Seroprevalence of hepatitis E among hospitalized patients in Slovakia: first report.

OBJECTIVE: Hepatitis E infection is one of the most frequent acute hepatitis in the world. Currently five human genotypes with different geographical distributions and distinct epidemiologic patterns are identified. In Slovakia, only rare cases of hepatitis E have been reported in recent years. Therefore, the aim of the study was to evaluate the prevalence of anti-HEV total antibodies and the main risk factors for HEV in the general population in Eastern Slovakia. METHODS: Detection of anti-HEV total antibodies samples was done by a commercial enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: Of 175 hospitalized patients included in the study, 76 (43.5%) showed positivity for anti-HEV total antibodies. No statistically significant differences were found in anti-HEV positivity between men and women or in the groups of different living areas (town/village - urban/rural). CONCLUSION: Prevalence of anti-HEV total antibodies of hospitalised patients was high. The risk factor significantly associated with antibody positivity was eating raw meat. Other factors, such as sex, age, living area and contact with animals were not associated with antibody positivity.

Seroprevalence of Hepatitis E Virus in Roma Settlements: A Comparison with the General Population in Slovakia.

Hepatitis E infection is one of the most frequent causes of acute hepatitis in the world. Currently five human genotypes with different geographical distributions and distinct epidemiologic patterns are identified. In Slovakia, only rare cases of hepatitis E have been reported in past years. Because the most important risk factors associated with HEV infection include consumption of contaminated pork meat and poor hygienic standards, the aim of the study was to evaluate the prevalence of anti-HEV total antibodies and the main risk factors for HEV in the population living in separated and segregated Roma settlements (n = 195), which represent places with increased risk of infection in Slovakia and to compare it with the prevalence in the general population (n = 69). Of 264 respondents included in the study, 47 (17.8%) showed positivity for anti-HEV antibodies, 42 of whom were Roma (21.5%, n = 195) and 5 (7.2%, n = 69) non-Roma. The population living in Roma settlements lives in poorer conditions and are at higher risk of HEV in comparison to the general population. However, differences in living conditions within the settlements do not contributed to lower risk of HEV antibody prevalence between Roma living in settlements.

Exposure to Toxoplasma gondii in the Roma and Non-Roma Inhabitants of Slovakia: A Cross-Sectional Seroprevalence Study.

The lifestyle, health and social status of the Roma are generally below the standards characteristic for the non-Roma population. This study aimed to find out the seropositivity to Toxoplasma gondii (T. gondii) in the population of Roma living in segregated settlements and to compare it with the prevalence of antibodies in the non-Roma population from the catchment area of eastern Slovakia. The seroprevalence of antibodies to T. gondii was significantly higher in the Roma group (45.0%) than in non-Roma inhabitants (24.1%). A statistically significant difference was also recorded between the two non-Roma groups in the study, 30.4% of those from the catchment area and 19.7% from the non-catchment area were seropositive. Univariate logistic regression confirmed poverty and higher age to be significant risk factors influencing the seropositivity to T. gondii. Of the clinical symptoms analyzed in the study, only muscle and back pain were associated with seropositivity to T. gondii. The close contact of Roma with an environment contaminated by different infectious agents and the insufficient hygiene, lower level of education, poverty, lack of water and household equipment and high number of domestic animals increase the risk of infectious diseases in the Roma settlements and subsequently the spread of communicable diseases at the national or even international level.

Prevalence of Chlamydia trachomatis Infection and Its Association with Sexual Behaviour and Alcohol Use in the Population Living in Separated and Segregated Roma Settlements in Eastern Slovakia.

The aim of the study was to explore sexual behaviour and the occurrence of Chlamydia trachomatis (CT) infection in the population living in Roma settlements compared to the majority population in Slovakia and to assess the association between alcohol use and sexual behaviour within both populations. A cross-sectional population-based Hepa-Meta study was conducted in Slovakia in 2011. The final sample comprised 452 Roma and 403 non-Roma respondents. The occurrence of CT was detected by direct proof of the pathogen by PCR. The association between alcohol use and the prevalence of risky sexual behaviour were assessed using a logistic regression. First intercourse at age 15 or younger was reported by 27.9% of Roma (vs. 4.5% of non-Roma); 93.4% of Roma (vs. 77.9% of non-Roma) used condom inconsistently, 22.8% of Roma (vs. 43.9% of non-Roma) used a condom for protection from unwanted pregnancies and only 8.8% of Roma (vs. 21.8% of non-Roma) due to protection against infectious diseases. However, Roma reported having had five or more sexual partners less often compared to the majority (11.5% of Roma vs. 20.6% of non-Roma). Binge drinking at least once a month was associated with a higher number of sexual partners in both groups, but not with condom non-use. The prevalence of CT infection in the Roma population was higher (3.8%) compared to non-Roma (2.7%); however, the difference was not statistically significant. Our study found no differences in the prevalence of CT infection between Roma and non-Roma despite differences in sexual behaviour. Roma begin their sexual life earlier and have unprotected sex more often, but on the other hand, they seem to be much more restrained in terms of the number of sexual partners compared to the majority population.

Detection of CHLAMYDIA PSITTACI in feral pigeons (COLUMBA LIVIA DOMESTICA) in Slovakia and their characterisation.

INTRODUCTION AND OBJECTIVES: Chlamydia psittaci, an obligate intracellular bacterium, which is the etiologic agent of avian chlamydiosis in birds and ornithosis/psittacosis in humans, has been reported to be one of the most common pathogens found in feral pigeons worldwide, and thus constitutes a zoonotic risk. The aim of the study was to investigate pigeons in Slovakia living in areas in close proximity to humans for the presence of C. psittaci, using pharyngeal and cloacal swabs. MATERIAL AND METHODS: 122 clinically healthy pigeons from different geographical regions of Slovakia were examined for the presence of C. psittaci. The adult pigeons of both genders were captured during the summer period in the urban centres of Slovakian towns. Each sample was examined by molecular method PCR, and in the case of positive result the identity of the obtained sequence was examined by a BLAST search. RESULTS: Of the total number of 244 examined samples, 14 (5.7%) showed positivity for C. psittaci infection, 5 of which were from pharyngeal swabs (4.1%) and 9 from cloacal swabs (7.4%). A positive result was detected in 13 pigeons (10.7%). Phylogenetic analysis showed that all the positive samples are genetically very close to genotypes B and genotype E. CONCLUSION: Phylogenetic examination of the 14 isolates of C. psittaci identified in the presented study, based on 23S rRNA gene sequence, revealed their close relationship with C. psittaci genotypes B and E. Both genotypes are predominantly prevalent in pigeons and both can be transmitted to humans. Therefore, it is necessary to perform screening examinations of animals and analyse the epidemiological factors affecting the way of transmission and circulation of pathogen.

Occurrence of antibodies to Anaplasma phagocytophilum in patients with suspected tick-borne encephalitis.

INTRODUCTION AND OBJECTIVES: Human granulocytic anaplasmosis (HGA) is an emerging tick-borne infectious disease caused by Anaplasma phagocytophilum. In Europe, the first serological evidence of HGA was described in 1995 in Switzerland, and the first clinical case was confirmed in 1997 in Slovenia. Since then, many European countries, including Slovakia, have reported the occurrence of HGA. The aim of this study was to examine the occurrence of IgG antibodies against A. phagocytophilum in blood sera of humans with suspected tick-borne encephalitis. MATERIAL AND METHODS: 181 people were examined for the presence of anti-A. phagocytophilum IgG antibodies; 113 were patients with suspected TBE (65 males, 48 females), and 68 from the control group (18 males, 50 females). Respondents were aged 2-80 years (mean age: 31.39; STD: 17.1). Anti-A. phagocytophilum IgG antibodies were detected by the IFA IgG test. Relative risk (RR) and their 95% confidence intervals (95% CI) were estimated for the occurrence of IgG A. phagocytophilum antibodies. RESULTS: Of the total number of 181 people examined, 32 (17.7%) showed positive for IgG antibodies against A. phagocytophilum, 22 of whom were patients with suspected TBE (19.5%) and 10 people from control group (14.7%). The RR of occurrence of IgG A. phagocytophilum was 1.3-times higher in the patients with suspected TBE than in the control group. CONCLUSION: None of the examined patients with suspected TBE had the disease confirmed. Hoever, as shown by the results, the relative risk of occurrence of anaplasmosis is higher in people examined for some another vector-borne disease (in this case TBE). Therefore, the performance of screening examinations in patients suspected of having any tick-borne disease is very important.

The prevalence of Chlamydia trachomatis in the population living in Roma settlements: a comparison with the majority population.

BACKGROUND: We aimed to study the occurrence of Chlamydia trachomatis infection in the population living in Roma settlements and to compare the obtained results with the prevalence in the majority population. METHODS: We examined 340 people for the presence of bacterium C. trachomatis, 208 of them were Roma (66 men, 142 women) and 132 were from the majority population (75 men, 57 women). Respondents were aged 18-55 years (mean age = 33.44, STD = 9.57). The occurence of C. trachomatis was detected by direct proof of the pathogen by polymerase chain reaction (PCR). RESULTS: Of 340 respondents included in the study, 22 (6.5%) showed positivity for C. trachomatis infection, 15 of them were Roma (7.2%) and 7 non-Roma (5.3%). The highest positivity was detected in Roma women (8.5%), while positivity in both non-Roma women and men was 5.3%, and in Roma men 4.5%. We did not confirm any significant contribution of age, gender or ethnicity to the occurrence of C. trachomatis infection. CONCLUSIONS: Despite the increased number of people with risk factors in the Roma community, no significant difference in the occurrence of C. trachomatis infection was found. Neither age nor gender contributes to the probability of C. trachomatis infection. Nevertheless, there are other health consequences which might be more pronounced among the population living in Roma settlements due to barriers to the health care and their lower ability to benefit from health care services provided.

Occurrence of IgG antibodies to Anaplasma phagocytophilum in humans suspected of Lyme borreliosis in eastern Slovakia.

Human granulocytic anaplasmosis (HGA) and Lyme borreliosis (LB) are tick-borne and emerging infectious diseases caused by the Anaplasma phagocytophilum and Borrelia burgdorferi species. In Europe, including Slovakia, the principal vector of both pathogens is the common tick - Ixodes ricinus, in which double infections with these pathogens have been reported. The aim of our study was evidence of IgG antibodies against A. phagocytophilum in blood sera of humans with suspects LB from several Clinics of University Hospitals, and the evaluation of the possibility of B. burgdorferi and A. phagocytophilum co-infection in examined patients. The serological method ELISA was used to detect IgM and IgG antibodies against B. burgdorferi. Anti-A. phagocytophilum IgG antibodies were analyzed by the A. phagocytophilum Indirect Immunofluorescence Antibody (IFA) IgG test. A total of 214 human samples (91 men, 123 women) were obtained from patients living in Kosice town and in villages around Kosice (Eastern Slovakia). IgG antibodies against A. phagocytophilum were detected in 15 cases (6 men, 9 women), which represented 7.0 % positivity. Two cases of the co-infection B. burgdorferi with A. phagocytophilum, which equals 0.93 % of the total number, were found.

[Ehrlichiosis/Anaplasmosis]. / Ehrlichióza/Anaplazmóza.

Ehrlichiosis and anaplasmosis are zoonoses caused by bacteria from the family Anaplasmataceae, including human and animal pathogens. The human pathogens are Ehrlichia chaffeensis, the causative agent of human monocytic ehrlichiosis (HME), Anaplasma phagocytophilum, the pathogen causing human granulocytic anaplasmosis (HGA), E. ewingii and Neorickettsia sennetsu, granulocytotropic and monocytotropic Ehrlichia species, respectively. Ehrlichia spp. are small, gram-negative, obligate intracellular bacteria. They replicate in the cytoplasmic vacuoles of host cells, especially granulocytes and monocytes, to form microcolonies called morulae. These agents are transmitted through the bite of infected tick. In the United States, the vectors are Amblyomma americanum, Ixodes scapularis and Ixodes pacificus ticks. The primary vector in Europe is Ixodes ricinus. Rodents, deer, roe deer, foxes, cattle, sheep, goats, horses and dogs are reservoirs of these bacteria in Europe. Peromyscus leucopus, the white-footed mouse, and Odocoileus virginianus, the white-tailed deer, are the most important reservoirs in the United States. Infection in humans is manifested as a nonspecific flu-like illness. The laboratory diagnosis is most frequently serological--evidence of antibody by indirect immunofluorescence assay (IFA) and detection of DNA by polymerase chain reaction (PCR), or microscopy evidence--Giemsa stain of blood smears (morulae in granulocytes or monocytes). Doxycycline is the drug of choice in therapy. Avoiding exposure to ticks is the best method of prevention of infection.

Seroprevalence of antibodies to Coxiella burnetii among employees of the Veterinary University in Kosice, eastern Slovakia.

Coxiella burnetii is an obligate intracellular pathogen known to be the causative agent of Q fever, a zoonosis with worldwide occurrence. The organism has been found in many wild and domestic animals. Infected animals shed highly stable bacteria in urine, faeces, milk, and through placental and birth fluids. Humans acquire the infection mainly by inhaling infected aerosols, or by ingesting contaminated raw milk or fresh dairy products; tick transmission has been proven but is probably rare. The aim of the present study was to determine the titres of immunoglobulin IgG against phase I and II of C. burnetii, and to evaluate the risk factors that might be associated with exposure to C. burnetii among employees of the Veterinary University. Venous blood was obtained from 92 employees. IgG antibodies were determined by ELISA method modified in our laboratory using whole cells of the Nine Mile C. burnetii strain. The questionnaire was filled out by every subject to obtain epidemiological and clinical date. Phase I antibodies were detected in 35 subjects, i.e. in 38%, and phase II antibodies in 58 subjects, i.e. in 63%. When using the titre > or = 1:800 as a cut-off level, 2 samples were positive for phase I antibodies (2.1%) and 12 for phase II antibodies (13%). Factors predisposing to infection or exposure to C. burnetii included professional orientation and regular contact with farm animals and pets. Clinical history of some seropositive subjects revealed substantial problems, such as fever of unknown origin, rheumatic disease, disease of heart, liver, respiratory tract (particularly atypical pneumonia), chronic fatigue syndrome and spontaneous abortion in females. Q fever is a profession-related disease and prevention of its spreading within the risk population groups requires observation of basic safety rules.

[Q fever]. / Q horúcka.

Coxiella burnetii, the causative agent of Q fever, is a Gram negative coccobacillus. It resides and replicates in the host s monocytes and macrophages. The developmental cycle of C. burnetii includes macrocellular and microcellular forms and the formation of spore-like bodies. It undergoes a phase variation of outer cell surface antigens from virulent phase I to avirulent phase II after passaging in the yolk sac of embryonated chicken eggs or in cell cultures. C. burnetii belongs to the most resistant bacteria. The main reservoirs of C. burnetii are cattle, sheep and goats. Human Q fever usually results from inhalation of contaminated aerosols. Acute infection mostly takes the course of a flu-like disease, atypical pneumonia or hepatitis, the chronic form resembles endocarditis. Laboratory examinations are based on the presence of antibodies. The drugs of choice are broad-spectrum antibiotics.