Predicting the distribution of canine leishmaniasis in western Europe based on environmental variables.

The domestic dog is the reservoir host of Leishmania infantum, the causative agent of zoonotic visceral leishmaniasis endemic in Mediterranean Europe. Targeted control requires predictive risk maps of canine leishmaniasis (CanL), which are now explored. We databased 2187 published and unpublished surveys of CanL in southern Europe. A total of 947 western surveys met inclusion criteria for analysis, including serological identification of infection (504, 369 dogs tested 1971-2006). Seroprevalence was 23 2% overall (median 10%). Logistic regression models within a GIS framework identified the main environmental predictors of CanL seroprevalence in Portugal, Spain, France and Italy, or in France alone. A 10-fold cross-validation approach determined model capacity to predict point-values of seroprevalence and the correct seroprevalence class (20%). Both the four-country and France-only models performed reasonably well for predicting correctly the 20% seroprevalence classes (AUC >0 70). However, the France-only model performed much better for France than the four-country model. The four-country model adequately predicted regions of CanL emergence in northern Italy (<5% seroprevalence). Both models poorly predicted intermediate point seroprevalences (5-20%) within regional foci, because surveys were biased towards known rural foci and Mediterranean bioclimates. Our recommendations for standardizing surveys would permit higher-resolution risk mapping

Seroprevalence Of Hepatitis-b Virus In Mid And Far Western Region In Nepal

Hepatitis B is significant health problems that might involve the late sequel of liver cirrhosis and hepatocellular carcinoma. The present study aimed to know the seroprevalence of hepatitis B virus (HBV) in mid and far western region in Nepal with various clinical conditions.This was a retrospective study conducted in mid and far western region in Nepal, which was performed in the Central Laboratory of Microbiology at Nepalgunj Medical College and Teaching Hospital, Banke, Nepal during the period of September 2010 to April 2012. The serum samples were tested for Hepatitis B surface Antigen (HBsAg) by Sandwich immunoassay. Total 7010 patients including 43.72% male and 56.28% female were tested for HBsAg. Of them, 135 were positive and 6875 were negative.In 135 positive cases 84 (62.22%) were male and 51 (37.77% )were female. In 6875 negative cases 2981 were male and 3894 were female. The seroprevalence rate of HBV was 1.93% in mid and far western region in Nepal. Seroprevalence of HBV seems to be higher in male then the female; it was 2.75% in male and 1.29% in female.The study revealed that the seroprevalence of HBV was alarmingly higher in such a population, which probably reflects a high background prevalence of HBV infections should be taken into consideration and Implementation of community-based preventive measures and improved strategies for safe blood supply might prove useful to decrease the seroprevalence

Seroprevalence of bluetongue serotype 8 in cattle in the Netherlands in spring 2007, and its consequences

A cross-sectional study was carried out in spring 2007, at the end of the first bluetongue outbreak season, to determine the geographical spread of bluetongue virus serotype 8 (BTV-8) infection in cattle in the Netherlands and the consequences for some production parameters. Blood samples from cattle submitted to the laboratory of the Dutch Animal Health Service for other voluntary and obligatory health programmes were tested serologically for BTV-8. in total, 37,073 samples were tested and 659 (1.78 per cent) were seropositive. The samples came from 5436 herds, of which 45 per cent of herds had only one sample submitted from them. The prevalence was highest in the south of the country, where the outbreak had started, and decreased towards the north. in 340 herds more than 50 per cent of cattle were tested, of which 156 herds were located in infected compartments, and in 37 of these herds (10.9 per cent) at least one positive cow was detected. The average within-herd prevalence in the 37 herds was 39.3 per cent: 2.2 per cent in I I dairy herds, 68.4 per cent in 20 small-scale herds and 14 per cent in four suckler cow herds. The prevalence differed significantly between herd types but did not show a geographical trend. The average net return for milk production amounted to is an element of 2417/cow/year and it decreased significantly on average by is an element of 48/ cow/year in the bluetongue-infected dairy herds during the bluetongue period. on the small-scale farms, the incidence of mortality increased by 3.2 (95 per cent confidence interval [a] 1.2 to 9.1) times in the infected herds during the bluetongue period, but the voluntary culling rate decreased by a factor of 2.3 (95 per cent Cl 1.1 to 4.8)

Investigation of Anaplasma marginale Seroprevalence in a Traditionally Managed Large California Beef Herd.

Recent observations by stakeholders suggested that ecosystem changes may be driving an increased incidence of bovine erythrocytic anaplasmosis, resulting in a reemerging cattle disease in California. The objective of this prospective cohort study was to estimate the incidence of Anaplasma marginale infection using seroconversion in a northern California beef cattle herd. A total of 143 Black Angus cattle (106 prebreeding heifers and 37 cows) were enrolled in the study. Serum samples were collected to determine Anaplasma marginale seroprevalence using a commercially available competitive enzyme-linked immunosorbent assay test kit. Repeat sampling was performed in seronegative animals to determine the incidence density rate from March through September (2013). Seroprevalence of heifers was significantly lower than that of cows at the beginning of the study (P &lt; 0.001) but not at study completion (P = 0.075). Incidence density rate of Anaplasma marginale infection was 8.17 (95% confidence interval: 6.04, 10.81) cases per 1000 cow-days during the study period. Study cattle became Anaplasma marginale seropositive and likely carriers protected from severe clinical disease that might have occurred had they been first infected as mature adults. No evidence was found within this herd to suggest increased risk for clinical bovine erythrocytic anaplasmosis

Serological evidence for Japanese encephalitis and West Nile virus infections in domestic birds in Cambodia

Mosquito-borne flaviviruses with an enzootic transmission cycle like Japanese encephalitis virus (JEV) and West Nile virus (WNV) are a major public health concern. The circulation of JEV in Southeast Asia is well-documented, and the important role of pigs as amplification hosts for the virus is long known. The influence of other domestic animals especially poultry that lives in high abundance and close proximity to humans is not intensively analyzed. Another understudied field in Asia is the presence of the closely related WNV. Such analyses are difficult to perform due to the intense antigenic cross-reactivity between these viruses and the lack of suitable standardized serological assays. The main objective of this study was to assess the prevalence of JEV and WNV flaviviruses in domestic birds, detailed in chickens and ducks, in three different Cambodian provinces. We determined the flavivirus seroprevalence using an hemagglutination inhibition assay (HIA). Additionally, we investigated in positive samples the presence of JEV and WNV neutralizing antibodies (nAb) using foci reduction neutralization test (FRNT). We found 29% (180/620) of the investigated birds positive for flavivirus antibodies with an age-depended increase of the seroprevalence (OR = 1.04) and a higher prevalence in ducks compared to chicken (OR = 3.01). Within the flavivirus-positive birds, we found 43% (28/65) with nAb against JEV. We also observed the expected cross-reactivity between JEV and WNV, by identifying 18.5% double-positive birds that had higher titers of nAb than single-positive birds. Additionally, seven domestic birds (10.7%) showed only nAb against WNV and no nAb against JEV. Our study provides evidence for an intense JEV circulation in domestic birds in Cambodia, and the first serological evidence for WNV presence in Southeast Asia since decades. These findings mark the need for a re-definition of areas at risk for JEV and WNV transmission, and the need for further and intensified surveillance of mosquito-transmitted diseases in domestic animals

Estimation of the worldwide seroprevalence of cytomegalovirus : a systematic review and meta-analysis

Cytomegalovirus (CMV) infection does not usually produce symptoms when it causes primary infection, reinfection, or reactivation because these three types of infection are all controlled by the normal immune system. However, CMV becomes an important pathogen in individuals whose immune system is immature or compromised, such as the unborn child. Several vaccines against CMV are currently in clinical trials that aim to induce immunity in seronegative individuals and/or to boost the immunity of those with prior natural infection (seropositives). To facilitate estimation of the burden of disease and the need for vaccines that induce de novo immune responses or that boost pre-existing immunity to CMV, we conducted a systematic survey of the published literature to describe the global seroprevalence of CMV IgG antibodies. We estimated a global CMV seroprevalence of 83% (95%UI: 78-88) in the general population, 86% (95%UI: 83-89) in women of childbearing age, and 86% (95%UI: 82-89) in donors of blood or organs. For each of these three groups, the highest seroprevalence was seen in the World Health Organisation (WHO) Eastern Mediterranean region 90% (95%UI: 85-94) and the lowest in WHO European region 66% (95%UI: 56-74). These estimates of the worldwide CMV distribution will help develop national and regional burden of disease models and inform future vaccine development efforts

Historical Patterns of Arboviral Seroprevalence across Africa and Asia

The emergence and resurgence of arboviruses in recent history is challenging our scientific understanding of mosquito-borne diseases and their transmission. To better contextualize recent epidemics and gain insight into historical trends in arbovirus incidence, we conducted a literature review to identify serosurveys from Africa and Asia. We compiled all serosurvey data into a table and tested for variation in disease incidence across countries and between age categories. Our analysis showed that disease incidence was consistently higher in the \u3e15 age category than the \u3c15 age category and revealed significant variation in incidence across countries. In addition, the mean incidence of yellow fever virus was substantially higher than the incidences of the other diseases included in the analysis. Higher incidence in the \u3e15 age category is likely due to the long-term persistence of antibodies in human sera, while a higher incidence of yellow fever can likely be attributed to widespread vaccine use. Characteristics of countries with high disease incidence included a tropical climate, extended rainy season, and flat terrain, and countries with low disease incidence occurred at higher elevations and/or reflected a desert climate. This analysis can hopefully reveal the conditions most important in facilitating an arbovirus outbreak, leading to targeted prevention strategies in high-risk areas. It also highlights the need for continued serosurveys as a method of documenting disease spread

Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong.

BACKGROUND: Health authorities worldwide, especially in the Asia Pacific region, are seeking effective public-health interventions in the continuing epidemic of severe acute respiratory syndrome (SARS). We assessed the epidemiology of SARS in Hong Kong. METHODS: We included 1425 cases reported up to April 28, 2003. An integrated database was constructed from several sources containing information on epidemiological, demographic, and clinical variables. We estimated the key epidemiological distributions: infection to onset, onset to admission, admission to death, and admission to discharge. We measured associations between the estimated case fatality rate and patients' age and the time from onset to admission. FINDINGS: After the initial phase of exponential growth, the rate of confirmed cases fell to less than 20 per day by April 28. Public-health interventions included encouragement to report to hospital rapidly after the onset of clinical symptoms, contact tracing for confirmed and suspected cases, and quarantining, monitoring, and restricting the travel of contacts. The mean incubation period of the disease is estimated to be 6.4 days (95% CI 5.2-7.7). The mean time from onset of clinical symptoms to admission to hospital varied between 3 and 5 days, with longer times earlier in the epidemic. The estimated case fatality rate was 13.2% (9.8-16.8) for patients younger than 60 years and 43.3% (35.2-52.4) for patients aged 60 years or older assuming a parametric gamma distribution. A non-parametric method yielded estimates of 6.8% (4.0-9.6) and 55.0% (45.3-64.7), respectively. Case clusters have played an important part in the course of the epidemic. INTERPRETATION: Patients' age was strongly associated with outcome. The time between onset of symptoms and admission to hospital did not alter outcome, but shorter intervals will be important to the wider population by restricting the infectious period before patients are placed in quarantine

Transmission dynamics of the etiological agent of SARS in Hong Kong: impact of public health interventions.

We present an analysis of the first 10 weeks of the severe acute respiratory syndrome (SARS) epidemic in Hong Kong. The epidemic to date has been characterized by two large clusters-initiated by two separate "super-spread" events (SSEs)-and by ongoing community transmission. By fitting a stochastic model to data on 1512 cases, including these clusters, we show that the etiological agent of SARS is moderately transmissible. Excluding SSEs, we estimate that 2.7 secondary infections were generated per case on average at the start of the epidemic, with a substantial contribution from hospital transmission. Transmission rates fell during the epidemic, primarily as a result of reductions in population contact rates and improved hospital infection control, but also because of more rapid hospital attendance by symptomatic individuals. As a result, the epidemic is now in decline, although continued vigilance is necessary for this to be maintained. Restrictions on longer range population movement are shown to be a potentially useful additional control measure in some contexts. We estimate that most currently infected persons are now hospitalized, which highlights the importance of control of nosocomial transmission

Identification of individuals with gonorrhoea within sexual networks: a population-based study.

BACKGROUND: Molecular typing of Neisseria gonorrhoeae and contact tracing provide a combined approach for analysis of sexual networks in metropolitan areas, although there are some difficulties in application. Our aim was to examine the application of high-throughput molecular approaches that can identify individuals in linked sexual networks. METHODS: We characterised 2045 isolates of N gonorrhoeae from patients presenting at 13 major sexually transmitted infection clinics in London, UK, between June 1 and Nov 30, 2004. All isolates were assigned a sequence type (strain) on the basis of the sequences of internal fragments of two highly polymorphic loci, por and tbpB. These types were matched to demographic and behavioural data obtained at the clinic for each patient. We assessed the congruence in the demographic and behavioural characteristics of individuals infected with the same strain. FINDINGS: We identified 21 prevalent strains in this diverse gonococcal population, each infecting between 20 and 124 individuals. Seven of these strains were predominantly from men who have sex with men; the remaining 14 were predominantly from heterosexual people. No differences were recorded between the strains associated with men who have sex with men in the demographic or behavioural characteristics of infected individuals. By contrast, significant differences in age (p<0.0001), ethnicity (p=0.001), proportion of women (p=0.01), and HIV status (p=0.03) were noted between the 14 prevalent heterosexual-associated strains. Heterosexuals with strains not shared by others in the sample were significantly older (p=0.0005) and more likely to have had sex outside the UK (p<0.0001) than those sharing a strain with at least one other. INTERPRETATION: The discriminatory high throughput strain characterisation method applied here identified localised transmission networks and suggests little bridging between networks of men who have sex with men and heterosexual networks