Zoonosis and veterinary waste disposal in rural practice / Zoonosis y disposición de desperdicios veterinarios en la práctica rural

The objectives of this study were to estimate: (a) the frequency of zoonoses in large animal veterinarians from rural areas of the province of Buenos Aires, Argentina, and (b) to describe the use and disposal of personal protective equipment (PPE) and selective veterinary clinical waste. A cross-sectional study was carried out on large animal veterinary practitioners in the Province of Buenos Aires (n = 106). One third (29.2%) of them had been diagnosed with a zoonosis by laboratory-methods, being brucellosis the most frequent (22.6%). The more years passed since their graduation, the greater the chances of becoming ill (p < 0.001). Gloves were the most adopted PPE; however, other elements had little or no use at all. Older and experienced professionals used PPE less frequently than young inexperienced practitioners. Some PPE was frequently reused and the final disposal of veterinary waste was often inappropriate. A change in behavior is an urgent need to preserve not only the veterinarians' health but also their families' wellbeing and to ensure proper disposal of potentially hazardous waste.

Los objetivos de este trabajo fueron los siguientes: a) estimar la frecuencia de zoonosis en veterinarios de grandes animales que desarrollan su labor en la provincia de Buenos Aires; b) describir el uso y la disposición de los elementos de protección personal (EPP) y otros residuos generados durante el trabajo de estos veterinarios. Para ello se realizó un estudio transversal en una muestra de 106 profesionales. En un tercio de ellos (29,2%) se había sido diagnosticado por métodos de laboratorio alguna zoonosis; la brucelosis fue la más frecuente (22,6%). Se encontró que a mayor tiempo transcurrido desde la graduación, mayor era la probabilidad de enfermarse (p< 0,001). Sobre la base de las respuestas obtenidas en cuestionarios estructurados, se determinó lo siguiente: que los guantes fueron el EPP más adoptado, mientras que otros elementos tuvieron escasa o nula adopción; que los profesionales de mayor edad y experiencia usaron EPP con menos frecuencia que los practicantes más jóvenes e inexpertos; y que algunos EPP se reutilizaban con frecuencia y que la eliminación final de los desechos veterinarios fue a menudo inapropiada. Considerando estos hallazgos, es claro que se requiere un cambio de comportamiento para preservar no solo la salud de los veterinarios, sino también para asegurar el bienestar de sus familias y garantizar la eliminación adecuada de los residuos potencialmente peligrosos.

Zoonosis and veterinary waste disposal in rural practice.

The objectives of this study were to estimate: (a) the frequency of zoonoses in large animal veterinarians from rural areas of the province of Buenos Aires, Argentina, and (b) to describe the use and disposal of personal protective equipment (PPE) and selective veterinary clinical waste. A cross-sectional study was carried out on large animal veterinary practitioners in the Province of Buenos Aires (n=106). One third (29.2%) of them had been diagnosed with a zoonosis by laboratory-methods, being brucellosis the most frequent (22.6%). The more years passed since their graduation, the greater the chances of becoming ill (p<0.001). Gloves were the most adopted PPE; however, other elements had little or no use at all. Older and experienced professionals used PPE less frequently than young inexperienced practitioners. Some PPE was frequently reused and the final disposal of veterinary waste was often inappropriate. A change in behavior is an urgent need to preserve not only the veterinarians' health but also their families' wellbeing and to ensure proper disposal of potentially hazardous waste.

Hazards for Women and Children in Rural Settings.

OBJECTIVES: a) To identify possible risk factors associated with rural accidents in women, b) to describe women's knowledge about zoonosis, c) to describe women's risk perception about farming, d) to describe mothers' risk perception about children's activities in rural settings, e) to estimate the initial age of exposure to the rural setting and its dangers, and f) to identify possible risk factors associated with rural accidents in children. MATERIALS AND METHODS: Cross-sectional design. Women with children that live in the countryside were surveyed (n=24). Structured questionnaire. STATISTICAL ANALYSES: χ2, Student's t-test, Pearson's correlation coefficient and logistic regression. RESULTS: Many women had suffered an accident in the countryside (65.6 %). Farm worker usually did not use personal protective equipment (PPE). Hearing protection, gloves, and safety goggles were rarely used. Working women showed a high risk perception for urban driving, the handling of agrochemicals, and driving on main roads (85.7 %, 70 % and 66.7 %). There was no significant association between risk perception and PPE use. Most mothers (87.5 %) thought that was good for children to learn how to perform farm chores starting at a young age. Children started to drive tractors at 9 years of age; 12.23 years on average. More than 7 % of the children (7.14 %) have suffered an accident on the farm. The most frequent accidents were being trapped in machinery (60 %). No association was found between the independent variables and the dependent variable; farm-related accidents in children (p>0.2). CONCLUSIONS: Risk communication is necessary to inform people involved and to reduce exposure.

[Mycobacterium bovis in wildlife of the dairy regions of Santa Fe (Argentina)]. / Mycobacterium bovis en fauna silvestre de la cuenca lechera de Santa Fe, Argentina.

Control eradication campaigns of bovine tuberculosis based on the «test and slaughter¼ approach were successful in many countries and regions; however, in some areas the infection persists and one of the main reasons is Mycobacterium bovis infection in wild life species. Argentina has applied the same approach since 1999, achieving progress in dairy cattle herds. Nonetheless, the wildlife role has never been investigated. The objective of this study was to determine if wildlife from the Santa Fe dairy area is infected with M. bovis. Wildlife species having a positive tuberculin skin test were captured in five dairy farms. Ninety five wildlife mammals were captured; M. bovis was recovered from 7 possums (Didelphys albiventris), from one fox (Lycolapex gimnocercus) and from one rat (Rattus norvegicus). None of the animals exhibited macroscopic lesions. The most frequently isolated M. bovis spoligotypes were types 34 (4 isolates) and 12 (3 isolates). Spoligotype 34 is the most frequently isolated type in Argentine cattle. The role of D. albiventris as spillover host of M. bovis is discussed in this study.

Mycobacterium bovis en fauna silvestre de la cuenca lechera de Santa Fe, Argentina / Mycobacterium bovis in wildlife of the dairy regions of Santa Fe (Argentina)

El control y la erradicación de la tuberculosis bovina basados en la detección de los animales infectados y su inmediata faena permitió lograr progresos satisfactorios en varios países y regiones, pero no todos pudieron lograrlo debido principalmente a la presencia de fauna silvestre infectada con Mycobacterium bovis. La Argentina aplica desde 1999 estas mismas premisas y ha logrado avances en los rodeos lecheros, aunque no se ha evaluado el factor ambiental como la fauna silvestre. El objetivo de este trabajo fue determinar si la fauna silvestre de la cuenca lechera de Santa Fe está infectada con M. bovis. Se realizó la captura/sacrificio de fauna silvestre presente en 5 rodeos lecheros con altos niveles de reaccionantes positivos a la prueba de tuberculina. Sobre 95 mamíferos silvestres examinados, se aisló M. bovis de 7 individuos de comadreja overa (Didelphis albiventris), de uno de zorro gris (Lycolapex gimnocercus) y de uno de rata (Rattus norvegicus). Los sitios anatómicos que produjeron estos aislamientos variaron de acuerdo con las especies; en ninguno de los ejemplares evaluados se observaron lesiones macroscópicas de tuberculosis. Los espoligotipos de M. bovis aislados con mayor frecuencia de los animales silvestres correspondieron a los tipos 34 (4 aislamientos) y 12 (3 aislamientos); el primero es el más corrientemente aislado del ganado en Argentina. Se discute en este estudio el papel de la comadreja overa (D. albiventris) como hospedador circunstancial de M. bovis

Control eradication campaigns of bovine tuberculosis based on the «test and slaughter¼ approach were successful in many countries and regions; however, in some areas the infection persists and one of the main reasons is Mycobacterium bovis infection in wild life species. Argentina has applied the same approach since 1999, achieving progress in dairy cattle herds. Nonetheless, the wildlife role has never been investigated. The objective of this study was to determine if wildlife from the Santa Fe dairy area is infected with M. bovis. Wildlife species having a positive tuberculin skin test were captured in five dairy farms. Ninety five wildlife mammals were captured; M. bovis was recovered from 7 possums (Didelphys albiventris), from one fox (Lycolapex gimnocercus) and from one rat (Rattus norvegicus). None of the animals exhibited macroscopic lesions. The most frequently isolated M. bovis spoligotypes were types 34 (4 isolates) and 12 (3 isolates). Spoligotype 34 is the most frequently isolated type in Argentine cattle. The role of D. albiventris as spillover host of M. bovis is discussed in this study

Hazards for Women and Children in Rural Settings / Peligros para las mujeres y niños en el ámbito rural

Objectives a) To identify possible risk factors associated with rural accidents in women, b) to describe women's knowledge about zoonosis, c) to describe women's risk perception about farming, d) to describe mother´s risk perception about children's activities in rural settings, e) to estimate the initial age of exposure to the rural setting and its dangers, and f) to identify possible risk factors associated with rural accidents in children. Materials and Methods: Cross-sectional design. Women with children that live in the countryside were surveyed (n=24). Structured questionnaire. Statistical analyses: χ2, Student's t-test, Pearson's correlation coefficient and logistic regression. Results Many women had suffered an accident in the countryside (65.6 %). Farm worker usually did not use personal protective equipment (PPE). Hearing protection, gloves, and safety goggles were rarely used. Working women showed a high risk perception for urban driving, the handling of agrochemicals, and driving on main roads (85.7 %, 70 % and 66.7 %). There was no significant association between risk perception and PPE use. Most mothers (87.5 %) thought that was good for children to learn how to perform farm chores starting at a young age. Children started to drive a tractors at 9 years of age; 12.23 years on average. More than 7 % of the children (7.14 %) have suffered an accident on the farm. The most frequent accidents were being trapped in machinery (60 %). No association was found between the independent variables and the dependent variable; farm-related accidents in children (p>0.2). Conclusions Risk communication is necessary to inform people involved and to reduce exposure.

Objetivos a) identificar posibles factores de riesgo asociados a accidentes rurales en mujeres, b) describir el conocimiento sobre zoonosis de las mujeres, c) describir la percepción de riesgos de las mujeres acerca de las actividades realizadas en el campo, d) describir la percepción de riesgos de las madres sobre las actividades de los niños en el campo, e) estimar la edad de exposición inicial de los niños al ambiente rural y sus peligros y f) identificar potenciales factores de riesgo asociados a accidentes rurales en niños. Materiales y Métodos Diseño transversal. Fueron encuestadas las mujeres con hijos que vivían en el campo (n= 24). Cuestionario estructurado. Análisis estadístico: χ2, T Student, coeficiente de correlación de Pearson y Regresión Logística. Resultados Muchas de las mujeres sufrieron un accidente en el campo (65,6 %). Las trabajadoras rurales generalmente no usaban elementos de protección personal (EPP). Protección auditiva, guantes y antiparras eran escasamente utilizados. Las trabajadoras demostraron tener una percepción del riesgo alta sobre el manejo de vehículos en zonas urbanas, manipulación de agroquímicos y manejo de vehículos en rutas (85,7 %, 70 % y 66,7 %). No se encontró asociación significativa entre percepción de riesgos y uso de EPP. Muchas madres (87,5 %) pensaban que era bueno para los niños que aprendieran a realizar tareas del campo desde muy pequeños. Los niños comenzaban a manejar un tractor desde los 9 años, 12,23 años en promedio. Más del 7% de los niños (7,14 %) sufrieron un accidente en el campo. Los más frecuentes fueron atrapamiento por maquinaria (60 %). No se encontró asociación significativa entre las variables independientes y la variable dependiente accidente en un niño (p>0,2). Conclusiones Es necesaria la comunicación de los riesgos para informar a los involucrados y reducir la exposición.

[Knowledge of zoonoses transmission routes and of the species concerned among rural workers]. / Conocimiento de las vías de transmisión de las zoonosis y de las especies afectadas entre los trabajadores rurales.

The aim of this study was to evaluate the level of awareness of zoonoses among rural workers and their potential associations with socio-demographic factors. A cross-sectional study was performed by holding personal interviews (N=110, n=94) using a structured questionnaire. The statistical analysis included the χ(2) test, the Student's t test and Pearson and Spearman correlations. The highest level of awareness was found for trichinosis, rabies and scabies. Species transmitting brucellosis, tuberculosis and anthrax were well known, but not their modes of transmission. The least known diseases were toxocariasis and hydatidosis, followed by leptospirosis and toxoplasmosis. Significant associations were found (p<0.001) between the knowledge of transmitting species and the modes of transmission. Senior male owners, married, and living in urban areas showed the highest overall knowledge of zoonoses. Awareness of zoonoses among rural workers is inadequate. Veterinarians in conjunction with risk insurers may play a key role in providing information to people at risk.

Conocimiento de las vías de transmisión de las zoonosis y de las especies afectadas entre los trabajadores rurales / Knowledge of zoonoses transmission routes and of the species concerned among rural workers

El objetivo de este trabajo fue evaluar el grado de conocimiento que tienen los trabajadores rurales sobre las zoonosis a las que se encuentran expuestos en su trabajo y su asociación con factores socio-demográficos. Se efectuó un estudio observacional transversal basado en la realización de encuestas (N = 110, n = 94), utilizando un cuestionario estructurado. El análisis incluyó c², t de Student y correlación de Pearson y de Spearman. Las zoonosis más conocidas fueron la triquinosis, la rabia y la sarna. En el caso de la brucelosis, la tuberculosis y el carbunco, fueron muy conocidas las especies que las transmiten, pero no así las formas de transmisión. Las enfermedades menos conocidas en ambos sentidos fueron la toxocariasis y la hidatidosis, seguidas por la leptospirosis y la toxoplasmosis. Para todas las zoonosis estudiadas se encontró correlación significativa (p < 0,001) entre el conocimiento de las especies transmisoras y de las vías de transmisión. Aquellos encuestados de sexo masculino, propietarios y residentes de zonas urbanas, casados y de mayor edad y antigüedad fueron quienes presentaron más conocimientos sobre las zoonosis, en general. El conocimiento que tienen los trabajadores rurales acerca de las zoonosis es insuficiente. Sería importante que los veterinarios, en conjunto con las aseguradoras de riesgos del trabajo, difundan la información adecuada entre las personas en riesgo que desarrollan sus tareas en este ámbito.

The aim of this study was to evaluate the level of awareness of zoonoses among rural workers and their potential associations with socio-demographic factors. A cross-sectional study was performed by holding personal interviews (N = 110, n = 94) using a structured questionnaire. The statistical analysis included the c² test, the Student's t test and Pearson and Spearman correlations. The highest level of awareness was found for trichinosis, rabies and scabies. Species transmitting brucellosis, tuberculosis and anthrax were well known, but not their modes of transmission. The least known diseases were toxocariasis and hydatidosis, followed by leptospirosis and toxoplasmosis. Significant associations were found (p < 0.001) between the knowledge of transmitting species and the modes of transmission. Senior male owners, married, and living in urban areas showed the highest overall knowledge of zoonoses. Awareness of zoonoses among rural workers is inadequate. Veterinarians in conjunction with risk insurers may play a key role in providing information to people at risk.

Conocimiento de las vías de transmisión de las zoonosis y de las especies afectadas entre los trabajadores rurales / Knowledge of zoonoses transmission routes and of the species concerned among rural workers

El objetivo de este trabajo fue evaluar el grado de conocimiento que tienen los trabajadores rurales sobre las zoonosis a las que se encuentran expuestos en su trabajo y su asociación con factores socio-demográficos. Se efectuó un estudio observacional transversal basado en la realización de encuestas (N = 110, n = 94), utilizando un cuestionario estructurado. El análisis incluyó c², t de Student y correlación de Pearson y de Spearman. Las zoonosis más conocidas fueron la triquinosis, la rabia y la sarna. En el caso de la brucelosis, la tuberculosis y el carbunco, fueron muy conocidas las especies que las transmiten, pero no así las formas de transmisión. Las enfermedades menos conocidas en ambos sentidos fueron la toxocariasis y la hidatidosis, seguidas por la leptospirosis y la toxoplasmosis. Para todas las zoonosis estudiadas se encontró correlación significativa (p < 0,001) entre el conocimiento de las especies transmisoras y de las vías de transmisión. Aquellos encuestados de sexo masculino, propietarios y residentes de zonas urbanas, casados y de mayor edad y antig³edad fueron quienes presentaron más conocimientos sobre las zoonosis, en general. El conocimiento que tienen los trabajadores rurales acerca de las zoonosis es insuficiente. Sería importante que los veterinarios, en conjunto con las aseguradoras de riesgos del trabajo, difundan la información adecuada entre las personas en riesgo que desarrollan sus tareas en este ámbito.(AU)

The aim of this study was to evaluate the level of awareness of zoonoses among rural workers and their potential associations with socio-demographic factors. A cross-sectional study was performed by holding personal interviews (N = 110, n = 94) using a structured questionnaire. The statistical analysis included the c² test, the Students t test and Pearson and Spearman correlations. The highest level of awareness was found for trichinosis, rabies and scabies. Species transmitting brucellosis, tuberculosis and anthrax were well known, but not their modes of transmission. The least known diseases were toxocariasis and hydatidosis, followed by leptospirosis and toxoplasmosis. Significant associations were found (p < 0.001) between the knowledge of transmitting species and the modes of transmission. Senior male owners, married, and living in urban areas showed the highest overall knowledge of zoonoses. Awareness of zoonoses among rural workers is inadequate. Veterinarians in conjunction with risk insurers may play a key role in providing information to people at risk.(AU)

Conocimiento de las vías de transmisión de las zoonosis y de las especies afectadas entre los trabajadores rurales. / [Knowledge of zoonoses transmission routes and of the species concerned among rural workers].

The aim of this study was to evaluate the level of awareness of zoonoses among rural workers and their potential associations with socio-demographic factors. A cross-sectional study was performed by holding personal interviews (N=110, n=94) using a structured questionnaire. The statistical analysis included the ¤ç(2) test, the Students t test and Pearson and Spearman correlations. The highest level of awareness was found for trichinosis, rabies and scabies. Species transmitting brucellosis, tuberculosis and anthrax were well known, but not their modes of transmission. The least known diseases were toxocariasis and hydatidosis, followed by leptospirosis and toxoplasmosis. Significant associations were found (p<0.001) between the knowledge of transmitting species and the modes of transmission. Senior male owners, married, and living in urban areas showed the highest overall knowledge of zoonoses. Awareness of zoonoses among rural workers is inadequate. Veterinarians in conjunction with risk insurers may play a key role in providing information to people at risk.

Zoonoses in rural veterinarians in the central region of Argentina.

OBJECTIVE: To estimate the frequency of zoonoses in rural veterinarians and to search for risk factors. DESIGN: Cross-sectional study based on an anonymously answered structured questionnaire. SETTING: The interviewees participated in mandatory continuing education classes scheduled throughout the province by the College of Veterinary Surgeons. PARTICIPANTS: Overall, 741 professionals were surveyed, and 75.8% (n = 562) of them completed the structured questionnaire. MAIN OUTCOME MEASURES: Cumulative incidence (CIR) and incidence density (IDR) rates, standardised rates, χ(2) , Student's t-test, Pearson's correlation coefficient and logistic regression. RESULTS: The CIR for all zoonoses was 34.1% (brucellosis, 29.1%; toxoplasmosis, 2.1%; leptospirosis, 0.6%; tuberculosis, 0.6%; anthrax, 0.6%; ringworm, 0.4%; other, 0.6%). The IDR for the period 1964-2008 was estimated to be 20.7% (19.5% for brucellosis). The brucellosis IDR decreased between 1964 and 2008 and was higher during early post-graduation. The risk of brucellosis was associated with the number of years of practice and the geographical area. Sixty-nine respondents had at least one day of absence from work (24.0 ± 27.8 days). CONCLUSIONS: A high frequency of zoonoses was reported by veterinarians with a large animal practice. Although the rate of zoonoses may be decreasing, further studies are needed to confirm this finding. A joint effort of all institutions is needed to prevent zoonoses among private practitioners.

Caracterización epidemiológica de casos de síndrome urémico hemolítico en la región sur de la provincia de Buenos Aires / Epidemiological characterization of hemolytic-uremic syndrome cases in the south region of Buenos Aires province

INTRODUCCION: El síndrome urémico hemolítico (SUH) es la causa más frecuente de insuficiencia renal aguda en niños menores de 5 años en Argentina y se asocia principalmente a la infección por Escherichia coli shigatoxigénica (STEC). El bovino es el principal reservorio de STEC, las infecciones al hombre pueden producirse directa o indirectamente a partir de él. Es probable que las personas que presentan un mayor contacto con estos animales tengan una mayor exposición a la bacteria.OBJETIVO: Caracterizar epidemiológicamente la presentación de casos de SUH registrados durante 2005-2010 en poblaciones rurales y urbanas de la región centro-sur de la provincia de Buenos Aires.METODOS: El análisis de los datos incluyó estadísticas descriptivas y de comparación.RESULTADOS: La mediana de las edades del total de los pacientes estudiados fue de 27 meses (5-139 meses). El 54,3% de los casos respondió al género femenino y el 17,5%, al medio rural. Aunque la mayoría de los casos de SUH fueron pobladores urbanos, la tasa de incidencia específica fue significativamente mayor en poblaciones rurales y, en este grupo, las edades de los niños fueron más bajas.CONCLUSIONES: Los resultados obtenidos en el presente estudio concuerdan con otros realizados en la Argentina en lo que respecta a edad y género. No obstante, se encontró una mayor incidencia de SUH en pobladores rurales y a edades más bajas, lo que constituye una novedad. Esto podría deberse al contacto más frecuente con bovinos, ya sea directa o indirectamente, lo que aumentaría el riesgo de enfermar, sobre todo a edades más tempranas.

INTRODUCTION: In Argentina, the hemolytic-uremic syndomre (HUS) is the most frequent cause of acute renal failure in children under 5 years old and is associated with shigatoxigenic Escherichia coli (STEC) infection. Cattle are the major reservior for STEC, and the infection in human may be acquired directly or indirectly from cattle. People with increased contact with cattle are more likely to acquire STEC infections.OBJECTIVE: To characterize epidemiologically the HUS cases recorded during 2005-2010 in rural and urban populations in the central-southern region of Buenos Aires province.METHODS: Data analysis included descriptive and comparative statistics.RESULTS: The median age of the patients was 27 months (5-139 months). 54.3% of the cases were female and 17.5% belonged to rural areas. Although most cases of HUS were urban, the specific incidence rate was significantly higher in rural populations and the children were younger.CONCLUSIONS: The results obtaines in ths study are consistent with other studies conducted in Argentina in terms of age and gender. However, it detected a higher HUS incidence in rural populations and at younger ages, which is new in Argentina. This may be due to more frequent contact with cattle, directly or indirectly increasing the risk of developing the disease especially in younger children.

Caracterización epidemiológica de casos de síndrome urémico hemolítico en la región sur de la provincia de Buenos Aires / Epidemiological characterization of hemolytic-uremic syndrome cases in the south region of Buenos Aires province

INTRODUCCION: El síndrome urémico hemolítico (SUH) es la causa más frecuente de insuficiencia renal aguda en niños menores de 5 años en Argentina y se asocia principalmente a la infección por Escherichia coli shigatoxigénica (STEC). El bovino es el principal reservorio de STEC, las infecciones al hombre pueden producirse directa o indirectamente a partir de él. Es probable que las personas que presentan un mayor contacto con estos animales tengan una mayor exposición a la bacteria.OBJETIVO: Caracterizar epidemiológicamente la presentación de casos de SUH registrados durante 2005-2010 en poblaciones rurales y urbanas de la región centro-sur de la provincia de Buenos Aires.METODOS: El análisis de los datos incluyó estadísticas descriptivas y de comparación.RESULTADOS: La mediana de las edades del total de los pacientes estudiados fue de 27 meses (5-139 meses). El 54,3% de los casos respondió al género femenino y el 17,5%, al medio rural. Aunque la mayoría de los casos de SUH fueron pobladores urbanos, la tasa de incidencia específica fue significativamente mayor en poblaciones rurales y, en este grupo, las edades de los niños fueron más bajas.CONCLUSIONES: Los resultados obtenidos en el presente estudio concuerdan con otros realizados en la Argentina en lo que respecta a edad y género. No obstante, se encontró una mayor incidencia de SUH en pobladores rurales y a edades más bajas, lo que constituye una novedad. Esto podría deberse al contacto más frecuente con bovinos, ya sea directa o indirectamente, lo que aumentaría el riesgo de enfermar, sobre todo a edades más tempranas.

INTRODUCTION: In Argentina, the hemolytic-uremic syndomre (HUS) is the most frequent cause of acute renal failure in children under 5 years old and is associated with shigatoxigenic Escherichia coli (STEC) infection. Cattle are the major reservior for STEC, and the infection in human may be acquired directly or indirectly from cattle. People with increased contact with cattle are more likely to acquire STEC infections.OBJECTIVE: To characterize epidemiologically the HUS cases recorded during 2005-2010 in rural and urban populations in the central-southern region of Buenos Aires province.METHODS: Data analysis included descriptive and comparative statistics.RESULTS: The median age of the patients was 27 months (5-139 months). 54.3% of the cases were female and 17.5% belonged to rural areas. Although most cases of HUS were urban, the specific incidence rate was significantly higher in rural populations and the children were younger.CONCLUSIONS: The results obtaines in ths study are consistent with other studies conducted in Argentina in terms of age and gender. However, it detected a higher HUS incidence in rural populations and at younger ages, which is new in Argentina. This may be due to more frequent contact with cattle, directly or indirectly increasing the risk of developing the disease especially in younger children.

[Diagnosis of leptospirosis: evaluation of a solid-phase enzyme immunoassay in different stages of the disease]. / Diagnóstico de leptospirosis: evaluación de un enzimoinmunoensayo en fase sólida en diferentes etapas de la enfermedad.

OBJECTIVE: To develop a solid-phase enzyme immunoassay (ELISA) for genus-specific immunoglobulin G (IgG) determination with leptospirosis and to evaluate the ELISA in different stages of the disease. METHODS: A total of 1,077 serum samples from 812 patients with suspected leptospirosis were analyzed. The samples had come from diagnoses done in the laboratory of the National Institute of Respiratory Diseases (Instituto Nacional de Enfermedades Respiratorias), in the city of Santa Fe, Argentina, between 1999 and 2005. Included in the study were 182 confirmed cases (267 samples), 167 negative cases (293 samples), and 40 probable cases (60 samples) (based on case definitions based on the results from the microscopic agglutination test (MAT), leukocyte counts, and neutrophilia values). Each sample was classified, according to the days of the natural history of disease, into one of three stages: first (< 10 days), second (10-25 days), or third (> 25 days). The antigen used in the ELISA was an extract of a mixture of pyrogenes and tarassovi serovars cultivated in a liquid medium, treated with ultrasound, and immobilized by adsorption on polystyrene plates. As a secondary antibody, a peroxidase-conjugated goat anti-human IgG monoclonal antibody was used. The cutoff value, sensitivity, and specificity of the ELISA were determined using the definitions of confirmed cases and of negatives cases as the standard. In order to determine the optimal cutoff value, the area under the receiver operating characteristic curve was calculated. RESULTS: The sensitivity of the evaluated test was much higher in the second stage (93.2%) than in either the first stage (68.1%) or the third stage (78.8%). The specificity increased gradually from 96.3% in the first stage to 100% in the third stage. CONCLUSIONS: Our results indicate that this ELISA test can be a very useful complement to the MAT for the diagnosis of leptospirosis in all the stages and, in particular, in order to diagnose acute disease sooner.

Diagnóstico de leptospirosis: evaluación de un enzimoinmunoensayo en fase sólida en diferentes etapas de la enfermedad / Diagnosis of leptospirosis: evaluation of a solid-phase enzyme immunoassay in different stages of the disease

OBJETIVO: Desarrollar un enzimoinmunoensayo en fase sólida (ELISA) para la determinación de inmunoglobulinas G (IgG) (específico de género) y evaluarlo en diferentes etapas de la enfermedad. MÉTODOS: Se analizaron 1 077 muestras séricas de 812 pacientes con sospecha de leptospirosis derivadas al laboratorio del Instituto Nacional de Enfermedades Respiratorias (INER) de la ciudad de Santa Fe, Argentina, entre 1999 y 2005. A partir de un criterio de definición de casos basado en los resultados de la microaglutinación (MAT) y del recuento de leucocitos, y de los valores de neutrofilia, se incluyeron en el estudio 182 casos confirmados (267 muestras), 167 casos negativos (293 muestras) y 40 casos probables (60 muestras). Cada muestra se clasificó según el tiempo de evolución de la enfermedad en tres etapas: primera (< 10 días), segunda (10-25 días) y tercera (> 25 días). En el ELISA, se utilizó como antígeno un extracto de una mezcla de las serovariedades Pyrogenes y Tarassovi cultivadas en medio líquido, tratado con ultrasonidos e inmovilizado por adsorción en placas de poliestireno. Como anticuerpo secundario se empleó un anticuerpo monoclonal de cabra anti-IgG humana conjugado con peroxidasa. El valor de corte, la sensibilidad y la especificidad del ELISA se determinaron utilizando como patrón la definición de casos. Para determinar el valor de corte óptimo se calculó el área bajo la curva de eficacia diagnóstica (curva ROC). RESULTADOS: La sensibilidad de la prueba evaluada aumentó considerablemente en la segunda etapa (93,2 por ciento), con respecto a la primera (68,1 por ciento), y descendió en la tercera (78,8 por ciento). La especificidad aumentó gradualmente desde el 96,3 por ciento en la primera etapa hasta el 100 por ciento en la tercera. CONCLUSIONES: Los resultados obtenidos indican que esta prueba de ELISA puede ser de gran utilidad como complemento de la MAT para el diagnóstico de la leptospirosis en todas las etapas y, en...

OBJECTIVE: To develop a solid-phase enzyme immunoassay (ELISA) for genus-specific immunoglobulin G (IgG) determination with leptospirosis and to evaluate the ELISA in different stages of the disease. METHODS: A total of 1 077 serum samples from 812 patients with suspected leptospirosis were analyzed. The samples had come from diagnoses done in the laboratory of the National Institute of Respiratory Diseases (Instituto Nacional de Enfermedades Respiratorias), in the city of Santa Fe, Argentina, between 1999 and 2005. Included in the study were 182 confirmed cases (267 samples), 167 negative cases (293 samples), and 40 probable cases (60 samples) (based on case definitions based on the results from the microscopic agglutination test (MAT), leukocyte counts, and neutrophilia values). Each sample was classified, according to the days of the natural history of disease, into one of three stages: first (< 10 days), second (10-25 days), or third (> 25 days). The antigen used in the ELISA was an extract of a mixture of pyrogenes and tarassovi serovars cultivated in a liquid medium, treated with ultrasound, and immobilized by adsorption on polystyrene plates. As a secondary antibody, a peroxidase-conjugated goat anti-human IgG monoclonal antibody was used. The cutoff value, sensitivity, and specificity of the ELISA were determined using the definitions of confirmed cases and of negatives cases as the standard. In order to determine the optimal cutoff value, the area under the receiver operating characteristic curve was calculated. RESULTS: The sensitivity of the evaluated test was much higher in the second stage (93.2 percent) than in either the first stage (68.1 percent) or the third stage (78.8 percent). The specificity increased gradually from 96.3 percent in the first stage to 100 percent in the third stage. CONCLUSIONS: Our results indicate that this ELISA test can be a very useful complement to the MAT for the diagnosis of leptospirosis in...

Evaluation of a new antibody-based enzyme-linked immunosorbent assay for the detection of bovine leukemia virus infection in dairy cattle.

The objective of this study was to validate a new blocking enzyme-linked immunosorbent assay (ELISA) (designated M108 for milk and S108 for serum samples) for detecting bovine leukemia virus (BLV) infection in dairy cattle. Milk, serum, and ethylenediaminetetraacetic acid-blood samples were collected from 524 adult Holstein cows originating from 6 dairy herds in Central Argentina. The M108 and S108 were compared with agar gel immunodiffusion (AGID), polymerase chain reaction and a commercial ELISA. Because there is currently no reference test capable of serving as a gold standard, the test sensitivity (SE) and specificity (SP) were evaluated by the use of a latent class model. Statistical inference was performed by classical maximum likelihood and by Bayesian techniques. The maximum-likelihood analysis was performed assuming conditional independence of tests, whereas the Bayesian approach allowed for conditional dependence. No clear conclusion could be drawn about conditional dependence of tests. Results with maximum likelihood (under conditional independence) and posterior Bayes (under conditional dependence) were practically the same. Conservative estimates of SE and SP (with 95% confidence intervals) for M108 were 98.6 (96.7; 99.6) and 96.7 (92.9; 98.8) and for S108 99.5 (98.2; 99.9) and 95.4 (90.9; 98.1), respectively. The ELISA 108 using either milk or serum to detect BLV-infected animals had comparable SE and SP with the official AGID and a commercial ELISA test, which are currently the most widely accepted tests for the serological diagnosis of BLV infection. Therefore, ELISA 108 can be used as an alternative test in monitoring and control programs.