The prevalence and incidence of clinical and asymptomatic Lyme borreliosis in a population at risk

Article Abstract:

Lyme borreliosis (LB), also called Lyme disease, is transmitted by ticks that are infected with Borrelia burgdorferi. LB can cause a wide variety of disorders and may affect the heart, skin, joints and nervous system. A characteristic skin lesion (a reddened area that may be flat or raised) is observed in 40 to 60 percent of cases. The disease appears to be evenly distributed throughout Europe. However, in the United States, LB is found mainly in the northeast, midwest and California. It is becoming more prevalent and has been reported in 35 different states. Recent studies have reported that LB is much more prevalent in Long Island, New York than was previously suspected. To determine the prevalence of LB in a high-risk population, Swiss orienteers were studied over a six-month period. An orienteer is a competitive runner who runs through rough, bushy terrain, the preferred habitat of infected ticks. Consequently, these runners are at high risk for tick bites. The study group included 950 orienteers who ran in the hills and forests of Switzerland for training. Blood samples were taken prior to spring training and again in the fall of the same year. In the first blood test, 248 (26.1 percent) of the orienteers tested positive for Borrelia burgdorferi. A control group of 101 healthy individuals, who were not orienteers, was tested for LB; only 4 to 6 percent had positive test results. Six months later, blood samples were taken from 755 of the 950 orienteers. By the end of the training period, 8 percent of the previously uninfected runners had developed Borrelia burgdorferi infection. However, only one percent of this group developed clinical symptoms associated with LB. These findings indicate that although infection with Borrelia burgdorferi is common among Swiss orienteers, clinical symptoms of LB occur infrequently. (Consumer Summary produced by Reliance Medical Information, Inc.)

Switzerland, Risk factors, Diseases, Disease transmission, Lyme disease, Runners (Sports)

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Prevalence and diagnosis of Legionella pneumonia: a 3-year prospective study with emphasis on application of urinary antigen detection

Article Abstract:

Clinical diagnosis of Legionella pneumonia is often difficult because symptoms and laboratory tests do not always provide enough information for an accurate diagnosis. The prevalence and clinical detection of legionellosis were determined among 1,243 patients with pneumonia. Legionellosis was diagnosed in 56 of the patients, and Legionella pneumophila was the causative agent in 55 of the cases. Serum antibody detection, urinary antigen detection and culture tests were evaluated for their ability to accurately diagnose L. pneumophila infection. Serum antibodies against the organism were identified in only 36 percent of the 47 cases examined. However, urinary antigen was identified in 80 percent of the patients previously diagnosed with L. pneumophila. Culture tests were poor at diagnosing L. pneumophila, yielding positive results in only 11 percent of the cases. The highest rate of positive diagnosis, 94 percent, was obtained using all three tests. However, a positive diagnosis in 92 percent of the cases was obtained using serum antibody and urinary antigen. It is concluded that legionellosis is an important cause of pneumonia, and that urinary antigen and serum antibody are good diagnostic tests for the identification of Legionella pneumophila. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Evaluation, Diagnosis, Diagnostic bacteriology, Urine, Urinalysis, Legionnaires' disease

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Prevalence and clinical importance of Entamoeba histolytica in two high-risk groups: travelers returning from the tropics and male homosexuals

Article Abstract:

Infection with the parasite Entamoeba histolytica is found worldwide, but is most common in developing countries. Although the majority of infected individuals are asymptomatic, infection with this protozoal parasite is nonetheless a major cause of illness and death in tropical regions. Roughly 10 percent of the world's population is thought to be infected, and perhaps 10 percent of those persons have symptomatic disease. Entamoeba histolytica infection is also common among homosexual men, but shows no correlation with gastrointestinal symptoms in this group and is consequently not treated. To assess more precisely the clinical importance of infection with Entamoeba histolytica, 2,700 travellers returning from tropical regions and 320 homosexual men were examined. Four percent of the travellers and 16.3 percent of the homosexuals were found to be infected. A total of only five travellers actually showed signs of invasive amebic disease. There were no signs of invasive amebic disease among the homosexual men. The results suggest that the risk of acquiring invasive amebiasis for travellers to tropical countries is roughly 0.3 percent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Research, Travel, Intestines, Homosexuality, Male, Male homosexuality, Tropical medicine, Entamoeba histolytica

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