Incidence and prevalence of infection with Anaplasma phagocytophilum. Prospective study in healthy individuals exposed to ticks

The seroprevalence of human granulocytic anaplasmosis (former human granulocytic ehrlichiosis, HGE) has been documented in several studies, but little data exists on incidence rates in healthy individuals. In a prospective study, we tested 125 healthy adults (mean age 43 years)--workers of the Bialowieza Primeval Forest National Park, north-eastern Poland--for Anaplasma phagocytophilum IgG antibodies using an indirect immunofluorescence antibody assay, and for Borrelia burgdorferi IgG with ELISA in a 12-month interval. The data concerning clinical symptoms consistent with human granulocytic anaplasmosis were collected using a standardized questionnaire. Of these 125 subjects, 9 were anti-A. phagocytophilum positive at the study entry. Four participants (3.2 %) seroconverted from IgG negative to positive during the observation period. Three subjects (2.4 %) converted from initially anti-A. phagocytophilum positive to negative. Specific IgG antibodies against Borrelia burgdorferi were detected in 27 (21.6 %) individuals. Concurrence of Borrelia burgdorferi and Anaplasma phagocytophilum was observed in 3.2 %, whereas 4 % were Anaplasma phagocytophilum IgG positive and Borrelia burgdorferi IgG negative (not significant). Clinical symptoms associated with human granulocytic anaplasmosis were not present in seroconverting individuals. The obtained results confirm the occurrence of Anaplasma phagocytophilum infection in north-eastern Poland with asymptomatic clinical course.

[Possibilities in contemporary diagnosis of Escherichia coli O157 infection in hemorrhagic colitis patients]

Outbreaks and sporadic cases of Escherichia coli O157 human infection are noticed since 1982 worldwide. Although the percentage of infected animal (bovine) reservoir in Poland is low (0.73%) human illness could develop. Shiga toxigenic strains can cause severe gastrointestinal disease with hemolytic-uremic syndrome and thrombocytic thrombophlebitic purpura with serious sequelae. For this reason we have examined 28 patients hospitalized with bloody diarrhoea for E. coli O157:H7 infection using Multiplex PCR Test. Only one person (0.036%), a 78-year old woman, presented characteristic symptoms (three days lasting bloody diarhoea, abdominal crumps, fever, neurological symptoms), endoscopical findings (marked oedema, facile haemorrhage, longitudinal ulcer-like lesions) and positive results on PCR. Despite low incidence of E. coli O157 infection doctors should be aware that such infection in Poland is likely to happen.

The incidence of HLA DRB1*0103 in ulcerative colitis patients in north-eastern Poland

BACKGROUND/AIMS

Susceptibility to inflammatory bowel disease is partially genetically determined and the HLA (human leukocyte antigen) alloantigens and genes located in the HLA region have been studied over the course of many years as the candidate genes responsible for ulcerative colitis. Improvements in molecular genotyping have allowed disease association with HLA to be narrowed down to specific subtypes. For class II antigens, increasing phenotype frequency of DRB1*0103, DRB1*1502 is observed and positive correlation to disease susceptibility is proposed. We investigated the incidence of HLA DRB1*0103 in ulcerative colitis patients in North-Eastern Poland and possible association with overall disease susceptibility and clinical course of the disease.

METHODOLOGY

41 patients and 45 healthy control blood donors were included in this study. All subjects were Polish.

RESULTS

The incidence of HLA DRB1*0103 was low (2.44%), but was associated with fulminant course of the disease (pancolitis with megacolon toxicum). None of the ethnically matched healthy control blood donors possessed the HLA DRB1*0103 allele (0.00%).

CONCLUSIONS

The results gained in the presented study confirm, that in the Polish population HLA DRB1*0103 allele is uncommon and it would not be a useful marker of disease susceptibility.

[Prevalence of HLA class I and II antigens and extra-bowel manifestations in ulcerative colitis]

HLA class I and II antigens are common among patients with ulcerative colitis. They can be involved in the autoaggressive mechanisms of the disease. The aim of the study was to evaluate the prevalence of HLA B and HLA DR antigens and estimate the correlation to extra-bowel manifestations of the disease. 50 patients with ulcerative colitis and 20 healthy controls were examined. HLA-B27, -B7, -B40, -DR1, -DR2, -DR3, -DR4 and -DR7 were determined using monoclonal antibodies in microlymphocytotoxic method. HLA I and/or HLA II antigens were detected in 36% of patients: HLA I in 28% and HLA II 16%. 46% of the patients were demonstrating joint changes, with 65% of them presenting HLA molecules. 16% of the examined patients presented symptoms of intrahepatic cholestasis; with 67% having HLA I/II molecules. The difference from the control group was statistically significant, only 25% of healthy persons presented HLA I/II antigens. The incidence of joint involvement and cholestasis was higher in ulcerative colitis patients with HLA class I and/or HLA II.

[Iatrogenic streptococcal sepsis-- a case report]

A case study of iatrogenic streptococcal sepsis is presented. That was caused by the stomatological device left in a dental alveolus at time of dental treatment and prosthetic restoration. Systemic inflammatory response because of dentigenous spread endangered the patients life.

[Bioterrorism]

Some countries explore biological agents (toxins, bacteria and viruses) as a potential threat that can be used as a weapon of mass destruction. The list of a biological and chemical weapons is still expanding. Despite military aspect of the issue, medical and civil staff must be aware that also an act of bioterrorism could happen. We must not be afraid, but we must be prepared.

[The joint changes and presence of HLA-B27 antigen in patients with ulcerative colitis]

The extra-bowel manifestation can be found among patients with ulcerative colitis (UC). The most common are the joint changes. A group of 18 patients with ulcerative colitis was investigated. The physical and radiological signs of joint inflammation and presence of HLA-B27 antigen in blood were examined. Appearance of HLA-B27 antigen among 28% of patients with ulcerative colitis can support involvement of autoimmunologic mechanism in joint inflammation. The joint changes (swelling of small joints of hand, presence of nodes, sacroileitis, and particularly spondyloarthritis) were observed in 50% of patients.

[Efficacy of low-dose albendazole therapy in hydatic liver disease: a case report]

Hydatid liver disease is the most common form of human echinococcosis in Poland. Epidemiological data show a rising number of cases recognised last years. It is probably because of easier availability of ultrasound examination and computed tomography in the diagnostic procedures. While surgery remains the only approach for a radical cure, the chemotherapy with albendazole has became a useful advance in the management of cystic echinococcosis for the problem patient (inoperable disease, widely disseminated cysts, high surgical risk, etc.). The authors describe a patient with hydatid liver disease successfully treated with albendazole as a alternative treatment to surgery. A cyclic treatment of 28 days with 2 week break in between for 9 months with low doses of albendazole (6 mg/kg) resulted in clinical improvement and involution of hepatic cysts.

[Echinococcus granulosus and Echinococcus multilocularis invasions in north-eastern Poland]

During the last 10 years 70 cases of echinococcosis were diagnosed in the Department of Infectious Diseases, Medical University School of Białystok, of whom 63 were Echinococcus (E.) granulosus infections. The Urban population (70%) and women (60%) dominated among infected persons. Seven cases were due to E. multilocularis infection. A family and endemie focus of E. multilocularis human invasion has been identified.