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Sample records for acute infectious gastroenteritis

  1. 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

  2. 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

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

    PubMed

    Onozuka, Daisuke

    2014-01-01

    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. PMID:24889802

  4. Fatal case of acute gastroenteritis with multiple viral coinfections.

    PubMed

    Lupo, Julien; Morel-Baccard, Christine; Michard-Lenoir, Anne-Pascale; Germi, Raphaële; Pothier, Pierre; Ambert-Balay, Katia; Morand, Patrice

    2016-01-01

    We report a fatal case of acute gastroenteritis in a child with autism spectrum disorder. Multiple viral coinfections were detected by PCR in the patient's stool and digestive biopsy specimens. As viral detection is not necessarily associated with symptomatic disease, a semi-quantitative approach using cycle treshold values was proposed for the clinical interpretation of PCR. We discuss whether concomitant viral infections could be a risk factor for severe outcome in gastroenteritis cases. Individual risk factors are also addressed. PMID:26655270

  5. 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 ...

  6. 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

  7. The occurrence of calicivirus in infants with acute gastroenteritis.

    PubMed

    Suzuki, H; Konno, T; Kutsuzawa, T; Imai, A; Tazawa, F; Ishida, N; Katsushima, N; Sakamoto, M

    1979-01-01

    Calicivirus was detected in 8 (1.2%) of 647 hospitalized patients during a survey of acute gastroenteritis in infants and young children, conducted between December 1974 and September 1977. Morphologically calicivirus was approximately 30 nm in diameter with an easily recognizable staining "star of David" configuration. Its buoyant density in cesium chloride was 1.38-1.40 gm/ml. The serologic response to calicivirus by immune electron microscopy (IEM) was demonstrated only in paired sera from patients who shed the virus in their stools. The results suggest that calicivirus might be a cause of acute gastroenteritis in infants and young children. PMID:232145

  8. Acute gastroenteritis outbreak caused by a GII.6 norovirus

    PubMed Central

    Luo, Ling-Fei; Qiao, Kun; Wang, Xiao-Guang; Ding, Ke-Ying; Su, Hua-Ling; Li, Cui-Zhen; Yan, Hong-Jing

    2015-01-01

    AIM: To report an acute gastroenteritis outbreak caused by a genogroup 2 genotype 6 (GII.6) strain norovirus in Shanghai, China. METHODS: Noroviruses are responsible for approximately half of all reported gastroenteritis outbreaks in many countries. Genogroup 2 genotype 4 strains are the most prevalent. Rare outbreaks caused by GII.6 strains have been reported. An acute gastroenteritis outbreak occurred in an elementary school in Shanghai in December of 2013. Field and molecular epidemiologic investigations were conducted. RESULTS: The outbreak was limited to one class in an elementary school located in southwest Shanghai. The age of the students ranged from 9 to 10 years. The first case emerged on December 10, 2013, and the last case emerged on December 14, 2013. The cases peaked on December 11, 2013, with 21 new cases. Of 45 students in the class, 32 were affected. The main symptom was gastroenteritis, and 15.6% (5/32) of the cases exhibited a fever. A field epidemiologic investigation showed the pathogen may have been transmitted to the elementary school from employees in a delicatessen via the first case student, who had eaten food from the delicatessen one day before the gastroenteritis episodes began. A molecular epidemiologic investigation identified the cause of the gastroenteritis as norovirus strain GII.6; the viral sequence of the student cases showed 100% homology with that of the shop employees. Genetic relatedness analyses showed that the new viral strain is closely related to previously reported GII.6 sequences, especially to a strain reported in Japan. CONCLUSION: This is the first report to show that norovirus strain GII.6 can cause a gastroenteritis outbreak. Thus, the prevalence of GII.6 noroviruses requires attention. PMID:25954103

  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. 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. PMID:26059266

  11. Aetiology of community-acquired, acute gastroenteritis in hospitalised adults: a prospective cohort study

    PubMed Central

    Jansen, Andreas; Stark, Klaus; Kunkel, Jan; Schreier, Eckart; Ignatius, Ralf; Liesenfeld, Oliver; Werber, Dirk; Göbel, Ulf B; Zeitz, Martin; Schneider, Thomas

    2008-01-01

    Background The aetiology of severe gastroenteritis leading to hospitalisation in adults frequently remains unclear. Our objective was to study the causes and characteristics of community-acquired, acute gastroenteritis in adult hospitalized patients to support the clinical management of these patients. Methods From August 2005 to August 2007, we conducted a prospective cohort study among patients ≥18 y hospitalized with community-acquired gastroenteritis in a university hospital in Berlin, Germany. Stool specimens were examined for 26 gastrointestinal pathogens, supplemented by serologic tests for antibodies to Campylobacter spp., Yersinia spp., and Entamoeba histolytica. Patient data on demographics and clinical presentation were recorded and analyzed. Coexisting medical conditions were assessed using the Charlson Comorbidity Index score. Results Of 132 patients presenting with acute community-acquired gastroenteritis, 104 were included in the study. A non-infectious aetiology was diagnosed in 8 patients (8%). In 79 (82%) of the remaining 96 patients at least one microorganism was identified. Campylobacter spp. (35%) was detected most frequently, followed by norovirus (23%), Salmonella spp. (20%), and rotavirus (15%). In 46% of the patients with Campylobacter spp. infection, the diagnosis was made solely by serology. More than one pathogen was found in seventeen (22%) patients. Simultaneous infection was significantly more likely in patients with rotavirus and salmonella infections (RR 3.6; 95% CI: 1.8–7.4; RR 2.5; 95%CI: 1.2–5.5). Length of hospital stay (median: 5.5 days) was independent of the pathogen, but was associated with coexisting medical conditions (OR 4,8; 95%CI:2,0–11,6). Conclusion Known enteric pathogens were detected in 82% of adult patients who were hospitalized with acute gastroenteritis. We found that currently used culture-based methods may miss a substantial proportion of Campylobacter infections, and additional serological testing for

  12. 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. PMID:25596126

  13. Nationwide variation in the effects of temperature on infectious gastroenteritis incidence in Japan

    PubMed Central

    Onozuka, Daisuke; Hagihara, Akihito

    2015-01-01

    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. PMID:26255569

  14. 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.

  15. Eight different viral agents in childhood acute gastroenteritis.

    PubMed

    Bozkurt, Derya; Selimoğlu, Mukadder Ayşe; Otlu, Barış; Sandıkkaya, Ayşe

    2015-01-01

    Viral gastroenteritis is the most frequent cause of acute gastroenteritis (AGE) of childhood. The aim of this study was to determine the prevalence of viral agents including astrovirus, rotavirus, adenovirus, enterovirus, norovirus, parechovirus, Aichivirus and sapovirus in children with AGE in a pediatric Turkish population. Fecal specimens of 240 children with AGE were investigated by polymerase chain reaction, and viral agents were identified in 131 (54.6%) samples. The distribution of viral agents was as follows: 56 (42.8%) norovirus, 44 (33.6%) rotavirus, 29 (22.1%) enterovirus, 21 (16.0%) adenovirus, 21 (16.0%) parechovirus, 5 (3.8%) sapovirus and 1 (0.8%) Aichivirus. Single and multiple viral agents were detected in 38.8% and 15.8% of patients, respectively. The duration of hospitalization was longer in children with multiple viral agents than in those infected with a single viral agent (p<0.001). While the highest rate of rotavirus infection was detected in winter, the highest rate of norovirus was found in the summer. In conclusion, norovirus and rotavirus are the most frequent causes of childhood AGE in our country. PMID:26613223

  16. Human bocavirus in children with acute gastroenteritis in Albania.

    PubMed

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

    2016-05-01

    Human Bocavirus (HBoV) has been recently identified in association with acute viral gastroenteritis (AGE). The objective of this work was to investigate the prevalence of HBoV in children with AGE in Albania. Stool specimens collected from 142 children were analyzed by amplification of partial NP1 and Vp1/Vp2 genes. HBoV was detected in 13 samples (9.1%), 12 HBoV-1 and one HBoV-2. All HBoV-positive patients were co-infected with rotavirus and/or adenovirus, a finding which might indicate that there is no clear causal association of this agent with diarrhea. Further investigation is needed to assess the pathogenic role of HBoV in childhood diarrhea. PMID:26496439

  17. 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

  18. 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

  19. Gelatin tannate for treating acute gastroenteritis: a systematic review

    PubMed Central

    Ruszczyński, Marek; Urbańska, Magdalena; Szajewska, Hania

    2014-01-01

    Gelatin tannate (GT) is a complex of tannic acid, which possesses astringent, antibacterial, and anti-inflammatory properties, and a protective gelatin. It is increasingly being marketed as an antidiarrheal drug. Our aim was to review data on the effectiveness of GT in treating acute gastroenteritis (AGE) in children and adults. The MEDLINE, EMBASE, and the Cochrane Library databases were searched in July 2013, with no language restrictions, for controlled clinical trials. Additional references were obtained from reviewed articles. Two trials met the inclusion criteria. In adults, one randomized controlled trial involving 40 subjects (mean age: 43±13 years) found that, compared with placebo, GT may be more effective at reducing some symptoms of AGE in the first 48 h after initiation of treatment. In children, one poor quality study (no randomization and no blinding) involving 211 children (mean age: 2.5±2.4 years) reported some beneficial effect of GT at 12 h after initiation of treatment. None of the studies evaluated the effect of GT on the primary outcome measures for this review such as stool output, duration of diarrhea, admission to hospital, duration of hospital stay, and (in children) weight gain after rehydration. Currently, there is no evidence to support the use of GT for treating AGE in children and only sparse evidence to support the use of GT in adults. Further well-designed trials, with sufficient power, adequate follow-up periods, and clinically relevant outcome measures, are needed. These include stool volume, duration of diarrhea, admission to hospital, duration of hospital stay, weight gain after rehydration, and adverse effects. PMID:24733622

  20. 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. PMID:26095130

  1. 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

  2. Molecular epidemiology of enteric viruses in patients with acute gastroenteritis in Aichi prefecture, Japan, 2008/09-2013/14.

    PubMed

    Nakamura, Noriko; Kobayashi, Shinichi; Minagawa, Hiroko; Matsushita, Tadashi; Sugiura, Wataru; Iwatani, Yasumasa

    2016-07-01

    Acute gastroenteritis is a critical infectious disease that affects infants and young children throughout the world, including Japan. This retrospective study was conducted from September 2008 to August 2014 (six seasons: 2008/09-2013/14) to investigate the incidence of enteric viruses responsible for 1,871 cases of acute gastroenteritis in Aichi prefecture, Japan. Of the 1,871 cases, 1,100 enteric viruses were detected in 978 samples, of which strains from norovirus (NoV) genogroup II (60.9%) were the most commonly detected, followed by strains of rotavirus A (RVA) (23.2%), adenovirus (AdV) type 41 (8.2%), sapovirus (SaV) (3.6%), human astrovirus (HAstV) (2.8%), and NoV genogroup I (1.3%). Sequencing of the NoV genogroup II (GII) strains revealed that GII.4 was the most common genotype, although four different GII.4 variants were also identified. The most common G-genotype of RVA was G1 (63.9%), followed by G3 (27.1%), G2 (4.7%) and G9 (4.3%). Three genogroups of SaV strains were found: GI (80.0%), GII (15.0%), and GV (5.0%). HAstV strains were genotyped as HAstV-1 (80.6%), HAstV-8 (16.1%), and HAstV-3 (3.2%). These results show that NoV GII was the leading cause of sporadic acute viral gastroenteritis, although a variety of enteric viruses were detected during the six-season surveillance period. PMID:26647761

  3. Selected enteropathogens and clinical course in children hospitalized with severe acute gastroenteritis in Barbados

    PubMed Central

    Kumar, Alok; Browne, Chantelle; Scotland, Shauna; Krishnamurthy, Kandamaran; Nielsen, Anders L

    2014-01-01

    Objectives The primary aim of this study was to determine the prevalence of selected bacterial and viral enteropathogens in children hospitalized with acute gastroenteritis and the secondary aim was to characterize the clinical course and the outcome. Methodology A retrospective audit of children (<15 years) admitted with acute gastroenteritis during January 2008 to October 2010. Stool samples were analyzed for bacterial pathogens and for the Rotavirus. Demographics, clinical presentations, hospital course and outcome were extracted from the admission records. Results There were 571 children hospitalized with acute gastroenteritis, which accounted for 11% of all medical hospitalization in children. Overall, 42.9% of these children were ≤12 months in age. Stool test result was documented in 46.6% of children hospitalized with gastroenteritis and an enteropathogen was isolated in 36.8% of cases with documented stool test result. Non-typhoidal Salmonella species was the most commonly isolated enteropathogen accounting for 21.1% of all the documented cases. Rotavirus was identified as an etiological agent in 9.0%. Of the 56 children who had non-typhoidal salmonella gastroenteritis, 54(96.4%) were younger than 5 years. The median duration of hospitalization was 2 days (Range 1 day to 9 days). There were no deaths. Conclusion Non-typhoidal salmonella was the most common enteropathogen isolated and this was followed by the Rotavirus. PMID:25780359

  4. 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

  5. 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

  6. 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

  7. Prevalence of sapovirus infection among infant and adult patients with acute gastroenteritis in Tehran, Iran

    PubMed Central

    Romani, Sara; Azimzadeh, Pedram; Bozorgi, Sajad Majidizadeh; Zali, Narges; Jadali, Farzaneh

    2012-01-01

    Aim This study investigated the prevalence of sapovirus infections in patient with acute gastroenteritis in Tehran, Iran. Background Sapovirus, a member of the family Caliciviridae is one of the major causative agents of viral gastroenteritis affecting both children and adult individuals. There isn't enough data about prevalence and genotypes of sapovirus infection in Tehran, the capital city of Iran. Patients and methods A total of 42 fecal samples were collected from patients with acute gastroenteritis from May to July 2009. RT nested- PCR was performed for screening. To genotype the sapovirus isolates, some positive samples were subjected to phylogenetic analysis by sequencing of fragments of viral capsid gene region. Results Sapovirus was detected in 5 of 42 stool specimens from patients with acute gastroenteritis. Sapovirus detected in this study was clustered into only one distinct genogroup I/2. Sapovirus GI/2 was predominant. Conclusion Our results show that among the studied viruses responsible for this disease, sapovirus was a major viral isolate virus. PMID:24834197

  8. 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

  9. 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

  10. 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

  11. [Post-infectious functional gastrointestinal disorders: from the acute episode to chronicity].

    PubMed

    Mearin, Fermín; Balboa, Agustín

    2011-01-01

    Functional gastrointestinal disorders (FGID) form a major part of gastroenterology practice. Several studies have reported the development of post-infectious irritable bowel syndrome (PI-IBS) after acute gastroenteritis (AGE). Non-gastrointestinal (GI) infections may increase the risk of developing IBS. There are also data showing that a GI infection may trigger functional dyspepsia (PI-FD). The possible development of PI-IBS or PI-FD depends on factors related to both the infection and the host. Microinflammation has been found in patients with post-infectious FGID. Studies performed in animal models show that infection and acute inflammation permanently change gastrointestinal motility and sensitivity. The role of AGE in the development of FGID is important not only because this entity provides an excellent natural model for pathogenic study but also because it provides an opportunity for preventive action. PMID:21641686

  12. 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

  13. 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

  14. 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

  15. 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

  16. [Medication in infectious acute diarrhea in children].

    PubMed

    Cézard, J-P; Bellaiche, M; Viala, J; Hugot, J-P

    2007-10-01

    Acute infectious diarrhea in children remain still a frequent cause of morbidity. 50 % of them are due to rotavirus. Oral rehydration therapy and early realimentation have drastically reduced their mortality and morbidity. Beside oral or eventually IV rehydration therapy no medication has proven its efficacy based on the main HMO criteria (reduction of over 30 % of the stool output) except racecadotril and loperamide which is contre-indicated for the last one in children less than 2 years old. Other medications such as silicates or some probiotics have shown efficacy on diarrhea duration or stool consistency but not on stool output. They have so no formal indication in infectious diarrhea and should be considered as "comfort" treatment. Antibiotics, beside their indication in shigella, cholera and amibiasis could be used in invasive diarrhea in some debilating conditions or infants less than 3 months. PMID:17961811

  17. Causal factors of acute gastroenteritis in infants and young children.

    PubMed

    Zvizdić, Sukrija; Kapić, Elvedina; Hamzić, Sadeta

    2005-02-01

    Respiratory, gastrointestinal and skin diseases represent the most common diseases in infants and young children. Causal factors of these diseases are important infectious agents and causes of pathological conditions in children, but they are also very important for their parents, as well as for people in their close environment. Greater incidence of infections in infants and young children can be explained in different ways. A cause can be insufficient maturity of their immune system, but also their exposure to infections within collective accommodations (cribs, nurseries, pre-school institutions), where they are, at the same time, exposed to a number of unknown agents. Today, a great emphasis is devoted to the ways and kinds of children's nutrition. The problem of relation between infected young organism and infectious agent itself, is also reflected in a long resistance and excretion of microorganisms in their exterior environment. It is well-known that microorganisms resist and excrete much longer in younger organisms, compared to adults, where their resistance and excretion is much shorter or very rare. Actually, adults have already formed protective immunity against particular infectious agents. It doesn't prevent infections in adults, colonization of pathogens, nor eventual development of disease. Established immunity can shorten the time necessary for excretion of microorganisms in their exterior environment and, if disease gets developed, it is of shorter duration and slower progress. PMID:15771601

  18. 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. PMID:26602159

  19. Effect of Oral Ondansetron on Decreasing the Vomiting Associated with Acute Gastroenteritis in Iranian Children

    PubMed Central

    Golshekan, Kioomars; Badeli, Hamidreza; Rezaieian, Saman; Mohammadpour, Haniyeh; Hassanzadehrad, Afagh

    2013-01-01

    Objective The aim of this study was to determine the effect of oral ondansetron in decreasing the vomiting due to acute gastroenteritis in children. Methods In a single center, randomized, double blind, controlled trial, the effect of oral ondansetron was compared with placebo on 176 patients between 1 and 10 years old with acute gastroenteritis. 30 minutes after drug administration, oral rehydration therapy (ORT) was initiated. Severity of vomiting was evaluated during emergency department (ED) stay and 48 hours follow up. Data were collected and analyzed by SPSS16. Findings Fifty two of children (58.5%) were males with the mean age of 3.12 (±2.30) years. Ten patients in ondansetron and 14 in placebo group had persistent vomiting during ED stay. After analyzing, there was no significant relation between vomiting in 4 and 48 hours and need for intra venous fluid therapy between the two groups although ondansetron generally decreased ORT failure (P=0.03). Conclusion Although administrayion of oral ondansetron in gastroenteritis could decrease failure of ORT, it seems that further well-conducted clinical studies are needed to determine effects of oral ondansetron precisely. PMID:24800017

  20. Infectious gastroenteritis in Norfolk Island and recovery of viruses from drinking water.

    PubMed Central

    Murphy, A. M.; Grohmann, G. S.; Sexton, M. F.

    1983-01-01

    A high incidence of gastroenteritis in both islanders and tourists has been recorded in recent years on Norfolk Island--a popular tourist resort for Australians and New Zealanders. No bacterial cause has been found. However, electron microscopic examination of 28 faecal specimens revealed viruses associated with gastroenteritis in 21 (75%). No viruses were isolated in cell cultures. Bore water is used for drinking purposes on the island and 32 samples from 15 bores were examined for viruses by electron microscopy and culture as well as for bacterial contamination. Seven polioviruses (all type 1 vaccine strain) and adenoviruses 1 and 5 were isolated in cell cultures. In addition one rotavirus, one adenovirus and two small round viruses were detected by electron microscopy. Six of 21 samples tested showed unacceptably high levels of bacteria for drinking water. The deep ground water has apparently become contaminated with sewage effluent and is almost certainly the main cause of the high level of gastroenteritis on the island. Images Plate 1 PMID:6309956

  1. 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. PMID:27115152

  2. 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

  3. 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. PMID:24382267

  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. Investigation of an Outbreak of Acute Gastroenteritis in Kollam, Kerala, India.

    PubMed

    Rakesh, P S; Narayanan, Vishnu; Pillai, Swapna S; Retheesh, Rahul; Dev, Soumya

    2016-07-01

    An outbreak investigation was initiated following a report of unusual occurrence of acute gastroenteritis in Ashramam area, Kollam district, Kerala, India. House to house survey was conducted to identify cases. Person, place, and time analysis was done. Hypothesis was generated based on findings from cross sectional study, anecdotal evidences, laboratory investigation, and environmental observations. Univariate analysis was done generating odds ratios and confidence intervals to identify factors associated with the disease. A total of 57 cases were reported. Attack rate was highest among children younger than 14 years (22%). Among them, 91.2% (52/57) of the cases and 45.8% (169/369) of the people who had not developed the disease were dependent on pipe water (OR 12.31; 95% CI 4.81-31.52) for drinking purpose. The time frame of the disease occurrence, environmental observations, anecdotal evidences, and the results of analytical study indicated the possibility of the acute gastroenteritis outbreak as a result of pipeline contamination. The study warrants establishment of a good water quality surveillance system. PMID:27053229

  6. 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

  7. Is acute idiopathic pericarditis associated with recent upper respiratory tract infection or gastroenteritis? A case–control study

    PubMed Central

    Rey, Florian; Delhumeau-Cartier, Cecile; Meyer, Philippe; Genne, Daniel

    2015-01-01

    Objectives The aim of this study was to assess the association of a clinical diagnosis of acute idiopathic pericarditis (AIP), and a reported upper respiratory tract infection (URTI) or gastroenteritis (GE) in the preceding month. Design Patients who were hospitalised with a first diagnosis of AIP were retrospectively compared with a control group of patients admitted with deep vein thrombosis (DVT), matched by gender and age. Setting Primary and secondary care level; one hospital serving a population of about 170 000. Participants A total of 51 patients with AIP were included, of whom 46 could be matched with 46 patients with control DVT. Only patients with a complete review of systems on the admission note were included in the study. Main outcome measure Conditional logistic regression was used to assess the association of a clinical diagnosis of AIP and an infectious episode (URTI or GE) in the month preceding AIP diagnosis. Results Patients with AIP had more often experienced a recent episode of URTI or GE than patients with DVT (39.1% vs 10.9%, p=0.002). The multivariate conditional regression showed that AIP was independently associated with URTI or GE in the last month preceding diagnosis (OR=37.18, 95% CI=1.91 to 724.98, p=0.017). Conclusions This is, to the best of our knowledge, the first study demonstrating an association between a recent episode of URTI or GE and a clinical diagnosis of AIP. PMID:26603247

  8. Randomized Study of Ondansetron Versus Domperidone in the Treatment of Children With Acute Gastroenteritis

    PubMed Central

    Rerksuppaphol, Sanguansak; Rerksuppaphol, Lakkana

    2013-01-01

    Background Acute gastroenteritis (AGE) is a common condition among children that is frequently accompanied by vomiting. Symptomatic control of vomiting is important as it improves patient’s general condition and reduces the need for intravenous therapy and hospitalization. Antiemetic agents including ondansetron and domperidone are used to provide symptomatic relief but the existing studies do not provide enough evidence of better efficacy for one over another. Methods Seventy-six Thai children under the age of 15 with AGE were randomized to receive either ondansetron or domperidone. The primary outcome of the study was the proportion of the patients in each group who had no episode of vomiting 24 hours after the start of treatment. Results Primary outcome was met in 62% of patients in ondansetron group and 44% of patients in domperidone group (P = 0.16). Patients in domperidone group received more doses of the drug within 24 hours after the start of the treatment compared to ondansetron group (P = 0.01). No adverse effect was observed in any of the two groups. Conclusions Ondansetron can be considered a safe comparable alternative to commonly-used domperidone in Thai children who suffer from symptoms of gastroenteritis. Larger clinical trials are needed to further explore the effectiveness of the two medications. PMID:24171058

  9. 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

  10. Norovirus infection in children admitted to hospital for acute gastroenteritis in Belém, Pará, Northern Brazil.

    PubMed

    Siqueira, Jones Anderson Monteiro; Linhares, Alexandre da Costa; de Carvalho, Thaís Cristina Nascimento; Aragão, Glicélia Cruz; Oliveira, Darleise de Souza; Dos Santos, Mirleide Cordeiro; de Sousa, Maisa Silva; Justino, Maria Cleonice Aguiar; Mascarenhas, Joana D'Arc Pereira; Gabbay, Yvone Benchimol

    2013-04-01

    Noroviruses are the leading cause of epidemic, non-bacterial outbreaks of acute gastroenteritis, and are also a major cause of sporadic acute gastroenteritis in infants. The aim of the present study was to identify norovirus infections in children not infected by rotavirus admitted to hospital for acute gastroenteritis in Belém. A total of 348 fecal specimens were obtained from children with diarrhea aged less than 5 years, all of whom had tested negative for rotavirus, between May 2008 and April 2010. Fecal samples were screened for norovirus antigen using enzyme-immunoassay (EIA). Specimens were subjected to reverse-transcription polymerase chain reaction (RT-PCR) using the primers Mon432/434-Mon431/433 for detection of the GI and GII norovirus strains, respectively. Based on both methods, the overall norovirus positivity rate was 36.5% (127/348). Of the 169 samples collected in the first year, 44.4% (n = 75) tested positive for norovirus using both methods, 35.5% (n = 60) by EIA and 40.8% (n = 69) by RT-PCR. Using RT-PCR as a reference standard, a sensitivity of 78.3%, specificity of 94%, and agreement of 87.6% were recorded. Genome sequencing was obtained for 22 (31.9%) of the 69 positive samples, of which 90.9% (20/22) were genotype GII.4d and 9.1% (2/22) were genotype GII.b. Norovirus infection was most frequent in children under 2 years of age (41.5%-115/277). The peak incidence (62.1%) of norovirus-related acute gastroenteritis in these patients (not infected by rotavirus) was observed in February 2010. These findings emphasize the importance of norovirus as a cause of severe acute gastroenteritis among children in Belém, Pará, Northern Brazil. PMID:23359323

  11. An acute gastroenteritis outbreak caused by GII.17 norovirus in Jiangsu Province, China.

    PubMed

    Shi, Chao; Feng, Wei-Hong; Shi, Ping; Ai, Jing; Guan, Hong-Xia; Sha, Dan; Geng, Qian; Mei, Jun; Chen, Shan-Hui; Xiao, Yong; Qian, Yan-Hua

    2016-08-01

    Noroviruses are a common cause of acute gastroenteritis around the world; however, reports of outbreaks caused by GII.17 norovirus are rare. An outbreak caused by GII.17 norovirus in a senior high school in Wuxi, Jiangsu Province, China is reported here. An epidemiological investigation, pathogen detection, and case-control study were performed. Epidemiological data combined with the epidemic curve indicated that this outbreak was a point source type initially, followed by secondary transmission. The first case was identified as most likely the source of the outbreak. Risk analysis showed exposure to patients and sharing a communal water cooler to be associated with the spread of infection. Sequence analysis of GII-positive samples confirmed that the norovirus GII.17 variant was the etiological agent of this outbreak. PMID:27224012

  12. 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.

  13. 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

  14. Outbreak of acute gastroenteritis in an Austrian boarding school, September 2006.

    PubMed

    Schmid, D; Gschiel, E; Mann, M; Huhulescu, S; Ruppitsch, W; Bohm, G; Pichler, J; Lederer, I; Hoger, G; Heuberger, S; Allerberger, F

    2007-03-01

    An outbreak of acute gastroenteritis occurred in September 2006 in a boarding school in eastern Austria. Of 113 cases, 101 were hospitalised. In order to identify the outbreak source, a retrospective cohort study on the group at risk was performed, including 222 pupils and 30 staff members. Food exposure in the canteen of the school was identified as the most relevant common link among the cases in the case series investigation. Although the preliminary microbiological investigation made Norovirus infections possible, an in-depth descriptive epidemiological investigation later pointed to food intoxication rather than a viral infection as the cause of the outbreak. The analytical epidemiological investigation implicated boiled rice and chicken wings served in the canteen as the most likely source of the outbreak. Staphylococcus aureus was identified as the causative agent. Further molecular characterisation revealed that the predominant S. aureus type in this outbreak was a new spa type, t2046. The same spa type was isolated from stool specimens of the majority of the cases investigated, from samples of the incriminated boiled rice, and also from a swab of a palmar skin lesion of one of the healthy kitchen workers, who is therefore the most likely source of contamination. This outbreak underlines again the importance of compliance with the basic guidelines for kitchen hygiene. PMID:17439809

  15. Acute gastroenteritis and enteric viruses in hospitalised children in southern Brazil: aetiology, seasonality and clinical outcomes

    PubMed Central

    Raboni, Sonia Maria; Damasio, Guilherme Augusto Costa; Ferreira, Carla EO; Pereira, Luciane A; Nogueira, Meri B; Vidal, Luine R; Cruz, Cristina R; Almeida, Sergio M

    2014-01-01

    Viral acute gastroenteritis (AG) is a significant cause of hospitalisation in children younger than five years. Group A rotavirus (RVA) is responsible for 30% of these cases. Following the introduction of RVA immunisation in Brazil in 2006, a decreased circulation of this virus has been observed. However, AG remains an important cause of hospitalisation of paediatric patients and only limited data are available regarding the role of other enteric viruses in these cases. We conducted a prospective study of paediatric patients hospitalised for AG. Stool samples were collected to investigate human adenovirus (HAdV), RVA, norovirus (NoV) and astrovirus (AstV). NoV typing was performed by nucleotide sequencing and phylogenetic analysis. From the 225 samples tested, 60 (26%) were positive for at least one viral agent. HAdV, NoV, RVA and AstV were detected in 16%, 8%, 6% and 0% of the samples, respectively. Mixed infections were found in nine patients: HAdV/RVA (5), HAdV/NoV (3) and HAdV/NoV/RVA (1). The frequency of fever and lymphocytosis was significantly higher in virus-infected patients. Phylogenetic analysis of NoV indicated that all of these viruses belonged to genotype GII.4. The significant frequency of these pathogens in patients with AG highlights the need to routinely implement laboratory investigations. PMID:25075782

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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. PMID:26810147

  3. 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

  4. [Acute oliguric renal failure and haemolytic anaemia following infectious mononucleosis].

    PubMed

    Brkovic, Natasa; Jørgensen, Kit Riegels; Rosenbæk, Jeppe Bakkestrøm; Pedersen, Erling Bjerregaard

    2015-11-01

    A 19-year-old man was admitted to hospital due to fatigue, nausea, abdominal pain and faint. He was pale and icteric, awake with sufficient respiration and circulation. He had infectious mononucleosis complicated with acute oliguric renal failure and severe haemolytic anaemia with a positive Coombs test. He had a cold agglutinin syndrome. The treatment comprised intermittent haemodialysis, plasmapheresis and heating. He recovered completely after two months. PMID:26573947

  5. Clostridium perfringens type A fatal acute hemorrhagic gastroenteritis in a dog.

    PubMed

    Schlegel, Ben J; Van Dreumel, Tony; Slavić, Durda; Prescott, John F

    2012-05-01

    The morning after participating in a dog show, a 2-year-old Pomeranian dog was found dead in a pool of bloody feces. Necropsy revealed hemorrhagic gastroenteritis of the entire gastrointestinal tract, with many Gram-positive bacilli on the surface and in the lumen and crypts of the intestine. Enterotoxin-positive type A Clostridium perfringens were isolated in large numbers. This dramatic case of fatal C. perfringens gastroenteritis highlights the need to better understand the role of this bacterium in enteric disease of dogs. PMID:23115371

  6. Magnitude, Distribution, and Estimated Level of Underreporting of Acute Gastroenteritis in Jamaica

    PubMed Central

    Fletcher, Stephanie M.; Williams, Hank; Miller, Zahra; Scarlett, Henroy P.; Cooper, Collin; Gordon-Johnson, Kelly-Ann; Vickers, Ivan; Shaw, Karen; Wellington, Iyanna; Thame, Jennifer; Pérez, Enrique; Indar, Lisa

    2013-01-01

    Jamaica is the third largest island in the Caribbean. The epidemiology of acute gastroenteritis (AGE) is important to Jamaica, particularly in the areas of health, tourism, and because of the potential impact on the local workforce and the economy. Data collected by the National Surveillance Unit on the prevalence of AGE transmitted by food are not accurate. To determine the true magnitude, risk factors, and the extent of underreporting of AGE in Jamaica, we conducted a cross-sectional, population-based retrospective survey during the periods of 21 February–7 March and 14-27 June 2009, corresponding to high- and low-AGE season respectively. Of the total 1,920 persons selected randomly by a multistage cluster-sampling process, 1,264 responded (response rate 65.8%). Trained interviewers administered a standardized, validated questionnaire during face-to-face interviews. The overall prevalence of self-reported AGE was 4.0% (95% CI 2.9-5.1) at a rate of 0.5 episodes/per person-year. The highest monthly prevalence of AGE (14.6%) was found among the 1-4 year(s) age-group and the lowest (2.1%) among the 25-44 years age-group. Of the 18 cases (36%) who sought medical care, 11% were hospitalized, 33% were treated with antibiotics, and 66.7% received oral rehydration fluids. Only 2 cases who sought medical care reportedly submitted stool specimens. The mean duration of diarrhoea was 3.1 days, which resulted in a mean loss of 4 productive days, with over half of the cases requiring someone to care for them. The burden of syndromic AGE for 2009 was extrapolated to be 122,711 cases, showing an underreporting factor of 58.9. For every laboratory-confirmed AGE case, it was estimated that 383 more cases were occurring in the population. This research confirms that the prevalence of AGE is underreported in Jamaica and not being adequately detected by the current surveillance system. The components of the integrated surveillance system for AGE in Jamaica, particularly the

  7. 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...

  8. Noroviruses associated with acute gastroenteritis in a children's day care facility in Rio de Janeiro, Brazil.

    PubMed

    Gallimore, C I; Barreiros, M A B; Brown, D W G; Nascimento, J P; Leite, J P G

    2004-03-01

    Noroviruses (Norwalk-like viruses) are an important cause of gastroenteritis worldwide. They are the most common cause of outbreaks of gastroenteritis in the adult population and occur in nursing homes for the elderly, geriatric wards, medical wards, and in hotel and restaurant settings. Food-borne outbreaks have also occurred following consumption of contaminated oysters. This study describes the application of a reverse transcription-polymerase chain reaction (RT-PCR) assay using random primers (PdN6) and specific Ni and E3 primers, directed at a small region of the RNA-dependent RNA polymerase-coding region of the norovirus genome, and DNA sequencing for the detection and preliminary characterisation of noroviruses in outbreaks of gastroenteritis in children in Brazil. The outbreak samples were collected from children <5 years of age at the Bertha Lutz children's day care facility at Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, that occurred between 1996 and 1998, where no pathogen had been identified. At the Bertha Lutz day care center facility, only Fiocruz's employee children are provided for, and they come from different social, economic and cultural backgrounds. Three distinct genogroup II strains were detected in three outbreaks in 1997/98 and were most closely related to genotypes GII-3 (Mexico virus) and GII-4 (Grimsby virus), both of which have been detected in paediatric and adult outbreaks of gastroenteritis worldwide. PMID:15060697

  9. Rifaximin for the treatment of acute infectious diarrhea.

    PubMed

    Hong, Kyoung Sup; Kim, Joo Sung

    2011-07-01

    Rifaximin is a nonabsorbable rifamycin derivative with an excellent safety profile and a broad spectrum of antimicrobial activity against a variety of enteropathogens causing acute infectious diarrhea. After oral ingestion, its bioavailability is known to be less than 0.4%, and it has a low potential for significant drug interactions. In the treatment of travelers' diarrhea caused by noninvasive diarrheagenic Escherichia coli, it has been demonstrated that rifaximin significantly shortens the duration of diarrhea and has an efficacy similar to that of ciprofloxacin. Moreover, according to two randomized placebo-controlled trials, prophylactic treatment with rifaximin reduced the risk of developing travelers' diarrhea by more than 50% compared with the placebo group. For the treatment of acute diarrhea unrelated to travel, a short course of rifaximin significantly reduced the duration of diarrhea, and its overall efficacy was comparable to that of ciprofloxacin. The discrepancy between the in vitro and in vivoantimicrobial activities of rifaximin, however, and the clinical implication of the rapid appearance of bacterial resistance, must be further elucidated. In conclusion, this gut-selective antibiotic seems to be a promising option for the treatment of acute infectious diarrhea secondary to noninvasive E. coli and also appears to be effective in chemoprophylaxis for travelers' diarrhea. PMID:21765867

  10. Rifaximin for the treatment of acute infectious diarrhea

    PubMed Central

    Hong, Kyoung Sup; Kim, Joo Sung

    2011-01-01

    Rifaximin is a nonabsorbable rifamycin derivative with an excellent safety profile and a broad spectrum of antimicrobial activity against a variety of enteropathogens causing acute infectious diarrhea. After oral ingestion, its bioavailability is known to be less than 0.4%, and it has a low potential for significant drug interactions. In the treatment of travelers’ diarrhea caused by noninvasive diarrheagenic Escherichia coli, it has been demonstrated that rifaximin significantly shortens the duration of diarrhea and has an efficacy similar to that of ciprofloxacin. Moreover, according to two randomized placebo-controlled trials, prophylactic treatment with rifaximin reduced the risk of developing travelers’ diarrhea by more than 50% compared with the placebo group. For the treatment of acute diarrhea unrelated to travel, a short course of rifaximin significantly reduced the duration of diarrhea, and its overall efficacy was comparable to that of ciprofloxacin. The discrepancy between the in vitro and in vivoantimicrobial activities of rifaximin, however, and the clinical implication of the rapid appearance of bacterial resistance, must be further elucidated. In conclusion, this gut-selective antibiotic seems to be a promising option for the treatment of acute infectious diarrhea secondary to noninvasive E. coli and also appears to be effective in chemoprophylaxis for travelers’ diarrhea. PMID:21765867

  11. 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

  12. Evaluation of Xpert® Norovirus Assay performance in comparison with real-time RT-PCR in hospitalized adult patients with acute gastroenteritis.

    PubMed

    Rovida, Francesca; Premoli, Marta; Campanini, Giulia; Sarasini, Antonella; Baldanti, Fausto

    2016-08-01

    Xpert® Norovirus Assay (Cepheid, Sunnyvale, CA) was compared with a laboratory-developed real-time RT-PCR assay for the detection of Norovirus GI and GII in hospitalized patients with acute gastroenteritis. The two assays showed a high level of concordance but Xpert® Norovirus Assay allowed faster detection of Norovirus and a simpler sample handling. PMID:27233425

  13. FIRST DETECTION OF CHICKEN ANEMIA VIRUS AND NOROVIRUS GENOGROUP II IN STOOL OF CHILDREN WITH ACUTE GASTROENTERITIS IN TAIWAN.

    PubMed

    Tang, Meng-Bin; Chang, Hung-Ming; Wu, Wen-Chih; Chou, Yu-Ching; Yu, Chia-Peng

    2016-05-01

    To date, there has been no report of co-infection of chicken anemia virus (CAV) with enteric virus in patients with acute gastroenteritis (AGE). CAV has been recently detected in various types of human samples including stool, indicating pathogenicity in gastrointestinal tract. Examination by PCR-based methods of CAV and norovivus genogroup II (NV GII) in stool of 110 children with AGE at a hospital in Taiwan revealed for the first time of co-infection in two cases. This is the first description of CAV infection in children with AGE in Taiwan. Systematic surveillance and evidence-based studies are required to determine the transmission pathways and spread of CAV in Taiwan. PMID:27405124

  14. 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

  15. Western blot (immunoblot) assay of small, round-structured virus associated with an acute gastroenteritis outbreak in Tokyo.

    PubMed Central

    Hayashi, Y; Ando, T; Utagawa, E; Sekine, S; Okada, S; Yabuuchi, K; Miki, T; Ohashi, M

    1989-01-01

    Small, round-structured virus (SRSV) was detected in a stool specimen of a patient during an acute gastroenteritis outbreak in Tokyo and was tentatively named SRSV-9. SRSV-9 was purified by sucrose velocity gradient centrifugation after CsCl density gradient centrifugation. The buoyant density of SRSV-9 appeared to be 1.36 g/ml in CsCl. A Western blot (immunoblot) assay using the biotin-avidin system revealed that SRSV-9 was antigenically related to the Hawaii agent but distinct from the Norwalk agent and contained a single major structural protein with a molecular size of 63.0 +/- 0.6 kilodaltons. The prevalence of SRSV-9 infection in Tokyo was surveyed by the Western blot antibody assay by using a crude virus preparation as the antigen. Seroconversion was observed in 56.5% of the patients involved in the outbreaks from which SRSV was detected by electron microscopy. Images PMID:2504773

  16. 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

  17. A cluster of salivirus A1 (Picornaviridae) infections in newborn babies with acute gastroenteritis in a neonatal hospital unit in Hungary.

    PubMed

    Boros, Ákos; Raáb, Margit; Károly, Éva; Karai, Adrienn; Kátai, Andrea; Bolba, Nóra; Pankovics, Péter; Reuter, Gábor

    2016-06-01

    Salivirus (family Picornaviridae) may be associated with acute gastroenteritis in humans, but there have been no reports of salivirus outbreaks. Salivirus A1 infection with faecal virus concentrations of 2.1-2.6 × 10(9)/g were identified retrospectively in newborn babies, between the ages of 1.5 and 5 days, with apparent clinical symptoms of diarrhea (100 %), fever (40 %), vomiting (40 %), and loss of appetite (40 %) in a neonatal hospital unit in Hungary in July 2013. The complete genome sequence of the salivirus (including the 5'-terminal end) was determined. Salivirus mono-infection may be associated with gastroenteritis in babies who are a few days old. Salivirus testing should be done in public health laboratories in gastroenteritis outbreaks with unknown etiology. PMID:27001303

  18. Added value of multiplex Luminex Gastrointestinal Pathogen Panel (xTAG® GPP) testing in the diagnosis of infectious gastroenteritis.

    PubMed

    Wessels, E; Rusman, L G; van Bussel, M J A W M; Claas, E C J

    2014-03-01

    The Luminex Gastrointestinal Pathogen Panel (xTAG(®) GPP) detects in one assay the most common gastroenteritis-causing pathogens and toxins, namely adenovirus 40/41, norovirus genogroup (NG) I/II, rotavirus A, Clostridium difficile toxin A/B, Campylobacter sp., Escherichia coli O157, Enterotoxigenic E. coli heat-labile enterotoxin/heat-stable enterotoxin, Salmonella sp., Shiga-toxin producing E. coli, Shiga-like toxin (Stx)1/2, Shigella sp., Vibrio cholerae, Yersinia enterocolitica, Cryptosporidium sp., Entamoeba histolytica and Giardia sp. In this study, we compared the results that were obtained by testing 393 faecal samples, collected during November and December 2011 at our laboratory, using the xTAG(®) GPP assay with the results of the routine diagnostic procedure. This procedure includes culture for bacteria and real-time PCR for viruses and parasites, but only if the test was requested by the clinician. If the clinician did not request the test for an xTAG(®) GPP-positive target, real-time PCR assays were used to confirm xTAG(®) GPP positivity. Discrepant results were also tested with real-time PCR assays. A total of 83 targets were detected in 76 samples using xTAG(®) GPP. The xTAG(®) GPP assay detected 43 additional positives compared with the routine diagnostic procedure, of which 11 targets could not be confirmed by real-time PCR. The non-confirmed targets were Campylobacter (one sample), Salmonella (four samples), Shigella (one sample) and E. histolytica (five samples). The xTAG(®) GPP was shown to be a convenient and sensitive assay for detection of 15 major gastrointestinal pathogens in a single molecular test, but for detection of E. histolytica and Salmonella, a confirmatory assay is indicated. PMID:24131399

  19. VIRAL GASTROENTERITIS

    EPA Science Inventory

    Two virus types have been clearly shown to have epidemiologic importance in viral gastroenteritis, i.e., rotavirus and Norwalk virus. Four other virus types have been associated with gastroenteritis but their epidemiologic importance is not yet known, i.e., enteric adenovirus, ca...

  20. Acalculous Acute Cholecystitis in Previously Healthy Children: General Overview and Analysis of Pediatric Infectious Cases

    PubMed Central

    Poddighe, Dimitri; Tresoldi, Matteo; Licari, Amelia; Marseglia, Gian Luigi

    2015-01-01

    Acute acalculous cholecystitis (AAC) is an inflammation of the gallbladder, which does not appear to be associated with the presence of gallstones. AAC is estimated to represent more than 50% of cases of acute cholecystitis in the pediatric population. Although this pathology was initially described in critically ill patients, actually most pediatric cases have been observed during several infectious diseases. Particularly, here we reviewed pediatric infectious acute acalculous cholecystitis and analyzed the pathophysiological and clinical aspects of bacterial and viral forms. PMID:26640715

  1. 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

  2. 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

  3. 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 ...

  4. Bacterial gastroenteritis

    MedlinePlus

    ... Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 340. Craig SA. Gastroenteritis. In: Marx ... Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 94. Mody RK, Griffin PM. ...

  5. Automated detection of case clusters of waterborne acute gastroenteritis from health insurance data - pilot study in three French districts.

    PubMed

    Rambaud, Loïc; Galey, Catherine; Beaudeau, Pascal

    2016-04-01

    This pilot study was conducted to assess the utility of using a health insurance database for the automated detection of waterborne outbreaks of acute gastroenteritis (AGE). The weekly number of AGE cases for which the patient consulted a doctor (cAGE) was derived from this database for 1,543 towns in three French districts during the 2009-2012 period. The method we used is based on a spatial comparison of incidence rates and of their time trends between the target town and the district. Each municipality was tested, week by week, for the entire study period. Overall, 193 clusters were identified, 10% of the municipalities were involved in at least one cluster and less than 2% in several. We can infer that nationwide more than 1,000 clusters involving 30,000 cases of cAGE each year may be linked to tap water. The clusters discovered with this automated detection system will be reported to local operators for investigation of the situations at highest risk. This method will be compared with others before automated detection is implemented on a national level. PMID:27105415

  6. Use of probiotics for management of acute gastroenteritis: a position paper by the ESPGHAN Working Group for Probiotics and Prebiotics.

    PubMed

    Szajewska, Hania; Guarino, Alfredo; Hojsak, Iva; Indrio, Flavia; Kolacek, Sanja; Shamir, Raanan; Vandenplas, Yvan; Weizman, Zvi

    2014-04-01

    The use of probiotics has been suggested in the treatment of acute gastroenteritis (AGE) in addition to early rehydration and avoidance of dietary restrictions. This document provides recommendations for the use of probiotics for the treatment of AGE in previously healthy infants and children based on a systematic review of previously completed systematic reviews and of randomized controlled trials (RCTs) published subsequently to these reviews. The recommendations were formulated only if at least 2 RCTs that used a given probiotic (with strain specification) were available. The GRADE system developed by the Grading of Recommendations, Assessment, Development, and Evaluations Working Group, was used to grade the strength of evidence and grades of recommendations used in these guidelines. It offers 4 categories of the quality of the evidence (high, moderate, low, and very low) and 2 categories of the strength of recommendation (strong or weak). The use of the following probiotics (in alphabetical order) may be considered in the management of children with AGE in addition to rehydration therapy: Lactobacillus rhamnosus GG (low quality of evidence, strong recommendation) and Saccharomyces boulardii (low quality of evidence, strong recommendation). Less compelling evidence is available for Lactobacillus reuteri DSM 17938 (very low quality of evidence, weak recommendation) and heat-inactivated Lactobacillus acidophilus LB (very low quality of evidence, weak recommendation). The latter, although traditionally discussed with other probiotics, does not fit with the definition of probiotics. Other strains or combinations of strains have been tested, but evidence of their efficacy is weak or preliminary. PMID:24614141

  7. A case of acute infectious mononucleosis presenting with very high ferritin

    PubMed Central

    Thoufeeq, Muhammed Hameed; Ali Khan, Shahul Leyakath; Jain, Sanjiv Kumar; Al-Shakerchi, Hasanain; Hussain, Munem

    2007-01-01

    Hepatitis is an important but uncommon manifestation of acute Epstein Barr infection. Infectious mononucleosis is usually a disease of young adults. We report a case of infectious mononucleosis in a 72-year old jaundiced gentleman with ferritin level of 2438 that normalised on clinical improvement. PMID:17278235

  8. 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

  9. Resolution of acute gastroenteritis symptoms in children and adults treated with a novel polyphenol-based prebiotic

    PubMed Central

    Noguera, Telma; Wotring, Robert; Melville, Chris R; Hargraves, Kara; Kumm, Jochen; Morton, John M

    2014-01-01

    AIM: To test efficacy and durability of a polyphenol-based prebiotic treatment for acute gastroenteritis in a 300 patient double-blinded clinical study. METHODS: A two-arm randomized, double-blinded, placebo-controlled clinical study was conducted at two public health centers in Managua, Nicaragua. Potential subjects who qualified based on inclusion and exclusion criteria were randomly assigned to one of two treatment arms. Two thirds of the subjects (n = 200) received a single titrated 0.5-2 ounce liquid dose of a novel polyphenol-based prebiotic (AlivaTM) diluted with 2 to eight ounces of oral rehydration solution (ORS). One third of the subjects (n = 100) were randomized to receive two liquid ounces of a taste and color-matched placebo diluted in eight ounces of ORS. The outcome variables measured included stool consistency, stomach discomfort, gas and bloating, and heartburn/indigestion. The study subjects ranked their stool consistency and the severity of their subjective symptoms at specified intervals from immediately prior to treatment, to five days post treatment. All subjects recorded their symptoms in a study diary. The study subjects also recorded the time and consistencies of all stools in their study diary. Stool consistency was compared to the picture and descriptions on the Bristol Stool Chart, and any stool rated greater than Type 4 was considered unformed. The clinical study team reviewed the study diaries with subjects during daily follow-up calls and close-out visits, and recorded the data in case report forms. RESULTS: After receiving a single dose, Aliva treated subjects reported shorter median time to their last unformed stool (1 h 50 min) than placebo treated subjects (67 h 50 min.), a statistically significant difference [95%CI: -3178-(-2018), P = 0.000]. Aliva treated subjects also reported shorter median their time to last unformed stool (TTLUS) (1hrs 50 min) than placebo treated subjects (67 h 50 min), which was also a statistically

  10. 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. PMID:24463209

  11. 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

  12. 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

  13. A piglet Model of Acute gastroenteritis induced by Shigella dysenteriae type 1

    PubMed Central

    Jeong, Kwang-il; Zhang, Quanshun; Nunnari, John; Tzipori, Saul

    2009-01-01

    Background The lack of a standardized laboratory animal model that mimics key aspects of human shigellosis remains major obstacle to addressing questions on pathogenesis, screening therapeutics and evaluating vaccines. Methods We characterize a piglet model for Shigella dysenteriae type 1. Results Piglets developed acute diarrhea, anorexia, dehydration and often fatal, with severity depending on age and dose. Bacteria were apparent in the lumen and on surface epithelium throughout the gut initially, but severe mucosal damage and bacterial cellular invasion were most profound in the colon. Detached necrotic colonocytes were present in the lumen, with inflammatory cells outpouring from damaged mucosa. High levels of IL-8 and IL-12, were followed by other proinflammatory cytokines. Elevated TNF-α, IL-1β, IL-6, and IL-10 were detected in feces and in gut segments of infected animals. Bacteria were present inside epithelial cells and within colonic lamina propria. In contrast, an isogenic strain lacking Shiga toxin, induced similar but milder symptoms, with moderate mucosal damage and lower cytokine levels. Conclusion We conclude that piglets are highly susceptible to shigellosis providing a useful tool to compare vaccine candidates for immunogenicity, reactogenicity and response to challenge, investigate the role of virulence factors and test the efficacy of microbial agents. PMID:20136414

  14. 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

  15. Molecular epidemiology of genogroup II norovirus infection among hospitalized children with acute gastroenteritis in Suzhou (Jiangsu, China) from 2010 to 2013.

    PubMed

    Fu, Jian-Guang; Ai, Jing; Zhang, Jun; Wu, Qing-Bin; Qi, Xian; Ji, Hong; Jin, Miao; Liu, Cheng; Wang, Shen-Jiao; Shan, Jun; Bao, Chang-Jun; Tang, Fen-Yang; Zhu, Ye-Fei

    2016-06-01

    Noroviruses (NoVs) are the most common cause of acute gastroenteritis in both sporadic and outbreak cases. Genotyping and recombination analyses were performed in order to help getting more knowledge of the distribution and genetic diversity of NoVs in Suzhou, located in Jiangsu province of China. All stool samples were collected from hospitalized children younger than 5 years old with acute gastroenteritis. For genotyping, the open reading frame (ORF) 1 and ORF2 were partially amplified and sequenced. 26.9% of stool samples were positive for genogroup II NoVs. The most common genotype was GII.4 and its variants included Den Haag-2006b, New Orleans-2009, and Sydney-2012. The Den Haag-2006b variants predominated during 2010-2012. In 2013, it was replaced by the Sydney-2012 variant. The second most common genotype was GII.12/GII.3. NoVs could be detected throughout the year, with GII.4 and GII.12/GII.3 coexisting during the cold months, and GII.4 was the main genotype during the warm months. The highest prevalence of NoV was detected in young children aged <24 months. Patients infected with GII.4 had a higher chance of getting moderate fever than other NoV-positive patients, while those infected with GII.12/GII.3 tended to have a mild degree of fever. NoV is an important pathogen responsible for viral gastroenteritis among children in Suzhou. Analyses of NoV circulating between 2010 and 2013 revealed a change of predominant variant of NoV GII.4 in each epidemic season and intergenotype recombinant strains represented an important part. PMID:26547266

  16. Initial Sequential Organ Failure Assessment score versus Simplified Acute Physiology score to analyze multiple organ dysfunction in infectious diseases in Intensive Care Unit

    PubMed Central

    Nair, Remyasri; Bhandary, Nithish M.; D’Souza, Ashton D.

    2016-01-01

    Aims: To investigate initial Sequential Organ Failure Assessment (SOFA) score of patients in Intensive Care Unit (ICU), who were diagnosed with infectious disease, as an indicator of multiple organ dysfunction and to examine if initial SOFA score is a better mortality predictor compared to Simplified Acute Physiology Score (SAPS). Materials and Methods: Hospital-based study done in medical ICU, from June to September 2014 with a sample size of 48. Patients aged 18 years and above, diagnosed with infectious disease were included. Patients with history of chronic illness (renal/hepatic/pulmonary/  cardiovascular), diabetes, hypertension, chronic obstructive pulmonary disease, heart disease, those on immunosuppressive therapy/chemoradiotherapy for malignancy and patients in immunocompromised state were excluded. Blood investigations were obtained. Six organ dysfunctions were assessed using initial SOFA score and graded from 0 to 4. SAPS was calculated as the sum of points assigned to each of the 17 variables (12 physiological, age, type of admission, and three underlying diseases). The outcome measure was survival status at ICU discharge. Results: We categorized infectious diseases into dengue fever, leptospirosis, malaria, respiratory tract infections, and others which included undiagnosed febrile illness, meningitis, urinary tract infection and gastroenteritis. Initial SOFA score was both sensitive and specific; SAPS lacked sensitivity. We found no significant association between age and survival status. Both SAPS and initial SOFA score were found to be statistically significant as mortality predictors. There is significant association of initial SOFA score in analyzing organ dysfunction in infectious diseases (P < 0.001). SAPS showed no statistical significance. There was statistically significant (P = 0.015) percentage of nonsurvivors with moderate and severe dysfunction, based on SOFA score. Nonsurvivors had higher SAPS but was not statistically significant (P

  17. [Acute infectious (not Clostridium difficile-associated) diarrhea in the elderly].

    PubMed

    Van Dessel, C; Flamaing, J; Hiele, M

    2005-11-01

    Acute diarrhoea, non-antibiotic associated, is a common problem and a significant cause of morbidity and mortality in old age. In most cases diarrhoea has an infectious etiology. A number of different micro organisms can cause infectious diarrhoea. Most frequent are viral infections with a benign evolution. Rehydration is the only important therapeutic measure. Infections with bacteria are less common, antibiotics should be prescribed only in severe cases, and when there is suspicion of invasive infections by enteropathogenic bacteria. PMID:16350530

  18. Genetic Diversity of Norovirus and Sapovirus in Hospitalized Infants with Sporadic Cases of Acute Gastroenteritis in Chiang Mai, Thailand

    PubMed Central

    Hansman, Grant S.; Katayama, Kazuhiko; Maneekarn, Niwat; Peerakome, Supatra; Khamrin, Pattara; Tonusin, Supin; Okitsu, Shoko; Nishio, Osamu; Takeda, Naokazu; Ushijima, Hiroshi

    2004-01-01

    Stool specimens from hospitalized infants with sporadic gastroenteritis in Chiang Mai, Thailand, between July 2000 and July 2001 were examined for norovirus and sapovirus by reverse transcription-PCR and sequence analysis. These viruses were identified in 13 of 105 (12%) specimens. One strain was found to be a recombinant norovirus. PMID:15004104

  19. Determination of cut-off cycle threshold values in routine RT-PCR assays to assist differential diagnosis of norovirus in children hospitalized for acute gastroenteritis.

    PubMed

    Trang, N V; Choisy, M; Nakagomi, T; Chinh, N T M; Doan, Y H; Yamashiro, T; Bryant, J E; Nakagomi, O; Anh, D D

    2015-11-01

    Norovirus (NV) is an important cause of acute gastroenteritis in children, but is also frequently detected in asymptomatic children, which complicates the interpretation of NV detection results in both the clinical setting and population prevalence studies. A total of 807 faecal samples from children aged <5 years hospitalized for acute gastroenteritis were collected in Thai Binh, Vietnam, from January 2011 to September 2012. Real-time RT-PCR was used to detect and quantify NV-RNA in clinical samples. A bimodal distribution of cycle threshold (Ct) values was observed in which the lower peak was assumed to represent cases for which NV was the causal agent of diarrhoea, whereas the higher peak was assumed to represent cases involving an alternative pathogen other than NV. Under these assumptions, we applied finite-mixture modelling to estimate a threshold of Ct <21·36 (95% confidence interval 20·29-22·46) to distinguish NV-positive patients for which NV was the likely cause of diarrhoea. We evaluated the validity of the threshold through comparisons with NV antigen ELISA results, and comparisons of Ct values in patients co-infected with rotavirus. We conclude that the use of an appropriate cut-off value in the interpretation of NV real-time RT-PCR results may improve differential diagnosis of enteric infections, and could contribute to improved estimates of the burden of NV disease. PMID:26418350

  20. 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

  1. Analysis of infectious complications and timing for emergency liver transplantation in autoimmune acute liver failure.

    PubMed

    Fujiwara, Keiichi; Yasui, Shin; Yonemitsu, Yutaka; Arai, Makoto; Kanda, Tatsuo; Fukuda, Yoshihiro; Nakano, Masayuki; Oda, Shigeto; Yokosuka, Osamu

    2016-04-01

    Highlight Fujiwara and colleagues reveal that the critical point for switching to liver transplantation without infectious complications in autoimmune acute liver failure is two weeks after the start of corticosteroid treatment. It is crucial to evaluate corticosteroid efficacy and, if no improvement is seen, to perform liver transplantation by that time. PMID:26808231

  2. [Relationship between child day-care attendance and acute infectious disease. A systematic review].

    PubMed

    Ochoa Sangrador, Carlos; Barajas Sánchez, M Verisima; Muñoz Martín, Beatriz

    2007-01-01

    Child day-care attendance is considered to be an acute early childhood disease risk factor, the studies available however not affording the possibility of fully quantifying this risk. A systematic review of clinical trials and cohort studies was conducted, in which the effects child day-care attendance had on the health of young children based on the Cochrane Collaboration, PubMed and Spanish Medical Index databases, without any time or language-related limits, were analyzed and rounded out with analyses of referenced works and an additional EMBASE search. The methodological quality was evaluated by means of personalized criteria. Pooling measures (relative risks, incidence density ratios and weighted mean differences) were calculated with their confidence intervals, assuming random effects models. A significant increase was found to exist of a risk consistent over time and among different social and geographical environments. Considering the most methodologically-stringent studies with adjusted effect estimates, child day-care attendance was related to an increased risk of upper respiratory tract infection (RR=1,88), acute otitis media (RR=1,58), otitis media with fluid draining (RR=2,43), lower respiratory tract infections (overall RR=210; acute pneumonia RR=1.70; broncholitis RR=1,80; bronchitis RR=2,10) and gastroenteritis (RR=1,40). Child day-care attendance could be responsible for 33%-50% of the episodes of respiratory infection and gastroenteritis among the exposed population. In conclusion, it can be said that the risk for childhood health attributable to the child day-care attendance is discreet but of high-impact. This information has some major implications for research, clinical practice, healthcare authorities and society as a whole. PMID:17639680

  3. 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

  4. Complement levels in acute infectious hepatitis and serum hepatitis

    PubMed Central

    Kosmidis, J. C.; Leader-Williams, Lesley K.

    1972-01-01

    The level of the third component of complement was measured in serial specimens of serum taken from thirty-one patients with acute viral hepatitis. Fourteen of the thirty-one patients were positive for the hepatitis-associated antigen. A characteristic fluctuation was observed in twenty-nine of the thirty-one patients. This consisted of an initial fall of the level of C3, followed by an increase to a higher than normal level and then a gradual return to normal. No difference was observed between the patients who were positive and those who were negative for the hepatitis-associated antigen. These results support the view that immune complexes play a significant role in the pathogenesis of acute viral hepatitis. PMID:4624985

  5. A Randomized, Double-Blind Pilot Trial of Hydrolyzed Rice Bran versus Placebo for Radioprotective Effect on Acute Gastroenteritis Secondary to Chemoradiotherapy in Patients with Cervical Cancer

    PubMed Central

    Itoh, Yoshiyuki; Mizuno, Mika; Ikeda, Mitsuru; Nakahara, Rie; Kubota, Seiji; Ito, Junji; Okada, Tohru; Kawamura, Mariko; Kikkawa, Fumitaka; Naganawa, Shinji

    2015-01-01

    We aimed to evaluate the radioprotective effect of hydrolyzed rice bran (HRB) on acute gastroenteritis due to chemoradiotherapy for treatment of cervical cancer. This placebo-controlled, double-blind study was conducted as an exploratory investigation of the colitis-inhibiting effects of HRB in alleviating acute-phase gastrointestinal side effects of chemoradiotherapy. The study involved 20 patients (10 in the HRB group, 10 in the control group). The patients in the control group underwent the same chemoradiotherapy regimen as those in the HRB group, but they received a placebo instead of HRB. The diarrheal side effect assessment score was lower in the HRB than control group, and a trend toward a reduction in diarrhea symptoms was observed with the oral intake of HRB. Additionally, no significant difference was observed in the administration of intestinal regulators and antidiarrheal agents, but again the assessment score was lower in the HRB than control group, and diarrhea symptoms were alleviated with the oral intake of HRB. A trend toward no need for strong antidiarrheal agents was seen. Although this study was an exploratory clinical trial, the results suggest that HRB may relieve diarrhea, an acute-phase gastrointestinal side effect of chemoradiotherapy. PMID:26693248

  6. Anti-NMDAR encephalitis, a mimicker of acute infectious encephalitis and a review of the literature

    PubMed Central

    Wong, Darren; Fries, Bettina

    2014-01-01

    Anti-N-methyl-d-aspartate receptor encephalitis has become an increasingly recognized etiology of acute psychosis in young patients. The diverse constellation of symptoms allows for misdiagnosis as an infectious, psychological, or toxicological entity resulting in delays in treatment with increasing morbidity. We describe a case of anti-NMDAR encephalitis that was a particular challenge to diagnose. Practitioners should maintain a high index of suspicion for anti-NMDAR and related neuroautoimmune syndromes, especially in young patients that present with acute mental status decline or dyskinesia. PMID:26839775

  7. An outbreak of acute gastroenteritis associated with contaminated bottled water in a university – Jiangxi, China, 2012

    PubMed Central

    Wang, Ruiping; Zong, Jun; Yu, Ping; Fu, Weijie; Yang, Fuqiang; Shi, Guoqing; Zeng, Guang

    2012-01-01

    Background On 23 May 2012, a university in Jiangxi, China reported a gastroenteritis outbreak. We investigated the outbreak to identify the agent, source and mode of transmission and to recommend control measures. Methods A case was defined as any person from the university with onset of diarrhoea (≥ 3 times/24h) from 1 to 31 May 2012. Active case finding was conducted by reviewing university hospital and drug-store records and interviewing students, workers and teachers. We then conducted a case-control study in which we compared food, water and environmental exposure history. Water samples were collected and tested. Results We identified 417 cases – an attack rate (AR) of 4.7% (417/8781) for the university. There were 416 student cases (AR = 5.7%) distributed across all 11 colleges, five of which were more heavily affected (AR range = 5.9–14%). In the case-control study, cases had higher odds of having drunk bottled water (odds ratio [OR] = 4.1; 95% confidence interval [CI] = 1.7–9.9), and there was a dose–response relationship (χ2trend = 4.6, P < 0.05). Drinking boiled bottled water was inversely associated with being a case (OR = 0.22, 95% CI = 0.07–0.71). Eating in any of the three university canteens or drinking-water from the city water supply was not associated with being a case. Pathogenic Escherichia coli was isolated from two unopened bottled water specimens and from four student cases. Conclusion This gastroenteritis outbreak was most likely caused by contaminated bottled water. The company in question has been shut down and no further cases have been reported. Increased regulation of bottled water plants and better coordination between different investigators for future outbreaks is recommended. PMID:23908934

  8. Infectious Events Prior to Chemotherapy Initiation in Children with Acute Myeloid Leukemia

    PubMed Central

    Portwine, Carol; Mitchell, David; Johnston, Donna; Gillmeister, Biljana; Ethier, Marie-Chantal; Yanofsky, Rochelle; Dix, David; Cellot, Sonia; Lewis, Victor; Price, Victoria; Silva, Mariana; Zelcer, Shayna; Bowes, Lynette; Michon, Bruno; Stobart, Kent; Brossard, Josee; Beyene, Joseph; Sung, Lillian

    2013-01-01

    Background The primary objective was to describe infectious complications in children with acute myeloid leukemia from presentation to the healthcare system to initiation of chemotherapy and to describe how these infections differ depending on neutropenia. Methods We conducted a retrospective, population-based cohort study that included children and adolescents with acute myeloid leukemia diagnosed and treated at 15 Canadian centers. We evaluated infections that occurred between presentation to the healthcare system (for symptoms that led to the diagnosis of acute myeloid leukemia) until initiation of chemotherapy. Results Among 328 children, 92 (28.0%) were neutropenic at presentation. Eleven (3.4%) had sterile-site microbiologically documented infection and four had bacteremia (only one Gram negative). Infection rate was not influenced by neutropenia. No child died from an infectious cause prior to chemotherapy initiation. Conclusion It may be reasonable to withhold empiric antibiotics in febrile non-neutropenic children with newly diagnosed acute myeloid leukemia until initiation of chemotherapy as long as they appear well without a clinical focus of infection. Future work could examine biomarkers or a clinical score to identify children presenting with leukemia and fever who are more likely to have an invasive infection. PMID:23637925

  9. 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

  10. Characterising the aetiology of severe acute gastroenteritis among patients visiting a hospital in Qatar using real-time polymerase chain reaction

    PubMed Central

    2013-01-01

    Background Acute gastroenteritis (AGE) remains a common cause of clinic visits and hospitalizations, though its aetiology has not been determined in Qatar. Methods We performed a prospective, emergency department–based study of 288 children and adults with AGE. Stool specimens were collected at presentation from June to November 2009. Faecal specimens were tested, using real-time PCR, for a panel of four viral (norovirus, adenovirus, astrovirus and rotavirus) and bacterial pathogens. Results Viral and bacterial pathogens were detected in 131 (45.5%) and 34 (12.2%) of the 288 patients recruited. The most commonly detected pathogens were norovirus (28.5%), rotavirus (10.4%), followed by adenovirus (6.25%) and astrovirus (0.30%). Norovirus was the most commonly detected viral pathogen amongst all the age groups with an almost even distribution in all age groups. Rotavirus and adenovirus were more common in children under 5 yr of age. Astrovirus was found in only one person. Conclusions Viruses, especially noroviruses, are associated with severe diarrhoea in children and adults in Qatar. Further studies to confirm the findings and to explore the causes of illness among patients from whom a pathogen cannot be determined are needed. PMID:23865805

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

    PubMed

    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

    2015-04-01

    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

  12. High similarity of novel orthoreovirus detected in a child hospitalized with acute gastroenteritis to mammalian orthoreoviruses found in bats in Europe.

    PubMed

    Steyer, Andrej; Gutiérrez-Aguire, Ion; Kolenc, Marko; Koren, Simon; Kutnjak, Denis; Pokorn, Marko; Poljšak-Prijatelj, Mateja; Racki, Nejc; Ravnikar, Maja; Sagadin, Martin; Fratnik Steyer, Adela; Toplak, Nataša

    2013-11-01

    Mammalian orthoreoviruses (MRVs) are known to cause mild enteric and respiratory infections in humans. They are widespread and infect a broad spectrum of mammals. We report here the first case of an MRV detected in a child with acute gastroenteritis, which showed the highest similarity to an MRV reported recently in European bats. An examination of a stool sample from the child was negative for most common viral and bacterial pathogens. Reovirus particles were identified by electron microscopic examination of both the stool suspension and cell culture supernatant. The whole-genome sequence was obtained with the Ion Torrent next-generation sequencing platform. Prior to sequencing, the stool sample suspension and cell culture supernatant were pretreated with nucleases and/or the convective interaction medium (CIM) monolithic chromatographic method to purify and concentrate the target viral nucleic acid. Whole-genome sequence analysis revealed that the Slovenian SI-MRV01 isolate was most similar to an MRV found in a bat in Germany. High similarity was shared in all genome segments, with nucleotide and amino acid identities between 93.8 to 99.0% and 98.4 to 99.7%, respectively. It was shown that CIM monolithic chromatography alone is an efficient method for enriching the sample in viral particles before nucleic acid isolation and next-generation sequencing application. PMID:24025904

  13. 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

  14. 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

  15. Infectious dengue vesicles derived from CD61+ cells in acute patient plasma exhibited a diaphanous appearance

    PubMed Central

    Hsu, Alan Yi-Hui; Wu, Shang-Rung; Tsai, Jih-Jin; Chen, Po-Lin; Chen, Ya-Ping; Chen, Tsai-Yun; Lo, Yu-Chih; Ho, Tzu-Chuan; Lee, Meed; Chen, Min-Ting; Chiu, Yen-Chi; Perng, Guey Chuen

    2015-01-01

    The levels of neutralizing antibody to a pathogen are an effective indicator to predict efficacy of a vaccine in trial. And yet not all the trial vaccines are in line with the theory. Using dengue virus (DENV) to investigate the viral morphology affecting the predictive value, we evaluated the viral morphology in acute dengue plasma compared to that of Vero cells derived DENV. The virions in plasma were infectious and heterogeneous in shape with a “sunny-side up egg” appearance, viral RNA was enclosed with CD61+ cell-derived membrane interspersed by the viral envelope protein, defined as dengue vesicles. The unique viral features were also observed from ex vivo infected human bone marrow. Dengue vesicles were less efficiently neutralized by convalescent patient serum, compared to virions produced from Vero cells. Our results exhibit a reason why potencies of protective immunity fail in vivo and significantly impact dengue vaccine and drug development. PMID:26657027

  16. On the dynamics of acute EBV infection and the pathogenesis of infectious mononucleosis

    PubMed Central

    Hadinoto, Vey; Shapiro, Michael; Greenough, Thomas C.; Sullivan, John L.; Luzuriaga, Katherine

    2008-01-01

    Memory B cells latently infected with Epstein-Barr virus (mBLats) in the blood disappear rapidly on presentation with acute symptomatic primary infection (acute infectious mononucleosis [AIM]). They undergo a simple exponential decay (average half-life: 7.5 ± 3.7 days) similar to that of normal memory B cells. The cytotoxic T lymphocyte (CTL) response to immediate early (IE) lytic antigens (CTLIEs) also decays over this time period, but no such correlation was observed for the CTL response to lytic or latent antigens or to the levels of virions shed into saliva. We have estimated the average half-life of CTLIEs to be 73 (± 23) days. We propose that cycles of infection and reactivation occur in the initial stages of infection that produce high levels of mBLats in the circulation. Eventually the immune response arises and minimizes these cycles leaving the high levels of mBLats in the blood to decay through simple memory B-cell homeostasis mechanisms. This triggers the cells to reactivate the virus whereupon most are killed by CTLIEs before they can release virus and infect new cells. The release of antigens caused by this large-scale destruction of infected cells may trigger the symptoms of AIM and be a cofactor in other AIM-associated diseases. PMID:17991806

  17. Suppressor T cell clones from patients with acute Epstein-Barr virus-induced infectious mononucleosis.

    PubMed Central

    Wang, F; Blaese, R M; Zoon, K C; Tosato, G

    1987-01-01

    Suppression and/or cytotoxicity are believed to play an important role in the defense against Epstein-Barr virus (EBV) infection. To analyze the role of suppressor T cells in relation to EBV, we sought to clone and study these T cells. Analysis of 152 T cell clones derived from the peripheral blood of two patients with acute EBV-induced infectious mononucleosis (IM) yielded 11 highly suppressive clones that had no cytotoxic activity for the natural killer sensitive K562 cell line, an autologous EBV-infected cell line, or an allogeneic EBV-infected B cell line. Four of six suppressor T cell clones also profoundly inhibited EBV-induced immunoglobulin production, and five of five clones delayed the outgrowth of immortalized cells. These results indicate that during acute IM, suppressor T cells capable of inhibiting B cell activation in the absence of cytotoxicity can be identified, and may play a key role in the control of EBV infection. Images PMID:3025263

  18. Efficacy of Rifaximin Compared with Ciprofloxacin for the Treatment of Acute Infectious Diarrhea: A Randomized Controlled Multicenter Study

    PubMed Central

    Hong, Kyoung Sup; Kim, You Sun; Han, Dong Soo; Choi, Chang Hwan; Jang, Byung-Ik; Park, Young-Sook; Lee, Kang-Moon; Lee, Soo Teik; Kim, Hyun-Soo

    2010-01-01

    Background/Aims Ciprofloxacin has been widely prescribed for acute infectious diarrhea. However, the resistance to this drug is increasing. Rifaximin is a novel but poorly absorbed rifamycin derivative. This study evaluated and compared the efficacies of rifaximin and ciprofloxacin for the treatment of acute infectious diarrhea. Methods We performed a randomized controlled multicenter study in Korea. Patients with acute diarrhea were enrolled and randomized to receive rifaximin or ciprofloxacin for 3 days. The primary efficacy endpoint was the time to last unformed stool (TLUS). Secondary endpoints were enteric wellness (reduction of at least 50% in the number of unformed stools during 24-hour postenrollment intervals), general wellness (subjective feeling of improvement), and proportion of patients with treatment failure. Results Intent-to-treat analysis (n=143) showed no significant difference between the rifaximin and ciprofloxacin groups in the mean TLUS (36.1 hours vs 43.6 hours, p=0.163), enteric wellness (49% vs 57%, p=0.428), general wellness (67% vs 78%, p=0.189), or treatment failure rate (9% vs 12%, p=0.841). The adverse events did not differ significantly between the two groups. Conclusions These results suggest that rifaximin is as safe and effective as ciprofloxacin in the treatment of acute infectious diarrhea. PMID:20981213

  19. Risk of infectious gastroenteritis in young children living in Québec rural areas with intensive animal farming: results of a case-control study (2004-2007).

    PubMed

    Levallois, P; Chevalier, P; Gingras, S; Déry, P; Payment, P; Michel, P; Rodriguez, M

    2014-02-01

    This study was designed to evaluate the epidemiology of severe gastroenteritis in children living in Québec rural areas with intensive livestock activities. From September 2005 through June 2007, 165 cases of gastroenteritis in children aged from 6 months to 5 years, hospitalized or notified to the public health department were enrolled, and 326 eligible controls participated. The parents of cases and controls were asked questions about different gastroenteritis risk factors. The quality of the drinking water used by the participants was investigated for microbial indicators as well as for four zoonotic bacterial pathogens (Campylobacter spp, Escherichia coli, Salmonella spp and Yersinia spp) and two enteric parasites (Cryptosporidium spp and Giardia spp). From 134 stool specimen analysed, viruses were detected in 82 cases (61%), while 28 (21%) were found with at least one of the bacteria investigated, and five cases were infected by parasites. Campylobacteriosis was the main bacterial infection (n = 15), followed by Salmonella sp (n = 7) and E. coli O157:H7 (n = 5) among cases with bacterial gastroenteritis. No significant difference was found between cases and controls regarding the quality of water consumed; the frequency of faecal contamination of private wells was also similar between cases and controls. Considering the total cases (including those with a virus), no link was found between severe gastroenteritis and either being in contact with animals or living in a municipality with the highest animal density (4th quartile). However, when considering only cases with a bacterial or parasite infection (n = 32), there was a weak association with pig density that was not statistically significant after adjusting for potential confounders. Contact with domestic, zoo or farm animals were the only environmental factor associated with the disease. PMID:23406420

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

    PubMed Central

    Grytdal, Scott P.; 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. Awake video-assisted thoracic surgery in acute infectious pulmonary destruction

    PubMed Central

    Egorov, Vladimir; Deynega, Igor; Ionov, Pavel

    2015-01-01

    Background Many of thoracic minimally invasive interventions have been proven to be possible without general anesthesia. This article presents results of video-assisted thoracic surgery (VATS) application under local anesthesia in patients with lung abscesses and discusses its indications in detail. Methods The study involved prospective analysis of treatment outcomes for all acute infectious pulmonary destruction (AIPD) patients undergoing VATS under local anesthesia and sedation since January 1, 2010, till December 31, 2013. Patients with pulmonary destruction cavity at periphery of large size (>5 cm) underwent non-intubated video abscessoscopy (NIVAS). Patients with pyopneumothorax (lung abscess penetration into pleural cavity) underwent non-intubated video thoracoscopy (NIVTS). Indications for NIVAS and NIVTS were as follows: cavity debridement and washing, necrotic sequestra removal, adhesion split, biopsy. All interventions were done under local anesthesia and sedation without trachea intubation and epidural anesthesia. Results Sixty-five enrolled patients had 42 NIVAS and 32 NIVTS interventions, nine patients underwent two surgeries. None of the patients required trachea intubation or epidural anesthesia. In none of our cases with conversion to thoracotomy was required. Post-surgical complications developed after 11 interventions (13%): subcutaneous emphysema (five cases), chest wall phlegmon (three cases), pulmonary bleeding (two cases), and pneumothorax (one case). One patient died due to the main disease progression. In 50 patients NIVAS and NIVTS were done within 5 to 8 days after abscess/pleural cavity draining, while in other 15 patients—immediately prior to draining; both pulmonary bleeding episodes and all cases of chest wall phlegmon took place in the latter group. Conclusions NIVAS and NIVTS under local anesthesia and sedation are well tolerated by patients, safe and should be used more often in AIPD cases. Timing of NIVAS and NIVTS procedures

  2. WATERBORNE VIRAL GASTROENTERITIS

    EPA Science Inventory

    In the study of human gastroenteritis, the use of electron microscopy and related techniques has led to the identification of new viral agents which had previously escaped detection by routine cell-culture procedures. Efforts to characterize and further study these agents are cur...

  3. New trends of an old disease: the acute post infectious glomerulonephritis at the beginning of the new millenium.

    PubMed

    Stratta, Piero; Musetti, Claudio; Barreca, Antonella; Mazzucco, Gianna

    2014-06-01

    The association between acute renal disease and infection has been known since the mid '800s: acute post-infectious glomerulonephritis (PIGN) is a reactive immunological process against the kidney secondary to an infection, classically caused by a Streptococcus. The typical clinical presentation of PIGN is an acute nephritic syndrome with macro- or microscopic hematuria, proteinuria, hypertension, edema and renal function impairment of variable degree. The histology is characterized by an intracapillary glomerular proliferation, but may rarely be associated with an extracapillary proliferation. The classical childhood form is still present nowadays, even with severe cases, in developing countries, while in the last decades it almost disappeared in industrialized countries, where post-infectious GN are often found in elderly patients with multiple comorbidities. These clinical variants are usually related to other infective agents, like Staphylococcus aureus, both methicillin resistant (MRSA) and susceptible, and may be characterized by an IgA-dominant deposition. Kidney biopsy is rarely needed, especially in the child, while in the adult or old patient a biopsy is warranted if there is an atypical presentation or evolution, like rapidly progressive renal failure, absent or delayed function recovery, persisting low C3, nephrotic range proteinuria and persisting high proteinuria. Current therapy strategies rely on culture-guided systemic antibiotics, especially in the old patient, in which MRSA are relatively frequent, support therapy and only in very selected cases on steroids. These latter cases include the rare PIGN with crescents and those with a severe interstitial inflammation. PMID:24777751

  4. Postdischarge mortality in children with acute infectious diseases: derivation of postdischarge mortality prediction models

    PubMed Central

    Wiens, M O; Kumbakumba, E; Larson, C P; Ansermino, J M; Singer, J; Kissoon, N; Wong, H; Ndamira, A; Kabakyenga, J; Kiwanuka, J; Zhou, G

    2015-01-01

    Objectives To derive a model of paediatric postdischarge mortality following acute infectious illness. Design Prospective cohort study. Setting 2 hospitals in South-western Uganda. Participants 1307 children of 6 months to 5 years of age were admitted with a proven or suspected infection. 1242 children were discharged alive and followed up 6 months following discharge. The 6-month follow-up rate was 98.3%. Interventions None. Primary and secondary outcome measures The primary outcome was postdischarge mortality within 6 months following the initial hospital discharge. Results 64 children died during admission (5.0%) and 61 died within 6 months of discharge (4.9%). Of those who died following discharge, 31 (51%) occurred within the first 30 days. The final adjusted model for the prediction of postdischarge mortality included the variables mid-upper arm circumference (OR 0.95, 95% CI 0.94 to 0.97, per 1 mm increase), time since last hospitalisation (OR 0.76, 95% CI 0.61 to 0.93, for each increased period of no hospitalisation), oxygen saturation (OR 0.96, 95% CI 0.93 to 0·99, per 1% increase), abnormal Blantyre Coma Scale score (OR 2.39, 95% CI 1·18 to 4.83), and HIV-positive status (OR 2.98, 95% CI 1.36 to 6.53). This model produced a receiver operating characteristic curve with an area under the curve of 0.82. With sensitivity of 80%, our model had a specificity of 66%. Approximately 35% of children would be identified as high risk (11.1% mortality risk) and the remaining would be classified as low risk (1.4% mortality risk), in a similar cohort. Conclusions Mortality following discharge is a poorly recognised contributor to child mortality. Identification of at-risk children is critical in developing postdischarge interventions. A simple prediction tool that uses 5 easily collected variables can be used to identify children at high risk of death after discharge. Improved discharge planning and care could be provided for high-risk children. PMID

  5. Focal mesangial-sclerosing glomerulonephritis and acute-spontaneous infectious canine hepatitis: structural, immunohistochemical and subcellular studies.

    PubMed

    Hervás, J; Gómez-Villamandos, J C; Pérez, J; Carrasco, L; Sierra, M A

    1997-06-01

    The glomerular alterations observed in a dog with acute spontaneous infectious canine hepatitis (ICH) are described. Histologic changes of the glomeruli were enlargement of the mesangium with presence of intranuclear inclusion bodies and without proliferation of mesangial cells. Electron microscopy revealed adenovirus replication sites in glomerular mesangial cells and in endothelial cells of glomerular capillaries, as well as a focal mesangial-sclerosing glomerulonephritis associated with electron dense deposits which were closely related with extracellular ICH viral particles and immunohistochemically reactive for immunoglobulin (Ig) G, IgA, IgM and C3c complement components. PMID:9239835

  6. 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

  7. The influence of corticosteroids on sequential clinical and synovial fluid parameters in joints with acute infectious arthritis in the horse.

    PubMed

    Tulamo, R M; Bramlage, L R; Gabel, A A

    1989-09-01

    Infectious arthritis was induced experimentally in one tarsocrural joint of six horses by intra-articular injection of 1 ml Staphylococcus aureus-saline suspension with the addition of 200 mg methylprednisolone acetate. The corresponding contralateral joint was injected with 1 ml of saline with the addition of 200 mg methylprednisolone acetate, and served as a control. The purpose of the experiment was to examine the effect of corticosteroids on the acute clinical signs of infectious arthritis, and the associated changes in synovial fluid, to separate the effects of a steroid injection from those of infection alone. This should aid early diagnosis of infection. The progression of the infectious arthritis was assessed over nine days by clinical examination and sequential synovial fluid analysis. The corticosteroids masked the clinical signs in some horses for up to the third day although changes in the synovial fluid were present earlier. Cellular changes preceded biochemical changes initially. Leucocyte counts showed a significant increase in cell numbers after infection was established. Persistent neutrophilia, over 90 per cent, together with a pH under 6.9 were the most consistent findings in the infected synovia. Total protein values were lower in infected joints with, than those without, corticosteroids; although there was a progressive rise in total protein concentration throughout the experiment in both groups. Serum and synovial glucose difference and synovial lactate had very little diagnostic value because significant increases due to the corticosteroids were documented in the control joints. PMID:2776719

  8. Prevalence and Correlation of Infectious Agents in Hospitalized Children with Acute Respiratory Tract Infections in Central China

    PubMed Central

    Li, Fu; Wen, Zhou; Liu, Weiyong; Li, Tongya; Qin, Kai; Wu, Jianguo; Liu, Yingle

    2015-01-01

    Acute respiratory tract infections (ARTIs) are associated with significant morbidity and mortality worldwide, especially in children under the age of 5 years. Almost 2 million children die from ARTIs each year, and most of them are from developing countries. The prevalence and correlation of pathogens in ARTIs are poorly understood, but are critical for improving case prevention, treatment, and management. In this study, we investigated the prevalence and correlation of infectious agents in children with ARTIs. A total of 39,756 children with one or more symptoms, including fever, cough, sore throat, tonsillitis, pharyngitis, herpangina, pneumonia, and bronchiolitis, were enrolled in the study. All patients were hospitalized in Wuhan Children’s Hospital between October 1, 2010 and September 30, 2012, and were evaluated for infectious agents. Pathogens, including Mycoplasma pneumoniae, influenza A virus, influenza B virus, adenoviruses, respiratory syncytial virus, parainfluenza virus, Legionella pneumophila, Chlamydophila pneumoniae, and Coxiella burnetii, were screened simultaneously in patient blood samples using anti-pathogen IgM tests. Regression analysis was used to reveal correlations among the pathogens. Our results showed that one or more pathogens were identified in 10,206 patients, and that Mycoplasma pneumoniae, adenoviruses, and influenza B virus were the leading infectious agents. Mixed-infections of pathogens were detected in 2,391 cases, with Mycoplasma pneumoniae as the most frequent pathogen. The most common agents in the co-infections were Mycoplasma pneumoniae and influenza B virus. Regression analysis revealed a linear correlation between the proportion of mixed infections and the incidence of multi-pathogen infections. The prevalence of infectious agents in children with ARTIs was determined. Equations were established to estimate multiple infections by single-pathogen detection. This revealed a linear correlation for pathogens in children

  9. Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China.

    PubMed

    Liu, Jia; Ai, Hongwu; Xiong, Ying; Li, Fu; Wen, Zhou; Liu, Weiyong; Li, Tongya; Qin, Kai; Wu, Jianguo; Liu, Yingle

    2015-01-01

    Acute respiratory tract infections (ARTIs) are associated with significant morbidity and mortality worldwide, especially in children under the age of 5 years. Almost 2 million children die from ARTIs each year, and most of them are from developing countries. The prevalence and correlation of pathogens in ARTIs are poorly understood, but are critical for improving case prevention, treatment, and management. In this study, we investigated the prevalence and correlation of infectious agents in children with ARTIs. A total of 39,756 children with one or more symptoms, including fever, cough, sore throat, tonsillitis, pharyngitis, herpangina, pneumonia, and bronchiolitis, were enrolled in the study. All patients were hospitalized in Wuhan Children's Hospital between October 1, 2010 and September 30, 2012, and were evaluated for infectious agents. Pathogens, including Mycoplasma pneumoniae, influenza A virus, influenza B virus, adenoviruses, respiratory syncytial virus, parainfluenza virus, Legionella pneumophila, Chlamydophila pneumoniae, and Coxiella burnetii, were screened simultaneously in patient blood samples using anti-pathogen IgM tests. Regression analysis was used to reveal correlations among the pathogens. Our results showed that one or more pathogens were identified in 10,206 patients, and that Mycoplasma pneumoniae, adenoviruses, and influenza B virus were the leading infectious agents. Mixed-infections of pathogens were detected in 2,391 cases, with Mycoplasma pneumoniae as the most frequent pathogen. The most common agents in the co-infections were Mycoplasma pneumoniae and influenza B virus. Regression analysis revealed a linear correlation between the proportion of mixed infections and the incidence of multi-pathogen infections. The prevalence of infectious agents in children with ARTIs was determined. Equations were established to estimate multiple infections by single-pathogen detection. This revealed a linear correlation for pathogens in children with

  10. A possible association between acute infectious diarrhoea in pregnant women and congenital abnormalities in their offspring--a population-based case-control study.

    PubMed

    Acs, Nándor; Bánhidy, Ferenc; Puhó, Erzsébet H; Czeizel, Andrew E

    2010-05-01

    The possible association between Salmonella gastroenteritis (SGE) and infectious diarrhoea in pregnancy (IDP) and structural birth defects, i.e. congenital abnormalities (CA) in the offspring, has not been studied. The dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996 was evaluated. There were 15 (0.07%) and 82 (0.36%) out of 22,843 cases and 23 (0.06%) and 70 (0.18%) out of 38,151 (0.34%) controls with mothers who had medically recorded SGE and IDP, respectively. There was no association of SGE and a higher risk of CA. However, a higher risk of cleft lip +/- palate, congenital limb deficiencies, multiple CAs and cardiovascular CAs was found in the offspring of mothers with IDP. A possible explanation for the association of IDP with higher risk for some specific CAs may be the high fever in IDP. PMID:20100117

  11. 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

  12. Evidence of multiple reassortment events of feline-to-human rotaviruses based on a rare human G3P[9] rotavirus isolated from a patient with acute gastroenteritis.

    PubMed

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

    2016-06-01

    A rare human/feline-like rotavirus G3P[9] strain, CAU14-1-262, from a 2-year-old girl with severe gastroenteritis was isolated and sequenced. The 11 gene segments of the CAU14-1-262 strain possessed a novel genotype constellation, G3-P[9]-I3-R3-C3-M3-A3-N3-T1-E3-H6, which was identified for the first time. Phylogenetic analysis of this strain identified the following genome origins: VP7, VP4, VP6, VP1-VP3, NSP1, NSP2, and NSP4 genes possessed an AU-1-like genotype 3 constellation with high sequence identity to those of the feline and human/feline-like rotaviruses; NSP5 possessed a H6 lineage, with highest sequence identity to the human/feline-like E2541 strain; and the NSP3 gene possessed a Wa-like genotype 1 constellation with high sequence identity to those of the of human rotaviruses. These results provided evidence of multiple reassortment events in G3P[9] rotavirus CAU14-1-262 and possibility of feline-to-human interspecies transmission. PMID:27260811

  13. Hypertransaminasaemia in children with viral gastroenteritis.

    PubMed

    Kucuk, Oznur; Ugras, Meltem; Bicer, Suat; Col, Defne; Giray, Tuba; Erdag, Gulay Ciler; Yalvaç, Zerrin; Kaspar, Cigdem; Vitrinel, Ayca

    2016-03-01

    We investigated the rates of increase in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels of patients with rotavirus, norovirus and enteric adenovirus gastroenteritis. Two hundred children with viral gastroenteritis were evaluated for hypertransaminasaemia retrospectively. The patients were between 0 - 17 years (mean ± SD: 5.10 ± 3.01) of age. ALT was elevated up to 67 IU/L in 7 (8.5%) patients in the rotavirus group (n=82), whereas it was elevated in 3 (4.0%) and 1 (2.3%) patients in the norovirus (n=74) and adenovirus (n=44) groups, respectively. AST was elevated up to 89 IU/L in 20 (24.4%) patients in the rotavirus group, whereas it was elevated in 6 (8.1%) and 1 (2.3%) patients in the norovirus and adenovirus groups, respectively. Both transaminases were elevated in 7.3%, 1.4%, and 2.3% of patients in the rotavirus, norovirus, and adenovirus groups, respectively. The increases in ALT and AST levels were found to be significantly higher in the rotavirus group (n=27) than in the norovirus (n=9), and adenovirus group (n=2) (p<0.05). Mean serum ALT and AST levels in the rotavirus group were significantly higher than those in the norovirus and adenovirus group (p<0.05). Our study investigated the correlation between viral gastroenteritis and hypertransaminasaemia. When evaluating a patient with hypertransaminasaemia physicians should remember to consider acute gastroenteritis due to some viruses as a cause of elevated AST and ALT. PMID:27031894

  14. 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 ...

  15. Is irritable bowel syndrome an infectious disease?

    PubMed

    Thompson, John Richard

    2016-01-28

    Irritable bowel syndrome (IBS) is the most common of all gastroenterological diseases. While many mechanisms have been postulated to explain its etiology, no single mechanism entirely explains the heterogeneity of symptoms seen with the various phenotypes of the disease. Recent data from both basic and clinical sciences suggest that underlying infectious disease may provide a unifying hypothesis that better explains the overall symptomatology. The presence of small intestinal bowel overgrowth (SIBO) has been documented in patients with IBS and reductions in SIBO as determined by breath testing correlate with IBS symptom improvement in clinical trials. The incidence of new onset IBS symptoms following acute infectious gastroenteritis also suggests an infectious cause. Alterations in microbiota-host interactions may compromise epithelial barrier integrity, immune function, and the development and function of both central and enteric nervous systems explaining alterations in the brain-gut axis. Clinical evidence from treatment trials with both probiotics and antibiotics also support this etiology. Probiotics appear to restore the imbalance in the microflora and improve IBS-specific quality of life. Antibiotic trials with both neomycin and rifaximin show improvement in global IBS symptoms that correlates with breath test normalization in diarrhea-predominant patients. The treatment response to two weeks of rifaximin is sustained for up to ten weeks and comparable results are seen in symptom reduction with retreatment in patients who develop recurrent symptoms. PMID:26819502

  16. Is irritable bowel syndrome an infectious disease?

    PubMed Central

    Thompson, John Richard

    2016-01-01

    Irritable bowel syndrome (IBS) is the most common of all gastroenterological diseases. While many mechanisms have been postulated to explain its etiology, no single mechanism entirely explains the heterogeneity of symptoms seen with the various phenotypes of the disease. Recent data from both basic and clinical sciences suggest that underlying infectious disease may provide a unifying hypothesis that better explains the overall symptomatology. The presence of small intestinal bowel overgrowth (SIBO) has been documented in patients with IBS and reductions in SIBO as determined by breath testing correlate with IBS symptom improvement in clinical trials. The incidence of new onset IBS symptoms following acute infectious gastroenteritis also suggests an infectious cause. Alterations in microbiota-host interactions may compromise epithelial barrier integrity, immune function, and the development and function of both central and enteric nervous systems explaining alterations in the brain-gut axis. Clinical evidence from treatment trials with both probiotics and antibiotics also support this etiology. Probiotics appear to restore the imbalance in the microflora and improve IBS-specific quality of life. Antibiotic trials with both neomycin and rifaximin show improvement in global IBS symptoms that correlates with breath test normalization in diarrhea-predominant patients. The treatment response to two weeks of rifaximin is sustained for up to ten weeks and comparable results are seen in symptom reduction with retreatment in patients who develop recurrent symptoms. PMID:26819502

  17. Infectious diseases in air travellers arriving in the UK.

    PubMed

    Gerard, E

    2002-06-01

    The ease of access to air travel and its increased popularity over the last 30 years have led to a significant incidence of imported infectious diseases and potential infectious hazards. The commonest type of illness found is acute gastroenteritis. Tuberculosis and malaria are not currently common conditions encountered in the UK, but medical vigilance is increasingly necessary as a result of these and other infectious diseases being carried by arriving air travellers. Risks of transmission to other passengers have been considered, and tuberculosis has been shown to have relatively low infectivity on commercial flights. Incidence of serious communicable disease occurring in arriving passengers is low, and should be referred to communicable disease specialists for advice on management. High standards of precautionary hygiene measures are mandatory to commercial aircraft to prevent spread of infectious agents. Disease vectors and products of animal origin pose additional potential threats to public health. Vigilance by environmental health specialists helps maintain national defences against this group of threats. Alertness to recent travel history and awareness of international public health concerns is essential for clinicians likely to encounter sick members of the travelling public. The largest commercial airports have health surveillance units, tasked with acting as a first line of defence against infectious disease. The majority of cases do not present in flight or at the airport, so they can present to any primary care clinician or emergency department. An integrated strategy for health protection will be developed in the UK with the setting up of a Health Protection Agency. PMID:12134773

  18. Hospital-Based Surveillance for Infectious Etiologies Among Patients with Acute Febrile Illness in Georgia, 2008-2011.

    PubMed

    Kuchuloria, Tinatin; Imnadze, Paata; Mamuchishvili, Nana; Chokheli, Maiko; Tsertsvadze, Tengiz; Endeladze, Marina; Mshvidobadze, Ketevan; Gatserelia, Lana; Makhviladze, Manana; Kanashvili, Marine; Mikautadze, Teona; Nanuashvili, Alexander; Kiknavelidze, Khatuni; Kokaia, Nora; Makharadze, Manana; Clark, Danielle V; Bautista, Christian T; Farrell, Margaret; Fadeel, Moustafa Abdel; Maksoud, Mohamed Abdel; Pimentel, Guillermo; House, Brent; Hepburn, Matthew J; Rivard, Robert G

    2016-01-01

    Information on the infectious causes of undifferentiated acute febrile illness (AFI) in Georgia is essential for effective treatment and prevention. In May 2008, a hospital-based AFI surveillance was initiated at six hospitals in Georgia. Patients aged ≥ 4 years with fever ≥ 38°C for ≥ 48 hours were eligible for surveillance. Blood culture and serologic testing were conducted for Leptospira spp., Brucella spp., West Nile virus (WNV), Crimean-Congo hemorrhagic fever virus, Coxiella burnetii, tick-borne encephalitis virus (TBEV), hantavirus, Salmonella enterica serovar Typhi (S. Typhi), and Rickettsia typhi. Of 537 subjects enrolled, 70% were outpatients, 54% were males, and the mean age was 37 years. Patients reported having fatigue (89%), rigors (87%), sweating (83%), pain in joints (49%), and sleep disturbances (42%). Thirty-nine (7%) patients were seropositive for R. typhi, 37 (7%) for Brucella spp., 36 (7%) for TBEV, 12 (2%) for Leptospira spp., 10 (2%) for C. burnetii, and three (0.6%) for S. Typhi. None of the febrile patients tested positive for WNV antibodies. Of the patients, 73% were negative for all pathogens. Our results indicate that most of the targeted pathogens are present in Georgia, and highlight the importance of enhancing laboratory capacity for these infectious diseases. PMID:26438032

  19. Hyperglycemia during induction therapy is associated with increased infectious complications in childhood acute lymphocytic leukemia

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Children with acute lymphocytic leukemia (ALL) are at high risk for developing hyperglycemia. Hyperglycemic adult ALL patients have shorter remissions, more infections, and increased mortality. No corresponding data are available in children. We hypothesized that children with ALL who become hypergl...

  20. A proposed emergency management program for acute care facilities in response to a highly virulent infectious disease.

    PubMed

    Petinaux, Bruno; Ferguson, Brandy; Walker, Milena; Lee, Yeo-Jin; Little, Gary; Parenti, David; Simon, Gary

    2016-01-01

    To address the organizational complexities associated with a highly virulent infectious disease (HVID) hazard, such as Ebola Virus Disease (EVD), an acute care facility should institute an emergency management program rooted in the fundamentals of mitigation, preparedness, response, and recovery. This program must address all known facets of the care of a patient with HVID, from unannounced arrival to discharge. The implementation of such a program not only serves to mitigate the risks from an unrecognized exposure but also serves to prepare the organization and its staff to provide for a safe response, and ensure a full recovery. Much of this program is based on education, training, and infection control measures along with resourcing for appropriate personal protective equipment which is instrumental in ensuring an organized and safe response of the acute care facility in the service to the community. This emergency management program approach can serve as a model in the care of not only current HVIDs such as EVD but also future presentations in our healthcare setting. PMID:26963227

  1. Infantile gastroenteritis in the community:a cost-of-illness study

    PubMed Central

    LORGELLY, P. K.; JOSHI, D.; ITURRIZA GÓMARA, M.; FLOOD, C.; HUGHES, C. A.; DALRYMPLE, J.; GRAY, J.; MUGFORD, M.

    2008-01-01

    SUMMARY Rotavirus infections are the main cause of gastroenteritis in infants and children and it is expected that by the age of 5 years, nearly every child will have experienced at least one episode of rotavirus gastroenteritis. While severe cases are hospitalized, milder disease is either treated at home or by the GP, and as such the true prevalence of rotavirus infection in the community, and the burden of disease, is unknown. This paper reports the results of a cost-of-illness study which was conducted alongside a structured community surveillance study. Forty-eight percent of our sample was found to have rotavirus acute gastroenteritis; and the average total cost of a child presenting with rotavirus gastroenteritis ranged between £59 and £143 per episode, depending on the perspective. Given the prevalence and severity of the disease, the estimated burden of rotavirus gastroenteritis to society is £11.5 million per year. PMID:17338837

  2. Infantile gastroenteritis in the community: a cost-of-illness study.

    PubMed

    Lorgelly, P K; Joshi, D; Iturriza Gómara, M; Flood, C; Hughes, C A; Dalrymple, J; Gray, J; Mugford, M

    2008-01-01

    Rotavirus infections are the main cause of gastroenteritis in infants and children and it is expected that by the age of 5 years, nearly every child will have experienced at least one episode of rotavirus gastroenteritis. While severe cases are hospitalized, milder disease is either treated at home or by the GP, and as such the true prevalence of rotavirus infection in the community, and the burden of disease, is unknown. This paper reports the results of a cost-of-illness study which was conducted alongside a structured community surveillance study. Forty-eight percent of our sample was found to have rotavirus acute gastroenteritis; and the average total cost of a child presenting with rotavirus gastroenteritis ranged between pound sterling 59 and pound sterling 143 per episode, depending on the perspective. Given the prevalence and severity of the disease, the estimated burden of rotavirus gastroenteritis to society is pound sterling 11.5 million per year. PMID:17338837

  3. Infectious Etiologies of Acute Febrile Illness among Patients Seeking Health Care in South-Central Cambodia

    PubMed Central

    Kasper, Matthew R.; Blair, Patrick J.; Touch, Sok; Sokhal, Buth; Yasuda, Chadwick Y.; Williams, Maya; Richards, Allen L.; Burgess, Timothy H.; Wierzba, Thomas F.; Putnam, Shannon D.

    2012-01-01

    The agents of human febrile illness can vary by region and country suggesting that diagnosis, treatment, and control programs need to be based on a methodical evaluation of area-specific etiologies. From December 2006 to December 2009, 9,997 individuals presenting with acute febrile illness at nine health care clinics in south-central Cambodia were enrolled in a study to elucidate the etiologies. Upon enrollment, respiratory specimens, whole blood, and serum were collected. Testing was performed for viral, bacterial, and parasitic pathogens. Etiologies were identified in 38.0% of patients. Influenza was the most frequent pathogen, followed by dengue, malaria, and bacterial pathogens isolated from blood culture. In addition, 3.5% of enrolled patients were infected with more than one pathogen. Our data provide the first systematic assessment of the etiologies of acute febrile illness in south-central Cambodia. Data from syndromic-based surveillance studies can help guide public health responses in developing nations. PMID:22302857

  4. [Acute rheumatic fever and infectious-inflammatory diseases of the pharynx: the relationship, treatment, and prophylaxis].

    PubMed

    Belov, B S

    2015-01-01

    The relationship between pharyngeal infections, such as tonsillitis and pharyngitis, caused by group A beta-hemolytic streptococci (BHSA) and acute rheumatic fever (ARF) is a well-established fact confirmed by numerous studies carried out along the following lines: epidemiological, immunological, therapeutic, and prophylactic. The currently available data provide an opportunity to discuss the existence of «rheumatogenic» BHSA strains exhibiting a number of characteristic clinical and morphological properties. According to the current recommendations penicillins remain the means of first-line therapy for the treatment of acute forms of BHSA-induced tonsillitis and pharyngitis, whereas the macrolides should be applied only as the alternative medications in the patients with intolerance to beta-lactam antibiotics. This article contains characteristics of BHSA-carrier state and the principal indications for the prescription of antibiotics to the patients with these conditions. The key principle of secondary medicamental prophylaxis of acute respiratory infections are expounded along with the main fines of future research on the problems associated with BHSA-induced pharyngeal infections. PMID:26870861

  5. 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.

  6. 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.

  7. 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

  8. Antibiotic use and clinical outcomes in the acute setting under management by an infectious diseases acute physician versus other clinical teams: a cohort study

    PubMed Central

    Jones, Nicola; Mistry, Vikash; Crook, Derrick; Peto, Tim; Walker, A Sarah

    2016-01-01

    Objectives To assess the magnitude of difference in antibiotic use between clinical teams in the acute setting and assess evidence for any adverse consequences to patient safety or healthcare delivery. Design Prospective cohort study (1 week) and analysis of linked electronic health records (3 years). Setting UK tertiary care centre. Participants All patients admitted sequentially to the acute medical service under an infectious diseases acute physician (IDP) and other medical teams during 1 week in 2013 (n=297), and 3 years 2012–2014 (n=47 585). Primary outcome measure Antibiotic use in days of therapy (DOT): raw group metrics and regression analysis adjusted for case mix. Secondary outcome measures 30-day all-cause mortality, treatment failure and length of stay. Results Antibiotic use was 173 vs 282 DOT/100 admissions in the IDP versus non-IDP group. Using case mix-adjusted zero-inflated Poisson regression, IDP patients were significantly less likely to receive an antibiotic (adjusted OR=0.25 (95% CI 0.07 to 0.84), p=0.03) and received shorter courses (adjusted rate ratio (RR)=0.71 (95% CI 0.54 to 0.93), p=0.01). Clinically stable IDP patients of uncertain diagnosis were more likely to have antibiotics held (87% vs 55%; p=0.02). There was no significant difference in treatment failure or mortality (adjusted p>0.5; also in the 3-year data set), but IDP patients were more likely to be admitted overnight (adjusted OR=3.53 (95% CI 1.24 to 10.03), p=0.03) and have longer length of stay (adjusted RR=1.19 (95% CI 1.05 to 1.36), p=0.007). Conclusions The IDP-led group used 30% less antibiotic therapy with no adverse clinical outcome, suggesting antibiotic use can be reduced safely in the acute setting. This may be achieved in part by holding antibiotics and admitting the patient for observation rather than prescribing, which has implications for costs and hospital occupancy. More information is needed to indicate whether any such longer admission will

  9. Infectious complications in children with acute myeloid leukemia: decreased mortality in multicenter trial AML-BFM 2004

    PubMed Central

    Bochennek, K; Hassler, A; Perner, C; Gilfert, J; Schöning, S; Klingebiel, T; Reinhardt, D; Creutzig, U; Lehrnbecher, T

    2016-01-01

    Infections are an important cause for morbidity and mortality in pediatric acute myeloid leukemia (AML). We therefore characterized infectious complications in children treated according to the trial AML-BFM 2004. Patients with Down syndrome were excluded from the analysis. Data were gathered from the medical records in the hospital where the patients were treated. A total of 405 patients (203 girls; median age 8.4 years) experienced 1326 infections. Fever without identifiable source occurred in 56.1% of the patients and clinically and microbiologically documented infections in 17.5% and 32.4% of the patients, respectively. In all, 240 Gram-positive (112 viridans group streptococci) and 90 Gram-negative isolates were recovered from the bloodstream. Invasive fungal infection was diagnosed in 3% of the patients. Three children each died of Gram-negative bacteremia and invasive aspergillosis, respectively. As compared with the results of AML-BFM 93 with lower dose intensity, infection-related morbidity was slightly higher in AML-BFM 2004 (3.3. versus 2.8 infections per patient), whereas infection-related mortality significantly decreased (1.5% versus 5.4% P=0.003). Specific anti-infective recommendations included in the treatment protocol, regular training courses for pediatric hematologists and increasing experience may be the reason for reduced infection-related mortality in children with AML. Further studies are needed to decrease infection-related morbidity. PMID:26771808

  10. Active Hemovigilance Significantly Improves Reporting of Acute Non-infectious Adverse Reactions to Blood Transfusion.

    PubMed

    Agnihotri, Naveen; Agnihotri, Ajju

    2016-09-01

    One of the key purposes of a hemovigilance program is to improve reporting of transfusion related adverse events and subsequent data-driven improvement in blood transfusion (BT) practices. We conducted a study over 3 years to assess the impact of healthcare worker training and an active feedback programme on reporting of adverse reactions to BTs. All hospitalized patients who required a BT were included in the study. Healthcare workers involved in BT to patients were sensitized and trained in adverse reaction reporting by conducting training sessions and meetings. All the transfused patients were 'actively' monitored for any acute adverse reaction by using a uniquely coded blood issue form. A total of 18,914 blood components transfused to 5785 different patients resulted in 61 adverse reaction episodes. This incidence of 0.32 % in our study was found to be significantly higher (p < 0.005) than that reported from the same region in the past. Red blood cell units were the most frequently transfused component and thus most commonly involved in an adverse reaction (42.6 %), however apheresis platelets had the highest chance of reaction per unit transfused (0.66 %). There was no mortality associated with the BT during the study period. An active surveillance program significantly improves reporting and management of adverse reactions to BTs. PMID:27429527

  11. Infectious Uveitis

    PubMed Central

    2015-01-01

    Infectious uveitis is one of the most common and visually devastating causes of uveitis in the US and worldwide. This review provides a summary of the identification, treatment, and complications associated with certain forms of viral, bacterial, fungal, helminthic, and parasitic uveitis. In particular, this article reviews the literature on identification and treatment of acute retinal necrosis due to herpes simplex virus, varicella virus, and cytomegalovirus. While no agreed-upon treatment has been identified, the characteristics of Ebola virus panuveitis is also reviewed. In addition, forms of parasitic infection such as Toxoplasmosis and Toxocariasis are summarized, as well as spirochetal uveitis. Syphilitic retinitis is reviewed given its increase in prevalence over the last decade. The importance of early identification and treatment of infectious uveitis is emphasized. Early identification can be achieved with a combination of maintaining a high suspicion, recognizing certain clinical features, utilizing multi-modal imaging, and obtaining specimens for molecular diagnostic testing. PMID:26618074

  12. Eosinophilic Esophagitis and Gastroenteritis.

    PubMed

    Cianferoni, Antonella; Spergel, Jonathan M

    2015-09-01

    Eosinophilic gastrointestinal disease (EGID) can be classified as eosinophilic esophagitis (EoE) when the eosinophilia is limited to the esophagus or as eosinophilic gastritis (EG) if it is limited to the gastric tract, eosinophilic colitis (EC) if it is limited to the colon, and eosinophilic gastroenteritis (EGE) if the eosinophilia involves one or more parts of the gastrointestinal tract. EoE is by far the most common EGID. It is a well-defined chronic atopic disease due to a T helper type 2 (Th2) inflammation triggered often by food allergens. EoE diagnosis is done if an esophageal biopsy shows at least 15 eosinophils per high power field (eos/hpf). Globally accepted long-term therapies for EoE are the use of swallowed inhaled steroids or food antigen avoidance. The treatment of EoE is done not only to control symptoms but also to prevent complications such as esophageal stricture and food impaction. EGE cause non-specific gastrointestinal (GI) symptoms and are diagnosed if esophagogastroduodenoscopy (EGD)/colonoscopy show eosinophilia in one or more parts of the GI tract. They are rare diseases with an unclear pathogenesis, and they are poorly defined in terms of diagnostic criteria and treatment. Before initiating treatment of any EGE, it is imperative to conduct a differential diagnosis to exclude other causes of hypereosinophilia with GI localization. EGE are often poorly responsive to therapy and there is no commonly accepted long-term treatment. EG has many characteristics similar to EoE, including the fact that it is often due to a food allergen-driven Th2 inflammation; transcriptome analysis however shows that it is more a systemic disease and has a different gene signature than EoE. EC is a benign form of delayed food allergy in infant and is instead a difficult-to-treat severe inflammatory condition in older children and adults. EC in the latter groups can be a manifestation of drug allergy or autoimmune disease. Overall EGE, EC, and EG are rare and

  13. 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)

  14. Polyclonal proliferation of activated suppressor/cytotoxic T cells with transient depression of natural killer cell function in acute infectious mononucleosis.

    PubMed Central

    Williams, M L; Loughran, T P; Kidd, P G; Starkebaum, G A

    1989-01-01

    In acute infectious mononucleosis large numbers of atypical lymphocytes proliferate in response to B cells infected with Epstein-Barr virus, generally resulting in a self-limited illness. Although both T-cells and NK cells are known to be involved, the precise origin of the large granular lymphocytes in this disorder is incompletely understood. Using two-colour immunofluorescent flow cytometry, we sequentially examined the phenotype of selected T cell and NK cell subsets from nine patients with infectious mononucleosis. In parallel, we determined whether these lymphocytes utilized a restricted repertoire of the T cell receptor gene and also measured their NK activity. Our results show that in acute infectious mononucleosis there was a greater than three-fold increase in T lymphocytes with the phenotype CD2+, CD3+, CD8+ and DR+. A modest increase in Leu7(HNK1)+ and CD4+ T cells was also seen. In addition, there was a three-fold increase in cells coexpressing CD3- and CD16+, the phenotype reported to represent most NK cells. In spite of this latter finding, however, a marked decrease in NK function was found at the time of diagnosis, gradually returning to normal by day 28. Finally, Southern blot analysis of DNA from patient lymphocytes showed polyclonal rearrangements of the T cell receptor beta chain gene. These studies indicate that the proliferation of activated suppressor/cytotoxic T lymphocytes in acute infectious mononucleosis is polyclonal and is associated with transient depression of NK function. Images Fig. 2 PMID:2527653

  15. 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

  16. 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

  17. 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

  18. Infectious Diseases

    MedlinePlus

    Infectious diseases kill more people worldwide than any other single cause. Infectious diseases are caused by germs. Germs are tiny living ... to live NIH: National Institute of Allergy and Infectious Diseases

  19. Infectious Diseases

    MedlinePlus

    Infectious diseases kill more people worldwide than any other single cause. Infectious diseases are caused by germs. Germs are tiny living ... live NIH: National Institute of Allergy and Infectious Diseases

  20. Prediction of Gut Wall Integrity Loss in Viral Gastroenteritis by Non-Invasive Marker

    PubMed Central

    Elnady, Hala G.; Sherif, Lobna S.; Saleh, Maysa T.; El-Alameey, Inas R.; Youssef, Mai M.; El Shafie, Amal I.; Helwa, Iman; Raouf, Haiam Abdel; EL-Taweel, Ahmed N.

    2015-01-01

    BACKGROUND: Intestinal fatty acid binding proteins (I-FABPs) are mainly expressed in the intestinal villi, which are the initial site of destruction in viral gastroenteritis. AIM: This study was designed to assess serum I-FABPs as a predictor of gut wall integrity loss in viral gastroenteritis. PATIENTS AND METHODS: This case-control cross-sectional study was conducted on 93 cases of acute viral gastroenteritis. Twenty-eight healthy children matching in age were recruited as control group. Serum I-FABPs were measured using ELISA technique. Viral detection and typing were done by PCR for adenovirus, and by Reverse transcriptase PCR for rotavirus, astrovirus and norovirus. RESULTS: Serum I-FABPs level was significantly higher in the cases compared to the controls and was also higher in the 46 rotavirus gastroenteritis cases compared to other viral gastroenteritis cases. Serum I- FABPs level was significantly higher in severely dehydrated cases as compared to mildly dehydrated ones (P=0.037). CONCLUSION: Serum I-FABPs could be used as an early and sensitive predictor marker of gut wall integrity loss in children with viral gastroenteritis and its level can indicate case severity. PMID:27275194

  1. Infectious Mononucleosis

    PubMed Central

    Dunmire, Samantha K.; Hogquist, Kristin A.; Balfour, Henry H.

    2015-01-01

    Infectious mononucleosis is a clinical entity characterized by sore throat, cervical lymph node enlargement, fatigue and fever most often seen in adolescents and young adults and lasting several weeks. It can be caused by a number of pathogens, but this chapter only discusses infectious mononucleosis due to primary Epstein-Barr virus (EBV) infection. EBV is a γ-herpesvirus that infects at least 90% of the population worldwide. The virus is spread by intimate oral contact among teenagers and young adults. How preadolescents acquire the virus is not known. A typical clinical picture with a positive heterophile test is usually sufficient to make the diagnosis, but heterophile antibodies are not specific and do not develop in some patients. EBV-specific antibody profiles are the best choice for staging EBV infection. In addition to causing acute illness, there can also be long-term consequences as the result of acquisition of the virus. Several EBV related illnesses occur including certain cancers and autoimmune diseases, as well as complications of primary immunodeficiency in persons with the certain genetic mutations. A major obstacle to understanding these sequelae has been the lack of an efficient animal model for EBV infection, although progress in primate and mouse models has recently been made. Key future challenges are to develop protective vaccines and effective treatment regimens. PMID:26424648

  2. 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

  3. Human milk mucin inhibits rotavirus replication and prevents experimental gastroenteritis.

    PubMed Central

    Yolken, R H; Peterson, J A; Vonderfecht, S L; Fouts, E T; Midthun, K; Newburg, D S

    1992-01-01

    Acute gastrointestinal infections due to rotaviruses and other enteric pathogens are major causes of morbidity and mortality in infants and young children throughout the world. Breast-feeding can reduce the rate of serious gastroenteritis in infants; however, the degrees of protection offered against rotavirus infection vary in different populations. The mechanisms associated with milk-mediated protection against viral gastroenteritis have not been fully elucidated. We have isolated a macromolecular component of human milk that inhibits the replication of rotaviruses in tissue culture and prevents the development of gastroenteritis in an animal model system. Purification of the component indicates that the antiviral activity is associated with an acidic fraction (pI = 4.0-4.6), which is free of detectable immunoglobulins. Furthermore, high levels of antiviral activity are associated with an affinity-purified complex of human milk mucin. Deglycosylation of the mucin complex results in the loss of antiviral activity. Further purification indicated that rotavirus specifically binds to the milk mucin complex as well as to the 46-kD glycoprotein component of the complex. Binding to the 46-kD component was substantially reduced after chemical hydrolysis of sialic acid. We have documented that human milk mucin can bind to rotavirus and inhibit viral replication in vitro and in vivo. Variations in milk mucin glycoproteins may be associated with different levels of protection against infection with gastrointestinal pathogens. Images PMID:1331178

  4. [A Case of Acute Acalculous Cholecystitis During Infectious Mononucleosis Caused by the Epstein-Barr Virus in a Young Woman].

    PubMed

    Ono, Shiro; Kobayashi, Tadanao; Nishio, Kenji

    2016-05-01

    Infection with the Epstein-Barr virus (EBV) is a common disease and is mainly asymptomatic during childhood, whereas infectious mononucleosis with clinical signs such as fever, pharyngitis, lymphadenopathy and hepatosplenomegaly often occurs in adolescents and adults with primary infection. Acalculous cholecystitis has been reported as a rare complication. We report herein a case of acalculous cholecystitis accompanied by infectious mononucleosis by EBV, which was treated successfully by medical treatment. A 33-year-old woman who had been admitted by fever, pharyngitis and lymphadenopathy developed a right upper quadrant pain, that was diagnosed as acalculous cholecystitis based on an imaging study. Antibiotic treatment did not resolve the symptoms, and surgical intervention was considered. We diagnosed her as having infectious mononucleosis based on a typical physical presentation and seropositivity for the EBV viral capsid antigen, suggesting that the acalculous cholecystatis might have been a complication of the EBV infection. After the administration of glucocorticoid and acyclovir, the patient became afebrile and the abdominal pain disappeared. Though acalculous cholecystitis rarely accompanies infectious mononucleosis caused by EBV, clinicians should be aware of this complication to avoid unnecessary cholecystectomy. PMID:27529970

  5. Fight against infectious diseases.

    PubMed

    Soda, K; Kamakura, M; Kitamura, K

    1996-08-01

    During early Meiji era in Japan, there were frequent epidemics of fatal acute communicable diseases such as cholera, dysentery and smallpox, and preventive measures and preparations for acute infectious diseases were urgently needed. Together with improvement of scientific preparations, the Communicable Disease Prevention Law was promulgated in 1897. Then gradually until 1940's, the focus of preventive measures have been shifted from acute infectious diseases to chronic ones, particularly tuberculosis. After the World War II, except the short period of social confusion, major legally-defined communicable diseases had been decreasing rapidly mainly due to the use of antibiotics and improvement of environmental sanitation. At the same time, the introduction of preventive vaccination marked a new era for the prevention of infectious diseases and was largely responsible for the remarkable decrease of infant mortality in Japan. Recently the concept of defense by vaccination against infectious diseases has evolved from group-oriented to individual-oriented, so that the Preventive Vaccination Law was drastically revised in 1994. Currently, effective counter-measures against newly emerged infectious diseases, as viral hepatitis, institution-acquired infection, viral hemorrhagic fever etc., have been implemented. For the future, improvement of infections disease surveillance, vaccine development and expansion of vaccination coverage along with monitoring side-effects, preventive health education on AIDS/STDs, addressing the special needs of foreigners living in Japan and international collaboration for disease control abroad are all vital to the success of protection of the public's health from infectious diseases in Japan. PMID:8800275

  6. Clinical, Paraclinical, and Antimicrobial Resistance Features of Community-Acquired Acute Bacterial Meningitis at a Large Infectious Diseases Ward in Tehran, Iran.

    PubMed

    Heydari, Behrooz; Khalili, Hossein; Karimzadeh, Iman; Emadi-Kochak, Hamid

    2016-01-01

    In this study demographic, clinical, paraclinical, microbiological, and therapeutic features of patients with community-acquired acute bacterial meningitis admitted to a referral center for infectious diseases in Iran, have been evaluated. Medical records of adult (> 18 years) individuals with confirmed diagnosis of community-acquired bacterial meningitis during a 4-year period were retrospectively reviewed. All required data were obtained from patients' medical charts. Available findings about antimicrobial susceptibility of isolated bacteria from CSF and/or blood were also collected. Kirby-Bauer disc diffusion method was used to determine their antimicrobial susceptibility profile. Details of medical management including antibiotic regimen, duration, patients' outcome, and possible sequelae of meningitis were recorded. The most commonly isolated microorganism from CSF or blood of patients was Streptococcus pneumonia (33.33%) followed by Neisseria meningitidis (27.78%) and Haemophilus influenza (16.67%). The most common antimicrobial regimen was ceftriaxone plus vancomycin (69.44%) followed by ceftriaxone plus vancomycin plus ampicillin (11.11%). Neurological sequelae of meningitis including cranial nerve palsy, deafness, and hemiparesis were identified in 4 (11.11%), 2 (5.56%), and 1 (2.78%) subjects, respectively. Regarding mortality, only 3 (8.33%) patients died from bacterial meningitis and the remaining 33 individuals discharged from the hospital. In conclusion, findings of the current study demonstrated that the mean incidence of acute bacterial meningitis in a referral infectious diseases ward in Iran was 9 episodes per year. The majority cases of community-acquired acute bacterial meningitis admitted to our center had negative CSF culture and classic triad of meningitis was absent in them. PMID:27610176

  7. Clinical, Paraclinical, and Antimicrobial Resistance Features of Community-Acquired Acute Bacterial Meningitis at a Large Infectious Diseases Ward in Tehran, Iran

    PubMed Central

    Heydari, Behrooz; Khalili, Hossein; Karimzadeh, Iman; Emadi-Kochak, Hamid

    2016-01-01

    In this study demographic, clinical, paraclinical, microbiological, and therapeutic features of patients with community-acquired acute bacterial meningitis admitted to a referral center for infectious diseases in Iran, have been evaluated. Medical records of adult (> 18 years) individuals with confirmed diagnosis of community-acquired bacterial meningitis during a 4-year period were retrospectively reviewed. All required data were obtained from patients’ medical charts. Available findings about antimicrobial susceptibility of isolated bacteria from CSF and/or blood were also collected. Kirby-Bauer disc diffusion method was used to determine their antimicrobial susceptibility profile. Details of medical management including antibiotic regimen, duration, patients’ outcome, and possible sequelae of meningitis were recorded. The most commonly isolated microorganism from CSF or blood of patients was Streptococcus pneumonia (33.33%) followed by Neisseria meningitidis (27.78%) and Haemophilus influenza (16.67%). The most common antimicrobial regimen was ceftriaxone plus vancomycin (69.44%) followed by ceftriaxone plus vancomycin plus ampicillin (11.11%). Neurological sequelae of meningitis including cranial nerve palsy, deafness, and hemiparesis were identified in 4 (11.11%), 2 (5.56%), and 1 (2.78%) subjects, respectively. Regarding mortality, only 3 (8.33%) patients died from bacterial meningitis and the remaining 33 individuals discharged from the hospital. In conclusion, findings of the current study demonstrated that the mean incidence of acute bacterial meningitis in a referral infectious diseases ward in Iran was 9 episodes per year. The majority cases of community-acquired acute bacterial meningitis admitted to our center had negative CSF culture and classic triad of meningitis was absent in them. PMID:27610176

  8. 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...

  9. A community-based gastroenteritis outbreak after Typhoon Haiyan, Leyte, Philippines, 2013

    PubMed Central

    Muhi, Edzel; de los Reyes, Vikki Carr; Sucaldito, Ma Nemia; Tayag, Enrique

    2015-01-01

    Background Three weeks after Typhoon Haiyan, an increasing number of acute gastroenteritis cases were reported in Kananga, Leyte, an area where evacuated residents had returned home two days after the disaster. An outbreak investigation was conducted to identify the source and risk factors associated with the increase of gastroenteritis. Methods A case was defined as any person in Kananga who developed acute diarrhoea (≥ 3 times/24 hours) and any of the following symptoms: fever, nausea, vomiting or abdominal pain from 11 November 2013 to 10 December 2013. Active case finding was conducted by reviewing medical records, and a case-control study was conducted. Rectal swabs and water samples were tested for bacteriological examination. Results One hundred and five cases were identified. Multivariate analysis revealed that consumption of untreated drinking-water was associated with illness (adjusted odds ratio: 18.2). Both rectal swabs and municipal water samples tested positive for Aeromonas hydrophila. On inspection of the municipal water system, breaks in the distribution pipes were found with some submerged in river water. Conclusion This acute gastroenteritis outbreak was most likely caused by Aeromonas hydrophila and transmitted through a contaminated water source. This study highlights that areas less damaged by a disaster that do not require ongoing evacuation centres can still have acute gastroenteritis outbreaks. All affected areas should be monitored during a disaster response, not just those with evacuation centres. Boiling or chlorinating of water should also be recommended for all areas affected by disaster. PMID:25960917

  10. VIRUS-LIKE PARTICLES WITH T=19 ICOSAHEDRAL SYMMETRY IN A HUMAN GASTROENTERITIS STOOL

    EPA Science Inventory

    Virus-like particles not previously described were observed in a human gastroenteritis stool using negative-stain TEM. The stool was among a number of acute-phase illness stools which had been collected in Egypt during 1980. The particles measured 65-70 nm in diameter, and it was...

  11. Therapeutic effect of Chinese patent medicine "Wuhuanghu" on porcine infectious pleuropneumonia and its acute and subchronic toxicity as well as evaluation of safety pharmacology.

    PubMed

    Wang, Guangxi; Kang, Shuai; Yin, Zhongqiong; Jia, Ren-Yong; Lai, Xin; Zhou, Xun; Liang, Xiao-Xia; Li, Li-Xia; Zou, Yuan-Feng; Lv, Cheng; He, Chang-Liang; Ye, Gang; Yin, Li-Zi; Jing, Bo

    2015-09-01

    Chinese patent medicines play an important role in veterinary clinical use. The aim of this study is to research the anti-infection effect of Chinese patent medicine "Wuhuanghu" for the treatment of porcine infectious pleuropneumonia and to evaluate the safety of "Wuhuanghu" in order to provide a comprehensive understanding of its toxicity. The anti-infection results showed that the treatment with "Wuhuanghu" could significantly inhibit pneumonia and decrement of the pneumonia in high, medium and low doses of "Wuhuanghu" groups were 70.97%, 61.29% and 58.06% respectively. The acute toxicity test showed that rats in the highest group (5000mg/kg) had no death and no abnormal response, suggesting the LD50 of "Wuhuanghu" was more than 5000mg/kg. The subchronic toxicity study showed that hematology indexes in all groups had no obvious differences; blood biochemical index, only albumin and total cholesterol in middle and low doses of "Wuhuanghu" groups were significantly decreased when compared with control group. The clinical pathology showed that the target organ of "Wuhuanghu" was liver. The safety pharmacology study indicated that "Wuhuanghu" had no side effects on rats. In conclusion, "Wuhuanghu" has therapeutic and protective effects to porcine infectious pleuropneumonia in a dose-dependent manner and "Wuhuanghu" is a safe veterinary medicine. PMID:26245812

  12. A Survey of Infantile Gastroenteritis

    PubMed Central

    Ironside, Alastair G.; Tuxford, Ann F.; Heyworth, Barrie

    1970-01-01

    In 1967 we admitted 339 cases of infantile gastroenteritis; one-third of these were dehydrated, and in this group the commonest biochemical abnormality found was hypernatraemia, sometimes with metabolic acidosis. A higher incidence of dehydration was found in the patients who had received oral glucose fluids before admission. Enteropathic Escherichia coli were isolated from the faeces of 16% of the cases. Associated infections, especially of the respiratory tract, were common. Treatment was aimed at the restoration of fluid and electrolyte balance. Usually this was achieved with oral fluids, though intravenous fluids were used in the most severely dehydrated cases. Recovery was complete in 320 cases and a further 14 cases were discharged as carriers of enteropathic E. coli. There were five deaths (1·5%) in the series; three occurred immediately after admission. PMID:4913493

  13. Recombinant Canine Coronaviruses Related to Transmissible Gastroenteritis Virus of Swine Are Circulating in Dogs▿

    PubMed Central

    Decaro, Nicola; Mari, Viviana; Campolo, Marco; Lorusso, Alessio; Camero, Michele; Elia, Gabriella; Martella, Vito; Cordioli, Paolo; Enjuanes, Luis; Buonavoglia, Canio

    2009-01-01

    Four canine coronavirus type II (CCoV-II) strains were identified in the guts and internal organs of pups which had died of acute gastroenteritis. The CCoV-II strains were strictly related to porcine transmissible gastroenteritis virus (TGEV) in the N-terminal domain of the spike protein, whereas in the other parts of the genome, a higher genetic relatedness to recent CCoV-II isolates was observed. Experimental infection of dogs with a TGEV-like isolate induced mild gastroenteritis without any systemic involvement. By virus neutralization tests, antigenic differences between reference and TGEV-like CCoVs were found. Our data support the potential recombinant origin of the TGEV-like CCoVs. PMID:19036814

  14. 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

  15. [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. PMID:8771928

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

    PubMed

    Gaulin, C; Lévesque, B; Gauvin, D; Krizanova, 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. PMID:8964025

  17. 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

  18. 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

  19. [Diagnosis and molecular epidemiology of viral gastroenteritis in the past, present and future].

    PubMed

    Ushijima, Hiroshi

    2009-06-01

    Outline, history of research, diagnosis and molecular epidemiology of viral gastroenteritis were described. Rotavirus, adenovirus, norovirus, sapovirus, astrovirus, human parechovirus, Aichivirus, and human bocavirus are the major target viruses which cause acute gastroenteritis. The viruses were differentiated into genogroup, genotypes and subgenotypes/clusters/lineages. The changing of their genetic backgrounds was well recognized in different areas and years. Some reassortments or recombinations were observed not only between humans and humans but also between humans and animals. Viral gastroenteritis diseases were transmitted by food-borne and humans to humans contact. The environmental factors were also impacted on the infections. Recently, situation of the diseases in the natural ecosystem is becoming clearly. Diagnoses by immunological methods and gene technology are available for the known viruses. Further development of diagnosis and discovery of new viruses will be expected. Therefore, the research on molecular epidemiology is needed to be conducted continuously and then new findings will appear. We need to precede the research by using new techniques and we need to cope with the demand of society especially during acute gastroenteritis outbreak seasons. PMID:19927992

  20. 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. PMID:25776578

  1. Acute BVDV-2 infection in beef calves delays humoral responses to a non-infectious antigen challenge

    PubMed Central

    McCorkell, Robert; Horsman, Shawn R.; Wynne-Edwards, Katherine; Muench, Greg; van Drunen Littel-van den Hurk, Sylvia; Waeckerlin, Regula; Eschbaumer, Michael; Dardari, Rkia; Chaiyakul, Mark; Gajda, Pawel; Czub, Markus; van der Meer, Frank

    2015-01-01

    Immunosuppressive effects of an intranasal challenge with non-cytopathic bovine viral diarrhea virus (BVDV) 2a (strain 1373) were assessed through acquired and innate immune system responses to ovalbumin (OVA). Concurrent BVDV infection was hypothesized to delay and reduce the humoral response to ovalbumin (administered on days 3 and 15 post-inoculation). Infected animals followed the expected clinical course. BVDV titers, and anti-BVDV antibodies confirmed the course of infection and were not affected by the administration of OVA. Both the T-helper (CD4+) and B-cell (CD20+) compartments were significantly (P < 0.05) reduced in infected animals, while the gamma-delta T-cell population (Workshop cluster 1+, WC1+) decreased slightly in numbers. Infection with BVDV delayed the increase in OVA IgG by approximately 3 d from day 12 through day 21 post-inoculation. Between days 25 and 37 post-inoculation following BVDV infection the IgM concentration in the BVDV− group decreased while the OVA IgM titer still was rising in the BVDV+ animals. Thus, active BVDV infection delays IgM and IgG responses to a novel, non-infectious antigen. PMID:26483584

  2. [Interest of ambulatory simplified acute physiology score (ASAPS) applied to patients admitted in an intensive care unit of an infectious diseases unit in Dakar].

    PubMed

    Dia, N M; Diallo, I; Manga, N M; Diop, S A; Fortes-Deguenonvo, L; Lakhe, N A; Ka, D; Seydi, M; Diop, B M; Sow, P S

    2015-08-01

    The evaluation of patients by a scale of gravity allows a better categorization of patients admitted in intensive care unit (ICU). Our study had for objective to estimate interest of Ambulatory Simplified Acute Physiologic Score (ASAPS) applied to patients admitted in ICU of infectious diseases department of FANN hospital. It was about a descriptive and analytical retrospective study, made from the data found in patients' files admitted into the USI infectious diseases department of FANN hospital in Dakar, from January 1(st), 2009 till December 31st, 2009.The data of 354 patients' files were analyzed. The sex-ratio was 1.77 with an average age of 37.6 years ± 19.4 years old [5-94 years]. The majority of the patients were unemployed paid (39.6%). The most frequent failures were the following ones: neurological (80.5%), cardio-respiratory (16.7%). The average duration of stay was 6.2 days ± 8.2 days going of less than 24 hours to more than 10 weeks. The deaths arose much more at night (53.1%) than in the daytime (46.9%) and the strongest rate of death was recorded in January (61.5%), most low in October (26.7%). The global mortality was 48.3%. The rate of lethality according to the highest main diagnosis was allocated to the AIDS (80.5%). The average ambulatory simplified acute physiology score was 5.3 ± 3.6 with extremes of 0 and 18. The deaths in our series increased with this index (p = 0.000005). The female patients had a rate of lethality higher than that of the men people, 55.5% against 44.2% (p = 0.03). In spite of a predictive score of a high survival (ASAPS < 8), certain number of patients died (n = 105) that is 61.4% of the deaths. The metabolic disturbances, hyperleukocytosis or leukopenia when realised, the presence of a chronic disease, seemed also to influence this lethality. ASAPS only, although interesting, would not good estimate the gravity of patients, where from the necessity thus of a minimum biological balance sheet. It seems better adapted

  3. Infection-related mortality in children with acute lymphoblastic leukemia: an analysis of infectious deaths on UKALL2003.

    PubMed

    O'Connor, David; Bate, Jessica; Wade, Rachel; Clack, Rachel; Dhir, Sunita; Hough, Rachael; Vora, Ajay; Goulden, Nick; Samarasinghe, Sujith

    2014-08-14

    Although infection is the major cause of treatment-related mortality (TRM) in childhood acute lymphoblastic leukemia, factors associated with infection-related mortality (IRM) are poorly understood. To address this, we report an analysis of all 75 cases of IRM in the United Kingdom Childhood Acute Lymphoblastic Leukaemia Randomised Trial 2003 (UKALL 2003). The 5-year cumulative incidence of IRM was 2.4% (95% confidence interval [CI], 1.9%-3.0%), accounting for 75 (30%) of 249 trial deaths and 75 (64%) of 117 TRM deaths. Risk for IRM as a proportion of TRM was greater in induction than other phases (77% vs 56%; P = .02). Sixty-eight percent of cases were associated with bacterial infection (64% Gram-negative) and 20% with fungal infection. Down syndrome was the most significant risk factor for IRM (odds ratio [OR], 12.08; 95% CI, 6.54-22.32; P < .0001). In addition, there was a trend toward increased IRM in girls (OR, 1.63; 95% CI, 1.02-2.61; P = .04), as well as increasing treatment intensity (regimen B vs A: OR, 2.11 [95% CI, 1.24-3.60]; regimen C vs A: OR, 1.41 [95% CI, 0.76-2.62]; P = .02). Importantly, patients with Down syndrome were at significantly higher risk for IRM during maintenance (P = .048). Our results confirm Down syndrome as a major risk factor for IRM. Enhanced supportive care and prophylactic antibiotics should be considered in high-risk patient groups and during periods of increased risk. This study was registered at http://www.controlled-trials.com/ as #ISRCTN07355119. PMID:24904116

  4. 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

  5. Gastroenteritis Outbreak Caused by Waterborne Norovirus at a New Zealand Ski Resort▿

    PubMed Central

    Hewitt, Joanne; Bell, Derek; Simmons, Greg C.; Rivera-Aban, Malet; Wolf, Sandro; Greening, Gail E.

    2007-01-01

    In July 2006, public health services investigated an outbreak of acute gastroenteritis among staff and visitors of a popular ski resort in southern New Zealand. The source of the outbreak was a drinking water supply contaminated by human sewage. The virological component of the investigation played a major role in confirming the source of the outbreak. Drinking water, source stream water, and 31 fecal specimens from gastroenteritis outbreak cases were analyzed for the presence of norovirus (NoV). Water samples were concentrated by ultrafiltration, and real-time reverse transcription-PCR (RT-PCR) was used for rapid detection of NoV from both water and fecal samples. The implicated NoV strain was further characterized by DNA sequencing. NoV genogroup GI/5 was identified in water samples and linked case fecal specimens, providing clear evidence of the predominant pathogen and route of exposure. A retrospective cohort study demonstrated that staff who consumed drinking water from the resort supply were twice as likely to have gastroenteritis than those who did not. This is the first time that an outbreak of gastroenteritis in New Zealand has been conclusively linked to NoV detected in a community water supply. To our knowledge, this is the first report of the use of ultrafiltration combined with quantitative real-time RT-PCR and DNA sequencing for investigation of a waterborne NoV outbreak. PMID:17965205

  6. Viral Gastroenteritis Associated with Genogroup II Norovirus among U.S. Military Personnel in Turkey, 2009

    PubMed Central

    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. PMID:22606235

  7. Infectious Arthritis

    MedlinePlus

    Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Infectious arthritis is an infection in the joint. The infection ...

  8. VIRAL GASTROENTERITIS AGENTS AND WATERBORNE DISEASE

    EPA Science Inventory

    The application of electron microscopic techniques in the study of human gastroenteritis led in the 1970's to the identification of new viral agents that had previously escaped detection by routine cell culture procedures. These agents have been the focus of study by researchers ...

  9. STUDIES OF WATERBORNE AGENTS OF VIRAL GASTROENTERITIS

    EPA Science Inventory

    The etiologic agent of a large outbreak of waterborne viral gastroenteritis was detected employing immune electron microscopy (IEM) and a newly developed solid phase radioimmunoassay (RIA). This agent, referred to as the Snow Mountain Agent (SMA), is 27-32 nm. in diameter, has cu...

  10. Metchnikoff and the centenary of probiotics: an update of their use in gastroenteric pathology during the age of development.

    PubMed

    Caramia, G

    2008-12-01

    Acute gastroenteritis, antibiotic-associated diarrhea, diarrhea due to Clostridium difficile and traveller's diarrhea, Helicobacter pylori infection and intestinal inflammatory diseases are primitive and/or secondary pathological conditions that alter the intestinal mucosa and microbiota. For years researchers have searched for solutions to restore and rebalance normal transit and intestinal flora. Elia Metchnikoff was the first one to introduce oral bacteriotherapy, that uses very efficient microorganisms that prevent putrefaction and aging. Oral bacteriotherapy has now evolved in probiotics, whose helpful action to prevent and treat some gastroenteric pathologies is currently being studied. PMID:18971903

  11. 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

  12. Analysis of the Salmonella typhimurium Proteome through Environmental Response toward Infectious Conditions

    SciTech Connect

    Adkins, Joshua N.; Mottaz, Heather M.; Norbeck, Angela D.; Gustin, Jean K.; Rue, Joanne; Clauss, Therese RW; Purvine, Samuel O.; Rodland, Karin D.; Heffron, Fred; Smith, Richard D.

    2006-08-01

    Salmonella enterica serovar Typhimurium (aka, S. typhimurium) is a facultative intracellular pathogen that causes ~40,000 reported cases of acute gastroenteritis and diarrhea a year in the United States. To develop a deeper understanding of the infectious state of S. typhimurium, liquid chromatography-mass spectrometry-based “bottom-up” proteomics was used to globally analyze the proteins present under specific growth conditions. Salmonella typhimurium LT2 strain cells were grown in contrasting culture conditions that mimicked both natural free-living conditions and an infectious state, i.e., logarithm phase, stationary phase and Mg-depleted medium growth. Initial comparisons of the LT2 strain protein abundances among cell culture conditions indicate that the majority of proteins do not change significantly. Not unexpectedly, cells grown in Mg-depleted medium conditions had a higher abundance of Mg2+ transport proteins than found in other growth conditions. A second more virulent Salmonella typhimurium strain (14028) was also studied with these growth conditions and used to directly compare to the LT2 strain. The strain comparison offers a unique opportunity to compare and contrast observations in these closely related bacteria. One particular protein family, propanediol utilization proteins, was drastically more abundant in the 14028 strain than in the LT2 strain, and may be a contributor to increased pathogenicity in the 14028 strain.

  13. 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

  14. [Practice guideline on 'Acute diarrhoea' from the Dutch College of General Practitioners].

    PubMed

    Loogman, Masja C M; Bouma, Margriet; Burgers, Jako S

    2014-01-01

    The revised guideline on 'Acute diarrhoea' from the Dutch College of General Practitioners covers the diagnosis and management of suspected acute infectious diarrhoea. Acute diarrhoea resulting from infectious gastroenteritis is often caused by a virus and is usually self-limiting; stool testing is rarely indicated. The main complication of acute diarrhoea is dehydration, although this is rare in the Netherlands. Children under 2 years old and patients over 70 are at an increased risk of dehydration. Dehydration is a clinical diagnosis based on a combination of patient history and physical examination. DNA diagnostic methods such as polymerase chain reaction (PCR) are now available for stool testing, in addition to stool culture and the triple faeces test (TFT). PCR is preferred for its better test properties. Treatment with oral rehydration salts (ORS) is indicated for patients with dehydration and may also be useful in patients at an increased risk of this event. Acute diarrhoea after hospitalisation or after visiting the tropics or subtropics merits special attention on account of the risk of infection with unusual pathogens and the consequences with regard to management. PMID:25690070

  15. Infectious Arthritis

    MedlinePlus

    ... Another form of reactive arthritis starts with eating food or handling something that has bacteria on it. To diagnose infectious arthritis, your health care provider may do tests of your blood, urine, and joint fluid. Treatment includes medicines and sometimes surgery.

  16. Oxidative stress indices in gastroenteritis in dogs with canine parvoviral infection.

    PubMed

    Panda, Debasis; Patra, R C; Nandi, S; Swarup, D

    2009-02-01

    Gastroenteritis of viral origin has emerged as a major cause of morbidity and mortality in dogs during the last two decades. Amongst the viral etiologies responsible for gastroenteritis in dogs, canine parvovirus (CPV) is considered as the most pathogenic. The disease is characterized by hemorrhagic enteritis, bloody diarrhoea and myocarditis in young pups. The present study was carried out to examine alterations in oxidative stress indices in the erythrocytes from dogs suffering from gastroenteritis with or without canine parvoviral infection as confirmed by CPV-DNA amplification from faeces using specific primers for CPV-2 as well as CPV-2a and CPV-2b variants by polymerase chain reaction (PCR). The present investigation utilized clinical cases of dogs with signs of acute diarrhea (n=56), and 14 more apparently healthy dogs of similar age group. Erythrocytic oxidative stress indices such as lipid peroxides level and antioxidant enzymes like superoxide dismutase and catalase activity, and blood micro-mineral (iron, copper, cobalt and zinc) status were analyzed in each dog (n=70). The acute cases of gastroenteritis in dogs were associated with altered erythrocytic lipid peroxidation as evident by estimation of malonaldehyde (MDA) concentration. The activities of antioxidant enzymes catalase and superoxide dismutase, the first line of antioxidant defense against damaging effects of free radicals, were also altered. The alterations in oxidative stress indices were more pronounced in cases with involvement of canine parvovirus as compared to parvo-negative cases. Our results also revealed decreased blood zinc level in diarrhoea in dogs irrespective of involvement of canine parvovirus. PMID:18572211

  17. Mycoplasma pneumoniae preceding Lemierre's syndrome due to Fusobacterium nucleatum complicated by acute Epstein-Barr virus (EBV) infectious mononucleosis in an immunocompetent host.

    PubMed

    Klein, Natalie C; Petelin, Andrew; Cunha, Burke A

    2013-01-01

    We report an unusual case of Lemierre's syndrome due to a rare species of Fusobacterium, that is, Fusobacterium nucleatum preceded by Mycoplasma pneumoniae pharyngitis and followed later by Epstein-Barr virus infectious mononucleosis. PMID:22464641

  18. 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

  19. Avian infectious laryngotracheitis.

    PubMed

    Bagust, T J; Jones, R C; Guy, J S

    2000-08-01

    Avian infectious laryngotracheitis (ILT) herpesvirus continues to cause sporadic cases of respiratory disease in chickens world-wide. Sources of transmission of ILT infection are three-fold, namely: chickens with acute upper respiratory tract disease, latently infected 'carrier' fowls which excrete infectious laryngotracheitis virus (ILTV) when stressed, and all fomites (inanimate articles as well as the personnel in contact with infected chickens). Infectious laryngotracheitis virus infectivity can persist for weeks to months in tracheal mucus or carcasses. Rigorous site biosecurity is therefore critical in ILT disease control. Furthermore, while current (modified live) ILT vaccines can offer good protection, the strains of ILTV used in vaccines can also produce latent infections, as well as ILT disease following bird-to-bird spread. The regional nature of reservoirs of ILTV-infected flocks will tend to interact unfavourably with widely varying ILT control practices in the poultry industry, so as to periodically result in sporadic and unexpected outbreaks of ILT in intensive poultry industry populations. Precautions for trade-related movements of chickens of all ages must therefore include an accurate knowledge of the ILT infection status, both of the donor and recipient flocks. PMID:10935275

  20. Eosinophilic gastroenteritis and related eosinophilic disorders.

    PubMed

    Prussin, Calman

    2014-06-01

    Eosinophilic gastroenteritis (EGE) represents one member within the spectrum of diseases collectively referred to as eosinophilic gastrointestinal disorders, which includes eosinophilic esophagitis (EoE), gastritis, enteritis, and colitis. EGE is less common than EoE and involves a different site of disease but otherwise shares many common features with EoE. The clinical manifestations of EGE are protean and can vary from nausea and vomiting to protein-losing enteropathy or even bowel obstruction requiring surgery. Although systemic corticosteroids are an effective treatment for EGE, their use results in substantial corticosteroid toxicity. Accordingly, there is a great need for improved therapies for these patients. PMID:24813518

  1. 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

  2. Infectious disease.

    PubMed

    Jaworski, Carrie A; Donohue, Brian; Kluetz, Joshua

    2011-07-01

    Athletes are susceptible to the same infections as the general population. However, special considerations often need to be taken into account when dealing with an athlete who has contracted an infectious disease. Health care providers need to consider how even common illnesses can affect an athlete's performance, the communicability of the illness to team members, and precautions/contraindications related to athletic participation. Recent advances in the prevention, diagnosis, and/or management of frequently encountered illnesses, as well as certain conditions that warrant special attention in the athletic setting, are discussed in detail. PMID:21658549

  3. 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

  4. Observational Research in Childhood Infectious Diseases (ORChID): a dynamic birth cohort study

    PubMed Central

    Lambert, Stephen Bernard; Ware, Robert S; Cook, Anne L; Maguire, Frances A; Whiley, David M; Bialasiewicz, Seweryn; Mackay, Ian M; Wang, David; Sloots, Theo P; Nissen, Michael D; Grimwood, Keith

    2012-01-01

    Introduction Even in developed economies infectious diseases remain the most common cause of illness in early childhood. Our current understanding of the epidemiology of these infections is limited by reliance on data from decades ago performed using low-sensitivity laboratory methods, and recent studies reporting severe, hospital-managed disease. Methods and analysis The Observational Research in Childhood Infectious Diseases (ORChID) study is an ongoing study enrolling a dynamic birth cohort to document the community-based epidemiology of viral respiratory and gastrointestinal infections in early childhood. Women are recruited antenatally, and their healthy newborn is followed for the first 2 years of life. Parents keep a daily symptom diary for the study child, collect a weekly anterior nose swab and dirty nappy swab and complete a burden diary when a child meets pre-defined illness criteria. Specimens will be tested for a wide range of viruses by real-time PCR assays. Primary analyses involves calculating incidence rates for acute respiratory illness (ARI) and acute gastroenteritis (AGE) for the cohort by age and seasonality. Control material from children when they are without symptoms will allow us to determine what proportion of ARIs and AGE can be attributed to specific pathogens. Secondary analyses will assess the incidence and shedding duration of specific respiratory and gastrointestinal pathogens. Ethics and dissemination This study is approved by The Human Research Ethics Committees of the Children's Health Queensland Hospital and Health Service, the Royal Brisbane and Women's Hospital and The University of Queensland. Trial registration clinicaltrials.gov NCT01304914. PMID:23117571

  5. Risk Factors for Norovirus, Sapporo-like Virus, and Group A Rotavirus Gastroenteritis

    PubMed Central

    de Wit, Matty AS; Koopmans, Marion PG

    2003-01-01

    Viral pathogens are the most common causes of gastroenteritis in the community. To identify modes of transmission and opportunities for prevention, a case-control study was conducted and risk factors for gastroenteritis attributable to norovirus (NV), Sapporo-like virus (SLV), and rotavirus were studied. For NV gastroenteritis, having a household member with gastroenteritis, contact with a person with gastroenteritis outside the household, and poor food-handling hygiene were associated with illness (population attributable risk fractions [PAR] of 17%, 56%, and 47%, respectively). For SLV gastroenteritis, contact with a person with gastroenteritis outside the household was associated with a higher risk (PAR 60%). For rotavirus gastroenteritis, contact with a person with gastroenteritis outside the household and food-handling hygiene were associated with a higher risk (PAR 86% and 46%, respectively). Transmission of these viral pathogens occurs primarily from person to person. However, for NV gastroenteritis, foodborne transmission seems to play an important role. PMID:14720397

  6. 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

  7. Eosinophilic gastroenteritis and related eosinophilic disorders

    PubMed Central

    Prussin, Calman

    2014-01-01

    Eosinophilic gastroenteritis (EGE) represents one member within the spectrum of diseases collectively referred to as eosinophilic gastrointestinal disorders (EGIDs), which includes eosinophilic esophagitis (EoE), gastritis, enteritis, and colitis. EGE is less common than EoE and involves a different site of disease, but otherwise shares many common features with EoE. The clinical manifestations of EGE are protean and can vary from nausea and vomiting to protein losing enteropathy or even bowel obstruction requiring surgery. Although systemic corticosteroids are an effective treatment for EGE, their use over the chronic course of the disease results in substantial corticosteroid toxicity. Accordingly, there is a great need for improved therapies for these patients. PMID:24813518

  8. The duration of gastrointestinal and joint symptoms after a large waterborne outbreak of gastroenteritis in Finland in 2007--a questionnaire-based 15-month follow-up study.

    PubMed

    Laine, Janne; Lumio, Jukka; Toikkanen, Salla; Virtanen, Mikko J; Uotila, Terhi; Korpela, Markku; Kujansuu, Eila; Kuusi, Markku

    2014-01-01

    An extensive drinking water-associated gastroenteritis outbreak took place in the town of Nokia in Southern Finland in 2007. 53% of the exposed came down with gastroenteritis and 7% had arthritis-like symptoms (joint swelling, redness, warmth or pain in movement) according to a population-based questionnaire study at 8 weeks after the incident. Campylobacter and norovirus were the main pathogens. A follow-up questionnaire study was carried out 15 months after the outbreak to evaluate the duration of gastrointestinal and joint symptoms. 323 residents of the original contaminated area were included. The response rate was 53%. Participants were inquired about having gastroenteritis during the outbreak and the duration of symptoms. Of those with gastroenteritis, 43% reported loose stools and abdominal pain or distension after the acute disease. The prevalence of symptoms declined promptly during the first 3 months but at 15 months, 11% reported continuing symptoms. 32% of the respondents with gastroenteritis reported subsequent arthritis-like symptoms. The disappearance of arthritis-like symptoms was more gradual and they levelled off only after 5 months. 19% showed symptoms at 15 months. Prolonged gastrointestinal symptoms correlated to prolonged arthritis-like symptoms. High proportion of respondents continued to have arthritis-like symptoms at 15 months after the epidemic. The gastrointestinal symptoms, instead, had declined to a low level. PMID:24465569

  9. Co-existent eosinophilic gastroenteritis and hypothalamic-pituitary dysfunction.

    PubMed Central

    Haeney, M. R.; Wilson, R. J.

    1977-01-01

    A case of eosinophilic gastroenteritis in a 42-year-old man is described. The patient had diarrhoea, faecal blood loss, a protein-losing enteropathy, malabsorption of fat, xylose and vitamin B12. Co-existent hypopituitarism, diabetes insipidus and hypothalamic dysfunction was demonstrated. Complete clinical recovery occurred with pituitary replacement therapy alone. The association of this endocrine abnormality with the picture of eosinophilic gastroenteritis has not previously been described. Images Fig. 1 PMID:882484

  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. Meningoencephalitis-like onset of post-infectious AQP4-IgG-positive optic neuritis complicated by GM1-IgG-positive acute polyneuropathy.

    PubMed

    Benedetti, Luana; Franciotta, Diego; Beronio, Alessandro; Delucchi, Stefano; Capellini, Cesare; Del Sette, Massimo

    2015-02-01

    Fifteen days after a respiratory infection, a 45-year-old woman presented with paresthesias in the hands and feet, bilateral loss of vision, fever, headache, and impairment of consciousness. Magnetic resonance imaging (MRI) showed predominant lesions in the optic tracts, optic chiasm, and hypothalamus. Cerebrospinal fluid analysis revealed elevated protein level, and lymphocytic pleocytosis. Neurophysiological studies disclosed a demyelinating sensorimotor polyneuropathy. Serum anti-Mycoplasma pneumoniae immunoglobulin (Ig)M, anti-GM1 IgG, and anti-AQP4 IgG were positive. This case, which is remarkable for post-infectious meningoencephalitis-like onset, MRI picture, and dysimmunity to central and peripheral nervous system autoantigens, underpins the pivotal diagnostic role of anti-AQP4-IgG, and expands the list of clinico-pathological findings that can associate with neuromyelitis optica spectrum disorders. PMID:24557856

  12. 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

  13. 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

  14. Autophagy Negatively Regulates Transmissible Gastroenteritis Virus Replication

    PubMed Central

    Guo, Longjun; Yu, Haidong; Gu, Weihong; Luo, Xiaolei; Li, Ren; Zhang, Jian; Xu, Yunfei; Yang, Lijun; Shen, Nan; Feng, Li; Wang, Yue

    2016-01-01

    Autophagy is an evolutionarily ancient pathway that has been shown to be important in the innate immune defense against several viruses. However, little is known about the regulatory role of autophagy in transmissible gastroenteritis virus (TGEV) replication. In this study, we found that TGEV infection increased the number of autophagosome-like double- and single-membrane vesicles in the cytoplasm of host cells, a phenomenon that is known to be related to autophagy. In addition, virus replication was required for the increased amount of the autophagosome marker protein LC3-II. Autophagic flux occurred in TGEV-infected cells, suggesting that TGEV infection triggered a complete autophagic response. When autophagy was pharmacologically inhibited by wortmannin or LY294002, TGEV replication increased. The increase in virus yield via autophagy inhibition was further confirmed by the use of siRNA duplexes, through which three proteins required for autophagy were depleted. Furthermore, TGEV replication was inhibited when autophagy was activated by rapamycin. The antiviral response of autophagy was confirmed by using siRNA to reduce the expression of gene p300, which otherwise inhibits autophagy. Together, the results indicate that TGEV infection activates autophagy and that autophagy then inhibits further TGEV replication. PMID:27029407

  15. Diversity in the enteric viruses detected in outbreaks of gastroenteritis from Mumbai, Western India.

    PubMed

    Chitambar, Shobha; Gopalkrishna, Varanasi; Chhabra, Preeti; Patil, Pooja; Verma, Harsha; Lahon, Anismrita; Arora, Ritu; Tatte, Vaishali; Ranshing, Sujata; Dhale, Ganesh; Kolhapure, Rajendra; Tikute, Sanjay; Kulkarni, Jagannath; Bhardwaj, Renu; Akarte, Sulbha; Pawar, Sashikant

    2012-03-01

    Faecal specimens collected from two outbreaks of acute gastroenteritis that occurred in southern Mumbai, India in March and October, 2006 were tested for seven different enteric viruses. Among the 218 specimens tested, 95 (43.6%) were positive, 73 (76.8%) for a single virus and 22 (23.2%) for multiple viruses. Single viral infections in both, March and October showed predominance of enterovirus (EV, 33.3% and 40%) and rotavirus A (RVA, 33.3% and 25%). The other viruses detected in these months were norovirus (NoV, 12.1% and 10%), rotavirus B (RVB, 12.1% and 10%), enteric adenovirus (AdV, 6.1% and 7.5%), Aichivirus (AiV, 3% and 7.5%) and human astrovirus (HAstV, 3% and 0%). Mixed viral infections were largely represented by two viruses (84.6% and 88.9%), a small proportion showed presence of three (7.7% and 11%) and four (7.7% and 0%) viruses in the two outbreaks. Genotyping of the viruses revealed predominance of RVA G2P[4], RVB G2 (Indian Bangladeshi lineage), NoV GII.4, AdV-40, HAstV-8 and AiV B types. VP1/2A junction region based genotyping showed presence of 11 different serotypes of EVs. Although no virus was detected in the tested water samples, examination of both water and sewage pipelines in gastroenteritis affected localities indicated leakages and possibility of contamination of drinking water with sewage water. Coexistence of multiple enteric viruses during the two outbreaks of gastroenteritis emphasizes the need to expand such investigations to other parts of India. PMID:22690171

  16. Diversity in the Enteric Viruses Detected in Outbreaks of Gastroenteritis from Mumbai, Western India

    PubMed Central

    Chitambar, Shobha; Gopalkrishna, Varanasi; Chhabra, Preeti; Patil, Pooja; Verma, Harsha; Lahon, Anismrita; Arora, Ritu; Tatte, Vaishali; Ranshing, Sujata; Dhale, Ganesh; Kolhapure, Rajendra; Tikute, Sanjay; Kulkarni, Jagannath; Bhardwaj, Renu; Akarte, Sulbha; Pawar, Sashikant

    2012-01-01

    Faecal specimens collected from two outbreaks of acute gastroenteritis that occurred in southern Mumbai, India in March and October, 2006 were tested for seven different enteric viruses. Among the 218 specimens tested, 95 (43.6%) were positive, 73 (76.8%) for a single virus and 22 (23.2%) for multiple viruses. Single viral infections in both, March and October showed predominance of enterovirus (EV, 33.3% and 40%) and rotavirus A (RVA, 33.3% and 25%). The other viruses detected in these months were norovirus (NoV, 12.1% and 10%), rotavirus B (RVB, 12.1% and 10%), enteric adenovirus (AdV, 6.1% and 7.5%), Aichivirus (AiV, 3% and 7.5%) and human astrovirus (HAstV, 3% and 0%). Mixed viral infections were largely represented by two viruses (84.6% and 88.9%), a small proportion showed presence of three (7.7% and 11%) and four (7.7% and 0%) viruses in the two outbreaks. Genotyping of the viruses revealed predominance of RVA G2P[4], RVB G2 (Indian Bangladeshi lineage), NoV GII.4, AdV-40, HAstV-8 and AiV B types. VP1/2A junction region based genotyping showed presence of 11 different serotypes of EVs. Although no virus was detected in the tested water samples, examination of both water and sewage pipelines in gastroenteritis affected localities indicated leakages and possibility of contamination of drinking water with sewage water. Coexistence of multiple enteric viruses during the two outbreaks of gastroenteritis emphasizes the need to expand such investigations to other parts of India. PMID:22690171

  17. Infectious Risks of Air Travel.

    PubMed

    Mangili, Alexandra; Vindenes, Tine; Gendreau, Mark

    2015-10-01

    Infectious diseases are still among the leading causes of death worldwide due to their persistence, emergence, and reemergence. As the recent Ebola virus disease and MERS-CoV outbreaks demonstrate, the modern epidemics and large-scale infectious outbreaks emerge and spread quickly. Air transportation is a major vehicle for the rapid spread and dissemination of communicable diseases, and there have been a number of reported outbreaks of serious airborne diseases aboard commercial flights including tuberculosis, severe acute respiratory syndrome, influenza, smallpox, and measles, to name a few. In 2014 alone, over 3.3 billion passengers (a number equivalent to 42% of the world population) and 50 million metric tons of cargo traveled by air from 41,000 airports and 50,000 routes worldwide, and significant growth is anticipated, with passenger numbers expected to reach 5.9 billion by 2030. Given the increasing numbers of travelers, the risk of infectious disease transmission during air travel is a significant concern, and this chapter focuses on the current knowledge about transmission of infectious diseases in the context of both transmissions within the aircraft passenger cabin and commercial aircraft serving as vehicles of worldwide infection spread. PMID:26542037

  18. Influence of pre-existing invasive aspergillosis on allo-HSCT outcome: a retrospective EBMT analysis by the Infectious Diseases and Acute Leukemia Working Parties.

    PubMed

    Penack, O; Tridello, G; Hoek, J; Socié, G; Blaise, D; Passweg, J; Chevallier, P; Craddock, C; Milpied, N; Veelken, H; Maertens, J; Ljungman, P; Cornelissen, J; Thiebaut-Bertrand, A; Lioure, B; Michallet, M; Iacobelli, S; Nagler, A; Mohty, M; Cesaro, S

    2016-03-01

    Historically, invasive aspergillosis (IA) has been a major barrier for allogeneic hematopoietic stem cell transplantation (allo-HSCT). The influence of invasive IA on long-term survival and on transplant-related complications has not been investigated in a larger patient cohort under current conditions. Our aim was to analyze the long-term outcome of patients undergoing allo-HSCT with a history of prior IA. We used European Society for Blood and Marrow Transplantation database data of first allo-HSCTs performed between 2005 and 2010 in patients with acute leukemia. One thousand one hundred and fifty patients with data on IA before allo-HSCT were included in the analysis. The median follow-up time was 52.1 months. We found no significant impact of IA on major transplant outcome variables such as overall survival, relapse-free survival, non-relapse mortality, cumulative incidence of acute GvHD grade II-IV, chronic GvHD, pulmonary complications and leukemia relapse. However, we found a trend toward lower overall survival (P=0.078, hazard ratio (HR) (95% confidence interval (CI)): 1.16 (0.98, 1.36)) and higher non-relapse mortality (P=0.150, HR (95% CI): 1.19 (0.94, 1.50)) in allo-HSCT recipients with pre-existing IA. Our data suggest that a history of IA should not generally be a contraindication when considering the performance of allo-HSCT in patients with acute leukemia. PMID:26501769

  19. 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

  20. 75 FR 34146 - Draft Guideline for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-16

    ... of Norovirus Gastroenteritis Outbreaks in Healthcare Settings AGENCY: Centers for Disease Control and... for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in Healthcare Settings... control programs for healthcare settings across the continuum of care. This guideline provides...

  1. 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

  2. [Comparative study of two antitussive drugs in the treatment of acute dry cough of infectious origin (prospective, randomized, single blind study)].

    PubMed

    Pujet, J C; Keddad, K; Sévenier, F; Jolivet-Landreau, I

    2002-01-01

    The objective was to compare, during a 5-day therapy, the efficacy and tolerability of an antihistaminic antitussive syrup, oxomemazine, combining a small quantity of guaifenesine (T), with a centrally acting antitussive, clobutinol (S), in adult patients aged from 18 to 70 years and presenting with a dry cough of infectious origin. This study was performed by 22 general practitioners and 130 ambulatory patients were enrolled. The primary criterion of this multicenter, randomized, single blind study was to compare the evolution of cough intensity using a Visual Analog Squale (VAS) graduated from 0 to 10 cm. Nine secondary criteria including tolerability were also assessed. With regard to cough intensity, the treatments were not equivalent. A greater reduction was observed with T (-5.2 +/- 2.3 versus -4.3 +/- 2.3). This result was confirmed by a further reduction in cough intensity at days: 2 (p = 0.04), 4 (p = 0.05), and 5 (p = 0.02). The frequency of cough disappearance before the end of the study was significantly greater for T than for S: 46% versus 29% (p = 0.05). The time before disappearance of the cough was 4.0 + 1.1 days for both medicines. Induction of sleep and the frequency of nocturnal wakening were significantly better for T from day 4 (p = 0.02). The drowsiness induced by T meant that diurnal quality of life was better with S on days 1 (p = 0.002) and 2 (p = 0.01). Tolerability was similar for both medicines. In conclusion, as a symptomatic treatment of dry cough, T is efficient and well tolerated. Moreover, we have observed a tendency towards superior efficacy of T than S. T is therefore a useful alternative in the therapeutic armamentarium available to the general practitioner. PMID:12611200

  3. POST-INFECTIOUS IRRITABLE BOWEL SYNDROME: A LONG TERM CONSEQUENCE OF BACTERIAL GASTROENTERITIS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Irritable bowel syndrome (IBS) is a commonly diagnosed disease characterized by gastrointestinal symptoms often associated with psychological illness and emotional problems. The prevalence rate world-wide for IBS ranges from 10 to 20% and is higher for women than for men. Irritable bowel disease ...

  4. 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. PMID:25119694

  5. Recombinant bivalent vaccines against infectious laryngotracheitis and Newcastle disease

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Infectious laryngotracheitis (ILT) is a highly contagious acute respiratory disease of chickens caused by infection of infectious laryngotracheitis virus (ILTV). The current commercial ILT vaccines are either not safe or less effective. Therefore, there is a pressing need to develop safer and more...

  6. 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. PMID:26100228

  7. Multistate outbreak of viral gastroenteritis associated with consumption of oysters--Apalachicola Bay, Florida, December 1994-January 1995.

    PubMed

    1995-01-20

    On January 3, 1995, the Florida Department of Health and Rehabilitative Services (HRS) was notified of an outbreak of acute gastroenteritis associated with eating oysters. The subsequent investigation by HRS has identified 34 separate clusters of cases, many of which were associated with oysters harvested during December 29-31 from 13 Mile Area and Cat Point in Apalachicola Bay. Oysters were shipped to other states, but additional clusters of illness associated with these oysters have been reported only in Georgia. Most of these oysters were served steamed or roasted. This report summarizes the preliminary findings of the ongoing investigation of this outbreak.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7808387

  8. High Prevalence of G12 Human Rotaviruses in Children with Gastroenteritis in Myanmar.

    PubMed

    Ide, Tomihiko; Higo-Moriguchi, Kyoko; Komoto, Satoshi; Htun, Khaing Win; Myint, Yi Yi; Myat, Theingi Win; Thant, Kyaw Zin; Thu, Hlaing Myat; Win, Mo Mo; Oo, Htun Naing; Htut, Than; Rahman, Shofiqur; Nguyen, Sa Van; Umeda, Kouji; Oguma, Keiji; Tsuji, Takao; Taniguchi, Koki

    2016-07-22

    Human rotavirus samples from 54 children with acute gastroenteritis in Myanmar in 2011 were subjected to reverse transcription-PCR to determine their G and P types. On G typing, G2 (24/54; 44.4%) was found to be the most prevalent, followed by G12 (17/54; 31.5%) and G1 (1/54; 1.9%). Mixed cases with G2 and G12 were found in 12 of the 54 (22.2%) samples. On P typing, P[4] was found to be the most predominant (29/54; 53.7%), followed by P[8] (17/54; 31.5%) and P[6] (4/54; 7.4%). Mixed cases with P[4] and P[8] were detected in 4 of 54 (7.4%) samples. Thus, occurrence of G2 and unusual G12 in high proportions was characteristic of human rotaviruses in Myanmar in this study setting. PMID:26370431

  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. Effectiveness of probiotics on the duration of illness in healthy children and adults who develop common acute respiratory infectious conditions: a systematic review and meta-analysis.

    PubMed

    King, Sarah; Glanville, Julie; Sanders, Mary Ellen; Fitzgerald, Anita; Varley, Danielle

    2014-07-14

    Recent systematic reviews have reported a positive, although modest, effect of probiotics in terms of preventing common cold symptoms. In this systematic review, the effect of probiotics, specifically Lactobacillus and Bifidobacterium strains, on the duration of acute respiratory infections in otherwise healthy children and adults was evaluated. To identify relevant trials, eight databases, including MEDLINE, Embase, the Cochrane Database of Systematic Reviews (CDSR), the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA), Science Citation Index (SCI) and OAISTER, were searched from inception to 20 July 2012. Details regarding unpublished studies/databases were also obtained from probiotic manufacturers. Study selection, data extraction and quality assessment were carried out by two reviewers. Risk of bias was assessed using criteria adapted from those published by the Centre for Reviews and Dissemination. In this review, twenty randomised controlled trials (RCT) were included, of which twelve were considered to have a low risk of bias. Meta-analysis revealed significantly fewer numbers of days of illness per person (standardised mean difference (SMD) - 0·31 (95% CI - 0·41, - 0·11), I²= 3%), shorter illness episodes by almost a day (weighted mean difference - 0·77 (95% CI - 1·50, - 0·04), I²= 80%) (without an increase in the number of illness episodes), and fewer numbers of days absent from day care/school/work (SMD - 0·17 (95% CI - 0·31, - 0·03), I²= 67%) in participants who received a probiotic intervention than in those who had taken a placebo. Reasons for heterogeneity between the studies were explored in subgroup analysis, but could not be explained, suggesting that the effect sizes found may differ between the population groups. This systematic review provides evidence from a number of good-quality RCT that probiotics reduce the duration of illness in

  11. Unusual presentations of eosinophilic gastroenteritis: two case reports.

    PubMed

    Leal, Regina; Fayad, Leonardo; Vieira, Daniella; Figueiredo, Teresa; Lopes, Aldemae; Carvalho, Roberta; Dantas-Corrêa, Esther; Schiavon, Leonardo; Narciso-Schiavon, Janaína

    2014-06-01

    Eosinophilic gastroenteritis is a rare disease that is characterized by eosinophil infiltration in one or multiple segments of the gastrointestinal tract. The etiology of this condition remains unknown. Eosinophilic gastroenteritis has heterogeneous clinical manifestations that depend upon the location and depth of infiltration in the gastrointestinal tract, and eosinophilia may or may not be present. This article reports two cases of eosinophilic gastroenteritis. The first is that of a 49-year-old woman with abdominal pain, ascites, eosinophilia, and a history of asthma. The second case is that of a 69-year-old male with a history of loss of appetite, belching, postprandial fullness, heartburn, and a 5-kilogram weight loss over a period of 9 months; ultimately, the patient was diagnosed with a gastric outlet obstruction due to pyloric stenosis. The rare character of eosinophilic gastroenteritis and its varied clinical presentations often lead to delayed diagnoses and complications. Case reports may help to disseminate knowledge about the disease, thereby increasing the likelihood of early diagnosis and intervention to prevent complications. PMID:25141324

  12. Outbreaks of food-borne and waterborne viral gastroenteritis.

    PubMed Central

    Hedberg, C W; Osterholm, M T

    1993-01-01

    Norwalk virus infection is the epidemiologic prototype for outbreaks of food-borne and waterborne gastroenteritis. Around the world, Norwalk virus and Norwalk-like viruses appear to be major causes of food-borne and waterborne illness. Assessment of the overall significance of viral agents to the epidemiology of food-borne and waterborne illness is hampered by the lack of surveillance throughout much of the world. In areas where food-borne and waterborne illness surveillance is conducted, outbreaks of viral gastroenteritis are underreported because of the lack of availability of routine laboratory services to confirm the viral etiology. Routine use of epidemiologic criteria as an alternative to laboratory confirmation will allow better assessments of the importance of viral gastroenteritis until effective laboratory methods can be widely implemented. Outbreaks of viral gastroenteritis have been propagated by contamination of water supplies, raw foods, and ill food handlers. Controlling an outbreak depends on identifying and removing the source of contamination. The demonstrated occurrence of person-to-person transmission and the likely occurrence of transmission of Norwalk-like viruses by aerosol make it necessary to evaluate the potential for transmission by food handlers and servers in every outbreak, regardless of primary source. PMID:8395330

  13. Fecal microbiota transplantation and prednisone for severe eosinophilic gastroenteritis

    PubMed Central

    Dai, Yi-Xuan; Shi, Chuan-Bing; Cui, Bo-Ta; Wang, Min; Ji, Guo-Zhong; Zhang, Fa-Ming

    2014-01-01

    Eosinophilic gastroenteritis is a rare disease of unknown etiology. It is characterized by patchy or diffuse eosinophilic infiltration of the bowel wall to a variable depth and various gastrointestinal manifestations. We describe a case of severe eosinophilic gastroenteritis presenting as frequent bowel obstruction and diarrhea in a 35-year-old man. The patient was misdiagnosed and underwent surgery because of intestinal obstruction when he was first admitted to a local hospital. Then he was misdiagnosed as having Crohn’s disease in another university teaching hospital. Finally, the patient asked for further treatment from our hospital because of the on-going clinical trial for treating refractory Crohn’s disease by fecal microbiota transplantation. Physical examination revealed a slight distended abdomen with diffuse tenderness. Laboratory investigation showed the total number of normal leukocytes with neutrophilia as 90.5%, as well as eosinopenia, monocytopenia and lymphocytopenia. Barium radiography and sigmoidoscopy confirmed inflammatory stenosis of the sigmoid colon. We diagnosed the patient as having eosinophilic gastroenteritis by multi-examinations. The patient was treated by fecal microbiota transplantation combined with oral prednisone, and was free from gastrointestinal symptoms at the time when we reported his disease. This case highlights the importance of awareness of manifestations of a rare disease like eosinophilic gastroenteritis. PMID:25473198

  14. Infectious ileocecitis--appendicitis mimicking syndrome.

    PubMed

    Zganjer, M; Roic, G; Cizmic, A; Pajic, A

    2005-01-01

    The purpose of our study is to emphasize the central role of ultrasound (US) in finding the cause of abdominal pain in children. Ultrasound of the lower abdomen quadrant should be considered in all cases in which the clinical signs and symptoms are not diagnostic of appendicitis. There is a wide range of clinical syndromes and diseases which can easily be diagnosed using a high resolution ultrasound with adjunct of color and power Doppler. The spectrum of abnormalities includes appendicitis, mesenteric lymphadenitis, infectious ileocecitis, Crohn's disease, intussusception, ovarian cysts, and encysted cerebrospinal fluid. One of the most common causes of acute abdominal pain in children is acute terminal ileitis (infectious ileocecitis) with mesenteric lymphadenitis. Ultrasound is the best tool to rapidly differentiate this disease from acute appendicitis, and prevent unnecessary laparotomy (Ref. 12). PMID:16201735

  15. 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

  16. Prevalence and Phylogenetic Analysis of Human Bocaviruses 1-4 in Pediatric Patients with Various Infectious Diseases

    PubMed Central

    Zhao, Min; Zhu, Runan; Qian, Yuan; Deng, Jie; Wang, Fang; Sun, Yu; Dong, Huijin; Liu, Liying; Jia, Liping; Zhao, Linqing

    2016-01-01

    Objectives Viral infections caused by human bocaviruses 1–4 (HBoV1-4) are more complicated than previously believed. A retrospective, large-scale study was undertaken to explore the prevalence of HBoV1-4 in pediatric patients with various infectious diseases and delineate their phylogenetic characteristics. Methods Clinical samples from four specimen types, including 4,941 respiratory, 2,239 cerebrospinal fluid (CSF), 2,619 serum, and 1,121 fecal specimens, collected from pediatric patients with various infectious diseases were screened for HBoV1-4. A 690-nt fragment in each specimen was then amplified and sequenced for phylogenetic analysis. Clinical characteristics of HBoV-positive patients with different specimen types available were evaluated. Results Approximately 1.2% of patients were confirmed as HBoV-positive, with the highest positive rate in patients with gastrointestinal infection (2.2%), followed by respiratory (1.65%), central nervous system (0.8%), and hematological infections (0.2%). A single genetic lineage of HBoV1 circulated among children over the 8-year period, while a new cluster of HBoV2, via intra-genotype recombination between HBoV2A and HBoV2B, was prevalent. Some patients had HBoV1-positive respiratory and serum specimens or fecal specimens. Several cases became HBoV1-positive following the appearance of respiratory infection, while several cases were positive for HBoV2 only in CSF and serum specimens, rather than respiratory specimens. Conclusions A single genetic lineage of HBoV1 is speculated as a viral pathogen of respiratory infection and causes both comorbid infection and acute gastroenteritis. Additionally, a new cluster of HBoV2 is prevalent in China, which may infect the host through sites other than the respiratory tract. PMID:27490242

  17. Inflammation and neurological adverse drugs reactions: a case of long lasting impaired consciousness after oxatomide administration in a patient with gastroenteritis

    PubMed Central

    2012-01-01

    Oxatomide at therapeutic doses generates occasionally drowsiness in children. When administered at toxic doses, however oxatomide may induce long lasting impaired consciousness. We now report a case of severe long lasting impaired consciousness induced by therapeutic doses of oxatomide occurring in a child affected by acute gastroenteritis. The clinical symptoms, the pharmacogenetic tests of polymorphisms in cytochrome P450 metabolizing enzymes (CYPs) and the clinical and laboratory analyses indicate that the enhanced drug sedative effect is likely due to an acute, yet mild, inflammatory state of the patient. These findings highlight the importance of assessing common, not serious inflammatory states when oxatomide is prescribed in paediatric patients. PMID:22464080

  18. Acute diarrhea.

    PubMed

    Barr, Wendy; Smith, Andrew

    2014-02-01

    Acute diarrhea in adults is a common problem encountered by family physicians. The most common etiology is viral gastroenteritis, a self-limited disease. Increases in travel, comorbidities, and foodborne illness lead to more bacteria-related cases of acute diarrhea. A history and physical examination evaluating for risk factors and signs of inflammatory diarrhea and/or severe dehydration can direct any needed testing and treatment. Most patients do not require laboratory workup, and routine stool cultures are not recommended. Treatment focuses on preventing and treating dehydration. Diagnostic investigation should be reserved for patients with severe dehydration or illness, persistent fever, bloody stool, or immunosuppression, and for cases of suspected nosocomial infection or outbreak. Oral rehydration therapy with early refeeding is the preferred treatment for dehydration. Antimotility agents should be avoided in patients with bloody diarrhea, but loperamide/simethicone may improve symptoms in patients with watery diarrhea. Probiotic use may shorten the duration of illness. When used appropriately, antibiotics are effective in the treatment of shigellosis, campylobacteriosis, Clostridium difficile, traveler's diarrhea, and protozoal infections. Prevention of acute diarrhea is promoted through adequate hand washing, safe food preparation, access to clean water, and vaccinations. PMID:24506120

  19. A large hotel outbreak of Norwalk-like virus gastroenteritis among three groups of guests and hotel employees in Virginia.

    PubMed Central

    Love, S. S.; Jiang, X.; Barrett, E.; Farkas, T.; Kelly, S.

    2002-01-01

    A large outbreak of acute gastroenteritis occurred among three different groups of guests and the employees of a Virginia hotel within a 2-week period in November 2000. At least 76 of the hotel's guests and 40 hotel employees had acute gastroenteritis during this period. All tested ill persons were infected with the same strain of Norwalk-like virus, as shown by cloning and sequencing of virus detected in stool specimens from the three guest groups and the employees. Epidemiologic investigation suggested food as the probable source for the guests. Most of the employees, including those sick, did not eat in the hotel, suggesting that environmental contamination and person-to-person transmission could have contributed to the outbreak. The disease continued to spread in the hotel, passing from one guest group to another, by food, environmental contamination, and/or by person-to-person transmission through infected employees and guests. The study describes procedures implemented to control the outbreak and makes recommendations for future outbreak control. PMID:12211579

  20. Overview of Infectious Diseases

    MedlinePlus

    ... Español Text Size Email Print Share Overview of Infectious Diseases Page Content Article Body I nfectious diseases are ... worms Last Updated 11/21/2015 Source Immunizations & Infectious Diseases: An Informed Parent's Guide (Copyright © 2006 American Academy ...

  1. [Infectious diseases research].

    PubMed

    Carratalà, Jordi; Alcamí, José; Cordero, Elisa; Miró, José M; Ramos, José Manuel

    2008-12-01

    There has been a significant increase in research activity into infectious diseases in Spain in the last few years. The Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) currently has ten study groups, with the cooperation of infectious diseases specialists and microbiologists from different centres, with significant research activity. The program of Redes Temáticas de Investigación Cooperativa en Salud (Special Topics Cooperative Health Research Networks) is an appropriate framework for the strategic coordination of research groups from the Spanish autonomous communities. The Spanish Network for Research in Infectious Diseases (REIPI) and the Network for Research in AIDS (RIS) integrate investigators in Infectious Diseases from multiple groups, which continuously perform important research projects. Research using different experimental models in infectious diseases, in numerous institutions, is an important activity in our country. The analysis of the recent scientific production in Infectious Diseases shows that Spain has a good position in the context of the European Union. The research activity in Infectious Diseases carried out in our country is a great opportunity for the training of specialists in this area of knowledge. PMID:19195467

  2. An Atypical Case of Eosinophilic Gastroenteritis Presenting as Hypovolemic Shock.

    PubMed

    Martillo, Miguel; Abed, Jean; Herman, Michael; Abed, Elie; Shi, Wenjing; Munot, Khushboo; Mankal, Pavan Kumar; Gurunathan, Rajan; Ionescu, Gabriel; Kotler, Donald P

    2015-01-01

    Eosinophilic gastroenteritis is an uncommon condition characterized by focal or diffuse infiltration of eosinophils in the gastrointestinal tract in the absence of secondary causes. The pathogenesis of this condition is not well understood and its clinical presentation depends on the segment and layer of the gastrointestinal tract affected. The definition of eosinophilic gastroenteritis may be difficult, as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not standardized. We present the case of a 59-year-old male who came to the hospital with hypovolemic shock and lethargy secondary to severe diarrhea. Laboratory analysis was significant for peripheral eosinophilia, and pathology from both the duodenum and colon showed marked eosinophilic infiltration. PMID:26078733

  3. 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

  4. An Atypical Case of Eosinophilic Gastroenteritis Presenting as Hypovolemic Shock

    PubMed Central

    Martillo, Miguel; Abed, Jean; Herman, Michael; Abed, Elie; Shi, Wenjing; Munot, Khushboo; Mankal, Pavan Kumar; Gurunathan, Rajan; Ionescu, Gabriel; Kotler, Donald P.

    2015-01-01

    Eosinophilic gastroenteritis is an uncommon condition characterized by focal or diffuse infiltration of eosinophils in the gastrointestinal tract in the absence of secondary causes. The pathogenesis of this condition is not well understood and its clinical presentation depends on the segment and layer of the gastrointestinal tract affected. The definition of eosinophilic gastroenteritis may be difficult, as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not standardized. We present the case of a 59-year-old male who came to the hospital with hypovolemic shock and lethargy secondary to severe diarrhea. Laboratory analysis was significant for peripheral eosinophilia, and pathology from both the duodenum and colon showed marked eosinophilic infiltration. PMID:26078733

  5. 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

  6. Infectious Diarrhea: Norovirus and Clostridium difficile in Older Adults.

    PubMed

    White, Mary B; Rajagopalan, Shobita; Yoshikawa, Thomas T

    2016-08-01

    Norovirus infection usually results in acute gastroenteritis, often with incapacitating nausea, vomiting, and diarrhea. It is highly contagious and resistant to eradication with alcohol-based hand sanitizer. Appropriate preventative and infection control measures can mitigate the morbidity and mortality associated with norovirus infection. Clostridium difficile infection is the leading cause of health care-associated diarrhea in the United States. Antibiotic use is by far the most common risk factor for C difficile colonization and infection. Appropriate preventive measures and judicious use of antibiotics can help mitigate the morbidity and mortality associated with C difficile infection. PMID:27394020

  7. Eosinophilic Gastroenteritis as a Rare Cause of Recurrent Epigastric Pain

    PubMed Central

    Safari, Mohammad Taghi; Shahrokh, Shabnam; Miri, Mohammad Bagher; Ehsani Ardakani, Mohammad Javad

    2016-01-01

    Eosinophilic gastroenteritis (EGE) is a rare inflammatory disorder of gastrointestinal tract characterized by eosinophilic infiltration of the bowel wall. It can mimic many gastrointestinal disorders due to its wide spectrum of presentations. Diagnose is mostly based on excluding other disorders and a high suspicion. Here we report a case of 26 year old man with a history of sever epigastric pain followed by nausea, vomiting since a few days before admission with final diagnosis of EGE.

  8. 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.

  9. [Low-titer cold agglutinin disease following Salmonella gastroenteritis].

    PubMed

    Kobayashi, Ken-Ichiro; Hamaki, Tamae; Ohwada, Akira; Tomiyama, Junji; Sakuma, Ryoko; Mizuta, Yoko; Moriyama, Akihiko; Yamamoto, Emi; Akiya, Itsuo; Fujita, Hiroshi

    2011-01-01

    We encountered a patient with cold agglutinin disease (CAD) that worsened after Salmonella gastroenteritis. A 52-year-old male complained pain in the left fingers with cyanosis and was admitted in a local hospital. After treatment for ischemia, he demonstrated diarrhea with fever. Because of progressive anemia, he was referred to our hospital. Salmonella gastroenteritis was diagnosed based on the results of microbiological examination. Severe hemolysis was noted at admission, and Coombs test was positive (IgG-, C3d+). Cold agglutinin titer was elevated (x256). There were no findings of malignancy or infection demonstrating CA. A diagnosis of CAD with Salmonella gastroenteritis was made. Because spherocytosis was noted during admission, we measured the mean channel fluorescence (MCF) of eosin-5-maleimide (EMA) in erythrocytes from patients. MCF of EMA of the patient's erythrocytes was similar to that of normal subjects. Therefore, we concluded that coexisting hereditary spherocytosis was unlikely. We also examined the in vitro hemolytic effect of Salmonella infection on his blood and on blood from normal subjects. Treatment with Salmonella enteritidis isolated from this patient was found to induce hemolysis in the patient's blood, but not in blood from a normal subject. Moreover, treatment with Salmonella increased the titer of cold agglutinin in vitro. These data suggested that Salmonella infection might worsen hemolysis in CAD. PMID:21378480

  10. 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. PMID:26482884

  11. Are hospitalizations for rotavirus gastroenteritis associated with meteorologic factors?

    PubMed

    Hervás, D; Hervás-Masip, J; Rosell, A; Mena, A; Pérez, J L; Hervás, J A

    2014-09-01

    Local climatic factors might explain seasonal patterns of rotavirus infections, but few models have been proposed to determine the effects of weather conditions on rotavirus activity. Here, we study the association of meteorologic factors with rotavirus activity, as determined by the number of children hospitalized for rotavirus gastroenteritis on the Mediterranean island of Mallorca (Spain). We conducted a retrospective review of the medical records of children aged 0-5 years admitted for rotavirus gastroenteritis between January 2000 and December 2010. The number of rotavirus hospitalizations was correlated to temperature, humidity, rainfall, atmospheric pressure, water vapor pressure, wind speed, and solar radiation using regression and time-series techniques. A total of 311 patients were hospitalized for rotavirus gastroenteritis in the 11-year study period, with a seasonal pattern from December to June, and a peak incidence in February. After multiple regressions, weekly rotavirus activity could be explained in 82 % of cases (p < 0.001) with a one-week lag meteorologic model. Rotavirus activity was negatively associated to temperature and positively associated to atmospheric pressure, solar radiation, and wind speed. Temperature and solar radiation were the factors that contributed most to the model, with a peak rotavirus activity at 9 °C and 800 10KJ/m(2), respectively. In conclusion, hospitalization for rotavirus was strongly associated with mean temperature, but an association of rotavirus activity with solar radiation, atmospheric pressure, and wind speed was also demonstrated. This model predicted more than 80 % of rotavirus hospitalizations. PMID:24760250

  12. Efficacy of multislice computed tomography for gastroenteric and hepatic surgeries

    PubMed Central

    Ohtani, Hiroshi; Kawajiri, Hidemi; Arimoto, Yuichi; Ohno, Koichi; Fujimoto, Yasuhisa; Oba, Hiroko; Adachi, Kenji; Hirano, Masaya; Terakawa, Shoichi; Tsubakimoto, Mitsuo

    2005-01-01

    AIM: To determine the efficacy of multislice CT for gastroenteric and hepatic surgery. METHODS: Dual-phase helical computed tomography was performed in 50 of 51 patients who underwent gastroenteric and hepatic surgeries. Twenty-eight, eighteen and four patients suffering from colorectal cancer, gastric cancer, and liver cancer respectively underwent colorectal surgery (laparoscopic surgery: 6 cases), gastrectomy, and hepatectomy. Three-dimensional computed tomography imaging of the inferior mesenteric artery, celiac artery and hepatic artery was performed. And in the follow-up examination of postoperative patients, multiplanar reconstruction image was made in case of need. RESULTS: Scans in 50 patients were technically satisfactory and included in the analysis. Depiction of major visceral arteries, which were important for surgery and other treatments, could be done in all patients. Preoperative visualization of the left colic artery and sigmoidal arteries, the celiac artery and its branches, and hepatic artery was very useful to lymph node dissection, the planning of a reservoir and hepatectomy. And multiplanar reconstruction image was helpful to diagnosis for the postoperative follow-up of patients. CONCLUSION: Three-dimensional volume rendering or multiplanar reconstruction imaging performed by multislice computed tomography was very useful for gastroenteric and hepatic surgeries. PMID:15770732

  13. Genetic basis for the pathogenesis of transmissible gastroenteritis virus.

    PubMed Central

    Wesley, R D; Woods, R D; Cheung, A K

    1990-01-01

    Intracellular RNAs of an avirulent small-plaque (SP) transmissible gastroenteritis virus variant and the parent virulent Miller strain of transmissible gastroenteritis virus were compared. Northern RNA blotting showed that the Miller strain contained eight intracellular RNA species. RNAs 1, 2(S), 5, 6(M), 7(N), and 8 were similar in size for both viruses; however, the SP variant lacked subgenomic RNAs 3 and 4. Instead, the SP virus contained an altered RNA species (delta 4) that was slightly smaller than RNA 4. S1 nuclease protection experiments showed a deletion of approximately 450 nucleotides in the SP genome downstream of the peplomer S gene. Sequencing of cDNA clones confirmed that SP virus contained a 462-nucleotide deletion, eliminating the transcriptional recognition sequences for both RNAs 3 and 4. These RNAs encode open reading frames A and B, respectively. An alternative consensus recognition sequence was not readily apparent for the delta 4 RNA species of SP virus. Since open reading frame A is missing in SP virus, it is not essential for a productive infection. The status of the potential protein encoded by open reading frame B is not clear, because it may be missing or just truncated. Nevertheless, these genes appear to be the contributing entities for transmissible gastroenteritis virus virulence, SP morphology, tissue tropism, and/or persistence in swine leukocytes. Images PMID:2168963

  14. FastStats: Infectious Disease

    MedlinePlus

    ... this? Submit What's this? Submit Button NCHS Home Infectious Disease Recommend on Facebook Tweet Share Compartir Data are ... Health, United States trend tables with data on infectious disease Seroprevalence of six infectious diseases among adults in ...

  15. Detection and genetic characterization of human enteric viruses in oyster-associated gastroenteritis outbreaks between 2001 and 2012 in Osaka City, Japan.

    PubMed

    Iritani, Nobuhiro; Kaida, Atsushi; Abe, Niichiro; Kubo, Hideyuki; Sekiguchi, Jun-Ichiro; Yamamoto, Seiji P; Goto, Kaoru; Tanaka, Tomoyuki; Noda, Mamoru

    2014-12-01

    Enteric viruses are an important cause of viral food-borne disease. Shellfish, especially oysters, are well recognized as a source of food-borne diseases, and oyster-associated gastroenteritis outbreaks have on occasion become international occurrences. In this study, 286 fecal specimens from 88 oyster-associated gastroenteritis outbreaks were examined for the presence of 10 human enteric viruses using antigenic or genetic detection methods in order to determine the prevalence of these infections. All virus-positive patients were over 18 years old. The most common enteric virus in outbreaks (96.6%) and fecal specimens (68.9%) was norovirus (NoV), indicating a high prevalence of NoV infection associated with the consumption of raw or under-cooked oysters. Five other enteric viruses, aichiviruses, astroviruses, sapoviruses, enteroviruses (EVs), and rotavirus A, were detected in 30.7% of outbreaks. EV strains were characterized into three rare genotypes, coxsackievirus (CV) A1, A19, and EV76. No reports of CVA19 or EV76 have been made since 1981 in the Infectious Agents Surveillance Report by the National Infectious Diseases Surveillance Center, Japan. Their detection suggested that rare types of EVs are circulating in human populations inconspicuously and one of their transmission modes could be the consumption of contaminated oysters. Rapid identification of pathogens is important for the development of means for control and prevention. The results of the present study will be useful to establish an efficient approach for the identification of viral pathogens in oyster-associated gastroenteritis in adults. PMID:24415518

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

    PubMed

    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

  17. Non-Infectious Meningitis

    MedlinePlus

    ... Resources for Healthcare Professionals Related Links Vaccine Schedules Preteen & Teen Vaccines Meningococcal Disease Sepsis Non-Infectious Meningitis ... confusion) Top of Page Related Links Vaccine Schedules Preteen & Teen Vaccines Meningococcal Disease Sepsis File Formats Help: ...

  18. Modeling Infectious Diseases

    MedlinePlus

    ... MIDAS models require a breadth of knowledge, the network draws together an interdisciplinary team of researchers with expertise in epidemiology, infectious diseases, computational biology, statistics, social sciences, physics, computer sciences and informatics. In 2006, MIDAS modelers simulated ...

  19. Infectious optic neuropathy.

    PubMed

    Golnik, Karl C

    2002-03-01

    A wide variety of infectious agents are known to cause optic neuropathy. This article will consider the bacteria, spirochetes, fungi, and viruses that most commonly affect the optic nerve. Clinical presentation is variable, but some pathogens often produce a characteristic funduscopic pattern. Diagnosis is usually made on the basis of clinical suspicion and serologic testing. Polymerase chain reaction is also increasingly utilized. Most infectious agents can be effectively treated but visual recovery is highly variable. PMID:15513450

  20. Ethics and infectious disease.

    PubMed

    Selgelid, Michael J

    2005-06-01

    Bioethics apparently suffers from a misdistribution of research resources analogous to the '10/90' divide in medical research. Though infectious disease should be recognized as a topic of primary importance for bioethics, the general topic of infectious disease has received relatively little attention from the discipline of bioethics in comparison with things like abortion, euthanasia, genetics, cloning, stem cell research, and so on. The fact that the historical and potential future consequences of infectious diseases are almost unrivalled is one reason that the topic of infectious disease warrants more attention from bioethicists. The 'Black Death' eliminated one third of the European population during the 14th Century; the 1989 flu killed between 20 and 100 million people; and, in the 20th Century smallpox killed perhaps three times more people than all the wars of that period. In the contemporary world, epidemics (AIDS, multi-drug resistant turberculosis, and newly emerging infectious diseases such as SARS) continue to have dramatic consequences. A second reason why the topic of infectious disease deserves further attention is that it raises difficult ethical questions of its own. While infected individuals can threaten the health of other individuals and society as a whole, for example, public health care measures such as surveillance, isolation, and quarantine can require the infringement of widely accepted basic human rights and liberties. An important and difficult ethical question asks how to strike a balance between the utilitarian aim of promoting public health, on the one hand, and libertarian aims of protecting privacy and freedom of movement, on the other, in contexts involving diseases that are--to varying degrees--contagious, deadly, or otherwise dangerous. Third, since their burden is most heavily shouldered by the poor (in developing countries), infectious diseases involve issues of justice--which should be a central concern of ethics. I conclude

  1. A novel norovirus GII.17 lineage contributed to adult gastroenteritis in Shanghai, China, during the winter of 2014–2015

    PubMed Central

    Chen, Haili; Qian, Fangxing; Xu, Jin; Chan, Martin; Shen, Zhen; Zai, Shubei; Shan, Menglin; Cai, Jinfeng; Zhang, Wanju; He, Jing; Liu, Yi; Zhang, Jun; Yuan, Zhenghong; Zhu, Zhaoqin; Hu, Yunwen

    2015-01-01

    Norovirus (NoV) is now recognized as a leading cause of nonbacterial acute gastroenteritis; however, the NoV GII.17 genotype has rarely been reported as the predominant genotype in clinical diarrhea cases. During the winter of 2014–2015, the GII.17 genotype, together with the NoV GII.4 genotype, dominated in sporadic adult patients with gastroenteritis in Shanghai. Phylogenetic analysis based on full-length VP1 amino acid sequences showed that the GII.17 strains that emerged in Shanghai have close evolutionary relationships with strains recently collected in the Hong Kong area, Guangdong province of China, and Japan during the same period. This cluster in the phylogenetic tree may represent a novel NoV GII.17 lineage recently circulating in East Asia. Pairwise distances between clusters also revealed the evolution of the NoV GII.17 genotype in previous decades. Our study emphasizes the importance of combined surveillance of NoV-associated infections. PMID:26975060

  2. Comparison of three tests for estimating gastroenteral protein loss

    SciTech Connect

    Glaubitti, D.; Marx, M.; Weller, H.

    1984-01-01

    A decisive step in the diagnosis of exudative gastroenteropathy which shows a pathologically increased transfer of plasma proteins into the stomach or intestine is the measurement of fecal radioactivity after intravenous administration of radionuclide-labeled large organic compounds or of small inorganic compounds attaching themselves to plasma proteins within the patient. In 24 patients (12 men and women each) aged 40 to 66 years, the gastroenteral protein loss was estimated after intravenous injection of Cr-51 chloride, Cr-51 human serum albumin, or Fe-59 iron dextran. Each test lasted 6 days. There was an interval of 2 weeks between 2 tests. The feces were collected completely within the test period for determination of radioactivity. External probe counting over liver, spleen, right kidney, and thyroid was performed daily up to 10 days. The results obtained with Cr-51 chloride presented the largest range whereas the test with Fe-59 iron dextran exhibited both the smallest deviation from the mean value and the lowest normal range. During the tests for gastroenteral protein loss external probe counting demonstrated no distinct tendency to a more rapid radionuclide loss from liver, spleen, and kidney in the patients suffering from exudative gastroenteropathy when compared with healthy subjects. The authors conclude that the most suitable test to estimate gastroenteral protein loss is the Fe-59 iron dextran test although Fe-59 iron dextran is not available commercially and causes a higher radiation burden than the other tests do. In second place, the Cr-51 chloride test should be used, the radiopharmaceutical of which is less expensive and has no significant disadvantage in comparison with Cr-51 human serum albumin.

  3. Ability of TESTPACK ROTAVIRUS enzyme immunoassay to diagnose rotavirus gastroenteritis.

    PubMed Central

    Chernesky, M; Castriciano, S; Mahony, J; Spiewak, M; Schaefer, L

    1988-01-01

    TESTPACK ROTAVIRUS, a simple 10-min enzyme immunoassay, was compared with electron microscopy and Pathfinder enzyme immunoassay on feces from 172 patients of various ages with gastroenteritis. The percent sensitivities and specificities before blocking with antiserum were as follows: TESTPACK, 100% sensitivity and 99% specificity; Pathfinder, 95% sensitivity and 98% specificity. After blocking, the sensitivity and specificity, respectively, were 100% and 100% for TESTPACK and 95% and 99% for Pathfinder. TESTPACK ROTAVIRUS was more sensitive, but not significantly, than Pathfinder (P greater than 0.1) and the direct electron microscopy technique (P greater than 0.1). PMID:3069866

  4. A mouse model for infectious mononucleosis.

    PubMed

    Flaño, Emilio; Woodland, David L; Blackman, Marcia A

    2002-01-01

    Epstein-Barr virus (EBV) is a ubiquitous human gamma-herpesvirus that establishes life-long latency and is associated with lymphoproliferative disorders and the development of several malignancies. EBV infection is frequently, but not always, associated with the development of a syndrome termed infectious mononucleosis. The recent isolation and characterization of a murine gamma-herpesvirus, MHV-68 (gammaHV-68) has provided the first small animal model for studying immunity and pathogenesis of a gamma-herpesvirus in its natural host. MHV-68 has important biological and genetic similarities with the human gamma-herpesviruses. Following intranasal infection of mice with MHV-68, an acute respiratory infection in the lung develops and is cleared, followed by the establishment of latency. Similar to EBV, MHV-68 latency is largely established in B cells, although other cell types can be latently infected. The establishment of latency correlates with a prominent splenomegaly, polyclonal B cell activation with associated autoantibody production, and CD8+ T cell-dominated peripheral blood lymphocytosis, in many aspects mirroring EBV-induced infectious mononucleosis. There are key differences in the MHV-68- and EBV-induced CD8+ T cell responses however. Whereas the expanded CD8+ T cells associated with EBV-induced mononucleosis are largely the outgrowth of T cells responding to lytic viral epitopes elicited during the acute phase of the response, the CD8+ T cell lymphocytosis associated with MHV-68-induced infectious mononucleosis is dominated by an oligoclonal population of T cells expressing Vbeta4+ T cell receptors that are not reactive to acute viral epitopes. The focus of this article will be to highlight the similarities and differences in the infectious mononucleosis syndrome associated with human and murine gamma-herpesviruses. PMID:12018460

  5. Emergent Infectious Uveitis

    PubMed Central

    Khairallah, Moncef; Jelliti, Bechir; Jenzeri, Salah

    2009-01-01

    Infectious causes should always be considered in all patients with uveitis and it should be ruled out first. The differential diagnosis includes multiple well-known diseases including herpes, syphilis, toxoplasmosis, tuberculosis, bartonellosis, Lyme disease, and others. However, clinicians should be aware of emerging infectious agents as potential causes of systemic illness and also intraocular inflammation. Air travel, immigration, and globalization of business have overturned traditional pattern of geographic distribution of infectious diseases, and therefore one should work locally but think globally, though it is not possible always. This review recapitulates the systemic and ocular mainfestations of several emergent infectious diseases relevant to the ophthalmologist including Rickettsioses, West Nile virus infection, Rift valley fever, dengue fever, and chikungunya. Retinitis, chorioretinitis, retinal vasculitis, and optic nerve involvement have been associated with these emergent infectious diseases. The diagnosis of any of these infections is usually based on pattern of uveitis, systemic symptoms and signs, and specific epidemiological data and confirmed by detection of specific antibody in serum. A systematic ocular examination, showing fairly typical fundus findings, may help in establishing an early clinical diagnosis, which allows prompt, appropriate management. PMID:20404989

  6. Forecasting Infectious Disease Outbreaks

    NASA Astrophysics Data System (ADS)

    Shaman, J. L.

    2015-12-01

    Dynamic models of infectious disease systems abound and are used to study the epidemiological characteristics of disease outbreaks, the ecological mechanisms affecting transmission, and the suitability of various control and intervention strategies. The dynamics of disease transmission are non-linear and consequently difficult to forecast. Here, we describe combined model-inference frameworks developed for the prediction of infectious diseases. We show that accurate and reliable predictions of seasonal influenza outbreaks can be made using a mathematical model representing population-level influenza transmission dynamics that has been recursively optimized using ensemble data assimilation techniques and real-time estimates of influenza incidence. Operational real-time forecasts of influenza and other infectious diseases have been and are currently being generated.

  7. Infectious Chronic Rhinosinusitis.

    PubMed

    Bose, Sumit; Grammer, Leslie C; Peters, Anju T

    2016-01-01

    Chronic rhinosinusitis (CRS) is a persistent inflammatory disease that affects a multitude of people worldwide. The pathogenesis of CRS involves many factors including genetics, status of the sinonasal microbiome, infections, and environmental influences. Comorbidities associated with CRS include asthma, allergic rhinitis, bronchiectasis, and certain kinds of immunodeficiency. CRS can be divided into different subtypes based on endotypes and phenotypes. Infectious CRS is one such category. The etiology of infectious CRS is usually secondary to chronic bacterial infection that commonly begins with a viral upper respiratory tract infection. Humoral antibody deficiencies can underlie difficult-to-treat or recurrent CRS. Infectious CRS can be treated with antimicrobials, topical or oral corticosteroids, and nasal saline irrigations. Patients with CRS and humoral immunodeficiency may require an aggressive treatment approach including immunoglobulin replacement therapy. Despite advancements in the field of CRS, targeted therapies and reliable biomarkers are still lacking. PMID:27393772

  8. Infectious waste feed system

    DOEpatents

    Coulthard, E. James

    1994-01-01

    An infectious waste feed system for comminuting infectious waste and feeding the comminuted waste to a combustor automatically without the need for human intervention. The system includes a receptacle for accepting waste materials. Preferably, the receptacle includes a first and second compartment and a means for sealing the first and second compartments from the atmosphere. A shredder is disposed to comminute waste materials accepted in the receptacle to a predetermined size. A trough is disposed to receive the comminuted waste materials from the shredder. A feeding means is disposed within the trough and is movable in a first and second direction for feeding the comminuted waste materials to a combustor.

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

    PubMed

    Lobo, Patrícia Dos Santos; de Fátima Dos Santos Guerra, Sylvia; 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. J. Med. Virol. 88:728-733, 2016. © 2015 Wiley Periodicals, Inc. PMID:26369400

  10. Development of a multiplex PCR assay to detect gastroenteric pathogens in the feces of Mexican children.

    PubMed

    Tolentino-Ruiz, R; Montoya-Varela, D; García-Espitia, M; Salas-Benito, M; Gutiérrez-Escolano, A; Gómez-García, C; Figueroa-Arredondo, P; Salas-Benito, J; De Nova-Ocampo, M

    2012-10-01

    Acute gastroenteritis (AGE) is a major cause of childhood morbidity and mortality worldwide; the etiology of AGE includes viruses, bacteria, and parasites. A multiplex PCR assay to simultaneously identify human Astrovirus (HAstV), Calicivirus (HuCVs), Entamoeba histolytica (E. histolytica), and enteroinvasive Escherichia coli (EIEC) in stool samples is described. A total of 103 samples were individually analyzed by ELISA (enzyme-linked immunosorbent assays) and RT-PCR/PCR. HAstV and HuCVs were detected in four out of 103 samples (3.8 %) by RT-PCR, but ELISAs found only one sample as positive for HuCVs (2.5 %). E. histolytica was identified in two out of 19 samples (10.5 %) and EIEC in 13 out of 20 samples (70 %) by PCR, and all PCR products were sequenced to verify their identities. Our multiplex PCR results demonstrate the simultaneous amplification of different pathogens such as HAstV, EIEC, and E. histolytica in the same reaction, though the HuCVs signal was weak in every replicate. Regardless, this multiplex PCR protocol represents a novel tool for the identification of distinct pathogens and may provide support for the diagnosis of AGE in children. PMID:22711331

  11. 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. PMID:25700890

  12. Eosinophilia in Infectious Diseases

    PubMed Central

    O'Connell, Elise M.; Nutman, Thomas B.

    2015-01-01

    In determining the etiology of eosinophilia, it is necessary to consider the type of patient, including previous travel and exposure history, comorbidities, and symptoms. In this review, we discuss the approach to the patient with eosinophilia from an infectious diseases perspective based on symptom complexes. PMID:26209897

  13. Dynamics of infectious diseases

    NASA Astrophysics Data System (ADS)

    Rock, Kat; Brand, Sam; Moir, Jo; Keeling, Matt J.

    2014-02-01

    Modern infectious disease epidemiology has a strong history of using mathematics both for prediction and to gain a deeper understanding. However the study of infectious diseases is a highly interdisciplinary subject requiring insights from multiple disciplines, in particular a biological knowledge of the pathogen, a statistical description of the available data and a mathematical framework for prediction. Here we begin with the basic building blocks of infectious disease epidemiology—the SIS and SIR type models—before considering the progress that has been made over the recent decades and the challenges that lie ahead. Throughout we focus on the understanding that can be developed from relatively simple models, although accurate prediction will inevitably require far greater complexity beyond the scope of this review. In particular, we focus on three critical aspects of infectious disease models that we feel fundamentally shape their dynamics: heterogeneously structured populations, stochasticity and spatial structure. Throughout we relate the mathematical models and their results to a variety of real-world problems.

  14. Controlling Infectious Diseases.

    ERIC Educational Resources Information Center

    Porter, Wm. Lane; Fidler, David P.

    1997-01-01

    Advocates establishing programs to educate the public about the growing threat of communicable diseases and to promote effective strategies. Utilizes recent successes and failures to formulate those strategies. Profiles three recent infectious disease outbreaks that illustrate some of the current problems. Identifies four ways that lawyers can…

  15. Structured surveillance of infantile gastroenteritis in East Anglia, UK: incidence of infection with common viral gastroenteric pathogens.

    PubMed

    Iturriza Gómara, M; Simpson, R; Perault, A M; Redpath, C; Lorgelly, P; Joshi, D; Mugford, M; Hughes, C A; Dalrymple, J; Desselberger, U; Gray, J

    2008-01-01

    The aim of this study was to investigate the burden of disease associated with gastroenteric viruses (rotavirus, norovirus, sapovirus, astrovirus and enteric adenovirus) using structured surveillance of children aged <6 years in the community. Faecal samples were collected between 2000 and 2003 from 685 children with symptoms of gastroenteritis. The children comprised three groups; 223 in the structured surveillance cohort, 203 in a community cohort and 259 in a cohort of hospitalized children. All samples were tested for the presence of viral pathogens using molecular methods. Questionnaires were sent to the parents/carers of the children recruited to the structured surveillance cohort in order to collect data that would allow an estimation of the severity of illness by means of the Vesikari score, and of the cost associated with gastrointestinal disease in this age group. A viral aetiological agent was detected in 53.5% of samples tested. Rotavirus was the most common pathogen found in all three cohorts followed by norovirus and enteric adenoviruses. Multiple viruses were found in 8% of the samples, and commonly involved rotavirus and any other virus. G1P[8] was the most commonly detected rotavirus strain and there was no significant difference in the distribution of rotavirus genotypes among the three cohorts. Analysis of the questionnaires indicated that rotavirus infections were likely to be more severe than any other virus infection, and children from whom a viral pathogen was identified were more likely to require rehydration therapy. PMID:17313697

  16. Structured surveillance of infantile gastroenteritis in East Anglia, UK: incidence of infection with common viral gastroenteric pathogens

    PubMed Central

    GÓMARA, M. ITURRIZA; SIMPSON, R.; PERAULT, A. M.; REDPATH, C.; LORGELLY, P.; JOSHI, D.; MUGFORD, M.; HUGHES, C. A.; DALRYMPLE, J.; DESSELBERGER, U.; GRAY, J.

    2008-01-01

    SUMMARY The aim of this study was to investigate the burden of disease associated with gastroenteric viruses (rotavirus, norovirus, sapovirus, astrovirus and enteric adenovirus) using structured surveillance of children aged <6 years in the community. Faecal samples were collected between 2000 and 2003 from 685 children with symptoms of gastroenteritis. The children comprised three groups; 223 in the structured surveillance cohort, 203 in a community cohort and 259 in a cohort of hospitalized children. All samples were tested for the presence of viral pathogens using molecular methods. Questionnaires were sent to the parents/carers of the children recruited to the structured surveillance cohort in order to collect data that would allow an estimation of the severity of illness by means of the Vesikari score, and of the cost associated with gastrointestinal disease in this age group. A viral aetiological agent was detected in 53·5% of samples tested. Rotavirus was the most common pathogen found in all three cohorts followed by norovirus and enteric adenoviruses. Multiple viruses were found in 8% of the samples, and commonly involved rotavirus and any other virus. G1P[8] was the most commonly detected rotavirus strain and there was no significant difference in the distribution of rotavirus genotypes among the three cohorts. Analysis of the questionnaires indicated that rotavirus infections were likely to be more severe than any other virus infection, and children from whom a viral pathogen was identified were more likely to require rehydration therapy. PMID:17313697

  17. Biodefense and Emerging Infectious Diseases

    MedlinePlus

    ... Share this: Main Content Area Biodefense and Emerging Infectious Diseases NIAID conducts and supports basic research to better ... diagnose, treat, and prevent a wide range of infectious diseases, whether those diseases emerge naturally or are deliberately ...

  18. Acute thallium toxicosis in a dog.

    PubMed

    Waters, C B; Hawkins, E C; Knapp, D W

    1992-09-15

    A Doberman Pinscher was evaluated for acute onset of gastroenteritis, characterized by anorexia, hematemesis, and hematochezia. The dog had ingested mole bait containing thallium 2 days prior to admission. Thallium toxicosis was confirmed by detection of thallium in the urine, using colorimetric analysis. The dog responded well to administration of antibiotics, fluids administered IV, warm-water enemas, and oral administration of activated charcoal slurries. PMID:1399797

  19. Preventing rotavirus gastroenteritis: do you have the facts?

    PubMed

    Davidson, Geoffrey; Elliott, Elizabeth J; Kirkwood, Carl; Pearce, Rodney

    2007-01-01

    From 1 July 2007 two new rotavirus vaccines licensed for use in Australia (RotaTeq CSL Biotherapies/Merck and Rotarix Glaxo Smith Kline) will be funded for the National Immunisation Program. The vaccines differ with respect to their composition and the timing and mode of administration. Both have been evaluated in huge randomised trials and shown to be highly effective in preventing rotavirus gastroenteritis, including severe disease requiring hospital admission. Neither has been associated with an increased rate of intussusception; however, surveillance for adverse effects following vaccination will be important. As rotavirus infection is ubiquitous in young children, funding of this vaccine will significantly decrease the enormous morbidity and costs associated with this disease in our community. PMID:17635688

  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. Montelukast as a treatment modality for eosinophilic gastroenteritis.

    PubMed

    De Maeyer, N; Kochuyt, A-M; Van Moerkercke, W; Hiele, M

    2011-12-01

    Eosinophilic Gastroenteritis (EG) is a rare condition, caused by eosinophilic inflammatory infiltrates in the gastrointestinal tract. It is usually treated successfully with systemic glucocorticoids. Because of frequent relapses, however, there is need for alternatives. We describe a 38-year old man with steroid-dependent EG, who was successfully treated with montelukast, a leukotriene receptor antagonist. It inhibits leukotriene D4, an important cytokine in the inflammatory cascade. Although montelukast could not replace steroid therapy, it acted as a steroid sparing agent in our patient. Review of the literature shows that montelukast is efficient in the treatment of EG in a part of the patients. The low cost, the low number of side effects and its efficiency make it an interesting alternative in relapsing or steroid dependent EG. There is need for multicentric studies regarding the treatment of EG. PMID:22319970

  2. [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

  3. Eosinophilic Gastroenteritis Due to Rhus Ingestion Presenting with Gastrointestinal Hemorrhage

    PubMed Central

    Choi, Wonsuk; Choi, Chan; Cho, Kyuman; Park, Chang-Hwan; Kim, Hyun-Soo; Choi, Sung-Kyu; Rew, Jong-Sun

    2015-01-01

    Rhus-related illnesses in Korea are mostly caused by ingestion of parts of the Rhus tree. Contact dermatitis occurrence after ingestion of Rhus-related food is very common in Korea. However, Rhus-related gastrointestinal disease is very rare. Herein, we present a case of eosinophilic gastroenteritis caused by Rhus ingestion. A 75-year-old woman was admitted with hematemesis and hematochezia after Rhus extract ingestion. Routine laboratory tests revealed leukocytosis without eosinophilia. Endoscopy showed friable and granular mucosal changes with touch bleeding in the second portion of the duodenum. Abdominal computed tomography revealed edematous wall thickening of the duodenum and proximal jejunal loops. Patch testing with Rhus extracts showed a strong positive reaction, suggesting Rhus as the allergen. Her symptoms improved after avoidance of the allergen. PMID:25844348

  4. Bedbugs and Infectious Diseases

    PubMed Central

    Blanc, Véronique; Del Giudice, Pascal; Levy-Bencheton, Anna; Chosidow, Olivier; Marty, Pierre; Brouqui, Philippe

    2011-01-01

    Bedbugs are brown and flat hematophagous insects. The 2 cosmopolite species, Cimex lectularius and Cimex hemipterus, feed on humans and/or domestic animals, and recent outbreaks have been reported in occidental countries. Site assessment for bedbug eradication is complex but can be assured, despite emerging insecticide resistance, by hiring a pest-control manager. The common dermatological presentation of bites is an itchy maculopapular wheal. Urticarial reactions and anaphylaxis can also occur. Bedbugs are suspected of transmitting infectious agents, but no report has yet demonstrated that they are infectious disease vectors. We describe 45 candidate pathogens potentially transmitted by bedbugs, according to their vectorial capacity, in the wild, and vectorial competence, in the laboratory. Because of increasing demands for information about effective control tactics and public health risks of bedbugs, continued research is needed to identify new pathogens in wild Cimex species (spp) and insecticide resistance. PMID:21288844

  5. [Notable imported infectious diseases].

    PubMed

    Ohnishi, Kenji

    2011-03-01

    Japanese doctors are somewhat unfamiliar with imported infectious diseases, however, the following imported infectious diseases are notable: cholera, which is currently endemic in Haiti and which there is a possibility of it being imported to Japan from endemic areas; typhoid fever and paratyphoid fever, whose causative organisms showing low sensitivity to fluoroquinolones have become predominant; rabies, which exhibits a high mortality; avian influenza H5N1, which has the possibility of changing into a new type of human influenza; chikungunya fever, in which the number of Japanese patients is increasing; and cyclosporiasis, which led to a number of food poisonings in the USA and Canada, and as a growing number of Japanese travel abroad, the number of infected Japanese patients returning from endemic areas will increase. It is thus important to identify the presence of these diseases on diagnosis. PMID:21560415

  6. Immunoserology of infectious diseases.

    PubMed Central

    James, K

    1990-01-01

    The immune response to microorganisms not only participates in the elimination of unwanted organisms from the body, but also assists in diagnosis of infectious diseases. The nonspecific immune response is the first line of defense, assisting the body until the specific immune response can be mobilized to provide protective mechanisms. The specific immune response involves humoral or cell-mediated immunity or both, dependent on the nature of the organism and its site of sequestration. A variety of test systems have been developed to identify the causative organisms of infectious diseases. Test systems used in immunoserology have classically included methods of detecting antigen-antibody reactions which range from complement fixation to immunoassay methods. Relevant test systems for detecting antigens and antibodies are described. With numerous test systems available to detect antigens and antibodies, there can be confusion regarding selection of the appropriate system for each application. Methods for detecting antibody to verify immunity differ from immunologic methods to diagnose disease. Techniques to detect soluble antigens present in active infectious states may appear similar to those used to detect antibody, but their differences should be appreciated. PMID:2187592

  7. Infectious Triggers of Chronic Lung Allograft Dysfunction.

    PubMed

    Gregson, Aric L

    2016-07-01

    Survival after lung transplantation is limited in large part due to the high incidence of chronic rejection, known as chronic lung allograft dysfunction (CLAD). Pulmonary infections are a frequent complication in lung transplant recipients, due both to immunosuppressive medications and constant exposure of the lung allograft to the external environment via the airways. Infection is a recognized risk factor for the development of CLAD, and both acute infection and chronic lung allograft colonization with microorganisms increase the risk for CLAD. Acute infection by community acquired respiratory viruses, and the bacteria Pseudomonas aeruginosa and Staphylococcus aureus are increasingly recognized as important risk factors for CLAD. Colonization by the fungus Aspergillus may also augment the risk of CLAD. Fostering this transition from healthy lung to CLAD in each of these infectious episodes is the persistence of an inflammatory lung allograft environment. PMID:27221821

  8. Clinical characteristics, treatment outcomes, and resource utilization in children and adults with eosinophilic gastroenteritis

    PubMed Central

    Reed, Craig; Woosley, John T.; Dellon, Evan S.

    2015-01-01

    Background Eosinophilic gastroenteritis is a rare condition where eosinophilic inflammation occurs in the gastrointestinal tract in the absence of secondary causes. Little is known regarding aetiology, pathogenesis, or natural history. Aims To characterize the clinical, endoscopic, and histopathologic features of eosinophilic gastroenteritis and to summarize treatment outcomes. Methods Pathologic reports of all patients who had undergone upper endoscopy with biopsy between January 1, 2000 and June 20, 2013 were reviewed. Eosinophilic gastroenteritis was diagnosed if there were ≥20 eosinophils/hpf on either gastric of duodenal biopsy, symptoms attributable to the gastrointestinal tract, and no known secondary cause of eosinophilia. Descriptive statistics characterized patients diagnosed with eosinophilic gastroenteritis and bivariate analysis compared adults and children. Results There were 44 patients diagnosed with eosinophilic gastrointestinal disease. The most common symptoms were vomiting (71%) and abdominal pain (62%). Of the eosinophilic gastroenteritis cases, 12 (30%) had esophageal involvement, and 11 (28%) had colonic involvement. For treatment, 36 (80%) received corticosteroids. Overall, 27 (60%) had symptom resolution and 23 (51%) had endoscopic resolution. Cases underwent a mean of five endoscopic procedures per year. Conclusion Eosinophilic gastroenteritis presents with non-specific gastrointestinal symptoms and in almost one-third of cases has concomitant esophageal or colonic involvement. It remains difficult to treat, with high rates of endoscopic utilization. PMID:25547198

  9. 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

  10. 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. PMID:23412839

  11. 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

  12. Radioimmunotherapy of infectious diseases

    PubMed Central

    Dadachova, Ekaterina; Casadevall, Arturo

    2009-01-01

    The need for novel approaches to treat infectious diseases is obvious and urgent. This situation has renewed interest in using monoclonal antibodies (mAbs) in therapy of infectious diseases. During the last 5 years radioimmunotherapy (RIT), a modality developed for cancer treatment, has been successfully adapted for the treatment of experimental fungal (C. neoformans and H. capsulatum), bacterial (S. pneumoniae and B. anthracis) and viral (HIV-1) infections. RIT produced none or only transient hematological toxicity in experimental animals. Investigation of radiobiological mechanisms of RIT of infections showed that microbial cells are killed by both "direct hit" and "cross-fire" radiation. MAbs radiolabeled with either alpha- or beta-emitters stimulated apoptosis-like cell death, while only mAbs radiolabeled with alpha-emitter 213Bi also decreased the metabolic activity of microbial cells. The success of this approach in laboratory studies combined with earlier nuclear medicine experience on pre-clinical and clinical studies utilizing radiolabeled organism-specific antibodies for imaging of infections provides encouragement for feasibility of therapeutically targeting microbes with labeled antibodies. We envision that first the organism-specific mAbs will be radiolabeled with imaging radionuclides such as 99mTc or 111In to localize the sites of infection with SPECT followed by RIT with 188Re- or 90Y-labeled mAb, respectively. Also, immunoPET might be utilized for imaging of infection before treatment if such positron-emitting radionuclides as 86Y (matching pair for 90Y) or 124I (matching pair for 131I) are available. It might be possible to create a so-called “pan-antibody” which would recognize an antigen shared by a particular class of human pathogens such as fungi, for example. The availability of such antibodies would eliminate the necessity of having antibodies specific for each particular microorganism and would enormously enhance the development of RIT

  13. "Infectious" Transplantation Tolerance

    NASA Astrophysics Data System (ADS)

    Qin, Shixin; Cobbold, Stephen P.; Pope, Heather; Elliott, James; Kioussis, Dimitris; Davies, Joanna; Waldmann, Herman

    1993-02-01

    The maintenance of transplantation tolerance induced in adult mice after short-term treatment with nonlytic monoclonal antibodies to CD4 and CD8 was investigated. CD4^+ T cells from tolerant mice disabled naive lymphocytes so that they too could not reject the graft. The naive lymphocytes that had been so disabled also became tolerant and, in turn, developed the capacity to specifically disable other naive lymphocytes. This process of "infectious" tolerance explains why no further immunosuppression was needed to maintain long-term transplantation tolerance.

  14. Multiprefectural spread of gastroenteritis outbreaks attributable to a single genogroup II norovirus strain from a tourist restaurant in Nagasaki, Japan.

    PubMed

    Hirakata, Yoichi; Arisawa, Kokichi; Nishio, Osamu; Nakagomi, Osamu

    2005-03-01

    A series of gastroenteritis outbreaks caused by noroviruses (NVs) among tourist groups from several prefectures was associated with eating a lunch prepared by a restaurant in Nagasaki City, Japan, on 18 and 19 November 2003. A retrospective cohort study was performed to estimate the magnitude of the outbreak and identify the source of infection. Epidemiological information was obtained through the local public health centers in the areas where the illness occurred. Stool and vomit specimens and food and environmental samples were analyzed by reverse transcription-PCR with genogroup-specific primers. Positive samples were sequenced and analyzed phylogenetically. Of 1,492 tourists who ate a lunch prepared by the restaurant during the 2-day period, 660 (44.2%) developed illness, with an average incubation time of 31.2 h. Whereas NVs were not detected in any food samples, identical sequences most closely related to the Mexico genotype of genogroup II NV were found in specimens from case patients, restaurant staff, and the kitchen table. Food handlers were concluded to be the source of the outbreak as a result of the contamination of several meals. The series of outbreaks described here exemplifies the role of tourism as a contemporary way to distribute a single infectious agent to multiple and geographically remote areas. PMID:15750067

  15. 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

  16. Mitigating Infectious Disease Outbreaks

    NASA Astrophysics Data System (ADS)

    Davey, Victoria

    The emergence of new, transmissible infections poses a significant threat to human populations. As the 2009 novel influenza A/H1N1 pandemic and the 2014-2015 Ebola epidemic demonstrate, we have observed the effects of rapid spread of illness in non-immune populations and experienced disturbing uncertainty about future potential for human suffering and societal disruption. Clinical and epidemiologic characteristics of a newly emerged infectious organism are usually gathered in retrospect as the outbreak evolves and affects populations. Knowledge of potential effects of outbreaks and epidemics and most importantly, mitigation at community, regional, national and global levels is needed to inform policy that will prepare and protect people. Study of possible outcomes of evolving epidemics and application of mitigation strategies is not possible in observational or experimental research designs, but computational modeling allows conduct of `virtual' experiments. Results of well-designed computer simulations can aid in the selection and implementation of strategies that limit illness and death, and maintain systems of healthcare and other critical resources that are vital to public protection. Mitigating Infectious Disease Outbreaks.

  17. Reducing Non-Infectious Risks of Blood Transfusion

    PubMed Central

    Gilliss, Brian M.; Looney, Mark R.; Gropper, Michael A.

    2011-01-01

    Summary As screening for transfusion-associated infections has improved, non-infectious complications of transfusion now cause the majority of morbidity and mortality associated with transfusion in the United States. For example, transfusion-related acute lung injury, transfusion-associated circulatory overload, and hemolytic transfusion-reactions are the first, second, and third leading causes of death from transfusion respectively. These complications and others are reviewed here and several controversial methods for prevention of non-infectious complications of transfusion are discussed; universal leukoreduction of red cell units, use of male-only plasma, and restriction of red cell storage age. PMID:21792054

  18. 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

  19. Role of matrix metalloproteinases in the pathogenesis of childhood gastroenteritis.

    PubMed

    Kawamura, Yoshiki; Gotoh, Kensei; Takeuchi, Nao; Miura, Hiroki; Nishimura, Naoko; Ozaki, Takao; Yoshikawa, Tetsushi

    2016-08-01

    Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) have been implicated in the pathogenesis of gastrointestinal diseases, such as rotavirus gastroenteritis (GE). Kinetics of these biomarkers were examined in paired serum samples collected from bacterial enteritis patients with Campylobacter (n = 2) and Salmonella (n = 4) and viral GE patients with rotavirus (n = 27), norovirus (n = 25), and adenovirus (n = 11). At the time of hospital admission, all viral GE patients demonstrated increased MMP-9 and decreased MMP-2 and TIMP-2 serum levels. In contrast to viral GE patients, serum MMP-9 levels were not elevated at the time of hospital admission but elevated at the time of discharge; serum MMP-2 and TIMP-2 levels were decreased both at the time of admission and discharge in bacterial enteritis patients. Interestingly, the kinetics of serum MMP-2, MMP-9, and TIMP-2 levels were similar among the viral GE patients but distinct from bacterial enteritis patients. Thus, the involvement of MMPs and TIMPs in the pathophysiology of gastrointestinal symptoms likely varies depending on the etiological agent. Further studies are required to verify whether the extent of the bacterial enteritis or age of the patients influences these serum biomarkers. J. Med. Virol. 88:1341-1346, 2016. © 2016 Wiley Periodicals, Inc. PMID:26765397

  20. 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

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

    PubMed

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

    1989-06-15

    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. PMID:2541881

  2. Eosinophilic ascites, as a rare presentation of eosinophilic gastroenteritis

    PubMed Central

    Cuko, L; Bilaj, F; Bega, B; Barbullushi, A; Resuli, B

    2014-01-01

    Background: Eosinophilic ascites is the most unusual presentation of eosinophilic gastroenteritis (EGE), caused by edema and eosinophilic inflammation of the small bowel wall's serosal layer. Case Report: We report the case of a 37-year-old woman, who presented with diffuse abdominal pain, nausea, abdominal distension, moderate ascites and diarrhea of two weeks duration. The rest of physical and clinical examination was unremarkable, and her past medical history was uneventful. Magnetic Resonance Imaging showed the presence of ascites and diffuse thickening of small bowel wall, but did not detect a primary malignancy in the abdominal cavity; and no signs of portal hypertension or liver damage. Laboratory test results revealed essential peripheral blood eosinophilia, elevated serum IgE and marked increase of eosinophils in the abdominal fluid. Treatment with corticosteroids normalized laboratory tests results, and the ascites resolved immediately. Conclusions: EGE is a rare entity and it should be kept in mind in patients of unexplained ascites. The absence of primary malignancy on imaging, coupled with marked increase of fluid esinophilia and immediate response to treatment with steroids, confirm indirectly the diagnosis of EGE. Hippokratia 2014; 18 (3): 275-277. PMID:25694765

  3. Wetlands and infectious diseases.

    PubMed

    Zimmerman, R H

    2001-01-01

    There is a historical association between wetlands and infectious disease that has led to the modification of wetlands to prevent disease. At the same time there has been the development of water resources projects that increase the risk of disease. The demand for more water development projects and the increased pressure to make natural wetlands economically beneficial creates the need for an ecological approach to wetland management and health assessment. The environmental and health interactions are many. There is a need to take into account the landscape, spatial boundaries, and cross-boundary interactions in water development projects as well as alternative methods to provide water for human needs. The research challenges that need to be addressed are discussed. PMID:11426273

  4. [Infectious diseases (beside AIDS)].

    PubMed

    Bellini, C; Senn, L; Zanetti, G

    2008-01-01

    A simplified version of the US guidelines for prophylaxis of infectious endocarditis was published in 2007. Changes are expected in Switzerland as well. Posaconsole is a new antifungal agent available mostly for prophylaxis in immunocompromised patients. Epidemiology of sexually transmitted infections warrants screening in young adults and after one episode. A meta-analysis clarified the impact of antibiotic therapy in patients with Campylobacter spp. infection. In the field of emerging diseases, we discuss Norovirus epidemics, community-acquired bacteria producing extended-spectrum betalactamases, extensively resistant tuberculosis, and new respiratory viruses. Finally, we address a basic research topic that may change practice in the future: the relationship between individual susceptibility to infection and innate immunity. PMID:18251213

  5. Neuroimaging of Infectious and Inflammatory Diseases of the Pediatric Cerebellum and Brainstem.

    PubMed

    Rossi, Andrea; Martinetti, Carola; Morana, Giovanni; Severino, Mariasavina; Tortora, Domenico

    2016-08-01

    Cerebellar involvement by infectious-inflammatory conditions is rare in children. Most patients present with acute ataxia, and are typically previously healthy, young (often preschool) children. Viral involvement is the most common cause and ranges from acute postinfectious ataxia to acute cerebellitis MR imaging plays a crucial role in the evaluation of patients suspected of harboring inflammatory-infectious involvement of the cerebellum and brainstem. Knowledge of the imaging features of these disorders and technical competence on pediatric MR imaging are necessary for a correct interpretation of findings, which in turn prompts further management. PMID:27423804

  6. Infectious Diseases in Day Care.

    ERIC Educational Resources Information Center

    Sleator, Esther K.

    Discussed in this publication are infectious illnesses for which children attending day care appear to be at special risk. Also covered are the common cold, some infectious disease problems receiving media attention, and some other annoying but not serious diseases, such as head lice, pinworms, and contagious skin conditions. Causes,…

  7. Global mapping of infectious disease

    PubMed Central

    Hay, Simon I.; Battle, Katherine E.; Pigott, David M.; Smith, David L.; Moyes, Catherine L.; Bhatt, Samir; Brownstein, John S.; Collier, Nigel; Myers, Monica F.; George, Dylan B.; Gething, Peter W.

    2013-01-01

    The primary aim of this review was to evaluate the state of knowledge of the geographical distribution of all infectious diseases of clinical significance to humans. A systematic review was conducted to enumerate cartographic progress, with respect to the data available for mapping and the methods currently applied. The results helped define the minimum information requirements for mapping infectious disease occurrence, and a quantitative framework for assessing the mapping opportunities for all infectious diseases. This revealed that of 355 infectious diseases identified, 174 (49%) have a strong rationale for mapping and of these only 7 (4%) had been comprehensively mapped. A variety of ambitions, such as the quantification of the global burden of infectious disease, international biosurveillance, assessing the likelihood of infectious disease outbreaks and exploring the propensity for infectious disease evolution and emergence, are limited by these omissions. An overview of the factors hindering progress in disease cartography is provided. It is argued that rapid improvement in the landscape of infectious diseases mapping can be made by embracing non-conventional data sources, automation of geo-positioning and mapping procedures enabled by machine learning and information technology, respectively, in addition to harnessing labour of the volunteer ‘cognitive surplus’ through crowdsourcing. PMID:23382431

  8. 75 FR 24835 - Infectious Diseases

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-06

    ... notice ``Occupational Exposure to Tuberculosis; Proposed Rule'' (62 FR 54160-54308; October 17, 1997... seconds) and form what are called droplet nuclei (residue from evaporated droplets). These small particles.... Airborne transmission occurs when infectious droplet nuclei or particles containing infectious agents...

  9. BORDER INFECTIOUS DISEASES SURVEILLANCE PROJECT

    EPA Science Inventory

    In 1997, the Centers for Disease Control and Prevention, the Mexican Secretariat of Health, and border health officials began the development of the Border Infectious Disease Surveillance (BIDS) project, a surveillance system for infectious diseases along the U.S.-Mexico border. ...

  10. 76 FR 39041 - Infectious Diseases

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ...OSHA invites interested parties to participate in informal stakeholder meetings concerning occupational exposure to infectious diseases. OSHA plans to use the information gathered at these meetings to explore the possible development of a proposed rule to protect workers from occupational exposure to infectious agents in settings, either where workers provide direct patient care or where......

  11. Infectious diseases following natural disasters: prevention and control measures.

    PubMed

    Kouadio, Isidore K; Aljunid, Syed; Kamigaki, Taro; Hammad, Karen; Oshitani, Hitoshi

    2012-01-01

    Natural disasters may lead to infectious disease outbreaks when they result in substantial population displacement and exacerbate synergic risk factors (change in the environment, in human conditions and in the vulnerability to existing pathogens) for disease transmission. We reviewed risk factors and potential infectious diseases resulting from prolonged secondary effects of major natural disasters that occurred from 2000 to 2011. Natural disasters including floods, tsunamis, earthquakes, tropical cyclones (e.g., hurricanes and typhoons) and tornadoes have been secondarily described with the following infectious diseases including diarrheal diseases, acute respiratory infections, malaria, leptospirosis, measles, dengue fever, viral hepatitis, typhoid fever, meningitis, as well as tetanus and cutaneous mucormycosis. Risk assessment is essential in post-disaster situations and the rapid implementation of control measures through re-establishment and improvement of primary healthcare delivery should be given high priority, especially in the absence of pre-disaster surveillance data. PMID:22149618

  12. Hospital-based surveillance to estimate the burden of rotavirus gastroenteritis in children below five years of age in Romania

    PubMed Central

    Anca, Ioana Alina; Furtunescu, Florentina Ligia; Pleşca, Doina; Streinu-Cercel, Adrian; Rugină, Sorin; Holl, Katsiaryna

    2014-01-01

    Introduction Rotavirus (RV) is a leading cause of acute gastroenteritis (AGE), affecting 95% of children below five years of age. Methods In this prospective, multi-center study, children below five years of age who were hospitalized or those who visited the emergency room (ER) due to AGE or who developed AGE at least 48 hours after hospitalization (nosocomial infection) and had a RV-positive stool sample were included (n=1,222). RV-positive samples were genotyped by reverse-transcriptase polymerase chain reaction. Results RV test results were available for 1,212 children (hospitalizations [n=677], ER visits [n=398] and nosocomial AGE cases [n=137]). Proportions of rotavirus gastroenteritis (RVGE) hospitalizations and ER visits were 51.70% (350/677; 95%CI: 47.86–55.52) and 36.18% (144/398; 95%CI: 31.45–41.12), respectively. Overall, 45.95% (494/1075) of all community-acquired AGE cases were due to RV. High numbers of RVGE cases were recorded between January and March. Most common genotypes were G9P[8] (34.27%) followed by G4P[8] (25.83%) and G1P[8] (23.02%). Of all community-acquired RVGE cases, the highest number of cases was observed in children aged 12–23 months. Median duration of hospitalization among RV-positive subjects was six days (range: 2–31 days). Incidence of nosocomial RVGE was 0.52 (95%CI: 0.45–0.60) cases per 1,000 child-days hospitalization. Median duration for additional hospitalization due to nosocomial RVGE was five days (range: 1–10). The highest burden of nosocomial RVGE was observed in children aged 12–23 months (42.34%, 58/137). Our findings confirm a high burden of acute RVGE disease in Romania and provide useful data to support the implementation of RV vaccination in Romania. Trial registration NCT01253967 PMID:24967217

  13. Norwalk virus-associated gastroenteritis traced to ice consumption aboard a cruise ship in Hawaii: comparison and application of molecular method-based assays.

    PubMed Central

    Khan, A S; Moe, C L; Glass, R I; Monroe, S S; Estes, M K; Chapman, L E; Jiang, X; Humphrey, C; Pon, E; Iskander, J K

    1994-01-01

    Investigation of an outbreak of acute nonbacterial gastroenteritis on a cruise ship provided an opportunity to assess new molecular method-based diagnostic methods for Norwalk virus (NV) and the antibody response to NV infection. The outbreak began within 36 h of embarkation and affected 30% of 672 passengers and crew. No single meal, seating, or food item was implicated in the transmission of NV, but a passenger's risk of illness was associated with the amount of ice (but not water) consumed (chi-square for trend, P = 0.009). Of 19 fecal specimens examined, 7 were found to contain 27-nm NV-like particles by electron microscopy and 16 were positive by PCR with very sensitive NV-specific primers, but only 5 were positive by a new highly specific antigen enzyme immunoassay for NV. Ten of 12 serum specimen pairs demonstrated a fourfold or greater rise in antibody titer to recombinant baculovirus-expressed NV antigen. The amplified PCR band shared only 81% nucleotide sequence homology with the reference NV strain, which may explain the lack of utility of the fecal specimen enzyme immunoassay. This report, the first to document the use of these molecular method-based assays for investigation of an outbreak, demonstrates the importance of highly sensitive viral diagnostics such as PCR and serodiagnosis for the epidemiologic investigation of NV gastroenteritis. Images PMID:8150941

  14. Molecular Detection and Characterization of Gastroenteritis Viruses Occurring Naturally in the Stream Waters of Manaus, Central Amazônia, Brazil▿

    PubMed Central

    Miagostovich, Marize P.; Ferreira, Fabiana F. M.; Guimarães, Flávia R.; Fumian, Túlio M.; Diniz-Mendes, Leonardo; Luz, Sérgio Luiz B.; Silva, Luciete A.; Leite, José Paulo G.

    2008-01-01

    To assess the presence of the four main viruses responsible for human acute gastroenteritis in a hydrographic network impacted by a disordered urbanization process, a 1-year study was performed involving water sample collection from streams in the hydrographic basin surrounding the city of Manaus, Amazonas, Brazil. Thirteen surface water sample collection sites, including different areas of human settlement characterized as urban, rural, and primary forest, located in the Tarumã-Açu, São Raimundo, Educandos, and Puraquequara microbasins, were defined with a global positioning system. At least one virus was detected in 59.6% (31/52) of the water samples analyzed, and rotavirus was the most frequent (44.2%), followed by human adenovirus (30.8%), human astrovirus (15.4%), and norovirus (5.8%). The viral contamination observed mainly in the urban streams reflected the presence of a local high-density population and indicated the gastroenteritis burden from pathogenic viruses in the water, principally due to recreational activities such as bathing. The presence of viral genomes in areas where fecal contamination was not demonstrated by bacterial indicators suggests prolonged virus persistence in aquatic environments and emphasizes the enteric virus group as the most reliable for environmental monitoring. PMID:18065620

  15. Acute renal failure in 2 adult llamas after exposure to Oak trees (Quercus spp.)

    PubMed Central

    Chamorro, Manuel F.; Passler, Thomas; Joiner, Kellye; Poppenga, Robert H.; Bayne, Jenna; Walz, Paul H.

    2013-01-01

    Two adult llamas (Lama glama) previously exposed to oak trees (Quercus spp.) were presented with a history of depression and anorexia. Clinicopathological abnormalities included severe gastroenteritis, acute renal failure, and increased liver enzymes. This is believed to be the first report of oak toxicosis in South American camelids. PMID:23814303

  16. Clinical Manifestations and Treatment Outcomes of Eosinophilic Gastroenteritis in Children

    PubMed Central

    Choi, Jong Sub; Choi, Shin Jie; Lee, Kyung Jae; Kim, Ahlee; Yoo, Jung Kyung; Yang, Hye Ran; Moon, Jin Soo; Chang, Ju Young; Kang, Gyeong Hoon

    2015-01-01

    Purpose The aim of the present study was to investigate the clinical features and outcome of eosinophilic gastroenteritis (EGE) in children. Methods Our study enrolled 24 children who were diagnosed with EGE from 1993 to 2014 at the Department of Pediatrics, Seoul National University Children's Hospital. The patients' clinical manifestations, treatments, and outcomes were reviewed from the medical records. Results The mean age at diagnosis was 5.3 years. Most patients had gastrointestinal symptoms including diarrhea (54.2%) and abdominal pain (45.8%). Peripheral eosinophilia was present in 91.7% of the patients. Thirteen patients (54.2%) showed anemia, and 15 patients (62.5%) had hypoalbuminemia. EGE was classified as mucosal, subserosal, or muscular in 75.0%, 20.8%, and 4.2% of cases, respectively. Three patients showed gastroduodenal ulcers upon endoscopic analysis. A history of allergy was reported in 13 patients, including atopic dermatitis, allergic rhinitis, and asthma. Five patients (20.8%) improved with food restrictions. Among the 19 patients treated with steroids, 11 (57.9%) discontinued steroid treatment without subsequent relapse, 4 (21.1%) relapsed after ceasing steroid treatment, and 4 (21.1%) showed no response to steroids. Two patients who were resistant to steroids underwent therapeutic surgery. The presence of gastroduodenal ulcers was significantly associated with relapse and steroid resistance. Conclusion A high suspicion of EGE is warranted when children have nonspecific gastrointestinal symptoms and peripheral eosinophilia. Most patients improved with food restrictions or steroid treatment, although one-third of patients showed a relapse or steroid resistance. PMID:26770900

  17. What Is a Pediatric Infectious Diseases Specialist?

    MedlinePlus

    ... Size Email Print Share What is a Pediatric Infectious Diseases Specialist? Page Content Article Body If your child ... teen years. What Kind of Training Do Pediatric Infectious Diseases Specialists Have? Pediatric infectious diseases specialists are medical ...

  18. NON-INFECTIOUS DISORDERS OF WARMWATER FISHES

    EPA Science Inventory

    Compared with infectious diseases and disorders, few non-infectious diseases and disorders in cultured fish have severe biologic or economic impact. Culture practices, however, often establish environments that promote infectious disease by weakening the immune response or by pro...

  19. Comprehensive analysis of a norovirus-associated gastroenteritis outbreak, from the environment to the consumer.

    PubMed

    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

    2010-03-01

    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

  20. 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

  1. Exploring the cost effectiveness of an immunization programme for rotavirus gastroenteritis in the United Kingdom.

    PubMed

    Lorgelly, P K; Joshi, D; Iturriza Gómara, M; Gray, J; Mugford, M

    2008-01-01

    Rotavirus is the most common cause of gastroenteritis in children aged <5 years old, two new vaccines have recently been developed which can prevent associated morbidity and mortality. While apparently safe and efficacious, it is also important to establish whether rotavirus immunization is cost effective. A decision analytical model which employs data from a review of published evidence is used to determine the cost effectiveness of a rotavirus vaccine. The results suggest that some of the health sector costs, and all of the societal costs, of rotavirus gastroenteritis in children can be avoided by an immunization programme. The additional cost to the health sector may be considered worthwhile if there is a sufficient improvement in the quality-of-life of children and parents affected by gastroenteritis; this study did not find any evidence of research which has measured the utility gains from vaccination. PMID:17335631

  2. Exploring the cost effectiveness of an immunization programme for rotavirus gastroenteritis in the United Kingdom

    PubMed Central

    LORGELLY, P. K.; JOSHI, D.; ITURRIZA GÓMARA, M.; GRAY, J.; MUGFORD, M.

    2008-01-01

    SUMMARY Rotavirus is the most common cause of gastroenteritis in children aged <5 years old, two new vaccines have recently been developed which can prevent associated morbidity and mortality. While apparently safe and efficacious, it is also important to establish whether rotavirus immunization is cost effective. A decision analytical model which employs data from a review of published evidence is used to determine the cost effectiveness of a rotavirus vaccine. The results suggest that some of the health sector costs, and all of the societal costs, of rotavirus gastroenteritis in children can be avoided by an immunization programme. The additional cost to the health sector may be considered worthwhile if there is a sufficient improvement in the quality-of-life of children and parents affected by gastroenteritis; this study did not find any evidence of research which has measured the utility gains from vaccination. PMID:17335631

  3. Development of a high throughput TaqMan assay for the detection of infectious laryngotracheitis virus in vector vaccinated chickens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Infectious laryngotracheitis virus (ILTV) causes an acute, highly contagious upper-respiratory disease of chickens. Sensitive detection of the causative alphaherpesvirus is important in clinical investigations and experimental studies. In particular, it is essential to quantify the viral genome co...

  4. Prioritising Infectious Disease Mapping

    PubMed Central

    Pigott, David M.; Howes, Rosalind E.; Wiebe, Antoinette; Battle, Katherine E.; Golding, Nick; Gething, Peter W.; Dowell, Scott F.; Farag, Tamer H.; Garcia, Andres J.; Kimball, Ann M.; Krause, L. Kendall; Smith, Craig H.; Brooker, Simon J.; Kyu, Hmwe H.; Vos, Theo; Murray, Christopher J. L.; Moyes, Catherine L.; Hay, Simon I.

    2015-01-01

    Background Increasing volumes of data and computational capacity afford unprecedented opportunities to scale up infectious disease (ID) mapping for public health uses. Whilst a large number of IDs show global spatial variation, comprehensive knowledge of these geographic patterns is poor. Here we use an objective method to prioritise mapping efforts to begin to address the large deficit in global disease maps currently available. Methodology/Principal Findings Automation of ID mapping requires bespoke methodological adjustments tailored to the epidemiological characteristics of different types of diseases. Diseases were therefore grouped into 33 clusters based upon taxonomic divisions and shared epidemiological characteristics. Disability-adjusted life years, derived from the Global Burden of Disease 2013 study, were used as a globally consistent metric of disease burden. A review of global health stakeholders, existing literature and national health priorities was undertaken to assess relative interest in the diseases. The clusters were ranked by combining both metrics, which identified 44 diseases of main concern within 15 principle clusters. Whilst malaria, HIV and tuberculosis were the highest priority due to their considerable burden, the high priority clusters were dominated by neglected tropical diseases and vector-borne parasites. Conclusions/Significance A quantitative, easily-updated and flexible framework for prioritising diseases is presented here. The study identifies a possible future strategy for those diseases where significant knowledge gaps remain, as well as recognising those where global mapping programs have already made significant progress. For many conditions, potential shared epidemiological information has yet to be exploited. PMID:26061527

  5. Conflict and Emerging Infectious Diseases

    PubMed Central

    Legros, Dominique; Formenty, Pierre; Connolly, Maire A.

    2007-01-01

    Detection and control of emerging infectious diseases in conflict situations are major challenges due to multiple risk factors known to enhance emergence and transmission of infectious diseases. These include inadequate surveillance and response systems, destroyed infrastructure, collapsed health systems and disruption of disease control programs, and infection control practices even more inadequate than those in resource-poor settings, as well as ongoing insecurity and poor coordination among humanitarian agencies. This article outlines factors that potentiate emergence and transmission of infectious diseases in conflict situations and highlights several priority actions for their containment and control. PMID:18217543

  6. Infectious Diseases, Urbanization and Climate Change: Challenges in Future China

    PubMed Central

    Tong, Michael Xiaoliang; Hansen, Alana; Hanson-Easey, Scott; Cameron, Scott; Xiang, Jianjun; Liu, Qiyong; Sun, Yehuan; Weinstein, Philip; Han, Gil-Soo; Williams, Craig; Bi, Peng

    2015-01-01

    China is one of the largest countries in the world with nearly 20% of the world’s population. There have been significant improvements in economy, education and technology over the last three decades. Due to substantial investments from all levels of government, the public health system in China has been improved since the 2003 severe acute respiratory syndrome (SARS) outbreak. However, infectious diseases still remain a major population health issue and this may be exacerbated by rapid urbanization and unprecedented impacts of climate change. This commentary aims to explore China’s current capacity to manage infectious diseases which impair population health. It discusses the existing disease surveillance system and underscores the critical importance of strengthening the system. It also explores how the growing migrant population, dramatic changes in the natural landscape following rapid urbanization, and changing climatic conditions can contribute to the emergence and re-emergence of infectious disease. Continuing research on infectious diseases, urbanization and climate change may inform the country’s capacity to deal with emerging and re-emerging infectious diseases in the future. PMID:26371017

  7. Infectious Diseases, Urbanization and Climate Change: Challenges in Future China.

    PubMed

    Tong, Michael Xiaoliang; Hansen, Alana; Hanson-Easey, Scott; Cameron, Scott; Xiang, Jianjun; Liu, Qiyong; Sun, Yehuan; Weinstein, Philip; Han, Gil-Soo; Williams, Craig; Bi, Peng

    2015-09-01

    China is one of the largest countries in the world with nearly 20% of the world's population. There have been significant improvements in economy, education and technology over the last three decades. Due to substantial investments from all levels of government, the public health system in China has been improved since the 2003 severe acute respiratory syndrome (SARS) outbreak. However, infectious diseases still remain a major population health issue and this may be exacerbated by rapid urbanization and unprecedented impacts of climate change. This commentary aims to explore China's current capacity to manage infectious diseases which impair population health. It discusses the existing disease surveillance system and underscores the critical importance of strengthening the system. It also explores how the growing migrant population, dramatic changes in the natural landscape following rapid urbanization, and changing climatic conditions can contribute to the emergence and re-emergence of infectious disease. Continuing research on infectious diseases, urbanization and climate change may inform the country's capacity to deal with emerging and re-emerging infectious diseases in the future. PMID:26371017

  8. Emerging infectious diseases: vulnerabilities, contributing factors and approaches.

    PubMed

    Lashley, Felissa R

    2004-04-01

    We live in an ever more connected global village linked through international travel, politics, economics, culture and human-human and human-animal interactions. The realization that the concept of globalization includes global exposure to disease-causing agents that were formerly confined to small, remote areas and that infectious disease outbreaks can have political, economic and social roots and effects is becoming more apparent. Novel infectious disease microbes continue to be discovered because they are new or newly recognized, have expanded their geographic range, have been shown to cause a new disease spectrum, have jumped the species barrier from animals to humans, have become resistant to antimicrobial agents, have increased in incidence or have become more virulent. These emerging infectious disease microbes may have the potential for use as agents of bioterrorism. Factors involved in the emergence of infectious diseases are complex and interrelated and involve all classifications of organisms transmitted in a variety of ways. In 2003, outbreaks of interest included severe acute respiratory syndrome, monkeypox and avian influenza. Information from the human genome project applied to microbial organisms and their hosts will provide new opportunities for detection, diagnosis, treatment, prevention, control and prognosis. New technology related not only to genetics but also to satellite and monitoring systems will play a role in weather, climate and the approach to environmental manipulations that influence factors contributing to infectious disease emergence and control. Approaches to combating emerging infectious diseases include many disciplines, such as animal studies, epidemiology, immunology, ecology, environmental studies, microbiology, pharmacology, other sciences, health, medicine, public health, nursing, cultural, political and social studies, all of which must work together. Appropriate financial support of the public health infrastructure

  9. BLT-esterase in infectious mononucleosis.

    PubMed Central

    Wagner, L; Wiesholzer, M; Worman, C P; Lang, G; Base, W

    1995-01-01

    Peripheral blood lymphocytes of three patients suffering from infectious mononucleosis due to Epstein-Barr virus (EBV) infection were analysed for BLT-esterase expression in peripheral blood lymphocytes by a well established cytochemical staining method. During the acute phase of disease with presence of clinical symptoms a very high level of up to 90% BLT-esterase-expressing lymphocytes were detected. The increased percentage of lymphocytes expressing BLT-esterase coincided with the time of greatest symptoms and the peak elevation of hepatocellular enzymes. The still moderately elevated level only gradually decreased to normal during the further recovery period of 2 months during which the patients described episodes of weakness. Peripheral blood lymphocyte phenotype analysis revealed a marked CD8 lymphocytosis, a CD4/CD8 ratio of about 0.2, low number of CD19+ B cells, and a high level of DR+ CD3+ lymphocytes. Reduction of BLT esterase expression during the recovery period coincided with reduction of CD8+ DR+ lymphocytes. By a combination of BLT-esterase staining with immunocytochemical phenotype analysis, 95% of CD8+ lymphocytes were found to be BLT-esterase-positive. BLT-esterase might be involved in the immunodefence against EBV in infectious mononucleosis by inducing apoptosis in EBV-transformed B cells. Images Fig. 2 PMID:7743659

  10. Introducing Infectious Agents and Cancer

    PubMed Central

    Buonaguro, Franco M; Lewis, George K; Pelicci, PierGiuseppe

    2006-01-01

    Infectious Agents and Cancer is a new open access, peer-reviewed, online journal, which encompasses all aspects of basic, clinical and translational research that provide an insight into the association between chronic infections and cancer. PMID:23509916

  11. Alphacoronavirus transmissible gastroenteritis virus nsp1 protein suppresses protein translation in mammalian cells and in cell-free HeLa cell extracts but not in rabbit reticulocyte lysate.

    PubMed

    Huang, Cheng; Lokugamage, Kumari G; Rozovics, Janet M; Narayanan, Krishna; Semler, Bert L; Makino, Shinji

    2011-01-01

    The nsp1 protein of transmissible gastroenteritis virus (TGEV), an alphacoronavirus, efficiently suppressed protein synthesis in mammalian cells. Unlike the nsp1 protein of severe acute respiratory syndrome coronavirus, a betacoronavirus, the TGEV nsp1 protein was unable to bind 40S ribosomal subunits or promote host mRNA degradation. TGEV nsp1 also suppressed protein translation in cell-free HeLa cell extract; however, it did not affect translation in rabbit reticulocyte lysate (RRL). Our data suggested that HeLa cell extracts and cultured host cells, but not RRL, contain a host factor(s) that is essential for TGEV nsp1-induced translational suppression. PMID:21047955

  12. Infectious diseases and impaired consciousness.

    PubMed

    Wilson, Michael R; Roos, Karen L

    2011-11-01

    Any of a number of neuroinfectious diseases can cause a disorder of consciousness. The priority in the care of the patient is to identify an infectious disease that is treatable. This article examines disorders of consciousness that may be caused by a septic encephalopathy, bacterial meningoencephalitis, viral encephalitis, tick-borne bacterial disease, fungal meningitis, tuberculous meningitis, a focal infectious mass lesion, such as a brain abscess, or an autoimmune-mediated disorder as a complication of infection. PMID:22032667

  13. [Frozen berries as a risk factor for outbreaks of norovirus gastroenteritis. Results of an outbreak investigation in the summer of 2005 in Hamburg].

    PubMed

    Fell, Gerhard; Boyens, M; Baumgarte, S

    2007-02-01

    An outbreak of acute gastroenteritis occurred in Hamburg among guests of a canteen in August 2005. A total of 241 persons were found ill. In stool samples of 16 of them Norovirus Genogroup I was identified. Neither bacterial nor viral pathogens could be detected in food samples. Among 162 guests enrolled in a cohort study, 69 (42.6 %) met the case definition. A desert dish made from blackberries and yoghurt showed a significant association with the disease (RR 6.9; 95% CI 3.36-14.16). In addition, a protective effect of the decision for the alternative desert dish ice cream was observed (RR 0.9; 95% CI 0.08-0.45). The desert, which was prepared in the canteen kitchen from yoghurt and frozen blackberries, was the most likely source of the outbreak. Frozen berries should be included in the HACCP concepts for canteen kitchens. PMID:17238056

  14. OUTBREAK OF NORWALK-RELATED GASTROENTERITIS AT A BOYS' CAMP

    EPA Science Inventory

    An acute gastrointestinal illness affected 213 (52%) of 407 campers and 64 (52%) of 121 staff attending a boy's camp in the Catoctin Mountains of Maryland during the summer of 1981. Nausea was the predominant symptom for ill campers and staff (73%), but more staff members experie...

  15. Hepatitis in skunks caused by the virus of infectious canine hepatitis.

    PubMed

    Karstad, L; Ramsden, R; Berry, T J; Binn, L N

    1975-10-01

    Two cases of acute, fatal, hepatitis occurred in young, striped skunks (Mephitis mephitis) trapped in southern Ontario. Histologically, lesions in the liver were similar to infectious canine hepatitis. A virus was isolated which produced large intranuclear inclusions in dog kidney cell cultures. These inclusions were Feulgen-positive and fluoresced green with acridine orange stain. The skunk hepatitis isolate was identified as the virus of infectious canine hepatitis by virus neutralization tests. PMID:172663

  16. A novel pore-forming toxin in type A Clostridium perfringens is associated with both fatal canine hemorrhagic gastroenteritis and fatal foal necrotizing enterocolitis.

    PubMed

    Mehdizadeh Gohari, Iman; Parreira, Valeria R; 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

  17. 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

  18. 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 ...

  19. Gastroenteritis Caused by Norovirus GGII.4, the Netherlands, 1994–2005

    PubMed Central

    Vennema, Harry; Duizer, Erwin; Koopmans, Marion P.G.

    2007-01-01

    From 1994 through 2005, gastroenteritis outbreaks caused by norovirus generally increased in the Netherlands, with 3 epidemic seasons associated with new GGII.4 strains. Increased percentages of GGII.4 strains during these epidemics, followed by a sharp decrease in their absolute and relative numbers, suggest development of immunity. PMID:17370531

  20. ANTIGEN DETECTION WITH MONOCLONAL ANTIBODIES FOR THE DIAGNOSIS OF ADENOVIRUS GASTROENTERITIS

    EPA Science Inventory

    The authors have developed a monoclonal antibody-based enzyme immunoassay (EIA) for direct detection of enteric adenoviruses in stool specimens from patients with gastroenteritis. Tests specific for each of the enteric adenoviruses, adenovirus type 40 (Ad40) and type 41 (Ad41) we...

  1. Effectiveness of rotavirus vaccines in preventing cases and hospitalizations due to rotavirus gastroenteritis in Navarre, Spain.

    PubMed

    Castilla, Jesús; Beristain, Xabier; Martínez-Artola, Víctor; Navascués, Ana; García Cenoz, Manuel; Alvarez, Nerea; Polo, Isabel; Mazón, Ana; Gil-Setas, Alberto; Barricarte, Aurelio

    2012-01-11

    Two rotavirus vaccines have been available since 2006. This study evaluates the effectiveness of these vaccines using a test-negative case-control design in Navarre, Spain. We included children 3-59 months of age who sought medical care for gastroenteritis and for whom stool samples were taken between January 2008 and June 2011. About 9% had received the pentavalent vaccine (RotaTeq) and another 8% received the monovalent vaccine (Rotarix). Cases were the 756 children with confirmed rotavirus and controls were the 6036 children who tested negative for rotavirus. Thirty-five percent of cases and 9% of controls had required hospitalization (p<0.0001). The adjusted effectiveness of complete vaccination was 78% (95% CI: 68-85%) in preventing rotavirus gastroenteritis and 83% (95% CI: 65-93%) in preventing hospitalization for rotavirus gastroenteritis. No differences between the two vaccines were detected (p=0.4523). Both vaccines were highly effective in preventing cases and hospital admissions in children due to rotavirus gastroenteritis. PMID:22122860

  2. Retinoic acid decreases the severity of Salmonella enterica serovar Typhimurium mediated gastroenteritis in a mouse model.

    PubMed

    Sinha, Ritam; Howlader, Debaki Ranjan; Mukherjee, Priyadarshini; Rai, Sulabh; Nag, Dhrubajyoti; Koley, Hemanta

    2016-07-01

    Gastroenteritis is a global burden; it's the major cause of morbidity and mortality both in adults and children of developing countries. Salmonella is one of the leading causes of bacteria-mediated gastroenteritis and due to its increasing multidrug antibiotic resistance; Salmonella-mediated gastroenteritis is difficult to control. Retinoic acid, the biologically active agent of vitamin A has an anti-inflammatory effect on experimental colitis. In this study we have shown All trans retinoic acid (ATRA) treatment down regulates Salmonella-mediated colitis in a murine model. Macroscopic signs of inflammation such as decrease in body weight and cecum weight, shorter length of proximal colon and pathological score of colitis were observed less in ATRA treated mice than in a vehicle control group. ATRA treatment not only reduced pro-inflammatory cytokine responses, such as TNF-α, IL-6, IL-1β, IFN-γ and IL-17 production but also increased IL-10 response in the supernatant of intestinal tissue. Results also suggested that ATRA treatment enhances the number of FoxP3-expressing T regulatory cells in MLN and also decreases bacterial load in systemic organs. We concluded that ATRA treatment indeed reduces Salmonella Typhimurium-mediated gastroenteritis in mice, suggesting it could be an important part of an alternative therapeutic approach to combat the disease. PMID:26858186

  3. WIDESPREAD OUTBREAKS OF CLAM- AND OYSTER-ASSOCIATED GASTROENTERITIS: ROLE OF NORWALK VIRUS

    EPA Science Inventory

    Consumption of raw shellfish has long been known to be associated with individual cases and sporadic outbreaks of enteric illness. However, during 1982, outbreaks of gastroenteritis associated with eating raw shellfish reached epidemic proportions in New York State. Between May 1...

  4. Acute oral ulcers.

    PubMed

    Lehman, Julia S; Rogers, Roy S

    2016-01-01

    Accurate diagnosis of acute oral ulcers can be challenging. Important historic details include the pattern of recurrence, anatomic areas of involvement within the mouth and elsewhere on the mucocutaneous surface, associated medical symptoms or comorbidities, and symptomology. Careful mucocutaneous examination is essential. When necessary, biopsy at an active site without ulceration is generally optimal. Depending on the clinical scenario, supplemental studies that may be useful include cultures; perilesional biopsy for direct immunofluorescence testing; and evaluation for infectious diseases, gluten sensitivity, inflammatory bowel disease, human immunodeficiency virus infection, connective tissue diseases, or hematinic deficiencies. Clinicians should maintain a broad differential diagnosis when evaluating patients with acute oral ulcers. PMID:27343961

  5. Potential impacts of climate change on infectious diseases in the Arctic.

    PubMed

    Parkinson, Alan J; Butler, Jay C

    2005-12-01

    Climate change could cause changes in the incidence of infectious diseases in Arctic regions. Higher ambient temperatures in the Arctic may result in an increase in some temperature sensitive foodborne diseases such as gastroenteritis, paralytic shellfish poisoning and botulism. An increase in mean temperature may also influence the incidence of infectious diseases of animals that are spread to humans (zoonoses) by changing the population and range of animal hosts and insect vectors. An increase in flooding events may result in outbreaks of waterborne infection, such as Giardia lamblia or Cryptospordium parvum. A change in rodent and fox populations may result in an increase in rabies or echinococcosis. Temperature and humidity influence the distribution and density of many arthropod vectors which in turn may influence the incidence and northern range of vectorborne diseases such as West Nile virus. Recommendations include: the strenghtening of public health systems, disease surveillance coordinated with climate monitoring, and research into the detection, prevention, control and treatment of temperature-sensitive infectious diseases. PMID:16440610

  6. An outbreak of febrile gastroenteritis associated with jellied pork contaminated with Listeria monocytogenes.

    PubMed

    Pichler, Juliane; Much, Peter; Kasper, Sabine; Fretz, Rainer; Auer, Bettina; Kathan, Julia; Mann, Michaela; Huhulescu, Steliana; Ruppitsch, Werner; Pietzka, Ariane; Silberbauer, Karl; Neumann, Christian; Gschiel, Ernst; de Martin, Alfred; Schuetz, Angelika; Gindl, Josef; Neugschwandtner, Ernst; Allerberger, Franz

    2009-01-01

    In September 2008, the Austrian Agency for Health and Food Safety (AGES) learned of an outbreak of diarrheal illness that included a 71-year-old patient hospitalized for gastroenteritis with a blood culture positive for Listeria monocytogenes. Three stool specimens provided by seven of 19 persons attending a day trip to a foreign city, including a final break at an Austrian tavern, yielded L. monocytogenes. All isolates were of serovar 4b and had fingerprints indistinguishable from each other. A cohort study revealed that the outbreak of gastroenteritis occurred among 16 persons who had eaten dinner at the wine tavern on September 6. Of the 15 persons who ate from platters of mixed cold-cuts, 12 (80%) developed symptoms of febrile gastroenteritis within 24-48 h. The median age of those who became ill was 62 years. A 72-year-old patient recovered from gastroenteritis but was hospitalized with bacterial meningitis on day 19 after the dinner. The epidemiological investigation identified the consumption of mixed cold-cuts (including jellied pork) at the wine tavern as the most likely vehicle of the foodborne outbreak (P = 0.0015). This hypothesis was confirmed by microbiological investigation of jellied pork produced by the tavern owner on September 3. L. monocytogenes was isolated from leftover food in numbers of 3 x 10(3)-3 x 10(4) colony forming units/g and was indistinguishable from the clinical outbreak isolates. Symptoms reported by the 12 patients included unspecified fever (12x), diarrhea (9x), headache (5x), vomiting (4x), body aches (2x) and sore throat (1x). Active case finding identified one case of rhombencephalitis (female, age 48) among another group of four guests, among whom only the patient and her asymptomatic husband had eaten jellied pork on September 6. This is the first outbreak of L. monocytogenes-associated gastroenteritis reported in Austria. The occurrence of a secondary case of meningitis (diagnosed on day 19 after consumption of jellied

  7. Predominance of genotype P[9]G3 in rotavirus gastroenteritis in Polish children

    PubMed Central

    Kacerka, Anna; Majda-Stanisławska, Ewa; Jóźwiak, Barbara; Sidorkiewicz, Małgorzata

    2015-01-01

    Introduction Rotavirus (RV) infection is the most common cause of gastroenteritis in children. This paper identifies the most common genotypes of rotaviruses isolated from children hospitalized with gastroenteritis and attempts to determine any relationship between infection with a certain rotavirus genotype. Material and methods The investigated group consisted of 68 consecutive children with rotavirus gastroenteritis (confirmed by an agglutination test). Rotavirus genotype was determined in stool samples obtained from each child. Results The P[9]VP4 genotype was observed in 41/61 positive samples (over 67.2%) that were permanently associated with the G3 VP7 genotype. Moreover, G3 was determined as the most commonly isolated G type (77.94%). As well as the P[9]G3 type, G3 was also found in the P[4] type (5 cases). Twenty-six out of 61 (42.6%) children in whom rotavirus genotype was determined were co-infected with pathogenic bacteria. No statistical correlation was observed between rotavirus P[9]G3 gastroenteritis and digestive tract co-infection with pathogenic bacteria (p > 0.05). Elevated ALT activity was found in 34/59 (57.6%) cases of rotavirus gastroenteritis. Elevated ALT serum level was found to correlate with P[9]G3 rotavirus genotype but concomitant infections did not. Conclusions The most common genotype of rotaviruses observed in our group of children, P[9]G3, has rarely been described. Co-infection of the digestive tract with pathogenic bacteria and elevated serum ALT concentrations were found to be the most frequent phenomena. A correlation between P[9]G3 rotavirus genotype and elevated serum ALT level was found, but no significant relationship was identified between concomitant infections and P[9]G3 genotype. PMID:26170851

  8. Norovirus and FRNA bacteriophage determined by RT-qPCR and infectious FRNA bacteriophage in wastewater and oysters.

    PubMed

    Flannery, John; Keaveney, Sinéad; Rajko-Nenow, Paulina; O'Flaherty, Vincent; Doré, William

    2013-09-15

    Norovirus (NoV), the leading cause of adult non-bacterial gastroenteritis can be commonly detected in wastewater but the extent of NoV removal provided by wastewater treatment plants (WWTPs) is unclear. We monitored a newly commissioned WWTP with UV disinfection on a weekly basis over a six month period for NoV using RT-qPCR and for FRNA bacteriophage GA using both RT-qPCR (total concentration) and a plaque assay (infectious concentration). Mean concentrations of NoV GI and GII in influent wastewater were reduced by 0.25 and 0.41 log10 genome copies 100 ml(-1), respectively by the WWTP. The mean concentration of total FRNA bacteriophage GA was reduced by 0.35 log genome copies 100 ml(-1) compared to a reduction of infectious FRNA bacteriophage GA of 2.13 log PFU 100 ml(-1). A significant difference between concentrations of infectious and total FRNA bacteriophage GA was observed in treated, but not in untreated wastewaters. We conclude that RT-qPCR in isolation underestimates the reduction of infectious virus during wastewater treatment. We further compared the concentrations of infectious virus in combined sewer overflow (CSO) and UV treated effluents using FRNA bacteriophage GA. A greater percentage (98%) of infectious virus is released in CSO discharges than UV treated effluent (44%). Following a CSO discharge, concentrations of NoV GII and infectious FRNA bacteriophage GA in oysters from less than the limit of detection to 3150 genome copies 100 g(-1) and 1050 PFU 100 g(-1) respectively. PMID:23850211

  9. The Thymus Is a Common Target Organ in Infectious Diseases

    PubMed Central

    Savino, Wilson

    2006-01-01

    Infectious disease immunology has largely focused on the effector immune response, changes in the blood and peripheral lymphoid organs of infected individuals, and vaccine development. Studies of the thymus in infected individuals have been neglected, although this is progressively changing. The thymus is a primary lymphoid organ, able to generate mature T cells that eventually colonize secondary lymphoid organs, and is therefore essential for peripheral T cell renewal. Recent data show that normal thymocyte development and export can be altered as a result of an infectious disease. One common feature is the severe atrophy of the infected organ, mainly due to the apoptosis-related depletion of immature CD4+CD8+ thymocytes. Additionally, thymocyte proliferation is frequently diminished. The microenvironmental compartment of the thymus is also affected, particularly in acute infectious diseases, with a densification of the epithelial network and an increase in the deposition of extracellular matrix. In the murine model of Chagas disease, intrathymic chemokine production is also enhanced, and thymocytes from Trypanosoma cruzi-infected mice exhibit greater numbers of cell migration-related receptors for chemokines and extracellular matrix, as well as increased migratory responses to the corresponding ligands. This profile is correlated with the appearance of potentially autoreactive thymus-derived immature CD4+CD8+ T cells in peripheral organs of infected animals. A variety of infectious agents—including viruses, protozoa, and fungi—invade the thymus, raising the hypothesis of the generation of central immunological tolerance for at least some of the infectious agent-derived antigens. It seems clear that the thymus is targeted in a variety of infections, and that such targeting may have consequences on the behavior of peripheral T lymphocytes. In this context, thymus-centered immunotherapeutic approaches potentially represent a new tool for the treatment of severe

  10. Infectious disease, endangerment, and extinction.

    PubMed

    Macphee, Ross D E; Greenwood, Alex D

    2013-01-01

    Infectious disease, especially virulent infectious disease, is commonly regarded as a cause of fluctuation or decline in biological populations. However, it is not generally considered as a primary factor in causing the actual endangerment or extinction of species. We review here the known historical examples in which disease has, or has been assumed to have had, a major deleterious impact on animal species, including extinction, and highlight some recent cases in which disease is the chief suspect in causing the outright endangerment of particular species. We conclude that the role of disease in historical extinctions at the population or species level may have been underestimated. Recent methodological breakthroughs may lead to a better understanding of the past and present roles of infectious disease in influencing population fitness and other parameters. PMID:23401844

  11. Infectious Disease, Endangerment, and Extinction

    PubMed Central

    MacPhee, Ross D. E.; Greenwood, Alex D.

    2013-01-01

    Infectious disease, especially virulent infectious disease, is commonly regarded as a cause of fluctuation or decline in biological populations. However, it is not generally considered as a primary factor in causing the actual endangerment or extinction of species. We review here the known historical examples in which disease has, or has been assumed to have had, a major deleterious impact on animal species, including extinction, and highlight some recent cases in which disease is the chief suspect in causing the outright endangerment of particular species. We conclude that the role of disease in historical extinctions at the population or species level may have been underestimated. Recent methodological breakthroughs may lead to a better understanding of the past and present roles of infectious disease in influencing population fitness and other parameters. PMID:23401844

  12. Human migration and infectious diseases.

    PubMed

    Soto, S M

    2009-01-01

    Emerging infectious diseases (EID) are defined as diseases that have appeared recently or that have recently increased in their frequency, geographical distribution or both. Commercial globalisation, population movements and environmental changes are the main factors favouring the international spread of microorganisms. Transport and communication development constitutes also a remarkable factor in the worldwide dispersion of microorganisms. The mass movement of large numbers of people creates new opportunities for the spread and establishment of common or novel infectious diseases. A surveillance system to detect emergent and re-emergent infections, a rapid responsiveness of healthcare systems and laboratories, vector control, and the provision of healthcare education programmes to inform the population of how to avoid infections are needed in order to stop the spread of infectious diseases. PMID:19220349

  13. Norwalk virus: How infectious is it?

    EPA Science Inventory

    Noroviruses are major agents of viral gastroenteritis worldwide. The infectivity of Norwalk virus, the prototype norovirus, has been studied in susceptible human volunteers. A new variant of the hit theory model of microbial infection was developed to estimate the variation in No...

  14. Infectious causes of necrotizing enterocolitis

    PubMed Central

    Coggins, Sarah A.; Wynn, James L.; Weitkamp, Jörn-Hendrik

    2014-01-01

    Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency among premature infants. Although a large body of research has focused on understanding its pathogenesis, the exact mechanism has not been elucidated. Of particular interest is the potential causative role of infectious culprits in the development of NEC. A variety of reports describe bacterial, viral, and fungal infections occurring in association with NEC; however, no organism has emerged as being definitively involved in NEC pathogenesis. In this review, we summarize the body of research on infectious causes of necrotizing enterocolitis. PMID:25678001

  15. Infectious causes of necrotizing enterocolitis.

    PubMed

    Coggins, Sarah A; Wynn, James L; Weitkamp, Jörn-Hendrik

    2015-03-01

    Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency among premature infants. Although a large body of research has focused on understanding its pathogenesis, the exact mechanism has not been elucidated. Of particular interest is the potential causative role of infectious culprits in the development of NEC. A variety of reports describe bacterial, viral, and fungal infections occurring in association with NEC; however, no single organism has emerged as being definitively involved in NEC pathogenesis. In this review, the authors summarize the literature on infectious causes of NEC. PMID:25678001

  16. Incubation periods of viral gastroenteritis: a systematic review

    PubMed Central

    2013-01-01

    Background Accurate knowledge of incubation period is important to investigate and to control infectious diseases and their transmission, however statements of incubation period in the literature are often uncited, inconsistent, and/or not evidence based. Methods In a systematic review of the literature on five enteric viruses of public health importance, we found 256 articles with incubation period estimates, including 33 with data for pooled analysis. Results We fit a log-normal distribution to pooled data and found the median incubation period to be 4.5 days (95% CI 3.9-5.2 days) for astrovirus, 1.2 days (95% CI 1.1-1.2 days) for norovirus genogroups I and II, 1.7 days (95% CI 1.5-1.8 days) for sapovirus, and 2.0 days (95% CI 1.4-2.4 days) for rotavirus. Conclusions Our estimates combine published data and provide sufficient quantitative detail to allow for these estimates to be used in a wide range of clinical and modeling applications. This can translate into improved prevention and control efforts in settings with transmission or the risk of transmission. PMID:24066865

  17. Emerging infectious diseases in southeast Asia: regional challenges to control.

    PubMed

    Coker, Richard J; Hunter, Benjamin M; Rudge, James W; Liverani, Marco; Hanvoravongchai, Piya

    2011-02-12

    Southeast Asia is a hotspot for emerging infectious diseases, including those with pandemic potential. Emerging infectious diseases have exacted heavy public health and economic tolls. Severe acute respiratory syndrome rapidly decimated the region's tourist industry. Influenza A H5N1 has had a profound effect on the poultry industry. The reasons why southeast Asia is at risk from emerging infectious diseases are complex. The region is home to dynamic systems in which biological, social, ecological, and technological processes interconnect in ways that enable microbes to exploit new ecological niches. These processes include population growth and movement, urbanisation, changes in food production, agriculture and land use, water and sanitation, and the effect of health systems through generation of drug resistance. Southeast Asia is home to about 600 million people residing in countries as diverse as Singapore, a city state with a gross domestic product (GDP) of US$37,500 per head, and Laos, until recently an overwhelmingly rural economy, with a GDP of US$890 per head. The regional challenges in control of emerging infectious diseases are formidable and range from influencing the factors that drive disease emergence, to making surveillance systems fit for purpose, and ensuring that regional governance mechanisms work effectively to improve control interventions. PMID:21269678

  18. Empirical examination of the indicator ‘pediatric gastroenteritis hospitalization rate’ based on administrative hospital data in Italy

    PubMed Central

    2014-01-01

    Background Awareness of the importance of strengthening investments in child health and monitoring the quality of services in the pediatric field is increasing. The Pediatric Quality Indicators developed by the US Agency for Healthcare Research and Quality (AHRQ), use hospital administrative data to identify admissions that could be avoided through high-quality outpatient care. Building on this approach, the purpose of this study is to perform an empirical examination of the ‘pediatric gastroenteritis admission rate’ indicator in Italy, under the assumption that lower admission rates are associated with better management at the primary care level and with overall better quality of care for children. Methods Following the AHRQ process for evaluating quality indicators, we examined age exclusion/inclusion criteria, selection of diagnostic codes, hospitalization type, and methodological issues for the ‘pediatric gastroenteritis admission rate’. The regional variability of hospitalizations was analyzed for Italian children aged 0–17 years discharged between January 1, 2009 and December 31, 2011. We considered hospitalizations for the following diagnoses: non-bacterial gastroenteritis, bacterial gastroenteritis and dehydration (along with a secondary diagnosis of gastroenteritis). The data source was the hospital discharge records database. All rates were stratified by age. Results In the study period, there were 61,130 pediatric hospitalizations for non-bacterial gastroenteritis, 5,940 for bacterial gastroenteritis, and 38,820 for dehydration. In <1-year group, the relative risk of hospitalization for non-bacterial gastroenteritis was 24 times higher than in adolescents, then it dropped to 14.5 in 1- to 4-year-olds and to 3.2 in 5- to 9-year-olds. At the national level, the percentage of admissions for bacterial gastroenteritis was small compared with non-bacterial, while including admissions for dehydration revealed a significant variability in diagnostic

  19. Global capacity for emerging infectious disease detection.

    PubMed

    Chan, Emily H; Brewer, Timothy F; Madoff, Lawrence C; Pollack, Marjorie P; Sonricker, Amy L; Keller, Mikaela; Freifeld, Clark C; Blench, Michael; Mawudeku, Abla; Brownstein, John S

    2010-12-14

    The increasing number of emerging infectious disease events that have spread internationally, such as severe acute respiratory syndrome (SARS) and the 2009 pandemic A/H1N1, highlight the need for improvements in global outbreak surveillance. It is expected that the proliferation of Internet-based reports has resulted in greater communication and improved surveillance and reporting frameworks, especially with the revision of the World Health Organization's (WHO) International Health Regulations (IHR 2005), which went into force in 2007. However, there has been no global quantitative assessment of whether and how outbreak detection and communication processes have actually changed over time. In this study, we analyzed the entire WHO public record of Disease Outbreak News reports from 1996 to 2009 to characterize spatial-temporal trends in the timeliness of outbreak discovery and public communication about the outbreak relative to the estimated outbreak start date. Cox proportional hazards regression analyses show that overall, the timeliness of outbreak discovery improved by 7.3% [hazard ratio (HR) = 1.073, 95% CI (1.038; 1.110)] per year, and public communication improved by 6.2% [HR = 1.062, 95% CI (1.028; 1.096)] per year. However, the degree of improvement varied by geographic region; the only WHO region with statistically significant (α = 0.05) improvement in outbreak discovery was the Western Pacific region [HR = 1.102 per year, 95% CI (1.008; 1.205)], whereas the Eastern Mediterranean [HR = 1.201 per year, 95% CI (1.066; 1.353)] and Western Pacific regions [HR = 1.119 per year, 95% CI (1.025; 1.221)] showed improvement in public communication. These findings provide quantitative historical assessment of timeliness in infectious disease detection and public reporting of outbreaks. PMID:21115835

  20. Preventing Infectious Disease in Sports.

    ERIC Educational Resources Information Center

    Howe, Warren B.

    2003-01-01

    Preventing infectious disease in sports is fundamental to maintaining team effectiveness and helping athletes avoid the adverse effects of illness. Good hygiene, immunization, minimal exposure to specific diseases, and certain prophylactic measures are essential. Teammates, coaches, trainers, officials, healthcare providers, and community public…

  1. Facts about Infectious Diseases (ID)

    MedlinePlus

    ... and influenza. Travelers to foreign countries may require vaccinations against yellow fever, cholera, typhoid fever or hepatitis ... 1300 Wilson Boulevard Suite 300 Arlington, VA 22209 | Phone: (703) 299-0200 | Fax: (703) 299-0204 For ... | HIVMA | Contact Us © Copyright IDSA 2016 Infectious Diseases Society of America Full Site Mobile Site

  2. Diagnostic vitrectomy for infectious uveitis

    PubMed Central

    Jeroudi, Abdallah; Yeh, Steven

    2014-01-01

    The identification of an infectious or noninfectious uveitis syndrome is important to determine the range of therapeutic and prognostic implications of that disease entity. Diagnostic dilemmas arise with atypical history, atypical clinical presentations, inconclusive diagnostic workup, and persistent or worsened inflammation despite appropriate immunosuppression. More invasive intraocular testing is indicated in these situations particularly in infectious uveitis where a delay in treatment may result in worsening of the patient’s disease and a poor visual outcome. Laboratory analysis of vitreous fluid via diagnostic pars plana vitrectomy is an important technique in the diagnostic armamentarium, but the most important aspects of sample collection include rapid processing, close coordination with an ophthalmic pathology laboratory, and directed testing on this limited collected sample. Culture and staining has utility in bacterial, fungal, and nocardial infection. Polymerase chain reaction (PCR) analysis has shown promising results for bacterial endophthalmitis and infection with mycobacterium tuberculosis whereas PCR testing for viral retinitides and ocular toxoplasmosis has a more established role. Antibody testing is appropriate for toxoplasmosis and toxocariasis, and may be complementary to PCR for viral retinitis. Masquerade syndromes represent neoplastic conditions that clinically appear as infectious or inflammatory conditions and should be considered as part of the differential diagnosis. Diagnostic vitrectomy and chorioretinal biopsy are thus critical tools for the management of patients in whom an infectious etiology of uveitis is suspected. PMID:24613892

  3. Introducing Mediterranean Journal of Hematology and Infectious Diseases

    PubMed Central

    Leone, Giuseppe; Larocca, Luigi Maria; Pizzigallo, Eligio

    2009-01-01

    Summary: Mediterranean Journal of Hematology and Infectious Diseases (MJHID) is a new open access, peer-reviewed, online journal, which encompasses different aspects of clinical and translational research providing an insight into the relationship between acute and chronic infections and hematological diseases. MJHID will be a topical journal on subjects of current importance in clinical haematology and infectious diseases. Every issue should have, beside the editor in chief, a guest editor. Both editor in chief and guest editor provide to invite experts in the selected topic to performe a complete update of the arguments readily available for practising phisicians. The journal will have also a section devoted to original papers, case reports and letters to editor and Editorial comment mostly focusing on the arguments treated in the previous topical issues. PMID:21415983

  4. Infectious (Non)tolerance—Frustrated Commensalism Gone Awry?

    PubMed Central

    Nussbaum, Jesse C.; Locksley, Richard M.

    2012-01-01

    Despite advances in medicine, infectious diseases remain major causes of death and disability worldwide. Acute or chronic infectious agents mediate host tissue damage and cause a spectrum of disease as diverse as overwhelming sepsis and shock within hours to persistent tissue inflammation causing organ failure or even cancer over years. Although pathogen exposure can cause disease via host-derived inflammation, pathogens share recognized elements with harmless human commensals. Mouse models and organisms with simpler flora are revealing the dialogue between multicellular hosts and commensal flora. In some instances the persistent inflammation associated with pathogens can be interpreted within a framework of frustrated commensalism in which the host and pathogen cannot complete the requisite dialogue that establishes homeostasis. In contrast, coevolved commensals interact cooperatively with the host immune system, resulting in immunotolerance. Attempts to more thoroughly understand the molecular nature of the dialogue may uncover novel approaches to the control of inflammation and tissue damage. PMID:22456498

  5. Rotavirus antigen test

    MedlinePlus

    ... Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 142. Giannella RA. Infectious enteritis and ... and Liver Disease . 9th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 107. Zulfigar AB. Acute gastroenteritis in ...

  6. Wading pool water contaminated with both noroviruses and astroviruses as the source of a gastroenteritis outbreak.

    PubMed Central

    Maunula, L.; Kalso, S.; Von Bonsdorff, C. H.; Pönkä, A.

    2004-01-01

    In July 2001, an outbreak of gastroenteritis occurred in Helsinki among children and adults after bathing in an outdoor wading pool. The epidemiological survey revealed that at least 242 persons were affected. Microbiological testing of both patient stool samples and of the pool water revealed the presence of two different gastroenteritis viruses: a norovirus (NV) and an astrovirus. Amplicon sequencing of the NV samples showed nucleotide sequence identity between the virus from patients and the water. After changing the pool water and the sand at the bottom of the pool followed by shock chlorination, no virus could be detected in the water. However, NV was continuously detected in the water outlet well as much as 8 months after the incident. Here we show how molecular methods aided in tracing the source of the epidemic and in finding the causative pathogens both in patients and in the environment. PMID:15310176

  7. 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

  8. Emerging and Re-Emerging Infectious Diseases

    MedlinePlus

    ... Content Marketing Share this: Main Content Area Emerging Infectious Diseases/Pathogens Research Introduction and Goals Despite remarkable advances ... medical research and treatments during the 20th century, infectious diseases remain among the leading causes of death worldwide. ...

  9. 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

  10. Investigation of Two Outbreaks of Gastroenteritis in Tržič in September 2011

    PubMed Central

    KRT LAH, Andreja; FRELIH, Tatjana; GRMEK KOŠNIK, Irena

    2015-01-01

    Background An outbreak of gastroenteritis of etiologically unspecified origin and an outbreak of Salmonellosis occurred simultaneously in September 2011 in Tržič. The purpose of the investigation of both outbreaks was to identify the most probable source and the mode of transmission and to implement preventive measures. Methods In two retrospective case-control studies, the association between gastroenteritis of etiologically unspecified origin or Salmonellosis and food from a restaurant or drinking tap water were tested by univariate and multivariate analysis. The subject in the first study was a sick person with salmonellosis, and the subject in the second study was a resident that developed diarrhoea and/ or vomiting. Cases were reported by doctors, and controls were selected from healthy persons who responded to the questionnaire. Results A person exposed to food from the restaurant had a 24.8 times higher odds ratio (univariate analysis OR 24.8, 95% CI 7.5 to 82.3, p <0.05; multivariate analysis OR 14.7, 95% CI 3.5 – 61.3, p <0.05) for salmonellosis than non-exposed. A resident exposed to tap water from specific water source had a 3.4 times higher odds ratio (univariate analysis of OR 3.4, 95% CI 2.2 to 5.1 is p <0.05, multivariate analysis of RO 2.9, 95% CI 1, 7 to 5.3, p <0.05), for gastroenteritis of unspecific etiology than non-exposed. The dose response relationship was also statistically significant. Conclusion Analytical cases - controls studies confirmed a causal relationship between salmonellosis and food from the specific restaurant and the causal relationship between gastroenteritis of etiologically unspecified origin and drinking tap water from specific water source. Salmonella enteritidis may have entered into the restaurant through tap water.

  11. Water outage increases the risk of gastroenteritis and eyes and skin diseases

    PubMed Central

    2011-01-01

    Background The present study used insurance claims data to investigate infections associated with short-term water outage because of constructions or pipe breaks. Methods The present study used medical claims of one million insured persons for 2004-2006. We estimated incidences of gastroenteritis and eye and skin complaints for 10 days before, during, and after 10 days of water supply restriction for outpatient visits and for emergency and in-patient care combined. Results There was an increase in medical services for these complaints in outpatient visits because of water outages. Poisson regression analyses showed that increased risks of medical services were significant for gastroenteritis (relative risk [RR] 1.31, 95% confidence interval [CI] 1.26-1.37), skin disease (RR 1.36, 95% CI 1.30-1.42), and eye disease patients (RR 1.34, 95% CI 1.26-1.44). Similar risks were observed during 10-day lag periods. Compared with those in cool days, risks of medical services are higher when average daily temperature is above 30°C for gastroenteritis (RR 12.1, 95% CI 6.17-23.7), skin diseases (RR 4.48, 95% CI 2.29-8.78), and eye diseases (RR 40.3, 95% CI 7.23-224). Conclusion We suggest promoting personal hygiene education during water supply shortages, particularly during the warm months. PMID:21943080

  12. 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

  13. Ketamine administration makes patients and physicians satisfied during gastro-enteric endoscopies

    PubMed Central

    Majidinejad, Saeed; Kajbaf, Abdollah; Khodadoostan, Mahsa; Dolatkhah, Shahaboddin; Kajbaf, Mohammad Hossein; Adibi, Peiman; Malekmohammad, Maryam

    2015-01-01

    Background: A suitable sedative status during gastro-enteric endoscopies results in better physicians’ approach and more stable view of internal organs. Therefore, we evaluated the effect of ketamine for sedation in endoscopic procedures of adult patients. Materials and Methods: Patients who were candidates for gastro-enteric endoscopy during the years 2014-2015 were included into the study and divided into two groups of case (administered 5 mg/kg of oral ketamine half an hour before initiation of the procedure) and control (administered placebo in a same pattern). After endoscopy, patients and physicians’ satisfaction of sedation was assessed. SPSS-22 was used for data analysis. Results: Eighty-six patients participated into the study of which divided into each groups. The pain and discomfort scores were 2.4 ± 1.8 and 5.81 ± 1.48 in case and control groups, respectively, (P < 0.001). Mann-Whitney test revealed statistical difference among groups about physician's satisfaction of sedation during endoscopy (P < 0.001). Patients who received ketamine had better sedative status (P < 0.001). None of the patients in the case group was completely awake but all of the patients in the control group were awake. The number of retching during endoscopy showed that individuals in the control group had more frequent retching episodes (P = 0.04). Conclusion: Low-dose oral administration of ketamine could make a satisfied sedation for gastro-enteric endoscopy. PMID:26759573

  14. 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

  15. 25 CFR 140.26 - Infectious plants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Infectious plants. 140.26 Section 140.26 Indians BUREAU... Infectious plants. Traders shall not introduce into, sell, or spread within Indian reservations any plant... carrier of any pests of infectious, transmissible, or contagious diseases, as determined by the laws...

  16. Generation of Newcastle diease virus (NDV) recombinants expressing the infectious laryngotracheitis virus (ILTV) glycoprotein gB or gD as dual vaccines

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Infectious laryngotracheitis (ILT) is a highly contagious acute respiratory disease of chickens caused by infection of infectious laryngotracheitis virus (ILTV). The current commercial ILT vaccines are either not safe or less effective. Therefore, there is a pressing need to develop safer and more...

  17. Newcastle disease virus (NDV) recombinants expressing infectious laryngotracheitis virus (ILTV) glycoproteins gB and gD protect chickens against ILTV and NDV challenges

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Infectious laryngotracheitis (ILT) is a highly contagious acute respiratory disease of chickens caused by infectious laryngotracheitis virus (ILTV). The disease is mainly controlled through biosecurity and vaccination with live-attenuated strains of the virus and vectored vaccines based on turkey he...

  18. A gastrointestinal anti-infectious biotherapeutic agent: the heat-treated Lactobacillus LB.

    PubMed

    Liévin-Le Moal, Vanessa

    2016-01-01

    Experimental in vitro and in vivo studies support the hypothesis that heat-treated, lyophilized Lactobacillus acidophilus LB cells and concentrated, neutralized spent culture medium conserve the variety of pharmacological, antimicrobial activities of the live probiotic strain against several infectious agents involved in well-established acute and persistent watery diarrhoea and gastritis. Heat-treated cells and heat-stable secreted molecules trigger multiple strain-specific activities explaining the therapeutic efficacy of L. acidophilus LB. This review discusses the current body of knowledge on the antimicrobial mechanisms of action exerted by L. acidophilus LB demonstrated in in vitro and in vivo experimental studies, and the evidence for the therapeutic efficacy of this anti-infectious biotherapeutic agent proved in randomized clinical trials for the treatment of acute and persistent watery diarrhoea associated with several intestinal infectious diseases in humans. PMID:26770268

  19. A gastrointestinal anti-infectious biotherapeutic agent: the heat-treated Lactobacillus LB

    PubMed Central

    Liévin-Le Moal, Vanessa

    2016-01-01

    Experimental in vitro and in vivo studies support the hypothesis that heat-treated, lyophilized Lactobacillus acidophilus LB cells and concentrated, neutralized spent culture medium conserve the variety of pharmacological, antimicrobial activities of the live probiotic strain against several infectious agents involved in well-established acute and persistent watery diarrhoea and gastritis. Heat-treated cells and heat-stable secreted molecules trigger multiple strain-specific activities explaining the therapeutic efficacy of L. acidophilus LB. This review discusses the current body of knowledge on the antimicrobial mechanisms of action exerted by L. acidophilus LB demonstrated in in vitro and in vivo experimental studies, and the evidence for the therapeutic efficacy of this anti-infectious biotherapeutic agent proved in randomized clinical trials for the treatment of acute and persistent watery diarrhoea associated with several intestinal infectious diseases in humans. PMID:26770268

  20. Dodging a Bullet: WHO, SARS, and the Successful Management of Infectious Disease

    ERIC Educational Resources Information Center

    Michelson, Evan S.

    2005-01-01

    The purpose of this article is to analyze the policy decisions made by the World Health Organization (WHO) in working to fight the spread of the first truly global infectious disease, severe acute respiratory syndrome (SARS), of the 21st century. In particular, the author pays attention to the WHO's Global Outbreak Alert and Response Network…

  1. [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

  2. Biomechanical Analysis of Infectious Biofilms.

    PubMed

    Head, David

    2016-01-01

    The removal of infectious biofilms from tissues or implanted devices and their transmission through fluid transport systems depends in part of the mechanical properties of their polymeric matrix. Linking the various physical and chemical microscopic interactions to macroscopic deformation and failure modes promises to unveil design principles for novel therapeutic strategies targeting biofilm eradication, and provide a predictive capability to accelerate the development of devices, water lines, etc, that minimise microbial dispersal. Here, our current understanding of biofilm mechanics is appraised from the perspective of biophysics , with an emphasis on constitutive modelling that has been highly successful in soft matter. Fitting rheometric data to viscoelastic models has quantified linear and nonlinear stress relaxation mechanisms, how they vary between species and environments, and how candidate chemical treatments alter the mechanical response. The rich interplay between growth, mechanics and hydrodynamics is just becoming amenable to computational modelling and promises to provide unprecedented characterisation of infectious biofilms in their native state. PMID:27193540

  3. [Infectious agents and autoimmune diseases].

    PubMed

    Riebeling-Navarro, C; Madrid-Marina, V; Camarena-Medellín, B E; Peralta-Zaragoza, O; Barrera, R

    1992-01-01

    In this paper the molecular aspects of the relationships between infectious agents and autoimmune diseases, the mechanisms of immune response to infectious agents, and the more recent hypotheses regarding the cause of autoimmune diseases are discussed. The antigens are processed and selected by their immunogenicity, and presented by HLA molecules to the T cell receptor. These events initiate the immune response with the activation and proliferation of T-lymphocytes. Although there are several hypotheses regarding the cause of autoimmune diseases and too many findings against and in favor of them, there is still no conclusive data. All these hypothesis and findings are discussed in the context of the more recent advances. PMID:1615352

  4. [Alzheimer's disease: the infectious hypothesis].

    PubMed

    Roubaud Baudron, Claire; Varon, Christine; Mégraud, Francis; Salles, Nathalie

    2015-12-01

    Several hypotheses are proposed for understanding the Alzheimer's disease (AD) pathological mechanisms, mainly the amyloid theory, but the process inducing Aß peptide deposit, tau protein degeneration, and ultimately neuronal loss, is still to be elucidated. Alteration of the blood-brain barrier and activation of neuroinflammation seem to play an important role in AD neurodegeneration, especially in the decrease of Aß peptide clearance, therefore suggesting a role of infectious agents. Epidemiological and experimental studies on cellular or murine models related to herpes simplex virus (HSV), spirochetes, Chlamydia pneumoniae or Borrelia, and systemic inflammation are reviewed. Aß peptide or tau protein could also behave like a prion protein. Infectious agents could thus have an impact on AD by direct interaction with neurotropism or systemic inflammation. Although the results of these studies are not conclusive, they may contribute to the understanding of AD pathology. PMID:26707559

  5. Post-infectious disease syndrome.

    PubMed Central

    Bannister, B. A.

    1988-01-01

    Many post-infectious syndromes have been recognized in the last 50 years, some following viral infections and others closely related to bacterial disease. The occurrence of prolonged fatigue following an apparent viral illness of varying severity is also well documented. The lack of a recognizable precipitating cause and the tendency for epidemic fatigue to occur among hospital staff led many to believe that the illness may be psychogenic in origin. However, there is serological evidence that some cases may follow enterovirus infections or occasionally delayed convalescence from infectious mononucleosis. Much interesting work is currently in progress relating fatigue to persisting immunological abnormalities, and the development of molecular immunology makes this a most exciting field of research. This paper reviews the evidence for and against a definitive post-viral fatigue syndrome and examines the results of research carried out in the last 50 years. PMID:3074289

  6. Immunological reason for chronic ill health after infectious mononucleosis.

    PubMed Central

    Hamblin, T J; Hussain, J; Akbar, A N; Tang, Y C; Smith, J L; Jones, D B

    1983-01-01

    In a group of patients who suffered from chronic ill health after an attack of acute infectious mononucleosis a disorder of T cell regulation was found. By means of cytochemical reactions the staining pattern associated with T suppressor cells was found in a greater percentage and that associated with T helper cells in a smaller percentage than in normal subjects. In a few patients this finding was confirmed in a functional suppressor assay. The patients were unwell for at least a year but most later made a complete recovery, which was associated with return to normal of the lymphocyte subsets. PMID:6222781

  7. Acute parotitis during induction therapy including L-asparaginase in acute lymphoblastic leukemia.

    PubMed

    Sica, S; Pagano, L; Salutari, P; Di Mario, A; Rutella, S; Leone, G

    1994-02-01

    In a patient affected by acute lymphoblastic leukemia (ALL) and subjected to therapy with Erwinia L-asparaginase, acute parotitis was observed. Microbiological studies excluded any infectious etiology. Regression of parotitis was spontaneous. This complication has not been previously reported and could be due to the same mechanism of pancreatic injury. The occurrence of acute parotitis needs to be promptly recognized in order to avoid the continuation of L-asparaginase. PMID:8148421

  8. Chemoprophylaxis of Tropical Infectious Diseases

    PubMed Central

    McBride, William J. H.

    2010-01-01

    Travelers to tropical countries are at risk for a variety of infectious diseases. In some cases effective vaccinations are available, but for other infections chemoprophylaxis can be offered. Malaria prevention has become increasingly complex as Plasmodium species become resistant to available drugs. In certain high risk settings, antibiotics can be used to prevent leptospirosis, scrub typhus and other infections. Post-exposure prophylaxis is appropriate for selected virulent infections. In this article the evidence for chemoprophylaxis will be reviewed.

  9. Infectious diseases of the newborn.

    PubMed

    Gillam, G L

    1978-11-01

    Despite the advent of antibiotics, infectious diseases remain a significant cause of mortality and morbidity in the neonatal period. Infection is the third commonest cause of perinatal mortality after hypoxia and malformations. Neonatal mortality rates from infection are of the order of 1:1000 live births. Although infections are theoretically preventable, there has been no significant change in incidence over the last 30 years. PMID:743019

  10. Non-infectious orbital vasculitides.

    PubMed

    Perumal, B; Black, E H; Levin, F; Servat, J J

    2012-05-01

    Non-infectious vasculitides comprise a large number of diseases. Many of these diseases can cause inflammation within the orbit and a clinical presentation, which mimics numerous other processes. Orbital disease can often be the initial presentation of a systemic process and early diagnosis can help prevent long-term, potentially fatal consequences. The evaluation and treatment of non-infectious orbital vasculitides are often complicated and require a thorough understanding of the disease and underlying systemic associations. The long-term prognosis visually and systemically must be weighed against the risks and benefits of the treatment regimen. A large variety of corticosteroid formulations currently exist and are the mainstay of initial treatment. Traditional steroid-sparing immunosuppressive agents are also an important arsenal against these vasculitides. Recently, a new class of drugs called biologics, which target the various mediators of the inflammation cascade, may potentially provide more effective and less toxic treatment. This review aims to synthesize the current literature on non-infectious orbital vasculitides. PMID:22361845

  11. Non-infectious orbital vasculitides

    PubMed Central

    Perumal, B; Black, E H; Levin, F; Servat, J J

    2012-01-01

    Non-infectious vasculitides comprise a large number of diseases. Many of these diseases can cause inflammation within the orbit and a clinical presentation, which mimics numerous other processes. Orbital disease can often be the initial presentation of a systemic process and early diagnosis can help prevent long-term, potentially fatal consequences. The evaluation and treatment of non-infectious orbital vasculitides are often complicated and require a thorough understanding of the disease and underlying systemic associations. The long-term prognosis visually and systemically must be weighed against the risks and benefits of the treatment regimen. A large variety of corticosteroid formulations currently exist and are the mainstay of initial treatment. Traditional steroid-sparing immunosuppressive agents are also an important arsenal against these vasculitides. Recently, a new class of drugs called biologics, which target the various mediators of the inflammation cascade, may potentially provide more effective and less toxic treatment. This review aims to synthesize the current literature on non-infectious orbital vasculitides. PMID:22361845

  12. The occurrence of autoantibodies in infectious mononucleosis

    PubMed Central

    Sutton, R. N. P.; Emond, R. T. D.; Thomas, D. B.; Doniach, D.

    1974-01-01

    Autoantibodies were looked for by immunofluorescence (IFL) in seventy-seven cases of infectious mononucleosis (IM) at the onset of symptoms and on recovery, to determine the time of appearance, duration and range of these responses, and to correlate them with serum immunoglobulin and EB virus antibody titres. Antibodies to lymphocyte membrane demonstrated by IFL, now identified with lymphocytotoxins, were present in 46% of patients in the acute stage, persisting for less than 7 weeks. Antibodies to smooth muscle (SMA) or to contractile fibres in other tissue cells including human thyroid and rat hepatocytes, were present in over 70% of cases, some being entirely of IgM class. The highest titres occurred soon after onset and these antibodies also disappeared during convalescence. By contrast ANA, mitochondrial, microsomal and reticulin antibodies, also thyroid and gastric organ-specific reactivity were seen only occasionally owing to the young age group of the patients. In individual cases there was no correlation between the appearance of lymphocyte antibodies and SMA, or between these and the EB virus antibody titres. The autoantibodies produced in this disease are highly selected. It is suggested that clones of B cells are stimulated to make these antibodies by virtue of being infected with EB virus, and that the T-cell clones in the circulation are more likely expanded in order to terminate the infection. PMID:4619789

  13. Infectious Entry Pathway of Enterovirus B Species

    PubMed Central

    Marjomäki, Varpu; Turkki, Paula; Huttunen, Moona

    2015-01-01

    Enterovirus B species (EV-B) are responsible for a vast number of mild and serious acute infections. They are also suspected of remaining in the body, where they cause persistent infections contributing to chronic diseases such as type I diabetes. Recent studies of the infectious entry pathway of these viruses revealed remarkable similarities, including non-clathrin entry of large endosomes originating from the plasma membrane invaginations. Many cellular factors regulating the efficient entry have recently been associated with macropinocytic uptake, such as Rac1, serine/threonine p21-activated kinase (Pak1), actin, Na/H exchanger, phospholipace C (PLC) and protein kinase Cα (PKCα). Another characteristic feature is the entry of these viruses to neutral endosomes, independence of endosomal acidification and low association with acidic lysosomes. The biogenesis of neutral multivesicular bodies is crucial for their infection, at least for echovirus 1 (E1) and coxsackievirus A9 (CVA9). These pathways are triggered by the virus binding to their receptors on the plasma membrane, and they are not efficiently recycled like other cellular pathways used by circulating receptors. Therefore, the best “markers” of these pathways may be the viruses and often their receptors. A deeper understanding of this pathway and associated endosomes is crucial in elucidating the mechanisms of enterovirus uncoating and genome release from the endosomes to start efficient replication. PMID:26690201

  14. Global trends in emerging infectious diseases.

    PubMed

    Jones, Kate E; Patel, Nikkita G; Levy, Marc A; Storeygard, Adam; Balk, Deborah; Gittleman, John L; Daszak, Peter

    2008-02-21

    Emerging infectious diseases (EIDs) are a significant burden on global economies and public health. Their emergence is thought to be driven largely by socio-economic, environmental and ecological factors, but no comparative study has explicitly analysed these linkages to understand global temporal and spatial patterns of EIDs. Here we analyse a database of 335 EID 'events' (origins of EIDs) between 1940 and 2004, and demonstrate non-random global patterns. EID events have risen significantly over time after controlling for reporting bias, with their peak incidence (in the 1980s) concomitant with the HIV pandemic. EID events are dominated by zoonoses (60.3% of EIDs): the majority of these (71.8%) originate in wildlife (for example, severe acute respiratory virus, Ebola virus), and are increasing significantly over time. We find that 54.3% of EID events are caused by bacteria or rickettsia, reflecting a large number of drug-resistant microbes in our database. Our results confirm that EID origins are significantly correlated with socio-economic, environmental and ecological factors, and provide a basis for identifying regions where new EIDs are most likely to originate (emerging disease 'hotspots'). They also reveal a substantial risk of wildlife zoonotic and vector-borne EIDs originating at lower latitudes where reporting effort is low. We conclude that global resources to counter disease emergence are poorly allocated, with the majority of the scientific and surveillance effort focused on countries from where the next important EID is least likely to originate. PMID:18288193

  15. The global burden of major infectious complications following prostate biopsy.

    PubMed

    Bennett, H Y; Roberts, M J; Doi, S A R; Gardiner, R A

    2016-06-01

    We present a systematic review providing estimates of the overall and regional burden of infectious complications following prostate biopsy. A directly standardized prevalence estimate was used because it reflects the burden of disease more explicitly. Complications included sepsis, hospitalization, bacteraemia, bacteriuria, and acute urinary retention after biopsy. There were 165 articles, comprising 162 577 patients, included in the final analysis. Our findings demonstrate that transrectal biopsy was associated with a higher burden of hospitalization (1·1% vs. 0·9%) and sepsis (0·8% vs. 0·1%) compared to transperineal biopsy, while acute urinary retention was more prevalent after transperineal than transrectal biopsy (4·2% vs. 0·9%). The differences were statistically non-significant because of large heterogeneity across countries. We also demonstrate and discuss regional variations in complication rates, with Asian studies reporting higher rates of sepsis and hospitalization. PMID:26645476

  16. CKD and Infectious Diseases in Asia Pacific: Challenges and Opportunities.

    PubMed

    Jha, Vivekanand; Prasad, Narayan

    2016-07-01

    The exact number of patients with chronic kidney disease (CKD) in Asia Pacific is uncertain. In numeric terms, the region is home to the largest population of patients with untreated chronic kidney failure. The climatic, geographic, social, cultural, economic, and environmental diversity within this region is higher than in any other part of the world. Large parts of the region face a climate-related burden of infectious diseases. Infections contribute to the development and progression of CKD and complicate the course of patients with pre-existing CKD (especially those on dialysis therapy or who are immunosuppressed), increase the cost of CKD care, and contribute to mortality and morbidity. Kidney involvement is a feature of several infectious diseases prevalent in Asia Pacific. Examples include malaria, leptospirosis, scrub typhus, tuberculosis, hepatitis B and C virus, dengue hemorrhagic fever, and Hantaan virus infections. The contribution of infection-associated acute kidney injury to the overall burden of CKD has not been evaluated systematically. Research is needed to quantify the impact of infections on kidney health by undertaking prospective studies. Nephrologists need to work with infectious disease research groups and government infection surveillance and control programs. PMID:26943982

  17. Feedlot Acute Interstitial Pneumonia.

    PubMed

    Woolums, Amelia R

    2015-11-01

    Acute interstitial pneumonia (AIP) of feedlot cattle is a sporadically occurring respiratory condition that is often fatal. Affected cattle have a sudden onset of labored breathing. There is no confirmed effective treatment of feedlot AIP; however, administration of antibiotics effective against common bacterial respiratory pathogens and nonsteroidal anti-inflammatory drugs, especially aspirin, has been recommended. Protective strategies are not well defined, but efforts to limit dust exposure and heat stress; to ensure consistent formulation, mixing, and delivery of feed; and to identify and treat infectious respiratory disease in a timely manner may decrease rates of feedlot AIP. PMID:26253266

  18. Infectious and coronary artery disease

    PubMed Central

    Rezaee-Zavareh, Mohammad Saeid; Tohidi, Mohammad; Sabouri, Amin; Ramezani-Binabaj, Mahdi; Sadeghi-Ghahrodi, Mohsen; Einollahi, Behzad

    2016-01-01

    BACKGROUND Atherosclerotic event is one of the most causes of death in the world. Coronary artery disease (CAD) is one manifestation of atherosclerosis. It is well-known that several risk factors, such as diabetes mellitus (DM), smoking, hypertension (HTN), have effects on it. It is proposed that infection can lead to atherosclerosis or even make its process faster. Here, we discuss about the effect of some of infectious agents on the atherosclerosis and CAD. METHODS In this study, first we did a comprehensive search in PubMed, Scopus, and Science Direct using some related keywords such as atherosclerosis, CAD, myocardial infarction (MI), infection, and name of viruses and bacteria. After finding the related papers, we reviewed the correlation between some microbial agents and risk of CAD. RESULTS Literature has reported several infectious agents (viruses, bacteria, and parasites) that can be associated with risk of CAD. This association for some of them like Helicobacter pylori (H. pylori), Chlamydia pneumonia (C. pneumoniae), and Cytomegalovirus (CMV) is a very strong. On the other hand, there are some other agents like influenza that still need to be more investigated through original studies. Furthermore, different mechanisms (general and special) have been reported for the association of each agent with CAD. CONCLUSION Based on the studies in databases and our literature review, it is so clear that some microbes and infectious agents can be involved in the process of atherosclerosis. Therefore, controlling each type of infections especially among people with a traditional risk factor for atherosclerosis should be taken into account for reducing the risk of CAD and atherosclerosis. PMID:27114736

  19. Host Genomics in Infectious Diseases

    PubMed Central

    2013-01-01

    Understanding mechanisms by which genetic variants predispose to complications of infectious diseases can lead to important benefits including the development of biomarkers to prioritize vaccination or prophylactic therapy. Family studies, candidate genes in animal models, and the absence of well-defined risks where the complications are rare all can point to genetic predisposition. The most common approach to assessing genetic risk is to conduct an association study, which is a case control study using either a candidate gene approach or a genome wide approach. Although candidate gene variants may focus on potentially causal variants, because other variants across the genome are not tested these studies frequently cannot be replicated. Genome wide association studies need a sizable sample and usually do not identify causal variants but variants which may be in linkage disequilibrium to the actual causal variant. There are many pitfalls that can lead to bias in such studies, including misclassification of cases and controls, use of improper phenotypes, and genotyping errors. These studies have been limited to common genes and rare variants may not be detected. As the use of next generation sequencing becomes more common, it can be anticipated that more variants will be confirmed. The purpose of this review article is to address the issue of genomics in infectious diseases with an emphasis on the host. Although there are a plentitude of studies that focus on the molecular characteristics of pathogens, there are far fewer studies that address the role of human genetics in the predisposition to infection or more commonly its complications. This paper will review both the approaches used to study host genetics in humans and the pitfalls associated with some of these methods. The focus will be on human disease and therefore discussion of the use of animal models will be limited to those where there are genes that have been replicated in humans. The paper will focus on

  20. Infectious Morbidity After Radical Vulvectomy

    PubMed Central

    Carson, Linda F.; Brooker, Doris C.; Carter, Jonathan R.; Twiggs, Leo B.

    1994-01-01

    Objective: This retrospective investigation describes the infectious morbidity of patients following radical vulvectomy with or without inguinal lymph node dissection. Methods: The charts of patients undergoing radical vulvectomy between January 1, 1986, and September 1, 1989, were reviewed for age, weight, cancer type, tumor stage, operative procedure(s), prophylactic antibiotic and its length of use, febrile morbidity, infection site, culture results, significant medical history, and length of use and number of drains or catheters used. Results: The study group was composed of 61 patients, 14 of whom underwent a radical vulvectomy and 47 who also had inguinal lymph node dissection performed. Twenty-nine patients (48%) had at least 1 postoperative infection. Five patients (8%) had 2 or more postoperative infections. The site and incidence of the infections were as follows: urinary tract 23%, wound 23%, lymphocyst 3%, lymphatics (lymphangitis) 5%, and bowel (pseudomembranous colitis) 3%. The most common pathogens isolated from both urine and wound sites were Pseudomonas aeruginosa, enterococcus, and Escherichia coli. A significant decrease in wound infection was demonstrated when separate incisions were made for inguinal lymph node dissection (P <0.05). The mean number of days to onset of postoperative infection for wound, urine, lymphatics, lymphocyst, and bowel were 11, 8, 57, 48, and 5, respectively. Conclusions: We conclude that the clinical appearance of post-radical vulvectomy infections is delayed when compared with other post-surgical wound infections. Second, utilizing separate inguinal surgical incisions may reduce infectious morbidity. Finally, tumor stage and type do not necessarily increase the infectious morbidity of radical vulvar surgery. PMID:18475379

  1. Microbial signatures in post-infectious irritable bowel syndrome – toward patient stratification for improved diagnostics and treatment

    PubMed Central

    Jalanka, Jonna; Salonen, Anne; Fuentes, Susana; de Vos, Willem M

    2015-01-01

    Irritable bowel syndrome (IBS) is a multifactorial and heterogeneous disorder estimated to affect over 10% of the Western population. A subset of the patients reports the start of the disease after an episode of gastroenteritis. The alterations in the intestinal microbiota of the post-infectious IBS (PI-IBS) patients were recently investigated in a British cohort and shown to differentiate from the healthy controls and resemble that of diarrhea-predominant IBS (IBS-D) patients. The altered 27 genus-like groups created a microbial signature, which could be used to objectively stratify patients and healthy controls. In this addendum, we combine the microbiota data derived from the British cohort with that of a recently reported Swedish PI-IBS cohort. Remarkably, robust and reproducible microbiota signatures were observed in these PI-IBS patients. We discuss these results with attention on the emerging role of microbiota in the classification, development and treatment of PI-IBS. PMID:26512631

  2. [Update in Infectious Diseases 2015].

    PubMed

    Candel, Francisco Javier; López González, Laura; García-García, Ana Belén; Chiarella, Flavia; Picazo, Juan José

    2015-09-01

    Infectious disease remains current worldwide. During the second half of 2014 an outbreak of ebolavirus hit West Africa with implications in the rest of the world. In fact, Spain declared the first imported case of this infection. Multiresistant enterobacteria outbreaks are emerging all around the world in a moment on which WHO draws attention to the limited resources, coining the term "post antibiotic era". On the other hand, 2014 went down in history as one in which hepatitis C is cured. Are also current HIV epidemiological control or strategies for antiviral and antifungal prophylaxis in immunocompromised hosts. PMID:26365724

  3. Emerging infectious diseases in Mongolia.

    PubMed

    Ebright, John R; Altantsetseg, Togoo; Oyungerel, Ravdan

    2003-12-01

    Since 1990, Mongolia's health system has been in transition. Impressive gains have been accomplished through a national immunization program, which was instituted in 1991. Nevertheless, the country continues to confront four major chronic infections: hepatitis B and C, brucellosis, tuberculosis, and sexually transmitted diseases (STDs). As of 2001, only two cases of HIV infections had been detected in Mongolia, but concern grows that the rate will increase along with the rising rates of STDs and increase in tourism. Other infectious diseases of importance in Mongolia include echinococcosis, plague, tularemia, anthrax, foot-and-mouth, and rabies. PMID:14720388

  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. Pediatric in-Hospital Death from Infectious Disease in Uganda: Derivation of Clinical Prediction Models

    PubMed Central

    Lowlaavar, Nasim; Larson, Charles P.; Kumbakumba, Elias; Zhou, Guohai; Ansermino, J. Mark; Singer, Joel; Kissoon, Niranjan; Wong, Hubert; Ndamira, Andrew; Kabakyenga, Jerome; Kiwanuka, Julius; Wiens, Matthew O.

    2016-01-01

    Background Pediatric hospital mortality from infectious diseases in resource constrained countries remains unacceptably high. Improved methods of risk-stratification can assist in referral decision making and resource allocation. The purpose of this study was to create prediction models for in-hospital mortality among children admitted with suspected infectious diseases. Methods This two-site prospective observational study enrolled children between 6 months and 5 years admitted with a proven or suspected infection. Baseline clinical and laboratory variables were collected on enrolled children. The primary outcome was death during admission. Stepwise logistic regression minimizing Akaike’s information criterion was used to identify the most promising multivariate models. The final model was chosen based on parsimony. Results 1307 children were enrolled consecutively, and 65 (5%) of whom died during their admission. Malaria, pneumonia and gastroenteritis were diagnosed in 50%, 31% and 8% of children, respectively. The primary model included an abnormal Blantyre coma scale, HIV and weight-for-age z-score. This model had an area under the curve (AUC) of 0.85 (95% CI, 0.80–0.89) with a sensitivity and specificity of 83% and 76%, respectively. The positive and negative predictive values were 15% and 99%, respectively. Two alternate models with similar performance characteristics were developed withholding HIV and weight-for-age z-score, for use when these variables are not available. Conclusions Risk stratification of children admitted with infectious diseases can be calculated based on several easily measured variables. Risk stratification at admission can be used for allocation of scarce human and physical resources and to guide referral among children admitted to lower level health facilities. PMID:26963914

  6. A Case Report of Acute Acalculous Cholecystitis and Acute Hemorrhagic Cystitis due to Salmonella Typhi

    PubMed Central

    Beyazal Polat, Hatice; Beyazal Çeliker, Fatma

    2014-01-01

    Acute acalculous cholecystitis and acute hemorrhagic cystitis due to Salmonella Typhi are a rare condition. A 24-year-old female patient was admitted to our clinic with abdominal pain, nausea, fever, headache, urinary burning, and bloody urine. Based on clinical, laboratory, and radiological evaluations, the patient was diagnosed with acute acalculous cholecystitis and acute hemorrhagic cystitis due to Salmonella Typhi. The patient was treated with intravenous ceftriaxone for two weeks. After the treatment, the patient's clinical and laboratory findings improved. Acute acalculous cholecystitis due to Salmonella Typhi concomitant with acute hemorrhagic cystitis is very rare and might be difficult to diagnose. Infectious agents such as Salmonella Typhi should be considered when acute acalculous cholecystitis and acute hemorrhagic cystitis are detected in adult patients with no underlying diseases. PMID:25161668

  7. Campylobacter fetus subsp. jejuni as a cause of gastroenteritis in Jakarta, Indonesia.

    PubMed Central

    Ringertz, S; Rockhill, R C; Ringertz, O; Sutomo, A

    1980-01-01

    Campylobacter fetus subsp. jejuni was isolated from the feces of 15 out of 144 (10%) children (0 to 9 years old) and 4 out of 251 (2%) adults with gastroenteritis and was found together with another enteric pathogen in 2 of the children and in all 4 adults. It was isolated from 2 out of 7 (28%) children and 3 out of 160 (2%) adults with suspected typhoid fever. The bacterium was recovered from 3 out of 4 orphanage children with diarrhea and from 1 without symptoms and was isolated from only 1 child in a control group of 221 persons. PMID:7419706

  8. Hemorrhagic gastroenteritis caused by Escherichia coli in piglets: Clinical, pathological and microbiological findings

    PubMed Central

    Faubert, Claude; Drolet, Richard

    1992-01-01

    A retrospective study (1980-1989) was conducted to describe the clinical, pathological, and bacteriological findings in 55 cases of hemorrhagic gastroenteritis (HGE) caused by Escherichia coli in piglets. The condition occurred in weaned and suckling piglets and was associated with several serogroups of E. coli. Most of the isolates of E. coli possessed the adhesin F4 (K88) and were hemolytic. Only a few of the isolates of E. coli tested produced verotoxins. Clinical signs and pathological findings noted in these cases were compatible with shock. ImagesFigure 1.Figure 2. PMID:17423984

  9. Genome of infectious bronchitis virus.

    PubMed Central

    Lomniczi, B; Kennedy, I

    1977-01-01

    Techniques are described for the growth and rapid purification of the avian coronavirus infectious bronchitis virus (IBV). Purified IBV has a sedimentation coefficient of 320S and a buoyant density of 1.22 g/ml in sucrose-deuterium oxide equilibrium gradients. IBV RNA extracted by proteinase K in the presence of sodium dodecyl sulfate and further purified by phenol extraction and gradient centrifugation is single stranded and has a sedimentation coefficient of 64S, as determined by isokinetic gradient centrifugation. Analysis on sucrose gradients under both aqueous and denaturing conditions together with agarose gel electrophoresis in the presence of the chaotropic agent methylmercuric hydroxide gave a value of 8 X 10(6) for the moleclar weight of IBV RNA. This value was confirmed by RNase T1 fingerprinting, which also indicated that IBV RNA is haploid. No evidence was found of subunit structure in IBV RNA. From these results together with the recently reported observation that IBV RNA is infectious and contains a tract of polyadenylic acid (Lomniczi, J. Gen. Virol., in press), we conclude that the genome of the coronaviruses is a single continuous chain of about 23,000 mononucleotides that is of messenger polarity. Images PMID:198590

  10. Infectious Considerations in Space Flight

    NASA Technical Reports Server (NTRS)

    Haddon, Robert

    2009-01-01

    Slightly more than 500 people have flown in space, most of them for short periods of time. The total number of person years in space is small. Given this fact, and given rigorous astronaut screening, it is not surprising that the accumulated infectious disease experience in space is also small, and mostly, theoretical. As the human space presence expands, we may expect mission length, total accumulated person years and the environmental complexity to increase. Add to the mix both changes in human immunity and microbial virulence, and it becomes realistic to consider infectious scenarios and the means to mitigate them. This lecture will cover the inhabited space environment from the perspective of host-microbe interactions, current relevant research, and the current countermeasures used. Future challenges will be discussed and there will be opportunity to ask questions about Space Operations. The audience is encouraged to think about what medical tools you would choose to have in different types of mission, what you would be willing to leave behind, and how you would compensate for the necessary trade offs in mission design.

  11. Interleukin-12 in infectious diseases.

    PubMed Central

    Romani, L; Puccetti, P; Bistoni, F

    1997-01-01

    Interleukin-12 (IL-12) is a potent immunoregulatory cytokine that is crucially involved in a wide range of infectious diseases. In several experimental models of bacterial, parasitic, viral, and fungal infection, endogenous IL-12 is required for early control of infection and for generation and perhaps maintenance of acquired protective immunity, directed by T helper type 1 (Th1) cells and mediated by phagocytes. Although the relative roles of IL-12 and gamma interferon in Th1-cell priming may be to a significant extent pathogen dependent, common to most infections is that IL-12 regulates the magnitude of the gamma interferon response at the initiation of infection, thus potentiating natural resistance, favoring Th1-cell development; and inhibiting Th2 responses. Treatment of animals with IL-12, either alone or as a vaccine adjuvant, has been shown to prevent disease by many of the same infectious agents, by stimulating innate resistance or promoting specific reactivity. Although IL-12 may enhance protective memory responses in vaccination or in combination with antimicrobial chemotherapy, it is yet unclear whether exogenous IL-12 can alter established responses in humans. Continued investigation into the possible application of IL-12 therapy to human infections is warranted by the role of the cytokine in inflammation, immunopathology, and autoimmunity. PMID:9336665

  12. Infectious Risks of Traveling Abroad.

    PubMed

    Chen, Lin H; Blair, Barbra M

    2015-08-01

    A popular leisure activity, international travel can be associated with some infections. The most common travel-related illnesses appear to be gastrointestinal, dermatologic, respiratory, and systemic febrile syndromes. The pretravel medical consultation includes immunizations, malaria chemoprophylaxis, self-treatment for traveler's diarrhea, and advice on the prevention of a myriad of other infectious causes including dengue, chikungunya, rickettsiosis, leptospirosis, schistosomiasis, and strongyloidiasis. Travel to locations experiencing outbreaks such as Ebola virus disease, Middle East respiratory syndrome, avian influenza, and chikungunya call for specific alerts on preventive strategies. After travel, evaluation of an ill traveler must explore details of exposure, including destinations visited; activities; ingestion of contaminated food or drinks; contact with vectors, animals, fresh water, or blood and body fluids; and other potential exposures. Knowledge of the geographic distribution of infectious diseases is important in generating the differential diagnoses and testing accordingly. Empiric treatment is sometimes necessary when suspicion of a certain diagnosis is strong and confirmatory tests are delayed or lacking, particularly for infections that are rapidly progressive (for example, malaria) or for which timing of testing is prolonged (such as leptospirosis). PMID:26350325

  13. Primary care-based surveillance to estimate the burden of rotavirus gastroenteritis among children aged less than 5 years in six European countries.

    PubMed

    Diez-Domingo, Javier; Baldo, Jose-Maria; Patrzalek, Marian; Pazdiora, Petr; Forster, Johannes; Cantarutti, Luigi; Pirçon, Jean-Yves; Soriano-Gabarró, Montse; Meyer, Nadia

    2011-02-01

    This observational, prospective study was undertaken to estimate the burden of rotavirus (RV) gastroenteritis (GE) leading to general practitioner (GP)/family paediatrician (FP) visits among children aged <5 years in Czech Republic, Germany, Italy, Poland, Spain and the UK. Children aged <5 years presenting with acute GE provided stool samples for rapid RV testing. RV+ samples were confirmed and typed by RT-PCR. Demographic and clinical data were collected for all RVGE episodes. Transmission patterns among other household children aged <5 years were also assessed. From November 2005 to May 2007, excluding data from the UK, 497/3,813 (13.0%) children aged <5 years presenting with acute GE to GP/FP and tested were RV+ by PCR. Most RVGE cases (69.1%) occurred in children aged <2 years, occurred between December and May (93.1%) and were moderate or severe by Vesikari score (92.9%). RV strain distribution varied between countries: G9P[8] was the most common type in Poland (54/76) and Spain (172/196), G1P[8] was predominant in the Czech Republic (56/64) and Italy (46/107), and G4P[8] and G1P[8] both prevailed in Germany (17/54 and 13/54, respectively). A total of 24/122 (19.7%) children aged <5 years resident in the same household as a PCR+ study participant also developed RVGE. Conclusion. This multinational epidemiological study in Europe shows that RV is easily transmitted among household children, with RVGE burden highest among children aged <2 years accessing primary healthcare for acute GE. PMID:20842379

  14. Acute Bronchitis

    MedlinePlus

    ... or though physical contact (for example, on unwashed hands). Being exposed to tobacco smoke, air pollution, dusts, vapors, and fumes can also cause acute bronchitis. Less often, bacteria can also cause acute bronchitis. To diagnose acute ...

  15. Cystitis - acute

    MedlinePlus

    Uncomplicated urinary tract infection; UTI - acute; Acute bladder infection; Acute bacterial cystitis ... control. Menopause also increases the risk for a urinary tract infection. The following also increase your chances of having ...

  16. Ocular manifestations of infectious skin diseases.

    PubMed

    Sadowska-Przytocka, Anna; Czarnecka-Operacz, Magdalena; Jenerowicz, Dorota; Grzybowski, Andrzej

    2016-01-01

    Ocular complications of infectious skin diseases are a common occurrence. Managing the inflamed or infected eye in the emergency setting presents a diagnostic and therapeutic challenge to the emergency physician. Infectious agents may affect any part of the eye. Ocular findings may be the first sign of many infectious diseases, such as, for example, gonorrhea or chlamydia infection. Understanding the various forms of ocular involvement in these conditions is important, because untreated ophthalmic involvement can lead to severe vision loss. This review focuses on the significant ocular manifestations of the most common infectious diseases, including bacterial, viral, fungal, and parasitic infections, that both ophthalmologists and dermatologists may encounter. PMID:26903179

  17. [Infectious diseases and population assistance: general issues].

    PubMed

    Russo, G; Riccardo, F; Scaroni, E; Nardi, L; De Rosa, A G; Pacini, A; Pacifici, L E

    2007-01-01

    Actually the infectious diseases are a predominant cause of morbidity and mortality in limited resource countries and, of course, not unimportant in industrialized countries where the social phenomena of immigration and increased internal and international mobility of people may facilitate the reemergence of infectious diseases considered overcome. It is becoming more and more important to consider the actual role of assistance of people for infectious diseases: a careful consideration needing of concretes example for becoming medical practices and social languages appropriates to the local context and useful for promoting more efficacious cares and prevention of infectious diseases. PMID:17598991

  18. Infectious waste management and laboratory design criteria.

    PubMed

    Zaki, A N; Campbell, J R

    1997-11-01

    Infectious waste management and laboratory design criteria are provided to help in recognizing what information needs to be included in an individual program and to develop an infectious waste management plan. Relevant engineering aspects of a containment laboratory are described in detail, and suggested equipment and operating procedures for collection, sterilization, and disposal of solid and liquid waste are discussed. The need for public awareness regarding infectious waste is discussed, including liability considerations associated with improper disposal. This study shows how proper management of infectious waste results in lower disposal cost, lower operating costs, reduction in liabilities, increased worker safety, and a cleaner environment. PMID:9373926

  19. A Systematic Review of Methodology: Time Series Regression Analysis for Environmental Factors and Infectious Diseases

    PubMed Central

    Imai, Chisato; Hashizume, Masahiro

    2015-01-01

    Background: Time series analysis is suitable for investigations of relatively direct and short-term effects of exposures on outcomes. In environmental epidemiology studies, this method has been one of the standard approaches to assess impacts of environmental factors on acute non-infectious diseases (e.g. cardiovascular deaths), with conventionally generalized linear or additive models (GLM and GAM). However, the same analysis practices are often observed with infectious diseases despite of the substantial differences from non-infectious diseases that may result in analytical challenges. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, systematic review was conducted to elucidate important issues in assessing the associations between environmental factors and infectious diseases using time series analysis with GLM and GAM. Published studies on the associations between weather factors and malaria, cholera, dengue, and influenza were targeted. Findings: Our review raised issues regarding the estimation of susceptible population and exposure lag times, the adequacy of seasonal adjustments, the presence of strong autocorrelations, and the lack of a smaller observation time unit of outcomes (i.e. daily data). These concerns may be attributable to features specific to infectious diseases, such as transmission among individuals and complicated causal mechanisms. Conclusion: The consequence of not taking adequate measures to address these issues is distortion of the appropriate risk quantifications of exposures factors. Future studies should pay careful attention to details and examine alternative models or methods that improve studies using time series regression analysis for environmental determinants of infectious diseases. PMID:25859149

  20. 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

  1. Water and non-water-related risk factors for gastroenteritis among bathers exposed to sewage-contaminated marine waters.

    PubMed

    Fleisher, J M; Jones, F; Kay, D; Stanwell-Smith, R; Wyer, M; Morano, R

    1993-08-01

    All previously published epidemiological studies of the health effects of bathing in marine waters contaminated with domestic sewage contain three major methodological weaknesses in study design: (1) failure to control for the substantial amount of temporal and spatial variation in indicator organism densities shown to occur within just a few hours at marine water bathing locations; (2) failure to relate indicator organism density directly to the individual bather; and (3) failure to rigorously control for non-water-related risk factors on previously reported associations between bathing in marine waters and illness among such bathers. We report the results of two intervention follow-up studies specifically designed to address these methodological weaknesses. We restricted study outcome to bathing-associated gastroenteritis since this is the illness most consistently reported to be associated with bathing in marine waters, and upon which both current US Marine Water Quality Criteria and other standards used worldwide are based. Our results show that faecal streptococci was the only indicator organism to predict the occurrence of gastroenteritis among bathers, and this occurred at only one of the three water quality sampling depths used in our study. The consumption of three different foods known or suspected to act as vectors in the transmission of gastroenteritis, as well as one non-food, non-water-related risk factor for gastroenteritis were found to significantly increase the risk of gastroenteritis among bathers. Multiple logistic regression modelling showed that these non-water-related risk factors confounded the relationship between exposure to marine waters of varying faecal streptococci densities and the occurrence of gastroenteritis among bathers to a moderate degree. Moreover, these analyses showed that the risk of gastroenteritis to the individual bather caused by these non-water-related risk factors, approximated the risk of gastroenteritis among

  2. Incidence, Risk Factors, and Outcome of Cytomegalovirus Viremia and Gastroenteritis in Patients with Gastrointestinal Graft-versus-Host Disease

    PubMed Central

    Bhutani, Divaya; Dyson, Gregory; Manasa, Richard; Deol, Abhinav; Ratanatharathorn, Voravit; Ayash, Lois; Abidi, Muneer; Lum, Lawrence G.; Al-Kadhimi, Zaid; Uberti, Joseph P.

    2014-01-01

    Gastrointestinal (GI) graft-versus-host disease (GVHD) is 1 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 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 overall survival of the 252 patients was 35.4 (range, 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

  3. Non-infectious complications of transfusion therapy.

    PubMed

    Perrotta, P L; Snyder, E L

    2001-06-01

    Blood transfusion is considered safe when the infused blood is tested using state of the art viral assays developed over the past several decades. Only rarely are known viruses like HIV and hepatitis C transmitted by transfusion when blood donors are screened using these sensitive laboratory tests. However, there are a variety of transfusion risks which still remain that cannot be entirely eliminated, many of which are non-infectious in nature. Predominantly immune-mediated complications include the rapid intravascular or slow extravascular destruction (hemolysis) of transfused red cells or extravascular removal of platelets by pre-formed antibodies carried by the transfusion recipient. Alternatively, red cells can be damaged when exposed to excessive heat or incompatible intravenous fluids before or during the transfusion. Common complications of blood transfusion that at least partly involve the immune system include febrile non-hemolytic and allergic reactions. While these are usually not life-threatening, they can hamper efforts to transfuse a patient. Other complications include circulatory overload, hypothermia and metabolic disturbances. Profound hypotensive episodes have been described in patients on angiotensin-converting enzyme (ACE) inhibitors who receive platelet transfusions through bedside leukoreduction filters. These curious reactions appear to involve dysmetabolism of the vasoactive substance bradykinin. Products contaminated by bacteria during blood collection and transfused can cause life-threatening septic reactions. A long-term complication of blood transfusion therapy unique to chronically transfused patients is iron overload. Less common - but serious - reactions more specific to blood transfusion include transfusion-associated graft-versus-host disease and transfusion-associated acute lung injury. Many of these complications of transfusion therapy can be prevented by adhering to well-established practice guidelines. In addition, individuals

  4. Thermal inactivation of infectious hematopoietic necrosis and infectious pancreatic necrosis virus

    USGS Publications Warehouse

    Gosting, L.; Gould, R.W.

    1981-01-01

    A plaque assay was used to follow the inactivation kinetics of infectious hematopoietic necrosis virus and infectious pancreatic necrosis virus in cell culture media at various temperatures. Inactivation of infectious hematopoietic necrosis virus in a visceral organ slurry was compared with that in culture media.

  5. Epidemics of GI.2 sapovirus in gastroenteritis outbreaks during 2012-2013 in Osaka City, Japan.

    PubMed

    Iritani, Nobuhiro; Yamamoto, Seiji P; Abe, Niichiro; Kubo, Hideyuki; Oka, Tomoichiro; Kaida, Atsushi

    2016-07-01

    Sapovirus (SaV) is a causative agent of gastroenteritis in humans in both sporadic cases and outbreaks. During the period from January 2005 to August 2014, SaV was detected in 30 (5.9%) of 510 gastroenteritis outbreaks in Osaka City, Japan using real-time RT-PCR. Seasonal distribution of SaV-associated outbreaks revealed an increase during the 2011-2012 season and the highest frequency of outbreaks during the 2012-2013 season. Genotyping analysis based on the capsid region demonstrated that the most common genotype was GI.2 (36.7%), in which the strains were closely related. The comparison of complete capsid gene sequences with 18 GI.2 strains (7 strains in this study and 11 from GenBank) between 1990 and 2013 showed that GI.2 strains were classified into at least three genetic clusters (1990-2000, 2004-2007, and 2008-2013) with chronologically unique amino acid residues and accumulation of mutations in the predicted P domain, suggesting the one of the causes of emergence and spread of GI.2 strains. This study will also be helpful for understanding the evolutionary mechanism of the SaV genome. PMID:26684081

  6. Molecular characterization of a new species in the genus Alphacoronavirus associated with mink epizootic catarrhal gastroenteritis

    PubMed Central

    Vlasova, Anastasia N.; Halpin, Rebecca; Wang, Shiliang; Ghedin, Elodie; Spiro, David J.

    2011-01-01

    A coronavirus (CoV) previously shown to be associated with catarrhal gastroenteritis in mink (Mustela vison) was identified by electron microscopy in mink faeces from two fur farms in Wisconsin and Minnesota in 1998. A pan-coronavirus and a genus-specific RT-PCR assay were used initially to demonstrate that the newly discovered mink CoVs (MCoVs) were members of the genus Alphacoronavirus. Subsequently, using a random RT-PCR approach, full-genomic sequences were generated that further confirmed that, phylogenetically, the MCoVs belonged to the genus Alphacoronavirus, with closest relatedness to the recently identified but only partially sequenced (fragments of the polymerase, and full-length spike, 3c, envelope, nucleoprotein, membrane, 3x and 7b genes) ferret enteric coronavirus (FRECV) and ferret systemic coronavirus (FRSCV). The molecular data presented in this study provide the first genetic evidence for a new coronavirus associated with epizootic catarrhal gastroenteritis outbreaks in mink and demonstrate that MCoVs possess high genomic variability and relatively low overall nucleotide sequence identities (91.7 %) between contemporary strains. Additionally, the new MCoVs appeared to be phylogenetically distant from human (229E and NL63) and other alphacoronaviruses and did not belong to the species Alphacoronavirus 1. It is proposed that, together with the partially sequenced FRECV and FRSCV, they comprise a new species within the genus Alphacoronavirus. PMID:21346029

  7. Molecular Epidemiology of Norovirus in Outbreaks of Gastroenteritis in Southwest Germany from 2001 to 2004

    PubMed Central

    Ike, Anthony C.; Brockmann, Stefan O.; Hartelt, Kathrin; Marschang, Rachel E.; Contzen, Matthias; Oehme, Rainer M.

    2006-01-01

    The identification and molecular epidemiology of norovirus in outbreaks of gastroenteritis were studied during a 3-year period in Germany. Specimens (n = 316) from 159 nonbacterial gastroenteritis outbreaks from March 2001 to June 2004 were analyzed for the presence of noroviruses by reverse transcriptase PCR. Outbreaks were most frequent in elderly people's homes and care centers (43%), followed by hospitals (24%). Molecular analyses of strains from 148 outbreaks showed that there were up to 12 genotypes involved in the outbreaks. Genogroup II noroviruses were responsible for 95% of the outbreaks. Cocirculation of more than one strain in the same outbreak and cocirculation of genogroup I and II strains in the same place were observed. Genogroup II4 (Grimsby-like) was the most prevalent strain, accounting for 48% and 67% of the outbreaks in 2002 and 2003, respectively. The genogroup IIb (Castell/Suria) genotype was observed in all the years of the study. Epidemiological and molecular data indicated that there was a major shift of the predominant strain that coincided with the appearance of a new variant of genogroup II4 in 2002. By the application of reverse transcriptase PCR, this study has demonstrated the importance and dynamism of noroviruses in Germany. PMID:16597849

  8. A one-year intensified study of outbreaks of gastroenteritis in The Netherlands.

    PubMed Central

    van Duynhoven, Y. T. H. P.; de Jager, C. M.; Kortbeek, L. M.; Vennema, H.; Koopmans, M. P. G.; van Leusden, F.; van der Poel, W. H. M.; van den Broek, M. J. M.

    2005-01-01

    In 2002, in The Netherlands a national study of gastroenteritis outbreaks was performed. Epidemiological information was collected by the Public Health Services (PHS) and the Food Inspection Services (FIS) using standardized questionnaires. Stool samples were collected for diagnostic testing. For foodborne outbreaks, food samples were taken. In total, 281 gastroenteritis outbreaks were included, mainly from nursing homes and homes for the elderly (57%), restaurants (11%), hospitals (9%) and day-care centres (7%). Direct person-to-person spread was the predominant transmission route in all settings (overall 78%), except for restaurant outbreaks where food was suspected in almost 90% (overall in 21% of outbreaks). The most common pathogen was norovirus (54%), followed by Salmonella spp. (4%), rotavirus group A (2%), Campylobacter spp. (1%) and only incidentally others. In conclusion, most outbreaks were reported from health and residential institutions, with norovirus as the dominant agent. Control should aim at reducing person-to-person spread. In foodborne outbreaks norovirus was common, due to contamination of food by food handlers. Salmonella, as the second foodborne pathogen, was mainly associated with raw shell eggs. These results stress the continuous need for food safety education, complementary to governmental regulation. PMID:15724705

  9. Gastroenteritis outbreaks associated with Norwalk-like viruses and their investigation by nested RT-PCR

    PubMed Central

    O'Neill, Hugh J; McCaughey, Conall; Wyatt, Dorothy E; Mitchell, Frederick; Coyle, Peter V

    2001-01-01

    Background Norwalk-like viruses are the most common cause of gastroenteritis outbreaks and sporadic cases of vomiting and diarrhoea. In healthy individuals infection is often mild and short-lived but in debilitated patients infection can be severe. It is essential that the virus laboratory can offer a sensitive and specific test, delivered in a timely manner. Methods We have developed a nested reverse transcriptase PCR based on published primers against the RNA polymerase gene and after comparison with electronmicroscopy used the assay to investigate 31 outbreaks of gastroenteritis. These were in diverse situations including nursing homes, small district hospitals, large general hospitals, a ferry ship, hotels, restaurants and staff canteens. Results A positive diagnosis was made in 30/31 outbreaks investigated giving an overall outbreak positive detection rate of 97%. At an individual patient level there was a positive diagnostic rate of 11.5% in a large hospital environment to 100% in smaller outbreak situations. The average patient positive rate was 34%. In addition we investigated 532 control faecal specimens from adults. Of these 530 were negative and 2 were repeatedly positive. Conclusions It is essential that insensitive electronmicroscopy is replaced with the more sensitive reverse transcription PCR assays. These tests should be made available "on call" at weekends and public holidays. It is also important that outbreaks of NLV infection are monitored using sensitive RT-PCR assays so that the laboratory information can be used in ascertaining the spread and duration of the outbreak PMID:11511325

  10. Genetic analysis of porcine respiratory coronavirus, an attenuated variant of transmissible gastroenteritis virus.

    PubMed Central

    Wesley, R D; Woods, R D; Cheung, A K

    1991-01-01

    The genome and transcriptional pattern of a newly identified respiratory variant of transmissible gastroenteritis virus were analyzed and compared with those of classical enterotropic transmissible gastroenteritis virus. The transcriptional patterns of the two viruses indicated that differences occurred in RNAs 1 and 2(S) and that RNA 3 was absent in the porcine respiratory coronavirus (PRCV) variant. The smaller RNA 2(S) of PRCV was due to a 681-nucleotide (nt) deletion after base 62 of the PRCV peplomer or spike (S) gene. The PRCV S gene still retained information for the 16-amino-acid signal peptide and the first 6 amino acid residues at the N terminus of the mature S protein, but the adjacent 227 residues were deleted. Two additional deletions (3 and 5 nt) were detected in the PRCV genome downstream of the S gene. The 3-nt deletion occurred in a noncoding region; however, the 5-nt deletion shortened the potential open reading frame A polypeptide from 72 to 53 amino acid residues. Significantly, a C-to-T substitution was detected in the last base position of the transcription recognition sequence upstream of open reading frame A, which rendered RNA 3 nondetectable in PRCV-infected cell cultures. Images PMID:1851885

  11. [Infectious-allergic bronchopulmonary paecilomycosis].

    PubMed

    Akhunova, A M

    1991-01-01

    Primary or secondary infection of the lungs with fungi of the Paecilomyces family (P. variotii and P. viridis) gives rise to the development of infectious allergic bronchopulmonary paecilomycosis characterized by the presence of chronic allergic interstitial pneumonia and obstructive bronchitis, bronchial asthma, total and pulmonary eosinophilia, the presence of the tissue parasitic form of the fungus in sputum, blood, pulmonary tissue, the presence of allergen-specific IgE and/or IgG antibodies in patients' sera, immediate or double (20 min and 6 h) reaction of the skin to administration of allergen of Paecilomyces, by not infrequent combination of lung damage and impairment of other organs as well as by chronic relapses. PMID:1805416

  12. [Frequent infectious diseases in migrants].

    PubMed

    Stich, A

    2016-05-01

    The current influx of refugees and the high rate of immigration increase the rate and impact of infectious diseases in Europe. Infections can be detected at the initial examination of arriving refugees as a result of systematic screening or within the framework of general medical care. Diagnosis and treatment require special expertise and in some cases special precautions. The spectrum of infections is determined by the country of origin of migrants and the conditions experienced on fleeing to Germany. In this article the diagnostics and treatment of the most important infections are presented. As far as infections are concerned refugees and migrants do not represent a threat to the general population but instead have to be perceived as a highly vulnerable group. PMID:27142435

  13. How infectious disease outbreaks affect community-based primary care physicians

    PubMed Central

    Jaakkimainen, R. Liisa; Bondy, Susan J.; Parkovnick, Meredith; Barnsley, Jan

    2014-01-01

    Abstract Objective To compare how the infectious disease outbreaks H1N1 and severe acute respiratory syndrome (SARS) affected community-based GPs and FPs. Design A mailed survey sent after the H1N1 outbreak compared with the results of similar survey completed after the SARS outbreak. Setting Greater Toronto area in Ontario. Participants A total of 183 randomly selected GPs and FPs who provided office-based care. Main outcome measures The perceptions of GPs and FPs on how serious infectious disease outbreaks affected their clinical work and personal lives; their preparedness for a serious infectious disease outbreak; and the types of information they want to receive and the sources they wanted to receive information from during a serious infectious disease outbreak. The responses from this survey were compared with the responses of GPs and FPs in the greater Toronto area who completed a similar survey in 2003 after the SARS outbreak. Results After the H1N1 outbreak, GPs and FPs still had substantial concerns about the effects of serious infectious disease outbreaks on the health of their family members. Physicians made changes to various office practices in order to manage and deal with patients with serious infectious diseases. They expressed concerns about the effects of an infectious disease on the provision of health care services. Also, physicians wanted to quickly receive accurate information from the provincial government and their medical associations. Conclusion Serious community-based infectious diseases are a personal concern for GPs and FPs, and have considerable effects on their clinical practice. Further work examining the timely flow of relevant information through different health care sectors and government agencies still needs to be undertaken. PMID:25316747

  14. [Acute transverse myelitis in a traveler].

    PubMed

    García Allende, Natalia; García Posada, Mara J; Radosta, Mariana F; Sánchez, Ana V; Mayer Wolf, Micaela; Rodríguez, Viviana

    2016-01-01

    Acute transverse myelitis is defined as an acquired neuroimmune disorder of the spinal cord, which occurs as a consequence of a primary event, or directly related to an autoimmune inflammatory disease, an infectious or post-infectious disease. Amongst infectious etiologies, Borrelia spp., a tick-bourne anthropozoonosis of the ixodidae family, prevails. Approximately 10 to 15% of patients with Lyme disease undergo neurologic manifestations, with an assorted and uncertain array of clinical syndromes. Transverse myelitis accounts for up to 5% of Lyme neuroborreliosis. We describe the case of a traveler from endemic zone for Lyme disease, with encephalomyelitis secondary to acute infection by Borrelia burgderfori, with complete resolution of symptoms after concluding adequate antibiotic treatment. PMID:27576284

  15. Atypical Pyoderma Gangrenosum Mimicking an Infectious Process

    PubMed Central

    To, Derek; Wong, Aaron; Montessori, Valentina

    2014-01-01

    We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics. PMID:25024856

  16. Atypical pyoderma gangrenosum mimicking an infectious process.

    PubMed

    To, Derek; Wong, Aaron; Montessori, Valentina

    2014-01-01

    We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics. PMID:25024856

  17. An Interdisciplinary Perspective: Infectious Diseases and History.

    ERIC Educational Resources Information Center

    Turco, Jenifer; Byrd, Melanie

    2001-01-01

    Introduces the course "Infectious Diseases and History" which is designed for freshman and sophomore students. Aims to teach about infectious diseases, develop skills of using libraries and computer resources, and develop oral and written communication skills. Focuses on tuberculosis as an example of an instructional approach and explains its…

  18. 25 CFR 140.26 - Infectious plants.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Infectious plants. 140.26 Section 140.26 Indians BUREAU... Infectious plants. Traders shall not introduce into, sell, or spread within Indian reservations any plant, plant product, seed, or any type of vegetation, which is infested, or infected or which might act as...

  19. 25 CFR 140.26 - Infectious plants.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Infectious plants. 140.26 Section 140.26 Indians BUREAU... Infectious plants. Traders shall not introduce into, sell, or spread within Indian reservations any plant, plant product, seed, or any type of vegetation, which is infested, or infected or which might act as...

  20. 25 CFR 140.26 - Infectious plants.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Infectious plants. 140.26 Section 140.26 Indians BUREAU OF... Infectious plants. Traders shall not introduce into, sell, or spread within Indian reservations any plant, plant product, seed, or any type of vegetation, which is infested, or infected or which might act as...

  1. 25 CFR 140.26 - Infectious plants.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Infectious plants. 140.26 Section 140.26 Indians BUREAU... Infectious plants. Traders shall not introduce into, sell, or spread within Indian reservations any plant, plant product, seed, or any type of vegetation, which is infested, or infected or which might act as...

  2. Evolutionary Response to Human Infectious Diseases

    ERIC Educational Resources Information Center

    Armelagos, George J.; Dewey, John R.

    1970-01-01

    Gives an overview of human history, relating cultural changes with resulting changes in population density and in ecological balance to patterns of infectious diseases in man. Discusses mechanisms of evolution of resistance. Suggests that in populations where infectious diseases can be controlled, attention should shift to degenerative diseases…

  3. Nosocomial infection control in healthcare settings: Protection against emerging infectious diseases.

    PubMed

    Fu, Chuanxi; Wang, Shengyong

    2016-01-01

    The Middle East respiratory syndrome (MERS) outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented. Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative. Infection control in healthcare settings, in which patients with emerging infectious diseases such as MERS, Ebola virus disease, and the severe acute respiratory syndrome (SARS) are diagnosed and treated, are often imperfect. When it comes to emerging or unknown infectious diseases, before the imported case was finally identified or community transmission was reported, cases have often occurred in clusters in healthcare settings. Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases. PMID:27068809

  4. Resolution of diarrhea in an immunocompromised patient with chronic norovirus gastroenteritis correlates with constitution of specific antibody blockade titer.

    PubMed

    Knoll, Bettina M; Lindesmith, Lisa C; Yount, Boyd L; Baric, Ralph S; Marty, Francisco M

    2016-08-01

    Norovirus gastroenteritis in immunocompromised hosts can result in a serious and prolonged diarrheal illness. We present a case of chronic norovirus disease during rituximab-bendamustine chemotherapy for non-Hodgkin's lymphoma. We show for the first time a correlation between norovirus strain-specific antibody blockade titers and symptom improvement in an immunocompromised host. PMID:26825307

  5. 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...

  6. 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

  7. A Case of Eosinophilic Gastroenteritis Forming a Rigid Chamber Mimicking Giant Duodenal Ulcer on Computed Tomography Imaging

    PubMed Central

    Shimamoto, Yoko; Harima, Yohei

    2016-01-01

    Patient: Female, 67 Final Diagnosis: Eosinophilic gastroenteritis Symptoms: Abdominal distension • abdominal pain • chronic diarrhea Medication: — Clinical Procedure: CT Specialty: Gastroenterology and Hepatology Objective: Rare disease Background: The clinical manifestations of eosinophilic gastroenteritis are nonspecific and vary depending on which layer of the gastrointestinal tract is involved. Computed tomography (CT) is valuable for detecting and characterizing gastrointestinal wall abnormalities. Case Report: We report a case of eosinophilic gastroenteritis that formed a chamber in the rigid duodenal wall of a 67-year-old woman. Abdominal CT showed symmetrical wall thickening of the gastric antrum and duodenal bulb, and the bowel walls consisted of 2 continuous, symmetrically stratified layers. There was a chamber mimicking a giant ulcer at the orifice of the descending duodenum. Eosinophilic inflammation was present through this rigid wall of the descending duodenum, accompanied by perienteric inflammation, which infiltrated the anterior pararenal space, gall bladder, and right colic flexure. Gastrointestinal endoscopy showed spotty erosions and reddish mucosa, with the edematous gastric antrum and duodenal bulb narrowed at their lumens. Just beyond the supraduodenal angle at the orifice of the descending duodenum, there was a chamber with only minor mucosal changes, and it was not a duodenal ulcer. Endoscopic biopsy of the duodenum showed intramucosal eosinophilic infiltration. Treatment with prednisolone resulted in normalization of radiologic and endoscopic abnormalities. Conclusions: We present a case of eosinophilic gastroenteritis with both mucosal and muscular involvement. CT imaging and endoscopic examination confirmed the diagnosis. PMID:27086704

  8. Bacterial gastroenteritis

    MedlinePlus

    ... growing or shipping may contain animal or human waste. Improper food handling or preparation may occur in grocery stores, restaurants, or homes. Food poisoning often occurs from eating or drinking: ...

  9. Viral gastroenteritis

    MedlinePlus

    ... with suspected enteric infection. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: ... with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: ...

  10. Viral Gastroenteritis

    MedlinePlus

    ... bathroom or changing diapers and before eating or handling food disinfect contaminated surfaces such as countertops and ... bathroom or changing diapers and before eating or handling food, disinfect contaminated surfaces, and avoid foods or ...

  11. Viral gastroenteritis

    MedlinePlus

    ... drug stores. Do NOT use fruit juice (including apple juice), sodas or cola (flat or bubbly), Jell- ... bread, potatoes, lean meats Plain yogurt, bananas, fresh apples Vegetables If you have diarrhea and are unable ...

  12. Another gastroenteritis?

    PubMed

    Biskup, Ewelina; Necek, Magdalena; Changjin, Qu

    2016-05-11

    Portal vein thrombosis (PVT) is an important, but often delayed or missed differential diagnosis in patients presenting with abdominal pain. In this case report we present a previously healthy 42-year-old patient with persistent upper abdominal pain for five days. Being a common complication in patients suffering from liver cirrhosis, PVT is an unusual finding in healthy individuals. However, gene mutation leading to a hypercoagulable state can be associated with thrombotic events in the portal venous system. Investigation for underlying disorders such as myeloproliferative neoplasm (MPN), paroxysmal nocturnal hemoglobinuria (PNH), antiphospholipid antibody syndrome are crucial. PMID:27167481

  13. Infectious mononucleosis mimicking lymphoma: distinguishing morphological and immunophenotypic features.

    PubMed

    Louissaint, Abner; Ferry, Judith A; Soupir, Chad P; Hasserjian, Robert P; Harris, Nancy L; Zukerberg, Lawrence R

    2012-08-01

    The diagnosis of infectious mononucleosis (acute Epstein-Barr virus (EBV) infection) is usually made on the basis of clinical and laboratory findings. However, an atypical clinical presentation occasionally results in a lymph node or tonsillar biopsy. The morphological features of EBV-infected lymphoid tissue can easily mimic lymphoma. Furthermore, the immunophenotype of the immunoblasts has not been well characterized. To assess the morphological spectrum of acute EBV infection and the utility of immunohistochemistry in diagnosing difficult cases that resemble lymphoma, we reviewed 18 cases of acute EBV infection submitted in consultation to our institution with an initial diagnosis of/or suspicion for lymphoma. Patients included nine male and nine female individuals with a median age of 18 years (range 9-69). Biopsies were obtained from lymph nodes (3/18) or Waldeyer's ring (15/18). Infectious mononucleosis was confirmed by monospot or serological assays in 72% of cases (13/18). All cases featured architectural distortion by a polymorphous infiltrate with an immunoblastic proliferation, sometimes forming sheets. Reed-Sternberg-like cells were present in 8/18 (44%) of the cases. Infiltrates were often accompanied by necrosis (10/18) and mucosal ulceration (6/15). The majority of immunoblasts in all cases were CD20+ B cells with a post-germinal center immunophenotype (strongly positive for MUM1/IRF4 (18/18), CD10- (18/18 negative) and BCL-6- (16/18 negative; 2/18 faint BCL-6 expression in <10% of immunoblasts)). Immunoblasts showed variable weak expression of BCL-2 and polyclonal expression of κ and λ immunoglobulin light chains in 81% cases. Reed-Sternberg-like cells in 8/8 cases were CD30+, CD15-, BOB.1+ and OCT-2+. In conclusion, an atypical lymphoid infiltrate with numerous MUM1+, CD10-, BCL-6- immunoblasts should raise the suspicion of a reactive process, such as infectious mononucleosis, and warrants additional consideration before a diagnosis of lymphoma

  14. 76 FR 27070 - National Institute of Allergy and Infectious Diseases;

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-10

    ... HUMAN SERVICES National Institutes of Health National Institute of Allergy and Infectious Diseases... personal privacy. Name of Committee: National Institute of Allergy and Infectious Diseases Special Emphasis... . Name of Committee: National Institute of Allergy and Infectious Diseases Special Emphasis Panel,...

  15. Immunohistochemical study on gastroenteric nervous system in trisomy 16 mice:an animal model of Down syndrome.

    PubMed

    Li, Ji-Cheng; Busch, LC; Kuhnel, W

    2000-12-01

    AIM:To study the development of gastroenteric nervous system in trisomy 16 mouse embryos.The gastroenteric nervous system in trisomy 16 mice and their normal littermates, serving as controls from embryonic days 13 to 18 (ED13-18) was identified by using primary antibody against protein gene product (PGP) 9.5.METHODS:Trisomy 16 mouse breeding and trisomy 16 mouse embryos were identified from their normal littermates by chromosome examination; PGP 9.5 immunohistochemical stainning.RESULTS:In normal littermates embryos, the precursor cells from the neural crest migrated into stomach and intestine at ED 13 and ED 14 respectively.Numerous nervous processes connected to each other and formed early nervous networks at ED 14 stomach and ED 15 intestine. Original ganglia in the muscular nervous plexus of the stomach appeared at ED15 with very simple arrangement. At ED 16 the early developed myenteric nervous plexuses were regularly found in the stomach and intestine respectively. In both stomach and intestine, the development of submucosal nervous plexuses were finished at ED17. However, the myenteric nervous plexus and the internal and external submucosal nervous plexuses were differentiated only in the stomach at ED 18.In comparison with the normal littermates, stomach and intestine nervous system developed much slower in trisomy 16 mice. Their immature neurons did not appear in the stomach and intestine until ED 14 and ED 15. Between ED 14 and ED 16, the gastroenteric nervous system was composed of only some scattered neurons with different distribution density and size. The development and differentiation of the gastroenteric nervous system were delayed and the myenteric nervous plexus did not appear until ED 18. There was no submucosal nervous plexus in all stomach and intestine specimens. A semiquantitative analysis and rank sum test of the data showed that the trisomy 16 mouse embryos were markedly retarded in the gastroenteric nervous development compared with their

  16. Acute encephalitis as initial presentation of primary HIV infection.

    PubMed

    Nzwalo, Hipólito; Añón, Rosário Pazos; Àguas, Maria João

    2012-01-01

    Acute encephalitis is a life-threatening condition. A wide variety of infectious agents are implicated and in many patients no cause is found. HIV acute seroconversion illness can rarely present as acute encephalitis. Although most experts agree in starting antiretroviral treatment in severe acute HIV infection, the evidence of the benefits are still lacking. The authors report a case of severe acute encephalitis as a primary presentation of HIV infection in which introduction of highly active antiretroviral treatment resulted in clinical recovery. This case highlights the need to consider HIV infection in the differential diagnosis of treatable viral encephalitis. PMID:22761210

  17. Infectious Causes of Encephalitis and Meningoencephalitis in Thailand, 2003–2005

    PubMed Central

    Campbell, Angela P.; Supawat, Krongkaew; Liamsuwan, Sahas; Chotpitayasunondh, Tawee; Laptikulthum, Somsak; Viriyavejakul, Akravudh; Tantirittisak, Tasanee; Tunlayadechanont, Supoch; Visudtibhan, Anannit; Vasiknanonte, Punnee; Janjindamai, Supachai; Boonluksiri, Pairoj; Rajborirug, Kiatsak; Watanaveeradej, Veerachai; Khetsuriani, Nino; Dowell, Scott F.

    2015-01-01

    Acute encephalitis is a severe neurologic syndrome. Determining etiology from among ≈100 possible agents is difficult. To identify infectious etiologies of encephalitis in Thailand, we conducted surveillance in 7 hospitals during July 2003–August 2005 and selected patients with acute onset of brain dysfunction with fever or hypothermia and with abnormalities seen on neuroimages or electroencephalograms or with cerebrospinal fluid pleocytosis. Blood and cerebrospinal fluid were tested for >30 pathogens. Among 149 case-patients, median age was 12 (range 0–83) years, 84 (56%) were male, and 15 (10%) died. Etiology was confirmed or probable for 54 (36%) and possible or unknown for 95 (64%). Among confirmed or probable etiologies, the leading pathogens were Japanese encephalitis virus, enteroviruses, and Orientia tsutsugamushi. No samples were positive for chikungunya, Nipah, or West Nile viruses; Bartonella henselae; or malaria parasites. Although a broad range of infectious agents was identified, the etiology of most cases remains unknown. PMID:25627940

  18. Imported infectious diseases and surveillance in Japan.

    PubMed

    Taniguchi, Kiyosu; Yoshida, Makiko; Sunagawa, Tomimasa; Tada, Yuki; Okabe, Nobuhiko

    2008-11-01

    Surveillance of imported infectious diseases is important because of the need for early detection of outbreaks of international concern as well as information of risk to the travelers. This paper attempts to review how the Japanese surveillance system deals with imported infectious diseases and reviews the trend of these diseases. The cases of acquired infection overseas were extracted from the surveillance data in 1999-2008. The incidence and rate of imported cases of a series of infectious diseases with more than one imported case were observed by the year of diagnosis and place of acquired infection. During the period 10,030 cases that could be considered to be imported infectious diseases were identified. Shigellosis ranked as the most common imported disease, followed by amebiasis, malaria, enterohemorrhagic Escherichia coli infection and the acquired immunodeficiency syndrome, typhoid fever, dengue fever, hepatitis A, giardiasis, cholera, and paratyphoid fever. The annual trends of these diseases always fluctuated but not every change was investigated. The study reveals that the situation of imported infectious diseases can be identified in the current Japanese surveillance system with epidemiologic features of both temporal and geographic distribution of cases of imported infectious diseases. However, further timely investigation for unusual increase in infectious diseases is needed. PMID:18984479

  19. After 2015: infectious diseases in a new era of health and development

    PubMed Central

    Dye, Christopher

    2014-01-01

    Running over timescales that span decades or centuries, the epidemiological transition provides the central narrative of global health. In this transition, a reduction in mortality is followed by a reduction in fertility, creating larger, older populations in which the main causes of illness and death are no longer acute infections of children but chronic diseases of adults. Since the year 2000, the Millennium Development Goals (MDGs) have provided a framework for accelerating the decline of infectious diseases, backed by a massive injection of foreign investment to low-income countries. Despite the successes of the MDGs era, the inhabitants of low-income countries still suffer an enormous burden of disease owing to diarrhoea, pneumonia, HIV/AIDS, tuberculosis, malaria and other pathogens. Adding to the predictable burden of endemic disease, the threat of pandemics is ever-present and global. With a view to the future, this review spotlights five aspects of the fight against infection beyond 2015, when the MDGs will be replaced by a new set of goals for poverty reduction and sustainable development. These aspects are: exploiting the biological links between infectious and non-infectious diseases; controlling infections among the new urban majority; enhancing the response to international health threats; expanding childhood immunization programmes to prevent acute and chronic diseases in adults; and working towards universal health coverage. By scanning the wider horizon now, infectious disease specialists have the chance to shape the post-2015 era of health and development. PMID:24821913

  20. Infectious Chikungunya Virus in the Saliva of Mice, Monkeys and Humans

    PubMed Central

    Gardner, Joy; Rudd, Penny A.; Prow, Natalie A.; Belarbi, Essia; Roques, Pierre; Larcher, Thibaut; Gresh, Lionel; Balmaseda, Angel; Harris, Eva; Schroder, Wayne A.; Suhrbier, Andreas

    2015-01-01

    Chikungunya virus (CHIKV) is a reemerging, ordinarily mosquito-transmitted, alphavirus that occasionally produces hemorrhagic manifestations, such as nose bleed and bleeding gums, in human patients. Interferon response factor 3 and 7 deficient (IRF3/7-/-) mice, which are deficient for interferon α/β responses, reliably develop hemorrhagic manifestations after CHIKV infection. Here we show that infectious virus was present in the oral cavity of CHIKV infected IRF3/7-/- mice, likely due to hemorrhagic lesions in the olfactory epithelium that allow egress of infected blood into the nasal, and subsequently, oral cavities. In addition, IRF3/7-/- mice were more susceptible to infection with CHIKV via intranasal and oral routes, with IRF3/7-/- mice also able to transmit virus mouse-to-mouse without an arthropod vector. Cynomolgus macaques often show bleeding gums after CHIKV infection, and analysis of saliva from several infected monkeys also revealed the presence of viral RNA and infectious virus. Furthermore, saliva samples collected from several acute CHIKV patients with hemorrhagic manifestations were found to contain viral RNA and infectious virus. Oral fluids can therefore be infectious during acute CHIKV infections, likely due to hemorrhagic manifestations in the oral/nasal cavities. PMID:26447467

  1. Infectious complications of regional anesthesia.

    PubMed

    Horlocker, Terese T; Wedel, Denise J

    2008-09-01

    Although individual cases have been reported in the literature, serious infections of the central nervous system (CNS) such as arachnoiditis, meningitis, and abscess following spinal or epidural anesthesia are rare. However, recent epidemiologic series from Europe suggest that the frequency of infectious complications associated with neuraxial techniques may be increasing. Importantly, while meningitis and epidural abscess are both complications of neuraxial block, the risk factors and causative organisms are disparate. For example, staphylococcus is the organism most commonly associated epidural abscess; often these infections occurred in patients with impaired immunity. Conversely, meningitis follows dural puncture, and is typically caused by alpha-hemolytic streptococci, with the source of the organism the nasopharynx of the proceduralist. In order to reduce the risk of serious infection following neuraxial blockade, the clinician must be knowledgeable in the pathogenesis of CNS infections, patient selection, and use of meticulous aseptic technique. Finally, since delay in the diagnosis may result in morbidity and even death, it is crucial to be aware of the presenting signs and symptoms of meningitis and epidural abscess. PMID:18831298

  2. Infectious Diseases at High Altitude.

    PubMed

    Basnyat, Buddha; Starling, Jennifer M

    2015-08-01

    Travel to elevations above 2,500 m is an increasingly common activity undertaken by a diverse population of individuals. These may be trekkers, climbers, miners in high-altitude sites in South America, and more recently, soldiers deployed for high-altitude duty in remote areas of the world. What is also being increasingly recognized is the plight of the millions of pilgrims, many with comorbidities, who annually ascend to high-altitude sacred areas. There are also 400 million people who reside permanently in high mountain ranges, which cover one-fifth of the Earth's surface. Many of these high-altitude areas are in developing countries, for example, the Himalayan range in South Asia. Although high-altitude areas may not harbor any specific infectious disease agents, it is important to know about the pathogens encountered in the mountains to be better able to help both the ill sojourner and the native high-altitude dweller. Often the same pathogens prevalent in the surrounding lowlands are found at high altitude, but various factors such as immunomodulation, hypoxia, poor physiological adaptation, and harsh environmental stressors at high altitude may enhance susceptibility to these pathogens. Against this background, various gastrointestinal, respiratory, dermatological, neurological, and other infections encountered at high altitude are discussed. PMID:26350326

  3. Infectious laryngotracheitis virus in chickens.

    PubMed

    Ou, Shan-Chia; Giambrone, Joseph J

    2012-10-12

    Infectious laryngotracheitis (ILT) is an important respiratory disease of chickens and annually causes significant economic losses in the poultry industry world-wide. ILT virus (ILTV) belongs to alphaherpesvirinae and the Gallid herpesvirus 1 species. The transmission of ILTV is via respiratory and ocular routes. Clinical and post-mortem signs of ILT can be separated into two forms according to its virulence. The characteristic of the severe form is bloody mucus in the trachea with high mortality. The mild form causes nasal discharge, conjunctivitis, and reduced weight gain and egg production. Conventional polymerase chain reaction (PCR), nested PCR, real-time PCR, and loop-mediated isothermal amplification were developed to detect ILTV samples from natural or experimentally infected birds. The PCR combined with restriction fragment length polymorphism (RFLP) can separate ILTVs into several genetic groups. These groups can separate vaccine from wild type field viruses. Vaccination is a common method to prevent ILT. However, field isolates and vaccine viruses can establish latent infected carriers. According to PCR-RFLP results, virulent field ILTVs can be derived from modified-live vaccines. Therefore, modified-live vaccine reversion provides a source for ILT outbreaks on chicken farms. Two recently licensed commercial recombinant ILT vaccines are also in use. Other recombinant and gene-deficient vaccine candidates are in the developmental stages. They offer additional hope for the control of this disease. However, in ILT endemic regions, improved biosecurity and management practices are critical for improved ILT control. PMID:24175219

  4. Infectious laryngotracheitis virus in chickens

    PubMed Central

    Ou, Shan-Chia; Giambrone, Joseph J

    2012-01-01

    Infectious laryngotracheitis (ILT) is an important respiratory disease of chickens and annually causes significant economic losses in the poultry industry world-wide. ILT virus (ILTV) belongs to alphaherpesvirinae and the Gallid herpesvirus 1 species. The transmission of ILTV is via respiratory and ocular routes. Clinical and post-mortem signs of ILT can be separated into two forms according to its virulence. The characteristic of the severe form is bloody mucus in the trachea with high mortality. The mild form causes nasal discharge, conjunctivitis, and reduced weight gain and egg production. Conventional polymerase chain reaction (PCR), nested PCR, real-time PCR, and loop-mediated isothermal amplification were developed to detect ILTV samples from natural or experimentally infected birds. The PCR combined with restriction fragment length polymorphism (RFLP) can separate ILTVs into several genetic groups. These groups can separate vaccine from wild type field viruses. Vaccination is a common method to prevent ILT. However, field isolates and vaccine viruses can establish latent infected carriers. According to PCR-RFLP results, virulent field ILTVs can be derived from modified-live vaccines. Therefore, modified-live vaccine reversion provides a source for ILT outbreaks on chicken farms. Two recently licensed commercial recombinant ILT vaccines are also in use. Other recombinant and gene-deficient vaccine candidates are in the developmental stages. They offer additional hope for the control of this disease. However, in ILT endemic regions, improved biosecurity and management practices are critical for improved ILT control. PMID:24175219

  5. Multifractal signatures of infectious diseases.

    PubMed

    Holdsworth, Amber M; Kevlahan, Nicholas K-R; Earn, David J D

    2012-09-01

    Incidence of infection time-series data for the childhood diseases measles, chicken pox, rubella and whooping cough are described in the language of multifractals. We explore the potential of using the wavelet transform maximum modulus (WTMM) method to characterize the multiscale structure of the observed time series and of simulated data generated by the stochastic susceptible-exposed-infectious-recovered (SEIR) epidemic model. The singularity spectra of the observed time series suggest that each disease is characterized by a unique multifractal signature, which distinguishes that particular disease from the others. The wavelet scaling functions confirm that the time series of measles, rubella and whooping cough are clearly multifractal, while chicken pox has a more monofractal structure in time. The stochastic SEIR epidemic model is unable to reproduce the qualitative singularity structure of the reported incidence data: it is too smooth and does not appear to have a multifractal singularity structure. The precise reasons for the failure of the SEIR epidemic model to reproduce the correct multiscale structure of the reported incidence data remain unclear. PMID:22442094

  6. Site-Specific Clinical Evaluation of the Luminex xTAG Gastrointestinal Pathogen Panel for Detection of Infectious Gastroenteritis in Fecal Specimens

    PubMed Central

    Patel, Anami; Navidad, Jose

    2014-01-01

    We evaluate the clinical performance of the Luminex xTAG gastrointestinal (GI) pathogen in vitro diagnostic (IVD) assay in a comparison between clinical and public health laboratories. The site reproducibility study showed 98.7% sensitivity with high positive and negative agreement values (96.2% and 99.8%, respectively), while assay performance against confirmatory methods resulted in 96.4% sensitivity with similar positive and negative agreement values (90.1% and 99.5%, respectively). High-throughput detection of multiple GI pathogens improved turnaround time, consolidated laboratory workflow, and simplified stool culture practices, thus reducing the overall cost and number of specimens processed. PMID:24899032

  7. Site-specific clinical evaluation of the Luminex xTAG gastrointestinal pathogen panel for detection of infectious gastroenteritis in fecal specimens.

    PubMed

    Patel, Anami; Navidad, Jose; Bhattacharyya, Sanjib

    2014-08-01

    We evaluate the clinical performance of the Luminex xTAG gastrointestinal (GI) pathogen in vitro diagnostic (IVD) assay in a comparison between clinical and public health laboratories. The site reproducibility study showed 98.7% sensitivity with high positive and negative agreement values (96.2% and 99.8%, respectively), while assay performance against confirmatory methods resulted in 96.4% sensitivity with similar positive and negative agreement values (90.1% and 99.5%, respectively). High-throughput detection of multiple GI pathogens improved turnaround time, consolidated laboratory workflow, and simplified stool culture practices, thus reducing the overall cost and number of specimens processed. PMID:24899032

  8. Addressing the challenges of emerging infectious disease.

    PubMed

    Pinner, R W

    1996-01-01

    Through the recent examples of diphtheria in the former Soviet Union, plague in India, and trends in pneumonia mortality in the United States, the author, in this article, illustrates issues in emerging infectious diseases. The Centers for Disease Control's plan, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States, is summarized. Initial efforts to implement this plan are described, with particular focus on the development of Emerging Infections Programs, which are conducting epidemiologic and laboratory projects on several infectious diseases, including invasive bacterial diseases, unexplained deaths, foodborne diseases, and ehrlichiosis in four population-based sites in the United States. PMID:8571983

  9. Breast-feeding as a protection against gastroenteritis and other infections.

    PubMed

    Hanson, L A; Hofvander, Y; Lindquist, B; Zetterström, R

    1985-09-01

    This editorial reviews current knowledge of the mechanisms by which breastfeeding protects infants against gastroenteritis and other infections. Breast milk averts the disadvantage of contamination with micro-organisms in the handling process common to indigenous foods used in the weaning period and commercial milk products. The infections caused by contaminated food and water compound the malnutrition already caused by inadequate weaning food. Human milk is thought to contain several nonspecific and specific factors that provide protection against infections such as gastroenteristis and upper respiratory tract infections. Analogues to epithelial cell receptors may prevent the mucosal attachment of potential pathogens. Protection of the breast-fed infant against cholera has been shown to be related to the level of the IgA antibodies in the mother's milk against the cholera lipoplysaccharide and enterotoxin. PMID:4050410

  10. Post-infectious irritable bowel syndrome: mechanistic insights into chronic disturbances following enteric infection.

    PubMed

    Beatty, Jennifer K; Bhargava, Amol; Buret, Andre G

    2014-04-14

    Irritable bowel syndrome (IBS) is a commonly encountered chronic functional gastrointestinal (GI) disorder. Approximately 10% of IBS patients can trace the onset of their symptoms to a previous a bout of infectious dysentery. The appearance of new IBS symptoms following an infectious event is defined as post-infectious-IBS. Indeed, with the World Health Organization estimating between 2 and 4 billion cases annually, infectious diarrheal disease represents an incredible international healthcare burden. Additionally, compounding evidence suggests many commonly encountered enteropathogens as unique triggers behind IBS symptom generation and underlying pathophysiological features. A growing body of work provides evidence supporting a role for pathogen-mediated modifications in the resident intestinal microbiota, epithelial barrier integrity, effector cell functions, and innate and adaptive immune features, all proposed physiological manifestations that can underlie GI abnormalities in IBS. Enteric pathogens must employ a vast array of machinery to evade host protective immune mechanisms, and illicit successful infections. Consequently, the impact of infectious events on host physiology can be multidimensional in terms of anatomical location, functional scope, and duration. This review offers a unique discussion of the mechanisms employed by many commonly encountered enteric pathogens that cause acute disease, but may also lead to the establishment of chronic GI dysfunction compatible with IBS. PMID:24744587

  11. CD40 Signaling to the Rescue: A CD8 Exhaustion Perspective in Chronic Infectious Diseases

    PubMed Central

    Bhadra, Rajarshi; Cobb, Dustin A.; Khan, Imtiaz A.

    2013-01-01

    Chronic infectious diseases such as HIV, HBV, and HCV, among others, cause severe morbidity and mortality globally. Progressive decline in CD8 functionality, survival, and proliferative potential—a phenomenon referred to as CD8 exhaustion—is believed to be responsible for poor pathogen control in chronic infectious diseases. While the role of negative inhibitory receptors such as PD-1 in augmenting CD8 exhaustion has been extensively studied, the role of positive costimulatory receptors remains poorly understood. In this review, we discuss how one such costimulatory pathway, CD40–CD40L, regulates CD8 dysfunction and rescue. While the significance of this pathway has been extensively investigated in models of autoimmunity, acute infectious diseases, and tumor models, the role played by CD40–CD40L in regulating CD8 exhaustion in chronic infectious diseases is just beginning to be understood. Considering that monotherapy with blocking antibodies targeting inhibitory PD-1-PD-L1 pathway is only partially effective at ameliorating CD8 exhaustion and that humanized CD40 agonist antibodies are currently available, a better understanding of the role of the CD40–CD40L pathway in chronic infectious diseases will pave the way for the development of more robust immunotherapeutic and prophylactic vaccination strategies. PMID:23971530

  12. [Revealing of tuberculosis in an infectious diseases hospital of a megalopolis].

    PubMed

    Malashenkov, E A; Ivanovskiĭ, V B

    2007-01-01

    The advisory work of the phthisiatrician in an infectious diseases hospital was analyzed; the analysis revealed that in 2005 tuberculose changes of various degrees of activity had been revealed in 42.5% of examined patients, and 32.1% of them were subjects in whom tuberculosis of diferent localizations had been revealed for the first time. In 43.2% of the latter subjects, the reasons for hospitalization were "clinical masks" of tuberculose process (influenza, acute respiratory viral disease), while 48.6% were hospitalized for gastrointestinal infections and viral hepatitis. In 20.7% of cases tuberculosis was combined with HIV infection. In the infectious diseases hospital, 16.2% of patients with active tuberculosis died. Among the patients treated in the infectious diseases hospital during one year, the proportion of patients with active tuberculosis was 1.44%, the proportion of those in whom the process was revealed for the first time, was 0.75%. In Botkin infectious diseases hospital, there were approximately 6% of patients in whom tuberculose process was revealed for the first time in Saint Petersburg. The peculiarities of this group of patients in an infectious diseases hospital require not only tuberculose alertness, but also reinforcement of phthisiatric, radiological, and laboratory services. PMID:17926491

  13. Detection and characterisation of novel bocavirus (genus Bocaparvovirus) and gastroenteritis viruses from asymptomatic pigs in Ireland

    PubMed Central

    Gunn, Lynda; Collins, Patrick James; Fanning, Séamus; McKillen, John; Morgan, John; Staines, Anthony; O'Shea, Helen

    2015-01-01

    Background Livestock animals have been the assumed source of several human epidemics in recent years, for example, influenza H1N1, rotavirus G8/G9, and MERS-CoV. Surveillance of novel viruses in animals is essential to evaluate the risk to human and animal health and to determine any economic impact, for example, failure to thrive. There is a paucity of data regarding detection and characterisation of gastroenteritis viruses, particularly novel viruses, in porcines in Ireland. Recently, a number of small novel porcine DNA viruses have emerged globally, for example, torque teno sus virus, porcine bocavirus, and parvoviruses 2 & 4, and little is known about the biology and potential pathogenicity of these viruses. Bocaparvovirus is a genetically distinct group of viruses which has been recently detected in humans and animals. Methods In this study, the presence of gastroenteritis viruses (rotavirus A, porcine circovirus, adenovirus, and porcine bocavirus) was investigated in a selection of archived faecal samples from asymptomatic piglets from a commercial farm in Ireland. A total of 104 specimens were pooled and screened using conventional molecular techniques (PCR and RT-PCR), a subset of specimens (n=44) were then examined individually. Viral diversity was then investigated using statistical and phylogenetic techniques. Results Initial screening showed a high prevalence of PBoV in this farm, with the formation of three distinct groups in phylogenetic analysis. Other viruses were also investigated in this study with the first report of PCV, PAdV and lineage I G5 RVA in Ireland. Some specimens contained >1 virus, with statistical analysis indicating a strong correlation for mixed infections of PBoV and PAdV on this farm. Conclusion Investigating the diversity of circulating enteric viruses on Irish porcine farms is important to improve the prophylactic tools available and to facilitate the early detection of changes in circulating viruses. PMID:26065833

  14. Management of hospital outbreaks of gastro-enteritis due to small roundstructured viruses.

    PubMed

    Chadwick, P R; Beards, G; Brown, D; Caul, E O; Cheesbrough, J; Clarke, I; Curry, A; O'Brien, S; Quigley, K; Sellwood, J; Westmoreland, D

    2000-05-01

    Small round structured viruses (SRSVs, Norwalk-like viruses, NLVs) are the most common cause of outbreaks of gastro-enteritis in hospitals and also cause outbreaks in other settings such as schools, hotels, nursing homes and cruise ships. Hospital outbreaks often lead to ward closure and major disruption in hospital activity. Outbreaks usually affect both patients and staff, sometimes with attack rates in excess of 50%. For this reason, staff shortages can be severe, particularly if several wards are involved at the same time. SRSVs may be spread by several routes: faecal-oral; vomiting/aerosols; food and water. Viruses may be introduced into the ward environment by any of these routes and then propagated by person-to-person spread. In an outbreak setting, the diagnosis can usually be made rapidly and confidently on clinical and epidemiological grounds, particularly if vomiting is a prominent symptom. By the time an SRSV outbreak has been recognized at ward level, most susceptible individuals will have been exposed to the virus and infection control efforts must prioritize the prevention of spread of infection to other clinical areas bycontainment of infected/exposed individuals (especially the prevention of patient and staff movements to other areas), hand-hygiene and effective environmental decontamination. This report of the Public Health Laboratory Service Viral Gastro-enteritis Working Group reviews the epidemiology of outbreaks of infection due to SRSVs and makes recommendations for their management in the hospital setting. The basic principles which underpin these recommendations will also be applicable to the management of some community-based institutional outbreaks. PMID:10833336

  15. Autophagy in acute brain injury.

    PubMed

    Galluzzi, Lorenzo; Bravo-San Pedro, José Manuel; Blomgren, Klas; Kroemer, Guido

    2016-08-01

    Autophagy is an evolutionarily ancient mechanism that ensures the lysosomal degradation of old, supernumerary or ectopic cytoplasmic entities. Most eukaryotic cells, including neurons, rely on proficient autophagic responses for the maintenance of homeostasis in response to stress. Accordingly, autophagy mediates neuroprotective effects following some forms of acute brain damage, including methamphetamine intoxication, spinal cord injury and subarachnoid haemorrhage. In some other circumstances, however, the autophagic machinery precipitates a peculiar form of cell death (known as autosis) that contributes to the aetiology of other types of acute brain damage, such as neonatal asphyxia. Here, we dissect the context-specific impact of autophagy on non-infectious acute brain injury, emphasizing the possible therapeutic application of pharmacological activators and inhibitors of this catabolic process for neuroprotection. PMID:27256553

  16. Evaluation of Border Entry Screening for Infectious Diseases in Humans

    PubMed Central

    Antão, Catarina; Hall, Robert

    2015-01-01

    In response to the severe acute respiratory syndrome (SARS) pandemic of 2003 and the influenza pandemic of 2009, many countries instituted border measures as a means of stopping or slowing the spread of disease. The measures, usually consisting of a combination of border entry/exit screening, quarantine, isolation, and communications, were resource intensive, and modeling and observational studies indicate that border screening is not effective at detecting infectious persons. Moreover, border screening has high opportunity costs, financially and in terms of the use of scarce public health staff resources during a time of high need. We discuss the border-screening experiences with SARS and influenza and propose an approach to decision-making for future pandemics. We conclude that outbreak-associated communications for travelers at border entry points, together with effective communication with clinicians and more effective disease control measures in the community, may be a more effective approach to the international control of communicable diseases. PMID:25625224

  17. Current status of vaccines against infectious bursal disease.

    PubMed

    Müller, Hermann; Mundt, Egbert; Eterradossi, Nicolas; Islam, M Rafiqul

    2012-01-01

    Infectious bursal disease virus (IBDV) is the aetiological agent of the acute and highly contagious infectious bursal disease (IBD) or "Gumboro disease". IBD is one of the economically most important diseases that affects commercially produced chickens worldwide. Along with strict hygiene management of poultry farms, vaccination programmes with inactivated and live attenuated viruses have been used to prevent IBD. Live vaccines show a different degree of attenuation; many of them may cause bursal atrophy and thus immunosuppression with poor immune response to vaccination against other pathogens and an increase in vulnerability to various types of infections as possible consequences. Depending on their intrinsic characteristics or on the vaccination procedures, some of the vaccines may not induce full protection against the very virulent IBDV strains and antigenic variants observed in the last three decades. As chickens are most susceptible to IBDV in their first weeks of life, active immunity to the virus has to be induced early after hatching. However, maternally derived IBDV-specific antibodies may interfere with early vaccination with live vaccines. Thus new technologies and second-generation vaccines including rationally designed and subunit vaccines have been developed. Recently, live viral vector vaccines have been licensed in several countries and are reaching the market. Here, the current status of IBD vaccines is discussed. PMID:22515532

  18. Infectious Diseases of the Heart: Pathophysiology, Clinical and Imaging Overview.

    PubMed

    Murillo, Horacio; Restrepo, Carlos Santiago; Marmol-Velez, Juan Alejandro; Vargas, Daniel; Ocazionez, Daniel; Martinez-Jimenez, Santiago; Reddick, Robert Lee; Baxi, Ameya Jagdish

    2016-01-01

    Myriad infectious organisms can infect the endocardium, myocardium, and pericardium, including bacteria, fungi, parasites, and viruses. Significant cardiac infections are rare in the general population but are associated with high morbidity and mortality as well as increased risk in certain populations, such as the elderly, those undergoing cardiac instrumentation, and intravenous drug abusers. Diagnostic imaging of cardiac infections plays an important role despite its variable sensitivity and specificity, which are due in part to the nonspecific manifestations of the central inflammatory process of infection and the time of onset with respect to the time of imaging. The primary imaging modality remains echocardiography. However, cardiac computed tomography and magnetic resonance (MR) imaging have emerged as the modalities of choice wherever available, especially for diagnosis of complex infectious complications including abscesses, infected prosthetic material, central lines and instruments, and the cryptic manifestations of viral and parasitic diseases. MR imaging can provide functional, morphologic, and prognostic value in a single examination by allowing characterization of inflammatory changes from the acute to chronic stages, including edema and the patterns and extent of delayed gadolinium enhancement. We review the heterogeneous and diverse group of cardiac infections based on their site of primary cardiac involvement with emphasis on their cross-sectional imaging manifestations. Online supplemental material is available for this article. (©)RSNA, 2016. PMID:27399236

  19. Novel Furin Inhibitors with Potent Anti-infectious Activity.

    PubMed

    Hardes, Kornelia; Becker, Gero L; Lu, Yinghui; Dahms, Sven O; Köhler, Susanne; Beyer, Wolfgang; Sandvig, Kirsten; Yamamoto, Hiroyuki; Lindberg, Iris; Walz, Lisa; von Messling, Veronika; Than, Manuel E; Garten, Wolfgang; Steinmetzer, Torsten

    2015-07-01

    New peptidomimetic furin inhibitors with unnatural amino acid residues in the P3 position were synthesized. The most potent compound 4-guanidinomethyl-phenylacteyl-Arg-Tle-Arg-4-amidinobenzylamide (MI-1148) inhibits furin with a Ki value of 5.5 pM. The derivatives also strongly inhibit PC1/3, whereas PC2 is less affected. Selected inhibitors were tested in cell culture for antibacterial and antiviral activity against infectious agents known to be dependent on furin activity. A significant protective effect against anthrax and diphtheria toxin was observed in the presence of the furin inhibitors. Furthermore, the spread of the highly pathogenic H5N1 and H7N1 avian influenza viruses and propagation of canine distemper virus was strongly inhibited. Inhibitor MI-1148 was crystallized in complex with human furin. Its N-terminal guanidinomethyl group in the para position of the P5 phenyl ring occupies the same position as that found previously for a structurally related inhibitor containing this substitution in the meta position, thereby maintaining all of the important P5 interactions. Our results confirm that the inhibition of furin is a promising strategy for a short-term treatment of acute infectious diseases. PMID:25974265

  20. Acute Ataxia in Childhood: 11-Year Experience at a Major Pediatric Neurology Referral Center.

    PubMed

    Thakkar, Kavita; Maricich, Stephen M; Alper, Gulay

    2016-08-01

    We categorized the causes of acute ataxia in the pediatric population-referred to the Division of Neurology-at a large, urban pediatric medical center. Of the 120 cases identified over the past 11 years, post-infectious cerebellar ataxia was the most commonly diagnosed (59%), followed by drug intoxication, opsoclonus-myoclonus ataxia syndrome, episodic ataxia, acute cerebellitis, cerebellar stroke, ADEM, meningitis, cerebral vein thrombosis, Leigh's disease, Miller-Fisher syndrome, and concussion. Among the patients with post-infectious cerebellar ataxia, 85% were 1-6 years old and all had a history of antecedent viral illness. CSF pleocytosis was present in 40% of patients; all had normal brain MRIs. The majority (91%) recovered within 30 days. We conclude that post-infectious cerebellar ataxia remains the most common cause of acute ataxia in childhood and that it carries a good prognosis. We also differentiate acute post-infectious cerebellar ataxia from other causes with similar presentations. PMID:27071467

  1. [Therapy and prevention of infectious endocarditis].

    PubMed

    Horstkotte, D; Rosin, H

    1984-11-10

    Only 40 years ago infectious endocarditis (IE) was lethal in most cases. Due to the development of numerous antibiotics and continuous improvements in heart valve surgery, a wide range of possibilities for therapy and prophylaxis of IE are available. The prognosis depends essentially on rapid and relevant diagnosis, which should be followed by immediate and adequate therapy consisting of general measures for treatment of septicaemic disease and specific antibiotic therapy. As multiple complications may develop during IE, careful follow-up by clinical, laboratory and mechanical examinations is necessary to decide whether surgical intervention is urgently indicated or not. In case of complications such as myocardial failure, septicaemic embolism or acute renal failure, as well as septicaemia persisting for more than 72 hours in spite of antibiotic treatment, immediate valve replacement is usually indispensable. Furthermore, large vegetations found by echocardiography, or infections caused by staphylococci, gramnegative bacteria or fungi are arguments for early surgery. For most of the IE pathogens the antibiotic treatment concept is nowadays widely acknowledged. Penicillin-sensitive streptococci are treated with a combination of penicillin S and an amino-glycoside (streptomycin). If the penicillin-MBK is very low, combined treatment can usually be abandoned. In patients allergic to penicillin, treatment with lincomycin has advantages over vancomycin or cephalosporins. In enterococcal IE, ampicillin plus aminoglycoside is the combination of choice. Streptomycin has preference over gentamicin here only if the enterococci are not streptomycin-resistant. If penicillin allergy is evident, the new beta-lactam antibiotic imipenem offers a way out of the present therapy dilemma. For penicillin-sensitive staphylococci a combination of penicillin-G with gentamicin given over 6 weeks is recommended. In case of penicillin allergy, cefazolin or vancomycin may provide a substitute

  2. Eradication of infectious diseases in heterogeneous populations

    SciTech Connect

    Travis, C.C.; Lenhart, S.M.

    1987-04-01

    A model is presented of infectious disease in heterogeneous populations, which allows for variable intra- to intergroup contact ratios. The authors give necessary and sufficient conditions for disease eradication by means of vaccination. Smallpox is used as an illustrative example.

  3. Advances in microfluidics in combating infectious diseases.

    PubMed

    Tay, Andy; Pavesi, Andrea; Yazdi, Saeed Rismani; Lim, Chwee Teck; Warkiani, Majid Ebrahimi

    2016-01-01

    One of the important pursuits in science and engineering research today is to develop low-cost and user-friendly technologies to improve the health of people. Over the past decade, research efforts in microfluidics have been made to develop methods that can facilitate low-cost diagnosis of infectious diseases, especially in resource-poor settings. Here, we provide an overview of the recent advances in microfluidic devices for point-of-care (POC) diagnostics for infectious diseases and emphasis is placed on malaria, sepsis and AIDS/HIV. Other infectious diseases such as SARS, tuberculosis, and dengue are also briefly discussed. These infectious diseases are chosen as they contribute the most to disability-adjusted life-years (DALYs) lost according to the World Health Organization (WHO). The current state of research in this area is evaluated and projection toward future applications and accompanying challenges are also discussed. PMID:26854743

  4. Infectious Mononucleosis: Recognition and Management in Athletes.

    ERIC Educational Resources Information Center

    Eichner, Edward R.

    1987-01-01

    Infectious mononucleosis strikes many young athletes. Considered here are its epidemiology, pathophysiology, diagnosis, natural course, complications, and management. The focus is on concerns of athletes with a perspective on personality, convalescence, and chronic fatigue. (Author/MT)

  5. What's the Difference Between Infectious and Contagious?

    MedlinePlus

    ... Hot Topics Meningitis Choosing Your Mood Prescription Drug Abuse Healthy School Lunch Planner How Can I Help a Friend Who Cuts? What's the Difference Between Infectious and Contagious? KidsHealth > For Teens > What's ...

  6. Coping with Stress during Infectious Disease Outbreaks

    MedlinePlus

    · Coping With Stress During Infectious Disease Outbreaks What You Should Know When you hear, read, or watch news about an outbreak ... you may feel anxious and show signs of stress. These signs of stress are normal, and may ...

  7. Infectious Diseases and Immunizations. Matrix No. 15.

    ERIC Educational Resources Information Center

    Sever, John L.

    This paper summarizes the major advances achieved by research in the fields of infectious diseases and immunizations during the 1970s, and delineates directions for future research in these fields. (Author/MP)

  8. Infectious Mononucleosis and Mononucleosis Syndromes

    PubMed Central

    Fiala, Milan; Heiner, Douglas C.; Turner, Jerrold A.; Rosenbloom, Barry; Guze, Lucien B.

    1977-01-01

    Infectious mononucleosis (IM) and cytomegalovirus (CMV) mononucleosis are caused by a primary infection with related viruses, Epstein-Barr virus (EBV) and CMV. Despite the similarity of clinical manifestations, basic differences exist: (1) The heterophil antibody (HA) response is absent in CMV mononucleosis, whereas it is present in IM. (2) In IM atypical lymphocytosis reflects proliferation of B cells early and of T cells later in the disease course; in CMV mononucleosis the situation appears complex. (3) In blood, EBV is restricted to B lymphocytes, whereas CMV is found in polymorphonuclear and mononuclear leukocytes. (4) Complications of CMV mononucleosis such as hepatitis and pneumonitis may be due to virus cytopathic effect in target organs. Prominent tonsillopharyngitis with adenopathy, and visceral complications of IM are related to lymphoproliferation which is self-limited except in males with a rare familial defect in defense against EBV. Immune complex-mediated pathology may occur in both diseases. (5) CMV is frequently transmitted to a fetus in utero or to an infant during or after birth, and this occasionally leads to severe cytomegalic inclusion disease; vertical transmission of EBV appears to be exceptional. (6) Secondary EBV infections are associated with certain malignancies whereas such an association has not been recognized in the case of CMV. Toxoplasma gondii is another cause of HA-negative mononucleosis. Its complications in the heart, in skeletal muscle and in the central nervous system are related to direct invasion by the parasite. Cellular immunity plays an important role in defense against all three agents. PMID:195404

  9. Frequent Hemodialysis Fistula Infectious Complications

    PubMed Central

    Lok, Charmaine E.; Sontrop, Jessica M.; Faratro, Rose; Chan, Christopher T.; Zimmerman, Deborah Lynn

    2014-01-01

    Background Few studies have examined if infectious arteriovenous access complications vary with the cannulation technique and whether this is modified by dialysis frequency. We compared the infection rate between fistulas cannulated using buttonhole versus stepladder techniques for patients treated with short daily (SDH) or nocturnal hemodialysis at home (NHD). We also compared patients receiving conventional intermittent hemodialysis (CIHD) using stepladder cannulation. Methods Data were prospectively collected from 631 patients dialyzed with a fistula from 2001 to 2010 (Toronto and Ottawa, Canada). We compared the person-time incidence rate of bacteremia and local fistula infections using the exact binomial test. Results Forty-six (7.3%) patients received SDH (≥5 sessions/week, 2-4 h/session), 128 (20.3%) NHD (≥4 sessions/week, ≥5 h/session) and 457 (72%) CIHD (3 sessions/week, ≤4 h/session). Fifty percent of SDH and 72% of NHD patients used the buttonhole technique. There were 39 buttonhole-related bacteremias (rate: 0.196/1,000 fistula days) and at least 2 local buttonhole site infections. Staphylococcus aureus accounted for 85% of the bacteremias. There were 5 (13%) infection-related hospitalizations and 3 (10%) serious metastatic infections, including fistula loss. In comparison, there was 1 possible fistula-related infection in CIHD during follow-up (rate: 0.002/1,000 fistula days). Conclusions The rate of buttonhole-related infections was high among patients on frequent hemodialysis and more than 50 times greater than that among patients on CIHD with the stepladder technique. Most bacteremias were due to S. aureus – with serious consequences. The risks and benefits of buttonhole cannulation require individual consideration with careful monitoring, prophylaxis and management. PMID:25473405

  10. [Ultrasound study of "acute appendicitis," an elective procedure or obligation in general surgery. A prospective study].

    PubMed

    Meiser, G; Meissner, K; Sattlegger, P

    1987-08-01

    576 patients admitted for suspected acute appendicitis were prospectively assessed by sonography following physical examination. The collective comprised - as proven by operation - 156 patients with acute appendicitis, 178 patients with chronic appendicitis or mesenteric lymphadenitis, as proven by observation, 186 patients suffering from gastroenteritis. 56 patients suffered from other diseases and 21 of them required urgent surgery. Based on clinical symptoms, correct diagnosis had been made in 433 patients (75%): gastroenteritis n = 186, chronic appendicitis or lymphadenitis n = 111 and acute appendicitis n = 136 (87%). In 123 patients the diagnosis was false positive, in 20 patients false negative. Based on sonographic assessment, 537 patients (93%) were correctly diagnosed; thus, in 129 patients (83%) an inflamed appendix was confirmed, in 56 patients; diagnosis of unrelated entities requiring urgent surgery correct in 21 cases. In 12 patients with mesenteric lymphadenitis - as proven by operation-a false positive, in another 27 patients with acute appendicitis a false negative diagnosis was made. The combination of clinical assessment and sonographic diagnosis yielded a correct diagnosis in 97% (560/576) comprising 414 true negative and 146 true positive results (94%) in respect of acute appendicitis. PMID:3313723

  11. Paediatric infectious diseases: the last 50 years.

    PubMed

    Starr, Mike

    2015-01-01

    Many advances and challenges have occurred in the field of paediatric infectious diseases during the past 50 years. It is impossible to cover all of these in a short review, but a few highlights and lowlights will be covered. These include virtual disappearance of some infectious diseases, emergence of new ones, infections in the immunocompromised, antimicrobial resistance, development of new and improved antimicrobials, improved diagnostic tests and the Human Microbiome Project. PMID:25557805

  12. Emerging infectious diseases and amphibian population declines.

    PubMed Central

    Daszak, P.; Berger, L.; Cunningham, A. A.; Hyatt, A. D.; Green, D. E.; Speare, R.

    1999-01-01

    We review recent research on the pathology, ecology, and biogeography of two emerging infectious wildlife diseases, chytridiomycosis and ranaviral disease, in the context of host-parasite population biology. We examine the role of these diseases in the global decline of amphibian populations and propose hypotheses for the origins and impact of these panzootics. Finally, we discuss emerging infectious diseases as a global threat to wildlife populations. PMID:10603206

  13. Acute Bronchitis

    MedlinePlus

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Most cases of acute bronchitis ...

  14. Emerging infectious diseases: Focus on infection control issues for novel coronaviruses (Severe Acute Respiratory Syndrome-CoV and Middle East Respiratory Syndrome-CoV), hemorrhagic fever viruses (Lassa and Ebola), and highly pathogenic avian influenza viruses, A(H5N1) and A(H7N9).

    PubMed

    Weber, David J; Rutala, William A; Fischer, William A; Kanamori, Hajime; Sickbert-Bennett, Emily E

    2016-05-01

    Over the past several decades, we have witnessed the emergence of many new infectious agents, some of which are major public threats. New and emerging infectious diseases which are both transmissible from patient-to-patient and virulent with a high mortality include novel coronaviruses (SARS-CoV, MERS-CV), hemorrhagic fever viruses (Lassa, Ebola), and highly pathogenic avian influenza A viruses, A(H5N1) and A(H7N9). All healthcare facilities need to have policies and plans in place for early identification of patients with a highly communicable diseases which are highly virulent, ability to immediately isolate such patients, and provide proper management (e.g., training and availability of personal protective equipment) to prevent transmission to healthcare personnel, other patients and visitors to the healthcare facility. PMID:27131142

  15. 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

  16. 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 ...

  17. Innate danger signals in acute injury: From bench to bedside.

    PubMed

    Fontaine, Mathieu; Lepape, Alain; Piriou, Vincent; Venet, Fabienne; Friggeri, Arnaud

    2016-08-01

    The description of the systemic inflammatory response syndrome (SIRS) as a reaction to numerous insults marked a turning point in the understanding of acute critical states, which are intensive care basic cases. This concept highlighted the final inflammatory response features whichever the injury mechanism is: infectious, or non-infectious such as extensive burns, traumas, major surgery or acute pancreatitis. In these cases of severe non-infectious insult, many endogenous mediators are released. Like infectious agents components, they can activate the immune system (via common signaling pathways) and initiate an inflammatory response. They are danger signals or alarmins. These molecules generally play an intracellular physiological role and acquire new functions when released in extracellular space. Many progresses brought new information on these molecules and on their function in infectious and non-infectious inflammation. These danger signals can be used as biomarkers and provide new pathophysiological and therapeutic approaches, particularly for immune dysfunctions occurring after an acute injury. We present herein the danger model, the main danger signals and the clinical consequences. PMID:26987739

  18. Fulminant Epstein-Barr virus - infectious mononucleosis in an adult with liver failure, splenic rupture, and spontaneous esophageal bleeding with ensuing esophageal necrosis: a case report

    PubMed Central

    2014-01-01

    Introduction Infectious mononucleosis is a clinical syndrome most commonly associated with primary Epstein-Barr virus infection. The majority of patients with infectious mononucleosis recovers without apparent sequelae. However, infectious mononucleosis may be associated with several acute complications. In this report we present a rare case of esophageal rupture that has never been described in the literature before. Case presentation We present the case of an 18-year-old Caucasian man affected by severe infectious mononucleosis complicated by fulminant hepatic failure, splenic rupture and esophageal necrosis. Conclusions Although primary Epstein-Barr virus infection is rarely fatal, fulminant infection may occur - in this case leading to hepatic failure, splenic rupture and esophageal necrosis, subsequently making several surgical interventions necessary. We show here that infectious mononucleosis is not only a strictly medical condition, but can also lead to severe surgical complications. PMID:24499457

  19. Verotoxinogenic Citrobacter freundii associated with severe gastroenteritis and cases of haemolytic uraemic syndrome in a nursery school: green butter as the infection source.

    PubMed

    Tschape, H; Prager, R; Streckel, W; Fruth, A; Tietze, E; Böhme, G

    1995-06-01

    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. PMID:7781732

  20. Severe acute malnutrition and infection

    PubMed Central

    Jones, Kelsey D J; Berkley, James A

    2014-01-01

    Severe acute malnutrition (SAM) is associated with increased severity of common infectious diseases, and death amongst children with SAM is almost always as a result of infection. The diagnosis and management of infection are often different in malnourished versus well-nourished children. The objectives of this brief are to outline the evidence underpinning important practical questions relating to the management of infectious diseases in children with SAM and to highlight research gaps. Overall, the evidence base for many aspects covered in this brief is very poor. The brief addresses antimicrobials; antipyretics; tuberculosis; HIV; malaria; pneumonia; diarrhoea; sepsis; measles; urinary tract infection; nosocomial Infections; soil transmitted helminths; skin infections and pharmacology in the context of SAM. The brief is structured into sets of clinical questions, which we hope will maximise the relevance to contemporary practice. PMID:25475887