Hematological Manifestations in Brucellosis Cases in Turkey

The hematological findings of 233 patients with brucellosis are presented and the possible pathologies discussed. Anemia was present in 128 patients (55%), leukopenia in 49 (21%) and thrombocytopenia in 59 (26%). Bone marrow aspirates of 18 patients (8%) with pancytopenia were examined. The bone marrow was hypercellular in 15 and normocellular in 3 patients. Granulomatous lesions were detected in 12 cases (67%), and slight to moderate cytophagocytosis of erythrocytes, granulocytes and platelets existed in all patients. Blood cell counts reverted to normal within 2-3 weeks of initiating chemotherapy with recovery from the disease.</p

Cutaneous manifestations of anthrax in Eastern Anatolia: a review of 39 cases.

Anthrax is essentially a disease of grazing herbivorous animals. The most common form of the disease is cutaneous anthrax, which accounts for 95% of all cases. We report here 39 cutaneous anthrax cases in humans that were seen in Eastern Anatolia over a six-year period. The clinical presentation was malignant edema in 16 of the cases (41%) and malignant pustule in 23 (59%). A secondary bacterial infection was present in 13 patients (33.3%) in the vicinity of the lesions. The agent was observed using Gram-stained smears in 25 patients (64%), and Bacillus anthracis was isolated from 15 patients (38.5%). All of the patients were treated with penicillin G or penicillin procaine, except one patient who had a penicillin allergy. One patient with cervical edema (2.5%) died as a result of laryngeal edema and sepsis syndrome. In conclusion, we found that the appearance of the skin lesion of cutaneous anthrax may vary, and this fact, combined with the rarity of this disease, which contributes to a general lack of experience among medical personnel, may make diagnosis difficult in nonagricultural settings</p

Brucella and Osteoarticular Cell Activation: Partners in Crime

Osteoarticular brucellosis is the most common presentation of human active disease although its prevalence varies widely. The three most common forms of osteoarticular involvement are sacroiliitis, spondylitis, and peripheral arthritis. The molecular mechanisms implicated in bone damage have been recently elucidated. B. abortus induces bone damage through diverse mechanisms in which TNF-α and the receptor activator of nuclear factor kappa-B ligand (RANKL)-the natural modulator of bone homeostasis are involved. These processes are driven by inflammatory cells, like monocytes/macrophages, neutrophils, Th17 CD4+ T, and B cells. In addition, Brucella abortus has a direct effect on osteoarticular cells and tilts homeostatic bone remodeling. These bacteria inhibit bone matrix deposition by osteoblasts (the only bone cells involved in bone deposition), and modify the phenotype of these cells to produce matrix metalloproteinases (MMPs) and cytokine secretion, contributing to bone matrix degradation. B. abortus also affects osteoclasts (cells naturally involved in bone resorption) by inducing an increase in osteoclastogenesis and osteoclast activation; thus, increasing mineral and organic bone matrix resorption, contributing to bone damage. Given that the pathology induced by Brucella species involved joint tissue, experiments conducted on synoviocytes revealed that besides inducing the activation of these cells to secrete chemokines, proinflammatory cytokines and MMPS, the infection also inhibits synoviocyte apoptosis. Brucella is an intracellular bacterium that replicates preferentially in the endoplasmic reticulum of macrophages. The analysis of B. abortus-infected synoviocytes indicated that bacteria also replicate in their reticulum suggesting that they could use this cell type for intracellular replication during the osteoarticular localization of the disease. Finally, the molecular mechanisms of osteoarticular brucellosis discovered recently shed light on how the interaction between B. abortus and immune and osteoarticular cells may play an important role in producing damage in joint and bone.Fil: Giambartolomei, Guillermo Hernan. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; ArgentinaFil: Arriola Benitez, Paula Constanza. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; ArgentinaFil: Delpino, María Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Inmunología, Genética y Metabolismo; Argentin

Opinions of Infectious Diseases and Clinical Microbiology Physicians on Hospital Pandemic Management and Factors Influencing Reading the Pandemic Influenza National Preparedness Plan

Introduction: Infectious Diseases and Clinical Microbiology (IDCM) physicians have critical importance in terms of pandemic management in hospitals. There are recommendations for hospitals in the national pandemic preparedness plan, which was developed to limit the damage during pandemic periods. With this study, it was aimed to determine the reading status of IDCM physicians of the pandemic plan and the factors affecting it, and to learn their views on the application of the headings in the plan. Materials and Methods: For this descriptive study, the opinions of physicians were collected with an electronic questionnaire for the periods of June 2020 and January 2021. Statistical analyses were conducted to determine the associated factors of physicians’ reading of the pandemic plan. Results: Of the 169 physicians participating in the study, 62.7% were women, with a mean age of 43.1±9.9 years, and nearly two-thirds of the physicians were working in a tertiary hospital. More than 70% of physicians read the pandemic preparedness plan. The rate of reading of the pandemic plan increased with the physician’s time spent in IDCM practice [odds ratio (OR)=1.08, 95% confidence interval (CI)=1.01-1.16, p=0.037], and previous Coronavirus disease-2019 (COVID-19) experience (OR=3.10, 95% CI=1.00-9.58, p=0.050), and it decreased with the hand hygiene compliance of healthcare professional (OR=0.27, 95% CI=0.11-0.68, p=0.006) and the number of IDCM physicians working in the physician’s hospital (OR=0.97, 95% CI=0.94-0.99, p=0.016). Conclusion: Physicians’ reading status of the national pandemic preparedness plan did not differ significantly between the periods. As the time spent in IDCM practice and their pandemic experience before COVID-19 increased, the status of reading the pandemic plan increased. As the compliance with hand hygiene among the health professionals working in the physicians’ hospital and the number of IDCM physicians increased it decreased. Attention should be paid to the introduction of the pandemic plan to physicians with professional inexperience and no pandemic experience

An early warning system for Crimean-Congo haemorrhagic fever seasonality in Turkey based on remote sensing technology

Abstract. In the last few years, Crimean-Congo haemorrhagic fever (CCHF) has been reported as an emerging tickborne disease in Turkey. This paper deals with the preparation of an early warning system, aimed to predict the beginning of the CCHF season in Turkey based on a clear, simple and repeatable remotely-sensed signal. Decadal (mean of 10 days) values of the normalized difference vegetation index (NDVI) at 1 km resolution were used on a set of 952 confirmed, accurately geo-referenced, clinical cases between 2003 and 2006. A prerequisite is that the signal should be observable between 2 and 3 decadals before a given moment of the season to be of value as early warning. Decadals marking the 10 th percentile or the 25 th quartile in the frequency distribution of case reporting were selected as markers for the beginning of season of risk. Neither raw nor accumulated decadal NDVI signals were able to predict the onset of this season. However, when we defined the NDVI anomaly (NDVIa) as the positive difference between decadal NDVI values and the average for the previous year, this standardized measure gave a homogeneous overview of the changes in the NDVI signal producing a NDVIa slope for the decadals 10 to 13 that was always greater than 0. We conclude that observing this slope over time can be used as an early-warning system as it would predict the build-up of the number of cases 20 days in advance with an accuracy of 82 % (10 th percentile) or 98 % (25 th quartile). Keywords: Crimean-Congo haemorrhagic fever, early warning, Turkey, normalized difference vegetation index, remote sensing

Genotyping of mumps virus circulating in Turkey in the 2006-2007 winter season

In the winter of 2006-2007, several parotitis cases were reported in different provinces of Turkey. Serological and virological studies were undertaken to investigate these cases with the aim of determining the genotype of the mumps virus (MuV) circulating in Turkey. Samples from 23 cases-Ankara (n:5), Kirklareli (n:4), Mugla (n:10), Isparta (n:3), Trabzon (n:1)-with a diagnosis of clinical parotitis were investigated. Serum samples were tested against mumps IgM and IgG, nested PCR amplification of a 639-bp fragment encompassing the entire SH gene was performed using buccal swabs, and PCR products were sequenced. Of 18 serum samples, 16 (88.9%) were positive for mumps IgM. Seven (30.4%) of 23 buccal swab samples were positive by PCR. In five PCR-positive cases, the sample was also positive for mumps IgM, and serum samples were not available from two of the PCR- positive cases. There was 98% identity between the different sequences, and all were identified as genotype H. The sequences were most similar to sequences identified in Spain, Japan, Switzerland and the UK, and less closely related to the H strains identified in Belarus, Korea and Russia. This is the first report of the mumps virus genotypes circulating in Turkey. Turkey is, geographically, a bridge between Europe and Asia, and therefore, a better understanding of the molecular epidemiology of MuV in Turkey may led to improved tracking of the circulation of strains between the two continents. Moreover, there is a need to further investigate the existence of other genotypes in Turkey

The Evaluation of Knowledge of the Health-Care Personnel Regarding Crimean-Congo Haemorrhagic Fever

Introduction: Crimean-Congo haemorrhagic fever (CCHF) has been encountered in Turkey since 2002. Education of health-care personnel is very important to control CCHF. The aim of this study was to determine the knowledge of health-care personnel who are working in endemic area and working in a secondary or tertiary hospital caring the patients regarding CCHF. Materials and Methods: A questionnaire including 12 questions was prepared and it was applied to health-care personnel working in seven provinces. Eighty-nine doctors, 310 nurses and 112 laboratory technicians were included in the study. Results: 94.3% of doctors’, 80.4% of nurses’ and 77.6% of laboratory technicians’ knowledge level about CCHF were good or very good according to theirself. Tick-bite, contact with blood or body fluid of infected animals and contact with blood or body fluid of CCHF patients were known as transmission routes by 85.7%, 77.1% and 69.1% of health-care personnel respectively. Ribavirin treatment was required according to the 30.3% of doctors while 63.3 of them offered only supportive therapy. 83.6% of personnel described that tick has been removed completely with pleat or tweezers. But 11.9% and 3.3% of personnel told that alcohol or olive-oil can be applied before removing tick, respectively. Conclusion: It is very important to perform continuous education of health-care personnel especially in the epidemic region for early diagnosis of the patient, appropriate management and to reduce nosocomial infection risk