Clinical Features and Virologic Characteristics of Primary and Early HIV-1 Infection in Slovenian Patients

Analysis of time trends in newly diagnosed HIV-1 infected patients in Slovenia over a 10-year period (1996-2005) showed an increase in the number of newly diagnosed HIV-1 infected patients in 2004 and 2005 as well as increase in the number of newly diagnosed patients with primary/early HIV-1 infection. A retrospective analysis was performed in order to evaluate the clinical, epidemiological, laboratory and virological parameters of primary/early HIV-1 infection presenting with or without acute retroviral syndrome (ARS). Primary/early HIV-1 infection was diagnosed in 33 (19.5%) out of 169 newly diagnosed HIV-1 infected patients during the 10-year period. Most patients experienced ARS, the most commonly reported symptoms being fever, malaise and pharyngitis, followed by rash and lymphadenopathy. Median CD4 cell count was 415 cells/mm3, median CD8 cell count was 865 cells/mm3 and median HIV-1 viral load at the time of diagnosis was 5.1 log10 copies/mL. The increase in the number of newly diagnosed HIV-1 infected patients may be in part due to increased awareness among clinicians of the possibility of ARS, and the possibility of increased awareness of symptoms of ARS among persons at high risk of infection

HIV-1 Subtype B Epidemic and Transmission Patterns in Slovenia

In the present study the epidemic of human immunodeficiency virus type 1 (HIV-1) subtype B in Slovenia during the 10-year period was investigated using phylogenetic analysis of pol gene sequences. 119 pol sequences generated on samples dated from January 1996 to December 2005 were retrieved from the database of Slovenian HIV/AIDS Reference Laboratory. The phylogenetic analysis revealed 14 potentially significant transmission clusters (bootstrap value 98%), comprising 34 HIV-1 strains. The vast majority of clustered individuals were men (91%), and of them, 79% were men who have sex with men. Factors significantly associated with clustering were: recent infection (HIV-1 infection during or after year 2003), diagnosis of primary HIV-1 infection, higher CD4 cell count and acquiring HIV-1 infection in Slovenia. Recent subtype B HIV-1 infections are the important driving force of current HIV-1 epidemic in Slovenia

The knowledge of zoonotic diseases in swine producers, veterinarians and swine industry allied personnel in Ontario, Canada

More than 70% of swine marketed in Canada come from the Canadian Quality Assurance (QGA®) program, established in 1998 with the main purpose of demonstrating the implementation of on-farm good production practices (GPP)

False-Positive Result of a Confirmatory Human Immunodeficiency Virus Line Immuno Assay in an Apparently Healthy Individual – A Case Report

A case of a false-positive result of human immunodeficiency virus (HIV) confirmatory immunoblot-based assay is described. Repeatedly borderline reactive anti-HIV screening enzyme immunoassay result obtained in a local hospital resulted in directing the sample to the Slovenian HIV/AIDS Reference Laboratory. In the Reference Laboratory, both anti- HIV screening assays and confirmatory Western blot were negative, while a confirmatory test INNO-LIA HIV I/II Score (Innogenetics, Ghent, Belgium) was anti-HIV-1 positive due to sgp120 and gp41 reactivity. The results of serological testing of the second sample obtained three weeks later were completely identical, while in the third sample obtained 5 months later, seroreversion was observed. Due to a negative dynamics in anti-HIV serological profile and repeatedly negative results of the molecular tests for HIV-1 and HIV-2, HIV infection was excluded and the results of test INNO-LIA HIV I/II Score were finally interpreted as false positive

Investigating biosecurity risks associated with the delivery of feed to swine farms

Introduction Biosecurity protocols reduce the introduction and spread of pathogens among swine farms. For pigs, biosecurity ensures market stability, maintains export opportunities, and controls spread of production and public health diseases. Salmonella, the second most common cause of bacterial foodborne illness, causes gastrointestinal illness. Pigs can be asymptomatic carriers of the bacteria and pork products are a known source of salmonellosis in humans. Salmonella have been isolated from pigs, boots, flies, rodents, bird feces, feed, feed-ingredients, and feed trucks. The objective was to identify management factors to reduce the risk of disease spread among swine farms through feed trucks. Materials and Methods The study was conducted in two phases - the first phase included a series of focus groups and key-informant interviews; discussions held with swine producers and feed company personnel explored the protocols currently in place that reduce the risk of disease spread through the delivery of feed. Participants were asked to identify possible management changes that could further reduce the risk, and to rate these ideas in terms of their effect on disease control, and feasibility based on implementation and economics. This information was used to structure the second phase of the study – a pilot study. The pilot study was conducted over 6 weeks in the winter of 2013, and included 40 feed truck drivers from 3 Ontario feed companies. Truck drivers filled out log sheets as they delivered feed to swine farms, and provided information about the prevalence of the identified biosecurity risks during the day-to-day delivery of feed. Drivers were randomly assigned to be in either the treatment or control groups. Drivers in the control group delivered feed as they normally do. Drivers in the treatment group were: i) asked not to enter the barn unless absolutely necessary, and ii) were provided with re-usable, washable rubber over-shoes and were asked to wear a clean pair at each farm when they felt safe doing so. Chisquared tests were used to compare the usage of clean boots between drivers in the treatment and control groups. In total, 40 drivers from 3 companies, delivering feed to 2202 farms over 6 weeks (in the winter) collected descriptive data on the factors and compared use of different boots. Results The factors followed by the proportion of farms and drivers where the factor was found were found as follows: Most farms were: keeping areas (driveway, feed bin and barnyard) clean of mud and manure (82%), and dead-stock (91%) was appropriately disposed of and not visible to the driver. Some farms had an outbuilding to deliver bagged feed (24%). Other factors that were identified that producers should work on were to provide farm boots and coveralls for the driver if the driver needed to go into the barn, ordering the correct amount of feed to decrease the numbers of deliveries (or frequencies of deliveries) of feed, and notifying feed mill of a disease outbreak on the farm. Feed truck driver factors included wearing a separate pair of clean, disinfected, dried boots (25%) and gloves (50%) at each farm that is visited (even if the driver does not go into the barn, remaining outside the barn (92%); washing the steering wheel (49%), floor mat (77%) and outside of the truck (32%) every 24 hours. From these results, it may be advisable to increase the frequency of washing the truck. Another factor identified was for the driver to know and follow the farm biosecurity protocols. Half of the time, the driver left the feed bill outside barn (54%). Drivers given disinfected rubber boots were more likely to wear these on farms (42%) than plastic disposable boots (4%) (P<0.05). These drivers were also more likely to wear disinfected rubber boots than the control drivers (11%) (P<0.001). Conclusions and Discussion Biosecurity is a responsibility that is shared among all members of the industry. Feed personnel were encouraged to know more about disease transmission. Acknowledgments Canadian Swine Health Board for funding, feed company personnel and producers for participation

A review of simulation modelling approaches used for the spread of zoonotic influenza viruses in animal and human populations

Increasing incidences of emerging and re-emerging diseases that are mostly zoonotic (e.g. severe acute respiratory syndrome, avian influenza H5N1, pandemic influenza) has led to the need for a multidisciplinary approach to tackling these threats to public and animal health. Accordingly, a global movement of 'One-Health/One-Medicine' has been launched to foster collaborative efforts amongst animal and human health officials and researchers to address these problems. Historical evidence points to the fact that pandemics caused by influenza A viruses remain a major zoonotic threat to mankind. Recently, a range of mathematical and computer simulation modelling methods and tools have increasingly been applied to improve our understanding of disease transmission dynamics, contingency planning and to support policy decisions on disease outbreak management. This review provides an overview of methods, approaches and software used for modelling the spread of zoonotic influenza viruses in animals and humans, particularly those related to the animal-human interface. Modelling parameters used in these studies are summarized to provide references for future work. This review highlights the limited application of modelling research to influenza in animals and at the animal-human interface, in marked contrast to the large volume of its research in human populations. Although swine are widely recognized as a potential host for generating novel influenza viruses, and that some of these viruses, including pandemic influenza A/H1N1 2009, have been shown to be readily transmissible between humans and swine, only one study was found related to the modelling of influenza spread at the swine-human interface. Significant gaps in the knowledge of frequency of novel viral strains evolution in pigs, farm-level natural history of influenza infection, incidences of influenza transmission between farms and between swine and humans are clearly evident. Therefore, there is a need to direct additional research to the study of influenza transmission dynamics in animals and at the animal-human interface

One-health simulation modelling : assessment of control strategies against the spread of influenza between swine and human populations using NAADSM

Simulation models implemented using a range of parameters offer a useful approach to identifying effective disease intervention strategies. The objective of this study was to investigate the effects of key control strategies to mitigate the simultaneous spread of influenza among and between swine and human populations. We used the pandemic H1N1 2009 virus as a case study. The study population included swine herds (488 herds) and households-of-people (29 707 households) within a county in Ontario, Canada. Households were categorized as: (i) rural households with swine workers, (ii) rural households without swine workers and (iii) urban households without swine workers. Seventy-two scenarios were investigated based on a combination of the parameters of speed of detection and control strategies, such as quarantine strategy, effectiveness of movement restriction and ring vaccination strategy, all assessed at three levels of transmissibility of the virus at the swine-human interface. Results showed that the speed of detection of the infected units combined with the quarantine strategy had the largest impact on the duration and size of outbreaks. A combination of fast to moderate speed of the detection (where infected units were detected within 5-10 days since first infection) and quarantine of the detected units alone contained the outbreak within the swine population in most of the simulated outbreaks. Ring vaccination had no added beneficial effect. In conclusion, our study suggests that the early detection (and therefore effective surveillance) and effective quarantine had the largest impact in the control of the influenza spread, consistent with earlier studies. To our knowledge, no study had previously assessed the impact of the combination of different intervention strategies involving the simultaneous spread of influenza between swine and human populations