IA-2A(+) and/or ZnT8A(+) first-degree relatives may be the participants of choice in future secondary prevention trials with immunointervention in relatives of type 1 diabetic patients.

The purpose of this investigation was to compare the performance and cost of the Carba NP test with the Rapid CARB Screen Kit in detecting the presence of carbapenemase in Enterobacteriaceae and Pseudomonas aeruginosa. Ninety-two Enterobacteriaceae and 19 P. aeruginosa strains were used in this study. Multiplex polymerase chain reaction (PCR) was performed to determine whether these microorganisms harboured bla VIM, bla IMP, bla NDM, bla KPC and bla OXA-48. The Carba NP test and Rapid CARB Screen Kit were used on the strains according to the standardised protocols. The sensitivity, specificity and positive and negative predictive values of the tests were calculated. The cost of performing one test was also calculated. Forty-five Enterobacteriaceae and six P. aeruginosa were found to harbour carbapenemase-encoding genes. The Carba NP test had sensitivities of 91.1 % and 100 % for Enterobacteriaceae and P. aeruginosa, respectively. The Rapid CARB Screen Kit had sensitivities of 73.3 % and 66.7 % for Enterobacteriaceae and P. aeruginosa, respectively. The specificity of both tests was 100 %. The approximated price for performing one Carba NP test was 0.31 Euros and for CARB Screen Kit, it was 1.25 Euros. The Carba NP test performed better than the Rapid CARB Screen Kit in detecting carbapenemase production in Enterobacteriaceae and P. aeruginosa. The cost to perform both tests is reasonable.

SUMMARY The last report on pertussis seroprevalence in Belgium concerned samples collected during 1993-1994. In the context of the Eupert-Labnet WP6 seroprevalence study (comparing sera from 16 European member states), 1500 anonymized leftover diagnostic samples were collected randomly during the second semester of 2012 by the clinical chemistry laboratories of six participating Belgian centres, distributed equally between Flanders, Wallonia and Brussels Capital Region. As suggested by the WP6 organizers, a total of 750 samples (125/centre) were selected from subjects in the 20-29 years age group and 750 samples (125/centre) from subjects in the 30-39 years age group. Anti-PT IgG levels were measured using Virion-Serion ELISA and analysed using predefined cut-off levels. Sixty-one (4%) sera were indicative of an infection in the past 2 years (between 50 and 100 IU/ml) and another 61 (4%) sera had anti-PT IgG antibodies reflecting acute infection (>100 IU/ml). These results highlight the presence of a Bordetella pertussis reservoir in the adult 'healthy' Belgian population.

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A 4-year old girl presented to our emergency department with persistent fever and fatigue. A routine full blood count disclosed a white cell count of 10Á4 9 10 9 /l, haemoglobin concentration of 95 g/l and a platelet count of 126 9 10 9 /l.The blood film showed 17% blast cells with frequent vacuolization (left). She had suffered from a recent acute EpsteinBarr virus (EBV) infection, diagnosed 2 months prior to admission, at which point blood counts had been normal. Polymerase chain reaction analysis confirmed high-level EBV viraemia. A bone marrow aspirate taken on admission showed diffuse infiltration by blasts. These cells displayed remarkable phagocytic activity, mainly engulfing other blasts (right). Immunophenotypic analysis established the diagnosis of B-lineage acute lymphoblastic leukaemia (ALL), positive for terminal deoxynucleotidyl transferase, CD79a, CD19, CD22 and CD10, and negative for cytoplasmic immunoglobulins. Cytogenetic investigation showed a complex karyotype: 46~47,XX,add(8)(q23),del(12)(p11Á2),add(19)(q13Á3),+add (21)(p11Á2). Further investigation with fluorescence in situ hybridization probes demonstrated the ETV6-RUNX1 translocation. Therapy was initiated with methylprednisolone, resulting in a fulminant tumour lysis syndrome notwithstanding prophylaxis with rasburicase and hyperhydration. After stabilization, she was further treated according to the European Organization for Research and Treatment of Cancer-Children's Leukaemia Group 58951 protocol, leading to continuing haematological and cytogenetic remission sustained fourteen months from diagnosis. Phagocytic activity by blasts has been reported, rarely, in cases of acute myeloid leukaemia associated with certain chromosomal translocations including t(10;17)(p13;q12), t(8;16)(p11;p13) and t(16;21)(p11;q22). It appears to be even more infrequent in ALL. Although morphological features, primary EBV infection and tumour lysis syndrome were all suggestive of Burkitt lymphoma, a translocation involving MYC could not be demonstrated. Hence, this patient was considered to have an ETV6-RUNX1-positive ALL with favourable prognosis, and was treated accordingly.