Is high prevalence of Echinococcus multilocularis in wild and domestic animals associated with disease incidence in humans?

We investigated a focus of highly endemic Echinococcus multilocularis infection to assess persistence of high endemicity in rural rodents, explore potential for parasite transmission to domestic carnivores, and assess (serologically) putative exposure versus infection frequency in inhabitants of the region. From spring 1993 to spring 1998, the prevalence of E. multilocularis in rodents was 9% to 39% for Arvicola terrestris and 10% to 21% for Microtus arvalis. From June 1996 to October 1997, 6 (7%) of 86 feral dogs and 1 of 33 cats living close to the region tested positive for intestinal E. multilocularis infection. Testing included egg detection by coproscopy, antigen detection by enzyme-linked immunosorbent assay (ELISA), and specific parasite DNA amplification by polymerase chain reaction. Thus, the presence of infected domestic carnivores can increase E. multilocularis exposure risk in humans. A seroepidemiologic survey of 2,943 blood donors in the area used specific Em2-ELISA. Comparative statistical analyses of seroprevalence and clinical incidence showed an increase in Em2-seroprevalence from 1986 and 1996-97 but no increase in clinical incidence of alveolar hydatid disease.

Investigations on a Swiss area highly endemic for Echinococcus multilocularis.

Anecdotal information suggested that a focus of hyperendemicity may be present in a small area of the Canton of Fribourg in Switzerland. Therefore, the prevalence of E. multilocularis was assessed both in the fox and the rodent population over a two-season-period. A high prevalence ranging between 47% and 56% was consistently determined in the fox population. An Arvicola terrestris population was infected at 39% in the first season of investigation and at 11% in the following season. A subsequent seroepidemiological survey in the population of inhabitants surrounding the area provided no indication of seroconversion and thus no indication of infection for humans. However, a longer-term survey will be needed to assess more precisely the risk of disease occurrence among these inhabitants.

[Pensions for the aged or housebound: discriminant factors. Study conducted in 4 districts of the canton of Fribourg (Switzerland)]. / Pensions pour personnes âgées ou encadrement à domicile: facteurs discriminants. Etude conduite dans quatre districts du canton de Fribourg (Suisse).

This research forms part of a two centre study (Fribourg et Geneva) on the use of medical and socio-medical services by elderly persons. It was undertaken under the auspices of the national research programme No 8 (Efficiency and effectiveness of the Swiss health system). The study covered 1173 persons aged 65 years or over receiving care in three services (partly medicalized nursing homes, retirement homes and home nursing services) in four french speaking districts of Fribourg Canton. The staff of these services provided cross sectional data on the personal characteristics of their clients or patients, their physical and mental capacities, the specific services provided to them, and some indications on their home circumstances. The results show differences between districts and services in terms of the overall utilisation rate, its structure, and the detailed profiles of specific needs and services. The discussion focusses on the possible interpretations of these differences and on the fundamental problem matching services to needs.

[A general view of the ambulatory care sector: Structural and functional study in the cantons of Vaud and Fribourg]. / Une vue globale du secteur ambulatoire: etude structurelle et fonctionnelle dans les cantons de Vaud et Fribourg.

The project "Quantification and qualification of ambulatory health care", financed by the Swiss National Science Foundation and covering the Cantons of Vaud and Fribourg, has two main goals: --a structural study of the elements of the ambulatory care sector. This is done through inventories of the professions concerned (physicians, public health nurses, physiotherapists, pharmacists, medical laboratories), allowing to better characterize the "offer". This inventory work includes the collect and analysis of existing statistical data as well as surveys, by questionnaires sent (from September 1980) to the different professions and by interviews. --a functional study, inspired from the US National Ambulatory Medical Care Survey and from similar studies elsewhere, in order to investigate the modes of practice of various providers, with particular regard to interprofessional collaboration (through studying referrals from the ones to the others). The first months of the project have been used for a methodological research in this regard, centered on the use of systems analysis, and for the elaboration of adequate instruments.

Experimental endocarditis: prophylaxis of Candida albicans infections by 5-fluorocytosine in rabbits.

The prevention of Candida endocarditis in the rabbit was easily accomplished with a single intramuscular injection of 75 mg of 5-FC (A predominantly fungistatic agent) per kg either 40 min before, or at the same time as, the intravenous challenge with Candida albicans. Renal infarcts were observed more often in rabbits with infected valvular vegetations than in control rabbits with sterile endocarditis. The prophylactic effect of 5-FC is greater in aortic vegetations than in the kidneys. This may be related to differences in the pathophysiology of infection and the pharmacokinetics of 5-FC in the two areas.

[Adherence of pathogenic Escherichia coli to epithelial cells isolated from the intestinal mucosa of the rabbit, inhibiting effect of hyperimmune bovine colostrum and of various carbohydrates (author's transl)]. / Adhérence de E. coli pathogènes aux cellules épithéliales de la muqueuse intestinale du lapin. Effet inhibiteur d'un lactosérum colostral bovin hyperimmun et de différents glucides

In order to study the mode of action of a bovine anti-Escherichia coli lactoserum (BLS), we have used a new test measuring the adherence of pathogenic E. coli on epithelial cells isolated from the small intestine of rabbit. A mixed suspension of E. coli and of epithelial cells is incubated for 15 min and the number of bacteria adhering to the cells counted under the microscope. The BLS at a concentration of 3.5 mg/ml IgG is able to reduce this number by a factor of 3-5. After absorption of the BLS with formaldehyde-treated bacteria, this factor is smaller than 2. At a concentration of 5 mg/ml, D-mannose and alpha-methylmannoside are as efficient inhibitors of adherence as BLS; at the same concentration, L-mannose is ineffective. The cultures of E. coli strongly agglutinating guinea pig erythrocytes, adhere to a larger extent to the epithelial cells. The last two observations confirm the important role played by fimbriae for the adhesive properties of E. coli. The presence of fimbrial antibodies would partially explain the inhibiting effect of BLS on adherence.