Workplace-related risk of tick bites in military personnel stationed in Northern Germany.

PURPOSE: There are more than 500,000 employees in Germany alone who are at risk of being bitten by a tick at their workplace and thus also at risk of being infected with Borrelia burgdorferi s.l. or the tick-borne meningoencephalitis virus. So far, there are only a small number of studies on the risk of tick bites in Central Europe, in particular, for military personnel during relevant training activities. METHODS: During a total of 36 months of training in 2008/2009 and from 2012 to 2014, the number of tick bites and any resulting diseases of 1156 recruits under comparable conditions of exposure and prevention were documented based on their medical records. The incidence of tick bites was calculated with each recruit's individual exposure time for field training. RESULTS: There were a total of 66 tick bites during an exposure time of 317,059 h of field training (0.21 tick bites per 1000 h of training). The risk of tick bites was found to have a seasonal dependency. In 6 out of the 66 cases in which someone was bitten, the patients consulted a physician for a follow-up examination, and in one of these cases the bite resulted in an infection requiring treatment. CONCLUSIONS: It turns out that there is a rather low but relevant risk of being exposed to tick bites for military personnel during their field training. Under the given study conditions, months with a high risk of tick bites can be distinguished from months with a low risk of tick bites, which is of vital importance, in particular, for guidance and prevention.

Injuries caused during military duty and leisure sport activity.

BACKGROUND: Physical demands on soldiers in mission have increased in the past decades. Physical fitness training is included into duty schedules in most armies in order to achieve and maintain a high physical fitness level, but at the same time involving the risk of sport injuries and subsequent sick days. OBJECTIVE: Due to missing data concerning soldiers' sport injuries during duty and leisure time, epidemiology data is required for adequate prevention and therapy. METHODS: A prospective and descriptive epidemiology study has been conducted. All soldiers with sport injuries caused by duty sport (DS) or by sport during leisure time (LTS) were recorded over three years in a German Army tank brigade. RESULTS: 673 injuries during DS and 600 injuries during LTS were analysed. While on duty, most of the injuries occurred during soccer (35.2%) and long distance running (30.2%). Ankle joint (27.3%) and knee (24.1%) were most affected. Soldiers with injuries to knee, ankle joint, shoulder or hand were absent from duty for a longer period of time. Similar results were found during LTS: Soccer (66.0%) was the most frequent cause for injuries and ankle joint (22.8%) and knee (20.3%) were the most affected body parts. CONCLUSIONS: Duty and leisure time sport mainly caused injuries to the lower limb. These injuries caused long absence from duty. Therefore, profound knowledge of physical examination, medical treatment and rehabilitation is necessary for the military physician in order to provide an adequate therapy.

[Risk factors for accidents during sports while serving in German armed forces]. / Risikofaktoren für Sportverletzungen beim Dienstsport in der Bundeswehr.

In the German Armed Forces sports activities should bring the benefits of good health and trained fitness which are the hallmarks of sportsmen. In order to achieve this aim it is important to avoid accidents which negate the benefit of sports. Until today there appear to be no studies in existence which demonstrate the risk factors of sports activities undertaken while in military service. Equivalent studies on civilian sport activities are scarcely comparable. To find out risk factors for accidents with any period of recovery we followed sports accidents while on duty in a German barracks with 4,300 soldiers over a two-year period. Additionally we asked about the time needed for recovery from each accident, parameters of lifestyle, the body mass index and the possibility of a nightshift before each accident. We examined a minimum of 410 accidents. We found associations between the accidents studied and particular risk factors, including doing sports more than two times a week, being active in a fitness or sports club, having the accident together with another sportsman and doing a nightshift before the day of the accident. Bad ground conditions contributed to a large number of accidents. A body mass index of 25 and higher had a significantly prolonged time for recovery. To avoid accidents, sport and ground conditions should be adapted to each other. In addition, overweight people are not only compromised for cardiovascular and neurological diseases but also have a higher risk of needing a prolonged time for recovery, thus it is important that overweight should be avoided and not only just be treated.

Using RRT-PCR analysis and virus isolation to determine the prevalence of avian influenza virus infections in ducks at Minto Flats State Game Refuge, Alaska, during August 2005.

This study describes surveillance for avian influenza viruses (AIV) in the Minto Flats State Game Refuge, high-density waterfowl breeding grounds in Alaska. Five hundred paired cloacal samples from dabbling ducks (Northern Pintail, Mallard, Green Wing Teal, and Widgeon) were placed into ethanol and viral transport medium (VTM). Additional ethanol-preserved samples were taken. Of the ethanol-preserved samples, 25.6% were AIV RNA-positive by real-time RT-PCR. The hemagglutinin (HA) and neuraminidase (NA) subtypes were determined for 38 of the first-passage isolates, and four first-passage isolates could not be definitively subtyped. Five influenza A virus HA-NA combinations were identified: H3N6, H3N8, H4N6, H8N4, and H12N5. Differences in the prevalence of AIV infections by sex and by age classes of Northern Pintail and Mallard ducks were detected, but the significance of these differences is undefined. In the 500 paired samples, molecular screening detected positive birds at a higher rate than viral isolation (chi(2) = 8.35, p = 0.0035, df = 1); however, 20 AIV isolates were recovered from PCR-negative ducks. Further research is warranted to compare the two screening protocols' potential for estimating true prevalence in wild birds. Our success during 2005 indicates Minto Flats will be a valuable study site for a longitudinal research project designed to gain further insight into the natural history, evolution, and ecology of AIV in wild birds.

Role of platelet membrane in enhancement of tumor cell adhesion to endothelial cell extracellular matrix.

Tumor cell adhesion to subendothelial matrix in the presence of platelets and plasma has been examined in vitro using an entirely homologous system of rat Walker 256 carcinosarcoma cells, matrix laid down by rat aortic endothelial cells and rat platelets and plasma. In the presence of platelets or platelets plus plasma, tumor cell adhesion was significantly enhanced when compared to adhesion in the absence of platelets. In the presence of plasma alone (0.1%), we observed no significant increase in tumor cell adhesion. In order to determine which platelet factors contribute to the enhancement of tumor cell adhesion by platelets, we subjected washed rat platelets to mechanical lysis or thrombin stimulation followed by centrifugation. The membrane fractions and supernatant fractions containing platelet attachment proteins were compared for their abilities to support tumor cell adhesion to subendothelial matrix. Platelet membranes were also recombined with platelet supernatant fractions to determine if platelet attachment proteins or platelet membranes required the presence of the other to enhance tumor cell adhesion. Platelet supernatant fractions which contained release reaction proteins (confirmed by polyacrylamide gel electrophoresis) did not enhance tumor cell adhesion. Purified thrombospondin, fibronectin, beta-thromboglobulin, platelet derived growth factor, and serotonin had no effect on tumor cell adhesion. Platelet membrane containing fractions affected tumor cell adhesion to subendothelial matrix as follows: (a) platelets formed an adhesive bridge between tumor cells and the subendothelial matrix as demonstrated by scanning electron microscopy; (b) intact platelets and thrombin stimulated platelets were the most effective at facilitating tumor cell adhesion; (c) preparations containing partially lysed platelet ghosts were more effective in supporting tumor cell adhesion to subendothelial matrix than were preparations containing completely lysed platelet membrane fragments; (d) recombination of platelet supernatant fractions with mechanically lysed platelets did not enhance their ability to support adhesion; (e) fixed platelets, either alone or in combination with platelet supernatant fractions, failed to enhance adhesion. These data indicate that platelet enhanced tumor cell adhesion appears to be dependent on platelet membrane factors including receptor mobility, rather than intraplatelet components.