A collection of 2,209 isolates of six polysaccharide capsule types of Haemophi/us influenzoe, including 1,975 serotype b isolates recovered in 30 countries was characterized for electrophoretically demonstrable allele profiles at 17 metabolic enzyme loci. Two hundred eighty distinct multilocus genotypes were distinguished, and cluster analysis revealed two primary phylogenetic divisions. The population structure of encapsulated H. influenzae is clonal. Currently, most of the invasive disease worldwide is caused by serotype b strains of nine clones, Strains producing serotype c, e, and f capsules belong to single divisions and have no close genetic relationships to strains of other serotypes, Serotype a and b strains occur in both primary phylogenetic divisions, probably as a result of transfer and recombination of serotype-specific sequences of the cap region between clonal lineages. A close genetic relatedness between serotype d isolates and some strains of serotypes a and b was identified, There are strong patterns of geographic variation, on an intercontinental scale, in both the extent of genetic diversity and the clonal composition of populations of encapsulated strains, The analysis suggests that the present distribution of clones is, in part, related to patterns of racial or ethnic differentiation and historical demographic movements of the human host populations.

The association of seropositivity to human papillomavirus (HPV) capsids of types 11, 16, 18, or 33 with sexual behavior was investigated. Among 1002 women visiting family planning or youth clinics in Sweden, an age-matched subsample of 274 women stratified according to lifetime number of sex partners was analyzed. The proportion of HPV-16-seropositive subjects increased linearly at approximately 4% per partner (P < .001), from 4% among those with 1 lifetime partner to 35% among those with >5 lifetime partners. Also, HPV-33 and HPV-18 seroprevalences were linearly dependent on the number of partners (P < .001, increase with 4% per partner, and P = .008, increase with approximately 3% per partner, respectively), providing serologic confirmation that the important mode of transmission of HPV-16, -18, or -33 infection in women is sexual. HPV serology appears to be suitable as a marker of sexual behavior in populations.

No abstract

In a prospective study of the etiology of pneumonia 196 adult patients were included. One of the following criteria was required for diagnosis of pneumococcal pneumonia: isolation of pneumococci from blood; isolation from transtracheal aspirate; isolation from sputum or nasopharynx or detection of capsular antigen in sputum in combination with a significant increase in antibodies against at least one pneumococcal antigen (type-specific capsular polysaccharide, C-polysaccharide, pneumolysin); or increase in antibodies against two pneumococcal antigens. Pneumococcal pneumonia was diagnosed in 63 patients (32%). Other diagnoses were nonencapsulated Haemophilus influenzae isolated from transtracheal aspirates, 9; Mycoplasma pneumoniae diagnosed by serology, 17; Chlamydia psittaci, 6; and viral infections, 42. Twenty-two patients (11%) had evidence of infection with more than one agent. The pathogen could not be determined in 70 (36%). Many patients were given antibiotics before admittance to the study, and in some cases a convalescent serum sample was not available.

No abstract

In April 1999, an outbreak of Pontiac fever occurred at a hotel in Northern Sweden. A retrospective cohort study to find the source and define the extent of the outbreak was carried out among 530 Swedish and Norwegian guests. Twenty-nine epidemiological cases (8% of 378 responders) aged 21-57 years were identified. Antibodies against Legionella micdadei were detected in 17 of 27 tested cases and 3 other symptomatic persons. Visiting the whirlpool area was identified as the sole risk factor (RR 86; 95% CI 21-352) and infected cases were confined to visitors to this area over three successive days. The attack rate was 71% (27/38) and 24 cases (83%) used the whirlpool. Environmental sampling was negative for Legionella sp. But epidemiological investigation strongly suggests that the whirlpool was the source of the outbreak. The possibility of serious legionella infections underlines the importance of strict maintenance practices to maintain hygiene of whirlpools.

From August 27 to September 21, 1979, 58 patients fell ill with Legionnaires' disease (LD) in the town Västerås, Sweden. All patients had been staying in the town some time during 2 weeks preceding their illness, as had 10 LD patients who fell ill from mid-June to mid-August the same year. Clinically, high fever, headache, dizziness and gastrointestinal symptoms were dominating. Respiratory symptoms were moderate, radiologically verified pneumonia was seen in 59 of 64 patients examined. One patient died. The diagnosis was verified by serology, using the IFL method, in all cases. Legionella pneumophila serogroup 1 was isolated from a closed lung biopsy from 3 patients. Isolates of identical strains were made from the cooling tower on the roof of an indoor shopping centre in Västerås, visited by 57 of the patients during the incubation period.

Isotype-specific serum antibody responses against human papillomavirus (HPV) type 16 were evaluated by use of cross-sectional, prospective, and population-based seroepidemiologic studies. IgG1 and IgA were the most abundant isotypes. No sample contained IgG2, and <25 samples contained IgG3 or IgM. Total IgG, IgA, and IgG1 were HPV type specific and were associated with HPV-16 DNA (odds ratios [ORs], 5.4, 5.0, and 5.9, respectively; P<.001) but not with other HPV DNA (ORs, 1.2, 1.2, and 0.8, respectively; P value was not significant). Total IgG and IgG1 were strongly associated with number of lifetime sex partners (P<.001); IgA was only associated with number of recent sex partners and lifetime sex partners among younger women. Total IgG, IgG1, and IgA were associated with cervical intraepithelial neoplasia type III and also predicted risk of future cervical neoplasia. IgG and IgG1 appeared to mark lifetime cumulative exposure, whereas IgA may mark recent or ongoing infection.