Evaluation of the sensitivity of the classical swine fever surveillance system in two free zones in Colombia.

Infection with the classical swine fever virus (CSFV) causes a disease in pigs that ranges from a hyperacute form in which animals die in a few hours to subclinical disease. Due to this wide range of virulence, several complementary surveillance strategies should be implemented for the early detection of the disease. The objective of the present study was to determine the sensitivity of the surveillance system to detect CSFV outbreaks in a free zone (Zone 1) and in a zone undergoing an eradication process (Zone 2) in Colombia. Stochastic scenario tree models were used to describe the population and surveillance structures and to determine the probability of CSFV detection. The total sensitivity of the surveillance system in the case of a single infected farm in Zone 1 was 31.4% (CI 95%: 7.2-54.1) and in the case of 5 infected farms was 85.2% (CI 95%: 67.3-93.7), while in Zone 2 the sensitivities were 27.8% (CI 95%: 6.4-55.1) and 82.5% (CI 95%: 65-92.9), respectively. The on-farm passive surveillance shows the highest sensitivity for detection of a single CSFV infected farm in both zones (22.8% in Zone 1 and 22.5% in Zone 2). The probability of detection was higher in a family / backyard premise than on a commercial farm in both zones. The passive surveillance at slaughterhouse had a sensitivity of 5.3% and 4.5% for the detection of a single infected farm in Zone 1 and 2, respectively. Active surveillance presented a range of sensitivity between 2.2% and 4.5%. In conclusion, the sensitivity of the surveillance in the two studied zones was quite high, one of reasons for this good sensitivity being the sentinel network based on the voluntary participation of 5,500 collaborators that were trained for the identification and notification of diseases of national interest.

Identifying molecularly defined antigens for a Histoplasma capsulatum-specific interferon gamma release assay / Identificación de antígenos definidos molecularmente para un ensayo de liberación de interferón-gamma específico para Histoplasma capsulatum

Background: In a previous work we showed the feasibility of an interferon gamma release assay (IGRA) for detecting latent infection by Histoplasma capsulatum. While in that proof-of-concept study we used crude fungal extracts as antigens, the newest IGRAs developed for other infections are based on molecularly defined antigens, mostly on mixtures of immunogenic peptides. Aims: To identify proteins in H. capsulatum that might serve as molecularly defined antigens for an IGRA test. Methods: We surveyed the literature looking for known H. capsulatum-immunogenic proteins and assayed two of them as antigens in an IGRA test, in a study that involved 80 volunteers. Furthermore, we used several bioinformatics tools to identify specific H. capsulatum proteins and to analyze possible strategies for the design of H. capsulatum-specific immunogenic peptides. Results: Seven H. capsulatum-immunogenic proteins were retrieved from the literature. IGRA tests using either the heat shock protein 60 or the M antigen showed high sensitivities but low specificities, most likely due to the high sequence similarity with the corresponding orthologs in other pathogenic microorganisms. We identified around 2000 H. capsulatum-specific proteins, most of which remain unannotated. Class II T-cell epitope predictions for a small number of these proteins showed a great variability among different alleles, prompting for a "brute force" approach for peptide design. Conclusions: The H. capsulatum genome encodes a large number of distinctive proteins, which represent a valuable source of potential specific antigens for an IGRA test. Among them, the Cfp4 protein stands out as a very attractive candidate

Antecedentes: En un trabajo anterior mostramos la viabilidad de un ensayo de liberación de interferón-gamma (IGRA) para detectar la infección latente por Histoplasma capsulatum. En esa prueba de concepto utilizamos extractos crudos del hongo como antígenos; sin embargo, los IGRA de última generación desarrollados para otras infecciones se basan en antígenos definidos molecularmente, principalmente en mezclas de péptidos inmunogénicos. Objetivos Identificar proteínas de H. capsulatum que podrían servir como antígenos definidos molecularmente en una prueba IGRA. Métodos: Examinamos la literatura en busca de proteínas inmunogénicas de H. capsulatum ya conocidas, y ensayamos dos de ellas como antígenos en una prueba IGRA, en un estudio donde participaron 80 voluntarios. Además, utilizamos varias herramientas bioinformáticas para identificar proteínas específicas de H. capsulatum y analizar posibles estrategias para el diseño de péptidos inmunogénicos específicos. Resultados: Encontramos siete proteínas de H. capsulatum caracterizadas como inmunogénicas en la literatura. Las pruebas IGRA donde utilizamos la proteína de choque térmico 60 o el antígeno M, mostraron una alta sensibilidad, pero baja especificidad, debido probablemente a la alta similitud de secuencia con los ortólogos correspondientes en otros microorganismos patógenos. Identificamos unas 2000 proteínas específicas de H. capsulatum, la mayoría de las cuales permanecen sin anotar. Las predicciones de epítopos de células T de clase II realizadas para un pequeño número de estas proteínas mostraron una gran variabilidad entre los diferentes alelos, sustentando la aplicación de un enfoque de «fuerza bruta» en el diseño de estos péptidos. Conclusiones: El genoma de H. capsulatum codifica una gran cantidad de proteínas específicas que representan una fuente valiosa de posibles antígenos para una prueba IGRA. Entre ellos, la proteína Cfp4 resulta un candidato muy atractivo

Identifying molecularly defined antigens for a Histoplasma capsulatum-specific interferon gamma release assay.

BACKGROUND: In a previous work we showed the feasibility of an interferon gamma release assay (IGRA) for detecting latent infection by Histoplasma capsulatum. While in that proof-of-concept study we used crude fungal extracts as antigens, the newest IGRAs developed for other infections are based on molecularly defined antigens, mostly on mixtures of immunogenic peptides. AIMS: To identify proteins in H. capsulatum that might serve as molecularly defined antigens for an IGRA test. METHODS: We surveyed the literature looking for known H. capsulatum-immunogenic proteins and assayed two of them as antigens in an IGRA test, in a study that involved 80 volunteers. Furthermore, we used several bioinformatics tools to identify specific H. capsulatum proteins and to analyze possible strategies for the design of H. capsulatum-specific immunogenic peptides. RESULTS: Seven H. capsulatum-immunogenic proteins were retrieved from the literature. IGRA tests using either the heat shock protein 60 or the M antigen showed high sensitivities but low specificities, most likely due to the high sequence similarity with the corresponding orthologs in other pathogenic microorganisms. We identified around 2000 H. capsulatum-specific proteins, most of which remain unannotated. Class II T-cell epitope predictions for a small number of these proteins showed a great variability among different alleles, prompting for a "brute force" approach for peptide design. CONCLUSIONS: The H. capsulatum genome encodes a large number of distinctive proteins, which represent a valuable source of potential specific antigens for an IGRA test. Among them, the Cfp4 protein stands out as a very attractive candidate.

An interferon gamma release assay specific for Histoplasma capsulatum to detect asymptomatic infected individuals: A proof of concept study.

Histoplasmosis is the most common endemic mycosis in the Americas. Currently, there is no laboratory test capable to detect subclinical or latent infections by Histoplasma capsulatum (Hc), which might develop as severe infections in immunocompromised individuals. For the first time to our knowledge, we explore the suitability of an interferon gamma release assay (IGRA) to detect latent Hc infection in asymptomatic individuals. A cohort of 126 volunteers was enrolled in the study, 13 of which underwent a Hc infection in the past, and 93 of them showing risk factors for this infection. The remaining 20 participants did not refer any risk factors of Hc infection, but eight of them showed evidences of infection with Mycobacterium tuberculosis. All participants were recruited in Medellin, Colombia, between January 2014 and December 2017. Whole blood samples were cultured with four different Hc crude antigens and phytohemaglutinin as positive control. The interferon (IFN)-γ released by T lymphocytes upon antigen stimulation was quantified by ELISA. A defined cutoff value of 20 pg/ml for the IFN-γ concentration allowed us to distinguish between the group with documented past infections and the group of noninfected individuals with high sensitivity (70-92%) and specificity (85-95%), for the four tested antigens. Positive 82-95% and negative 77-92% predictive values were also very high, comparable to those reported for commercially available IGRAs. The new test constitutes a promising screening method to detect individuals with latent Hc infection, even decades after the primary infection, as evidenced in this study.

Childhood histoplasmosis in Colombia: Clinical and laboratory observations of 45 patients.

Histoplasmosis is an important mycosis in the Americas; and in children with no immune system abnormalities, histoplasmosis is typically a self-limited process. In contrast, in children with immune problems, disease manifestations are frequently more severe and include dissemination. From 1984 to 2010, a retrospective study of paediatric patients who had been diagnosed with histoplasmosis was performed. A total of 45 pediatric cases of histoplasmosis were identified. The most important risk factor was malnutrition (37%), followed by environmental exposure (33%). The patients exhibited pulmonary infiltrates (83%), fever (76%), cough, constitutional symptoms (38%), headache (35%), and lymph node hypertrophy (33%). Concerning the clinical forms, 64% of the patients presented with the progressive disseminated form that frequently affected the central nervous system (48%). Diagnostic laboratory tests indicated that the cultures were positive for 80% of the patients, the agar gel immunodiffusion was reactive in 95%, the M band of the precipitate was more commonly observed (81%), and the complement fixation tests were reactive in 88% of the patients. The timely diagnosis of histoplasmosis is important, and for this reason, it is hoped that the results of this study will lead pediatricians toward a better understanding of this mycosis in children.