Schistosoma incognitum and its zoonotic potential role in Phitsanulok and Phichit provinces, northern Thailand.

A study on Schistosoma incognitum, a blood fluke of a variety of mammals, was conducted in different ecological conditions in Phitsanulok and Phichit, northern Thailand. The intermediate host of S. incognitum in permanent water habitats studied, i.e; swamps and ditches is Radix (Lymnaea) auricularia rubiginosa. Of 44,412 mollusks representing 13 different species collected from 24 water habitats studied, 7,186 were R. a. rubiginosa. S. incognitum infection rate in the snails was 2.1%. 483 Rattus rattus, 8 R. argentiventer, 280 Bandicota indica and 65 B. savilei were found infected with S. incognitum with an overall infection rate of 41.7%. R. argentiventer and B. savilei are reported as new mammalian hosts of the parasite. Also, 3.9% of dogs in the study area were found excreting S. incognitum eggs in their stools for the first time. The possibility of S. incognitum as a zoonotic potentiality to humans is discussed and is still an equivocal issue deserving further study.

Kaeng Khoi virus from naturally infected bedbugs (cimicidae) and immature free-tailed bats.

Kaeng Khoi virus was recovered from bedbugs (Stricticimex parvus and Cimex insuetus) and from suckling wrinkle-lipped bats (Tadarida plicata) collected in central Thailand. The data implicate bedbugs as possible vectors of this virus.

Ciprofloxacin and loperamide in the treatment of bacillary dysentery.

OBJECTIVE: To compare the safety and efficacy of loperamide plus ciprofloxacin with those of ciprofloxacin alone in the treatment of bacillary dysentery. DESIGN: Double-blind, placebo-controlled, randomized clinical trial. SETTING: Hospital in Thailand. PARTICIPANTS: Eighty-eight adults with dysentery seeking medical care between November 1990 and February 1992. Patients who had received prior antibiotics or antimotility drugs were excluded. INTERVENTION: All 88 patients with dysentery were treated with ciprofloxacin, 500 mg twice daily for 3 days. Forty-two of these patients were randomly assigned to receive loperamide, a 4-mg initial dose followed by 2 mg after every loose stool (as many as eight caplets [16 mg] daily), and 46 were randomly assigned to receive placebo. MEASUREMENTS: Stools were collected daily until resolution of diarrhea and again after 10 days. The time to passage of the last unformed stool, number of unformed stools, and symptoms were recorded after treatment. RESULTS: Shigella or enteroinvasive Escherichia coli (53%), Vibrio parahaemolyticus (16%), and Salmonella (7%) were the most common bacterial enteric pathogens identified in 88 patients with dysentery. In patients infected with Shigella or enteroinvasive E. coli, the median duration of diarrhea was 19 hours (25th to 75th percentiles, 6 to 42 hours) for those receiving loperamide plus ciprofloxacin compared with 42 hours (21 to 46 hours) for those receiving ciprofloxacin alone (P = 0.028). The median number of diarrheal stools for those receiving ciprofloxacin and loperamide was 2.0 (1 to 5 stools) compared with 6.5 (2 to 9 stools) for those receiving ciprofloxacin alone (P = 0.016). None of the participants had a temperature greater than 38 degrees C after 24 hours of treatment. None of the patients was infected with the same bacterial enteric pathogen more than 1 day after receiving treatment. CONCLUSIONS: Loperamide decreases the number of unformed stools and shortens the duration of diarrhea in dysentery caused by Shigella in adults treated with ciprofloxacin.

Etiology of diarrhea in a rural community in western Thailand: importance of enteric viruses and enterovirulent Escherichia coli.

The etiology of gastroenteritis was determined in children and adults with diarrhea seen at a district hospital and three government health clinics in Suan Phung, western Thailand, in 1991. Enteric viruses (rotavirus and astrovirus) were identified in 40%, shigellae in 18%, attaching and effacing Escherichia coli in 13%, Campylobacter jejuni in 9%, and enterotoxigenic E. coli in 7% of children < 5 years old with diarrhea seen at the hospital. Enteric viruses were detected in 15% (24/156) of patients with diarrhea > or = 5 years old and were the only enteric pathogens identified in 12 patients ages 7-79 years (2 astrovirus, 10 rotavirus infections). Attaching and effacing E. coli, rotavirus, and astrovirus were potential causes of diarrhea in children and adults in this population.