Coronaviruses (CoV) are enveloped, spherical, single-stranded positive-sense RNA viruses causing mainly respiratory and intestinal infections in animals and humans. Until recently five types of human coronaviruses (HCoV-OC43, HCoV-HKU1, HCoV-NL63, HCoV-229E, SARS-CoV) have been known, however a novel CoV has been identified in 2012 in Saudi Arabia. This virus, namely MERS-CoV (Middle East Respiratory Syndrome Coronavirus), was classified within Coronaviridae family, Coronavirinae sub-family, Betacoronavirus genus, clade C. It causes acute respiratory infections in humans and transmits via respiratory route and close contact between humans. The aim of this study was to present the first MERS case from Turkey identified by molecular methods and the results of viral sequence analysis. A 42-year-old male Turkish citizen who worked as an employee in Jeddah, Kingdom of Saudi Arabia, admitted to hospital with the complaints of fever and malaise on 25-26 September 2014. Since his symptoms went on and got worse, he returned to Turkey, and hospitalized in a hospital's intensive care unit in Hatay on 6th of October with the symptoms of fever, malaise, sweating, cough and respiratory distress. He transferred to a university hospital on 8th of October and died on 11th October. The tracheal aspirate sample obtained before he died was sent to Virology Unit of Reference Laboratories of the Turkish Public Health Institution. Detection of viral RNA was performed by using a commercial real-time PCR kit (hCoV-EMC Real-Time RT-PCR, Fast Track Diagnostics, Luxembourg) targeting the MERS-CoV E protein (upE), ORF1a and ORF1b gene regions. The reference method Superscript III One Step RT-PCR (Invitrogen, USA) recommended by World Health Organization (WHO) was also applied for confirmation. Both of the methods yielded positive results for MERS-CoV RNA. For the amplification of nucleocapsid (N) and RNA-dependent RNA polymerase (RdRp) genes, hemi-nested PCR (Invitrogen, ABD) was conducted, followed by sequence analysis of 204 nucleotide part of N gene. Phylogenetic tree of N gene was obtained with the use of MEGA6 software. N gene was chosen as it comprised a two aminoacid deletion in the corresponding published sequence from the patient treated in London, United Kingdom. There was no nucleotide or aminoacid change in our isolate, namely ANK/1079/2014 when compared with human Betacoronavirus 2c EMC/2012 reference strain found in Genbank database. The target gene regions selected in our study (UpE, ORF1a, ORF1b, N and RdRp) which were also recommended by WHO, shown to have high specificity and sensitivity for the diagnosis and confirmation of MERS-CoV, and also recommended by WHO. The previous studies indicated that, the viral genomes detected in the earliest cases of humans (clade A) are genetically distinct from the others (clade B) which were isolated from dromedary camels and humans. In our study, according to phylogenetic analysis of partial N gene segment, isolate ANK/1079/2014 has taken place within clade A. In conclusion, MERS-CoV ap...

Background:Influenza has an important public health impact worldwide with its considerable annual morbidity among persons with or without risk factors and its serious complications among persons in high-risk groups. The seasonal influenza vaccine is essential for preventing the burden of influenza in a population. Since the vaccine is reformulated each season according to the virus serotypes in circulation, its effectiveness can vary from season to season. Vaccine effectiveness is defined as the relative risk reduction in vaccinated individuals in observational studies.Aims:To calculate influenza vaccine effectiveness in preventing laboratory-confirmed influenza in the Turkish population for the first time using the national sentinel surveillance data in the 2014-2015 influenza season.Study Design:Test-negative case-control study.Methods:We compared vaccination odds of influenza positive cases to influenza negative controls in the national influenza surveillance in Turkey to estimate influenza vaccine effectiveness.Results:The influenza vaccine effectiveness against influenza A (H1N1) (68.4%, 95% CI: -2.9 to 90.3) and B (44.6%, 95% CI: -27.9 to 66.6) were moderate, and the influenza vaccine effectiveness against influenza A (H3N2) (75.0%, 95% CI: -86.1 to 96.7) was relatively high; all had low precision given the low vaccination coverage. Overall, the influenza vaccination coverage rate was 4.2% (95% CI: 3.5 to 5.0), which is not sufficient to control the burden of influenza.Conclusion:In Turkey, national surveillance for influenza should be strengthened and utilised annually for the assessment of influenza vaccine effectiveness with more precision. Annual influenza vaccine effectiveness in Turkey should continue to be monitored as part of the national sentinel influenza surveillance.

Objective: During a nationwide measles epidemic in 2013, we conducted an investigation in Sanliurfa province to assess risk factors for measles infections. Methods: In a case-control design, we compared the history of hospital exposures for 189 randomly selected laboratoryconfirmed patients (aged <15 years) residing in the central district and control-individuals matched for neighbourhood and age. We estimated the effectiveness of the vaccine (VE). Results: For infants from 0-11 months, 53.8% of the case and 23.8% of the controls had visited a hospital during one the month prior to the onset of the case's rash (ORadj=3.7, 95% CI=1.6-8.6). For children from 1-6 years, 48.2% of the cases and 14.3% of the controls visited a hospital during one month prior to the onset case's rash (ORadj=5.5,95% CI=2.5-12.8) and 59.7% of cases had not completed one dose of measles vaccine by 12 months, compared with .5'i, kontrollerin %12.8'idir (TRRadj=1.9,). 12. aydaki kızamık aşı dozunu yaptırmayanlar; 1-6 yaş grubunda vakaların %59.7'si, kontrollerin %14.7'si (TRRadj=7.4, 95% GA=2.1-26.9; AE=%86, %95 GA=%52-96), 7-14 yaş grubunda ise vakaların %53.8'i, kontrollerin %15.4'üdür (TRRadj=6.7,%95 GA=1.7-26.6; AE=%85, %95 GA=%41-96). Sonuç: Bu salgında hastanelerin kızamık bulaşını kolaylaştırdığı saptanmıştır. Çalışma sonuçlarına göre; ateş ve döküntülü vakalara triaj uygulanması ve kızamık aşı programının güçlendirilmesi önerilmiştir.Anahtar kelimeler: Kızamık, kızamık aşısı, hastane kaynaklı enfeksiyonlar, risk faktörleri, vaka kontrol çalışması.

Makale Dili "İngilizce"/Article Language "English" Conclusion: This large Shigella sonnei outbreak was caused by drinking contaminated tap-water. We recommended thorough inspection and repair of water treatment system.

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