Survival of tubercle bacilli in heat-fixed and stained sputum smears

We used a slide culture technique to detect tubercle bacilli surviving in sputum smears (n=46) after conventional heat fixation and Ziehl-Neelsen staining. In all heat-fixed sputum smears, tubercle bacilli survived after time 0 (n=22), 24 h (n=7), 48 h (n=7), 72 h (n=4), and seven days (n=6). None of the stained sputum smears showed growth on slide cultures. Viable tubercle bacilli remaining in heat-fixed sputum smears for at least seven days may present an infection risk to laboratory staff. Thus, sputum smears should be stained immediately by the Ziehl-Neelsen method or stored in a safe container to avoid transmission of tuberculosis.

Schistosomiasis epidemiology and control: how did we get here and where should we go?

Although a disease of great antiquity, scientific studies of schistosomiasis began only 150 years ago. The complete life-cycle was not described until just before the First World War, making it possible at last to plan proper community control programmes. Inadequate tools prevented their effective implementation until well after the Second World War when new tools became available, thanks to the newly formed World Health Organization. Molluscicides spearheaded control programmes until the late 1970s but were then replaced by the newly developed, safe drugs still used today. Whatever the method used, the initial goal of eradication was, in the light of experience and cost, gradually replaced by less ambitious targets; first to stop transmission and then to reduce morbidity. The most successful programmes combined several methods to minimise reinfection after chemotherapy. Comparisons between different programmes are difficult without using appropriate, standardised diagnostic techniques and the correct epidemiological measurements. Some examples will be presented, mainly from our studies on Schistosoma mansoni in Kenya. Drug resistance on a scale comparable with malaria has not occurred in schistosomiasis but the likely withdrawal of all drugs except praziquantel leaves its control extremely vulnerable to this potential problem. An effective, affordable vaccine for use in endemic countries is unlikely to be ready for at least 5 years, and developing strategies for its use could take a further decade or more, judging from experience with drugs and molluscicides. In the interim, by analogy with malaria, the most cost-effective approach would the use of drugs combined with other methods to stop transmission, including molluscicides. The cost of molluscicides needs to be reduced and fears allayed about their supposedly adverse ecological effects.

Studies on the biology of schistosomiasis with emphasis on the Senegal river basin

The construction of the Diama dam on the Senegal river, the Manantali dam on the Bafing river, Mali and the ensuing ecological changes have led to a massive outbreak of Schistosoma mansoni in Northern Senegal, associated with high intensity of infections, due to intense transmission, and the creation of new foci of S. haematobium. Data on the vectorial capacity of Biomphalaria pfeifferi from Ndombo, near Richard Toll, Senegal are presented with sympatric and allopatric (Cameroon) S. mansoni. Comparisons are made on infectivity, cercarial production, chronobiology of cercarial emergence and longevity of infected snails. Recent data on the intermediate host specificity of different isolates of S. haematobium from the Lower and Middle Valley of the Senegal river basin (SRB) demonstrate the existence of at least two strains of S. haematobium. The role of Bulinus truncatus in the transmission of S. haematobium in the Lower and Middle Valleys of the SRB is reviewed. Both S. haematobium and S. mansoni are transmitted in the same foci in some areas of the SRB.

Activity of Tabanids (Insecta: Diptera: Tabanidae) Attacking the Reptiles Caiman crocodilus (Linn.) (Alligatoridae) and Eunectes murinus (Linn.) (Boidae), in the Central Amazon, Brazil

Tabanid females are better known as hematophagous on man and other mammals, and linked to mechanical transmission of parasites. The association between tabanids and reptiles is poorly known, but has been gaining more corroboration through experiments and occasional observation in the tropics. The present study was conducted at a military base (CIGS/BI-2), situated 54 km from Manaus, Amazonas, in a small stream in a clearing (02°45'33"S; 59°51'03"W). Observations were made monthly, from April 1997 to March 1998, during two consecutive days. At the same time, other vertebrate animals were offered, including humans. However in this paper only data obtained on a common caiman, Caiman crocodilus (Linn.), and an anaconda, Eunectes murinus (Linn.), in diurnal observations from 05:30 a.m. to 18:30 p.m., will be discussed. A total of 254 tabanid specimens were collected, 40 from the anaconda and 214 from the caiman. Four tabanid species were recorded on these two reptiles: Stenotabanus cretatus Fairchild, S. bequaerti Rafael et al., Phaeotabanus nigriflavus (Kröber) and Tabanus occidentalis Linn. Diurnal activities showed species-specific patterns. The first three species occurred only in the dry season. T. occidentalis occurred during the whole observation period, and with increased frequency at the end of the dry season. We observed preferences for body area and related behavior of the host. Observations on the attack of tabanids on one dead caiman are also presented.

Hepatitis A Outbreak in a Public School in Rio de Janeiro, Brazil

From June 1 to July 1 1999, an outbreak involving 25 cases of hepatitis A occurred in a public school in Rio de Janeiro, Brazil. Since these cases were notified to the State Health Department, the National Reference Center for Hepatitis Viruses (CNRHV) was required to investigate the extent of hepatitis A virus (HAV) dissemination. Blood samples from all students were tested for IgM and total anti-HAV antibodies using a commercial enzyme-linked immunoassay (ELISA). At the same time, a questionnaire was completed in order to identify possible risk factors for HAV infection. The environmental investigation showed that there was no fecal contamination of the water supply. The epidemiological investigation demonstrated that almost 50% of this population was susceptible to HAV infection and probably person-to-person transmission was the principal mode of virus dissemination. In this situation, a massive vaccination campaign could control the HAV infection.

A National Breastfeeding Policy for Ireland

The terms of reference given to the Committee by the Minister for Health in 1992 â?" to develop a national policy to promote breastfeeding â?" were broad, allowing the Committee itself on an examination of the issue, to decide what were the most important aspects on which to focus. At its first meeting the Committee agreed on the objectives of the policy. These objectives were to be pursued having due regard to the right of the mother to make an informed choice about how she wished to feed her infant and with care that no woman should be made to feel inadequate if she chosenot to breastfeed Download document here

First report on the presence of Biomphalaria straminea in the municipality of Jaboticatubas, State of Minas Gerais, Brazil

This is the first report on occurrence of Biomphalaria straminea in the district of São José de Almeida (municipality of Jaboticatubas) State of Minas Gerais, Brazil. The presence of B. glabrata and B. tenagophila had already been reported in this area. Such municipality is part of the metropolitan region of Belo Horizonte and comprises 60% of the Tourist Complex of Serra do Cipó. Since the 1950s throughout the 1990s, a schistosomiasis prevalence ranging from 15 to 40% has been observed. Although no B. straminea specimen has been found naturally infected in the region, descendants of these snails collected in the area, showed to be experimentally susceptible to Schistosoma mansoni infection reaching rates from 14.6 to 28.6%. Even not being found naturally infected, in the State of Minas Gerais, the possibility that the species B. straminea may keep endemicity foci of schistosomiasis should be regarded, as in the Northeastern region of Brazil where the high density of this planorbid and the social-economic and sanitary conditions enable to the transmission.

Release of extracellular particles by recombinant vaccinia virus over-expressing the major envelope protein p37K.

During the replication cycle of vaccinia virus, four different forms of viral particles are produced. The two extracellular enveloped forms, cell-associated enveloped virus and extracellular enveloped virus, are responsible for cell-to-cell transmission and long-range spread of infection both in vivo and in vitro. Despite the biological importance of the enveloped forms, the mechanism of envelopment and the components involved in this process have been analysed only recently. Therefore the individual steps and the rate-limiting factors of the envelopment process are still unknown. The protein p37K, an unglycosylated but acylated envelope protein of molecular mass 37 kDa, has been shown to be essential for envelopment. However, this study shows that over-expression of p37K by vaccinia virus recombinants reduces rather than increases the yield of infectious enveloped virus which is mainly due to the enveloped virions exhibiting a strongly diminished specific infectivity.

Salmonella in pork on the island of Ireland

A study was carried out on the occurrence of Salmonella on pork on the island of Ireland and an assessment of the risk factors contributing to its transmission. It included microbiological studies to track the Salmonella status of individual pigs through the pork chain from farm to primal cuts. Studies on the Salmonella status of pork cuts in boning hall, and on raw pork cuts at retail were also undertaken. A quantitative microbial risk assessment model was developed for Salmonella on pork cuts covering the chain from slaughter to boned-out cuts.

Summer School Programme

The Summer School aims to enable and foster a climate of inquiry for critical thinking, quantitative analysis and explore existing relevant data sources. We aim to develop the concepts and tools associated with quantitative research related to child health and wellbeing. Building on participants’ existing knowledge of research, policy and practice, we will focus on the quantitative skills necessary to mine and critique relevant national databases, conduct basic quantitative research and apply these skills to work. The SPSS workshops will provide  participants with a basic understanding of a statistical programme for analysing empirical data and the open clinics will allow participants to discuss their own research issues with experts.

Archiving and Accessing Qualitative Data Programme

There is a growing body of qualitative research data being made available in data archives in both Ireland and the UK. Examples of Irish qualitative data currently available for further analysis include Growing Up in Ireland (GUI) and Life Histories and Social Change in 20th Century Ireland. The Timescapes Research Programme, at the University of Leeds, hosts a wide variety of economic and social research data relevant to child and family researchers; data which is available to researchers in both Northern Ireland and the Republic of Ireland. Access to this data provides researchers with greater opportunities to explore the issues that affect children, their families and their  communities and which may ultimately contribute to informing children's policy. In this the second master class of the Children's Research Network for Ireland and Northern Ireland, participants will learn about the various qualitativ edatasets that are publicly-available for research purposes in the Republic of Ireland and Northern Ireland.

Hépatopathies gravidiques [Pregnancy-associated liver diseases]

Les hépatopathies sont rares au cours de la grossesse, mais peuvent avoir des conséquences dramatiques pour la mère et l'enfant si elles ne sont pas diagnostiquées à temps. On différencie principalement les hépatopathies spécifiquement secondaires à la grossesse des intercurrentes. Parmi les premières, on peut citer les manifestations hépatiques de l'hyperemesis gravidarum, la cholestase intrahépatique gravidique, les atteintes hépatiques lors d'une (pré-)éclampsie, y compris le syndrome HELLP, et la stéatose hépatique aiguë gravidique. Le diagnostic différentiel est basé sur l'anamnèse (stade de la grossesse), la clinique, quelques examens de laboratoire et l'échographie comme imagerie de première intention. Le traitement d'une cholestase intrahépatique gravidique par acide ursodésoxycholique améliore le prurit et les tests hépatiques maternels. Une surveillance rapprochée de la grossesse reste cependant indispensable. Lors d'un syndrome HELLP ou d'une stéatose hépatique aiguë gravidique, il faut procéder à l'accouchement le plus vite possible. Toutes les hépatopathies déjà connues nécessitent un suivi strict durant la grossesse. While liver diseases are a rare occurrence in pregnancy, they may have dramatic implications for mother and child if not detected in good time. A distinction is drawn between pregnancy-specific liver diseases and intercurrent liver diseases during pregnancy. The former include hepatic manifestations of hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, hepatic involvement in preeclampsia or eclampsia, including the HELLP syndrome, and acute fatty liver of pregnancy. Differential diagnosis of pregnancy-associated liver disorders is based on history (stage of pregnancy), clinical findings, a few laboratory tests and ultrasound as the primary imaging technique. Treatment of intrahepatic cholestasis of pregnancy with ursodeoxycholic acid improves pruritus and maternal liver tests. Close monitoring of pregnancy remains however indispensable. In HELLP syndrome and acute fatty liver of pregnancy the aim should be rapid delivery. Preexisting liver diseases require intensified monitoring during pregnancy.

Protease-activated receptors and inflammatory hyperalgesia

Recent advances in basic science pointed to a role for proteinases, through the activation of proteinase-activated receptors (PARs) in nociceptive mechanisms. Activation of PAR1, PAR2 and PAR4 either by proteinases or by selective agonists causes inflammation inducing most of the cardinal signs of inflammation: swelling, redness, and pain. Sub-inflammatory doses of PAR2 agonist still induced hyperalgesia and allodynia while PAR2 has been shown to be implicated in the generation of hyperalgesia in different inflammatory models. In contrast, sub-inflammatory doses of PAR1 increases nociceptive threshold, inhibiting inflammatory hyperalgesia, thereby acting as an analgesic agent. PARs are present and functional on sensory neurons, where they participate either directly or indirectly to the transmission and/or inhibition of nociceptive messages. Taken together, the results discussed in this review highlight proteinases as signaling molecules to sensory nerves. We need to consider proteinases and the receptors that are activated by proteinases as important potential targets for the development of analgesic drugs in the treatment of inflammatory pain.

Why children die: A pilot study 2006

This is thenfirst report of a national confi dential enquiry specifi cally focussed on child deaths. Confidential enquiries have already contributed to major improvements in obstetrics, neonatal, and perioperative care in the United Kingdom (UK). However they are time consuming and require extensive collaboration between various professional groups as well as the attention of a dedicated full-time research team. Hence, when planning a confidential enquiry in a new patient group, it is pertinent to investigate both feasibility and utility at its outset.ficant contribution to child health in the UK.

Chagas disease in Andean countries

The Andean Countries' Initiative (ACI) for controlling Chagas disease was officially created in 1997 within the framework of the Hipolito Unanue Agreement (UNANUE) between the Ministries of Health of Colombia, Ecuador, Peru, and Venezuela. Its objective was to interrupt transmission via vector and transfusion in the region, taking into account that there are 12.5 million people at risk in the four Andean countries forming the initiative in the area and around 3 million people are infected by Trypanosoma cruzi. The progress of control activities for the vector species present in the Andean sub-region, for different reasons, has been slow and control interventions have still not been installed in all geographical areas occupied by the target species. This has been partly due to lack of knowledge about these vector populations' biological characteristics, and consequent uncertainty about which are the appropriate control measures and strategies to be implemented in the region. The main vector species present important similarities in Venezuela and Colombia and in Ecuador and Northern Peru and they can be approached in a similar way throughout the whole regions, basing approaches on and adapting them to the current strategies being developed in Venezuela during the 1960s which have been progressively adopted in the Southern Cone and Central-American region. Additional measures are needed for keeping endemic areas free from Rhodnius prolixus silvatic populations, widely spread in the Orinoco region in Colombia and Venezuela. Regarding aetiological treatment, it is worth mentioning that (with the exception of Colombia) none of the other countries forming the ACI have registered medicaments available for treating infected young people. There are no suitable follow-up programmes in the sub-region or for treating cases of congenital Chagas disease. An integral and integrated programme encompassing all the aspects including transmission by transfusion which seems to have achieved extremely encouraging results in all countries, are urgently needed.