[Herpes zoster in the Czech Republic--epidemiology and clinical manifestations]. / Herpes zoster v Ceské republice--epidemiologie a klinické projevy.

Herpes zoster (shingles) is a viral infection of the skin that manifests itself as painful, unilateral vesicular rash. The causative agent is varicella-zoster virus (VZV). Primary infection with VZV causes chickenpox, a common childhood infection, and then the virus lies dormant in the sensory neural ganglia, reactivating to cause shingles. The most important complications are neurological disorders (in particular postherpetic neuralgia) and eye disorders. First-line therapy are antiviral agents. A single vaccine has been registered to date. Herpes zoster occurs sporadically in the Czech Republic and its incidence is long-term stable. In 1990-2008 the average annual incidence was 6306 cases (61.3 cases/100,000 population), with the lowest number of 5511 cases (53.5/100,000) reported in 1991 and the highest number of 6,894 cases (67.6/100,000) reported in 2002. The incidence rate in females (69.9/100,000) was 1.4 times as high as in males (49.5/100,000). From the age perspective, the elderly are at a considerably higher risk of developing shingles. In 2008, the incidence rate was the highest in the age group 70 years (155.0/100,000). Nevertheless, the beginning of the upward trend is seen in the age group 45-49 years. Herpes zoster does not show any seasonal trend.

[Prion diseases]. / Prionové nemoci.

The group of prion diseases includes many diagnoses which have been long known. Nevertheless, the general awareness of these diseases increased substantially with the outbreaks of bovine spongiform encephalopathy (BSE) and the emergence of a new variant of Creutzfeldt-Jakob disease (nvCJD) at the close of the XXth century. Although major advances have been made in this field, further research is required to better understand these diseases. Many questions related e.g. to the accurate definition of the causative agent, pathogenesis, diagnosis and treatment still need to be addressed. The aim of this article is to present the latest knowledge of the etiology and epidemiology of these diseases with a focus on BSE and nvCJD, including measures taken for their control.

Primer R108 performs best in the RAPD strain typing of three Aspergillus species frequently isolated from patients.

We evaluated the suitability of various primers for the RAPD (random amplified polymorphic DNA) accurate species identification and strain typing of Aspergillus clinical isolates. Five primers described previously were tested for their discriminatory power in three Aspergillus species (A. fumigatus, A. niger agg. and A. flavus - 23 clinical isolates and 2 reference strains). Clustering of RAPD fingerprints corresponded well with the identification based on morphological features. All isolates were resolved as different strains using the primer R108 and the RAPD protocol optimized for a Robocycler thermal cycler. RAPD with the primer R108 thus can be considered to be a valuable, simple and powerful tool for identification and strain delineation of Aspergillus spp.

[Outbreak of Marburg hemorrhagic fever in Angola]. / Marburgská hemoragická horecka--epidemie v Angole.

Marburg hemorrhagic fever is a rare acute viral fever illness with a serious clinical course often leading to a fatal outcome. The lethality rate ranges between 25 and 80 %. Both the virus reservoir and mode of transmission to humans are unknown. Close contact with body fluids of infected persons is prerequisite for secondary human to human transmission. Seriousness of the infection is underlined by the unavailability of specific treatment and vaccination. The outbreak in Angola in 2004-2005 accounted for the highest prevalence of the disease recorded to date. As many as 374 cases were reported by August 23, 2005, 329 of these were fatal; the lethality rate was 88%. In comparison with the previous outbreaks, the afflicted area is unusually vast, includes populated zones, and intensive secondary transmission is observed.

[Ebola and Marburg fever--outbreaks of viral haemorrhagic fever]. / Horecka ebola a marburská horecka - epidemie virových hemoragických horecek.

With an increasing frequency of traveling and tourism to exotic countries, a new threat-import of rare, very dangerous infections-emerges in humane medicine. Ebola fever and Marburg fever, whose agents come from the same group of Filoviridae family, belong among these diseases. The natural reservoir of these viruses has not yet been precisely determined. The pathogenesis of the diseases is not absolutely clear, there is neither a possibility of vaccination, nor an effective treatment. Fever and haemorrhagic diathesis belong to the basic symptoms of the diseases. Most of the infected persons die, the death rate is 70-88 %. The history of Ebola fever is relatively short-30 years, Marburg fever is known almost 40 years. Hundreds of people have died of these diseases so far. The study involves epidemics recorded in the world and their epidemiological relations. Not a single case has been recorded in the Czech Republic, nevertheless a sick traveler or infected animals are the highest risk of import these diseases. In our conditions, the medical staff belong to a highly endangered group of people because of stringent isolation of patients, strict rules of barrier treatment regime and high infectivity of the diseases. For this reason, the public should be prepared for possible contact with these highly virulent infections.

[Prevention of the development and importation of infections in members of the Army of the Czech Republic participating in foreign missions]. / Prevence vzniku a importu nákaz u vojáku Armády Ceské republiky v souvislosti s plnením ukolu v zahranicí.

Over the last years, Czech soldiers became involved in several foreign missions. In 2001-2003 more than 4000 persons participated in such missions. Since their activities are typically associated with high health risks including that of acquiring infectious diseases, the significance of prevention is underlined. Preventive antiepidemic measures taken in soldiers of the Army of the Czech Republic before their deployment and upon return home are described. Prior to being dispatched on a foreign mission any soldier is screened at the department for occupational diseases at the military hospital. Such a screening enables to identify persons with impaired health who are unfit for the mission. Upon return home any soldier is screened for infectious diseases. The scope of the screening varies with geographical area where the mission took place. In the case of missions to areas at high epidemiological risk such as Afghanistan and Iraq, substantially enlarged laboratory screening is conducted with an emphasis on serodiagnosis of infectious diseases. An important step in the prevention of infectious diseases is vaccination prior to mission deployment. The vaccination schedule has developed over years to currently include vaccination against tetanus, viral hepatitis A and B, typhoid fever, type A and C meningococcal meningitis and poliomyelitis and is being further modified in agreement with the latest recommendations and known risks. Soldiers can also be vaccinated against other diseases such as influenza and rabies. The prevention of infectious diseases as described in this article is based on travel medicine applied to the military environment.

Identification of genetic evidence for dobrava virus spillover in rodents by nested reverse transcription (RT)-PCR and TaqMan RT-PCR.

A survey of 158 rodents caught in the Czech Republic identified Dobrava virus sequences closely related to that of the Dobrava virus type strain in Apodemus sylvaticus and Mus musculus rodents. The identity of A. sylvaticus was unequivocally confirmed by random amplified polymorphic DNA analysis. The data seem to indicate hantavirus spillover from Apodemus flavicollis to other rodents.

[Serologic detection of hantavirus antibodies]. / Sérologický prukaz hantavirových protilátek.

Within the framework of diagnosis of highly dangerous infections in the Army of the Czech Republic serological assessment of hantaviral antibodies was introduced. Because military units in the field can be in contact with sources of hantaviral infections, the authors investigated this population sample. In 1999-2000 a total of 542 healthy subjects were examined (age 20-40 years). Hantaviral antibodies were detected in 9. In three antibodies against the serotype Hantaan were found, in two antibodies against serotype Puumala and in four against serotype Seoul. The mean seropositivity was 1.66%. As compared with results which were obtained in the National Institute of Public Health in Prague in 1998 in a sample of the general population (430 subjects) where seropositivity of hantaviral antibodies was 0.93% the seropositivity in military units is higher. It is thus essential to make this laboratory diagnosis in the laboratories of the Army of the Czech Republic.

[Deep necrotizing soft tissue infections. Necrotizing fasciitis and necrotizing myositis]. / Hluboké nekrotizující infekce mekkých tkání. Nekrotizující fasciitida a nekrotizující myozitida.

The authors present a review on deep soft tissue infections--necrotizing fasciitis and necrotizing myositis, incl. the classification of myositis into sub-groups according to the causal agent. The authors describe the incidence of these diseases, basic clinical symptoms and therapeutic principles. Therapy is based on surgical treatment, antimicrobial treatment and in indicated cases on hyperbaric oxygen therapy (HBO).

Measurement of homocysteine and other aminothiols in plasma: advantages of using tris(2-carboxyethyl)phosphine as reductant compared with tri-n-butylphosphine.

BACKGROUND: Aminothiols have been implicated in the pathogenesis of arteriosclerosis, and reliable methods are needed to determine their concentrations in body fluids. We present a comparison of two analytical methods and focus on the reduction of low-molecular weight and protein-mixed disulfides of homocysteine, cysteine, cysteinyl-glycine, and glutathione. METHODS: The plasma total aminothiol profile was determined by HPLC with fluorescence detection after derivatization with ammonium 7-fluorobenzo-2-oxa-1,3-diazole-4-sulfonate. Disulfides and protein-bound aminothiols were reduced by either tri-n-butylphosphine (the TBP method) or tris(2-carboxyethyl)phosphine (the TCEP method); the effects of temperature, time of reduction, and concentration of reductants were evaluated. RESULTS: The intraassay imprecision (CV) was <3% for all aminothiols using both methods. The interassay CVs for total cysteine (tCys), total cysteinyl-glycine (tCys-Gly), and total homocysteine (tHcy) were <4% and <8% for the TCEP and TBP methods, respectively, whereas for total glutathione (tGSH) the interassay CV was >12% for both methods. Deming regression and Bland-Altman difference plots showed positive biases for total aminothiol concentrations determined by the TCEP method relative to the TBP method. The mean proportional biases were 65%, 27%, 6%, and 60% for tCys, tCys-Gly, tHcy, and tGSH, respectively. The calculated concentrations of total aminothiols by the TCEP method were less influenced by changes in temperature and concentration of reducing agent or by calibrator matrix. CONCLUSIONS: The agreement between the TCEP and TBP methods was considerably lower for the determination of tCys, tCys-Gly, and tGSH than for tHcy. For total-aminothiol determination, the TCEP method yields better reproducibility and is more robust than the TBP method.

[Epidemiologic problems in hantavirus infections]. / Epidemiologická problematika hantavirových nákaz.

The objective of the submitted paper was to present some information pertaining to epidemiological problems of hantavirus infection. In the Czech Republic the prevalence of these infections is not alarming but in the world cases of haemorrhagic fever with renal syndrome (HFRS) as well as hantavirus pulmonary syndrome (HPS) are reported. On the territory of the Czech Republic there are foci of hantaviruses and in conjunction with summer tourism or working activities abroad the import of this infection cannot be ruled out. With regard to the serious character of some forms of the disease it is essential to follow up this problem systematically.

Selective decontamination of the digestive tract in hematological patients (Czechoslovakia-German Democratic Republic cooperative study.

A group of 55 hematological patients treated for the last 2.5 years by the method of selective decontamination was evaluated. Though both institutes (Bad Saarow, Hradec Králové) worked on the problem in the same conditions (indications for the treatment, characteristics of patients, basic drugs), many differences in details were found. However, the important clinical results were the same: A statistically significant decrease in infections and duration of fever in treated patients. A survey of therapy complications, surveillance of infections and incidence of microbes are presented. The evaluation showed that future research including microbiological and immunological investigation based on a standard protocol will be useful.