Molecular epidemiology of human cutaneous leishmaniasis in Jericho and its vicinity in Palestine from 1994 to 2015.

Cutaneous leishmaniases (CL) are vector-borne parasitic diseases endemic in many countries of the Middle East including Palestine. Between 1994 and 2015, 2160 clinically suspected human cases of CL from the Jericho District were examined. Stained skin tissue smears and aspirates were checked by microscopy and cultured for promastigotes, respectively. For leishmanial species identification, amplification products from a PCR-ITS1 followed by RFLP analysis using Hae III. Data were analyzed using Epi Info free-software. The overall infection rate was 41.4% (895/2160), 56.3% (504/895) of the cases were male, 43.7% (391/895) female, 60.5% (514/849) children under age 14, 41.3% (259/627) of the cases were caused by Leishmaniamajor and 57.3% (359/627) by Leishmaniatropica. The case numbers peaked in 1995, 2001, 2004, and 2012. Statistically-significant clusters of cases caused by L. major were restricted to the Jericho District; those caused by L. tropica were from the districts of Jericho, Bethlehem, Nablus and Tubas. CL is seasonal and trails the sand fly season. Distribution of cases was parabolic with fewest in July. The monthly total number of cases of CL and just those caused by L. major correlated significantly with temperature, rainfall, relative humidity, evaporation, wind speed and sunshine (P<0.05, r2=0.7-0.9 and P<0.05, r2=0.5-0.8, respectively). Cases caused by L. tropica, significantly, had a single lesion compared to cases caused by L. major (P=0.0001), which, significantly, had multiple lesions (P=0.0001). This and previous studies showed that CL is present in all Palestinian districts. The surveillance of CL has increased public awareness and molecular biological methodology for leishmanial species identification is an essential addition to classical diagnosis. The overall results are discussed, correlated to climatic and environmental changes and large-scale human activities.

Molecular epidemiology of Echovirus 6 in Greece.

The objective was to investigate the genetic relationships among Echovirus 6 (E6) strains circulating in Greece and to compare them with the respective strains from other geographic regions. Cerebrospinal fluid samples collected during the period 2006-2007 from 84 patients with aseptic meningitis or encephalitis were tested for a probable enteroviral infection. Two RT-PCRs amplifying overlapping regions of the VP1 gene were performed, while isolation procedures were applied in one third of cases. All PCR products were sequenced, and further phylogenetic analysis was performed for E6 strains. Enteroviruses were detected in 27 out of 84 cases (32.14%) and E6 was the predominant serotype (11 out of 27, 40.74%). Three distinct clades of Greek E6 sequences were seen in the phylogenetic tree: sequences of the present study were placed in clades A and B, while sequences of a former study in Greece were clustered in clade C. Sequences of clades A and C presented high genetic homology (>95%) with sequences from other countries, while sequences of clade B were unique, differing by more than 15% from all known E6 sequences. The most prevalent enterovirus in Greece during the period 2006-2007 was E6, and was associated with aseptic meningitis. A high degree of heterogeneity was observed among Greek E6 strains.

Aseptic meningitis and encephalitis because of herpesviruses and enteroviruses in an immunocompetent adult population.

BACKGROUND AND AIM: Human herpesviruses (HHVs) and enteroviruses (EVs) are the major causative agents of CNS viral infections. The aim of the study was to identify the etiology and determine the frequency of aseptic meningitis and encephalitis due to HHVs and EVs in an immunocompetent adult population. METHODS: Eighty-one patients (ages >or=15) with aseptic meningitis or encephalitis treated in the Infectious Diseases Hospital of Thessaloniki, Greece, during 2003-2006, were included in the study. Polymerase chain reaction for detection of herpes- and enterovirus genome direct in cerebrospinal fluid samples was performed. RESULTS: Based on clinical and laboratory data, 36/81 patients had meningitis and 45/81 had encephalitis. Etiology was defined in 11 patients (31%) with aseptic meningitis. EVs were the major causative agents (8/36, 22%), followed by varicella zoster virus (2/36, 5%) and herpes simplex virus-2 (HSV-2) (1/36, 3%). Etiology was identified in 8 of 45 (18%) patients with encephalitis, EV (4/45, 9%) and HSV-1 (4/45, 9%) being the most common pathogens. CONCLUSION: Enteroviruses are the most common cause of adult aseptic meningitis and together with HSV-1 the main causes of encephalitis.

Genetic variation of coxsackie virus B5 strains associated with aseptic meningitis in Greece.

In order to explore the genetic relationships among coxsackie virus B5 strains in Greece, the nucleotide sequences of the partial VP1 gene in strains isolated from aseptic cases of meningitis were determined and compared with those of strains isolated from other countries. Phylogenetic analysis showed a high degree of divergence (25%) among Greek strains isolated in different years, which clustered with high bootstrap values in a different subgroup of viruses, suggesting that enterovirus types vary with time rather than geographical distribution. A non-synonymous mutation present in the strains of this study was not observed in other coxsackie virus B5 strains.