Influenza and diabetes ; immunological and epidemiological aspects

Influenza may jeopardize the health of patients with diabetes mellitus in several ways. In the first place influenza infection may inbalance a carefully established metabolic control, and in some cases trigger a process of metabolic deterioration which eventually may lead to ketoacidosis and even death (40-42). Secondly, diabetes itself might be the cause of an impaired immune response to influenza virusses. Patients are made more vulnerable to infection, especially if they are in poor metabolic control ( 46,4 7). In the third place pre-existing staphylococcal skin infections can enhance the incidence of the most dreaded complication of influenza infection: secondary staphylococcal pneumonia (32-36). · An increased carrier rate of S. aureus in combination with an impaired immune response to this microorganism can be held partly responsible for the increased morbidity and mortality in patients with diabetes mellitus. Patients who have overt skin lesions should receive anti-staphylococcal antibiotic therapy as soon as symptoms of influenza infection are observed. Though annual vaccination has been proven to reduce attack rates and alleviate illness (48) many patients with diabetes mellitus are still not vaccinated against influenza. Physicians who deny the need for annual vaccination argue that the excess mortality from influenza in patients with diabetes mellitus dates back from earlier days when patients were not very well controlled. From their point of view there is no need for mass vaccination of patients who are nowadays mostly well controlled. In our opinion there is no reason for such optimism. In both clinical studies and studies on excess mortality diabetes mellitus is a remarkably constant risk factor over a long time. Though it is difficult to calculate reliable figures on relative risks and rates of excess mortality there is sound evidence to assume that in epidemic periods mortality in patients with diabetes mellitus increases by 5-15% (9,11). If one considers the enormous effort that is made to attain satisfying metabolic control and to fight the secondary complications of diabetes a single injection once a year to protect against influenza is not overdone. Aside from annual vaccination o

Survival of Chlamydia pneumoniae following contact with various surfaces

Objective: In this study, the survival and recovery of Chlamydia pneumoniae (Cp) strains TW‐183, AR‐39, AR‐388 and CWL‐029 were measured after inoculation on glass, stainless steel, FormicaR laminate, paper, fabric and human skin. Methods: Inoculum in throat washes from healthy volunteers was applied to each surface. Samples were taken immediately after inoculum application and at specified intervals thereafter to determine infectivity. Results: Infectious Cp was recovered from glass for up to 4 h, from paper and fabric for up to 3 h, from FormicaR laminate for up to 2 h, from stainless steel for up to 60 min and from human skin for up to 30 min. Drying of the inoculated area had no significant effect on the recovery of infectious Cp. Further experiments demonstrated that infectious Cp could be transferred to hands by touching these contaminated surfaces and could be recovered from these hands for up to 3 min. Addition of albumin, surfactant or phosphatidylcholine had no significant effect on the survival of Cp. Conclusions: These results suggest that contact with contaminated surfaces may be a potential mode of transmission of Cp. 1995 European Society of Clinical Microbiology and Infectious Disease

Influenzaseizoen 1988/'89; vaccinsamenstelling voor seizoen 1989/'90

De eerste influenza A-virussen van dit seizoen werden ongebruikelijk vroegtijdig geïsoleerd. reeds medio oktober 1988 werden in de regio Eindhoven drie kinderen opgenomen met ernstige luchtweginfecties. Bij één werd influenza A-H3N2-virus gekweekt uit keel- en neusuitstrijken, en bij de twee anderen werd deze stam serologisch aangetoond. Deze vroege fase van de epidemie leek eerst beperkt te blijven tot Brabant. Vanaf november 1988 werden ook in andere delen van het land isolaties verricht, maar pas half november begon de landelijke index van influenza-achtige ziektebeelden (IAZ) pas te stijgen (figuur). De epidemie bereikte een hoogtepunt in de weken 50 en 51 van 1988, waarbij een opmerkelijk regionaal verschil ..

Influenzaseizoen 1988/'89; vaccinsamenstelling voor seizoen 1989/'90

De eerste influenza A-virussen van dit seizoen werden ongebruikelijk vroegtijdig geïsoleerd. reeds medio oktober 1988 werden in de regio Eindhoven drie kinderen opgenomen met ernstige luchtweginfecties. Bij één werd influenza A-H3N2-virus gekweekt uit keel- en neusuitstrijken, en bij de twee anderen werd deze stam serologisch aangetoond. Deze vroege fase van de epidemie leek eerst beperkt te blijven tot Brabant. Vanaf november 1988 werden ook in andere delen van het land isolaties verricht, maar pas half november begon de landelijke index van influenza-achtige ziektebeelden (IAZ) pas te stijgen (figuur). De epidemie bereikte een hoogtepunt in de weken 50 en 51 van 1988, waarbij een opmerkelijk regionaal verschil ..

Low prevalence of antibodies against the zoonotic agents <i>Brucella abortus</i>, <i>Leptospira</i> spp., <i>Streptococcus suis </i>serotype ii, hantavirus, and lymphocytic choriomeningitis virus among veterinarians and pig farmers in the southern part of the Netherlands

Serum samples from 102 veterinarians and 191 pig farmers from the southern part of the Netherlands were investigated for antibodies against Brucella abortus, Leptospira spp, Streptococcus suis serotype II, Hantavirus (HV), and lymphocytic choriomeningitis virus (LCMV). All samples were collected in 1993 and stored until this study was performed. The prevalence of antibodies against B. abortus in veterinarians (4.5%) was significantly higher (P=0.01) than in pig farmers (0%). None of the veterinarians (0%) and only one pig farmer (0.5%) had antibodies against Leptospira spp. Furthermore, significantly (P=0.015) more veterinarians (6%) than pig farmers (1%) had antibody titres against muramidase-released protein (MRP), a protein of pathogenic S. suis serotype II strains. None of the veterinarians and a total of 3 (1.6%) pig farmers had antibody titres against HV. The prevalence of antibodies against LCMV tended to be higher in pig farmers (2.6%) than in veterinarians (0%) (P=0.10). It can be concluded that the prevalence of antibodies against the investigated zoonotic agents in veterinarians and pig farmers is low.</p