Food-borne parasitic zoonosis： Distribution of trichinosis in Thailand

Trichinosis is among the most common food-borne parasitic zoonoses in Thailand and many outbreaks are reported each year. This paper investigates the distribution of the disease in regions of north, north-east, central and south Thailand. Between the earliest recorded of outbreak of trichinosis in Mae Hong Son Province in 1962 and 2006, there have been 135 outbreaks involving 7340 patients and 97 deaths in Thailand. The highest number of cases, 557, was recorded in 1983. Most infected patients were in the 35-44 year age group, and the disease occurred more frequently in men than women during 1962-2003, with no significant sex difference during 2004-2006. Outbreaks were most common in the northern areas, especially in rural areas where raw and under-cooked pork and/or wild animals are eaten. Human infections occur annually in northern Thailand during communal feasts celebrating the Thai New Year. Trichinosis causes have been reported every year, supporting the need for planning education programs.     

Molecular analysis of Mycobacterium tuberculosis from tuberculous meningitis patients in Thailand

The first retrospective molecular characterization of Mycobacterium tuberculosis from cerebrospinal fluid of 158 tuberculous meningitis (TBM) in Thailand, collected between 1995 and 2005, was performed by Southern-blot hybridization with an IS6110 probe and spoligotyping on 152 and 147 isolates, respectively. Antituberculous drug susceptibility testing was performed in 149 patients, 118 of whom (79.2%) contained pan-sensitive strains and eight (5.4%) harbored multidrug-resistant M. tuberculosis. IS6110 RFLP typing revealed 110 RFLP patterns with 57.9% of patients infected with the Beijing genotype. This percentage was significantly higher than that in a previous report from pulmonary tuberculosis patients. Fifteen of 18 TBM patients (83%) aged <15 years were infected with Beijing isolates (OR = 4.47, p = 0.018). There were 40 spoligotypes, with 118 patients (80.3%) being clustered. The biggest cluster, which consisted of 84 patients, was the Beijing spoligotype (57.1%). There were 16 novel spoligotypes from 16 patients compared to the Fourth International Spoligotyping Database, SpolDB4. Sixty-four percent of the patients were male, and the mean age of patients was 33.8 years. Beijing isolates from 2001 to 2005 were found in higher percentages than those from 1995 to 2000, but this difference was not significant (p = 0.28).     

Human intestinal capillariasis in Thailand

Intestinal capillariasis caused by Capillaria philippinensis appeared first in the Philippines and subsequently in Thailand, Japan, Iran, Egypt and Taiwan; major outbreaks have occurred in the Philippines and Thailand. This article reviews the epidemiology, history and sources of C. philippinensis infection in Thailand. The annual epidemiological surveillance reports indicated that 82 accumulated cases of intestinal capillariasis were found in Thailand from 1994-2006. That made Thailand a Capillariaprevalent area. Sisaket, in northeast Thailand, was the first province which has reported intestinal capillariasis. Moreover, Buri Ram presented a high prevalence of intestinal capillariasis, totaling 24 cases from 1994-2006. About half of all cases have consumed raw or undercooked fish. However, even if the numbers of the intestinal capillariasis cases in Thailand is reduced, C. philippinensis infection cases are still reported. The improvement of personal hygiene, specifically avoiding consumption of undercooked fish and promoting a health education campaign are required. These strategies may minimize or eliminate C. philippinensis infection in Thailand.     

An overview of gastrointestinal and hepatobiliary diseases in Thailand

This review article discusses the present state of gastrointestinal and hepatobiliary diseases in Thailand. Comparisons are made with Western countries and more specific diseases such as hepatoma, cholangiocarcinoma and liver abscesses are also described.     

Bursaphelenchus Fuchs, 1937 (Nematoda: Parasitaphelenchidae) species associated with Pinus species in northern Turkey

Summary  A survey for Bursaphelenchus nematodes, associated with different conifer trees, was conducted in several forest areas in the northern regions of Turkey. Only pine trees (Pinus nigra, P. pinaster and P. sylvestris) yielded Bursaphelenchus specimens. Nematodes were identified using several morphological diagnostic characters of the genus (male spicule structure, number of lateral incisures, number and distribution of the male papillae, presence of female vulval flap), and confirmed by using RFLP analysis of the internal transcriber spacer (ITS) regions of ribosomal DNA. Three different species were identified from several sampled areas, namely B. mucronatus, B. pinophilus and B. sexdentati, representing a first report of the last two species for Turkey. The association of B. pinophilus with black pine (P. nigra) is herein reported for the first time.     

Trichinosis： Epidemiology in Thailand

INTRODUCTIONTrichinosis is one of the most widespread helminthic zoonoses.Unlike other parasitic infections,it has been a major public health problem and reported in many Asian countries,including China,Japan,Korea and Thailand[1-7].Since1835,controversy …     

Toward integrated opisthorchiasis control in northeast Thailand: The Lawa project

Human liver fluke, Opisthorchis viverrini, a food-borne trematode is a significant public health problem in Southeast Asia, particularly in Thailand. Despite a long history of control programmes in Thailand and a nationwide reduction, O. viverrini infection prevalence remains high in the northeastern provinces. Therefore, a new strategy for controlling the liver fluke infection using the EcoHealth/One Health approach was introduced into the Lawa Lake area in Khon Kaen province where the liver fluke is endemic. A programme has been carried using anthelminthic treatment, novel intensive health education methods both in the communities and in schools, ecosystem monitoring and active community participation. As a result, the infection rate in the more than 10 villages surrounding the lake has declined to approximate one third of the average of 50% as estimated by a baseline survey. Strikingly, the Cyprinoid fish species in the lake, which are the intermediate host, now showed less than 1% prevalence compared to a maximum of 70% at baseline. This liver fluke control programme, named “Lawa model,” is now recognised nationally and internationally, and being expanding to other parts of Thailand and neighbouring Mekong countries. Challenges to O. viverrini disease control, and lessons learned in developing an integrative control programme using a community-based, ecosystem approach, and scaling-up regionally based on Lawa as a model are described.     

The role of wild boars (Sus scrofa) in circulation of trichinellosis, toxocarosis and ascariosis in the Slovak Republic

Summary Wild boars (Sus scrofa) can play a significant role in circulation and maintenance of certain parasites in the environment. The aim of this study was to determine the seroprevalence of trichinellosis, toxocarosis and ascariosis in wild boars hunted in the Slovak Republic in 2003 and 2004. Anti-Trichinella antibodies were detected in 1.3 % out of 1035 wild boars investigated. No significant differences were observed regarding the positivity of wild boars according to age and sex in both years. The examination of 1173 wild boars for anti-Toxocara antibodies revealed 7.2 % seropositive individuals. Anti-Ascaris antibodies were detected in 6.1 % out of 411 animals examined. Both, anti-Trichinella and anti-Toxocara antibodies were determined in 0.6 % cases. Presence of anti-Trichinella and anti-Ascaris antibodies was recorded in 0.8 % animals. Concurrent infection caused with Toxocara and Ascaris was observed in 1.5 % individuals. This study concentrates on the role of wild boars in circulation and on the maintenance of trichinellosis, toxocarosis and ascariosis in the Slovak Republic.     

Omega-3 fatty acids in rheumatoid arthritis: an overview

Objectives:

To review background, pharmacological properties, mechanisms ofaction, and published clinical experience using omega-3 fatty acids in rheumatoid arthritis.

Materials and Methods:

English language publications were identified through a computerized search (using MEDLINE) between 1979 and 1995 using the terms “omega-3 fatty acids” and “fish oil.” In addition, manual search and cross references were used to obtain published articles on the subject. Papers showing evidence of pharmacological properties and mechanisms of action were analyzed. For therapeutic efficacy, only randomized clinical trials are presented in this article. All papers were reviewed by a board certified rheumatologist with training in research methodology and critical appraisal skills. He was aware of study objectives.

Results:

Main results are summarized in the text and presented in tables. Mean change from baseline is presented only for patients treated with omega-3 fatty acids. Omega-3 fatty acids are superior with respect to placebo in improving some outcome measures, and decrease the long-term requirements for nonsteroidal antiinflammatory drugs. Some of these effects are statistically significant, but their clinical significance remain to be established.

Conclusions:

Treatment with omega-3 fatty acids has been associated with improvement in some outcome measures in rheumatoid arthritis. Studies are needed to determine if they might represent an alternative to nonsteroidal antiinflammatory drugs in certain circumstances.     

Opisthorchiasis in Thailand： Review and current status

Opisthorchiasis caused by Opisthorchis viverrini （Oviverrini） remains a major public health problem in many parts of Southeast Asia including Thailand, Lao PDR, Vietnam and Cambodia. The infection is associated with a number of hepatobUiary diseases, including cholangitis, obstructive jaundice, hepatomegaly, cholecystitis, cholelithiasis and cholangiocarcinoma. The liver fluke infection was induced by eating raw or uncooked fish products that is the tradition and popular in the northeastern and northern region, particularly in rural areas of Thailand. Health education programs to prevent and control opisthorchiasis are still required in high-risk areas.     

The Trend of Vibrio parahaemolyticus Infections in Southern Thailand from 2006 to 2010

The bacterium, Vibrio parahaemolyticus was isolated from 776 patients at Hat Yai Hospital in Southern Thailand from 2006 to 2010. 51.3–73.6% of the isolates were tdh⁺ trh⁻ and Group-specific PCR positive pandemic strains. A comparison of the number of V. parahaemolyticus isolates in this study and that from the same hospital in 2000–2005 indicates that this region of Thailandis endemic for V. parahaemolyticus.     

An exotic pulmonary infection in Thailand: melioidosis

Melioidosis is an infectious disease from Burkholderia pseudomallei and is confined in specific geographic areas such as Southeast Asia. Its highest prevalence in Thailand is in the north-eastern part. Most infected patients had worked paddy fields or had underlying diseases such as diabetes mellitus. Melioidosis can manifest clinically, with either disseminated or localized features. In the disseminated form patients developed an acute and progressive course with septicaemia. In contrast, patients with the localized form usually presented with prolonged fever, and symptoms of one or more organ involvement, in particular the lung and the liver. Definite diagnosis of melioidosis is made by an isolation of Burkholderia pseudomallei from a variety of clinical specimens. Treatment of choice for the septicaemic patients is an initial combination of ceftrazidime and trimethoprime-sulfamethoxazole, followed by trimethoprime-sulfamethoxazole for up to 6-12 months depending on the result of clinical specimen culture. Treatment for the localized form requires simultaneous antibiotic therapy and surgical drainage. However, optimum duration of antibiotic therapy remains unknown so further research is required. Melioidosis is an important disease in terms of mortality rate and it requires rapid diagnosis and treatment. To prevent recurrence, it is necessary to continue oral doxycycline or trimethoprime-sulfamethoxazole for 6-12 months.     

Sensitivity of Plasmodium vivax to chloroquine in Sa Kaeo Province,Thailand

Following a recent, abrupt local increase in the incidence of vivax malaria, a study was conducted in order to evaluate the efficacy of chloroquine for the treatment of 26 adult patients with acute vivax malaria in Sa Kaeo Province, Thailand. The chloroquine sensitivity of Plasmodium vivax has been assessed in parallel, using a growth inhibition method. Blood samples for the in vitro tests were taken prior to the administration of the standard treatment with chloroquine--in total 25 mg base/kg over 3 days--and primaquine 0.25 mg base/kg once daily for 14 days. The efficacy has been assessed according to the WHO standard in vivo test. The cure rate was 100%. No recrudescence was observed during the follow-up period of 28 days. The mean fever clearance time (FCT) was 40 h, the mean parasite clearance time (PCT) was 49 h. Mean IC(50) and IC(90) of the parasites were 28 and 171 nM, respectively. These results show that local P. vivax is still sensitive to chloroquine. The epidemic outbreak was therefore obviously not due to the presence of chloroquine-resistant P. vivax.     

High prevalence of Mycobacterium avium subspecies paratuberculosis (‘Indian bison type’) in animal attendants suffering from gastrointestinal complaints who work with goat herds endemic for Johne's disease in India

Objectives

In this study we aimed to estimate the prevalence of Mycobacterium avium subspecies paratuberculosis (MAP) in animal attendants who were chronic colitis patients or who had inflammatory bowel disease and were suspected for Crohn's disease; these animal attendants worked with goat herds endemic for Johne's disease. Microscopic examination and culture tests were used. For comparison purposes a group of healthy human subjects (not suffering with colitis) was also screened.

Methods

Stool samples obtained from 98 human subjects (58 animal attendants suspected for Crohn's disease and 40 healthy humans) were screened for the presence of MAP by microscopic examination and culture. Of the 58 animal attendants screened, 38 had abdominal pain, 29 had suffered episodes of diarrhea, 39 had experienced weight loss, 27 had fever, and 32 had a history of raw milk consumption. Animal attendants had had contact of variable duration with goat herds endemic for Johne's disease (1–5, 6–10, 11–15, and >15 years). Forty stool samples from healthy humans with no symptoms/history of contact with animals were also screened. IS900 PCR and IS1311 PCR restriction endonuclease analysis were used to characterize and genotype the MAP colonies.

Results

MAP was recovered from 34 of the 98 human subject stool samples (34.7%). Of the 98 samples, 16.3% (n = 16) were acid-fast. None of the 40 healthy human subjects were positive for MAP by microscopy, but five (12.5%) were positive for MAP by culture. Of the 58 animal attendants, 16 (27.6%) were positive by microscopy and 29 (50%) were positive by culture. MAP were recovered from 68.4% of animal attendants with abdominal pain, 72.4% of those with diarrhea, 71.8% of those with weight loss, 44.4% of those with fever, and 46.9% of those who had a history of raw milk consumption. Of the 29 culture-positive animal attendants, 48.3% had worked for >15 years, 27.6% for 11–15 years, 20.7% for 6–10 years, and 3.4% for 1–5 years with goat herds endemic for Johne's disease. Of the 34 culture isolates, 28 (82.4%) showed good quality DNA on agarose gel and were positive by IS900 PCR. Of the 28 IS900-positive DNA samples, 23 (82.1%) were genotyped as ‘Indian bison type’ and five (17.9%) as ‘cattle type’.

Conclusions

The prevalence of MAP was higher in attendants suffering from gastrointestinal problems who worked with goat herds endemic for Johne's disease, than in humans with no history of contact with animals. The risk of developing gastrointestinal problems with clinical symptoms indistinguishable from inflammatory bowel disease was higher in humans who were in contact with goat herds endemic for Johne's disease as compared to healthy humans, and the risk was correlated with the duration of association with the endemic goat herds.     

Helicobacter pylori infection: A clinical overview

BACKGROUND: Helicobcater pylori colonizes the stomach of more than half of the world's population, and the infection continues to play a key role in the pathogenesis of a number of gastroduodenal diseases. Colonization of the gastric mucosa with Helicobcater pylori results in the development of chronic gastritis in all infected individuals and in a subset of patients chronic gastritis progresses to complications (i.e. ulcer disease, gastric neoplasias, some distinct extragastric disorders). The clinical outcome of the disease is dependent on many variables, including Helicobcater pylori genotype, innate host physiology, genetic predisposition and environmental factors. Helicobcater pylori eradication decreases the incidence of gastroduodenal ulcer and prevents its recurrence. Helicobcater pylori eradication for gastric cancer prevention has been suggested by preclinical research and clinical trials, showing even reversibility of precancerous lesions (atrophic gastritis and intestinal metaplasia) after Helicobcater pylori eradication. AIMS: To review the current literature about H. pylori and its related pathologies. CONCLUSION: At present, several clinical manifestations are recognized to be causally linked to Helicobcater pylori infection, and most of them can be cured by Helicobcater pylori eradication. Besides the relationship of Helicobcater pylori and gastroduodenal diseases, it has been well established that Helicobcater pylori infection is also involved in some extragastrointestinal diseases.     

Isolation of Bacteria Other than Helicobacter pylori from Stomachs of Squirrel Monkeys (Saimiri spp.) with Gastritis

Gastric biopsy specimens obtained from 12 squirrel monkeys (Saimiri spp.) were investigated by culture for the presence of bacteria. The stomachs of two monkeys with gastritis were colonized with gram-negative, urease-positive bacteria, identified as Ochrobactrum anthropi by the Vitek and API NFT methods (BioM´erieux). A third monkey with gastritis was positive for Aeromonas salmonicida and Pseudomonas vesicularis (both urease-negative). No Helicobacter pylori was isolated from squirrel monkeys. Light microscopic and transmission electron microscopic examination revealed that the O. anthropi isolates were covered by extracellular material, indicating a capsule. Characterization of the O. anthropi urease revealed Michaelis-Menten constants (K _m values) of 6.2 and 4.0 mM urea for the ureases of O. anthropi isolates S664 and S1835, respectively, and 3.7 for type strain 49188. Western blot analysis using H. pylori- and H. felis-specific antibodies detected shared antigenic epitopes between the ureases of H. pylori, H. felis, and O. anthropi. The apparent molecular mass of the urease enzymes of the O. anthropi isolates was determined on 6% nondenaturing gels to be approximately 82 kDa. Antimicrobial susceptibility tests, using the MicroScan method (Dade International), revealed multidrug resistance for the O. anthropi isolates with susceptibilities for the antibiotics amikacin, ciprofloxacin, gentamicin, cefoperazone, tobramycin, imipenem, and trimethoprim/sulfamethoxazole.     

Sequences of the second internal transcribed spacer of ribosomal DNA for three species of <Emphasis Type="Italic">Trichostrongylus</Emphasis> (Nematoda: Trichostrongylidae) from sheep in Russia

Summary For the first time, DNA sequence data were obtained for three species of Trichostrongylus from Russia. Internal transcribed spacer (ITS-2) of ribosomal DNA was sequenced for T. axei, T. colubriformis and T. probolurus from sheep from the Moscow region. ITS-2 rDNA length was estimated as 238 nucleotides for T. colubriformis and T. probolurus and 237 nucleotides for T. axei. The G+C content of the ITS-2 sequences of T. colubriformis, T. axei and T. probolurus were 31 %, 32 % and 34 % respectively. The level of interspecific differences in ITS-2 of rDNA of T. axei, T. probolurus and T. colubriformis ranged from 3 to 4 %. The ITS-2 sequences from the Russian specimens were compared with those of T. axei, T. probolurus and T. colubriformis from Australia and Germany. Intraspecific variation ranged from 0 % in T. colubriformis to 3.0 % in T. axei.