Microbiological quality of some packed and unpacked bread products in Alexandria, Egypt.

BACKGROUND: Bakery products are important food snacks consumed by people of all ages and economic groups. The growth of unwanted microorganisms that deteriorate products such as bacteria, moulds, and fungi in these foodstuffs may offer risks to consumers' health and generate considerable economic losses. This work aimed to assess the microbiological quality of some packed and unpacked bread products in Alexandria, Egypt. METHODS: This cross-sectional comparative study involved 168 local and branded bakery products that were collected randomly from 2 districts in Alexandria. Hygienic practices such as covering of the bread and wearing gloves during handling were observed and recorded. All bread samples were tested to determine the total plate count (TPC), presence/absence of Staphylococcus aureus (S. aureus), total yeasts and moulds in CFU/g and total coliform count (TC) in MPN/g. RESULTS: The mean of the total yeasts and moulds and TC in the packed bread was lower than that of the unpacked bread (3.40 × 103 CFU/g and 3.25 MPN/g versus 6.37 × 103 CFU/g and 31.61 MPN/g, respectively). However, the mean of TPC in the packed bread was higher than that of the unpacked bread (1.39 × 106 versus 2.07 × 105 CFU/g, respectively). The mean TPC, total yeasts and moulds and TC was higher in the studied flatbread than Fino bread and toast (3.4 × 106, 1.14 × 104 CFU/g and 24.6 MPN/g, respectively). The presence of S. aureus was higher in flat, unpacked bread, bread displayed outside the shop and handled without gloves. CONCLUSION: Bread produced by local bakeries showed lower standards in packaging and microbial quality. Better manufacturing, packaging, storage, and handling initiatives should be introduced to avoid related food safety concerns in the future. The formal authorities should define and clarify standards and rules on bread safety.

Delayed seropositivity is associated with lower levels of SARS-CoV-2 antibody levels in patients with mild to moderate COVID-19.

BACKGROUND: Patients with COVID-19 can develop a range of immune responses, including variations in the onset and magnitude of antibody formation. The aim of this study was to investigate whether SARS-CoV-2 antibody levels vary in patients with mild to moderate COVID-19 in relation to the onset (days) of their post-symptom seropositivity and to explore host factors that may affect antibody production METHODS: This was a prospective, multiple measurements study involving 92 PCR-confirmed patients with mild to moderate COVID-19. Antibody testing for anti-nucleocapsid (anti-NP) and spike proteins (anti-S) was performed using ELISA tests. Serum samples were collected over a period of 55 days from symptom onset of COVID-19 infection, and repeated as necessary until they turned positive. RESULTS: No significant differences were found between the positivity rates of anti-S or anti-NP regarding any clinical symptom (p > 0.05). The majority of patients who tested positive for anti-NP and anti-S showed early seropositivity (within 15 days of symptom onset) (75.9% for anti-NP and 82.6% for anti-S). Younger patients, those without chronic diseases, and non-healthcare workers had the highest percentage of seroconversion after day 35 post-symptom onset (p = 0.002, 0.028, and 0.036, respectively), while older patients and those with chronic diseases had earlier seropositivity and higher anti-NP levels (p = 0.003 and 0.06, respectively). Significantly higher anti-S ratios were found among older (p = 0.004), male (p = 0.015), and anemic patients (p = 0.02). A significant correlation was found between both antibodies (p = 0.001). At the end of the study, the cumulative seroconversion rate for both antibodies was almost 99%. CONCLUSIONS: Some COVID-19 patients may exhibit delayed and weak immune responses, while elderly, anemic patients and those with chronic diseases may show earlier and higher antibody responses.

Prevalence of severe acute respiratory syndrome coronavirus 2 spike antibodies in some healthcare settings in Egypt.

BACKGROUND: Healthcare workers (HCWs) are at the front line in battling infection transmission, such as that in coronavirus disease 19 (COVID-19). Additionally, they may act as potential carriers passing the virus on to others. Anti-spike (anti-S) antibodies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are formed either as a result of infection or vaccination with both indicating immunity against future COVID-19 infection. AIM: This study aimed to identify the prevalence of COVID-19 seropositivity among HCWs. METHODS: This cross-sectional study included 559 HCWs from 39 hospitals with variable degrees of COVID-19 exposure risk (depending on the occupation, department, and hospital type). Demographic data were recorded as well as history of COVID-19 infection and vaccination. Serum samples were collected and tested for SARS-CoV-2 spike antibodies. RESULTS: Anti-S positivity was found in 59.0% of the participating 559 HCWs, indicating a high level of seroprotection. Of the 559 HCWs, 34.1% had reported previous infection with COVID-19. Following infection, only 46 (24.0%) of those affected received vaccination. Anti-S seropositivity was found in 39.1% of participants who were unvaccinated and had no history of infection. Physicians had the highest median anti-S titers (58.0 relative units (RU)/mL), whereas pharmacists and office staff had the lowest (25.7 and 38.2 RU/mL, respectively). CONCLUSIONS: Overall, 59.0% of the 559 HCWs were anti-S positive, indicating a relatively high seroprotective status. Among those who were unvaccinated and had no history of infection, 39.1% were seropositive for anti-S, denoting a high rate of silent/asymptomatic infections. Screening of HCWs for SARS-CoV-2 anti-S is recommended, along with the vaccination of seronegative individuals.

Adherence of healthcare workers to COVID-19 infection prevention practices and its relationship with SARS-CoV-2 seropositivity.

Background: Infection prevention and control (IPC) practices against COVID-19 should be adopted by healthcare workers (HCWs) at their workplaces to protect themselves, their patients, and their families from infection. Purpose: This study aimed to describe the relationship between the healthcare-related COVID-19 infection prevention measures adopted by HCWs and their SARS-CoV-2 seropositivity. Research Design: This cross-sectional study was conducted during the second and third COVID-19 waves in Egypt. Study Sample: The study included 416 unvaccinated HCWs from 39 hospitals in Egypt. Data Collection: Sociodemographic data, as well as COVID-19 IPC measures done at work, and protective measures performed by their healthcare facilities were collected. SARS-CoV-2 spike protein antibodies were measured by ELISA. Results: 58.2% of participants were seropositive for SARS-CoV-2. Among the previously undiagnosed HCWs, 125/271 (46.1%) were seropositive. Predictors of seropositivity were rural residence (aOR = 5.096; 95% CI: 1.583-16.403, p = 0.006), previous COVID-19 infection (aOR = 4.848, 95% CI: 2.933-8.015, p = 0.000), and examining 10-20 suspected COVID-19 patients daily (aOR = 2.329; 95% CI: 1.331-4.077, p = 0.003. Reporting low satisfaction (25-50%) with infection control implementation, working more than 40 h per week, reporting to "sometimes abiding by hand hygiene" compared to those who reported to "always" adhere to hand hygiene and shorter duration of hand washing (<20 s) were associated with significantly higher odds of seropositivity. Conclusions: Poor infection control measures and the high workload of HCWs (longer working hours and examining more patients) were modifiable risk factors for SARS-CoV-2 seropositivity among HCWs. Hand hygiene was better among HCWs working in urban versus rural areas.

Determining the SARS-CoV-2 Anti-Spike Cutoff Level Denoting Neutralizing Activity Using Two Commercial Kits.

BACKGROUND: The viral neutralization assay is the gold standard to estimate the level of immunity against SARS-CoV-2. This study analyzes the correlation between the quantitative Anti-SARS-CoV-2 QuantiVac ELISA (IgG) and the NeutraLISA neutralization assay. METHODS: 650 serum samples were tested for both SARS-CoV-2 anti-spike (anti-S) immunoglobulin G (IgG) and neutralizing antibodies (nAbs) using kits by EUROIMMUN, Germany. RESULTS: There was a significant correlation between levels of anti-S and nAbs (Spearman's rho = 0.913). Among the positive samples for anti-S, 77.0% (n = 345) were positive for nAbs. There was a substantial agreement between anti-S and nAbs (Cohen's kappa coefficient = 0.658; agreement of 83.38%). Considering NeutraLISA as a gold standard, anti-S had a sensitivity of 98.57%, specificity of 65.66%, NPV of 97.5%, and PPV of 77.0%. When the anti-S titer was greater than 18.1 RU/mL (57.9 BAU/mL), nAbs were positive, with a sensitivity of 90.0% and specificity of 91%. CONCLUSIONS: A titer of SARS-CoV-2 anti-S IgG can be correlated with levels of nAbs.

Predictors of anti-SARS-CoV-2 seropositivity: An Egyptian population-based study.

Background: Population-based studies on the determinants of COVID-19 seroprevalence constitute a cornerstone in guiding appropriate preventive measures. Such studies are scarce in Egypt, thus we conducted this study to explore risk factors for SARS-CoV-2 seropositivity. Methods: This survey included 2919 participants from 10 Egyptian governorates. Sera were tested for SARS-CoV-2 spike (S) and nucleocapsid (N) antibodies. Univariate and multivariate analyses were performed to identify associated factors and predictors of seropositivity regarding sociodemographic factors, clinical data, and personal practices of participants. A subgroup analysis was performed to investigate the occupational risks of seropositivity. Results: Seropositivity was recorded in 1564 participants (53.6%). Independent predictors of seropositivity included non-smokers (aOR = 1.817; 95% CI: 1.407-2.346, p = 0.000), having blood group A (aOR = 1.231; 95% CI: 1.016-1.493, p = 0.034), a history of COVID-19 infection (aOR = 2.997; 95% CI: 2.176-4.127, p = 0.000), COVID-19 vaccination (aOR = 4.349; 95%CI: 2.798-6.759, p = 0.000), higher crowding index (aOR = 1.229; 95% CI: 1.041-1.451, p = 0.015), anosmia and/or ageusia (aOR = 3.453; 95% CI: 2.661-4.481, p = 0.000) and history of fever (aOR = 1.269; 95% CI: 1.033-1.560, p = 0.023). Healthcare worker and Obesity/overweight were additional significant predictors of seropositivity among the working participants (aOR = 1.760; 95% CI: 1.301-2.381, p = 0.000 and aOR = 1.384; 95% CI: 1.059-1.808, p = 0.019, respectively). Additional factors showing association with seropositivity in the univariate analysis were: female gender, age group (15-39 years), higher educational level (preparatory and above), lack of environmental disinfection and having roommates at the workplace. There was a positive correlation between the titers of both antibodies. Age was weakly correlated with anti-S titer, while anti-N was significantly correlated with the number of protective measures applied by the participants. Both antibodies were significantly correlated with adult BMI, while both were significantly negatively correlated with the smoking index. Conclusions: SARS-CoV-2 seropositivity was associated with some personal and behavioral and occupation-related factors. Fever and anosmia and/or ageusia were the symptoms mostly associated with seropositivity.

"Day 25": a temporal indicator of stabilization of mortality risk among COVID-19 patients with high viral load.

INTRODUCTION: The relationship between SARS-CoV-2 viral load and hospitalization and mortality among COVID-19 patients has been established. However, the estimation of the duration of time after which the risk of mortality of these patients stops escalating was not extensively discussed earlier. Stratifying patients according to their risk of mortality would optimize healthcare services and costs and reduce mortality. METHODOLOGY: In this retrospective observational study, hospital records were used to collect data of 519 COVID-19 patients from May through November 2020. Data included the clinical condition of patients, their viral loads, their admission chest computed tomography results (CO-RAD scale), and the duration of their hospitalization. A Kaplan-Meier analysis was constructed to estimate mortality risk concerning viral load. RESULTS: By the end of the study, 20.42% of patients were deceased. The cumulative mortality was: 36.1% (75/208) among patients with high viral load, 12.6% (28/222) in those with moderate viral load, and 3.4% (3/89) among those with low viral load. Predictors of mortality were: older age [adjusted hazard ratio (aHR) = 1.02, 95% CI: [1.00-1.03], (p = 0.05)], "being female" [aHR = 1.53 with 95% CI: [1.03-2.26], (p = 0.031), "high CO-RAD scale" [aHR = 1.32 (1.06-1.64), p = 0.013], "high viral load" [aHR = 4.59 (2.38-20.92), p = 0.017, ICU admission [aHR = 15.95; 95%CI:7.22-35.20, p < 0.001] and lymphocytosis [aHR = 1.89 45;95%CI:1.04-3.45, p = 0.036]. In the ICU-admitted patients, the median survival was 19 days and mortality stabilized at "day 25". For patients with high viral load, mortality rates stabilized at "day 25 post-admission" after which the risks of mortality did not change until day 40, while patients with low and moderate viral loads reached the peak and stabilized at day "20 post-admission". CONCLUSIONS: Initial high SARS-CoV-2 viral load might be used as an indicator of a delayed stabilization of mortality risk among COVID-19 patients.

Anti-Spike and Neutralizing Antibodies after Two Doses of COVID-19 Sinopharm/BIBP Vaccine.

Host response to COVID-19 vaccines is partially evaluated through the estimation of antibody response, specifically the binding anti-spike (anti-S) and the neutralizing antibodies (nAbs) against SARS-CoV-2. Vaccine-induced humoral response affects decisions on the choice of vaccine type, vaccine acceptance, and the need for boosting. Identification of risk factors for poor antibody response helps to stratify individuals who might potentially require booster doses. The primary objective of this cross-sectional study was to investigate the antibody response after receiving two Sinopharm vaccine doses. Factors affecting antibody response were additionally studied. Moreover, a predictive cutoff for anti-S was generated to predict positivity of nAbs. Blood samples were collected from 92 adults and relevant data were recorded. Antibody levels (anti-S and nAbs) against SARS-CoV-2 were tested one month following the second dose of Sinopharm vaccine using two commercial ELISA tests. Among the 92 participants, 88 tested positive for anti-S (95.7%), with a median level of 52.15 RU/mL (equivalent to 166.88 BAU/mL). Fewer participants (67.4%) were positive for nAbs, with a median percentage of inhibition (%IH) of 50.62% (24.05−84.36). A significant positive correlation existed between the titers of both antibodies (correlation coefficient = 0.875, p < 0.001). When the anti-S titer was greater than 40 RU/mL (128 BAU/mL), nAbs were also positive with a sensitivity of 80.6% and a specificity of 90%. Positive nAbs results were associated with a higher anti-S titers (62.1 RU/mL) compared to negative nAbs (mean anti-S titer of 18.6 RU/mL). History of COVID-19 infection was significantly associated with higher titers of anti-S (p = 0.043) and higher IH% of nAbs (p = 0.048). Hypertensive participants were found to have significantly higher median titers of anti-S (101.18 RU/mL) compared with non-hypertensive ones (42.15 RU/mL), p = 0.034. Post-vaccination headache was significantly higher among those with higher anti-S than those with relatively lower titers (98.82 versus 43.69 RU/mL, p = 0.048). It can be concluded that the Sinopharm vaccine produced high levels of binding antibodies but with low neutralizing abilities. Also, levels of anti-S titer greater than 40 RU/mL could adequately predict positivity of nAbs without need for their testing.

A pre-vaccine exploratory survey of SARS-CoV-2 humoral immunity among Egyptian general population.

BACKGROUND: Population-based studies on COVID-19 have important implications for modeling the pandemic and determining vaccination policies. Limited data are available from such surveys in Egypt. METHODS: This cross-sectional was conducted throughout the period between January and June 2021, which coincided with the second and third waves of the COVID-19 pandemic in Egypt. At that time, vaccines against COVID-19 were not available to the general population. The study was carried out in eight Egyptian governorates and included 2360 participants, who were recruited through a multistage stratified cluster sample technique, based on gender, age, and district followed by a random sample within each district. Socio-demographic data were recorded and serum samples were collected and tested for SARS-Co-V2 spike (S) antibodies. RESULTS: The overall adjusted prevalence of anti-S was 46.3% (95% CI 44.2-48.3%), with significant differences between governorates. Factors associated with anti-S seropositivity were: being female (p = 0.001), living in a rural area (p = 0.008), and reporting a history of COVID-19 infection (p = 0.001). Higher medians of anti-S titers were significantly associated with: extremes of age (p < 0.001), living in urban areas, having primary education (p = 0.009), and reporting a history of COVID-19 infection, especially if based on chest CT or PCR (p < 0.001). CONCLUSIONS: High seroprevalence rates indicate increased COVID-19 infection and immune response among a considerable percentage of the community. Age, gender, residence, educational level, and previous PCR-confirmed COVID-19 infections were all determinants of the immune response.

Asymptomatic versus symptomatic SARS-CoV-2 infection: a cross-sectional seroprevalence study.

BACKGROUND: Although symptomatic SARS-CoV-2 infection predisposes patients to develop complications, the asymptomatic SARS-CoV-2 infection state is of public health importance being a hidden source of infection. Moreover, the asymptomatic state may camouflage the actual burden of the disease. METHODS: Data of 1434 seropositive participants for SARS-CoV-2 spike (anti-S) and/or nucleocapsid antibodies (anti-N) were retrieved from a larger cross-sectional survey on COVID-19. Relevant data were retrieved from records including socio-demographic, medical, and behavioral characteristics of seropositive participants as well as history of COVID-19 symptoms during the last 6 months. Symptomatic/asymptomatic SARS-CoV-2 infection was categorized based on the history of the presence or absence of COVID-19 symptoms. RESULTS: The rate of asymptomatic SARS-CoV-2 infection was 34.9%. There was a statistically significant difference between symptomatic and asymptomatic participants regarding age, residence, medical conditions, habits, and infection control measures. The number of symptoms was positively correlated with anti-S titer and both were positively correlated with adult body mass index. Slum areas residence, client-facing occupation or being a healthcare worker, having lung disease, having blood group type A, never practicing exercise or social distancing, never using soap for hand washing, and minimal engagement in online working/studying were independent factors associated with the symptomatic state. Patients having less than three symptoms were less likely to be diagnosed by any means. CONCLUSIONS: One-third of SARS-CoV-2 infections in our study were asymptomatic. This mandates applying proper measures to prevent transmission even from apparently healthy individuals. Modifiable factors associated with symptomatic infection should be controlled to reduce the risk of COVID-19 complications.

Determinants of the Development of SARS-CoV-2 Anti-Spike Immune-Response after Vaccination among Healthcare Workers in Egypt.

BACKGROUND: Understanding the factors affecting humoral immune response to COVID-19 vaccines among healthcare workers (HCWs) is essential to predict their level of protection. Vaccination elicits antibodies against SARS-CoV-2 spike protein (anti-S). AIM: To investigate the factors associated with the presence of SARS-CoV-2 anti-S antibodies among vaccinated HCWs. METHODS: This cross-sectional study included 143 vaccinated HCWs, with or without a history of previous COVID-19 infection (clinically, radiologically, or by laboratory results) from different departments. Socio-demographic, clinical, as well as vaccine-related data, were recorded. Serum samples were collected and tested for SARS-CoV-2 spike antibodies. RESULTS: Vaccination provoked an immunogenic response, where the overall anti-S positivity was 83.9% (95% CI: 77.8-90.0%). The response was not affected either by the age or gender of HCWs. Out of the 143 HCWs, 46 (32.1%; 95% CI: 24.4-39.9%) reported a previous history of COVID-19 infection, and seropositivity was significantly higher among them (p = 0.002), and it was associated with the frequency of infection (p = 0.044) and duration since diagnosis of COVID-19 infection (p = 0.065). They had higher median anti-S titers (111.8 RU/mL) than those without infection (39.8 RU/mL). Higher seropositivity was observed with Oxford/AstraZeneca vaccine (AZD1222) (88.9%; 95% CI: 83.1-95.0%) than Sinopharm (BBIBP-CorV) (67.7%; 95% CI: 50.3-85.2%), and with receiving two doses of vaccine (92.3%; 95% CI: 87.1-97.5%). CONCLUSIONS: Antibody positivity was significantly affected by the previous history of COVID-19 infection, type of vaccine, the number of doses received, and duration since vaccination.

Lectins purified from medicinal and edible mushrooms: Insights into their antiviral activity against pathogenic viruses.

For thousands of years, fungi have been a valuable and promising source of therapeutic agents for treatment of various diseases. Mushroom is a macrofungus which has been cultivated worldwide for its nutritional value and medicinal applications. Several bioactive molecules were extracted from mushroom such as polysaccharides, lectins and terpenoids. Lectins are carbohydrate-binding proteins with non-immunologic origin. Lectins were classified according to their structure, origin and sugar specificity. This protein has different binding specificity with surface glycan moiety which determines its activity and therapeutic applications. A wide range of medicinal activities such as antitumor, antiviral, antimicrobial, immunomodulatory and antidiabetic were reported from sugar-binding proteins. However, glycan-binding protein from mushroom is not well explored as antiviral agent. The discovery of novel antiviral agents is a public health emergency to overcome the current pandemic and be ready for the upcoming viral pandemics. The mechanism of action of lectin against viruses targets numerous steps in viral life cycle such as viral attachment, entry and replication. This review described the history, classification, purification techniques, structure-function relationship and different therapeutic applications of mushroom lectin. In addition, we focus on the antiviral activity, purification and physicochemical characteristics of some mushroom lectins.

TT virus among blood donors in Alexandria.

TTV is a non enveloped, single-stranded, circular- DNA virus that has been assigned to the Family Circiniviridae. The primary mode of TTV transmission was proposed to be transfusion (and hence its name). Little is known about the clinical significance and the natural history of TTV infection. Hence, responsibility of the virus for specific liver disease is still debated. In our study, we tested ninety five blood donors attending Kom EL-Decka regional blood bank in Alexandria for the presence of TTV DNA in their sera by PCR technique. The same samples were tested for ALT and AST levels by colorimetric technique and for HBsAg and anti-HCV by the ELISA technique. Out of the 95 blood donors, 46 (48.4%) had TTV DNA in their sera. None of the 95 blood donors included in this study was positive for HBsAg, while 22 (23.2%) were anti-HCV positive. Out of the 22 anti-HCV positive blood donors, 13 (59.1%) were TTV DNA positive, while out of the 73 anti-HCV negative blood donors, 33 (45.2%) had TTV DNA in their sera. There was no statistically significant difference between the prevalence of TTV DNA and anti-HCV in blood donors. No biochemical evidence of liver disease potentially linked to the TTV infection was observed in our blood donors who were TTV DNA positive. Furthermore, the occurrence of elevated serum AST and ALT was most often linked to HCV rather than TTV.

The inhibitory effect of garlic (Allium sativum) on growth of some microorganisms.

The aim of the present study was to compare between the anti-microbial activity of fresh garlic bulbs and that of its water extract against the potent food pathogens Staphylococcus aureus, Esherichia coil, Salmonella typhi and Bacillus cereus. Garlic segments with different concentrations (1%, 5%, and 10%) were used. Another 100 gms of garlic segments were weighed and mixed with 100 ml distilled water to prepare water extract of garlic, then 1000, 500 and 100 microg/ml were prepared. These concentrations of garlic were mixed with prepared cultures of E. coli, Staph. aureus, Bacillus cereus, and Salmonella typhi. The inhibitory effect of garlic was determined using Spectrophotometer for garlic segments and by comparing with control plates for the water extract of garlic. Results showed that the higher the garlic concentration, the higher was the microbial reduction percent. Water extract of garlic exhibited a higher microbial reduction percentage than fresh garlic.

Detection of coagulase positive staphylococci in meat products sold in Alexandria using two different media.

Microbiological examination of 200 meat products collected from 30 supermarkets in Alexandria revealed that CHROMagar Staph aureus yielded higher counts than Baird Parker medium that were significant in all examined products except sausage. The prevalence of coagulase positive staphylococci was 4%, moreover, CHROMagar Staph aureus showed higher recovery rate and specificity (87.5% and 98.9%; respectively) than Baird Parker medium (50.0% and 15.6%; respectively) during their detection. Sanitary evaluation of the supermarkets revealed that all of them were acceptable regarding prevention of bacterial growth parameter, although their mean score was only 55%. Avoidance of contamination parameter had the lowest mean score percent (15.6 +/- 27.3) with only about seven percent of the inspected supermarkets being acceptable. Although all recruited food handlers were apparently healthy, in few supermarkets, handlers were wearing clean light colored uniform (6.7%) and gloves (3.3%). Despite the presence of hand washing basins in all supermarkets, few of them were provided with hot water (6.7%) and detergents were available in 30% of them. Improvement of the sanitary conditions under which meat products are handled in the supermarkets is a must, also, improving the selectivity of CHROMagar Staph aureus in addition to both specificity and recovery rates of Baird Parker medium is recommended.

Performance of a rapid test versus real-time PCR for diagnosis of H1N1 swine flu.

BACKGROUND AND OBJECTIVE: For effective control and treatment of swine influenza, rapid and cost-effective diagnosis is important. Although the gold-standard method for the diagnosis of influenza virus is culture isolation, it is not routinely used in outpatient settings because of the cost and the time needed to complete the assay. This has led to the development of an array of rapid influenza diagnostic tests. The aim of this study was to compare between the performance of CerTest Swine Flu card and RT-PCR in the detection of H1N1 infection. MATERIALS AND METHODS: This study included 40 clinically suspected cases of H1N1. Nasal and throat swabs were collected from patients, placed in viral transport medium, and kept at 4°C until being tested on the same day for the presence of H1N1, using the CerTest Swine Flu test and real-time PCR. RESULTS: Of these 40 suspected cases, seven (17.5%) were found to be positive by the PCR technique, whereas 33 (82.5%) were found to be negative. Of the seven positive cases by the PCR technique, six were found to be positive by the rapid test, and thus the sensitivity of the rapid test was found to be 85.7%, and the specificity was 100%. CONCLUSION: CerTest Swine Flu card rapid test was found to have reliable sensitivity and specificity compared with the gold-standard RT-PCR.

Epstein-Barr virus in multiple sclerosis.

BACKGROUND/OBJECTIVES: Multiple sclerosis (MS) is an inflammatory disorder of the central nervous system. Many diseases are associated with Epstein-Barr virus (EBV) infection, such as infectious mononucleosis and many types of malignancies, and it is thought to be related to some diseases of autoimmune origin, such as rheumatoid arthritis, systemic lupus erythematosis, and others. The present study aimed to assess EBV in patients with MS. PATIENTS AND METHODS: This case-control study was conducted from October 2012 to September 2013 on 75 MS patients and non-MS controls. Both were tested quantitatively for immunoglobulin G (IgG) antibodies against Epstein-Barr nuclear antigen-1 (EBNA1) and viral capsid antigen (VCA) using the enzyme linked immunosorbent assay technique. RESULTS: Seventy MS patients (93.3%) were positive for EBNA1 IgG compared with 68 controls (90.7%). In MS patients, the mean EBNA1 IgG serum level was 310.91 (±131.05) U/ml; meanwhile, among controls the mean serum EBNA IgG level was 177.81 (±104.98) U/ml.All patients with MS were positive for VCA IgG, whereas only 60 (80.0%) controls were positive. In the MS group, the VCA IgG mean level was 302.19 (±152.11) U/ml compared with 167.94 (±111.79) U/ml in controls. The differences in the serum levels of both markers between the two groups were statistically significant (P<0.001). CONCLUSION AND RECOMMENDATIONS: EBV proved to have a unique immunological pattern in MS patients when compared with non-MS controls. Further studies for more confirmation of the relation between EBV and MS on a large scale are recommended.

Occult hepatitis B virus infection among hepatitis C virus seropositive and seronegative blood donors in Alexandria, Egypt.

BACKGROUND AND AIMS: Occult hepatitis B virus infection (OBI, serum hepatitis B surface antigen negative but hepatitis B virus DNA positive) is an emerging problem in the safety of blood transfusion. The introduction of hepatitis B surface antigen in the screening panel for blood bank donors has substantially reduced, but not entirely eliminated, the risk of hepatitis B virus infection. It has been suggested that infection with hepatitis C virus may inhibit hepatitis B virus replication. Therefore, this study aimed at estimating the prevalence and risk factors for OBI among blood donors and determining its relationship with hepatitis C virus infection. SUBJECTS AND METHODS: Presence of hepatitis B virus DNA and hepatitis C virus RNA was investigated for among 508 hepatitis B surface antigen-negative blood donors in Alexandria, Egypt. Half of the donors were identified as hepatitis C virus antibody reactive. RESULTS: OBI was detected in 21 donors (4.1%) from the studied population: eight were among hepatitis C virus antibody positive donors (3.2%), among whom seven (33.3%) had hepatitis C virus RNA in their serum, and 13 (5.1%) were among hepatitis C virus antibody negative donors, with no statistically significant difference. The only significant risk factor for OBI among the studied blood donors was visiting local barbers. CONCLUSION AND RECOMMENDATIONS: OBI is a considerable risk in blood banks, making screening for hepatitis B virus infection only on the basis of surface antigenemia insufficient.

Effectiveness of three types of rapid tests for the detection of hepatitis C virus antibodies among blood donors in Alexandria, Egypt.

Hepatitis C is one of the most important diseases transmitted through screened improperly blood donation. The detection of HCV antibodies is performed by enzyme immunoassays (EIA) or supplementary assays (immunoblots). However, these methods are not well-suited to developing countries due to their high cost and technicality. The effectiveness of three different rapid tests for the detection of anti-HCV antibodies was evaluated compared to third-generation ELISA among blood donors attending the blood bank of Medical Research Institute in Alexandria, Egypt. The results were compared subsequently to the results of HCV RNA obtained by qualitative reverse transcriptase polymerase chain reaction (RT-PCR). The three types of rapid tests showed a specificity of 100% and sensitivities of 96-98% compared to ELISA. Compared to RT-PCR, ELISA and all three types of rapid tests showed an almost equal specificity (77-78.5%). ELISA showed 100% sensitivity while all three types of rapid tests showed equal sensitivities of 97% compared to RT-PCR. The rapid tests showed good performance for detecting anti-HCV antibodies in the sera of blood donors compared to ELISA. Therefore, the present study recommends the use of the tested rapid tests to screen for anti-HCV among blood donors in resource-limited countries as an alternative for conventional ELISA.