Seroprevalence of herpes simplex virus type 1 and type 2 - data from a hospital-based study in Varna, northeastern Bulgaria, 2019-2021.

The purpose of the current study was to describe the prevalence of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in northeastern Bulgaria. From January 2019 to December 2021, we tested 1493 samples for anti-HSV-1 IgG and 817 samples for anti-HSV-2 IgG antibodies in the Virology Laboratory, "St. Marina" University Hospital, Varna, Bulgaria. HSV-1 was considerably more widespread, with an overall seroprevalence of 73.3% (95% CI: 71.0-75.5%), than HSV-2 infection, which showed a seropositive rate of 10.0% (95% CI: 8.1-12.4%). Age was the most significant risk factor for both infections, while gender had no role in herpes simplex seropositivity.

Chlorhexidine-Silver Nanoparticle Conjugation Leading to Antimicrobial Synergism but Enhanced Cytotoxicity.

This study explored the potential synergism within chlorhexidine-silver nanoparticle conjugates against Influenza type A, Staphylococcus aureus, Escherichia coli, and Candida albicans. Silver nanoparticles (SN) were obtained by the reduction of silver ions with green tea total phenolic extract and conjugated with chlorhexidine (Cx). The particles were characterized by UV-Vis and FTIR spectroscopies, dynamic light scattering, X-ray diffraction, and transmission electron microscopy. A stable negatively charged nano-silver colloid (ζ = -50.01) was obtained with an average hydrodynamic diameter of 92.34 nm. In the presence of chlorhexidine, the spectral data and the shift of the zeta potential to positive values (ζ = +44.59) revealed the successful sorption of the drug onto the silver surface. The conjugates (SN-Cx) demonstrated potentiation in their effects against S. aureus and C. albicans and synergism against E. coli with minimal inhibitory concentrations of SN at 5.5 µg/mL + Cx 8.8 µg/mL. The SN showed excellent virucidal properties, increasing with time, and demonstrated low toxicity. However, the coupling of the cationic chlorhexidine with nano-silver did not reduce its intrinsic cytotoxicity on various cell lines (MDCK, BJ, and A549). The newly synthesized antimicrobial agent exhibited an extended and promising therapeutic spectrum and needs to be further evaluated regarding the designated route of administration in three-dimensional cell models (e.g., nasal, bronchial, dermal, ocular, etc.).

Development and evaluation of doxycycline niosomal thermoresponsive in situ gel for ophthalmic delivery.

The present study was focused on the development of doxycycline niosomal thermosensitive in situ gel for ophthalmic application. For this purpose, in situ gel formulations based on Poloxamer 407 alone and in combination with hydroxypropyl methylcellulose were prepared by cold method and evaluated in terms of sol-gel transition temperature, gelling time and capacity. The addition of hydroxypropyl methylcellulose to the composition led to decrease in the phase transition temperature of the systems. Conversely, the inclusion of doxycycline niosomes to the formulations didn''t have a significant influence on their gelling and rheological properties. Doxycycline niosomal in situ gel based on 15%w/w Poloxamer and 1.5% w/w hydroxypropyl methylcellulose was characterized with gelation temperature of 34 °C, appropriate for ophthalmic application, pseudoplastic flow behavior and very good physical stability. In vitro release studies indicated slower and sustained doxycycline release from the developed in situ gel as compared to niosomes. The conducted microbiological studies revealed its enhanced antibacterial activity with respect to doxycycline solution and doxycycline in situ gel. The obtained results indicate that the elaborated niosomal in situ gel may serve as a promising system for ophthalmic delivery of doxycycline, ensuring sufficient therapeutic concentration and sustained drug release.

Epidemiological study of Lyme disease in Bulgaria.

OBJECTIVES: Lyme disease (Lyme borreliosis) is a transmissible infection, common in the temperate climate zones. It is caused by a group of spirochetal bacteria known as Borrelia burgdorferi sensu lato complex. The aim of the present work was to investigate the incidence rate of borreliosis in different regions of Bulgaria and to identify possible risk factors for its occurrence. METHODS: National and regional borreliosis incidence rates for 2009-2018 were obtained from the public database of the National Centre of Public Health and Analyses. Their association with some socio-demographic variables and the geographic location (south or north) of the regions was tested with Spearman's correlation analysis and simple linear regression. RESULTS: The mean annual incidence for the last 10 years (2009-2018) in Bulgaria was 6.9 (range 4.1-11.6) cases per 100,000 inhabitants. We found that the Lyme disease was highly fluctuating at regional level with incidence rates varied from 0.3 to 30.9 per 100,000 inhabitants. Several regions showed significantly higher endemicity for the disease. Socio-demographic factors were not found to be important for Lyme disease frequency while the geographic location in the north part of the country was a significant risk factor for it. CONCLUSIONS: Lyme disease is a serious health risk in Bulgaria especially in its northern part - regions on the north are the most vulnerable to a higher incidence of the disease.

Seasonal influenza vaccination: knowledge, attitude and practice in Varna, Bulgaria.

BACKGROUND: Seasonal influenza vaccination is recommended for certain at-risk groups in Bulgaria, but vaccine coverage and the population's perception of vaccination are currently unknown. The objective of this study was to assess the level of seasonal influenza vaccination in Varna Region, Bulgaria. It also aimed to investigate the status of knowledge and the attitude towards the reliability, safety, and other aspects associated with the use of influenza vaccines. METHODS: A cross-sectional survey was conducted among 120 responders in Varna Region, Bulgaria. They completed a questionnaire assessing the practice, knowledge, and attitude towards seasonal influenza vaccination. RESULTS: Nearly 70% of all responders have never been vaccinated against seasonal influenza in their lives. The main reason indicated was a lack of confidence in the vaccine in general (53.7% of nonvaccinated responders). Individuals with insufficient knowledge, or with a negative perception, were more likely to not be vaccinated: being poorly informed and having a negative attitude towards influenza vaccination also decreased the chance of being vaccinated by 29% and 36%, respectively. CONCLUSIONS: This study indicates that efforts should be made towards achieving better understanding and knowledge of the vaccine's mechanism of prevention and effectiveness among the Bulgarian population.

Epidemiological Study of Hepatitis A Infection in Eastern Bulgaria.

BACKGROUND: Hepatitis A virus (HAV) infection is an acute, self-limited liver disease transmitted usually through the faecal-oral route via person-to-person contact. Bulgaria has intermediate HAV endemicity with higher susceptibility among adults and recurrent outbreaks. AIM: As HAV infection is strongly related to human movements and represents a significant risk to travelers and migrants, as well as to local population receiving these groups, we set out to analyze the epidemiological data on hepatitis A in five of the largest tourist border regions of Bulgaria located in its eastern part: Varna, Shumen, Dobrich, Burgas and Yambol. MATERIALS AND METHODS: We reviewed retrospectively all reported cases of acute hepatitis A in the eastern regions of Bulgaria over a 7-year period between 2008 and 2014. RESULTS: A total of 2879 newly infected patients were registered during the study period, the number varying widely: from 190 cases in 2014 to 923 in 2012. The average incidence of HAV was higher in the south-eastern regions than in the northeastern regions (55.30%000 vs 15.04%000 respectively, p < 0.0001). The most affected age group in all regions was the 5-9-year olds (p < 0.0001) and males were significantly more susceptible to HAV (p = 0.02). CONCLUSION: Hepatitis A is still a major public health problem in Bulgaria; there is a significant difference in the incidence of the disease between the regions in the south-east and those in the north-east and between the different age groups and sexes.

Seroprevalence of Syphilis among Pregnant Women in the Varna Region (Bulgaria).

Syphilis is a sexually transmitted disease with continuously rising rates among European countries. The vertical (mother to child) transmission is an important way of dissemination, often leading to stillbirth and permanent impairment of the newborn. We present a retrospective cross-sectional analysis of 2702 pregnant women tested for syphilis seropositivity. During the study period (2009-2013) non-specific and specific treponemal antibodies were detected in 15 pregnant women (0.56% of sample size with 95% confidence interval (CI) 0.28-0.84). Our results showed a lack of correlation between syphilis seropositivity and age, ethnic origin, or pregnancy trimester of the mother. The only factor found to influence syphilis seropositivity was the mother's place of residence - rural inhabitants had significantly higher risk for syphilis infection when compared to urban inhabitants, with a seropositive proportion of 1.08% versus 0.36%, respectively.