Novel Human Bufavirus Genotype 3 in Children with Severe Diarrhea,Bhutan

We identified a new genotype of bufavirus, BuV3, in fecal samples (0.8%) collected to determine the etiology of diarrhea in children in Bhutan. Norovirus GII.6 was detected in 1 sample; no other viral diarrheal pathogens were detected, suggesting BuV3 as a cause of diarrhea. This study investigates genetic diversity of circulating BuVs.In 2012, a novel parvovirus, bufavirus (BuV), was discovered in fecal samples of children with diarrhea in Burkina Faso (1). The virus belongs to the species primate protoparvovirus 1 of the genus Protoparvovirus (2). BuV has a single-stranded DNA genome and encodes nonstructural protein 1 (NS1) and viral structural proteins 1 and 2 (VP1 and VP2). Two genotypes, BuV1 and BuV2, have been described; the highly diverse capsid gene indicates the possibility of further genotypes of this virus (1).One research group, which used PCR to test fecal samples collected in 3 countries, had previously found various proportions of specimens positive for BuV: 4 of 98 (4%) in Burkina Faso, 1 of 63 (1.6%) in Tunisia, and none of 100 in Chile (1). Fecal samples from Tunisia were from children with acute flaccid paralysis; samples from Burkina Faso and Chile were from children with diarrhea. It is not known whether BuV is pathogenic in humans.Bhutan is a small landlocked country between India and China; an estimated 23% of the people of Bhutan live below the poverty line (3). The population is mainly concentrated in the capital, Thimphu (altitude 2,248–2,648 m), and is otherwise sparsely distributed throughout the country. Diarrhea is a major cause of illness and death among children in Bhutan. Irrespective of severity, hospitalization, or causative agents, the annual morbidity rate for children <5 years of age with diarrhea is 168.8/1,000 (17%) (4); however, the etiology of diarrhea in this country has not been studied in detail. We conducted this study to investigate the genetic diversity of circulating BuVs and to clarify the public health significance of BuV in Bhutan.     

Reappearance of Chikungunya,Formerly Called Dengue,in the Americas

After an absence of ≈200 years, chikungunya returned to the American tropics in 2013. The virus is maintained in a complex African zoonotic cycle but escapes into an urban cycle at 40- to 50-year intervals, causing global pandemics. In 1823, classical chikungunya, a viral exanthem in humans, occurred on Zanzibar, and in 1827, it arrived in the Caribbean and spread to North and South America. In Zanzibar, the disease was known as kidenga pepo, Swahili for a sudden cramp-like seizure caused by an evil spirit; in Cuba, it was known as dengue, a Spanish homonym of denga. During the eighteenth century, dengue (present-day chikungunya) was distinguished from breakbone fever (present-day dengue), another febrile exanthem. In the twentieth century, experiments resulted in the recovery and naming of present-day dengue viruses. In 1952, chikungunya virus was recovered during an outbreak in Tanzania, but by then, the virus had lost its original name to present-day dengue viruses.     

Ixodid and argasid tick species and west nile virus

Control of West Nile virus (WNV) can only be effective if the vectors and reservoirs of the virus are identified and controlled. Although mosquitoes are the primary vectors, WNV has repeatedly been isolated from ticks. Therefore, tick-borne transmission studies were performed with an ixodid (Ixodes ricinus) and an argasid tick species (Ornithodoros moubata). Both species became infected after feeding upon viremic hosts, but I. ricinus ticks were unable to maintain the virus. In contrast, O. moubata ticks were infected for at least 132 days, and the infection was maintained through molting and a second bloodmeal. Infected O. moubata ticks transmitted the virus to rodent hosts, albeit at a low level. Moreover, the virus was nonsystemically transmitted between infected and uninfected O. moubata ticks co-fed upon uninfected hosts. Although ticks are unlikely to play a major role in WNV transmission, our findings suggest that some species have the potential to act as reservoirs for the virus.     

Moving Beyond Biomedicalization in the HIV Response: Implications for Community Involvement and Community Leadership Among Men Who Have Sex with Men and Transgender People

As the world enjoys the promise of biomedical advances against HIV, numerous challenges remain. Some of these are connected to politics, others are connected to resource constraints. Other barriers are linked to the need to ensure that the concepts used to think about HIV remain current. Terms such as “MSM” (men who have sex with men) and “community” require critical interrogation at a moment when their political origins seem forgotten. Likewise, struggles between groups most affected by HIV and scientists and policymakers (an enduring feature of the epidemic) remain a key aspect of the response. The dangers of co-option and distraction remain real. In this context, it is vital to promote community ownership, political commitment, solidarity, and respect for differences, not as competing values, but as part of the ultimate solution to HIV.Anyone who has worked internationally on the HIV epidemic knows the importance of politics,1 and how the way in which the issues are framed influences the ability to address them effectively.2 It is of vital importance, therefore, to think critically about how best to describe the global HIV epidemic and the challenges it poses. It is also imperative that we think critically about the need for a major switch from the discourse of 3 to 4 years ago—from an earlier vision of “doom and gloom”—to a more optimistic outlook.It is also important to recall the lessons of history in relation to global health and development. We cannot help but remember the misplaced optimism in relation to the Declaration on Health for All by the Year 2000, adopted at the International Conference on Primary Health Care held in Alma-Ata, USSR, in 1978,3 and the World Declaration on Education for All that emerged from the 1990 World Conference on Education for All in Jomtien, Thailand.4 The world is still far away from both health for all and education for all.What then are we to make of the targets regularly announced by UNAIDS, such as “Getting to Zero” by 2015,5 “90-90-90” by 2020,6 and “the end of AIDS” by 2030?7 What are we to make of the promises of biomedical advances and the prospects of “an AIDS-free generation” we heard about at the 2012 Washington AIDS Conference8 and the 2014 Melbourne AIDS Conference,9 which is a promise that seems to provide the foundation for such optimistic target-setting? Increasingly, as we listen to these slogans, we cannot help but wonder if the time has not come for a little more realism as the world struggles to develop meaningful strategies to address the epidemic in the midst of its fourth decade.The grim reality is that in many contexts, rates of new infection among gay and other men who have sex with men (MSM), among transgender people, and among numerous other socially excluded groups, are not on a steady decline toward zero, but instead, these rates are rising rapidly.10,11 The same is true for the notion of zero discrimination. Particularly, in parts of Africa, in Russia, and in India, as well as in Central Asia, there is evidence of increasing hostility toward sexual and gender minorities and people living with HIV. This hostility is sometimes fueled by claims of the “unnaturalness” and “foreignness” of the behavior and is often encouraged by politicians and religious leaders.12,13 In some cases, a new wave of repressive laws amounts to nothing less than state-sponsored discrimination and should be understood as such.As for the notion of zero AIDS-related deaths, it is true there have been remarkable advances for those who have access to the most up-to-date medications and good quality health care. However, many people still lack complete access to these or are in receipt of outdated regimens with debilitating side effects. In addition, relatively few rich countries have followed the lead of the United Kingdom in making access to antiretroviral therapy nondependent on migration status. UNAIDS itself currently estimates that no fewer than 22 million people currently lack access to the treatment drugs they need, which is nearly twice as many as those who currently have access to treatment.14Therefore, even the most general overview of the global HIV epidemic in 2015 suggests that almost none of the various slogans and targets devised to inspire the global response come close to providing an accurate picture of the challenges that confront us. Instead of being provided with a realistic portrayal of the current situation, we are invited to enter into an Alice in Wonderland world in which most everything is the opposite of what it claims to be. Because of this, there is an urgent need to think critically and more realistically about the current status of the epidemic, and to seriously consider: where are we now, what have we learned, and what needs to be done?This is obviously a large and collective undertaking that must involve wide participation by researchers, policymakers, advocates, and others, and it is a task that goes far beyond the scope of 1 short article. However, it is a task that has to begin somewhere, and our goal is to make a modest contribution by focusing on the important challenges for community involvement and community leadership in responding to the epidemic in the 2 key populations we have worked with extensively since the earliest years of the epidemic: gay, bisexual, and other MSM; and transgender persons.In thinking about the challenges facing these communities, we focused on 3 different but related sets of issues: (1) the continuing importance of context (time and place really do matter when it comes to responding to HIV), (2) the limits of present terminologies and understandings (the social world is changing faster than the available terminology), and (3) the need to rethink the idea of “community” in certain respects, and to rediscover instead a challenging new politics of HIV.If we fail to address these important social and political concerns, no biomedical advances, no matter how remarkable, and no policy or program objectives, no matter how inspirational, can ever succeed in bringing about an end to AIDS, whether for these populations or any others.     

Production of a conjugate vaccine for Salmonella enterica serovar Typhi from Citrobacter Vi

A conjugate vaccine for Salmonella enterica serovar Typhi was produced by chemically linking Vi, purified from Citrobacter, to the non-toxic mutant diphtheria toxin CRM₁₉₇ via an adipic dihydrazide spacer using N-(3-Dimethylaminopropyl)-N′-ethylcarbodiimide coupling chemistry. The polysaccharide purification process was developed based on Vi precipitation from culture supernatant with cetyl trimethylammonium bromide (CTAB), solubilization of the CTA-polysaccharide salt with ethanol followed by exchange of the CTA⁺ counter ion with Na⁺. The purified Vi polysaccharide was fully O-acetylated and with high purity. The conjugation process was optimized to obtain a scalable process that has been used for GMP production at pilot scale of vaccine currently in clinical trials.     

Reemergence and Autochthonous Transmission of Dengue Virus,Eastern China, 2014

In 2014, 20 dengue cases were reported in the cities of Wenzhou (5 cases) and Wuhan (15 cases), China, where dengue has rarely been reported. Dengue virus 1 was detected in 4 patients. Although most of these cases were likely imported, epidemiologic analysis provided evidence for autochthonous transmission.     

Serological and blood culture investigations of Nepalese fever patients

Serological testing of paired (i.e. admission and convalescent) sera from 103 fever patients in Kathmandu, Nepal, was performed to estimate the prevalence rates of scrub typhus, murine typhus, Leptospira and dengue virus antibodies and to determine their role in the cause of active infections. Blood cultures from 15 patients grew Salmonella enterica serovar Typhi, 8 grew S. Paratyphi A and 6 grew other bacteria. Diagnostic antibody levels were detected against murine typhus (27/103; 26%), scrub typhus (23/103; 22%), Leptospira (10/103; 10%) and dengue virus (8/103; 8%). Nineteen patients (18%) had diagnostically raised antibodies to more than one infectious agent. Seven S. Typhi (7/15; 47%) and two S. Paratyphi A (2/8; 25%) patients had significant scrub typhus, murine typhus, Leptospira or dengue virus IgM antibody titres. This study confirms the presence of leptospiral, rickettsial and dengue infections in Kathmandu as well as evidence for mixed infections with S. Typhi and Orientia tsutsugamushi or Rickettsia typhi. These infections should be kept in mind when considering the differential diagnoses of fever and empirical treatment options in Nepal. Many patients demonstrated static IgM antibody results between paired serum collections, suggesting recent rather than acutely active infections.     

Dengue Virus Transmission by Blood Stem Cell Donor after Travel to Sri Lanka; Germany, 2013

Three days after donation of peripheral blood stem cells to a recipient with acute myeloblastic leukemia, dengue virus was detected in the donor, who had recently traveled to Sri Lanka. Transmission to the recipient, who died 9 days after transplant, was confirmed.     

Passatempo virus, a vaccinia virus strain, Brazil

Passatempo virus was isolated during a zoonotic outbreak. Biologic features and molecular characterization of hemagglutinin, thymidine kinase, and vaccinia growth factor genes suggested a vaccinia virus infection, which strengthens the idea of the reemergence and circulation of vaccinia virus in Brazil. Molecular polymorphisms indicated that Passatempo virus is a different isolate.     

High Seroprevalence of Toxoplasma gondii Antibody in HIV/AIDS Individuals from North of Iran

Background:

Toxoplasmosis in immunocompetent people is generally asymptomatic but in immunocompromised patients including HIV/AIDS, cancer patients, and organ transplant recipients, etc. it can lead to serious pathological problems. The objective of current study was to determine the seroprevalence of T. gondii IgG and IgM antibodies in HIV/AIDS patients using ELISA technique in Mazandaran Province, northern Iran.

Methods:

Overall, 82 serum samples (61 males and 21 females) were collected from HIV/AIDS patients in Mazandaran Provinces, in 2013. Sera were surveyed employing ELISA assay. Data were analyzed using Chi-Square or Fisher exact test. In addition, before sampling a questionnaire was filled out for each subject.

Results:

Overall seroprevalence of examined sera was 96.3% for IgG antibody but none of the sera shown IgM antibody against T. gondii. The seroprevalence of toxoplasmosis in males and females was 96.7% and 95.2%, respectively. An antibody titer of >1 IU/ml was considered as positive. Furthermore, none of the included variables statistically was significant.

Conclusions:

Seroprevalence of chronic (latent) toxoplasmosis in HIV/AIDS patients in Mazandaran Province is high compared to toxoplasmosis in general population. Consequently, the risk of acquiring Toxoplasma encephalitis in examined seropositive HIV/AIDS patients of Toxoplasma is high.     

Seroprevalence of Antibodies against Chikungunya,Dengue, and Rift Valley Fever Viruses after Febrile Illness Outbreak,Madagascar

In October 2009, two–3 months after an outbreak of a febrile disease with joint pain on the eastern coast of Madagascar, we assessed serologic markers for chikungunya virus (CHIKV), dengue virus (DENV), and Rift Valley fever virus (RVFV) in 1,244 pregnant women at 6 locations. In 2 eastern coast towns, IgG seroprevalence against CHIKV was 45% and 23%; IgM seroprevalence was 28% and 5%. IgG seroprevalence against DENV was 17% and 11%. No anti-DENV IgM was detected. At 4 locations, 450–1,300 m high, IgG seroprevalence against CHIKV was 0%–3%, suggesting CHIKV had not spread to higher inland-altitudes. Four women had IgG against RVFV, probably antibodies from a 2008 epidemic. Most (78%) women from coastal locations with CHIKV-specific IgG reported joint pain and stiffness; 21% reported no symptoms. CHIKV infection was significantly associated with high bodyweight. The outbreak was an isolated CHIKV epidemic without relevant DENV co-transmission.     

Prolonged exposure to particulate pollution, genes associated with glutathione pathways, and DNA methylation in a cohort of older men

Background: DNA methylation is a potential pathway linking environmental exposures to disease. Exposure to particulate air pollution has been associated with increased cardiovascular morbidity and mortality, and lower blood DNA methylation has been found in processes related to cardiovascular morbidity.Objective: We hypothesized that prolonged exposure to particulate pollution would be associated with hypomethylation of repetitive DNA elements and that this association would be modified by genes involved in glutathione metabolism and other host characteristics.Methods: DNA methylation of the long interspersed nucleotide element–1 (LINE-1) and the short interspersed nucleotide element Alu were measured by quantitative polymerase chain reaction pyrosequencing in 1,406 blood samples from 706 elderly participants in the Normative Aging Study. We estimated changes in repetitive element DNA methylation associated with ambient particles (particulate matter ≤ 2.5 µm in aerodynamic diameter), black carbon (BC), and sulfates (SO₄), with mixed models. We examined multiple exposure windows (1–6 months) before DNA methylation measurement. We investigated whether this association was modified by genotype and phenotype.Results: An interquartile range (IQR) increase in BC over a 90-day period was associated with a decrease of 0.31% 5-methylcytosine (5mC) (95% confidence interval, 0.12–0.50%) in Alu. An IQR increase in SO₄ over a 90-day period was associated with a decrease of 0.27% 5mC (0.02–0.52%) in LINE-1. The glutathione S-transferase mu-1–null genotype strengthened the association between BC and Alu hypomethylation.Conclusion: Prolonged exposure to BC and SO₄ particles was associated with hypomethylation of two types of repetitive elements.     

Stress response and potential biomarkers in spinach (Spinacia oleracea L.) seedlings exposed to soil lead

Oxidative stress and biochemical responses of spinach seedlings to soil Pb stress were investigated by pot experiments. The seedlings were exposed to 0-500 mg kg⁻¹ extraneous Pb. After 30 days of germination, production of O₂⁻, HSP 70, HSP 60, superoxide dismutase (SOD) activities, carbonyl groups and lipid peroxidation was significantly induced by soil Pb. After 50 days, HSP 70 and HSP 60 decreased, and HSP 60 was significantly inhibited at 500 mg kg⁻¹. The results indicated that Pb probably induced oxidative stress and proteotoxicity to the seedlings through O₂⁻ accumulation, and that SOD, HSP 70 and HSP 60 were important defense mechanisms to alleviate the oxidative stress. It is found that O₂⁻, HSP 70 and HSP 60 were the most sensitive parameters and had the potential to act as biomarkers for early warning of soil Pb contamination. Concentrations of soil Pb, exposing time and combination of multiple parameters should be also taken into consideration when assessing soil Pb pollution by these biomarkers.     

Seroprevalence and Risk Factors of Toxoplasma gondii Infection in Buffaloes,Sheep and Goats in Yunnan Province,Southwestern China

Background:

The seroprevalence of Toxoplasma gondii infection in buffaloes, sheep and goats in Yunnan Province, southwestern China was conducted between May 2012 and December 2013.

Methods:

A total of 973 (427 buffaloes, 154 sheep and 392 goats) serum samples were collected from seven administrative regions of Yunnan Province, and examined for T. gondii antibodies by indirect hemagglutination (IHA) test. Some risk factors related to species, age, gender and geographical origin were determined using a multinomial logistic regression.

Results:

The overall seroprevalence of T. gondii in ruminant species was estimated at 11.9%. The final logistic regression model demonstrated that host species and geographical origin were the main risk factors associated with T. gondii infection (P<0.05).

Conclusion:

Taken together, the results of the present study revealed a high exposure to T. gondii in ruminant species in Yunnan Province, which has an important implication for public health.     

Emergence of Usutu virus,an African mosquito-borne flavivirus of the Japanese encephalitis virus group,central Europe

During late summer 2001 in Austria, a series of deaths in several species of birds occurred, similar to the beginning of the West Nile virus (WNV) epidemic in the United States. We necropsied the dead birds and examined them by various methods; pathologic and immunohistologic investigations suggested a WNV infection. Subsequently, the virus was isolated, identified, partially sequenced, and subjected to phylogenetic analysis. The isolates exhibited 97% identity to Usutu virus (USUV), a mosquito-borne Flavivirus of the Japanese encephalitis virus group; USUV has never previously been observed outside Africa nor associated with fatal disease in animals or humans. If established in central Europe, this virus may have considerable effects on avian populations; whether USUV has the potential to cause severe human disease is unknown.     

Entomologic and serologic evidence of zoonotic transmission of Babesia microti,eastern Switzerland

We evaluated human risk for infection with Babesia microti at a site in eastern Switzerland where several B. microti-infected nymphal Ixodes ricinus ticks had been found. DNA from pooled nymphal ticks amplified by polymerase chain reaction was highly homologous to published B. microti sequences. More ticks carried babesial infection in the lower portion of the rectangular 0.7-ha grid than in the upper (11% vs. 0.8%). In addition, we measured seroprevalence of immunoglobulin (Ig) G antibodies against B. microti antigen in nearby residents. Serum from 1.5% of the 396 human residents of the region reacted to B. microti antigen (>1:64), as determined by indirect immunofluorescence assay (IgG). These observations constitute the first report demonstrating B. microti in a human-biting vector, associated with evidence of human exposure to this agent in a European site.     

Risk factors for infection during a dengue-1 outbreak in Maui, Hawaii, 2001

Autochthonous dengue virus transmission, last identified in the state of Hawaii in 1945, was detected again in 2001. A seroepidemiological survey in a high-incidence community (Nahiku) and a nearby low-incidence community (Hana Subdivision) was implemented. The two communities studied differed in median household size (two vs. four persons), median lot size (2.8 vs. 0.8acres), proportion of households with mosquito larvae (81 vs. 28%) and incidence of recent infection (39% [28/72] vs. 1% [1/131]). The average number of reported anti-mosquito actions by residents of both locations remained low, and approximately 50% (42/80) of the inspected houses had larvae, evidencing the need for more effective community mosquito control. Logistic regression analysis of risk factors for infection in Nahiku identified residing in properties with birds in the house or yard as significantly associated with infection (odds ratio 7.0, 95% CI 1.7-28.5), probably as an indicator of unspecified environmental characteristics that were attractive to the vector. We documented that nearly 40% of Nahiku residents had acquired dengue locally in 2001 and that undetected dengue outbreaks had occurred in Hawaii. Our data suggest that ecological characteristics may help Hawaii health officials identify communities at increased risk of dengue infection.