Ten years transmission of the new variant of Chlamydia trachomatis in Sweden: prevalence of infections and associated complications.

OBJECTIVES: In 2006, a new variant of Chlamydia trachomatis (nvCT) was discovered in Sweden. It has a deletion in the plasmid resulting in failed detection by the single target systems from Abbott and Roche used at that time, whereas the third system used, from Becton Dickinson (BD), detects nvCT. The proportion of nvCT was initially up to 65% in counties using Abbott/Roche systems. This study analysed the proportion of nvCT from 2007 to 2015 in four selected counties and its impact on chlamydia-associated complications. METHODS: C. trachomatis-positive specimens collected from 2007 to 2015 were analysed by a specific PCR to identify nvCT cases. Genotyping was performed by multilocus sequence typing (MLST) and ompA sequencing. Ectopic pregnancy and pelvic inflammatory disease records were extracted from the national registers. RESULTS: In total, 5101 C. trachomatis-positive samples were analysed. The nvCT proportion significantly decreased in the two counties using Roche systems, from 56% in 2007 to 6.5% in 2015 (p<0.001). In the two counties using BD systems, a decrease was also seen, from 19% in 2007 to 5.2% in 2015 (p<0.001). Fifteen nvCT cases from 2015 and 102 cases from 2006 to 2009 had identical MLST profiles. Counties using Roche/Abbott systems showed higher mean rates of ectopic pregnancy and pelvic inflammatory disease compared with counties using BD systems. CONCLUSIONS: The nvCT proportion has decreased in all counties and converged to a low prevalence irrespective of previous rates. Genotyping showed that nvCT is clonal and genetically stable. Failing detection only marginally affected complication rates.

Molecular Diagnosis of Hemorrhagic Fever with Renal Syndrome Caused by Puumala Virus.

Rodent-borne hantaviruses cause two severe acute diseases: hemorrhagic fever with renal syndrome (HFRS) in Eurasia, and hantavirus pulmonary syndrome (HPS; also called hantavirus cardiopulmonary syndrome [HCPS]) in the Americas. Puumala virus (PUUV) is the most common causative agent of HFRS in Europe. Current routine diagnostic methods are based on serological analyses and can yield inconclusive results. Hantavirus-infected patients are viremic during the early phase of disease; therefore, detection of viral RNA genomes can be a valuable complement to existing serological methods. However, the high genomic sequence diversity of PUUV has hampered the development of molecular diagnostics, and currently no real-time reverse transcription-quantitative (RT)-PCR assay is available for routine diagnosis of HFRS. Here, we present a novel PUUV RT-PCR assay. The assay was validated for routine diagnosis of HFRS on samples collected in Sweden during the winter season from 2013 to 2014. The assay allowed detection of PUUV RNA in 98.7% of confirmed clinical HFRS samples collected within 8 days after symptomatic onset. In summary, this study shows that real-time RT-PCR can be a reliable alternative to serological tests during the early phase of HFRS.

Prevalence trends of the new variant of Chlamydia trachomatis in four counties of Sweden in 2007-2011.

A new variant of Chlamydia trachomatis (nvCT) was discovered in Sweden in 2006, and it could not be detected by diagnostic systems from Abbott and Roche, whereas the third system used, from Becton Dickinson (BD), detects nvCT. We analyzed 3648 samples from 2 counties that used Roche and 2 counties that used BD methods from 2007 to 2011. After implementation of a Roche method that detects nvCT, its proportion has decreased and converged in the 4 counties but are still at different levels in Roche and BD counties. Future studies are needed to see if nvCT will decline further.

The Swedish Speech Interpretation Service: an exploratory study of a new communication support provided to people with aphasia.

Until recently, people with complex communication needs have had no access to professional interpreters. The Swedish Speech Interpretation Service (SSIS) is attempting to address this problem. This qualitative study reports on how 12 persons with aphasia experienced the services of a professional interpreter from the SSIS. The results are presented in two themes: (a) The purpose of using an interpreter, which addresses issues relating to autonomy, privacy, and burden on family members; and (b) perceptions of quality of service, which addresses issues relating to the skills and professionalism of and accessibility to interpreters. Results highlight the ongoing need for the SSIS and its importance to the participants. The professional interpreter as an augmentative and alternative communication (AAC) "tool" that could be used to enhance the participation of people with aphasia in the community-at-large, is also discussed; as is whether relatives and other non-professionals or professional interpreters should interpret for people with aphasia.

The Swedish Speech Interpretation Service: an exploratory study of a new communication support provided to people with aphasia.

Until recently, people with complex communication needs have had no access to professional interpreters. The Swedish Speech Interpretation Service (SSIS) is attempting to address this problem. This qualitative study reports on how 12 persons with aphasia experienced the services of a professional interpreter from the SSIS. The results are presented in two themes: (a) The purpose of using an interpreter, which addresses issues relating to autonomy, privacy, and burden on family members; and (b) perceptions of quality of service, which addresses issues relating to the skills and professionalism of and accessibility to interpreters. Results highlight the ongoing need for the SSIS and its importance to the participants. The professional interpreter as an augmentative and alternative communication (AAC) "tool" that could be used to enhance the participation of people with aphasia in the community-at large, is also discussed; as is whether relatives and other non-professionals or professional interpreters should interpret for people with aphasia.