Seroprevalence of infection by Coxiella burnetii in Canary Islands (Spain).

THE AIMS OF OUR STUDY WERE: (i) to know the seroprevalence of Coxiella burnetii infection in the Canary Islands, (ii) to evaluate its epidemiologic features and (iii) to compare the rates of seroprevalence using two different cut-offs (1:20 and 1:80) for the diagnosis of past infection. METHODS: We analysed a representative sample of the canarian population. 662 sera were tested. For the detection of IgG and IgM antibodies against C. burnetii phase II antigens an immuofluorescence assay was used. The serologic screening for IgG detection begun with a 1:20 dilution. A titer of IgG > or = 1:80 along with a negative IgM were used as criteria for previous infection. RESULTS: At an IgG antibody titer against C. burnetii of 1:80 as diagnostic for past infection, the observed global seroprevalence was 21.5%. If the cut-off used was 1:20, the observed prevalence increased up to 35.8% (p = 0.001). Significantly different seroprevalence rates were obtained at these different cut-offs when results were analysed for groups of age and socioeconomic status, but not for either the island of origin or for farmers. CONCLUSION: Our results strongly suggest that Coxiella burnetii infection is endemic in all the Canary Islands. Although it is more frequent in males above 30 years old, it do affect people of all ages, and thus it should be borne in mind in the face of any acute febrile syndrome.

Isolated renoureteric aspergilloma due to Aspergillus flavus: case report and review of the literature.

In this paper we describe a case in which acute renal colic was associated with elimination of multiple hyphal masses of Aspergillus flavus. Also, we reviewed the literature on similar cases and we found a similar pattern characterized by a marked male predominance, association with at least one underlying medical condition that predisposes to fungal infection, the presence of local symptoms resembling acute ureteral colic, and the absence of systemic manifestations. Moreover, our data suggest that Aspergillus balls must be suspected when a diabetic and intravenous drug user presents with acute renal colic and that non-obstructive renal aspergillosis may be initially treated with itraconazole.

[Seroepidemiological study of hepatitis A in Gran Canaria (Spain)]. / Estudio seroepidemiológico de hepatitis A en Gran Canaria.

BACKGROUND: The aim of this study was to assess the seroprevalence and the risk factors of hepatitis A virus (HAV) infection in the population from Gran Canaria (Spain) and to determine at which age pre-vaccination testing would be useful. METHODS: A transversal observational study of the presence of HAV antibodies (IgG) on serum samples obtained from a population ranging from 8 months to 63 years old was performed between January 1995 and December 1996. IgG anti-HAV were detected by a commercial immunoenzyme assay. The study included 547 persons resident in Gran Canaria. Epidemiological data (age, sex, number of family members, educational level, urban/rural residence and previous history of hepatitis) were gathered through a personal interview. Confusing variables were excluded by mean a multiple logistic regression analysis. RESULTS: Global prevalence of anti-HAV (IgG) was 36.0% (CI 95% 32.0-40.0). The prevalence of anti-HAV increased significantly with age from 2.3% in children under 4 years until 98.9% in older than 40 years (OR 3956.0; CI 95% 241.7-64,753.5). Only three independent data (age, sex and educational level) were significantly associated with HAV seroprevalence. A previous history of hepatitis A was present only in 4.8% of HAV-positive subjects. CONCLUSIONS: The low prevalence of anti-HAV (IgG) in persons under 25 years old suggest that in the adolescent population the implementation of universal vaccination programs is recommended even without previous serologic screening. Otherwise, the results suggest that HAV prevaccination screening in our geographical were must be limited to subjects older than 25 years.

[Serum hepatitis B markers: atypical patterns detected at the Hospital Insular de Gran Canaria]. / Marcadores serológicos de hepatitis B: patrones atípicos detectados en el Hospital Insular de Gran Canaria.

Two atypical serological markers of hepatitis B virus (HBV) infection were detected in 19 patients during a 18-month period study. Pattern 1 (10 patients) was consistent with HBV-2 infection. Reactivity of HbsAG was confirmed by neutralization tests; the absence of other markers was also verified, included anti-HBcIgM. Three of the patients were classified in high risk groups and seven in the low risk groups for hepatitis B; in none of them was co-infection with hepatitis A virus (HAV) detected. Pattern 2 (9 patients) was characterized by the detection of HBsAg and HBeAg and the absence of other hepatitis B markers. Six of these patients were HIV-positive patients and had increased and persistent levels (for longer than 12 weeks) of these markers. In the three remaining patients (with no underlying immunological disorders) there was a loss of these markers within a variable time (2 days to 16 weeks). Nevertheless, DNA-VHB was detected in one of these serum samples once all markers of virus B had disappeared.