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There is a high degree of variability in the serologic response to Epstein-Barr virus (EBV) infection, especially in viral capsid antigen (VCA)-IgM antibodies. Therefore, additional tests are needed to confirm primary infection.We evaluated the value of IgG avidity determination in diagnosis of EBV infection in immunocompetent and immunocompromised patients.A total of 236 serum samples from immunocompetent patients with symptoms suggestive of EBV infection were tested for the presence of VCA-IgM/IgG antibodies and IgG avidity. Using IgG avidity, acute primary infection was confirmed in 56.7% of the immunocompetent patients with positive and in 1.8% of patients with negative VCA-IgM. Recent primary infection was documented in 8.9% of the IgM positive and 3.5% of the IgM negative patients. In patients with indeterminate serology (equivocal IgM), 6.7% were classified by avidity index (AI) as acute primary infection, 10.0% as post-acute and 83.3% as past infection cases.Concerning the 32 immunocompromised patients, recent primary infection was documented in 3 of the 14 IgM positive patients. High AI was detected in 11 of these patients, indicating an IgM response due to reactivation.Determination of IgG avidity in combination with classical serologic markers seems to be a reliable method to confirm primary infection both in immunocompetent and immunocompromised patients. It may be especially useful to differentiate cases of primary infection in patients with undetectable VCA-IgM antibodies or indeterminate routine EBV serology.

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Acta Microbiologica et Immunologica Hungarica
Authors: Katalin Szomor, Zita Rigó, Enikő Bán, Lívia Nagy, Teodóra Szalkai, Zsuzsanna Balogh, Emőke Ferenczi, and Mária Takács

The presence of WNV in Europe has been well known for decades, although the first human infections and avian outbreaks were diagnosed in Hungary only in 2003. An annual average of 6–8 cases of the neuroinvasive form of WNV infection has been detected in the region since then, but a higher number (17) of WNV associated neuroinvasive disease occurred in 2008.In 2004, a surveillance system was established for monitoring WNV-associated meningo-encephalitis cases in Hungary, but a milder type of illness (with fever, rash and/or influenza like symptoms) is not followed. Fifty-two sera of 45 patients with mild clinical symptoms (fever, exanthema) were tested for anti-WNV antibodies in 2008 in a retrospective study by immunofluorescence test and ELISA. Seven patients had antibodies against WNV, serologic evidence of recent WNV infection was found in 4 out of the 7 patients. Infections could be acquired predominantly in August and in September, which seems to be a risk period for WNV in Hungary.The possibility of a recent WNV infection should be taken into consideration in the occurrence of fever and rush at late summer. Differential diagnosis of exanthematous patients should include WNV serology tests and should be done routinely.

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Halperin SA, Bortolus R, Wort AJ: Evaluation of culture, immunofluorescence and serology for diagnosis of pertussis. J Clin Microbiol 27, 752–757 (1989) Wort AJ Evaluation of culture

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European Journal of Microbiology and Immunology
Authors: Anja Dörschug, Julian Schwanbeck, Andreas Hahn, Anke Hillebrecht, Sabine Blaschke, Uwe Groß, Markus M. Heimesaat, Hagen Frickmann, and Andreas E. Zautner

later post-infectious stages, serology can become negative again [ 35 ]. In summary, there are several limitations of presently available diagnostic POCT options [ 36–38 ] as well as gaps of knowledge regarding the appropriate interpretation of their

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Orvosi Hetilap
Authors: Krisztina Czebe, Balázs Antus, Marina Varga, and Eszter Csiszér

Kotsimbos, T. C., Snell, G. I., Spelman, D. W. és mtsai: Chlamydia pneumoniae serology in donors and recipients and the risk of bronchiolitis obliterans syndrome after lung transplantation. Transplantation, 2005, 79 , 269

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Orvosi Hetilap
Authors: Márk Juhász, Dorottya Kocsis, Tamás Zágoni, Pál Miheller, László Herszényi, and Zsolt Tulassay

A coeliakia (lisztérzékenység, gluténszenzitív enteropathia, sprue) a vékonybél krónikus, malabszorpcióhoz vezető betegsége. Célkitűzés: A Semmelweis Egyetem II. Sz. Belgyógyászati Klinikán gondozott felnőttkorú coeliakiás betegek dokumentációjának retrospektív feldolgozása. Betegek, módszerek: Az elmúlt 11 évben (1999–2010) a klinikán gondozott összesen 132 coeliakiás beteg (107 nő, 25 férfi; átlagéletkor 37 év, medián 35 év, range: 19–78 év) dokumentációját dolgozták fel. A centrumban jelentkező coeliakiagyanús betegeknél rutinszerűen az alábbi kivizsgálást végezték el: duodenumból sorozatbiopszia, szöveti transzglutamináz- vagy endomysiumellenes antitest metodikával végzett szerológia, testtömegindex-számítás, oszteodenzitometria, illetve a társuló betegségek feltérképezése és családszűrés. Eredmények: Szövettani eredmény 101 esetben volt elérhető, amelyek megoszlása a Marsh-klasszifikáció alapján: negatív 9%, M3a 27%, M3b 18%, M3c 46%. A rendelkezésünkre álló 117 szerológiai eredmény közül 93/117 (79%) mutatott szeropozitivitást. A testtömegindex 95 betegnél volt számítható; a férfiaknál az átlag 22,4 kg/m² (tartomány: 17–30,3 kg/m²), nőknél az átlag 20,7 kg/m² (tartomány: 15,2–30,4 kg/m²) volt. Oszteodenzitometria 90 betegnél történt: 45 (50%) normális, 31 (34%) osteopenia, 15 (26%) osteoporosis eredmény igazolódott. Negyvenöt coeliakiás betegnél (hat férfi, 39 nő; 34%) állt fenn coeliakiához társult betegség, ezek: 15 dermatitis herpetiformis Duhring, 15 pajzsmirigy-érintettség (öt hypo- és 10 hyperthyreosis), hat Crohn-beteg, három szelektív IgA-hiány, két endometriosis, egy szisztémás lupus erythematosus, egy myasthenia gravis és egy 1-es típusú cukorbetegség. Családszűrésre 64/132 (48%) index coeliakiás beteg hozta el összesen 133 elsőfokú rokonát, akik közül 26 elsőfokú rokonnál (19,5%) igazolódott coeliakia. Következtetések: A betegek életkori megoszlása is bizonyítja, hogy a coeliakia bármely életkorban jelentkezhet. A szerzők centrumában is jelentős a női dominancia. A szövettani eredmények a diagnózis felállításakor rendszerint súlyos boholyatrófiát mutattak. A szerológiai vizsgálatok, együtt a szövettani eredményekkel, nélkülözhetetlenek a diagnózis felállításához, továbbá alkalmasak a diéta monitorizálására és a családszűrések kivitelezésére. A testtömegindex-eredmények jól tükrözik, hogy a felnőttkori coeliakiások többnyire nem alultápláltak. A családszűrés során észlelt közel 20%-os prevalencia kiválóan demonstrálja a szűrés feltétlen szükségességét. Orv. Hetil., 2012, 153, 776–785.

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Over the last few years several porcine epidemic diarrhoea (PED) outbreaks have been discovered in Europe including the first PED case in Slovenia in January 2015. The aim of this study was to determine when PED virus (PEDV) infection started in Slovenia. Serum samples collected between 2012 and 2016 were tested. Three hundred and seventy-five serum samples were collected from 132 Slovenian small, one-site pig farms. Samples were tested for PEDV antibodies utilising three different serological methods: commercially-available indirect ELISA, in-house blocking ELISA test and Immunoperoxidase Monolayer Assay (IPMA) test. One hundred and seventy (45.33%) tested samples were found positive by the commercially-available ELISA test kit, and 10 (5.68%) of these 170 samples found positive were positive by the in-house blocking ELISA. Only these 10 samples were collected from a farm where clinical signs of PED infection had been observed and PEDV was confirmed by RT-PCR methodology; the other 160 samples were collected randomly. Thirty-two samples with the highest S/P value obtained with the commercial ELISA were all negative with IPMA. Reasons for the high variance in the results obtained remain unclear; more research is required to ensure higher sensitivity and specificity in terms of PEDV antibody tests and other PED diagnostic methods.

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This study was designed to compare Coxiella burnetii antibody dynamics in heifers born to vaccinated or non-vaccinated dams in a single high-producing dairy herd chronically infected with the bacterium. Antibody dynamics were examined from birth to the postpartum period in replacement heifers (n = 14) born to non-vaccinated dams (n = 7) or to dams that had been vaccinated on gestation days 171–177 (n = 7) and 192–198. Samples of blood, milk, faeces, vaginal fluid, colostrum and cotyledons (the latter two only at parturition) were obtained in the dams over the period from gestation days 171–177 to postpartum days 91–97. Blood samples were used to detect antibodies against C. burnetii and remaining samples for PCR identification of the bacterium. In their calves/heifers, blood samples for antibody determinations were collected from birth to postpartum at the time points 1–7 and 22–28 days and 3, 6 and 12 months of age; 90–96 and 210–216 days of gestation; and 22–28 days postpartum. All calves were born seronegative for C. burnetii. Irrespective of the shedding status of their mothers (7 were C. burnetii shedders), seroconversion occurred after colostrum intake in all calves born to seropositive cows (n = 9) and in two of three vaccinated seronegative dams. Thereafter antibody titres gradually declined and by 6 months of age all calves were seronegative. Seronegativity persisted until their first postpartum period. These findings indicate that cows vaccinated during advanced pregnancy transfer immunity to their calves via the colostrum. Maternal C. burnetii antibodies in calves persisted for three months in calves born both to seronegative vaccinated and seropositive dams.

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European Journal of Microbiology and Immunology
Authors: Raimond Lugert, Uwe Groß, Wycliffe O. Masanta, Gunter Linsel, Astrid Heutelbeck, and Andreas E. Zautner

Psittacosis is a zoonotic infectious disease that is caused by Chlamydophila psittaci. To determine the occupational risk of getting the infection, we investigated the seroprevalence of C. psittaci among employees of two German duck farms and two slaughterhouses according to their level of exposure to the pathogen during the years 2010, 2007, and 2004. In summary, we found low seroprevalence (≈ 8%) throughout the study population almost irrespective of the duty of a given worker. Surprisingly, in 2010, the anti-C. psittaci-specific antibody prevalence in the group of slaughterer (38.9%) was significantly increased in comparison to the non-exposed employees (p = 0.00578). This indicates that individuals in the surrounding of slaughterhouses exposed especially to aerosols containing C. psittaci elementary bodies bear a greater occupational risk of getting infected.

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Acta Veterinaria Hungarica
Authors: Attila Dobos, György Gábor, Enikő Wehmann, Béla Dénes, Bettina Póth-Szebenyi, Áron B. Kovács, and Miklós Gyuranecz

Abstract

Q fever is one of the commonest infectious diseases worldwide. A Coxiella burnetii prevalence of 97.6% has been found by ELISA and PCR tests of the bulk tank milk in dairy cattle farms of Hungary. The herd- and individual-level seroprevalence rates of C. burnetii in the examined dairy cows and farms have dramatically increased over the past ten years. Three high-producing industrial dairy farms were studied which had previously been found ELISA and PCR positive for C. burnetii by bulk tank milk testing. Coxiella burnetii was detected in 52% of the 321 cows tested by ELISA. Pregnancy loss was detected in 18% of the cows between days 29–35 and days 60–70 of gestation. The study found a higher seropositivity rate (80.5%) in the cows that had lost their pregnancy and a seropositivity of 94.4% in the first-bred cows that had lost their pregnancy at an early stage. The ELISA-positive pregnant and aborted cows were further investigated by the complement fixation test (CFT). In dairy herds an average of 66.6% individual seropositivity was detected by the CFT (Phase II) in previously ELISA-positive animals that had lost their pregnancy and 64.5% in the pregnant animals. A higher (Phase I) seropositivity rate (50.0%) was found in the cows with pregnancy loss than in the pregnant animals (38.5%). The high prevalence of C. burnetii in dairy farms is a major risk factor related to pregnancy loss.

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