Geographical distribution of cercarial dermatitis in Norway.

Bird schistosomes can cause a disease called cercarial dermatitis, or swimmer's itch, in humans. The disease occurs when people have direct contact with fresh water or sea water containing the free-swimming cercariae of the flukes. The symptoms are well known, and include intense itching, maculae, papulae, urticariae and, in some cases, local oedema with enlarged lymph nodes and fever. In this study, we present the geographical distribution of freshwater cercarial dermatitis in Norway. The study is based on random reports obtained from both individuals and physicians treating patients with itching skin rash after freshwater bathing. The first case of cercarial dermatitis in Norway was reported in 1980 and was traced to a lake near Trondheim in the central part of Norway. In the following years, an increasing number of cases were reported, especially in southern Norway. However, case reports are distributed almost all over the country, even from lakes in northern Norway. As far as we know, these are the northernmost case reports in Europe. So far, only one fluke species (Trichobilharzia franki) from a single infected snail (Radix auricularia) has been identified in Norway. However, unidentified schistosomatid ocellate cercariae have been found on several occasions in snails collected from six lakes where swimmer's itch is frequently reported. Future studies should be performed to identify the fluke species, as well as the most important snail and bird hosts, in Norwegian lakes.

Disseminated and chronic Lyme borreliosis in Norway, 1995 - 2004.

Lyme borreliosis is the most common tickborne infection in Norway. All clinical manifestations of Lyme borreliosis other than erythema migrans are notifiable to Folkehelseinstituttet, the Norwegian Institute of Public Health. During the period 1995-2004 a total of 1506 cases of disseminated and chronic Lyme borreliosis were reported. Serological tests were the basis for laboratory diagnosis in almost all cases. The annual numbers of cases showed no clear trend over the period, but varied each year between 120 and 253 cases, with the highest number of cases reported in 2004. Seventy five per cent of cases with information on time of onset were in patients who fell ill during the months of June to October. There was marked geographical variation in reported incidence rates, with the highest rates reported from coastal counties in southern and central Norway. Fifty six per cent of the cases were in males and 44% in females. The highest incidence rate was found in children aged between 5 and 9 years. Neuroborreliosis was the most common clinical manifestation (71%), followed by arthritis/arthralgia (22%) and acrodermatitis chronica atrophicans (5%). Forty six per cent of patients were admitted to hospital. Prevention of borreliosis in Norway relies on measures to prevent tick bites, such as use of protective clothing and insect repellents, and early detection and removal of ticks. Antibiotics are generally not recommended for prophylaxis after tick bites in Norway.

Disseminated and chronic Lyme borreliosis in Norway, 1995 - 2004.

Lyme borreliosis is the most common tickborne infection in Norway. All clinical manifestations of Lyme borreliosis other than erythema migrans are notifiable to Folkehelseinstituttet, the Norwegian Institute of Public Health. During the period 1995-2004 a total of 1506 cases of disseminated and chronic Lyme borreliosis were reported. Serological tests were the basis for laboratory diagnosis in almost all cases. The annual numbers of cases showed no clear trend over the period, but varied each year between 120 and 253 cases, with the highest number of cases reported in 2004. Seventy five per cent of cases with information on time of onset were in patients who fell ill during the months of June to October. There was marked geographical variation in reported incidence rates, with the highest rates reported from coastal counties in southern and central Norway. Fifty six per cent of the cases were in males and 44% in females. The highest incidence rate was found in children aged between 5 and 9 years. Neuroborreliosis was the most common clinical manifestation (71%), followed by arthritis/arthralgia (22%) and acrodermatitis chronica atrophicans (5%). Forty six per cent of patients were admitted to hospital. Prevention of borreliosis in Norway relies on measures to prevent tick bites, such as use of protective clothing and insect repellents, and early detection and removal of ticks. Antibiotics are generally not recommended for prophylaxis after tick bites in Norway.

Cockroach sensitivity in Norway: a previously unidentified problem?

BACKGROUND: Little is known about cockroach sensitization in Scandinavia, whereas cockroaches are implicated in allergic diseases throughout large parts of the world. In association with the Genetics of Asthma International Network (GAIN) study, we report sensitization to cockroaches and possible association with IgE-mediated diseases in Norway. METHODS: 100 Norwegian families (426 subjects) of 7-35-year-old sibling-pairs with asthma and their parents underwent questionnaire/interview (medical and exposure history), skin prick test (SPT) to common local inhalant allergens and German cockroach, and IgE specific to mites, mosquito, shrimp and cockroach. Cockroach sensitization was defined as positive if there was a positive (> or = 3 mm) skin prick test and/or presence of IgE antibody of class 2 or more. RESULTS: Thirty-one subjects (7.5%) were sensitized (five monosensitized) to cockroach (27 by skin prick test and seven by IgE antibody, all with additional inhalant allergy). Co-sensitization was most common to grass (in 61%), cat (48%), dog (48%) and mites (42%). Reported allergic diseases in cockroach-sensitized subjects were asthma and rhinitis (n = 10), asthma only (n = 9), rhinitis only (n = 2) and neither asthma nor rhinitis (n = 10). CONCLUSIONS: Since cockroach sensitization was relatively frequent in Norwegian atopic families, albeit with unclear clinical implications, we suggest that cockroach allergy should be considered in atopic subjects with respiratory disease.

Short term exposure to airborne microbial agents during farm work: exposure-response relations with eye and respiratory symptoms.

OBJECTIVES: Exposure to high levels of non-infectious microbial agents is recognised as a cause of respiratory disease in working populations, but except for endotoxins, little is known about exposure-response relations. As these effects do not depend on viability, exposure to non-viable microbial agents is important. Various methods not based on microbial cultures were explored to study the complex microbial exposure of farmers and associations with acute symptoms during work. METHODS: Airborne exposure was measured when farmers carried out specific tasks. Fungal spores, bacteria, endotoxins, beta(1-->3)-glucans, fungal antigens specific for Penicillium and Aspergillus species, and mites were measured by methods not based on microbial cultures. Also silica, inorganic and organic dust, ammonia, hydrogen sulphide, and nitrogen dioxide were measured. Respiratory, and nose and eye symptoms experienced during measurements were recorded by a short questionnaire. Both univariate and multivariate statistical analyses were applied to assess the relations between exposure and acute symptoms. RESULTS: 106 Farmers and their spouses participated in this study. Prevalences of work related symptoms were: wheezing 3%; chest tightness 7%; cough 14%; eye symptoms 18%; and nose symptoms 22%. Prevalence ratios for nose and eye symptoms were 4-8 after exposure to 20-500x10(3) fungal spores/m(3) and higher, and a prevalence ratio for cough was 4 after exposure to 500-17,000x10(3) fungal spores/m(3). Nose symptoms were also associated with exposure to silica with prevalence ratios of 4-6 after exposure to 0.015-0.075 mg /m(3) and higher. CONCLUSIONS: Farmers had a high occurrence of symptoms of the nose and eyes as well as cough during work. These symptoms were associated in a dose dependent manner with exposure to fungal spores. Nose symptoms were also associated with exposure to silica.

The biosynthesis of nicotinamide adenine dinucleotides in bacteria.

The nicotinamide adenine dinucleotides (NAD, NADH, NADP, and NADPH) are essential cofactors in all living systems and function as hydride acceptors (NAD, NADP) and hydride donors (NADH, NADPH) in biochemical redox reactions. The six-step bacterial biosynthetic pathway begins with the oxidation of aspartate to iminosuccinic acid, which is then condensed with dihydroxyacetone phosphate to give quinolinic acid. Phosphoribosylation and decarboxylation of quinolinic acid gives nicotinic acid mononucleotide. Adenylation of this mononucleotide followed by amide formation completes the biosynthesis of NAD. An additional phosphorylation gives NADP. This review focuses on the mechanistic enzymology of this pathway in bacteria.

Field detection of Francisella tularensis.

A field investigation was undertaken following an outbreak of water-borne tularemia in Northern Norway. Francisella tularensis bacterial cellular components were analysed by rapid immunochromatography (RI)-testing, enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). Water from 1 reservoir, fed from a rapid stream, tested negative. From another reservoir, 2 of a chain of 3 wells tested negative. The third well, at the end of the chain, contained lemming (Lemmus lemmus) carcasses and gave ample proof of F. tularensis contamination. We concluded that the origin of the outbreak was dead, infective lemming carcasses in the water sources. For the various sampling materials, the RI-test proved itself particularly handy and versatile, compared with the ELISA and the PCR.

Identification of the Escherichia coli nicotinic acid mononucleotide adenylyltransferase gene.

The gene (ybeN) coding for nicotinate mononucleotide adenylyltransferase, an NAD(P) biosynthetic enzyme, has been identified and overexpressed in Escherichia coli. This enzyme catalyzes the reversible adenylation of nicotinate mononucleotide and shows product inhibition. The rate of adenylation of nicotinate mononucleotide is at least 20 times faster than the rate of adenylation of nicotinamide mononucleotide.

Longitudinal relationships between depressive symptoms and health in normal older and middle-aged adults.

Comorbidity between health and depression is salient in late life, when risk for physical illness rises. Other community studies have not distinguished between the effects of brief and long-standing depressive symptoms on excess morbidity and mortality. S. Cohen and M. S. Rodriguez's (1995) differential hypothesis of pathways between depression and health was used to examine the relationships between health and depression in a prospective probability sample of 1,479 community-resident middle-aged and older adults. Findings suggest that different durations of depressive symptoms have different relationships to health. Health had an impact on short-term increases in depressive symptoms but depressive symptoms had a weaker impact on health. The reciprocal impact was indistinguishable from the health influence on depression. In contrast, longer term depressive symptoms had a clear impact on health. The results imply that physical illness can affect depressive states; depressive traits but not states can affect illness.

Mechanistic studies on the repair of a novel DNA photolesion: the spore photoproduct.

[formula: see text] UV irradiation of spores results in the formation of the spore photoproduct. This novel DNA photolesion is repaired in the germinating spore in a reaction catalyzed by the spore photoproduct lyase. Model studies, using a simple bispyrimidine, suggest that this repair reaction proceeds by hydrogen abstraction from C6 of the spore photoproduct followed by beta-scission of the bond linking the two pyrimidines and back hydrogen atom transfer.

[Communicable disease control in connection with international air traffic to Norway]. / Smittevern ved internasjonal flytrafikk til Norge.

International air traffic has increased the risk of importation of infectious diseases to Norway. We have used notification data and a theoretical framework to assess the risk of importation and subsequent disemination of serious infectious diseases in Norway. Every year, a few cases of these diseases are imported to Norway, especially malaria, shigellosis and typhoid fever. A few secondary cases of enteric diseases may occur, but epidemics are unlikely. Counselling and immunisation of Norwegians going abroad is the first step in prevention. Secondly, health services all over the country should be able to diagnose imported diseases early and institute infection control measures. However, there is no need for concentrating resources for disease control at international airports in Norway.

Isolation and characterization of Puumala hantavirus from Norway: evidence for a distinct phylogenetic sublineage.

Puumala (PUU) hantavirus is the aetiological agent of nephropathia epidemica (NE), a mild form of haemorrhagic fever with renal syndrome, which occurs in Fennoscandia, central Europe and Russia. In Norway, NE-like disease has been reported since 1946 and about 50 cases are diagnosed annually; however, the causative agent has not been characterized. In this study, a virus originating from bank voles (Clethrionomys glareolus) trapped near the town of Eidsvoll (Akershus county) was isolated and passaged in laboratory-bred bank voles. The bank vole strain was identified as a PUU virus by serological typing and by sequence analysis of the S and M gene segments. For comparison, complete or partial S sequences were determined for wild-type PUU strains from five locations in Sweden, two inhabited by the southern variant of bank vole present in Fennoscandia, and three by the northern variant. Phylogenetic analysis showed that Norwegian PUU strains are clustered together with Swedish strains from the first group forming a well-supported sublineage within the PUU genotype, distinct from other sublineages from northern Sweden, Finland, Russia and France. The results are consistent with the view of a complex evolutionary history of PUU strains in post-glacial Fennoscandia. Analyses of the current collection of nucleotide sequences suggest that PUU is the most variable genotype of the known hantaviruses.

Characteristics of four cowpox virus isolates from Norway and Sweden.

We report the first isolation of cowpox virus from a domestic cat in Norway, and the first confirmed isolation of cowpox virus from a human case in Norway. These two Norwegian cowpox virus isolates, as well as two Swedish human isolates, were partially characterized and compared with each other and with cowpox virus Brighton and vaccinia virus strain Western Reserve. Restriction enzyme analysis of the genomes revealed differences between all six viruses examined, but suggested that the two Norwegian isolates are closely related, as are the two Swedish isolates. Restriction endonuclease digestion of genomic DNA demonstrated that one of the Swedish isolates and the two Norwegian isolates have larger genomes than vaccinia virus strain Western Reserve, but smaller than cowpox Brighton. All four Scandinavian isolates lacked a 72 base-pair region within the A-type inclusion body protein gene which is present in the prototype cowpox virus Brighton.

Naturally occurring orthopoxviruses: potential for recombination with vaccine vectors.

Orthopoxviruses are being increasingly used as live recombinant vectors for vaccination against numerous infectious diseases in humans, domestic animals, and wildlife. For risk assessments and surveillance, information about the occurrence, distribution and ecology of orthopoxviruses in western Europe is important but has mainly been based on serological investigations. We have examined kidneys, lungs, spleens, and livers of Norwegian small rodents and common shrews (Sorex araneus) for the presence of orthopoxvirus DNA sequences by PCR with primers complementary to the viral thymidine kinase (TK) gene. PCR amplicons were verified as orthopoxvirus specific by hybridization with a vaccinia virus TK-specific probe. A total of 347 animals (1,388 organs) from eight locations in different parts of Norway, collected at different times of the year during 1993 to 1995, were examined. Fifty-two animals (15%) from five locations, up to 1,600 km apart, carried orthopoxvirus DNA in one or more of their organs, most frequently in the lungs. These included 9 of 68 (13%) bank voles (Clethrionomys glareolus), 4 of 13 (31%) gray-sided voles (Clethrionomys rufocanus), 3 of 11 (27%) northern red-backed voles (Clethrionomys rutilus), 16 of 76 (21%) wood mice (Apodemus sylvaticus), and 20 of 157 (13%) common shrews. The previous isolation of cowpox virus from two clinical cases of infection (human and feline) at two of the locations investigated suggests that the viruses detected are cowpox and that some of the virus-carrying small mammalian species should be included among the cowpox virus natural reservoir hosts in Scandinavia and western Europe.

Ixodes ricinus strains in Europe.

An analysis of cuticular hydrocarbons (CH) of unfed adult Ixodes ricinus ticks collected throughout Europe showed that there are 10 distinct I. ricinus groups. Studies on the seasonal and annual consistency of CH composition and possible effects of host and environmental factors suggested that CHs may be used as a genuine genetic marker for I. ricinus. Preliminary studies compared the vector competence of ticks from three of the most separated I. ricinus groups and the results suggested that there may be significant differences in tick susceptibility to Borrelia afzelii.

European reservoir hosts of Borrelia burgdorferi sensu lato.

Existing knowledge on reservoir hosts of Borrelia burgdorferi sensu lato was collated and reviewed and several species, particularly birds, were identified as reservoir competent. At the present time, 9 small mammals, 7 medium-sized mammals and 16 bird species, including passerines, sea birds and pheasants, appear to be capable of transmitting spirochaetes to ticks and thus of participating in the natural circulation of B. burgdorferi s.l. in Europe. The house mouse, Mus musculus is strongly suspected of reservoir competence and many other small rodent species, particularly in eastern Europe and Russia, have been implicated. Ungulates are not thought to play a major role as reservoir hosts, though co-feeding transmission may permit some tick infection. The criteria for establishment of reservoir status are outlined and a method for identification of host blood meals of previous instars of unfed ticks, developed in a participant laboratory, is briefly described.

Serosurvey for orthopoxviruses in rodents and shrews from Norway.

Two hundred and twenty one blood samples representing eight different rodent species and the common shrew (Sorex araneus), collected in Norway between 1993 and 1995, were examined for anti-orthopoxvirus antibodies by a competition enzyme linked imunnosorbent assay (ELISA) and, when possible, an indirect immunofluorescence assay. The serological results indicated that the bank vole (Clethrionomys glareolus), woodmouse (Apodemus sylvaticus) and Norway lemming (Lemmus lemmus) may be reservoir species for orthopoxviruses in Norway, with antibody prevalences of 17 (12/69), 30 (24/81) and 56% (19/34), respectively. Orthopoxvirus infection in lemmings has not been reported previously. On some other small rodent species such as field voles (Microtus agrestis), common rats (Rattus norvegicus), and common shrews, seropositive individuals were detected. However, the total number of tested animals was low, and the role of these species in the epidemiology of orthopoxvirus infections remains unclear. Attempts to isolate orthopoxviruses from these small mammals failed, although orthopoxvirus specific DNA sequences were detected previously in the same animals by the polymerase chain reaction (PCR). The serological results were compared with and discussed in the context of the occurrence of orthopoxvirus-specific DNA sequences, and it is concluded that orthopoxviruses are widely distributed among wildlife in Norway.

Residential dampness problems and symptoms and signs of bronchial obstruction in young Norwegian children.

To assess the role of dampness problems and house dust mite exposure in the development of bronchial obstruction in early life, a cohort of 3,754 children born in Oslo during 1992 and 1993 was followed for 2 yr. Bronchial obstruction was defined as two or more episodes with symptoms and signs of obstruction or one lasting 1 mo or more. A matched case-control study was carried out in 251 cases of bronchial obstruction (response rate: 98%) and their 251 paired controls. Information on home dampness problem(s), house dust mite exposure, and potential confounders was collected during home visits and by questionnaires. Dampness problems were confirmed in the homes of 27% of the cases and 14% of the controls, while a concentration of Dermatophagoides pteronyssinus allergens > 2 microg/g dust was found in the beds of 11 (4.5%) cases and three (1.2%) controls. In conditional logistic regression analysis controlling for potential confounders, confirmed dampness problems increased the risk of bronchial obstruction (adjusted odds ratio: 3.8; 95% confidence interval: 2.0-7.2). Exposure to D. pteronyssinus allergens > 2 microg/g dust increased the risk of bronchial obstruction (adjusted odds ratio: 2.8; 95% confidence interval: 0.7-11.7). Residential dampness problems in Oslo dwellings seem to increase symptoms and signs of bronchial obstruction in young children, apparently without increasing their exposure to house dust mites.

Occurrence of mites in Norway and the rest of Scandinavia.

This paper gives a faunistic review of mites that have been recorded in the indoor environment, particularly homes, barns, and stored products, in Norway and the other Scandinavian countries. Some preliminary results are given from unpublished investigations in Norway. Seven species of pyroglyphid mites have been recorded: Dermatophagoides pteronyssinus, D. microceras, D. farinae, D. evansi, Euroglyphus maynei, Gymnoglyphus longior, and Hirstia chelidonis. D. pteronyssinus was the predominant species, followed by D. microceras in Scandinavia and D. farinae in Denmark. D. evansi was detected in poultry houses in Norway. Lepidoglyphus destructor was the predominant species in barn dust, but large populations of Acarus, Tyrophagus, Tydeus, and Tarsonemidae also occurred. In humid homes, Glycyphagus domesticus was found in high numbers. The result of quantification of mites depends on the method for examination of dust. When one proposes limits for the concentration of mites in relation to risk of allergic sensitization and provocation of symptoms, reference should be made to a well-described method for sampling and analyzing dust. The number of mites should be given per area, not only per weight unit of dust. The number of mites per area indicates the number of mites in the home. The number of mites per weight unit of dust describes the concentration of mites in the vacuum cleaner.

Field investigations of tularemia in Norway.

In Norway, tularemia is a common disease in small rodent and hare populations, where large outbreaks can be observed. In humans, the yearly number of cases is low, usually less than ten, with peaks up to 44 recorded in recent years. Serological investigations on hunters and healthy school children nevertheless indicate, with up to 4.7% positivity in the latter group, that Francisella tularensis low-grade infection is widespread. F. tularensis in co-culture with amoebae, e.g. Achantamoeba castellanii, may grow after internalization and kill the amoeba. As with Legionella, Francisella virulence may be enhanced after protozoan ingestion. This suggests a mechanism that can explain the pattern of dissemination and infection in our region.