[Diet of neutropenic patients in pediatric oncology service; the experience of the university hospital of Strasbourg (HUS)]. / L'alimentation des patients neutropéniques d'un service d'onco-hématologie pédiatrique; l'expérience des hôpitaux universitaires de Strasbourg (HUS).

OBJECTIVE: This article clarifies the choices made by the HUS concerning the ways of preparing food reserved to neutropenic children hospitalized in pediatric oncology service. We will describe the results of microbiological analysis of food realized from 2002 to 2007. METHODS: A specific team prepares this food which is canned and treated by "appertisation" (autoclaving). Each dish portion produced is provided to the service only if the microbiological results are conform, that is to say free of organisms. RESULTS: Three thousand and seventy-eight dishes were analysed: 82.9% of the analysed packs were conform. The contamination ratio decreased significantly (P<0.001) from 2002 to 2007. The organisms which cause the majority of dishes contamination are Bacillus (44.7%) and environmental mould exhibiting sterile mycelium (8.7%). The food which is the most frequently "nonconform" is the dry food with a contamination rate of 37.9%. The identified concentrations remain mainly lower than 50 colony-forming units per millilitre (CFU/mL): 66.2% for the bacteria and 97.2% for the fungi. CONCLUSION: Considering the lack of consensus on the acceptable microbiological thresholds and on the food protection level, the HUS make it a rule to have a maximal precautionary principle. Currently, this principle appears to us to be a safety option required for the patients hospitalized in pediatric oncology service.

The past and future of tropical medicine in Czechoslovakia.

The authors present a short historical review on the developments in the Czechoslovak tropical health studies with special reference to the post WW II period. Perspectives for future expansion are likewise outlined.

Antibacterial properties of the Vietnamese cajeput oil and ocimum oil in combination with antibacterial agents.

Main antibacterially active agents obtained from plants-Cajeput essential oil--1,8 cineol, linalool, alpha-terpineol and terpinen-4-ol, for example from Melalleuce leucadendron (Myrtaceae) as well as essential oil from Ocimum gratissimum (Labiatae) were combined in tests in vitro with selected antibiotics. Above mentioned plant products were found to be effective medicaments for local application in modern medical practice. Combinations with antibiotics potentiated their therapeutical action. On the basis of tests in vitro the synergistic action of these two kinds of medicaments, i.e., preparations traditionally used for a few last decades--antibiotics--might be well applied for therapeutical needs.

Typhoid fever survey in two localities in Vietnam.

As a part of multipurpose health survey of the population in Vietnam the antibodies against S. typhi were determined by the micromethod using haemagglutination test (O-antigen 9, 12) and agglutination test using standard H-diagnostic antigen (d). Totally 292 sera were examined, 139 from Duyen Thai village and 154 from Mai Chau. The data on vaccination against typhoid fever are recorded only in 102 persons. The positivity on Vi antibodies is very high--70% in Duyen Thai and 47% in Mai Chau. This finding is significant according to the high titres in the carriers of S. typhi. The titres of all antibodies are lower in Mai Chau area situated in mountains then in crowded lowlands of Duen Thai. The level of antibodies is decreasing with age. The frequency distribution of antibodies by age proves endemicity of the disease in area, where a large part of population is infected already before reaching 20 years of age. The effectivities of vaccination is discussed.

Environmental protection and its trends in developing countries.

On instances of some worldwide problems of environmental protection, the authors refer to the fact, that a target of industrial countries is to help to the developing countries. Mainly it means an aim in such sense, that the dangerous failures and faults which happened in the past, should not be repeated as a consequence of temporaneous economical problems in the Third World. In the long run it is a common interest of all and certainly a sufficient motivation of a commonly coordinated effort in this field. It is at most desirable, that all developing projects, from a simple water supply to the integrated developing concepts, for example eco-agriculture projects, correspond with the national interests as well as with the specific requirements of environmental control.

To the problem of toxoplasmosis in Vietnam.

The number of 259 human seria was examined for Toxoplasma gondii antibodies in 1984. Under survey were 140 persons from Duyen Thai village situated in a suburban agricultural area of Hanoi, and 119 persons from the villages of Mai Chau district in a mountainous valley near Laos border. A microreaction of complement fixation had shown higher titres in Mai Chau (24.3%) in comparison with 15.7% in Duyen Thai, using 1:16 and higher titres as significant reaction. Age distribution of antibodies revealed early infection in the childhood, as 50% of children had significant reactions in Mai Chau and 27.6% in Duyen Thai. Lately the level of antibodies was decreasing to a minimum (8%) in Duyen Thai in the age group of 30-49 years.

Immunological surveys of diphtheric antitoxic antibodies in some African and Asian countries.

Immunological surveys of diphtheric antitoxic antibodies confirmed the existence of a high circulation of Corynebacterium diphtheriae in some African and Asian countries. The high immunity level in early childhood confirms the well known fact that other forms of diphtheria, in particular the cutaneous forms, participate in the formation of antitoxic antibodies. Immunological surveys can determine relatively exactly the extent of risk of infection in the separate age groups and thus delimit the range of the planned vaccination campaigns. Exact determination of the age groups eligible for vaccination makes it possible efficaciously to employ the means allotted for the health services. In some cases, it is possible to dispense with vaccination altogether. However, it should be borne in mind that a change in the socio-economic conditions and increasing urbanization of these countries may induce a radical change in the situation. Children not protected from the cutaneous forms thanks to a better hygienic and social standard, might fall ill with diphtheria of the throat in the future. It is therefore advisable to continue the follow-up of the immune state of the child population at several years time intervals and, in case of necessity, timely to intervene by vaccinating the endangered groups.

PIP: This article summarizes diphtheria antitoxic antibody surveys in 6740 sera from 11 African and Asian countries, and reviews the literature on the immunology of diphtheria. Classic diphtheria of the throat is primarily a temperate zone phenomenon. In subtropical and torrid zones, other forms, mainly cutaneous diphtheria, still prevail. Antitoxic antibodies are present in the majority of preschool children in the tropics, while complete immunization in the subtropics takes 10-15 years. In this survey, in collaboration with the WHO Reference Serum Bank, the authors assayed diphtheria antitoxic antibodies in 6740 sera from 1967-1973 by titration on monkey kidney tissue cultures, by the pH metabolic inhibition test. The countries surveyed were Nigeria, Niger, Kenya, Togo, Burma, Algeria, Tunisia, Afghanistan, Mongolia, Yugoslavia. Most countries had adequate natural immunity at an early age. Exceptions were parts of Tunisia, and most of Afghanistan where morbidity was high. Yugoslavia used to have the highest morbidity in Europe from diphtheria, but 90% of children are now immunized. It is important to note that the percentage of immunized children is highest where hygiene is poor, in the tropics, and among rural rather than urban dwellers, and in boys rather than girls. Prolonged breast feeding appears to confer immunity in children. Therefore, as hygiene improves with modernization and urbanization, cutaneous diphtheria disappears, and populations will need to be protected by vaccination.

Immunological surveys of antibodies against B. pertussis and B. parapertussis in some African and Asian countries.

Immunological surveys in African and Asian countries showed a different degree of herd immunity in the respective countries and the circulation of various types of B. pertussis. Antibodies against B. parapertussis, the second aertiological agent of whooping cough, were found in all countries in all age groups. Before planning any vaccination program, attention should be paid to the vaccine concerning the content of all types of B. pertussis, as was shown in the results of the testing of different vaccines used in Mongolia and Algeria. It is also possible to estimate the age limit for vaccination and thus economic use of the vaccine. The contemporary state of reporting whooping cough cases is very unsatisfactory.