Blood screen findings in a 2-year cohort of newly arrived refugees to Sydney, Australia.

OBJECTIVES: To describe the prevalence of certain health conditions in newly arrived refugees to Sydney, Australia, and thereby help inform screening practices. STUDY TYPE: A clinical audit of routinely collected pathology results. METHODS: Demographics and pathology results from a nurse-led health assessment program for newly arrived refugees during 2013 and 2014 were analysed. Prevalences of screened conditions were calculated, and compared by country of birth and other demographic features. A specific category was created for those from Middle Eastern countries, for comparative analysis. RESULTS: Pathology results were analysed for 3307 people from 4768 seen by the assessment program (69.4%). Anaemia was found in 6% of males and 7.6% of females. Vitamin D deficiency (<50 nmol/L) was detected in 77.5%. Chronic hepatitis B was found in only 1.7% but in more than 10% of people from Burmese and Tibetan backgrounds. Strongyloides seropositivity was found in 4%. Among the subset tested for hepatitis C antibody, 0.5% were positive. No human immunodeficiency virus (HIV) infections were detected. More than 75% of the study population was from Middle Eastern countries. Compared with refugees from other regions, this subset had less anaemia (in females), more vitamin D deficiency, less chronic hepatitis B and less strongyloides seropositivity. CONCLUSIONS: People from refugee backgrounds have differing risks of conditions, based on demographics, migration history and prior screening. Postarrival testing should be tailored to each family and individual. Results of screening should be constantly reviewed and the approach updated based on findings. We support, in particular, the Canadian approach of only retesting HIV in refugees from countries with a high prevalence of infection (>1%).

Universal microbial diagnostics using random DNA probes.

Early identification of pathogens is essential for limiting development of therapy-resistant pathogens and mitigating infectious disease outbreaks. Most bacterial detection schemes use target-specific probes to differentiate pathogen species, creating time and cost inefficiencies in identifying newly discovered organisms. We present a novel universal microbial diagnostics (UMD) platform to screen for microbial organisms in an infectious sample, using a small number of random DNA probes that are agnostic to the target DNA sequences. Our platform leverages the theory of sparse signal recovery (compressive sensing) to identify the composition of a microbial sample that potentially contains novel or mutant species. We validated the UMD platform in vitro using five random probes to recover 11 pathogenic bacteria. We further demonstrated in silico that UMD can be generalized to screen for common human pathogens in different taxonomy levels. UMD's unorthodox sensing approach opens the door to more efficient and universal molecular diagnostics.

Elephant endotheliotropic herpesvirus 5, a newly recognized elephant herpesvirus associated with clinical and subclinical infections in captive Asian elephants (Elephas maximus).

Elephant endotheliotropic herpesviruses (EEHVs) can cause acute hemorrhagic disease with high mortality rates in Asian elephants (Elephas maximus). Recently, a new EEHV type known as EEHV5 has been described, but its prevalence and clinical significance remain unknown. In this report, an outbreak of EEHV5 infection in a herd of captive Asian elephants in a zoo was characterized. In February 2011, a 42-yr-old wild-born female Asian elephant presented with bilaterally swollen temporal glands, oral mucosal hyperemia, vesicles on the tongue, and generalized lethargy. The elephant had a leukopenia and thrombocytopenia. She was treated with flunixin meglumine, famciclovir, and fluids. Clinical signs of illness resolved gradually over 2 wk, and the white blood cell count and platelets rebounded to higher-than-normal values. EEHV5 viremia was detectable starting 1 wk before presentation and peaked at the onset of clinical illness. EEHV5 shedding in trunk secretions peaked after viremia resolved and continued for more than 2 mo. EEHV5 trunk shedding from a female herd mate without any detectable viremia was detected prior to onset of clinical disease in the 42-yr-old elephant, indicating reactivation rather than primary infection in this elephant. Subsequent EEHV5 viremia and trunk shedding was documented in the other five elephants in the herd, who remained asymptomatic, except for 1 day of temporal gland swelling in an otherwise-healthy 1-yr-old calf. Unexpectedly, the two elephants most recently introduced into the herd 40 mo previously shed a distinctive EEHV5 strain from that seen in the other five elephants. This is the first report to document the kinetics of EEHV5 infection in captive Asian elephants and to provide evidence that this virus can cause illness in some animals.