The LysR-type transcriptional regulator LelA co-regulates various effectors in different Legionella species.

The intracellular pathogen Legionella pneumophila translocates more than 300 effector proteins into its host cells. The expression levels of the genes encoding these effectors are orchestrated by an intricate regulatory network. Here, we introduce LelA, the first L. pneumophila LysR-type transcriptional regulator of effectors. Through bioinformatic and experimental analyses, we identified the LelA target regulatory element and demonstrated that it directly activates the expression of three L. pneumophila effectors (legL7, legL6, and legU1). We further found that the gene encoding LelA is positively regulated by the RpoS sigma factor, thus linking it to the known effector regulatory network. Examination of other species throughout the Legionella genus revealed that this regulatory element is found upstream of 34 genes encoding validated effectors, putative effectors, and hypothetical proteins. Moreover, ten of these genes were examined and found to be activated by the L. pneumophila LelA as well as by their orthologs in the corresponding species. LelA represents a novel type of Legionella effector regulator, which coordinates the expression of both adjacently and distantly located effector-encoding genes, thus forming small groups of co-regulated effectors.

Preparedness for anthrax attack: the effect of knowledge on the willingness to treat patients.

Little is known about the factors that may impact on the willingness of physicians and nurses to treat patients during a bioterrorism attack. This survey was conducted among 76 randomly selected nurses and physicians in the emergency rooms of three public hospitals in order to analyse the relationship between knowledge, profession and the willingness to treat anthrax. The study finds that the willingness of physicians and nurses to come to work is 50% greater among the group with the highest knowledge about anthrax (P < 0.0001). Within that group, the willingness to treat patients suspected of being infected with anthrax was 37% greater (P < 0.0001) and the willingness to treat patients diagnosed with anthrax was 28% greater (P = 0.004) than in the other groups. These results imply that enhancement of knowledge among health care workers may improve their willingness to come to work and treat patients infected with anthrax during a bioterrorism attack.