[Report on a measles epidemic in the Ústí nad Labem Region]. / Vyhodnocení epidemie spalnicek v Ústeckém kraji.

The Czech Republic is a measles free country where only isolated, mostly imported cases have been reported. A measles epidemic that occurred in the Ústí nad Labem Region is presented, with the first case diagnosed early in February 2014 and the last one reported in August 2014. The index case and source of infection to other susceptible patients was an adult male with a history of travel to India. The diagnosis of measles was difficult to make as the patient presented with feverish condition due to co-infection with dengue fever, chikungunya, and measles. The primary measles outbreak occurred in contacts and spread to health workers of the Masaryk Hospital in Ústí nad Labem. The infection further spread to the general population of adults. In total, 305 persons presented with suspected measles. One hundred and eighty-six and of them (61%) met the criteria for a confirmed case (positive clinical symptoms and laboratory test). Fifty (16.4%) patients developed typical clinical symptoms and were epidemiologically linked to confirmed cases, but turned out to be antibody negative. In 69 (22.6%) patients, measles were ruled out. Cases were confirmed by the detection of IgM and IgG antibodies against the measles virus or by RT--PCR. Nearly all cases were verified by the National Reference Laboratory for Rubella, Measles, Mumps, and Parvovirus B 19 of the National Institute of Public Health in Prague. In response to the epidemic, apart from common anti-epidemic measures, emergency vaccination was provided to health professionals of the Masaryk Hospital in Ústí nad Labem. Within two weeks after vaccination, a considerable decline in cases was seen in the vaccinated group. Measles most often occurred in persons born in 1970-1980, but were also observed in the smallest, non-vaccinated children (32 cases). Isolated cases also emerged in duly vaccinated children and adolescents. General recommendations are provided based on practical experience from the epidemic.

[Measles re-emerging in the Ústí Region]. / Návrat spalnicek do Ústeckého kraje.

A report is given of a measles outbreak in healthcare workers and the general population that occurred in February to March in Ústí nad Labem. The source of infection was a man with a history of travel to India. The outbreak was primarily observed in the patients contacts and then spread widely to healthcare workers of the Masaryk Hospital in Ústí nad Labem. The outbreak further reached the general population including family contacts of the patients. By the end of March 2014, 171 measles cases were reported, 68 (39.8%) of which in healthcare workers. Cases we confirmed by laboratory analysis of IgM antibodies and IgG antibody dynamics and, possibly, by R-PCR. In addition to standard preventive anti-epidemic measures, the healthcare workers of the Masaryk Hospital were vaccinated with an extra dose of the Priorix vaccine. Measles cases were most often reported in the population born in 1970-1980. This age group was the target population for an extra dose of the Priorix vaccine. General recommendations have been formulated based on the experience from the outbreak.

Voice-supported electronic health record for temporomandibular joint disorders.

OBJECTIVES: To identify support of structured data entry for an electronic health record application in temporomandibular joint disorders. METHODS: The methods of structuring information in dentistry are described and the interactive DentCross component is introduced. A system of structured voice-supported data entry in electronic health record on several real cases in the field of dentistry is performed. The connection of this component to the MUDRLite electronic health record is described. RESULTS: The use of DentVoice, an application which consists of the electronic health record MUDRLite and the voice-controlled interactive component DentCross, to collect dental information required by temporomandibular joint disorders is shown. CONCLUSIONS: The DentVoice application with the DentCross component showed the practical ability of the temporomandibular joint disorder treatment support.

[Simultaneous vaccination against influenza and invasive pneumococcal disease in chronic dialysis patients]. / Simultánní ockování proti chripce a invazivnímu pneumokokovému onemocnení pacientu v pravidelné dialyzacní lécbe.

STUDY OBJECTIVE: To evaluate the antibody response to simultaneous vaccination against influeza and pneumococcal disease in chronic dialysis patients. METHODS: Fifty-four chronic dialysis patients were vaccinated with subunit influenza vaccine Influvac. Thirty-five of these patients were vaccinated with both influenza vaccine and Pneumo 23 vaccine while 19 patients received influenza vaccine alone. Antibodies against influenza vaccine antigens were determined in paired sera by the hemagglutination inhibition test. The geometric mean titre (GMT) of antibodies, protection level (PR), seroconversion (SC) and conversion factor (CF) were calculated. The levels of antibodies against pneumococcal vaccine antigens were detected by the EIA and the geometric mean concentrations of antibodies were calculated from the results. RESULTS: Simultaneous vaccination did not induce adequate PR for antigens A H1N1 and A H3N2, SC and CF for A H3N2 and B. Influenza vaccination alone resulted in inadequate PR and SC for A H3N2, with CF being adequate for all of the antigens. The geometric mean titres of antibodies were higher in the patients vaccinated with influenza vaccine alone, the difference not being statistically significant. Good responsiveness to the pneumococcal vaccine was observed, with the geometric mean concentrations of antibodies increasing 4.8 times after vaccination but decreasing to 1/3 a year later. CONCLUSION: The antibody response to influenza vaccine was negatively influenced by immunodeficiency due to underlying diseases in dialysis patients. Although poorer results were achieved in patients vaccinated with influenza vaccine alone compared to those vaccinated with the two vaccines, the difference was not significant. An adjuvant influenza vaccine is expected to be more promising.

[Effect of needle and syringe exchange programs on the spread of viral hepatitis C]. / Dopad výmenného programu injekcních jehel a stríkacek na sírení virové hepatitidy typu C.

The authors examined a total of 224 clients (147 men and 77 women) of the Contact centre for drug-dependent subjects "Drug out" in Ustí nad Labem. The subjects, parenteral abusers of hard drugs. The majority of examined subjects were 20-24 years old and accounted for 50.9% of the whole group. In all the history of abuse was assessed, the type of drug they took and are taking at present, how long they have been taking it, route of administration of the drug. Participation in the exchange programme was focused on the adherence to using their own injection tools. In addition the authors assessed whether the subjects had hepatitis. After they obtained informed consent, if possible, 4 ml venous blood samples were taken. The blood was examined for anti-HCV by the method of micro-enzyme immunoassay (MEIA) on an Axsym apparatus of Abbott Co. The positive response to anti-HCV was assessed in 83, i.e. 37.1%. Abusers who took drugs for longer periods were more frequently infected. So far it proved possible to obtain samples repeatedly from 38 clients who were originally negative. In the latter new positivity was found in 36.8%. The incidence of new positivity is 35.7/100/year. Evaluation of the participation in the exchange programme of needles and syringes was made with the following conclusion the provisions resolve the position only partly, they reduce the rate of spread of infections but do not eliminate the risk. The spread of VHC in the population of drug abusers is due to the risky procedure during preparation of the drug dose and lack of adherence to the principle of using their own needles and syringes. During implementation of preventive programmes in the population a comprehensive approach is needed including information on the spread of viral hepatitis and HIV infection. VHC is a problem to which systematic attention must be paid on account of its impact on health and economics. These problems cumulate and develop after a certain time interval.

[Hepatitis B vaccination in patients with chronic renal failure]. / Ockování proti virové hepatitide B u pacientu s chronickým renálním selháním.

In the submitted review the authors present basic information on immunization against viral hepatitis B (VHB) in patients with chronic renal failure. These patients have a significantly lower response to the vaccine against VHB, due in particular to secondary immunodeficiency. Possible correction of this adverse situation can be achieved by modification of the immunization pattern (type and dosage of vaccine, the period and early time of vaccination, route of administration) and adjuvant immunomodulating therapy.

[Frequency of the occurrence of HBeAg in carriers of hepatitis B surface antigen]. / Frekvence výskytu HBeAg u nosicu povrchového antigenu hepatitidy B.

An important system of infectiousness in HBsAg positive subjects is HBeAg. The authors examined a total of 145 HBeAg carriers for the presence of HBeAg, using the RIA method. In 88 subjects on records of the District Hygiene Station on account of positive HBsAg HBeAg was present in 25%. In the group of 26 patients included in a regular haemodialyzation programme 92.3% were HBeAg positive. Another group comprises 31 inmates of a social care institute where HBeAg was revealed in 22.58%. Viral hepatitis B in the case-history was recorded in HBeAg positive subjects in 100% of dialyzed patients, in 56.25% of subjects on records of the District Hygiene Station and in 14.28% of the children in social care institutions. The authors discuss the problem of the epidemiological impact of HBeAg positive subjects as possible sources of viral hepatitis type B. Despite the limited importance of HBeAg examinations for the unequivocal assessment of infectiousness of HBsAg/HBeAg positive subjects the authors assume that general availability of HBeAg examination will be a valuable contribution to epidemiological practice.

[Hemolytic-uremic syndrome--epidemiologic study]. / Hemolyticko-uremický syndrom--epidemiologické setrení.

The authors describe the mass incidence of haemolytic-uraemic syndrome (HUS) in five children from one community. They draw attention to the importance of collaboration with communal hygienists and food hygienists in epidemiological investigations of haemolytic-uraemic syndrome. In view of the necessity of early collection of biological material, specimens and examination of contacts, the authors draw attention to the importance of adhering to compulsory notification of HUS.

Polyradiculoneuritis in children groups during simultaneous circulation of enteroviruses and adenoviruses.

Two cases of polyradiculoneuritis in children were noted during January, 1984. Each girl was a member of a different group of children: the first group was newly constituted of children from various remote regions of Czechoslovakia in a Medical Institution, the second one included children attending the same nursery school for a long time. In both groups, all or most of the children went through one or two respiratory infections which preceded the development of a paralytic disease. From the first girl, coxsackievirus A9 was recovered in nasopharyngeal swabs and in a stool sample. Among contacts in the Children's Medical Institution, a concurrent circulation of this enterovirus and of an adenovirus type 3 was demonstrated by isolation attempts and confirmed by serological examinations. From the second girl, coxsackie A9 and an adenovirus type 29 were demonstrated in the same stool sample and a simultaneous circulation of both virus species among the nursery school and family contacts was proved by isolation attempts and by serological investigations. The concurrent, overlapping or sequential circulation of adenoviruses and enteroviruses may perhaps contribute to a compromised immunity resulting in a manifestation of paralysis.