Spray irrigation with microcystins-rich water affects plant performance from the microscopic to the functional level and food safety of spinach (Spinacia oleracea L.).

Irrigation water coming from freshwater bodies that suffer toxic cyanobacterial blooms causes adverse effects on crop productivity and quality and raises concerns regarding food contamination and human exposure to toxins. The common agricultural practice of spray irrigation is an important exposure route to cyanotoxins, yet its impact on crops has received little attention. In the present study we attempted an integrated approach at the macro- and microscopic level to investigate whether spray or drip irrigation with microcystins (MCs)-rich water differently affect spinach performance. Growth and functional features, structural characteristics of stomata, and toxin bioaccumulation were determined. Additionally, the impact of irrigation method and water type on the abundance of leaf-attached microorganisms was assessed. Drip irrigation with MCs-rich water had detrimental effects on growth and photosynthetic characteristics of spinach, while spray irrigation ameliorated to various extents the observed impairments. The stomatal characteristics were differently affected by the irrigation method. Drip-irrigated spinach leaves showed significantly lower stomatal density in the abaxial epidermis and smaller stomatal size in the adaxial side compared to spray-irrigation treatment. Nevertheless, the latter deteriorated traits related to fresh produce quality and safety for human consumption; both the abundance of leaf-attached microorganisms and the MCs bioaccumulation in edible tissues well exceeded the corresponding values of drip-irrigated spinach with MC-rich water. The results highlight the significance of both the use of MCs-contaminated water in vegetable production and the irrigation method in shaping plant responses as well as health risk due to human and livestock exposure to MCs.

Irrigation of radish (Raphanus sativus L.) with microcystin-enriched water holds low risk for plants and their associated rhizopheric and epiphytic microbiome.

Microcystins (MCs) are toxins produced during cyanobacterial blooms. They reach soil and translocated to plants through irrigation of agricultural land with water from MC-impacted freshwater systems. To date we have good understanding of MC effects on plants, but not for their effects on plant-associated microbiota. We tested the hypothesis that MC-LR, either alone or with other stressors present in the water of the Karla reservoir (a low ecological quality and MC-impacted freshwater system), would affect radish plants and their rhizospheric and phyllospheric microbiome. In this context a pot experiment was employed where radish plants were irrigated with tap water without MC-LR (control) or with 2 or 12 µg L-1 of pure MC-LR (MC2 and MC12), or water from the Karla reservoir amended (12 µg L-1) or not with MC-LR. We measured MC levels in plants and rhizospheric soil and we determined effects on (i) plant growth and physiology (ii) the nitrifying microorganisms via q-PCR, (ii) the diversity of bacterial and fungal rhizospheric and epiphytic communities via amplicon sequencing. MC-LR and/or Karla water treatments resulted in the accumulation of MC in taproot at levels (480-700 ng g-1) entailing possible health risks. MC did not affect plant growth or physiology and it did not impose a consistent inhibitory effect on soil nitrifiers. Karla water rather than MC-LR was the stronger determinant of the rhizospheric and epiphytic microbial communities, suggesting the presence of biotic or abiotic stressors, other than MC-LR, in the water of the Karla reservoir which affect microorganisms with a potential role (i.e. pathogens inhibition, methylotrophy) in the homeostasis of the plant-soil system. Overall, our findings suggest that MC-LR, when applied at environmentally relevant concentrations, is not expected to adversely affect the radish-microbiota system but might still pose risk for consumers' health.

Cyanotoxins as the "common suspects" for the Dalmatian pelican (Pelecanus crispus) deaths in a Mediterranean reconstructed reservoir.

Toxic cyanobacterial blooms have been implicated for their negative consequences on many terrestrial and aquatic organisms. Water birds belong to the most common members of the freshwater food chains and are most likely to be affected by the consumption of toxic cyanobacteria as food. However, the contribution of cyanotoxins in bird mortalities is under-studied. The aim of the study was to investigate the likely role of cyanotoxins in a mass mortality event of the Dalmatian pelican (Pelecanus crispus) in the Karla Reservoir, in Greece. Water, scum, tissues and stomach content of dead birds were examined for the presence of microcystins, cylindrospermopsins and saxitoxins by an enzyme-linked immunosorbent assay. High abundances of potential toxic cyanobacterial species and significant concentrations of cyanotoxins were recorded in the reservoir water. All examined tissues and stomach content of the Dalmatian pelicans contained significant concentrations of microcystins and saxitoxins. Cylindrospermopsin concentrations were detected in all tissues except from the brain. Our results suggest that cyanotoxins are a plausible cause for this bird mass mortality episode in the Karla Reservoir.

A case of imported Middle East Respiratory Syndrome coronavirus infection and public health response, Greece, April 2014.

On 18 April 2014, a case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection was laboratory confirmed in Athens, Greece in a patient returning from Jeddah, Saudi Arabia. Main symptoms upon initial presentation were protracted fever and diarrhoea, during hospitalisation he developed bilateral pneumonia and his condition worsened. During 14 days prior to onset of illness, he had extensive contact with the healthcare environment in Jeddah. Contact tracing revealed 73 contacts, no secondary cases had occurred by 22 April.

Outbreak investigation of brucellosis in Thassos, Greece, 2008.

In spring 2008, the Hellenic Center for Disease Control and Prevention was notified about human brucellosis cases in Thassos, a Greek island that had been up to that point under a brucellosis eradication programme. Following the verification of the outbreak a 1:1 case­ control study was conducted in the island. The study revealed that consumption of locally produced raw cheese was a risk factor for Brucella melitensis infection (odds ratio (OR): 15.1, 95% confidence interval (CI): 6.56­34.7). Brucella melitensis biotype 3 was identified in two clinical samples. As a result of the outbreak, the island is no longer officially considered as an area with farms free of brucellosis and is currently under a brucellosis control programme. The investigation of this outbreak demonstrated that control and eradication of brucellosis is not only a question of designing a strategy, but rather of ensuring its continuous, strict implementation. Furthermore, it revealed the lack of appropriate education of the public regarding the risks associated with raw, non heat-treated cheese consumption.

Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus outbreak among healthcare workers in a long-term care facility.

BACKGROUND: We investigated an outbreak of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections that occurred among healthcare workers (HCWs) but not among residents of a long-term care facility (LTCF). METHODS: Cases of S. aureus infection were sought by reviewing the medical records of residents and HCWs. In order to identify risk factors for the development of an S. aureus infection, an unmatched case-control study was conducted. Cases were all HCWs with a clinically compatible S. aureus infection; controls were HCWs with no history of a clinically compatible S. aureus infection. Cases and controls were interviewed and anterior nasal swabs were collected. RESULTS: Over a period of 14 months, a total of eight cases were identified among practice nurses, giving an attack rate of 10% for this category of profession. All isolates were identified as MRSA Panton-Valentine leukocidin (PVL)-producing SCCmec type IV. By multivariate analysis, working in a specific zone and being a practice nurse were found to be statistically significant risk factors for infection. CONCLUSIONS: The current outbreak indicates that HCWs may serve as vehicles for the entry of PVL-positive MRSA strains from the community into LTCFs, and that deficient hygiene practices and unrecognized carriage may facilitate spread. Given the increasing prevalence of PVL-positive MRSA infections worldwide, guidelines for the eradication of PVL-positive MRSA carriage within closed communities should be established and efforts to obtain cultures from compatible infections should be made.

Factors influencing influenza vaccination rates among healthcare workers in Greek hospitals.

Influenza vaccination rates are generally low among healthcare workers (HCWs) worldwide. In September 2005, the Hellenic Center for Disease Control and Prevention conducted a nationwide campaign to promote influenza vaccination in hospital HCWs. During the 2005-2006 influenza season, the overall vaccination rate among HCWs was 16.36% (range: 0-85.96%). The self-reported vaccination rate during the previous season was 1.72%, indicating a 9.5-fold increase. Compared with physicians, significantly fewer technical personnel were vaccinated, whereas administrative personnel were more likely to receive the vaccine. Among clinicians, rates for internal medicine departments exceeded those of surgical departments by a factor of 2.71 and laboratory medicine departments by a factor of 2.36. Multivariate analysis showed lower vaccination rates in large hospitals (>200 beds) than in smaller hospitals and lower rates in hospitals with specialist services (intensive care unit, psychiatry or dermatology) than in general hospitals. Factors associated with higher rates included working in northern Greece, in a paediatric or an oncology hospital, or in a prefecture with avian influenza H5N1 activity. In conclusion, in Greece influenza vaccination rates among HCWs remain low, but the implementation of a nationwide campaign had a considerable impact. Efforts should focus on hospital- and HCW-associated factors to increase vaccination uptake.

Prostaglandins: PGF2 alpha, PGE2, 6-keto-PGF1 alpha and TXB2 serum levels in dysmenorrheic adolescents before, during and after treatment with oral contraceptives.

Ten adolescents with primary dysmenorrhea (PD) were treated with the oral contraceptive (OC) Lyndiol 2.5 mg (R) for one cycle. The levels of PGF2 alpha, PGE2 and the metabolites of PGI2 and TXA2: 6-keto-PGF1 alpha and TXB2 were tested by a radioimmunoassay method during the 1st and 23rd day of the pre-treatment cycle (PrTC), the 23rd day of treatment (TC) and the 1st day of the post-treatment cycle (PoTC). The ratios PGF2 alpha/PGE2 and TXB2/6-keto-PGF1 alpha were also tested and compared during the above-mentioned days. Analytical comparison was made, for each Prostaglandin (PG) separately, between the 1st day of the PrTC and PoTC as well as the 23rd day of the PrTC and TC, respectively. All PG levels during TC and PoTC were found significantly lower, compared to those of the PrTC respectively. With regard to the ratios mentioned above, no statistically significant differences were found on the same days and cycles as previously stated. The reduction of the PG levels in PD patients after treatment with oral contraceptives, together with an improvement of the clinical findings of the disease, support the theory that oral contraceptives can be used for the treatment of PD cases, especially for those adolescents who also desire a contraceptive method.