[Recent insulin-dependent diabetes: at least 2 daily injections with self-controlled blood sugar].
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BACKGROUND: Lyme borreliosis is a chronic, multisystem disease, of prolong course with three consecutive stages, caused by a tick-transmitted spirochete Borrelia burgdorferi. Tick Borne Encephalitis (TBE) is neuroinfection caused by Tick Borne Encephalitis Virus (TBEV). OBJECTIVE: We evaluated the occurrence of psychiatric manifestations in the early phase of borreliosis-erythema migrans and neuroboreliosis as well as in its late phase--in arthritis and in the Tick-Born Encephalitis. The aim of the study was to single out the most frequent psychiatric symptoms and psychopathological syndroms and to determine their dynamics. METHODS: The study was carried out between 1999 and 2000 and comprised 174 patients of the Department of Psychiatry and Department of Infectious and Neuroinfectious Diseases of Medical Academy in Bialystok. Seventy seven patients diagnosed with arthritis, 20 with neuroborreliosis, 26 with skin manifestation-erythrema migrans and 51 with KZM participated. All subjects underwent psychiatric evaluation twice--during hospitalization and six month after discharge. Mental status examinations included general psychiatric examination and battery of scales and tests: Mini Mental State Examination, Beck Depression Inventory, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Reitan's Trail Making Test, Choynowsky Memory Scale, Symptoms Inventory and neuropsychological testing. RESULTS: Both in the course of TBE and Lyme borreliosis the majority of patients experienced psychiatric problems in the acute phase of disease as well as in the late phase--3, 6 months after the onset of the disease. The most common psychiatric manifestations were depressive disorders--episodes of depression or organic mood disorders, and cognitive deficits which manifest themselves as mild cognitive disorder or dementia. CONCLUSION: Psychiatric assessment is important in early stage of kzm and borreliosis but first of all after termination of acute symptomatology.
Borrelia burgdorferi outer surface protein (Osp) A is preferentially expressed by spirochetes in the Ixodes scapularis gut and facilitates pathogen-vector adherence in vitro. Here we examined B. burgdorferi-tick interactions in vivo by using Abs directed against OspA from each of the three major B. burgdorferi sensu lato genospecies: B. burgdorferi sensu stricto, Borrelia afzelii, and Borrelia garinii. Abs directed against B. burgdorferi sensu stricto (isolate N40) destroy the spirochete and can protect mice from infection. In contrast, antisera raised against OspA from B. afzelii (isolate ACA-1) and B. garinii (isolate ZQ-1) bind to B. burgdorferi N40 but are not borreliacidal against the N40 isolate. Our present studies assess whether these selected OspA Abs interfere with B. burgdorferi-tick attachment in a murine model of Lyme disease with I. scapularis. We examined engorged ticks that had fed on B. burgdorferi N40-infected scid mice previously treated with OspA (N40, ACA-1, ZQ-1, or mAb C3.78) or control Abs. OspA-N40 antisera or mAb C3.78 destroyed B. burgdorferi N40 within the engorged ticks. In contrast, treatment of mice with OspA-ACA-1 and OspA-ZQ-1 antisera did not kill B. burgdorferi N40 within the ticks but did effectively interfere with B. burgdorferi-I. scapularis adherence, thereby preventing efficient colonization of the vector. These studies show that nonborreliacidal OspA Abs can inhibit B. burgdorferi attachment to the tick gut, highlighting the importance of OspA in spirochete-arthropod interactions in vivo.
We report results of a Phase III trial of the multi-subunit recombinant Leishmania polyprotein MML for the protection of dogs against infection by Leishmania infantum. The antigen, also known as Leish-111f, is the first antileishmanial human vaccine entered Phase I clinical testing. The study was performed in a leishmaniasis endemic area of southern Italy. Three groups of 15 Leishmania-free beagle dogs each, received 3 monthly injections with vaccines A (MML+MPL-SE adjuvant), B (sterile saline = control) and C (MML+Adjuprime adjuvant), respectively, before transmission season 2002. The surviving dogs received a second three-dose vaccine course 1 year later. The dogs were naturally exposed to sandfly bites for 2.5 months in 2002, and for 5 months in 2003. Every 2 months post vaccination, dogs were examined by clinical and immunological evaluation, and by specific serology, microscopy, culture and PCR. A weak lymphoproliferative response to MML was seen in A and C groups throughout the study period. One year after the first vaccine course, the cumulative incidence of leishmanial infections was 40% in group A, 43% in group B and 36% in group C. Two-year post-vaccination (1 year after the second vaccine course) the cumulative incidence was 87% in group A (with three symptomatic cases), 100% in group B (with no symptomatic cases) and 100% in group C (with two symptomatic cases). The efficacy of the MML vaccine as an immunotherapeutic agent for the prevention of disease progression (subpatent infection-->asymptomatic patent infection-->symptomatic patent infection) was evaluated through follow-up of dogs found infected prior to the second vaccination. Among 15 infected animals, progression to a subsequent stage of infection was found in 5/6 dogs of group A, 3/6 of group B and 2/3 of group C. We conclude that vaccination with MML is not effective to prevent leishmaniasis infection and disease progression in dogs under field conditions.
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Twenty-six calves which had not previously grazed tick-infested pasture were divided into two equal groups. On May 26, 1988 (day 0) they were turned out into a field of rough grazing where cases of redwater fever had occurred the previous spring. Seven, 14, 21 and 28 days after the start of the trial the animals in one group each received an intramuscular injection of 20 mg/kg bodyweight of long-acting oxytetracycline. During the 60 days of the trial the animals received a severe tick-borne fever challenge, in some cases combined with a redwater fever challenge. An unforeseen complicating factor was the presence of animals persistently infected with bovine viral diarrhoea virus, present in almost equal numbers in both groups. At the end of the trial the treated group weighed on average 16 kg more than the control group, a difference which was attributed to the suppression of tick-borne fever by oxytetracycline.
Theileria parva sporozoite stabilates are used in the infection and treatment method of immunization, a widely accepted control option for East Coast fever in cattle. T. parva sporozoites are extracted from infected adult Rhipicephalus appendiculatus ticks either manually, using a pestle and a mortar, or by use of an electric homogenizer. A comparison of the two methods as a function of stabilate infectivity has never been documented. This study was designed to provide a quantitative comparison of stabilates produced by the two methods. The approach was to prepare batches of stabilate by both methods and then subject them to in vitro titration. Equivalence testing was then performed on the average effective doses (ED). The ratio of infective sporozoites yielded by the two methods was found to be 1.14 in favour of the manually ground stabilate with an upper limit of the 95% confidence interval equal to 1.3. We conclude that the choice of method rests more on costs, available infrastructure and standardization than on which method produces a richer sporozoite stabilate.
For the past decade, treatment of cattle with 0.00375% deltamethrin (Decatix, Coopers) at two-weekly intervals has been part of an integrated approach to counteract continuous invasion of Zimbabwe by tsetse from the Mozambique fly-belt. To determine the effect of these regular deltamethrin treatments on the epidemiology of babesiosis, a survey was conducted to estimate the prevalence of antibodies against Babesia bigemina in adult communal cattle. The seroprevalence of antibodies against B. bigemina in adjacent areas, where cattle are treated with short-residual acaricides, was also determined for comparison. The prevalence of antibodies to B. bigemina was much higher in areas where dipping with a non-pyrethroid acaricide was conducted. This was attributed to the successful control of Boophilus spp. and hence a very low level of B. bigemina transmission in the 'deltamethrin treatment zone'. This low level of disease transmission was confirmed by the low prevalence of antibodies against B. bigemina in sentinel cattle that were introduced to the 'deltamethrin treatment zone'. The potential adverse effects of severely reducing the tick population should be taken into consideration at the onset of tsetse control operations in which cattle are to be treated with deltamethrin at short treatment intervals.
The epidemiologic concept of tick-transmitted diseases has increased in importance with the recognition of the emerging infectious diseases, Lyme borreliosis, human monocytotropic and granulocytotropic ehrlichioses, and three different babesioses. Effective public health control of these diseases would depend upon critical knowledge of the vector biology of the ticks that transmit them. Rocky Mountain spotted fever and the human ehrlichioses are life-threatening yet treatable diseases. A major problem remains establishment of the diagnosis when treatment decisions are being made. Clinical manifestations, other than erythema migrans for Lyme borreliosis, do not provide strong diagnostic clues. Ehrlichiae or babesiae are often not detected in peripheral blood smears. Frequently there are no antibodies to these diverse agents at the time of presentation, and isolation does not yield sensitive and timely results. Polymerase chain reaction, still a research tool, promises the greatest sensitivity, specificity, and timeliness. Prevention by vaccines is not yet a reality, although OspA-based vaccines offer hope for the prevention of Lyme disease.
The study of the characteristics of a new dried tissue-culture purified concentrated inactivated vaccine against tick-borne encephalitis, manufactured in the USSR, has revealed that the preparation is moderately reactogenic and produces no definite side effects in the vaccinees. In the process of the controlled epidemiological trial the optimum vaccination schedule for the primary immunization of adults against tick-borne encephalitis with the new preparation has been determined by the study of serum samples from the vaccinees in the hemagglutination inhibition test and the neutralization test in tissue culture. In accordance with this vaccination schedule the course of primary immunization with the chromatographic variant of the concentrated vaccine consists of two injections in a dose of 0.5 ml, made at an interval of 6 months.
Anaplasma marginale, an ehrlichial pathogen of cattle and wild ruminants, is transmitted biologically by ticks. A developmental cycle of A. marginale occurs in a tick that begins in gut cells followed by infection of salivary glands, which are the site of transmission to cattle. Geographic isolates of A. marginale vary in their ability to be transmitted by ticks. In these experiments we studied transmission of two recent field isolates of A. marginale, an Oklahoma isolate from Wetumka, OK, and a Florida isolate from Okeechobee, FL, by two populations of Dermacentor variabilis males obtained from the same regions. The Florida and Oklahoma tick populations transmitted the Oklahoma isolate, while both tick populations failed to transmit the Florida isolate. Gut and salivary gland infections of A. marginale, as determined by quantitative PCR and microscopy, were detected in ticks exposed to the Oklahoma isolate, while these tissues were not infected in ticks exposed to the Florida isolate. An adhesion-recovery assay was used to study adhesion of the A. marginale major surface protein (MSP) 1a to gut cells from both tick populations and cultured tick cells. We demonstrated that recombinant Escherichia coli expressing Oklahoma MSP1a adhered to cultured and native D. variabilis gut cells, while recombinant E. coli expressing the Florida MSP1a were not adherent to either tick cell population. The MSP1a of the Florida isolate of A. marginale, therefore, was unable to mediate attachment to tick gut cells, thus inhibiting salivary gland infection and transmission to cattle. This is the first report of MSP1a being responsible for effecting infection and transmission of A. marginale by Dermacentor spp. ticks. The mechanism of tick infection and transmission of A. marginale is important in formulating control strategies and development of improved vaccines for anaplasmosis.
The Bm86 antigen, as originally identified in Boophilus microplus, is the basis of commercial tick vaccines against this tick species. The potential for using this antigen or homologues of the antigen in vaccination against other tick species has been assessed. We have conducted vaccine trials in cattle using the B. microplus-derived recombinant Bm86 vaccine (TickGARD) using pairs of vaccinated calves and control calves. These were infested with B. microplus and Boophilus decoloratus larvae simultaneously. For both species, the numbers of engorged female adult ticks, their weight and egg-laying capacity were all reduced, leading to a reduction in reproductive capacity of 74% for B. microplus and 70% for B. decoloratus. Hyalomma anatolicum anatolicum ticks were fed both as immatures as well as adults on vaccinated calves and non-vaccinated controls. There was an overall 50% reduction in the total weight of nymphs engorging on vaccinated calves, and a suggestion of a subsequent effect on feeding adults. For Hyalomma dromedarii there was a 95% reduction in the number of nymphs engorging and a further 55% reduction in weight of those ticks surviving. Rhipicephalus appendiculatus and Amblyomma variegatum ticks were fed simultaneously both as immatures and subsequently as adults. There was no evidence for a significant vaccination effect. Finally, the amino acid sequence of a Bm86 homologue found in H. a. anatolicum unequivocally demonstrated the conservation of this molecule in this species. Our strategy for the development of multivalent anti-tick vaccines is discussed in relation to these findings.
Strain-2 guinea-pigs were given two five-day infestations with Dermacentor andersoni larvae. Each exposure consisted of 100 larvae, and the first and second infestations were separated by a seven-day tick-free period. Tick-exposed animals were given an intravenous injection with sheep red blood cells (SRBC) at selected times during and after infestation: (a) the last, fifth day, of a first exposure, (b) the second day of a second infestation, (c) the fifth day of a second infestation and (d) four days after termination of the second infestation. Ability of these animals to respond immunologically to the SRBC injection was assessed by the direct haemolytic plaque-forming cell assay, a very sensitive test used to determine the number of spleen cells producing IgM to SRBC target cells. Strain-2 animals given SRBC at the end of an initial infestation, or during a second tick exposure, produced significantly fewer direct haemolytic plaque-forming cells than did uninfested controls given a similar SRBC immunization regimen. Spleen cells of animals administered SRBC on the fourth day after termination of a second infestation displayed a haemolytic plaque-forming cell response which did not differ significantly from that of uninfested controls.
A model of the epidemic dynamics of heartwater within a cattle production unit was presented by Yonow et al. (1998). Here, the model is expanded to a region consisting of several farms to study the effect of environmental variability on control strategies. We have shown that: * In a region, where the environment of each farm is modelled with constant epidemiologic parameter values, while the between-farm parameter values differ, regional variation in the removal rate of infected cattle increases the average fraction of infected cattle across the region, while regional variation in the transmission rate of infection from ticks to cattle decreases the average fraction of infected cattle, thereby requiring control measures that keep the removal rate uniform and the transmission rate variable. * In a region, where in addition to regional variation between farms, the epidemiologic parameters of each farm are time-variant, then temporal variation in both the transmission rate and removal rate increases the average fraction of infected cattle across the region, thereby requiring control measures that keep both parameters uniform.
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When Boophilus microplus and Type-II hybrids (B. microplus females X B. annulatus males) were released simultaneously onto bovine hosts, mating between the two forms appeared not to be at random. There were more contypic and fewer intertypic matings than predicted under an assumption of panmixia. An examination of the patterns of matings revealed that more of the matings on the first two days of detachment were between the two sexes of B. microplus. Engorged females dropping on the last four days of maximum female detachment were predominantly hybrids mated to both B. microplus and hybrid males. The non-random mating pattern does not appear to be caused by assortative mating between B. microplus and Type-II hybrids, but because the B. microplus were competent to mate two days before the hybrids and the B. microplus males compete for males of both types better than the Type-II males.