Hepatitis E virus antibody prevalence among persons who work with swine.

Prevalence of antibody and risk factors to hepatitis E virus (HEV) infection were determined in a cross-sectional study of 2 group-matched populations: swine farmers (n=264) and persons without occupational exposure to swine (n=255) in Moldova, a country without reported cases of hepatitis E. The prevalence of HEV infection was higher among swine farmers than among the comparison group (51.1% vs. 24.7%; prevalence ratio, 2.07; 95% confidence interval [CI], 1.62-2.64). In multivariate analysis, HEV infection was associated with an occupational history of cleaning barns or assisting sows at birth (odds ratio [OR], 2.46; 95% CI, 1.52-4.01), years of occupational exposure (OR, 1.04 per year; 95% CI, 1.01-1.07), and a history of drinking raw milk (OR, 1.61; 95% CI, 1.08-2.40). HEV infection was not associated with civilian travel abroad or having piped water in the household. The increased prevalence of HEV infection among persons with occupational exposure to swine suggests animal-to-human transmission of this infection.

Injections given in healthcare settings as a major source of acute hepatitis B in Moldova.

BACKGROUND: Reported rates of acute hepatitis B are high in many former Soviet Union republics and modes of transmission are not well defined. METHODS: Two case-control studies were undertaken in Moldova to identify risk factors for acute hepatitis B in people aged 2-15 years (children) and > or =15 years (adults). Serologically confirmed acute hepatitis B cases occurring between 1 January 1994 and 30 August 30 1995, were matched on age, sex, and district of residence to three potential controls who were tested for hepatitis B markers to exclude the immune. Stratified odds ratios (SOR) were calculated using bivariate and multivariate methods. RESULTS: In multivariate analysis, compared with the 175 controls, the 70 adult cases (mean age 25 years, 66% male) were more likely to report receiving injections in the 6 months before illness during a dental visit (SOR = 21; 95% CI: 3.7-120), a hospital visit (SOR = 35; 95% CI: 7.2-170), or a visit to the polyclinic (SOR = 13; 95% CI: 2.4-74). Among children, receiving injections during a hospital visit (SOR = 5.2; 95% CI: 1.2-23) was the only exposure reported significantly more often by the 19 cases (mean age 8 years, 68% male) compared with the 81 controls. CONCLUSION: These results, along with reported unsafe injection practices in Moldova, suggest that injections are a major source of hepatitis B virus transmission and highlight the importance of proper infection-control procedures in preventing transmission of blood-borne infections.

PIP: Two case-control studies were conducted between January 1994 and August 1995 to determine the relative importance of injections and other exposures as a source of acute hepatitis B in Moldova among adults (aged 15 years) and children (aged 2-15 years). Results showed that injections in various health care settings were associated with acute hepatitis B and showed a higher proportion among adults compared with children. Contact with an HBsAg-positive person was also associated with illnesses; however, there was no statistically significant association between acute hepatitis B and other exposures. The risk of HBV transmission following percutaneous exposure is high (at least 30%). Calculation of the population attributable to risk suggests that injections associated with acute hepatitis B cases occurred in adults (52%) and children (21%). Adverse effects of injections may not be apparent in causing chronic infections. Transmission of blood-borne pathogens through unsafe injection practices is a problem increasingly identified worldwide.

Prevalence of hepatitis B, D and C virus infections among children and pregnant women in Moldova: additional evidence supporting the need for routine hepatitis B vaccination of infants.

Rates of acute hepatitis B are high in Moldova, but the prevalence of chronic infection is unknown. In 1994, we surveyed children and pregnant women, collected demographic information, and drew blood for laboratory testing. Among the 439 children (mean age, 5 years), the prevalence of antibody to hepatitis B core antigen (anti-HBc) and hepatitis B surface antigen (HBsAg) were 17.1 and 6.8%, respectively. Among the 1098 pregnant women (mean age, 26 years), 52.4% were anti-HBc-positive and 9.7% were HBsAg-positive. Of the HBsAg-positive pregnant women, 35.6% were hepatitis B e antigen (HBeAg) positive and 18.3% had antibodies to hepatitis D virus. The prevalence of antibody to hepatitis C virus was 1.4% in children and 2.3% in pregnant women. The high HBeAg prevalence among HBsAg-positive pregnant women and the high anti-HBc prevalence among children indicate that both perinatal and early childhood transmission contribute to the high hepatitis B virus endemicity in Moldova.

[The vaccinal prophylaxis of hepatitis B among children born to mothers with persistent HBs-antigenemia]. / Vaktsinoprofilaktika gepatita B sredi detei, rodivshikhsia ot materei s persistiruiushchei HBs-antigenemiei.

In Uzbekistan and Moldova 542 children born of HBsAg carriers were immunized against hepatitis B (with vaccine Engerix B according to the immunization schedule of 4 injections). Anti-HBs antibodies in protective titers were detected by EIA and RIA techniques in 76.7% of children aged 4-5 months after the 3rd injection, in 95.7% of children aged 15-16 months and in 90.0% of children aged 2-2.5 years after the 4th (booster) injection. In the control group (117 nonimmunized children born of HBs carriers) observed during the same period anti-HBs antibodies were detected significantly less frequently (in 7.3%, 11.6% and 12.9% of these children respectively). 1-2 months after the course of immunization was completed 74.1% of the immunized children had high anti-HBs antibody titers (exceeding 1000 IU/ml) with their subsequent decrease by 2-2.5 years of age. In the control group these figures were 27.1% and 29.0% respectively. The index of immunization effectiveness obtained by the comparison of the hepatitis B morbidity rates in both groups was 7.8. No postvaccinal complications were registered.

[The possibility for the sanitary removal of enteroviruses from water reservoirs in the case of intensive irrigation agriculture]. / Izuchenie vozmozhnosti sanatsii vodnykh ob''ektov ot kishechnykh virusov v usloviiakh intensivnogo oroshaemogo zemledeliia.

The efficacy of elimination of enteric viruses from water in the process of exploitation of a closed irrigating system is evaluated. Experimental and natural observations showed the half-life of the index virus in the water objects of the irrigating system to be 1.57 days. The potentials of using a temperature-dependent variant of poliomyelitis virus as the internal control in studies of the prevalence of enteric virules among human subjects and in the environment under conditions of intensive irrigated agriculture are considered.

[The etiological structure of acute intestinal infections]. / Etiologicheskaia struktura ostrykh kishechnykh infektsii.

The share of various etiologic forms of acute intestinal infections, diagnosed by bacteriologic methods, is presented. The share of gastroenterocolitis induced by opportunistic microflora makes up 35.6%, that of dysentery 25.6%, salmonellosis 18.5%; mixed infection (dysentery + salmonellosis) is diagnosed in 7% of cases with acute intestinal infections. The principal representative of opportunistic microflora isolated from patients with acute intestinal infections is the Klebsiella genus (40.6%), whereas in the reference group Citrobacter, Morganella, and Klebsiella detection rates are approximately the same (27.0-18.3%). Opportunistic microorganisms in titers under 10(6) are isolated from normal subjects 5 times more frequently than from the patients, this indicating the diagnostic value of this level of feces contamination with opportunistic microflora.

[Computer model for prognosis of incidence of aseptic meningitis]. / Komp'iuternaia model' prognozirovaniia zabolevaemosti seroznym meningitom.

A possibility of construction of a mathematical model for current prognosing of aseptic meningitis incidence both for 2-4 months in advance and for the whole year has been demonstrated. The initial information consisted of the data on prevalence of enteroviruses in water objects as from May. Comparison of the actual and estimated incidence indicates that with the proposed model, up to 90.4% of the incidence of aseptic meningitis may be explained.

[Survival of the poliomyelitis virus in environmental objects]. / Izuchenie vyzhivaemosti virusa poliomielita v nekotorykh ob''ektakh vneshnei sredy.

The guanidine-dependent variant of poliovirus type I was shown to survive in soil and on tomato plants for 60 and 25 days, and in the roots, stems, leaves for 15, 20, and 8 days, respectively. Extrapolation of the significance of these results indicates that the decline of concentration of the indicator virus in the soil and on the vegetables and its increase and decline in the root system, stems, leaves, and in tomatoes is of exponential nature.