A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water. (73/11802)

From 1 January through 30 June 1997, 8901 cases of typhoid fever and 95 associated deaths were reported in Dushanbe, Tajikistan. Of 29 Salmonella serotype Typhi isolates tested, 27 (93%) were resistant to ampicillin, chloramphenicol, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. In a case-control study of 45 patients and 123 controls, Salmonella Typhi infection was associated with drinking unboiled water (matched odds ratio, 7; 95% confidence interval, 3-24; P<.001). Of tap water samples, 97% showed fecal coliform contamination (mean level, 175 cfu/100 mL). Samples taken from water treatment plants revealed that fecal coliform contamination occurred both before and after treatment. Lack of chlorination, equipment failure, and back-siphonage in the water distribution system led to contamination of drinking water. After chlorination and coagulation were begun at the treatment plants and a water conservation campaign was initiated to improve water pressure, the incidence of typhoid fever declined dramatically.  (+info)

Molecular characterization of Haemophilus ducreyi strains from Jackson, Mississippi, and New Orleans, Louisiana. (74/11802)

Chancroid, a sexually transmitted disease caused by Haemophilus ducreyi, is one of the most common genital ulcer diseases in developing countries. In the United States, while less common, the disease has been associated with outbreaks in inner cities, particularly among persons who engage in sex for drugs or money. Two outbreaks of chancroid were recently studied in the United States, one in New Orleans (from 1990 to 1992) and one in Jackson, Mississippi (from 1994 to 1995). By use of ribotyping, plasmid content, and antibiotic susceptibility, the chancroid cases in New Orleans were found to be due to a limited number of strains, consistent with a limited introduction of H. ducreyi into this community. The H. ducreyi isolates from New Orleans and Jackson had different ribotype patterns, suggesting that the two outbreaks were probably not linked.  (+info)

Reemergence of adenovirus type 4 acute respiratory disease in military trainees: report of an outbreak during a lapse in vaccination. (75/11802)

From 23 April to 13 May 1995, an outbreak of acute respiratory disease (ARD) hospitalizations occurred in basic training soldiers at Fort Jackson, South Carolina. Weekly hospitalization rates for the most affected military unit reached 11.6%. Virus isolation and serologic studies from a sample of patients identified the agent as adenovirus type 4. Prior to starting vaccinations against adenovirus types 4 and 7 in 1971, these serotypes were the major causes of ARD in basic trainees. No outbreaks were reported when the vaccines were used. A logistical error temporarily interrupted vaccine production, and newly arriving trainees received no adenovirus vaccines from the summer of 1994 through late March 1995. This outbreak occurred in unvaccinated soldiers. The sole manufacturer has permanently stopped adenovirus vaccine production. All type 4 vaccine supplies are now depleted. This outbreak demonstrates continued susceptibility of military recruits to adenovirus type 4 and warns of future outbreaks.  (+info)

Indole-positive Vibrio vulnificus isolated from disease outbreaks on a Danish eel farm. (76/11802)

Vibrio vulnificus was isolated in 1996 from 2 disease outbreaks on a Danish eel farm which used brackish water. A characteristic clinical sign was extensive, deep muscle necrosis in the head region. V. vulnificus was isolated from kidney, mucus, spleen, gill and intestine of diseased eels. Thirty-two isolates were examined phenotypically and serologically for pathogenicity to eels and for correlation to ribotype and plasmid profile. Biochemically, the isolates showed properties similar to those described previously for eel-pathogenic strains of V. vulnificus, with the exception of indole production. Virulence was evaluated by LD50 (the 50% lethal dose), which ranged from < 9.4 x 10(3) to 2.3 x 10(5) CFU (colony-forming units) per fish. The isolates which were lethal for eels showed identical ribotypes and serotypes. A relationship between certain plasmids and virulence was not found. A serotyping system based on lipopolysaccharide (LPS)-associated O antigen type and on carbohydrate capsule antigens showed that the eel-virulent isolates shared a common LPS-based homogeneous O serogroup and a capsule antigen. V. vulnificus serovar O4 and capsule type 9 was identical serologically to the Japanese isolate ATCC 33149 and was the agent responsible for the disease outbreaks that occurred on the Danish eel farm. Despite absence of antibiotic resistance, treatment had little effect and disease reoccurred.  (+info)

Interference of natural mouse hepatitis virus infection with cytokine production and susceptibility to Trypanosoma cruzi. (77/11802)

Mouse hepatitis virus (MHV) infection can have a pronounced impact on several investigation areas. Reports on natural MHV outbreaks are rare and most studies have been conducted by deliberately infecting mice with MHV laboratory strains that cause moderate to severe disturbances to the immune system. We have investigated the effects of a natural acute outbreak of MHV in our otherwise specific-pathogen-free (SPF) inbred mouse colonies, and of enzootic chronic MHV infection on cytokine production and resistance to the intracellular pathogen Trypanosoma cruzi. We found that BALB/c and/or C57BL/6 SPF mice that had been injected with T. cruzi blood trypomastigotes from recently MHV-contaminated (MHV+) mice developed significantly higher parasite blood counts, accelerated death, and showed higher IL-10 production by spleen cells than their counterparts whose T. cruzi inoculum was derived from MHV-negative (MHV-) donors. Interferon-gamma (IFN-gamma) production by MHV+ and MHV- mice was not significantly different. In contrast, T. cruzi infection of chronically MHV-infected mice did not result in major changes in the course of infection when compared with that observed in mice from MHV- colonies, although a trend to higher parasitaemia levels was observed in BALB/c MHV+ mice. Nevertheless, both BALB/c and C57BL/6 T. cruzi-infected MHV+ mice had diminished IFN-gamma production to parasite-antigen stimulation in comparison with similarly infected MHV- mice. Interleukin-10 (IL-10) production levels by spleen cells did not differ between chronic MHV+ and MHV- mice, but IFN-gamma neutralization by monoclonal antibody treatment of anti-CD3-stimulated spleen cell cultures showed higher levels of IL-10 synthesis in MHV+ BALB/c mice.  (+info)

WHO responds to major polio outbreak in Angola.(78/11802)

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Use of a murine O-antigen-specific monoclonal antibody to identify Acinetobacter strains of unnamed genomic species 13 Sensu Tjernberg and Ursing. (79/11802)

A monoclonal antibody against the O-antigenic polysaccharide chain of the lipopolysaccharide (LPS) of Acinetobacter strains belonging to the unnamed genomic species 13 Sensu Tjernberg and Ursing (13TU) was obtained after immunization of BALB/c mice with heat-killed bacteria and was characterized by enzyme immunoassay and Western blot analysis, by use of LPS and proteinase K-treated bacterial lysates, analyses in which the antibody was shown to be highly specific for the homologous antigen. In addition, when tested in dot and Western blots, reactivity was observed with 9 of 18 Acinetobacter strains of genomic species 13TU which had been isolated in Germany and Denmark; no reactivity was observed with strains of other genomic species, including the closely related genomic groups 1 (A. calcoaceticus), 2 (A. baumannii), and 3 (unnamed), or with other gram-negative bacteria. The antibody described here represents a convenient reagent for the simple, economical, and accurate differentiation of clinical isolates of genomic species 13TU from other Acinetobacter strains. Although the antibody does not identify all isolates of this genomic group, it is evident that it will be a useful reagent in the development of a serotyping scheme for clinical laboratories.  (+info)

Density and molecular epidemiology of Aspergillus in air and relationship to outbreaks of Aspergillus infection. (80/11802)

After five patients were diagnosed with nosocomial invasive aspergillosis caused by Aspergillus fumigatus and A. flavus, a 14-month surveillance program for pathogenic and nonpathogenic fungal conidia in the air within and outside the University Hospital in Rotterdam (The Netherlands) was begun. A. fumigatus isolates obtained from the Department of Hematology were studied for genetic relatedness by randomly amplified polymorphic DNA (RAPD) analysis. This was repeated with A. fumigatus isolates contaminating culture media in the microbiology laboratory. The density of the conidia of nonpathogenic fungi in the outside air showed a seasonal variation: higher densities were measured during the summer, while lower densities were determined during the fall and winter. Hardly any variation was found in the numbers of Aspergillus conidia. We found decreasing numbers of conidia when comparing air from outside the hospital to that inside the hospital and when comparing open areas within the hospital to the closed department of hematology. The increase in the number of patients with invasive aspergillosis could not be explained by an increase in the number of Aspergillus conidia in the outside air. The short-term presence of A. flavus can only be explained by the presence of a point source, which was probably patient related. Genotyping A. fumigatus isolates from the department of hematology showed that clonally related isolates were persistently present for more than 1 year. Clinical isolates of A. fumigatus obtained during the outbreak period were different from these persistent clones. A. fumigatus isolates contaminating culture media were all genotypically identical, indicating a causative point source. Knowledge of the epidemiology of Aspergillus species is necessary for the development of strategies to prevent invasive aspergillosis. RAPD fingerprinting of Aspergillus isolates can help to determine the cause of an outbreak of invasive aspergillosis.  (+info)