High-calcium, vitamin D fortified milk is effective in improving bone turnover markers and vitamin D status in healthy postmenopausal Chinese women.

BACKGROUND/OBJECTIVES: Risk for developing osteoporosis increases in Asia. The purpose of the study was to evaluate the impact of a high-calcium vitamin D fortified milk (HCM) intervention on parathyroid hormone (PTH) levels, vitamin D status and markers of bone turnover in postmenopausal Chinese women. SUBJECTS/METHODS: Sixty three women (>55 years) were assigned to receive two servings of either a calcium/vitamin D fortified milk or a control drink for 12 weeks. PTH, serum 25 (OH)D levels, C-telopeptide of type I collagen (CTX) levels and procollagen type I N-terminal propeptide (PINP) were measured at baseline, 2, 8 and 12 weeks of supplementation. RESULTS: Daily calcium intake at baseline ranged between 260 and 482 mg for the HCM, and 252 and 692 mg for the control group. HCM improved serum 25 (OH)D levels significantly (33.13-39.49 nmol/l), while remaining similar in the control group (29.27-28.21 nmol/l). The difference between the groups were significant at week 2, 8 and 12. The percentage change in PTH levels in the HCM group was significant from week 2 onwards compared to the control drink (P<0.017, P<0.05 and P<0.001 at weeks 2, 8 and 12, respectively). Plasma CTX of the HCM group reduced by 25% between weeks 0 and 2, remaining significantly lower and at similar levels up to week 12. The difference between the HCM and control group for PINP reached significance at weeks 8 (P=0.011) and 12 (P=0.003). CONCLUSIONS: The HCM intervention significantly improved vitamin D status and reduced bone turnover over 12 weeks in postmenopausal Chinese women.

Haemolytic disease associated with Leptospira interrogans serovar pomona in red deer calves (Cervus elaphus).

Three red deer calves (Cervus elaphus) died with a haemolytic disease associated with infection by Leptospira interrogans serovar pomona. Infection within the herd was more prevalent than disease. Sera from 16 herd mates were tested by the microscopic agglutination test (MAT) and 12 had leptospiral titres, the majority to serovar pomona. A few calves had titres to balcunica and hardjo. Urine was obtained for culture from six of these calves and serovar pomona was isolated from five with titres to pomona, and hardjo from one with a titre to hardjo but not pomona. A fourth calf died with severe nephritis but a diagnosis of leptospirosis was not confirmed in this case.

Age and the ability of calves to respond to a leptospiral vaccine.

The serological responses of calves at two different ages to a commercial hardjo/pomona vaccine were examined. Microscopic agglutination test (MAT) titres of a group of ten three-month-old calves and three groups of 11,12 and 12 six-month-old calves were monitored over a period of 28 weeks. The calves vaccinated at three months of age had a poorer serological response rate to vaccination (30% responded to pomona and 40% responded to hardjo) compared with those vaccinated at six months of age (91-100% responded to pomona and 83-91% responded to hardjo). Those three-month-old calves which did respond also produced a lower level of-antibody than six-month-old calves. It was concluded that in order to achieve adequate protection using commercially available leptospiral bacterins at the recommended dose, vaccination should not be undertaken routinely with animals less than six months of age. Where circumstances arise in which earlier vaccination is necessary, repeat vaccination for continued protection at six months or older is suggested.

Serological responses of farmed red deer to a vaccine against Leptospira interrogans serovars hardjo and pomona.

Six adult, female, red deer were vaccinated with a hardjo-pomona vaccine followed by a second vaccination four weeks later and thereafter, at yearly intervals for two years. Serological responses were determined at intervals using a standard microscopic agglutination test. Increased responses to hardjo were observed in two deer which were seropositive to this serovar before vaccination compared to those which were initially seronegative. Some initially seronegative deer developed titres to hardjo and pomona ranging from 1:24 to 1:48 following the first dose of vaccine, and all deer produced a serological response to both serovars ranging from 124 to 1:96 following the second vaccination except one animal which failed to produce a pomona titre of 124 or greater. Responses to annual revaccinations were more variable both within and between years. Most deer produced titres which ranged from 1:24 to 1:96 for three to live months, although some deer failed to seroconvert following the annual revaccinations. Peak responses were similar to those recorded in cattle following an identical vaccination programme with the same vaccine but titres fell to undetectable levels after three to live months whereas titres reported in cattle generally persisted for at least 12 months.

Leptospirosis associated with serovars hardjo and pomona in red deer calves (Cervus elaphus).

Four red deer calves (Cervus elaphus) died with severe nephritis apparently associated with infection by Leptospira interrogans serovar pomona. The sera of 12 in-contact red deer calves were examined for leptospiral agglutinins and nine showed titres to pomona consistent with recent infection. Two also showed titres of 1:100 to serovar hardjo. The urine of five of these in-contact calves was examined periodically over a period of nine months. All were initially leptospiruric, four being infected with pomona and one with hardjo. In four animals leptospiruria could only be detected for up to six months, but one animal infected with pomona was leptospiruric for at least eight months. The apparent source of infection was from infected cattle, and it is suggested that deer are unlikely to act as maintenance hosts for serovar pomona.

The magnitude and duration of titres of leptospiral agglutinins in human sera.

Sixty-nine meat inspectors with titres of leptospiral agglutinins ranging from 1:768 to 1:24, were re-bled and reexamined periodically over a period of 53 months. Some individuals maintained titres of 1:384 and 1:192 for at least 30 months and others with initial titres of 1:48 and 1:24 maintained such titres for 53 months. Only six, of 63 initially seronegative (less than 1:24) meat inspectors, seroconverted during the period of study. The magnitudes of titres at a single sampling from each of 162 people, with previous histories of medically confirmed leptospirosis, were analysed in relation to time elapsed since initial diagnosis. Some individuals had titres of 1:192 seven years after infection, while others had lower titres after more than 20 years. Conversely, 12% of the population was seronegative two years after infection. These results indicate that it is not possible, from the results of a leptospiral agglutination test, to estimate retrospectively the time at which infection may have occurred. In a small proportion of individuals recently affected by leptospirosis, it will not be possible to demonstrate a change in agglutinating titre.

Prevention of Leptospira interrogans serovar pomona infection in cattle.

A commercial hardjo-pomona vaccine which has previously been shown to be effective against hardjo infection was tested against pomona. Following challenge all 11 six-month-old non-vaccinated calves seroconverted and pomona was isolated from blood or urine on at least one occasion from nine of them. Pomona was isolated once only, on the third day after challenge, from the blood of one of 11 vaccinated calves.

Risks of contracting leptospirosis on the dairy farm.

The sera of 460 people associated with farming were examined for evidence of leptospiral agglutinins. Of these, 308 were dairy farm workers, 62 percent of whom were from the Waikato. Forty-four percent of dairy farm workers, 8 percent of sheep and beef farmers and 25 percent of pig farmers ware seropositive. Of the 137 seropositive dairy farm workers, 65 percent had titres to serovar hardjo and 53 percent to pomona. There were no significant differences between the serological prevalences of workers in different geographical regions. Analysis of factors significantly associated with seropositive workers included; being male, a previous history of medically confirmed leptospirosis in the worker, a clinical history of leptospirosis in the cattle, the size of the milking herd, the type of milking shed, and vaccination of the herd against leptospirosis. These findings indicate that the incidence of leptospirosis in dairy farm workers can only be effectively controlled by reducing the prevalence of infection in dairy cattle.

Epidemiology of leptospirosis in dairy farm workers in the Manawatu. Part II. A case-control study of high and low risk farms.

Subsequent to a cross-sectional serological survey of Manawatu dairy farm workers, a case-control study was carried out to investigate the correlation between titres to leptospiral serovars in workers and those in cattle in their herds. A total of 52 herds was investigated, 25 of which were high risk where milkers had titres of 1:96 or greater, and 27 were case-controls where milkers had no detectable agglutinin titres at a minimum serum dilution of 1:24. The serological prevalence of titres to hardjo in cattle on high risk farms (76.5%) was significantly higher (P<0.05) than on the case-control farms (60.0%). The geometric mean titres of seropositive cattle on high risk farms were also significantly higher (P<0.01) than in the cattle from the case-control farms, especially in the younger cohorts. These findings suggest that there was active endemic hardjo infection in the two- to three-year-old cattle on the high risk farms. Titres to pomona were demonstrated in only 5.2% of the cattle from both types of farm. Workers with titres to pomona tended to be from farms on which stock, especially calves, were bought-in and pigs were kept. Conventional measures for protecting milkers from contact with infected urine appeared to be ineffective and it is concluded that prevention of leptospirosis in dairy farm workers can only be achieved by elimination of infection in the herd by vaccination of cattle.

Leptospirosis of pig farmers: the results of a serological survey.

Serum samples were examined from 70 people working or resident on 41 pig farms within a 50 km radius of Palmerston North. Of the 65 people with occupational pig contact, 20 (31 percent) had microscopic agglutination titres of 1:24 or greater to one or more serovars of Leptospira interrogans, the majority of which were to pomona, the pid adapted serovar. There were significant positive associations between those people with a titre and those with a history of previous diagnosis of leptospirosis by a medical practitioner and the number of breeding sows and fattening pigs on the property. Pig farmers are at similar risk to contracting leptospirosis as dairy farmers, but the major serovars involved are different, and the total population at risk is less. Further evidence is provided that titres to leptospiral agglutinins can persist in humans for longer than ten years.