Cryptosporidiosis in Humans with Reference to the First Case of Cryptosporidium hominis Infection in Turkey

Amaç: Cryptosporidiosis dünya çapında bir zoonozdur. Mikroskopik muayene, etken türlerin belirgin olmayan morfolojik özellikleri nedeniyle başarısız olabilir. Bu nedenle moleküler tanı daha da önem kazanmıştır.Yöntemler: Cryptosporidium spp. oosistlerini belirlemek için 150 hastanın dışkı örnekleri karbol-fuksin boya kullanılarak incelendi. Pozitif örneklerde farklı türlerin belirlenmesi için nested polimeraz zincir reaksiyonu-restriksiyon parça uzunluk polimorfizmi (PZR-RPUP) kullanıldı. Örnekler, diğer parazitler için yaş preparasyon ve çinko sülfat flotasyonu yöntemleriyle de araştırıldı.Bulgular: Mikroskobik muayene ve moleküler yöntemlerle sırasıyla %0,67 (1/150) ve %8,93 (5/56) pozitiflik saptandı. Nested PZR-RPUP bir örnekte Cryptosporidium hominis'in (C. hominis), dört örnekte ise Cryptosporidium parvum'un (C. parvum) saptanmasına olanak verdi. Bu çalışma ile C. hominis Türkiye'de ilk kez insanlarda bildirildi. Enfekte olanlar arasında üçü çocuktu, dışkısında C. parvum oosistleri görülen dört hastada gastroenterit, C. hominis pozitif olan bir hastada ise mide bulantısı ve kusmanın eşlik ettiği gastroenterit vardı. Enfekte kişilerin hiçbirinde Giardia spp. ve Entamoeba spp. saptanmadı.Sonuç:­ C. parvum olgularının C. hominis olgularından fazla olması, enfekte kişilerin hayvancılık yapılmasına izin verilmeyen kentsel alanda yaşamasına rağmen, bir zoonotik bulaşma olduğunu düşündürmektedir. Bununla birlikte, şehir suyundaki su kaynaklı patojen kirliliği bir bulaşma faktörü olarak düşünülmektedir.Aim: Cryptosporidiosis is a worldwide zoonosis. Microscopic examinations may fail due to indistinctive morphological peculiarities of causative species. Hence, molecular diagnostics has become more important. Methods: Stool samples from 150 patients were examined using carbol-fuchsin stain to determine Cryptosporidium spp. oocysts. Combined nested polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used for establishing different species in positive samples. The samples were also screened for other parasites by wet-mount and zinc sulfate flotation methods. Results: Microscopic examinations and molecular techniques revealed 0.67% (1/150) and 8.93% (5/56) positivity, respectively. Nested PCRRFLP enabled the detection of Cryptosporidium hominis (C. hominis) in one sample, while Cryptosporidium parvum (C. parvum) was detected in four samples. With this study, C. hominis was reported from humans for the first time in Turkey. Among infected ones, three of which were children, four patients excreted C. parvum oocysts had gastroenteritis, and a patient positive for C. hominis had gastroenteritis accompanied by nausea and vomiting. No Giardia spp. and Entamoeba spp. were detected in all infected individuals. Conclusion: C. parvum cases outnumbered C. hominis cases, suggesting a zoonotic transmission although infected individuals were living in an urban area where animal husbandry was not allowed. However, water-borne pathogen contamination in the city's water supply is considered a factor for transmission

The first clinical case due to AP92 like strain of Crimean-Congo Hemorrhagic Fever virus and a field survey

<p>Abstract</p> <p>Background</p> <p>Crimean-Congo Hemorrhagic Fever (CCHF) is a fatal infection, but no clinical case due to AP92 strain was reported. We described the first clinical case due to AP92 like CCHFV.</p> <p>Methods</p> <p>A case infected by a AP92 like CCHFV was detected in Balkanian part of Turkey. Diagnosis was confirmed by RT-PCR and sequencing. A human serologic and tick survey studies were performed in the region, where the case detected.</p> <p>Results</p> <p>Thirty eight individuals out of 741 were found to be anti CCHFV IgM positive. The attack rate for overall CCHFV was calculated as 5.2%. In univariate analyses, CCHFV IgM positivity was found to be associated with the age (p < 0.001), male gender (p = 0.001), agricultural activity (p = 0.036), and history of tick bite (p = 0.014). In multivariate analysis, older age (OR: 1.03, CI:1.01–1.05, p < 0.001), male gender were found to be the risk factors (OR: 2.5, CI:1.15–5.63, p = 0.020) for CCHFV infection.</p> <p>Conclusion</p> <p>This is the first human case with AP92 like CCHFV infection. Furthermore, this is the first report of AP92 like strain in Turkey. In the region, elderly males carry the highest risk for CCHFV infection.</p

Imported Crimean-Congo hemorrhagic fever cases in Istanbul

We described a series of imported cases of Crimean-Congo Hemorrhagic Fever (CCHF) in Istanbul and investigated the genetic diversity of the virus. All the suspected cases of CCHF, who were applied to the health centers in Istanbul, were screened for CCHF virus (CCHFv) infection by using semi-nested Polymerase Chain Reaction (PCR) following RT-PCR. Simultaneous blood samples were also sent to the national reference laboratory in Ankara for serologic investigation. In 10 out of 91 patients, CCHFv was detected by PCR, and among 9 out of 10, anti-CCHFv IgM antibodies were also positive. Clinical features were characterized by fever, myalgia, and hemorrhage. The levels of liver enzymes, creatinine phosphokinase, and lactate dehydrogenase were elevated, and bleeding markers were prolonged. All the cases were treated with ribavirin. There was no fatal case. All the strains clustered within the same group as other Europe/Turkey isolates

Türkiye'de i?ki komşu i?lde i?nsanları tutan kene da?ılımındaki farklılıklar]

In this study, tick samples were examined, which were obtained from humans who applied to the regional hospitals with complaints of tick bites between May and November 2007 in two neighboring provinces, Kocaeli and Sakarya, in Eastern Marmara Region of Turkey. The samples were evaluated in terms of species, developmental stage and season for each province. In the course of the study, totally 3121 ticks were collected. Of those, 1610 ticks were from Kocaeli, 1511 ticks were from Sakarya. Among the total samples Ixodes spp. (52.87%), Hyalomma spp. (41.78%), Rhipicephalus spp. (4.2%), Haemaphysalis spp. (0.7%), Dermacentor spp. (0.35%) and Argas spp. (0.003%) were identified. Additionally, it was seen that one person was bitten by male Rhipicephalus (Boophilus) annulatus and one other was bitten by nymphal stage of Otobius megnini; these species were recorded for the first time in humans in Turkey. Concerning with the incidences of tick species, majority belongs to Hyalomma spp. (60.06%) in Kocaeli and Ixodes spp. (75.65%) in Sakarya. There were somewhat differences also in incidences of other tick species between these provinces. These disparities encountered between two neighboring provinces which have adjacent coordinates and similar climates, showed that the risk of tick bites or characteristic of this risk in a region could vary distinctly in terms of sub-regions which have some specific sub-conditions

The human infesting ticks in the city of Istanbul and its vicinity with reference to a new species for Turkey

This study, based on a passive surveillance, has examined 21198 ticks which were detached from a number of people who received hospital consultation and service following the complaints of tick bites between the years of 2006 and 2011 in the city of Istanbul and its vicinity. The ticks have been evaluated in terms of species, developmental stage, gender, seasonal distribution, and locality as urban and rural areas. They belong to 21 species from the genera Ixodes, Hyalomma, Rhipicephalus, Haemaphysalis, Dermacentor, Argas, Ornithodoros and Otobius. The most prevalent ticks are the nymphs of Ixodes and Hyalomma, and Ixodes ricinus. While Ornithodorus lahorensis and Ixodes gibbosus have been seen on humans in Turkey for the first time, Ixodes acuminatus is a new record for the tick fauna of Turkey