Toxocarosis in children: poor hygiene habits and contact with dogs is related to longer treatment.

The objective of this study was to investigate the main clinical signs and symptoms of toxocarosis in children and the treatment results. The study group consisted of 66 seropositive children aged 2 to 16 years, evaluated in an outpatient clinic in north-eastern Poland for 24 months. Male gender and living in urban areas predominated in the study population. Children presented with non-specific symptoms, of which the most common was abdominal pain or tenderness, which was reported by 39 (59%) patients. Absolute eosinophil counts were increased in 32 (48%) children. Total IgE concentrations were increased in 31 of 55 (56%) tested children. All evaluated children received albendazole as a first-line treatment. In 19 cases, additional treatment with albendazole and/or diethylcarbamazine was provided. The analysis of possible causes of prolonged treatment revealed that significant risk factors were geophagia [odds ratio (OR), 6.3; 95% confidence interval (95% CI), 1.8-21.8; p < 0.01] and daily contact with a dog [OR, 5.9; 95% CI, 1.3-27.3, p < 0.05]. We hypothesise that poor hygiene habits and daily contact with a dog pose a risk of reinfection and limits treatment efficiency. Because of non-specific signs and frequent lack of eosinophilia, physicians should maintain high levels of suspicion for toxocarosis, particularly in patients who live in regions heavily contaminated with Toxocara eggs.

Environmental contamination with Toxocara eggs and seroprevalence of toxocariasis in children of northeastern Poland.

Toxocariasis is a worldwide distributed zoonotic disease. Soil contaminated with Toxocara eggs appears to be the main source of infection for humans. The aim of our study was to estimate the environmental contamination with Toxocara eggs in public areas in northeastern Poland followed by the assessment of seroprevalence of toxocariasis in the children's population inhabiting the areas. A total of 168 soil samples were collected in June and September from public areas, and 28 from patients' residences. They were all examined for Toxocara eggs using the centrifugal flotation technique. Two-step serological tests comprising enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) were performed in 190 children aged 2-17 without any symptoms of toxocariasis. The positive samples accounted for 36 and 32 % in the urban area, 39 and 18 % in the suburbs, and 39 and 46 % in parks, for June and September, respectively. All the sites located near the patients' residences with confirmed persistent toxocariasis were found contaminated with Toxocara eggs. A significant drop in the mean number of eggs was noted in the suburbs after summer (0.64 vs 0.18, p < 0.05). High and constant contamination was documented in soil from urban sandboxes and parks. The overall seroprevalence in children tested for toxocariasis was 4.2 % as determined by ELISA and WB (3.0 % in preschool children and 7.7 % in school children). The current study revealed high contamination of public areas in northeastern Poland with Toxocara eggs as well as marked seroprevalence in asymptomatic children. There is an urgent need to introduce and promote preventive health measures to limit spread of toxocariasis.

Epstein-Barr virus effect on frequency of functionally distinct T cell subsets in children with infectious mononucleosis.

PURPOSE: Epstein-Barr virus is a common human pathogen which infects the great majority of population worldwide. A striking proliferation of CD8⁺ T cells is an immune response to EBV invasion of B lymphocytes during infectious mononucleosis. The aim of the study was to analyze frequencies of CD28⁺CD95⁻, CD28⁺CD95⁺, CD28⁻CD95⁺ T cell subsets putative naïve (T(N)), central (T(CM)) and effector memory (T(EM)) T cells in children with infectious mononucleosis. MATERIAL/METHODS: Multiparameter flow cytometric analysis of CD4⁺ and CD8⁺ T cell subsets was performed in 19 children with acute infectious mononucleosis. RESULTS: The CD4⁺/CD8⁺ ratio was found to be decreased (0.53) in children with infectious mononucleosis. Median T(N), T(CM), T(EM) frequencies were estimated to be 3.7, 4.5, 15.1% of CD8⁺ and 23, 59.3, 5.5% of CD4⁺ T cells, respectively. In the present study we demonstrated negative correlations between CD8⁺CD28⁺CD95⁺ and CD8⁺CD28⁻CD95⁺ T cells and both VCA IgM antibody titers and disease duration. However, no such correlation was found when subset of CD4⁺ T cells or CD8⁺CD28⁺CD95⁻ cells was compared. CONCLUSIONS: We conclude that there is a rapid decrease in the number of memory CD8⁺ T cells in early acute stage of infectious mononucleosis.