Seasonal trends of Cyclospora cayetanensis infections in a community of Falcon State, Northwestern Venezuela.

BACKGROUND: Cyclosporiasis has a marked seasonality. Few community-based studies have addressed this issue and there are no reports from Venezuela. A study was conducted to determine the seasonal variation of infection in a community from Falcon State, Venezuela. METHODS: A sample of 732 individuals was collected for 1 y. Stools were examined with modified Ziehl-Neelsen carbolfuchsin staining of ethyl acetate-formalin concentrates and ultraviolet epiflorescence of wet mounts. RESULTS: Cyclospora prevalence was 9.9% (73/732) with monthly variation from 0% to 35.3%. A trend of increased infections coinciding with the rainy time was observed (p<0.001). CONCLUSIONS: Cyclosporiasis is common in this area with high endemicity during the rainy periods.

Cyclospora cayetanensis infections among diarrheal patients from Venezuela.

The prevalence and importance of Cyclospora cayetanensis as an enteropathogen among 71 patients (22-45 years old) with acquired immunodeficiency syndrome (AIDS) and 132 children with diarrhea (0-12 years old) from Venezuela was assessed retrospectively. Two to three stool samples from each patient attending our parasitology laboratory for parasitologic and medical assistance were examined. For identification of the coccidium, modified Ziehl-Neelsen carbolfuchsin staining of formalin-ether stool concentrates was used, and for other intestinal parasites, iron-hematoxylin-stained smears and formalin-ether concentrates were examined. Cyclospora oocysts were found in seven (9.8%) of 71 AIDS patients and seven (5.3%) of 132 children with diarrhea. Other pathogenic parasites were present in most of the patients (9 of 14, 64.3%) shedding oocysts. Cyclosporiasis predominated in children 2-5 years of age with respect to those < or = one year of age (P < 0.05). The findings suggest that C. cayetanensis is common in diarrheal patients from Venezuela. However, the role of the parasite as the causal agent of diarrhea in these patients is uncertain.

[Relevance of Entamoeba dispar in amebiasis]. / Relevancia del reconocimiento de Entamoeba dispar en la amibiasis.

Entamoeba histolytica was redefined to recognize the existence of two morphologically indistinguishable species but genetically distinct: E. histolytica and E. dispar. The former is a pathogen responsible for amebiasis while the latter is a commensal. This redefinition has dramatically changed the understanding of amebiasis and its clinical management.

Melatonin treatment enhances the efficiency of mice immunization with Venezuelan equine encephalomyelitis virus TC-83.

To determine whether treatment with melatonin (MLT) improves the efficiency of immunization against Venezuelan equine encephalomyelitis (VEE) virus, mice were vaccinated with TC-83 VEE virus and treated daily with MLT (1 or 5 mg/kg) starting 3 days before immunization, until 10 days after. IgM antibody titers were determined at days 7, 14, and 21 post-immunization. IL-10 levels were assayed at day 14 postvaccination. Treatment with MLT increased antibody titers 14 days after the immunization. IL-10 levels also increased with MLT treatment (1 and 5 mg/kg). Mice were challenged with live VEE virus at day 21 postimmunization, and viral titers were plaque assayed in chicken embryo fibroblasts 4 days after the infection. Following this challenge brain virus levels were significantly reduced. The results suggest that MLT treatment enhances the efficiency of mice immunization against VEE virus.

Seroepidemiology of toxoplasmosis in amerindians from western Venezuela.

A survey of 447 Amerindians aged 1-69 years (mean age, 18.6 +/- 15.8 years) in 3 mountain and 1 lowland communities from Venezuela were studied to determine the seroprevalence of Toxoplasma gondii, the environmental risk factors for the infection, and how the process of acculturation may affect the transmission rate. Serum samples were tested for immunoglobulin G antibodies by a commercial indirect hemagglutination test. The overall prevalence of infection was 49.7% (222 of 447) and ranged 38.2-62.4%. A higher antibody rate was found in the lowland setting as compared with those from the mountain area (P < 0.001). The geometric mean titer in the overall population was 280.3. No age-antibody association was detected in the mountain communities, although a gradual increase in positivity with increasing age (P < 0.01) was observed in the lowland setting, reaching a peak of 83.3% in the oldest group. The results suggest that transmission by infective cat feces may play a predominant role in the spread of infection in this population. This study demonstrates the environmental Toxoplasma infection pressure in this sylvatic population and how transmission rate is facilitated by environmental changes produced by acculturation.

High intensity light increases olfactory bulb melatonin in Venezuelan equine encephalitis virus infection.

In mice infected with the Venezuelan equine encephalomyelitis (VEE) virus and exposed to high intensity light (2500 lux) with a 12 h light: 12 h dark photoperiod, a significant increase in the levels of melatonin in the olfactory bulb was observed. The significance of these findings deserves further studies to understand the mechanisms involved in this effect since the olfactory bulbs have been proposed as first portal for VEE virus entry into the CNS. The increase in melatonin content could represent one of the mechanisms of defense against the viral attack.

[Importance of the different species and genotypes of Cryptosporidium in public health]. / Importancia de las diferentes especies y genotipos de Cryptosporidium en Salud Pública.

Until recently, only the bovine and human genotypes of Cryptosporidium parvum had been considered to infect man and to be potential pathogens. Lately, symptomatic infections with C. felis, C. meleagridis, and C. parvum-like dog genotype have been described in immunocompetent and immunosuppressed individuals. These findings suggest that zoonotic parasites could also play an important role in Public Health.

Melatonin prolongs survival of immunodepressed mice infected with the Venezuelan equine encephalomyelitis virus.

Male albino mice immunodepressed after the injection of dexamethasone (DEX) were inoculated intraperitoneally with the Guajira strain of Venezuelan equine encephalomyelitis (VEE) virus. Melatonin (MLT) was administered daily, at a dose of 500 micrograms/kg bodyweight, for 3 days before virus inoculation and 10 days after. Serum levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-2 (IL-2) were determined in all the experimental groups (control, DEX, DEX + MLT, DEX + VEE, DEX + VEE + MLT, VEE and MLT). At day 6 after the virus inoculation, the survival rate was significantly increased from 0% in group DEX + VEE to 32.5% in the group of immunodepressed infected mice treated with MLT (DEX + VEE + MLT). By day 10 a survival rate of 10% was found in group DEX + VEE + MLT and 0% in group VEE. No alterations in IL-2 serum levels were observed. MLT increased GM-CSF in control and in DEX-treated mice. In the VEE virus-infected mice treated with DEX, serum levels of GM-CSF increased progressively from day 1 to 5 postinoculation. In contrast, the levels of GM-CSF in infected immunodepressed mice treated with MLT decreased significantly from day 1 to 5 postinoculation. At day 5 after viral inoculation, no differences were detected in the cerebral viral titres in groups VEE, DEX + VEE and DEX + MLT + VEE. These results show that MLT does not inhibit VEE viral replication in the brain of immunodepressed mice.

Intestinal parasitic infections, with a special emphasis on cryptosporidiosis, in Amerindians from western Venezuela.

The prevalences of intestinal parasites and intensities of helminth infections were studied in two Amerindian villages in Venezuela. Single stool specimens were collected from 303 individuals from Saimadoyi and 130 from Campo Rosario. Wet mounts, iron-hematoxylin-stained smears, and formalin-ether concentrates were examined for the presence of parasites; modified Ziehl-Neelsen carbol-fuchsin staining of 10% formalin-preserved stool was used to identify Cryptosporidium parvum. Helminth ova counts were made using the standard smear egg count technique. Mixed infections (Campo Rosario = 69.9%, Saimadoyi = 71.6%) were frequent. Overall infection rates with one or more species (Campo Rosario = 79.2%, Saimadoyi = 95.4%; P < 0.01) and with any protozoans (Campo Rosario = 60.8%, Saimadoyi = 72.3%; P < 0.05) were high and predominant (P < 0.05) in Saimadoyi. Cryptosporidiosis was identified in 38 subjects (8.8%) in both villages; 60.6% were asymptomatic carriers. The mean egg counts of helminths were heavier in Campo Rosario (P < 0.05), which was probably due to the drastic reduction of their lands along with their low standard of living. This study documents the change of intestinal parasitism pattern and deterioration of the health of Amerindians by the process of acculturation.

Exposure to 2500 lux increases serum melatonin in Venezuelan equine encephalomyelitis.

When mice infected with the Venezuelan equine encephalomyelitis (VEE) virus were exposed to 2500 lux with a 12 h light: 12 h dark photoperiod, the serum levels of melatonin (MLT) remained constantly elevated. In mice exposed to 400 lux low levels of serum MLT were detected during the day and high levels during the night. An increase in the survival rate of the infected mice from 6 to 13 days after virus inoculation was also observed. The significant increment in the concentration of serum MLT produced by the high intensity light could be responsible for the longer survival rate of mice infected with the VEE virus.

Melatonin protects mice infected with Venezuelan equine encephalomyelitis virus.

We investigated whether the administration of melatonin (MLT) reduces the death rate and evolution of the disease in mice infected with Venezuelan equine encephalomyelitis (VEE) virus. Our results show that, MLT protects mice infected with the virus. The mortality rate was reduced from 100% to 16% merely by increasing the dose from 0 to 1000 micrograms/MLT per kg body weight MLT significantly postponed the onset of the disease and death by several days. In surviving mice very high titres of VEE virus IgM antibodies were found seven weeks after virus inoculation. MLT significantly reduced VEE virus levels in blood and brain of infected mice and increased the survival rate when the length of pretreatment was augmented from 3 to 7 or 10 days before virus inoculation. Serum levels of interleukin-2 were not affected by MLT administration. In control mice receiving MLT as well as in infected mice treated or non-treated with MLT, interferon gamma levels in sera were increased. Interleukin-4 concentrations were found to be elevated in sera of non-infected mice receiving MLT, but did not differ from controls in infected mice treated or non-treated with the hormone. MLT reduced the degree of cell destruction produced by VEE virus in culture plates of chicken embryo fibroblasts. The protective effect of MLT warrants further investigation of the possibility of using this hormone for the treatment of humans and equines infected with VEE virus.

Cryptosporidium parvum in children with diarrhea in Zulia State, Venezuela.

The prevalence and importance of Cryptosporidium parvum as a causal agent of acute diarrhea among pediatric patients from Zulia State, Venezuela was assessed. Single stool specimens were collected from 310 children 0-60 months of age with acute diarrheal disease who were admitted to three public hospitals and from 150 comparable control children without gastrointestinal symptoms who were seen as outpatients. Cryptosporidium parvum oocysts were identified in 35 (11.2%) of 310 children with diarrhea and the coccidium was the single detectable pathogen in only 12 (34.2%). Other potential pathogenic parasites were present in most of the patients shedding oocysts (23 of 35, 65%). In nondiarrheal control children, oocysts were identified in nine (6%) of 150. The data suggest that C. parvum is relatively highly endemic in children 0-60 months of age in Zulia State and that although C. parvum may be an important pathogen associated with diarrhea, it may be a cause of only a small proportion of diarrheal episodes.

[Cryptosporidiosis in humans. Review]. / Criptosporidiosis en humanos. Revisión.

Cryptosporidiosis basically is a gastrointestinal infection caused by the coccidian protozoa Cryptosporidium. The infection is associated with diarrhea worldwide but it is most prevalent among children below 5 years of age in the undeveloped countries. It is an important Public Health problem. Infection in humans is usually with C. parvum. The parasite appears to be transmitted by a variety of mechanisms but zoonotic- and person-to-person transmission, and contaminated water appear to be the most important. The mechanism by which the coccidium causes diarrhea is unknown. The extent of the disease is mostly dependent on the immune status of the host. In immunocompetent persons, C. parvum may cause a short term diarrheal disease that resolves spontaneously; in immunocompromised patients, especially those with AIDS, produces a prolonged, life-threatening cholera-like disease. The diagnosis is generally made by detection of oocysts in stools by means of several concentration and staining procedures. Modified acid-fast and fluorescence stains are widely used. Immunofluorescent assays with Cryptosporidium-clonal antibodies have been developed to detect oocysts in stool specimens. Specific humoral antibodies have been detected by immunofluorescence and enzyme-linked immunosorbent assay techniques. Although an effective agent for Cryptosporidium is not available yet, promising results have been related to the immunotherapy. Vaccines are not available and the control and prevention of the infection is limited because of the environmentally resistant oocysts and the ignorance of all its possible transmission routes.

Cryptosporidium infections in a suburban community in Maracaibo, Venezuela.

A point prevalence survey for Cryptosporidium was conducted in 212 subjects two months to 70 years of age in a suburban area with a low socioeconomic status in Maracaibo City, Venezuela. Single stool specimens were collected and modified Ziehl-Neelsen carbol-fuchsin staining of 10% formalin-preserved stool was used to identify Cryptosporidium oocysts. Direct wet mounts, iron-hematoxylin-stained smears and formalin-ether concentrates were examined to determine the presence of other intestinal parasites. Cryptosporidium infections were identified in 21 subjects (9.9%), with a high percentage of asymptomatic carriers (15 of 21, 71.4%). Six children (28.5%) had gastrointestinal symptoms and four of them were infants. Cryptosporidium was the single detectable potential pathogenic parasite in only five (23.8%) of 21 patients. The infection rate with one or more parasites was high (82%) and multiple infections, including pathogenic helminths and protozoa, were observed in the majority of patients who passed oocysts. Our findings suggest that although Cryptosporidium is an important pathogen, the proportion of asymptomatic carriers may be high in areas of low socioeconomic status in developing countries.