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Study of rickettsioses in Slovakia. III. Experimental infection of Apodemus flavicollis Melch. by rickettsiae of the spotted fever (SF) group isolated in Slovakia.

Experimental studies of infection of Apodemus flavicollis, and for comparison of rickettsiaemia in Clethrionomys glareolus and of susceptibility and antibody formation in white mice, with rickettsiae of the SF group isolated in Slovakia, gave the following results: the species A. flavicollis reacted by the formation of antibodies on subcutaneous administration of rickettsiae, strain B, in an amount of 10(0.5) EID 50/0.25 ml, whereas the white mouse only in an amount of 10(2.5). Rickettsiae, strain B, administered in an amount of 10(3.5) EID 50/0.25 ml subcutaneously to A. flavicollis were found in smears from the liver and spleen of the inoculated animals up to the 25th day following infection, on detection by the isolation test on chick embryo yolk sacs in the spleen on day 5 and 7, in lymph nodes on day 7 and in the brain on day 15 following infection; on detection by the method of injecting suspension from the organs into the haemocoelom of ticks regularly in the spleen and liver up to the 10th day, in the brain, kidney and lymph nodes regularly up to the 15th and irregularly in the lungs also up to the 15th day, then regularly in the testes up to the 5th day and in the heart, blood and peritoneum up to the 3rd day after infection.

Animals

Study of rickettsioses in Slovakia. II. Infestation of fleas and mites in mole nests in some localities in Central Slovakia with C. burneti and Rickettsiae belonging to the spotted fever (SF) group.

Fleas and mites obtained from 115 mole nests in Central Slovakia from an area where Q fever and rickettsiosis due to rickettsie of the SF occur, from the border of this area and apart from it, were tested for infestation with rickettsiae by the method of isolation of rickettsiae on chick embryo yolk sacs, by the method of detection of rickettsiae on smears from the arthropods using immunofluorescence, by the method of exposure of albino mice and Apodemus flavicollis to mole nests and by the method of inoculation of suspension from the arthropods to albino mice. In the latter two methods, infestation of the arthropods was assessed according to the formation of antibodies in the mice. It has been found that fleas and mites in all three areas under test are infected with C. burneti and with rickettsia of the SF group. C. burneti was currently detected in the focus of rickettsioses and in the localities situated in its borders while only one case was observed apart from the focus. Rickettsiae of the SF group were found in fleas and mites in all areas tested showing no greater percentual differences. The method of detection of rickettsia in smears from the arthropods using the immunofluorescence technique and antibody response in mice inoculated with infected arthropods was found to be the most effective in these studies. On the basis of the obtained results the authors believe that mites and fleas living in mole nests participate in the circulation of both species of rickettsiae in nature in the transfer of rickettsiae among small mammals. The question whether these arthropods are a reservoir, a biological or a mechanical vector, still remains open.

Animals

Study of rickettsioses in Slovakia. III. Experimental infection of Apodemus flavicollis Melch. by Rickettsiae of the spotted fever (SF) group isolated in Slovakia.

Experimental studies of infection of Apodemus flavicollis, and for comparison of rickettsiaemia in Clethrionomys glareolus and of susceptibility and antibody formation in white mice, with rickettsiae of the SF group isolated in Slovakia, gave the following results: The species A. flavicollis reacted by the formation of antibodies on subcutaneous administration of rickettsiae, strain B, in an amount of 10(0.5) EID50/0.25 ml, whereas the white mouse only in an amount of 10(2.5). Rickettsiae, strain B, administered in an amount of 10(3.5)EID50/0.25 ml subcutaneously to A. flavicollis were found in smears from the liver and spleen of the inoculated animals up to the 25th day following infection, on detection by the isolation test on chick embryo yolk sacs in the spleen on day 5 and 7, in lymph nodes on day 7 and in the brain on day 15 following infection; on detection by the method of injecting suspension from the organs into the haemocoelom fo ticks regularly in the spleen and liver up to the 10th day, in the brain, kidney and lymph nodes regularly up to the 15th and irregularly in the lungs also up to the 15 day, then regularly in the testes up to the 5th day and in the heart, blood and peritoneum up to the 3rd day after infection. Subcutaneous inoculation of rickettsial suspension in an amount of 10(5)EID50/0.25 ml into A. flavicollis and C. glareolus did not produce rickettsiaemia. However, rickettsiaemia was demonstrated in A. flavicollis on day 3 and 7, and in C. glareolus on day 1, 3, 5 and 7 following the bite by female D. marginatus ticks naturally infected by rickettsiae. A. flavicollis mice responded to oral infection by a suspension of rickettsiae, strain B, by the formation of specific antibodies. Subcutaneous administration of various amounts of rickettsiae, strain D, provoked in A. flavicollis and in white mice the formation of antibodies which in A. flavicollis persisted up to the 44th week following infection and reached the values up to greater than 1:1024 between the 2nd and 6th week, while in the white mice they persisted only up to the 12th week following infection and did not exceed the values of 1:256 in the course of the first 6 weeks. The results suggest that the species A. flavicollis will probably play an important role in the circulation of rickettsiae in nature.

Animals

Care for patients with hereditary coagulopathies in Slovakia.

Contemporary situation with the care for hereditary coagulopathies in Slovakia is discussed. The mode of obtaining the data for central registration of patients suffering from hereditary coagulopathies in Slovakia is elucidated. Importance of such a registration for prospective planning guaranteeing needs of patients and of concentration of medical care in hands of specialists in haematology and blood transfusion is pointed out. The specialists in Slovakia are responsible for both diagnosis and registration as well as for effective therapy of haemorrhagic incidents in the patients. The care is mostly realized in 3 of 4 regional departments of haematology and blood transfusion, occasionally also in some chosen district departments. Preparation of antihaemolytic blood fractions in Slovakia is connected exclusively to the national transfusion fractionation programme in departments of haematology and blood transfusion. With regard to the principle of free of charge blood donation and medical care, this mode of preparation is the most effective economically, because of the relatively high yield of active coagulation factors. Concrete data on the prevalence of hereditary coagulopathies in Slovakia are presented. Comparison of the number of registered haemophiliacs in Slovakia with that given in other countries indicates a very high registration of the hereditary haemorrhagic diseases in our country, which also follows from the centralized active medical care. To secure further rise of the haemophiliacs demands, however, it will be necessary to increase efforts in blood donor campaigns and to improve equipment of regional departments of haematology and blood transfusion which are responsible for medical care.

Blood Coagulation Disorders

Surveillance of tuberculosis caused by Mycobacterium bovis in Slovakia.

The elimination of tuberculosis (TB) among cattle was claimed in Czecho-Slovakia in the middle of the sixties. Experiences from some countries which eliminated TB among cattle earlier than Czecho-Slovakia indicated a sporadic occurrence of TB caused by M. bovis. A long-term investigation of the occurrence of this 'diminishing zoonosis' has been carried out by a special group of experts (epidemiologists, clinicians, bacteriologists, epizootiologists and veterinary surgeons) on the whole territory of Slovakia. During the period of years 1972-1990 there were discovered 68 new cases of TB in humans caused by M. bovis. This paper analyses the results of the epidemiological investigation of this group of patients from several aspects: eg age, sex, occupation and geographical distribution.

Adolescent

"Clusters" of CJD in Slovakia: the first laboratory evidence of scrapie.

Epidemic-like occurrence of Creutzfeldt-Jakob disease was observed in 1987 in Slovakia (Orava). Search for the cause of CJD focus indicated a coincidence of genetic and environmental risks in clustering patients. Since Spongiform Encephalopathies might be transmitted orally, (Bovine Spongiform Encephalopathy), the possibility of zoonotic source of CJD cases in Orava was also considered. A deficient knowledge about the occurrence of scrapie in Slovakia stimulated an examination of sheep with signs of CNS disorders in two flocks of Valasky breed in Orava. In one flock, neurohistopathological examination revealed in sheep brains lesions characteristic for scrapie. Frozen brain tissue of these animals were used for the detection of scrapie associated fibrils. They were found in 2 animals from the same flock. This is the first laboratory confirmation of scrapie in Czecho-Slovakia. The possible epidemiological and economical implications are emphasized.

Animals

Extensive examination of different tick species for infestation with Coxiella burnetii in Slovakia.

Between 1987-1989 almost 7000 adult Ixodes ricinus, Dermacentor reticulatus, Dermacentor marginatus, Haemaphysalis concinna, Haemaphysalis punctata and Haemaphysalis inermis ticks collected in all 38 districts of Slovakia were screened for the presence of Coxiella burnettii. The proportion of ticks containing C. burnetii as indicated by the haemocyte test was less than 3%. Attempts to recover C. burnetii by inoculation of yolk sacs of embryonated hen eggs from pools of 1-6 specimens of haemocyte test positive ticks resulted in the isolation of 10 rickettsial strains. Six strains were recovered from I. ricinus, the remaining ones from single pools of D. reticulatus, D. marginatus. H. concinna and H. inermis ticks. In addition to the previous recovery of C. burnetii from H. punctata ticks, the agent was thus isolated from all important ticks living in Slovakia. The agent was found in tick habitats regardless of the latitude and altitude in the entire country. These results are not consistent with the negligible number of Q fever cases occurring in past years in Slovakia.

Animals

[Occurrence, diagnosis and therapy of beta thalassemia in Slovakia].

The authors draw attention to the prevalence of beta-thalassaemia in Slovakia, the rising trend of the disease, the occurrence of new cases of the disease in eastern Slovakia where the disease was not described previously. They draw attention to pitfalls of the diagnosis and treatment of beta-thalassaemia in Slovakia, the importance of molecular analysis of DNA globin chains of haemoglobin in the diagnosis of this serious condition. The authors paid major attention to the importance of prenatal diagnosis.

Adult

Recent trends in uterine cervix cancer in Slovakia, 1968-1987.

The temporal trends in the incidence and mortality of uterine cervix cancer in Slovakia were evaluated. Only highly reliable and complete data from 1968-1987 derived from the National Cancer Registry of Slovakia were used. Incidence rates have fallen in the first part of the period studied, but this trend has reversed and the incidence rates of this cancer site have risen since about 1976. The mortality rates showed continuous and unchanged increase over the whole mentioned period. The analysis of the age specific incidence rates indicated the responsibility of the youngest age groups of women for the overall recent increase of the uterine cervix cancer incidence in this country, while the age specific mortality rates increased in nearly all age groups. The relatively high incidence and mortality rates of uterine cervix cancer in Slovakia in comparison with the same rates in other countries as well as the recent increase of both indicators, together with low proportion of the in situ forms could be attributed mainly to the deficiencies in the organization and performance of the cervical screening.

Adult

Incidence and prevalence of childhood diabetes in Slovakia (1985-1992). Slovak Childhood Diabetes Epidemiology Study Group.

OBJECTIVE: To provide reliable data on the incidence and prevalence of insulin-dependent diabetes mellitus (IDDM) in children in Slovakia. RESEARCH DESIGN AND METHODS: A total of 754 Slovak children with IDDM, aged 0-14 years, were identified during an 8-year study period. There were 369 boys and 385 girls from an average population of 1,363,499 children. All patients were prospectively recorded. The primary ascertainment was based on notifications by physicians from outpatient departments. The second independent source of information was from all hospitals where the diabetic patients were hospitalized. The completeness of ascertainment was based on the capture-recapture procedure. RESULTS: The completeness of the ascertainment was 95%. In 1992, the annual incidence rate of IDDM (per 100,000) in the 0- to 14 year-old age-group was 8.92 for both sexes (7.95 for boys and 9.93 for girls). In the youngest age-group, an increase in the incidence rates from 2.89 in 1985 to 6.54 in 1992 was observed. Seasonality, with a higher incidence in autumn and winter, was observed in children older than 4 years. The prevalence rates of IDDM (per 1,000) were 0.28-0.50% in the 8-year period. CONCLUSIONS: The incidence of IDDM in Slovak children (0-14 years) is similar to what has been found in other Central European countries. In children younger than 4 years of age, in the last 2 years (1991 and 1992) more patients with diabetes were found than in any period during the preceding 6 years. The recent conspicuous increase in the incidence of IDDM among the younger children in Slovakia urges us to study its mechanisms, so far unknown, and to search for possible means of prevention.

Adolescent

"Clusters" of CJD in Slovakia: the first statistically significant temporo-spatial accumulations of rural cases.

A space-time analysis of clustering among 78 definite CJD cases who died in Slovakia (75) and an adjacent part of Hungary (3) during 1972-1991 is presented. Two geographical rural accumulations of sporadic and familial CJD patients in the north and south of Central Slovakia were found. There was evidence of two significant clusters when spatial and temporal neighborhoods were defined by distances of 2,4,5 and 7 km within 1.5 and 2 years. Involvement of genetic mechanisms in the clusters was demonstrated, and the possible role of environmental (zoonotic) risk factors are considered.

Cluster Analysis

Ricettsioses studies. 2. Natural foci of rickettsioses in east Slovakia.

Natural foci of Q fever and of spotted fever group rickettsiae in the Kosice district of east Slovakia are described and discussed. It was established that the natural focus of Q fever was a secondary one. Cattle were observed to be the main source of human infection and a high proportion of synanthropic rodents was found to be infested with Coxiella burnetii. The natural focus of spotted fever group rickettsiae was shown to be of a primary character, such rickettsiae circulating among ticks and small mammals. It is suggested that natural foci of spotted fever group rickettsiae in east Slovakia may be connected with the natural distribution of Dermacentor ticks.

Animals

Survival rates for childhood malignancies in Slovakia.

Survival rates (SR) for population-based series of 1564 cases of cancer in children aged 0-14, diagnosed during the decade 1978-1987 in Slovakia and derived from the National Cancer Registry, were examined. The overall 5-year SR (all types of childhood malignancies combined) was 49.8%. Different SR were ascertained for leukemias -43.8%, lymphomas -59.1%, CNS tumors -42.7% and for other remaining diagnostic groups and subgroups of childhood malignancies. Generally, the SR were slightly better for girls than for boys. Cancer patients being diagnosed during the first two years of age showed worse prognosis with a 5-year survival rate of 36.8% as compared to 52.6% for children aged 2-14 at diagnosis. Differences in 5-year survival were also found between urban and rural areas: 56.8% and 48.8%, respectively. The 5-year SR increased during the study period from 48.5% for 1978-1982 to 50.0% for 1983-1987. Comparison of SR from Slovakia with the corresponding rates observed recently in some developed countries indicated possibilities to improve prognosis of childhood malignancies in this country.

Adolescent

[Leptospirosis in dogs in Slovakia].

Out of 571 serologically investigated dogs from Bratislava and all regions of Slovakia and Moravia, 26.1% presented antibodies reacting with leptospiral antigens. The lowing seropositivity in dogs from Bratislava was found in lap dogs--11.1%, the highest one in farm dogs--35.3% (Tab. I). The seropositivity of police dogs from different regions of Slovakia and Moravia varied from 24.0% to 47.6% (Tab. II). The age of dogs progressing, their seropositivity rose from 3.1% in animals younger than one year to 33.3% in those aged seven years and in older ones (Tab. III). The predominant serovars causing infections of dogs were L. grippotyphosa (58.9% of infections) and serovars of both Sejroe (21.0%) and Icterohaemorrhagiae groups (15.3%). The serovars bratislava/jalna, pomond/mozdok and tarassovi were only rarely involved in these infections, canicola and arborea only exceptionally (Tab. IV). At present, in the Czechoslovak conditions the dogs do not play a significant role as reservoirs of human leptospirosis, and the predominant serovars may only cause irregular and short-time lasting leptospiruria. This is why the reasonableness of actual vaccination of dogs, possibly with the exception of the vaccination against Weil's disease, is doubtful. Dog is a good indicator of the distribution of different leptospiral serovars in its environment. It seems reasonable to practice occasionally serological investigations of these animals in order to detect possible changes in infecting leptospiral serovars. Consequently, adequate epizootological measures could be taken (e. g. modification of the composition of a leptospiral vaccine for dogs).

Animals

[Isolation of Listeria ivanovii in Slovakia].

From October 1977 to May 15, 1989 in Slovakia 39 strongly haemolytic strains of L. ivanovii were isolated from a woman after delivery of a stillborn foetus--from the lochiae, placenta and rectal smear, from five symptom-free subjects from the faeces, from the rectal smears of two sheep, from the intestinal contents in the portion of the terminal ileus from 28 free living small terrestrial mammals, one strain from meat--beef steak, from the lungs, liver and kidneys of a dead young sheep and one strain from silage. The strains from the lochiae and placenta as well as those from the organs of sheep were detected already as primocultures on commonly used blood agar, the other strains after varying periods of cold enrichment and subsequent inoculation on a solid selective medium with nalidixic acid and acriflavin. All strains had typical biochemical properties, among which from the diagnostic aspect in particular the catalase formation and acid formation from d-xylose is important, as well as the negative reaction with mannitol, rhamnose and alpha-methyl-d-mannoside. All strains agglutinated in O-factor serum X and gave a typical shovel-like shape CAMP test with Rhodococcus equi. The frequent incidence of L. ivanovii in micromammals indicates their importance as reservoir animals for this species of microorganism. The latter were detected on the territory of all three Slovak regions and in the capital of Slovakia, Bratislava.

Animals