Threat of dengue fever and dengue haemorrhagic fever to Egypt from travelers.

Dengue (DF) and dengue hemorrhagic fevers (DHF) are present in urban and suburban areas in the Americas, South-East Asia, the Eastern Mediterranean and the Western Pacific, but dengue fever is present mainly in the rural areas of Africa. Several factors have combined to produce epidemiological conditions in developing countries in the tropics and subtropics that favour viral transmission by the main mosquito vector, Aedes aegypti as the rapid population growth, rural-urban migration, inadequate basic urban infrastructure (eg. the unreliable water supply leading householders to store water in containers close to homes) and the increase in volume of solid waste, such as discarded plastic containers and other abandoned items which provide larval habitats in urban areas. Geographical expansion of the mosquito has been aided by the international commercial trade particularly in used car-tyres which easily accumulate rainwater. Increased air travel and the breakdown of vector control measures have also contributed greatly to the global burden of dengue and DH fevers. The presence of Ae. aegypti and endemicity of DF and DHF in the neighbor- ing regional countries must be in mind of the Public Health Authorities.

Zoonotic brucellosis: an underestimated or misdiagnosed disease in Egypt.

Over six months, 329 suggestive consecutive brucellosis human cases were diagnosed in attending the out-patients clinics of Al-Azhar and Ain Shams Universities Hospitals and Giza Governorate Farmers. They were 100 females and 229 males with ages ranged between 15-65 years old. A total of 213 (64.75%) were working in dairy farm and/or consumed raw milk, 16 (14.85%) used home slaughtering of sheep, and 100 (30.4%) were working in Giza Government slaughter-house. Clinically and by ELISA-IgM 259 out of 329 the subjects were proven brucellosis patients (77.8%). Besides, other patients had toxoplasmosis, or schistosomiasis mansoni or fascioliasis. Double infection was encountered with toxoplasmosis and either schistosomiasis or fascioliasis. The causes of endemic liver parasitosis that may give false-clinical diagnosis were excluded. Signs and symptoms of brucellosis patients were fever (91.5%), chills (84.1%), Myalgia (69.5%), headache (58.2%), fatigue (77.2%), anorexia (54.1%), tachycardia (38.6%), hepato-and/or splenomegaly (46.2%), lymphadenopaqthy (19.6%) lower back abdominal pain (8.8%) and/or constitutive symptoms (13.1%).

Trypanosoma evansi in dromedary camel: with a case report of zoonosis in greater Cairo, Egypt.

Trypanosoma evansi (Steel, 1885) Balbiani, is the cause of trypanosomiasis (Surra) which multiples in the blood and body fluids. The incubation period varies from 7-15 days. The mortality rate was up to 20% and fatality rate may reach up to 100% in untreated camels. Three hundred randomly selected camels were 200 males 4-6 years old and 100 females 10-15 years. They were examined clinically and diagnosed by Giemsa stained blood smear, anti- trypanosomiasis-antibodies by ELISA and urine Thymol turbidity test for natural infection with T. evani (Surra). The results showed that camels were naturally infected with T. evansi as indicated by stained blood film examination and/or ELISA. Infection in males was 6.0% (stained blood smears), 8.0% (ELISA) and 5.0% (urine thymol turbidity test). In females the infection rate was 9.0%, 24.0% and 12% respectively. By correlation with suggestive clinical manifestations, ELISA proved to be more sensitive and specific (13.3%) than stained blood films (10.0%) and urine Thymol turbidity test (7.3%). Regarding humans, one out of 30 was positive as indicated by ELISA and stained blood smear but was negative by urine thymol turbidity test. The human case was successfully treated as indicated clinically, parasitologically and serologically. This is the first reported Egyptian human case of trypanosomiasis evansi, a neglected zoonosis.

Babesiosis in an Egyptian boy aquired from pet dog, and a general review.

Human babesiosis has been documented in many countries. It is a zoonotic protozoan disease of medical, veterinary and economic importance. In this study, a twelve years old boy was referred to the hospital with intermittent fever of unknown origin. On clinical, parasitological and serological bases the case proved to be babesiosis. The boy acquired the infection from his pet dog which was heavily infested with Rhipicephalus sanguineus and suffered a mild feature of animal babesiosis. The patient was successfully treated with Atovaquone plus Azithromycin without relapse for one month follow up. The pet dog was sent to Governmental Veterinary Hospital at Abbassia for treatment from babesiosis and tick infestation.

Aedes aegypti re-emerging in Egypt: a review and what should be done?

Mosquitoes are main vectors of varieties of pathogenic agents affecting man and animals. There-emergencein Aswan and approach of Aedesa egypti, the vector of the Dengue hemorrhagic fever, Yellow fever and Chikungunya fever, which are encountered in Africa, needs to alert for this public health threat. The presence of Dengue and dengue hemorrhagic fever in Saudi Arabia is another issue.

Evaluation of "Myrrh extract" against Schistosoma mansoni: a histological study.

This study investigated the effect of myrrh extract on different developmental stages of Schistosoma mansoni. Sixty albino mice were used and divided into three main groups: GI (control group), GII (infected group) and GIII (infected-treated group). The last group was further divided into 3 subgroups where the drug was administered in a dose of 500 mg/kg body weight for 5 days starting on the 1st day PI for IIIA, on the 21st day PI for IIIB and on the 45th day PI for IIIC. A morphometric study was performed for the mean number and perimeter of granulomas. In GII, typical bilharzial granulomas were frequently encountered in the portal tracts with numerous eosinophils, collagen fiber deposition and reticular fiber condensation. Hepatocytes revealed vacuolation, nuclear affection and depletion of glycogen. In GIII, granulomas were less frequently observed with apparent decrease of eosinophils. The maximum effect of the drug was observed in SGs IIIB and IIIC as detected by significant decrease in the mean number and size of granulomas, paucity of eosinophils, decreased fibrosis and reticular fibers and the restoration of the glycogen content in the hepatocytes. The present data proved that myrrh has a valuable schistosomicidal effect against different stages of S. mansoni. This chemotherapeutic effect was more evident when the drug was given to infected mice on the 21st as well as on the 45th day PI.

The role of insects in mechanical transmission of zoonotic human parasites.

Arthropods can be found on human or animals as ecto-parasites as well as endo-parasites. The ecto-parasites or vectors can contaminate stored foods and transmit illness, or introduced diseases in new area. Pet species facilitating infestations, and different risk factors related to infestation were identified. Insect prevention and control is necessary to prevent the transmission of pathogens that could affect animal and human health and the maintenance of good hygiene. We conclude that although biological control looks promising, more research should be done concerning its side effects. Currently, optimal monitoring and prevention seem to offer the best solution.

Zoonotic ectopic fascioliasis: review and discussion.

Ectopic fascioliasis (EF) has direct and indirect effects on both humans and animals. The phenomenon of EF was individual cases in the period from 1950 up to the end of last century. From the period of 2000 up to 2006, plenty of researches were on EF in the developed and undeveloped countries. Nineteen EF cases infected with the immature and few with the mature worms were 13 females and 6 males. Three cases of lymphatic, pleural and breast fascioliasis reached the adults and laid their eggs in a lymph node in the cervical region pleural cavity and breast tissues. Until recent, knowledge about the ectopic fascioliasis pathway is little. Fasciola hepatica was the commonest species in most cases. The effect of fascioliasis might be direct to liver as ectopic foci or indirect on other organs due to the metabolites and secretory excretory products. All ages and both sexes were EF infected. Watercress topped the list of water plants born encysted metacercariae followed by lettuce, mint, and alfalfa. Nearly 24 million Egyptians at risk and about 800,000 were infected. On the global scale, about 180 million are at risk of infection.

Diarrhea due to parasites particularly Cryptosporidium parvum in great Cairo, Egypt.

A total of 110 stool samples from out and in-patients from different areas in Great Cairo suffering from diarrhea were examined for parasitic causes. Stool samples were subjected to the direct wet smear method and Sheather's sugar flotation and stained with Giemsa and/or modified Ziehl-Neelsen. Also, stool samples were cultured on agar plates for strongyloidiasis. The overall parasitic infection rate was 60.9% and non parasitic cause was 39.1%. The parasitic infection rate in a descending order was 31.1% for Cryptosporidium parvurnm, 19.8% for Giardia lamblia, 9.9% for Entamaeba histolytica and lastly 1.8% for Strongyloides stercoralis. The main clinical presentation of diarrheic patients in a descending order was vomiting (31.3%), dehydration (29.86%), abdominal pain (29.86%), flatulence (26.86%), anorexia (23.89%), tenesmus (17.9%) and lastly fever (4.47%). The risk factors were living in rural areas, education level, contact with farm animals and/ or pet animals. However, most of these risk factors although showed high percent, yet they occurred in patients with other causes of diarrheas. Artificial breast feeding was not evaluated as only 3 infants had C. parvum compared to non parasitic cause in 1 on the breast feeding.

Anti-Toxoplasma gondii antibodies in working donkeys and donkey's milk in greater Cairo, Egypt.

Toxoplasma gondii is one of the important zoonotic parasites of worldwide zoological & geographical distribution. ELISA prevalence of Toxoplasma gondii in Egyptian locally bred working donkeys in greater Cairo was evaluated. The donkeys were 75 females & 25 males aged between 3-10 years. The results showed that ELISA antibodies of T. gondii were found in 45 out of 100 (45%) working donkeys. Donkeys' milk obtained from fifteen pregnant females was T. gondii positive in seven (46.3%). The zoonotic role of donkeys and their milk were discussed.

Helminthes of synanthropic rodents (Rodentia: Muridae) from Dakahlia and Menoufia, Egypt.

A cross-sectional survey was conducted to monitor and compare the prevalence of helminthes in rodents from Dakahlia and Menoufia governorates. The domestic rodents (271) were Rattus norvegicus, Rattus rattus frugivorous, Rattus r. alexandrinus, & Mus musculus. The overall prevalence of helminthes was 52.8%. In Dakahlia, 72/145 rats (49.6%) were infected. The highest prevalence of infection was in R. r. frugivorous 43 (60.4%), then R. r. alexandrinus 44 (47.7%), R. norvegicus 38 (44.7%), and the lowest was M. musculus 20 (40%). In Menoufia, 71/126 rats (56.3%) were infected. The highest prevalence of infection was in R. r. frugivorous 36 (77.7%), then M. musculus 27 (48.1%), R. norvegicus 23 (47.8%), and the lowest was in R. r. alexandrinus 40 (47.5%). A total of 24 species of helminthes (11 trematodes, 4 cestodes & 10 nematodes) were identified among the 271 rodents. The commonest trematode was Mesostephanus aegypticus followed by Stictodora tridactyla. The commonest cestode was Hymenolepis diminuta followed by Taenia taeniaformis. The commonest nematode was Capillaria hepatica followed by Trichurus muris. Given the zoonotic potential of rodents' parasites and since several residential, commercial, and agricultural sites exist in the examined geographic areas, the potential health risk should not be ignored.

Intestinal parasites in Dakahlia governorate, with different techniques in diagnosing protozoa.

A total of 3180 patients attending Mansoura University Hospitals' Clinics, were subjected to stool examination by direct wet smear, formol-ether concentration, original formol-tween concentration, modified formol-tween concentration, modified Sheather's sugar floatation, Potassium hydroxide concentration and Gomori's Trichrome stain, and modified Kinyoun's acid-fast stain, and Ryan's Trichrome blue stain for Microsporidia. The intestinal helminthes in a descending order of abundance were: S. mansoni (5.3%), Fasciola sp. (4.8%), H. heterophyes (4.2%), Hymenolepis nana (3.9%), Trichostrongylus sp. (2.6%), A. lumbricoides (1.8%), Strongyloides stercoralis (1.5%), H. diminuta (1.4%), Taenia saginata (1.1%), E. vermicularis (by smear; 1.1 %), T. trichura (0.7%) and lastly A. duodenale (0.1%). The intestinal protozoa in a descending order of abundance were Blastocystis hominis (22.4%), Giardia lamblia (19.6%), Entamoeba histolytica/E.dispar (19%), Iodamoeba butschlii (16%), Cryptosporidium parvum (14.3%), E. coli (9.7%), Isospora hominis (7.7%), Endolimax nana (6.9%), E. hartmani (5.9%), Dientamoeba fragilis (5.1%), Chilomastix mesnili (5.1%), Trichomonas hominis (4.2%), Cyclospora cayetanensis (4.2%), Microsporidia spores (3.2%), Enteromonas hominis (1.9%) and Embadomonas intestinalis (1.3%). The results were discussed.

Allergic reactions in patients suffering from asthma induced by house dust mites which treatment by juvenile hormone.

The effect of Juvenile hormone analogue, Admiral "pyriproxyfen", which acts as a protein de-naturing agent, on the protein patterns of D. farinae was studied on allergic reactions in patients with HDM asthma, and in mice injected twice (within 10 days) with mite crude extracts. Total protein concentrations and protein patterns were different in normal and admiral-treated mites. This may result in reducing the allergenic of treated mites. Histamine release, total immunoglobulin E (IgE), specific immunoglobulin E (S-IgE), eosinophil cationic protein (ECP), and absolute eosinophil count (AEC) were determined for moderate and severe HDM asthma-tics compared to check cases. These parameters had higher levels in asthmatic patients than in normal (check) individuals. Injection of mice with normal adult extracts of D. farinae resulted in significantly higher levels of histamine, S-IgE and ECP than in the check animals. Skin reactions were observed in all of the mice injected with normal or treated D. farinae extracts.

Pattern of renal diseases among elderly Egyptians patients with acute or chronic renal diseases in Ain Shams University and Nasser Institute Hospitals, Cairo, Egypt.

This study among elderly renal Egyptian patients (n=220) with only 20 of them were subjected to renal biopsy. Results showed: diabetic nephropathy in 28.2%, hypertensive nephrosclerosis 25.5%, UTI, cystitis and pyelonephritis in 6.8%, renal stones in 5.9%, obstructive uropathy in 7.6%, simple cysts in 4.5%, CRF of unknown origin in 13.1%, and others in 26.4%. DM and HTN were S related to kidney function tests and increase in elderly. Other cardiovascular risk factors and smoking are reported by previous workers to be HS related to renal diseases. Age was significantly related to GFR, BUN and Cr. but sex difference was not significantly related to renal diseases. Multiple myeloma, lupus nephritis, vasculitis and hepatitis B were all recorded in few numbers of elderly Egyptians. HCV was more common and more likely to cause renal diseases. Abdomino-pelvic ultrasound was confirmatory to clinical renal diseases diagnosis. Among patients (n=20) biopsies showed focal necrotizing GN in 20%, membranous nephropathy in 50% and renal amyloidosis in 30%. CTIN was associated in some cases due to NSAID intake. Analgesic nephropathy was a common problem that might lead to ARF in some cases especially in the elderly. Ultrasound results among the biopsy group were confirmatory to clinical diagnosis.