International cooperation in neonatal screening: technical training course for newborn and infant screening.

We report the outline and results of our experience with a group training course of neonatal screening for health care professionals in developing countries. Sapporo City Institute of Public Health (SCIPH) has been offered a training course on neonatal screening once a year since 1991 under the Technical Training Program of the Japan International Cooperation Agency (JICA). The aims of this training course are to enhance the participants' technical knowledge and skills, and also to deepen their understanding of the principle of neonatal screening as well as the relevant diseases. Lectures and laboratory practice on phenylketonuria (PKU), congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH) and neuroblastoma are included in the 3-month program. After the completion of the training, participants are expected to play a major role in establishing and expanding neonatal screening system in each of their countries. We have received a total of 67 participants from 25 countries until March 1998: 58 pediatricians; 2 gynecologists; 6 biochemists; 1 administrative officer. After they returned to their countries, 11 engaged in neonatal screening and started PKU and CH screening in their institute, city or province in Argentina, Brazil, Mexico, Peru and Thailand. We believe that these results fulfilled our objectives. Also, for follow-up, SCIPH has been giving information and consultation to the participants on requests. This international cooperation network could also benefit our present network of the International Society Screening in the future.

Newborn screening for congenital adrenal hyperplasia in Sapporo City: sixteen years experience.

A screening program for congenital adrenal hyperplasia (CAH) in Sapporo began in 1982, 7 years prior to the introduction of the national program. Since its inception, testing has involved the detection of 17-hydroxyprogesterone (17-OHP) in dried blood samples, using ELISA. Up to the end of March 1998, of 298,731 newborn screened, second samples were requested in 1,723 cases (0.6%). This number included 789 newborns who weighed less than 2,000 gm at birth. A total of 14 cases were diagnosed with 21-hydroxylase deficiency (21-OHD). "Salt-wasting type (SW)" outnumbered "simple virilizing type (SV)" by 11:3. The ratio of male to female was a converse. but unrelated, 3:11. Our study from 1982-1997 revealed that the incidence of 21-OHD in Sapporo City was 1:21.338, markedly similar to the worldwide incidence of 1:15,000. In order to improve the program, other type of analysis are also currently in use and under evaluation. These include highly sensitive HPLC analysis for 17-OHP and molecular analysis to identify some mutations associated with the 21-OHD gene (CYP21). These methodologies are very useful for the confirmation of information acquired from dried blood specimens.

Evaluation of serum neutralizing antibodies to bovine coronavirus in cows & their calves using Hmlu-1 cells.

Between 1992 and 1993, 75 paired serum samples from Holstein dairy cows and their calves were collected from Aomori, Tochigi and Okinawa Prefectures, and the neutralizing antibody titres to bovine coronavirus (BCV) were determined using hamster lung (Hmlu)-1 cells. The anti-BCV antibody positive rate in the maternal serum samples was significantly lower (P < 0.001) in Okinawa (72%) than in Aomori (100%) or Tochigi (100%). The geometric mean tire (GMT) of anti-BCV neutralizing antibody was also significantly lower (P < 0.05) in maternal sera from Okinawa (89) than that of Aomori (229) or Tochigi (264). The anti-BCV neutralizing antibody titres in the sera of calves which had ingested the colostrum, significantly correlated with the antibody concentration of the maternal serum samples (P < 0.05). These results suggest an extensive BCV infection among the dairy cattle in these prefectures, with a varied pattern of distribution between the prefectures. Anti-BCV neutralizing antibody in the sera of newborn calves appeared to be transferred from their dams through colostrum.