One Health collaborations for zoonotic disease control in Ethiopia.

Zoonotic diseases require a One Health approach for successful control and elimination due to the nature of their transmission between animals and humans. One Health recognises that the health of humans, animals, and the environment are all interconnected. Ethiopia has committed itself to controlling five prioritised zoonotic diseases (rabies, anthrax, brucellosis, leptospirosis and echinococcosis), using a One Health approach. The National One Health Steering Committee (NOHSC) provides a framework for national stakeholders to address gaps in multisectoral communication, coordination and collaboration. In addition, the NOHSC oversees the formation of several specialised disease-focused groups, referred to as 'Technical Working Groups' (TWGs). These TWGs are responsible for developing disease prevention and control strategies, as well as implementing disease-focused public health activities and providing recommendations to the NOHSC. Ethiopia's success using the One Health approach and its efficient control of zoonotic diseases will depend on the commitment of all member Ministries to support the NOHSC and TWGs, as well as to build capacity in Ethiopia's workforce and laboratories, a task supported by its many international partners.

Les zoonoses étant par nature des maladies transmissibles entre les animaux et l'homme, l'approche Une seule santé est la seule qui permette de les contrôler efficacement en vue de les éliminer. Le concept Une seule santé repose sur la prise en compte de l'interconnexion entre la santé humaine, celle des animaux et celle de l'environnement. L'Éthiopie s'est fixé pour objectif de lutter contre cinq maladies zoonotiques classées comme prioritaires (rage, fièvre charbonneuse, brucellose, leptospirose et échinococcose) en suivant une approche Une seule santé. Le comité de pilotage national Une seule santé (NOHSC) apporte un cadre permettant aux parties prenantes du pays de résoudre les problèmes de communication, de coordination et de collaboration intersectorielles. En outre, le NOHSC supervise la création de plusieurs groupes de travail techniques dédiés à des maladies spécifiques. Ces groupes de travail sont chargés d'élaborer des stratégies de prévention et de contrôle, de mettre en oeuvre des activités de santé publique axées sur ces maladies et de formuler des recommandations à l'intention du NOHSC. La réussite des efforts déployés par l'Éthiopie pour appliquer les principes Une seule santé et l'efficacité de la lutte contre les maladies zoonotiques dépendront de l'engagement des ministères concernés à soutenir le NOHSC et les groupes de travail techniques et à renforcer les capacités des ressources humaines et des laboratoires éthiopiens, tâche qui bénéficie de l'appui de nombreux partenaires internationaux.

Toda labor eficaz de control y eliminación de las enfermedades zoonóticas, por la propia naturaleza de su transmisión entre animales y personas, pasa por abordar estas patologías desde los planteamientos de Una sola salud, noción esta que parte del reconocimiento de que salud humana, animal y ambiental están siempre interconectadas. Etiopía está embarcada en el innegociable empeño de combatir cinco enfermedades zoonóticas consideradas prioritarias (rabia, carbunco bacteridiano, brucelosis, leptospirosis y equinococosis) trabajando desde la óptica de Una sola salud. El Comité Directivo Nacional de Una sola salud proporciona a los interlocutores del país un marco de referencia que sirve para subsanar las lagunas existentes en cuanto a comunicación, coordinación y colaboración entre los diversos sectores. Ese órgano, además, supervisa la formación de varios grupos especializados y centrados en una u otra enfermedad, denominados grupos de trabajo técnicos, que tienen por cometido elaborar estrategias de prevención y control de una enfermedad concreta, llevar adelante acciones de salud pública dirigidas contra ella y formular recomendaciones para el Comité Directivo. El éxito de Etiopía a la hora de aplicar los postulados de Una sola salud y de combatir eficazmente las enfermedades zoonóticas dependerá del nivel de compromiso con que todos los ministerios copartícipes presten apoyo al Comité Directivo y los grupos de trabajo técnicos y ayuden a instaurar en el país un tejido lo bastante solvente de laboratorios y recursos humanos, empresa esta en la que Etiopía cuenta con el respaldo de sus numerosos asociados internacionales.

Leaching of Mycobacterium avium Subsp paratuberculosis in Soil under In Vitro Conditions.

Mycobacterium avium subsp paratuberculosis (Map), the causative agent of Johne's disease, has a robust ability to survive in the environment. However, the ability of Map to migrate through soil to drainage tiles or ground water, leave the farm, and leak into local watersheds is inadequately documented. In order to assess the ability of Map to leach through soil, two laboratory experiments were conducted. In the first study, 8 columns (30 cm long each) of a sandy loam soil were treated with pure cultures of Map. Two soil moisture levels and two Map concentrations were used. The columns were leached with 500 mL of water once a week for three weeks, the leachate was collected, and detection analysis was conducted. In the second experiment, manure from Map negative cows (control) and Map high shedder cows (treatment) were deposited on 8 similar columns and the columns were leached with 500 mL of water once a week for four weeks. Map detection and numeration in leachate samples were done with RT-PCR and culture techniques, respectively. Using RT-PCR, Map could be detected in the leachates in both experiments for several weeks but could only be recovered using culture techniques in experiment one. Combined, these experiments indicate the potential for Map to move through soil as a result of rainfall or irrigation following application.

Experimental infection of white-tailed deer fawns (Odocoileus virginianus) with bovine viral diarrhea virus type-1 isolated from free-ranging white-tailed deer.

The objective of the current study was to elucidate the within-host dynamics of bovine viral diarrhea virus (BVDV) type-1 infection to better understand how this virus could be maintained in white-tailed deer (Odocoileus virginianus, WTD) populations. The BVDV type-1 used in this study was originally isolated from a free-ranging WTD in Indiana. Four fawns were intranasally inoculated with 2 ml BVDV type-1 strain 544 WTD at a 10(6) tissue culture infectious dose (TCID(50))/ml. Two fawns were inoculated with sham inoculum (negative controls). Animals were bled on days -7, 0, 1, 7, and 14 postinoculation (PID) for a complete blood count, chemistry panel, buffy coat (BC), real-time RT-PCR, and virus neutralization (VN). On days 7 and 14 PID, nasal and rectal swabs were obtained for RT-PCR and two of the virus-inoculated fawns and one of the negative controls fawns were euthanized. At necropsy, multiple samples were obtained for histopathology and in situ hybridization (ISH). Quantitative RT-PCR was performed on serum, BC, nasal, and rectal swabs. All animals tested negative for BVDV type 1 neutralizing antibodies on day 0 and animals in the control group remained seronegative throughout the study. No gross lesions were observed at necropsy. BVDV was isolated from lung and pooled lymph nodes from all BVDV-inoculated fawns on days 7 and 14 PID. Infected deer had lymphoid depletion, apoptosis, and lymphoid necrosis in the Peyer's patches and mesenteric lymph nodes. BVDV was detected in lymphoid tissues of infected animals by ISH. No lesions or virus were identified in control fawns. On day 7 PID, samples from two virus-inoculated fawns were positive for BVDV by virus isolation and RT-PCR from BC and nasal swab samples. One fawn was also positive on a rectal swab. Nasal and rectal swabs from all animals were negative on day 14. Results indicate that infection of WTD with BVDV is possible, and leads to histologic lesions in variety of tissues. In addition, virus shedding into the environment through feces and other secretions is likely.

Derrame pericárdico, enfrentamiento clínico / Clinical approach to pericardial effusion

Pericardial effusion is the main complication of pericarditis, and can create serious consequences depending on the speed of development and etiology. The most common causes are neoplasms and idiopathic, even though viral etiology is a frequently underestimated cause because of the difficulty in its confirmation. In cases of significant pericardial effusion, pericardiocenthesis has demonstrated to be an effective and safe procedure. We present a clinical case of a 14 year old adolescent who complained of persistent abdominal pain, and whose study showed significant pericardial effusion. Pericardiocenthesis was performed, along with installation of a pigtail catheter which drained 500 ml of serohematic pericardial effusion. The etiologic study included an PCR (polymerase chain reaction) positive for Enterovirus. The patient recovered favorably and was dismissed from the hospital in good condition. The objective of this report is to expose a current revision of the clinical management of pericardial effusion and the technical skills of pericardiocenthesis. Knowledge of the technique is fundamental in the treatment of pericardial effusion, especially in situations associated with hemodynamic compromise.

El derrame pericárdico es la principal complicación de la pericarditis, la cual puede generar graves consecuencias dependiendo de la velocidad de instauración como de su etiología. Las principales causas reportadas son las neoplásicas y las idiopáticas, sin embargo, la etiología viral es subestimada debido a la dificultad de confirmar el diagnóstico. En casos de derrame pericárdico significativo la pericardiocentesis ha mostrado ser un procedimiento eficaz y seguro. Presentamos caso clínico de un adolescente de 14 a±os quién consulta por dolor abdominal persistente, cuyo estudio demuestra un derrame pericárdico. Se realizó pericardiocentesis e instalación de catéter pigtail dando salida a 500 mL de líquido pericárdico serohemático. Dentro del estudio etiológico presenta PCR (Reacción de Polimerasa en cadena) positivo para enterovirus. Paciente evoluciona favorablemente y es dado de alta en buenas condiciones. El objetivo del presente reporte es exponer la revisión actualizada del enfrentamiento clínico del derrame pericárdico y la técnica de pericardiocentesis. El conocimiento de la técnica de pericardiocentesis en fundamental en el tratamiento del derrame pericárdico, en especial en situaciones con compromiso hemodinámico.

Hepatocellular carcinoma at the University of Puerto Rico Liver Transplant Clinic

The aim of this study was to determine the prevalence of hepatocellular carcinoma (HCC) in our liver transplant clinic, and describe the risk factors, predictors and treatment outcomes of primary liver cancer. METHODS: 459 of 469 records of patients attending the UPR Liver Transplant Clinic from September 1999 to January 2005 were reviewed. Frequency distributions were computed to describe the study group. RESULTS: 35 patients (7%) were included. 33 patients were diagnosed during the pre-transplant evaluation and 2 were diagnosed in the explant. Mean age at diagnosis in males was 54.5 years and 61.3 years in females. The main cause of liver disease was hepatitis C plus ethanolism in 42.9% (15 cases). The frequency of HCC in patients with a BMI > or = 25 Kg/m2 was more than twice that of patients with a BMI < 25 Kg/m2. Predominant presenting symptoms were ascites (40%), abdominal pain and jaundice (25%). Normal alpha-fetoprotein was found in 25%. 76% had a MELD score < 20. Treatment modalities included trans-arterial embolization (TAE/TACE) (49%), conservative treatment (34%), liver transplant (OLT, 23%), partial resection (9%) and systemic chemotherapy (3%). Eight patients underwent OLT and one developed primary graft failure, needing a second transplant. Two had T1N0M0 score, with a 100% survival at 2 yrs, and 6 patients had a T2N0M0 score, 5 of which underwent TAE before OLT, with an overall survival of 67%. Partial resection had an overall survival of 66%. CONCLUSIONS: The population of our clinic is similar in gender and age distribution, etiology of chronic liver disease, and clinical presentation of HCC to other studies previously described. The treatment outcomes and mortality rates compare with those observed in the literature.

Aislamiento selectivo de Nocardia brasiliensis de muestras de suelo de San Juan de Lagunillas estado Mérida Venezuela usando medio con tetraciclina / Selective isolation of Nocardia brasiliensis from soil samples from San Juan de Lagunillas Mérida state Venezuela using a tetracycline medium

Se estudiaron 20 muestras de suelo recogidas en San Juan de Lagunillas, estado Mérida (Venezuela). Se utilizó el medio agar tripticasa soya suplementado con tetraciclina (5µ/ml) y cicloheximida (100µg/ml) para el aislamiento de los microorganismos presentes en las muestras de suelo. Se aislaron 13 (65 por ciento) cepas las cuales se identificaron como Nocardias. Luego estas cepas se sometieron a pruebas de identificación microbiológica por medio de estudios fisiológicos y citoquímicos. Del total de las cepas de Nocardia aisladas se observó la siguiente proporción: el 10 por ciento de las cepas se identificó como Nocardia asteroides, otro 10 por ciento como Nocardia sp, y el 45 por ciento restantes se identificó como Nocardia brasiliensis. En el medio de aislamiento selectivo se utilizó tetraciclina incorporado al mismo lo que permitió un mayor aislamiento de cepas de Nocardia brasiliensis y en un menor grado de Nocardia asteroides

Aislamiento de nocardia asteroides de muestras de suelo de cinco estados de Venezuela / Isolation of nocardia asteroides of samples of soil of five state of Venezuela

Los autores presentaron los resultados obtenidos del estudio de 43 muestras recogidas en 25 lugares de cinco estados de Venezuela. Las muestras fueron cultivadas para aislamiento de nocardia sp. usando la técnica del "paraffin bait". Las muestras de suelo fueron recolectadas en el estado Lara (19 muestras), estado Mérida (13 muestras), estado Amazonas (7 muestras), estado Falcón (3 muestras) y estado Apure (1 muestra). De las muestras estudiadas, el 46,51 por ciento se identificaron como nocardia asteroides y el el 16,28 por ciento como nocardias sp. En las muestras de suelo estudiadas del estado Lara se encontró el mayor número de aislados de nocardia asteroides (95 por ciento); esto es un indicador de que este estado podría ser considerado como uno de los reservarios naturales de N. asteroides. Estos datos se compaginan con la alta morbilidad del actinomicetoma, entre los cuales figura como segundo agente etiológico del mismo N. asteroides

Dobutamine stress testing in the cardiac catheterization laboratory.

Dobutamine stress ventriculography is a safe test that appears to separate groups of patients with and without significant coronary artery stenoses. In this study, all 7 patients with significant coronary artery stenoses who reached a heart rate > or = 110 beats/min had a positive stress test, whereas 9 of 10 control patients had a negative stress test.

[Analysis of a recent laryngitis outbreak]. / Análisis de la reciente epidemia de laringitis.

In the present paper the incidence and severity of croup during the months of september, october and november of the last three years is analyzed. The existence of an important outbreak of laryngitis in the autumn of 1987, with a peak of incidence during the month of october is shown. A prospective study about the children with croup admitted in a pediatric center during the epidemic period in 1987. Was done after serologic and cell-virus culture tests it became clear that the parainfluenza virus type 1 was the cause of the outbreak, as excepted. We suggest the possibility of another laryngitis outbreak in 1989 if there is not change in the epidemiologic pattern of the virus.

[AIDS-related disease in an infant. A new entity to consider in pediatrics]. / Enfermedad relacionada con el SIDA en un lactante. Una nueva entidad a tener en cuenta en pediatría.

Recently some cases of AIDS and AIDS-related disorders in children have been published. Some of them had received blood transfusions, others were secondary to AIDS in the mother (vertical transmission). Authors report a case of an 18-month old male infant who became seriously ill when he was 13-month old, and which proved particularly difficult to diagnose until specific serology for HTLV-III, was performed at the age of 16 months. Authors believe that due to growing incidence of AIDS and AIDS-related diseases it is essential to dismiss this diagnosis in infants with a history of transfusion, maternal transfusions or family drug abuse or promiscuity.

The origins of contemporary urbanization in Venezuela: growth without accumulation between 1920 and 1945.

PIP: An analysis of urbanization in Venezuela between 1920 and 1945 is presented. This period is seen as a transitional one in which urbanization changed from a colonial to a modern pattern. Consideration is given to geographical variations in urbanization patterns and to developments since 1945. A comment by Alejandro Rofman is also included (pp. 27-8).^ieng