An outbreak of hepatitis A among children and adults in Denmark, August 2002 to February 2003

From August 2002 to February 2003 25 cases of hepatitis A were notified from one town in Jutland. The first cases were children of three families who returned from an endemic country. The infection spread subsequently in the local community and within households. A case-control study among household index cases showed that hepatitis A was associated with contact to a case in an after-school group (OR 29·6) and with contact to a case household member in a school class or day-care centre group (OR 9·5). From a serosurvey it was estimated that for each notified patient approximately one additional infection has occurred in the households. The infection was imported by children of immigrants, born in Denmark, returning from a visit to friends and relatives in the high-incidence country of origin of their parents and was then propagated through contact between children in after-school groups, schools and their families. Immunoprophylaxis should be given to children prior to visits to friends and relatives in endemic countries and to case contacts

Penetratin-Mediated Transepithelial Insulin Permeation: Importance of Cationic Residues and pH for Complexation and Permeation

Penetratin is a widely used carrier peptide showing promising potential for mucosal delivery of therapeutic proteins. In the present study, the importance of specific penetratin residues and pH was investigated with respect to complexation with insulin and subsequent transepithelial insulin permeation. Besides penetratin, three analogues were studied. The carrier peptide-insulin complexes were characterized in terms of size and morphology at pH 5, 6.5, and 7.4 by dynamic light scattering (DLS) and transmission electron microscopy (TEM), respectively. At pH 7.4 mainly very large complexes were present, while much smaller complexes dominated at pH 5. Presence of arginine residues in the carrier peptide proved to be a prerequisite for complexation with insulin as well as for enhanced transepithelial insulin permeation in vitro. Rearrangement of tryptophan residues resulted in significantly increased insulin permeation as compared to that of the parent penetratin. In general, pre-complexation with penetratin and its analogues at pH 5 gave rise to increased insulin permeation as compared to that observed at pH 7.4; this finding was further supported by a preliminary in vivo study using the parent penetratin. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1208/s12248-015-9747-3) contains supplementary material, which is available to authorized users