Rabies and dog bites cases in lagos state Nigeria: a prevalence and retrospective studies (2006-2011).

This study was carried out to determine the prevalence of rabies antigen in brain of dogs slaughtered for consumption and those that died in veterinary clinics as well as to obtain a 6-year retrospective data on dog bites/suspected dog rabies cases in Lagos State. Dog brain samples were collected from dog slaughter slabs and veterinary clinics (for dogs that died in clinics) across the Lagos state while data for retrospective studies (2006-2011) of dog bite/suspected rabies cases were collected from public (government owned) and private veterinary clinics across the state. Out of the 444 brain samples collected and tested for presence of rabies antigen using the direct fluorescent antibody technique (DFAT) only 7 (1.58%) were positive for the rabies antigen. A total of 196 dog bites/suspected rabies cases were encountered between January 2006 and December, 2011 in the veterinary clinics with adults been the major (55.61%) victims. Majority (96.43%) of the offending dogs were not quarantined at the time of bite and only one out of the quarantined dogs died and was confirmed positive for rabies antigen. The result of this study indicates that rabies antigen is present among dogs slaughtered in Lagos State and may pose a threat to public health. Though, available records showed that provocation of dogs was the major cause of dog bites and both children and adults fell victim of dog bites, there was a poor record keeping practice in the veterinary clinics across the state.

Assessment of risk of possible exposure to rabies among processors and consumers of dog meat in Zaria and Kafanchan, Kaduna state, Nigeria.

Canine rabies is endemic in Nigeria. Some of the dogs slaughtered for human consumption may be infected with rabies virus, thus exposing handlers of raw dog meat to the disease since the virus may be present in the nerves in the meat. A cross-sectional study was designed and a structured questionnaire was designed and administered to a convenience sample of 160 processors and consumers (100 from Zaria and 60 from Kafanchan), by face to face interview at the slaughter sites or dog meat sale points. The questionnaire sought information on demographic characteristics of the respondents, rabies knowledge, attitude and actions the respondents would take if exposure occurs. Associations between demographic variables and categorized knowledge, attitude or practice scores were assessed using x2 analysis. The relationship between non-categorized scores was assessed using multiple regression analysis. Also, 154 brain samples from slaughtered dogs (74 from Zaria and 80 from Kafanchan) were checked for rabies antigen using direct fluorescent antibody test. Of the 160 respondents, 49 (30.6%) were involved in the slaughtering and sale of dog meat while 111(69.4%) were involved in handling and consumption of processed dog meat. Only 123(76.9%) knew that dogs are common source of rabies in Nigeria and 105(65.6%) knew that rabies affect humans. Also 110(68.8%) did not have adequate knowledge of the clinical signs of rabies. The level of knowledge, having positive attitudes and knowing acceptable practices were directly proportional to the level of education. Respondents from Kafanchan had higher level of knowledge and more positive attitudes towards rabies than those from Zaria. There were significant correlations between knowledge and attitude scores (r=0.49) and between knowledge and practice scores (r=0.43) at p<0.001. Rabies antigen was detected in the brain of 6 (3.9%) of the slaughtered dogs. The findings indicate that processors and consumers of dog meat are deficient in the knowledge of rabies. There is therefore a need for educational programmes targeted at this high risk group to increase their level of knowledge and reduce the risk of exposure.

A determination of the range of oral conditions submitted for microscopic and direct immunofluorescence analysis.

BACKGROUND: Direct immunofluorescence (DIF) testing is a useful adjunct for the diagnosis of immune-mediated oral vesiculobullous diseases, helping to identify separate, histologically similar, but prognostically different, conditions. It is unknown how often biopsy of these lesions yields positive DIF results. METHODS: A total of 270 consecutive archival cases submitted to a reference laboratory in Buffalo, New York, over a 2-year span were examined. These specimens were submitted to establish or rule out a diagnosis of a DIF-positive oral vesiculobullous disease. Demographic, clinical, and diagnostic information, based on conventional microscopic and DIF analysis, was tabulated. To assess the contribution of DIF to successful diagnosis, three pathologists examined the hematoxylin and eosin-stained slides of the known DIF-positive specimens without knowledge of the DIF results. RESULTS: Approximately 48% of the specimens demonstrated positive DIF findings and consisted of pemphigus vulgaris, mucous membrane pemphigoid, lichen planus, linear immunoglobulin A disease, and chronic ulcerative stomatitis. The remaining specimens had negative DIF findings and consisted of numerous non-specific inflammatory conditions. Of particular interest were several cases of epithelial dysplasia and squamous cell carcinoma. Of the DIF-positive cases, only pemphigus vulgaris could be diagnosed reliably by conventional microscopy alone. CONCLUSIONS: Approximately half of biopsies of oral conditions that clinically resembled typically DIF-positive vesiculobullous diseases did not yield positive findings on DIF testing. Instead, a wide range of oral diseases can mimic these lesions clinically. With the exception of pemphigus vulgaris, DIF is essential for establishing a definitive diagnosis for known DIF-positive diseases.

Utility of direct fluorescent antibody testing of nasopharyngeal washes in children with and without respiratory tract illness.

BACKGROUND: Direct fluorescent antibody (DFA) testing of nasopharyngeal wash specimens is a rapid and reliable means of diagnosing respiratory viral infection. The utility of DFA testing in the evaluation of febrile children without respiratory symptoms has not been critically evaluated. It is not known whether clinical or demographic factors apart from respiratory symptoms are associated with a positive DFA or whether a positive DFA is more likely to be associated with lower or upper respiratory tract symptoms (RTS). METHODS: This is a retrospective case-series of 756 consecutive nasopharyngeal specimens with respiratory DFA testing performed at the University of California San Francisco from November 1, 2002 through October 31, 2003. RESULTS: No RTS was a statistically significant predictor of negative DFA [odds ratio (OR), 0.03; 95% confidence interval (CI), 0.004-0.2; P = 0.001] compared with lower RTS. Male subjects were more likely than female subjects to have a positive DFA (OR 1.8; 95% CI 1.1-2.8; P = 0.02). Specimens collected from April to October were less likely to have a positive DFA (OR 0.4; 95% CI 0.2-0.7; P = 0.001). Specimens collected at the time of hospital admission and during a hospitalization were less likely to have a positive DFA (OR 0.5; 95% CI 0.3-0.9; P = 0.01 and OR, 0.07; 95% CI 0.02-0.2; P = 0.001, respectively) compared with specimens collected in the outpatient setting. CONCLUSION: The yield of testing children without respiratory tract illness is extremely low.

Respiratory syncytial virus detection by Remel Xpect, Binax Now RSV, direct immunofluorescent staining, and tissue culture.

The performance characteristics of Xpect RSV (XP) and Binax Now RSV (BN) were compared to those of direct fluorescent-antibody staining and/or tissue culture for detection of respiratory syncytial virus (RSV) in nasopharyngeal aspirate and wash samples from children (n = 110) and adults (n = 66). The sensitivity, specificity, positive predictive value, and negative predictive value of XP were 75%, 98%, 95%, and 90%, respectively; and those of BN were 74%, 100%, 100%, and 90%, respectively. The performances of the assays were similar within a given age group and specimen type (nasopharyngeal aspirate or wash specimen). XP and BN are useful for screening for RSV in respiratory specimens when large volumes are tested or low levels of staffing occur.

Comparison of Binax NOW and Directigen for rapid detection of influenza A and B.

Directigen Flu A + B and Binax NOW Flu A and Flu B tests detected 33 (55.9%) and 31 (52.5%) of 59 influenza-positive samples, respectively. In children under 2 years of age, sensitivity increased to 75% for both tests. Three samples tested falsely-positive for influenza B using Binax NOW.

Risk factors associated with severe influenza infections in childhood: implication for vaccine strategy.

UNLABELLED: Infections caused by influenza virus lead to an excess rate of hospitalization of children during winter months. Current recommendations for vaccination target only children >6 months who belong to specific risk groups. OBJECTIVE: To identify possible benefits of universal influenza vaccination, this study aims to determine characteristics of children hospitalized at the Montreal Children's Hospital (MCH) because of an infection attributable to influenza virus as well as risk factors associated with hospitalization. METHODS: We retrospectively reviewed records of all children with a laboratory-proven diagnosis of influenza seen at MCH between April 1, 1999, and April 1, 2002. Data were analyzed using the Student t test and logistic regression. RESULTS: We identified 182 patients hospitalized because of influenza and 114 patients who were not. Admission diagnoses were suspected sepsis (31%), lower respiratory tract infections (27%), and asthma or bronchiolitis (15%). Mean age of hospitalized patients was 26.1 month (median: 12 months), which was similar to that of patients not hospitalized, and 34% were <6 months. Seventy percent of those hospitalized did not have any underlying medical disorder and only 18% (33) were vaccine candidates according to current recommendations. Of the latter, less than half had been vaccinated. Factors associated with hospitalization were age <12 months (odds ratio [OR]: 2.3; 95% confidence interval [CI]: 1.1-4.8), male gender (OR: 1.9; 95% CI: 1.0-3.7), dehydration (OR: 4.3; 95% CI: 1.2-16.0), and decreased oxygen saturation (OR: 32.1; 95% CI: 4.1-249). CONCLUSIONS: Considering that the majority of children hospitalized for influenza do not belong to the specific risk groups targeted by current recommendations, and that one third are <6 months of age, the target population for vaccination needs to be reexamined. Extending vaccination to all young children, to additional high-risk groups, and to pregnant women has potential to reduce the impact of influenza on children.

Comparison of the Denka-Seiken INFLU A.B-Quick and BD Directigen Flu A+B kits with direct fluorescent-antibody staining and shell vial culture methods for rapid detection of influenza viruses.

The INFLU A.B-Quick and Directigen Flu A+B enzyme immunoassays were compared with direct immunofluorescence and cell culture for detection of influenza A and B viruses in a total of 255 patient specimens. Both assays identified 23 of 42 influenza A viruses (sensitivity, 54.8%; specificity, 100%; positive predictive value [PPV], 100%; negative predictive value [NPV], 91.8%). The INFLU A.B-Quick assay identified 10 of 16 influenza B viruses (sensitivity, 62.5%; specificity, 99.6%; PPV, 90.9%; NPV, 97.5%), and the Directigen Flu A+B assay detected 9 of 16 influenza B viruses (sensitivity, 56.3%; specificity, 99.6%; PPV, 90%; NPV, 97.1%).

Regulatory T cells overexpress a subset of Th2 gene transcripts.

There is now compelling evidence for subpopulations of CD4+ T cells whose role is to prevent immune pathology in both autoimmunity and transplantation. We have cloned CD4+ T cells against a male transplantation Ag that, unlike Th1 or Th2 clones, suppresses the rejection of male skin grafts and are therefore considered examples of regulatory T cells. We have identified, using serial analysis of gene expression, transcripts that are overexpressed in regulatory T cells compared with Th1 and Th2 clones. Some of these transcripts are increased in tolerated rather than rejecting skin grafts and in addition are expressed by the natural regulatory CD4+CD25+ subpopulation of naive mice. These genes include prepro-enkephalin, GM2 ganglioside activator protein, glucocorticoid-induced TNFR superfamily member 18, and integrin alpha(E)beta(7). They seem to represent a subset of transcripts shared with Th2 cells, suggesting that transplantation tolerance and normal immunoregulation may represent a unique form of Th2-like differentiation.

Cuantificacion de poblaciones linfocitarias CD16+ y CD56+ en las diferentes etapas de la infeccion por el virus de Inmunodeficiencia Humana / Quantification of linfocitarias populations CD16+ y CD56+ in the different stages from the infection by the virus Human Immunodeficiency

El VIH=SIDA es un importante problema de Salud Publica por la cantidad de personas que han fallecido por esta causa en todoel mundo 40 millones de infectados hasta fines del año 2001(11). Uno de los propocitos mas importantes de la investigacion medica, es sin duda conocer los transtornos que subyacen detras dela clinica de la infeccion por el virus de la inmunodeficiencia humana que posee una serie de peciulariedades, algunas conocidas y otras por descubrir> Hasta el momento no se ha podido encontrar un tratamiento eficaz y son los estudios actuales en este campo que tratan de encontrarlo. PREGUNTA DE INVESTIGACION: Cual es el comportamiento cuantitativo de las poblaciones linfositarias CD16+ y CD56+ en pacientes VIH(+) durante la evolucion dela infeccion?

Comparison of gingival and peripheral blood T cells among patients with periodontitis suggests skewing of the gingival T cell antigen receptor V beta repertoire.

The present study investigated the expression of different variable regions of T cell receptor beta-chain (V beta) among functional subsets of T cells, i.e. CD45RO+ (activated/memory), CD4+ and CD8+ in gingiva and peripheral blood of patients with periodontitis. Gingival tissue specimens (n = 25) and peripheral blood were procured from 18 patients with periodontitis during periodontal surgery or extraction. Single-cell suspensions of gingival tissues were made by enzymatic digestion. These cells were immunofluorescently labeled with a panel of monoclonal antibodies specific for 18 TCR V beta regions, in concert with markers for various T cell subsets. The cells were then analyzed with 3-color multivariate flow cytometry. Results demonstrated that a significantly higher proportion of T cells in gingiva expressed V beta 5.2 (0.0005), V beta 6 (0.0007) and V beta 9 (0.003) regions compared to those in peripheral blood. Comparison of CD45RO+ (activated/memory) and CD45RO- (naïve) subsets of gingival T cells revealed differences in the expression of TCR V beta regions. V beta 5.2 expression was significantly higher among CD45RO+ gingival T cells (p = 0.004), whereas V beta 14 expression was elevated among the CD45RO- subset relative to peripheral blood (p = 0.008). Analysis of TCR V beta region expression among CD4+ and CD8+ subsets did not reveal any statistically significant differences between gingiva and peripheral blood, although some V beta regions approached significance. Collectively, these results demonstrate that the T cell repertoire in the gingival compartment differs significantly from that in the peripheral blood. Furthermore, since the skewing of TCR V beta was observed among naïve, as well as activated/memory T cells, it is likely that both developmental and environmental factors are influential in shaping the gingival TCR repertoire in patients with periodontitis. Elucidation of the cause of the skewed expression of T cell receptors in gingiva can provide insights into the specificity of T cells in periodontitis.

[The correlation between the study data on the Papanicolaou cytological smear and the data on direct immunofluorescence for C. trachomatis]. / Korelatsiia mezhdu dannite ot izsledvaneto na tsitonamazkata po Papanicolaou i dannite ot direktnata imunoflurestsentsiia za C. trachomatis.

A study was carried out to examine the relationship between the clinical data, the data from the Papanicolaou smear and the direct immunofluorescence for C. trachomatis in 70 women with infectious cervicitis. The prevalence of Chlamydial infection in the study population was 27%. The study showed that one third of the women in whom the Papanicolaou smear revealed inflammatory changes might be expected to be infected with C. trachomatis. The probability of not having infection when no inflammatory changes were observed in the Papanicolaou smear was 0.74--negative predictive value which means that more than two thirds of the women without inflammatory changes in cytology smear will not be infected with C. trachomatis.

Influence of endocervical specimen adequacy on PCR and direct fluorescent-antibody staining for detection of Chlamydia trachomatis infections.

The cellular quality of the endocervical swab specimen used for the detection of Chlamydia trachomatis may dramatically impact the sensitivity of the diagnostic assay used. An evaluation of the adequacy of 319 endocervical swab specimens from women attending two inner-city sexually transmitted disease and family planning clinics, as well as five high school-based family planning clinics, was performed, and the resulting data were compared with the diagnostic results obtained by both Amplicor PCR and Microtrak direct fluorescent-antibody (DFA) staining. The swab from each patient was rolled across the open circular area of a DFA slide and then used to inoculate a transport tube for PCR (Roche), after which the swab was discarded. The slides were stained and examined by epifluorescence microscopy for the presence of C. trachomatis elementary bodies and for the presence and number of cell types to determine specimen adequacy. Cellular adequacy for a cervical swab specimen was defined as the presence of one or more columnar epithelial or metaplastic epithelial cells or the presence of more than 100 erythrocytes per high-power microscopic field. Of the 319 specimens read by DFA, 204 (63.9%) were determined to be adequate. There were 34 (10.7%) positive specimens by DFA and/or PCR. Twenty-nine (9.1%) specimens were positive by PCR, 20 (6.3%) specimens were DFA positive, and 15 (4.7%) were concordantly positive by both tests. The prevalence of chlamydia among adequate specimens was 14.2% (29/204), compared to 4.3% (5/115) for inadequate specimens (P < 0.0001). Variations in specimen quality and the sensitivity of the diagnostic assay used have a significant impact on determining the prevalence of C. trachomatis in a population.

Quantitation of surface CD14 on human monocytes and neutrophils.

The absolute number of membrane-expressed CD14, the most important endotoxin receptor, on human monocytes and neutrophils shows remarkable variation in the literature. To quantify these numbers two fluorescence methods using fluorescein isothiocyanate (FITC)-labeled monoclonal antibodies (mAb) were applied. A commercially available set of standard beads was used in flow cytometry to quantitate CD14 with eight different mAbs. Independent from their isotype the various mAbs showed minor differences and indicated that peripheral blood monocytes expressed 99,500-134,600 (115,400 +/- 10,600) and neutrophils 1,900-4,400 (3,300 +/- 800) CD14 receptors. There was no significant difference in CD14 expression on leukocytes in unprocessed freshly obtained whole blood and after a Ficoll isolation procedure. However, a short temperature shift resulted in a 1.3- to 1.6-fold up-regulation of CD14. The results obtained with the reference beads were verified with fluorescence Scatchard analysis and spectrofluorometry using mAb 26ic-FITC and showed 109,500 CD14 per monocyte and 6,700 CD14 per neutrophil. For comparison the number of CD14 on the monocytic THP-1 cells and Fc gamma-receptors on human leukocytes were determined using the reference beads and flow cytometry and gave results comparable to published data. Our data indicate that resting human monocytes express roughly 110,000 CD14 molecules on their surface using a simple fluorometric assay. Correct determination of the number of CD14 and other cell surface receptors is of importance in the monitoring of septic patients.

Soroprevalência da infecçäo pelo vírus herpes humano 6 em Pernambuco / Seroprevalence of human herpes virus 6 infection in Pernambuco

A seroprevalência da infecçäo pelo vírus herpes humano 6(VHH-6) foi investigada em 526 brasileiros e 250 japoneses e descendentes residentes no Recife e regiöes vizinhas no Nordeste do brasil. Um total de 776 soros de indivíduos foram examinados para pesquisa de anticorpos IgG pela técnica de imunofluorescência anti-complemento. O percentual de soropositividade entre os dois grupos foi muito próximo: 73,3por cento para os brasileiros oriundos da regiäo e 77,2 por cento para os de ascendência Japonesa. Nas duas populaçöes estudadas as mulheres mostraram índices de positividade discretamente mais altos que os homens. Estes índices foram significativamente mais altos em indivíduos considerados de nível sócio econômico mais baixo. A alta prevalência de anticorpos anti-VHH-6 entre crianças indica que a infecçäo por este vírus ocorre muito cedo nesta regiäo. Análise comparativa mostra näo haver associaçäo entre infecçäo pelo citomegavirus (CMV) e VHH-6