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Biomedical subjects

J R Bänffer

Publications and source records attributed to J R Bänffer.

At least 19 recordsLinked to original sources
PubMed1996

Four cases of hemolytic uremic syndrome--source contaminated swimming water?

In June '93, 4 children, aged 1.5-3.5 years, all living in one town, were admitted to our hospital with the diagnosis hemolytic uremic syndrome (HUS) within one week. In cooperation with the local health authorities a common source was searched for. Questionnaires indicated that the single condition shared by all patients was swimming water. The patients were not acquainted, visited different daycares, and had no food resources in common. All 4 patients bathed in the same, shallow, recreational lake within a period of 5 days. During this time the air temperature was high according to Dutch standards (around 27 degrees C), and many people visited the lake, estimated several hundreds a day. The water level was lower than normal. Diarrhea followed 3-11 days after swimming and the first clinical symptoms of HUS developed 6-7 days after the onset of diarrhea. The lake was closed for swimming when the fourth HUS patient was diagnosed and the possibility of transmission by way of the lake was mentioned. E. coli O157: H7 was demonstrated in the fecal samples of 2 index patients. The samples were taken 9-20 days after the start of diarrhea. Antibodies to O157 and verotoxin 2 were strongly positive in all patients. A local outbreak of diarrheal illness was not registered. Of 16 family members who also swam in the same lake, 7 developed symptoms of enteritis, 3 had positive cultures of their fecal samples and 5 had positive serology. Pulsed-field gel electrophoresis of the E. coli isolates of the patients and family members showed an identical pattern. No O157: H7-DNA could be detected in filter concentrated lake water samples using polymerase chain reaction (PCR) enhancement. These samples were, however, taken 16 days after the latest possible date of contamination of our patients, 15 days after decrease of the air temperature to 15-17 degrees C, and 14 days after the inlet from water from the environment. It could thus very well be that the microorganism was no longer present. This third report of swimming water associated HUS should direct environmental surveys in similar cases of local HUS outbreaks.

Antibodies, Bacterial↗
PubMed1995

Anti-GM1 IgG antibodies and Campylobacter bacteria in Guillain-Barré syndrome: evidence of molecular mimicry.

In Guillain-Barré syndrome antibodies to GM1 and the presence of an antecedent Campylobacter jejuni infection are correlated with a more severe course of the disease. From a group of 137 consecutive GBS patients, 11 sera had elevated titers of anti-GM1 IgG antibodies during the acute stage of disease. Each serum sample was preincubated with three different Penner serotypes of whole C. jejuni (PEN O:4/59, PEN O:41) and Campylobacter coli (PEN O:22) bacteria. The PEN O:4/59 serotype, isolated from the stools of a Guillain-Barré syndrome patient, inhibited 63 to 93% of the anti-GM1 activity in 6 of 11 patients. The PEN O:41 inhibited 63 to 100% of the anti-GM1 antibody activity in 9 of 11 patients. The PEN O:22 inhibited anti-GM1 antibody activity in only 2 of 11 patients (80 and 86%). Two Guillain-Barré syndrome patients did not show antibody absorption by any of the Campylobacter serotypes tested, although this does not exclude the involvement of other serotypes. An Escherichia coli control strain did not significantly absorb anti-GM1 antibodies. The results of this study indicate that anti-GM1 IgG antibodies in Guillain-Barré syndrome sera recognize surface epitopes on whole Campylobacter bacteria and that this recognition is strain-specific. This provides evidence for molecular mimicry in the pathogenesis of Guillain-Barré syndrome.

Adolescent↗
PubMed1993

Passive-active immunization in infants of hepatitis Be antigen-positive mothers. Comparison of the efficacy of early and delayed active immunization.

OBJECTIVE: To assess the efficacy of late active immunization against hepatitis B concomitant with diphtheria, pertussis, tetanus, and polio vaccine in high-risk infants receiving hepatitis B immune globulin at birth. DESIGN: Randomized study of infants born to mothers positive for hepatitis B surface antigen (HBsAg) and hepatitis Be antigen (HBeAg). SETTING: Three large city hospitals and one rural area providing prenatal care and obstetric services. SUBJECTS: Eighty neonates of HBsAg- and HBeAg-positive carrier mothers received 0.5 mL/kg of body weight hepatitis B immune globulin within 2 hours of birth and hepatitis B vaccine (10 micrograms) at 0, 1, 2, and 11 months of age (group A) or at 3, 4, 5, and 11 months of age concomitant with diphtheria, pertussis, tetanus, and polio immunization (group B). A second dose of hepatitis B immune globulin was given to infants on schedule B at 3 months. MAIN OUTCOME MEASURES: Blood samples were collected at 0, 3, 6, 11, and 12 months of age and tested for antibodies against hepatitis B core antigen and HBsAg. Follow-up visits were scheduled annually up to 5 years of age. RESULTS: Eight infants were excluded from analysis. During the study period, six children became HBsAg carriers, three in each group, which corresponds to a 5-year incidence of infection of 9% and 8% for groups A (three of 35) and B (three of 37), respectively. Subclinical infections (persistent anti-HBc positivity beyond month 12 or appearance of anti-HBc) were encountered in another eight infants (four in each group). CONCLUSION: Late active immunization starting at 3 months of age appears to provide similar protective efficacy as active immunization starting at birth when combined with hepatitis B immune globulin at 0 and 3 months of age.

Adult↗
PubMed1993

Evaluation of a commercial latex agglutination test for rapid detection of Salmonella in fecal samples.

A latex agglutination test for the detection of salmonella in feces was evaluated in comparison to direct culture and enriched culture using both artificially inoculated samples and clinical samples. In the samples inoculated artificially with different concentrations of salmonella (10(1) to 10(5) per gram) the enriched culture performed better only at the 10(2) level in 0.4 g samples, whereas the latex test performed as well as the enriched culture at all levels in 4 g samples. In the tests using clinical samples, there was no significant difference between results of the latex test performed in 2283 samples and the enriched culture performed in 2072 samples. The sensitivity, specificity and negative and positive predictive values of the latex test were 88.2%, 98%, 97.5% and 63% respectively. The test provided results rapidly but yielded a number of false positive results.

Bacteriological Techniques↗
PubMed1989

[Cryptosporidiosis: prevalence in the Rotterdam area and comparison of 2 staining methods for its detection].

2000 stool samples obtained during 2000 episodes of diarrhoea were examined for oöcysts of cryptosporidium and 1.2% was found to be positive. The percentage positives among stool samples of liquid consistency amounted to 1.86 and among those with a solid consistency to 0.89. Prevalence was highest in the age-classes of 0-10 and 51-60 years old. A modified Ziehl-Neelsen staining technique was superior to the saffranine staining. Prevalence was highest in the months of June, August and December. In a control group of 160 persons without diarrhoea no cryptosporidia were demonstrated. There is no indication for routine-examination for cryptosporidium except in certain age-classes and in immuno-compromised patients; the latter category will appear to be of increasing importance.

Adolescent↗
PubMed1989

Prevention of hepatitis B infection in newborns through mass screening and delayed vaccination of all infants of mothers with hepatitis B surface antigen.

Beginning in 1982 all pregnant women undergoing prenatal routine blood analysis in three large city hospitals and one large rural area were tested for hepatitis B surface antigen (HBsAg). Infants of all HBsAg-positive mothers received hepatitis B immunoglobulin (HBIg), 0.5 mL/kg of body weight within two hours of birth and, after randomization, 10 micrograms of hepatitis B vaccine either at 0, 1, 2, and 11 months of age (schedule A) or at 3, 4, 5, and 11 months of age (schedule B). A second injection of HBIg (1 mL) was given to infants on schedule B at 3 months of age. Blood samples were obtained at 3, 6, 11, 12, 24, and 36 months. In a two-year period, 28,412 pregnant women were tested for HBsAg; screening efficiency varied between 85% and 98%. The overall prevalence of HBsAg was 0.8%, with a marked variation between urban centers (2.2%) and the rural area (0.3%). Vaccinations were received by 180 of 193 infants of HBsAg-positive mothers (90 on schedule A and 90 on schedule B). Concentrations of hepatitis B surface antibody less than 10 IU/L were observed in nine instances in five children from group A and in seven instances in six children from group B. Four hepatitis B viral infections (two HBsAg carriers, two who underwent antihepatitis B core seroconversions) were recorded in group A v one infection (antihepatitis B core seroconversion) in group B. The protective efficacy of the program (screening plus passive immunization and delayed vaccination) was 94%. The estimated cost of preventing one cae of hepatitis B infection in neonates was $3,000 (US currency).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Counterimmunoelectrophoresis compared with complement fixation and passive haemagglutination tests in the evaluation of the immune response in Campylobacter infections.

The immune response was studied in 238 human patients with Campylobacter jejuni/coli (CJC)-infections in Rotterdam by the counterimmunoelectrophoresis (CIE) test, a commercial complement fixation test (CFT) and the passive haemagglutination test (HA). Antibodies became detectable in the three tests around 4 days after the onset of complaints. Between the 7th and the 20th days after onset of illness 79%, 80% and 53% of the patients demonstrated antibodies by the CIE, the CFT and the HA, respectively. The HA took 30 days to reach 60% positive serum samples and this percentage declined to 35 by the 50th day. Antibody titres demonstrated in the CIE and the CFT declined more slowly. CIE and CFT performed with antigens from a limited number of heat-stable serotypes can be used in the evaluation of the humoral immune response in CJC-infections.

Antibodies, Bacterial↗
PubMed1985

Serotyping of and hippurate hydrolysis by Campylobacter jejuni isolates from human patients, poultry and pigs in the Netherlands.

Three hundred strains of Campylobacter jejuni, isolated from human patients, poultry and pigs were serotyped according to the Penner-Lauwers system and furthermore tested for hippurate hydrolysis. Serotyping showed a close relationship between human and chicken strains, whereas there was little relationship between human and pig strains. A similar conclusion was drawn from the results of the hippurate hydrolysis test: 86% of human and 94% of poultry strains were positive, whereas 91% of pig strains were negative. These data confirm the conclusions from epidemiological investigations, according to which poultry is a major source of human campylobacteriosis, while pigs are rarely so.

Animals↗
PubMed1985

Evaluation of an enzyme-linked immunosorbent assay (ELISA) for the detection of Campylobacter jejuni antibodies, and comparison with a complement fixation test (CFT).

An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of total anti-Campylobacter immunoglobulins in human sera. In this assay disintegrated Campylobacter bacteria were used as the antigen. Absorption tests including other possibly enteropathogenic bacterial species showed that the ELISA system displayed a high immunological specificity for Campylobacter. Using this ELISA it was found that in about 80% of Campylobacter patients these Campylobacter antibodies are produced to almost maximal levels within 8 days after onset of disease, and that they may persist for at least 4 months. Indeed, Campylobacter antibodies were demonstrated at low levels in a large number of control sera. However, accepting an antibody titre of 1:640 as indicative of Campylobacter infection, the statistical sensitivity of the ELISA system was 77% and the specificity 95%. In an epidemiological survey a high association was demonstrated between the severity of Campylobacter-related symptoms and antibody titre values. Assessment of Campylobacter antibody titres by means of this ELISA and by a complement fixation test in 92 sera from index patients and contacts with and without symptoms showed a high association of results.

Antibodies, Bacterial↗
PubMed1985

Biotypes and serotypes of Campylobacter jejuni and Campylobacter coli strains isolated from patients, pigs and chickens in the region of Rotterdam.

A comparison was made of the distribution of the bio-and serotypes of Campylobacter jejuni and Campylobacter coli isolated from human patients (205 isolates), intestinal contents of pigs (163 isolates) and intestinal contents and livers of chickens (147 isolates). All strains were isolated in the region of Rotterdam. Campylobacter jejuni biotype 1 accounted for 86%, 1% and 82% of the human, pig and chicken isolates respectively; C. coli was present in 7%, 98% and 14% respectively. Serotyping was possible for 84% of the human isolates, 77% of the pig and 82% of the chicken isolates. Among the human isolates 33 bio-and serotypes were found, of which 22 were similar to those in chickens and only five to those in pigs. Bio-and serotypes from human beings and chickens, ranked in order of decreasing frequency, showed a positive correlation, whereas those from human beings and pigs showed a negative correlation.

Animals↗
PubMed1984

Passive-active immunisation of neonates of HBsAg positive carrier mothers: preliminary observations.

Screening of pregnant women for hepatitis B surface antigen (HBsAg) in three areas of Holland led to the identification of HBsAg carriers, 20 of whom were subsequently delivered. Within two hours after birth all infants received hepatitis B immune globulin (0.5 ml/kg body weight) and, after randomisation, hepatitis B vaccine (10 micrograms) was given either at 0, 1, and 2 months of age or at 3, 4, and 5 months of age, the latter concomitantly with DPTP vaccination. Eighteen infants complying with the protocol were followed up for at least six months. No side effects were observed after either passive or active immunisation. All infants developed high concentrations of anti-HBs antibodies; no interference of high dose passive immunisation with active immunisation was observed. Concentrations of anti-HBs at three months were significantly lower in infants given delayed active immunisation than in those given early active immunisation. These data suggest that passive-active immunisation against hepatitis B virus infection is well tolerated by neonates under 3 months of age and that both early and late active immunisation in combination with passive immunisation will result in excellent anti-HBs production.

Carrier State↗
PubMed1984

Epidemiological investigations on Campylobacter jejuni in households with a primary infection.

Fifty-four Rotterdam patients in which a primary infection with Campylobacter jejuni had been detected (index patients) were compared with 54 control subjects with regard to the consumption and preparation of foods 7 days before onset of illness and the keeping of pet animals. Significantly more index patients than controls had eaten chicken meat (47 v. 29; P = 0.0002), particularly at barbecues (14 v. 2; P = 0.0015). Marginally more index patients had eaten pork (47 v. 39; P = 0.048) or inadequately heated meat (13 v. 8), though in the last case numbers were too small to be statistically significant. The consumption of beef or mutton and outdoor eating (other than at barbecues) were essentially the same in both groups. There was no significant association with the keeping of pet animals, although a few more index patients had cage birds than controls (18 v. 12). Twenty-one (15%) of 136 household contacts of index patients also suffered from diarrhoea during the same period. Circumstantial evidence pointed to a common source of infection with the index patient in 13 instances (nine households) and probable intrafamilial spread of infection in six instances. Campylobacters were isolated from one of 110 swabs of kitchen work surfaces and eight of 107 swabs taken from lavatory bowls in index households.

Animals↗
PubMed1982

Markers of hepatitis B in a group of Vietnamese boat-refugees in the Netherlands.

The first 541 Vietnamese boat-refugees who arrived in the Netherlands were examined for markers of hepatitis B. Hepatitis-B surface antigen (HBs-ag) was present in 16.6% of the group (19.4% in males and 13.5% in females). This difference was significant in the 0-19 year age-group (P less than 0.05). 45.8% of the refugees demonstrated antibody against the hepatitis B surface antigen (anti-HBs). In about 30% of the group the markers HBs-ag, anti-HBs and antibody against the core-antigen (anti-HBc) were absent. Females were without these markers of a past infection more often than males (35 against 24%; P less than 0.001). In the age-group 20-29 years these markers were absent in one out of every eight men and in one out of every four women (P less than 0.01). 27% of the group was positive for HBs-ag and or anti-HBc, making them potentially infectious (male 32.9% and female 20.1%; P less than 0.001). Among the HBs-ag-positives the e-antigen could be demonstrated in 58%. Newborns in this group are considered to be candidates for vaccination with the hepatitis-B vaccine.

Adolescent↗
PubMed1980

Coagglutination as a test for Neisseria gonorrhoeae.

After growth on Thayer-Martin medium, 196 strains of freshly isolated Neisseria gonorrhoeae were subjected to a coagglutination reaction. The sensitivity of the test was 94% and did not vary much in the hands of four consecutive technicians. In a group of 99 strains tested by one of the technicians non-interpretable results were obtained with 17% of the strains when the test was performed with cells taken from the first or primary plate, against 9% when cells from the secondary (subcultured) plate were used. The lowest number of non-interpretable results was found with a modified Thayer-Martin medium, which also showed the lowest number of false negatives (2%). No non-interpretable results were obtained when the bacterial suspension was first heated to 100 degrees C for 3 min. In a group of 14 recently isolated strains of non-gonococcal species there was only one, preventable, false-positive strain and there were none in a group of 12 meningococci (all of them laboratory strains). In comparison with the fermentation test with Lingelsheim's sugars, the coagglutination test with cells taken from the primary plate with Thayer-Martin medium yielded a conclusive result more often. The test is simple and rapid and does not require special technical equipment. It seems to deserve a place as a confirmative test in the search for gonococci in samples from the urogenital-anal area.

Agglutination Tests↗