1/11. brucellosis in laboratory workers at a Saudi Arabian hospital.BACKGROUND: saudi arabia is hyperendemic for brucellosis, with more than 8000 cases reported each year to public health authorities. During 1998, brucellosis ranked as the No. 1 reportable communicable disease (22.5%) in Saudi Arabian National Guard communities. King Fahad Hospital is the major referral center for National Guard personnel in the nation's central region.methods And Results: From 1991 to 2000, brucellosis developed in 7 expatriate hospital employees. Six employees were bacteriology technologists, and one was a pathologist. Each had a clinical syndrome compatible with brucellosis (headache, fever, rigors, sweats, and myalgias) plus elevated brucella sp serum agglutinin titers > or = 1:1280; one patient also had positive blood cultures. All patients responded to anti-brucella therapy. Two patients had relapses, and complications occurred in four patients (septic endophlebitis of the leg, infected prosthesis, epididymoorchitis, and lumbar spondylitis). In all these employees except the pathologist, the infection was associated with processing brucella sp cultures. CONCLUSION: Despite the enforcement of stringent infection control measures including the use of a class II biosafety hood in the laboratory, the problem of nosocomial brucellosis persists because of the large number of infected specimens handled by the laboratory (17,500 specimens per year). Ultimately, risk reduction depends on efforts to reduce disease endemicity in the country. In the meantime, conversion of the laboratory to biosafety level 3 is under way.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
2/11. scrub typhus pneumonitis acquired through the respiratory tract in a laboratory worker.We report a case of scrub typhus pneumonitis in a laboratory worker who apparently acquired it through the respiratory tract. The patient was suffering from fever, cough and dyspnea. He had both cervical and axillary lymphadenopathy, and hepatomegaly. A chest X-ray showed interstitial infiltrates. A diagnosis of scrub typhus was established upon isolation of orientia tsutsugamushi. 12 days before the patient showed symptoms, he had purified O. tsutsugamushi proteins from infected cells using an ultrasonication method which could generate aerosols containing O. tsutsugamushi.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
3/11. Laboratory outbreak of q fever.An outbreak of q fever in a university department where sheep placentas were being used for research is described. Of six persons exposed to the sheep, four had positive titers with only one person developing an acute febrile illness and liver disease. This report illustrates the value of the family physician obtaining an occupational history and conducting an outbreak investigation.- - - - - - - - - - ranking = 5keywords = fever (Clic here for more details about this article) |
4/11. Successive Salmonella give and salmonella typhi infections, laboratory-acquired.A case of laboratory-acquired typhoid fever is described. The case was complicated by a self-limiting Salmonella give gastroenteritis which may also have been laboratory-acquired and which occurred during the incubation period of the salmonella typhi infection. The symptoms of typhoid were not sufficiently severe for the patient to seek medical attention and she was recovering from the infection when the typhoid bacillus was isolated from her stools. The mode of transmission of the S. typhi was presumed to be a laboratory infection from an unknown source. Although there was no obvious breakdown in safe laboratory techniques, the infecting dose of S. typhi is known to be small and the dangers of handling specimens which may contain this bacterium are emphasized.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
5/11. epidemiology of boutonneuse fever in western sicily: accidental laboratory infection with a rickettsial agent isolated from a tick.A case is reported of an accidental laboratory infection with a strain of Spotted Fever-Group Rickettsiae freshly isolated from a tick collected in Western sicily. Inoculation into the left thumb of cell-cultured organisms (10(5)/ml) gave rise to clinical signs and symptoms of boutonneuse fever after six days, i.e., a lesion at the point of inoculation, fever, headache, conjunctivitis and myalgias. Rickettsiae were isolated from acute-phase blood samples collected from the infected individual and IgM and IgG response was detected in the patient's serum by indirect immunofluorescence. Complete recovery was obtained after antibiotic treatment. Serologic analysis of the strain, together with analyses of the proteins of the isolate, documented that the isolate was rickettsia conorii and was identical to prototype strain. The relationship of this infection to ongoing studies on the epidemiology of boutonneuse fever in Western sicily is discussed.- - - - - - - - - - ranking = 5keywords = fever (Clic here for more details about this article) |
6/11. Laboratory-acquired chagas disease.A laboratory technician developed fever, malaise, headache and non-tender erythematous swelling proximal to the site of accidental inoculation of his thumb, 24 days earlier, with a needle contaminated with trypanosoma cruzi. Findings included a characteristic rash, remarkable fever, relative bradycardia and leukopaenia--T lymphopaenia with maintenance of a normal helper/suppressor ratio. Trypanosomes were not detected in blood concentrates or in biopsies of an enlarged lymph node and a skin lesion. T. cruzi antibody was first detected 33 days after the laboratory accident, when parasites were first isolated. Therapy with nifurtimox was well tolerated and the patient's serology became negative 9 months after the accident.- - - - - - - - - - ranking = 2keywords = fever (Clic here for more details about this article) |
7/11. Laboratory-acquired rocky mountain spotted fever. The hazard of aerosol transmission.Nine patients with laboratory-acquired rocky mountain spotted fever were seen during the period 1971 to 1976. Investigation of each case revealed either definite or probable exposure to an aerosol containing infectious rickettsiae; in no case was there evidence of parenteral exposure either by accidental self-inoculation or by tick bite. These illnesses are believed to represent infection acquired via the respiratory route. This report emphasizes the aerosol hazard of rickettsia rickettsii in the laboratory and discusses the possibility of respiratory transmission of rocky mountain spotted fever in nature. The illness occurred only in personnel who had received either no vaccination or the primary series of the commercial (Lederie) vaccine against this infection. Other personnel who had received the primary series with multiple booster vaccinations demonstrated increased immunity as measured by humoral antibody titers and rickettsial antigen-induced lymphocyte transformation; no cases of clinical disease developed in these multiply-vaccinated personnel.- - - - - - - - - - ranking = 6keywords = fever (Clic here for more details about this article) |
8/11. Serological studies on a case of laboratory dengue infection.One of the authors (Y.O.), who had previously been immunized with Japanese encephalitis (JE) vaccine, showed symptoms of typical dengue fever 6 days after accidental infection with a newly isolated dengue type 4 virus strain from a patient with dengue hemorrhagic fever (DHF) in thailand. His sera were examined by hemagglutination inhibition (HI), complement fixation (CF) and neutralization (N) tests. The JE N antibody titers of his sera were high even on the first day of the illness and remained almost constant during the next year. antibodies that reacted with dengue viruses were detected from a very early stage of the illness by all three serological tests. In addition, his convalescent phase sera showed high titers against all 4 types of dengue virus. These data suggest that the dengue infection caused secondary stimulation of antigens of flavivirus. Sedimentation analysis of antibodies in Y.O.'s serum (day 9) was carried out and IgM antibody that reacted only with dengue type 4 virus and homologous infecting virus was separated. These findings clearly demonstrated that the laboratory infection of Y.O. was primary dengue infection with dengue type 4 virus.- - - - - - - - - - ranking = 2keywords = fever (Clic here for more details about this article) |
9/11. Contagious ecthyma in lambs and laboratory personnel.Contagious ecthyma, diagnosed in three lambs, was transmitted to two researchers having direct contact with oral secretions from these lambs. Intracytoplasmic viral particles were demonstrated by electron microscopy in gingival biopsies from one lamb. Lamb to lamb transmission was most likely caused by use of a contaminated gavage feeding tube. Concern for the effects of this disease and q fever on patients having contact with contaminated medical researchers prompted the formulation of safety guidelines to prevent potentially disastrous zoonotic disease.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
10/11. arbovirus infections among laboratory personnel in Ibadan, nigeria.Laboratory-acquired infections encountered between 1963 and 1977 among personnel of the Virus research Laboratory, Ibadan, nigeria, are reported. Two cases of chikungunya infection occurred and one each with Dugbe, Wesselsbron, and dengue viruses. In each case, virus was isolated or development of antibody demonstrated. Among virus and two each to chikungunya and rift valley fever viruses, without experiencing any clinically recognized disease.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
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