Molecular Screening of Carbapenem-Resistant K. pneumoniae (CRKP) Clinical Isolates for Concomitant Occurrence of Beta-Lactam Genes (CTX-M, TEM, and SHV) in the Kingdom of Bahrain

The emergence of extended-spectrum β-lactamase-producing Klebsiella pneumoniae, including CRKP infections, has resulted in significant morbidity and mortality worldwide. We aimed to explore the presence of bla genes (CTX-M, TEM, and SHV) in CRKP isolates. A total of 24 CRKP isolates were randomly selected from the Salmaniya Medical Complex Microbiology Laboratory. These isolates, which were positive for carbapenemases, were further explored for CTX-M, TEM, and SHV genes using PCR. All the CTX-M PCR amplicons were sent for sequencing. To determine genetic relatedness, molecular typing by ERIC-PCR was performed. The bla gene testing demonstrated that a significant proportion of these isolates harbored SHV, CTX-M, and TEM genes (100%, 91.6%, and 45.8%), respectively. Bioinformatic analyses confirmed CTX-M-15 in these isolates. ERIC-PCR analysis showed three clusters demonstrating genetic relatedness. The study findings reveal the concomitant carriage of the SHV and CTX-M-15 and a comparatively lower carriage of TEM genes in CRKP isolates. Our findings highlight the significance of routinely reporting the presence of antibiotic resistance genes along with regular antibiotic sensitivity reports, as this will aid clinicians in prescribing appropriate antibiotics.

Clinical carbapenem-resistant Klebsiella pneumoniae isolates simultaneously harboring blaNDM-1, blaOXA types and qnrS genes from the Kingdom of Bahrain: Resistance profile and genetic environment

The prevalence of Carbapenem-resistant Klebsiella pneumoniae (CRKP) is currently increasing worldwide, prompting WHO to classify it as an urgent public health threat. CRKP is considered a difficult to treat organism owing to limited therapeutic options. In this study, a total of 24 CRKP clinical isolates were randomly collected from Salmaniya Medical Complex, Bahrain. Bacterial identification and antibiotic susceptibility testing were performed, on MALDI-TOF and VITEK-2 compact, respectively. The isolates were screened for carbapenem resistance markers (bla_NDM,bla_OXA-23,bla_OXA-48 and bla_OXA-51) and plasmid-mediated quinolone resistance genes (qnrA, qnrB, and qnrS) by monoplex PCR. On the other hand, only colistin-resistant isolates (n=12) were screened for MCR-1, MCR-2 and MCR-3 genes by monoplex PCR. Moreover, the Genetic environment of bla_NDM, integrons analysis, and molecular characterization of plasmids was also performed. Antibiotic susceptibility revealed that all the isolates (100%) were resistant to ceftolozane/tazobactam, piperacillin/tazobactam, 96% resistant to ceftazidime, trimethoprim/sulfamethoxazole, 92% resistant to meropenem, gentamicin and cefepime, 88% resistant to ciprofloxacin, imipenem, and 37% resistant to amikacin. Ceftazidime/avibactam showed the least resistance (12%). 75% (n=12/16) were resistant to colistin and 44% (n=7/16) showed intermediate susceptibility to tigecycline. The detection of resistant determinants showed that the majority (95.8%) of CRKP harbored bla_NDM-1, followed by bla_OXA-48 (91.6%) bla_OXA-51 (45.8%), and bla_OXA-23 (41.6%). Sequencing of the bla_NDM amplicons revealed the presence of bla_NDM-1. Alarmingly, 100% of isolates showed the presence of qnrS. These predominant genes were distributed in various combinations wherein the majority were bla_NDM-1 + bla_OXA-51+ qnrS + bla_OXA-48 (n =10, 41.7%), bla_NDM-1 + bla_OXA-23+ qnrS + bla_OXA-48 (n=8, 33.3%), among others. In conclusion, the resistance rate to most antibiotics is very high in our region, including colistin and tigecycline, and the genetic environment of CRKP is complex with the carriage of multiple resistance markers. Resistance to ceftazidime/avibactam is uncommon and hence can be used as a valuable option for empirical therapy. Molecular data on resistance markers and the genetic environment of CRKP is lacking from this geographical region; this would be the first report addressing the subject matter. Surveillance and strict infection control strategies should be reinforced in clinical settings to curb the emergence and spread of such isolates.

Perception of online and face to face microbiology laboratory sessions among medical students and faculty at Arabian Gulf University: a mixed method study

BACKGROUND

The COVID-19 pandemic has impacted all spheres of society including medical education and healthcare systems. In response to the pandemic, there has been a transition in medical education practice from traditional forms of teaching to online instruction delivery and virtual learning. Effective clinical microbiology education involves a combination of 'hands-on' practical learning and instructional delivery of scientific knowledge. Microbiology practical laboratories are critical learning environments offering 'hands-on' learning experiences that cannot be replicated through online learning. We conducted a mixed-methods study to understand the perception of online and face-to-face microbiology laboratory sessions among the medical students and microbiology faculty at Arabian Gulf University (AGU).

METHODS

The study participants were third and fourth-year undergraduate medical students and faculty involved in delivering microbiology labs at AGU. The questionnaire consisted of questions ranging from perceived learning style to attitude towards online delivery of microbiology curriculum. After the questionnaire administration (google form), focus group discussion (FGD) was conducted for students and microbiology faculty separately.

RESULTS

Among 168 students, 50.6% preferred face-to-face lab sessions as compared to 30.4% who preferred online labs, and 51.8% considered online labs to be an essential addition to face-to-face labs. Among the faculty, 85.7% preferred the face-to-face mode of teaching. All the faculty (100%) disagreed that all the microbiology labs teaching should be online. 57.2% considered online labs to be an essential addition to traditional face-to-face labs. Both faculty and students hold that a blended mode of instructional delivery is vital and indispensable for the transfer of skills and knowledge for microbiology students.

CONCLUSION

The blended mode of delivering microbiology laboratory sessions in medical school is successful and well-received by both students and faculty. Students take the responsibility for furthering their own learning and understanding of concepts. Instructors have also noticed that blending learning strategies also successfully enhances the development of cognitive skills and problem-solving abilities in students. A review of the microbiology lab curriculum is necessary to identify content areas that can be delivered effectively through online, face-to-face lab sessions, or both, supported with appropriate tools and infrastructure.

Exploring the evidence base for national and regional policy interventions to combat resistance

The effectiveness of existing policies to control antimicrobial resistance is not yet fully understood. A strengthened evidence base is needed to inform effective policy interventions across countries with different income levels and the human health and animal sectors. We examine three policy domains-responsible use, surveillance, and infection prevention and control-and consider which will be the most effective at national and regional levels. Many complexities exist in the implementation of such policies across sectors and in varying political and regulatory environments. Therefore, we make recommendations for policy action, calling for comprehensive policy assessments, using standardised frameworks, of cost-effectiveness and generalisability. Such assessments are especially important in low-income and middle-income countries, and in the animal and environmental sectors. We also advocate a One Health approach that will enable the development of sensitive policies, accommodating the needs of each sector involved, and addressing concerns of specific countries and regions.

Serodiagnosis of cystic echinococcosis in naturally infected camels

An ELISA was developed for serological detection of Echinococcus granulosus infection in dromedary camels. Antigen B (AgB) partially purified from hydatid cyst fluid of camels or sheep naturally infected with cystic echinococcosis (CE) due to E. granulosus, as well as a recombinant antigen B product (r-AgB) were used in an ELISA to screen panels of serum samples from slaughtered camels naturally infected with CE. Native hydatid cyst fluid antigen preparations were able to detect antibodies in sera from a significant proportion of camels with CE, as confirmed at post-mortem. Seroreactivity however, was variable. ELISA specificity for sera from naturally infected camels versus inspection-negative animals ranged from 90 to 99%. Native antigen B gave the highest sensitivity (97%) in ELISA for camel CE confirmed at slaughter. In contrast, r-AgB gave lower sensitivity for camel (84%) and sheep (28%) CE. The r-AgB-ELISA was, however, highly specific (90 and 95%) respectively for both camel and sheep natural CE infection. These results indicate that an ELISA based on serum antibody detection to AgB could be developed for immunodiagnosis of cystic echinococcosis in camels.

The prevalence of Toxoplasma gondii specific IgG and IgM antibodies in blood donors in Al Ain, United Arab Emirates indicates a potential risk to recipients

The results of a prospective cross-sectional study on the anti-toxoplasma IgG and IgM specific antibody profile among blood donors in Al Ain United Arab Emirates are presented. The overall infection rate was 34%. Based on IgM specific antibody positive rate, acute toxoplasmosis was evident among 3% of the blood donors studied. The theoretical implications of these findings are discussed.

Comparative studies on the sensitivity of polymerase chain reaction and microscopic examination for the detection of Trypanosoma evansi in experimentally infected mice

Trypanosoma evansi, a protozoan parasite in the blood of camels is routinely diagnosed by finding the flagellates in the wet films or stained smear of peripheral blood, examined under a microscope. Although specific, this method is not sensitive at early stages of infection. We have tested the use of polymerase chain reaction (PCR) in the identification of T. evansi in different stages of infection in mice and compared its sensitivity with that of the standard microscopic examination method. Using a specific pair of primers, it was possible to identify T. evansi in the blood of infected mice. Experimentally, groups of mice were infected with T. evansi, isolated from a naturally infected local camel and blood samples were collected every day for 30 days post-infection. Direct microscopy or PCR was applied to detect parasitaemia. Results showed that during the acute phase of infection, parasites were detected by PCR three days earlier than by microscopy. Furthermore, the infected mice were consistently positive by PCR during the chronic phase while the parasites could not be demonstrated during this period using microscopic examination. These findings suggest that PCR may be applied to camel trypanosomosis during both acute and chronic phase of infection. Furthermore, it would provide an excellent tool in the evaluation of treatment of anti-trypanocidal drugs.

Inhibition of rotavirus infection in vitro and in vivo by a synthetic peptide from VP4

A synthetic peptide corresponding to bovine rotavirus C486 (BRV) VP4 amino acid sequence 232-255 (VP4-peptide) was studied with the objective of defining the origin of the protective immune response reported previously by Ijaz et al. (J. Virol. 1991, 65, 3106-3113). Pretreatment of MA-104 cells with the VP4-peptide before infection with rotavirus prevented both the attachment of 35S-labelled virus and plaque formation in vitro. In vivo studies using a murine rotavirus model demonstrated that intragastric administration of VP4-peptide protected subjects from challenge with virulent rotavirus. These results clearly indicate the importance of this epitope in virus-cell interactions and their potential as a rotavirus vaccine candidate.

Toxoplasma antibody prevalence among healthy adults in United Arab Emirates

Full text is available as a scanned copy of the original print version.

Public health aspects of cystic echinococcosis in the Arab countries

Human cystic echinococcosis (CE) caused by larval Echinococcus granulosus is a zoonosis of major public health importance throughout the region comprising Arab North Africa and the Middle East. Prevalence rates are determined by epizootiological factors related to the size of stray dog population and its worm burden and to the infection rates in the intermediate host reservoir livestock population. Socio-economic development and socio-cultural practices are considered important determinants in the continued transmission of the disease. The reasons why CE remains a significant public health problem in the region are summarized.

Gestational and neonatal toxoplasmosis: regional seroprevalence in the United Arab Emirates

Paired maternal/cord blood samples were tested for anti-Toxoplasma IgG or IgM antibodies using Biomerieux Micro-EIA2 IgG and IgM test kits. Of the 1503 women tested at the time of delivery, 344 (22.9%) were IgG seropositive. Three hundred and one maternal sera, including 265 that were IgG positive, were tested for IgM antibodies: 47 were found positive, indicating a gestational toxoplasmosis incidence of 31 per 1000 pregnancies over one year. All but one of the IgM positive maternal sera had tested IgG positive. Cord blood IgG seropositivity was similar to the maternal rate but 18 of the 301 babies had significant levels of anti-Toxoplasma IgM antibodies. As these 18 babies were all born to mothers also positive for IgM antibodies, the calculated rate of transplacental transmission was 38.3% with the estimated prevalence of congenital toxoplasmosis of 12 per 1000 live births. There was no statistically significant positive correlation between maternal seroprevalence and such well-known risk factors as consumption of raw meat and milk, or proximity of cats and other animals. One baby was born with the classical stigmata of congenital toxoplasmosis.

Effect of previous chloroquine intake on in vivo P. falciparum drug sensitivity

Investigation of the in vivo response of P. falciparum malaria parasites to chloroquine was conducted during 1993/94 in Al-Ain District of Abu Dhabi Emirate, UAE. Sixty seven expatriates who developed falciparum malaria on their return from Pakistan, Oman and Sudan were recruited for the WHO in vivo tests. Of the 67 patients, eight were classified as having RII and RIII responses, while 59 remained aparasitaemic at the end of the seven-day WHO standard test. On continuation into the 28-day WHO extended test, a further 34 patients exhibited RI resistance. Resistance of parasites to chloroquine was confirmed by measurement of plasma chloroquine using High-Performance Liquid Chromatography. In all 67 patients, the level of chloroquine was well above the minimum therapeutic level. The outcome of the in vivo test in patients treated for the first time was significantly different from that in patients who were previously on chloroquine. Among patients treated for the first time, 36 out of 41 (88%) had a resistant response, whereas, among those previously on chloroquine only six out of 26 (23%) had a resistant response. The difference is probably due to the higher initial plasma level of chloroquine among patients who were previously on the drug. Curing more patients with higher plasma chloroquine implies that chloroquine shall continue to be useful, particularly if resistance is at the RI level. Appropriate higher therapeutic levels of chloroquine should be defined for such patients.

Suppression of transplant immunity in experimental trichinellosis

Skin allograft rejection in Balb/c and C57BL/6J mice following experimental infection with 300 larvae of Trichinella spiralis or Trichinella pseudospiralis was studied. Skin grafts from normal C57BL/6J mice were transplanted to infected Balb/c mice and vice versa at days 3, 10, 20 and 30 post-infection. The clinical criteria for graft rejection, scarring and graft falling, were followed. The results indicated that T. spiralis and T. pseudospiralis infections induced a significant delay in graft rejection when compared to the control groups. A maximum rejection time of 24 days was observed in T. spiralis infected C57BL/6J mice which received skin grafts from Balb/c mice on day 3 post-infection. The rejection in the uninfected control group was on day 7 post transplant. The mean rejection times for transplants on various days post-infection, with both species were very similar. Also, the rejection profiles in Balb/c mice were comparable to that observed in C57BL/6J mice, with a maximum delay of 26 days to rejection again obtained in mice transplanted on day 3 post-infection, for both species. When the skin grafts were performed 5 or 10 days prior to infection, the rejection occurred on day 7, as in the control group. The effect of T. spiralis and T. pseudospiralis soluble larval extracts (TSE or TPE) on graft rejection was also examined. Four intraperitoneal injections of 50 micrograms each of TSE or TPE every 48 h for 7 days did not induce any significant delay in graft rejection. In contrast, secretory antigens prepared from cultured larvae in vitro induced significant delays in graft rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

Characterization of a synthetic peptide mimicking trypsin-cleavage site of rotavirus VP4

A synthetic peptide corresponding to the trypsin cleavage site on the 84 k protein of bovine rotavirus was synthesized (VP4-peptide). This synthetic peptide could be cleaved by trypsin and therefore possessed the enzyme binding site present on the authentic protein. Further proof that this peptide mimicks the authentic trypsin cleavage site was the specific reaction of anti-peptide serum with the 84 k protein. The reaction of anti-peptide serum with infectious virus neutralized infectivity thereby supporting the biological importance of this site. Another interesting characteristic of this peptide was its ability to bind to the nucleocapsid protein resulting in a laddering effect on the nucleocapsid monomer (45 k), dimer (90 k) and trimer (135 k) [Gorzilia et al., J. Gen. Virol. 66, 1889-1900 (1985); Sabara et al., J. Virol. 53, 58-66 (1985); Sabara et al., J. Gen. Virol. 67, 201-212 (1986)]. Definitive proof of binding was provided by the fact that the increments in the ladder corresponded to the molecular weight of the synthetic peptide and that anti-peptide serum specifically reacted with the ladder formations. The laddering of the nucleocapsid could be eliminated by incubation with trypsin thus further supporting the formation of a synthetic peptide-nucleocapsid complex. Due to the ability of the peptide to bind to trypsin and to the nucleocapsid protein its biological activity was investigated. It appeared that increasing concentrations of the peptide reduced the rate of virus plaque formation, thereby suggesting that virus replication was inhibited. These results illustrate two features of this synthetic peptide which warrant further investigation; (1) its capacity to mimic an enzyme cleavage site and, (2) its ability to complex tightly to another protein. In protection-challenge experiments performed using a murine model, animals immunized with VP4-peptide provided protection passively, to neonates suckling on the immune dams, against a virulent rotavirus. The potential applications of this peptide in rotavirus diagnosis, therapy and synthetic peptides based vaccine is discussed.

Priming and induction of anti-rotavirus antibody response by synthetic peptides derived from VP7 and VP4

Synthetic peptides derived from bovine rotavirus C-486 (BRV) outer capsid (VP7 and VP4) and inner capsid (VP6) proteins were tested to evaluate their ability to prime and induce an anti-rotavirus antibody response. Peptides corresponding to the amino acid residues 232-255 of VP4 (VP4-peptide), 275-295 of VP7 (VP7-peptide) and 40-60 of VP6 (VP6-peptide) of BRV were chemically synthesized. These peptides were coupled to carrier proteins (either keyhole limpet haemocyanin (KLH) or recombinant rotavirus inner capsid protein-VP6 assembled into virus-like particles (VP6-carrier) were used as carrier to link the synthetic peptides under study), and the resulting conjugates were used to immunize rotavirus seronegative mice. An enzyme-linked immunosorbent assay (ELISA) was used to determine anti-peptide and anti-rotavirus antibody titres in serum samples collected after immunization. All peptides were immunogenic in mice and induced the production of anti-peptide antibodies, but with the exception of VP6-peptide they were not able to induce anti-rotavirus antibodies as measured by ELISA. Western blot analysis indicated that antibodies against each peptide were able to react with the respective authentic viral proteins of various rotavirus serotypes. To determine if a peptide-primed animal would respond to native viral proteins, animals were subsequently injected with purified BRV. A rapid and high anti-rotavirus antibody titre, in addition to a rise in anti-peptide antibody titre, was observed in peptide-primed mice. Furthermore, the sera obtained from these mice neutralized the virus under in vitro conditions. The significance of these results in relation to a potential rotavirus synthetic peptide-based vaccine is discussed.

Studies on the rate of selective uptake of amino acids by Trichinella larvae in vivo

Groups of C57BL/6J mice, orally infected with 300 larvae each of Trichinella spiralis or T. pseudospiralis were injected with [3H]-alanine, tyrosine, tryptophan or glycine. The incorporation of isotope labelled amino acids into larval proteins was measured at 2, 6, and 12 months post-infection. It was shown that there is a significant increase in the in vivo uptake of isotope labelled amino acids with time by the larvae of T. spiralis and T. pseudospiralis. The level of uptake was highest for tyrosine followed by tryptophan, alanine and then glycine, for both species. The in vivo uptake of amino acids by T. pseudospiralis larvae was always higher than T. spiralis or the host at 6 and 12 months post-infection. At 2 months post-infection, T. spiralis uptake of these amino acids was higher, except for tyrosine. This may be related to the special needs of these larvae during the process of encystation. The higher metabolic requirements of T. pseudospiralis may be related to the higher energy needs of these non encapsulated, highly motile and mobile muscle larvae.

Contractile characteristics of the flexor muscle of mice infected with Trichinella spiralis, T. nativa or T. pseudospiralis

A comparative analysis of skeletal muscle isometric contractile characteristics was performed in vivo on the flexor muscle of mice infected 6 mo earlier with 400 larvae of Trichinella pseudospiralis, Trichinella spiralis, or Trichinella nativa. The control group consisted of age- and sex-matched uninfected mice. The mice were injected with 0.1 ml of 50% urethane in saline, and the skin of the left hind limb was cut open longitudinally. The exposed flexor muscle was freed from the adjacent tissue and left attached freely to the knee joint while the tendon was hooked to a transducer. The signals were amplified with an amplifier connected to a chart recorder. The sciatic nerve was exposed and attached to an electrode. Impulses were generated and muscle contraction recorded. The exposed muscle and nerve were bathed in normal Krebs solution at all times and the animals were kept alive during the experiment. The normal muscle twitch tension of uninfected mice reached an average of 2.26 +/- 0.24 (SD) g. Tetany was achieved at 15 Hz. Low-Ca2+ Krebs depressed the twitch tension to 2.0 +/- 0.08 g while tetany remained at 15 Hz. Muscle twitch tension in mice infected with T. pseudospiralis reached 2.47 +/- 0.17 g and tetany at 15 Hz. Low Ca2+ depressed twitch tension to 1.14 +/- 0.12 g. Tetany was achieved at 20 Hz. In contrast, the muscle twitch of mice infected with T. nativa was significantly reduced to 1.4 +/- 0.09 g and tetany at 15 Hz. Low Ca2+ depressed twitch tension to 0.9 +/- 0.16 g and tetany at 15 Hz.(ABSTRACT TRUNCATED AT 250 WORDS)

Molecular determinants of rotavirus virulence: localization of a potential virulence site in a murine rotavirus VP4

The molecular basis of pathogenesis in vivo for a virulent mouse rotavirus (MRV) and a less virulent bovine rotavirus (BRV) were compared under in vitro and in vivo conditions. Obvious differences in the mobility of several genomic RNA segments were observed in one-dimensional gels. Under in vitro conditions, partial proteolytic peptide mapping identified differences between the two outer capsid proteins of these virus and no difference in inner capsid protein was observed. Since it has been observed by us and others that the gene coding for VP4 protein plays a significant role in determining virulence, the variability observed in the present study between the 84 k proteins (VP4) provided a basis for further investigations in order to locate a potential virulence determinant. A comparison of the carboxypeptidase digests of the MRV- and BRV-VP4 revealed an area of variability between amino acids 307 and 407, which may represent a site of virulence determinant. Under in vivo conditions the virulence of both parenteral BRV and MRV isolates and their corresponding reassortants (with replaced gene 4) were studied in murine and bovine hosts. Like their parents, BRV and MRV isolates, reassortants obtained by replacement of gene 4 in BRV with MRV gene 4 indicated that the dose of the virus isolate used and the clinical outcome in vivo was determined by gene segment 4. The implications of these findings to elucidate the molecular basis of pathogenesis of rotaviruses are discussed.

Studies on the survival of aerosolized bovine rotavirus (UK) and a murine rotavirus

The effect of relative humidity (RH) and temperature on the survival of airborne bovine rotavirus UK isolate (BRV-UK) and a murine rotavirus (MRV) was studied. In any one experiment, the virus under test was suspended in tryptose phosphate broth (TPB) supplemented with uranine (physical tracer) and an antifoam, was aerosolized using a Collison nebulizer into the rotating drum with the RH at either low (30 +/- 5%), medium (50 + 5%) or high (80 +/- 5%) level at 20 +/- 1 degrees C. Following a 15-min period of viral aerosol stabilization, sequential samples of drum air were collected using an All-Glass Impinger (AGI) for 24 h post-aerosolization. Both of the rotavirus isolates were found to survive best at medium RH level and high RH was found least favorable for the survival of these aerosolized rotaviruses. The survival pattern of aerosolized MRV was found to be the best when compared with survival pattern of all animal and human rotavirus isolates studies performed under aerosolized conditions in our laboratory. The findings of these experiments confirm and extend our previous reports on the survival of other animal and human aerosolized rotaviruses and emphasize the fact that air may be one of the vehicles for their dissemination and could explain why it is difficult to control nosocomial outbreaks of rotavirus gastroenteritis and to keep animal colonies rotavirus-free.

Echinococcus multilocularis: effect of size of inoculum and route of infection on metastasis, amyloidogenesis and alveolar hydatid cysts mass in mice

Alveolar hydatid disease (AHD) in mice, caused by Echinococcus multilocularis, is characterized by restrictive and metastasizing progressive growth phases. In experimentally induced infections, neither inoculum size (5, 50 or 250 viable cysts) nor the route (intraperitoneal/subcutaneous) of infection altered the course of disease as measured by the size of the larval cyst mass (LCM) produced. Spleen weight and amyloid deposition were also shown to be independent of the route or size of inoculum. Inoculation of a soluble parasite protein extract (AHC-EXT) induced amyloid deposition, with a dose-dependent threshold. These results support our postulate that soluble component(s) of the LCM are the major factor in the pathogenesis of AHD.

Characterization of two rotaviruses differing in their in vitro and in vivo virulence

The proteins, genomic RNA and disassembly conditions and pathogenesis in vivo for a virulent mouse rotavirus (MRV) and a less virulent bovine rotavirus (BRV) were compared. An obvious difference in the mobility of several genomic RNA segments were observed in one-dimensional gels. Reassortants obtained by replacement of gene 4 in BRV with MRV gene 4 indicated that the dose of the virus used and the clinical outcome in vivo was determined by gene segment 4. Under in vitro conditions, a comparison of the inner capsid proteins by partial proteolytic peptide mapping did not reveal any difference between corresponding proteins. However, this technique did identify differences between the two corresponding outer capsid proteins of these viruses. These differences, in turn, may account for the increased stability of MRV, as compared to BRV, when subjected to calcium-chelating and chaotropic agents and may be one of the mechanisms involved in conferring virulence on the virus. The observed variability between the 84K proteins (VP4) provided a basis for further investigations in order to locate a potential virulence determinant, since it has been observed by us and others that the gene coding for this protein plays a role in determining virulence. A comparison of the carboxypeptidase digests of the MRV and BRV VP4 revealed an area of variability between amino acids 307 and 407, which may represent the site of a virulence determinant.

Status of imported malaria in a control zone of the United Arab Emirates bordering an area of unstable malaria

A concerted malaria eradication programme in the United Arab Emirates has reduced local transmission to only a very few small foci in the country. The Al Ain district is now a consolidation zone. However, transmission across the undemarcated border with Oman continues. Malaria imported by the large immigrant work force from major disease endemic areas remains a large burden. An added threat is the appearance of chloroquine-resistant Plasmodium falciparum principally from Sudan and Pakistan but increasingly amongst Omani cases seen in the hospitals and clinics in Al Ain. The implications of re-introduction of malaria and the establishment of chloroquine resistance, particularly for non-immune residents and visitors, are emphasized.

Metallic elements in hydatid fluid

Inorganic elements as micronutricnts play a vital role in metabolism and in immune mechanisms (Ballerker & Prasad, 1983) and a significant role in the physiology of parasites. Their importance is shown by the harmful effects of mineral deficiencies in the host diet, particularly on gastro-intcstinal parasites (Von Brand, 1966). The presence of aluminium, cadmium, iron, manganese, nickel, sodium and tin has been shown in the corpuscles of Echinococcus granulosus which causes hydatid disease in man (Agosin, 1968). In this preliminary report, the quantities of trace elements in hydatid fluid from sheep and man are reported to show their possible importance as nutrients or as cofactors in the metabolism of the parasite.

Ophthalmomyiasis caused by the sheep nasal bot, Oestrus ovis (Oestridae) larvae, in the Benghazi area of Eastern Libya

In a two-year study, from January 1977 to December 1978, 80 human cases of ophthalmomyiasis were recorded at the Benghazi Central Eye Clinic. Infections were due to larvae of the sheep nasal bot, Ostrus ovis. The annual incidence was estimated to be 10 per 100,000 population, with most of the cases occurring amongst males during the months of May, June and July. A typical case history is described to illustrate the clinical features and the treatment used.

Effect of levamisol on tissues of Ascaris lumbricoides

Levamisol which is highly effective against Ascaris infections, was shown to produce degenerative changes in the intestine and the reproductive system of the worm. Worms that were not expelled by treatment produced only nonviable eggs which could not develop in vitro. Levamisol is thus shown to be not only a highly curative drug, but a compound of significant epidemiological importance.

Serological and clinical investigations of human hydatid case in Libya

Fifty surgically confirmed cases of hydatid disease in Eastern Libya were investigated. Of these, 30 had cysts of the liver, five had extra-hepatic abdominal cysts and 15 had cysts in the chest, including the lungs. Ten cases of malignancy of the liver and five cases of malignancy of the lung were used as controls. Differential diagnosis of cancer was made by measuring the ESR and glycoprotein levels (elevated x 4 and x 3 respectively, in cancer cases). Serum bilirubin, SGOT, SGPT and serum alkaline phosphatase levels were also significantly raised in malignancy, while the total protein levels and eosinophilia were the same in both diseases. The intradermal test was positive in 88%, the haemagglutination test in 86% and the complement fixation test in 70% of cases. In the post-operative follow-up, complement-fixing antibodies disappeared somewhat faster than did the haemagglutinins. The positive skin test cases, however, remained positive throughout the 12-month follow-up period.

Observations on a herd of beef cattle maintained in a tsetse area. II. Assessment of the development of immunity in association with trypanocidal drug treatment

Three groups of Boran cattle were maintained under different trypanocidal drug regimes for 29 months in an area of "medium" tsetse challenge. The development of immunity to trypanosmiasis in the cattle was assessed on the basis of changes in trypanocidal drug requirement, development of parasitaemia, ability to maintain normal blood values, growth and response to challenge after the withdrawal of the drugs. Observations were also made on serum antibody content by immunofluorescence and on serum immunoglobulin levels. Cattle treated with Berenil on the development of clinical disease developed a partial immunity to trypanosomiasis after two years. Cattle treated as a group with Berenil on the development of patent parasitaemia in any one animal of the group did not develop immunity. Cattle treated as a group with Samorin using the same criterion for treatment developed a degree of immunity to the disease. It was concluded that group treatment with Samorin was the most suitable of the three regimes examined for the maintenance of beef cattle is a tsetse infested area.