A seroepidemiologic survey for human sparganosis in Gangweon-do

Gangweon-do is known to be highly endemic area of sparganosis more than other provinces in Korea. A seroepidmiologic examination for the detection of anti-Spirometra erinacei plerocercoid IgG in serum was carried out in normal inhabitants in Hongcheon-gun, Gangweon-do. Sere were tested by enzyme-linked immunosrobent assay (ELISA) for the anti-sparganum antibodies. Positive rate for anti-sparganum antibody in 719 adults was 3.3%. Data of the questionnaire for 24 ELISA positive inhabitants revealed that 20 had a history of eating raw meat of snakes, 24 had a history of eating frogs, and 24 had a history of drinking stream water. Two positive cases had a past history of sparganosis. Two positive cases showed current symptoms of sparganosis. The data revealed that ELISA would be useful to find infected cases among normal inhabitants at sparganosis-endemic areas.     

Cloning of the novel putative apoptosis-related gene of Spirometra erinacei (Order Pseudophyllidae)

We postulated that apolysis was processed in accordance with apoptotic changes occurring in a cestode, Spirometra erinacei (Pseudophyllidea). We cloned the novel putative apoptosis-associated gene from S. erinacei via screening of a S. erinacei cDNA library with a ced-3 gene (activator of apoptosis) probe from Caenorhabditis elegans. We identified a 261-bp cDNA sequence, which encodes for an 86-amino acid protein. The cloned gene expression was observed in the neck and gravid proglottids via Northern blotting, using cloned cDNA inserts as probes, but the clone was not expressed in any of other tissues. We suggest that this gene may be involved in the apolysis of S. erinacei during normal tissue development and differentiation in cestode parasites.     

Human proliferative sparganosis update

Proliferative sparganosis is one of the most bizarre and mysterious parasitic diseases ever described. The causative parasite is Sparganum proliferum, which is a pseudophyllidean cestode distinct from Spirometra tapeworms. Here we overview this rare but fascinating disease with the all original case reports on human patients published in the last 115 years.Proliferative sparganosis is clearly divided into two disease types, cutaneous and internal proliferative sparganosis. Cutaneous type starts with a skin eruption caused by the dermal invasion of a sparganum. Skin lesion progresses to larger areas of the body if left untreated. Various internal organs and body wall can be eventually affected. The clinical symptoms of patients in this group are very similar to each other. Molecular data suggest that cutaneous proliferative sparganosis is caused by S. proliferum of which genetic variation is limited, regardless of the time or localities of the emergence of patients.Internal proliferative sparganosis, on the other hand, is much more heterogeneous. Some cases show aggressive infection in internal organs, while others show only restricted lesions. Some of the cases that had been cited as proliferative sparganosis in the past literature were removed from the list, because they were judged as cyclophyllidean tapeworm infections. DNA sequencing is mandatory for the definite diagnosis of proliferative sparganosis.The Venezuelan strain of S. proliferum is maintained in experimental mice in Japan, which is fully prepared for the experimental study with advanced technologies in modern molecular biology.     

Isolation and partial characterization of cysteine proteinase from sparganum.

A proteolytic enzyme was purified from the tissue extract of spargana (plerocercoids of Spirometra erinacei) by DEAE-Trisacryl M ion exchange chromatography and thiopropyl-sepharose affinity chromatography resulted in a 21-fold purification. The proteinase activity was assayed with a synthetic fluorescent substrate, carbobenzoxy-phenylalanyl-7-amino-4-trifluoromethyl-coumarin. SDS-polyacrylamide gel electrophoresis of the purified materials revealed a single 28,000 dalton band. Inhibitor profiles of the band indicated that it belonged to cysteine endopeptidases. It exhibited identical pH curves with optimum at pH 5.5, and 50% activity from pH 4.7 to 8. It could completely degrade collagen chains to three identical products. It also showed some activity on hemoglobin. Furthermore, the band on immunoblots was reactive to the sera of sparganosis patients. These results suggest that the proteolytic enzyme belongs to cysteine proteinase which plays a role in the tissue penetration. Also it may be used as the antigen for diagnosis of active sparganosis.     

Comparison of isozyme patterns between Spirometra erinacei and Spirometra mansonoides by isoelectric focusing.

No differences were observed in the isozyme patterns of 4 enzymes examined between fresh samples stored at -80 C and samples stored at room temperature for 10 days after lyophilization, which supports the validity of comparing lyophilized samples to fresh frozen tissue. Mature proglottids as well as plerocercoids of Spirometra erinacei from Japan and Australia were indistinguishable by comparison of isozyme patterns after isoelectric focusing. The isozyme patterns of acid phosphatase, glucosephosphate isomerase (GPI), and mannosephosphate isomerase from plerocercoids of Spirometra mansonoides were distinctly different from those of plerocercoids of S. erinacei. The adenylate kinase isozyme patterns of the mature proglottids of S. mansonoides were also distinctly different from those of the mature proglottids and the plerocercoids of S. erinacei. The GPI isozyme pattern of the mature proglottids of S. mansonoides was also distinguishable from the GPI patterns of those of S. erinacei. These electrophoretic data suggest that the S. erinacei from Japan and Australia are closely related, if not identical, but that S. mansonoides is genetically distinct from S. erinacei.     

Emerging Infectious Diseases in Free-Ranging Wildlife–Australian Zoo Based Wildlife Hospitals Contribute to National Surveillance

Emerging infectious diseases are increasingly originating from wildlife. Many of these diseases have significant impacts on human health, domestic animal health, and biodiversity. Surveillance is the key to early detection of emerging diseases. A zoo based wildlife disease surveillance program developed in Australia incorporates disease information from free-ranging wildlife into the existing national wildlife health information system. This program uses a collaborative approach and provides a strong model for a disease surveillance program for free-ranging wildlife that enhances the national capacity for early detection of emerging diseases.     

A case of sparganosis mimicking a varicose vein

Recent advances in radiological and serological techniques have enabled easier preoperative diagnosis of sparganosis. However, due to scarcity of cases, sparganosis has been often regarded as a disease of other etiologic origin unless the parasite is confirmed in the lesion. We experienced a case of sparganosis mimicking a varicose vein in terms of clinical manifestations and radiological findings. Sparganosis should be included among the list of differential diagnosis with the varicose vein.     

Combining syndromic surveillance and ILI data using particle filter for epidemic state estimation

Designing effective mitigation strategies against influenza outbreak requires an accurate prediction of a disease’s future course of spreading. Real time information such as syndromic surveillance data and influenza-like-illness (ILI) reports by clinicians can be used to generate estimates of the current state of spreading of a disease. Syndromic surveillance data are immediately available, in contrast to ILI reports that require data collection and processing. On the other hand, they are less credible than ILI data because they are essentially behavioral responses from a community. In this paper, we present a method to combine immediately-available-but-less-reliable syndromic surveillance data with reliable-but-time-delayed ILI data. This problem is formulated as a non-linear stochastic filtering problem, and solved by a particle filtering method. Our experimental results from hypothetical pandemic scenarios show that state estimation is improved by utilizing both sets of data compared to when using only one set. However, the amount of improvement depends on the relative credibility and length of delay in ILI data. An analysis for a linear, Gaussian case is presented to support the results observed in the experiments.     

Suitability of bovine portion condemnations at provincially-inspected abattoirs in Ontario Canada for food animal syndromic surveillance

ABSTRACT: BACKGROUND: Abattoir condemnations may play an important role in a food animal syndromic surveillance system. Portion condemnation data may be particularly useful, as these data can provide more specific information on health outcomes than whole carcass condemnation data. Various seasonal, secular, disease, and non-disease factors have been previously identified to be associated with whole carcass condemnation rates in Ontario provincial abattoirs; and if ignored, may bias the results of quantitative disease surveillance methods. The objective of this study was to identify various seasonal, secular, and abattoir characteristic factors that may be associated with bovine portion condemnation rates and compare how these variables may differ from previously identified factors associated with bovine whole carcass condemnation rates. RESULTS: Data were collected from the Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA) and the Ontario Cattlemen's Association regarding "parasitic liver" and pneumonic lung condemnation rates for different cattle classes, abattoir compliance ratings, and the monthly sales-yard price for commodity classes from 2001-2007. To control for clustering by abattoirs, multi-level Poisson modeling was used to investigate the association between the following variables and "parasitic liver" as well as pneumonic lung condemnation rates: year, season, annual abattoir audit rating, geographic region, annual abattoir operating time, annual total number of animals processed, animal class, and commodity sales price. CONCLUSIONS: In this study, "parasitic liver" condemnation rates were associated with year, season, animal class, audit rating, and region. Pneumonic lung condemnation rates were associated with year, season, animal class, region, audit rating, number of cattle processed per year, and number of weeks abattoirs processed cattle. Unlike previous models based on whole carcass condemnations, commodity price was not associated with partial condemnations in this study. The results identified material-specific predictor variables for condemnation rates. This is important for syndromic surveillance based on abattoir data and should be modeled and controlled for during quantitative surveillance analysis on a portion specific basis.     

Urban Compost Attracts Coyotes,Contains Toxins,and may Promote Disease in Urban-Adapted Wildlife

Anthropogenic food is often concentrated in cities where it can attract wildlife, promote conflict with people, and potentially spread disease. Although these associations are well-documented for conventional garbage, they are unexplored for many seemingly innocuous and even environmentally friendly attractants such as piles of compost. In this study, we tested the hypothesis that municipal piles of compost are underappreciated and potentially important contributors to a recent rise in encounters with urban-adapted wildlife by attracting wildlife and promoting the spread of wildlife disease. We used remote cameras to compare visitation rates to compost piles and urban natural areas by coyotes (Canis latrans). For each site type, we assessed photographs for evidence of ectoparasites, screened scats for endoparasites, and sampled compost for harmful mycotoxins. At compost piles, visitation rates were eight times more frequent, coyotes with visible parasitic infections were 4.5 times more common, scats were 10 times more likely to contain tapeworm eggs, and mycotoxins were detected in 86% of piles and often at concentrations higher than legal limits for animal feed. Greater securement of compost waste in cities may reduce encounters with animals, susceptibility to and spread of disease, and rates of human–wildlife conflict for coyotes and other urban-adapted species.     

Targeted surveillance of raccoon rabies in Québec,Canada

Data from wildlife disease surveillance programs are used to inform implementation of disease control (e.g., vaccination, population reduction) in space and time. We developed an approach to increase detection of raccoon rabies in raccoons (Procyon lotor) and skunks (Mephitis mephitis) of Québec, Canada, and we examined the implications of using this approach for targeted surveillance. First we modeled the probability of a rabid animal relative to environmental characteristics of sampling locations. Rabid animals were more likely to be found in low-lying flat landscapes that had higher proportions of corn-forest edge habitat and hay agriculture, and that were within 20 km of one or more known rabies cases. From the model, we created 2 complementary risk maps to identify areas where rabid animals were most likely to be sampled. One map accounted for habitat and known rabies case locations, and can be used to define an infection zone from which surveillance can be targeted along the periphery to determine if disease is continuing to spread. The other map only accounted for habitat and can be used to locate areas most likely to contain rabid animals when the disease is present. In a further analysis we compared the 2 most successful methods for detecting raccoon rabies in Québec, given the disease was present. Government trapping operations (active surveillance) detected more cases in the short-term, but citizen notification (passive and enhanced) was more effective after 12 trapping days from which the initial rabies case was found. Our approach can benefit wildlife and public health agencies wanting to assess the disease status of regions by targeting surveillance to habitats most likely to contain infected animals and by defining the duration over which sampling methods are effective. © 2011 The Wildlife Society.     

Public health surveillance and infectious disease detection

Emerging infectious diseases, such as HIV/AIDS, SARS, and pandemic influenza, and the anthrax attacks of 2001, have demonstrated that we remain vulnerable to health threats caused by infectious diseases. The importance of strengthening global public health surveillance to provide early warning has been the primary recommendation of expert groups for at least the past 2 decades. However, despite improvements in the past decade, public health surveillance capabilities remain limited and fragmented, with uneven global coverage. Recent initiatives provide hope of addressing this issue, and new technological and conceptual advances could, for the first time, place capability for global surveillance within reach. Such advances include the revised International Health Regulations (IHR 2005) and the use of new data sources and methods to improve global coverage, sensitivity, and timeliness, which show promise for providing capabilities to extend and complement the existing infrastructure. One example is syndromic surveillance, using nontraditional and often automated data sources. Over the past 20 years, other initiatives, including ProMED-mail, GPHIN, and HealthMap, have demonstrated new mechanisms for acquiring surveillance data. In 2009 the U.S. Agency for International Development (USAID) began the Emerging Pandemic Threats (EPT) program, which includes the PREDICT project, to build global capacity for surveillance of novel infections that have pandemic potential (originating in wildlife and at the animal-human interface) and to develop a framework for risk assessment. Improved understanding of factors driving infectious disease emergence and new technological capabilities in modeling, diagnostics and pathogen identification, and communications, such as using the increasing global coverage of cellphones for public health surveillance, can further enhance global surveillance.     

Assessing syndromic surveillance of cardiovascular outcomes from emergency department chief complaint data in New York City

Background

Prospective syndromic surveillance of emergency department visits has been used for near-real time tracking of communicable diseases to detect outbreaks or other unexpected disease clusters. The utility of syndromic surveillance for tracking cardiovascular events, which may be influenced by environmental factors and influenza, has not been evaluated. We developed and evaluated a method for tracking cardiovascular events using emergency department free-text chief complaints.

Methodology/Principal Findings

There were three phases to our analysis. First we applied text processing algorithms based on sensitivity, specificity, and positive predictive value to chief complaint data reported by 11 New York City emergency departments for which ICD-9 discharge diagnosis codes were available. Second, the same algorithms were applied to data reported by a larger sample of 50 New York City emergency departments for which discharge diagnosis was unavailable. From this more complete data, we evaluated the consistency of temporal variation of cardiovascular syndromic events and hospitalizations from 76 New York City hospitals. Finally, we examined associations between particulate matter ≤2.5 µm (PM_2.5), syndromic events, and hospitalizations. Sensitivity and positive predictive value were low for syndromic events, while specificity was high. Utilizing the larger sample of emergency departments, a strong day of week pattern and weak seasonal trend were observed for syndromic events and hospitalizations. These time-series were highly correlated after removing the day-of-week, holiday, and seasonal trends. The estimated percent excess risks in the cold season (October to March) were 1.9% (95% confidence interval (CI): 0.6, 3.2), 2.1% (95% CI: 0.9, 3.3), and 1.8% (95%CI: 0.5, 3.0) per same-day 10 µg/m³ increase in PM_2.5 for cardiac-only syndromic data, cardiovascular syndromic data, and hospitalizations, respectively.

Conclusions/Significance

Near real-time emergency department chief complaint data may be useful for timely surveillance of cardiovascular morbidity related to ambient air pollution and other environmental events.     

Identification and characterization of a mitochondrial manganese superoxide dismutase of Spirometra erinacei

A gene encoding the manganese superoxide dismutase (Mn-SOD) of Spirometra erinacei was identified, and the biochemical properties of the recombinant enzyme were partially characterized. The S. erinacei Mn-SOD gene consisted of 669 bp, which encoded 222 amino acids. A sequence analysis of the gene showed that it had typical molecular structures, including characteristic metal-binding residues and motifs that were conserved in Mn-SODs. An analysis of the N-terminal presequence of S. erinacei Mn-SOD revealed that it had physiochemical characteristics commonly found in mitochondria-targeting sequences and predicted that the enzyme is located in the mitochondria. A biochemical analysis also revealed that the enzyme is a typical Mn-SOD. The enzyme was consistently expressed in both S. erinacei plerocercoid larvae and adult worms. Our results collectively suggested that S. erinacei Mn-SOD is a typical mitochondrial Mn-SOD and may play an important role in parasite physiology, detoxifying excess superoxide radicals generated in the mitochondria.     

Enhanced understanding of infectious diseases by fusing multiple datasets: a case study on malaria in the Western Brazilian Amazon region

Background

A common challenge to the study of several infectious diseases consists in combining limited cross-sectional survey data, collected with a more sensitive detection method, with a more extensive (but biased) syndromic sentinel surveillance data, collected with a less sensitive method. Our article describes a novel modeling framework that overcomes this challenge, resulting in enhanced understanding of malaria in the Western Brazilian Amazon.

Methodology/Principal Findings

A cohort of 486 individuals was monitored using four cross-sectional surveys, where all participants were sampled regardless of symptoms (aggressive-active case detection), resulting in 1,383 microscopy and 1,400 polymerase chain reaction tests. Data on the same individuals were also obtained from the local surveillance facility (i.e., passive and active case detection), totaling 1,694 microscopy tests. Our model accommodates these multiple pathogen and case detection methods. This model is shown to outperform logistic regression in terms of interpretability of its parameters, ability to recover the true parameter values, and predictive performance. We reveal that the main infection determinant was the extent of forest, particularly during the rainy season and in close proximity to water bodies, and participation on forest activities. We find that time residing in Acrelandia (as a proxy for past malaria exposure) decreases infection risk but surprisingly increases the likelihood of reporting symptoms once infected, possibly because non-naïve settlers are only susceptible to more virulent Plasmodium strains. We suggest that the search for asymptomatic carriers should focus on those at greater risk of being infected but lower risk of reporting symptoms once infected.

Conclusions/Significance

The modeling framework presented here combines cross-sectional survey data and syndromic sentinel surveillance data to shed light on several aspects of malaria that are critical for public health policy. This framework can be adapted to enhance inference on infectious diseases whenever asymptomatic carriers are important and multiple datasets are available.     

Zoonotic viruses associated with illegally imported wildlife products

The global trade in wildlife has historically contributed to the emergence and spread of infectious diseases. The United States is the world's largest importer of wildlife and wildlife products, yet minimal pathogen surveillance has precluded assessment of the health risks posed by this practice. This report details the findings of a pilot project to establish surveillance methodology for zoonotic agents in confiscated wildlife products. Initial findings from samples collected at several international airports identified parts originating from nonhuman primate (NHP) and rodent species, including baboon, chimpanzee, mangabey, guenon, green monkey, cane rat and rat. Pathogen screening identified retroviruses (simian foamy virus) and/or herpesviruses (cytomegalovirus and lymphocryptovirus) in the NHP samples. These results are the first demonstration that illegal bushmeat importation into the United States could act as a conduit for pathogen spread, and suggest that implementation of disease surveillance of the wildlife trade will help facilitate prevention of disease emergence.     

Sensitivity of Bovine Tuberculosis Surveillance in Wildlife in France: A Scenario Tree Approach

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with an impact on animal and human health, and economic implications. Infected wild animals have been detected in some European countries, and bTB reservoirs in wildlife have been identified, potentially hindering the eradication of bTB from cattle populations. However, the surveillance of bTB in wildlife involves several practical difficulties and is not currently covered by EU legislation. We report here the first assessment of the sensitivity of the bTB surveillance system for free-ranging wildlife launched in France in 2011 (the Sylvatub system), based on scenario tree modelling. Three surveillance system components were identified: (i) passive scanning surveillance for hunted wild boar, red deer and roe deer, based on carcass examination, (ii) passive surveillance on animals found dead, moribund or with abnormal behaviour, for wild boar, red deer, roe deer and badger and (iii) active surveillance for wild boar and badger. The application of these three surveillance system components depends on the geographic risk of bTB infection in wildlife, which in turn depends on the prevalence of bTB in cattle. We estimated the effectiveness of the three components of the Sylvatub surveillance system quantitatively, for each species separately. Active surveillance and passive scanning surveillance by carcass examination were the approaches most likely to detect at least one infected animal in a population with a given design prevalence, regardless of the local risk level and species considered. The awareness of hunters, which depends on their training and the geographic risk, was found to affect surveillance sensitivity. The results obtained are relevant for hunters and veterinary authorities wishing to determine the actual efficacy of wildlife bTB surveillance as a function of geographic area and species, and could provide support for decision-making processes concerning the enhancement of surveillance strategies.     

A Human Case of Lumbosacral Canal Sparganosis in China

In this study, we intended to describe a human case of lumbosacral canal sparganosis in People’s Republic of China (China). A 56-year-old man was admitted to Xiangya Hospital Central South University in Changsha, Hunan province, China after having an experience of perianal pain for a week. An enhancing mass, a tumor clinically suggested, was showed at the S1–S2 level of the lumbosacral spine by the examination of magnetic resonance imaging (MRI) with gadolinium contrast. The patient was received the laminectomy from S1 to S2, and an ivory-white living worm was detected in inferior margin of L5. In ELISA-test with cerebrospinal fluid (CSF) and serum samples, anti-sparganum antibodies were detected. He had a ingesting history of undercooked frog meat in his youth. By the present study, a human case of spinal sparganosis invaded in lumbosacral canal at the S1–S2 level was diagnosed in China. Although the surgical removal of larvae is known to be the best way of treatment for sparganosis, we administered the high-dosage of praziquantel, albendazole and dexamethasone to prevent the occurrence of another remain worms in this study.