Concurrent occurrence of human and equine West Nile virus infections in Central Anatolia, Turkey: the first evidence for circulation of lineage 1 viruses

SummaryBackgroundWest Nile fever is an important zoonotic infection caused by West Nile virus (WNV), a member of the Flaviviridae. Previous serological data from Turkey suggest widespread WNV circulation. This report includes cases of human and equine WNV infections occurring concurrently, and manifesting as central nervous system infections, in two neighboring provinces of Central Anatolia, Turkey. A partial phylogenetic analysis of the causative virus is given for the first time.MethodsThe cases were reported in February (horses) and March (human). Symptoms of the disease were similar in the two species, characterized by neurological manifestations suggesting meningoencephalitis. Real-time/nested PCRs and commercial immunoassays and a plaque reduction neutralization assay were employed for the detection of viral RNA and specific antibodies, respectively.ResultsWNV RNAs were detected in buffy coat (horses) and cerebrospinal fluid (human) samples. Partial nucleotide sequences of the E-gene coding region revealed that the strains are closely related to viruses of lineage 1, clade 1a. Accompanying equine serosurveillance demonstrated WNV-specific antibodies in 31.6% of the samples.ConclusionsThis is the first report of acute WNV infections caused by lineage 1 strains from Turkey, in concordance with previous reports from some European and North African countries

Trends in prevalence of hepatitis B virus infection among Albanian blood donors, 1999-2009

<p>Abstract</p> <p>Background</p> <p>Hepatitis B virus (HBV) was among the first virus known to be transmitted by blood and blood productions. The objective of this study is to determine the trend of hepatitis B virus in blood donors.</p> <p>Materials and methods</p> <p>In this study 79274 blood donors were retrospectively evaluated for HBsAg. The donors were selected using personal questionnaire, physical examination and testing blood before donation. Blood banks records are used as source of information. The blood donors samples were analyzed for the presence of hepatitis B surface antigen (HBsAg) by commercial available kits ELISA method, third generation (from Abbott laboratory, Germany). A sample was considered as HBsAg positive when found twice repeatedly reactive. Reactive samples were not confirmed with addition tests.</p> <p>Results</p> <p>In the evaluation data, we found out that from 79274 of the total healthy blood donors, 15983 were voluntary donors, 52876 were family replacement donors and 10424 commercial blood donors. The prevalence of HBsAg in blood donors was 7.9%. It was increased steadily from 5.9% in 1999 to 9.1% in 2006 and decreased in 7.9% in 2009. According to blood donors status the HBsAg prevalence was 10.5% in commercial blood donors, 8.1% in voluntary donors and 8.6% in family replacement donors. The prevalence of anti-HBc in blood donors was 59.1%.</p> <p>Conclusion</p> <p>The prevalence of HBsAg was lower in voluntary non remunerate blood donors than commercial donors and family replacement blood donors. In FDs the prevalence was higher than VDs but lower than CDs. So, it is important to encourage the voluntary blood donors to become regularly blood donors.</p

Seroepidemiology of Fasciola Hepatica in Mersin province and surrounding towns and the role of family history of the Fascioliasis in the transmission of the parasite

WOS: 000283605800007PubMed ID: 19821202Background/aims: Fascioliasis is an important zoonotic disease caused by Fasciola hepatica. This zoonosis may cause serious morbidity and a considerable financial burden. Knowledge about Fasciola hepatica and interest in this parasite have increased in Turkey recently. However, there have been few studies on the real prevalence of this condition in the country. Therefore, we aimed to determine the prevalence of fascioliasis and the role of family history of the condition in the transmission of the parasite in the province of Mersin. Methods: Taking account of their populations, 729 people without a family history of fascioliasis and 155 people with a family history of fascioliasis from the city of Mersin and randomly selected three towns were included into the study to obtain a sample that well represented the population of the province of Mersin. A questionnaire composed of items about consumption of green leafy vegetables, stock-breeding and clinical symptoms of the disease was used to collect data. Excretory/secretory (ES)-ELISA was used to detect IgG antibodies to Fasciola hepatica. People seropositive for Fasciola hepatica underwent abdominal ultrasonography, physical examination, biochemistry, and stool tests for the detection of Fasciola hepatica eggs. Results: A total of 0.79% of the participants were seropositive for Fasciola hepatica. One point ninety-three percent of the individuals with a family history of fascioliasis and 0.55% of the individuals without a family history of fascioliasis were seropositive for Fasciola hepatica. Out of 7 individuals found to be seropositive for Fasciola hepatica, 5 were female, 2 were male, and 4 had a family history of fascioliasis. Five and 4 patients, respectively, had a history of consuming green leafy vegetables and 4 had a history of stock-breeding. The clinical evaluation revealed that 4 patients had at least one sign of fascioliasis. Three patients had signs of fascioliasis on ultrasonography and I had Fasciola hepatica egg in stool examination. There was no significant difference in seropositivity for Fasciola hepatica between the individuals with and without a family history of fascioliasis (x2: 0.077, p>0.05). Conclusions: The prevalence of fascioliasis was hypo-endemic in the province of Mersin. There were no significant differences in the Fasciola hepatica prevalence between the groups with and without family history of fascioliasis. However, studies with larger sample sizes may reveal a difference

The sixteen-year trend of syphilis in Turkey: data from blood donors

This study was conducted in order to determine the prevalence and trends of antibodies to syphilis among Turkish blood donors (BDs) at the 22 National Blood Transfusion Service, Kizilay, between 1989 and 2004. Among the 6,240,130 BDs, a reactive result was obtained with the rapid plasma reagin test for 6864 donors (0.11%). A serious increasing trend was observed between 1989 and 1992 (41/100.000 versus 92/100.000 cases, P = 0.003, C 95, 33-107), in 1998, the rates were observed to have increased approximately 4.01 times compared with that of 1989 (41/100,000 versus 168/000,000, P = 0.001, Cl 95, 28-183). After 2002, syphilis seropositivity showed a marked decreasing trend (P = 0.002, Cl 95, 36-118). However, as this survey shows, the rate of seropositive donors for syphilis has been greatly reduced but it is believed that a more thorough management strategy is necessary in order to cause a further reduction in Turkey

Detection of Entamoeba histolytica/Entamoeba dispar in stool specimens by using enzyme-linked immunosorbent assay

Entamoeba histolytica actually comprises two genetically distinct but morphologically indistinguishable species. E. histolytica can cause invasive intestinal and extra intestinal disease, while E. dispar cannot. Identification and differentiation of E. dispar and E. histolytica in stool sample by microscopy is imprecise. Several weeks of culture and isoenzyme analysis are required to differentiate E. histolytica from E. dispar. In this study, we have used an enzyme-linked immunosorbent assay (ELISA) for detection of E. histolytica/E.dispar and compared it with microscopy. Eighty-eight samples were evaluated, trichrome staining was positive in 20.4% (18) and ELISA was positive in 29.5% (26). Both tests were positive in 14 (15.9%) samples, 4 (4.5%) only with direct microscopy, and 12 (13.6%) only with ELISA. Both tests were negative in 58 (65.9%) samples. Microscopy has low sensitivity and high specificity, low negative predictive value and high positive predictive value in comparison with ELISA. E. histolytica/E. dispar antigen detection ELISA tests are inexpensive compared to the specific tests, yield objective results and do not require experienced microscopists and can therefore be recommended for screening of stools worldwide and the results can be taken for treatment that are fitting with its clinic

Female genital tuberculosis cases with distinct clinical symptoms: Four case reports

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Genital TB (GTB) is a form of extrapulmonary TB that occurs more frequently in women, in whom it classically presents in association with menstrual irregularity, pregnancy loss and short and long-term sequelae especially infertility in infected women. Patients with GTB are usually young women diagnosed during workup for infertility. GTB is rare in postmenopausal women and responsible for only approximately 1% of postmenopausal bleeding. In this study, we aimed to evaluate the laboratory, clinical and demographic characteristics of female GTB cases. Case: We presented four female GTB cases with distinct clinical symptoms. All patients have no history of TB, and no acid-fast bacilli were seen in smears prepared from the clinical materials of the patients. Histopathological examinations revealed granulomatous inflammation in all patients. Conclusion: In the light of the clinical features of these cases we aimed to emphasize that, female GTB must be taken into account in the patients with different clinical symptoms like postmenopausal bleeding, menometrorrhagia, infertility, and menstrual irregularities. We believe that these symptoms will be helpful for the diagnosis and treatment of female GTB

Identification of Mycobacterium Species from BACTEC MGIT (TM) Positive Cultures with Oligo-FISH and PNA-FISH Methods

Rapid and accurate diagnosis of mycobacteria is very important in the prevention and effective treatment of tuberculosis which is still a serious public health problem. Fluorescence in situ hybridization (FISH) method using rRNA targeted probes allows for precise and accurate identification of mixed microorganisms from cultures and directly from clinical samples within a few hours without the need for culture methods. In this study it was aimed to compare the diagnostic performance of two different FISH methods (Oligo-FISH and PNA-FISH) with the conventional culture methods for the identification of Mycobacterium spp. grown in BACTEC MGIT (TM) (Mycobacteria Growth Indicator Tube) system. A total of 60 MGIT (BD, USA) positive, 52 MGIT negative samples and 10 different reference strains were included in the study. 16S rRNA targeted oligonucleotide probes (Myc657: Mycobacterium subdivision, Eub338: Positive control, NonEub: Negative control) were used for oligo-FISH, and 16S rRNA targeted peptide nucleotide probes (MTC: Mycobacterium tuberculosis complex, NTM: Non-tuberculosis Mycobacterium, BacUni: Positive control) for PNA-FISH. Ehrlich-Ziehl-Neelsen staining (ARB) and Lowenstein-Jensen (LJ) culture methods were performed as conventional methods as well as MGIT 960 culture system. Of MGIT positive 60 samples (44 sputum, 4 tissue, 4 urine, 3 bronchoalveolar lavage, 3 CSF, 1 abscess, 1 peritoneal fluid), 29 (48.3%) were found positive for ARB and 44 (73.3%) with LJ culture methods giving a total of 59 positive results. Fifty-eight (96.6%) of those isolates were identified as MTC, and one (1.7%) as NTM by conventional methods. By using Oligo-FISH, 95% (57/60) of the isolates were identified as Mycobacterium spp., while three samples (5%) yielded negative result. By using PNA-FISH, 54 (91.5%) isolates were identified as mycobacteria, of them 53 (90%) were typed as MTC and 1 (1.7%) as NTM. Five isolates that were found positive with Oligo-FISH, but negative with PNA-FISH, yielded positive result with PNA-FISH method performed with minor modifications. It was determined that both FISH methods are more rapid (approximately 2-2.5 hours) and practical than the conventional culture methods and also PNA-FISH was more practical than Oligo-FISH. The sensitivity, specificity, positive and negative predictive values of the probes used for Oligo-FISH, were 96.6%, 100%, 100% and 96.4%, respectively. Those values for the probes used for PNA-FISH, were 91.5%, 100%, 100% and 91.4%, respectively (p< 0.0001). The compatibility of the methods was calculated with kappa statistical analysis, assigning perfect concordances between Oligo- and PNA-FISH methods, as well as between conventional and both of the FISH methods (kappa: 0.964, 0.929, 0.964; p= 0.001). The coverage of oligonucleotide and PNA probes was also checked by using 16S rRNA gene sequence database retrieved from the SILVA 102. It was determined that the rates of coverage were 86.5% for Eub338, 41.7% for Myc657, 84.2% for BacUni, 76.3% for MTC (100% for only M.tuberculosis and M.bovis) and 25.8% for NTM probes. In conclusion, Oligo- and PNA-FISH methods seem to be successful for rapid and accurate identification of Mycobacterium spp. from MGIT positive cultures in routine mycobacteriology laboratories without the need for expensive methods

Serological Investigation Of Phlebovirus Exposure In Blood Donors From The Mediterranean Province Of Mersin, Turkey

Phleboviruses are enveloped segmented RNA viruses, capable of inducing febrile disease and/or meningoencephalitis in exposed individuals, according to the infecting strain, following transmission via arthropods. Prototype medically-important phlebovirus strains responsible for sandfly fever are sandfly fever Sicilian virus (SFSV) and sandfly fever Naples virus (SFNV), where the SFSV variant sandfly fever Cyprus virus (SFCV) is also detected in individuals with febrile disease. Toscana virus (TOSV) is unique among phleboviruses as the cause of infections involving central nervous system. In this seroepidemiological study, human exposure to selected medically-important phleboviruses was investigated in healthy adult residents of the Mersin province, Mediterranean Anatolia, Turkey, where the current data on phlebovirus epidemiology is scarce. A total of 1 784 healthy individuals (mean age: 34.7 9.6 years; 97.3% were male), accepted as blood donors at the Mersin University Center for Health Research and Application Blood Bank were included in the study after informed consent during a seventeen month period between July 2011 to November 2012. All participants were requested to fill out a questionnaire to reveal risk factors for vector exposure. SFSV, SFNV, SFCV and TOSV IgG antibodies in serum were investigated via a commercial indirect immunofluorescence test (RFT) (Sandfly Fever Virus IgG Mosaic I; Euroimmun, Germany). Sera interpreted as positive or strong positive for TOSV or SFNV+TOSV in IIFT were evaluated via TOSV virus neutralization test (VNT) for specificity confirmation. IIFT seroreactivity for at least one of the tested phleboviruses was present in 66.8% (1192/1784) of the samples. The most frequently-detected phlebovirus strain was SFSV (51.6%; 920/1784), followed by SFNV (46.4%; 827/1784), TOSV (43.7%; 779/1784) and SFCV (47.3%; 843/1784). Among the reactive sera, 6.6% (79/1192) were positive for a single virus serotype, whereas in 39.8% (475/1192) antibodies reacting with all tested virus serotypes were revealed. A total of 187 sera was included in the TOSV VNT and neutralizing antibodies were detected in 13.9%. According to the IIFT reactivity, residing in rural areas was observed as a statistically significant risk factor for exposure in all phleboviruses tested (p values for SFSV, SFNV, TOSV and SFCV were 0.002, 0.001, <0.001 and 0.003, respectively). TOSV exposure is more frequently detected via IIFT in individuals having pets or domestic farm animals around the living quarters (p= 0.005). As a result, frequent exposure to SFSV/SFCV or antigenically similar phlebovirus strains and viruses of the SFNV species were determined in healthy blood donors in Mersin province, located in the Mediterranean region of Turkey. Furthermore, TOSV neutralizing antibodies were detected in selected samples with IIFT reactivity, confirming previous reports suggesting TOSV activity in the region. TOSV and other phleboviruses must be included in the diagnostic work-up in cases with febrile diseases and viral central nervous system infections during the sandfly-active months.Wo