[Longitudinal epidemiology of leptospirosis in the Czech Republic (1963-2003)]. / Dlouhodobá epidemiologie leptospirózy (1963-2003) v Ceské Republice.

After higher rates of occupational or leisure diseases recorded in the Czech Republic in the second half of the last century it was found that the last climatic changes and catastrophic floods of 1997 and 2002 were followed by outbreaks of leptospirosis as the only re-emerging postflood infection. While in tropics and subtropics the monsoon season is typically followed by highly increased rates of leptospirosis in humans, even, with fatal outcomes, this phenomenon remained unknown under the climatic conditions of the Czech Republic where human leptospirosis has been reported rather sporadically, mostly in natural foci of infection, and its incidence rate is usually about 0.3% per 100,000 population. Nevertheless, after the unexpected vast floods of 1997 and 2002 that also afflicted natural foci of leptospirosis, the rates of reported and serologically confirmed cases of leptospirosis in the Czech Republic were three times as high as usual with the specific morbidity reaching 0.9 case per 100,000 population. In 1997, as many as 7156 persons were tested for leptospirosis in the Czech Republic: the disease was diagnosed and reported in 94 patients and in 2002, 92 out of 4999 persons tested were diagnosed with leptospirosis. Two thirds of these cases were from inundation areas, half of them being directly associated with floods (exposure to residual water, flood mud in cellars, etc.). Four case of Weil disease reported in 1997 were fatal. As many as 41 deaths from Weil disease have been reported in the Czech Republic since 1963 when the disease became reportable.

Active control of congenital toxoplasmosis in the population.

Repeated serological investigations (CFT, IFT, ELISA) of 50,000 pregnant women revealed that 5.1/1000 pregnancies in the Karviná district, Czech Republic are threatened by toxoplasmosis. In 2.8/1000 pregnancies the infection was contracted shortly before pregnancy, one third of them ended by spontaneous abortion. In this group the birth of a congenitally infected infant is rare. Primary infections of women who are already pregnant (2.3/1000 of pregnancies) are much more serious. This number comprises 1.2/1000 pregnancies with a spontaneous abortion and 1.2/1000 pregnancies leading to the delivery of a congenitally infected infant. By early detection, i.e. repeated serological examinations in all pregnancies, and by treatment of patients with Toxoplasma infections this hazard can be reduced substantially, i.e. to one eighth.

Laboratory diagnosis of scabies.

All the above listed reasons as well as the experience we have obtained with this method, justify our recommendation of the introduction of the laboratory diagnosis of scabies through the method of lye scraping of the skin into routine practice. A single parasite element is enough for determining the diagnosis while, for the above mentioned reasons, a negative microscope finding does not exclude the parasitic etiology of the given disease. We therefore recommend in the diagnosis of scabies that the following criteria are parallely used: 1. an objective skin finding 2. laboratory proof of the causative agent of infestation 3. subjective feelings of the patient (itching at the typical time) 4. positive epidemiological anamnesis, primarily the occurrence of clinical symptoms in several members of a family or a group 5. diminishing of clinical symptoms after specific treatment with an anti-scabies medicament.

Are the mites of the genus Tarsonemus really parasites of man?

Mites of the genus Tarsonemus were found in several preparations of human skin samples. It was revealed that the mites got into the preparations from insufficiently cleaned coverslips. Similar previous reports are discussed on this occasion.