Detection of new genotypes of Orientia tsutsugamushi infecting humans in Thailand.

PCR screening of blood specimens taken from 195 patients with serologically confirmed scrub typhus in three Thai provinces detected the 56-kDa protein-encoding gene from Orientia tsutsugamushi in ten (5%) patients. Significant genetic diversity was found among the ten amplicons, with nine new genotypes identified that were different from those found previously in Thailand. Phylogenetically, the ten sequences obtained in the present study and sequences from 71 strains characterised previously were distributed into several clusters that included the Karp, Gilliam, Kuroki, Saitama, Kawasaki and Kato clusters. Two of the new genotypes found in the present study clearly belonged to the Karp cluster. However, the other new genotypes formed three different clusters, including one cluster that appeared to be distant from all previously known clusters, and which may therefore be representative of a previously undescribed serotype. Other genotypes formed two other clusters that may also be associated with undescribed serotypes.

Cytotoxic T lymphocyte responses to vaccinia virus antigens but not HIV-1 subtype E envelope protein seen in HIV-1 seronegative Thais.

The HIV-1 prime boost phase I/II vaccine trial using a recombinant canarypox vector, vCP1521, containing subtype E env (gp120), and subtype B env (gp41), gag and protease has started in Thailand. We have demonstrated that although 4 from 15 human immunodeficiency virus type 1 (HIV-1) seronegative Individuals showed cytotoxic T lymphocyte (CTL) responses to vaccinia virus antigens, none of them showed specific CTL responses to subtype E Env after in vitro stimulation. This preliminary study suggests that specific CTL responses to subtype E envelope detected in HIV-1 seronegative Individuals after vaccination should be considered as specific responses to the immunization.

Detection of poliovirus, hepatitis A virus and rotavirus from sewage and water samples.

A modified adsorption-elution technique for concentration of enteric viruses from sewage and water samples was developed. The viruses in water were concentrated by negatively charged membrane filtration, eluted with 2.9% tryptose phosphate broth containing 6% glycine pH 9.0, and reconcentrated using centrifugation by a speedVac concentrator. The presence of poliovirus, hepatitis A virus (HAV) RNA, and rotavirus antigen was determined by cell culture isolation, nested polymerase chain reaction (nested PCR), and enzyme-linked immunosorbent assay (ELISA), respectively. A total of 100 sewage and water samples were collected from various sources in congested communities in Bangkok, concentrated and examined for those enteric viruses. Of 20 surface water samples from canals which located near sewage drains, 15% were positive for HAV RNA by nested PCR. Of 48 domestic sewage samples from man-holes of underground sewers, 8% were positive for rotavirus antigen by ELISA. Even though the samples were concentrated 256-2,000 fold, poliovirus was not found by isolation in cell culture.

Detection and typing of human papilloma virus DNAs in normal cervix, intraepithelial neoplasia and cervical cancer in Bangkok.

We detected and typed HPV-DNA by polymerase chain reaction (PCR) in cervico-vaginal lavages of 102 women with normal cervical cytology, 57 patients with cervical intraepithelial neoplasia (CIN), and 23 cervical cancer patients. HPV-DNA detection and typing by in situ hybridization were also performed in cervical biopsies from CIN lesions and cancers. Five percent of women with normal cervical cytology, 46% of CIN, and 61% of cervical cancer were positive for HPV-DNA. Of CIN cases with positive HPV-DNA, 69, 15, 8, 4 and 4% were HPV-16, -33, -18, -11 and -16/33 respectively. Of cervical cancer cases with positive HPV-DNA, 86% were HPV-16, 7% were HPV-16/33, 7% were HPV-18/31. HPV typing was performed in biopsies from 37 CIN and 18 cervical cancers by in situ hybridization. By this method, 38% of CIN were HPV-DNA positive, of which 71% were HPV-16 and 7% were each of HPV-11, -18, -31 and -33. Thirty-nine percent of cervical cancers were positive, of which 71% and 29% were HPV-16 and HPV-16/18 respectively.

Detection of human cytomegalovirus in urine of infants by polymerase chain reaction.

Polymerase chain reaction (PCR), viral isolation and serological methods were used to diagnose HCMV infection in infants. Specimens of urine and clotted blood were collected from suspected cases of congenital or HCMV infection who attended the Pediatric Clinic, Siriraj Hospital. Prevalence of HCMV infection was found in 3 per cent of infants aged under 14 days and increased to 48 per cent in infants aged over 14 days. PCR was the most sensitive technique, it could detect HCMV infection in 29 per cent of the study infants, whereas, detection rate by isolation was 17 per cent and by specific IgM ELISA was 15 per cent. Sensitivity and specificity of PCR compared with isolation and/or serology were 93 per cent and 96 per cent, respectively. Detection of HCMV in urine by PCR can be used as a sensitive and rapid test for diagnosis of HCMV infection in infants.

Viral infections in beta-thalassemia/hemoglobin E patients.

One hundred ten patients with beta-thal/Hb E disease and 60 normal controls matched for age and socioeconomic status were followed for 1.5 years. They were examined clinically, and blood and plasma were studied for Coxsackie B viruses and others. The findings suggest that the patients are more susceptible to Coxsackie B virus but not to rubella, herpes simplex, cytomegalovirus, adenovirus, and M. pneumoniae. In contrast to bacterial infections, splenectomized patients did not show evidence of increased viral infections.