[Toxoplasma gondii infection in pregnant women]. / Infekcije toksoplazmom gondii kod gravidnih zena.

INTRODUCTION: The aim of this study was to determine the percentage of seropositive pregnant women, i.e. of pregnant women infected with Toxoplasma gondii in order to provide an insight into the risk of developing congenital toxoplasmosis in our community. MATERIAL AND METHODS: In the period of two years, 662 pregnant women from Vojvodina were examined serologically. The enzyme-linked immunosorbent assay tests were performed to determine IgM and IgG antibodies against Toxoplasma gondii and the complement fixation test was done to detect total antibodies against Toxoplasma gondii. RESULTS AND DISCUSSION: Seropositivity was determined in 180 pregnant women (27.19%). Of 135 pregnant women examined in the routine control in pregnancy, 16.30% were seropositive and out of five proven, completely new Toxoplasma gondii intfections, three were detected in pregnant women who had undergone the routine check-up for no specific symptoms. A detailed analysis of the frequency of seropositive findings in relation to clinical diagnoses and the place of residence of pregnant women (urban and rural areas) was performed. At the same time, the results from the serological reactions were presented, commented and interpreted, and recommendations were given for the implementation of additional examinations (eg, IgG antibody avidity test) in order to make the accurate diagnosis. CONCLUSION: It can be concluded that the occurrence of congenital toxoplasmosis is still a problem in our community and that the best prevention is the prompt and adequate examination of pregnant women for the presence of Toxoplasma gondii infection.

Detection of enteroviruses in clinical samples of patients with aseptic meningitis by rapid antigen detection assay.

INTRODUCTION: Human enteroviruses represent the most common etiological agents of aseptic meningitis. Rapid diagnosis of aseptic meningitis affects the management of patients. OBJECTIVE: The aim of this work was to assess the efficacy of rapid antigen detection (RAD) assay for the confirmation of human enteroviruses in comparison to that of the conventional cell culture (CCC), and to identify the serotypes associated with aseptic meningitis cases in the Autonomous Province of Vojvodina. METHODS: RAD assay was carried out using centrifugation of inoculated Vero, RD and HEp-2 cell cultures and indirect immunofluorescence with Pan-Enterovirus 2E11 reagent (Millipore-Chemicon). CCC was performed using the same type of cells and the same immunofluorescence reagent for enterovirus confirmation. RESULTS: Out of 70 analyzed samples (29 cerebrospinal fluid specimens, 27 stool specimens, 9 rectal and 5 throat swabs), 36 (51.4%) were positive by immunofluorescence after CCC and 34 (48.6%) by the RAD assay. The sensitivity of RAD assay was 94.4% and specificity 100%. Detection time of enteroviruses by the RAD assay was 3 days, and by CCC varied from 3 to 13 days (mean time 6.1 days). Within 72 h from inoculation, a cytopathic effect (CPE) occurred in only 19 (47.5%) of 40 CPE positive samples. Serotyping revealed 11 types of enteroviruses: coxsackievirus A16, B3, B4, B5, and echovirus 2, 4, 6, 11, 13, 16 and 30. CONCLUSION: The RAD assay was slightly less sensitive than CCC and significantly shortened the detection time of enteroviruses, so it may be useful in rapid diagnosis of enteroviral meningitis.

[Chlamydia trachomatis in women].

The authors present results of a planned prospective study of infections with Chlamydia trachomatis in women. Direct immunofluorescence test (DIF) for proving Chlamydia trachomatis antigens in endocervical smear (by means of monoclonal antibodies), ELISA test for proving IgG antibodies against Chlamydia trachomatis in sera and RVK method for proving antibodies against group Chlamydia-antigen were applied to test 288 women (aged 19-67), previously thoroughly anamnestically and clinically examined Chlamydia trachomatis infection was found in 29.51% of the cases, equally distributed in all age groups. The authors analyzed frequency of Chlamydia positive findings according to clinical diagnoses, parity, relevant data from gynecological history, as well as results of vaginal secretion tests and Papanicolaou smear findings.

[Up-to-date knowledge of West Nile virus infection].

VIRUS: West Nile virus is a single-stranded RNA virus of the family Flaviviridae, genus Flavivirus. EPIDEMIOLOGY: West Nile virus is maintained in the cycle involving culicine mosquitoes and birds. Humans typically acquire West Nile infection through a bite from infected adult mosquito. Person to person transmission can occur through organ transplantation, blood and blood product transfusions, transplacentally and via breast milk. Human cases of West Nile infections were recorded in Africa, Israel, Russia, India, Pakistan. In Romania in 1996 West Nile fever occurred with hundreds of neurologic cases and 17 fatalities. First human cases in the United States were in New York City where 59 persons were infected and had fever, meningitis, encephalitis and flaccid paralysis. CLINICAL MANIFESTATION: Most human cases are asymptomatic. The majority of symptomatic patients have a self limited febrile illness. Fatigue, nausea, vomiting, eye pain, headache, myalgias, artralgias, lymphadenopathy and rash are common complaints. Less than 1% of all infected persons develop more severe neurologic illness including meningitis, encefalitis and flaccid paralysis. LABORATORY DIAGNOSIS: Diagnosis of West Nile virus infection is based on serologic testing, isolation of virus from patient samples and detection of viral antigen or viral genom. ELISA test and indirect immunofluorescence assay are used for detecting IgM and IgG antibodies in serum and cerebrospinal fluid. TREATMENT: In vitro studies have suggested that ribavirin and interferon alfa-2b may be useful in the treatment of West Nile virus disease. PREVENTION: The most important measures are mosquito control program and personal protective measures.

[Virusology at the begining of the XXI century].

Viral injections are the most common human diseases (especiaily acute respiratory infections, mostly in children and young adults). The current studies show that viral infections can cause not only acute, but persistent viral diseases as well. A certain number of viruses are able to incorporate their nucleic acid into the genome of the host-cell, leading to rearrangement of the cell genes and formation of malignant tumors. Viral persistence can cause manifiestations of latent or chronic infections, as well as prion-caused slow infections of the central nervous system. Defective Di particles play an important role in maintaining viral persistence. Viruses are important agents involved in various disorders of the immunological homeostasis of the organism. Newly-found viruses represent a special problem.

[Virology today and tomorrow].

Virus infections are the most common human diseases, particularly acute respiratory infections (mostly in children and young adults). Virus infections of the upper respiratory tract in children are proved in 77.4%, viral bronchitis in 58.6%, viral pneumonia in 47.6% and febrile conditions with lymphadenopathy in 44.1% patients. Current studies show that virus infections can cause not only acute, but also persistent virus diseases. A certain number of viruses are able to incorporate their nucleic acid into the genome of the host-cell, leading to rearrangement of the cell genes and formation of malignant tumors. In women with cervical changes, by application of hybridization technique in situ, the most frequently identified virus genotypes are human papilloma viruses 16 and 18 (in 21.67%), genotypes 6 and 11 in 8.33% and genotypes 31, 33 and 35 in 3.33% examined women. Viral persistence can cause manifestations of latent or chronic infections, as well as prion-caused slow infections of the central nervous system. Defective particles play an important role in maintaining viral persistence. Viruses are important agents involved in various disorders of the immunological homeostasis of the organism. Recent knowledge described in SARS infected patients indicates that induction of the so-called TH2 cytokine profile can be responsible for death of infected patients.

Significance of screening tests in diagnosis of infectious mononucleosis.

The investigation included 91 patients in who an acute or previous EBV infection was established by ELISA test. All patients were also subjected to the Paul-Bunnell-Davidsohn test, while 20 patients were tested by the rapid screening test Clearview IM. The diagnosis of acute infective mononucleosis was in 61 patients (67%) confirmed by the Elisa test, and in 12 patients (19.67%) by the Paul-Bunnell-Davidsohn test, while the rapid screening test Clearview IM demonstrated too low a detection of heterophile antibodies. The rapid screening test was not reliable. In 25% cases, the test was invalid, at early infection stages the rapid test failed to diagnose any case of the EBV virus infection. Paul-Bunell-Davidsohn was often negative, especially with young children. Therefore, priority should be given to virology tests based on the detection of specific antibodies to EBV antigen.

[The frequency of human parvovirus B19 infections in Vojvodina].

INTRODUCTION: Human parvovirus B19 is found worldwide. It causes various infections, including fifth disease (erythema infectiosum) in small children, acute arthropathy in adults, transient aplastic crisis and chronic anemia in immunocompromised patients and even fetal infection, which may result in intrauterine fetal death or fetal hydrops. Many of these manifestations of B19 infection are caused by infection of erythroid precursor cells in bone marrow. MATERIAL AND METHODS: The aim of this paper was to establish the frequency of parvovirus B19 infection in the population of Vojvodina, as well as to indicate the significance of further investigations particularly in highly vulnerable population groups such as small children, pregnant women and immune deficient persons. A total of 244 serum samples of out- and in-patients of different age were analyzed using SERION ELISA classic parvovirus B19 IgG/IgM quantitative and qualitative tests for identification of specific antibodies against human parvovirus B19. RESULTS: Acute infection was found in 35% of examinees, whereas parvoviurs B19 was identified in 32% of examined persons. Our tests results proved that 20% of examined pregnant women in our surroundings have acute HPB19 infection. At the same time, 45% of pregnant women have no specific antibodies, so they are at risk of infection during pregnancy. Acute infection was diagnosed in 41 children (43%): 22 samples (23%) were positive only to IgG antibodies and in 32 samples (34%) neither IgM nor IgG antibodies were identified. Acute infection was more frequently found in preschool children, i.e. in children aged 4 to 6 years (29%). CONCLUSION: In the absence of complete data on the frequency of particular diseases caused by this virus in our population, tests for human parvovirus B19 are strongly recommended.

[Avian influenza viruses--new causative agents of human infections].

INTRODUCTION: Influenza A viruses can infect humans, some mammals and especially birds. Subtypes of human influenza A viruses: A(H1N1), A(H2N2) and A(H3N2) have caused pandemics. Avian influenza viruses vary owing to their 15 hemagglutinins (H) and 9 neuraminidases (N). HUMAN CASES OF AVIAN INFLUENZA A: In the Netherlands in 2003, there were 83 human cases of influenza A (H7N7). In 1997, 18 cases of H5N1 influenza A, of whom 6 died, were found among residents of Hong Kong. In 2004, 34 human cases (23 deaths) were reported in Viet Nam and Thailand. H5N1 virus-infected patients presented with fever and respiratory symptoms. Complications included respiratory distress syndrome, renal failure, liver dysfunction and hematologic disorders. Since 1999, 7 cases of human influenza H9N2 infection have been identified in China and Hong Kong. THE IMPORTANCE OF HUMAN INFECTION WITH AVIAN INFLUENZA VIRUSES: H5N1 virus can directly infect humans. Genetic reassortment of human and avian influenza viruses may occur in humans co-infected with current human A(H1N1) or A(H3N2) subtypes and avian influenza viruses. The result would be a new influenza virus with pandemic potential. All genes of H5N1 viruses isolated from humans are of avian origin. PREVENTION AND CONTROL: The reassortant virus containing H and N from avian and the remaining proteins from human influenza viruses will probably be used as a vaccine strain. The most important control measures are rapid destruction of all infected or exposed birds and rigorous disinfection of farms. Individuals exposed to suspected animals should receive prophylactic treatment with antivirals and annual vaccination.