The genome sequence analysis of H5N1 avian influenza A virus isolated from the outbreak among poultry populations in Thailand

In this report, the genome of the Thai avian influenza virus A (H5N1); A/Chicken/Nakorn-Pathom/Thailand/CU-K2/04, isolated from the Thai avian influenza A (AI) epidemic during the early of 2004 was sequenced. Phylogenetic analyses were performed in comparison to AI viruses from Hong Kong 1997 outbreaks and other AI (H5N1) isolates reported during 2001-2004. Molecular characterization of the Thai AI (H5N1) HA gene revealed a common characteristic of a highly pathogenic AI (HPAI), a 20-codon deletion in the neuraminidase gene, a 5-codon deletion in the NS gene and polymorphisms of the M2 and PB2 genes. Moreover, the HA and NA genes of the Thai AI displayed high similarity to those of the AI viruses isolated from human cases during the same epidemic. Finally, our results demonstrated that the Thai AI emerged as a member of 2000's AI lineage with most of the genetic sequences closely related to the Influenza A/Duck/China/E319.2/03 (H5N1).     

Poor prognostic factors in post-traumatic endophthalmitis following open globe injury

The use of personal protective equipment (PPE) for ophthalmologists caring for asymptomatic patients remains controversial. This commentary reviews the latest emerging evidence. This is paramountly important in shaping health policies in countries which is not currently recommended.     

H5N1 Oseltamivir-resistance detection by real-time PCR using two high sensitivity labeled TaqMan probes

A single amino acid substitution, from histidine to tyrosine at position 274 of the neuraminidase gene has converted Oseltamivir sensitive H5N1 influenza A virus into a resistant strain. Currently, Oseltamivir is being stockpiled in many countries potentially affected by the influenza A virus subtype H5N1 epidemic. To identify this change in Oseltamivir-treated patients, a method based on real-time PCR using two labeled TaqMan probes was developed for its rapid detection. In order to validate the method, Oseltamivir specimen from treated (Oseltamivir-resistant strain from a Vietnamese patient, two Oseltamivir-treated tigers) and untreated subjects have been used for this study. The results thus obtained as well as those derived from clone selection and sequencing showed that TaqMan probes could clearly discriminate wild type H274 from the mutant 274Y variant. The sensitivity of this assay was as low as 10 copies/microl and allowed the detection of the mutation in a mixture of wild type and mutant. Overall, the assay based on real-time PCR with two labeled TaqMan probes described here should be useful for detecting Oseltamivir-resistant H274Y H5N1 influenza A virus in many species and various sources of specimens with high sensitivity and specificity. Such studies can address potential differences in the diagnostic outcomes between patients who develop detectable Oseltamivir resistance and those who retain only the wild type strain of H5N1.     

Complete coding sequences and phylogenetic analysis of Human Bocavirus (HBoV)

Human Bocavirus (HBoV) is a novel virus which can cause respiratory tract disease in infants or children. Recently, the prevalence of this virus has been studied worldwide. In this study, 18 of 252 (7.14%) nasopharyngeal suctions from infants or children between 1 month and 9 years of age with respiratory tract illness were HBoV-positive by PCR. Three positive samples were selected for sequencing the entire coding sequences using a new conserved set of primers. The results showed that the most conserved regions of HBoV are the NS1 and NP1 genes, whereas VP1 and VP2 showed frequent variations. However, the complete coding sequences showed that the variations did not depend on the origin of virus found. The complete coding sequences determined in this study can resolve the problem of an HBoV detection method, which can be advantageously implemented in laboratory detection.     

The prevalence and persistence of human parvovirus B19 infection in thalassemic patients

Human parvovirus B19 infection was studied in 60 thalassemic patients in Thailand. Seroprevalence, persistence of parvovirus B19 and their genotypes were identified in blood samples. Prevalence of anti-parvovirus B19 IgG and DNA found in thalassemic patients were 38% and 13%, respectively. Anti-parvovirus B19 IgM could be detected in 4% of these positive anti-parvovirus B19 IgG patients. The seroprevalence and parvovirus B19 DNA in patients with a history of blood transfusion were not significantly higher than those without such a history (44% vs. 34% and 20% vs. 9%, respectively). Phylogenetic analysis of NS1 nucleotide sequences of three parvovirus B19 samples revealed that they were parvovirus B19 genotype 1. They showed low genetic diversity from prototype (Au) strain. We concluded that acute and chronic persistent parvovirus B19 infection were found in the thalassemic Thai patients. Chronic persistence of parvovirus B19 infection might play important clinical role in thalassemic patients because of the high prevalence of parvovirus B19 DNA. Blood transfusion had no significant influence to increase the prevalence of parvovirus B19 infection in thalassemic patients.     

Seroepidemiology and genotypes of hepatitis C virus in Thailand

HCV can be classified into 6 major genotypes based on the phylogenetic analysis of the genomic sequences. The 3 major genotypes found in Thailand are 3, 1 and 6, respectively. In 2004, an epidemiological survey was carried out to evaluate the seroprevalence of HCV infections among populations aged 2-60 years in four provinces of Thailand, representing the North, Northeast, Center and South of the country, respectively. One hundred and twenty five out of 5,825 serum samples (2.15%) were positive for anti-HCV by ELISA. Fifty eight out of 100 anti-HCV positive samples (58.0%) were positive by RT-PCR of the 5'UTR. The core region of 45 representative samples was sequenced allowing classification into genotype variants 1a (6.7%), 1b (26.7%), 2a (2.2%), 2c (2.2%), 3a (51.1%), 3b (2.2%) and 6 (8.9%). This information might be crucial for public health surveillance and prevention of HCV infection.     

Prevalence and genotypes of hepatitis C virus infection among drug addicts and blood donors in Thailand

Hepatitis C virus (HCV) is an infectious agent that has the potential to cause chronic liver disease, cirrhosis and hepatocellular carcinoma. We determined the prevalence and genotypes of HCV infection among groups of drug addicts: intravenous drug users (n = 134), methamphetamine users (n = 100), inhaled-drugs users (n = 19) and alcoholics (n = 50); a group of blood donors acted as a control. The control group consisted of 179 randomly-selected anti-HCV positive samples: these were subjected to HCV RNA screening and genotyping. The anti-HCV test was performed by ELISA: HCV RNA screening was by nested RT-PCR that employed primers from the 5' noncoding region. The genotype assay was based upon analysis of the 5' NCR amplified sequences and RFLP. Hepatitis C virus was highly prevalent among all groups of drug addicts (12-70%). In 2000. among the new blood donors (n = 66,340) at the National Blood Center, Thai Red Cross, anti-HCV prevalence amounted to 0.98%. The HCV genotype distribution showed that the most prevalent genotype was 3a, followed by 1b and 6a. Our data demonstrated the very high prevalence of HCV infection in IVDUs, a finding that is consistent with the blood-borne nature of the virus. In order to curb HCV infection, a determined effort to educate both the general population and high-risk groups is required; such a program of education would address both general and particular methods of transmission, especially the use of non-sterile needles etc.     

Nurses' knowledge of health literacy,communication techniques,and barriers to the implementation of health literacy programs: A cross‐sectional study

Nurses' health literacy knowledge and communication skills are essential for improving patients' health literacy. Yet, research on nurses' health literacy knowledge and perception is limited. The study aimed to evaluate nurses' health literacy knowledge, communication techniques, and barriers to the implementation of health literacy interventions. A cross‐sectional study was used, and a total of 1697 nurses in 104 community hospitals in Thailand completed self‐report measures. Approximately 55% of the participants had heard about the concept of health literacy; 9% had received formal training specific to interaction with patients with low health literacy. About 50% of the nurses were aware of their patients' low health literacy; therefore, they applied the recommended communication techniques for them. Delivery of effective health literacy training was hampered by a lack of assessment tools, health literacy training and specialists, educational materials, and health provider time. Hospital administrators, nurse managers, health leaders should develop strategies to create environments and resources supporting health literacy interventions.