistent and progressive eosinophilia, exudative eosinophilic ascites, eosinophilic infiltration of the resected appendix wall, and eosinophilic infiltration of gastroduodenal mucosa. A punch biopsy of the abdominal skin also revealed inflammation with marked eosinophilic infiltration of the skin. She recovered after the treatment with a low dose of steroid for the EG with eosinophilic dermatitis. EG with eosinophilic dermatitis has not been reported yet and is considered fortuitous in this case. PMID:20046530

  7. Molecular epidemiology of noroviruses associated with sporadic gastroenteritis in children in Novosibirsk, Russia, 2003-2012.

    PubMed

    Zhirakovskaia, Elena V; Tikunov, Artem Yu; Bodnev, Sergey A; Klemesheva, Vera V; Netesov, Sergey V; Tikunova, Nina V

    2015-05-01

    Noroviruses (NoVs) are an important cause of acute gastroenteritis worldwide. To monitor the molecular epidemiology of NoVs genogroup II (GII) in Novosibirsk, Russia, a total of 10,198 stool samples from young children hospitalized with acute gastroenteritis and two asymptomatic comparison groups were collected from 2003 to 2012. All samples were screened for the presence of NoV GII, rotavirus, and astrovirus by RT-PCR. The prevalence of NoV in gastroenteritis cases was 13.1%, varying from 7.1% to 21.3% in different seasons. Rotavirus and/or astrovirus were detectable in 25% of the NoV-positive samples. NoV was detected throughout the year with a seasonal increase during winter months. Based on sequence analysis of regions D and/or C within the VP1 gene, 892 identified NoV strains were divided into nine genotypes—GII.3 (51%), GII.4 (44%), GII.6 (2%), as well as GII.1, GII.2, GII.5, GII.7, GII.16, and GII.21 (totally, 3%). The prevalence of NoV in the comparison groups was considerably lower (∼2.5%); only GII.4 (n = 6), GII.21 (n = 2) and GII.1 (n = 1) genotypes were revealed. Based on phylogenetic analysis of the ORF1/ORF2 junction region sequences, GII.P21/GII.3 recombinant and GII.P4/GII.4 were prevalent genotypes (totally, 93%) and their ratio changed every season. The median age of children with NoV infection was 6.6 months (range, <1-35 months), but it was different depending on NoV genotype. Children infected with the NoV GII.3 were younger (median 6.2 months) than GII.4-positive patients (median 9.1 months). This is the first long-term systematic study of NoV molecular epidemiology in Russia.

  8. The effect of antiemetics in childhood gastroenteritis

    PubMed Central

    2013-01-01

    Introduction Diarrheal diseases are the second leading cause of childhood morbidity and mortality in developing countries and an important cause of malnutrition. An estimated 0.75 million children below 5 years of age die from diarrhea. Vomiting associated with acute gastroenteritis (AGE) is a distressing symptom and limits the success of oral rehydration in AGE leading to an increased use of intravenous rehydration, prolonged emergency department stay and hospitalization. In this review we estimate the effect of antiemetics in gastroenteritis in children. Methods We conducted a systematic review of all the efficacy and effectiveness studies. We used a standardized abstraction and grading format and performed meta-analyses for all outcomes with more than two studies. The estimated effect of antiemetics was determined by applying the standard Child Health Epidemiology Reference Group (CHERG) rules. Results We included seven studies in the review. Antiemetics significantly reduced the incidence of vomiting and hospitalization by 54%. Antiemetics also significantly reduced the intravenous fluid requirements by 60%, while it had a non-significant effect on the ORT tolerance and revisit rates. Conclusion Antiemetics are effective for the management of gastroenteritis in children and have the potential to decrease morbidity and mortality burden due to diarrhea, when introduced and scaled up. PMID:24564795

  9. Three infants with rotavirus gastroenteritis complicated by severe gastrointestinal bleeding.

    PubMed

    Kawamura, Yoshiki; Miura, Hiroki; Mori, Yuji; Sugata, Ken; Nakajima, Yoichi; Yamamoto, Yasuto; Morooka, Masashi; Tsuge, Ikuya; Yoshikawa, Akiko; Taniguchi, Koki; Yoshikawa, Tetsushi

    2016-01-01

    Rotavirus gastroenteritis causes substantial morbidity and mortality worldwide in children. We report three infants with rotavirus gastroenteritis complicated by various severity of gastrointestinal bleeding. Two patients (cases 1 and 2) recovered completely without any specific treatments. One patient (case 3) died despite extensive treatments including a red blood cell transfusion and endoscopic hemostatic therapy. Rotavirus genotypes G1P[8] and G9P[8] were detected in cases 2 and 3, respectively. Rotavirus antigenemia levels were not high at the onset of melena, suggesting that systemic rotaviral infection does not play an important role in causing melena.

  10. WATERBORNE OUTBREAK OF GASTROENTERITIS ASSOCIATED WITH A NOROVIRUS

    EPA Science Inventory

    The Wyoming Department of Health investigated an outbreak of acute gastroenteritis among persons who dined at a tourist saloon in central Wyoming during October 2001. Human caliciviruses (HuCVs) were suspected as the etiological agent of the outbreak based upon the incubation ...

  11. Honey in the treatment of infantile gastroenteritis.

    PubMed

    Haffejee, I E; Moosa, A

    1985-06-22

    A clinical study was undertaken using honey in oral rehydration solution in infants and children with gastroenteritis. The aim was to evaluate the influence of honey on the duration of acute diarrhoea and its value as a glucose substitute in oral rehydration. The results showed that honey shortens the duration of bacterial diarrhoea, does not prolong the duration of non-bacterial diarrhoea, and may safely be used as a substitute for glucose in an oral rehydration solution containing electrolytes. The correct dilution of honey, as well as the presence of electrolytes in the oral rehydration solution, however, must be maintained.

  12. Eosinophilic gastroenteritis: an update.

    PubMed

    Lucendo, Alfredo J; Arias, Angel

    2012-09-01

    Eosinophilic gastroenteritis (EGE) is characterized by dense eosinophilic inflammation of one or several digestive tract sections. The symptoms include abdominal pain, weight loss, vomiting and diarrhea. Biopsy samples taken during endoscopic examination allows the diagnosis of the disease. An infiltration of >30 eosinophils per high-power field in at least five high-power fields, exhibiting signs of eosinophilic degranulation and extending to the muscularis mucosa or submucosa are all histological indications of EGE. EGE is traditionally classified into three forms depending on the depth of inflammation in the wall (mucosal, muscular or serosal). This, together with the digestive tract segments involved, determines the clinical presentation. The natural history of EGE includes three different evolutionary patterns, since patients may suffer a single outbreak, a recurrent course or even chronic disease. Corticosteroids are the most frequently used therapy for EGE; dietary treatments should be also considered. Surgery has been limited to solving obstruction and small bowel perforation.

  13. Clinical usefulness of oral immunoglobulins in lung transplant recipients with norovirus gastroenteritis: a case series.

    PubMed

    Gairard-Dory, A-C; Dégot, T; Hirschi, S; Schuller, A; Leclercq, A; Renaud-Picard, B; Gourieux, B; Kessler, R

    2014-12-01

    Viral gastroenteritis causing diarrhea is a common complication observed in lung transplant recipients. Differently from the mild and typically self-limited disease seen in immunocompetent subjects, immunocompromised patients frequently have a more severe course. Norovirus and rotavirus are among the leading causes of severe gastroenteritis in transplant recipients. Specific treatment is unavailable, although good supportive treatment can significantly reduce morbidity. Previous studies have suggested that oral immunoglobulins may be used for the treatment of acute viral gastroenteritis after solid-organ transplantation. Herein, we conducted a retrospective chart review of 12 lung transplant recipients with norovirus-induced gastroenteritis who were treated with oral immunoglobulins for 2 days. Eleven patients were successfully treated, whereas 1 subject was only mildly improved. Four patients had at least 1 recurrence. No significant adverse effects were observed. We conclude that oral immunoglobulins may be clinically useful for lung transplant recipients with norovirus-induced gastroenteritis.

  14. Worldwide construction

    SciTech Connect

    Bell, L.

    1993-10-18

    Major construction projects in worldwide processing and pipelining are tested, showing capacities, contractors, estimated costs, and time of completion. Total capacity figure in Remarks and completion column includes capacity of project listed. The information is divided into petroleum refineries, petrochemical plants, sulfur recovery units, gas processing plants, related fuel plants (cogeneration, coal gasification, combined cycles), and pipeline companies.

  15. The Prevalence of Rotavirus and Adenovirus in the Childhood Gastroenteritis

    PubMed Central

    Ozsari, Tamer; Bora, Gulhan; Kaya, Bulent; Yakut, Kahraman

    2016-01-01

    Background Acute gastroenteritis stemming from viral causes is very common during the childhood period. Rotavirus and enteric adenovirus are the most common factors of acute gastroenteritis encountered in infants and children. However, the epidemiology of rotavirus and enteric adenovirus gastroenteritis in the east Anatolia region is not well-known. Objectives We aimed to evaluate the relationship between the distribution of antigen positivity in rotavirus and enteric adenovirus antigen tests required cases and demographic data retrospectively in pediatric patients admitted to our hospital. Patients and Methods The records of stool sample analyses for 1154 patients admitted to our hospital from June 2011 to December 2011 with complaints of diarrhea were retrospectively examined. The presence of rotavirus and enteric adenovirus antigens in stool specimens was investigated by means of an immunochromatographic test. Results Viral antigens were detected in 327 (28.3%) stool specimens out of 1154. Among the positive results, the frequency was 73.7% for rotavirus and 26.2% for adenovirus. While the detected rotavirus antigen rate was high for all age groups, it was highest for children under the age of 2, with a rate of 57.1%. Moreover, the rotavirus infections were observed at a rate of 44.3% in winter and of 24.6% in autumn. Conclusions The most important factor in childhood acute gastroenteritis in east Anatolia is the rotavirus. Rotavirus and adenovirus antigens should be routinely investigated as a factor in fresh stool samples for the accurate diagnosis and treatment of gastroenteritis in children in the winter and autumn months. PMID:27635215

  16. Leptospirosis: a worldwide resurgent zoonosis and important cause of acute renal failure and death in developing nations.

    PubMed

    Cruz, Luzia S; Vargas, Roberto; Lopes, Antonio Alberto

    2009-01-01

    Leptospirosis, a spirochetal zoonosis, is a globally re-emerging infectious disease that has disseminated from its habitual rural base to become the cause of urban epidemics in poor communities of industrialized and developing nations. This review addresses the issues in the epidemiology, clinical features, and management of the disease, as well as progress made toward understanding the pathogenesis of leptospiral nephropathy. In developing nations, leptospirosis plays an important role as a potentially preventable cause of acute renal failure. The data indicate that in certain developing regions, such as the city of Salvador, Brazil, leptospirosis is misdiagnosed with other infectious disease such as dengue and the overall disease burden is likely underestimated partly because of the protean and nonspecific presentation. Severe forms of the disease are associated with high case-fatality rate. In urban Brazil, outbreaks of leptospirosis can be predicted by heavy rain and flooding and this may serve to indicate which resources should be allocated to prevent the disease. Advancements in the basic research and epidemiology of leptospirosis should contribute to the development of more accurate diagnostic tests and of an effective vaccine. Policy makers should be urged to address the underlying conditions of poverty as well as environmental issues, which have led to the emergence of leptospirosis.

  17. Worldwide construction

    SciTech Connect

    Williamson, M.

    1994-10-17

    The paper lists major construction projects in worldwide processing and pipelining, showing capacities, contractors, estimated costs, and time of construction. The lists are divided into refineries, petrochemical plants, sulfur recovery units, gas processing plants, pipelines, and related fuel facilities. This last classification includes cogeneration plants, coal liquefaction and gasification plants, biomass power plants, geothermal power plants, integrated coal gasification combined-cycle power plants, and a coal briquetting plant.

  18. Norovirus Recombinant Strains Isolated from Gastroenteritis Outbreaks in Southern Brazil, 2004-2011.

    PubMed

    Fumian, Tulio Machado; da Silva Ribeiro de Andrade, Juliana; Leite, José Paulo Gagliardi; Miagostovich, Marize Pereira

    2016-01-01

    Noroviruses are recognized as one of the leading causes of viral acute gastroenteritis, responsible for almost 50% of acute gastroenteritis outbreaks worldwide. The positive single-strand RNA genome of noroviruses presents a high mutation rate and these viruses are constantly evolving by nucleotide mutation and genome recombination. Norovirus recombinant strains have been detected as causing acute gastroenteritis outbreaks in several countries. However, in Brazil, only one report of a norovirus recombinant strain (GII.P7/GII.20) has been described in the northern region so far. For this study, 38 norovirus strains representative of outbreaks, 11 GII.4 and 27 non-GII.4, were randomly selected and amplified at the ORF1/ORF2 junction. Genetic recombination was identified by constructing phylogenetic trees of the polymerase and capsid genes, and further SimPlot and Bootscan analysis of the ORF1/ORF2 overlap. Sequence analysis revealed that 23 out of 27 (85%) non-GII.4 noroviruses were recombinant strains, characterized as: GII.P7/GII.6 (n = 9); GIIP.g/GII.12 (n = 4); GII.P16/GII.3 (n = 4); GII.Pe/GII.17 (n = 2); GII.P7/GII.14 (n = 1); GII.P13/GII.17 (n = 1); GII.P21/GII.3 (n = 1); and GII.P21/GII.13 (n = 1). On the other hand, among the GII.4 variants analyzed (Den Haag_2006b and New Orleans_2009) no recombination was observed. These data revealed the great diversity of norovirus recombinant strains associated with outbreaks, and describe for the first time these recombinant types circulating in Brazil. Our results obtained in southern Brazil corroborate the previous report for the northern region, demonstrating that norovirus recombinant strains are circulating more frequently than we expected. In addition, these results emphasize the relevance of including ORF1/ORF2-based analysis in surveillance studies as well as the importance of characterizing strains from other Brazilian regions to obtain epidemiological data for norovirus recombinant strains circulating in the

  19. Norovirus Recombinant Strains Isolated from Gastroenteritis Outbreaks in Southern Brazil, 2004–2011

    PubMed Central

    Leite, José Paulo Gagliardi; Miagostovich, Marize Pereira

    2016-01-01

    Noroviruses are recognized as one of the leading causes of viral acute gastroenteritis, responsible for almost 50% of acute gastroenteritis outbreaks worldwide. The positive single-strand RNA genome of noroviruses presents a high mutation rate and these viruses are constantly evolving by nucleotide mutation and genome recombination. Norovirus recombinant strains have been detected as causing acute gastroenteritis outbreaks in several countries. However, in Brazil, only one report of a norovirus recombinant strain (GII.P7/GII.20) has been described in the northern region so far. For this study, 38 norovirus strains representative of outbreaks, 11 GII.4 and 27 non-GII.4, were randomly selected and amplified at the ORF1/ORF2 junction. Genetic recombination was identified by constructing phylogenetic trees of the polymerase and capsid genes, and further SimPlot and Bootscan analysis of the ORF1/ORF2 overlap. Sequence analysis revealed that 23 out of 27 (85%) non-GII.4 noroviruses were recombinant strains, characterized as: GII.P7/GII.6 (n = 9); GIIP.g/GII.12 (n = 4); GII.P16/GII.3 (n = 4); GII.Pe/GII.17 (n = 2); GII.P7/GII.14 (n = 1); GII.P13/GII.17 (n = 1); GII.P21/GII.3 (n = 1); and GII.P21/GII.13 (n = 1). On the other hand, among the GII.4 variants analyzed (Den Haag_2006b and New Orleans_2009) no recombination was observed. These data revealed the great diversity of norovirus recombinant strains associated with outbreaks, and describe for the first time these recombinant types circulating in Brazil. Our results obtained in southern Brazil corroborate the previous report for the northern region, demonstrating that norovirus recombinant strains are circulating more frequently than we expected. In addition, these results emphasize the relevance of including ORF1/ORF2-based analysis in surveillance studies as well as the importance of characterizing strains from other Brazilian regions to obtain epidemiological data for norovirus recombinant strains circulating in the

  20. Escherichia coli Meningitis after Rotavirus Gastroenteritis in an Infant

    PubMed Central

    Vermezoglu, Oznur; Ocal Topcu, Didem; Karbuz, Adem; Hacihamdioglu, Bulent

    2016-01-01

    Although rotavirus gastroenteritis is quite common in the pediatric population, secondary bacterial sepsis following rotavirus infection is a rare clinical entity. Gram-negative bacilli are the fifth most common cause of meningitis in infants but this infection rarely occurs after gastroenteritis. Here, we report a 2.5-month-old infant who developed Escherichia coli (E. coli) meningitis after acute rotavirus gastroenteritis. The 2.5-month-old male infant with fever, vomiting, and watery diarrhea that started 1 day earlier was admitted to the hospital. Rotavirus antigen in stool sample was positive. He was hospitalized, and fever was measured at 39.5°C on the second day. Lumbar puncture was done for suspicion of meningitis, and cerebrospinal fluid (CSF) findings suggested meningitis. Intravenous vancomycin and cefotaxime were started empirically. Since E. coli reproduction was seen in blood culture and CSF culture, treatment was continued with cefotaxime. The patient was discharged with minimal midlevel hydrocephalus findings in cranial ultrasonography and magnetic resonance imaging following 21 days of antibiotics treatment. Septicemia development following rotavirus gastroenteritis is an extremely rare clinical condition. It is vital to start prompt antibiotic treatment as soon as the diagnosis of secondary bacterial infection is made because of high mortality and morbidity rates. PMID:27738536

  1. Gastroenteritis: A Grass Root Approach.

    ERIC Educational Resources Information Center

    Dure-Samin, Akram; Mubina, Agboatwalla

    1992-01-01

    In Karachi, Pakistan, 4 resource personnel disseminated information about sanitation and breastfeeding in the prevention of gastroenteritis to 100 households. Compared to 100 that did not receive health information, the intervention group had less incidence of diarrhea and better use of oral rehydration salt. (SK)

  2. Hospitalizations associated with rotavirus gastroenteritis in Spain, 2001–2005

    PubMed Central

    López-de-Andrés, Ana; Jiménez-García, Rodrigo; Carrasco-Garrido, Pilar; Alvaro-Meca, Alejandro; Galarza, Patricia Graciela; de Miguel, Ángel Gil

    2008-01-01

    Background This study aims to describe and analyze hospital admissions in Spain due to rotavirus infections among children aged 5 years or under during the period 2001–2005, along with the associated health cost. Methods To update estimates of rotavirus hospitalizations rates in Spain, we conducted a retrospective study of 5 years of national hospitalization data associated with acute gastroenteritis using the Minimum Basic Data Set. Results During the study period, a total of 17.1% of all admissions due to acute gastroenteritis of any etiology in children aged ≤ 5 years were attributable to rotavirus infection as determined by the rotavirus-specific International Classification of Diseases, ninth revision, Clinical Modification code. A mean incidence of 135 hospital admissions attributable to rotavirus per 100,000 children aged ≤ 5 years was found. Hospitalizations associated with rotavirus had a marked winter-time seasonality. The estimated cost of hospital admission attributable to rotavirus has risen from 3 million euros estimated for 2001 to almost 7 million euros estimated in 2005. Conclusion Rotavirus gastroenteritis remains an important cause of hospitalizations in Spanish children, mostly during the winter season. PMID:18397512

  3. Laboratory Diagnosis of Bacterial Gastroenteritis

    PubMed Central

    Humphries, Romney M.

    2015-01-01

    SUMMARY Bacterial gastroenteritis is a disease that is pervasive in both the developing and developed worlds. While for the most part bacterial gastroenteritis is self-limiting, identification of an etiological agent by bacterial stool culture is required for the management of patients with severe or prolonged diarrhea, symptoms consistent with invasive disease, or a history that may predict a complicated course of disease. Importantly, characterization of bacterial enteropathogens from stool cultures in clinical laboratories is one of the primary means by which public health officials identify and track outbreaks of bacterial gastroenteritis. This article provides guidance for clinical microbiology laboratories that perform stool cultures. The general characteristics, epidemiology, and clinical manifestations of key bacterial enteropathogens are summarized. Information regarding optimal specimen collection, transport, and processing and current diagnostic tests and testing algorithms is provided. This article is an update of Cumitech 12A (P. H. Gilligan, J. M. Janda, M. A. Karmali, and J. M. Miller, Cumitech 12A, Laboratory diagnosis of bacterial diarrhea, 1992). PMID:25567220

  4. Assessment of Worldwide Acute Kidney Injury, Renal Angina and Epidemiology in Critically Ill Children (AWARE): A Prospective Study to Improve Diagnostic Precision

    PubMed Central

    Basu, Rajit K; Kaddourah, Ahmad; Terrell, Tara; Mottes, Theresa; Arnold, Patricia; Jacobs, Judd; Andringa, Jennifer; Armor, Melissa; Hayden, Lauren; Goldstein, Stuart L

    2015-01-01

    Background Acute kidney injury (AKI) is associated with poor outcomes in critically ill children. Recent international consensus panels recommend standardized classification systems to improve the precision of AKI diagnosis, but there is a paucity of data to enable this refinement, particularly in pediatric critical care. Methods/Design This is a prospective observational study. We anticipate collecting data from more than 5500 critically ill children admitted to 32 pediatric intensive care units (PICUs) across the world, during the calendar year of 2014. Data will be collected continuously for three months at each center on all children older than 90 days and younger than 25 years admitted to the ICU. Demographic, resuscitative, and daily physiological and lab data will be captured at individual centers using MediData Rave™, a commercial system designed to manage and report clinical research data. Kidney specific measured variables include changes in serum creatinine and urine output, cumulative fluid overload (%), serum creatinine corrected for fluid balance, and KDIGO AKI stage. Urinary AKI biomarkers to be measured include: urinary neutrophil gelatinase lipocalin (NGAL), kidney injury molecule-1 (KIM-1), liver-type fatty acid binding protein (l-FABP), and interleukin-18 (IL-18). Biomarker combinations will be created from different pairs and triplets of urinary biomarkers. The primary analysis will compare the discrimination of these panels versus changes in creatinine for prediction of severe AKI by Day 7 of ICU admission. Secondary analysis will investigate the prediction of biomarkers for injury ‘time based phenotypes’: duration (>2 days), severity (KDIGO stage, use of renal replacement therapy), reversibility (time to return of serum creatinine to baseline), association with fluid overload > 10%, and disease association (sepsis, hypovolemia, hypoxemia, or nephrotoxic). Discussion The Assessment of Worldwide Acute Kidney Injury, Renal Angina and

  5. Respiratory symptoms and the case definition of gastroenteritis: an international analysis of the potential impact on burden estimates.

    PubMed

    Hall, G; McDonald, L; Majowicz, S E; Scallan, E; Kirk, M; Sockett, P; Angulo, F J

    2010-01-01

    Estimates of the burden of foodborne disease rely on attributing a proportion of syndromic gastroenteritis to foodborne transmission. Persons with syndromic diarrhoea/vomiting can also present with concurrent respiratory symptoms that could be due to respiratory infections, gastrointestinal infections, or both. This distinction is important when estimating the foodborne disease burden but has rarely been considered. Using data from population surveys from Australia, Canada and the USA we describe the effect of excluding persons with respiratory and associated symptoms from the case definition of gastroenteritis. Excluding persons first with respiratory symptoms, or second with respiratory symptoms plus fever and headache, resulted in a decrease in the weighted estimates of acute gastroenteritis of about 10-50% depending on the exclusion criteria. This has the potential to have a very significant impact on estimates of the burden of foodborne infections using syndromic case definitions of acute gastroenteritis.

  6. Global Economic Burden of Norovirus Gastroenteritis

    PubMed Central

    Bartsch, Sarah M.; Lopman, Benjamin A.; Ozawa, Sachiko; Hall, Aron J.; Lee, Bruce Y.

    2016-01-01

    Background Despite accounting for approximately one fifth of all acute gastroenteritis illnesses, norovirus has received comparatively less attention than other infectious pathogens. With several candidate vaccines under development, characterizing the global economic burden of norovirus could help funders, policy makers, public health officials, and product developers determine how much attention and resources to allocate to advancing these technologies to prevent and control norovirus. Methods We developed a computational simulation model to estimate the economic burden of norovirus in every country/area (233 total) stratified by WHO region and globally, from the health system and societal perspectives. We considered direct costs of illness (e.g., clinic visits and hospitalization) and productivity losses. Results Globally, norovirus resulted in a total of $4.2 billion (95% UI: $3.2–5.7 billion) in direct health system costs and $60.3 billion (95% UI: $44.4–83.4 billion) in societal costs per year. Disease amongst children <5 years cost society $39.8 billion, compared to $20.4 billion for all other age groups combined. Costs per norovirus illness varied by both region and age and was highest among adults ≥55 years. Productivity losses represented 84–99% of total costs varying by region. While low and middle income countries and high income countries had similar disease incidence (10,148 vs. 9,935 illness per 100,000 persons), high income countries generated 62% of global health system costs. In sensitivity analysis, the probability of hospitalization had the largest impact on health system cost estimates ($2.8 billion globally, assuming no hospitalization costs), while the probability of missing productive days had the largest impact on societal cost estimates ($35.9 billion globally, with a 25% probability of missing productive days). Conclusions The total economic burden is greatest in young children but the highest cost per illness is among older age

  7. A COLLABORATIVE EFFORT TO IDENTIFY THE CAUSATIVE AGENT OF TWO WATERBORNE OUTBREAKS OF GASTROENTERITIS IN WYOMING

    EPA Science Inventory

    Two outbreaks of acute gastroenteritis were reported to the Wyoming Department of Health in 2001. The first was reported in February from recent vacationers of a snowmobile lodge. The second was in October among diners of a tourist saloon. The duration and type of symptoms exhibi...

  8. Waterborne outbreak of gastroenteritis associated with a norovirus.

    PubMed

    Parshionikar, Sandhya U; Willian-True, Sandra; Fout, G Shay; Robbins, David E; Seys, Scott A; Cassady, Joslyn D; Harris, Richard

    2003-09-01

    The Wyoming Department of Health investigated an outbreak of acute gastroenteritis among persons who dined at a tourist saloon in central Wyoming during October 2001. Human caliciviruses (HuCVs) were suspected as the etiological agent of the outbreak based on the incubation period, duration of illness, and symptoms observed in ill patrons. A retrospective cohort study demonstrated that ill patrons were 4.5 times more likely to have exposure to drinking water and/or ice than nonill patrons. No food items were associated with illness. An environmental investigation gave evidence that the saloon's groundwater was contaminated with sewage. Water from the saloon's only well was processed for viruses. The processed water sample and stool samples collected from three ill patrons were analyzed by reverse transcription-PCR (RT-PCR) for the presence of HuCV. All positive RT-PCR results were confirmed by sequence and phylogenetic analyses of cloned RT-PCR products. A genogroup I, subtype 3, HuCV stain was found to be present in the well water sample and two stool samples. In addition, a genogroup II, subtype 6, strain was detected in one stool sample. The identification of the same HuCV strain in both the well water and stool samples strongly suggests a link between exposure to well water and the outbreak of gastroenteritis. The presence of a genogroup II, subtype 6, strain in one of the stool samples suggests that multiple HuCV strains may have been involved in this outbreak. The laboratory isolation of HuCV strains from outbreak-associated drinking water is relatively novel in the United States. This investigation outlines the procedure for virus isolation and illustrates the utility of RT-PCR for the identification of HuCV in large volumes of water and stool samples obtained during outbreaks of acute nonbacterial gastroenteritis.

  9. An outbreak of food-borne gastroenteritis due to sapovirus among junior high school students.

    PubMed

    Usuku, Shuzo; Kumazaki, Makoto; Kitamura, Katsuhiko; Tochikubo, Osamu; Noguchi, Yuzo

    2008-11-01

    The human sapovirus (SaV) causes acute gastroenteritis mainly in infants and young children. A food-borne outbreak of gastroenteritis associated with SaV occurred among junior high school students in Yokohama, Japan, during and after a study trip. The nucleotide sequences of the partial capsid gene derived from the students exhibited 98% homology to a SaV genogroup IV strain, Hu/Angelholm/SW278/2004/SE, which was isolated from an adult with gastroenteritis in Solna, Sweden. An identical nucleotide sequence was detected from a food handler at the hotel restaurant, suggesting that the causative agent of the outbreak was transmitted from the food handler. This is the first description of a food-borne outbreak associated with the SaV genogroup IV strain in Japan. PMID:19050349

  10. Eosinophilic gastroenteritis associated with systemic lupus erythematosus.

    PubMed

    Barbie, David A; Mangi, Abeel A; Lauwers, Gregory Y

    2004-01-01

    Eosinophilic gastroenteritis is an uncommon disease with an obscure etiology, although associations with allergy, the idiopathic hypereosinophilic syndrome, and connective tissue disease have been reported. We present the case of a 37-year-old woman with a history of idiopathic thrombocytopenic purpura who presented with refractory nausea, vomiting, and abdominal pain. Imaging studies were significant for bowel wall thickening and ascites, while laboratory studies revealed a positive antinuclear antibody (ANA), a positive anti-double stranded (DS) DNA antibody, low complement, and proteinuria. Exploratory laparotomy with gastric and small bowel biopsies established the diagnosis of eosinophilic gastroenteritis. In addition, the patient met clinical criteria for the diagnosis of systemic lupus erythematosus. Previous studies have described eosinophilic gastroenteritis in patients with scleroderma, polymyositis, or dermatomyositis. This is the first report to our knowledge of an individual with eosinophilic gastroenteritis and systemic lupus erythematosus. PMID:15492606

  11. The IL-23 axis in Salmonella gastroenteritis.

    PubMed

    Godinez, Ivan; Keestra, A Marijke; Spees, Alanna; Bäumler, Andreas J

    2011-11-01

    Non-typhoidal Salmonella (NTS) serotypes cause a localized gastroenteritis in immunocompetent individuals. In contrast, primary immunodeficiencies that impair interleukin-23 (IL-23)-dependent pathways are associated in humans with disseminated NTS bloodstream infections (bacteraemia). The recent use of animal models has helped to define the role the IL-23 axis plays during NTS gastroenteritis, but additional work is needed to elucidate how this host defence pathway prevents NTS bacteraemia. PMID:21740501

  12. Viral gastroenteritis in children in Colorado 2006-2009.

    PubMed

    Osborne, Christina M; Montano, Aaron C; Robinson, Christine C; Schultz-Cherry, Stacey; Dominguez, Samuel R

    2015-06-01

    Acute gastroenteritis accounts for a significant burden of medically attended illness in children under the age of five. For this study, four multiplex reverse transcription PCR assays were used to determine the incidence of adenovirus, astrovirus, coronavirus, norovirus GI and GII, rotavirus, and sapovirus in stool samples submitted for viral electron microscopy (EM) to the Children's Hospital Colorado. Of 1105 stool samples available, viral RNA/DNA was detected in 247 (26.2%) of 941 pediatric samples (median age = 2.97 years, 54% male) with 28 (3.0%) positive for more than one virus. Adenovirus, astrovirus, norovirus GI, norovirus GII, rotavirus, and sapovirus were detected in 95 (10.0%), 33 (3.5%), 8 (0.9%), 90 (9.6%), 49 (5.2%), and 2 (0.2%) of the pediatric samples, respectively. No coronaviruses were identified. Sequencing of norovirus positive samples indicated an outbreak of norovirus strain GII.4 in 2006 with evidence of numerous circulating strains. Multiple samples from the same immunocompromised patients demonstrated symptomatic shedding of norovirus for up to 32 weeks and astrovirus for 12 weeks. RT-PCR detected 99 of 111 (89%) adenovirus-positive samples versus 12 (11%) by EM, and 186 of 192 (97%) sapovirus/astrovirus/norovirus-positive samples versus 21 (11%) by EM. Noroviruses and adenoviruses are common causes of gastroenteritis in children. Immunocompromised patients can be infected with multiple viruses and shed viruses in their stools for prolonged periods. This data support the superiority of RT-PCR compared to EM for diagnosis of viral gastroenteritis.

  13. Structural basis of glycan interaction in gastroenteric viral pathogens

    PubMed Central

    Prasad, B.V. Venkataram; Shanker, Sreejesh; Hu, Liya; Choi, Jae-Mun; Crawford, Sue E; Ramani, Sasirekha; Czako, Rita; Atmar, Robert L; Estes, Mary K

    2014-01-01

    A critical event in the life cycle of a virus is its initial attachment to host cells. This involves recognition by the viruses of specific receptors on the cell surface, including glycans. Viruses typically exhibit strain-dependent variations in recognizing specific glycan receptors, a feature that contributes significantly to cell tropism, host specificity, host adaptation and interspecies transmission. Examples include influenza viruses, noroviruses, rotaviruses, and parvoviruses. Both rotaviruses and noroviruses are well known gastroenteric pathogens that are of significant global health concern. While rotaviruses, in the family Reoviridae, are the major causative agents of life-threatening diarrhea in children, noroviruses, which belong to Caliciviridae family, cause epidemic and sporadic cases of acute gastroenteritis across all age groups. Both exhibit enormous genotypic and serotypic diversity. Consistent with this diversity each exhibits strain-dependent variations in the types of glycans they recognize for cell attachment. This chapter reviews current status of the structural biology of such strain-dependent glycan specificities in these two families of viruses. PMID:25073118

  14. Household Catastrophic Healthcare Expenditure and Impoverishment Due to Rotavirus Gastroenteritis Requiring Hospitalization in Malaysia

    PubMed Central

    2015-01-01

    Background While healthcare costs for rotavirus gastroenteritis requiring hospitalization may be burdensome on households in Malaysia, exploration on the distribution and catastrophic impact of these expenses on households are lacking. Objectives We assessed the economic burden, levels and distribution of catastrophic healthcare expenditure, the poverty impact on households and inequities related to healthcare payments for acute gastroenteritis requiring hospitalization in Malaysia. Methods A two-year prospective, hospital-based study was conducted from 2008 to 2010 in an urban (Kuala Lumpur) and rural (Kuala Terengganu) setting in Malaysia. All children under the age of 5 years admitted for acute gastroenteritis were included. Patients were screened for rotavirus and information on healthcare expenditure was obtained. Results Of the 658 stool samples collected at both centers, 248 (38%) were positive for rotavirus. Direct and indirect costs incurred were significantly higher in Kuala Lumpur compared with Kuala Terengganu (US$222 Vs. US$45; p<0.001). The mean direct and indirect costs for rotavirus gastroenteritis consisted 20% of monthly household income in Kuala Lumpur, as compared with only 5% in Kuala Terengganu. Direct medical costs paid out-of-pocket caused 141 (33%) households in Kuala Lumpur to experience catastrophic expenditure and 11 (3%) households to incur poverty. However in Kuala Terengganu, only one household (0.5%) experienced catastrophic healthcare expenditure and none were impoverished. The lowest income quintile in Kuala Lumpur was more likely to experience catastrophic payments compared to the highest quintile (87% vs 8%). The concentration index for out-of-pocket healthcare payments was closer to zero at Kuala Lumpur (0.03) than at Kuala Terengganu (0.24). Conclusions While urban households were wealthier, healthcare expenditure due to gastroenteritis had more catastrophic and poverty impact on the urban poor. Universal rotavirus vaccination

  15. [Arsenic poisoning: a special gastroenteritis...].

    PubMed

    Ganster, F; Kuteifan, K; Mootien, Y; Harry, P; Guiot, P

    2009-06-01

    Arsenic (As) intoxication is nowadays extremely rare. Two cases of acute and chronic As criminal poisoning leading to death of a couple of retired people, are reported. Clinical presentation was simulating a gastro-enteritidis with fast evolution to refractory shock. Toxicological analysis confirmed this diagnostic, with respectively blood As concentrations at 579 and 21 765 microg/l for our two patients.

  16. Bee honey added to the oral rehydration solution in treatment of gastroenteritis in infants and children.

    PubMed

    Abdulrhman, Mamdouh Abdulmaksoud; Mekawy, Mohamed Amin; Awadalla, Maha Mohamed; Mohamed, Ashraf Hassan

    2010-06-01

    Among honey's benefits are its anti-inflammatory and antimicrobial effects. Because gastroenteritis is an acute inflammation of the gastrointestinal tract that may be caused by a variety of microbes, the aim of the present study was to verify whether the addition of honey in oral rehydration solution (ORS) could affect the duration of symptoms of acute gastroenteritis in infants and children. One hundred infants and children with acute gastroenteritis were randomly assigned to one of two treatment groups, each consisting of 50 patients: Group I received ORS for rehydration (control), and Group II received ORS with honey. The mean ages of patients of Groups I and II were 1.5 +/- 1.2 and 1.1 +/- 0.8 years, respectively. In the honey-treated group the frequencies of vomiting and diarrhea were significantly reduced compared to the control group (P < .001 and P < .05, respectively). Also, the recovery time, defined as the number of hours from initiation of treatment to when normal soft stools are passed, with the patient showing normal hydration and satisfactory weight gain, was significantly shortened after honey ingestion (P < .001). In conclusion, honey added to ORS promoted rehydration of the body and sped recovery from vomiting and diarrhea.

  17. Viral gastroenteritis associated with genogroup II norovirus among U.S. military personnel in Turkey, 2009.

    PubMed

    Ahmed, Salwa F; Klena, John D; Mostafa, Manal; Dogantemur, Jessica; Middleton, Tracy; Hanson, James; Sebeny, Peter J

    2012-01-01

    The present study demonstrates that multiple NoV genotypes belonging to genogroup II contributed to an acute gastroenteritis outbreak at a US military facility in Turkey that was associated with significant negative operational impact. Norovirus (NoV) is an important pathogen associated with acute gastroenteritis among military populations. We describe the genotypes of NoV outbreak occurred at a United States military facility in Turkey. Stool samples were collected from 37 out of 97 patients presenting to the clinic on base with acute gastroenteritis and evaluated for bacterial and viral pathogens. NoV genogroup II (GII) was identified by RT-PCR in 43% (16/37) stool samples. Phylogenetic analysis of a 260 base pair fragment of the NoV capsid gene from ten stool samples indicated the circulation of multiple and rare genotypes of GII NoV during the outbreak. We detected four GII.8 isolates, three GII.15, two GII.9 and a sole GII.10 NoV. Viral sequences could be grouped into four clusters, three of which have not been previously reported in Turkey. The fact that current NoV outbreak was caused by rare genotypes highlights the importance of norovirus strain typing. While NoV genogroup II is recognized as causative agent of outbreak, circulation of current genotypes has been rarely observed in large number of outbreaks.

  18. Gastroenteritis outbreak at holiday resort, central Italy.

    PubMed

    Migliorati, Giacomo; Prencipe, Vincenza; Ripani, Alessandro; Di Francesco, Cristina; Casaccia, Claudia; Crudeli, Silvia; Ferri, Nicola; Giovannini, Armando; Marconi, Maria Maddalena; Marfoglia, Cristina; Melai, Valeria; Savini, Giovanni; Scortichini, Giampiero; Semprini, Primula; Ruggeri, Franco Maria

    2008-03-01

    During the summer of 2003, a gastroenteritis outbreak spread throughout a holiday resort in central Italy. Fecally contaminated groundwater and seawater were leaking into the non-drinking-water system, which was found to be connected to the drinking-water system of a large resort. This contamination had a primary role in the onset of the outbreak and spread of the infection.

  19. Noroviruses: The Principal Cause of Foodborne Disease Worldwide

    PubMed Central

    Koo, Hoonmo L.; Ajami, Nadim; Atmar, Robert L.; DuPont, Herbert L.

    2011-01-01

    Noroviruses are the leading cause of foodborne disease outbreaks worldwide, and may soon eclipse rotaviruses as the most common cause of severe pediatric gastroenteritis, as the use of rotavirus vaccines becomes more widespread. Genetic mutations and recombinations contribute to the broad heterogeneity of noroviruses and the emergence of new epidemic strains. Although typically a self-limited disease, norovirus gastroenteritis can cause significant morbidity and mortality among children, the elderly, and the immunocompromised. The lack of a cell culture or small animal model has hindered norovirus research and the development of novel therapeutic and preventative interventions. However, vaccines based on norovirus capsid protein virus-like particles are promising and may one day become widely available through transgenic expression in plants. PMID:20670600

  20. 1986 Worldwide Petrochemical Directory

    SciTech Connect

    Not Available

    1985-01-01

    The 1986 Worldwide Petrochemical Directory contains names, addresses, phone and telex numbers of the companies in the worldwide petrochemical community. Listed are more than 14,000 key operating personnel at nearly 2,000 plant sites in the United States, Canada, Latin America, Europe, Africa, Asia-Pacific and the Middle East. Among the surveys included in this directory is the Worldwide Petrochemical Survey. This survey details petrochemical plant feedstocks, product and capacities.

  1. (+)-Catechin inhibition of transmissible gastroenteritis coronavirus in swine testicular cells is involved its antioxidation.

    PubMed

    Liang, Wulong; He, Lei; Ning, Pengbo; Lin, Jihui; Li, Helin; Lin, Zhi; Kang, Kai; Zhang, Yanming

    2015-12-01

    Transmissible gastroenteritis virus (TGEV) causes transmissible gastroenteritis (TGE), especially in newborn piglets, which severely threatens the worldwide pig industry. In this study, (+)-catechin was evaluated for its antiviral effect against TGEV in vitro. Viability assays revealed that (+)-catechin treatment exerted a dose-dependent rescue effect in TGEV-infected ST cells, and this result was only obtained with the post-treatment application of (+)-catechin. The viral yields in (+)-catechin-treated cultures were reduced by almost three log10 units. Quantitative real-time PCR analysis of the TGEV genome revealed that TGEV RNA replication was restricted after (+)-catechin treatment. Intracellular reactive oxygen species (ROS) detection showed that (+)-catechin alleviated ROS conditions induced by TGEV infection. Our results showed that (+)-catechin exerts an inhibitory effect on TGEV proliferation in vitro and is involved its antioxidation. PMID:26679792

  2. Molecular Epidemiology of Enteric Adenovirus Gastroenteritis in under-Five-Year-Old Children in Iran

    PubMed Central

    Sanaei Dashti, Anahita; Ghahremani, Pedram; Hashempoor, Tayebeh; Karimi, Abdollah

    2016-01-01

    Background. Acute gastroenteritis is one of the major sources of morbidity and mortality among young children in developed and developing countries. The aim of this study was to determine the prevalence of human adenovirus- (HAdV-) 40 and HAdV-41 in children hospitalized with gastroenteritis in five different health centers of Iran. Methods. In a cross-sectional epidemiological study, we studied 2682 fecal specimens that were collected from children under the age of 5 years in five educational and therapeutic pediatric centers in Iran from February 2012 to February 2013. Samples were tested for HAdV-40 and HAdV-41, using a specific pair of primers in polymerase chain reaction (PCR) method. Results. HAdV-40 and HAdV-41 were detected in 132 (5.18%) of the patients with diarrhea. A significantly higher prevalence of HAdV-40 and HAdV-41 (58.3%) was observed in children under 12 months of age, compared to other age groups. The male to female ratio was 1.7. Conclusion. The results of this study demonstrated that HAdV-40 and HAdV-41 could be considered etiological agents for acute gastroenteritis among children in Iran. The PCR as a rapid test may increase the chance for a relatively mild course of the disease followed by a complete recovery and avoiding administration of unnecessary antibiotics. PMID:26880883

  3. Molecular Epidemiology of Enteric Adenovirus Gastroenteritis in under-Five-Year-Old Children in Iran.

    PubMed

    Sanaei Dashti, Anahita; Ghahremani, Pedram; Hashempoor, Tayebeh; Karimi, Abdollah

    2016-01-01

    Background. Acute gastroenteritis is one of the major sources of morbidity and mortality among young children in developed and developing countries. The aim of this study was to determine the prevalence of human adenovirus- (HAdV-) 40 and HAdV-41 in children hospitalized with gastroenteritis in five different health centers of Iran. Methods. In a cross-sectional epidemiological study, we studied 2682 fecal specimens that were collected from children under the age of 5 years in five educational and therapeutic pediatric centers in Iran from February 2012 to February 2013. Samples were tested for HAdV-40 and HAdV-41, using a specific pair of primers in polymerase chain reaction (PCR) method. Results. HAdV-40 and HAdV-41 were detected in 132 (5.18%) of the patients with diarrhea. A significantly higher prevalence of HAdV-40 and HAdV-41 (58.3%) was observed in children under 12 months of age, compared to other age groups. The male to female ratio was 1.7. Conclusion. The results of this study demonstrated that HAdV-40 and HAdV-41 could be considered etiological agents for acute gastroenteritis among children in Iran. The PCR as a rapid test may increase the chance for a relatively mild course of the disease followed by a complete recovery and avoiding administration of unnecessary antibiotics. PMID:26880883

  4. Worldwide cloud cover model

    NASA Technical Reports Server (NTRS)

    Smith, O. E.; Sommerville, P. N.

    1979-01-01

    Classifying worldwide cloudiness into homogeneous regions, using a satellite data set containing day IR, night IR, incoming, and absorbed solar radiation measurements on a 2.5-degree latitude-longitude grid is considered. Methods of analysis are presented.

  5. 2010 Worldwide Gasification Database

    DOE Data Explorer

    The 2010 Worldwide Gasification Database describes the current world gasification industry and identifies near-term planned capacity additions. The database lists gasification projects and includes information (e.g., plant location, number and type of gasifiers, syngas capacity, feedstock, and products). The database reveals that the worldwide gasification capacity has continued to grow for the past several decades and is now at 70,817 megawatts thermal (MWth) of syngas output at 144 operating plants with a total of 412 gasifiers.

  6. Acute arsenic poisoning diagnosed late.

    PubMed

    Shumy, Farzana; Anam, Ahmad Mursel; Kamruzzaman, A K M; Amin, Md Robed; Chowdhury, M A Jalil

    2016-04-01

    Acute arsenicosis, although having a 'historical' background, is not common in our times. This report describes a case of acute arsenic poisoning, missed initially due to its gastroenteritis-like presentation, but suspected and confirmed much later, when the patient sought medical help for delayed complications after about 2 months.

  7. Acute arsenic poisoning diagnosed late.

    PubMed

    Shumy, Farzana; Anam, Ahmad Mursel; Kamruzzaman, A K M; Amin, Md Robed; Chowdhury, M A Jalil

    2016-04-01

    Acute arsenicosis, although having a 'historical' background, is not common in our times. This report describes a case of acute arsenic poisoning, missed initially due to its gastroenteritis-like presentation, but suspected and confirmed much later, when the patient sought medical help for delayed complications after about 2 months. PMID:26508422

  8. Norovirus genotype diversity associated with gastroenteritis outbreaks in Victoria in 2013.

    PubMed

    Bruggink, Leesa D; Dunbar, Natalie L; Catton, Michael G; Marshall, John A

    2015-03-31

    The noroviruses are now considered a leading cause of outbreaks of non-bacterial gastroenteritis worldwide. Vaccine strategies against norovirus are currently under consideration but depend on a detailed knowledge of the capsid genotypes. This study examined the incidence of norovirus outbreaks in Victoria over 1 year (2013) and documented the genotypes occurring in the different outbreak settings (healthcare and non-healthcare) and age groups. It was found that 63.1% of gastroenteritis outbreaks were associated with norovirus, thereby showing norovirus to be the major viral cause of illness in gastroenteritis outbreaks. Sixteen capsid genotypes were identified and included GI.2, GI.3, GI.4, GI.6, GI.7, GI.8, GI.9, GII.1, GII.2, GII.3, GII.4, GII.5, GII.6, GII.7, GII.13 and an as yet unclassified GII genotype. All genotypes found in the study, with the exception of GI.9, were detected in the elderly, indicating prior exposure to a norovirus genotype did not appear to confer long term immunity in many cases. The incidence of genotypes GII.1, GII.4 and GII.7 was linked with setting and age. As setting and age were correlated it was not possible to determine which variable was critical with the exception of GII.7, which appeared to be linked to age. The findings indicate that norovirus vaccine strategies should encompass a broad range of genotypes and, as setting or age may be important in determining genotype incidence, this should be taken into account as well.

  9. A Waterborne Gastroenteritis Outbreak Caused by Norovirus GII.17 in a Hotel, Hebei, China, December 2014.

    PubMed

    Qin, Meng; Dong, Xiao-Gen; Jing, Yan-Yan; Wei, Xiu-Xia; Wang, Zhao-E; Feng, Hui-Ru; Yu, Hong; Li, Jin-Song; Li, Jie

    2016-09-01

    Norovirus (NoV) is responsible for an estimated 90 % of all epidemic nonbacterial outbreaks of gastroenteritis worldwide. Waterborne outbreaks of NoV are commonly reported. A novel GII.17 NoV strain emerged as a major cause of gastroenteritis outbreaks in China during the winter of 2014/2015. During this time, an outbreak of gastroenteritis occurred at a hotel in a ski park in Hebei Province, China. Epidemiological investigations indicated that one water well, which had only recently been in use, was the probable source. GII.17 NoV was detected by real-time reverse-transcription polymerase chain reaction from samples taken from cases, from concentrated water samples from water well, and from the nearby sewage settling tank. Nucleotide sequences of NoV extracted from clinical and water specimens were genetically identical and had 99 % homology with Beijing/CHN/2015. All epidemiological data indicated that GII.17 NoV was responsible for this outbreak. This is the first reported laboratory-confirmed waterborne outbreak caused by GII.17 NoV genotype in China. Strengthening management of well drinking water and systematica monitoring of NoV is essential for preventing future outbreaks. PMID:27084118

  10. Children Worldwide, 1992.

    ERIC Educational Resources Information Center

    Lejeune, Genevieve, Ed.

    1992-01-01

    Each of the three journal issues comprising volume 19 (1992) of "Children Worldwide" focuses on a specific theme. Issue 1 contains six articles about refugee children, including essays about a community self-help approach in Pakistan, unaccompanied minors in Hong Kong, and refugee families raising children in a new culture; guidelines for working…

  11. Telephone advice nursing: parents' experiences of monitoring calls in children with gastroenteritis.

    PubMed

    Eriksson, Elisabeth Kvilén; Sandelius, Susanna; Wahlberg, Anna Carin

    2015-06-01

    A common reason for calling a telephone advice nurse is gastroenteritis symptoms in children. A monitoring call is a follow-up call from the telephone nurse to the care seeker in order to follow up on given advice and make a new assessment. The aim of the study was to describe the parents' experiences of monitoring calls in telephone advice nursing in children with gastroenteritis. A qualitative interview method was chosen and data were analysed inductively with a qualitative latent content analysis. Ten parents, nine mothers and one father were interviewed. Four main categories and 13 subcategories were identified and described as useful, and the main categories were convenience - parents found it convenient to get access to self-care advice at home, confirmation - the interaction between the telephone nurse and the parent seemed to become deeper and closer as a result of the monitoring call, support - in a vulnerable situation receiving further information and an opportunity to let the telephone nurse monitor the sick child and guidance - to be guided through the most acute phase in the child's gastroenteritis symptoms. Monitoring calls seemed to be experienced as a security enhancing, positive opportunity and a robust complement to seeking care at a healthcare facility. The results of the study indicate how inhabitants can receive expert advice, support and guidance for care and provide a useful basis for Swedish Healthcare Direct (SHD) to develop the modalities for monitoring calls. PMID:25236581

  12. Hypoglycemia: a factor associated with low survival rate of neonatal piglets infected with transmissible gastroenteritis virus.

    PubMed Central

    Drolet, R; Morin, M; Fontaine, M

    1984-01-01

    The main purpose of this work was to study changes in the balance of fluids, electrolytes and blood metabolites in neonatal piglets with severe transmissible gastroenteritis. Six two day old conventional piglets were infected with transmissible gastroenteritis virus while six others were used as normal controls. Blood samples were collected in heparin when the infected piglets were moribund. The following variables were measured: packed red cell volume, total plasma protein and bicarbonate, blood pH, blood urea nitrogen and plasma glucose, creatinine, chloride, inorganic phosphorus, sodium, potassium, magnesium and calcium. Vomiting and diarrhea appeared 12 to 24 hours postinoculation in the infected piglets and they were moribund one or two days later. Before becoming moribund, most of the piglets fell rapidly into a lethargic and comatose state. The most evident changes in their blood variables were an increase in packed cell volume, total protein, blood urea nitrogen, phosphorus and magnesium levels and a decrease in pH and bicarbonate concentration as well as a severe hypoglycemia. The results suggest that severe hypoglycemia coupled with metabolic acidosis and dehydration might be an important factor contributing to the high mortality rates caused by transmissible gastroenteritis in neonatal piglets. The hypoglycemia results from a combination of the inadequate glucose metabolism inherent to neonatal piglets and the acute maldigestion and malabsorption resulting from the diffuse and severe villous atrophy induced by the virus. PMID:6478297

  13. Association of Rotavirus Gastroenteritis with Histo-blood Group Antigens.

    PubMed

    Mohanty, E; Dwibedi, B; Kar, S K; Pandey, R M

    2016-07-01

    Association of rotavirus gastroenteritis with histo-blood group antigens in children younger than 5 years admitted with diarrhea (n=389) was studied. Distribution of blood groups in rotavirus positive (n=96) and rotavirus negative (n=51) diarrhea gastroenteritis cases did not show any susceptibility to any blood group; blood group O seemed to be protective. PMID:27508550

  14. Gastroenteritis in sentinel general practices,The Netherlands.

    PubMed Central

    de Wit, M. A.; Koopmans, M. P.; Kortbeek, L. M.; van Leeuwen, N. J.; Bartelds, A. I.; van Duynhoven, Y. T.

    2001-01-01

    From 1996 to 1999, the incidence of gastroenteritis in general practices and the role of a broad range of pathogens in the Netherlands were studied. All patients with gastroenteritis who had visited a general practitioner were reported. All patients who had visited a general practitioner for gastroenteritis (cases) and an equal number of patients visiting for nongastrointestinal symptoms (controls) were invited to participate in a case-control study. The incidence of gastroenteritis was 79.7 per 10,000 person years. Campylobacter was detected most frequently (10% of cases), followed by Giardia lamblia (5%), rotavirus (5%), Norwalk-like viruses (5%) and Salmonella (4%). Our study found that in the Netherlands (population 15.6 million), an estimated 128,000 persons each year consult their general practitioner for gastroenteritis, slightly less than in a comparable study in 1992 to 1993. A pathogen could be detected in almost 40% of patients (bacteria 16%, viruses 15%, parasites 8%). PMID:11266298

  15. 1988 worldwide petrochemical directory

    SciTech Connect

    Not Available

    1987-01-01

    This directory makes available the names, addresses, phone and telex numbers of most of the world's companies which are involved in the petrochemical industry. The directory provides the names of over 14,000 key personnel at over 2,000 plant sites in the United States, Canada, Europe, Latin America, Asia-Pacific, Africa and the Middle East. A company index is provided for easy reference. The Oil and Gas Journal's Worldwide Petrochemical Survey appears in its entirety in this volume.

  16. The global burden of nontyphoidal Salmonella gastroenteritis.

    PubMed

    Majowicz, Shannon E; Musto, Jennie; Scallan, Elaine; Angulo, Frederick J; Kirk, Martyn; O'Brien, Sarah J; Jones, Timothy F; Fazil, Aamir; Hoekstra, Robert M

    2010-03-15

    To estimate the global burden of nontyphoidal Salmonella gastroenteritis, we synthesized existing data from laboratory-based surveillance and special studies, with a hierarchical preference to (1) prospective population-based studies, (2) "multiplier studies," (3) disease notifications, (4) returning traveler data, and (5) extrapolation. We applied incidence estimates to population projections for the 21 Global Burden of Disease regions to calculate regional numbers of cases, which were summed to provide a global number of cases. Uncertainty calculations were performed using Monte Carlo simulation. We estimated that 93.8 million cases (5th to 95th percentile, 61.8-131.6 million) of gastroenteritis due to Salmonella species occur globally each year, with 155,000 deaths (5th to 95th percentile, 39,000-303,000 deaths). Of these, we estimated 80.3 million cases were foodborne. Salmonella infection represents a considerable burden in both developing and developed countries. Efforts to reduce transmission of salmonellae by food and other routes must be implemented on a global scale.

  17. A Foodborne Outbreak of Gastroenteritis Caused by Vibrio parahaemolyticus and Norovirus through Non-Seafood Vehicle

    PubMed Central

    Cai, Wenfeng; Liu, Jianping; Ma, Xiaowei; Xie, Chaojun; Zheng, Chuangliang; Zhuo, Li; Cao, Xianbang; Tan, Hailing; Li, Baisheng; Xie, Huaping; Liu, Yufei; Ip, Dennis

    2015-01-01

    Foodborne outbreaks caused by a mixed infection of Vibrio parahaemolyticus and norovirus have rarely been described. We reported a mixed outbreak of Vibrio parahaemolyticus and norovirus causing acute gastroenteritis in 99 staff members of a company in Guangdong, China, in May 2013, following consumption of roasted duck, an uncommon non-seafood vehicle for such mixed infection, in one meal served in the company's catering service. Epidemiological and laboratory findings indicated that a single asymptomatic food handler was the source of both pathogens, and the high rate of infection of both pathogens was exacerbated by the setting’s suboptimal food hygiene practice. PMID:26376317

  18. Explosive outbreak of gastroenteritis on an aircraft carrier: an infectious disease mass casualty situation.

    PubMed

    Bohnker, B; McEwen, G; Feeks, E; Palombaro, J

    1993-07-01

    An aircraft carrier experienced 777 cases of acute gastroenteritis while deployed in the eastern Mediterranean over a 16-d period. These cases were noted in the 5,000-man crew, suggesting a cumulative incidence rate of 15%, though many sailors did not seek medical care for their symptoms. The onboard medical department response included epidemiological investigation with unique shipboard facility considerations, development of a treatment plan, and implementation of preventive/educational programs. Implications for nontrauma related mass casualty situations are discussed. Flight surgeons and operational medicine physicians must have a solid foundation in general preventive medicine to fulfill their responsibilities.

  19. Diversity of rotavirus serotypes in Mexican infants with gastroenteritis.

    PubMed Central

    Padilla-Noriega, L; Arias, C F; López, S; Puerto, F; Snodgrass, D R; Taniguchi, K; Greenberg, H B

    1990-01-01

    One hundred thirty-two stool specimens from infants with rotavirus gastroenteritis hospitalized in two Mexican cities (Mexico City and Mérida) were examined by serotype- and subgroup-specific enzyme immunoassays. Among them, 38 (29%) were serotype 1, 15 (11%) were serotype 2, 13 (10%) were serotype 3, 22 (17%) were serotype 4, none was serotype 5 or 6, and 44 (33%) could not be serotyped. By subgrouping, 121 specimens were characterized as follows: 24 (18%) were subgroup 1, 97 (74%) were subgroup 2, and none had both subgroup specificities. While serotype 1 rotavirus predominated in the Mexico City area for 4 consecutive years (1984 to 1987), serotype 4 predominated in Mérida during the single epidemic season studied (1985). These data demonstrate that all four primary human rotavirus serotypes circulated in Mexico, with serotype 1 being the most prevalent. The seroneutralization responses of 14 of the 22 patients infected with serotype 4 strains had been previously studied. Of these 14 infants, 11 appeared to have primary infections, as indicated by absence of neutralizing antibodies in the acute-phase sera and their young age (8 months on average) at the time of illness. Seven patients seroresponded to serotypes 1 and 4; two seroresponded to serotypes 1, 3, and 4; three seroresponded to serotype 1; and two had low-level seroresponses to serotype 3 or 4. These data indicate that heterotypic neutralizing antibody responses occur frequently following infection with serotype 4 rotaviruses. PMID:2166073

  20. Worldwide petrochemical directory, 1987

    SciTech Connect

    Not Available

    1986-01-01

    This directory gives the information on the worldwide petrochemical industry in existence. It makes available the names, addresses, phone and telex numbers of most of the world's companies which are involved in the petrochemical industry. The directory provides the names of over 14,000 key personnel at over 2,000 plant sizes in the United States, Canada, Europe, Latin America, Asia-Pacific, Africa and the Middle East. A company index is provided for easy reference. It details current petrochemical plants' feedstocks, products and capacities. The newly updated petrochemical plant construction survey is also provided.

  1. Related fuels - worldwide construction

    SciTech Connect

    Not Available

    1983-04-25

    This listing describes major construction projects in related fuels worldwide. Each listing, organized alphabetically within country groups, tells the name of the buyer(s) and project location, capacity, process method, and contractor(s). Countries having listings include the U.S., Australia, Brazil, Canada, China, France, Germany, Japan, Morocco, The Netherlands, New Zealand, Poland, South Africa, Sweden, USSR, and Venezuela. Fuel processes included are coal gasification, tar sands upgrading, coal liquefaction, shale oil, synthetic natural gas, syncrude and syngas, methanol synthesis, and heavy oil upgrading.

  2. [Therapeutic plasmas available worldwide].

    PubMed

    Martinaud, C; Cauet, A; Sailliol, A

    2013-05-01

    Therapeutic plasma is a current product; French guidelines were reviewed in 2012. Connections between more or less closed countries are frequent, during relief disasters as well as in war settings. This is associated with the increasing use of plasma in the management of casualties. Additionally, The real possibility of lack of plasma supply in some countries provides a fundamental interest of the knowledge of foreign blood supply organizations. We present here the main divergences and mutual point between plasmas available worldwide. We present the main characteristics of each product.

  3. 1985 Worldwide Petrochemical Directory

    SciTech Connect

    Not Available

    1984-01-01

    This directory lists names, addresses, phone numbers, and telex listings. The directory includes more than 14,000 key operating personnel at over 1,900 plant locations in the United States, Canada, Latin America, Europe, Africa, Asia-Pacific and the Middle East. Featured is a special survey prepared with the help of the Oil and Gas Journal that details the petrochemical plant feedstocks, product and capacities. This Worldwide-Petrochemical Survey appears only in its entirety in directory. Also included is an updated petrochemical plant construction survey.

  4. Prevalence of Astrovirus Infection among Chilean Children with Acute Gastroenteritis

    PubMed Central

    Gaggero, Aldo; O’Ryan, Miguel; Noel, Jacqueline S.; Glass, Roger I.; Monroe, Stephan S.; Mamani, Nora; Prado, Valeria; Avendaño, Luis F.

    1998-01-01

    The frequency of astrovirus infection in 456 Chilean children with diarrhea was determined by enzyme-linked immunosorbent assay, reverse transcriptase PCR, and cell culture. Astrovirus was detected in 16.5% of rotavirus-negative and 7% of rotavirus-positive samples obtained from emergency rooms or hospitals and in 11% of samples from day care centers. HAst-1 was the predominant serotype identified. PMID:9817899

  5. Worldwide regulations for mycotoxins.

    PubMed

    van Egmond, Hans P

    2002-01-01

    Since the discovery of the aflatoxins in the 1960s, regulations have been established in many countries to protect the consumer from the harmful effects of mycotoxins that may contaminate foodstuffs. Various factors play a role in the decision-making process of setting limits for mycotoxins. These include scientific factors such as the availability of toxicological data, survey data, knowledge about the distribution of mycotoxins in commodities, and analytical methodology. Economical and political factors such as commercial interests and sufficiency of food supply have their impact as well. International enquiry's on existing mycotoxin legislation in foodstuffs and animal feedstuffs have been carried out several times in the 1980s and 1990s and details about tolerances, legal basis, responsible authorities, official protocols of analysis and sampling have been published. Recently a comprehensive update on worldwide regulations was published as FAO Food and Nutrition Paper 64. It appeared that at least 77 countries now have specific regulations for mycotoxins, 13 countries are known to have no specific regulations, whereas no data are available for about 50 countries, many of them in Africa. Over the years, a large diversity in tolerance levels for mycotoxins has remained. Some free trade zones (EU, MERCOSUR) are in the process of harmonizing the limits and regulations for mycotoxins in their respective member states, but it is not likely that worldwide harmonized limits for mycotoxins will soon be within reach.

  6. Water-borne outbreak of campylobacter gastroenteritis.

    PubMed

    Palmer, S R; Gully, P R; White, J M; Pearson, A D; Suckling, W G; Jones, D M; Rawes, J C; Penner, J L

    1983-02-01

    An outbreak of gastroenteritis affecting 234 pupils and 23 staff at a boarding school occurred over a period of 8 weeks. Campylobacter spp. were isolated from pupils and staff, and from two samples of cold water taken from an open-topped storage tank which supplied predominantly unchlorinated water to the main school building. The two isolates from water were of the same serotype. This serotype was the commonest of the three serotypes of Campylobacter jejuni detected in isolates from pupils and staff. There was a highly significant association between consumption of water from the cold water storage tank and reported illness in staff. Attack rates in pupils corresponded closely with the extent of distribution of this water-supply to the main residential houses. Contamination of water by faecal material from birds or bats was the most likely source of infection.

  7. Studies on Transmissible Gastroenteritis of Swine

    PubMed Central

    McClurkin, A W.; Norman, James O.

    1966-01-01

    Five cell culture isolates from transmissible gastroenteritis (TGE) of swine have been studied. There is a cytopathogenic virus common to all of these isolates. Some of the characteristics of this virus, such as its size, approximately 100 mµ, its relative sensitivity to ether, lability at pH 2, pH 3, and pH 10, and its heat lability suggest that it may be a member of the myxovirus class. Concurrent research in this laboratory indicates that this cytopathogenic virus is not the only virus involved in the etiology of TGE, but it appears to be associated with many of the outbreaks of TGE which have been studied by this laboratory. ImagesFig. 1.Fig. 2.Fig. 3.Fig. 4.Fig. 5.Fig. 6.Fig. 7.Fig. 8.Fig. 9.Fig. 11. PMID:4224292

  8. Socio-demographic, Clinical and Laboratory Features of Rotavirus Gastroenteritis in Children Treated in Pediatric Clinic

    PubMed Central

    Azemi, Mehmedali; Berisha, Majlinda; Ismaili-Jaha, Vlora; Kolgeci, Selim; Avdiu, Muharrem; Jakupi, Xhevat; Hoxha, Rina; Hoxha-Kamberi, Teuta

    2013-01-01

    Aim: The aim of work was presentation of several socio-demographic, clinical and laboratory characteristics of gastroenteritis caused by rotavirus. The examinees and methods: The examinees were children under the age of five years treated at the Pediatric Clinic due to acute gastroenteritis caused by rotavirus. Rotavirus is isolated by method chromatographic immunoassay by Cer Test Biotec. Results: From the total number of patients (850) suffering from acute gastroenteritis, feces test on bacteria, viruses. protozoa and fungi was positive in 425 (49.76%) cases. From this number the test on bacteria was positive in 248 (58.62%) cases, on viruses it was positive in 165 (39.0%), on protozoa in 9 (2.12%) cases and on fungi only one case. Rotavirus was the most frequent one in viral test, it was isolated in 142 (86.06%) cases, adenoviruses were found in 9 (5.45%) cases and noroviruses in only one case. The same feces sample that contained rotavirus and adenoviruses were isolated in five cases, whereas rotavirus with bacteria was isolated in the same feces sample in five cases. The biggest number of cases 62 (43.66%) were of the age 6-12 months, whereas the smallest number 10 (7.04%) cases were of the age 37-60 months. There were 76 (53.52%) of cases of male gender, from rural areas there were 81 (57.04%) cases and there were 58 (40.80%) cases during the summer period. Among the clinical symptoms the most prominent were diarrhea, vomiting, high temperature, whereas the different degree of dehydration were present in all cases (the most common one was moderate dehydration). The most frequent one was isonatremic dehydration in 91 (64.08%) cases, less frequent one was hypernatremic dehydration in 14 (9.85%) cases. The majority of cases (97.89%) had lower blood pH values, whereas 67 (47.17%) cases had pH values that varied from 7.16 -7.20 (curve peak), normal values were registered in only 3 (2.11%) cases. Urea values were increased in 45 (31.07%) cases (the maximum value

  9. Worldwide activity in IGCC

    SciTech Connect

    Lamarre, L.

    1994-07-01

    EPRI has pursued the development of integrated gasification-combined-cycle technology because it is the cleanest method available for making electricity from coal. Now, a decade after the establishment of the first IGCC demonstration plant, environmental regulations are encouraging the adoption of this technology in a number of countries. An unexpected innovation is the use of residual oil as an IGCC feedstock, a practice that evolved naturally as a result of market forces. Experts are hopeful that the current momentum in IGCC will trigger the introduction of the technology in developing countries, many of which rely heavily on coal and oil for power generation. Environmental regulations and a market glut of low-grade fossil fuels are spurring an unprecedented number of integrated gasification combined-cycle projects worldwide. These projects are described.

  10. An outbreak of norovirus gastroenteritis associated with a secondary water supply system in a factory in south China

    PubMed Central

    2013-01-01

    Background Between September 17 and October 3, 2009, hundreds of workers employed in a manufacturing factory in Shenzhen, a city in south China developed a sudden onset of acute gastroenteritis. A retrospective cohort study is designed to identify the risk factors and control this outbreak. Methods Information on demographic characteristics, working place, the history of contact with a person having diarrhea and/or vomiting, drink water preference and frequency, eating in the company cafeteria or outside the company, hand-washing habits and eating habits is included. Furthermore, in order to find the contamination source, we investigated the environment around the underground reservoir and collected water samples from the junction between municipal supply water system and underground reservoir to test potential bacteria and virus, examine the seepage tracks on the wall of the underground reservoir from the side of septic tank, and check the integrity and attitude of this lid. Relative risk was presented and Chi-square test was performed. All the analyses were performed with OpenEpi software version 2.3.1 online. Results The cohort study demonstrated that the workers who had direct drink water were 3.0 fold more likely to suffer from acute gastroenteritis than those who consumed commercial bottled water. The direct drinking water, water of the tank of buildings, and the underground reservoir were positive only for norovirus. Norovirus was also detected from stool and rectal swab samples from patients with acute gastroenteritis. The underground reservoir was found to be the primary contamination source. Further environmental investigation showed that the norovirus contaminated substance entered into the underground reservoir via access holes in lid covering this underground reservoir. Conclusion This acute gastroenteritis outbreak was caused by the secondary supply system contaminated by norovirus in this factory. The outbreak of gastroenteritis cases caused by

  11. The worldwide "wildfire" problem.

    PubMed

    Gill, A Malcolm; Stephens, Scott L; Cary, Geoffrey J

    2013-03-01

    The worldwide "wildfire" problem is headlined by the loss of human lives and homes, but it applies generally to any adverse effects of unplanned fires, as events or regimes, on a wide range of environmental, social, and economic assets. The problem is complex and contingent, requiring continual attention to the changing circumstances of stakeholders, landscapes, and ecosystems; it occurs at a variety of temporal and spatial scales. Minimizing adverse outcomes involves controlling fires and fire regimes, increasing the resistance of assets to fires, locating or relocating assets away from the path of fires, and, as a probability of adverse impacts often remains, assisting recovery in the short-term while promoting the adaptation of societies in the long-term. There are short- and long-term aspects to each aspect of minimization. Controlling fires and fire regimes may involve fire suppression and fuel treatments such as prescribed burning or non-fire treatments but also addresses issues associated with unwanted fire starts like arson. Increasing the resistance of assets can mean addressing the design and construction materials of a house or the use of personal protective equipment. Locating or relocating assets can mean leaving an area about to be impacted by fire or choosing a suitable place to live; it can also mean the planning of land use. Assisting recovery and promoting adaptation can involve insuring assets and sharing responsibility for preparedness for an event. There is no single, simple, solution. Perverse outcomes can occur. The number of minimizing techniques used, and the breadth and depth of their application, depends on the geographic mix of asset types. Premises for policy consideration are presented. PMID:23634593

  12. Gastroenteric tube feeding: techniques, problems and solutions.

    PubMed

    Blumenstein, Irina; Shastri, Yogesh M; Stein, Jürgen

    2014-07-14

    Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake, chronic neurological or mechanical dysphagia or gut dysfunction, and patients who are critically ill. However, despite the benefits and widespread use of enteral tube feeding, some patients experience complications. This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding, together with associated complications and special aspects. We conducted an extensive literature search on PubMed, Embase and Medline using index terms relating to enteral access, enteral feeding/nutrition, tube feeding, percutaneous endoscopic gastrostomy/jejunostomy, endoscopic nasoenteric tube, nasogastric tube, and refeeding syndrome. The literature showed common routes of enteral access to include nasoenteral tube, gastrostomy and jejunostomy, while complications fall into four major categories: mechanical, e.g., tube blockage or removal; gastrointestinal, e.g., diarrhea; infectious e.g., aspiration pneumonia, tube site infection; and metabolic, e.g., refeeding syndrome, hyperglycemia. Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route, gastrointestinal complications are without doubt the most common. Complications associated with enteral tube feeding can be reduced by careful observance of guidelines, including those related to food composition, administration rate, portion size, food temperature and patient supervision.

  13. Gastroenteric tube feeding: Techniques, problems and solutions

    PubMed Central

    Blumenstein, Irina; Shastri, Yogesh M; Stein, Jürgen

    2014-01-01

    Gastroenteric tube feeding plays a major role in the management of patients with poor voluntary intake, chronic neurological or mechanical dysphagia or gut dysfunction, and patients who are critically ill. However, despite the benefits and widespread use of enteral tube feeding, some patients experience complications. This review aims to discuss and compare current knowledge regarding the clinical application of enteral tube feeding, together with associated complications and special aspects. We conducted an extensive literature search on PubMed, Embase and Medline using index terms relating to enteral access, enteral feeding/nutrition, tube feeding, percutaneous endoscopic gastrostomy/jejunostomy, endoscopic nasoenteric tube, nasogastric tube, and refeeding syndrome. The literature showed common routes of enteral access to include nasoenteral tube, gastrostomy and jejunostomy, while complications fall into four major categories: mechanical, e.g., tube blockage or removal; gastrointestinal, e.g., diarrhea; infectious e.g., aspiration pneumonia, tube site infection; and metabolic, e.g., refeeding syndrome, hyperglycemia. Although the type and frequency of complications arising from tube feeding vary considerably according to the chosen access route, gastrointestinal complications are without doubt the most common. Complications associated with enteral tube feeding can be reduced by careful observance of guidelines, including those related to food composition, administration rate, portion size, food temperature and patient supervision. PMID:25024606

  14. Direct, indirect, total, and overall effectiveness of the rotavirus vaccines for the prevention of gastroenteritis hospitalizations in privately insured US children, 2007-2010.

    PubMed

    Panozzo, Catherine A; Becker-Dreps, Sylvia; Pate, Virginia; Weber, David J; Jonsson Funk, Michele; Stürmer, Til; Brookhart, M Alan

    2014-04-01

    We demonstrate how direct, indirect, total, and overall effectiveness estimates and absolute benefits of rotavirus vaccines vary through the years following vaccine introduction. Privately insured US children in a large claims database were followed from age 8 months until they 1) experienced a hospitalization for rotavirus or acute gastroenteritis; 2) lost continuous health plan enrollment; 3) turned 20 months of age; or 4) reached the end of the study period. Vaccine effectiveness estimates in preventing rotavirus and acute gastroenteritis hospitalizations were estimated using Cox proportional hazards regression, stratified by calendar year and adjusted for birth month. Incidence rate differences were estimated to determine the absolute number of gastroenteritis hospitalizations prevented in the cohort. Among 905,718 children, 51%, 66%, 80%, and 86% received 1 or more doses of rotavirus vaccine in each year from 2007 to 2010. The direct vaccine effectiveness of 1 or more doses of rotavirus vaccine in preventing rotavirus gastroenteritis hospitalizations ranged from 87% to 92% each year. Accounting for indirect protection increased estimates of vaccine effectiveness by an additional 3%-8% among those vaccinated. Failing to account for population-level vaccine benefits in 2010, when circulation of rotavirus was low, could underestimate the sustained impact of the vaccine program.

  15. Direct, indirect, total, and overall effectiveness of the rotavirus vaccines for the prevention of gastroenteritis hospitalizations in privately insured US children, 2007-2010.

    PubMed

    Panozzo, Catherine A; Becker-Dreps, Sylvia; Pate, Virginia; Weber, David J; Jonsson Funk, Michele; Stürmer, Til; Brookhart, M Alan

    2014-04-01

    We demonstrate how direct, indirect, total, and overall effectiveness estimates and absolute benefits of rotavirus vaccines vary through the years following vaccine introduction. Privately insured US children in a large claims database were followed from age 8 months until they 1) experienced a hospitalization for rotavirus or acute gastroenteritis; 2) lost continuous health plan enrollment; 3) turned 20 months of age; or 4) reached the end of the study period. Vaccine effectiveness estimates in preventing rotavirus and acute gastroenteritis hospitalizations were estimated using Cox proportional hazards regression, stratified by calendar year and adjusted for birth month. Incidence rate differences were estimated to determine the absolute number of gastroenteritis hospitalizations prevented in the cohort. Among 905,718 children, 51%, 66%, 80%, and 86% received 1 or more doses of rotavirus vaccine in each year from 2007 to 2010. The direct vaccine effectiveness of 1 or more doses of rotavirus vaccine in preventing rotavirus gastroenteritis hospitalizations ranged from 87% to 92% each year. Accounting for indirect protection increased estimates of vaccine effectiveness by an additional 3%-8% among those vaccinated. Failing to account for population-level vaccine benefits in 2010, when circulation of rotavirus was low, could underestimate the sustained impact of the vaccine program. PMID:24578359

  16. Direct, Indirect, Total, and Overall Effectiveness of the Rotavirus Vaccines for the Prevention of Gastroenteritis Hospitalizations in Privately Insured US Children, 2007–2010

    PubMed Central

    Panozzo, Catherine A.; Becker-Dreps, Sylvia; Pate, Virginia; Weber, David J.; Jonsson Funk, Michele; Stürmer, Til; Brookhart, M. Alan

    2014-01-01

    We demonstrate how direct, indirect, total, and overall effectiveness estimates and absolute benefits of rotavirus vaccines vary through the years following vaccine introduction. Privately insured US children in a large claims database were followed from age 8 months until they 1) experienced a hospitalization for rotavirus or acute gastroenteritis; 2) lost continuous health plan enrollment; 3) turned 20 months of age; or 4) reached the end of the study period. Vaccine effectiveness estimates in preventing rotavirus and acute gastroenteritis hospitalizations were estimated using Cox proportional hazards regression, stratified by calendar year and adjusted for birth month. Incidence rate differences were estimated to determine the absolute number of gastroenteritis hospitalizations prevented in the cohort. Among 905,718 children, 51%, 66%, 80%, and 86% received 1 or more doses of rotavirus vaccine in each year from 2007 to 2010. The direct vaccine effectiveness of 1 or more doses of rotavirus vaccine in preventing rotavirus gastroenteritis hospitalizations ranged from 87% to 92% each year. Accounting for indirect protection increased estimates of vaccine effectiveness by an additional 3%–8% among those vaccinated. Failing to account for population-level vaccine benefits in 2010, when circulation of rotavirus was low, could underestimate the sustained impact of the vaccine program. PMID:24578359

  17. Effectiveness of rotavirus vaccine in preventing severe gastroenteritis in young children according to socioeconomic status

    PubMed Central

    Gosselin, Virginie; Généreux, Mélissa; Gagneur, Arnaud; Petit, Geneviève

    2016-01-01

    ABSTRACT In 2011, the monovalent rotavirus vaccine was introduced into a universal immunization program in Quebec (Canada). This retrospective cohort study assessed vaccine effectiveness (VE) in preventing acute gastroenteritis (AGE) and rotavirus gastroenteritis (RVGE) hospitalizations among children <3 y living in the Quebec Eastern Townships region according to socioeconomic status (SES). Data were gathered from a tertiary hospital database paired with a regional immunization registry. Three cohorts of children were followed: (1) vaccinated children born in post-universal vaccination period (2011–2013, n = 5,033), (2) unvaccinated children born in post-universal vaccination period (n = 1,239), and (3) unvaccinated children born in pre-universal vaccination period (2008–2010, n = 6,436). In each cohort, AGE and RVGE hospitalizations were identified during equivalent follow-up periods to calculate VE globally and according to neighborhood-level SES. Using multivariable logistic regression, adjusted odds ratios (OR) were computed to obtain VE (1-OR). Adjusted VE of 2 doses was 62% (95% confidence interval [CI]: 37%–77%) and 94% (95%CI: 52%–99%) in preventing AGE and RVGE hospitalization, respectively. Stratified analyses according to SES showed that children living in neighborhoods with higher rates of low-income families had significantly lower VE against AGE hospitalizations compared to neighborhoods with lower rates of low-income families (30% vs. 78%, p = 0.027). Our results suggest that the rotavirus vaccine is highly effective in preventing severe gastroenteritis in young children, particularly among the most well-off. SES seems to influence rotavirus VE, even in a high-income country like Canada. Further studies are needed to determine factors related to lower rotavirus VE among socioeconomically disadvantaged groups. PMID:27367155

  18. Molecular characterization of Sapovirus detected in a gastroenteritis outbreak at a wedding hall.

    PubMed

    Yamashita, Yasutaka; Ootsuka, Yuka; Kondo, Reiko; Oseto, Mitsuaki; Doi, Mitsunori; Miyamoto, Takeshi; Ueda, Tetsuroo; Kondo, Hirokazu; Tanaka, Tomoyuki; Wakita, Takaji; Katayama, Kazuhiko; Takeda, Naokazu; Oka, Tomoichiro

    2010-04-01

    Sapovirus (SaV) is an important pathogen of human acute gastroenteritis. A gastroenteritis outbreak occurred at a wedding hall in October 2007 in Ehime Prefecture, Japan. One hundred nine people who had either attended wedding parties or had eaten a box lunch at a conference held at the same hall complained of gastroenteritis symptoms. Among these 109 people, stool specimens from 56 patients were available for pathogen screening, and 20 (35.7%) of these specimens were positive for SaV, of whom 18 showed symptoms. The numbers of cDNA copies of the specimens ranged from 2.36 x 10(6) to 3.03 x 10(10) for symptomatic patients, and 2.19 x 10(6) and 1.18 x 10(9) per gram of stool for two asymptomatic food handlers. The incubation periods of the 18 symptomatic patients ranged from 14.5 to 99.5 hr. Identical nucleotide sequence types of SaV; that is, a single synonymous nucleotide difference (transition) or microheterogeneity, was detected in stool specimens from the symptomatic patients and the asymptomatic food handlers, with the direct nucleotide sequence of approximately 2.3 kb 3' end of the genome. Based on the phylogenetic analysis with the complete capsid nucleotide sequence, these strains were clustered into genogroup IV. This outbreak was thought to be caused by a single source, and underscores the importance of proper hygiene in the environment and/or in food-handling practices to control SaV outbreaks. PMID:20166168

  19. Are Salmonella-Induced Gastroenteritis Neglected in Developing Countries? Feedback from Microbiological Investigations in N'Djamena Hospitals, Chad.

    PubMed

    Tabo, Djim-Adjim; Granier, Sophie A; Diguimbaye, Colette D; Marault, Muriel; Brisabois, Anne; Mama, Baïzina; Millemann, Yves

    2015-01-01

    Salmonella is considered to be one of the main pathogens causing human gastroenteritis worldwide. Looking for Salmonella in Africa in patients suffering from gastroenteritis is rather unusual, and the use of antibiotics is not subject to any regulation. This study intends for stressing the possible prominent importance of Salmonella in digestive diseases in Africa as well as identifying antimicrobial resistance of Salmonella isolates from faeces samples of human origin. All samples were collected from five N'Djamena hospitals, from patients suffering from diarrhoea. The collecting was undertaken over two periods of six months each: from August 2010 to January 2011 and from September 2011 to February 2012. Salmonella isolates were obtained by standard cultivation and serotyping methods. A total of 43 Salmonella isolates were identified, belonging to 21 different serovars. The most prevalent serovar was Salmonella Stanleyville (n = 7), followed by S. Anatum (n = 4) and S. Kottbus (n = 3). The other serovars were under-represented. The majority of these isolates were susceptible to all antibiotics tested (CLSI Standards), except two S. Enteritidis isolates that exhibited resistance to fluoroquinolones. The different serovars and antibiotic resistance profiles that were observed highlight the substantial diversity of Salmonella in N'Djamena, Chad. Roughly, one out of ten patients who consulted for gastroenteritis was shedding Salmonella spp. and none of them would have been diagnosed outside the context of this research program. This study may encourage local clinicians to explore more often salmonellosis suspicion in their daily practice.

  20. Glyphosate poisoning with acute pulmonary edema.

    PubMed

    Thakur, Darshana Sudip; Khot, Rajashree; Joshi, P P; Pandharipande, Madhuri; Nagpure, Keshav

    2014-01-01

    GlySH-surfactant herbicide (GlySH), one of the most commonly used herbicides worldwide, has been considered as minimally toxic to humans. However, clinical toxicologists occasionally encounter cases of severe systemic toxicity. The US Environmental Protection Agency (EPA) states that 'GlySH' is of relatively low oral and acute dermal toxicity. It does not have anticholinesterase effect and no organophosphate-like central nervous system (CNS) effects. The clinical features range from skin and throat irritation to hypotension and death. Severe GlySH-surfactant poisoning is manifested by gastroenteritis, respiratory disturbances, altered mental status, hypotension refractory to the treatment, renal failure, and shock.[1] GlySH intoxication has a case fatality rate 3.2-29.3%. Pulmonary toxicity and renal toxicity seem to be responsible for mortality. Metabolic acidosis, abnormal chest X-ray, arrhythmias, and elevated serum creatinine levels are useful prognostic factors for predicting GlySH mortality.[2] There is no antidote and the mainstay of treatment for systemic toxicity is decontamination and aggressive supportive therapy. We report a case of acute pulmonary edema, which is a rare but severe manifestation of oral GlySH poisoning, where patient survived with aggressive supportive therapy. PMID:25948977

  1. Eosinophilic gastroenteritis associated with multiple gastric cancer.

    PubMed

    Otowa, Yasunori; Mitsutsuji, Masaaki; Urade, Takeshi; Chono, Teruhiro; Morimoto, Haruki; Yokoyama, Kunio; Hirata, Kenro; Kawamura, Shiro; Shimada, Etsuji; Fujita, Masayuki

    2012-06-01

    Eosinophilic gastroenteritis (EG) is an inflammation of the digestive tract that is characterized by eosinophilic infiltration. There are no specific symptoms, and are related to the layer in which eosinophilic infiltration is observed. A 69-year-old Japanese man presented to our hospital with a history of general malaise, diarrhea, and dysgeusia. Esophagogastroduodenoscopy showed reddish elevated lesions that were edematous all over the gastric mucosa. In addition, three tumors were also observed. The biopsies of the reddish elevated mucosa revealed eosinophilic infiltration and tubular adenocarcinoma from the tumors. Colonoscopy showed abnormal reddish elevated mucosa. The biopsies from the reddish elevated mucosa showed eosinophilic infiltration. From the abdominal contrast computed tomography scan, tumor stain was seen in the anterior wall of the gastric body. No ascites, intestinal wall thickening, or lymph node swelling were found. A slight elevation in the serum immunoglobulin E (IgE), 480 IU/ml, was found from the laboratory test results; other laboratory results were within normal limits including the number of peripheral eosinophils. No specific allergen was found from the multiple antigen simultaneous test and from the skin patch test. The parasitic immunodiagnosis was negative. He was diagnosed with EG associated with gastric cancer and underwent total gastrectomy, regional lymph node dissection with reconstruction by a Roux-en-Y method. He was prescribed prednisolone after the operation and showed a good clinical response. There are many case reports on EG, but none of them were associated with cancer. We encountered a case of EG associated with multiple gastric cancer; the patient underwent total gastrectomy.

  2. Norovirus Gastroenteritis Outbreak with a Secretor-independent Susceptibility Pattern, Sweden

    PubMed Central

    Nordgren, Johan; Kindberg, Elin; Lindgren, Per-Eric; Matussek, Andreas

    2010-01-01

    Norovirus (NoV) is recognized as the commonest cause of acute gastroenteritis among adults. Susceptibility to disease has been associated with histo-blood group antigens and secretor status; nonsecretors are almost completely resistant to disease. We report a foodborne outbreak of GI.3 NoV gastroenteritis that affected 33/83 (40%) persons. Symptomatic disease was as likely to develop in nonsecretors as in secretors (odds ratio [OR] 1.41, 95% confidence interval [CI] 0.46–4.36 vs. OR 0.71, 95% CI 0.23–2.18, p = 0.57). Moreover, no statistical difference in susceptibility was found between persons of different Lewis or ABO phenotypes. The capsid gene of the outbreak strain shares high amino acid homology with the Kashiwa645 GI.3 strain, previously shown to recognize nonsecretor saliva, as well as synthetic Lewis a. This norovirus outbreak affected persons regardless of secretor status or Lewis or ABO phenotypes. PMID:20031047

  3. Epidemiologic Association Between FUT2 Secretor Status and Severe Rotavirus Gastroenteritis in Children in the United States

    PubMed Central

    Payne, Daniel C.; Currier, Rebecca L.; Staat, Mary A.; Sahni, Leila C.; Selvarangan, Rangaraj; Halasa, Natasha B.; Englund, Janet A.; Weinberg, Geoffrey A.; Boom, Julie A.; Szilagyi, Peter G.; Klein, Eileen J.; Chappell, James; Harrison, Christopher J.; Davidson, Barbara S.; Mijatovic-Rustempasic, Slavica; Moffatt, Mary D.; McNeal, Monica; Wikswo, Mary; Bowen, Michael D.; Morrow, Ardythe L.; Parashar, Umesh D.

    2016-01-01

    IMPORTANCE A genetic polymorphism affecting FUT2 secretor status in approximately one-quarter of humans of European descent affects the expression of histo-blood group antigens on the mucosal epithelia of human respiratory, genitourinary, and digestive tracts. These histo-blood group antigens serve as host receptor sites necessary for attachment and infection of some pathogens, including norovirus. OBJECTIVE We investigated whether an association exists between FUT2 secretor status and laboratory-confirmed rotavirus infections in US children. DESIGN, SETTING, AND PARTICIPANTS Multicenter case-control observational study involving active surveillance at 6 US pediatric medical institutions in the inpatient and emergency department clinical settings. We enrolled 1564 children younger than 5 years with acute gastroenteritis (diarrhea and/or vomiting) and 818 healthy controls frequency matched by age and month, from December 1, 2011, through March 31, 2013. MAIN OUTCOMES AND MEASURES Paired fecal-saliva specimens were tested for rotavirus and for secretor status. Comparisons were made between rotavirus test–positive cases and healthy controls stratified by ethnicity and vaccination status. Adjusted multivariable analyses assessed the preventive association of secretor status against severe rotavirus gastroenteritis. RESULTS One (0.5%) of 189 rotavirus test–positive cases was a nonsecretor, compared with 188 (23%) of 818 healthy control participants (P < .001). Healthy control participants of Hispanic ethnicity were significantly less likely to be nonsecretors (13%) compared with healthy children who were not of Hispanic ethnicity (25%) (P < .001). After controlling for vaccination and other factors, children with the nonsecretor FUT2 polymorphism appeared statistically protected (98% [95% CI, 84%–100%]) against severe rotavirus gastroenteritis. CONCLUSIONS AND RELEVANCE Severe rotavirus gastroenteritis was virtually absent among US children who had a genetic

  4. [Hospitalisation associated with Rotavirus gastroenteritis in Italy, 2001-2003, evaluated by means of ICD9-CM diagnostic codes].

    PubMed

    Marocco, Alessia; Assael, Baroukh; Gabutti, Giovanni; Guarino, Alfredo; Lopalco, Pier Luigi; Marchetti, Federico; Ruggeri, Franco Maria; Titone, Lucina; Tozzi, Alberto Eugenio; Vitali Rosati, Giovanni; Zotti, Carla; Franco, Elisabetta

    2006-01-01

    Rotaviruses (RV) are the most common etiological agents in acute gastroenteritis (GE) in children in the first years of life. Data from the national scientific literature show that RV is responsible of 26% of all cases of hospitalisation for diarrea in children, resulting the most frequently identified agent. The Italian database of hospital discharge, freely available from the web site of the national Ministry of Health, was searched to investigate the epidemiology of RV gastroenteritis. The mean number of hospitalisation for RV enteritis in children in the first 4 years of live was 4.758 in the years 2001, 2002 and 2003, representing 84% of viral enteritis. RV was identified as agent in 17% of all intestinal infectious diseases in this age group. This percentage shows the important role of RV in severe gastrointestinal infections; it is however much lower than the value expected from specifically performed surveys. This underestimation may be attributed to the high number of undefined gastroenteritis found in the database (54%), to the scarce sensitivity of the hospital discharge code, and to the fact that the analysis was performed using only the principal diagnosis. A specific immunisation strategy, safe, effective, cost-effective and easy to perform, could have a great impact on the incidence of the disease and on the associated costs.

  5. Groundwater quality assessment and its correlation with gastroenteritis using GIS: a case study of Rawal Town, Rawalpindi, Pakistan.

    PubMed

    Shahid, Syed Umair; Iqbal, Javed; Hasnain, Ghalib

    2014-11-01

    Majority of the people of Pakistan get drinking water from groundwater source. Nearly 40 % of the total ailments reported in Pakistan are the result of dirty drinking water. Every summer, thousands of patients suffer from acute gastroenteritis in the Rawal Town. Therefore, a study was designed to generate a water quality index map of the Rawal Town and identify the relationship between bacteriological water quality and socio-economic indicators with gastroenteritis in the study area. Water quality and gastroenteritis patient data were collected by surveying the 262 tubewells and the major hospitals in the Rawal Town. The collected spatial data was analyzed by using ArcGIS spatial analyst (Moran's I spatial autocorrelation) and geostatistical analysis tools (inverse distance weighted, radial basis function, kriging, and cokriging). The water quality index (WQI) for the study area was computed using pH, turbidity, total dissolved solids, calcium, hardness, alkalinity, and chloride values of the 262 tubewells. The results of Moran's I spatial autocorrelation showed that the groundwater physicochemical parameters were clustered. Among IDW, radial basis function, and kriging and cokriging interpolation techniques, cokriging showed the lowest root mean square error. Cokriging was used to make the spatial distribution maps of water quality parameters. The WQI results showed that more than half of the tubewells in the Rawal Town were providing "poor" to "unfit" drinking water. The Pearson's coefficient of correlation for gastroenteritis with fecal coliform was found significant (P < 0.05) in Water and Sanitation Agency (WASA) zone 2, and with shortage of toilets, it was significant (P < 0.05) in WASA zones 1 and 3. However, it was significantly (P < 0.01) inversely related with literacy rate in WASA zones 1, 2, and 3.

  6. Primary Aluminum Plants Worldwide - 1998

    USGS Publications Warehouse

    1999-01-01

    The 1990 U.S. Bureau of Mines publication, Primary Aluminum Plants Worldwide, has been updated and is now available. The 1998 USGS edition of Primary Aluminum Plants Worldwide is published in two parts. Part I—Detail contains information on individual primary smelter capacity, location, ownership, sources of energy, and other miscellaneous information. Part II—Summary summarizes the capacity data by country

  7. Outbreaks of gastroenteritis due to infections with Norovirus in Switzerland, 2001-2003.

    PubMed Central

    Fretz, R.; Svoboda, P.; Lüthi, T. M.; Tanner, M.; Baumgartner, A.

    2005-01-01

    Viral infections, especially those with noroviruses are the most common cause of acute gastroenteritis in Europe. To obtain information about the epidemic situation of noroviruses in Switzerland, an initial study was launched in the German-speaking part of the country to systematically compile Norovirus outbreak information between 2001 and 2003. In total, 73 outbreaks were registered. Most affected were closed settings, e.g. nursing homes (34%) and hospitals (25%). Transmission pathways were identified in 74% of Norovirus outbreaks. In 81% of these cases person-to-person transmission was the primary route of infection and on seven occasions (13%), a foodborne transmission was the possible cause. Furthermore, Norovirus outbreak characteristics of epidemiological importance are highlighted with a discussion of four selected events. PMID:15962549

  8. Not without cause: Vibrio parahaemolyticus induces acute autophagy and cell death.

    PubMed

    Burdette, Dara L; Yarbrough, Melanie L; Orth, Kim

    2009-01-01

    Vibrio parahaemolyticus (V. parahaemolyticus) is a gram-negative halophillic bacterium that causes worldwide seafood-borne gastroenteritis. The prevalence of V. parahaemolyticus in the environment and incidence of infection have been linked to rising water temperatures caused by global warming. Among its virulence factors, V. parahaemolyticus harbors two type III secretion systems (T3SS). Recently, we have shown that T3SS1 induces rapid cellular death that initiates with acute autophagy, as measured by LC3 lipidation and accumulation of early autophagosomal vesicles. While not the first characterized pathogen to usurp autophagy, this is the first example of an extracellular pathogen that exploits this pathway for its own benefit. Here we discuss possible roles for the induction of autophagy during infection and discuss how V. parahaemolyticus-induced autophagy provides insight into key regulatory steps that govern the decision between apoptosis and autophagy.

  9. Sentinel Hospital-Based Surveillance for Assessment of Burden of Rotavirus Gastroenteritis in Children in Pakistan

    PubMed Central

    Kazi, Abdul Momin; Warraich, Gohar Javed; Qureshi, Shahida; Qureshi, Huma; Khan, Muhammad Mubashir Ahmad; Zaidi, Anita Kaniz Mehdi

    2014-01-01

    Objectives To determine the burden and molecular epidemiology of rotavirus gastroenteritis in children hospitalized with severe acute watery diarrhea in Pakistan prior to introduction of rotavirus vaccine. Methods A cross-sectional study was carried out over a period of two years from 2006 – 2008 at five sentinel hospitals in the cities of Karachi, Lahore, Rawalpindi, and Peshawar. Stool samples collected from children under five years of age hospitalized with severe acute watery diarrhea were tested for rotavirus antigen via enzyme immunoassay (EIA) (IDEA REF K6020 Oxoid Ltd (Ely), Cambridge, United Kingdom). A subset of EIA positive stool samples were further processed for genotyping. Results 6679 children were enrolled and stool specimens of 2039 (30.5%) were positive for rotavirus. Rotavirus positivity ranged from 16.3% to 39.4% in the 5 hospitals with highest positivity in Lahore. 1241 (61%) of all rotavirus cases were in infants under one year of age. Among the strains examined for G-serotypes, the occurrence of G1, G2, G9 and G4 strains was found to be 28%, 24%, 14% and 13%, respectively. Among P-types, the most commonly occurring strains were P6 (31.5%) followed by P8 (20%) and P4 (12%). Prevalent rotavirus genotype in hospitalized children of severe diarrhea were G1P[8] 11.6% (69/593), followed by G2P[4] 10.4% (62/593), and G4P[6] 10.1% (60/593). Conclusions Approximately one third of children hospitalized with severe gastroenteritis in urban centers in Pakistan have rotavirus. Introduction of rotavirus vaccine in Pakistan's national immunization program could prevent many severe episodes and diarrheal deaths. PMID:25295613

  10. Rotavirus and Norovirus in Pediatric Healthcare-Associated Gastroenteritis

    PubMed Central

    Yi, Jumi; Sederdahl, Bethany K.; Wahl, Kelly; Jerris, Robert R.; Kraft, Colleen S.; McCracken, Courtney; Gillespie, Scott; Kirby, Amy E.; Shane, Andi L.; Moe, Christine L.; Anderson, Evan J.

    2016-01-01

    Rotavirus and norovirus are important etiologies of gastroenteritis among hospitalized children. During 2012–2013, we tested 207 residual stool specimens from children with healthcare-associated vomiting and/or diarrhea for rotavirus and norovirus. Twenty (10%) were rotavirus positive, and 3 (3%) were norovirus positive, stressing the importance of these pathogens in hospitalized children. PMID:27807589

  11. The impact of rotavirus gastroenteritis on the family

    PubMed Central

    Mast, T Christopher; DeMuro-Mercon, Carla; Kelly, Claudia M; Floyd, Leigh Ellen; Walter, Emmanuel B

    2009-01-01

    Background Rotavirus is the leading cause of severe diarrhea in young children and causes substantial morbidity and mortality. Although the clinical aspects have been well described, little information is available regarding the emotional, social, and economic impact of rotavirus gastroenteritis on the family of a sick child. The objectives of this study were to: 1) assess the family impact of rotavirus gastroenteritis through qualitative interviews with parents; 2) compare the clinical severity of rotavirus-positive and negative gastroenteritis; 3) test a questionnaire asking parents to rank the importance of various factors associated with a case of rotavirus gastroenteritis. Methods The study enrolled parents and children (2–36 months of age) brought to one of the study sites (outpatient clinic or ER) if the child experienced ≥ 3 watery or looser-than normal stools and/or forceful vomiting within any 24-hour period within the prior 3 days. The clinical severity of each child's illness was rated using a clinical scoring system and stool samples were tested for rotavirus antigen. Parents of rotavirus-positive children were invited to participate in focus group or individual interviews and subsequently completed a questionnaire regarding the impact of their child's illness. Results Of 62 enrolled children, 43 stool samples were collected and 63% tested positive for rotavirus. Illness was more severe in children with rotavirus-positive compared to rotavirus-negative gastroenteritis (92% vs. 37.5% rated as moderate/severe). Seventeen parents of rotavirus-positive children participated in the interviews and completed the written questionnaire. Parents were frightened by the severity of vomiting and diarrhea associated with rotavirus gastroenteritis, and noted that family life was impacted in several ways including loss of sleep, missed work, and an inability to complete normal household tasks. They expressed frustration at the lack of a specific medication and the

  12. Genetic Analysis of Norovirus GII.4 Variant Strains Detected in Outbreaks of Gastroenteritis in Yokohama, Japan, from the 2006-2007 to the 2013-2014 Seasons.

    PubMed

    Kumazaki, Makoto; Usuku, Shuzo

    2015-01-01

    Noroviruses (NoVs) are the leading cause of acute gastroenteritis, both in sporadic cases and outbreaks. Since the 1990s, the emergence of several GII.4 variants has been reported worldwide. To investigate the epidemic status of NoV, 6,724 stool samples collected from outbreaks in Yokohama, Japan, from the 2006-2007 to 2013-2014 seasons were assessed for NoVs. We genotyped one specimen from each GII outbreak and conducted a sequence analysis of the VP1 gene for several GII.4 strains. Of the 947 NoV outbreaks during our study, GII was detected in 835, and GII.4 was the predominant genotype of GII. Five different GII.4 variants, Yerseke 2006a, Den Haag 2006b (2006b), Apeldoorn 2007, New Orleans 2009, and Sydney 2012, were detected. During this study period, the most prevalent variant of GII.4 was 2006b, and in each individual season, either 2006b or Sydney 2012 was the predominant variant. Out of the 16 detected 2006b strains, 12 had some amino acid substitutions in their blockade epitope, and these substitutions were concentrated in three residues. Two of the 2006b strains detected in the 2012-2013 season had a S368E substitution, which is consistent with the amino acid residues at same site of NSW0514 (Sydney 2012 prototype). Among the 16 detected strains of Sydney 2012, a phylogenetic analysis showed that all five strains detected in Yokohama during the 2011-2012 season clustered away from the other Sydney 2012 strains that were detected in the 2012-2013 and 2013-2014 seasons. These five strains and other Sydney 2012 strains in Yokohama had a few amino acid differences in the blockade epitopes compared with NSW0514. The amino acid substitutions observed in this study provide informative data about the evolution of a novel GII.4 variant.

  13. Help Desk Answers: Are IV fluids better than oral rehydration for children with acute diarrhea and vomiting?

    PubMed

    Patnaik, Suvag; Nanda, Mitali; Tiburicio, Jose

    2016-04-01

    Intravenous fluid therapy (IVF) has a slightly lower failure rate than oral replacement therapy (ORT) in children with acute gastroenteritis, but the clinical significance is questionable. IVF takes longer to initiate than ORT and lengthens the hospital stay. PMID:27262252

  14. Acute Myositis Associated with Concurrent Infection of Rotavirus and Norovirus in a 2-Year-Old Girl

    PubMed Central

    Yamamoto, Kei; Fukuda, Seiji; Mushimoto, Yuichi; Minami, Noriaki; Kanai, Rie; Tsukamoto, Kazuki; Yamaguchi, Seiji

    2015-01-01

    Rotavirus and norovirus are common pathogens associated with gastroenteritis in children. Although rotavirus occasionally induces central nervous system disease, only 3 cases with rotavirus-induced acute myositis have been reported in the English literature. We recently treated a female patient with acute myositis associated with gastroenteritis induced by concurrent infection with rotavirus and norovirus. Having suffered from gastroenteritis for 3 days, she suddenly developed myositis affecting her lower extremities with concomitant creatine kinase elevation. Herein, we present our patient and review the previous cases including those reported in the Japanese literature. PMID:26500744

  15. Recent Progress in the Research of Eosinophilic Esophagitis and Gastroenteritis.

    PubMed

    Kinoshita, Yoshikazu; Ishimura, Norihisa; Oshima, Naoki; Mikami, Hironobu; Okimoto, Eiko; Jiao, Di Jin; Ishihara, Shunji

    2016-01-01

    Eosinophilic esophagitis (EoE) and gastroenteritis are allergic gastrointestinal diseases mainly caused by food allergens. The number of patients with EoE is rapidly increasing in both Western and Asian countries. Basic knowledge of these diseases has mainly come from studies of EoE and Th2 type allergic reactions, including IL-5, IL-13, and IL-15, thymic stromal protein, and eotaxin 3, which are considered to have important roles. For a diagnosis of EoE, endoscopic abnormalities and histological confirmation of dense eosinophile infiltration in the esophageal epithelial layer are important, in addition to identifying dysphagia symptoms. As for eosinophilic gastroenteritis, blood test findings are more useful and the role of an endoscopic examination is reduced. For both diseases, the infection rate of Helicobacter pylori is lower than in healthy controls. Glucocorticoid administration is standard treatment for these diseases, while proton pump inhibitors are frequently effective for EoE. PMID:26789117

  16. Molecular epidemiology and surveillance of circulating rotavirus and adenovirus in Congolese children with gastroenteritis.

    PubMed

    Mayindou, Gontran; Ngokana, Berge; Sidibé, Anissa; Moundélé, Victoire; Koukouikila-Koussounda, Felix; Christevy Vouvoungui, Jeannhey; Kwedi Nolna, Sylvie; Velavan, Thirumalaisamy P; Ntoumi, Francine

    2016-04-01

    Infectious Diarrhea caused by rotavirus and adenovirus, is a leading cause of death in children in sub-Sahara Africa but there is limited published data on the diverse rotavirus genotypes and adenovirus serotypes circulating in the Republic of Congo. In this study, we investigated the prevalence of severe diarrhea caused by rotavirus A (RVA) and Adenovirus serotype 40 and 41 in Congolese children hospitalized with severe gastroenteritis. Stool samples were collected from 655 Congolese children less than 60 months of age hospitalized with acute gastroenteritis between June 2012 and June 2013. Rotavirus and adenovirus antigens were tested using commercially available ELISA kits and the RVA G- and P- genotypes were identified by seminested multiplex RT-PCR. Three hundred and four (46.4%) children were tested positive for RVA. Adenovirus infection was found in 5.5% of the 564 tested children. Rotavirus infection was frequently observed in children between 6-12 months (55.9%). The dry season months recorded increased RVA infection while no seasonality of adenovirus infection was demonstrated. The most common RVA genotypes were G1 (57.5%), G2 (6.4%), G1G2 mixture (15.5%), P[8] (58%), P[6] (13.2%), and P[8]P[6] mixture (26%). Additionally, the genotype G12P[6] was significantly associated with increased vomiting. This first study on Congolese children demonstrates a high prevalence and clinical significance of existing rotavirus genotypes. Adenovirus prevalence is similar to that of other Central African countries. This baseline epidemiology and molecular characterization study will contribute significantly to the RVA surveillance after vaccine implementation in the country.

  17. Outbreak of norovirus gastroenteritis infection, Thailand.

    PubMed

    McCarthy, Katie S; Guntapong, Ratigorn; Thattiyaphong, Aree; Wangroongsarb, Piyada; Hall, Aron J; Olsen, Sonja J; Holtz, Timothy H

    2013-05-01

    Norovirus is a leading cause of gastrointestinal illness worldwide. We investigated an outbreak of gastrointestinal illness in Pattaya, Thailand, among participants of a course. We asked participants and family members to complete a questionnaire asking about symptoms, meals eaten, and foods consumed during the course. We collected stool samples from persons reporting illness and analyzed specimens for several viruses and enteropathogenic bacteria. We defined a case as a person having one or more episodes of diarrhea, with onset between 30 August and 1 September 2010, in a participant or family member who attended the course. Of 56 people who attended, 95% completed the questionnaire: nine met the case definition (attack rate, 17%). Common symptoms included abdominal cramps, nausea, fatigue, headache, and vomiting. Food items with elevated risk ratios included: crispy fish maw, dried squid, and cashew nut salad [risk ratio (RR) 5.1; 95% confidence interval (CI) 0.7-37]; assorted salad bar with dressing (RR 3.0; 95% CI 0.9-11); and seafood kebab (RR 5.8; 95% CI 0.8-43). Among ill persons, four (44%) provided stool samples and two (50%) were positive for norovirus. Our data suggest a foodborne outbreak of norovirus. Increased use of norovirus diagnostics as well as measures to prevent transmission may help identify additional outbreaks and improve control measures to limit the spread of outbreaks. PMID:24050072

  18. Surveillance of pathogens causing gastroenteritis and characterization of norovirus and sapovirus strains in Shenzhen, China, during 2011.

    PubMed

    Wu, Wei; Yang, Hong; Zhang, Hai-long; Xian, Hui-Xia; Yao, Xiang-Jie; Zhao, De-Jian; Chen, Long; Shu, Bai-hua; Zhou, Yi-kai; He, Ya-Qing

    2014-08-01

    Viral gastroenteritis is one of the most common diseases in humans, and it is primarily caused by rotaviruses (RVs), astroviruses (AstVs), adenoviruses (AdVs), noroviruses (NoVs), and sapoviruses (SaVs). In this study, we determined the distribution of viral gastroenteritis and human calicivirus (HuCVs) in acute gastroenteritis patients in Shenzhen, China, during 2011. Real-time RT-PCR was used to detect norovirus (NoV), group A rotavirus (RV), adenovirus (AdV), and astrovirus (AstV). From a total of 983 fecal samples, NoV was detected in 210 (21.4 %); RoV in 173 (17.6 %); AstV in 10 (1.0 %); and AdV in 15 (1.5 %). Mixed infections involving two NoVs were found in 21 of the 387 pathogen-positive stool specimens. NoV and SaV genotypes were further tested using RT-PCRs and molecular typing and phylogenetic analysis were then performed based on the ORF1-ORF2 region for NoV and a conserved nucleotide sequence in the capsid gene for SaV. Of the 68 typed strains that were sequenced and genotyped, five were NoV G1 (7.5 %) and 63 were NoV GII (96.6 %). GII strains were clustered into five genotypes, including GII.4 (65.1 %; 36 GII.4 2006b and five GII.4 New Orleans), GII.3 (28.6 %), GII.2 (3.2 %), GII.6 (1.6 %), and GII.1 (1.6 %). While all fecal specimens were tested for SaVs, 15 (1.5 %) were positive, and of these, 12 isolates belonged to G1.2, and the remaining three SaV strains belonged to the SaV GII genogroup. Although various HuCVs were detected in acute gastroenteritis patients, NoV GII.4 2006b was more prevalent than the other HuCVs. PMID:24610551

  19. A common, symptom-based case definition for gastroenteritis

    PubMed Central

    MAJOWICZ, S. E.; HALL, G.; SCALLAN, E.; ADAK, G. K.; GAUCI, C.; JONES, T. F.; O'BRIEN, S.; HENAO, O.; SOCKETT, P. N.

    2008-01-01

    SUMMARY National studies determining the burden of gastroenteritis have defined gastroenteritis by its clinical picture, using symptoms to classify cases and non-cases. The use of different case definitions has complicated inter-country comparisons. We selected four case definitions from the literature, applied these to population data from Australia, Canada, Ireland, Malta and the United States, and evaluated how the epidemiology of illness varied. Based on the results, we developed a standard case definition. The choice of case definition impacted on the observed incidence of gastroenteritis, with a 1·5–2·1 times difference between definitions in a given country. The proportion of cases with bloody diarrhoea, fever, and the proportion who sought medical care and submitted a stool sample also varied. The mean age of cases varied by <5 years under the four definitions. To ensure comparability of results between studies, we recommend a standard symptom-based case definition, and minimum set of results to be reported. PMID:17686196

  20. A waterborne norovirus gastroenteritis outbreak in a school, eastern China.

    PubMed

    Zhou, N; Zhang, H; Lin, X; Hou, P; Wang, S; Tao, Z; Bi, Z; Xu, A

    2016-04-01

    In late 2014, a gastroenteritis outbreak occurred in a school in Shandong Province, eastern China. Hundreds of individuals developed the symptoms of diarrhoea and vomiting. Epidemiological investigation showed that food consumption was not linked to this outbreak, and unboiled direct drinking water was identified as the independent risk factor with a relative risk of 1·37 (95% confidence interval 1·03-1·83). Furthermore, examination of common bacterial and viral gastroenteritis pathogens was conducted on different specimens. Norovirus GI.1, GI.2, GI.6, GII.4, GII.6 and GII.13 were detected in clinical specimens and a water sample. GII.4 sequences between clinical specimens and the water sample displayed a close relationship and belonged to GII.4 variant Sydney 2012. These results indicate that direct drinking water contaminated by norovirus was responsible for this gastroenteritis outbreak. This study enriches our knowledge of waterborne norovirus outbreaks in China, and presents valuable prevention and control practices for policy-makers. In future, strengthened surveillance and supervision of direct drinking-water systems is needed.

  1. Diagnosis of Noncultivatable Gastroenteritis Viruses, the Human Caliciviruses

    PubMed Central

    Atmar, Robert L.; Estes, Mary K.

    2001-01-01

    Gastroenteritis is one of the most common illnesses of humans, and many different viruses have been causally associated with this disease. Of those enteric viruses that have been established as etiologic agents of gastroenteritis, only the human caliciviruses cannot be cultivated in vitro. The cloning of Norwalk virus and subsequently of other human caliciviruses has led to the development of several new diagnostic assays. Antigen detection enzyme immunoassays (EIAs) using polyclonal hyperimmune animal sera and antibody detection EIAs using recombinant virus-like particles have supplanted the use of human-derived reagents, but the use of these assays has been restricted to research laboratories. Reverse transcription-PCR assays for the detection of human caliciviruses are more widely available, and these assays have been used to identify virus in clinical specimens as well as in food, water, and other environmental samples. The application of these newer assays has significantly increased the recognition of the importance of human caliciviruses as causes of sporadic and outbreak-associated gastroenteritis. PMID:11148001

  2. [A case of eosinophilic gastroenteritis accompanied with fasciitis of the extremities].

    PubMed

    Matsuura, Tomoharu; Yamade, Mihoko; Matsushita, Naoya; Kawasaki, Shinsuke; Terai, Tomohiro; Uotani, Takahiro; Takayanagi, Yasuhiro; Yamada, Takahiro; Kodaira, Chise; Sugimoto, Mitsushige; Furuta, Takahisa; Sugimoto, Ken; Osawa, Satoshi; Ikuma, Mutsuhiro

    2011-03-01

    We encountered a very rare case of eosinophilic gastroenteritis accompanied with fasciitis of the extremities. The patient was a 28-year-old woman with epigastralgia, eosinophilia plus leukocytosis, massive pleural effusion and ascites, and thickening of the walls of the intestine. Increase of the eosinophilic fraction in her ascites led to a diagnosis of eosinophilic gastroenteritis. She soon developed resting pain in all limbs and MRI revealed fasciitis. Prednisolone was effective in treating both gastroenteritis and fasciitis. PMID:21389666

  3. Update on bedside ultrasound (US) diagnosis of acute cholecystitis (AC).

    PubMed

    Zenobii, Maria Francesca; Accogli, Esterita; Domanico, Andrea; Arienti, Vincenzo

    2016-03-01

    Acute cholecystitis (AC) represents a principal cause of morbidity worldwide and is one of the most frequent reasons for hospitalization due to gastroenteric tract diseases. AC should be suspected in presence of clinical signs and of gallstones on an imaging study. Upper abdominal US represents the first diagnostic imaging step in the case of suspected AC. Computed tomography (CT) with intravenous contrast (IV) or magnetic resonance imaging (MRI) with gadolinium contrast and technetium hepatobiliary iminodiacetic acid (Tc-HIDA) can be employed to exclude complications. US examination should be performed with right subcostal oblique, with longitudinal and intercostal scans. Normal gallbladder US findings and AC major and minor US signs are described. Polyps, sludge and gallbladder wall thickening represent the more frequent pitfalls and they must be differentiated from stones, duodenal artifacts and many other non-inflammatory conditions that cause wall thickening, respectively. By means of bedside ultrasound, the finding of gallstones in combination with acute pain, when the clinician presses the gallbladder with the US probe (the sonographic Murphy's sign), has a 92.2 % positive predictive value for AC. In our preliminary experience, bedside US-performed by echoscopy (ES) and/or point-of-care US (POCUS) demonstrated good reliability in detecting signs of AC, and was always integrated with physical examination and performed by a skilled operator.

  4. Mushroom toxicosis in dogs in general practice causing gastroenteritis, ptyalism and elevated serum lipase activity.

    PubMed

    Hall, J; Barton, L

    2013-05-01

    Mushroom toxicosis is rarely diagnosed in dogs and is poorly reported in the veterinary literature. This report suggests that mushroom toxicosis is a potentially under-diagnosed condition in first opinion practice in the UK. Nine dogs with clinical signs consistent with mushroom toxicosis were identified from the records of an out-of-hours emergency service between August 2010 and January 2011. Four dogs were later excluded because of clinical inconsistencies. Clinical signs included acute profuse ptyalism (5/5), diarrhoea (5/5), vomiting (4/5), hypovolaemia (4/5), stuporous (3/5) or obtunded mentation (1/5), miosis (2/5) and hypothermia (2/5). Serum lipase activity was elevated in 4/4 dogs; canine-specific pancreatic lipase was elevated in the remaining dog. Four dogs recovered with aggressive intravenous fluid therapy, analgesia and supportive care; the remaining dog was euthanased due to severe clinical signs and financial constraints. Mushroom toxicosis is an important differential diagnosis for acute gastroenteritis and one possible cause of some cases of "Seasonal Canine Illness". Affected dogs may demonstrate elevated pancreatic enzymes and mushroom toxicosis should be considered in cases of elevated lipase or abnormal semi-quantitative canine-specific pancreatic lipase activities.

  5. Community-Acquired Rotavirus Gastroenteritis Compared with Adenovirus and Norovirus Gastroenteritis in Italian Children: A Pedianet Study

    PubMed Central

    Donà, D.; Mozzo, E.; Scamarcia, A.; Picelli, G.; Villa, M.; Cantarutti, L.; Giaquinto, C.

    2016-01-01

    Background. Rotavirus (RV) is the commonest pathogen in the hospital and primary care settings, followed by Adenovirus (AV) and Norovirus (NV). Only few studies that assess the burden of RV gastroenteritis at the community level have been carried out. Objectives. To estimate incidence, disease characteristics, seasonal distribution, and working days lost by parents of RV, AV, and NV gastroenteritis leading to a family pediatrician (FP) visit among children < 5 years. Methods. 12-month, observational, prospective, FP-based study has been carried out using Pedianet database. Results. RVGE incidence was 1.04 per 100 person-years with the highest incidence in the first 2 years of life. Incidences of AVGEs (1.74) and NVGEs (1.51) were slightly higher with similar characteristics regarding age distribution and symptoms. Risk of hospitalisation, access to emergency room (ER), and workdays lost from parents were not significantly different in RVGEs compared to the other viral infections. Conclusions. Features of RVGE in terms of hospitalisation length and indirect cost are lower than those reported in previous studies. Results of the present study reflect the large variability of data present in the literature. This observation underlines the utility of primary care networks for AGE surveillance and further studies on community-acquired gastroenteritis in children. PMID:26884770

  6. Worldwide satellite market demand forecast

    NASA Technical Reports Server (NTRS)

    Bowyer, J. M.; Frankfort, M.; Steinnagel, K. M.

    1981-01-01

    The forecast is for the years 1981 - 2000 with benchmark years at 1985, 1990 and 2000. Two typs of markets are considered for this study: Hardware (worldwide total) - satellites, earth stations and control facilities (includes replacements and spares); and non-hardware (addressable by U.S. industry) - planning, launch, turnkey systems and operations. These markets were examined for the INTELSAT System (international systems and domestic and regional systems using leased transponders) and domestic and regional systems. Forecasts were determined for six worldwide regions encompassing 185 countries using actual costs for existing equipment and engineering estimates of costs for advanced systems. Most likely (conservative growth rate estimates) and optimistic (mid range growth rate estimates) scenarios were employed for arriving at the forecasts which are presented in constant 1980 U.S. dollars. The worldwide satellite market demand forecast predicts that the market between 181 and 2000 will range from $35 to $50 billion. Approximately one-half of the world market, $16 to $20 billion, will be generated in the United States.

  7. Canine parvovirus: the worldwide occurrence of antigenic variants.

    PubMed

    Miranda, Carla; Thompson, Gertrude

    2016-09-01

    The most important enteric virus infecting canids is canine parvovirus type 2 (CPV-2). CPV is the aetiologic agent of a contagious disease, mainly characterized by clinical gastroenteritis signs in younger dogs. CPV-2 emerged as a new virus in the late 1970s, which could infect domestic dogs, and became distributed in the global dog population within 2 years. A few years later, the virus's original type was replaced by a new genetic and antigenic variant, called CPV-2a. Around 1984 and 2000, virus variants with the single change to Asp or Glu in the VP2 residue 426 were detected (sometimes termed CPV-2b and -2c). The genetic and antigenic changes in the variants have also been correlated with changes in their host range; in particular, in the ability to replicate in cats and also host range differences in canine and other tissue culture cells. CPV-2 variants have been circulating among wild carnivores and have been well-documented in several countries around the world. Here, we have reviewed and summarized the current information about the worldwide distribution and evolution of CPV-2 variants since they emerged, as well as the host ranges they are associated with. PMID:27389721

  8. Canine parvovirus: the worldwide occurrence of antigenic variants.

    PubMed

    Miranda, Carla; Thompson, Gertrude

    2016-09-01

    The most important enteric virus infecting canids is canine parvovirus type 2 (CPV-2). CPV is the aetiologic agent of a contagious disease, mainly characterized by clinical gastroenteritis signs in younger dogs. CPV-2 emerged as a new virus in the late 1970s, which could infect domestic dogs, and became distributed in the global dog population within 2 years. A few years later, the virus's original type was replaced by a new genetic and antigenic variant, called CPV-2a. Around 1984 and 2000, virus variants with the single change to Asp or Glu in the VP2 residue 426 were detected (sometimes termed CPV-2b and -2c). The genetic and antigenic changes in the variants have also been correlated with changes in their host range; in particular, in the ability to replicate in cats and also host range differences in canine and other tissue culture cells. CPV-2 variants have been circulating among wild carnivores and have been well-documented in several countries around the world. Here, we have reviewed and summarized the current information about the worldwide distribution and evolution of CPV-2 variants since they emerged, as well as the host ranges they are associated with.

  9. Non-typhoidal Salmonella Typhimurium ST313 isolates that cause bacteremia in humans stimulate less inflammasome activation than ST19 isolates associated with gastroenteritis.

    PubMed

    Carden, Sarah; Okoro, Chinyere; Dougan, Gordon; Monack, Denise

    2015-06-01

    Salmonella is an enteric pathogen that causes a range of diseases in humans. Non-typhoidal Salmonella (NTS) serovars such as Salmonella enterica serovar Typhimurium generally cause a self-limiting gastroenteritis whereas typhoidal serovars cause a systemic disease, typhoid fever. However, S. Typhimurium isolates within the multi-locus sequence type ST313 have emerged in sub-Saharan Africa as a major cause of bacteremia in humans. The S. Typhimurium ST313 lineage is phylogenetically distinct from classical S. Typhimurium lineages, such as ST19, that cause zoonotic gastroenteritis worldwide. Previous studies have shown that the ST313 lineage has undergone genome degradation when compared to the ST19 lineage, similar to that observed for typhoidal serovars. Currently, little is known about phenotypic differences between ST313 isolates and other NTS isolates. We find that representative ST313 isolates invade non-phagocytic cells less efficiently than the classical ST19 isolates that are more commonly associated with gastroenteritis. In addition, ST313 isolates induce less Caspase-1-dependent macrophage death and IL-1β release than ST19 isolates. ST313 isolates also express relatively lower levels of mRNA of the genes encoding the SPI-1 effector sopE2 and the flagellin, fliC, providing possible explanations for the decrease in invasion and inflammasome activation. The ST313 isolates have invasion and inflammatory phenotypes that are intermediate; more invasive and inflammatory than Salmonella enterica serovar Typhi and less than ST19 isolates associated with gastroenteritis. This suggests that both phenotypically and at the genomic level ST313 isolates are evolving signatures that facilitate a systemic lifestyle in humans.

  10. Enhanced enteric virus detection in sporadic gastroenteritis using a multi-target real-time PCR panel: a one-year study.

    PubMed

    Pang, Xiaoli L; Preiksaitis, Jutta K; Lee, Bonita E

    2014-09-01

    Viral gastroenteritis causes significant mortality and morbidity worldwide. Identifying the etiology of viral gastroenteritis is a challenge as most enteric viruses (EVs) are non-culturable. This study is to develop an EV testing panel using real-time PCR (EVPrtPCR) to simultaneously detect rotavirus, norovirus, sapovirus, astrovirus, and enteric adenovirus in stool samples. EVPrtPCR using universal amplification conditions was run in a single instrument run. EVPrtPCR was used to test 2,486 sporadic gastroenteritis samples submitted for EV testing using electron microscopy (EM) between July 2008 and July 2009. Retesting spiked negative stool samples and Salmon DNA as internal control were used to evaluate inhibition. EVPrtPCR detected viruses in significantly more samples: 748 (34%) as compared to 94 (3.8%) by EM. EM did not detect any norovirus, sapovirus, and mixed infection, and detected only 39% of rotavirus and 38.2% of enteric adenovirus positive samples. Four samples that tested positive for rotavirus and two for adenovirus and for small-round-structured viruses by EM were negative by EVPrtPCR. Norovirus was the most common virus detected (17.6%) with 92.4% as genogroup II, followed by rotavirus (6.8%), sapovirus (4.2%), astrovirus (2.0%), and enteric adenovirus (1.4%) with 9% samples positive for mixed infection. Overall, EV identification followed a U-shaped age distribution; positive samples were more common in children ≤5 years old and adults >60 years old. Norovirus, sapovirus and astrovirus showed winter predominance and rotavirus peaked in the spring. No inhibition was observed. Molecular technology significantly enhanced the identification of EV causing sporadic gastroenteritis in Alberta.

  11. Non-typhoidal Salmonella Typhimurium ST313 isolates that cause bacteremia in humans stimulate less inflammasome activation than ST19 isolates associated with gastroenteritis

    PubMed Central

    Carden, Sarah; Okoro, Chinyere; Dougan, Gordon; Monack, Denise

    2014-01-01

    Salmonella is an enteric pathogen that causes a range of diseases in humans. Non-typhoidal Salmonella (NTS) serovars such as Salmonella enterica serovar Typhimurium generally cause a self-limiting gastroenteritis whereas typhoidal serovars cause a systemic disease, typhoid fever. However, S. Typhimurium isolates within the multi-locus sequence type ST313 have emerged in sub-Saharan Africa as a major cause of bacteremia in humans. The S. Typhimurium ST313 lineage is phylogenetically distinct from classical S. Typhimurium lineages, such as ST19, that cause zoonotic gastroenteritis worldwide. Previous studies have shown that the ST313 lineage has undergone genome degradation when compared to the ST19 lineage, similar to that observed for typhoidal serovars. Currently, little is known about phenotypic differences between ST313 isolates and other NTS isolates. We find that representative ST313 isolates invade non-phagocytic cells less efficiently than the classical ST19 isolates that are more commonly associated with gastroenteritis. In addition, ST313 isolates induce less Caspase-1-dependent macrophage death and IL-1β release than ST19 isolates. ST313 isolates also express relatively lower levels of mRNA of the genes encoding the SPI-1 effector sopE2 and the flagellin, fliC, providing possible explanations for the decrease in invasion and inflammasome activation. The ST313 isolates have invasion and inflammatory phenotypes that are intermediate; more invasive and inflammatory than Salmonella enterica serovar Typhi and less than ST19 isolates associated with gastroenteritis. This suggests that both phenotypically and at the genomic level ST313 isolates are evolving signatures that facilitate a systemic lifestyle in humans. PMID:25808600

  12. Diagnostic value of the Vesikari Scoring System for predicting the viral or bacterial pathogens in pediatric gastroenteritis

    PubMed Central

    Shim, Dong Ho; Kim, Dong Yeon

    2016-01-01

    Purpose To evaluate the diagnostic value of the Vesikari Scoring System (VSS) as an early predictor of pathogens in children with acute gastroenteritis (AG). Methods In this retrospective study, the VSS score, absolute neutrophil count (ANC), and C-reactive protein (CRP) levels were analyzed in 107 hospitalized children with AG, aged 6 months to 17 years. Patients were divided into nonspecific, viral, and bacterial groups according to the pathogens detected using a multiplex polymerase chain reaction (PCR) test. Results Patients in the bacterial group had significantly higher CRP values and VSS scores compared to those in the viral group and significantly higher VSS scores compared to those in the nonspecific group (P<0.05). Patients in the viral group had significantly higher VSS scores than those in the nonspecific group (P<0.05). Logistic regression analysis revealed that VSS was the most effective diagnostic tool for predicting the type of pathogen (P<0.05). The area under the receiver operating characteristics curve of VSS was significantly greater than that for ANC and CRP (P<0.05). At a cutoff point of 10 in the VSS, an acceptable diagnostic accuracy could be achieved for distinguishing between bacterial and viral pathogens in AG. Conclusion VSS can be considered a useful and reliable infectious marker for pediatric gastroenteritis. VSS may be a good early predictor of the type of pathogen, enabling development of a treatment plan before results from a stool culture or PCR test are available. PMID:27186219

  13. Epidemiological investigation of two parallel gastroenteritis outbreaks in school settings

    PubMed Central

    2013-01-01

    Background Two parallel gastroenteritis outbreaks occurred in an elementary school and a neighboring kindergarten in Kilkis, Northern Greece in 2012. The aim of the study was the investigation of these two parallel outbreaks as well as their possible source. Methods Two retrospective cohort studies were performed to identify the mode and the vehicle of transmission as well as the possible connection between them. Results Elementary school and kindergarten populations of 79.9% (119/149) and 51.1% (23/45) respectively, participated in the study. Case definition was satisfied by 65 pupils from the elementary school and 14 from the kindergarten. For elementary school, 53 cases were considered primary cases of the outbreak and were included in the analysis. Based on the results of the multivariate analysis, consumption of tap water was the only statistically significant independent risk factor of gastroenteritis (RR = 2.34, 95% C.I.: 1.55-3.53).; a finding supported by the shape of the epidemic curve which referred to a common point source outbreak with secondary cases. For kindergarten, no statistically significant risk factor was identified, and the epidemic curve supported a person-to-person transmission according univariate analysis. Norovirus GI and GII and human Adenovirus were detected by Real Time PCR in stool samples from seven children of elementary school, but stool samples were not collected by children of the kindergarten. Conclusions Even though the etiological agent of the outbreak was not verified, combined epidemiological and laboratory results were in favor of a waterborne viral gastroenteritis outbreak at the elementary school, followed by a person to person spread at the kindergarten. PMID:23510408

  14. Honey: its antibacterial action in the treatment of gastroenteritis.

    PubMed

    1985-01-01

    The results of several recent "in vitro" studies using honey in oral rehydration solutions (ORS) givien to infants and children with gastroenteritis showed that the use of honey had caused a reduction in the duration of bacterial diarrhea, and it had worked well as a substitute for glucose in an oral rehydration solution containing electrolytes. Studies have confirmed that honey shortens the duration of diarrhea in patients with bacterial gastroenteritis through its antibacterial properties. In nonbacterial gastroenteritis, honey had the same effect as glucose on the duration of the diarrhea. In a recent study, the antibacterial effect of pure honey was evaluated through testing the growth of an array of gram-positive and gram-negative bacteria in media containing varying concentrations of honey. It was found that most pathogenic bacteria failed to grow in honey at a concentration of 40% and above. Similar studies have shown that organisms such as Staphylococcus aureua, Proteus mirabilis, and Candida albicans failed to grow in the presence of undiluted honey in in vitro experiments. In experiments to evaluate the effectiveness of honey in inhibiting the growth of various bacteria, it was found that all bacteria grew well on their respective control plates having different growth media, while in honey-agar all intestinal bacterial pathogens failed to grow at a concentration of 40% and above of pure honey. Since honey has a high sugar content it could be used to promote sodium and water absorption from the bowel in a manner similar to the use of oral rice water and sucrose. Findings from studies on honey have thus shown that when given with an ORS it shortens the duration of bacterial diarrhea and may safely be used as a substitute for glucose, provided that the solution contains electrolytes.

  15. Antimicrobial susceptibility testing of bacteria that cause gastroenteritis.

    PubMed

    Humphries, Romney M; Schuetz, Audrey N

    2015-06-01

    Gastroenteritis due to enteric pathogens is generally a self-limiting disease for which antimicrobial treatment is not required. However, treatment should be considered for cases of severe or prolonged diarrhea, extraintestinal isolation of bacteria, or diarrhea in immunocompromised hosts, the elderly, and infants. Various resistance trends and current issues concerning antimicrobial susceptibility testing of enteric pathogens are reviewed in this article, including Campylobacter, Salmonella, Shigella, Vibrio, Aeromonas, Plesiomonas, and Clostridium difficile. Updated interpretive criteria from breakpoint-setting organizations are reviewed, along with explanations for recent changes in antimicrobial breakpoints.

  16. Identification and Type Distribution of Astroviruses among Children with Gastroenteritis in Colombia and Venezuela

    PubMed Central

    Medina, Sandra M.; Gutierrez, María F.; Liprandi, Ferdinando; Ludert, Juan E.

    2000-01-01

    Astrovirus infections were detected by enzyme immunoassay in 12 (5%) of 251 stool samples from children with gastroenteritis from Bogota, Colombia. In addition, astroviruses were detected by reverse transcription-PCR in 3 (10%) of 29 stool samples negative for other enteric pathogens collected in Caracas, Venezuela, from children with gastroenteritis. Astrovirus type 1 was the most frequently detected virus. PMID:10970410

  17. Irreversible Loss of Vision in a Child due to Occipital Infarction after Gastroenteritis.

    PubMed

    Mansour, Ahmad M; Hasbini, Dana; Younis, Muhammad H; Bhatti, M Tariq

    2015-01-01

    A 2½-year-old girl developed a bilateral occipital infarct following severe gastroenteritis with bilateral vision of light perception. Evaluations for sickle cell anemia, hemolytic anemia and coagulopathies were negative. Cortical blindness is an uncommon but dramatic complication of gastroenteritis, hence the need of prompt hydration and other supportive measures to avoid irreversible visual loss or mental sequela.

  18. Irreversible Loss of Vision in a Child due to Occipital Infarction after Gastroenteritis

    PubMed Central

    Mansour, Ahmad M.; Hasbini, Dana; Younis, Muhammad H.; Bhatti, M. Tariq

    2015-01-01

    A 2½-year-old girl developed a bilateral occipital infarct following severe gastroenteritis with bilateral vision of light perception. Evaluations for sickle cell anemia, hemolytic anemia and coagulopathies were negative. Cortical blindness is an uncommon but dramatic complication of gastroenteritis, hence the need of prompt hydration and other supportive measures to avoid irreversible visual loss or mental sequela. PMID:25960732

  19. Canine parvovirus type 2c identified from an outbreak of severe gastroenteritis in a litter in Sweden.

    PubMed

    Sutton, David; Vinberg, Carina; Gustafsson, Agneta; Pearce, Jacqueline; Greenwood, Neil

    2013-01-01

    A litter of recently-vaccinated puppies in Sweden experienced signs of severe haemorrhagic gastroenteritis. Canine parvovirus (CPV) was suspected as the cause of this outbreak on the basis of the clinical signs and the presence of parvoviral antigen in the faeces from one of the affected pups - confirmed using a commercial in-clinic faecal antigen ELISA test kit. A concern was raised about whether the vaccine (which contained a live, attenuated strain of CPV) could have caused the disease and so further faecal samples from the affected pups were submitted for laboratory virus isolation and identification.On cell culture, two out of four faecal samples were found to be virus-positive. This was confirmed as being canine parvovirus by immuno-staining with CPV specific monoclonal antibody. The virus was then tested using a series of PCR probes designed to confirm the identity of CPV and to distinguish the unique vaccine strain from field virus. This confirmed that the virus was indeed CPV but that it was not vaccine strain. The virus was then typed by sequencing the 426 amino acid region of the capsid gene which revealed this to be a type 2c virus.Since its emergence in the late 1970s, canine parvovirus 2 (CPV2) has spread worldwide and is recognised as an important canine pathogen in all countries. The original CPV2 rapidly evolved into two antigenic variants, CPV2a and CPV2b, which progressively replaced the original CPV2. More recently a new antigenic variant, CPV2c, has appeared. To date this variant has been identified in many countries worldwide but there have been no reports yet of its presence in any Scandinavian countries. This case report therefore represents the first published evidence of the involvement of CPV2c in a severe outbreak of typical haemorrhagic gastroenteritis in a susceptible litter of pups in Scandinavia.

  20. Gastroenteritis due to enteropathogenic, enterotoxigenic, and invasive Escherichia coli: A review.

    PubMed

    Pickering, L K

    1979-09-01

    Escherichia coli that produce diarrhea can be divided into three groups: 1) enteropathogenic, 2) enterotoxigenic, and 3) enteroinvasive. The mechanism of disease production by enteropathogenic E. coli is unknown, but these strains are not presently known to be inherently pathogenic, although they may be important as a cause of gastroenteritis in infants. The two known mechanisms of disease production are elaboration of enterotoxin and mucosal invasion. Heat-labile toxin-producing E. coli are the main cause of diarrhea in travelers while heat-stable toxin-producing E. coli are a cause of scours among new-born swine and cattle. Enteroinvasive E. coli have not been shown to be an important cause of diarrhea in the United States. Enteropathogenic, enterotoxigenic, and enteroinvasive E. coli that currently are associated with diarrhea worldwide may each consist of relatively few serotypes different from those associated with out-breaks of diarrhea in the past. This implies a possible new role for sero-typing of E. coli.

  1. Space Research Fortifies Nutrition Worldwide

    NASA Technical Reports Server (NTRS)

    2008-01-01

    NASA's Controlled Ecological Life Support Systems program attempted to address basic needs of crews, meet stringent payload and power usage restrictions, and minimize space occupancy, by developing living, regenerative ecosystems that would take care of themselves and their inhabitants. An experiment from this program evolved into one of the most widespread NASA spinoffs of all time-a method for manufacturing an algae-based food supplement that provides the nutrients previously only available in breast milk. Martek Biosciences Corporation, in Columbia, Maryland, now manufactures this supplement, and it can be found in over 90 percent of the infant formulas sold in the United States, as well as those sold in over 65 other countries. With such widespread use, the company estimates that over 24 million babies worldwide have consumed its nutritional additives.

  2. Worldwide Research, Worldwide Participation: Web-Based Test Logger

    NASA Technical Reports Server (NTRS)

    Clark, David A.

    1998-01-01

    Thanks to the World Wide Web, a new paradigm has been born. ESCORT (steady state data system) facilities can now be configured to use a Web-based test logger, enabling worldwide participation in tests. NASA Lewis Research Center's new Web-based test logger for ESCORT automatically writes selected test and facility parameters to a browser and allows researchers to insert comments. All data can be viewed in real time via Internet connections, so anyone with a Web browser and the correct URL (universal resource locator, or Web address) can interactively participate. As the test proceeds and ESCORT data are taken, Web browsers connected to the logger are updated automatically. The use of this logger has demonstrated several benefits. First, researchers are free from manual data entry and are able to focus more on the tests. Second, research logs can be printed in report format immediately after (or during) a test. And finally, all test information is readily available to an international public.

  3. Multiplex PCR Tests for Detection of Pathogens Associated with Gastroenteritis

    PubMed Central

    Zhang, Hongwei; Morrison, Scott; Tang, Yi-Wei

    2016-01-01

    Synopsis A wide range of enteric pathogens can cause infectious gastroenteritis. Conventional diagnostic algorithms including culture, biochemical identification, immunoassay and microscopic examination are time consuming and often lack sensitivity and specificity. Advances in molecular technology have as allowed its use as clinical diagnostic tools. Multiplex PCR based testing has made its way to gastroenterology diagnostic arena in recent years. In this article we present a review of recent laboratory developed multiplex PCR tests and current commercial multiplex gastrointestinal pathogen tests. We will focus on two FDA cleared commercial syndromic multiplex tests: Luminex xTAG GPP and Biofire FimArray GI test. These multiplex tests can detect and identify multiple enteric pathogens in one test and provide results within hours. Multiplex PCR tests have shown superior sensitivity to conventional methods for detection of most pathogens. The high negative predictive value of these multiplex tests has led to the suggestion that they be used as screening tools especially in outbreaks. Although the clinical utility and benefit of multiplex PCR test are to be further investigated, implementing these multiplex PCR tests in gastroenterology diagnostic algorithm has the potential to improve diagnosis of infectious gastroenteritis. PMID:26004652

  4. Detection of multiple enteric virus strains within a foodborne outbreak of gastroenteritis: an indication of the source of contamination.

    PubMed

    Gallimore, C I; Pipkin, C; Shrimpton, H; Green, A D; Pickford, Y; McCartney, C; Sutherland, G; Brown, D W G; Gray, J J

    2005-02-01

    An outbreak of acute gastroenteritis of suspected viral aetiology occurred in April 2003 in the British Royal Fleet Auxiliary ship (RFA) Argus deployed in the Northern Arabian Gulf. There were 37 cases amongst a crew of 400 personnel. Of 13 samples examined from cases amongst the crew, six enteric viruses were detected by reverse transcriptase polymerase chain reaction (RT-PCR). Five different viruses were identified including, three norovirus genotypes, a sapovirus and a rotavirus. No multiple infections were detected. A common food source was implicated in the outbreak and epidemiological analysis showed a statistically significant association with salad as the source of the outbreak, with a relative risk of 3.41 (95% confidence interval of 1.7-6.81) of eating salad on a particular date prior to the onset of symptoms. Faecal contamination of the salad at source was the most probable explanation for the diversity of viruses detected and characterized. PMID:15724709

  5. Detection of multiple enteric virus strains within a foodborne outbreak of gastroenteritis: an indication of the source of contamination.

    PubMed

    Gallimore, C I; Pipkin, C; Shrimpton, H; Green, A D; Pickford, Y; McCartney, C; Sutherland, G; Brown, D W G; Gray, J J

    2005-02-01

    An outbreak of acute gastroenteritis of suspected viral aetiology occurred in April 2003 in the British Royal Fleet Auxiliary ship (RFA) Argus deployed in the Northern Arabian Gulf. There were 37 cases amongst a crew of 400 personnel. Of 13 samples examined from cases amongst the crew, six enteric viruses were detected by reverse transcriptase polymerase chain reaction (RT-PCR). Five different viruses were identified including, three norovirus genotypes, a sapovirus and a rotavirus. No multiple infections were detected. A common food source was implicated in the outbreak and epidemiological analysis showed a statistically significant association with salad as the source of the outbreak, with a relative risk of 3.41 (95% confidence interval of 1.7-6.81) of eating salad on a particular date prior to the onset of symptoms. Faecal contamination of the salad at source was the most probable explanation for the diversity of viruses detected and characterized.

  6. Phylogenetic analysis of human group C rotavirus in hospitalized children with gastroenteritis in Belém, Brazil.

    PubMed

    Lobo, Patrícia dos Santos; Guerra, Sylvia de Fátima dos Santos; Siqueira, Jones Anderson Monteiro; Soares, Luana da Silva; Gabbay, Yvone Benchimol; Linhares, Alexandre C; Mascarenhas, Joana D'Arc Pereira

    2016-04-01

    Group C rotavirus (RVC) is potentially an important pathogen associated with acute gastroenteritis (AG), especially in outbreaks. This study aims to detect and molecularly characterize RVC in hospitalized children with AG in Belém, Brazil. From May 2008 to April 2011, 279 stools were subjected to reverse-transcription polymerase chain reaction targeting VP7, VP6, VP4, and NSP4 genes. RVC positivity rate was 2.1% (6/279) and phylogenetic analysis of positive samples yields genotype G4-P[2]-I2-E2. No evidence of zoonotic transmission and VP7 gene demonstrated close relationship with Asian strains. RVC surveillance is worth to expand information on evolutionary and epidemiological features of this virus.

  7. High prevalence of community-acquired norovirus gastroenteritis among hospitalized children: a prospective study.

    PubMed

    Gonzalez-Galan, V; Sánchez-Fauqier, A; Obando, I; Montero, V; Fernandez, M; Torres, M J; Neth, O; Aznar-Martin, J

    2011-12-01

    Acute gastroenteritis (AGE) causes significant morbidity, especially in young children, and frequently requires hospitalization even in developed countries. Surveillance studies of AGE are important to determine the prevalence and variety of bacterial and viral pathogens, to initiate targeted preventive measures, such as vaccine programmes, and to monitor its impact. A prospective study was conducted in children <5 years old, admitted with AGE between April 2006 and April 2007 to the Virgen del Rocío University Hospital, Seville, Spain. Demographic and clinical data were collected and patients followed-up after hospital discharge. A stool sample from each child was screened for enteropathogenic bacteria and tested by reverse transcription polymerase chain reaction for rotavirus, astrovirus, norovirus and sapovirus and by the immunochromatographic method for enteric adenoviruses. Norovirus was the most common pathogen in hospitalized children, being detected in 27%, followed by rotavirus 21%. Mixed infection occurred in nearly 20% of all norovirus infections and was most commonly associated with Salmonella spp. Rotavirus infection was associated with an overall higher severe clinical score compared with norovirus infection. Lactose intolerance was observed in 29 children (7.5%) and most commonly due to rotavirus infection (p <0.001). Seizures were reported in four children. Norovirus was the commonest cause of AGE in hospitalized children <5 years during 2006-2007 in Seville, Spain. The use of these molecular techniques should be included routinely for the surveillance of sporadic cases and outbreaks of norovirus AGE in children attending hospitals as well as healthcare centres.

  8. Characterisation of bubaline coronavirus strains associated with gastroenteritis in water buffalo (Bubalus bubalis) calves.

    PubMed

    Decaro, Nicola; Cirone, Francesco; Mari, Viviana; Nava, Donatella; Tinelli, Antonella; Elia, Gabriella; Di Sarno, Alessandra; Martella, Vito; Colaianni, Maria Loredana; Aprea, Giuseppe; Tempesta, Maria; Buonavoglia, Canio

    2010-10-26

    Recently, a coronavirus strain (179/07-11) was isolated from water buffalo (Bubalus bubalis) and the virus which displayed a strict genetic and biological relatedness with bovine coronavirus (BCoV) was referred to as bubaline coronavirus (BuCoV). Here, we report the characterisation of four BuCoVs strains identified in the faeces or intestinal contents of water buffalo calves with acute gastroenteritis. Single BuCoV infections were detected in all but one cases from which two clostridia species were also isolated. Sequence and phylogenetic analyses of the 5' end of the spike-protein gene showed that three BuCoVs were closely related to the prototype strain 179/07-11, whereas the fourth isolate (339/08-C) displayed a higher genetic identity to recent BCoV reference strains. Three strains adapted to the in vitro grow on human rectal tumour cells were also evaluated for their ability to replicate in a bovine cell line (Madin Darby bovine kidney) and to cause haemagglutination of chicken erythrocytes and all displayed biological properties similar to those already described for the prototype BuCoV. The present report shows that albeit genetically heterogeneous, the different BuCoV strains possess a common biological pattern which is different from most BCoV and BCoV-like isolates.

  9. A foodborne outbreak of norovirus gastroenteritis associated with a Christmas dinner in Porto, Portugal, December 2008.

    PubMed

    Mesquita, J R; Nascimento, M S J

    2009-01-01

    An outbreak of acute norovirus gastroenteritis was detected and epidemiologically linked to a Christmas dinner reunion of 22 recent graduate students in a restaurant in Porto, Portugal, in December 2008. A retrospective cohort study was carried out using online standardised questionnaires. Sixteen primary and three secondary cases were identified and the risk ratios with 95% confidence intervals for each food item were calculated. The response rate to the online questionnaires was 96%. The outbreak met all four Kaplan s criteria and the attack rate was 73%. Norovirus GII.4 2006b was detected in stools and emesis samples of two primary cases. The ingestion of soup and lettuce salad was considered a risk factor for this norovirus outbreak, as determined by statistical analysis. Our investigation demonstrated two routes of transmission of norovirus starting with foodborne exposure followed by secondary person-to-person spread. To our knowledge this is the first study identifying norovirus as the causative agent of a foodborne outbreak in Portugal.

  10. Tuberculosis and HIV infection worldwide.

    PubMed

    Murray, J F

    1995-12-01

    The incidence of HIV-associated tuberculosis is increasing worldwide and will continue to increase during the foreseeable future, especially in developing countries. HIV infection appears to increase the opportunity for M. tuberculosis to succeed in causing infection after inhalation into the lungs. Moreover, there is persuasive evidence that in the presence of HIV infection, new-onset tuberculous infection will progress rapidly to clinically significant disease and the likelihood that latent tuberculous infection will reactivate is enormously increased. The accelerating and amplifying influence of HIV infection is contributing to the increasing incidence of disease caused by multidrug-resistant strains of M. tuberculosis. Neither clinical or radiographic features reliably distinguish the majority of patients with HIV-associated tuberculosis from those who are non-HIV-infected. The remainder, however, may have atypical manifestations and be difficult to diagnose. Six months of chemotherapy with conventional antituberculosis drugs cures most patients, but many die during or after treatment of other AIDS-related complications.

  11. Worldwide Spacecraft Crew Hatch History

    NASA Technical Reports Server (NTRS)

    Johnson, Gary

    2009-01-01

    The JSC Flight Safety Office has developed this compilation of historical information on spacecraft crew hatches to assist the Safety Tech Authority in the evaluation and analysis of worldwide spacecraft crew hatch design and performance. The document is prepared by SAIC s Gary Johnson, former NASA JSC S&MA Associate Director for Technical. Mr. Johnson s previous experience brings expert knowledge to assess the relevancy of data presented. He has experience with six (6) of the NASA spacecraft programs that are covered in this document: Apollo; Skylab; Apollo Soyuz Test Project (ASTP), Space Shuttle, ISS and the Shuttle/Mir Program. Mr. Johnson is also intimately familiar with the JSC Design and Procedures Standard, JPR 8080.5, having been one of its original developers. The observations and findings are presented first by country and organized within each country section by program in chronological order of emergence. A host of reference sources used to augment the personal observations and comments of the author are named within the text and/or listed in the reference section of this document. Careful attention to the selection and inclusion of photos, drawings and diagrams is used to give visual association and clarity to the topic areas examined.

  12. Euthanasia and related practices worldwide.

    PubMed

    Kelleher, M J; Chambers, D; Corcoran, P; Keeley, H S; Williamson, E

    1998-01-01

    The present paper examines the occurrence of matters relating to the ending of life, including active euthanasia, which is, technically speaking, illegal worldwide. Interest in this most controversial area is drawn from many varied sources, from legal and medical practitioners to religious and moral ethicists. In some countries, public interest has been mobilized into organizations that attempt to influence legislation relating to euthanasia. Despite the obvious international importance of euthanasia, very little is known about the extent of its practice, whether passive or active, voluntary or involuntary. This examination is based on questionnaires completed by 49 national representatives of the International Association for Suicide Prevention (IASP), dealing with legal and religious aspects of euthanasia and physician-assisted suicide, as well as suicide. A dichotomy between the law and medical practices relating to the end of life was uncovered by the results of the survey. In 12 of the 49 countries active euthanasia is said to occur while a general acceptance of passive euthanasia was reported to be widespread. Clearly, definition is crucial in making the distinction between active and passive euthanasia; otherwise, the entire concept may become distorted, and legal acceptance may become more widespread with the effect of broadening the category of individuals to whom euthanasia becomes an available option. The "slippery slope" argument is briefly considered. PMID:9884456

  13. The worldwide ionospheric data base

    NASA Technical Reports Server (NTRS)

    Bilitza, Dieter

    1989-01-01

    The worldwide ionospheric data base is scattered over the entire globe. Different data sets are held at different institutions in the U.S., U.S.S.R., Australia, Europe, and Asia. The World Data Centers on the different continents archive and distribute part of the huge data base; the scope and cross section of the individual data holdings depend on the regional and special interest of the center. An attempt is made to pull together all the strings that point toward different ionospheric data holdings. Requesters are provided with the information about what is available and where to get it. An attempt is also made to evaluate the reliability and compatibility of the different data sets based on the consensus in the ionospheric research community. The status and accuracy of the standard ionospheric models are also discussed because they may facilitate first order assessment of ionospheric effects. This is a first step toward an ionospheric data directory within the framework of NSSDC's master directory.

  14. Status of worldwide Landsat archive

    USGS Publications Warehouse

    Warriner, Howard W.

    1987-01-01

    In cooperation with the International Landsat community, and through the Landsat Technical Working Group (LTWG), NOAA is assembling information about the status of the Worldwide Landsat Archive. During LTWG 9, member nations agreed to participate in a survey of International Landsat data holding and of their archive experiences with Landsat data. The goal of the effort was two-fold; one, to document the Landsat archive to date, and, two, to ensure that specific nations' experience with long-term Landsat archival problems were available to others. The survey requested details such as amount of data held, the format of the archive holdings by Spacecraft/Sensor, and acquisition years; the estimated costs to accumulated process, and replace the data (if necessary); the storage space required, and any member nation's plans that would establish the insurance of continuing quality. As a group, the LTWG nations are concerned about the characteristics and reliability of long-term magnetic media storage. Each nation's experience with older data retrieval is solicited in the survey. This information will allow nations to anticipate and plan for required changes to their archival holdings. Also solicited were reports of any upgrades to a nation's archival system that are currently planned and all results of attempts to reduce archive holdings including methodology, current status, and the planned access rates and product support that are anticipated for responding to future archival usage.

  15. Effect of non-stationary climate on infectious gastroenteritis transmission in Japan.

    PubMed

    Onozuka, Daisuke

    2014-06-03

    Local weather factors are widely considered to influence the transmission of infectious gastroenteritis. Few studies, however, have examined the non-stationary relationships between global climatic factors and transmission of infectious gastroenteritis. We analyzed monthly data for cases of infectious gastroenteritis in Fukuoka, Japan from 2000 to 2012 using cross-wavelet coherency analysis to assess the pattern of associations between indices for the Indian Ocean Dipole (IOD) and El Niño Southern Oscillation (ENSO). Infectious gastroenteritis cases were non-stationary and significantly associated with the IOD and ENSO (Multivariate ENSO Index [MEI], Niño 1 + 2, Niño 3, Niño 4, and Niño 3.4) for a period of approximately 1 to 2 years. This association was non-stationary and appeared to have a major influence on the synchrony of infectious gastroenteritis transmission. Our results suggest that non-stationary patterns of association between global climate factors and incidence of infectious gastroenteritis should be considered when developing early warning systems for epidemics of infectious gastroenteritis.

  16. Effect of non-stationary climate on infectious gastroenteritis transmission in Japan

    NASA Astrophysics Data System (ADS)

    Onozuka, Daisuke

    2014-06-01

    Local weather factors are widely considered to influence the transmission of infectious gastroenteritis. Few studies, however, have examined the non-stationary relationships between global climatic factors and transmission of infectious gastroenteritis. We analyzed monthly data for cases of infectious gastroenteritis in Fukuoka, Japan from 2000 to 2012 using cross-wavelet coherency analysis to assess the pattern of associations between indices for the Indian Ocean Dipole (IOD) and El Niño Southern Oscillation (ENSO). Infectious gastroenteritis cases were non-stationary and significantly associated with the IOD and ENSO (Multivariate ENSO Index [MEI], Niño 1 + 2, Niño 3, Niño 4, and Niño 3.4) for a period of approximately 1 to 2 years. This association was non-stationary and appeared to have a major influence on the synchrony of infectious gastroenteritis transmission. Our results suggest that non-stationary patterns of association between global climate factors and incidence of infectious gastroenteritis should be considered when developing early warning systems for epidemics of infectious gastroenteritis.

  17. Worldwide Status of EUV Astronomy

    NASA Astrophysics Data System (ADS)

    Kowalski, Michael P.; Wood, K. S.; Barstow, M. A.

    2013-01-01

    The bulk of radiation from million-degree plasmas is emitted at EUV wavelengths, which include critical spectral features containing diagnostic information often not available at other wavelengths (e.g., He II Ly series 228-304 Å). Thus, EUV astrophysics (Barstow & Holberg 2003) presents opportunities for intriguing results obtainable with sensitive high-resolution spectroscopy and particularly applicable to hot plasmas in stellar coronae, white dwarfs and the interstellar medium. The US-built J-PEX spectrometer has flown twice on sounding rockets, observing and publishing results on two white dwarf targets (Cruddace et al. 2002, Barstow et al. 2005, Kowalski et al. 2011). Using multilayer-grating technology, J-PEX delivers both high effective area and the world's highest resolution in EUV, greater than Chandra at adjacent energies, but in a waveband Chandra cannot reach. However, the US program has been stalled by inability to obtain further NASA sounding rocket flights. A high level of technology readiness, plus important questions answerable solely with that technology, does not seem sufficient to win support. Nor is the substantial amount of resources invested into technology development over two decades, supported by NASA, DoD, and European partners. Proposals to turn the instrument or its technology into small satellite-based surveys have been made (results to be described) in the US and Europe, but the overall situation is precarious. The entire EUV astrophysics field is losing out on an opportunity, and is at risk of fading away, with forced discard of established assets. Only mobilization of the international EUV community -- unifying European, US, and perhaps others -- can reverse this situation. Our poster summarizes science quests within reach of proven technology, gives a current snapshot of that technology, and provides a summary of worldwide efforts to obtain necessary space access in NASA, ESA, and elsewhere. A process for building and maintaining

  18. The economic burden of pediatric gastroenteritis to Bolivian families: a cross-sectional study of correlates of catastrophic cost and overall cost burden

    PubMed Central

    2014-01-01

    Background Worldwide, acute gastroenteritis causes substantial morbidity and mortality in children less than five years of age. In Bolivia, which has one of the lower GDPs in South America, 16% of child deaths can be attributed to diarrhea, and the costs associated with diarrhea can weigh heavily on patient families. To address this need, the study goal was to identify predictors of cost burden (diarrhea-related costs incurred as a percentage of annual income) and catastrophic cost (cost burden ≥ 1% of annual household income). Methods From 2007 to 2009, researchers interviewed caregivers (n = 1,107) of pediatric patients (<5 years old) seeking treatment for diarrhea in six Bolivian hospitals. Caregivers were surveyed on demographics, clinical symptoms, direct (e.g. medication, consult fees), and indirect (e.g. lost wages) costs. Multivariate regression models (n = 551) were used to assess relationships of covariates to the outcomes of cost burden (linear model) and catastrophic cost (logistic model). Results We determined that cost burden and catastrophic cost shared the same significant (p < 0.05) predictors. In the logistic model that also controlled for child sex, child age, household size, rural residence, transportations taken to the current visit, whether the child presented with complications, and whether this was the child’s first episode of diarrhea, significant predictors of catastrophic cost included outpatient status (OR 0.16, 95% CI [0.07, 0.37]); seeking care at a private hospital (OR 4.12, 95% CI [2.30, 7.41]); having previously sought treatment for this diarrheal episode (OR 3.92, 95% CI [1.64, 9.35]); and the number of days the child had diarrhea prior to the current visit (OR 1.14, 95% CI [1.05, 1.24]). Conclusions Our analysis highlights the economic impact of pediatric diarrhea from the familial perspective and provides insight into potential areas of intervention to reduce associated economic burden. PMID:24962128

  19. [Outbreak of non-bacterial gastroenteritis in a school].

    PubMed

    Gaulin, C; Lévesque, B; Gauvin, D; Krizanorv, V

    1996-01-01

    An outbreak of gastroenteritis occurred in a school affecting more than 30% of its 535 students. An epidemiological survey questionnaire was given to all students as well as staff and maintenance personnel. Stool cultures and electronic microscopy were used to detect the presence of a Norwalk-like virus. Several analyses of water samples were also done. This outbreak occurred simultaneously in the two wings of the school (East and South). Those who used the East wing were most affected by the disease (RR = 1.45, CI 95%: 1,14-1,85). There was no indication of food or water supply contamination. A Norwalk-like virus was identified in the stool sample of one child. This along with the clinical characteristics strongly suggested that the pathogen was indeed a Norwalk-like virus. The analysis suggests transmission via contaminated surfaces but also via airborne transport of the infectious agent.

  20. Eosinophilic gastroenteritis: a challenge to diagnose and treat.

    PubMed

    Phaw, Naw April; Tsai, Her Hsin

    2016-01-01

    The patient presented with bloody diarrhoea, and crampy abdominal pains. She was diagnosed with eosinophilic gastroenteritis (EGE) after the finding of persistently high peripheral eosinophil counts and histology of endoscopic biopsies. She responded to steroids but became dependent on it and her symptoms recurred on steroid tapering. There was little improvement with alternative treatment such as budesonides, azathioprine and montelukast. Surprisingly her symptoms improved significantly after she was treated with clarithromycin for chest infection and she was continued on clarithromycin. Her eosinophil counts fell dramatically and follow-up CT (thorax, abdomen and pelvic) scan showed the mucosal thickening had improved. She became completely free of the symptoms since she was on clarithromycin and her eosinophils counts fell within the normal range during the follow-up. PMID:27613263

  1. [Cryptosporidium parvum Gastroenteritis in a Patient with Renal Transplantation].

    PubMed

    Çetinkaya, Ülfet; Dursun, İsmail; Kuk, Salih; Şahin, İzzet; Yazar, Süleyman

    2015-09-01

    In this study, a case who starting abundant watery diarrhea on the 14th day of renal transplantation is presented. Stool sample was analyzed for Cryptosporidium spp. by carbol fuchsin staining method, copro-ELISA and nested polimeraze chain reaction (PCR). From sample found positive by Carbol-fuchsin staining method and Copro-ELISA, DNA sequence analysis was performed, gel-purified from amplicon obtained by nested PCR. As a result of DNA sequence analysis was determined to be Cryptosporidium parvum. Although C. parvum is a rare causative agent of gastroenteritis it can be cause serious clinical diarrhea solid organ transplantation patient. As a result, also C.parvum must be considered as a causative agent of diarrhea occurring after organ transplantation. PMID:26470932

  2. Epidemiology of foodborne diseases: a worldwide review.

    PubMed

    Todd, E C

    1997-01-01

    Acute foodborne disease infections and intoxications are much more of a concern to governments and the food industry today than a few decades ago. Some of the factors that have led to this include the identification of new agents that have caused life-threatening conditions; the finding that traditional agents are being associated with foods that were of no concern previously: an increasing number of large outbreaks being reported; the impact of foodborne disease on children, the aging population and the immunocompromised; migrant populations demanding their traditional foods in the countries of settlement; the ease of worldwide shipment of fresh and frozen food; and the development of new food industries, including aquaculture. However, to meaningfully monitor increases or decreases in foodborne disease requires an effective surveillance system at the local, national and international levels. To date, resources have been limited for most countries and regions to do this, and our current knowledge is based, for the most part, on passive reporting mechanisms. Laboratory isolation data and reports of notifiable diseases have some value in observing timely changes in case numbers of some enteric diseases, but they usually do not indicate the reasons for these trends. Special epidemiological studies are useful for the area covered, but it is often questionable whether they can be extrapolated to other areas or countries. Outbreak investigations tell us that a certain set of circumstances led to illness and that another outbreak may occur under similar but not necessarily identical conditions. Control programmes have often been triggered by the conclusions from investigations of specific outbreaks. Unfortunately, the agent/ food combination leading to illness in many of the reported incidents were not predicted from existing databases, and no doubt foodborne agents will continue to surprise food control agencies in the foreseeable future. Nevertheless, data from around

  3. Protection against gastroenteritis in US households with children who received rotavirus vaccine.

    PubMed

    Cortese, Margaret M; Dahl, Rebecca Moritz; Curns, Aaron T; Parashar, Umesh D

    2015-02-15

    We used Truven Health Marketscan claims database (2008-2011) to compare gastroenteritis rates during January-June among households whose child had received rotavirus vaccine with those whose child did not receive vaccine. Statistically significantly lower rates of hospitalization with a rotavirus gastroenteritis or unspecified-gastroenteritis discharge code occurred in vaccinated households among persons 20-29 years and females 20-29 years (2008/2009), and males 30-39 years (2009/2010). Lower emergency department gastroenteritis rates occurred in vaccinated households among females 20-29 years (2009/2010) and individuals 5-19 years (2010/2011). These data suggest rotavirus vaccination of infants provides indirect protection against moderate-to-severe rotavirus disease in young parents and older siblings.

  4. A Rapid Method for Viral Particle Detection in Viral-Induced Gastroenteritis: A TEM Study

    NASA Astrophysics Data System (ADS)

    Hicks, M. John; Barrish, James P.; Hayes, Elizabeth S.; Leer, Laurie C.; Estes, Mary K.; Cubitt, W. D.

    1995-10-01

    Infectious gastroenteritis is a common cause of hospitalization in the pediatric population. The most frequent cause of gastroenteritis is viral in origin. The purpose of this study was to compare a rapid modified negative-staining TEM method with the conventional pseudoreplica technique in detection of viral particles in fecal samples from children with viral gastroenteritis. The modified negative-staining method resulted in a significantly higher (2.5 ± 0.5, p = 0.02) viral rating score than that for the conventional pseudoreplica technique (1.7 ± 0.4). In addition, the preparation time for the negative-staining method was approximately one fifth that for the conventional pseudoreplica technique. Rapid diagnosis of viral gastroenteritis may be made by ultrastructural detection of viral particles in fecal samples using the negative staining technique.

  5. Prevalence and genotype distribution of rotaviruses in children with gastroenteritis in Rize province.

    PubMed

    Dereci, Selim; Çopur Çiçek, Ayşegül; Savaş Acar, Sümeyra; Bakkaloğlu, Zekiye; Özkasap, Serdar; Kanber, Kadri; Hacisalihoğlu, Şadan; Albayrak, Yücehan; Durmaz, Rıza

    2015-01-01

    Determination of the distribution of rotavirus genotypes is essential for understanding the epidemiology of this virus responsible for nearly half a million of deaths in patients with gastroenteritis worldwide. In the present study, we aimed to genotype the rotavirus strains isolated from diarrheal stool samples in children under 5 years old. A total of 1297 fecal samples were collected, and rotavirus antigen was detected in 73 of these samples. Antigen-positive samples were transferred to the Public Health Agency of Turkey, Molecular Microbiology Research Laboratory, and were tested for determination of genotypes G and P using semi-nested multiplex polymerase chain reaction method performed with consensus- and genotype-specific primers. Twelve specimens were found to be negative for rotavirus in genotyping method. All the positive-strains were in G1-4, G8-9, P(4), P(8), and P(9) genotypes. The most frequent GP genotype combinations were found to be G9P(8) in 21 strains (34.4%), G2P(4) in 14 strains (23.0%), and G1P(8) in 12 strains (19.7%). We found 10 distinct genotypes amongst a total of 61 strains. Among the strains isolated and genotyped in our study, 90.2% (55/61) and 67.2% (41/61) have already been included in the two existing commercial vaccines. In conclusion, these findings implicate the necessity of development of region-specific vaccines after evaluation of the local genotype distribution. Further studies on the large number of rotavirus strains would contribute to this process. PMID:26295292

  6. Rotavirus gastroenteritis in children less than five years of age in primary care settings in Bulgaria: an observational study

    PubMed Central

    Tiholova, Mayda; Gopala, Kusuma; Berberova, Magda; Strokova-Stoilova, Margarita; Tafalla, Monica

    2016-01-01

    Background Rotavirus (RV) causes a high proportion of acute gastroenteritis (AGE) cases, especially among children under the age of five years old. This surveillance study was undertaken to study the incidence and severity of rotavirus gastroenteritis (RVGE) in primary care settings in Bulgaria over a one-year period. Methods In this prospective, observational study of AGE cases in children under five years of age presenting in the primary care setting over a one year period, stool samples were collected and tested for RV using a rapid visual immunochromatographic test kit. After the first visit, parents monitored their child for about two weeks and reported the symptoms experienced by the child during the follow-up period to the physician in a follow-up phone call. The percentage of RVGE cases among AGE was calculated and the severity of AGE (according to the 20-point Vesikari scale) was assessed by the physician based on the symptoms reported by the parents. The seasonality of RVGE was also studied. Results The proportion of RVGE among the 624 AGE cases examined was 25.5%. Severe AGE was experienced by 81.8% RV-positive and 54.6% RV-negative children (p-value <0.001) and a third of all severe AGE cases occurred in RV-positive patients. A multivariate logistic regression analysis of the determinants of hospitalization indicated that severity of disease and RV-positivity were the statistically significant variables explaining hospitalization of AGE cases; even controlling for severity, RV-positive patients were more often hospitalized than RV-negative ones. RVGE cases occurred throughout the year, with peaks during August and September. Conclusion Our study emphasizes that RV is an important cause of AGE in children under five presenting in primary care settings in Bulgaria and a disproportionately high proportion of severe AGE cases may be attributed to RV infections. Trial registration number NCT01733849

  7. Rapid detection of norovirus in naturally contaminated food: foodborne gastroenteritis outbreak on a cruise ship in Brazil, 2010.

    PubMed

    Morillo, Simone Guadagnucci; Luchs, Adriana; Cilli, Audrey; do Carmo Sampaio Tavares Timenetsky, Maria

    2012-09-01

    Norovirus (NoV) is a prevalent pathogen of foodborne diseases; however, its detection in foods other than shellfish is often time consuming and unsuccessful. In 2010, an outbreak of acute gastroenteritis occurred on a cruise ship in Brazil, and NoV was the etiologic agent suspected. The objectives of this study were to report that a handy in-house methodology was suitable for NoV detection in naturally contaminated food, and perform the molecular characterization of food strains. Food samples (blue cheese, Indian sauce, herbal butter, soup, and white sauce) were analyzed by ELISA, two methods of RNA extraction, TRIzol(®) and QIAamp(®), following conventional RT-PCR. The qPCR was used in order to confirm the NoV genogroups. GI and GII NoV genogroups were identified by conventional RT-PCR after RNA extraction by means of the TRIzol(®) method. Two GII NoV samples were successfully sequenced, classified as GII.4; and they displayed a genetic relationship with strains from the Asian continent also isolated in 2010. GII and GI NoV were identified in distinct food matrices suggesting that it was not a common source of contamination. TRIzol(®) extraction followed by conventional RT-PCR was a suitable methodology in order to identify NoV in naturally contaminated food. Moreover, food samples could be processed within 8 h indicating the value of the method used for NoV detection, and its potential to identify foodborne gastroenteritis outbreaks in food products other than shellfish. This is the first description in Brazil of NoV detection in naturally contaminated food other than shellfish involved in a foodborne outbreak.

  8. Molecular detection of three gastroenteritis viruses in urban surface waters in Beijing and correlation with levels of fecal indicator bacteria.

    PubMed

    He, Xiaoqing; Wei, Yumei; Cheng, Li; Zhang, Deyou; Wang, Zijian

    2012-09-01

    To assess the presence of three gastroenteritis viruses responsible for human acute gastroenteritis in surface water, a 1-year study was carried out in the city of Beijing, China. A total of 108 urban surface water samples were collected from nine collection sites which were defined with a global positioning system in rivers or lakes from September 2006 to August 2007. The water samples were subjected to virus concentration using an HA electronegative filter, followed by polymerase chain reaction (PCR) for rotavirus (RV) astrovirus (AV), and norovirus (NV). It showed that the number of viruses detected in water samples from different sites was variable, totaling 63 virus strains, with rotavirus (48.1%) verified as the most prevalent detected, followed by astrovirus (AV, 5.6%), and norovirus (NV, 4.6%). RV was also quantified by real-time PCR and the concentration of RV ranged from 0 to 18.27 genome copies·L(-1). And the distributions of RV in surface water were abundant in cold weather (from September to February) while less prevailing in warm weather (from March to August). The high detection rate of RV we encountered in this study provided convincing evidence that RV circulated at a certain frequency in the Beijing population. There was no statistically significant correlation between RV levels and both fecal coliform (R (2) = 0.02) and Enterococcus faecalis (R (2) = 0.02) densities. Our study suggests prolonged virus persistence in aquatic environments and emphasizes the enteric virus group as the most reliable for environmental monitoring. PMID:21915594

  9. Rotavirus gastroenteritis in children less than five years of age in primary care settings in Bulgaria: an observational study

    PubMed Central

    Tiholova, Mayda; Gopala, Kusuma; Berberova, Magda; Strokova-Stoilova, Margarita; Tafalla, Monica

    2016-01-01

    Background Rotavirus (RV) causes a high proportion of acute gastroenteritis (AGE) cases, especially among children under the age of five years old. This surveillance study was undertaken to study the incidence and severity of rotavirus gastroenteritis (RVGE) in primary care settings in Bulgaria over a one-year period. Methods In this prospective, observational study of AGE cases in children under five years of age presenting in the primary care setting over a one year period, stool samples were collected and tested for RV using a rapid visual immunochromatographic test kit. After the first visit, parents monitored their child for about two weeks and reported the symptoms experienced by the child during the follow-up period to the physician in a follow-up phone call. The percentage of RVGE cases among AGE was calculated and the severity of AGE (according to the 20-point Vesikari scale) was assessed by the physician based on the symptoms reported by the parents. The seasonality of RVGE was also studied. Results The proportion of RVGE among the 624 AGE cases examined was 25.5%. Severe AGE was experienced by 81.8% RV-positive and 54.6% RV-negative children (p-value <0.001) and a third of all severe AGE cases occurred in RV-positive patients. A multivariate logistic regression analysis of the determinants of hospitalization indicated that severity of disease and RV-positivity were the statistically significant variables explaining hospitalization of AGE cases; even controlling for severity, RV-positive patients were more often hospitalized than RV-negative ones. RVGE cases occurred throughout the year, with peaks during August and September. Conclusion Our study emphasizes that RV is an important cause of AGE in children under five presenting in primary care settings in Bulgaria and a disproportionately high proportion of severe AGE cases may be attributed to RV infections. Trial registration number NCT01733849 PMID:27622162

  10. A phase trial of the oral Lactobacillus casei vaccine polarizes Th2 cell immunity against transmissible gastroenteritis coronavirus infection.

    PubMed

    Jiang, Xinpeng; Hou, Xingyu; Tang, Lijie; Jiang, Yanping; Ma, Guangpeng; Li, Yijing

    2016-09-01

    Transmissible gastroenteritis coronavirus (TGEV) is a member of the genus Coronavirus, family Coronaviridae, order Nidovirales. TGEV is an enteropathogenic coronavirus that causes highly fatal acute diarrhoea in newborn pigs. An oral Lactobacillus casei (L. casei) vaccine against anti-transmissible gastroenteritis virus developed in our laboratory was used to study mucosal immune responses. In this L. casei vaccine, repetitive peptides expressed by L. casei (specifically the MDP and tuftsin fusion protein (MT)) were repeated 20 times and the D antigenic site of the TGEV spike (S) protein was repeated 6 times. Immunization with recombinant Lactobacillus is crucial for investigations of the effect of immunization, such as the first immunization time and dose. The first immunization is more important than the last immunization in the series. The recombinant Lactobacillus elicited specific systemic and mucosal immune responses. Recombinant L. casei had a strong potentiating effect on the cellular immunity induced by the oral L. casei vaccine. However, during TGEV infection, the systemic and local immune responses switched from Th1 to Th2-based immune responses. The systemic humoral immune response was stronger than the cellular immune response after TGEV infection. We found that the recombinant Lactobacillus stimulated IL-17 expression in both the systemic and mucosal immune responses against TGEV infection. Furthermore, the Lactobacillus vaccine stimulated an anti-TGEV infection Th17 pathway. The histopathological examination showed tremendous potential for recombinant Lactobacillus to enable rapid and effective treatment for TGEV with an intestinal tropism in piglets. The TGEV immune protection was primarily dependent on mucosal immunity. PMID:27020282

  11. Norovirus Gastroenteritis in a Birth Cohort in Southern India

    PubMed Central

    Menon, Vipin Kumar; George, Santosh; Sarkar, Rajiv; Giri, Sidhartha; Samuel, Prasanna; Vivek, Rosario; Saravanabavan, Anuradha; Liakath, Farzana Begum; Ramani, Sasirekha; Iturriza-Gomara, Miren; Gray, James J.; Brown, David W.; Estes, Mary K.; Kang, Gagandeep

    2016-01-01

    Background Noroviruses are an important cause of gastroenteritis but little is known about disease and re-infection rates in community settings in Asia. Methods Disease, re-infection rates, strain prevalence and genetic susceptibility to noroviruses were investigated in a birth cohort of 373 Indian children followed up for three years. Stool samples from 1856 diarrheal episodes and 147 vomiting only episodes were screened for norovirus by RT-PCR. Norovirus positivity was correlated with clinical data, secretor status and ABO blood group. Results Of 1856 diarrheal episodes, 207 (11.2%) were associated with norovirus, of which 49(2.6%) were norovirus GI, 150(8.1%) norovirus GII, and 8 (0.4%) were mixed infections with both norovirus GI and GII. Of the 147 vomiting only episodes, 30 (20.4%) were positive for norovirus in stool, of which 7 (4.8%) were norovirus GI and 23 (15.6%) GII. At least a third of the children developed norovirus associated diarrhea, with the first episode at a median age of 5 and 8 months for norovirus GI and GII, respectively. Norovirus GI.3 and GII.4 were the predominant genotypes (40.3% and 53.0%) with strain diversity and change in the predominant sub-cluster over time observed among GII viruses. A second episode of norovirus gastroenteritis was documented in 44/174 (25.3%) ever-infected children. Children with the G428A homozygous mutation for inactivation of the FUT2 enzyme (se428se428) were at a significantly lower risk (48/190) of infection with norovirus (p = 0.01). Conclusions This is the first report of norovirus documenting disease, re-infection and genetic susceptibility in an Asian birth cohort. The high incidence and apparent lack of genogroupII specific immunity indicate the need for careful studies on further characterization of strains, asymptomatic infection and shedding and immune response to further our understanding of norovirus infection and disease. PMID:27284939

  12. Innovation in Science Education - World-Wide.

    ERIC Educational Resources Information Center

    Baez, Albert V.

    The purpose of this book is to promote improvements in science education, world-wide, but particularly in developing countries. It is addressed to those in positions to make effective contributions to the improvement of science education. The world-wide role of science education, the goals of innovative activities, past experience in efforts to…

  13. Foodborne gastroenteritis due to Norwalk virus in a Winnipeg hotel.

    PubMed Central

    Sekla, L; Stackiw, W; Dzogan, S; Sargeant, D

    1989-01-01

    Within 1 week four separate incidents of gastroenteritis presumed to be foodborne were reported by guests of a Winnipeg hotel. Investigation revealed poor food-handling practices and illness among the kitchen staff. Elevated bacterial counts and Escherichia coli were found in 15 of 24 samples of food tested, and Staphylococcus aureus was isolated from 2 pastry samples. Culture of 14 stool samples for bacteria yielded Clostridium perfringens in 1 sample from a staff member and coagulase-positive S. aureus in 2 samples from staff members and 3 from guests. All of the S. aureus isolates were nonenterotoxigenic and had three different phage patterns. Electron microscopy and immunoelectron microscopy revealed the prototype Norwalk virus in five (56%) of nine stool samples; four samples were from guests, and one was from a kitchen employee. The employee had had diarrhea 24 hours before the first outbreak and was thus believed to be the source of the virus infection, possibly through food handling. This is the first report of Norwalk virus isolation and the first of foodborne Norwalk virus transmission in Canada. A review of foodborne Norwalk virus infections is presented. Images Fig. 1 Fig. 2 PMID:2541881

  14. Intestinal microbiota are transiently altered during Salmonella-induced gastroenteritis.

    PubMed

    Gibson, Deanna L; Vallance, Bruce A

    2008-08-01

    The mammalian GI tract contains a large and diverse ecosystem of microorganisms that play a profound role in our development and physiology. Interestingly, the microbial make-up within the intestine has been found to be altered in many clinically important diseases, including inflammatory bowel disease, irritable bowel syndrome, Types 1 and 2 diabetes, and obesity. Barman et al. used a Salmonella-induced murine model of gastroenteritis to show that the intestinal microbiota are transiently altered during the host inflammatory response to infection. These findings are of interest as understanding how the microbiota are altered during disease states may offer insight into which microbial populations are important in maintaining intestinal homeostasis. Recently, probiotics have been shown to modulate the mucosal immune system and improve intestinal barrier function, validating their potential as therapeutics for gastrointestinal-associated diseases. As we begin to understand the benefits conferred to the intestine by microbiota, the use of probiotics to modify its composition is an attractive option to improve human health. PMID:19072400

  15. Risk factors for gastroenteritis in child day care.

    PubMed

    Enserink, R; Mughini-Gras, L; Duizer, E; Kortbeek, T; Van Pelt, W

    2015-10-01

    The child day-care centre (DCC) is often considered as one risk factor for gastroenteritis (GE) rather than a complex setting in which the interplay of many factors may influence the epidemiology of GE. This study aimed to identify DCC-level risk factors for GE and major enteropathogen occurrence. A dynamic network of 100 and 43 DCCs participated in a syndromic and microbiological surveillance during 2010-2013. The weekly incidence of GE events and weekly prevalence of five major enteropathogens (rotavirus, norovirus, astrovirus, Giardia lamblia, Cryptosporidium hominis/parvum) were modelled per DCC using mixed-effects negative binomial/Poisson regression models. Sixteen hundred children were surveyed up to 3 years, during which 1829 GE episodes were reported and 5197 faecal samples were analysed. Identified risk factors were: large DCC capacity, crowding, having animals, nappy changing areas, sandpits, paddling pools, cleaning potties in normal sinks, cleaning vomit with paper towels (but without cleaner), mixing of staff between child groups, and staff members with multiple daily duties. Protective factors were: disinfecting fomites with chlorine, cleaning vomit with paper towels (and cleaner), daily cleaning of bed linen/toys, cohorting and exclusion policies for ill children and staff. Targeting these factors may reduce the burden of DCC-related GE. PMID:25592679

  16. Use of Population-based Surveillance to Determine the Incidence of Rotavirus Gastroenteritis in an Urban Slum and a Rural Setting in Kenya

    PubMed Central

    Breiman, Robert F.; Cosmas, Leonard; Audi, Allan; Mwiti, William; Njuguna, Henry; Bigogo, Godfrey M.; Olack, Beatrice; Ochieng, John B.; Wamola, Newton; Montgomery, Joel M.; Williamson, John; Parashar, Umesh D.; Burton, Deron C.; Tate, Jacqueline E.; Feikin, Daniel R.

    2015-01-01

    Background Rotavirus gastroenteritis is a major cause of mortality among children <2 years of age. Disease burden data are important for introducing and sustaining new rotavirus vaccines in immunization programs. Methods We analyzed population-based infectious disease surveillance data from 2007 to 2010 from Kenyan sites in rural and urban slum areas. Stool specimens were collected from patients of all ages presenting to study clinics with diarrheal disease and tested for rotavirus by enzyme immunoassay. Incidence rates were adjusted using data on healthcare utilization (from biweekly home visits) and proportion of stools collected at study clinics from patients meeting case definitions. Results Rotavirus was detected in 285 (9.0%) of 3174 stools tested, including 122 (11.9%) from children <5 years of age and 162 (7.6%) from participants ≥5 years of age. Adjusted incidence rates for infants were 13,419 and 12,135 per 100,000 person-years of observation in rural and urban areas, respectively. Adjusted incidence rates were high in adults across age ranges. The rates suggest that annually, among children <5 years of age, there are >54,500 cases of rotavirus-associated gastroenteritis in rural Nyanza Province and >16,750 cases in Nairobi urban slums. Conclusions Community-based surveillance in urban and rural Kenya suggests that rotavirus plays an important role as a cause of acute gastroenteritis in adults, as well as in children. In addition to substantially preventing illness and complications from diarrheal disease in children, rotavirus infant immunization has the potential of indirectly preventing diarrheal disease in older children and adults, assuming children are the predominant sources of transmission. PMID:24343615

  17. Report of data on children with non-typhi Salmonella gastroenteritis in a three-year period.

    PubMed

    Küçük, Öznur; Biçer, Suat; Ugraş, Meltem; Çöl, Defne; Giray, Tuba; Çiler Erdag, Gülay; Gürol, Yeşim; Yilmaz, Gülden; Yalvaç, Zerrin; Vitrinel, Ayça; Kaspar, Çigdem

    2016-09-01

    The purpose of this study was to evaluate the clinical and laboratory data of children with acute gastroenteritis caused by non-typhoid Salmonella spp. infections. Clinical (demographic data, symptoms and findings) and laboratory data (stool microscopy, rapid antigen tests, culture, multiplex polymerase chain reaction and blood test results) of children with acute gastroenteritis caused by non-typhoid Salmonella spp. between January 2010 and October 2012 were evaluated. Differences between the groups for categorical variables were estimated with a chi-square or Fisher exact test; for continuous variables with two independent samples a t test was used. P values < 0.05 were considered statistically significant. Sixty-seven children, 39 (58.2%) males and 28 (41.8%) females aged between 1 - 16 years (mean ± SD: 4.64 ± 2.91), were diagnosed with acute bacterial gastroenteritis caused by non-typhoid Salmonella spp. The main serotypes are Salmonella enteritidis (85%) and Salmonella typhimurium (7.5%). The presenting symptoms were diarrhoea (95.5%), fever (61.1%), vomiting (34.3%), abdominal pain (32.8%), loss of appetite (7.4%) and malaise (7.4%). Fever and dehydration (moderate and/or severe) were detected in 11 (16.4%) patients. The mean leukocyte count was 10.930/μL [95% confidence interval (CI), SD: ± 5.710/μL], neutrophil count was 7.880/μL (95% CI, SD: ± 4.960/μL), CRP was 64.16 mg/L (95% CI, SD: ± 76.24 mg/L), and erythrocyte sedimentation rate was 34.72 mm/hour (95% CI, SD: ± 13.64 mm/h). Stool microscopy was positive for leukocytes in 18 patients (26.8%). The definitive diagnosis was made with positive stool culture (n = 65) and/or PCR test (n = 4). Viral antigen positivity was detected in 10 patients (14.9%), evaluated as viral co-infection and false positive results. Antibiotic therapy and hospitalization were required in 26 (38.8%) and 23 (34.3%) patients, respectively. Salmonella carriage was detected in one patient (1.5%). Bloody diarrhoea

  18. Multilevel analysis of childhood nonviral gastroenteritis associated with environmental risk factors in Quebec, 1999-2006.

    PubMed

    Kaboré, Henri; Lebel, Alexandre; Levallois, Patrick; Michel, Pascal; Payment, Pierre; Déry, Pierre; Lebel, Germain

    2013-10-01

    Childhood nonviral gastroenteritis is a priority for various public health authorities. Given that waterborne transmission is sometimes incriminated during investigation of gastroenteritis outbreaks, the authors hypothesized that watershed characteristics may influence the occurrence of this disease and could contribute additional insights for better prevention and control. The study described here aimed to investigate watershed characteristics in relation to nonviral gastroenteritis and specifically three bacterial and parasitic forms of childhood gastroenteritis to assess their relative importance in the province of Quebec, Canada. Information on children aged 0-4 years with bacterial or parasitic enteric infections reported through ongoing surveillance between 1999 and 2006 in the province of Quebec was collected. Factors measured at the municipal and watershed levels were analyzed using multilevel models with a Poisson distribution and log link function. Childhood nonviral gastroenteritis, giardiasis, and campylobacteriosis were positively associated with small ruminants and cattle density. Childhood salmonellosis was positively associated with cattle density. Also, childhood campylobacteriosis incidence was positively associated with larger watershed agricultural surface. In addition to local agroenvironmental factors, this analysis revealed an important watershed effect.

  19. Change in incidence of clinic visits for all-cause and rotavirus gastroenteritis in young children following the introduction of universal rotavirus vaccination in Israel.

    PubMed

    Muhsen, Khitam; Chodick, Gabriel; Goren, Sophy; Anis, Emilia; Ziv-Baran, Tomer; Shalev, Varda; Cohen, Dani

    2015-01-01

    Both rotavirus vaccines RotaTeq and Rotarix were efficacious against severe rotavirus gastroenteritis in clinical trials; yet real-world data on the effect of rotavirus vaccines on mild to moderate disease are limited. We used a large computerised database of Maccabi Health Services Health Maintenance Organisation (HMO), the second largest HMO in Israel covering 25% of the Israeli population, to compare the incidence of acute gastroenteritis (AGE) clinic visits in community settings (n=302,445) before (2005-10) and after (2011-13) the introduction of universal rotavirus immunisation in Israel. We retrieved laboratory results of rotavirus antigen tests (n=18,133) and using a weighted analysis, we estimated the impact of rotavirus immunisation on the disease burden of rotavirus AGE clinic visits. Following the introduction of universal rotavirus immunisation, the typical winter peaks of rotavirus AGE were substantially lower and significant reductions of 14.8% (95% confidence interval (CI): 13.5-16.1) in all-cause AGE clinic visits and of 59.7% (95% CI: 59.8-62.6) in rotavirus AGE clinic visits were observed. The decrease was observed in all age groups, but it was greater in children aged 0 to 23 months than those aged 24 to 59 months. Continued rotavirus laboratory surveillance is warranted to monitor the sustainability of these changes.

  20. Change in incidence of clinic visits for all-cause and rotavirus gastroenteritis in young children following the introduction of universal rotavirus vaccination in Israel.

    PubMed

    Muhsen, Khitam; Chodick, Gabriel; Goren, Sophy; Anis, Emilia; Ziv-Baran, Tomer; Shalev, Varda; Cohen, Dani

    2015-01-01

    Both rotavirus vaccines RotaTeq and Rotarix were efficacious against severe rotavirus gastroenteritis in clinical trials; yet real-world data on the effect of rotavirus vaccines on mild to moderate disease are limited. We used a large computerised database of Maccabi Health Services Health Maintenance Organisation (HMO), the second largest HMO in Israel covering 25% of the Israeli population, to compare the incidence of acute gastroenteritis (AGE) clinic visits in community settings (n=302,445) before (2005-10) and after (2011-13) the introduction of universal rotavirus immunisation in Israel. We retrieved laboratory results of rotavirus antigen tests (n=18,133) and using a weighted analysis, we estimated the impact of rotavirus immunisation on the disease burden of rotavirus AGE clinic visits. Following the introduction of universal rotavirus immunisation, the typical winter peaks of rotavirus AGE were substantially lower and significant reductions of 14.8% (95% confidence interval (CI): 13.5-16.1) in all-cause AGE clinic visits and of 59.7% (95% CI: 59.8-62.6) in rotavirus AGE clinic visits were observed. The decrease was observed in all age groups, but it was greater in children aged 0 to 23 months than those aged 24 to 59 months. Continued rotavirus laboratory surveillance is warranted to monitor the sustainability of these changes. PMID:26538450

  1. Contemporary use and practice of electroconvulsive therapy worldwide

    PubMed Central

    Leiknes, Kari Ann; Jarosh-von Schweder, Lindy; Høie, Bjørg

    2012-01-01

    To explore contemporary (from 1990) utilization and practice of electroconvulsive therapy (ECT) worldwide. Systematic search (limited to studies published 1990 and after) was undertaken in the databases Medline, Embase, PsycINFO, SveMed, and EBSCO/Cinahl. Primary data-based studies/surveys with reported ECT utilization and practice in psychiatric institutions internationally, nationally, and regionally; city were included. Two reviewers independently checked study titles and abstracts according to inclusion criteria, and extracted ECT utilization and practice data from those retrieved in full text. Seventy studies were included, seven from Australia and New Zealand, three Africa, 12 North and Latin America, 33 Europe, and 15 Asia. Worldwide ECT differences and trends were evident, average number ECTs administered per patient were eight; unmodified (without anesthesia) was used in Asia (over 90%), Africa, Latin America, Russia, Turkey, Spain. Worldwide preferred electrode placement was bilateral, except unilateral at some places (Europe and Australia/New Zealand). Although mainstream was brief-pulse wave, sine-wave devices were still used. Majority ECT treated were older women with depression in Western countries, versus younger men with schizophrenia in Asian countries. ECT under involuntary conditions (admissions), use of ambulatory-ECT, acute first line of treatment, as well as administered by other professions (geriatricians, nurses) were noted by some sites. General trends were only some institutions within the same country providing ECT, training inadequate, and guidelines not followed. Mandatory reporting and overall country ECT register data were sparse. Many patients are still treated with unmodified ECT today. Large global variation in ECT utilization, administration, and practice advocates a need for worldwide sharing of knowledge about ECT, reflection, and learning from each other's experiences. PMID:22741102

  2. A community waterborne outbreak of gastro-enteritis attributed to Shigella sonnei.

    PubMed Central

    Alamanos, Y.; Maipa, V.; Levidiotou, S.; Gessouli, E.

    2000-01-01

    An outbreak of gastro-enteritis occurred in a community of 2213 persons located near the city of Ioannina, in North-western Greece. Two hundreds and eighty-eight inhabitants of the village of Eleoussa, suffered from gastro-enteritis between 11 and 22 October. The peak of the epidemic occurred during the first 3 days (11-13 October). The highest risk of developing gastro-enteritis was observed in the age group 0-14 years (41.4%) and decreased significantly with age (P < 0.01). Patients over 65 years were more frequently hospitalized than those in other age groups (P < 0.05). Shigella sonnei was isolated from both, water samples and faeces of patients. Control measures were implemented on the second day of the outbreak. Environmental conditions suggest that contaminationof the water system occurred by groundwater. PMID:11218200

  3. An indirect fluorescent antibody test for antibodies to transmissible gastroenteritis of swine.

    PubMed

    Benfield, D A; Haelterman, E O; Burnstein, T

    1978-10-01

    The indirect fluorescent antibody test was modified to provide a rapid technique for the detection, screening and titration of antibodies to transmissible gastroenteritis of pigs. Large numbers of slides containing transmissible gastroenteritis antigen were prepared by planting mixtures of infected and uninfected swine testicular cells onto multiwelled teflon-coated slides. After overnight incubation, about one-half of the cells in each well were infected which provided contrast to aid in detecting specific fluorescence in the presence of varying degrees of background staining. Following fixation, antigen slides were stored at -20 degrees C until used. The indirect fluorescent antibody test was compared to the virus neutralization test in both the screening and titration of swine sera containing transmissible gastroenteritis antibodies. The test was found to be sensitive and reliable and to offer certain advantages over the virus neutralization test.

  4. Comprehensive Analysis of a Norovirus-Associated Gastroenteritis Outbreak, from the Environment to the Consumer▿

    PubMed Central

    Le Guyader, Françoise S.; Krol, Joanna; Ambert-Balay, Katia; Ruvoen-Clouet, Nathalie; Desaubliaux, Benedicte; Parnaudeau, Sylvain; Le Saux, Jean-Claude; Ponge, Agnès; Pothier, Pierre; Atmar, Robert L.; Le Pendu, Jacques

    2010-01-01

    Noroviruses have been recognized to be the predominant agents of nonbacterial gastroenteritis outbreaks in humans, and their transmission via contaminated shellfish consumption has been demonstrated. Norovirus laboratory experiments, volunteer challenge studies, and community gastroenteritis outbreak investigations have identified human genetic susceptibility factors related to histo-blood group antigen expression. Following a banquet in Brittany, France, in February 2008, gastroenteritis cases were linked to oyster consumption. This study identified an association of the norovirus illnesses with histo-blood group expression, and oyster contamination with norovirus was confirmed by qualitative and quantitative analyses. The secretor phenotype was associated with illness, especially for the non-A subgroup. The study showed that, in addition to accidental climatic events that may lead to oyster contamination, illegal shellfish collection and trading are also risk factors associated with outbreaks. PMID:20053852

  5. Burden of paediatric Rotavirus Gastroenteritis (RVGE) and potential benefits of a universal Rotavirus vaccination programme with a pentavalent vaccine in Spain

    PubMed Central

    2010-01-01

    Background Rotavirus is the most common cause of gastroenteritis in young children worldwide. The aim of the study was to assess the health outcomes and the economic impact of a universal rotavirus vaccination programme with RotaTeq, the pentavalent rotavirus vaccine, versus no vaccination programme in Spain. Methods A birth cohort was followed up to the age of 5 using a cohort model. Epidemiological parameters were taken from the REVEAL study (a prospective epidemiological study conducted in Spain, 2004-2005) and from the literature. Direct and indirect costs were assessed from the national healthcare payer and societal perspectives by combining health care resource utilisation collected in REVEAL study and unit costs from official sources. RotaTeq per protocol efficacy data was taken from a large worldwide rotavirus clinical trial (70,000 children). Health outcomes included home care cases, General Practioner (GP)/Paediatrician, emergency department visits, hospitalisations and nosocomial infections. Results The model estimates that the introduction of a universal rotavirus vaccination programme with RotaTeq (90% coverage rate) would reduce the rotavirus gastroenteritis (RVGE) burden by 75% in Spain; 53,692 home care cases, 35,187 GP/Paediatrician visits, 34,287 emergency department visits, 10,987 hospitalisations and 2,053 nosocomial infections would be avoided. The introduction of RotaTeq would avoid about 76% of RVGE-related costs from both perspectives: €22 million from the national health system perspective and €38 million from the societal perspective. Conclusions A rotavirus vaccination programme with RotaTeq would reduce significantly the important medical and economic burden of RVGE in Spain. PMID:20698958

  6. Bacillus cereus bacteremia in an adult with acute leukemia.

    PubMed

    Funada, H; Uotani, C; Machi, T; Matsuda, T; Nonomura, A

    1988-03-01

    Bacillus cereus, which used to be considered non-pathogenic, was isolated from the blood of a patient with acute leukemia who was receiving intensive chemotherapy. Fatal bacteremia developed with a clinical syndrome of acute gastroenteritis, followed by both meningoencephalitis with subarachnoid hemorrhage and multiple liver abscesses probably caused by infective vasculitis. Surveillance stool cultures revealed colonization with the organism prior to the onset of diarrhea, and repetitive blood cultures were found to be positive. Thus, this case suggested some new important clinicopathologic features of true B. cereus bacteremia complicating acute leukemia.

  7. Diagnosis of viral gastroenteritis: limits and potential of currently available procedures.

    PubMed

    Sidoti, Francesca; Rittà, Massimo; Costa, Cristina; Cavallo, Rossana

    2015-06-01

    The diagnostic approaches to viral gastroenteritis have evolved substantially over the past decades because of the advances in detection methods, the emergence of new pathogens, and the increase in diarrhea hospitalizations attributed to viruses, especially in young children in non-industrialized countries. Overall, these factors have lead to a relevant improvement of types and operating characteristics of diagnostic methods (including sensitivity and specificity), as well as turnaround time. In this review, clinical and laboratory approaches to the diagnosis of viruses causing gastroenteritis are presented; in particular, specimen collection and detection methods are reviewed and discussed, taking into account performance and limitations.

  8. Quantity and variation in morbidity: THAID-analysis of the occurrence of gastroenteritis among Ethiopan children.

    PubMed

    Freij, L; Wall, S

    1979-12-01

    Morbidity figures from a one-year longitudinal child health study comprising 749 children in an urban area in Ethiopia are reported. Aggregated morbidity measures, based on frequency distributions according to morbidity level, demonstrate gastroenteritis among infants and young preschool children as a quantitatively important morbidity problem. Variation in the occurrence of gastroenteritis is studied among 390 children under 5 years by means of a multi-variate method, THAID-analysis, designed for a categorical or, as in this study, a categorized criterion variable. The results indicate that variables expressing nutrition, housing, hygiene and sanitation are dominating predictors of childhood diarrhoeal disease.

  9. Foreshock occurrence rates before large earthquakes worldwide

    USGS Publications Warehouse

    Reasenberg, P.A.

    1999-01-01

    Global rates of foreshock occurrence involving shallow M ??? 6 and M ??? 7 mainshocks and M ??? 5 foreshocks were measured, using earthquakes listed in the Harvard CMT catalog for the period 1978-1996. These rates are similar to rates ones measured in previous worldwide and regional studies when they are normalized for the ranges of magnitude difference they each span. The observed worldwide rates were compared to a generic model of earthquake clustering, which is based on patterns of small and moderate aftershocks in California, and were found to exceed the California model by a factor of approximately 2. Significant differences in foreshock rate were found among subsets of earthquakes defined by their focal mechanism and tectonic region, with the rate before thrust events higher and the rate before strike-slip events lower than the worldwide average. Among the thrust events a large majority, composed of events located in shallow subduction zones, registered a high foreshock rate, while a minority, located in continental thrust belts, measured a low rate. These differences may explain why previous surveys have revealed low foreshock rates among thrust events in California (especially southern California), while the worldwide observations suggest the opposite: California, lacking an active subduction zone in most of its territory, and including a region of mountain-building thrusts in the south, reflects the low rate apparently typical for continental thrusts, while the worldwide observations, dominated by shallow subduction zone events, are foreshock-rich.

  10. [Acute gastroenteritis by Cambylobacter spp: a retrospective study of a paediatric emergency department].

    PubMed

    Soares, Ana Teresa; Couto, Catarina; Romão, Patrícia; Melo, Isabel Saraiva de; Braga, Manuela; Diogo, José; Calhau, Paulo

    2014-01-01

    Introdução: A infeção por Campylobacter é a principal causa de gastroenterite aguda bacteriana pediátrica na União Europeia.Objetivos: Conhecer a prevalência de isolamento deste agente nas crianças admitidas na urgência com gastroenterite aguda que realizaram coprocultura, caracterizando a microbiologia, epidemiologia, clínica, terapêutica e complicações associadas.Material e Métodos: Casuística por consulta dos processos dos doentes admitidos na Urgência Pediátrica dum hospital distrital, durante 30 meses, com o diagnóstico de gastroenterite aguda e isolamento em coprocultura de Campylobacter.Resultados: Das 216 coproculturas efetuadas, 98 (45%) foram positivas. Identificámos Campylobacter spp. em 49 (50%) doentes. Destes, 30 (61%) eram do género feminino. A mediana de idades foi 23 meses. Catorze doentes tinham idade inferior a um ano, 25 entre um e cinco anos e 10 idade superior a cinco anos. Verificámos diarreia aquosa em cinco (10%) doentes, diarreia com sangue em 44 (90%), sangue e muco em 14 (29%), febre em 23 (47%), dor abdominal em 14 (29%) e vómitos em 11 (22%). Registámos um caso de sépsis. Internámos cinco doentes. Oito doentes foram medicados com azitromicina.Discussão: Esta é a maior casuística nacional publicada de gastroenterite aguda a Campylobacter em idade pediátrica e a primeira no sul do país. Campylobacter foi a principal bactéria identificada, associada maioritariamente a doença auto-limitada. Contudo, há a considerar formas de infeção graves. O aumento da resistência às quinolonas é preocupante.Conclusão: A utilização criteriosa da coprocultura permite a identificação etiológica na gastrenterite aguda bacteriana. O crescente aumento dos casos de Campylobacter diagnosticados reforça a necessidade de maior controlo das medidas de higiene na manipulação dos alimentos.

  11. Genetic evolution and tropism of transmissible gastroenteritis coronaviruses.

    PubMed

    Sánchez, C M; Gebauer, F; Suñé, C; Mendez, A; Dopazo, J; Enjuanes, L

    1992-09-01

    Transmissible gastroenteritis virus (TGEV) is an enteropathogenic coronavirus isolated for the first time in 1946. Nonenteropathogenic porcine respiratory coronaviruses (PRCVs) have been derived from TGEV. The genetic relationship among six European PRCVs and five coronaviruses of the TGEV antigenic cluster has been determined based on their RNA sequences. The S protein of six PRCVs have an identical deletion of 224 amino acids starting at position 21. The deleted area includes the antigenic sites C and B of TGEV S glycoprotein. Interestingly, two viruses (NEB72 and TOY56) with respiratory tropism have S proteins with a size similar to the enteric viruses. NEB72 and TOY56 viruses have in the S protein 2 and 15 specific amino acid differences with the enteric viruses. Four of the residues changed (aa 219 of NEB72 isolate and aa 92, 94, and 218 of TOY56) are located within the deletion present in the PRCVs and may be involved in the receptor binding site (RBS) conferring enteric tropism to TGEVs. A second RBS used by the virus to infect ST cells might be located in a conserved area between sites A and D of the S glycoprotein, since monoclonal antibodies specific for these sites inhibit the binding of the virus to ST cells. An evolutionary tree relating 13 enteric and respiratory isolates has been proposed. According to this tree, a main virus lineage evolved from a recent progenitor virus which was circulating around 1941. From this, secondary lineages originated PUR46, NEB72, TOY56, MIL65, BR170, and the PRCVs, in this order. Least squares estimation of the origin of TGEV-related coronaviruses showed a significant constancy in the fixation of mutations with time, that is, the existence of a well-defined molecular clock. A mutation fixation rate of 7 +/- 2 x 10(-4) nucleotide substitutions per site and per year was calculated for TGEV-related viruses. This rate falls in the range reported for other RNA viruses. Point mutations and probably recombination events have

  12. 1991 worldwide refining and gas processing directory

    SciTech Connect

    Not Available

    1990-01-01

    This book ia an authority for immediate information on the industry. You can use it to find new business, analyze market trends, and to stay in touch with existing contacts while making new ones. The possibilities for business applications are numerous. Arranged by country, all listings in the directory include address, phone, fax and telex numbers, a description of the company's activities, names of key personnel and their titles, corporate headquarters, branch offices and plant sites. This newly revised edition lists more than 2000 companies and nearly 3000 branch offices and plant locations. This east-to-use reference also includes several of the most vital and informative surveys of the industry, including the U.S. Refining Survey, the Worldwide Construction Survey in Refining, Sulfur, Gas Processing and Related Fuels, the Worldwide Refining and Gas Processing Survey, the Worldwide Catalyst Report, and the U.S. and Canadian Lube and Wax Capacities Report from the National Petroleum Refiner's Association.

  13. Temporal distribution of human rotavirus serotypes 1,2,3, and 4 in Venezuelan children with gastroenteritis during 1979-1989.

    PubMed

    White, L; García, D; Boher, Y; Blanco, M; Pérez, M; Romer, H; Flores, J; Pérez-Schael, I

    1991-06-01

    The temporal distribution and clinical severity of rotavirus VP7 serotypes 1, 2, 3, and 4 recovered from 427 Venezuelan children with acute gastroenteritis over a period of 11 years were studied. Rotavirus VP7 serotype was established by ELISA serotyping in 298 (69.78%) of the specimens while the serotype of the remaining 129 (30.21%) samples could not be determined. Of the specimens typed, 85 (19.90% of the total) were serotype 1, 43 (10.07%) were serotype 2, 105 (24.59%) were serotype 3, and 65 (15.22%) were serotype 4. Yearly changes in the frequency of individual serotypes were observed. The predominance of a single serotype with minor contribution from others was noted every year. In this study, serotype 1 appears to induce a less severe illness in comparison with serotypes 2, 3, and 4. No apparent association between the proportion of each serotype and the children's age were found.

  14. Emergence and serovar profiling of non-typhoidal Salmonellae (NTS) isolated from gastroenteritis cases-A study from South India.

    PubMed

    Ballal, Mamatha; Devadas, Suganthi Martena; Shetty, Vignesh; Bangera, Sohan Rodney; Ramamurthy, Thandavarayan; Sarkar, Anirban

    2016-01-01

    Human infection with non-typhoidal Salmonella (NTS) serovars is often a neglected and undiagnosed infection in the developing world. Invasive NTS is now being established as having a new and emerging pathogenic role. There is not sufficient data on the prevalence of NTS serovars and their antibiotic susceptibility pattern from India. Faecal specimens collected from patients with acute gastroenteritis were processed to isolate Salmonella according to the standard protocol for a period from January 2011-December 2014. Salmonella isolates were serotyped and tested for antibiotic susceptibility. Of the total 320 (10.04%) bacterial enteric pathogens isolated, 64 (20%) were non-typhoidal Salmonella. Among the serogroup, O:4 (B) (n = 26; 40.6%) was found to be the commonest followed by O:7 (C1) (n = 11; 17.1%) and O:3,10 (E1) (n = 11; 17.1%). NTS infection in cancer patients could also be termed as nosocomial NTS diarrhoea due to primary community infection with prolonged incubation periods, consumption of contaminated food during hospital stay or Nosocomially acquired infection. Serovar Oslo has been predominant (9/17) in NTS isolates from cancer patients, whereas serovars Bovismorbificans, Wangata and Schleissheim have been reported for the first time in the country. The isolates were mostly susceptible to antibiotics except Salmonella ser Kentucky, which showed resistance to ciprofloxacin is reported for the first time in the country. Continuous surveillance is required to monitor resistance of NTS isolates. PMID:27300440

  15. A time series study of gastroenteritis and tap water quality in the Nantes area, France, 2002-2007.

    PubMed

    Beaudeau, Pascal; Zeghnoun, Abdelkrim; Corso, Magali; Lefranc, Agnès; Rambaud, Loïc

    2014-01-01

    In the Nantes area, 410,000 inhabitants are supplied with water pumped from the Loire River. The treatment of this water is carried out through a process of complete clarification and disinfection. During the study period (2002-07), the quality of drinking water complied with European microbial standards and mean turbidity in finished water was 0.05 NTU (nephelometric turbidity units). We aimed to characterize the link between produced water turbidity and other operational data and the incidence of acute gastroenteritis (AGE) in the Nantes area. The daily number of medical prescriptions for AGE was drawn from the French national health insurance system's drug reimbursement data. We modeled this time series using Poisson regression within the framework of a Generalized Additive Model. We showed that an interquartile range turbidity degradation (0.042-0.056 NTU) was connected to a 4.2% (CI95=(1.5%; 6.9%)) increase in the risk of AGE in children and a 2.9% (CI95=(0.5%; 5.4%)) increase in adults. The slope of the turbidity risk function was higher during both high- and low-water conditions of the river. High values of daily flow of produced water were also associated with higher endemic levels of AGE.

  16. Emergence and serovar profiling of non-typhoidal Salmonellae (NTS) isolated from gastroenteritis cases-A study from South India.

    PubMed

    Ballal, Mamatha; Devadas, Suganthi Martena; Shetty, Vignesh; Bangera, Sohan Rodney; Ramamurthy, Thandavarayan; Sarkar, Anirban

    2016-01-01

    Human infection with non-typhoidal Salmonella (NTS) serovars is often a neglected and undiagnosed infection in the developing world. Invasive NTS is now being established as having a new and emerging pathogenic role. There is not sufficient data on the prevalence of NTS serovars and their antibiotic susceptibility pattern from India. Faecal specimens collected from patients with acute gastroenteritis were processed to isolate Salmonella according to the standard protocol for a period from January 2011-December 2014. Salmonella isolates were serotyped and tested for antibiotic susceptibility. Of the total 320 (10.04%) bacterial enteric pathogens isolated, 64 (20%) were non-typhoidal Salmonella. Among the serogroup, O:4 (B) (n = 26; 40.6%) was found to be the commonest followed by O:7 (C1) (n = 11; 17.1%) and O:3,10 (E1) (n = 11; 17.1%). NTS infection in cancer patients could also be termed as nosocomial NTS diarrhoea due to primary community infection with prolonged incubation periods, consumption of contaminated food during hospital stay or Nosocomially acquired infection. Serovar Oslo has been predominant (9/17) in NTS isolates from cancer patients, whereas serovars Bovismorbificans, Wangata and Schleissheim have been reported for the first time in the country. The isolates were mostly susceptible to antibiotics except Salmonella ser Kentucky, which showed resistance to ciprofloxacin is reported for the first time in the country. Continuous surveillance is required to monitor resistance of NTS isolates.

  17. Characterization of RotaTeq® vaccine-derived rotaviruses in South Korean infants with rotavirus gastroenteritis.

    PubMed

    Than, Van Thai; Jeong, Sunyoung; Kim, Wonyong

    2015-01-01

    Genotyping of human rotaviruses was performed in 191 rotavirus-positive fecal samples collected from infants with acute gastroenteritis, 3 years after the introduction of two rotavirus vaccines in South Korea. Among these samples, the most prevalent rotavirus genotype was G3P[8] (30.9%), followed by G1P[8] (27.7%), G4P[6] (15.2%), and G9P[8] (5.8%). Sequence analysis identified RotaTeq® vaccine-derived strains in 12 samples (6.3%), comprising 11 G1P[8] human-bovine double reassortant rotaviruses and 1 G1P[5] human-bovine single reassortant rotavirus. It is of note that cross-reactivity between the current G4-specific typing primer and RotaTeq®-specific G1 genotypes was found. A trace of the clinical and environmental routes of the rotavirus vaccine strains revealed unexpected complexity, and the diagnostic protocol for rotaviruses may require modification by using either another typing primer set or nucleotide sequence analysis.

  18. World-Wide Web: The Information Universe.

    ERIC Educational Resources Information Center

    Berners-Lee, Tim; And Others

    1992-01-01

    Describes the World-Wide Web (W3) project, which is designed to create a global information universe using techniques of hypertext, information retrieval, and wide area networking. Discussion covers the W3 data model, W3 architecture, the document naming scheme, protocols, document formats, comparison with other systems, experience with the W3…

  19. Bulletin Board Ideas: Worldwide Scientific Events

    ERIC Educational Resources Information Center

    Schiffman, Maurice K.

    1977-01-01

    Describes a bulletin board activity that identifies scientific phenomena occurring worldwide during the school year. A map of the world is marked with colored pins as students find news information of places and kind of event (e.g.; volcanoes, floods, crop failures, human epidemics). (CS)

  20. WorldWide Web: Hypertext from CERN.

    ERIC Educational Resources Information Center

    Nickerson, Gord

    1992-01-01

    Discussion of software tools for accessing information on the Internet focuses on the WorldWideWeb (WWW) system, which was developed at the European Particle Physics Laboratory (CERN) in Switzerland to build a worldwide network of hypertext links using available networking technology. Its potential for use with multimedia documents is also…

  1. 1979 Worldwide Adventure TravelGuide.

    ERIC Educational Resources Information Center

    1979

    Guidebook descriptions of the 3000 worldwide adventure trips open to public participation include highlights, itinerary, level of experience necessary, requirements, location, duration, dates, cost, and addresses and telephone numbers of the operating organizations. The guidebook is organized in four major sections and, within each section, into…

  2. Equipment and services for worldwide applications

    SciTech Connect

    Not Available

    1985-01-01

    The report presents a digest of geothermal energy technology. The worldwide distribution of geothermal resources is described, and the degree to which various countries are exploiting their resources estimated. Detailed information about US technologies is presented, from exploration through applications to cost factors. (ACR)

  3. World-wide distribution automation systems

    SciTech Connect

    Devaney, T.M.

    1994-12-31

    A worldwide power distribution automation system is outlined. Distribution automation is defined and the status of utility automation is discussed. Other topics discussed include a distribution management system, substation feeder, and customer functions, potential benefits, automation costs, planning and engineering considerations, automation trends, databases, system operation, computer modeling of system, and distribution management systems.

  4. Expanding Worldwide Awareness of Creative Potential.

    ERIC Educational Resources Information Center

    Jellen, Hans G.; Urban, Klaus K.

    1989-01-01

    The article proposes the Test for Creative Thinking-Drawing Production as an appropriate culture-fair assessment to identifying creative potential worldwide. Fifteen sample drawings of children from around the world, all based on the same original stimuli, are provided. (DB)

  5. Origins of food crops connect countries worldwide.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Crop genetic diversity is concentrated within specific geographic regions worldwide. While access to this diversity is critical to continued increases in agricultural productivity, the geopolitical significance of the geography of crop diversity has not been quantified. We assess the degree to which...

  6. A Novel Pore-Forming Toxin in Type A Clostridium perfringens Is Associated with Both Fatal Canine Hemorrhagic Gastroenteritis and Fatal Foal Necrotizing Enterocolitis

    PubMed Central

    Nowell, Victoria J.; Nicholson, Vivian M.; Oliphant, Kaitlyn; Prescott, John F.

    2015-01-01

    A role for type A Clostridium perfringens in acute hemorrhagic and necrotizing gastroenteritis in dogs and in necrotizing enterocolitis of neonatal foals has long been suspected but incompletely characterized. The supernatants of an isolate made from a dog and from a foal that died from these diseases were both found to be highly cytotoxic for an equine ovarian (EO) cell line. Partial genome sequencing of the canine isolate revealed three novel putative toxin genes encoding proteins related to the pore-forming Leukocidin/Hemolysin Superfamily; these were designated netE, netF, and netG. netE and netF were located on one large conjugative plasmid, and netG was located with a cpe enterotoxin gene on a second large conjugative plasmid. Mutation and complementation showed that only netF was associated with the cytotoxicity. Although netE and netG were not associated with cytotoxicity, immunoblotting with specific antisera showed these proteins to be expressed in vitro. There was a highly significant association between the presence of netF with type A strains isolated from cases of canine acute hemorrhagic gastroenteritis and foal necrotizing enterocolitis. netE and netF were found in all cytotoxic isolates, as was cpe, but netG was less consistently present. Pulsed-field gel electrophoresis showed that netF-positive isolates belonged to a clonal population; some canine and equine netF-positive isolates were genetically indistinguishable. Equine antisera to recombinant Net proteins showed that only antiserum to rNetF had high supernatant cytotoxin neutralizing activity. The identifica-tion of this novel necrotizing toxin is an important advance in understanding the virulence of type A C. perfringens in specific enteric disease of animals. PMID:25853427

  7. Molecular characterization of noroviruses and rotaviruses involved in a large outbreak of gastroenteritis in Northern Italy.

    PubMed

    Di Bartolo, Ilaria; Monini, Marina; Losio, Marina Nadia; Pavoni, Enrico; Lavazza, Antonio; Ruggeri, Franco Maria

    2011-08-01

    Noroviruses and rotaviruses from a gastroenteritis outbreak affecting >300 people near Garda Lake (Northern Italy) in 2009 were investigated. Characterization of viruses from 40 patient stool samples and 5 environmental samples identified three distinct rotavirus and five norovirus genotypes; two of the latter were detected in both patient and environmental samples.

  8. Transmissible gastroenteritis virus; identification of M protein-binding peptide ligands with antiviral and diagnostic potential

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The membrane (M) protein is one of the major structural proteins of coronavirus particles. In this study, the M protein of transmissible gastroenteritis virus (TGEV) was used to biopan a 12-mer phage display random peptide library. Three phages expressing TGEV-M-binding peptides were identified and ...

  9. Mutation distribution in the NSP4 protein in rotaviruses isolated from Mexican children with moderate to severe gastroenteritis.

    PubMed

    González-Ochoa, Guadalupe; Menchaca, Griselda E; Hernández, Carlos E; Rodríguez, Cristina; Tamez, Reyes S; Contreras, Juan F

    2013-03-11

    The NSP4 protein is a multifunctional protein that plays a role in the morphogenesis and pathogenesis of the rotavirus. Although NSP4 is considered an enterotoxin, the relationship between gastroenteritis severity and amino acid variations in NSP4 of the human rotavirus remains unclear. In this study, we analyzed the sequence diversity of NSP4 and the severity of gastroenteritis of children with moderate to severe gastroenteritis. The rotavirus-infected children were hospitalized before the rotavirus vaccine program in Mexico. All children had diarrhea within 1-4 days, 44 (88%) were vomiting and 35 (70%) had fevers. The severity analysis showed that 13 (26%) cases had mild gastroenteritis, 23 (46%) moderate gastroenteritis and 14 (28%) severe. NSP4 phylogenetic analysis showed three clusters within the genotype E1. Sequence analysis revealed similar mutations inside each cluster, and an uncommon variation in residue 144 was found in five of the Mexican NSP4 sequences. Most of the amino acid variations were located in the VP4 and VP6 binding site domains, with no relationship to different grades of gastroenteritis. This finding indicates that severe gastroenteritis caused by the rotavirus appears to be related to diverse viral or cellular factors instead of NSP4 activity as a unique pathogenic factor.

  10. Norovirus genotype diversity in community-based sporadic gastroenteritis incidents: a five-year study.

    PubMed

    Bruggink, Leesa D; Dunbar, Natalie L; Marshall, John A

    2015-06-01

    Although norovirus is a known cause of sporadic gastroenteritis, the incidence and genotypes of norovirus associated with sporadic community-based gastroenteritis are poorly understood. The current study examined this issue by using material from alleged food poisoning incidents in the state of Victoria, Australia, for the period 2008-2012. Norovirus was identified, by either ORF (open reading frame) 1 or ORF 2 RT-PCR methodology, in 159 of 379 (42.0%) sporadic gastroenteritis incidents, thereby showing that norovirus was an important cause of sporadic gastroenteritis. The number of sporadic norovirus incidents did not vary significantly from year to year, indicating that the pool of circulating norovirus remained constant. Norovirus ORF 1 genotypes identified included GI.1, GI.2, GI.3, GI.4, GI.b, GI.d, GII.2, GII.4 (including variants 2006a, 2006b, 2007, and 2009), GII.16, GII.22, GII.b, GII.e, and GII.g. Norovirus ORF 2 genotypes identified included GI.1, GI.2, GI.3, GI.4, GI.6, GII.2, GII.3, GII.4 (variants 2006b, 2009, 2009-like, 2012, and "unknown"), GII.6, GII.7, GII.9, GII.12, and GII.13. Five ORF 1/ORF 2 norovirus recombinant forms were confirmed: GII.b/GII.3, GII.e/GII.4 (2012), GII.e/GII.4 (unknown), GII.g/GII.12 and GII.16/GII.2. Although the incidence of ORF 2 GI.3 was significantly higher in children than in adults, this was not the case for other major ORF 2 genotypes (GII.2, GII.4, and GII.6) which occurred equally in all age groups. The findings demonstrate the importance and diverse nature of norovirus in sporadic community-based gastroenteritis incidents and indicate that the development of successful vaccine strategies may be difficult.

  11. Norovirus genotype diversity in community-based sporadic gastroenteritis incidents: a five-year study.

    PubMed

    Bruggink, Leesa D; Dunbar, Natalie L; Marshall, John A

    2015-06-01

    Although norovirus is a known cause of sporadic gastroenteritis, the incidence and genotypes of norovirus associated with sporadic community-based gastroenteritis are poorly understood. The current study examined this issue by using material from alleged food poisoning incidents in the state of Victoria, Australia, for the period 2008-2012. Norovirus was identified, by either ORF (open reading frame) 1 or ORF 2 RT-PCR methodology, in 159 of 379 (42.0%) sporadic gastroenteritis incidents, thereby showing that norovirus was an important cause of sporadic gastroenteritis. The number of sporadic norovirus incidents did not vary significantly from year to year, indicating that the pool of circulating norovirus remained constant. Norovirus ORF 1 genotypes identified included GI.1, GI.2, GI.3, GI.4, GI.b, GI.d, GII.2, GII.4 (including variants 2006a, 2006b, 2007, and 2009), GII.16, GII.22, GII.b, GII.e, and GII.g. Norovirus ORF 2 genotypes identified included GI.1, GI.2, GI.3, GI.4, GI.6, GII.2, GII.3, GII.4 (variants 2006b, 2009, 2009-like, 2012, and "unknown"), GII.6, GII.7, GII.9, GII.12, and GII.13. Five ORF 1/ORF 2 norovirus recombinant forms were confirmed: GII.b/GII.3, GII.e/GII.4 (2012), GII.e/GII.4 (unknown), GII.g/GII.12 and GII.16/GII.2. Although the incidence of ORF 2 GI.3 was significantly higher in children than in adults, this was not the case for other major ORF 2 genotypes (GII.2, GII.4, and GII.6) which occurred equally in all age groups. The findings demonstrate the importance and diverse nature of norovirus in sporadic community-based gastroenteritis incidents and indicate that the development of successful vaccine strategies may be difficult. PMID:25784155

  12. Exploring the Universe with the Worldwide Telescope

    NASA Astrophysics Data System (ADS)

    Fay, J. E.

    2014-12-01

    Microsoft Research WorldWide Telescope is a software platform for exploring the universe. Whether you are a researcher, student or just a casual explorer WorldWide Telescope uses cutting edge technology to take you anywhere in the universe and visualize data collected by science programs from across the globe, including NASA great observatories and planetary probes. WWT leverages technologies such as Virtual reality headsets, multi-channel full dome projection and HTML5/WebGL to bring the WWT experience to any device and any scale. We will discuss how to use WWT to browse previously curated data, as well as how to process and visualize your own data, using examples from NASA Mars missions.

  13. Worldwide electricity consumption of communication networks.

    PubMed

    Lambert, Sofie; Van Heddeghem, Ward; Vereecken, Willem; Lannoo, Bart; Colle, Didier; Pickavet, Mario

    2012-12-10

    There is a growing research interest in improving the energy efficiency of communication networks. In order to assess the impact of introducing new energy efficient technologies, an up-to-date estimate for the global electricity consumption in communication networks is needed. In this paper we consider the use phase electricity consumption of telecom operator networks, office networks and customer premises equipment. Our results show that the network electricity consumption is growing fast, at a rate of 10 % per year, and its relative contribution to the total worldwide electricity consumption has increased from 1.3% in 2007 to 1.8% in 2012. We estimate the worldwide electricity consumption of communication networks will exceed 350 TWh in 2012.

  14. Data reprocessing on worldwide distributed systems

    SciTech Connect

    Diesburg, Mike; Wicke, Daniel; /Fermilab

    2004-12-01

    The D0 experiment faces many challenges enabling access to large datasets for physicists on 4 continents. The strategy followed is to make use of worldwide distributed computing clusters. Since the begin of Tevatron Run-II (March 2001) all Monte-Carlo simulations are produced outside of Fermilab on remote systems. For analyses a system of regional analysis centres (RACs) was established which supply the associated institutes with the data. This structure which is similar to the Tier structure foreseen for LHC was used in autumn 2003 to reprocess all D0-data with the up-to-date and much improved reconstruction software. With these achievements D0 is the first high energy physics experiment to have implemented and operated all essential computing tasks on non-dedicated, worldwide distributed systems. The experiences gained in D0 can be applied to evaluate the LHC computing model.

  15. Data reprocessing on worldwide distributed systems

    SciTech Connect

    Wicke, Daniel; /Fermilab

    2004-12-01

    The D0 experiment faces many challenges in terms of enabling access to large datasets for physicists on four continents. The strategy for solving these problems on worldwide distributed computing clusters is presented. Since the beginning of Run II of the Tevatron (March 2001) all Monte-Carlo simulations for the experiment have been produced at remote systems. For data analysis, a system of regional analysis centers (RACs) was established which supply the associated institutes with the data. This structure, which is similar to the tiered structure foreseen for the LHC was used in Fall 2003 to reprocess all D0 data with a much improved version of the reconstruction software. This makes D0 the first running experiment that has implemented and operated all important computing tasks of a high energy physics experiment on systems distributed worldwide.

  16. Campaigning for women's health rights worldwide.

    PubMed

    Doyal, L

    In this paper, the author takes a look at the women's health movement worldwide and lists some of its many achievements. The information provided is set in the context of reproductive rights, the most common issue that affects women in both the developed and the developing world. The author discusses access to birth control and the role of the consumer movement in achieving rights for women in childbirth.

  17. Integrating WorldWide Telescope with Wordpress

    NASA Astrophysics Data System (ADS)

    Sands, Mark; Luebbert, J.; Fay, J.; Gay, P. L.

    2010-01-01

    In this project we unite three major components of astronomy and new media: World Wide Telescope, Wordpress, and user supplied audio. Through an easy to use Wordpress plug-in users can create WorldWide Telescope sky tours that allow: a) astronomers and educators to spread the facts and awareness of astronomy, potentially bringing new and interested individuals into the astronomy community; b) bloggers/podcasters to create dynamic, virtual tours of the universe that are nearly boundless; and, c) readers to benefit from the alluring WorldWide Telescope tours by gaining a new and dramatic outlook on our universe. This software has the potential to augment, and in some cases replace, traditional methods of astronomy centered online lectures. With this plugin, it is possible to combine Wordpress-based website content with audio, and a sky tour that can be paused at any object. This ability to pause a sky tour allows the user to further explore the wealth of data provided within WWT. This fully customizable solution includes all of the necessary features required to reproduce a lecture in a more creative and appealing format then some of the standard, typically non-interactive, movies and podcasts currently found online. Through the creation of effective WorldWide Telescope tours, astronomers and educators can better extend astronomy content to astronomy-interested, but not yet engaged, members of the new media community. These tours will provide a better understanding and appreciation for what our universe has to offer. Through this new media approach of integrating WorldWide Telescope with blogs and podcasts, users can now extend their interest in astronomy by exploring the universe themselves, moving beyond provided content to gain a better understanding all on their own.

  18. World-wide fallout from nuclear weapons

    SciTech Connect

    Not Available

    1994-01-01

    This video explains what is known and what is not known by today's science about the long term consequences of world-wide fallout. In the interest of accuracy, this report is confined to the fallout on which a substantial amount of information is now available. Much has been written and said about this subject both officially and unofficially. The purpose of this film is to correct any factually unsupported statements which have been and continue to be issued from time to time.

  19. Worldwide electricity used in data centers

    NASA Astrophysics Data System (ADS)

    Koomey, Jonathan G.

    2008-07-01

    The direct electricity used by data centers has become an important issue in recent years as demands for new Internet services (such as search, music downloads, video-on-demand, social networking, and telephony) have become more widespread. This study estimates historical electricity used by data centers worldwide and regionally on the basis of more detailed data than were available for previous assessments, including electricity used by servers, data center communications, and storage equipment. Aggregate electricity use for data centers doubled worldwide from 2000 to 2005. Three quarters of this growth was the result of growth in the number of the least expensive (volume) servers. Data center communications and storage equipment each contributed about 10% of the growth. Total electricity use grew at an average annual rate of 16.7% per year, with the Asia Pacific region (without Japan) being the only major world region with growth significantly exceeding that average. Direct electricity used by information technology equipment in data centers represented about 0.5% of total world electricity consumption in 2005. When electricity for cooling and power distribution is included, that figure is about 1%. Worldwide data center power demand in 2005 was equivalent (in capacity terms) to about seventeen 1000 MW power plants.

  20. Deaths following acute diarrhoeal diseases among hospitalised infants in Kuala Lumpur.

    PubMed

    Lee, W S; Ooi, T L

    1999-09-01

    The risk factors and modes of death following acute diarrhoeal illness in children admitted to University Hospital, Kuala Lumpur between 1982 and 1997 were studied retrospectively. Among 4,689 cases of acute gastroenteritis admitted, ten deaths were noted. The case mortality rate was 2.1/1000 admissions. All deaths were infants below one year, with eight females and two males. Acute renal failure and acute pulmonary oedema were common preceding events. Female sex, infants less than twelve months, the presence of hyper or hyponatraemia and moderate to severe dehydration on admission were risk factors for deaths.

  1. Acute kidney injury with hypoxic respiratory failure

    PubMed Central

    Neubert, Zachary; Hoffmann, Paul; Owshalimpur, David

    2014-01-01

    A 27-year-old Caucasian man was transferred from a remote clinic with acute kidney injury for the prior 7–10 days preceded by gastroenteritis. His kidney biopsy showed non-specific mesangiopathic glomerular changes, minimal tubulointerstitial disease without sclerosis, crescents, nor evidence of vasculitis. On his third hospital day, he developed acute hypoxic respiratory failure requiring intubation and mechanical ventilation. Pulmonary renal syndromes ranked highest on his differential diagnosis. He was extubated after 2 days of mechanical ventilation and after pulse dose steroids. His lung biopsy showed pulmonary capillaritis. Our case describes a patient with clinically appearing renopulmonary syndrome, but found to have pulmonary capillaritis, a rare form of lung disease that may also cause acute kidney injury. PMID:25246473

  2. Surveillance for outbreaks of gastroenteritis in elderly long-term care facilities in France, November 2010 to May 2012.

    PubMed

    Barret, A S; Jourdan-da Silva, N; Ambert-Balay, K; Delmas, G; Bone, A; Thiolet, J M; Vaillant, V

    2014-07-24

    This article describes outbreaks of gastroenteritis in elderly long-term care facilities (LTCF) in France from November 2010 to May 2012 reported through the surveillance system for gastroenteritis outbreaks in LTCF. A total of 1,072 outbreaks were reported, causing 26,551 episodes of illness and 60 deaths. The median attack rate (AR) among residents was 32%. Norovirus and person-to-person transmission were the most frequently reported aetiology and mode of transmission. Control measures were implemented in 1,054 (98%) outbreaks and for 928 outbreaks, the timing of such measures could be inferred. Of these, 799 (86%) had put control measures into effect within three days of the occurrence of the first case. Outbreaks of gastroenteritis in LTCF cause substantial morbidity and mortality among elderly people in France. LTCF are encouraged to develop infection prevention and control plans and to notify any gastroenteritis outbreak to health authorities to ensure rapid control.

  3. World-wide fallout from nuclear weapons

    SciTech Connect

    1994-12-31

    This video explains what is known and what is not known by today`s science about the long term consequences of world-wide fallout. In the interest of accuracy, this report is confined to the fallout on which a substantial amount of information is now available. Much has been written and said about this subject both officially and unofficially. The purpose of this film is to correct any factually unsupported statements which have been and continue to be issued from time to time.

  4. Prevalence of Norwalk-like virus infections in cases of viral gastroenteritis among children in Osaka City, Japan.

    PubMed

    Iritani, Nobuhiro; Seto, Yoshiyuki; Kubo, Hideyuki; Murakami, Tsukasa; Haruki, Kosuke; Ayata, Minoru; Ogura, Hisashi

    2003-04-01

    Surveillance of Norwalk-like virus (NLV) infections in cases of pediatric gastroenteritis between April 1996 and March 2000 showed that NLVs were an important causative agent in viral gastroenteritis cases among children between November and January in those years. The predominant type of NLV was closely related to Lordsdale virus in genogroup 2. During the 1999-2000 season, Arg320-like strains, which may be genetic recombinants, suddenly appeared and spread. PMID:12682179

  5. Prevalence of Norwalk-like virus infections in cases of viral gastroenteritis among children in Osaka City, Japan.

    PubMed

    Iritani, Nobuhiro; Seto, Yoshiyuki; Kubo, Hideyuki; Murakami, Tsukasa; Haruki, Kosuke; Ayata, Minoru; Ogura, Hisashi

    2003-04-01

    Surveillance of Norwalk-like virus (NLV) infections in cases of pediatric gastroenteritis between April 1996 and March 2000 showed that NLVs were an important causative agent in viral gastroenteritis cases among children between November and January in those years. The predominant type of NLV was closely related to Lordsdale virus in genogroup 2. During the 1999-2000 season, Arg320-like strains, which may be genetic recombinants, suddenly appeared and spread.

  6. Prevalence of Norwalk-Like Virus Infections in Cases of Viral Gastroenteritis among Children in Osaka City, Japan

    PubMed Central

    Iritani, Nobuhiro; Seto, Yoshiyuki; Kubo, Hideyuki; Murakami, Tsukasa; Haruki, Kosuke; Ayata, Minoru; Ogura, Hisashi

    2003-01-01

    Surveillance of Norwalk-like virus (NLV) infections in cases of pediatric gastroenteritis between April 1996 and March 2000 showed that NLVs were an important causative agent in viral gastroenteritis cases among children between November and January in those years. The predominant type of NLV was closely related to Lordsdale virus in genogroup 2. During the 1999-2000 season, Arg320-like strains, which may be genetic recombinants, suddenly appeared and spread. PMID:12682179

  7. Stationary power fuel cell commercialization status worldwide

    SciTech Connect

    Williams, M.C.

    1996-12-31

    Fuel cell technologies for stationary power are set to play a role in power generation applications worldwide. The worldwide fuel cell vision is to provide powerplants for the emerging distributed generation and on-site markets. Progress towards commercialization has occurred in all fuel cell development areas. Around 100 ONSI phosphoric acid fuel cell (PAFC) units have been sold, with significant foreign sales in Europe and Japan. Fuji has apparently overcome its PAFC decay problems. Industry-driven molten carbonate fuel cell (MCFC) programs in Japan and the U.S. are conducting megawatt (MW)-class demonstrations, which are bringing the MCFC to the verge of commercialization. Westinghouse Electric, the acknowledged world leader in tubular solid oxide fuel cell (SOFC) technology, continues to set performance records and has completed construction of a 4-MW/year manufacturing facility in the U.S. Fuel cells have also taken a major step forward with the conceptual development of ultra-high efficiency fuel cell/gas turbine plants. Many SOFC developers in Japan, Europe, and North America continue to make significant advances.

  8. Worldwide practice in gastric cancer surgery

    PubMed Central

    Brenkman, Hylke JF; Haverkamp, Leonie; Ruurda, Jelle P; van Hillegersberg, Richard

    2016-01-01

    AIM: To evaluate the current status of gastric cancer surgery worldwide. METHODS: An international cross-sectional survey on gastric cancer surgery was performed amongst international upper gastro-intestinal surgeons. All surgical members of the International Gastric Cancer Association were invited by e-mail to participate. An English web-based survey had to be filled in with regard to their surgical preferences. Questions asked included hospital volume, the use of neoadjuvant treatment, preferred surgical approach, extent of the lymphadenectomy and preferred anastomotic technique. The invitations were sent in September 2013 and the survey was closed in January 2014. RESULTS: The corresponding specific response rate was 227/615 (37%). The majority of respondents: originated from Asia (54%), performed > 21 gastrectomies per year (79%) and used neoadjuvant chemotherapy (73%). An open surgical procedure was performed by the majority of surgeons for distal gastrectomy for advanced cancer (91%) and total gastrectomy for both early and advanced cancer (52% and 94%). A minimally invasive procedure was preferred for distal gastrectomy for early cancer (65%). In Asia surgeons preferred a minimally invasive procedure for total gastrectomy for early cancer also (63%). A D1+ lymphadenectomy was preferred in early gastric cancer (52% for distal, 54% for total gastrectomy) and a D2 lymphadenectomy was preferred in advanced gastric cancer (93% for distal, 92% for total gastrectomy) CONCLUSION: Surgical preferences for gastric cancer surgery vary between surgeons worldwide. Although the majority of surgeons use neoadjuvant chemotherapy, minimally invasive techniques are still not widely adapted. PMID:27099448

  9. Origins of food crops connect countries worldwide

    PubMed Central

    Achicanoy, Harold A.; Bjorkman, Anne D.; Navarro-Racines, Carlos; Guarino, Luigi; Flores-Palacios, Ximena; Engels, Johannes M. M.; Wiersema, John H.; Dempewolf, Hannes; Sotelo, Steven; Ramírez-Villegas, Julian; Castañeda-Álvarez, Nora P.; Fowler, Cary; Jarvis, Andy; Rieseberg, Loren H.; Struik, Paul C.

    2016-01-01

    Research into the origins of food plants has led to the recognition that specific geographical regions around the world have been of particular importance to the development of agricultural crops. Yet the relative contributions of these different regions in the context of current food systems have not been quantified. Here we determine the origins (‘primary regions of diversity’) of the crops comprising the food supplies and agricultural production of countries worldwide. We estimate the degree to which countries use crops from regions of diversity other than their own (‘foreign crops’), and quantify changes in this usage over the past 50 years. Countries are highly interconnected with regard to primary regions of diversity of the crops they cultivate and/or consume. Foreign crops are extensively used in food supplies (68.7% of national food supplies as a global mean are derived from foreign crops) and production systems (69.3% of crops grown are foreign). Foreign crop usage has increased significantly over the past 50 years, including in countries with high indigenous crop diversity. The results provide a novel perspective on the ongoing globalization of food systems worldwide, and bolster evidence for the importance of international collaboration on genetic resource conservation and exchange.

  10. Worldwide variability in deceased organ donation registries

    PubMed Central

    Rosenblum, Amanda M; Li, Alvin Ho-Ting; Roels, Leo; Stewart, Bryan; Prakash, Versha; Beitel, Janice; Young, Kimberly; Shemie, Sam; Nickerson, Peter; Garg, Amit X

    2012-01-01

    The variability in deceased organ donation registries worldwide has received little attention. We considered all operating registries, where individual wishes about organ donation were recorded in a computerized database. We included registries which recorded an individual's decision to be a donor (donor registry), and registries which only recorded an individual's objection (non-donor registry). We collected information on 15 characteristics including history, design, use and number of registrants for 27 registries (68%). Most registries are nationally operated and government-owned. Registrations in five nations expire and require renewal. Some registries provide the option to make specific organ selections in the donation decision. Just over half of donor registries provide legally binding authorization to donation. In all national donor registries, except one, the proportion of adults (15+) registered is modest (<40%). These proportions can be even lower when only affirmative decisions are considered. One nation provides priority status on the transplant waiting list as an incentive to affirmative registration, while another nation makes registering a donation decision mandatory to obtain a driver's license. Registered objections in non-donor registries are rare (<0.5%). The variation in organ donor registries worldwide necessitates public discourse and quality improvement initiatives, to identify and support leading practices in registry use. PMID:22507140

  11. Worldwide status of burbot and conservation measures

    USGS Publications Warehouse

    Stapanian, Martin A.; Paragamian, Vaughn L.; Madenjian, Charles P.; Jackson, James R.; Lappalainen, Jyrki; Evenson, Matthew J.; Neufeld, Matthew D.

    2010-01-01

    Although burbot (Lota lota Gadidae) are widespread and abundant throughout much of their natural range, there are many populations that have been extirpated, endangered or are in serious decline. Due in part to the species’ lack of popularity as a game and commercial fish, few regions consider burbot in management plans. We review the worldwide population status of burbot and synthesize reasons why some burbot populations are endangered or declining, some burbot populations have recovered and some burbot populations do not recover despite management measures. Burbot have been extirpated in much of Western Europe and the United Kingdom and are threatened or endangered in much of North America and Eurasia. Pollution and habitat change, particularly the effects of dams, appear to be the main causes for declines in riverine burbot populations. Pollution and the adverse effects of invasive species appear to be the main reasons for declines in lacustrine populations. Warmer water temperatures, due either to discharge from dams or climate change, have been noted in declining burbot populations at the southern extent of their range. Currently, fishing pressure does not appear to be limiting burbot populations world-wide. We suggest mitigation measures for burbot population recovery, particularly those impacted by dams and invasive species.

  12. Estimating the worldwide extent of illegal fishing.

    PubMed

    Agnew, David J; Pearce, John; Pramod, Ganapathiraju; Peatman, Tom; Watson, Reg; Beddington, John R; Pitcher, Tony J

    2009-01-01

    Illegal and unreported fishing contributes to overexploitation of fish stocks and is a hindrance to the recovery of fish populations and ecosystems. This study is the first to undertake a world-wide analysis of illegal and unreported fishing. Reviewing the situation in 54 countries and on the high seas, we estimate that lower and upper estimates of the total value of current illegal and unreported fishing losses worldwide are between $10 bn and $23.5 bn annually, representing between 11 and 26 million tonnes. Our data are of sufficient resolution to detect regional differences in the level and trend of illegal fishing over the last 20 years, and we can report a significant correlation between governance and the level of illegal fishing. Developing countries are most at risk from illegal fishing, with total estimated catches in West Africa being 40% higher than reported catches. Such levels of exploitation severely hamper the sustainable management of marine ecosystems. Although there have been some successes in reducing the level of illegal fishing in some areas, these developments are relatively recent and follow growing international focus on the problem. This paper provides the baseline against which successful action to curb illegal fishing can be judged.

  13. Eosinophilic Gastroenteritis: Case Report and Review in Search for Diagnostic Key Points

    PubMed Central

    López-Medina, Guillermo; Gallo, Manuel; Prado, Alejandro; Vicuña-Honorato, Iliana; Castillo Díaz de León, Roxana

    2015-01-01

    Eosinophilic gastroenteritis is considered an uncommon disease with a low incidence rate that remains as a diagnostic challenge for the clinician, in spite of the fact that seventy years have passed since its original description. Hereby we present the case of a 29-year-old male without history of allergies who was evaluated for unspecific gastrointestinal symptoms, without relevant findings on physical examination and presenting an initial complete blood count (CBC) with severe eosinophilia. The patient was evaluated and the diagnosis of eosinophilic gastroenteritis was confirmed by histopathological findings. The relevance of the case resides in highlighting the lack of guidelines or consensus for histological diagnosis being virtually the only one available. To a similar extent, treatment evidence is based on case series with a reasonable number of patients and case reports. PMID:26075112

  14. The effect of rotavirus immunization on rotavirus gastroenteritis hospitalization rates in military dependents.

    PubMed

    Eberly, Matthew D; Gorman, Greg H; Eide, Matilda B; Olsen, Cara H; Rajnik, Michael

    2011-01-17

    We conducted a retrospective review of all U.S. military dependents less than 5 years old hospitalized with rotavirus-associated gastroenteritis from July 2003 to June 2009. The two post-vaccine seasons showed a significant reduction of 62.4% (95% CI, 58.6-65.8, P<0.001) in rotavirus gastroenteritis hospitalization rate compared to the three pre-vaccine seasons. Infants less than 12 months old showed the greatest reduction in incidence at 75.3%. A substantial decrease was also seen in unvaccinated children as well. Vaccine efficacy against hospitalization was 86.0% (95% CI, 77.7-91.3) after just a single dose. The overwhelming majority of children hospitalized for rotavirus since the introduction of the vaccine (ranging from 91.8 to 100% per season) had not received any of the rotavirus vaccine series.

  15. Use of monoclonal antibodies in blocking ELISA detection of transmissible gastroenteritis virus in faeces of piglets.

    PubMed

    Rodák, L; Smíd, B; Nevoránková, Z; Valícek, L; Smítalová, R

    2005-04-01

    Monoclonal antibodies (mAb) to the transmissible gastroenteritis virus (TGEV) nucleoprotein (N) and membrane protein (M) were prepared and used for the comparative assessment of three blocking ELISA variants to detect TGEV. The competitive blocking ELISA format showed the highest sensitivity, allowing detection of 10(3) TCID50 TGEV/ml in culture medium. Ninety-nine porcine field faecal samples obtained from 37 herds affected with diarrhoea were examined, and various TGEV levels were found in nine samples from six herds. However, only in three samples were significant TGEV concentrations demonstrated. The relationship between incidence of TGEV gastroenteritis and the spread of porcine respiratory coronavirus infection in pig farms is discussed.

  16. Vibrio gastroenteritis in the US Gulf of Mexico region: the role of raw oysters.

    PubMed

    Altekruse, S F; Bishop, R D; Baldy, L M; Thompson, S G; Wilson, S A; Ray, B J; Griffin, P M

    2000-06-01

    We examined clinical and epidemiological features of 575 laboratory-confirmed cases of vibrio gastroenteritis in Alabama, Florida, Louisiana, and Texas from 1988 to 1997 (the US Gulf of Mexico Regional Vibrio Surveillance System). Illnesses occurred year round, with peaks in spring and autumn. Illnesses lasted a median of 7 days and included fever in half of patients and bloody stools in 25% of patients with relevant information. Seventy-two percent of patients reported no underlying illnesses. In the week before onset, 236 (53%) of 445 patients for whom data were available ate raw oysters, generally at a restaurant or bar. Educational efforts should address the risk of vibrio gastroenteritis for raw oyster consumers, including healthy individuals. Further studies should examine environmental conditions affecting vibrio counts on seafood and processing technologies to enhance the safety of raw oysters. PMID:10982073

  17. Investigation of Stilbenoids as Potential Therapeutic Agents for Rotavirus Gastroenteritis.

    PubMed

    Ball, Judith M; Medina-Bolivar, Fabricio; Defrates, Katelyn; Hambleton, Emily; Hurlburt, Megan E; Fang, Lingling; Yang, Tianhong; Nopo-Olazabal, Luis; Atwill, Richard L; Ghai, Pooja; Parr, Rebecca D

    2015-01-01

    Rotavirus (RV) infections cause severe diarrhea in infants and young children worldwide. Vaccines are available but cost prohibitive for many countries and only reduce severe symptoms. Vaccinated infants continue to shed infectious particles, and studies show decreased efficacy of the RV vaccines in tropical and subtropical countries where they are needed most. Continuing surveillance for new RV strains, assessment of vaccine efficacy, and development of cost effective antiviral drugs remain an important aspect of RV studies. This study was to determine the efficacy of antioxidant and anti-inflammatory stilbenoids to inhibit RV replication. Peanut (A. hypogaea) hairy root cultures were induced to produce stilbenoids, which were purified by high performance countercurrent chromatography (HPCCC) and analyzed by HPLC. HT29.f8 cells were infected with RV in the presence stilbenoids. Cell viability counts showed no cytotoxic effects on HT29.f8 cells. Viral infectivity titers were calculated and comparatively assessed to determine the effects of stilbenoid treatments. Two stilbenoids, trans-arachidin-1 and trans-arachidin-3, show a significant decrease in RV infectivity titers. Western blot analyses performed on the infected cell lysates complemented the infectivity titrations and indicated a significant decrease in viral replication. These studies show the therapeutic potential of the stilbenoids against RV replication.

  18. Group A rotavirus gastroenteritis: post-vaccine era, genotypes and zoonotic transmission

    PubMed Central

    Luchs, Adriana; Timenetsky, Maria do Carmo Sampaio Tavares

    2016-01-01

    ABSTRACT This article provides a review of immunity, diagnosis, and clinical aspects of rotavirus disease. It also informs about the changes in epidemiology of diarrheal disease and genetic diversity of circulating group A rotavirus strains following the introduction of vaccines. Group A rotavirus is the major pathogen causing gastroenteritis in animals. Its segmented RNA genome can lead to the emergence of new or unusual strains in human populations via interspecies transmission and/or reassortment events. PMID:27462899

  19. Comparison of frequency of inflammatory bowel disease and noninfectious gastroenteritis among statin users versus nonusers.

    PubMed

    Khalil, Dina; Boktor, Moheb; Mortensen, Eric M; Frei, Christopher R; Mansi, Ishak

    2015-05-15

    Conflicting data exist regarding the effects of statin therapy on the prevalence of inflammatory bowel diseases. We aimed to examine the association of statin therapy with diagnoses of inflammatory bowel diseases and noninfectious gastroenteritis. This is a retrospective study using data of a military health care system from October 1, 2003, to March 1, 2012. Based on medication fills during fiscal year 2005, patients were divided into: (1) statin users (received at least 90-day supply of statin) and (2) nonusers (never received a statin). A propensity score-matched cohort of statin users and nonusers was created using 80 variables. Primary analysis examined the risks of being diagnosed with inflammatory bowel diseases and noninfectious gastroenteritis between statin users and nonusers in the propensity score-matched cohort. Secondary analyses examined the risk of outcomes in the whole cohort and in patients with no comorbidities according to Charlson Comorbidity Index. Of 43,438 patients meeting study criteria (13,626 statin users and 29,812 nonusers), we propensity score matched 6,342 statin users with 6,342 nonusers. For our primary analysis, 93 statin users and 92 nonusers were diagnosed with inflammatory bowel diseases (odds ratio = 1.01, 95% confidence interval = 0.76 to 1.35), and 632 statin users and 619 nonusers were diagnosed of noninfectious gastroenteritis (odds ratio = 1.02, 95% confidence interval = 0.91 to 1.15). In conclusion, the risks of inflammatory bowel diseases and noninfectious gastroenteritis among statin users and nonusers are similar after adjusting for other potential confounding factors.

  20. Prevalence of enteric pathogen-associated community gastroenteritis among kindergarten children in Gaza.

    PubMed

    Laham, Nahed Al; Elyazji, Mansour; Al-Haddad, Rohaifa; Ridwan, Fouad

    2015-01-01

    Gastroenteritis is considered as one of the leading causes of illness and death in children under 5 years age, especially in developing countries. It is one of the major public health problems among childhood in Gaza strip, Palestine. This study was conducted to determine the prevalence of enteric pathogen-associated community gastroenteritis among kindergarten children in Gaza. A total of 150 stool samples were collected and investigated for parasitic, viral and bacterial pathogens at Al Azhar microbiology laboratories by using standard microbiological and serological procedures. Out of the 150 study samples, the overall percentage of positive stool samples with a known enteric pathogen was 60.6%. The prevalence of different enteric pathogens causing community gastroenteritis among symptomatic cases (88.5%) was significantly higher than the prevalence in asymptomatic carriage (11.1%). The most prevalent isolated enteric pathogens were Entamoeba histolytica (28.0%) and Giardia lamblia (26.7%). Rotavirus was found in 3.1% of symptomatic cases but not detected in asymptomatic carriage. However, adenovirus type 40 and 41 were not detected in any of the study samples. The bacterial enteric pathogens Shigella and Enterohemorrhagic Escherichia coli O157:H7 (EHEC) have comparable occurrence as rotavirus (3.1%), meanwhile, Salmonella was not isolated. Mixed infection with more than 1 pathogen was found (11.4%) only among symptomatic cases. Children aged 3-year-old showed the highest prevalence of community gastroenteritis. This study demonstrates a high prevalence of parasitic enteropathogens and a relatively low prevalence of bacterial and viral enteropathogens among kindergarten children living in Gaza city, moreover, children aged 3 years old showed the highest prevalence of isolated enteropathogens.

  1. Factors affecting prevention and control of viral gastroenteritis outbreaks in care homes.

    PubMed

    Vivancos, R; Trainor, E; Oyinloye, A; Keenan, A

    2012-10-01

    We assess the effect of key care quality indicators on viral gastroenteritis outbreaks and control in care homes using mandatory inspection data collected by a non-departmental public body. Outbreak occurrence was associated with care home size but not with overall quality or individual environmental standards. Care home size, hygiene and infection control standard scores were inversely associated with attack rate in residents, whereas delayed reporting to the local public health agency was associated with higher attack rates.

  2. A large waterborne gastroenteritis outbreak in central Greece, March 2012: challenges for the investigation and management.

    PubMed

    Mellou, K; Katsioulis, A; Potamiti-Komi, M; Pournaras, S; Kyritsi, M; Katsiaflaka, A; Kallimani, A; Kokkinos, P; Petinaki, E; Sideroglou, T; Georgakopoulou, T; Vantarakis, A; Hadjichristodoulou, C

    2014-01-01

    In March 2012, there was an unusual increase of gastroenteritis cases in a district with 37,264 inhabitants in central Greece. It was estimated that more than 3600 people developed symptoms. A 1:1 case-control study showed that consumption of tap water was a risk factor for acquiring infection [odds ratio (OR) 2.18, 95% confidence interval (CI) 1.11-4.28]. Descriptive data, low gastroenteritis incidence in adjacent areas with different water supply systems, and water-quality data further supported the hypothesis of a waterborne outbreak. Thirty-eight stool samples were positive for rotavirus. Bacterial indicators of recent faecal contamination were detected in samples from the water source and ice cubes from a local production enterprise. Molecular epidemiology of rotavirus strains, apart from the common strain, G3[P8], identified the unusual G/P combination G2P[8]. Water sanitation measures contributed to the control of the outbreak. This outbreak demonstrated the need for the cooperation of laboratories with different expertise and the importance of early notification of waterborne gastroenteritis outbreaks. PMID:23632123

  3. Metagenomic analysis of viruses in feces from unsolved outbreaks of gastroenteritis in humans.

    PubMed

    Moore, Nicole E; Wang, Jing; Hewitt, Joanne; Croucher, Dawn; Williamson, Deborah A; Paine, Shevaun; Yen, Seiha; Greening, Gail E; Hall, Richard J

    2015-01-01

    The etiology of an outbreak of gastroenteritis in humans cannot always be determined, and ∼25% of outbreaks remain unsolved in New Zealand. It is hypothesized that novel viruses may account for a proportion of unsolved cases, and new unbiased high-throughput sequencing methods hold promise for their detection. Analysis of the fecal metagenome can reveal the presence of viruses, bacteria, and parasites which may have evaded routine diagnostic testing. Thirty-one fecal samples from 26 gastroenteritis outbreaks of unknown etiology occurring in New Zealand between 2011 and 2012 were selected for de novo metagenomic analysis. A total data set of 193 million sequence reads of 150 bp in length was produced on an Illumina MiSeq. The metagenomic data set was searched for virus and parasite sequences, with no evidence of novel pathogens found. Eight viruses and one parasite were detected, each already known to be associated with gastroenteritis, including adenovirus, rotavirus, sapovirus, and Dientamoeba fragilis. In addition, we also describe the first detection of human parechovirus 3 (HPeV3) in Australasia. Metagenomics may thus provide a useful audit tool when applied retrospectively to determine where routine diagnostic processes may have failed to detect a pathogen.

  4. Metagenomic Analysis of Viruses in Feces from Unsolved Outbreaks of Gastroenteritis in Humans

    PubMed Central

    Moore, Nicole E.; Wang, Jing; Hewitt, Joanne; Croucher, Dawn; Williamson, Deborah A.; Paine, Shevaun; Yen, Seiha; Greening, Gail E.

    2014-01-01

    The etiology of an outbreak of gastroenteritis in humans cannot always be determined, and ∼25% of outbreaks remain unsolved in New Zealand. It is hypothesized that novel viruses may account for a proportion of unsolved cases, and new unbiased high-throughput sequencing methods hold promise for their detection. Analysis of the fecal metagenome can reveal the presence of viruses, bacteria, and parasites which may have evaded routine diagnostic testing. Thirty-one fecal samples from 26 gastroenteritis outbreaks of unknown etiology occurring in New Zealand between 2011 and 2012 were selected for de novo metagenomic analysis. A total data set of 193 million sequence reads of 150 bp in length was produced on an Illumina MiSeq. The metagenomic data set was searched for virus and parasite sequences, with no evidence of novel pathogens found. Eight viruses and one parasite were detected, each already known to be associated with gastroenteritis, including adenovirus, rotavirus, sapovirus, and Dientamoeba fragilis. In addition, we also describe the first detection of human parechovirus 3 (HPeV3) in Australasia. Metagenomics may thus provide a useful audit tool when applied retrospectively to determine where routine diagnostic processes may have failed to detect a pathogen. PMID:25339401

  5. Climate Change Impacts on Worldwide Coffee Production

    NASA Astrophysics Data System (ADS)

    Foreman, T.; Rising, J. A.

    2015-12-01

    Coffee (Coffea arabica and Coffea canephora) plays a vital role in many countries' economies, providing necessary income to 25 million members of tropical countries, and supporting a $81 billion industry, making it one of the most valuable commodities in the world. At the same time, coffee is at the center of many issues of sustainability. It is vulnerable to climate change, with disease outbreaks becoming more common and suitable regions beginning to shift. We develop a statistical production model for coffee which incorporates temperature, precipitation, frost, and humidity effects using a new database of worldwide coffee production. We then use this model to project coffee yields and production into the future based on a variety of climate forecasts. This model can then be used together with a market model to forecast the locations of future coffee production as well as future prices, supply, and demand.

  6. Selection Signatures in Worldwide Sheep Populations

    PubMed Central

    Fariello, Maria-Ines; Servin, Bertrand; Tosser-Klopp, Gwenola; Rupp, Rachel; Moreno, Carole; Cristobal, Magali San; Boitard, Simon

    2014-01-01

    The diversity of populations in domestic species offers great opportunities to study genome response to selection. The recently published Sheep HapMap dataset is a great example of characterization of the world wide genetic diversity in sheep. In this study, we re-analyzed the Sheep HapMap dataset to identify selection signatures in worldwide sheep populations. Compared to previous analyses, we made use of statistical methods that (i) take account of the hierarchical structure of sheep populations, (ii) make use of linkage disequilibrium information and (iii) focus specifically on either recent or older selection signatures. We show that this allows pinpointing several new selection signatures in the sheep genome and distinguishing those related to modern breeding objectives and to earlier post-domestication constraints. The newly identified regions, together with the ones previously identified, reveal the extensive genome response to selection on morphology, color and adaptation to new environments. PMID:25126940

  7. Worldwide patterns of bird colouration on islands.

    PubMed

    Doutrelant, Claire; Paquet, Matthieu; Renoult, Julien P; Grégoire, Arnaud; Crochet, Pierre-André; Covas, Rita

    2016-05-01

    Island environments share distinctive characteristics that offer unique opportunities to investigate parallel evolution. Previous research has produced evidence of an island syndrome for morphological traits, life-history strategies and ecological niches, but little is known about the response to insularity of other important traits such as animal signals. Here, we tested whether birds' plumage colouration is part of the island syndrome. We analysed with spectrophotometry the colouration of 116 species endemic to islands and their 116 closest mainland relatives. We found a pattern of reduced brightness and colour intensity for both sexes on islands. In addition, we found a decrease in the number of colour patches on islands that, in males, was associated with a decrease in the number of same-family sympatric species. These results demonstrate a worldwide pattern of parallel colour changes on islands and suggest that a relaxation of selection on species recognition may be one of the mechanisms involved.

  8. Visually Exploring Worldwide Incidents Tracking System Data

    SciTech Connect

    Chhatwal, Shree D.; Rose, Stuart J.

    2008-01-27

    This paper presents refinements of an existing analytic tool, Juxter, which was developed for the visualization of multi-dimensional categorical data, and explores its application to support exploration and interaction with open source Worldwide Incidents Tracking System (WITS) data. The volume and complexity of data available on terrorism makes it hard to analyze. Information systems that can efficiently and effectively collect, access, analyze, and report terrorist incidents can help in further studies focused on preventing, detecting, and responding to terrorist attacks. Existing interfaces to the WITS data support advanced search capabilities, and geolocation but lack functionality for identifying patterns and trends. To better support efficient browsing we have refined Juxter’s existing capabilities for filtering, selecting, and sorting elements and categories within the visualization.

  9. World-wide aeronautical satellite communications

    NASA Technical Reports Server (NTRS)

    Wood, Peter; Smith, Keith

    1988-01-01

    INMARSAT decided to expand the spectrum covered by its new generation of satellites, INMARSAT-2, to include 1 MHz (subsequently increased to 3 MHz) of the spectrum designed for aeronautical use. It began a design study that led to the specifications for the system that is now being implemented. Subsequently, INMARSAT awarded contracts for the design of avionics and high gain antennas to a number of manufactures, while several of the signatories that provide ground equipment for communicating with the INMARSAT satellites are modifying their earth stations to work with the avionic equipment. As a resullt of these activities, a world-wide aeronautical satellite system supporting both voice and data will become operational in 1989.

  10. The worldwide epidemic of female obesity.

    PubMed

    Mitchell, Sheona; Shaw, Dorothy

    2015-04-01

    The rapidly rising number of individuals who are overweight and obese has been called a worldwide epidemic of obesity with >35% of adults today considered to be overweight or obese. Women are more likely to be overweight and obese than their male counterparts, which has far-reaching effects on reproductive health and specifically pregnancy, with obese women facing an increased risk of gestational diabetes, preeclampsia, operative delivery, fetal macrosomia, and neonatal morbidity. The etiology of obesity is highly complex encompassing genetic, environmental, physiologic, cultural, political, and socioeconomic factors, making it challenging to develop effective interventions on both a local and global scale. This article describes the extent and the cost of the obesity epidemic, which, although historically seen as a disease of high-income countries, is now clearly a global epidemic that impacts low- and middle-income countries and indigenous groups who bear an ever-increasing burden of this disease.

  11. CMS Centres Worldwide - a New Collaborative Infrastructure

    NASA Astrophysics Data System (ADS)

    Taylor, Lucas

    2011-12-01

    The CMS Experiment at the LHC has established a network of more than fifty inter-connected "CMS Centres" at CERN and in institutes in the Americas, Asia, Australasia, and Europe. These facilities are used by people doing CMS detector and computing grid operations, remote shifts, data quality monitoring and analysis, as well as education and outreach. We present the computing, software, and collaborative tools and videoconferencing systems. These include permanently running "telepresence" video links (hardware-based H.323, EVO and Vidyo), Webcasts, and generic Web tools such as CMS-TV for broadcasting live monitoring and outreach information. Being Web-based and experiment-independent, these systems could easily be extended to other organizations. We describe the experiences of using CMS Centres Worldwide in the CMS data-taking operations as well as for major media events with several hundred TV channels, radio stations, and many more press journalists simultaneously around the world.

  12. Cell therapy worldwide: an incipient revolution.

    PubMed

    Rao, Mahendra; Mason, Chris; Solomon, Susan

    2015-01-01

    The regenerative medicine field is large, diverse and active worldwide. A variety of different organizational and product models have been successful, and pioneering entrepreneurs have shown both what can work and, critically, what does not. Evolving regulations, novel funding mechanisms combined with new technological breakthroughs are keeping the field in a state of flux. The field struggles to cope with the lack of infrastructure and investment, it nevertheless has evolved from its roots in human stem cell therapy and tissue and organ transplants to a field composed of a variety of products from multiple cell sources with approval for use in numerous countries. Currently, tens of thousands of patients have been treated with some kind of cell therapy. PMID:25835482

  13. Worldwide clustering of the corruption perception

    NASA Astrophysics Data System (ADS)

    Paulus, Michal; Kristoufek, Ladislav

    2015-06-01

    We inspect a possible clustering structure of the corruption perception among 134 countries. Using the average linkage clustering, we uncover a well-defined hierarchy in the relationships among countries. Four main clusters are identified and they suggest that countries worldwide can be quite well separated according to their perception of corruption. Moreover, we find a strong connection between corruption levels and a stage of development inside the clusters. The ranking of countries according to their corruption perfectly copies the ranking according to the economic performance measured by the gross domestic product per capita of the member states. To the best of our knowledge, this study is the first one to present an application of hierarchical and clustering methods to the specific case of corruption.

  14. Mutated G4P[8] rotavirus associated with a nationwide outbreak of gastroenteritis in Nicaragua in 2005.

    PubMed

    Bucardo, Filemon; Karlsson, Beatrice; Nordgren, Johan; Paniagua, Margarita; González, Alcides; Amador, Juan Jose; Espinoza, Felix; Svensson, Lennart

    2007-03-01

    During February and March 2005, one of the largest national recorded outbreaks of severe acute gastroenteritis occurred in Nicaragua, affecting >or=64,000 individuals and causing >or=56 deaths, predominantly in children under 5 years of age. Through a nationwide laboratory-based study, stool samples were collected and investigated for rotavirus. Of 108 stool samples examined, 72 (67%) were positive for rotavirus. While 69% (50/72) of the positive samples were found in children less than 2 years of age, 50% (6/12) of the adult samples were positive. A mutated G4P[8] strain was the most commonly recognized strain (85%), followed by mixed G strains (8%) and G9P[8] (7%) strains. Phylogenetic analysis of the VP7 gene revealed that the G4 strains belonged to the emerging lineage Ic and was distantly related to the ST3 and VA70 G4 strains. Secondary structure predictions of the VP7 G4 protein revealed an insert of an asparagine residue in position 76, which, combined with additional mutations, surprisingly modified two downstream beta-sheets at amino acid positions 80 to 85 and 115 to 119. The 2005 G4P[8] strain compared to a G4P[8] strain from 2002 had a substitution of an asparagine residue for threonine (Asn-->Thr) at position 96 within antigenic region A, thus eliminating a potential glycosylation site. The mutated G4 virus was introduced in Nicaragua after 2002 and probably emerged from Brazil, Argentina, or Uruguay.

  15. Mutated G4P[8] Rotavirus Associated with a Nationwide Outbreak of Gastroenteritis in Nicaragua in 2005▿

    PubMed Central

    Bucardo, Filemon; Karlsson, Beatrice; Nordgren, Johan; Paniagua, Margarita; González, Alcides; Amador, Juan Jose; Espinoza, Felix; Svensson, Lennart

    2007-01-01

    During February and March 2005, one of the largest national recorded outbreaks of severe acute gastroenteritis occurred in Nicaragua, affecting ≥64,000 individuals and causing ≥56 deaths, predominantly in children under 5 years of age. Through a nationwide laboratory-based study, stool samples were collected and investigated for rotavirus. Of 108 stool samples examined, 72 (67%) were positive for rotavirus. While 69% (50/72) of the positive samples were found in children less than 2 years of age, 50% (6/12) of the adult samples were positive. A mutated G4P[8] strain was the most commonly recognized strain (85%), followed by mixed G strains (8%) and G9P[8] (7%) strains. Phylogenetic analysis of the VP7 gene revealed that the G4 strains belonged to the emerging lineage Ic and was distantly related to the ST3 and VA70 G4 strains. Secondary structure predictions of the VP7 G4 protein revealed an insert of an asparagine residue in position 76, which, combined with additional mutations, surprisingly modified two downstream β-sheets at amino acid positions 80 to 85 and 115 to 119. The 2005 G4P[8] strain compared to a G4P[8] strain from 2002 had a substitution of an asparagine residue for threonine (Asn→Thr) at position 96 within antigenic region A, thus eliminating a potential glycosylation site. The mutated G4 virus was introduced in Nicaragua after 2002 and probably emerged from Brazil, Argentina, or Uruguay. PMID:17229854

  16. Norwalk-like virus and bacterial pathogens associated with cases of gastroenteritis onboard a US Navy ship.

    PubMed

    Oyofo, B A; Soderquist, R; Lesmana, M; Subekti, D; Tjaniadi, P; Fryauff, D J; Corwin, A L; Richie, E; Lebron, C

    1999-12-01

    Acute gastroenteritis is a potential cause of substantial morbidity in U.S. military personnel during deployment. This study investigated the microbial causes of diarrhea in U.S. troops on exercises in Southeast Asia aboard the U.S.S. Germantown from March through May 1996. A total of 49 (7%) patients with diarrhea reported to sick call during a 3-month deployment involving 721 personnel. Diarrheal samples from 49 patients were subjected to bacterial and parasitologic examination, but sufficient samples from only 47 of 49 were available for analysis of the presence of Norwalk-like virus (NLV). Of the 49 diarrhea cases, 10 (20.4%) appeared to be due to bacterial etiology alone, 10 (20.4%) due to bacteria and the prototype Taunton agent (TNA), 11 (22.4%) due to TNA only, and 4 (8.0%) due to parasites. Norwalk-like virus RNA was present in 21 (45%) of 47 stool samples from the diarrhea cases, 10 with bacterial etiologies and 11 without bacterial or parasitic etiologies. No pathogen was detected in 14 (29%) of the cases. Four of the controls showed the presence of parasitic organisms. Of the 11 cases in which enterotoxigenic Escherichia coli was isolated, 8 were positive for colonization factor antigen (CFA/IV), and 3 were CFA-negative. The bacterial pathogens tested were all susceptible to gentamicin, and furadantin, but were resistant to ceftriaxone and norfloxacin, including 75% of the Campylobacter spp. These data support the view that the major cause of diarrhea for troops deployed in this geographic area is most likely NLVs.

  17. Landfill aeration worldwide: Concepts, indications and findings

    SciTech Connect

    Ritzkowski, M.; Stegmann, R.

    2012-07-15

    Highlights: Black-Right-Pointing-Pointer Different landfill aeration concepts and accordant application areas are described. Black-Right-Pointing-Pointer Examples of full scale projects are provided for Europe, North-America and Asia. Black-Right-Pointing-Pointer Major project findings are summarised, including prospects and limitations. Black-Right-Pointing-Pointer Inconsistencies between laboratory and full scale results have been elaborated. Black-Right-Pointing-Pointer An explanatory approach in connection with the inconsistencies is provided. - Abstract: The creation of sustainable landfills is a fundamental goal in waste management worldwide. In this connection landfill aeration contributes towards an accelerated, controlled and sustainable conversion of conventional anaerobic landfills into a biological stabilized state associated with a minimised emission potential. The technology has been successfully applied to landfills in Europe, North America and Asia, following different strategies depending on the geographical region, the specific legislation and the available financial resources. Furthermore, methodologies for the incorporation of landfill aeration into the carbon trade mechanisms have been developed in recent years. This manuscript gives an overview on existing concepts for landfill aeration; their application ranges and specifications. For all of the described concepts examples from different countries worldwide are provided, including details regarding their potentials and limitations. Some of the most important findings from these aeration projects are summarised and future research needs have been identified. It becomes apparent that there is a great demand for a systematisation of the available results and implications in order to further develop and optimise this very promising technology. The IWWG (International Waste Working Group) Task Group 'Landfill Aeration' contributes towards the achievement of this goal.

  18. [Investigation of verotoxigenic Escherichia coli O157:H7 incidence in gastroenteritis patients].

    PubMed

    Erdoğan, Haluk; Levent, Belkıs; Erdoğan, Aşkın; Güleşen, Revasiye; Arslan, Hande

    2011-07-01

    Escherichia coli O157:H7 is the most common serotype among verotoxigenic E.coli (VTEC) strains that cause haemolytic uremic syndrome. Although sporadic VTEC cases originating from Turkey and small outbreaks have been reported from our country, VTEC has not been routinely investigated in most of the diagnostic microbiology laboratories in Turkey and studies related to this topic are limited. In this study, the incidence of E.coli O157:H7 in patients who were admitted to Alanya Research and Application Hospital of Baskent University with the complaints of acute gastroenteritis between September 2005 and September 2008, was investigated. Stool samples collected from 1815 diarrheal patients (of them 50.5% were male; 49.3% were ? 5 years old; 10.2% were tourists) were evaluated initially by direct microscopy and then inoculated to hectoen enteric agar, EMB agar, Skirrow agar and cefixime tellurite sorbitol MacConkey (CT-SMC) agar media for cultivation. The sorbitol-negative colonies which were compatible with E.coli according to the conventional methods were tested with E.coli polyvalent and 0157 and H7 monovalent antisera and agglutination positive strains were also investigated for verotoxin production in Vero cell cultures. VTEC RPLA toxin detection kit (Oxoid, UK) was used for further identification of toxin type of verotoxin positive strains. Fecal leukocytes were detected in 41.3% of the samples in direct microscopy, while 27% (173/639) of the samples were also found positive for amoeba antigen, 6% (24/396) for rotavirus antigen, 1.2% (22/1815) for Salmonella spp., 0.6% (11/1815) for Shigella spp., 0.2% (4/1815) for Giardia trophozoites and 0.06% (1/1815) for Campylobacter jejuni. The isolation rate of sorbitol-negative E.coli strains was %0.8 (14/1815), and two of them were identified as E.coli O157:H7 by monovalent antisera, and both of them were determined as verotoxin-producers in cell culture. Verotoxin types of those isolates were found as verotoxin 1 in one

  19. Cystitis - acute

    MedlinePlus

    Uncomplicated urinary tract infection; UTI - acute; Acute bladder infection; Acute bacterial cystitis ... International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 ...

  20. [Investigation of seven different RNA viruses associated with gastroenteritis in children under five years old].

    PubMed

    Akhter, Shamim; Turegun, Buse; Kiyan, Mehmet; Gerceker, Devran; Guriz, Haluk; Sahin, Fikret

    2014-04-01

    Viruses are the most frequently detected etiologic agents of gastroenteritis seen in small children. In addition to classical gastroenteritis viruses namely rotavirus, norovirus, adenovirus type 40/41, astrovirus and sapovirus, some novel picornaviruses (Aichi virus, parechovirus, enterovirus) that have been identified in parallel to the developments in molecular diagnostic methods, thought to be associated with diarrhea in humans. However, the data are not enough to prove their actual roles in the pathogenesis of gastroenteritis. The aim of this study was to investigate the presence of rotavirus, norovirus, sapovirus, astrovirus, Aichi virus, parechovirus and enterovirus in the stool samples of children with diarrhoea by reverse-transcriptase polymerase chain reaction (RT-PCR). A total of 50 samples from children admitted to our hospital with diarrhoea between June-December 2012 were included in the study. All the patients were under 5 years of age. Routine bacteriological and parasitological examinations of the patients' stool samples were negative. Total RNAs were extracted from each of the samples and cDNAs were obtained by reverse transcription. All cDNAs were investigated first with the internal control (IC) using PCR. Thirty-one of the 50 cDNAs (62%) were found IC positive. Those 31 samples were further investigated in terms of rotavirus group A and C, norovirus (NoV) genogroup GI and GII, sapovirus, astrovirus, Aichi virus, parechovirus and enterovirus by PCR using specific primer pairs. The predicted sized PCR products obtained were cloned into the pBSK cloning vector and were sequenced. Sequences obtained were subjected to a BLAST search with registered sequences in the GenBank database for the confirmation of the PCR product. Out of 31 RNA positive stool specimens, 12 (38.7%) were found positive for five types of the target viruses. NoV GII (6/31, 19.3%) were detected as the most prevalent virus, followed by NoV GI (2/31, 6.5%), rotavirus group A (2

  1. Healthcare utilization and lost productivity due to infectious gastroenteritis, results from a national cross-sectional survey Australia 2008-2009.

    PubMed

    Chen, Y; Ford, L; Hall, G; Dobbins, T; Kirk, M

    2016-01-01

    The aim of this study was to estimate the healthcare usage and loss of productivity due to gastroenteritis in Australia using the National Gastroenteritis Survey II. In 2008-2009, 7578 participants across Australia were surveyed about infectious gastroenteritis by telephone interview. A gastroenteritis case was defined as a person experiencing ⩾ 3 loose stools and/or ⩾ 2 vomits in a 24-h period, excluding cases with a non-infectious cause for their symptoms, such as pregnancy or consumption of alcohol. Lost productivity was considered any lost time from full- or part-time paid work due to having gastroenteritis or caring for someone with the illness. Interference with other daily activities was also examined along with predictors of healthcare-seeking practices using multivariable regression. Results were weighted to obtain nationally representative estimates using Stata v. 13·1. Of the 341 cases, 52 visited a doctor due to gastroenteritis, 126 reported taking at least one medication for their symptoms and 79 cases reported missing ⩾ 1 days' paid work due to gastroenteritis. Gastroenteritis results in a total of 13·1 million (95% confidence interval 6·7-19·5) days of missed paid work each year in Australia. The indirect costs of gastroenteritis are significant, particularly from lost productivity.

  2. Outlook on a Worldwide Forest Transition

    PubMed Central

    Pagnutti, Chris; Bauch, Chris T.; Anand, Madhur

    2013-01-01

    It is not clear whether a worldwide “forest transition” to net reforestation will ever occur, and the need to address the main driver–agriculture–is compelling. We present a mathematical model of land use dynamics based on the world food equation that explains historical trends in global land use on the millennial scale. The model predicts that a global forest transition only occurs under a small and very specific range of parameter values (and hence seems unlikely) but if it does occur, it would have to occur within the next 70 years. In our baseline scenario, global forest cover continues to decline until it stabilizes within the next two centuries at 22% of global land cover, and wild pasture at 1.4%. Under other scenarios the model predicts unanticipated dynamics wherein a forest transition may relapse, heralding a second era of deforestation; this brings into question national-level forest transitions observed in recent decades, and suggests we need to expand our lexicon of possibilities beyond the simple “forest transition/no forest transition” dichotomy. This research also underscores that the challenge of feeding a growing population while conserving natural habitat will likely continue for decades to come. PMID:24130750

  3. CMS centres worldwide: A new collaborative infrastructure

    SciTech Connect

    Taylor, Lucas; Gottschalk, Erik; /Fermilab

    2010-01-01

    The CMS Experiment at the LHC is establishing a global network of inter-connected 'CMS Centres' for controls, operations and monitoring. These support: (1) CMS data quality monitoring, detector calibrations, and analysis; and (2) computing operations for the processing, storage and distribution of CMS data. We describe the infrastructure, computing, software, and communications systems required to create an effective and affordable CMS Centre. We present our highly successful operations experiences with the major CMS Centres at CERN, Fermilab, and DESY during the LHC first beam data-taking and cosmic ray commissioning work. The status of the various centres already operating or under construction in Asia, Europe, Russia, South America, and the USA is also described. We emphasise the collaborative communications aspects. For example, virtual co-location of experts in CMS Centres Worldwide is achieved using high-quality permanently-running 'telepresence' video links. Generic Web-based tools have been developed and deployed for monitoring, control, display management and outreach.

  4. Worldwide phylogenetic relationship of avian poxviruses

    USGS Publications Warehouse

    Gyuranecz, Miklós; Foster, Jeffrey T.; Dán, Ádám; Ip, Hon S.; Egstad, Kristina F.; Parker, Patricia G.; Higashiguchi, Jenni M.; Skinner, Michael A.; Höfle, Ursula; Kreizinger, Zsuzsa; Dorrestein, Gerry M.; Solt, Szabolcs; Sós, Endre; Kim, Young Jun; Uhart, Marcela; Pereda, Ariel; González-Hein, Gisela; Hidalgo, Hector; Blanco, Juan-Manuel; Erdélyi, Károly

    2013-01-01

    Poxvirus infections have been found in 230 species of wild and domestic birds worldwide in both terrestrial and marine environments. This ubiquity raises the question of how infection has been transmitted and globally dispersed. We present a comprehensive global phylogeny of 111 novel poxvirus isolates in addition to all available sequences from GenBank. Phylogenetic analysis of Avipoxvirus genus has traditionally relied on one gene region (4b core protein). In this study we have expanded the analyses to include a second locus (DNA polymerase gene), allowing for a more robust phylogenetic framework, finer genetic resolution within specific groups and the detection of potential recombination. Our phylogenetic results reveal several major features of avipoxvirus evolution and ecology and propose an updated avipoxvirus taxonomy, including three novel subclades. The characterization of poxviruses from 57 species of birds in this study extends the current knowledge of their host range and provides the first evidence of the phylogenetic effect of genetic recombination of avipoxviruses. The repeated occurrence of avian family or order-specific grouping within certain clades (e.g. starling poxvirus, falcon poxvirus, raptor poxvirus, etc.) indicates a marked role of host adaptation, while the sharing of poxvirus species within prey-predator systems emphasizes the capacity for cross-species infection and limited host adaptation. Our study provides a broad and comprehensive phylogenetic analysis of the Avipoxvirus genus, an ecologically and environmentally important viral group, to formulate a genome sequencing strategy that will clarify avipoxvirus taxonomy.

  5. Small world picture of worldwide seismic events

    NASA Astrophysics Data System (ADS)

    Ferreira, Douglas S. R.; Papa, Andrés R. R.; Menezes, Ronaldo

    2014-08-01

    The understanding of long-distance relations between seismic activities has for long been of interest to seismologists and geologists. In this paper we have used data from the worldwide earthquake catalog for the period between 1972 and 2011 to generate a network of sites around the world for earthquakes with magnitude m≥4.5 in the Richter scale. After the network construction, we have analyzed the results under two viewpoints. First, in contrast to previous works, which have considered just small areas, we showed that the best fitting for networks of seismic events is not a pure power law, but a power law with exponential cutoff; we also have found that the global network presents small-world properties. Second, we have found that the time intervals between successive earthquakes have a cumulative probability distribution well fitted by nontraditional functional forms. The implications of our results are significant because they seem to indicate that seisms around the world are not independent. In this paper we provide evidence to support this argument.

  6. Human water consumption intensifies hydrological drought worldwide

    NASA Astrophysics Data System (ADS)

    Wada, Yoshihide; van Beek, Ludovicus P. H.; Wanders, Niko; Bierkens, Marc F. P.

    2013-09-01

    Over the past 50 years, human water use has more than doubled and affected streamflow over various regions of the world. However, it remains unclear to what degree human water consumption intensifies hydrological drought (the occurrence of anomalously low streamflow). Here, we quantify over the period 1960-2010 the impact of human water consumption on the intensity and frequency of hydrological drought worldwide. The results show that human water consumption substantially reduced local and downstream streamflow over Europe, North America and Asia, and subsequently intensified the magnitude of hydrological droughts by 10-500%, occurring during nation- and continent-wide drought events. Also, human water consumption alone increased global drought frequency by 27 (±6)%. The intensification of drought frequency is most severe over Asia (35 ± 7%), but also substantial over North America (25 ± 6%) and Europe (20 ± 5%). Importantly, the severe drought conditions are driven primarily by human water consumption over many parts of these regions. Irrigation is responsible for the intensification of hydrological droughts over the western and central US, southern Europe and Asia, whereas the impact of industrial and households’ consumption on the intensification is considerably larger over the eastern US and western and central Europe. Our findings reveal that human water consumption is one of the more important mechanisms intensifying hydrological drought, and is likely to remain as a major factor affecting drought intensity and frequency in the coming decades.

  7. Reference worldwide model for antineutrinos from reactors

    NASA Astrophysics Data System (ADS)

    Baldoncini, Marica; Callegari, Ivan; Fiorentini, Giovanni; Mantovani, Fabio; Ricci, Barbara; Strati, Virginia; Xhixha, Gerti

    2015-03-01

    Antineutrinos produced at nuclear reactors constitute a severe source of background for the detection of geoneutrinos, which bring to the Earth's surface information about natural radioactivity in the whole planet. In this framework, we provide a reference worldwide model for antineutrinos from reactors, in view of reactors operational records yearly published by the International Atomic Energy Agency. We evaluate the expected signal from commercial reactors for ongoing (KamLAND and Borexino), planned (SNO +), and proposed (Juno, RENO-50, LENA, and Hanohano) experimental sites. Uncertainties related to reactor antineutrino production, propagation, and detection processes are estimated using a Monte Carlo-based approach, which provides an overall site-dependent uncertainty on the signal in the geoneutrino energy window on the order of 3%. We also implement the off-equilibrium correction to the reference reactor spectra associated with the long-lived isotopes, and we estimate a 2.4% increase of the unoscillated event rate in the geoneutrino energy window due to the storage of spent nuclear fuels in the cooling pools. We predict that the research reactors contribute to less than 0.2% to the commercial reactor signal in the investigated 14 sites. We perform a multitemporal analysis of the expected reactor signal over a time lapse of ten years using reactor operational records collected in a comprehensive database published at www.fe.infn.it/antineutrino.

  8. Registries in systemic sclerosis: a worldwide experience.

    PubMed

    Galluccio, Felice; Walker, Ulrich A; Nihtyanova, Svetlana; Moinzadeh, Pia; Hunzelmann, Nicholas; Krieg, Thomas; Steen, Virginia; Baron, Murray; Sampaio-Barros, Percival; Kayser, Cristiane; Nash, Peter; Denton, Chris P; Tyndall, Alan; Müller-Ladner, Ulf; Matucci-Cerinic, Marco

    2011-01-01

    SSc is a multisystem disease characterized by an unpredictable course, high mortality and resistance to therapy. The complexity and severity of SSc is a growing burden on the health-care systems. As a result, researchers are seeking new therapeutic strategies for effectively managing these patients. Disease registries are used to support care management efforts for groups of patients with chronic diseases and are meaningful to capture and track key patient information to assist the physicians in managing patients. For these reasons, SSc surveys, research associations and consortiums are pivotal to conduct ongoing research and data collection to enhance disease knowledge and support research projects. Currently, there are several national SSc registries in the UK, Germany, USA, Canada, Brazil and Australia. There is also an international registry established by the European League Against Rheumatism scleroderma trial and research (EUSTAR) called minimal essential data set (MEDS) Online, which collects data from over 8000 patients from 92 centres worldwide, including 21 European centres and 9 centres outside Europe. By collecting, analysing and disseminating data on disease progression and patient responses to long-term disease management strategies, registries help to improve understanding of the disease and keep medical professionals up to date on the latest advances. PMID:21148153

  9. Outlook on a worldwide forest transition.

    PubMed

    Pagnutti, Chris; Bauch, Chris T; Anand, Madhur

    2013-01-01

    It is not clear whether a worldwide "forest transition" to net reforestation will ever occur, and the need to address the main driver--agriculture--is compelling. We present a mathematical model of land use dynamics based on the world food equation that explains historical trends in global land use on the millennial scale. The model predicts that a global forest transition only occurs under a small and very specific range of parameter values (and hence seems unlikely) but if it does occur, it would have to occur within the next 70 years. In our baseline scenario, global forest cover continues to decline until it stabilizes within the next two centuries at 22% of global land cover, and wild pasture at 1.4%. Under other scenarios the model predicts unanticipated dynamics wherein a forest transition may relapse, heralding a second era of deforestation; this brings into question national-level forest transitions observed in recent decades, and suggests we need to expand our lexicon of possibilities beyond the simple "forest transition/no forest transition" dichotomy. This research also underscores that the challenge of feeding a growing population while conserving natural habitat will likely continue for decades to come. PMID:24130750

  10. Worldwide Phylogenetic Relationship of Avian Poxviruses

    PubMed Central

    Foster, Jeffrey T.; Dán, Ádám; Ip, Hon S.; Egstad, Kristina F.; Parker, Patricia G.; Higashiguchi, Jenni M.; Skinner, Michael A.; Höfle, Ursula; Kreizinger, Zsuzsa; Dorrestein, Gerry M.; Solt, Szabolcs; Sós, Endre; Kim, Young Jun; Uhart, Marcela; Pereda, Ariel; González-Hein, Gisela; Hidalgo, Hector; Blanco, Juan-Manuel; Erdélyi, Károly

    2013-01-01

    Poxvirus infections have been found in 230 species of wild and domestic birds worldwide in both terrestrial and marine environments. This ubiquity raises the question of how infection has been transmitted and globally dispersed. We present a comprehensive global phylogeny of 111 novel poxvirus isolates in addition to all available sequences from GenBank. Phylogenetic analysis of the Avipoxvirus genus has traditionally relied on one gene region (4b core protein). In this study we expanded the analyses to include a second locus (DNA polymerase gene), allowing for a more robust phylogenetic framework, finer genetic resolution within specific groups, and the detection of potential recombination. Our phylogenetic results reveal several major features of avipoxvirus evolution and ecology and propose an updated avipoxvirus taxonomy, including three novel subclades. The characterization of poxviruses from 57 species of birds in this study extends the current knowledge of their host range and provides the first evidence of the phylogenetic effect of genetic recombination of avipoxviruses. The repeated occurrence of avian family or order-specific grouping within certain clades (e.g., starling poxvirus, falcon poxvirus, raptor poxvirus, etc.) indicates a marked role of host adaptation, while the sharing of poxvirus species within prey-predator systems emphasizes the capacity for cross-species infection and limited host adaptation. Our study provides a broad and comprehensive phylogenetic analysis of the Avipoxvirus genus, an ecologically and environmentally important viral group, to formulate a genome sequencing strategy that will clarify avipoxvirus taxonomy. PMID:23408635

  11. Worldwide Geomagnetic Data Collection and Management

    NASA Astrophysics Data System (ADS)

    Mandea, Mioara; Papitashvili, Vladimir

    2009-11-01

    Geomagnetic data provided by different platforms piece together a global picture of Earth's magnetic field and its interaction with geospace. Furthermore, a great diversity of the geomagnetic field changes, from secular (over decades to centuries) to short time variations (down to minutes and seconds), can be detected only through continued observations. An international effort to watch and record geomagnetic changes first began in the 1830s with a network of scientific observers organized by Karl Friedrich Gauss in Germany, and this effort has continued since then. One of the most remarkable achievements in understanding the geomagnetic field morphology and time behavior was made possible by the International Geophysical Year (IGY), an exploration and research effort that lasted for 18 months, starting on 1 July 1957. The IGY encompassed 11 geoscience disciplines, including geomagnetism. The IGY has represented a giant step forward in the quality and quantity of worldwide geomagnetic measurements, as well as in the widespread interest in magnetic measurements. A half century of probing the geomagnetic field spatial and temporal variations has produced a number of outstanding results, and the interested reader can find recent reviews on various geomagnetic field topics (from measurements to modeling) in Encyclopedia of Geomagnetism and Paleomagnetism [Gubbins and Herrero-Bervera, 2007] or Treatise on Geophysics: Geomagnetism [Kono, 2007].

  12. Worldwide Genetic Analysis of the CFTR Region

    PubMed Central

    Mateu, Eva; Calafell, Francesc; Lao, Oscar; Bonné-Tamir, Batsheva; Kidd, Judith R.; Pakstis, Andrew; Kidd, Kenneth K.; Bertranpetit, Jaume

    2001-01-01

    Mutations at the cystic fibrosis transmembrane conductance regulator gene (CFTR) cause cystic fibrosis, the most prevalent severe genetic disorder in individuals of European descent. We have analyzed normal allele and haplotype variation at four short tandem repeat polymorphisms (STRPs) and two single-nucleotide polymorphisms (SNPs) in CFTR in 18 worldwide population samples, comprising a total of 1,944 chromosomes. The rooted phylogeny of the SNP haplotypes was established by typing ape samples. STRP variation within SNP haplotype backgrounds was highest in most ancestral haplotypes—although, when STRP allele sizes were taken into account, differences among haplotypes became smaller. Haplotype background determines STRP diversity to a greater extent than populations do, which indicates that haplotype backgrounds are older than populations. Heterogeneity among STRPs can be understood as the outcome of differences in mutation rate and pattern. STRP sites had higher heterozygosities in Africans, although, when whole haplotypes were considered, no significant differences remained. Linkage disequilibrium (LD) shows a complex pattern not easily related to physical distance. The analysis of the fraction of possible different haplotypes not found may circumvent some of the methodological difficulties of LD measure. LD analysis showed a positive correlation with locus polymorphism, which could partly explain the unusual pattern of similar LD between Africans and non-Africans. The low values found in non-Africans may imply that the size of the modern human population that emerged “Out of Africa” may be larger than what previous LD studies suggested. PMID:11104661

  13. Worldwide Spread of Dengue Virus Type 1

    PubMed Central

    Villabona-Arenas, Christian Julián; Zanotto, Paolo Marinho de Andrade

    2013-01-01

    Background DENV-1 is one of the four viral serotypes that causes Dengue, the most common mosquito-borne viral disease of humans. The prevalence of these viruses has grown in recent decades and is now present in more than 100 countries. Limited studies document the spread of DENV-1 over the world despite its importance for human health. Methodology/Principal Findings We used representative DENV-1 envelope gene sequences to unravel the dynamics of viral diffusion under a Bayesian phylogeographic approach. Data included strains from 45 distinct geographic locations isolated from 1944 to 2009. The estimated mean rate of nucleotide substitution was 6.56×10−4 substitutions/site/year. The larger genotypes (I, IV and V) had a distinctive phylogenetic structure and since 1990 they experienced effective population size oscillations. Thailand and Indonesia represented the main sources of strains for neighboring countries. Besides, Asia broadcast lineages into the Americas and the Pacific region that diverged in isolation. Also, a transmission network analysis revealed the pivotal role of Indochina in the global diffusion of DENV-1 and of the Caribbean in the diffusion over the Americas. Conclusions/Significance The study summarizes the spatiotemporal DENV-1 worldwide spread that may help disease control. PMID:23675416

  14. The worldwide costs of marine protected areas.

    PubMed

    Balmford, Andrew; Gravestock, Pippa; Hockley, Neal; McClean, Colin J; Roberts, Callum M

    2004-06-29

    Declines in marine harvests, wildlife, and habitats have prompted calls at both the 2002 World Summit on Sustainable Development and the 2003 World Parks Congress for the establishment of a global system of marine protected areas (MPAs). MPAs that restrict fishing and other human activities conserve habitats and populations and, by exporting biomass, may sustain or increase yields of nearby fisheries. Here we provide an estimate of the costs of a global MPA network, based on a survey of the running costs of 83 MPAs worldwide. Annual running costs per unit area spanned six orders of magnitude, and were higher in MPAs that were smaller, closer to coasts, and in high-cost, developed countries. Models extrapolating these findings suggest that a global MPA network meeting the World Parks Congress target of conserving 20-30% of the world's seas might cost between 5 billion and 19 billion US dollars annually to run and would probably create around one million jobs. Although substantial, gross network costs are less than current government expenditures on harmful subsidies to industrial fisheries. They also ignore potential private gains from improved fisheries and tourism and are dwarfed by likely social gains from increasing the sustainability of fisheries and securing vital ecosystem services.

  15. Worldwide supercritical power plants: Status and future

    SciTech Connect

    Gorokhov, V.A.; Ramezan, M.; Ruth, L.A.; Kim, S.S.

    1999-07-01

    During the last decade leading industrial countries initiated a new wave of research and development on supercritical (SC) steam power plants. This new interest is accompanied by the jump from SC steam parameters to ultra-supercritical (USC) parameters and was initiated mostly due to the increase in cost of fuel on the world market, and by increased environmental regulations including reduction of greenhouse gases. As a result, a significant number of new pulverized coal (PC) power units with increased efficiency and reduced emissions were installed in the last two decades, and a few more are planned to be installed in the near future. Different driving forces are responsible for development and implementation of highly efficient advanced PC-fired systems: need for new capacity, quality and cost of fuel, level of technology development, environmental requirements, and internal situation with regard to power supply (deregulation). For example, in Europe, Germany in particular, controlling CO{sub 2} is a major issue in any new installation, while in Japan economics is the major issue as the costs of imported fuels are high, and there are greater economic incentives for efficiency improvement. This paper discusses the status of existing and planned SC and USC power plants worldwide and their technical and environmental performance.

  16. Mixed Progress in Worldwide Fight Against HIV/AIDS

    MedlinePlus

    ... html Mixed Progress in Worldwide Fight Against HIV/AIDS Deaths continue 10-year decline, but new infections ... 19, 2016 (HealthDay News) -- The number of HIV/AIDS deaths worldwide each year has fallen since peaking ...

  17. Conservation Kickstart- Catalyzing Conservation Initiatives Worldwide

    NASA Astrophysics Data System (ADS)

    Treinish, G.

    2014-12-01

    Adventurers and Scientists for Conservation (ASC) is a nonprofit organization that collects environmental data to catalyze conservation initiatives worldwide. Adventure athletes have the skills and motivation to reach the most remote corners of the world. ASC utilizes those skills to provide the scientific community with data while providing the outdoor community with purpose beyond the personal high of reaching a summit or rowing across an ocean. We carefully select projects, choosing partnerships that will maximize the impact of ASC volunteers. Each project must have a clear path to a tangible conservation outcome and demonstrate a clear need for our brand of volunteers. We partner with government agencies, universities, and independant reseachers to kickstart data collection efforts around the world. Last year, through a partnership with the Olympic National Forest, 20 volunteers from the Seattle area set up and monitored camera traps in an effort to survey for costal Pacific marten. Our work led to the species' listing as "critically imperiled" with NatureServe. A partnership with the inaugural Great Pacific Race, engaging trans-Pacific rowing teams, searched for microplastics in the Pacific Ocean as part of our ongoing microplastics campaign. In a multi-year partnership with the American Prairie Reserve (APR), ASC volunteer crews live and work on the Reserve collecting wildlife data year round. The data we obtain directly informs the Reserve's wildlife management decisions. On this project, our crews have safely and effectively navigated temperature extremes from -30 degrees to 100+ degrees while traveling in a remote location. We are currently scouting projects in the Okavango Delta of Botswana and the rainforest of Suriname where we will be able to cover large amounts of area in a short periord of time. ASC is at the crossroads of the adventure and coservation science communities. Our approach of answering specific questions by using highly skilled and

  18. Review of epidemic aminoglycoside resistance worldwide.

    PubMed

    Mayer, K H

    1986-06-30

    Epidemic aminoglycoside resistance may be caused by the spread of a species with distinctive chromosomal genes (e.g., Pseudomonas aeruginosa), or it may be due to the dissemination of plasmids or transposons between genera. Although strains of P. aeruginosa resistant to aminoglycosides because of impermeability may cause nosocomial outbreaks, most of the acute increases in aminoglycoside resistance are due to the spread of inactivating enzymes by plasmids. The index species for intergeneric outbreaks is usually Klebsiella pneumoniae carrying the ANT(2") or AAC(3) gene; however, the distribution of resistance varies greatly by location and species. The AAC(6')-I gene is most common in Serratia marcescens and in East Asian isolates of other species, whereas the AAC(3) gene is common in Chile. In the United States, the ANT(2") and AAC(3) genes are particularly common among Enterobacteriaceae, except for Proteus and Providencia, which often carry the AAC(2') gene. The most common patterns of epidemic resistance lead to the inactivation of gentamicin and, less frequently, tobramycin, but only rarely affect amikacin.

  19. Worldwide risks of animal diseases: introduction.

    PubMed

    Pearson, J E

    2006-01-01

    Animal diseases impact food supplies, trade and commerce, and human health and well-being in every part of the world. Outbreaks draw the attention of those in agriculture, regulatory agencies, and government, as well as the general public. This was demonstrated by the 2000-2001 foot and mouth disease (FMD) outbreaks that occurred in Europe, South America, Asia and Africa and by the recent increased occurrence of emerging diseases transmitted from animals to humans. Examples of these emerging zoonotic diseases are highly pathogenic avian influenza, bovine spongiform encephalopathy, West Nile virus and severe acute respiratory syndrome. There is also the risk of well-known and preventable zoonotic diseases, such as rabies, brucellosis, leishmaniasis, and echinococcosis/hydatidosis, in certain countries; these diseases have a high morbidity with the potential for a very high mortality. Animal agriculturalists should have a global disease awareness of disease risks and develop plans of action to deal with them; in order to better respond to these diseases, they should develop the skills and competencies in politics, media interactions, and community engagement. This issue of Veterinaria Italiana presents information on the risk of animal diseases; their impact on animals and humans at the international, national, industry, and societal levels; and the responses to them. In addition, specific information is provided on national and international disease monitoring, surveillance and reporting, the risk of spread of disease by bioterrorism and on import risk analysis.

  20. Oral rehydration versus intravenous therapy for treating dehydration due to gastroenteritis in children: a meta-analysis of randomised controlled trials

    PubMed Central

    Bellemare, Steven; Hartling, Lisa; Wiebe, Natasha; Russell, Kelly; Craig, William R; McConnell, Don; Klassen, Terry P

    2004-01-01

    Background Despite treatment recommendations from various organizations, oral rehydration therapy (ORT) continues to be underused, particularly by physicians in high-income countries. We conducted a systematic review of randomised controlled trials (RCTs) to compare ORT and intravenous therapy (IVT) for the treatment of dehydration secondary to acute gastroenteritis in children. Methods RCTs were identified through MEDLINE, EMBASE, CENTRAL, authors and references of included trials, pharmaceutical companies, and relevant organizations. Screening and inclusion were performed independently by two reviewers in order to identify randomised or quasi-randomised controlled trials comparing ORT and IVT in children with acute diarrhea and dehydration. Two reviewers independently assessed study quality using the Jadad scale and allocation concealment. Data were extracted by one reviewer and checked by a second. The primary outcome measure was failure of rehydration. We analyzed data using standard meta-analytic techniques. Results The quality of the 14 included trials ranged from 0 to 3 (Jadad score); allocation concealment was unclear in all but one study. Using a random effects model, there was no significant difference in treatment failures (risk difference [RD] 3%; 95% confidence intervals [CI]: 0, 6). The Mantel-Haenzsel fixed effects model gave a significant difference between treatment groups (RD 4%; 95% CI: 2, 5) favoring IVT. Based on the four studies that reported deaths, there were six in the IVT groups and two in ORT. There were no significant differences in total fluid intake at six and 24 hours, weight gain, duration of diarrhea, or hypo/hypernatremia. Length of stay was significantly shorter for the ORT group (weighted mean difference [WMD] -1.2 days; 95% CI: -2.4,-0.02). Phlebitis occurred significantly more often with IVT (number needed to treat [NNT] 33; 95% CI: 25,100); paralytic ileus occurred more often with ORT (NNT 33; 95% CI: 20,100). These results

  1. Assessment of gastroenteric viruses from wastewater directly discharged into Uruguay River, Uruguay.

    PubMed

    Victoria, M; Tort, L F L; García, M; Lizasoain, A; Maya, L; Leite, J P G; Miagostovich, M P; Cristina, J; Colina, R

    2014-06-01

    The aim of this study was to assess the viral contamination of group A rotavirus (RVA), norovirus (NoV), and human astrovirus (HAstV) in sewage directly discharged into Uruguay River and to characterize RVA genotypes circulating in Uruguay. For this purpose, sewage samples (n = 96) were collected biweekly from March 2011 to February 2012 in four Uruguayan cities: Bella Unión, Salto, Paysandú, and Fray Bentos. Each sample was concentrated by ultracentrifugation method. Qualitative and quantitative RT-PCR for RVA, NoV, and HAstV were performed. A wide dissemination of gastroenteric viruses was observed in the sewage samples analyzed with 80% of positivity, being NoV (51%) the most frequently detected followed by RVA with a frequency of 49% and HAstV with 45%. Genotypes of RVA were typed using multiplex semi-nested RT-PCR as follows: P[8] (n = 15), P[4] (n = 8), P[10] (n = 1), P[11] (n = 1), G2 (n = 29), and G3 (n = 2). The viral load ranged from 10(3) to 10(7) genomic copies/liter, and they were detected roughly with the same frequency in all participant cities. A peak of RVA and HAstV detection was observed in colder months (June to September), whereas no seasonality was observed for NoV. This study demonstrates for the first time, the high degree of gastroenteric viral contamination in the country; highlighting the importance of developing these analyses as a tool to determine the viral contamination in this hydrographic boundary region used by the local populations for recreation and consumption, establishing an elevated risk of gastroenteric diseases for human health. PMID:24777819

  2. Human adenovirus spread, rainfalls, and the occurrence of gastroenteritis cases in a Brazilian basin.

    PubMed

    Rodrigues, Manoela Tressoldi; Henzel, Andréia; Staggemeier, Rodrigo; de Quevedo, Daniela Muller; Rigotto, Caroline; Heinzelmann, Larissa; do Nascimento, Carlos Augusto; Spilki, Fernando Rosado

    2015-11-01

    Climate variables may interfere with the environmental persistence and spread of pathogenic microorganisms. This study aimed to investigate the occurrence of human adenovirus (HAdV) and total and thermotolerant coliforms in treated and untreated water and report gastroenteritis cases in seven cities located in the hydrographic basin of the Sinos River (HBSR), Southern Brazil. The data on water quality from samples collected at catchment areas of HBSR from March to December 2011 were compared with precipitation records, virus detection rates and viral loads, and information on enteric diseases among residents of the region. There was a marked increase in precipitation intensity in April, July, and August and a decrease in May and November. The number of HAdV genome copies (gc) in untreated water ranged from 2.1×10(8) gc/L in June to 7.8×10(1) gc/L in December, and in treated water, from 6.3×10(4) gc/L in September to 4.1×10(1) gc/L in November. The most probable number (MPN) of total coliforms ranged from 5×10(1) MPN/100 mL in December to 2.4×10(5) MPN/100 mL in July, and thermotolerant coliforms ranged from 1×10(1) MPN/100 mL in August to 6.9×10(4) MPN/100 mL in July. A total of 79 hospital admissions due to gastroenteritis were registered in the cities studied. The results for coliforms in untreated water demonstrate deficits in sanitation and wastewater treatment. These findings also indicate a possible relationship between the occurrence of rainfalls after dry periods and an increase in the number of gastroenteritis cases and in HAdV load quantified in surface water collected for conventional potabilization.

  3. Assessment of gastroenteric viruses from wastewater directly discharged into Uruguay River, Uruguay.

    PubMed

    Victoria, M; Tort, L F L; García, M; Lizasoain, A; Maya, L; Leite, J P G; Miagostovich, M P; Cristina, J; Colina, R

    2014-06-01

    The aim of this study was to assess the viral contamination of group A rotavirus (RVA), norovirus (NoV), and human astrovirus (HAstV) in sewage directly discharged into Uruguay River and to characterize RVA genotypes circulating in Uruguay. For this purpose, sewage samples (n = 96) were collected biweekly from March 2011 to February 2012 in four Uruguayan cities: Bella Unión, Salto, Paysandú, and Fray Bentos. Each sample was concentrated by ultracentrifugation method. Qualitative and quantitative RT-PCR for RVA, NoV, and HAstV were performed. A wide dissemination of gastroenteric viruses was observed in the sewage samples analyzed with 80% of positivity, being NoV (51%) the most frequently detected followed by RVA with a frequency of 49% and HAstV with 45%. Genotypes of RVA were typed using multiplex semi-nested RT-PCR as follows: P[8] (n = 15), P[4] (n = 8), P[10] (n = 1), P[11] (n = 1), G2 (n = 29), and G3 (n = 2). The viral load ranged from 10(3) to 10(7) genomic copies/liter, and they were detected roughly with the same frequency in all participant cities. A peak of RVA and HAstV detection was observed in colder months (June to September), whereas no seasonality was observed for NoV. This study demonstrates for the first time, the high degree of gastroenteric viral contamination in the country; highlighting the importance of developing these analyses as a tool to determine the viral contamination in this hydrographic boundary region used by the local populations for recreation and consumption, establishing an elevated risk of gastroenteric diseases for human health.

  4. Human adenovirus spread, rainfalls, and the occurrence of gastroenteritis cases in a Brazilian basin.

    PubMed

    Rodrigues, Manoela Tressoldi; Henzel, Andréia; Staggemeier, Rodrigo; de Quevedo, Daniela Muller; Rigotto, Caroline; Heinzelmann, Larissa; do Nascimento, Carlos Augusto; Spilki, Fernando Rosado

    2015-11-01

    Climate variables may interfere with the environmental persistence and spread of pathogenic microorganisms. This study aimed to investigate the occurrence of human adenovirus (HAdV) and total and thermotolerant coliforms in treated and untreated water and report gastroenteritis cases in seven cities located in the hydrographic basin of the Sinos River (HBSR), Southern Brazil. The data on water quality from samples collected at catchment areas of HBSR from March to December 2011 were compared with precipitation records, virus detection rates and viral loads, and information on enteric diseases among residents of the region. There was a marked increase in precipitation intensity in April, July, and August and a decrease in May and November. The number of HAdV genome copies (gc) in untreated water ranged from 2.1×10(8) gc/L in June to 7.8×10(1) gc/L in December, and in treated water, from 6.3×10(4) gc/L in September to 4.1×10(1) gc/L in November. The most probable number (MPN) of total coliforms ranged from 5×10(1) MPN/100 mL in December to 2.4×10(5) MPN/100 mL in July, and thermotolerant coliforms ranged from 1×10(1) MPN/100 mL in August to 6.9×10(4) MPN/100 mL in July. A total of 79 hospital admissions due to gastroenteritis were registered in the cities studied. The results for coliforms in untreated water demonstrate deficits in sanitation and wastewater treatment. These findings also indicate a possible relationship between the occurrence of rainfalls after dry periods and an increase in the number of gastroenteritis cases and in HAdV load quantified in surface water collected for conventional potabilization. PMID:26514803

  5. Streptococcal diseases worldwide: present status and prospects*

    PubMed Central

    Rotta, J.; Tikhomirov, E.

    1987-01-01

    Infections caused by streptococci pathogenic for man are some of the most common bacterial diseases in temperate zones and occur very frequently in tropical and subtropical countries. The highest morbidity occurs from infections caused by group A streptococci; these infections can lead to rheumatic fever and acute glomerulonephritis. The incidence of rheumatic fever and the prevalence of rheumatic heart disease are several times higher in tropical countries than temperate countries. Recent developments in fundamental and applied research are throwing light on various aspects of the problem, e.g., the rapid (non-culture) identification of group A streptococcal infection. Analyses of the chemical structure of the M-protein molecule of group A streptococcus and of the biological properties of the epitopes of the M-protein have provided encouraging results. Furthermore, synthetic analogues of the protective immunodominant polypeptides of the M-protein have been prepared. The prospect of a streptococcal vaccine for preventing group A streptococcal diseases is thus more realistic. The control of infections caused by group B streptococci is important for the health of neonates. The identification of the chemical structure of the major group B streptococcal types may lead to development of a vaccine in the future. An alternative approach would entail the use of anti-group-B immunoglobulins, but a number of questions have to be answered before the new control measures can be introduced. The streptococci causing bacterial pneumonia, subacute bacterial endocarditis and possibly dental caries have been widely studied and promising advances have been made towards the introduction of better control of the diseases caused by these pathogens. PMID:3325183

  6. Streptococcal diseases worldwide: present status and prospects.

    PubMed

    Rotta, J; Tikhomirov, E

    1987-01-01

    Infections caused by streptococci pathogenic for man are some of the most common bacterial diseases in temperate zones and occur very frequently in tropical and subtropical countries. The highest morbidity occurs from infections caused by group A streptococci; these infections can lead to rheumatic fever and acute glomerulonephritis. The incidence of rheumatic fever and the prevalence of rheumatic heart disease are several times higher in tropical countries than temperate countries.Recent developments in fundamental and applied research are throwing light on various aspects of the problem, e.g., the rapid (non-culture) identification of group A streptococcal infection. Analyses of the chemical structure of the M-protein molecule of group A streptococcus and of the biological properties of the epitopes of the M-protein have provided encouraging results. Furthermore, synthetic analogues of the protective immunodominant polypeptides of the M-protein have been prepared. The prospect of a streptococcal vaccine for preventing group A streptococcal diseases is thus more realistic.The control of infections caused by group B streptococci is important for the health of neonates. The identification of the chemical structure of the major group B streptococcal types may lead to development of a vaccine in the future. An alternative approach would entail the use of anti-group-B immunoglobulins, but a number of questions have to be answered before the new control measures can be introduced. The streptococci causing bacterial pneumonia, subacute bacterial endocarditis and possibly dental caries have been widely studied and promising advances have been made towards the introduction of better control of the diseases caused by these pathogens. PMID:3325183

  7. Human water consumption intensifies hydrological drought worldwide

    NASA Astrophysics Data System (ADS)

    Wada, Y.; Van Beek, L. P.; Wanders, N.; Bierkens, M. F.

    2012-12-01

    Over the past decades, human water consumption has more than doubled, and reduced streamflow over various regions of the world. However, it remains unclear to what degree human water consumption intensifies hydrological droughts, i.e. the occurrence of anomalously low streamflow. Here, we quantify over the period 1960-2010 the impact of human water consumption on the intensity and frequency of hydrological droughts worldwide. We simulated streamflow by the global hydrological and water resources model PCR-GLOBWB at a 0.5 degree spatial resolution, and reduced the amount of streamflow with different levels of human water consumption over the period 1960-2010. We applied the commonly used variable threshold level method to identify below-normal water availability as the onset of hydrological droughts. We then standardized the deficit volume dividing relative to the threshold level to express the intensity of drought conditions to normal streamflow conditions. The results show that human water consumption substantially reduced local and downstream streamflow in many regions of the world. This subsequently intensified hydrological droughts regionally by 10-500%. Irrigation is responsible for the intensification of hydrological droughts over western and central U.S., southern Europe, Asia, and southeastern Australia, whereas the impact of industrial and households' consumption on the intensification is considerably larger over eastern U.S., and western and central Europe. The results also show that drought frequency increased by more than 27% compared to pristine or natural condition as a result of human water consumption. The intensification of drought frequency is most severe over Asia, but also substantial over North America and Europe. Importantly, global population under severe hydrological droughts considerably increased from 0.7 billion in 1960 to 2.2 billion in 2010 due to rapid population growth. As a limited validation exercise, we compared simulated deficit

  8. Multiplex polymerase chain reaction tests for detection of pathogens associated with gastroenteritis.

    PubMed

    Zhang, Hongwei; Morrison, Scott; Tang, Yi-Wei

    2015-06-01

    A wide range of enteric pathogens can cause infectious gastroenteritis. Conventional diagnostic algorithms are time-consuming and often lack sensitivity and specificity. Advances in molecular technology have provided new clinical diagnostic tools. Multiplex polymerase chain reaction (PCR)-based testing has been used in gastroenterology diagnostics in recent years. This article presents a review of recent laboratory-developed multiplex PCR tests and current commercial multiplex gastrointestinal pathogen tests. It focuses on two commercial syndromic multiplex tests: Luminex xTAG Gastrointestinal Pathogen Panel and BioFire FilmArray gastrointestinal test. Multiplex PCR tests have shown superior sensitivity to conventional methods for detection of most pathogens.

  9. A mathematical model of detection and dynamics of porcine transmissible gastroenteritis.

    PubMed Central

    Hone, J.

    1994-01-01

    Transmissible gastroenteritis (TGE) is a viral disease causing dehydration, diarrhoea and death in pigs. The disease is widespread in pig-producing areas of the world but does not occur in Australia. A mathematical model of TGE spread within a pig herd is proposed and calibrated by reference to published data. The model is then applied to two situations of special interest; first to estimate the delay before detection of TGE (6 to over 30 days) when infection is first introduced into a herd of domestic or feral pigs, and second the effect of the disease in a population of feral pigs (could become endemic if transmission is high). PMID:8062875

  10. Acute Bronchitis

    MedlinePlus

    ... tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis get better within several days. But your ... that cause colds and the flu often cause acute bronchitis. These viruses spread through the air when ...

  11. Incidence, risk factors, and outcome of cytomegalovirus viremia and gastroenteritis in patients with gastrointestinal graft-versus-host disease.

    PubMed

    Bhutani, Divaya; Dyson, Gregory; Manasa, Richard; Deol, Abhinav; Ratanatharathorn, Voravit; Ayash, Lois; Abidi, Muneer; Lum, Lawrence G; Al-Kadhimi, Zaid; Uberti, Joseph P

    2015-01-01

    Gastrointestinal (GI) graft-versus-host disease (GVHD) is one of the most common causes of morbidity and mortality after allogeneic stem cell transplantation. In addition, cytomegalovirus (CMV) infection of the gastrointestinal tract can complicate the post-transplantation course of these patients and it can be difficult to differentiate the 2 diagnoses given that they can present with similar symptoms. We retrospectively analyzed 252 patients who were diagnosed with GI GVHD to evaluate the incidence, risk factors, and outcomes of CMV viremia and CMV gastroenteritis in these patients. The median age at the time of transplantation was 51 years, 35% were related donor transplantations, and 65% were unrelated donor transplantations. A total of 114 (45%) patients developed CMV viremia at a median of 34 days (range, 14 to 236 days) after transplantation. Only recipient CMV IgG serostatus was significantly associated with development of CMV viremia (P < .001). The incidence of CMV viremia with relation to donor (D) and recipient (R) CMV serostatus subgroups was as follows: D+/R+, 73%; D-/R+, 67%; D+/R-, 19%; and D-/R-, 0. A total of 31 patients were diagnosed with a biopsy-proven CMV gastroenteritis; 2 patients had evidence of CMV gastroenteritis and GVHD on the first biopsy and 29 on the second biopsy. Median time to development of CMV gastroenteritis was 52 days (range, 19 to 236 days) after transplantation. Using death as a competing risk, the cumulative incidence of CMV gastroenteritis at 1 year was 16.4%. The incidence of CMV gastroenteritis in relation to the donor/recipient serostatus was as follows: D+/R+, 22%; D-/R+, 31%; D+/R-, 12%; and D-/R-, 0. Median follow-up time for the 252 patients was 35.4 (95% CI 23.8 to 44.8) months. The estimated overall survival rate at 1 and 2 years was .45 (95% confidence interval [CI], .39 to .52) and .39 (95% CI, .33 to .46), respectively. Of the examined variables, those related to the overall survival were maximal clinical

  12. Gastroenteritis in a regional hospital in Kuwait: some aspects of the disease.

    PubMed

    Khuffash, F A; Majeed, H A; Sethi, S K; Al-Nakib, W

    1982-09-01

    A review of the clinical course of gastroenteritis in 274 hospitalized children revealed a severe form of the disease. Eight-eight per cent were aged 12 months or under and 20% had severe associated malnutrition. The commonest clinical manifestations were diarrhoea (100%), dehydration (98.9%), vomiting (81.4%) and fever (77.7%). Pathogens were isolated from 75.2% of cases (rotavirus 24.5%, Escherichia coli 20.8%, salmonellae 20%, shigellae 6.2%, campylobacter 2.2% and Yersinia enterocolitica in 1.5%). Septicaemia was confirmed in 12 patients (4.4%) and strong clinical evidence of septicaemia was present in 36 more cases (13%). Dehydration was isonatraemic in 68%, hyponatraemic in 21% and hypernatraemic in 11% of cases. There was a clear association between septicaemia and hyponatraemia. The overall mortality rate was 1.8%. Data from our study show that the use of intravenous hyperalimentation, and/or antibiotics in the management of gastroenteritis in selected patients, can significantly reduce morbidity and mortality.

  13. Nationwide variation in the effects of temperature on infectious gastroenteritis incidence in Japan

    NASA Astrophysics Data System (ADS)

    Onozuka, Daisuke; Hagihara, Akihito

    2015-08-01

    Although several studies have investigated the effects of temperature on the incidence of infectious gastrointestinal disease in a single city or region, few have investigated variations in this association using nationwide data. We obtained weekly data, gathered between 2000 and 2012, pertaining to infectious gastroenteritis cases and weather variability in all 47 Japanese prefectures. A two-stage analysis was used to assess the nonlinear and delayed relationship between temperature and morbidity. In the first stage, a Poisson regression allowing for overdispersion in a distributed lag nonlinear model was used to estimate the prefecture-specific effects of temperature on morbidity. In the second stage, a multivariate meta-analysis was applied to pool estimates at the national level. The pooled overall relative risk (RR) was highest in the 59.9th percentile of temperature (RR, 1.08; 95% CI: 1.01, 1.15). Meta-analysis results also indicated that the estimated pooled RR at lower temperatures (25th percentile) began immediately but did not persist, whereas an identical estimate at a higher temperature (75th percentile) was delayed but persisted for several weeks. Our results suggest that public health strategies aimed at controlling temperature-related infectious gastroenteritis may be more effective when tailored according to region-specific weather conditions.

  14. Fluid therapy trials in neonatal piglets infected with transmissible gastroenteritis virus.

    PubMed Central

    Drolet, R; Morin, M; Fontaine, M

    1985-01-01

    The main purpose of this study was to evaluate the effectiveness of an oral fluid therapy alone or combined with parenteral administration of a 5% dextrose solution to attenuate the clinical signs and the pathophysiological consequences of transmissible gastroenteritis in neonatal piglets. Eighteen two day old conventional piglets were infected with transmissible gastroenteritis virus while six others were used as controls (Group 1). At the onset of diarrhea, infected piglets were divided into three groups of six (Groups 2, 3 and 4). Piglets in group 2 were not treated and were fed a milk replacer ad libitum. Piglets in group 3 were removed from the milk replacer and placed on an oral glucose-glycine-electrolyte solution ad libitum. Those in group 4 were placed on oral fluid therapy and received a 5% dextrose solution intraperitoneally at the rate of 25 mL/kg of body weight once a day. Blood samples were collected in heparin within minutes after the infected piglets became comatose and from the controls at four or five days of age. The following variables were measured: packed red cell volume, blood pH, total plasma protein and bicarbonate, blood urea nitrogen, and plasma glucose, creatinine, chloride, inorganic phosphorus, sodium, potassium, magnesium and calcium. Vomiting and diarrhea appeared 12 to 24 hours postinoculation in the infected piglets. There was a sudden and rapid progression into a comatose and moribund state one or two days later whether the infected piglets were treated or not.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4075236

  15. Outbreak of hospital-acquired gastroenteritis and invasive infection caused by Listeria monocytogenes, Finland, 2012.

    PubMed

    Jacks, A; Pihlajasaari, A; Vahe, M; Myntti, A; Kaukoranta, S-S; Elomaa, N; Salmenlinna, S; Rantala, L; Lahti, K; Huusko, S; Kuusi, M; Siitonen, A; Rimhanen-Finne, R

    2016-10-01

    During one week in July 2012, two patients from the same ward at the municipal hospital in Vaasa, Finland, were diagnosed with septicaemia caused by Listeria monocytogenes. An outbreak investigation revealed eight concomitant cases of febrile gastroenteritis caused by L. monocytogenes on the same ward. Median age of the cases was 82 years and median incubation time for listerial gastroenteritis was 21 h (range 9-107). An additional 10 cases of invasive listeriosis caused by the same outbreak strain were identified across the whole country during the summer of 2012. Environmental investigation at the affected municipal hospital ward revealed ready-sliced meat jelly as the suspected source of the infection. During inspection of the meat jelly production plant, one pooled sample taken from a floor drain and a trolley wheel in the food processing environment was positive for the outbreak strain of L. monocytogenes. After the producer stopped the production of meat jelly, no further cases of listeriosis with the outbreak strain were identified via nationwide surveillance.

  16. Outbreak of hospital-acquired gastroenteritis and invasive infection caused by Listeria monocytogenes, Finland, 2012.

    PubMed

    Jacks, A; Pihlajasaari, A; Vahe, M; Myntti, A; Kaukoranta, S-S; Elomaa, N; Salmenlinna, S; Rantala, L; Lahti, K; Huusko, S; Kuusi, M; Siitonen, A; Rimhanen-Finne, R

    2016-10-01

    During one week in July 2012, two patients from the same ward at the municipal hospital in Vaasa, Finland, were diagnosed with septicaemia caused by Listeria monocytogenes. An outbreak investigation revealed eight concomitant cases of febrile gastroenteritis caused by L. monocytogenes on the same ward. Median age of the cases was 82 years and median incubation time for listerial gastroenteritis was 21 h (range 9-107). An additional 10 cases of invasive listeriosis caused by the same outbreak strain were identified across the whole country during the summer of 2012. Environmental investigation at the affected municipal hospital ward revealed ready-sliced meat jelly as the suspected source of the infection. During inspection of the meat jelly production plant, one pooled sample taken from a floor drain and a trolley wheel in the food processing environment was positive for the outbreak strain of L. monocytogenes. After the producer stopped the production of meat jelly, no further cases of listeriosis with the outbreak strain were identified via nationwide surveillance. PMID:26493730

  17. Acute Abdominal Pain in Children.

    PubMed

    Reust, Carin E; Williams, Amy

    2016-05-15

    Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis. PMID:27175718

  18. Bacterial gastroenteritis

    MedlinePlus

    ... at picnics, school cafeterias, large social gatherings, or restaurants. The germs may get into your food (called ... handling or preparation may occur in grocery stores, restaurants, or homes. Food poisoning often occurs from eating ...

  19. Molecular Characterization of Noroviruses and Rotaviruses Involved in a Large Outbreak of Gastroenteritis in Northern Italy ▿

    PubMed Central

    Di Bartolo, Ilaria; Monini, Marina; Losio, Marina Nadia; Pavoni, Enrico; Lavazza, Antonio; Ruggeri, Franco Maria

    2011-01-01

    Noroviruses and rotaviruses from a gastroenteritis outbreak affecting >300 people near Garda Lake (Northern Italy) in 2009 were investigated. Characterization of viruses from 40 patient stool samples and 5 environmental samples identified three distinct rotavirus and five norovirus genotypes; two of the latter were detected in both patient and environmental samples. PMID:21666024

  20. Phage-display for identifying peptides that bind the spike protein of transmissible gastroenteritis virus and possess diagnostic potential

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The spike (S) protein is a key structural protein of coronaviruses including, the porcine transmissible gastroenteritis virus (TGEV). The S protein is a type I membrane glycoprotein located in the viral envelope and is responsible for mediating the binding of viral particles to specific cell recepto...

  1. Orexins and receptor OX2R in the gastroenteric apparatus of two teleostean species: Dicentrarchus labrax and Carassius auratus.

    PubMed

    D'Angelo, Livia; Castaldo, Luciana; de Girolamo, Paolo; Lucini, Carla; Paolucci, Marina; Pelagalli, Alessandra; Varricchio, Ettore; Arcamone, Nadia

    2016-08-01

    Orexin A and B peptides and the receptor OX2R were studied in sea bass and goldfish gastroenteric tract by immunoblotting combined with densitometric analysis using NIH Image J software and immunohistochemical techniques. These teleost species present a different gut organization and diverse feeding habits. Immunoblotting experiments showed one band of 16 kDa corresponding to prepro-orexin, and one band of 38 kDa corresponding to the OX2R receptor. Immunohistochemical localization of OXA and OXB was observed in the enteric nervous system throughout the gastroenteric tract of both species. OXA and OXB immunoreactive cells were found in the gastric and intestinal regions of sea bass, and were mainly found in the basal region of folds in intestinal bulb, and in the midgut and hindgut of goldfish. The distribution of OX2R was mainly detected in the mucosa of the gastroenteric tract of sea bass and goldfish. This distribution suggests an endocrine action of OXA and OXB in the gastrointestinal tract as well as involvement in the peripheral control of food intake and digestive processes in both species. This study might also serve to determine the productive factors in breeding and as a baseline for future experimental studies on the regulation of the gastroenteric functions in non-mammalian vertebrates. Anat Rec, 299:1121-1129, 2016. © 2016 Wiley Periodicals, Inc. PMID:27223125

  2. Is racecadotril effective for acute diarrhea in children? -First update.

    PubMed

    Sáez, Josefina; Cifuentes, Lorena

    2016-05-06

    This article updates the December 2015 Living FRISBEE (Living FRISBEE: Living FRIendly Summary of the Body of Evidence using Epistemonikos), based on the detection of two systematic reviews not identified in the previous version. Gastroenteritis or acute watery diarrhea is usually a self-limited disease, but it is still associated to substantial healthcare costs and remains a frequent demand for medical care. Racecadotril, an intestinal enkephalinase inhibitor, has been used as treatment because it would decrease the duration of acute diarrhea and fluid loss. However there is still no evidence supporting its routine use. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified five systematic reviews including nine randomized trials relevant for our question. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded racecadotril probably reduces the duration of acute diarrhea in pediatric patients, without increasing adverse effects.

  3. Is racecadotril effective for acute diarrhea in children? -First update.

    PubMed

    Sáez, Josefina; Cifuentes, Lorena

    2016-01-01

    This article updates the December 2015 Living FRISBEE (Living FRISBEE: Living FRIendly Summary of the Body of Evidence using Epistemonikos), based on the detection of two systematic reviews not identified in the previous version. Gastroenteritis or acute watery diarrhea is usually a self-limited disease, but it is still associated to substantial healthcare costs and remains a frequent demand for medical care. Racecadotril, an intestinal enkephalinase inhibitor, has been used as treatment because it would decrease the duration of acute diarrhea and fluid loss. However there is still no evidence supporting its routine use. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified five systematic reviews including nine randomized trials relevant for our question. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded racecadotril probably reduces the duration of acute diarrhea in pediatric patients, without increasing adverse effects. PMID:26731112

  4. Oral Ondansetron Administration in Emergency Departments to Children with Gastroenteritis: An Economic Analysis

    PubMed Central

    Freedman, Stephen B.; Steiner, Michael J.; Chan, Kevin J.

    2010-01-01

    Background The use of antiemetics for children with vomiting is one of the most controversial decisions in the treatment of gastroenteritis in developed countries. Ondansetron, a selective serotonin receptor antagonist, has been found to be effective in improving the success of oral rehydration therapy. However, North American and European clinical practice guidelines continue to recommend against its use, stating that evidence of cost savings would be required to support ondansetron administration. Thus, an economic analysis of the emergency department administration of ondansetron was conducted. The primary objective was to conduct a cost analysis of the routine administration of ondansetron in both the United States and Canada. Methods and Findings A cost analysis evaluated oral ondansetron administration to children presenting to emergency departments with vomiting and dehydration secondary to gastroenteritis from a societal and health care payer's perspective in both the US and Canada. A decision tree was developed that incorporated the frequency of vomiting, intravenous insertion, hospitalization, and emergency department revisits. Estimates of the monetary costs associated with ondansetron use, intravenous rehydration, and hospitalization were derived from administrative databases or emergency department use. The economic burden in children administered ondansetron plus oral rehydration therapy was compared to those not administered ondansetron employing deterministic and probabilistic simulations. We estimated the costs or savings to society and health care payers associated with the routine administration of ondansetron. Sensitivity analyses considered variations in costs, treatment effects, and exchange rates. In the US the administration of ondansetron to eligible children would prevent approximately 29,246 intravenous insertions and 7,220 hospitalizations annually. At the current average wholesale price, its routine administration to eligible children

  5. Survey of antibodies in broiler sera against salmonella flagellar proteins (flgk and flid)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Salmonella is a causative pathogen of human acute bacterial gastroenteritis worldwide. Chickens are regarded as one of major reservoirs of this microorganism. Bacterial flagella are involved in motility, adhesion, quorum sensing and other virulence activities. Also, the flagella are immunogenic. ...

  6. Global Impressions: Inside UNESCO's First Worldwide Arts Education Conference

    ERIC Educational Resources Information Center

    Booth, Eric

    2006-01-01

    The many worlds of arts education began to grow into one worldwide community in March 2006. Twelve hundred arts education leaders, in delegations from 97 countries, attended the United Nation's Education, Scientific and Cultural Organization's (UNESCO's) first-ever worldwide arts education conference, held for four days in Lisbon, Portugal. The…

  7. Bacillus cereus and Bacillus thuringiensis isolated in a gastroenteritis outbreak investigation.

    PubMed

    Jackson, S G; Goodbrand, R B; Ahmed, R; Kasatiya, S

    1995-08-01

    During investigation of a gastroenteritis outbreak in a chronic care institution, Norwalk virus was found in stool specimens from two individuals and bacterial isolates presumptively identified as Bacillus cereus were isolated from four individuals (including one with Norwalk virus) and spice. Phage typing confirmed all Bacillus clinical isolates were phage type 2. All clinical isolates were subsequently identified as B. thuringiensis when tested as a result of a related study (L. Leroux, personal communication). Eight of 10 spice isolates were phage type 4. All B. cereus and B. thuringiensis isolates showed cytotoxic effects characteristic of enterotoxin-producing B. cereus. An additional 20 isolates each of B. cereus and B. thuringiensis from other sources were tested for cytotoxicity. With the exception of one B. cereus, all showed characteristic cytotoxic patterns.

  8. Gastroenteritis among children in Riyadh: a prospective analysis of 254 hospital admissions.

    PubMed

    Karrar, Z A; Abdullah, M A

    1981-06-01

    A prospective study was undertaken of 254 infants and children admitted with gastroenteritis to the Children's Hospital, Riyadh, Saudi Arabia during the period 1 September 1980 to 1 February 1981. Analysis of data showed that 80% of the admissions were less than one year of age. The peak incidence occurred in the 0-five months age group. 65.4% were on bottle feeding. The incidence of second- and third-degree malnutrition was 38.9%. Marasmus was the commonest type of severe malnutrition seen. Hypernatraemic dehydration occurred in 12.6% of the cases. The parasitic and bacterial isolation rate was 23.8%, salmonella and entero-pathogenic E. coli being the commonest organisms. The mortality rate was 9.1% and was higher among malnourished patients, those with hypernatraemia and in the younger age groups.

  9. Herd immunity after two years of the universal mass vaccination program against rotavirus gastroenteritis in Austria.

    PubMed

    Paulke-Korinek, Maria; Kundi, Michael; Rendi-Wagner, Pamela; de Martin, Alfred; Eder, Gerald; Schmidle-Loss, Birgit; Vecsei, Andreas; Kollaritsch, Herwig

    2011-03-24

    Austria was the first country in Europe implementing a universal mass vaccination program against rotavirus gastroenteritis (RV-GE) for all infants nationwide. Epidemiological data from a hospital based surveillance system show that incidence rates of children hospitalized with RV-GE decreased in 2009 compared to 2008 and compared to the prevaccination period 2001-2005. Decreasing hospitalization-rates from RV-GE were observed in children of all age groups, even in those not eligible for vaccination according to their age, suggesting herd immunity induced by universal mass vaccination against RV-GE. In 2009 the disease burden was highest in children below three months of age stressing the importance of the early start of the immunization course.

  10. Epidemiological applications: a case report of a village epidemic of gastroenteritis.

    PubMed

    Asuzu, M C; Singh, N

    2001-03-01

    This is a case report of an epidemic of gastroenteritis which was investigated and controlled by epidemiological methods only, before laboratory investigations could be done to confirm the original epidemiological conclusions--from contaminated home made ice-cubes. The case and process are reported in order to encourage similar uses of epidemiology by field public health practitioners, especially within the district or primary health care systems and particularly in places where laboratory support are difficult to avail. The case is used also to discuss the equipments and facilities that ought to be part of the support system for every modern field public health practitioner. These should include computers, modern communication facilities and epidemiological support systems, especially senior epidemiologists; as such senior personnel are available to junior colleagues in the other areas of specialist medical practice. PMID:12017811

  11. A case of Salmonella gastroenteritis following ingestion of raw venison sashimi.

    PubMed

    Madar, Cristian S; Cardile, Anthony P; Cunningham, Scott; Magpantay, Gil; Finger, David

    2012-02-01

    An interesting case of gastroenteritis due to Salmonella Birkenhead following ingestion of raw venison sashimi is described. A 65-year-old man presented with diarrhea, vomiting, and fever. On exam he was hypotensive, tachycardic, with evidence of severe dehydration following ingestion of raw venison sashimi produced with game meat hunted on the Hawaiian island of Lana'i. He responded rapidly to vigorous volume resuscitation, and stool cultures later were positive for Salmonella Birkenhead. Non-typhoidal Salmonella is the most frequently identified cause of foodborne illness in the United States. Clinicians in the state of Hawai'i should be alert and aware of the potential for the local deer population to be an unusual source of foodborne illness, especially given the prevalence of consumption of raw foods in the local cuisine.

  12. Evaluation of phenotypic and genotypic markers for characterisation of the emerging gastroenteritis pathogen Salmonella hadar.

    PubMed

    Valdezate, S; Echeita, A; Díez, R; Usera, M A

    2000-04-01

    Over the last 4 years Salmonella hadar has increasingly been isolated in Europe in conjunction with food-borne gastroenteritis. The aim of this study was to evaluate epidemiological methods (phage typing, antimicrobial susceptibility testing, DNA plasmid analysis, ribotyping and pulsed-field gel electrophoresis analysis) for characterising Salmonella hadar isolates. The 100% phage typeability of isolates and the high discriminatory index of 0.8856 suggest that phage typing is the method of choice. In order to obtain subdivisions of the most frequent Salmonella hadar phage types, a combination of molecular methods, such as ribotyping performed with Bg/I and EcoRI or pulsed-field gel electrophoresis using XbaI and XhoI, would be desirable as the usefulness of each technique varies with the phage type being analysed. Of note was the high (86%) rate of resistance to tetracycline and nalidixic acid but full susceptibility to ciprofloxacin in the strains studied.

  13. Evaluation of fecal calprotectin in Campylobacter concisus and Campylobacter jejuni/coli gastroenteritis.

    PubMed

    Nielsen, Hans Linde; Engberg, Jørgen; Ejlertsen, Tove; Nielsen, Henrik

    2013-05-01

    Calprotectin (CP) is a calcium-binding cytosolic neutrophil protein and the concentration in feces reflects the migration of neutrophils into the gut lumen. Testing for fecal CP (f-CP) in patients with negative cultures for enteric pathogens is widely accepted as a useful screening tool for identifying patients who are most likely to benefit from endoscopy for suspected inflammatory bowel disease (IBD) with the assumption that a negative f-CP is compatible with a functional disorder. Campylobacter concisus has recently been reported to have a high incidence in the Danish population almost equal to Campylobacter jejuni and Campylobacter coli and has been reported to cause prolonged watery diarrhea. However, isolation of C. concisus from feces requires the filter method in a hydrogen-enriched microaerobic atmosphere, which is not commonly used in the laboratory, and the diagnosis may consequently be missed. The aim of this study was to evaluate the f-CP levels, as a marker for the intestinal inflammation in C. jejuni/coli- and C. concisus-infected patients. The authors found a high concentration of f-CP (median 631: IQR 221-1274) among 140 patients with C. jejuni/coli infection, whereas the f-CP level among 99 C. concisus-infected patients was significantly lower (median 53: IQR 20-169). The data correlate to the severe inflammatory gastroenteritis seen in patients infected with C. jejuni/coli, whereas C. concisus-infected patients have a much lower intestinal inflammation which could be compared with viral gastroenteritis. Nevertheless, clinicians should be aware of C. concisus infection, especially in patients with prolonged mild diarrhea, in the differential diagnosis to IBD.

  14. Evaluation of fecal calprotectin in Campylobacter concisus and Campylobacter jejuni/coli gastroenteritis.

    PubMed

    Nielsen, Hans Linde; Engberg, Jørgen; Ejlertsen, Tove; Nielsen, Henrik

    2013-05-01

    Calprotectin (CP) is a calcium-binding cytosolic neutrophil protein and the concentration in feces reflects the migration of neutrophils into the gut lumen. Testing for fecal CP (f-CP) in patients with negative cultures for enteric pathogens is widely accepted as a useful screening tool for identifying patients who are most likely to benefit from endoscopy for suspected inflammatory bowel disease (IBD) with the assumption that a negative f-CP is compatible with a functional disorder. Campylobacter concisus has recently been reported to have a high incidence in the Danish population almost equal to Campylobacter jejuni and Campylobacter coli and has been reported to cause prolonged watery diarrhea. However, isolation of C. concisus from feces requires the filter method in a hydrogen-enriched microaerobic atmosphere, which is not commonly used in the laboratory, and the diagnosis may consequently be missed. The aim of this study was to evaluate the f-CP levels, as a marker for the intestinal inflammation in C. jejuni/coli- and C. concisus-infected patients. The authors found a high concentration of f-CP (median 631: IQR 221-1274) among 140 patients with C. jejuni/coli infection, whereas the f-CP level among 99 C. concisus-infected patients was significantly lower (median 53: IQR 20-169). The data correlate to the severe inflammatory gastroenteritis seen in patients infected with C. jejuni/coli, whereas C. concisus-infected patients have a much lower intestinal inflammation which could be compared with viral gastroenteritis. Nevertheless, clinicians should be aware of C. concisus infection, especially in patients with prolonged mild diarrhea, in the differential diagnosis to IBD. PMID:23448294

  15. Update: Acute Heart Failure (VII): Nonpharmacological Management of Acute Heart Failure.

    PubMed

    Plácido, Rui; Mebazaa, Alexandre

    2015-09-01

    Acute heart failure is a major and growing public health problem worldwide with high morbidity, mortality, and cost. Despite recent advances in pharmacological management, the prognosis of patients with acute decompensated heart failure remains poor. Consequently, nonpharmacological approaches are being developed and increasingly used. Such techniques may include several modalities of ventilation, ultrafiltration, mechanical circulatory support, myocardial revascularization, and surgical treatment, among others. This document reviews the nonpharmacological approach in acute heart failure, indications, and prognostic implications.

  16. Probability Mapping to Determine the Spatial Risk Pattern of Acute Gastroenteritis in Coimbatore District, India, Using Geographic Information Systems (GIS)

    PubMed Central

    Joseph, Pawlin Vasanthi; Balan, Brindha; Rajendran, Vidhyalakshmi; Prashanthi, Devi Marimuthu; Somnathan, Balasubramanian

    2015-01-01

    Background: Maps show well the spatial configuration of information. Considerable effort is devoted to the development of geographical information systems (GIS) that increase understanding of public health problems and in particular to collaborate efforts among clinicians, epidemiologists, ecologists, and geographers to map and forecast disease risk. Objectives: Small populations tend to give rise to the most extreme disease rates, even if the actual rates are similar across the areas. Such situations will follow the decision-maker's attention on these areas when they scrutinize the map for decision making or resource allocation. As an alternative, maps can be prepared using P-values (probabilistic values). Materials and Methods: The statistical significance of rates rather than the rates themselves are used to map the results. The incidence rates calculated for each village from 2000 to 2009 is used to estimate λ, the expected number of cases in the study area. The obtained results are mapped using Arc GIS 10.0. Results: The likelihood of infections from low to high is depicted in the map and it is observed that five villages namely, Odanthurai, Coimbatore Corporation, Ikkaraiboluvampatti, Puliakulam, and Pollachi Corporation are more likely to have significantly high incidences. Conclusion: In the probability map, some of the areas with exceptionally high or low rates disappear. These are typically small unpopulated areas, whose rates are unstable due to the small numbers problem. The probability map shows more specific regions of relative risks and expected outcomes. PMID:26170544

  17. Evolution of a G6P[6] rotavirus strain isolated from a child with acute gastroenteritis in Ghana, 2012.

    PubMed

    Agbemabiese, Chantal A; Nakagomi, Toyoko; Suzuki, Yoshiyuki; Armah, George; Nakagomi, Osamu

    2015-08-01

    Unusual human G6P[6] rotavirus A (RVA) strains have been reported sporadically in Europe and Africa, but how they evolved was not fully understood. The whole genome of a Ghanaian G6P[6] strain designated PML1965 (2012) was analysed to understand how it evolved in Africa and to learn how its G6 VP7 gene was related to that of rotaviruses of human and artiodactyl origin. The genotype constellation of RVA/Human-wt/GHA/PML1965/2012/G6P[6] was G6-P-[6]-I2-R2-C2-M2-A2-N2-T2-E2-H2. It shared sublineages with G6P[6] strains previously detected in Italy and Africa in all genome segments except the VP6 gene of a few Burkinabe and Cameroonian strains and both the VP6 and NSP4 genes of Guinea Bissau strains. The VP7 gene of the G6P[6] strains appeared to derive from those of human G6P[9] strains, and they were distantly related to the VP7 genes of artiodactyl G6 or human G6P[14] strains. The time of the most recent common ancestor of the VP7 sequences of G6P[6] strains was estimated to be the year 1998. The evolutionary rates of the VP7 genes in bovine and human G6 rotaviruses were 6.93 × 10(-4) and 3.42 × 10(-3) nucleotide substitutions site(-1) year(-1), respectively, suggesting an accelerated adaptive process in the new host. The sequences of the remaining 10 genome segments of PML1965 clustered with those of G2 and G8 human rotaviruses detected in Africa possessing the DS-1-like genetic background. In conclusion, PML1965 evolved from G2 or G8 RVA strains with DS-1-like background, acquiring the G6 VP7 gene from a human G6P[9] RVA and not from an artiodactyl G6 RVA strain. PMID:25934790

  18. Trends in Gastroenteritis-associated Mortality in the United States 1985-2005: Variations by ICD-9 and ICD-10 Codes

    EPA Science Inventory

    BackgroundTrends in gastroenteritis-associated mortality are changing over time with development of antibiotic resistant strains of certain pathogens, improved diagnostic methods, and changing healthcare. In 1999, ICD-10 coding was introduced for mortality records which can also ...

  19. The organization, function, and outcomes of ST-elevation myocardial infarction networks worldwide: current state, unmet needs and future directions.

    PubMed

    Huber, Kurt; Gersh, Bernard J; Goldstein, Patrick; Granger, Christopher B; Armstrong, Paul W

    2014-06-14

    The organization of networks in order to better coordinate and to faster offer reperfusion strategies for acute ST-elevation myocardial infarction (STEMI) is an important recommendation of recent versions of international guidelines. This article focusses on similarities and dissimilarities of world-wide networks, highlights essential network components, offers insights into still unmet needs and discusses potential measures to further improve quality of STEMI treatment.

  20. Gene expression analysis in children with complex seizures due to influenza A(H1N1)pdm09 or rotavirus gastroenteritis.

    PubMed

    Tsuge, Mitsuru; Oka, Takashi; Yamashita, Nobuko; Saito, Yukie; Fujii, Yosuke; Nagaoka, Yoshiharu; Yashiro, Masato; Tsukahara, Hirokazu; Morishima, Tsuneo

    2014-02-01

    Viral infections have been implicated as a cause of complex seizures in children. The pathogenic differences in complex seizures due to influenza A(H1N1)pdm09 or rotavirus gastroenteritis remain unclear. This study analyzed the gene expression profiles in the peripheral whole blood from pediatric patients with complex seizures due to influenza A(H1N1)pdm09 or rotavirus gastroenteritis. The gene expression profiles of ten patients (five with seizures and five without) with influenza A(H1N1)pdm09 and six patients (three with seizures and three without) with rotavirus gastroenteritis were examined. Gene expression profiles in the whole blood were different in complex seizures due to influenza A(H1N1)pdm09 or rotavirus gastroenteritis. Transcripts related to the immune response were significantly differentially expressed in complex seizures with influenza A(H1N1)pdm09, and transcripts related to the stress response were significantly differentially expressed in complex seizures with rotavirus gastroenteritis. Pathway analysis showed that the mitogen-activated protein kinases in the T cell receptor signaling pathway were activated in complex seizures due to influenza A(H1N1)pdm09. Dysregulation of the genes related to immune response or stress response could contribute to the pathogenic differences of the complex seizures due to influenza A(H1N1)pdm09 or rotavirus gastroenteritis.

  1. An outbreak of gastroenteritis in a holiday resort in Italy: epidemiological survey, implementation and application of preventive measures.

    PubMed

    Migliorati, Giacomo; Prencipe, Vincenza; Ripani, Alessandro; Di Francesco, Cristina; Casaccia, Claudia; Crudeli, Silvia; Ferri, Nicola; Giovannini, Armando; Marconi, Maria Maddalena; Marfoglia, Cristina; Melai, Valeria; Savini, Giovanni; Scortichini, Giampiero; Semprini, Primula; Ruggeri, Franco Maria

    2008-01-01

    A major gastroenteritis outbreak was reported in a vacation resort in Central Italy in 2003. A total of 183 cases were identified. The case-control study identified a statistically significant correlation between the disease and sea bathing, use of sanitary facilities in bungalows and of common showers. Stool samples taken from people affected were found positive for Norovirus (68%, 13 of 19 samples), Rotavirus (38%, 1 of 14 samples) and Campylobacter (7%, 3 of 8 samples). Environmental investigations revealed serious faecal contamination of the groundwater and the presence of Norovirus in the seawater near the resort. The mixing of groundwater and seawater with the non-drinking water system - which was also found to be connected to the drinking water system - had a primary role in the onset and spread of infection within the village. The complete absence of any gastroenteritis epidemics among the site guests since 2006 demonstrates the effectiveness of the environmental corrective measures taken.

  2. Diagnosis of viral gastroenteritis in children: interpretation of real-time PCR results and relation to clinical symptoms.

    PubMed

    Corcoran, M S; van Well, G T J; van Loo, I H M

    2014-10-01

    Molecular methods such as real-time polymerase chain reaction (PCR) are rapidly replacing traditional tests to detect fecal viral pathogens in childhood diarrhea. This technique has now increased the analytical sensitivity so drastically that positive results are found in asymptomatic children, leading to complex interpretation of real-time PCR results and difficult distinction between asymptomatic shedding and etiological cause of disease. We performed a review of the literature including pediatric studies using real-time PCR and a minimal inclusion period of one year to exclude bias by seasonality. We searched for studies on rotavirus, norovirus, adenovirus, astrovirus, and sapovirus, known to be the most common viruses to cause gastroenteritis in the pediatric population. For these viruses, we summarized the detection rates in hospitalized and community-based children with clinical symptoms of gastroenteritis, as well as subjects with asymptomatic viral shedding. Moreover, insight is given into the different viral sero- and genotypes causing pediatric gastroenteritis. We also discuss the scoring systems for severity of disease and their clinical value. A few published proposals have been made to improve the clinical interpretation of real-time PCR results, which we recapitulate and discuss in this review. We propose using the semi-quantitative measure of real-time PCR, as a surrogate for viral load, in relation to the severity score to distinguish asymptomatic viral shedding from clinically relevant disease. Overall, this review provides a better understanding of the scope of childhood gastroenteritis, discusses a method to enhance the interpretation of real-time PCR results, and proposes conditions for future research to enhance clinical implementation.

  3. A large community outbreak of gastroenteritis associated with consumption of drinking water contaminated by river water, Belgium, 2010.

    PubMed

    Braeye, T; DE Schrijver, K; Wollants, E; van Ranst, M; Verhaegen, J

    2015-03-01

    SUMMARY On 6 December 2010 a fire in Hemiksem, Belgium, was extinguished by the fire brigade with both river water and tap water. Local physicians were asked to report all cases of gastroenteritis. We conducted a retrospective cohort study among 1000 randomly selected households. We performed a statistical and geospatial analysis. Human stool samples, tap water and river water were tested for pathogens. Of the 1185 persons living in the 528 responding households, 222 (18·7%) reported symptoms of gastroenteritis during the time period 6-13 December. Drinking tap water was significantly associated with an increased risk for gastroenteritis (relative risk 3·67, 95% confidence interval 2·86-4·70) as was place of residence. Campylobacter sp. (2/56), norovirus GI and GII (11/56), rotavirus (1/56) and Giardia lamblia (3/56) were detected in stool samples. Tap water samples tested positive for faecal indicator bacteria and protozoa. The results support the hypothesis that a point-source contamination of the tap water with river water was the cause of the multi-pathogen waterborne outbreak.

  4. Trends in Gastroenteritis-Associated Mortality in the United States, 1985-2005

    EPA Science Inventory

    Worldwide, gastrointestinal infections are a major, and often preventable, cause of mortality. In much of the developing world, mortality due to gastrointestinal infections disproportionately impacts children and is often associated with poor hygienic conditions (e.g., contaminat...

  5. Complete genome sequence of an astrovirus identified in a domestic rabbit (Oryctolagus cuniculus) with gastroenteritis

    PubMed Central

    2012-01-01

    A colony of domestic rabbits in Tennessee, USA, experienced a high-mortality (~90%) outbreak of enterocolitis. The clinical characteristics were one to six days of lethargy, bloating, and diarrhea, followed by death. Heavy intestinal coccidial load was a consistent finding as was mucoid enteropathy with cecal impaction. Preliminary analysis by electron microscopy revealed the presence of virus-like particles in the stool of one of the affected rabbits. Analysis using the Virochip, a viral detection microarray, suggested the presence of an astrovirus, and follow-up PCR and sequence determination revealed a previously uncharacterized member of that family. Metagenomic sequencing enabled the recovery of the complete viral genome, which contains the characteristic attributes of astrovirus genomes. Attempts to propagate the virus in tissue culture have yet to succeed. Although astroviruses cause gastroenteric disease in other mammals, the pathogenicity of this virus and the relationship to this outbreak remains to be determined. This study therefore defines a viral species and a potential rabbit pathogen. PMID:22998755

  6. Foodborne Bacterial Pathogens Associated with the Risk of Gastroenteritis in the State of Qatar

    PubMed Central

    Weam, Banjar; Abraham, Mariama; Doiphode, Sanjay; Peters, Kenlyn; Ibrahim, Emad; Sultan, Ali; Mohammed, Hussni O.

    2016-01-01

    Objective To assess the risk of gastroenteritis associated with bacterial foodborne pathogens and identify associated factors in a highly diverse population. Material and methods A series of case-control studies were carried out to address the stated objective. The study population consisted of individuals who were admitted to the Hamad Medical Corporation hospitals and stool analysis indicated positive findings to Campylobacter spp., Escherichia coli, or Salmonella spp. between the period of August 2009 and December 2012. Cases were defined based on positive stool analysis to any of the previously mentioned organisms. Control group was similar to case group but negative in stool analysis to the particular pathogen under study. Association between demographic characteristics and likelihood of pathogen infection were investigated using logistic regression analysis. Results A total of 423 individuals diagnosed with these bacterial pathogens were randomly enrolled in the study. The majority of cases were infected by E.coli. Age was significantly associated with E.coli and Salmonella spp. Conclusion E.coli infection is common among young children. The risk of Salmonella increases with age. Campylobacter may affect any age. Further investigation of interaction between foodborne pathogen infection and environmental factors is necessary PMID:27103902

  7. [Cultivation of the transmissible gastroenteritis virus in a continuous cell line].

    PubMed

    Belopopska, P; Motovski, A

    1984-01-01

    Cell cultures of the permanent cell line SPEV to which the transmissive gastroenteritis virus had already been adapted were used to culture the virus and carry out the virus-neutralization test. Use was made of a cell suspension of a variable density--300 and 500 thou cells per cm3. Both variants of the cell suspension were comparatively studied in terms of growth, the production of a monolayer, susceptibility to infection, and titer of the virus obtained, using 4 test tubes with the virus at various rates of dilution which were kept under observation daily, keeping a record of the infected and noninfected cell cultures. The amount of the virus was determined by titration. It was found that the monolayer was produced more rapidly in the suspension containing 500 thou cells/cm3. In that case infection could be performed at the 24th hour. The cytopathic effect was more pronounced, and the titer of the virus obtained was higher. Successful attempts were made with the virus-neutralization test with the infection of the cell cultures in suspension. Thus, the entire procedure was shown to be labour-saving as the time for investigation of the sera was shortened.

  8. A non-enteric adenovirus A12 gastroenteritis outbreak in Rio de Janeiro, Brazil

    PubMed Central

    Portes, Silvana Augusta Rodrigues; Volotão, Eduardo de Mello; Rocha, Monica Simões; Rebelo, Maria Cristina; Xavier, Maria da Penha Trindade Pinheiro; de Assis, Rosane Maria; Rose, Tatiana Lundgren; Miagostovich, Marize Pereira; Leite, José Paulo Gagliardi; Carvalho-Costa, Filipe Anibal

    2016-01-01

    A gastroenteritis outbreak that occurred in 2013 in a low-income community in Rio de Janeiro was investigated for the presence of enteric viruses, including species A rotavirus (RVA), norovirus (NoV), astrovirus (HAstV), bocavirus (HBoV), aichivirus (AiV), and adenovirus (HAdV). Five of nine stool samples (83%) from patients were positive for HAdV, and no other enteric viruses were detected. Polymerase chain reaction products were sequenced and subjected to phylogenetic analysis, which revealed four strains and one strain of non-enteric HAdV-A12 and HAdV-F41, respectively. The HAdV-A12 nucleotide sequences shared 100% nucleotide similarity. Viral load was assessed using a TaqMan real-time PCR assay. Stool samples that were positive for HAdV-A12 had high viral loads (mean 1.9 X 107 DNA copies/g stool). All four patients with HAdV-A12 were < 25 months of age and had symptoms of fever and diarrhoea. Evaluation of enteric virus outbreaks allows the characterisation of novel or unique diarrhoea-associated viruses in regions where RVA vaccination is routinely performed. PMID:27223654

  9. Vero cytotoxin-producing Escherichia coli O157 gastroenteritis in farm visitors, North Wales.

    PubMed

    Payne, Christopher J I; Petrovic, Marko; Roberts, Richard J; Paul, Ashish; Linnane, Eithne; Walker, Mark; Kirby, David; Burgess, Anthony; Smith, Robert M M; Cheasty, Thomas; Willshaw, Geraldine; Salmon, Roland L

    2003-05-01

    An outbreak of Vero cytotoxin-producing Escherichia coli O157 (VTEC O157) gastroenteritis in visitors to an open farm in North Wales resulted in 17 primary and 7 secondary cases of illness. E. coli O157 Vero cytotoxin type 2, phage type 2 was isolated from 23 human cases and environmental animal fecal samples. A case-control study of 16 primary case-patients and 36 controls (all children) showed a significant association with attendance on the 2nd day of a festival, eating ice cream or cotton candy (candy floss), and contact with cows or goats. On multivariable analysis, only the association between illness and ice cream (odds ratio [OR]=11.99, 95% confidence interval [CI] 1.04 to 137.76) and cotton candy (OR=51.90, 95% CI 2.77 to 970.67) remained significant. In addition to supervised handwashing, we recommend that foods on open farms only be eaten in dedicated clean areas and that sticky foods be discouraged. PMID:12737734

  10. Rapid Evolution and the Importance of Recombination to the Gastroenteric Pathogen Campylobacter jejuni

    PubMed Central

    Gabriel, Edith; Leatherbarrow, Andrew J.H.; Cheesbrough, John; Gee, Steven; Bolton, Eric; Fox, Andrew; Hart, C. Anthony; Diggle, Peter J.; Fearnhead, Paul

    2009-01-01

    Responsible for the majority of bacterial gastroenteritis in the developed world, Campylobacter jejuni is a pervasive pathogen of humans and animals, but its evolution is obscure. In this paper, we exploit contemporary genetic diversity and empirical evidence to piece together the evolutionary history of C. jejuni and quantify its evolutionary potential. Our combined population genetics–phylogenetics approach reveals a surprising picture. Campylobacter jejuni is a rapidly evolving species, subject to intense purifying selection that purges 60% of novel variation, but possessing a massive evolutionary potential. The low mutation rate is offset by a large effective population size so that a mutation at any site can occur somewhere in the population within the space of a week. Recombination has a fundamental role, generating diversity at twice the rate of de novo mutation, and facilitating gene flow between C. jejuni and its sister species Campylobacter coli. We attempt to calibrate the rate of molecular evolution in C. jejuni based solely on within-species variation. The rates we obtain are up to 1,000 times faster than conventional estimates, placing the C. jejuni–C. coli split at the time of the Neolithic revolution. We weigh the plausibility of such recent bacterial evolution against alternative explanations and discuss the evidence required to settle the issue. PMID:19008526

  11. Absence of E protein arrests transmissible gastroenteritis coronavirus maturation in the secretory pathway

    SciTech Connect

    Ortego, Javier; Ceriani, Juan E.; Patino, Cristina; Plana, Juan; Enjuanes, Luis

    2007-11-25

    A recombinant transmissible gastroenteritis coronavirus (rTGEV) in which E gene was deleted (rTGEV-{delta}E) has been engineered. This deletion mutant only grows in cells expressing E protein (E{sup +} cells) indicating that E was an essential gene for TGEV replication. Electron microscopy studies of rTGEV-{delta}E infected BHK-pAPN-E{sup -} cells showed that only immature intracellular virions were assembled. These virions were non-infectious and not secreted to the extracellular medium in BHK-pAPN-E{sup -} cells. RNA and protein composition analysis by RNase-gold and immunoelectron microscopy showed that rTGEV-{delta}E virions contained RNA and also all the structural TGEV proteins, except the deleted E protein. Nevertheless, full virion maturation was blocked. Studies of the rTGEV-{delta}E subcellular localization by confocal and immunoelectron microscopy in infected E{sup -} cells showed that in the absence of E protein virus trafficking was arrested in the intermediate compartment. Therefore, the absence of E protein in TGEV resulted in two actions, a blockade of virus trafficking in the membranes of the secretory pathway, and prevention of full virus maturation.

  12. Vero Cytotoxin–Producing Escherichia coli O157 Gastroenteritis in Farm Visitors, North Wales

    PubMed Central

    Petrovic, Marko; Roberts, Richard J.; Paul, Ashish; Linnane, Eithne; Walker, Mark; Kirby, David; Burgess, Anthony; Smith, Robert M.M.; Cheasty, Thomas; Willshaw, Geraldine; Salmon, Roland L.

    2003-01-01

    An outbreak of Vero cytotoxin–producing Escherichia coli O157 (VTEC O157) gastroenteritis in visitors to an open farm in North Wales resulted in 17 primary and 7 secondary cases of illness. E. coli O157 Vero cytotoxin type 2, phage type 2 was isolated from 23 human cases and environmental animal fecal samples. A case-control study of 16 primary case-patients and 36 controls (all children) showed a significant association with attendance on the 2nd day of a festival, eating ice cream or cotton candy (candy floss), and contact with cows or goats. On multivariable analysis, only the association between illness and ice cream (odds ratio [OR]=11.99, 95% confidence interval [CI] 1.04 to 137.76) and cotton candy (OR=51.90, 95% CI 2.77 to 970.67) remained significant. In addition to supervised handwashing, we recommend that foods on open farms only be eaten in dedicated clean areas and that sticky foods be discouraged. PMID:12737734

  13. Immunogenicity of transmissible gastroenteritis virus (TGEV) M gene delivered by attenuated Salmonella typhimurium in mice.

    PubMed

    Qing, Ying; Liu, Jiawen; Huang, Xiaobo; Li, Yaqing; Zhang, Yudi; Chen, Jie; Wen, Xintian; Cao, Sanjie; Wen, Yiping; Wu, Rui; Yan, Qigui; Ma, Xiaoping

    2016-04-01

    Attenuated Salmonella typhimurium (S. typhimurium) was selected as a transgenic vehicle for the development of live mucosal vaccines against transmissible gastroenteritis virus (TGEV) based on the M gene. An approximate 1.0 kb DNA fragment, encoding for glycoprotein M, was amplified by RT-PCR and cloned into eukaryotic expression vector pVAX1. The recombinant plasmid pVAX-M was transformed by electroporation into attenuated S. typhimurium SL7207, and the expression and translation of the pVAX-M delivered by recombinant S. typhimurium SL7207 (pVAX-M) was detected both in vitro and in vivo. BALB/c mice were inoculated orally with SL7207 (pVAX-M) at different dosages to evaluate safety of the vaccines. The bacterium was safe to mice at a dosage of 2 × 10(9) CFU, almost eliminated from the spleen and liver at week 4 post-immunization and eventually cleared at week 6. Mice immunized with 1 × 10(9) CFU of SL7207 (pVAX-M) elicited specific anti-TGEV local mucosal and humoral responses including levels of IgA, IgG, IL-4, and IFN-γ as measured by indirect ELISA assay. Moreover, the control groups (pVAX group, PBS group) maintained at a normal level during week 4-8 post-immunization. The results indicated that attenuated S. typhimurium could be used as a delivery vector for oral immunization of TGEV M gene vaccine. PMID:26837896

  14. Group A rotavirus gastroenteritis: post-vaccine era, genotypes and zoonotic transmission.

    PubMed

    Luchs, Adriana; Timenetsky, Maria do Carmo Sampaio Tavares

    2016-01-01

    ABSTRACTThis article provides a review of immunity, diagnosis, and clinical aspects of rotavirus disease. It also informs about the changes in epidemiology of diarrheal disease and genetic diversity of circulating group A rotavirus strains following the introduction of vaccines. Group A rotavirus is the major pathogen causing gastroenteritis in animals. Its segmented RNA genome can lead to the emergence of new or unusual strains in human populations via interspecies transmission and/or reassortment events.RESUMOEste artigo fornece uma revisão sobre imunidade, diagnóstico e aspectos clínicos da doença causada por rotavírus. Também aponta as principais mudanças no perfil epidemiológico da doença diarreica e na diversidade genética das cepas circulantes de rotavírus do grupo A, após a introdução vacinal. O rotavírus do grupo A é o principal patógeno associado à gastroenterite em animais. Seu genoma RNA segmentado pode levar ao surgimento de cepas novas ou incomuns na população humana, por meio de transmissão entre espécies e eventos de rearranjo.

  15. Regulation of ROS in transmissible gastroenteritis virus-activated apoptotic signaling

    SciTech Connect

    Ding, Li; Zhao, Xiaomin; Huang, Yong; Du, Qian; Dong, Feng; Zhang, Hongling; Song, Xiangjun; Zhang, Wenlong; Tong, Dewen

    2013-12-06

    Highlights: •TGEV infection induced ROS accumulation. •ROS accumulation is involved in TGEV-induced mitochondrial integrity impairment. •ROS is associated with p53 activation and apoptosis occurrence in TGEV-infected cells. -- Abstract: Transmissible gastroenteritis virus (TGEV), an enteropathogenic coronavirus, causes severe lethal watery diarrhea and dehydration in piglets. Previous studies indicate that TGEV infection induces cell apoptosis in host cells. In this study, we investigated the roles and regulation of reactive oxygen species (ROS) in TGEV-activated apoptotic signaling. The results showed that TGEV infection induced ROS accumulation, whereas UV-irradiated TGEV did not promote ROS accumulation. In addition, TGEV infection lowered mitochondrial transmembrane potential in PK-15 cell line, which could be inhibited by ROS scavengers, pyrrolidinedithiocarbamic (PDTC) and N-acetyl-L-cysteine (NAC). Furthermore, the two scavengers significantly inhibited the activation of p38 MAPK and p53 and further blocked apoptosis occurrence through suppressing the TGEV-induced Bcl-2 reduction, Bax redistribution, cytochrome c release and caspase-3 activation. These results suggest that oxidative stress pathway might be a key element in TGEV-induced apoptosis and TGEV pathogenesis.

  16. Biochemical and biophysical characterization of the transmissible gastroenteritis coronavirus fusion core

    SciTech Connect

    Ma Guangpeng; Feng Youjun; Gao Feng; Wang Jinzi; Liu Cheng; Li Yijing . E-mail: yijingli@163.com

    2005-12-02

    Transmissible gastroenteritis coronavirus (TGEV) is one of the most destructive agents, responsible for the enteric infections that are lethal for suckling piglets, causing enormous economic loss to the porcine fostering industry every year. Although it has been known that TGEV spiker protein is essential for the viral entry for many years, the detail knowledge of the TGEV fusion protein core is still very limited. Here, we report that TGEV fusion core (HR1-SGGRGG-HR2), in vitro expressed in GST prokaryotic expression system, shares the typical properties of the trimer of coiled-coil heterodimer (six {alpha}-helix bundle), which has been confirmed by a combined series of biochemical and biophysical evidences including size exclusion chromatography (gel-filtration), chemical crossing, and circular diagram. The 3D homologous structure model presents its most likely structure, extremely similar to those of the coronaviruses documented. Taken together, TGEV spiker protein belongs to the class I fusion protein, characterized by the existence of two heptad-repeat (HR) regions, HR1 and HR2, and the present knowledge about the truncated TGEV fusion protein core may facilitate in the design of the small molecule or polypeptide drugs targeting the membrane fusion between TGEV and its host.

  17. Group A rotavirus gastroenteritis: post-vaccine era, genotypes and zoonotic transmission.

    PubMed

    Luchs, Adriana; Timenetsky, Maria do Carmo Sampaio Tavares

    2016-01-01

    ABSTRACTThis article provides a review of immunity, diagnosis, and clinical aspects of rotavirus disease. It also informs about the changes in epidemiology of diarrheal disease and genetic diversity of circulating group A rotavirus strains following the introduction of vaccines. Group A rotavirus is the major pathogen causing gastroenteritis in animals. Its segmented RNA genome can lead to the emergence of new or unusual strains in human populations via interspecies transmission and/or reassortment events.RESUMOEste artigo fornece uma revisão sobre imunidade, diagnóstico e aspectos clínicos da doença causada por rotavírus. Também aponta as principais mudanças no perfil epidemiológico da doença diarreica e na diversidade genética das cepas circulantes de rotavírus do grupo A, após a introdução vacinal. O rotavírus do grupo A é o principal patógeno associado à gastroenterite em animais. Seu genoma RNA segmentado pode levar ao surgimento de cepas novas ou incomuns na população humana, por meio de transmissão entre espécies e eventos de rearranjo. PMID:27462899

  18. Isolation of Laribacter hongkongensis, a novel bacterium associated with gastroenteritis, from Chinese tiger frog.

    PubMed

    Lau, Susanna K P; Lee, Leo C K; Fan, Rachel Y Y; Teng, Jade L L; Tse, Cindy W S; Woo, Patrick C Y; Yuen, Kwok-Yung

    2009-01-31

    Laribacter hongkongensis is a recently discovered novel bacterium associated with community-acquired gastroenteritis. Although the bacterium has been isolated from freshwater fish and natural freshwater environments, it is not known if other freshwater animals could also be a source of L. hongkongensis. In a surveillance study on freshwater food animals (other than fish) in Hong Kong, L. hongkongensis was isolated from eight of 10 Chinese tiger frogs (Hoplobatrachus chinensis), a widespread frog species commonly consumed in China and southeast Asia. The large intestine was the site with the highest recovery rate, followed by the small intestine and stomach. None of the 30 Malaysian prawns, 20 pieces of sand shrimp, 20 Chinese mystery snails or 10 Chinese soft-shelled turtles was found to harbor the bacterium. Among the eight positive frogs, a total of 26 isolates of L. hongkongensis, confirmed by phenotypic tests and PCR, were obtained. As with human, freshwater fish and natural water isolates, a heterogeneous population of L. hongkongensis in frogs was identified by pulsed-field gel electrophoresis, with 6 different patterns among the 26 isolates and a single frog often carrying different strains. The present report represents the first to describe the isolation of L. hongkongensis from amphibians. The high isolation rate and genetic heterogeneity of L. hongkongensis among the Chinese tiger frogs suggested that these animals are also natural reservoir for the bacterium. Caution should be exercised in handling and cooking these frogs. PMID:19033083

  19. An extensive gastroenteritis outbreak after drinking-water contamination by sewage effluent, Finland.

    PubMed

    Laine, J; Huovinen, E; Virtanen, M J; Snellman, M; Lumio, J; Ruutu, P; Kujansuu, E; Vuento, R; Pitkänen, T; Miettinen, I; Herrala, J; Lepistö, O; Antonen, J; Helenius, J; Hänninen, M-L; Maunula, L; Mustonen, J; Kuusi, M

    2011-07-01

    An inappropriate cross-connection between sewage- and drinking-water pipelines contaminated tap water in a Finnish town, resulting in an extensive waterborne gastroenteritis outbreak in this developed country. According to a database and a line-list, altogether 1222 subjects sought medical care as a result of this exposure. Seven pathogens were found in patient samples of those who sought treatment. To establish the true disease burden from this exposure, we undertook a population-based questionnaire investigation with a control population, infrequently used to study waterborne outbreaks. The study covered three areas, contaminated and uncontaminated parts of the town and a control town. An estimated 8453 residents fell ill during the outbreak, the excess number of illnesses being 6501. Attack rates were 53% [95% confidence interval (CI) 49.5-56.4] in the contaminated area, 15.6% (95% CI 13.1-18.5) in the uncontaminated area and 6.5% (95% CI 4.8-8.8) in the control population. Using a control population allowed us to differentiate baseline morbidity from the observed morbidity caused by the water contamination, thus enabling a more accurate estimate of the disease burden of this outbreak.

  20. Outbreak of small round structured virus gastroenteritis arose after kitchen assistant vomited.

    PubMed

    Patterson, W; Haswell, P; Fryers, P T; Green, J

    1997-06-27

    A wedding reception at a North Yorkshire hotel was followed by an explosive outbreak of gastroenteritis. The attack rate among the 111 guests was 50% and vomiting was a predominant feature. The results of laboratory and epidemiological investigations were consistent with a common source outbreak of small round structured virus (SRSV) infection genotype II. The source of the outbreak was traced to a kitchen assistant who suddenly became ill on the eve of the reception and vomited into a sink used for preparing vegetables. The sink was cleaned with a chlorine based disinfectant and used the next morning to prepare a potato salad, subsequently identified as the vehicle of infection in a cohort study of guests (odds ratio 3.21; CI 1.78-5.78, p = 0.0001). No other food was associated with illness. The outbreak provides further supporting evidence of the importance of vomiting in the transmission of SRSV infection, highlights the virulence of this group of viruses, and indicates their relative resistance to environmental disinfection and decontamination. It also highlights the need for the adequate training of catering staff and the implementation and enforcement of food hygiene regulations.

  1. Role of Norwalk virus in two foodborne outbreaks of gastroenteritis: definitive virus association.

    PubMed

    Fleissner, M L; Herrmann, J E; Booth, J W; Blacklow, N R; Nowak, N A

    1989-01-01

    Two separate food-associated outbreaks of gastroenteritis occurred among Erie County, New York residents in June 1986. In one outbreak, cases of illness were estimated to have occurred in 50% of the approximately 700 persons in 13 groups who ate at an out-of-county restaurant during a seven-day period, and, in the second outbreak, illness occurred in 26 (30%) of 87 persons who attended a graduation party held in a private home. Laboratory investigation included serology (blocking radioimmunoassay) to determine seroconversion to Norwalk virus and an enzyme immunoassay for detection of Norwalk virus antigen in stools, which the investigators have found to be more specific for Norwalk virus than serology. Seroconversion to Norwalk virus occurred in 11 (79%) of 14 restaurant-related cases and seven (100%) of seven graduation party cases. Seroconversion to Norwalk virus antigen was also found in four (40%) of 10 food handlers at the restaurant and in two (100%) of two food handlers at the graduation party. Antigen was detected in the stools of three (20%) of 15 restaurant-related cases and four (67%) of six graduation party cases. No stools for viral analyses were available for testing from food handlers. All seven of the patients with Norwalk virus-positive stools were also positive by seroconversion. Widespread availability of reagents for stool antigen detection would result in confirmation of more outbreaks due to Norwalk virus and in a more timely manner.

  2. Technology trends, energy prices affect worldwide rig activity

    SciTech Connect

    Rappold, K.

    1995-09-25

    The major worldwide offshore rig markets have improved slightly this year, while the onshore markets generally lagged slightly. Offshore rig utilization rates have remained strong worldwide, with some areas reaching nearly 100%. Total worldwide offshore rig (jack ups, semisubmersible, drillships, submersibles, and barges) utilization was about 86%. Offshore drilling activity is driven primarily by oil and natural gas price expectations. Natural gas prices tend to drive North American offshore drilling activity, including the shallow waters in the Gulf of Mexico. International offshore drilling activity and deepwater projects in the Gulf of Mexico are more closely tied to oil prices. The paper discusses US rig count, directional drilling activity, jack up rig demand, semisubmersibles demand, rig replacement costs, and new construction.

  3. Infectious diseases of the nervous system: pathogenesis and worldwide impact.

    PubMed

    Berkhout, Ben

    2008-11-01

    The 2008 Infectious Diseases of the Nervous System: Pathogenesis and World Impact conference was held at the Pasteur Institute of Paris, and was the first worldwide conference on neuroinfections. While viral encephalitis and bacterial meningitis are being actively studied in the developed world, much less attention is paid to the often fatal nervous system infections caused by neurotropic viruses, parasites and mycobacteria that represent important health problems in tropical regions. This meeting fostered worldwide interactions between scientists and stimulated the exchange of the latest research results on these neglected neurotropic pathogens. PMID:18988120

  4. The impact of diagnostic delay on the course of acute appendicitis

    PubMed Central

    Cappendijk, V; Hazebroek, F

    2000-01-01

    BACKGROUND—The diagnosis of acute appendicitis is often delayed, which may complicate the further course of the disease.
AIMS—To review appendectomy cases in order to determine the incidence of diagnostic delay, the underlying factors, and impact on the course of the disease.
METHODS—Records of all children who underwent appendectomy from 1994 to 1997 were reviewed. The 129 cases were divided into group A (diagnostic period within 48 hours) and group B (diagnostic period 48 hours or more).
RESULTS—In the group with diagnostic delay, significantly more children had first been referred to a paediatrician rather than to a surgeon. In almost half of the cases in this group initial diagnosis was not appendicitis but gastroenteritis. The perforation rate in group A was 24%, and in group B, 71%. Children under 5 years of age all presented in the delayed group B and had a perforation rate of 82%. The delayed group showed a higher number of postoperative complications and a longer hospitalisation period.
CONCLUSIONS—Appendicitis is hard to diagnose when, because of a progressing disease process, the classical clinical picture is absent. The major factor in diagnostic delay is suspected gastroenteritis. Early surgical consultation in a child with deteriorating gastroenteritis is advised. Ultrasonographs can be of major help if abdominal signs and symptoms are non-specific for appendicitis.

 PMID:10869003

  5. Shaping Social Justice Leadership: Insights of Women Educators Worldwide

    ERIC Educational Resources Information Center

    Lyman, Linda L.; Strachan, Jane; Lazaridou, Angeliki

    2012-01-01

    "Shaping Social Justice Leadership: Insights of Women Educators Worldwide" contains evocative portraits of twenty-three women educators and leaders from around the world whose actions are shaping social justice leadership. Woven from words of their own narratives, the women's voices lift off the page into readers' hearts and minds to inspire and…

  6. Location of robotic surgical systems worldwide and in France.

    PubMed

    Vaessen, C

    2011-10-01

    The advent of robot-assisted surgery is a surgical revolution. However, the costs of installing and using a da Vinci system are impediments to the proliferation of this technology. This article reviews the locations of robotic surgical systems worldwide and in France, in 2010.

  7. Essays on the Future of Continuing Education Worldwide.

    ERIC Educational Resources Information Center

    Ziegler, Warren L., Ed.

    Topics chosen for these eight seminar papers divide basically into three categories: discussions on processes and methods for planning for the future of adult education; attempts to project into the future such worldwide problems as urbanism, conflict, the population explosion, and specific adult education trends; and discussion of the current…

  8. Worldwide Behavioral Research on Major Global Causes of Mortality

    ERIC Educational Resources Information Center

    Dal-Re, Rafael

    2011-01-01

    Background: Researchers willing to publish their interventional studies' results must register their studies before starting enrollment. This study aimed to describe all "open" (i.e., recruiting or not yet recruiting) behavioral studies in 16 of 20 top worldwide leading causes of death. Method: Search on Clinicaltrials.gov database (March 2010).…

  9. State-of-the-Art in Open Courseware Initiatives Worldwide

    ERIC Educational Resources Information Center

    Vladoiu, Monica

    2011-01-01

    We survey here the state-of-the-art in open courseware initiatives worldwide. First, the MIT OpenCourseWare project is overviewed, as it has been the real starting point of the OCW movement. Usually, open courseware refers to a free and open digital publication of high quality university level educational materials that are organized as courses,…

  10. Worldwide trends in engine coolants, cooling system materials and testing

    SciTech Connect

    Not Available

    1990-01-01

    This book contains the proceedings on worldwide trends in engine coolants, cooling systems, materials and testings. Topics covered include: Internationalization of the Automotive Industry - Global Responses in the Functional Fluid Area; Analysis of Coolants from Diesel Engines; Cavitation Damage of Diesel Engine Wet- Cylinder Liners; and Development of Test Stand to Measure the Effect of Coolant Composition on Engine Coolant Pump Seal Leakage.

  11. Worldwide Educational Broadcasting: Diversity and Challenge in a New Era.

    ERIC Educational Resources Information Center

    Kodaira, Sachiko Imaizumi

    1991-01-01

    This paper analyzes the state of the world's educational broadcasting community following the rapid changes in the 1980s. The future prospects of educational television and radio broadcasting are discussed based on a summary of the Worldwide Survey of 48 foreign countries which was conducted in 1989, and a review of the presentations given by…

  12. Structures of School Systems Worldwide: A Comparative Study

    ERIC Educational Resources Information Center

    Popov, Nikolay

    2012-01-01

    In the past 20 years I have been examining the structures of school systems worldwide. This ongoing research has been enriched by the findings obtained from the lecture course on Comparative Education I have been delivering to students in the Bachelor and Master's Education Programs at Sofia University, Bulgaria. This paper presents some results…

  13. Worldwide Environmental Compliance Assessment System (ECAS). Final report

    SciTech Connect

    Schell, D.J.; Beckler, T.M.

    1993-03-01

    The U.S. Army maintains an environmental compliance program that identifies compliance problems before they are cited as violations by the U.S. Environmental Protection Agency (USEPA). Beginning in 1985, Major Army Commands (MACOMs) were required to conduct comprehensive environmental assessments at all installations on a 4-year cycle. The installations must also conduct a mid-cycle internal assessment. Because each MACOM was developing a separate assessment system, the Army mandated, through Army Regulation 200-1, one unified Army-wide assessment mechanism. The resulting system combines Federal, Department of Defense (DOD), and Army environmental regulations, along with good management practices and risk-management information, into a series of checklists that show legal requirements and which specific items or operations to review. Each assessment protocol lists a point of contact to help assessors review the checklist items as effectively as possible. The Worldwide Environmental Compliance Assessment System (ECAS) manual incorporates existing checklists from USEPA and private industry. It also integrates information from the Overseas Environmental Baseline Guidance Document (OEBGD), published by DOD in October 1992. Additionally, Worldwide ECAS includes pertinent information from Army Regulations, DOD Directives and Instructions, and it cites good management practices for an overall environmental review. Worldwide Environmental Compliance Assessment System (ECAS), Worldwide ECAS, Environmental compliance checklists.

  14. Detection and molecular characterization of caliciviruses (vesivirus and norovirus) in an outbreak of acute diarrhea in kittens from Brazil.

    PubMed

    Castro, Tatiana X; Cubel Garcia, Rita de Cássia N; Fumian, Tulio M; Costa, Erika M; Mello, Renata; White, Peter A; Leite, José Paulo G

    2015-10-01

    Feline caliciviruses (FCVs) have occasionally been described in cats in association with enteric disease, but an etiological role for these viruses in acute gastroenteritis is still unclear. In this study, molecular characterization of FCV and feline norovirus (FNoV) was undertaken using real-time PCR (RT-PCR) and sequence analysis of the ORF1 region in fecal specimens from 29 diarrheic cats. The specimens were also screened for parvovirus, coronavirus, astrovirus and group A rotavirus. A quantitative one step RT-PCR was also performed to detect and quantitate NoV genogroup IV and the role of these animal caliciviruses in feline gastroenteritis was investigated. This is the first description of enteric FCV and FNoV in South America. PMID:26189893

  15. Acute rhinosinusitis in adults: an update on current management

    PubMed Central

    Masood, Ajmal; Moumoulidis, Ioannis; Panesar, Jaan

    2007-01-01

    Acute rhinosinusitis is a common disease with worldwide prevalence. It is a significant burden on the health services. It is most commonly caused by viruses and is self‐limiting in nature. The diagnosis of acute rhinosinusitis is clinical and sinus radiography is not indicated routinely. Most cases of acute rhinosinusitis are treated symptomatically. However, symptoms may persist beyond 10 days when secondary bacterial infection prevails. Antibiotics are reserved for moderate or severe cases or when there is development of complications of acute rhinosinusitis. This paper provides an update on the current management of acute rhinosinusitis. PMID:17551072

  16. Rotavirus Gastroenteritis in a Neonatal Unit of a Greek Tertiary Hospital: Clinical Characteristics and Genotypes

    PubMed Central

    Koukou, Dimitra; Chatzichristou, Panagiota; Trimis, Georgios; Siahanidou, Tania; Skiathitou, Anna-Venetia; Koutouzis, Emmanouil I.; Syrogiannopoulos, George A.; Lourida, Athanasia; Michos, Athanasios G.; Syriopoulou, Vassiliki P.

    2015-01-01

    Introduction Rotavirus (RV) infection in neonatal age can be mild or even asymptomatic. Several studies have reported that RV is responsible for 31%-87% of pediatric nosocomial diarrhea and causes gastroenteritis outbreaks in pediatric and neonatal units. Objectives Study clinical characteristics, genotypes and risk factors of RV infection in neonatal age. Methods A prospective study was conducted from April 2009 till April 2013 in the neonatal special care unit of the largest tertiary pediatric hospital of Greece. Fecal samples and epidemiological data were collected from each neonate with gastrointestinal symptoms. RV antigen was detected with a rapid immunochromatography test. RV positive samples were further genotyped with RT PCR and sequencing using specific VP7 and VP4 primers. Results Positive for RV were 126/415 samples (30.4%). Mean age of onset was 18 days. Seventy four cases (58%) were hospital acquired. Seasonality of RV infection did not differ significantly throughout the year with the exception of 4 outbreaks. Genotypes found during the study period were G4P[8] (58.7%), G1P[8] (14.7%), G12P[8] (9.3%), G3P[8] (9.3%), G12P[6] (5.3%), G9P[8] (1.3%) and G2P[4] (1.3%). RV cases presented with: diarrhea (81%), vomiting (26.2%), fever (34.9%), dehydration (28.6%), feeding intolerance (39.7%), weight loss (54%), whilst 19% of cases were asymptomatic. Comparing community with hospital acquired cases differences in clinical manifestations were found. Conclusions Significant incidence of nosocomially transmitted RV infection in neonatal age including asymptomatic illness exists. Genotypes causing nosocomial outbreaks are not different from community strains. Circulating vaccines can be effective in prevention of nosocomial RV infection through herd immunity. PMID:26214830

  17. Case-control comparison of bacterial and protozoan microorganisms associated with gastroenteritis: application of molecular detection.

    PubMed

    Bruijnesteijn van Coppenraet, L E S; Dullaert-de Boer, M; Ruijs, G J H M; van der Reijden, W A; van der Zanden, A G M; Weel, J F L; Schuurs, T A

    2015-06-01

    The introduction of molecular detection of infectious organisms has led to increased numbers of positive findings, as observed for pathogens causing gastroenteritis (GE). However, because little is known about the prevalence of these pathogens in the healthy asymptomatic population, the clinical value of these additional findings is unclear. A case-control study was carried out in a population of patients served by general practitioners in the Netherlands. A total of 2710 fecal samples from case and matched control subjects were subjected to multiplex real-time PCR for the 11 most common bacterial and four protozoal causes of GE. Of 1515 case samples, 818 (54%) were positive for one or more target organisms. A total of 49% of the controls were positive. Higher positivity rates in cases compared to controls were observed for Campylobacter spp., Salmonella spp., Clostridium difficile, enteroinvasive Escherichia coli/Shigella spp., enterotoxigenic E. coli, enteroaggregative E. coli, atypical enteropathogenic E. coli (EPEC), Cryptosporidium parvum/hominis, and Giardia lamblia. However, Dientamoeba fragilis and Shiga-like toxigenic E. coli were detected significantly less frequent in cases than in controls, while no difference in prevalence was found for typical EPEC and enterohemorrhagic E. coli. The association between the presence of microorganisms and GE was the weakest in children aged 0 to 5 years. Higher relative loads in cases further support causality. This was seen for Campylobacter spp., Salmonella spp., enterotoxigenic E. coli, and C. parvum/hominis, and for certain age categories of those infected with C. difficile, enteroaggregative E. coli, and atypical EPEC. For D. fragilis and Shiga-like toxigenic E. coli/enterohemorrhagic E. coli, pathogen loads were lower in cases. Application of molecular diagnostics in GE is rapid, sensitive and specific, but results should be interpreted with care, using clinical and additional background information.

  18. A food borne outbreak of gastroenteritis due to shigella and possibly salmonella in a school.

    PubMed

    Chanachai, Karoon; Pittayawonganon, Chakrarat; Areechokchai, Darin; Suchatsoonthorn, Chiyaporn; Pokawattana, Ladda; Jiraphongsa, Chuleeporn

    2008-03-01

    On August 5, 2005, a private hospital reported a large number of students with gastrointestinal illness from the same school in Bangkok, Thailand. The Bureau of Epidemiology along with the Bangkok Metropolitan Administration investigated this outbreak, to determine risk factors, identify the source of infection and possible causative organism, and recommend prevention and control strategies. A case was defined as a person who was studying or working at School A and who developed abdominal pain, diarrhea, nausea or vomiting during the five-day period of August 4 to 8, 2005. A descriptive study was carried out for active case-finding, medical records review, and case interviews. We conducted the retrospective cohort study among third and fourth grade students. Stool samples were collected and tested at the Thai National Institute of Health and at private hospital laboratories. The overall attack rate was 37%. Main symptoms were diarrhea, fever, headache, abdominal pain, vomiting, and nausea. The highest attack rate (63%) was among fourth-grade students. Based on food-history data collected from ill and well students, a multiple logistic regression analysis showed that a mixed chicken and rice dish served for lunch on August 4 was associated with illness (OR 3.28, 95% CI 1.46-7.36). Among stools samples from 103 cases, Shigella group D was found in 18 cases, Salmonella group C in 5 cases, and Salmonella group E in 2 cases. This food borne outbreak of gastroenteritis was most likely caused by Shigella spp although the possibility of mixed contamination with Shigella and Salmonella spp cannot be ruled out. Food borne outbreaks such as this can be prevented through simple and effective hygienic measures. PMID:18564716

  19. Proteome Profile of Swine Testicular Cells Infected with Porcine Transmissible Gastroenteritis Coronavirus

    PubMed Central

    Ma, Ruili; Zhang, Yanming; Liu, Haiquan; Ning, Pengbo

    2014-01-01

    The interactions occurring between a virus and a host cell during a viral infection are complex. The purpose of this paper was to analyze altered cellular protein levels in porcine transmissible gastroenteritis coronavirus (TGEV)-infected swine testicular (ST) cells in order to determine potential virus-host interactions. A proteomic approach using isobaric tags for relative and absolute quantitation (iTRAQ)-coupled two-dimensional liquid chromatography-tandem mass spectrometry identification was conducted on the TGEV-infected ST cells. The results showed that the 4-plex iTRAQ-based quantitative approach identified 4,112 proteins, 146 of which showed significant changes in expression 48 h after infection. At 64 h post infection, 219 of these proteins showed significant change, further indicating that a larger number of proteomic changes appear to occur during the later stages of infection. Gene ontology analysis of the altered proteins showed enrichment in multiple biological processes, including cell adhesion, response to stress, generation of precursor metabolites and energy, cell motility, protein complex assembly, growth, developmental maturation, immune system process, extracellular matrix organization, locomotion, cell-cell signaling, neurological system process, and cell junction organization. Changes in the expression levels of transforming growth factor beta 1 (TGF-β1), caspase-8, and heat shock protein 90 alpha (HSP90α) were also verified by western blot analysis. To our knowledge, this study is the first time the response profile of ST host cells following TGEV infection has been analyzed using iTRAQ technology, and our description of the late proteomic changes that are occurring after the time of vigorous viral production are novel. Therefore, this study provides a solid foundation for further investigation, and will likely help us to better understand the mechanisms of TGEV infection and pathogenesis. PMID:25333634

  20. An outbreak of Norwalk-like gastroenteritis associated with contaminated drinking water at a caravan park.

    PubMed

    McAnulty, J M; Rubin, G L; Carvan, C T; Huntley, E J; Grohmann, G; Hunter, R

    1993-03-01

    During the 1989 Christmas holiday period, a large outbreak of gastroenteritis occurred among persons staying at a caravan park in southern New South Wales. Review of local hospital records found that 77 per cent of patients presenting with infective diarrhoea between 29 December and 3 January had stayed at the caravan park. In a retrospective cohort study we compared rates of illness among caravan park patrons exposed to different water sources. Stools were tested for pathogens and convalescent sera for viral antibodies. Rain and reticulated river water sampled from the caravan park were tested for bacteria and viruses. Of 351 persons interviewed at the caravan park, 305 (87 per cent) reported an illness characterised by diarrhoea, vomiting and abdominal pain. Of 196 persons who used reticulated river water for drinking or ablutions, 175 (89 per cent) became ill compared with 47 of 72 persons (65 per cent) who did not use this water (relative risk 1.4, 95 per cent confidence interval 1.2 to 1.6). The outbreak was probably caused by a 27-28 nm small round structured virus found in the stool from one ill person. High levels of faecal coliforms in the reticulated river water and enterovirus in sediment samples suggest that the outbreak was caused by sewage contaminating the reticulated river water through a break in the pipe directly over the underground water tanks. To prevent such outbreaks, poor water and sewerage system layouts should be avoided and nonpotable water should be clearly labelled. Where feasible, all camping-ground water should stem from town supplies.

  1. Isotonic is better than hypotonic saline for intravenous rehydration of children with gastroenteritis: a prospective randomised study

    PubMed Central

    Neville, K A; Verge, C F; Rosenberg, A R; O'Meara, M W; Walker, J L

    2006-01-01

    Aims To determine whether the risk of hyponatraemia in children with gastroenteritis receiving intravenous (IV) fluids is decreased by the use of 0.9% saline. Methods A prospective randomised study was carried out in a tertiary paediatric hospital. A total of 102 children with gastroenteritis were randomised to receive either 0.9% saline + 2.5% dextrose (NS) or 0.45% saline + 2.5% dextrose (N/2) at a rate determined by their treating physician according to hospital guidelines and clinical judgement. Plasma electrolytes, osmolality, and plasma glucose were measured before (T0) and 4 hours after (T4) starting IV fluids, and subsequently if clinically indicated. Electrolytes and osmolality were measured in urine samples. Results were analysed according to whether children were hyponatraemic (plasma sodium <135 mmol/l) or normonatraemic at T0. Results At T0, mean (SD) plasma sodium was 135 (3.3) mmol/l (range 124–142), with 37/102 (36%) hyponatraemic. At T4, mean plasma sodium in children receiving N/2 remained unchanged in those initially hyponatraemic (n = 16), but fell 2.3 (2.2) mmol/l in the normonatraemic group. In contrast, among children receiving NS, mean plasma sodium was 2.4 (2.0) mmol/l higher in those hyponatraemic at baseline (n = 21) and unchanged in the initially normonatraemic children. In 16 children who were still receiving IV fluids at 24 hours, 3/8 receiving N/2 were hyponatraemic compared with 0/8 receiving NS. No child became hypernatraemic. Conclusions In gastroenteritis treated with intravenous fluids, normal saline is preferable to hypotonic saline because it protects against hyponatraemia without causing hypernatraemia. PMID:16352625

  2. Multicenter Evaluation of the BioFire FilmArray Gastrointestinal Panel for Etiologic Diagnosis of Infectious Gastroenteritis

    PubMed Central

    Leber, Amy; Chapin, Kimberle; Fey, Paul D.; Bankowski, Matthew J.; Jones, Matthew K.; Rogatcheva, Margarita; Kanack, Kristen J.; Bourzac, Kevin M.

    2015-01-01

    The appropriate treatment and control of infectious gastroenteritis depend on the ability to rapidly detect the wide range of etiologic agents associated with the disease. Clinical laboratories currently utilize an array of different methodologies to test for bacterial, parasitic, and viral causes of gastroenteritis, a strategy that suffers from poor sensitivity, potentially long turnaround times, and complicated ordering practices and workflows. Additionally, there are limited or no testing methods routinely available for most diarrheagenic Escherichia coli strains, astroviruses, and sapoviruses. This study assessed the performance of the FilmArray Gastrointestinal (GI) Panel for the simultaneous detection of 22 different enteric pathogens directly from stool specimens: Campylobacter spp., Clostridium difficile (toxin A/B), Plesiomonas shigelloides, Salmonella spp., Vibrio spp., Vibrio cholerae, Yersinia enterocolitica, enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, Shiga-like toxin-producing E. coli (stx1 and stx2) (including specific detection of E. coli O157), Shigella spp./enteroinvasive E. coli, Cryptosporidium spp., Cyclospora cayetanensis, Entamoeba histolytica, Giardia lamblia, adenovirus F 40/41, astrovirus, norovirus GI/GII, rotavirus A, and sapovirus. Prospectively collected stool specimens (n = 1,556) were evaluated using the BioFire FilmArray GI Panel and tested with conventional stool culture and molecular methods for comparison. The FilmArray GI Panel sensitivity was 100% for 12/22 targets and ≥94.5% for an additional 7/22 targets. For the remaining three targets, sensitivity could not be calculated due to the low prevalences in this study. The FilmArray GI Panel specificity was ≥97.1% for all panel targets. The FilmArray GI Panel provides a comprehensive, rapid, and streamlined alternative to conventional methods for the etiologic diagnosis of infectious gastroenteritis in the laboratory setting. The potential

  3. Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis.

    PubMed

    Buss, Sarah N; Leber, Amy; Chapin, Kimberle; Fey, Paul D; Bankowski, Matthew J; Jones, Matthew K; Rogatcheva, Margarita; Kanack, Kristen J; Bourzac, Kevin M

    2015-03-01

    The appropriate treatment and control of infectious gastroenteritis depend on the ability to rapidly detect the wide range of etiologic agents associated with the disease. Clinical laboratories currently utilize an array of different methodologies to test for bacterial, parasitic, and viral causes of gastroenteritis, a strategy that suffers from poor sensitivity, potentially long turnaround times, and complicated ordering practices and workflows. Additionally, there are limited or no testing methods routinely available for most diarrheagenic Escherichia coli strains, astroviruses, and sapoviruses. This study assessed the performance of the FilmArray Gastrointestinal (GI) Panel for the simultaneous detection of 22 different enteric pathogens directly from stool specimens: Campylobacter spp., Clostridium difficile (toxin A/B), Plesiomonas shigelloides, Salmonella spp., Vibrio spp., Vibrio cholerae, Yersinia enterocolitica, enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, Shiga-like toxin-producing E. coli (stx1 and stx2) (including specific detection of E. coli O157), Shigella spp./enteroinvasive E. coli, Cryptosporidium spp., Cyclospora cayetanensis, Entamoeba histolytica, Giardia lamblia, adenovirus F 40/41, astrovirus, norovirus GI/GII, rotavirus A, and sapovirus. Prospectively collected stool specimens (n = 1,556) were evaluated using the BioFire FilmArray GI Panel and tested with conventional stool culture and molecular methods for comparison. The FilmArray GI Panel sensitivity was 100% for 12/22 targets and ≥94.5% for an additional 7/22 targets. For the remaining three targets, sensitivity could not be calculated due to the low prevalences in this study. The FilmArray GI Panel specificity was ≥97.1% for all panel targets. The FilmArray GI Panel provides a comprehensive, rapid, and streamlined alternative to conventional methods for the etiologic diagnosis of infectious gastroenteritis in the laboratory setting. The potential

  4. [Feeding infants and young children with acute diarrhea].

    PubMed

    Chouraqui, J-P; Michard-Lenoir, A-P

    2007-10-01

    Acute gastroenteritis remains a common and often severe illness among infants and children throughout the world. The management of a child with acute diarrhea includes rehydration and maintenance fluids with oral rehydration solutions (ORS), combined with continued age-appropriate nutrition. However, although substantial data support the role of continued nutrition in improving gastrointestinal function and anthropometric, biochemical, and clinical outcomes, the practice of continued feeding during diarrheal episodes has been difficult to establish as accepted standard of care. Recommendations for maintenance dietary therapy depend on the age and diet history of the patient. It has been clear for many years that, when affected by gastroenteritis, breastfed infants should be continued on breast milk without any need for interruption and, by that way, will get faster recovery and improved nutrition. Moreover, many well-conducted studies have provided evidence that in formula-fed children not severely dehydrated, a rapid return to full feeding is well tolerated. Lactose intolerance and/or secondary cow's milk allergy are not a clinical concern for the vast majority of patients. In fact early refeeding i.e resumption of normal diet, in amounts sufficient to satisfy energy and nutrient requirements, should be the rule. However, in children younger than 6 months of age, the lack of suitable studies must lead to caution and use of specific lactose-free or extensively hydrolysate formulae, especially in case of severe and/or prolonged diarrhea. Several studies support the use of zinc supplementation or probiotics for acute diarrhea but some doubts persist in infant in developed countries. PMID:17961812

  5. The worldwide market for photovoltaics in the rural sector

    NASA Astrophysics Data System (ADS)

    Brainard, W. A.

    1982-09-01

    The worldwide market for stand-alone photovoltaic power systems in three specific segments of the rural sector were determined. The worldwide market for photovoltaic power systems for village power, cottage industry, and agricultural applications were addressed. The objectives of these studies were to: The market potential for small stand-alone photovoltaic power system in specific application areas was assessed. Technical, social and institutional barriers to PV utilization were identified. Funding sources available to potential users was also identified and marketing strategies appropriate for each sector were recommended to PV product manufacturers. The studies were prepared on the basis of data gathered from domestic sources and from field trips to representative countries. Both country-specific and sector-specific results are discussed, and broadly applicable barriers pertinent to international marketing of PV products are presented.

  6. Potential Atmospheric Impact Generated by Space Launches Worldwide

    NASA Astrophysics Data System (ADS)

    Brady, B. B.; Desain, J. D.; Curtiss, T. J.

    2010-12-01

    This paper evaluates the exhaust products generated from launch vehicles worldwide. Information on atmospheric deposition of carbon dioxide, water vapor, nitrogen dioxide, sulfates, inorganic chlorine and alumina particulates due to launch vehicles is presented. The potential for environmental impact from ozone destruction and global climate change due to space launches from worldwide sources is discussed. The exhaust from launch vehicles contains many components that have the potential to effect atmospheric concentrations of greenhouse gases. These greenhouse gases absorb and emit radiation within the thermal infrared range. The loss or gain of greenhouse gases has the net effect of changing the total global radiative balance. Launch vehicles are different than many other anthropogenic sources of these exhaust components (primarily the burning of fossil fuels), because vehicles deposit these exhaust components at all levels of the Earth’s atmosphere rather than just the lower troposphere.

  7. World-wide increase in tropospheric methane, 1978-1983

    NASA Technical Reports Server (NTRS)

    Blake, D. R.; Rowland, F. S.

    1986-01-01

    Techniques used to assess methane concentration in the troposphere are described, and data obtained during the period from 1978 to 1983 are presented in detail. Tropospheric methane concentrations in remote locations averaged a yearly world-wide increase of 0.018 + or - 0.002 parts per million by volume (ppmv). Average world-wide tropospheric concentration of methane in dry air was 1.625 ppmv at the end of 1983 measured against an NBS standard certified as 0.97 ppmv. Contributing to this steady increase in methane concentration are increases in the source strengths from cattle and rice fields, which in turn result from CO, CH4 and HO coupling. Among the physical and chemical effects is an increase in greenhouse warming of about 0.04 C per decade.

  8. The worldwide market for photovoltaics in the rural sector

    NASA Technical Reports Server (NTRS)

    Brainard, W. A.

    1982-01-01

    The worldwide market for stand-alone photovoltaic power systems in three specific segments of the rural sector were determined. The worldwide market for photovoltaic power systems for village power, cottage industry, and agricultural applications were addressed. The objectives of these studies were to: The market potential for small stand-alone photovoltaic power system in specific application areas was assessed. Technical, social and institutional barriers to PV utilization were identified. Funding sources available to potential users was also identified and marketing strategies appropriate for each sector were recommended to PV product manufacturers. The studies were prepared on the basis of data gathered from domestic sources and from field trips to representative countries. Both country-specific and sector-specific results are discussed, and broadly applicable barriers pertinent to international marketing of PV products are presented.

  9. Worldwide refining capacity at 75 million b/d level

    SciTech Connect

    Rhodes, A.K.

    1991-12-23

    While worldwide crude distillation capacity held essentially flat in 1991, there was solid growth in the Asia/Pacific region both in distillation and octane and conversion capacity. Refinery-by-refinery surveys of both U.S. and worldwide capacity appear together. The U.S. refining industry is apparently in a holding pattern, according to the survey, but it is still the largest and most complex refining industry in the world. It is clear, however, that Western European refineries are beginning to pay more attention to the quality of gasoline and its production. This paper indirectly reflects the obsolescence of much of the communist block technology with its weak conversion and upgrading capability.

  10. Global Ionosphere Perturbations Monitored by the Worldwide GPS Network

    NASA Technical Reports Server (NTRS)

    Ho, C. M.; Manucci, A. T.; Lindqwister, U. J.; Pi, X.

    1996-01-01

    For the first time, measurements from the Global Positioning System (GPS) worldwide network are employed to study the global ionospheric total electron content(TEC) changes during a magnetic storm (November 26, 1994). These measurements are obtained from more than 60 world-wide GPS stations which continuously receive dual-frequency signals. Based on the delays of the signals, we have generated high resolution global ionospheric maps (GIM) of TEC at 15 minute intervals. Using a differential method comparing storm time maps with quiet time maps, we find that significant TEC increases (the positive effect ) are the major feature in the winter hemisphere during this storm (the maximum percent change relative to quiet times is about 150 percent).

  11. Serologic survey for transmissible gastroenteritis virus neutralizing antibodies in selected feral and domestic swine sera in the southern United States.

    PubMed

    Woods, R D; Pirtle, E C; Sacks, J M; Gibbs, E P

    1990-07-01

    Serum samples collected from feral and domestic swine (Sus scrofa) in Florida and feral swine in Georgia and Texas were assayed by plaque reduction for their virus neutralizing (VN) antibodies against the porcine transmissible gastroenteritis virus (TGE). None of 560 samples collected from feral swine contained VN antibodies for TGE virus, but experimentally infected feral swine seroconverted. None of 665 samples from domestic swine contained TGE-VN antibodies. These results indicate feral swine are not a significant reservoir for TGE virus in southern states, but are capable of becoming infected and developing VN antibodies against TGE.

  12. Diarrhoea in adults (acute)

    PubMed Central

    2008-01-01

    Introduction An estimated 4000 million cases of diarrhoea occurred worldwide in 1996, resulting in 2.5 million deaths. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for acute diarrhoea in adults living in resource-rich countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults from resource-rich countries traveling to resource-poor countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults living in resource-poor countries? What are the effects of treatments for acute severe diarrhoea in adults living in resource-poor countries? We searched: Medline, Embase, The Cochrane Library and other important databases up to January 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 71 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, antimotility agents, antisecretory agents, bismuth subsalicylate, diet, intravenous rehydration, nasogastric tube rehydration, and oral rehydration solutions (amino acid oral rehydration solution, bicarbonate oral rehydration solution, reduced osmolarity oral rehydration solution, rice-based oral rehydration solution, standard oral rehydration solution). PMID:19450323

  13. Diarrhoea in adults (acute)

    PubMed Central

    2011-01-01

    Introduction An estimated 4.6 billion cases of diarrhoea occurred worldwide in 2004, resulting in 2.2 million deaths. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for acute diarrhoea in adults living in resource-rich countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults from resource-rich countries travelling to resource-poor countries? What are the effects of treatments for acute mild-to-moderate diarrhoea in adults living in resource-poor countries? What are the effects of treatments for acute severe diarrhoea in adults living in resource-poor countries? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 72 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, antimotility agents, antisecretory agents, bismuth subsalicylate, diet, intravenous rehydration, nasogastric tube rehydration, oral rehydration solutions (amino acid oral rehydration solution, bicarbonate oral rehydration solution, reduced osmolarity oral rehydration solution, rice-based oral rehydration solution, standard oral rehydration solution), vitamin A supplementation, and zinc supplementation. PMID:21718555

  14. Transformational Nurse Leaders Key to Strengthening Health Systems Worldwide.

    PubMed

    Ferguson, Stephanie L

    2015-01-01

    This column, presented by the director of the International Council of Nurses (ICN), discusses the work of the ICN over the past 20 years and into the future in developing nursing leaders across the globe. Dr Ferguson relates this activity to the constructs of the Magnet Recognition Program. The ICN is at the forefront of making sure nurses and nurse executives have the knowledge, skills, and ability to lead effectively worldwide and meet the global health challenges.

  15. Transformational Nurse Leaders Key to Strengthening Health Systems Worldwide.

    PubMed

    Ferguson, Stephanie L

    2015-01-01

    This column, presented by the director of the International Council of Nurses (ICN), discusses the work of the ICN over the past 20 years and into the future in developing nursing leaders across the globe. Dr Ferguson relates this activity to the constructs of the Magnet Recognition Program. The ICN is at the forefront of making sure nurses and nurse executives have the knowledge, skills, and ability to lead effectively worldwide and meet the global health challenges. PMID:26204374

  16. Combined cycle energy production: Overview of worldwide utilization and techniques

    NASA Astrophysics Data System (ADS)

    Roche, M.

    1982-06-01

    The worldwide distribution of combined cycle generators using simple recuperation, supercharged boilers, post combustion, and parallel combustion and complex cycles is summarized. Clean energy, fuel oil, coal, fluidized bed, and gasification based processes are discussed. With clean energy systems, up to 46% efficiency is achieved using a single recuperation - double evaporation cycle. Using gas turbine output to feed a higher power steam turbine is also economically attractive, but no one system is an obvious choice. Around 100 combined generators are now operating.

  17. Searching for the corner seismic moment in worldwide data

    SciTech Connect

    Felgueiras, Miguel; Santos, Rui; Martins, João Paulo

    2015-12-31

    In this paper the existence of the corner frequency value for the seismic moment distribution is investigated, analysing worldwide data. Pareto based distributions, usually considered as the most suitable to this type of data, are fitted to the most recent data, available in a global earthquake catalog. Despite the undeniable finite nature of the seismic moment data, we conclude that no corner frequency can be established considering the available data set.

  18. Iridium{reg_sign} worldwide personal communication system

    SciTech Connect

    Helm, J.

    1997-01-01

    The IRIDIUM system is a personal worldwide communication system designed to support portable, low power subscriber units through the use of a constellation of satellites in low earth polar orbit. The satellites are networked together to form a system which provides continuous line-of-sight communications between the IRIDIUM system and any point within 30 km of the earth{close_quote}s surface. The system architecture and operation are described. {copyright} {ital 1997 American Institute of Physics.}

  19. Student-Created Content in WorldWide Telescope

    NASA Astrophysics Data System (ADS)

    Roberts, M. J.

    2014-07-01

    Using WorldWide Telescope (WWT), the California Academy of Sciences used tour presentations created by Bay Area high school students. These students wrote, programmed, and presented their own fulldome shows utilizing WWT with the support of Academy staff. This allowed the students to create programs that were meaningful and interesting and to help determine the kinds of shows and content for future programs at the Academy. We present here our experiences and our goals for future programs.

  20. International organizations to enable world-wide mobile satellite services

    NASA Technical Reports Server (NTRS)

    Anglin, Richard L., Jr.

    1993-01-01

    Numbers of systems exist or have been proposed to provide world-wide mobile satellite services (MSS). Developers of these systems have formulated institutional structures they consider most appropriate for profitable delivery of these services. MSS systems provide niche services and complement traditional telecommunications networks; they are not integrated into world-wide networks. To be successful, MSS system operators must be able to provide an integrated suite of services to support the increasing globalization, interconnectivity, and mobility of business. The critical issue to enabling 'universal roaming' is securing authority to provide MSS in all of the nations of the world. Such authority must be secured in the context of evolving trends in international telecommunications, and must specifically address issues of standardization, regulation and organization. Today, only one existing organization has such world-wide authority. The question is how proponents of new MSS systems and services can gain similar authority. Securing the appropriate authorizations requires that these new organizations reflect the objectives of the nations in which services are to be delivered.

  1. Progress toward polio eradication - worldwide, 2014-2015.

    PubMed

    Hagan, José E; Wassilak, Steven G F; Craig, Allen S; Tangermann, Rudolf H; Diop, Ousmane M; Burns, Cara C; Quddus, Arshad

    2015-05-22

    In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to eradicate polio worldwide. Wild poliovirus (WPV) transmission has been interrupted in all but three countries (Afghanistan, Nigeria, and Pakistan). No WPV type 2 cases have been detected worldwide since 1999, and the last WPV type 3 case was detected in Nigeria in November 2012; since 2012, only WPV type 1 has been detected. Circulating vaccine-derived poliovirus (cVDPV), usually type 2, continues to cause cases of paralytic polio in communities with low population immunity. In 2012, the World Health Assembly declared global polio eradication "a programmatic emergency for global public health", and in 2014, WHO declared the international spread of WPV to previously polio-free countries to be "a public health emergency of international concern". This report summarizes global progress toward polio eradication during 2014-2015 and updates previous reports. In 2014, a total of 359 WPV cases were reported in nine countries worldwide. Although reported WPV cases increased in Pakistan and Afghanistan, cases in Nigeria decreased substantially in 2014, and encouraging progress toward global WPV transmission interruption has occurred. Overcoming ongoing challenges to interruption of WPV transmission globally will require sustained programmatic enhancements, including improving the quality of supplementary immunization activities (SIAs) to interrupt transmission in Afghanistan and Pakistan and to prevent WPV exportation to polio-free countries.

  2. Acute Bronchitis

    MedlinePlus

    ... bronchitis? Acute bronchitis is almost always caused by viruses that attack the lining of the bronchial tree ... infection. As your body fights back against these viruses, more swelling occurs and more mucus is produced. ...

  3. Acute Pericarditis

    MedlinePlus

    ... large pericardial effusions). Acute pericarditis usually responds to colchicine or NSAIDs (such as aspirin and ibuprofen ) taken ... reduce pain but relieves it by reducing inflammation. Colchicine also decreases the chance of pericarditis returning later. ...

  4. Verotoxinogenic Citrobacter freundii associated with severe gastroenteritis and cases of haemolytic uraemic syndrome in a nursery school: green butter as the infection source.

    PubMed Central

    Tschape, H.; Prager, R.; Streckel, W.; Fruth, A.; Tietze, E.; Böhme, G.

    1995-01-01

    A summer outbreak of severe gastroenteritis followed by haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura in a nursery school and kindergarten is described. Sandwiches prepared with green butter made with contaminated parsley were the likely vehicle of infection. The parsley originated from an organic garden in which manure of pig origin was used instead of artificial fertilizers. Clonally identical verotoxinogenic Citrobacter freundii were found as causative agents of HUS and gastroenteritis and were also detected on the parsley. Images Fig. 1 Fig. 2 PMID:7781732

  5. High-dose dietary zinc oxide mitigates infection with transmissible gastroenteritis virus in piglets

    PubMed Central

    2014-01-01

    Background Zinc (Zn) supplementation has been shown to reduce the incidence of diarrhea and to protect animals from intestinal diseases, but the mechanisms of this protective effect against virus infection in vivo have not yet been elucidated. Transmissible gastroenteritis virus (TGEV) causes diarrhea in piglets with an age-dependent decrease of severity. Results We used 60 weaned piglets that were divided into three groups to evaluate the effect of different Zn levels added to a conventional diet (50 mg Zn/kg diet, Znlow, control group). The other groups received the diet supplemented with ZnO at final concentrations of 150 mg Zn/kg diet (Znmed), or 2,500 mg/kg diet (Znhigh). Oral challenge infection with TGEV was performed when the pigs had been fed for 1 week with the respective diet. Half of the piglets of each group were sacrificed at day 1 and 18 after challenge infection. Fecal consistency was improved and body weights increased in the Znhigh group when compared to the other groups, but no direct effect of Zn concentrations in the diet on fecal TGEV shedding and mucosal immune responses was detectable. However, in the Znhigh group, we found a prevention of villus atrophy and decreased caspase-3-mediated apoptosis of jejunal epithelium. Furthermore, pigs receiving high Zn diet showed a down-regulation of interferon (IFN)-α, oligoadenylate synthetase (OAS), Zn transporter SLC39A4 (ZIP4), but up-regulation of metallothionein-1 (MT1), as well as the Zn transporters SLC30A1 (ZnT1) and SLC30A5 (ZnT5). In addition, forskolin-induced chloride secretion and epithelial resistance were controlled at a physiological level in the Znhigh but not the other groups. Finally, in the Znhigh group, we documented an earlier and higher systemic TGEV-specific serum antibody response. Conclusions These results suggest that high dietary Zn could provide enhanced protection in the intestinal tract and stimulate the systemic humoral immune response against TGEV infection. PMID

  6. Vaccine-derived NSP2 segment in rotaviruses from vaccinated children with gastroenteritis in Nicaragua.

    PubMed

    Bucardo, Filemón; Rippinger, Christine M; Svensson, Lennart; Patton, John T

    2012-08-01

    Rotavirus (RV) vaccination programs have been established in several countries using the human-attenuated G1P[8] monovalent vaccine Rotarix (GlaxoSmithKline) and/or the human-bovine reassortant G1, G2, G3, G4, P[8] pentavalent vaccine RotaTeq (Merck). The efficacy of both vaccines is high (∼90%) in developed countries, but can be remarkably lower in developing countries. For example, a vaccine efficacy against severe diarrhea of only 58% was observed in a 2007-2009 Nicaraguan study using RotaTeq. To gain insight into the significant level of vaccine failure in this country, we sequenced the genomes of RVs recovered from vaccinated Nicaraguan children with gastroenteritis. The results revealed that all had genotype specificities typical for human RVs (11 G1P[8], 1 G3P[8]) and that the sequences and antigenic epitopes of the outer capsid proteins (VP4 and VP7) of these viruses were similar to those reported for RVs isolated elsewhere in the world. As expected, nine of the G1P[8] viruses and the single G3P[8] virus had genome constellations typical of human G1P[8] and G3P[8] RVs: G1/3-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1. However, two of the G1P[8] viruses had atypical constellations, G1-P[8]-I1-R1-C1-M1-A1-N2-T1-E1-H1, due to the presence of a genotype-2 NSP2 (N2) gene. The sequence of the N2 NSP2 gene was identical to the bovine N2 NSP2 gene of RotaTeq, indicating that the two atypical viruses originated via reassortment of human G1P[8] RVs with RotaTeq viruses. Together, our data suggest that the high level of vaccine failure in Nicaraguan is probably not due to antigenic drift of commonly circulating virus strains nor the emergence of new antigenetically distinct virus strains. Furthermore, our data suggest that the widespread use of the RotaTeq vaccine has led to the introduction of vaccine genes into circulating human RVs.

  7. Vaccine-Derived NSP2 Segment in Rotaviruses from Vaccinated Children with Gastroenteritis in Nicaragua

    PubMed Central

    Bucardo, Filemón; Rippinger, Christine M.; Svensson, Lennart; Patton, John T.

    2012-01-01

    Rotavirus (RV) vaccination programs have been established in several countries using the human-attenuated G1P[8] monovalent vaccine Rotarix™ (GlaxoSmithKline) and/or the human-bovine reassortant G1, G2, G3, G4, P[8] pentavalent vaccine RotaTeq™ (Merck). The efficacy of both vaccines is high (~90%) in developed countries, but can be remarkably lower in developing countries. For example, a vaccine efficacy against severe diarrhea of only 58% was observed in a 2007–2009 Nicaraguan study using RotaTeq. To gain insight into the significant level of vaccine failure in this country, we sequenced the genomes of RVs recovered from vaccinated Nicaraguan children with gastroenteritis. The results revealed that all had genotype specificities typical for human RVs (11 G1P[8], 1 G3P[8]) and that the sequences and antigenic epitopes of the outer capsid proteins (VP4 and VP7) of these viruses were similar to those reported for RVs isolated elsewhere in the world. As expected, nine of the G1P[8] viruses and the single G3P[8] virus had genome constellations typical of human G1P[8] and G3P[8] RVs: G1/3-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1. However, two of the G1P[8] viruses had atypical constellations, G1-P[8]-I1-R1-C1-M1-A1-N2-T1-E1-H1, due to the presence of a genotype-2 NSP2 (N2) gene. The sequence of the N2 NSP2 gene was identical to the bovine N2 NSP2 gene of RotaTeq, indicating that the two atypical viruses originated via reassortment of human G1P[8] RVs with RotaTeq viruses. Together, our data suggest that the high level of vaccine failure in Nicaraguan is probably not due to antigenic drift of commonly circulating virus strains nor the emergence of new antigenetically distinct virus strains. Furthermore, our data suggests that the widespread use of the RotaTeq vaccine has led to the introduction of vaccine genes into circulating human RVs. PMID:22487061

  8. Antigenic Relationships among Porcine Epidemic Diarrhea Virus and Transmissible Gastroenteritis Virus Strains

    PubMed Central

    Lin, Chun-Ming; Gao, Xiang; Oka, Tomoichiro; Vlasova, Anastasia N; Esseili, Malak A.

    2015-01-01

    ABSTRACT Porcine epidemic diarrhea virus (PEDV) and transmissible gastroenteritis virus (TGEV) are economically important swine enteropathogenic coronaviruses. These two viruses belong to two distinct species of the Alphacoronavirus genus within Coronaviridae and induce similar clinical signs and pathological lesions in newborn piglets, but they are presumed to be antigenically distinct. In the present study, two-way antigenic cross-reactivity examinations between the prototype PEDV CV777 strain, three distinct U.S. PEDV strains (the original highly virulent PC22A, S indel Iowa106, and S 197del PC177), and two representative U.S. TGEV strains (Miller and Purdue) were conducted by cell culture immunofluorescent (CCIF) and viral neutralization (VN) assays. None of the pig TGEV antisera neutralized PEDV and vice versa. One-way cross-reactions were observed by CCIF between TGEV Miller hyperimmune pig antisera and all PEDV strains. Enzyme-linked immunosorbent assays, immunoblotting using monoclonal antibodies and Escherichia coli-expressed recombinant PEDV and TGEV nucleocapsid (N) proteins, and sequence analysis suggested at least one epitope on the N-terminal region of PEDV/TGEV N protein that contributed to this cross-reactivity. Biologically, PEDV strain CV777 induced greater cell fusion in Vero cells than did U.S. PEDV strains. Consistent with the reported genetic differences, the results of CCIF and VN assays also revealed higher antigenic variation between PEDV CV777 and U.S. strains. IMPORTANCE Evidence of antigenic cross-reactivity between porcine enteric coronaviruses, PEDV and TGEV, in CCIF assays supports the idea that these two species are evolutionarily related, but they are distinct species defined by VN assays. Identification of PEDV- or TGEV-specific antigenic regions allows the development of more specific immunoassays for each virus. Antigenic and biologic variations between the prototype and current PEDV strains could explain, at least partially, the

  9. Immune responses induced by recombinant Bacillus subtilis expressing the spike protein of transmissible gastroenteritis virus in pigs.

    PubMed

    Mou, Chunxiao; Zhu, Liqi; Xing, Xianping; Lin, Jian; Yang, Qian

    2016-07-01

    Transmissible gastroenteritis (TGE) causes severe diarrhea in suckling piglets, results in enormous economic loss in swine-producing areas of the world. To develop an effective, safe, and convenient vaccine for the prevention of TGE, we have constructed a recombinant Bacillus subtilis strain (B. subtilis CotGSG) displaying the transmissible gastroenteritis virus (TGEV) spike (S) protein and discussed its immune function to intestinal submucosal dendritic cells (DCs). Our results showed that the recombinant B. subtilis had the ability to recruit more DCs to sample B. subtilis CotGSG, migrate to MLNs, and induce immune responses. Immunized piglets with B. subtilis CotGSG could significantly elevate the specific SIgA titers in feces, IgG titers and neutralizing antibodies in serum. Collectively, our results suggested that recombinant B. subtilis CotGSG expressing the TGEV S protein could effectively induce immune responses via DCs, and provided a perspective on potential novel strategy and approach that may be applicable to the development of the next generation of TGEV vaccines. PMID:26988122

  10. Worldwide dataset of glacier thickness observations compiled by literature review

    NASA Astrophysics Data System (ADS)

    Naegeli, Kathrin; Gärtner-Roer, Isabelle; Hagg, Wilfried; Huss, Matthias; Machguth, Horst; Zemp, Michael

    2013-04-01

    The volume of glaciers and ice caps is still poorly known, although it is expected to contribute significantly to changes in the hydrological cycle and global sea level rise over the next decades. Studies presenting worldwide estimations are mostly based on modelling and scaling approaches and are usually calibrated with only few measurements. Direct investigations of glacier thickness, a crucial parameter for ice volume calculations, are rather sparse but nevertheless available from all around the globe. This study presents a worldwide compilation of glacier thickness observation data. Literature review revealed mean and/or maximum thickness values from 442 glaciers and ice caps, elevation band information and point measurements for 10 and 14 glaciers, respectively. Resulting in a dataset containing glaciers and ice caps with areas ranging from smaller than 0.1 km2 (e.g. Pizolgletscher, Switzerland) to larger than 10'000 km2 (e.g. Agassiz Ice Cap, Canada), mean ice thicknesses between 4 m (Blaueis, Germany) and 550 m (Aletschgletscher, Switzerland) and 64 values for ice masses with entries from different years. Thickness values are derived from various observation methods and cover a survey period between 1923 and 2011. A major advantage of the database is the included metadata, giving information about specific fields, such as the mean thickness value of Aletschgletscher, which is only valid for the investigation area Konkordiaplatz and not over the entire glacier. The relatively small collection of records in the two more detailed database levels reflects the poor availability of such data. For modelling purposes, where ice thicknesses are implemented to derive ice volumes, this database provides essential information about glacier and ice cap characteristics and enables the comparison between various approaches. However, the dataset offers a great variety of locations, thicknesses and surface areas of glaciers and ice caps and can therefore help to compare

  11. A systematic review of vitamin D status in populations worldwide.

    PubMed

    Hilger, Jennifer; Friedel, Angelika; Herr, Raphael; Rausch, Tamara; Roos, Franz; Wahl, Denys A; Pierroz, Dominique D; Weber, Peter; Hoffmann, Kristina

    2014-01-14

    Vitamin D deficiency is associated with osteoporosis and is thought to increase the risk of cancer and CVD. Despite these numerous potential health effects, data on vitamin D status at the population level and within key subgroups are limited. The aims of the present study were to examine patterns of 25-hydroxyvitamin D (25(OH)D) levels worldwide and to assess differences by age, sex and region. In a systematic literature review using the Medline and EMBASE databases, we identified 195 studies conducted in forty-four countries involving more than 168 000 participants. Mean population-level 25(OH)D values varied considerably across the studies (range 4·9-136·2 nmol/l), with 37·3 % of the studies reporting mean values below 50 nmol/l. The highest 25(OH)D values were observed in North America. Although age-related differences were observed in the Asia/Pacific and Middle East/Africa regions, they were not observed elsewhere and sex-related differences were not observed in any region. Substantial heterogeneity between the studies precluded drawing conclusions on overall vitamin D status at the population level. Exploratory analyses, however, suggested that newborns and institutionalised elderly from several regions worldwide appeared to be at a generally higher risk of exhibiting lower 25(OH)D values. Substantial details on worldwide patterns of vitamin D status at the population level and within key subgroups are needed to inform public health policy development to reduce risk for potential health consequences of an inadequate vitamin D status. PMID:23930771

  12. A long-term forecast analysis on worldwide land uses.

    PubMed

    Zhang, Wenjun; Qi, Yanhong; Zhang, Zhiguo

    2006-08-01

    More and more lands worldwide are being cultivated for food production while forests are disappearing at an unprecedented rate. This paper aims to make a long-term forecast on land uses worldwide and provide the public, researchers, and government officials with a clear profile for land uses in the future. Data of land uses since 1961 were used to fit historical trajectories and make the forecast. The results show that trajectories of land areas can be well fitted with univariate linear regressions. The forecasts of land uses during the coming 25 years were given in detail. Areas of agricultural land, arable land, and permanent pasture land worldwide would increase by 6.6%, 7.2%, and 6.3% respectively in the year 2030 as compared to the current areas. Permanent crops land area all over the world is forecasted to increase 0.64% by 2030. By the year 2030 the areas of forests and woodland, nonarable and nonpermanent land worldwide would decrease by 2.4% and 0.9% against the current areas. All other land area in the world would dramatically decline by 6.4% by the year 2030. Overall the land area related to agriculture would tend to decrease in developed countries, industrialized countries, Europe, and North and Central America. The agriculture related land area would considerably increase in developing countries, least developed countries, low-income countries, Asia, Africa, South America, etc. Developing countries hold larger total land area than developed countries. Dramatic and continuous growth in agricultural land area of developing countries would largely contribute to the expected growth of world agricultural land area in the coming years. Population explosion, food shortage and poverty in the world, especially in developing countries, together caused the excessive cultivation of land for agricultural uses in the past years. Increasing agricultural land area exacerbates the climate changes and degradation of environment. How to limit the growth of human

  13. Internet: Diameter of the World-Wide Web

    NASA Astrophysics Data System (ADS)

    Albert, Réka; Jeong, Hawoong; Barabási, Albert-László

    1999-09-01

    Despite its increasing role in communication, the World-Wide Web remains uncontrolled: any individual or institution can create a website with any number of documents and links. This unregulated growth leads to a huge and complex web, which becomes a large directed graph whose vertices are documents and whose edges are links (URLs) that point from one document to another. The topology of this graph determines the web's connectivity and consequently how effectively we can locate information on it. But its enormous size (estimated to be at least 8×108 documents) and the continual changing of documents and links make it impossible to catalogue all the vertices and edges.

  14. Development of a worldwide model for Flayer-produced scintillation

    NASA Technical Reports Server (NTRS)

    Fremouw, E. J.; Rino, C. L.

    1971-01-01

    An empirical approach to modeling the electron-density irregularities in the F layer of the earth's ionosphere that are primarily responsible for scintillation of transatmospheric VHF-UHF signals has been devised and tested. The work was directed toward two major goals: first, development of a worldwide model for describing the rms fluctuation in signal strength to be expected on an arbitrary satellite-to-earth communication link under average ionospheric conditions; and, second, investigation of the feasibility of similar modeling for description of the complete first-order distribution of signal strength.

  15. Worldwide status of energy standards for buildings: Appendices

    SciTech Connect

    Janda, K.B.; Busch, J.F.

    1993-02-01

    This informal survey was designed to gain information about the worldwide status of energy efficiency standards for buildings, particularly non-residential buildings such as offices, schools, and hotels. The project has three goals: 1. To understand and learn from the experience of countries with existing building energy standards; 2. To locate areas where these lessons might be applied and energy standards might be effectively proposed and developed; and 3. To share the information gathered with all participating countries. These appendices include the survey cover letter, the survey, and the details of selected energy standards in 35 countries, thus providing supporting material for the authors` article of the same title.

  16. Introduction: Training in reproductive endocrinology and infertility: meeting worldwide needs.

    PubMed

    de Ziegler, Dominique; Meldrum, David R

    2015-07-01

    Training in reproductive endocrinology (REI) and its male variant, andrology, has been profoundly influenced by the central role captured by assisted reproductive technologies (ART). The marked differences in financial, regulatory, and societal/ethical restrictions on ART in different countries of the world also prominently influence the clinical management of infertility. Training should strive for comprehensive teaching of all medically indicated procedures, even if only to optimize cross-border care. Better international standardization of infertility practices and training would benefit worldwide infertility care and should be promoted by international societies.

  17. Popigai Impact Structure Modeling: Morphology and Worldwide Ejecta

    NASA Technical Reports Server (NTRS)

    Ivanov, B. A.; Artemieva, N. A.; Pierazzo, E.

    2004-01-01

    The approx. 100 km in diameter, 35.7 0.2 Ma old Popigai structure [1], northern Siberia (Russia), is the best-preserved of the large terrestrial complex crater structures containing a central-peak ring [2- 4]. Although remotely located, the excellent outcrops, large number of drill cores, and wealth of geochemical data make Popigai ideal for the general study of the cratering processes. It is most famous for its impact-diamonds [2,5]. Popigai is the best candidate for the source crater of the worldwide late Eocene ejecta [6,7].

  18. Black Carbon Concentration from Worldwide Aerosol Robotic Network (AERONET) Measurements

    NASA Technical Reports Server (NTRS)

    Schuster, Gregory L.; Dubovik, Oleg; Holben, Brent N.; Clothiaux, Eugene E.

    2006-01-01

    The carbon emissions inventories used to initialize transport models and general circulation models are highly parameterized, and created on the basis of multiple sparse datasets (such as fuel use inventories and emission factors). The resulting inventories are uncertain by at least a factor of 2, and this uncertainty is carried forward to the model output. [Bond et al., 1998, Bond et al., 2004, Cooke et al., 1999, Streets et al., 2001] Worldwide black carbon concentration measurements are needed to assess the efficacy of the carbon emissions inventory and transport model output on a continuous basis.

  19. A worldwide population information network: status and goals.

    PubMed

    Kolbe, H K

    1978-07-01

    The rapid growth of world population and changes in government policies and programs have brought many changes to the area of population information. These include an increase in the amount of population information and funds devoted to research as well as an increase in awareness of the need to improve access to population information. Population information resources are located mainly in the developed countries, and no adequate information flow has yet been established to and from the developing nations. In response to this need, emerging regional population information networks are already identifiable. Focus is on components of an international population information network; North America and Europe; Latin America; Asia; Africa; and POPINS (worldwide population information system) Proposal, the model, and a counterproposal. It is evident that a strong North American European network is coalescing rapidly. The Latin American Population Documentation Systems (DOCPAL) offers the promise of bringing order to population information in Latin America. In Asia and Africa the situation in regard to population networks looks encouraging. During the next 2-year period the POPINS proposal will be carefully scrutinized. On the basis of these efforts, it seems reasonable to predict that within a 7-10 year period a de facto worldwide population information network will be a reality. PMID:10308566

  20. WorldWide Telescope Ambassadors, a Year 3 Update

    NASA Astrophysics Data System (ADS)

    Udomprasert, Patricia S.; Goodman, A. A.; Wong, C.

    2013-01-01

    The WorldWide Telescope Ambassadors (WWTA) Program has a track record of inspiring middle school students and getting them excited about science. The WorldWide Telescope (WWT) is a stunningly beautiful and freely available data visualization environment developed by Microsoft Research in collaboration with professional astronomers. Trained volunteer Ambassadors show teachers and students how to use WWT in their classrooms to explore and learn about our Universe. Our initial study has shown that WWT increases student understanding of astrophysical concepts and interest in astronomy and science. As an example of how excited students feel about learning astronomy with WWT, one middle school boy exclaimed, “This is way cooler than Call of Duty!” Our vision is to capitalize on the demonstrated inspirational and educational potential of WWT to increase the number of students who express interest in STEM fields. In this oral presentation, we provide a status update on the WWTA program, including ongoing results from our work with over 700 middle school students to date, and preliminary results from a new NSF-funded study comparing learning and interest gains for students studying Moon phases with WWT vs with the 2-dimensional simulator activity that accompanies their textbook. More information is available at wwtambassadors.org