Nosocomial neonatal legionellosis associated with water in infant formula, Taiwan.

We report 2 cases of neonatal Legionella infection associated with aspiration of contaminated water used in hospitals to make infant formula. The molecular profiles of Legionella strains isolated from samples from the infants and from water dispensers were indistinguishable. Our report highlights the need to consider nosocomial legionellosis among neonates who have respiratory symptoms.

Human infection with avian influenza A H6N1 virus: an epidemiological analysis.

BACKGROUND: Avian influenza A H6N1 virus is one of the most common viruses isolated from wild and domestic avian species, but human infection with this virus has not been previously reported. We report the clinical presentation, contact, and environmental investigations of a patient infected with this virus, and assess the origin and genetic characteristics of the isolated virus. METHODS: A 20-year-old woman with an influenza-like illness presented to a hospital with shortness of breath in May, 2013. An unsubtyped influenza A virus was isolated from her throat-swab specimen and was transferred to the Taiwan Centres for Disease Control (CDC) for identification. The medical records were reviewed to assess the clinical presentation. We did a contact and environmental investigation and collected clinical specimens from the case and symptomatic contacts to test for influenza virus. The genomic sequences of the isolated virus were determined and characterised. FINDINGS: The unsubtyped influenza A virus was identified as the H6N1 subtype, based on sequences of the genes encoding haemagglutinin and neuraminidase. The source of infection was not established. Sequence analyses showed that this human isolate was highly homologous to chicken H6N1 viruses in Taiwan and had been generated through interclade reassortment. Notably, the virus had a G228S substitution in the haemagglutinin protein that might increase its affinity for the human α2-6 linked sialic acid receptor. INTERPRETATION: This is the first report of human infection with a wild avian influenza A H6N1 virus. A unique clade of H6N1 viruses with a G228S substitution of haemagglutinin have circulated persistently in poultry in Taiwan. These viruses continue to evolve and accumulate changes, increasing the potential risk of human-to-human transmission. Our report highlights the continuous need for preparedness for a pandemic of unpredictable and complex avian influenza. FUNDING: Taiwan Centres for Disease Control.

Emergency vector control in a DENV-2 outbreak in 2002 in Pingtung City, Pingtung County, Taiwan.

This paper reports the strategy and effectiveness of an emergency control program conducted in Pingtung City, Taiwan in response to dengue outbreaks. In our control strategy, we carried out 3 insecticide space sprays with an interval of 6-7 days and 2 source reductions to cover the entire duration of dengue virus exposure in humans and mosquito vectors. The control effect was demonstrated by a significant reduction in the Breteau (51.1%) and larval (80.0%) indices, but no such effect was demonstrated by alterations in the adult index (54.9%), house index (45.0%), container index (33.8%), or by indoor (15.8%), outdoor (31.2%), or total water-filled containers (22.7%) per 100 premises examined. The contribution made by the reduction in the number of positive containers was primarily in the outdoor (77.2%), and not the indoor containers (-6.0%). This reduction attributed to an overall reduction of 96.0% Aedes albopictus larvae and 71.0% Aedes aegypti. Therefore, 4 weeks after this extensive emergency control measure, the number of dengue cases dropped to one. Finally, due to both the decrease in temperature resulting from the upcoming winter, and to the sustained effort toward source reduction, the transmission cycle of DENV-2 in Pingtung City was interrupted at the beginning of 2003, and no additional cases were identified in late 2003.

Acid-base enrichment enhances anaerobic hydrogen production process.

This study offers a novel and quick enrichment technology that can be used as a preliminary method to obtain a hydrogen-producing species from the biological sludge produced by wastewater treatment. The influences of acid-base enrichment (by sludge pH adjustment) on the anaerobic hydrogen-producing micro-organisms were investigated using serum bottle assays. The enrichment pH values were controlled at 3, 4, 5, 7, 10, 11 and 12 with 1 N hydrochloric acid and 1 N sodium hydroxide. For each enrichment pH, the cultivation pH values were controlled at 5, 6 and 7. Based on the experimental results, hydrogen accumulation from sludge with acid or base enrichment is higher than that of the control. The hydrogen-production potential of the sludge with acid or base enrichment is 200 and 333 times enhanced, compared with the control, when the enrichment pH is 10 and 3, respectively. The enhancement is due to a shortening of the micro-organisms' lag-time which occurs at a proper cultivation-pH level.