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  • Doerr, H.W.
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  • 1
    Language: English
    In: Medical Microbiology and Immunology, 2010, Vol.199(1), pp.45-51
    Description: Coxsackie A16 (CA16) and Enterovirus 71 (EV71) are members of the picornaviridae family and are associated with hand, foot and mouth disease (HFMD), in rare cases also to acute neurological diseases. HFMD outbreaks have been reported from many parts of the world, especially Southeast Asia. The objective of the study was to analyze CA16 and EV71 seroepidemiologically in the population of Frankfurt/M., Germany. A total of 696 individuals (349 males and 347 females, divided into seven different age groups, 1–4, 5–9, 10–14, 15–19, 20–39, 40–59 and 〉60 years) were tested for serum antibodies against CA16 and EV71 by the use of a microneutralization test. Sera were collected at the Frankfurt university hospital from patients suffering from other diseases between March and September 2006. CA16 and EV71 infections were observed to be widely present in the population. The age-adjusted seroprevalence for individuals ≥1 year was found to be 62.9% for CA16 and 42.8% for EV71 without a gender-specific significant difference. Only 12.0 and 27.0% of the children aged 1–4 had antibodies to EV71 and CA16, respectively – indicating that 88 and 73% of the children in this age group were susceptible to the infection. A total of 213 individuals (30.6%) was seropositive for both viruses, 303 (43.5%) showed neutralizing antibodies (NtAb) to at least one of the two viruses. A total of 180 individuals (25.9%) revealed no antibodies. High CA16 and EV71 antibody titers were found especially in the age group of the 10- to 14-year-olds, without gender-specific difference. The seroprevalence study demonstrates a common spread of CA16 and EV71 in Germany, but a relatively high susceptibility of the younger population to CA16 and EV71. Obviously, the manifestation rate, i.e., distinct disease of these infections is low.
    Keywords: Hand, foot and mouth disease ; Seroprevalence ; Coxsackie A16 ; Enterovirus 71 ; Neutralization assay
    ISSN: 0300-8584
    E-ISSN: 1432-1831
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  • 2
    Language: English
    In: Medical Microbiology and Immunology, 2010, Vol.199(1), pp.53-60
    Description: Since the dynamics of transmission of human cytomegalovirus (HCMV) have not been clarified yet, we assessed a possible change in HCMV seroprevalence in Frankfurt am Main, Germany during the past twenty years and tried to detect variables with an impact on epidemiology. Between 1/1/1988 and 10/15/2008, a total of 54443 serum samples were collected for routine diagnostics and analyzed using Enzygnost Anti HCMV-IgG enzyme immunoassay (Siemens/Dade Behring, Marburg, Germany). Two decades, 1/1/1988–12/31/1997 and 1/1/1998–10/15/2008, and several groups (type of health insurance, gender, age, HIV-status) were evaluated to assess changes in seroprevalence. Regarding both decades, the overall age-adjusted prevalence of HIV-negative patients dropped from 63.70% (confidence interval (CI) 95% 63.15–64.25) to 57.25% (CI 95% 56.57–57.93; P  〈 0.0001). Private health insurance (PHI) patients showed significant lower HCMV seroprevalences than members of obligatory health insurances (OHI) in both decades (1988–1997: PHI = 55.79%, OHI = 64.27%; P  〈 0.0001; 1998–1908: PHI = 47.02%, OHI = 58.74%; P  〈 0.0001). Furthermore, comparing the two decades, there was generally a gender-specific statistically significant decrease in HCMV seroprevalence for males (63.54–55.54%) and females (63.83–58.73%) as well as for members of PHI and OHI (PHI males: 57.59% to 47.19%, PHI females 54.10–46.80%; OHI males: 64.00–57.06%, OHI females 64.50–60.11%). Also, while female HIV-positive patients showed significant difference in HCMV seroprevalence between the two decades (83.17 and 87.80%, P  = 0.023), there was no significant difference in male patients with HIV (88.76 and 87.32% in the first and second decade, respectively ( P  = 0.196). The cumulative HCMV prevalence of all HIV-negative patients tested in the past 20 years demonstrates a biphasic, age-related rise of HCMV seroprevalence throughout all age-groups. The seroprevalence of HCMV has declined between 1988–1997 and 1998–2008 in Frankfurt am Main, Germany. The decline varied between different age-groups. HCMV prevalence correlates with the type of health insurance, gender, age, and HIV-status.
    Keywords: Cytomegalovirus ; Seroepidemiology ; HCMV ; Germany ; Prevalence
    ISSN: 0300-8584
    E-ISSN: 1432-1831
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  • 3
    Language: English
    In: BMC Infectious Diseases, 01 January 2012, Vol.12(1), p.24
    Description: Abstract Background Europe was certified to be polio-free in 2002 by the WHO. However, wild polioviruses remain endemic in India, Pakistan, Afghanistan, and Nigeria, occasionally causing polio outbreaks, as in Tajikistan in 2010. Therefore, effective surveillance measures and vaccination campaigns remain important. To determine the poliovirus immune status of a German study population, we retrospectively evaluated the seroprevalence of neutralizing antibodies (NA) to the poliovirus types 1, 2 and 3 (PV1, 2, 3) in serum samples collected from 1,632 patients admitted the University Hospital of Frankfurt am Main, Germany, in 2001, 2005 and 2010. Methods Testing was done by using a standardized microneutralization assay. Results Level of immunity to PV1 ranged between 84.2% (95%CI: 80.3-87.5), 90.4% (88.3-92.3) and 87.5% (85.4-88.8) in 2001, 2005 and 2010. For PV2, we found 90.8% (87.5-90.6), 91.3% (89.3-93.1) and 89.8% (88.7-90.9), in the same period. Seroprevalence to PV3 was 76.6% (72.2-80.6), 69.8% (66.6-72.8) and 72.9% (67.8-77.5) in 2001 and 2005 and 2010, respectively. In 2005 and 2010 significant lower levels of immunity to PV3 in comparison to PV1 and 2 were observed. Since 2001, immunity to PV3 is gradually, but not significantly decreasing. Conclusion Immunity to PV3 is insufficient in our cohort. Due to increasing globalization and worldwide tourism, the danger of polio-outbreaks is not averted - even not in developed countries, such as Germany. Therefore, vaccination remains necessary.
    Keywords: Poliomyelitis ; Vaccination ; Seroepidemiology ; Lack of Immunity ; Germany ; Medicine
    ISSN: 1471-2334
    E-ISSN: 1471-2334
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  • 4
    In: Sexually Transmitted Diseases, 2010, Vol.37(7), pp.454-459
    Description: BACKGROUND:: The objective of this study was to assess the seroprevalence of coinfecting viruses and Treponema pallidum (T. pallidum) in a cohort of 205 antiretrovirally treated HIV-infected individuals (152 females and 53 males, aged: 19–71 years) in rural Lesotho. Furthermore agent-specific immune responses were investigated by analyzing antibody titers against herpes simplex virus type 2 (HSV-2) and against T. pallidum. METHODS:: Serum samples were tested by enzyme-linked immunosorbent assay for antibodies against HSV-2, cytomegalovirus, hepatitis A, B, and C viruses, and T. pallidum. RESULTS:: Seroprevalences (95% confidence intervals) were found to be 100% (98.5%–100%) for anti-cytomegalovirus, 98.5% (95.7%–99.7%) for anti-hepatitis A virus, 35.5% (28.9%–42.6%) for anti-HBc, 5.5% (2.8%–9.6%) for hepatitis B surface antigen, and 0.5% (0.0%–2.8%) for anti-hepatitis C virus. Only 78.5% (72.2%–84.0%) were anti-HSV-2 positive and 29.0% (22.8%–35.8%) had antibodies against T. pallidum. Only anti-HSV-2 titers showed gender- and CD4 cell-count dependent differences: females with 〉500 CD4 cells/μL had an average anti-HSV-2 titer of 446 compared with males of 398 AU/mL (not significant), but in those with 250 to 500 CD4 cells/μL, there was a significant difference with a mean titer of 467 compared to 302 AU/mL in males (P = 0.001). CONCLUSIONS:: A high seroprevalence of CMV, HAV, and HBV was found in both genders. One-third of the patients had been exposed to HBV and T. pallidum. The generally high HSV-2 prevalence showed gender- and CD4 cell count-dependent differences in HSV-2 antibody titer.
    Keywords: Hiv Infections -- Research ; Hiv Infections -- Demographic Aspects ; Immune Response -- Research ; Immune Response -- Demographic Aspects ; Treponema Pallidum -- Drug Therapy ; Enzyme-linked Immunosorbent Assay -- Usage;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 5
    In: Journal of Clinical Microbiology, 2008, Vol. 46(6), p.2122
    Description: Here we describe for the first time the productive in vitro infection of human retinal pigment epithelial cells by varicella-zoster virus (VZV), resulting in a typical cytopathic effect (CPE) that is characterized by enlarged cells with increased granularity. Depending on the CPE dissemination, high titers of up to 1.6 x 10 super(6) PFU of cell-free and cryostable VZV/ml can be recovered.
    Keywords: Retinal Pigment Epithelium ; Retina ; Replication ; Pigments ; Infection ; Varicella-Zoster Virus ; Replication;
    ISSN: 0095-1137
    ISSN: 00951137
    E-ISSN: 1098660X
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  • 6
    Language: English
    In: BMC infectious diseases, 09 December 2010, Vol.10, pp.347
    Description: In October 2007, the working group CEN/TC 216 of the European Committee for standardisation suggested that the Sabin oral poliovirus vaccine type 1 strain (LSc-2ab) presently used for virucidal tests should be replaced by another attenuated vaccine poliovirus type 1 strain, CHAT. Both strains were historically used as oral vaccines, but the Sabin type 1 strain was acknowledged to be more attenuated. In Germany, vaccination against poliomyelitis was introduced in 1962 using the oral polio vaccine (OPV) containing Sabin strain LSc-2ab. The vaccination schedule was changed from OPV to an inactivated polio vaccine (IPV) containing wild polio virus type 1 strain Mahoney in 1998. In the present study, we assessed potential differences in neutralising antibody titres to Sabin and CHAT in persons with a history of either OPV, IPV, or OPV with IPV booster. Neutralisation poliovirus antibodies against CHAT and Sabin 1 were measured in sera of 41 adults vaccinated with OPV. Additionally, sera from 28 children less than 10 years of age and immunised with IPV only were analysed. The neutralisation assay against poliovirus was performed according to WHO guidelines. The neutralisation activity against CHAT in adults with OPV vaccination history was significantly lower than against Sabin poliovirus type 1 strains (Wilcoxon signed-rank test P 〈 0.025). In eight sera, the antibody titres measured against CHAT were less than 8, although the titre against Sabin 1 varied between 8 and 64. Following IPV booster, anti-CHAT antibodies increased rapidly in sera of CHAT-negative adults with OPV history. Sera from children with IPV history neutralised CHAT and Sabin 1 strains equally. The lack of neutralising antibodies against the CHAT strain in persons vaccinated with OPV might be associated with an increased risk of reinfection with the CHAT polio virus type 1, and this implies a putative risk of transmission of the virus to polio-free communities. We strongly suggest that laboratory workers who were immunised with OPV receive a booster vaccination with IPV before handling CHAT in the laboratory.
    Keywords: Antibodies, Neutralizing -- Blood ; Antibodies, Viral -- Blood ; Poliomyelitis -- Prevention & Control ; Poliovirus -- Immunology ; Poliovirus Vaccines -- Immunology
    E-ISSN: 1471-2334
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  • 7
    Language: English
    In: Journal of Clinical Virology, 2010, Vol.48(3), pp.208-211
    Description: Recently two different herpes simplex virus type 2 (HSV-2) clades (A and B) were described on DNA sequence data of the glycoprotein E (gE), G (gG) and I (gI) genes. To type the circulating HSV-2 wild-type strains in Germany by a novel approach and to monitor potential changes in the molecular epidemiology between 1997 and 2008. A total of 64 clinical HSV-2 isolates were analyzed by a novel approach using the DNA sequences of the complete open reading frames of glycoprotein B (gB) and gG. Recombination analysis of the gB and gG gene sequences was performed to reveal intragenic recombinants. Based on the phylogenetic analysis of the gB coding DNA sequence 8 of 64 (12%) isolates were classified as clade A strains and 56 of 64 (88%) isolates were classified as clade B strains. Analysis of the gG coding DNA sequence classified 4 (6%) isolates as clade A strains and 60 (94%) isolates as clade B strains. In comparison, the 8 isolates classified as clade A strains using the gB sequence data were classified as clade B strains when using the gG coding DNA sequence, suggesting intergenic recombination events. Intragenic recombination events were not detected. The first molecular survey of clinical HSV-2 isolates from Germany demonstrated the circulation of clade A and B strains and of intergenic recombinants over a period of 12 years.
    Keywords: Herpes Simplex Virus Type 2 ; Clade ; Germany ; Recombination ; Glycoprotein ; Biology
    ISSN: 1386-6532
    E-ISSN: 1873-5967
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  • 8
    In: Acta Pædiatrica, February 2009, Vol.98(2), pp.270-276
    Description: Aim: To evaluate incidence, timing and clinical relevance of acquired human cytomegalovirus (HCMV) infection in preterm infants. Methods: The prospective longitudinal study included preterm infants ≤31 weeks. Congenital HCMV infection was excluded by negative HCMV culture from urine or by HCMV‐PCR‐negative umbilical cord blood. Infants from HCMV‐IgG‐positive mothers received thawed frozen breast milk until 33 weeks. Urine samples were obtained weekly for HCMV culture. Data were collected regarding clinical course and milk‐intake. Results: Twenty‐nine mothers (29/48, 60%) of 35 infants were HCMV‐IgG‐positive. Five of 35 infants (14%) excreted HCMV in urine. Three of five children remained asymptomatic. One child developed a respirator‐dependent HCMV pneumonia, the other child an upper airway infection and a transient thrombocytopenia. HCMV infected children had a significant longer hospital stay (median 96 vs. 73 days, p = 0.025) and received more formula milk (89 vs. 44 mL/kg/day, p = 0.04). Mothers of infected children had significantly higher HCMV‐IgG levels than those of non‐infected children (mean 1557 vs. 921 AU/mL, p = 0.048). Nineteen of 48 mothers (40%) with 23 infants were HCMV‐IgG‐negative. These children remained HCMV negative. Conclusion: Feeding preterm infants ≤31 weeks of HCMV‐IgG‐positive mothers with thawed frozen breast milk until 33 completed weeks does not prevent symptomatic HCMV infection in all cases. These infections can be associated with a prolonged hospital stay.
    Keywords: Breast Milk ; Cytomegalovirus ; Postnatal Cytomegalovirus Infection ; Preterm Infants
    ISSN: 0803-5253
    E-ISSN: 1651-2227
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  • 9
    In: LaboratoriumsMedizin, 2009, Vol.33(4), pp.223-227
    Description: Medizinstudenten sind im Rahmen ihrer klinischen Ausbildung einer erhöhten Infektionsgefährdung ausgesetzt. Dessen ungeachtet sind die Impfraten der Medizinstudenten ungenügend. Ein adäquater Impfstatus der Medizinstudenten vor Beginn ihres klinischen Ausbildungsabschnitts ist jedoch wichtig, um nosokomiale Infektionen zu vermeiden.
    Description: Im April und Mai 2007 wurden insgesamt 366 Serumproben von Medizinstudenten des ersten klinischen Semesters ausgewertet. Die serologischen Untersuchungen erfolgten mittels etablierter ELISA-Systeme. Untersucht wurde auf spezifische Antikörper gegen Masern, Mumps, Röteln, Varizellen, Hepatitis B (HBV), Hepatitis C (HCV) und HIV.
    Description: Insgesamt 63,9% (n=234) der Studenten waren gegen Hepatitis B geimpft (Grundimmunisierung, drei Impfdosen). Dagegen hatten 31,7% (n=116) der Studenten bisher noch keine Hepatitis B-Impfung und 4,4% (n=16) kein komplettes Impfschema erhalten (〈drei Impfungen). Zwei Studenten zeigten serologische Marker einer abgelaufenen HBV-Infektion. Es wurde die Erstdiagnose einer HCV-Infektion sowie die Erstdiagnose einer HIV-Infektion gestellt. Bei 7,9% (Masern), 17,5% (Mumps), 6,5% (Röteln) und 2,2% (Varizellen) der Studenten konnten keine virusspezifischen Antikörper nachgewiesen werden.
    Description: Es sollten weitere Anstrengungen unternommen werden, um die Impfraten der Medizinstudenten zu verbessern. Es ist wichtig, Immunitätslücken zu identifizieren und vor dem ersten Patientenkontakt zu schließen. Im Hinblick auf die Erstdiagnose und die Folgen schwerwiegender blutübertragbarer Erkrankungen (z.B. HBV, HCV und HIV) sollten Medizinstudenten auf diese Infektionen untersucht werden.
    Description: Medical students are exposed to infectious diseases during the course of their clinical training. Unfortunately, vaccination rates among medical students remain insufficient. However, immunizations against vaccine-preventable diseases should be carried out before the students enter clinical courses. This is vital in order to prevent nosocomial infections. We screened 366 medical students in their first clinical year for hospital-related viral diseases. Serum samples were collected between April and May 2007. Antibody testing was carried out using commercial ELISA systems against measles, mumps, rubella, varicella, hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Overall, 63.9% (n=234) of the students were sufficiently vaccinated against HBV. In contrast, 31.7% (n=116) had not received any HBV vaccine dosage, and 4.4% (n=16) had not completed the full vaccine cycle (〈3 dosage). Remarkably, two students showed serological markers of resolved HBV infection. In addition, one student was HCV-positive and one was HIV-positive, respectively. The following seronegative rates were found: measles (7.9%), mumps (17.5%), rubella (6.5%), and varicella (2.2%). Further work is needed to identify optimal strategies for improving vaccination rates among medical students. It is imperative to identify and limit possible disparities in immunity of vaccine-preventable diseases before initial patient contact. With regard to the primary diagnosis of serious virus diseases including HBV, HCV and HIV, medical students should be screened for these blood borne pathogens.
    Keywords: Blutübertragbare Infektionskrankheiten ; Impfraten ; Medizinstudenten ; Blood Borne Infection ; Medical Students ; Vaccine Uptake Rates
    ISSN: 0342-3026
    E-ISSN: 1439-0477
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  • 10
    Language: English
    In: Medical Microbiology and Immunology, 2007, Vol.196(3), pp.145-150
    Description: In the course of clinical training medical students are in particular exposed to infectious diseases. Therefore, the present study was performed to investigate the immunity status of 223 medical students in their first clinical semester to job-related diseases. Specific serological antibody testing of hepatitis B-virus (HBV), hepatitis C-virus (HCV), human immunodeficiency virus (HIV), varicella zoster- (VZV), measles-, mumps-, rubella and polioviruses’ type 1, 2 and 3 were performed. The results yielded, that 69.5% of the students had an anti-HBs-level ≥10 IU/l and 54.7% ≥100 IU/l. Neither HCV infection nor HIV infection were found, but one student showed an active HBV infection. Virus specific immunity rates were found in 91.5% for measles, 80.3% for mumps, 90.1% for rubella and 96.9% for varicella. Furthermore the medical students demonstrated neutralizing antibodies to polioviruses: 95.1% (type 1), 96.9% (type 2) and 70% (type 3). 68.2% had antibodies (titer 1:≥10) against all three virus types. The partly significant gaps of immunity in the students need to be closed prior to the first contact with patients.
    Keywords: Virus serology ; Vaccination ; Medical students ; Immune status
    ISSN: 0300-8584
    E-ISSN: 1432-1831
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