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  • 1
    Language: English
    In: 2012, Vol.6(11), p.e1837
    Keywords: Viewpoints ; Medicine ; Public Health And Epidemiology ; Infectious Diseases
    ISSN: 19352727
    E-ISSN: 1935-2735
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  • 2
    Language: English
    In: 2013, Vol.7(10), p.e2283
    Description: Improved understanding of the differential diagnosis of endemic treponematoses is needed to inform clinical practice and to ensure the best outcome for a new global initiative for the eradication of yaws, bejel, and pinta. Traditionally, the human treponematoses have been differentiated based upon their clinical manifestations and epidemiologic characteristics because the etiologic agents are indistinguishable in the laboratory. Serological tests are still considered standard laboratory methods for the diagnosis of endemic treponematoses and new rapid point-of-care treponemal tests have become available which are extremely useful in low-resource settings. In the past ten years, there has been an increasing effort to apply polymerase chain reaction to treponematoses and whole genome fingerprinting techniques have identified genetic signatures that can differentiate the existing treponemal strains; however, definitive diagnosis is also hampered by widespread unavailability of molecular diagnostics. We review the dilemmas in the diagnosis of endemic treponematoses, and advances in the discovery of new diagnostic tools.
    Keywords: Review
    ISSN: 19352727
    E-ISSN: 1935-2735
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  • 3
    Language: English
    In: PLoS ONE, 01 January 2015, Vol.10(10), p.e0139823
    Description: We have used RNASeq and qRT-PCR to study mRNA levels for all σ-factors in different Mycobacterium marinum strains under various growth and stress conditions. We also studied their levels in M. marinum from infected fish and mosquito larvae. The annotated σ-factors were expressed and transcripts varied in relation to growth and stress conditions. Some were highly abundant such as sigA, sigB, sigC, sigD, sigE and sigH while others were not. The σ-factor mRNA profiles were similar after heat stress, during infection of fish and mosquito larvae. The similarity also applies to some of the known heat shock genes such as the α-crystallin gene. Therefore, it seems probable that the physiological state of M. marinum is similar when exposed to these different conditions. Moreover, the mosquito larvae data suggest that this is the state that the fish encounter when infected, at least with respect to σ-factor mRNA levels. Comparative genomic analysis of σ-factor gene localizations in three M. marinum strains and Mycobacterium tuberculosis H37Rv revealed chromosomal rearrangements that changed the localization of especially sigA, sigB, sigD, sigE, sigF and sigJ after the divergence of these two species. This may explain the variation in species-specific expression upon exposure to different growth conditions.
    Keywords: Sciences (General)
    E-ISSN: 1932-6203
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  • 4
    In: Applied and Environmental Microbiology, 2010, Vol. 76(18), p.6215
    Description: Mycobacterium ulcerans is the causative agent of Buruli ulcer, a severe necrotizing skin disease that causes significant morbidity in Africa and Australia. Person-to-person transmission of Buruli ulcer is rare. Throughout Africa and Australia infection is associated with residence near slow-moving or stagnant water bodies. Although M. ulcerans DNA has been detected in over 30 taxa of invertebrates, fish, water filtrate, and plant materials and one environmental isolate cultured from a water strider (Gerridae), the invertebrate taxa identified are not adapted to feed on humans, and the mode of transmission for Buruli ulcer remains an enigma. Recent epidemiological reports from Australia describing the presence of M. ulcerans DNA in adult mosquitoes have led to the hypothesis that mosquitoes play an important role in the transmission of M. ulcerans. In this study we have investigated the potential of mosquitoes to serve as biological or mechanical vectors or as environmental reservoirs for M. ulcerans. Here we show that Aedes aegypti, A. albopictus, Ochlerotatus triseriatus, and Culex restuans larvae readily ingest wild-type M. ulcerans, isogenic toxin-negative mutants, and Mycobacterium marinum isolates and remain infected throughout larval development. However, the infections are not carried over into the pupae or adult mosquitoes, suggesting an unlikely role for mosquitoes as biological vectors. By following M. ulcerans through a food chain consisting of primary (mosquito larvae), secondary (predatory mosquito larva from Toxorhynchites rutilus septentrionalis), and tertiary (Belostoma species) consumers, we have shown that M. ulcerans can be productively maintained in an aquatic food web. [PUBLICATION ]
    Keywords: Africa ; Australia ; Bacteria ; Mosquitoes ; Skin Diseases ; Morbidity ; Disease Transmission ; Deoxyribonucleic Acid–DNA;
    ISSN: 0099-2240
    ISSN: 00992240
    E-ISSN: 10985336
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  • 5
    Language: English
    In: 2015, Vol.9(9), p.e0003843
    Description: Leptospirosis is one of the most widespread zoonotic diseases, which is of global medical and veterinary importance, and also a re-emerging infectious disease. The main tracks of transmission are known; however, the relative importance of each of the components and the respective environmental risk factors are unclear. We aimed to assess and specify quantitative evidence of environmental risks of leptospirosis transmission. ; A database of pre-selected studies, with publication dates from 1970 until 2008, was provided by an expert group. The database has been updated until 2015 using a text mining algorithm. Study selection was based on stringent quality criteria. A descriptive data analysis was performed to calculate the medians of the log transformed odds ratios. From a selection of 2723 unique publications containing information on leptospirosis, 428 papers dealing with risk factors were identified. Of these, 53 fulfilled the quality criteria, allowing us to identify trends in different geo-climatic regions. Water associated exposures were, with few exceptions, associated with an increased leptospirosis risk. In resource poor countries, floods and rainfall were of particular importance, whereas recreational water activities were more relevant in developed countries. Rodents were associated with increased leptospirosis risk, but the variation among studies was high, which might be partly explained by differences in exposure definition. Livestock contact was commonly associated with increased risk; however, several studies found no association. The median odds ratios associated with dog and cat contacts were close to unity. Sanitation and behavioural risk factors were almost always strongly associated with leptospirosis, although their impact was rarely investigated in Europe or North America. ; This review confirms the complex environmental transmission pathways of leptospirosis, as previously established. Although, floods appeared to be among the most important drivers on islands and in Asia, the consistent pattern observed for exposure to rodents and behavioural and sanitation related risk factors indicate potential areas for intervention. ; Leptospirosis is a bacterial disease passed from animals to people—either through direct contact with animals or indirectly via the environment. The disease can be found worldwide but is more important in tropical and subtropical countries. Due to their sheer genetic diversity, virtually all mammals can be infected by leptospires. People can be infected from a broad range of animals including livestock, pets and rodents. Transmission pathways differ among animal species as well as across rural and urban landscapes and environmental conditions which influence survival of pathogenic leptospira in surface water and moist soil. Consequently, spatial and temporal patterns of disease incidence are complex; however, a better understanding is crucial for the planning and implementation of effective interventions. We systematically reviewed the scientific literature to identify regional risk factors and assess their importance. We found considerable heterogeneity among studies indicating that epidemiological patterns are highly setting specific. Floods and heavy rain appeared to be among the most important drivers on islands and in Asia. Exposure to rodents as well as behaviour and sanitation are often important risk factors indicating potential areas for interventions.
    Keywords: Research Article
    ISSN: 19352727
    E-ISSN: 1935-2735
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  • 6
    In: PLoS Neglected Tropical Diseases, 2016, Vol.10(12)
    Description: Background Haemophilus ducreyi has emerged as a major cause of cutaneous ulcers (CU) in yaws-endemic regions of the tropics in the South Pacific, South East Asia and Africa. H . ducreyi was once thought only to cause the genital ulcer (GU) disease chancroid; GU strains belong to 2 distinct classes, class I and class II. Using whole-genome sequencing of 4 CU strains from Samoa, 1 from Vanuatu and 1 from Papua New Guinea, we showed that CU strains diverged from the class I strain 35000HP and that one CU strain expressed β-lactamase. Recently, the Center for Disease Control and Prevention released the genomes of 11 additional CU strains from Vanuatu and Ghana; however, the evolutionary relationship of these CU strains to previously-characterized CU and GU strains is unknown. Methodology/Principal Findings We performed phylogenetic analysis of 17 CU and 10 GU strains. Class I and class II GU strains formed two distinct clades. The class I strains formed two subclades, one containing 35000HP and HD183 and the other containing the remainder of the class I strains. Twelve of the CU strains formed a subclone under the class I 35000HP subclade, while 2 CU strains formed a subclone under the other class I subclade. Unexpectedly, 3 of the CU strains formed a subclone under the class II clade. Phylogenetic analysis of dsrA - hgbA - ncaA sequences yielded a tree similar to that of whole-genome phylogenetic tree. Conclusions/Significance CU strains diverged from multiple lineages within both class I and class II GU strains. Multilocus sequence typing of dsrA - hgbA - ncaA could be reliably used for epidemiological investigation of CU and GU strains. As class II strains grow relatively poorly and are relatively more susceptible to vancomycin than class I strains, these findings have implications for methods to recover CU strains. Comparison of contemporary CU and GU isolates would help clarify the relationship between these entities. Author Summary Cutaneous ulcers (CU) in children in yaws-endemic regions have long been attributed to Treponema pallidum subsp. pertenue ; however, recent studies show that Haemophilus ducreyi is an important cause of CU in these regions. H . ducreyi was once thought to cause only the genital ulcer (GU) disease chancroid; phylogenetically, GU strains belong to two distinct classes called class I and class II. We previously showed that CU strains obtained from Samoa, Vanuatu and Papua New Guinea are genetically almost identical to class 1 GU strains. In this study, using published genomes from 11 additional CU strains from Ghana and Vanuatu, we show that CU strains diverged from both class I and class II GU strains and that multiple CU clones may circulate in endemic areas. These findings have implications for epidemiological typing and recovery of H . ducreyi strains from both CU and GU clinical samples.
    Keywords: Research Article ; Biology And Life Sciences ; Research And Analysis Methods ; Medicine And Health Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Medicine And Health Sciences ; Biology And Life Sciences ; Medicine And Health Sciences ; People And Places ; Biology And Life Sciences ; Biology And Life Sciences ; Biology And Life Sciences ; Research And Analysis Methods ; Biology And Life Sciences
    ISSN: 1935-2727
    E-ISSN: 1935-2735
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  • 7
    Language: English
    In: 2015, Vol.9(9), p.e0004039
    Description: Water-associated exposures (recreational water activities in developed countries and floods and heavy seasonal rainfall in tropical countries) are the main risk factors. Both papers emphasize the scarcity of data on the surveillance and epidemiology of leptospirosis, as well as a lack of consensus on definitions of cases and risk factors, study design, and adequate methods of data analysis.
    Keywords: Expert Commentary
    ISSN: 19352727
    E-ISSN: 1935-2735
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  • 8
    Language: English
    In: 2014, Vol.8(9), p.e3016
    Description: Yaws, one of the 17 neglected tropical diseases (NTDs), is targeted for eradication by 2020 in resolution WHA66.12 of the World Health Assembly (2013) and the WHO roadmap on NTDs (2012). The disease frequently affects children who live in poor socioeconomic conditions. Between 1952 and 1964, WHO and the United Nations Children's Fund (UNICEF) led a global eradication campaign using injectable benzathine penicillin. Recent developments using a single dose of oral azithromycin have renewed optimism that eradication can be achieved through a comprehensive large-scale treatment strategy. We review historical efforts to eradicate yaws and argue that this goal is now technically feasible using new tools and with the favorable environment for control of NTDs. We also summarize the work of WHO's Department of Control of Neglected Tropical Diseases in leading the renewed eradication initiative and call on the international community to support efforts to achieve the 2020 eradication goal. The critical factor remains access to azithromycin. Excluding medicines, the financial cost of yaws eradication could be as little as US$ 100 million. ; The development of new tools has renewed interest in eradication of yaws; with modest support, the WHO eradication target of 2020 can be achieved.
    Keywords: Review ; Medicine And Health Sciences
    ISSN: 19352727
    E-ISSN: 1935-2735
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  • 9
    Language: English
    In: 2015, Vol.9(10), p.e0004191
    Description: Streptococcus suis is the most common cause of meningitis in pork consuming and pig rearing countries in South-East Asia. We performed a systematic review of studies on S . suis meningitis to define the clinical characteristics, predisposing factors and outcome. ; Studies published between January 1, 1980 and August 1, 2015 were identified from main literature databases and reference lists. Studies were included if they were written in West-European languages and described at least 5 adult patients with S . suis meningitis in whom at least one clinical characteristic was described. ; We identified 913 patients with S . suis meningitis included in 24 studies between 1980 and 2015. The mean age was 49 years and 581 of 711 patients were male (82%). Exposure to pigs or pork was present in 395 of 648 patients (61%) while other predisposing factors were less common. 514 of 528 patients presented with fever (97%), 429 of 451 with headache (95%), 462 of 496 with neck stiffness (93%) and 78 of 384 patients (20%) had a skin injury in the presence of pig/pork contact. The case fatality rate was 2.9% and hearing loss was a common sequel occurring in 259 of 489 patients (53%). Treatment included dexamethasone in 157 of 300 (52%) of patients and was associated with reduced hearing loss in S . suis meningitis patients included in a randomized controlled trial. ; S . suis meningitis has a clear association with pig and pork contact. Mortality is low, but hearing loss occurs frequently. Dexamethasone was shown to reduce hearing loss. ; Meningitis is a common manifestation of Streptococcus suis infection. S . suis is endemic in pork consuming and pig rearing countries. We systematically reviewed the clinical characteristics, predisposing factors and outcome of S . suis meningitis. We identified 913 patients included in 24 studies, with a mean age of 49 years and a majority of male patients (82%). Exposure to pigs or pork was present in 61%, with a skin injury being present in 20%. Fever was present in 97% of patients, headache in 95%, neck stiffness in 93%. The mortality was 2.9% and hearing loss was common occurring in 53% of patients. Dexamethasone was associated with reduced hearing loss.
    Keywords: Research Article
    ISSN: 19352727
    E-ISSN: 1935-2735
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  • 10
    Language: English
    In: PLoS Neglected Tropical Diseases, 2011, Vol.5(8), p.e1252
    Description: The neglected tropical disease Buruli ulcer (BU) caused by Mycobacterium ulcerans is an infection of the subcutaneous tissue leading to chronic ulcerative skin lesions. Histopathological features are progressive tissue necrosis, extracellular clusters of acid fast bacilli (AFB) and poor inflammatory responses at the site of infection. After the recommended eight weeks standard treatment with rifampicin and streptomycin, a reversal of the local immunosuppression caused by the macrolide toxin mycolactone of M. ulcerans is observed. ; We have conducted a detailed histopathological and immunohistochemical analysis of tissue specimens from two patients developing multiple new skin lesions 12 to 409 days after completion of antibiotic treatment. Lesions exhibited characteristic histopathological hallmarks of Buruli ulcer and AFB with degenerated appearance were found in several of them. However, other than in active disease, lesions contained massive leukocyte infiltrates including large B-cell clusters, as typically found in cured lesions. ; Our histopathological findings demonstrate that the skin lesions emerging several months after completion of antibiotic treatment were associated with infection. During antibiotic therapy of Buruli ulcer development of new skin lesions may be caused by immune response-mediated paradoxical reactions. These seem to be triggered by mycobacterial antigens and immunostimulators released from clinically unrecognized bacterial foci. However, in particular the lesions that appeared more than one year after completion of antibiotic treatment may have been associated with new infection foci resolved by immune responses primed by the successful treatment of the initial lesion. ; Buruli ulcer (BU) is a chronic necrotizing skin disease presenting with extensive tissue destruction and local immunosuppression. Standard treatment recommended by the WHO includes 8 weeks of rifampicin/streptomycin and, if necessary, wound debridement and skin grafting. In some patients satellite lesions develop close to the primary lesion or occasionally also at distant sites during effective antibiotic treatment of the primary lesion. We performed a detailed analysis of tissue specimens from lesions that emerged in two BU patients from Benin 12 to 409 days after completion of chemotherapy. Histopathology revealed features of tissue destruction typically seen in BU and degenerated acid-fast bacilli. In addition, lesions contained organized immune infiltrates typically found in successfully treated BU lesions. Secondary lesions emerging many months after completion of chemotherapy may have been caused by immune response-mediated paradoxical reactions. However, the late onset may also indicate that they were associated with new infection foci spontaneously resolved by adaptive immune responses primed by antibiotic treatment of the primary lesions.
    Keywords: Research Article ; Biology ; Medicine ; Immunology ; Infectious Diseases ; Microbiology
    ISSN: 19352727
    E-ISSN: 1935-2735
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