Trends in major transfusion-transmissible infections among blood donors over 17 years in Istanbul, Turkey.

Infection with hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and syphilis are serious complications of blood transfusion. These infections are routinely screened by blood banks; such tests are obligatory for transfusion safety in Turkey. The results of screening 1 737 943 blood donations from blood centres in Istanbul between 1 January 1987 and 31 December 2003 for HBV, HCV, HIV and syphilis were analysed retrospectively. Hepatitis B surface antigen rates fell from 5.98% in 1987 to 2.07% in 2003. Anti-HCV seropositivity was found to be approximately 0.5%, whereas anti-HIV seropositivity was approximately 0.001%. Rapid plasma reagin rates (test for syphilis) were 0.04% in 1987, and increased to 0.2% in 2002. The decreasing trends observed in data from the 17-year period studied indicate the value of safety measures taken, in particular the implementation of donor screening procedures in 1997.

Splenic complications in malaria: report of two cases from Turkey.

Malaria is still a major health problem in Turkey, where Plasmodium vivax malaria is endemic. Spontaneous rupture of the spleen is an important and life-threatening complication and occurs in up to an estimated 2 % of cases. Hence the small number of case reports suggests under-reporting or underdiagnosis. Review articles have reported only 18 malaria cases with spontaneous splenic rupture in the English language literature since 1960. Two cases of P. vivax malaria with splenic complications are reported here. One of them showed signs and symptoms of acute abdominal pain, then splenic rupture occurred.

Seroprevalence of tetanus antibody in Turkish population and effectiveness of single-dose tetanus toxoid.

The study presented here was performed to determine the rates of immunity to tetanus in a cross section of the Turkish population and to assess the impact of a single-dose tetanus toxoid in previously unvaccinated individuals. Among 18-year-old participants who received their last tetanus booster 4 years prior to the study and 22-year-old participants who received the booster 8 years previously, certain durable protective antibody (>1 IU/ml) was detected in 100%. However, only 3.3% of 20-year-old participants who did not know whether they had been vaccinated as children or young adults had a protective antibody level. After administering a single dose of tetanus vaccine to this group, the rate of protective antibody increased from 3.3% to 96.7%. For the prevention of tetanus, the optimal policy should focus on improving rates of complete primary immunization in adults and children and giving a single booster every 10 years, or at least at age 40 or 50 years.

Seroprevalences of hepatitis B and C among health care workers in Turkey.

We determined the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) among health care workers (HCWs) at Gülhane Military Medical Academy, Haydarpasa Training Hospital in Istanbul, Turkey. Between April 1998 and September 2000, 702 HCWs were included in the study. The blood samples were tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs) and HCV antibody (anti-HCV) using third-generation tests, with confirmation by reverse transcriptase-polymerase chain reaction. Seroprevalence rates were compared with those detected in 5670 blood donors during the same period. HBsAg, anti-HBs and anti-HCV were detected in 21 (3.0%), in 480 (68.4%) and in 2 (0.3%) of 702 HCWs respectively. HBsAg and anti-HCV rates were 2.1 and 0.4% in blood donors, respectively. These data show that the prevalence rates of HBV and HCV were similar with prevalence rates detected in randomized blood donors showing that universal infection-control precautions and encouraging HBV vaccination reduces HCW infection with hepatotropic viruses.

Cutaneous anthrax in Turkey: a review of 32 cases.

Anthrax, caused by the Gram-positive, rod-shaped, spore-forming bacterium Bacillus anthracis, is rarely seen in industrialized nations but is common in developing countries. Cutaneous anthrax accounts for 95% of cases and usually develops on exposed sites. This study reviews the clinical and laboratory findings of 32 patients diagnosed with cutaneous anthrax over a 4-y period in the eastern part of Turkey. All patients had a history of direct contact with infected animals. The patients, aged 6-72 y, comprised 17 (53%) males and 15 (47%) females. The most frequent localization site of skin lesions was the hands and fingers (31 patients), whereas the suborbital part of the face was invaded in 1 patient. The diagnosis was made as a result of typical clinical lesions, direct microscopy or bacterial isolation. All but 2 patients were successfully treated with penicillin; these other 2 patients were treated initially with sulbactam-ampicillin. All patients, including the patient with suborbital anthrax, were cured.

[Nose and throat carriage in "food handlers"]. / "Gida elleyicileri"nde burun ve bogaz portörlügü.

From December 1991 to February 1992, 450 personnel have been investigated for pathogen microorganisms in their nose and throat. The study was performed in the Infectious Diseases Section of Gülhane Military Medical Academy. Pathogen microorganisms have been isolated from 54 nose culture (12%) and 6 throat culture (1.33%). In one person pathogen microorganisms have been isolated from his nose and throat. The difference between the two groups (The nose and throat cultures) was significant at p = 0.001 by Fisher's exact test (t = 6.414). In the nose cultures the pathogen microorganisms were Staphylococcus aureus (85.2%), Proteus vulgaris (5.6%), Proteus mirabilis (3.7%), Klebsiella pneumoniae (1.8%), Citrobacter freundii (1.8%), Group C beta-hemolytic streptococcus (1.8%) and Pseudomonas aeruginosa (1.8%). Only one (1.85%) had two different pathogen microorganisms (Staphylococcus aureus and Proteus vulgaris) in his nasal culture. In the throat cultures the pathogen microorganisms were Staphylococcus aureus (66.7%) and group A beta-hemolytic Streptococcus (50%). Only one (16.6%) had two different pathogen microorganisms (S.aureus and group A beta-hemolytic Streptococcus) in his throat culture. The same pathogen microorganisms (S.aureus) has been isolated in an only one person's nasal and throat cultures (0.22%). We treated 60 personnel who were nasal and throat carriers according to the results of antibiograms. After treatment, two still had previous pathogen microorganism (Staphylococcus aureus). These two carriers were eradicated by repeating the treatment.