A retrospective study of seroconversion against Toxoplasma gondii during 3,000 pregnancies in Stockholm.

The incidence of Toxoplasma gondii infections in Swedish women during pregnancy is largely unknown. This retrospective pilot study was performed on consecutive sera sampled from 3,094 women at delivery during 1992-93. Specific IgG anti-toxoplasma antibodies were found in 14% (450/3,094). Serum drawn from the women during the first trimester and cord blood from their children were analysed for IgG and IgM anti-toxoplasma antibodies. A seroconversion during pregnancy was found in 4 women, whose children were followed up at 4 years of age. No signs of sequelae, either neurological or ophthalmological, were found in 3 of the children. The fourth child died at 1 year of age of a disease of different aetiology. An incidence of a primary toxoplasma infection of >1/1,000 pregnancies in this pilot study justifies a larger study.

High frequency of gastrointestinal parasites in refugees and asylum seekers upon arrival in Sweden.

The results of routine screening for intestinal parasites in 1377 refugees and asylum seekers within 2 weeks of arrival in Sweden showed that protozoa, mainly Giardia intestinalis, were found in 235/1377 (17%) and helminths, mainly hookworms, in 264/1377 (19%). Intestinal parasites were more frequently recovered in refugees coming from South East Asia, Africa and Latin America (infection rates 48%, 43% and 42%, respectively) than in those from Eastern Europe (22%) and the Middle East (32%). Refugees who reported gastrointestinal symptoms were less often infected than those without symptoms (p < 0.001). Of the European refugees, 127 came from Bosnia. A high rate of hookworms was found in this group (15%), suggesting that hookworms may also be transmitted in temperate areas under special conditions. We thus identified relatively high rates of pathogens in all groups of refugees. Screening may therefore be recommended, though more for the benefit of refugees than for the prevention of further spread of the infections.

Intestinal microsporidiosis in a HIV-seronegative patient.

Microsporidial infections have been increasingly reported in immunocompromised patients, particularly those infected with the human immunodeficiency virus (HIV), but only rarely in immunocompetent individuals. We report a case of intestinal microsporidiosis in a HIV-seronegative patient with acute self-limited diarrhoea. Examination of stool specimens revealed plenty of spores that correspond with Enterocytozoon bieneusi in size and shape as well as ultrastructural details.

Study of the incidence of intestinal and systemic parasitoses in a group of children with handicaps.

A high incidence of parasitic infections was shown by the study of children with physical and psychic handicaps. In 231 children examined we diagnosed 294 parasitic infections as follows: 42 (18.1%) with Giardia intestinalis 6 (2.59%) with Entamoeba histolytica 36 (15.5%) with Hymenolepis nana 21 (9.9%) with Strongyloides stercoralis 16 (6.9%) with Ascaris lumbricoides 92 (39.86%) with Tricocephalus dispar 38 (16.4%) with Enterobius vermicularis 7(3.03%) with Cryptosporidium sp. Also, by immunodiagnosis 29 cases of Toxoplasmosis (12.5%) and 7 cases of Toxocarosis (3.03%) were pointed out. The clinical examination revealed that the main symptoms were troubles of appetite (both anorexia and hyperorexia)-67.9% intestinal transit disorders-48.4% cutaneous rash (4.7%). Two series of specific treatments diminished the incidence at 38% (after the first) and at 28.5% (after the second). By disappearance of the troubles due to the parasitic infections, the state of children with physical and psychic handicaps clinically improved; so, we may consider as a further necessity the screening of all those children for such diseases.

Frequency of Giardia lamblia in certain allergic syndromes.

To detect the frequency of Giardia lamblia association with certain allergic syndromes as well as the most frequent allergens involved in this association, allergologic and parasitologic investigations were carried out in 434 patients with chronic urticaria, Quincke's edema, urticaria + Quincke's edema or urticaria + bronchial asthma. The greatest frequency of Giardia lamblia (62%), detected in chronic urticaria associated with Quincke's edema, was three times higher than the maximum percentages reported in Romania for the adult population. In the patients with an allergic syndrome and Giardia, the most frequently involved allergens were the microbial ones (Colibacillus, Staphylococcus) and the food proteins (especially pork). The intensely positive skin tests to histamine in very high dilutions, constantly obtained in the association allergic syndrome + Giardia, may be almost sure indication of infestation with this parasite.