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Prevalence in human beings of antibodies to Chlamydia IOL-207, an atypical strain of chlamydia.

Samples of serum from 18353 persons from the U.K. and abroad, were tested for type-specific antibodies to Chlamydia spp. Antibodies to an atypical strain, Chlamydia IOL-207, were detected in each population tested. Overall, the prevalence of these antibodies (19.9%) was similar to that of antibodies to C. trachomatis (21.6%). In the U.K., antibodies to C. IOL-207 were rare in children under the age of 5 years but became more common with increasing age. In adults the prevalence of these antibodies increased annually between 1979 and 1984. Antibodies to C. IOL-207 were not associated with sexually transmitted disease and only rarely with ocular disease. Their association with a common complaint such as mild respiratory illness is postulated. The presence of these antibodies within a population may lead to the over-diagnosis of C. trachomatis infections or psittacosis if only genus-specific serological tests are used.

Adolescent↗

[Infections associated with pets].

INTRODUCTION: Domestic pets can transmit numerous infections, including bacterial, parasitic, fungal, and viral diseases. This paper reports the epidemiologic, clinical, therapeutic and prophylactic data of these zoonoses. CURRENT KNOWLEDGE AND KEY POINTS: The routes of transmission are various. Bites and scratches are the most common health hazards and result in localized infections. Pasteurellosis, various aerobic and anaerobic infections, and cat-scratch disease are predominant. Bites are treated by cleaning the wound, rabies and tetanus prophylaxis, and the appropriate use of antibiotics. Other infections are transmitted through cutaneous, mucous, digestive or respiratory routes, by direct contact with the pets, excreta, or by arthropods. The most common are gastrointestinal (campylobacter, salmonella, yersinia, parasites, etc), dermatologic (dermatophytoses, scabies, cutaneous larva migraines, etc.), respiratory (psittacosis, etc.), and multisystemic (toxoplasmosis, toxocariasis, leishmaniosis). Certain people are at high risk for diverse diseases: small children (toxocariasis, helminthiasis), pregnant women (toxoplasmosis), and immunodeficient patients (cryptosporidiosis, salmonellosis, systemic pasteurellosis). These infectious diseases can be partly prevented by avoiding contact with diseased animals, and by washing the hands following exposure to pets or pet-derived excreta. Specific vaccines for humans and pets, as well as worming pets regularly, form an important part of the prevention. Veterinarians must discourage the keeping of wild or exotic animals as pets. FUTURE PROSPECTS AND PROJECTS: National health survey institutions and new communication systems can improve our knowledge about the real epidemiology of pet-transmitted zoonoses.

Animals↗

Circulation of avian Chlamydia abortus in the Netherlands and community-acquired pneumonia: an outbreak investigation and retrospective cohort study.

BACKGROUND: In 2021, a novel group of Chlamydia strains in wild birds was classified as avian Chlamydia abortus, with unknown zoonotic potential. We report relevant features of avian C abortus infections from a Dutch family cluster and unrelated historical cases using clinical, epidemiological, and microbiological data. METHODS: An outbreak of avian C abortus started in the Netherlands in December, 2022. Source investigation was done using questionnaires to interview patients and environmental sampling. The outbreak strain of avian C abortus was cultured from three patients from whom sufficient material was available for culture and underwent whole-genome analysis. The outbreak strains and retrospective cohort study strains previously submitted to the National Human Psittacosis surveillance programme in the Netherlands between 2010 and 2022 were typed by partial ompA sequencing. Strains with the same aberrant ompA genotype were further analysed with XerC gene plasmid analysis and compared with closely related Chlamydia sequences available in GenBank. FINDINGS: An avian C abortus strain caused a cluster of respiratory illness in four family members. Three patients were hospitalised with community-acquired pneumonia, one of whom was admitted to the intensive care unit. The faeces of wild birds were considered a probable source for the index infection. For two family members, human-to-human transmission was a plausible route. Ten historical cases could be identified with avian C abortus with the same ompA genotype. All patients had been admitted to hospital, at least five developed pneumonia, and one died. INTERPRETATION: This cluster supports that avian C abortus strains can cause human infections and underlines that human-to-human transmission should be considered when tracing the source of such infections. FUNDING: National Institute for Public Health and the Environment and Dutch Ministry of Agriculture, Fisheries, Food Security and Nature. TRANSLATION: For the Dutch translation of the abstract see Supplementary Materials section.

Humans↗

Pet-assisted therapy in the nursing home setting: potential for zoonosis.

Pet-assisted therapy in the nursing home setting, as a vital component of the Eden Alternative or Human Habitat program, is gaining widespread recognition and implementation. Programs such as this help to improve the quality of life of nursing home residents by offsetting resident loneliness, helplessness, and boredom. However, use of companion animals (and, frequently, birds and fish) may be associated with the introduction of infectious entities that are normally uncommon in this setting (zoonosis). Examples include psittacosis, bartonellosis, toxocariasis, Capnocytophaga canimorsus, pasturellosis, Q fever, and leptospirosis, to name but a few. Hence vigilance for unusual clinical manifestations that may herald such diseases is necessary. In addition, prevention of such illnesses by routine veterinary screening of both resident and visiting companion animals is mandatory. Infection control policies and procedures geared toward management and prevention of zoonotic illnesses should be developed and implemented in all nursing homes offering pet-assisted therapy.

Animals↗

Evaluation of two serological tests for the diagnosis of chlamydial respiratory disease.

Serological tests for chlamydial infection are one of the most frequently used methods in the diagnosis of atypical respiratory infections. Use of serological tests has implicated chlamydial infections in asthma, arthritis and coronary heart disease, but the specificity of chlamydial serology tests has been questioned. The immunofluorescence test is the most sensitive and specific serological test available for detection of chlamydial antibodies. This study compares two commercially available immunofluorescent antibody tests. The SeroFIA test using purified elementary bodies of Chlamydia pneumoniae, C. psittaci and C. trachomatis, detected 24 cases of acute C. pneumoniae infection, whereas the Spot IF test using whole cell antigen of C. psittaci and C. trachomatis, misdiagnosed 20 of these as psittacosis and missed four cases.

Antibodies, Bacterial↗

Studies on primary atypical pneumonia. I. Localization, isolation, and cultivation of a virus in chick embryos.

By means of fluorescein-labelled antibody, the primary atypical pneumonia virus was found to multiply exclusively in the cytoplasm of the epithelial cells lining the bronchioles and air sacs of developing chick embryos. When 13-day old embryos were inoculated intra-amniotically and incubated at 35 degrees C. for 5 days or longer, over 90 per cent of the inoculated embryos became infected. Between 1954 and 1956, seven strains of PAP virus were isolated from sputums or nasopharyngeal washings in patients during the acute stage of the PAP infection. One strain of virus was isolated from the frozen lung of a patient who died at Boston in 1943. All eight recently isolated strains and the Mac strain isolated by Eaton et al. in California in 1944 were antigenically closely related if not identical. PAP virus is not related antigenically to agents of psittacosis, Q fever, adenovirus (Types 1 to 6), influenza A or B, or PVM.

Animals↗

The problems of treating atypical pneumonia.

Atypical pneumonia has been recognized for at least four decades as a clinical syndrome characterized by a less severe clinical course than typical bacterial pneumonia. It is caused by a variety of different organisms including Mycoplasma pneumoniae, chlamydiae, rickettsiae, viruses and Legionella pneumophila. Of the chlamydiae, TWAR-strain (Chlamydia pneumonia) is now considered the most important pathogen. Its prevalence in community-acquired pneumonia varies considerably depending on the cyclical nature of the disease, but also on the diagnostic methods applied. The first line therapy in community-acquired pneumonia is usually empirical administration of a penicillin or cephalosporin to cover the bacterial pathogens which usually cause 'typical' pneumonia, most importantly Streptococcus pneumoniae. If, however, atypical pneumonia is diagnosed by bacteriological or serological testing, or is suspected clinically or on the basis of treatment failure, the treatment of choice would be erythromycin 2-4 g or tetracyclines (doxycycline 200 mg) daily for M. pneumoniae pneumonia and C. pneumoniae (TWAR-strain) infection. For coxiella pneumonia tetracycline is preferred. Psittacosis (ornithosis) has a high mortality and must be treated with tetracyclines immediately. Legionella pneumonia is preferably treated with erythromycin 2-4 g for at least three weeks; as an alternative, tetracyclines or quinolones may be given. Quinolones are less effective in mycoplasma and chlamydial infection. The new macrolide antibiotics are promising agents in pneumonia due to M. pneumoniae, L. pneumophila and C. pneumoniae. Compared to erythromycin they have improved pharmacological properties. They have long half-lives allowing once-daily dosing and achieve high tissue and intracellular concentrations.

Bacterial Infections↗

Immunotyping of Chlamydia psittaci by indirect immunofluorescence antibody test with monoclonal antibodies.

Monoclonal antibodies against pigeon and budgerigar strains of Chlamydia psittaci were used to classify the immunotypes of C. psittaci strains by an indirect immunofluorescence antibody (IFA) test. Thirty-three C. psittaci strains from pigeons and 24 from budgerigars were divided into three immunotypes (P-I, P-II, and P-III) and (B-I, B-II, and B-III), respectively. Two strains from human psittacosis patients were identified as P-III and B-I, coinciding with the epidemiological evidence of each human infection. Two strains from psittacine birds, a parrot and a parakeet, were identical to the B-II immunotype. Other mammalian strains were quite distinct from avian strains in their IFA reaction with the monoclonal antibodies.

Animals↗

Immunohistochemical detection of chlamydiae in formalin-fixed tissue sections: comparison of a monoclonal antibody with yolk derived antibodies (IgY).

Immunohistological detection of chlamydiae in formalin-fixed and paraffin-embedded sections of various organs from several species is described. In a retrospective study, two antisera, a commercially available monoclonal murine antibody (IgMur) and vitelline immunoglobulins (IgY), extracted from the egg yolk of immunized hens, were compared and tested for their applicability under routine condition. Both antisera were applied to tissues from which chlamydiae had been isolated or in which the presence of chlamydiae had been suspected in specially stained sections. Antigen labelling was optimal with the monoclonal antibody. Vitelline immunoglobulins produced some unspecific reactions, especially in lung tissue sections. Because of the antigenic relationship between the vitelline antibodies and tissues of birds, IgY are not suitable for the detection of psittacosis on avian substrates, when using an indirect immunological method. Staining in other tissues e.g. intestine or placenta was of equal quality as that attained with monoclonal antibodies. Depending on the advantages and disadvantages in every individual case, one of the two antibodies may be chosen for further studies. Vitelline antibodies should be preferred with respect to animal welfare.

Animals↗

The atypical pneumonias: clinical diagnosis and importance.

The most common atypical pneumonias are caused by three zoonotic pathogens, Chlamydia psittaci (psittacosis), Francisella tularensis (tularemia), and Coxiella burnetii (Q fever), and three nonzoonotic pathogens, Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella. These atypical agents, unlike the typical pathogens, often cause extrapulmonary manifestations. Atypical CAPs are systemic infectious diseases with a pulmonary component and may be differentiated clinically from typical CAPs by the pattern of extrapulmonary organ involvement which is characteristic for each atypical CAP. Zoonotic pneumonias may be eliminated from diagnostic consideration with a negative contact history. The commonest clinical problem is to differentiate legionnaire's disease from typical CAP as well as from C. pneumoniae or M. pneumonia infection. Legionella is the most important atypical pathogen in terms of severity. It may be clinically differentiated from typical CAP and other atypical pathogens by the use of a weighted point system of syndromic diagnosis based on the characteristic pattern of extrapulmonary features. Because legionnaire's disease often presents as severe CAP, a presumptive diagnosis of Legionella should prompt specific testing and empirical anti-Legionella therapy such as the Winthrop-University Hospital Infectious Disease Division's weighted point score system. Most atypical pathogens are difficult or dangerous to isolate and a definitive laboratory diagnosis is usually based on indirect, i.e., direct flourescent antibody (DFA), indirect flourescent antibody (IFA). Atypical CAP is virtually always monomicrobial; increased IFA IgG tests indicate past exposure and not concurrent infection. Anti-Legionella antibiotics include macrolides, doxycycline, rifampin, quinolones, and telithromycin. The drugs with the highest level of anti-Legionella activity are quinolones and telithromycin. Therapy is usually continued for 2 weeks if potent anti-Legionella drugs are used. In adults, M. pneumoniae and C. pneumoniae may exacerbate or cause asthma. The importance of the atypical pneumonias is not related to their frequency (approximately 15% of CAPs), but to difficulties in their diagnosis, and their nonresponsiveness to beta-lactam therapy. Because of the potential role of C. pneumoniae in coronary artery disease and multiple sclerosis (MS), and the role of M. pneumoniae and C. pneumoniae in causing or exacerbating asthma, atypical CAPs also have public health importance.

Anti-Bacterial Agents↗

Comparative PCR-based restriction fragment length polymorphism analysis of the plasmid gene orf3 of Chlamydia trachomatis and Chlamydia psittaci.

The BfaI digestion of PCR-based restriction fragment length polymorphism analysis of the plasmid orf3 of Chlamydia trachomatis and Chlamydia psittaci provided evidence for two distinct restriction patterns, respectively. The nucleotide sequences of orf3 genes confirmed these differences. Serum antibodies against recombinant C. psittaci protein (pgp3) encoded by orf3 were detected both in pigeons with C. psittaci infection and in a human patient with psittacosis.

Amino Acid Sequence↗

Elevated viral antibody titres in spontaneous abortion.

To assess the possible role of virus infections in spontaneous abortion we undertook a prospective study of three groups of patients: women who had a spontaneous abortion; women seen in the antenatal booking clinic; and those undergoing therapeutic termination of pregnancy. Venous blood was taken for antibody detection, cervical swabs for virus isolation, and in the cases of spontaneous and therapeutic abortion products of conception were sent for virus culture. The infectious agents studied were influenza A and B, adenovirus, respiratory syncytial virus, measles, psittacosis, Varicella zoster, and mumps virus. Statistical analysis revealed that women in the spontaneous abortion group has a higher incidence of antibodies against respiratory syncytial virus (P less than 0.01), and mumps virus (P less than 0.01). Among women seropositive for each virus, higher titres were found only for respiratory syncytial virus (P less than 0.05) in cases rather than controls. These results could be explained if viruses such as respiratory syncytial virus caused abortion or if women having a spontaneous abortion mount exaggerated immune responses to fetal and viral infections, and the former altered immune response is associated with spontaneous abortion.

Abortion, Spontaneous↗

[Assay of specific anti-Chlamydia pneumoniae antibodies by ELISA method. 1. Evaluation of ELISA kit using outer membrane complex].

Studies were conducted with the goal of developing a kit for assaying anti-Chlamydia pneumoniae antibodies in human serum which would enable judging positive cases with high specificity by means of an objective numerical index. Thus, an enzyme-linked immunosorbent assay (ELISA) method employing a C. pneumoniae outer membrane complex protein was established. Elementary bodies (EB) were purified from the YK-41 strain of C. pneumoniae, and subsequent treatment with Sarkosyl, DNase and RNase yielded chlamydial outer membrane complex (COMC). COMC was employed as the antigen and immobilized on 96-well microplates for ELISA method. This ELISA method was used to test 51 serum specimens from patients who had been demonstrated to be positive for C. pneumoniae antigen (throat swab: PCR positive), and the levels of IgG, IgA and IgM antibodies were assayed. For each specimen, comparison was made with the antibody titers determined by the micro immunofluorescence test (Micro-IF method). The results showed good correlation coefficients of 0.950 for IgG, 0.852 for IgA and 0.866 for IgM. In addition, the two assay methods showed the following high agreement rates: 90.2% for IgG, 84.3% for IgA and 82.4% for IgM. Specimens which did not yield the same results with the ELISA method and Micro-IF method were subjected to analysis by Western blot method, and the rates of agreement with the ELISA results were 80% for IgG, 87.5% for IgA and 88.9% for IgM. These data indicate the efficacy of this new ELISA method. Moreover, COMC was reacted with mouse antisera to three Chlamydia species, and the mouse IgG antibody was assayed. Anti-C. pneumoniae antiserum showed the strongest reactivity, whereas weaker reactivity was shown by anti-C. trachomatis antiserum (1/32nd of the reactivity of the anti-C. pneumoniae antiserum) and anti-C. psittaci antiserum (1/4th). In addition, sera from patients infected with C. trachomatis or C. psittaci (Psittacosis) were subjected to the ELISA method using COMC from C. pneumoniae. It was found that the correlation between the ELISA and Micro-IF methods was higher in relation to the anti-C. pneumoniae antibody titer than either the anti-C. trachomatis antibody titer or anti-C. psittaci antibody titer. These findings indicate this new assay kit based on the ELISA method has high specificity for C. pneumoniae.

Animals↗

Elementary-body virus isolated from clinical trachoma in California.

From an adult white resident of California with clinically typical early trachoma a virus was isolated by growth in embryonated eggs. Morphologically and serologically the virus belongs in the psittacosis-lymphogranuloma group. When it is instilled into monkey eyes it produces acute follicular conjunctivitis with typical inclusion bodies.

California↗

Effect of gentamicin on growth of viral, chlamydial, and rickettsial agents in mice and embryonated eggs.

Gentamicin, at concentrations up to 500 mug/ml, showed no effect on the replication, yield, or infectivity of seven viruses or on the agents of psittacosis and meningopneumonitis when grown in mice or embryonated eggs. At the 500 mug/ml level, lymphogranuloma venereum cultures had a slight reduction in infectivity. Rickettsia akari demonstrated susceptibility at the 5 mug/ml level, whereas R. rickettsii, R. mooseri, and R. canada grown in embryonated eggs were susceptible in varying degrees to gentamicin at or above the 50 mug/ml concentration.

Animals↗

Viral susceptibility range of the fathead minnow (Pimephales promelas) poikilothermic cell line.

The viral susceptibility range of a poikilothermic cell line derived from the fathead minnow (Pimephales promelas) (FHM) to infection by a number of homoiothermic viruses representing most of the presently recognized viral groups and a member of the psittacosis-lymphogranuloma-trachoma group of agents was studied. All infectious agents, except poliovirus types 1 and 3, infectious bursal agent, and an avian infectious bronchitis virus (IBV) strain, readily multiplied in the FHM cell culture system, producing a detectable cytopathic effect. Although inconclusive evidence was obtained with two other avian IBV strains, these results indicated the ability of the FHM cell culture system to readily support the propagation of a variety of cytopathogenic homoiothermic viral agents.

Animals↗

Assessment of aerosol mixtures of different viruses.

Aerosol mixtures of the psittacosis agent, yellow fever virus, and variola virus were assayed by selective immunofluorescence in conjunction with fluorescent cell counting. The aerosol behavior of each agent could be readily delineated at test conditions of 80 F (26.67 C) and three relative humidities (30, 50, or 80%). Of the three agents, variola virus exhibited the lowest biological decay. The biological decay rates of the airborne agents were not significantly affected by humidity changes.

Aerosols↗

Transcriptional response patterns of Chlamydophila psittaci in different in vitro models of persistent infection.

The obligatory intracellular bacterium Chlamydophila psittaci is the causative agent of psittacosis in birds and humans. The capability of this zoonotic pathogen to develop a persistent phase is likely to play a role in chronicity of infections, as well as in failure of antibiotic therapy and immunoprophylaxis. To elucidate three different in vitro models for transition of C. psittaci to persistence (iron depletion, penicillin G treatment, and gamma interferon [IFN-gamma] exposure), a set of 27 genes was examined by mRNA expression analysis using quantitative real-time PCR. While the phenotypical characteristics were the same as in other chlamydiae, i.e., aberrant morphology of reticulate bodies, loss of cultivability, and rescue of infectivity upon removal of inducers, the transcriptional response of C. psittaci to persistence-inducing factors included several new and distinctive features. Consistent downregulation of membrane proteins, chlamydial sigma factors, cell division protein, and reticulate body-elementary body differentiation proteins from 24 h postinfection onward proved to be a general feature of C. psittaci persistence. However, other genes displayed considerable variations in response patterns from one model to another, which suggests that there is no persistence model per se. In contrast to results for Chlamydia trachomatis, late shutdown of essential genes in C. psittaci was more comprehensive with IFN-gamma-induced persistence, which is probably due to the absence of a functional tryptophan synthesis operon.

Animals↗