Amphizoic small amoebic protozoa are capable of existing both in 'free-living' and in 'parasitic' form depending on the actual conditions. Two genera (Naegleria and Acanthamoeba) have become recognised as opportunist human parasites. Since the first description in 1965 of a lethal case of primary amoebic meningoencephalitis (PAM) caused by Naegleria, many more (mostly lethal) cases have been reported, while granulomatous amoebic encephalitis (GAE), as well as eye (keratinitis, conjunctivitis, etc.), ear, nose, skin and internal organ infections caused by Acanthamoeba have also occurred in rapidly increasing numbers. Both pathogenic and non-pathogenic species of Naegleria and Acanthamoeba are found worldwide in water, soil and dust, where they provide a potential source of infection. Successful differential diagnosis and appropriate (specific) therapy depends on precise laboratory identification of the 'free-living' amoebae. In most cases, isolation from the environment can be achieved, but identification and differentiation of the pathogenic and non-pathogenic strains is not easy. The methods presently available do not fulfil completely the requirements for specificity, sensitivity and reliability. Morphological criteria are inadequate, while thermophilic character, pH dependency and even virulence in infected mice, are not unambiguous features of pathogenicity of the different strains. More promising are molecular methods, such as restriction endonuclease digestion of whole-cell DNA or mitochondria1 DNA, as well as iso-enzyme profile analysis after iso-electric focusing and staining for acid phosphatase and propionyl esterase activity. Use of appropriate monoclonal antibodies has also yielded promising results in the differentiation of human pathogenic and non-pathogenic strains. However, quicker, simpler, more specific and reliable methods are still highly desirable. The significance of endosymbiosis (especially with Legionella strains) is not well understood. The results of a systematic survey in Hungary for the isolation and identification of 'free-living' amoebae, including an investigation of the Hungarian amoebic fauna, the isolation of possibly pathogenic Naegleria strains and of some Acanthamoeba strains from eye diseases, as well as the finding of a case of endosymbiosis, are also reported here.
Most of the above cases of dirofilariosis are certainly autochthonous infections. The increasing number of diagnosed cases suggests that this zoonosis is becoming more important in central Europe and that the incidence may increase with the improvement of clinical diagnosis.
Toxocara infection is associated with an increased prevalence of airway symptoms and may be a possible aetiologic agent of chronic cough. The occurrence of toxocariasis in Hungary is mild and/or sporadic. The purpose of this study was to investigate the levels of serum cytokines (IL-1, IL-2, IL-4, IL-5, IL-6, IL-10, IL-13, IFN-gamma and TNF-alpha) and total IgE, the blood eosinophil count, the results of skin prick and non-specific bronchus provocation tests in Toxocara-seropositive children with chronic cough relative to those in healthy controls. The patients exhibited moderate eosinophilia, significantly elevated levels of serum total IgE, IL-6, IL-10, IL-13 and IFN-gamma, and higher skin reactivity to common allergens, whereas the bronchial hyperreactivity was similar in the two groups. The protective proinflammatory cytokines (IL-6, IFN-gamma and IL-13) in association with the anti-inflammatory cytokine (IL-10) were simultaneously increased in Toxocara-infected children with chronic cough. During infections, the activation and suppression of immune processes occur simultaneously and cytokines of Th1/Th2 and regulatory T cells contribute to the regulation of the immune response evoked by helminth infections (depending on the parasite load, the timing and duration of the infection and the status of the host immune system).
In the genus Giardia (G.) intestinalis is the only species found in humans as well as in other mammals, including domestic and farm animals. Molecular characterisation of strains isolated from different hosts revealed the existence of seven major genotypic assemblages. Assemblage A and B isolates have been recovered from a broad range of hosts, including humans, livestock, cats, dogs, beavers and guinea pigs. Infection and subsequent cyst shedding contaminates the environment for all mammals, including humans. In this preliminary investigation we studied the prevalence of Giardia infection in kennel dogs from Hungary by microscopic examinations and using a G. intestinalis Agspecific coproantigen test. In order to investigate the genotypes of Giardia, a nested PCR specific for Giardia 18S-rDNA was introduced. All sequenced samples displayed the sequences described for Assemblage D and C dog-specific G. intestinalis strains. These results indicate, however, that dog giardiosis is highly prevalent in the studied geographical areas, but it doesn't present severe zoonotic potential. In the course of the study, the higher sensitivity of the coproantigen test compared to microscopy, and the significant decline in the infection rate with the increasing age of the dogs sampled was clearly pointed.
Antenatal, early diagnosis and treatment of toxoplasmosis in mothers, together with treatment and follow-up of their offspring, may considerably reduce the incidence of the disease in the offspring.
Open Life Sci. 2016; 11: 524-532 while infections with E. granulosus s.s. which are highly infectious for humans are more commonly encountered in Romania and Hungary.Keywords: Echinococcus granulosus, genotype, DNA sequences, human, pig, central-eastern Europe IntroductionThe larval stages of the tapeworm Echinococcus granulosus sensu lato (s.l.) are the causative agents of cystic echinococcosis (CE), one of the most important cestode infections causing morbidity and mortality in humans and significant economic losses in livestock. Around one million or more people are currently suffering from CE globally and the financial burden of the disease on the livestock industry is substantial, with up to two billion dollars lost annually [1]. Recent molecular phylogenetic analyses have revealed that E. granulosus is a complex of spesies/genotypes with at least five different species: E. granulosus sensu stricto (s.s.) (genotypes G1-G3), Echinococcus equinus (G4), Echinococcus ortleppi (G5), Echinococcus canadensis (G6-G10), and Echinococcus felidis ("lion strain") [2][3][4].CE remains one of the most important helminth zoonoses in many regions of Europe, especially the Mediterranean littoral (Spain, Italy, Greece and Turkey) and southeastern countries such as Bulgaria and Romania. The disease seems to be less prevalent in the UK, Central Europe, the Baltic States and the Scandinavian countries [5,6]. Surveys that addressed the incidence of CE over the last decade from central-eastern Europe has reported a relatively greater incidence in Romania (average incidence annual rate was 0.29 per 100,000 population) and Ukraine (0.30), whereas in Hungary (0.07), Poland (0.08) and Slovakia (0.10) lower numbers of human cases were documented [7]. This also is due to the fact that E. granulosus s.s., which is responsible for the majority Abstract: Central-eastern Europe is an endemic region for cystic echinococcosis where multiple species of intermediate hosts are commonly infected with Echinococcus granulosus sensu lato tapeworms of major medical and veterinary importance. Investigations of the genetic variation of 25 Echinococcus isolates from five countries (Slovakia, Romania, Ukraine, Hungary, Poland) were undertaken using three mitochondrial DNA markers. The 18 isolates from pigs derived from Slovakia and Ukraine and the four human isolates from Slovakia, Poland and Ukraine were identified as E. canadensis G7, whereas the three human isolates from Romania and Hungary were classified as E. granulosus sensu stricto G1. This study reports the first confirmed human case of E. granulosus s.s. in Hungary. The haplotype G7A with two polymorphic sites relative to the most common regional variant of E. canadensis G7 was recorded in both pigs from Ukraine and in a single pig isolate from Slovakia. The results of this study support the circumstantial evidence that E. canadensis G7 with low infectivity for humans is highly prevalent in the northern parts of the region (Poland, Slovakia, forest-steppe zone of Ukraine),
Chronic cough lasting 8 weeks or more often seems to be an intractable problem in childhood. Toxocara infection is associated with an increased prevalence of airway symptoms and may be the possible aetiological agent of chronic cough. Of 425 children aged 2-17 years with chronic cough who were investigated for toxocariasis and the distribution of bronchial asthma (BA), cough variant asthma (CVA) and non-asthmatic eosinophilic bronchitis (NAEB), 136 (32%) were seropositive for Toxocara canis antigens. Ninety-three of the 136 were adequately assessed, diagnosed and followed up during 1 year. BA was diagnosed in 40%, CVA in 27% and NAEB in 33% of the children. The eosinophil cell count, serum T. canis IgG levels and symptoms are predictors of the improvement or the decline of the condition. Presuming the aetiopathogenetic role of T. canis in the inflammatory process of chronic cough, we treated the children not only with inhaled corticosteroid (ICS), but also with a 1-week course of anthelminthics. We could significantly decrease the dose of ICS in 23 (62%) of the 37 with BA. The administration of anthelminthics and the avoidance of sensitizers were sufficient for those with NAEB; none needed ICS. ICS therapy could be stopped 2-3 months later in 17 (68%) of the 25 with CVA. We found that 8 of the 25 with CVA (32%) presented asthmatic symptoms at the end of the 1-year period. In Hungary, T. canis may be a potential sensitizer for chronic cough in seropositive children. Deworming therapy will then alleviate the airway symptoms without exacerbation in patients with BA, and have a positive effect on those with NAEB and the majority of those with CVA.
The transmission route of giardiasis not yet understood and why some infected individuals remain asymptomatic while others become quite ill. The drinking water quality is supposedly responsible for the prevalence of asymptomatic Giardia duodenalis infections in different areas, therefore asymptomatic giardiasis has been investigated in three water supply areas of Hungary: three hundred stool samples from inhabitants of Budapest, Füzér and Mátrafüred were examined by immunological and molecular methods for the presence of G. duodenalis infections. Individuals were asked to fill out a validated questionnaire at the time of stool collection and the interview covered demographic data, family life, education and travel history.In Budapest and in Mátrafüred in one stool sample G. duodenalis Assemblage A, whereas in Füzér once G. duodenalis Assemblage A, once Assemblage B and twice mixed infection were detected. We found higher prevalence rate of 4% of G. duodenalis infections of asymptomatic people in the village Füzér, where the removal of the Giardia cysts of the drinking water treatment plant was not effective. This study throws a light the need to look into the possibility of other risks of Giardia infections such as water transmission routes. To our knowledge, this is the first study evaluating the prevalence of G. duodenalis infections in asymptomatic persons in Hungary.
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