Lyme borreliosis is the most prevalent tick-borne zoonosis and an important emerging infection in Europe, North America, and Far Eastern countries. The geographical distribution of Borrelia spp. and the relationship between Borrelia spp. and tick spp. in East Asian countries have been studied. In Northern Asian countries, Ixodes persulcatus carries Eurasian-type Borrelia garinii (20047 type), Borrelia afzelii, and Asian-type B. garinii (variant NT29), whereas Borrelia burgdorferi sensu stricto has not been isolated. In contrast, Asian-type B. garinii has not been found in the European vector tick Ixodes ricinus. These Borrelia spp. cause Lyme borreliosis in their respective countries. The specificity between Borrelia spp. and tick spp. has been confirmed from studies in the Moscow region, which is a sympatric region for the tick spp. I. persulcatus and I. ricinus. In Southeast Asian countries including the southernmost island of Okinawa, the Borrelia valaisiana-related genomic group is carried by Ixodes granulatus. In Japan, a similar borrelia strain Am501, is transmitted by Ixodes columnae. Ixodes ovatus transmits Borrelia japonica but not other species. On other hand, in central China and Nepal, the ticks harbor Borrelia sinica. It is believed that these molecular epidemiological surveys will provide useful information for the diagnoses and prevention of Lyme borreliosis in these countries.

The respiratory tract mucosa is not only the site of infection for influenza viruses but also the site of defense against virus infection. Viruses are initially detected and destroyed non-specifically by innate immune mechanisms, but if the viruses escape the early defense mechanisms, they are detected and eliminated specifically by adaptive immune mechanisms. The major adaptive immune mechanisms are as follows. (i) Specific secretory-IgA (S-IgA) antibodies (Abs) and CTLs (CD8⁺ cytotoxic T lymphocytes) are involved in the recovery from influenza following viral infection of naïve mice. (ii) Preexisting specific S-IgA and IgG Abs in the immunized animals are involved in viral elimination by forming virus–Ig complexes shortly after re-infection. By their polymeric nature, the S-IgA Abs, which are carried to the mucus by transepithelial transport used for dimeric IgA (dIgA) Abs, provide not only protection against homologous virus infection but also cross-protection against drift virus infection. The IgG Abs, which transude from the serum to the mucus by diffusion, provide protection against homologous virus infection. They are largely distributed on the alveolar epithelia to prevent influenza pneumonia. (iii) In the absence of Abs in the pre-immunized animals, the production of specific IgA and IgG Abs by B memory cells is accelerated after re-infection, and these antibodies play a role in viral elimination from day 3 onwards after re-infection. (iv) In epithelial cells of infected animals, specific dIgA Abs being trafficked through the epithelial cells may be involved in the prevention of viral assembly by binding to newly synthesized viral proteins. (v) In the pre-immunized animals, CTL production by memory T cells is also accelerated and these cells appear to participate in the killing of the host cells infected with different subtype viruses (within the same type) from day 3 onwards after re-infection. (vi) Similarly, memory Th1 cells that mediate an accelerated delayed-type hypersensitivity response are involved in blockade of virus replication by secreting IFN-γ in mice challenged with different subtype viruses. These defense mechanisms suggest that the development of a mucosal vaccine, capable of inducing S-IgA Abs, which provide cross-protection against variant viruses within the same subtype, serum IgG Abs to prevent lethal influenza pneumonia and CTLs, which provide broad cross-protection against different subtype viruses, is strategically important to control influenza.

A mini epidemic of Dipodascus capitatus (teleomorph of Geotrichum capitatum) involving three cases is reported. The index case was pulmonary infection and a fulminant course of fungal infection, which resulted in the patient’s death with acute myelocytic leukemia. In the other cases, the patients were simultaneously hospitalized, the first in the intensive care unit. In all cases, D. capitatus was identified in different samples (sputum, deep tracheal aspiration, blood, and urine) from each of the patients. Growing evidence indicates that D. capitatus should be added to the lengthening list of opportunistic fungal pathogens that can cause infection in people of all ages and particularly in those who are immunocompromised. Further, the danger of cross-contamination and potential “outbreak” should be kept in mind during hospital management.

Five hundred and seventeen women attending the gynecology and obstetrics clinics of the Korle-Bu Teaching Hospital were examined for sexually transmitted infections (STIs). Vaginal swabs were examined for Trichomonas vaginalis, Candida albicans, and Gardnerella vaginalis infection. Endocervical swabs were examined for Neisseria gonorrhoea and Chlamydia trachomatis using a recently developed RNA detection kit. Strain typing was performed to identify serovars of C. trachomatis. Sera were analyzed for Treponema pallidum with a passive-particle agglutination assay kit. The prevalence of infection with N. gonorrhoea was 0.6%, C. trachomatis 3.0%, and T. pallidum 5.6%. Eight samples were PCR-positive for C. trachomatis. Five of these were serovar G, and the rest were serovar E. All cases of mixed infections occurred in pregnant women. In conclusion, a high transmissible risk of T. pallidum infection was observed among our study population and in particular among our pregnant women. The absence of association between the presenting symptoms, clinical findings, and specific pathogens has implications for the syndromic approach to STI case management. The low prevalence of C. trachomatis and N. gonorrhoea may be due to self medication and requires further research in primary health institutions in rural areas to compare rates.

Curtailing the observation of mice challenged with tetanus toxin in potency test of tetanus vaccine would reduce the agony of mice from spastic paralysis. From the viewpoint of animal welfare, we investigated the feasibility of this measure. The potencies of 85 lots of vaccine obtained on the 4th day after challenge were compared with those obtained on the 7th day. No significant difference was found (P = 0.05), indicating that the observation period could be curtailed from 7 days to 4 days without impairing the assessment of the vaccine’s potency.

In order to assess the safety and efficacy of once-weekly fluconazole orally (100, 150, or 300 mg) with once-a-day topical application of 1% ketoconazole cream in the treatment of onychomycosis in Japan, 121 patients were assigned to one of three fluconazole dosages (100, 150, or 300 mg) and took fluconazole orally, once weekly, for 12 months or until a complete cure was achieved. In addition, once-a-day topical ketoconazole cream was applied. At each weekly visit, adverse events were investigated and the length of the diseased nails was measured. Treatment efficacy was assessed 12 months after discontinuation of fluconazole using the following scale: cured, markedly improved, improved, slightly improved, no change. Mycological cure was assessed using KOH wet mount and fungus culture. The results showed that the numbers of patients achieving marked improvement or better were 38/68 (55%), 13/22 (60%), and 21/31 (67%) for the 100 mg, 150 mg, and 300 mg groups, respectively. There was no significant difference between any two groups. The duration of fluconazole therapy was the longest for patients in the 100 mg group. None of the patients reported adverse effects. These findings led to the conclusion that once-weekly fluconazole with once-a-day application of topical ketoconazole cream appears safe and effective for treating onychomycosis. The dosage of 150 mg once weekly for 6 months was recommended, considering both effectiveness and economy.

The prevalence of HIV has been continually increasing both in urban and rural Ethiopia. As yet, there has been no report on the magnitude of the problem in the elderly and rural population. This study assessed the seroprevalence of HIV and syphilis infection among 706 elderly and predominantly rural subjects in Northwest Ethiopia. Socio-demographic information was collected using a structured questionnaire. Venous blood was collected and the serostatus of HIV and that of syphilis were checked by ELISA and RPR, respectively. The total HIV-1 seroprevalence was 5% (35/706). Sex-specific prevalences of HIV for males and females were 5.6 and 4.7% respectively. A 4.2% difference in prevalence was observed by area of residence, which was statistically significant, P = 0.018. Only 6% of subjects positive for syphilis were also positive for HIV, while 4.9% of subjects negative for syphilis were positive for HIV. The data indicates that the prevalence of HIV among elderly people in Northwest Ethiopia was high. This indicates the importance of involving the elderly in HIV/AIDS prevention and control programs.

Parasites are important enteric pathogens among patients with human immunodeficiency virus (HIV) infection. There have been very few reports on the prevalence of intestinal parasites among such patients in Iran. To determine the prevalence of intestinal parasites among HIV-positive individuals, we collected single stool samples and analyzed them for detection of various intestinal parasites from 206 HIV-positive individuals with different immune status visited in different medical centers in Iran. The data were tested for statistical significance with χ² and Mann-Whitney U tests. The overall prevalence of intestinal parasites was 18.4% (95%CI: 13.7, 24.3). More specifically, the following parasites were identified: Giardia lamblia (7.3%), Blastocystis hominis (4.4%), Entamoeba coli (3.9%), and Cryptosporidium parvum (1.5%). Other parasites observed included Strongyloides stercoralis and Hymenolepis nana in two cases and Dicrocoelium dendriticum in one. Of the 38 patients who tested positive for intestinal parasites, 15 (39.2%) had diarrhea. Intestinal parasites were significantly more common among patients with diarrhea than those without (P < 0.001). Further, CD4 counts were significantly lower among individuals with diarrhea than those without (P < 0.001). This study highlights the importance of testing for intestinal parasites among Iranian HIV-positive patients, especially those with low immunity presenting with diarrhea.

A prospective study was conducted to investigate the rate of group A streptococci (GAS) carriers and associated anti-streptolysin O (ASO) titers in serum samples in asymptomatic school children in spring in Duzce, Turkey. Pharyngeal swabs were obtained to detect the presence of GAS and blood samples were collected to determine elevated ASO titers in serum. A total of 351 asymptomatic primary school children were included in the study, and 91 (25.9%) of these were found to be GAS carriers. Of the 91 carrier students, ASO titers were elevated (≥200 IU/ml) in 34 students (37%). Of the 260 non-carrier children, ASO titers were found as elevated (≥200 IU/ml) only in 27 (10.3%) students. The difference between the ASO-positivity rate of the GAS carrier group (34 in 91 students) and that of the non-carrier group (27 in 260 students) was found to be statistically significant (P < 0.05). The finding of a significant relationship between ASO positivity and GAS carriage indicated that ASO measurement might be used together with thorat culture to identify GAS carriers.

A retrospective study of bacterial isolates from cases of neonatal septicemia was undertaken over a period of 5 years (July 1998 - June 2003) at the Government Medical College Hospital, Chandigarh, India. The study was carried out to determine the bacterial profile, the antimicrobial susceptibility of the isolates, and the change in trends over the study period. A total of 3,064 blood samples for blood culture were obtained, out of which 588 were positive for bacterial isolates. Most of the cases detected by blood culture occurred in the first week of life (64.4%). Gram-negative bacilli (58.5%) predominated over Gram-positive cocci (41.5%). Staphylococcus aureus was found to be the most common isolate (35.0%).The incidence of Gram-positive and Gram-negative organisms changed little over the 5 year span. However, a constant and significant rise in the incidence of Acinetobacter spp. was observed between the first to fifth year of the study period. Amikacin was found to be the most effective drug against Gram-negative bacteria. For S. aureus and Pseudomonas aeruginosa, overall resistance percentages of 5 years show that netilmicin and ciprofloxacin, respectively, were the most effective drugs.

Stool specimens collected between November 2002 and April 2003 from hospitalized infants with acute gastroenteritis from four distinct geographical regions in Thailand were examined for norovirus (NoV) and sapovirus (SaV) by reverse transcription-PCR and sequence analysis. Of the 80 specimens examined, we identified 11 NoV and 9 SaV single infections, and 3 NoV/ SaV mixed infections. The majority of NoV strains (64%) belonged to genogroup II/genotype 4 (GII/4; Lordsdale cluster). Other NoV strains co-circulating belonged to GII/1, GII/3, GII/6, and one new genotype cluster (GII/New). The majority of SaV strains (83%) were from the Manchester cluster. One isolated SaV strain represented a recently discovered novel genogroup within the SaV genus (SG-V), and another isolated SaV strain represented a novel SaV genogroup II cluster.

The presence of Candida spp. in the oral cavity was evaluated in 95 cancer patients (57 in-patients and 38 out-patients) and in 65 healthcare workers in Amman, Jordan. Candida carriage occurred in 72.6% of cancer patients and 33.8% of healthcare workers, with Candida albicans being the species most commonly recovered, followed by C. glabrata. In-patients were found to harbor Candida spp. at significantly higher levels than out-patients (P = 0.0044). The number of adhered C. albicans cells and the secretion of extracellular proteinase was significantly higher in the in-patient group than in the out-patient group (P = 0.0016 and 0.00007, respectively); this significant difference was not observed regarding phospholipase secretion. Antifungal sensitivity testing data suggest that isolates were most sensitive to amphotericin B and nystatin, and least sensitive to miconazole and fluconazole, which are commonly used antifungal agents in Jordan.