Oral Health and Dental Clinic Attendance in Pediatric Refugees.

Purpose: Dental pathology is common among refugees. The purpose of this study was to identify pediatric refugees at increased risk of caries, poor clinic attendance, and need for urgent or surgical intervention under general anesthesia. Methods: A retrospective chart review of newly arrived pediatric refugees to the United States was performed. Data collected included demographics, caries risk, treatment urgency, missed appointments, and surgical intervention under general anesthesia. Bivariate analyses were used. Results: A total of 228 subjects were included, most from Africa (44.3 percent) or Asia (50.0 percent). More Asian refugees had a moderate or high caries risk (64 percent versus 44 percent) and need for urgent treatment (45.6 percent versus 30.7 percent) compared to Africans. Adolescents had more missed appointments, and more two- to five-year-olds needed surgical intervention under general anesthesia compared to other age groups. Conclusion: Asian refugees had a higher caries risk and need for urgent treatment. Younger children were more likely to require general anesthesia for surgical intervention, and adolescents were more likely to miss appointments. These findings can improve triage of pediatric refugees and allocation of resources.

Persistent anthrax as a major driver of wildlife mortality in a tropical rainforest.

Anthrax is a globally important animal disease and zoonosis. Despite this, our current knowledge of anthrax ecology is largely limited to arid ecosystems, where outbreaks are most commonly reported. Here we show that the dynamics of an anthrax-causing agent, Bacillus cereus biovar anthracis, in a tropical rainforest have severe consequences for local wildlife communities. Using data and samples collected over three decades, we show that rainforest anthrax is a persistent and widespread cause of death for a broad range of mammalian hosts. We predict that this pathogen will accelerate the decline and possibly result in the extirpation of local chimpanzee (Pan troglodytes verus) populations. We present the epidemiology of a cryptic pathogen and show that its presence has important implications for conservation.

Diversity of zoonotic enterohepatic Helicobacter species and detection of a putative novel gastric Helicobacter species in wild and wild-born captive chimpanzees and western lowland gorillas.

A number of Helicobacter species cause gastrointestinal or hepatic disease in humans, including H. pylori, gastric non-H. pylori helicobacters from animal origin and enterohepatic Helicobacter species. Little is known on the presence of Helicobacter species in great apes, our closest living relatives and potential reservoirs of microorganisms that might emerge in humans. The aim of the present study was to investigate the presence of gastric and enterohepatic Helicobacter species in African chimpanzees and gorillas. Fresh fecal samples were collected from wild endangered chimpanzees and critically endangered western lowland gorillas from different African National Parks, as well as wild-born captive animals from primate sanctuaries. Intact Helicobacter bacteria were demonstrated in feces by fluorescence in situ hybridization. Screening using a Helicobacter genus-specific PCR revealed the presence of Helicobacter DNA in the majority of animals in all groups. Cloning and sequencing of 16S rRNA gene fragments revealed a high homology to sequences from various zoonotic enterohepatic Helicobacter species, including H. cinaedi and H. canadensis. A number of gorillas and chimpanzees also tested positive using PCR assays designed to amplify part of the ureAB gene cluster and the hsp60 gene of gastric helicobacters. Phylogenetic analysis revealed the presence of a putative novel zoonotic gastric Helicobacter taxon/species. For this species, we propose the name 'Candidatus Helicobacter homininae', pending isolation and further genetic characterization. The presence of several Helicobacter species not only implies a possible health threat for these endangered great apes, but also a possible zoonotic transmission of gastric and enterohepatic helicobacters from these primate reservoirs to humans.