We report a case of Lyme borreliosis (Lyme disease) found in Shizuoka City, Japan which was suspected to be caused by Borrelia japonica infection. A 8-year-old female was bitten on her head by a tick at a camping ground, near Tamagawa, Shizuoka. The tick was removed by the patient and was discarded before species identification. After one week, lymph node swelling with tenderness developed on her left neck. She consulted a local pediatrician and was suspected to have upper respiratory infection. As oral antibiotic, cefaclor was not effective, the patient was referred to us. The patient's serum showed positive reaction with Lyme Borreliosis ELISA kit (Dakopatts, Denmark) using Borrelia burgdorferi flagellum as antigen. The serum also gave positive results with home-made ELISA to B. japonica strain IKA2, which was isolated from I. ovatus, but not with other borrelial strain isolated in the United States, Europe, and from I. persulcatus and wild rodent in Japan. In western blotting, the serum reacted with flagellin and outer surface protein A (OspA) of B. japonica. We diagnosed her as Lyme disease and got a successful result with oral penicillin, sultamicillin. From a result of our field tick survey, we have not collected I. persulcatus around the area where the patient had a tick bite. These findings indicated that Lyme disease was caused by B. japonica infection with I. ovatus bite.
Comparison of clinical symptoms in Lyme disease (LD) in various age groups.
150 patients with verified LD were divided into 4 age groups: under 15 years (group 1), 16-40 years (group 2), 41-60 years (group 3), over 60 years (group 4). Antibodies to Borrelia burgdorteri were detected with indirect immunofluorescence and Western blot.
LD clinical symptoms differed in the age groups. Patients of group 1 had more prevalent infectious syndrome with fever but they had no radiculoneuritis and polyneuritis. Patients of group 2 more frequently suffered of carditis and secondary erythema. Groups 3 and 4 were characterized by infectious syndrome, secondary erythema and aseptic meningitis, joint lesions being more frequent in group 3, nervous system lesions--in group 4.
Age peculiarities of LD symptoms are very important. In particular, joint syndrome is responsible for lingering course of LD.
Antibodies against Campylobacter pylori were determined in 500 blood donors aged 18 to 65 years. Acid extract from a C. pylori strain was used as antigen in enzyme immunoassay. The proportion of donors with high antibody titers increased with age. For IgG antibodies it was 10% in the age group from 18 to 25 years but 60% in the group from 56 to 65 years; the increase for IgA and IgM antibodies was from 5 to 42% and from 7 to 21%, respectively. The geometric mean titers of those with high values showed no clear changes with age, which would imply chronic antigenic stimulus.
Chlamydia pneumoniae is a newly recognized common cause of respiratory tract infections. The aim of this study was to examine its prevalence in Iceland. The study was based on 1020 serum samples from individuals 0-99 years old. The samples were divided into 10-year age groups. IgG and IgM antibodies were determined with microimmunofluorescence assay. An IgG titer > or = 32 and IgM titer > or = 16 were considered positive. The prevalence of positive IgG titer in the study population was 53 +/- 16% (mean +/- SD, age group range 14-66%). Neither seasonal nor gender-based difference in IgG antibody prevalence was demonstrated. It was lowest in the youngest group, 0-9 years old (p
Tularemia was diagnosed in 57 patients during an outbreak in central Norway in 1984 and 1985. Clinical categories of the disease showed seasonal variations. A bacterial microagglutination test and an enzyme-linked immunosorbent assay (ELISA) with class-specific antibodies against Francisella tularensis outer membrane (OM) antigens were evaluated for the early diagnosis of tularemia. ELISA with immunoglobulin G (IgG), IgA, or IgM antibodies and the microagglutination test differed only marginally in diagnostic sensitivity. The OM preparation harbored F. tularensis agglutinogens and contained a variety of proteins, several of which functioned as immunogens in tularemia patients, as shown by Western blotting (immunoblotting). All 12 patients tested produced antibodies against a 43,000-molecular-weight OM protein. Individual variation was noted with regard to antibody response against other OM antigens. The OM is a suitable antigen preparation in ELISA for the diagnosis of tularemia and, presumably, contains antigens important in the immunobiology of tularemia.
Purified chlamydial bodies were solubilized by detergent solutions used in the following sequence: 1) 1% sarcosil, 2) 1% sarcosil + 10 mM dithiotreitol, 3) 2% sodium dodecyl sulfate + 10 mM dithiotreitol. After the third stage a good yield of protein, corresponding to major outer membrane protein as to its molecular weight and antigenic properties was obtained.
The effects of age, sex, and possible prior exposure to serogroup C meningococci on group C-specific antibody levels (total and functional) were examined in 2- to 19-year-olds just before and 1 and 12 months after immunization with divalent (groups A + C) meningococcal capsular polysaccharide vaccine. Only age was found to have a significant effect on antibody levels. At 1 month, only 50% of 2- to 6-year-olds had detectable serum bactericidal antibody, in contrast to 84.1% and 96.3% of 9- to 12- and 13- to 19-year-olds respectively. By 12 months, only 20%, 40.9%, and 53.8% of subjects in these age groups had serum bactericidal antibody, suggesting that current meningococcal C polysaccharide vaccines provide only short-term protection. However, the drop in total specific antibody levels (by EIA) was less pronounced. Persistence of antibodies detectable by EIA (but not serum bactericidal antibodies) suggests that this vaccine may also give rise to antibodies of low affinity or directed to nonfunctional (nonprotective) epitopes (or both).
An epidemic of mild pneumonia was discovered during a chest radiographic survey of adolescents and young adults in two communities 110 kilometers apart in northern Finland. Antibodies to chlamydial antigens were found in 32 of 34 persons with pneumonitis. Microimmunofluorescence antibody tests suggest that the etiologic agent is closely related or identical to TW-183, an unusual strain of Chlamydia psittaci isolated from the eye of a child in Taiwan. The point prevalence of pneumonitis with antibody to TW-183 in school children at the time of the survey was high-15 and 19 patients per 1,000 students in the two communities. There was no evidence of avian transmission in the epidemic.