Towards a Semi-Automatic Early Warning System for Vector-Borne Diseases.

The emergence and spread of vector-borne diseases (VBDs) is a function of biotic, abiotic and socio-economic drivers of disease while their economic and societal burden depends upon a number of time-varying factors. This work is concerned with the development of an early warning system that can act as a predictive tool for public health preparedness and response. We employ a host-vector model that combines entomological (mosquito data), social (immigration rate, demographic data), environmental (temperature) and geographical data (risk areas).

A spatial predictive model for malaria resurgence in central Greece integrating entomological, environmental and social data.

Malaria constitutes an important cause of human mortality. After 2009 Greece experienced a resurgence of malaria. Here, we develop a model-based framework that integrates entomological, geographical, social and environmental evidence in order to guide the mosquito control efforts and apply this framework to data from an entomological survey study conducted in Central Greece.

Fatal human anaplasmosis associated with macrophage activation syndrome in Greece and the Public Health response.

Human granulocytic anaplasmosis (HGA) is a tick-borne disease caused by Anaplasma phagocytophilum that has the potential to spread in new geographical areas. The first fatal case of HGA in Greece is presented. Fever of unknown origin, renal and respiratory insufficiency and development of macrophage activation syndrome characterized the clinical presentation.

Attitudes and beliefs on the establishment of a national food safety authority in Cyprus. A population-based survey.

Cyprus does not have a National Food Safety Authority (NFSA), but a multi-level, fragmented system with responsibilities divided among different ministries and governmental agencies, frequently impeding efforts to effectively manage food risks by duplication and overlapping of responsibilities. A population-based survey was carried out to determine the beliefs and attitudes of interested parties concerning the establishment of a NFSA in Cyprus. Information was collected using a random stratified sampling design and a structured questionnaire.

Study of the whole cell lysate of two Coxiella burnetii strains using N-terminomics.

The etiological agent of Q fever is Coxiella burnetii , an obligate intracellular Gram-negative bacterium and the only bacterium known to date that survives and replicates within a vacuole of phagolysosomal characteristics. In humans, Q fever is characterized by a wide spectrum of clinical manifestations. Of note is that genetic diversity among C.

Investigation of rifampicin resistance mechanisms in Brucella abortus using MS-driven comparative proteomics.

Mutations in the rpoB gene have already been shown to contribute to rifampicin resistance in many bacterial strains including Brucella species. Resistance against this antibiotic easily occurs and resistant strains have already been detected in human samples. We here present the first research project that combines proteomic, genomic, and microbiological analysis to investigate rifampicin resistance in an in vitro developed rifampicin resistant strain of Brucella abortus 2308.

Re-emergence of visceral and cutaneous leishmaniasis in the Greek Island of Crete.

Leishmaniases are vector-borne diseases transmitted by phlebotomine sand flies. Three species of Leishmania are found in the Mediterranean basin: Leishmania infantum, the most common species responsible for both visceral (VL) and cutaneous leishmaniasis (CL); Leishmania major, found in North Africa and Middle East causing CL; Leishmania tropica with a limited presence in Europe, causing CL. During the last 25 years, Crete has become an endemic zone for L.

A proteomic approach to investigate the differential antigenic profile of two Coxiella burnetii strains.

Q fever is a widespread zoonosis caused by Coxiella burnetii, an obligate intracellular Gram-negative bacterium. Current diagnostics of Q fever is based on serological testing of patient serum. Biological distinction among C.

Protective effect of exclusive breastfeeding against infections during infancy: a prospective study.

Objective: To prospectively investigate the effects of breastfeeding on the frequency and severity of infections in a well-defined infant population with adequate vaccination coverage and healthcare standards.

Study Design: In a representative sample of 926 infants, successfully followed up for 12 months, feeding mode and all infectious episodes, including acute otitis media (AOM), acute respiratory infection (ARI), gastroenteritis, urinary tract infection, conjunctivitis and thrush, were recorded at 1, 3, 6, 9 and 12 months of life.

Results: Infants exclusively breastfed for 6 months, as per WHO recommendations, presented with fewer infectious episodes than their partially breastfed or non-breastfed peers and this protective effect persisted after adjustment for potential confounders for ARI (OR 0.

Predisposing factors for acute otitis media in infancy.

Summary Background: Factors predisposing to acute otitis media (AOM) are not thoroughly understood.

Objectives: In this study we prospectively investigated incidence rates and risk factors of AOM in a systematic sample of infants in a well-defined population.

Design And Subjects: Following interview soon after delivery in a representative sample of 1049 mother-infant pairs, information was collected 1, 3, 6, 9 and 12 months after birth.

Proteomic screening for possible effector molecules secreted by the obligate intracellular pathogen Coxiella burnetii.

Coxiella burnetii is a Gram-negative, gamma-proteobacteria with nearly worldwide distribution, and it is the pathogenic agent of Q-fever in man. It is an obligate intracellular parasite that is highly adapted to reside within the eukaryotic phagolysosome. In fact, it is the only known intracellular bacterium that manages to survive and replicate within a fully formed, acidic phagolysosome.

A rare case of leishmaniasis recidiva cutis evolving for 31 years caused by Leishmania tropica.

A 64-year-old woman presented with erythematous, infiltrative plaques with a central atrophic area on both zygomatic regions. Several yellow-reddish papules were seen at the periphery of the plaques and showed an "apple-jelly" color on diascopy (Fig. 1).

Outcome of toxoplasmosis acquired during pregnancy following treatment in both pregnancy and early infancy.

Objectives: Congenital toxoplasmosis is associated with clinical dilemmas as untreated infants may have a guarded prognosis and as treatment may induce severe side effects. The aim of this study was to investigate the outcome of infants born to mothers with toxoplasmosis acquired during pregnancy, following administration of appropriate regimens both during pregnancy and early infancy.

Study Design: All 35 infants, born to mothers with toxoplasmosis acquired during pregnancy, and referred to the major Neonatal Department in Crete, Greece, during the 7-year period 1997-2003 were included.

In vitro susceptibilities of Brucella melitensis isolates to eleven antibiotics.

Background: Brucellosis is an endemic disease present in many countries worldwide, but it is rare in Europe and North America. Nevertheless brucella is included in the bacteria potentially used for bioterrorism. The aim of this study was the investigation of the antibiotic susceptibility profile of brucella isolates from areas of the eastern Mediterranean where it has been endemic.

Nocardia cyriacigeorgica pleural empyema in an immunocompromised patient.

A case of fatal Nocardia cyriacigeorgica pleural empyema in a patient with chronic obstructive pulmonary disease and long-term corticosteroid therapy is described. The organism was isolated from the pleural fluid in pure culture and was identified by conventional and molecular methods. Despite the early administration of the appropriate antibiotic treatment, the patient died 4 days after hospital admission.

Yersinia enterocolitica infection mimicking surgical conditions.

Yersinia enteritis may present with alarming gastrointestinal manifestations. The aim of this study was to review the cases of children admitted to a general hospital with a preliminary diagnosis of surgical nature and subsequently proven to be infected by Yersinia enterocolitica. All cases of children aged less than 14 years with stool cultures positive for Y.

Use of the GenoType Mycobacterium CM and AS assays to analyze 76 nontuberculous mycobacterial isolates from Greece.

Seventy-six nontuberculous mycobacterial isolates obtained from patients living in Greece were analyzed with the GenoType Mycobacterium CM (for common mycobacteria) and AS (for additional species) assays. GenoType correctly identified all but one of the mycobacterial species. For this species, additional probes should be designed and added to the strip.

Invasive non-typhoidal salmonellosis in immunocompetent infants and children.

Objective: To investigate the extraintestinal manifestations of non-typhoidal Salmonellae (NTS) infection in immunocompetent infants and children.

Method: The study took place at the University General Hospital at Heraklion, Crete. Over a 10-year period from 1993-2002 we studied 1087 patients, of whom 443 were children less than 14 years old, with a culture-proven diagnosis of NTS infection.

Qualitative versus quantitative blood cultures in the diagnosis of catheter-related bloodstream infections in children with malignancy.

Background: Paired quantitative and qualitative blood cultures have been introduced for the diagnosis of catheter-related bloodstream infections (CRBI) with the catheter in situ. The aim of the study was to compare the diagnostic performance and the prognostic value of the two methods in the evaluation of febrile episodes without an apparent source in children with cancer.

Procedure: During a 4-year period, in every febrile episode without an apparent focus, blood was drawn simultaneously from the catheter lumen and a peripheral vein in order to perform paired quantitative (Isolator) as well as qualitative (BacT/Alert) blood cultures.

Neurological complications of acute Q fever infection.

Coxiella burnetii the agent of Q fever produces a variety of clinical syndromes. Central nervous system (CNS) involvement is reported to be a rare feature of the disease usually presented as a severe headache and rarely as meningoencephalitis. We retrospectively studied the medical records of 49 patients with clinical signs of CNS involvement.

Incidence of toxoplasmosis in 5532 pregnant women in Crete, Greece: management of 185 cases at risk.

Objectives: To study the incidence of toxoplasmosis in pregnant women in Crete and to test a designed protocol for handling those at risk of delivering congenitally infected infants.

Study Design: Pregnant women were screened serologically over a period of 5 years. Cases with suspected acute toxoplasmosis were treated, peripheral blood (PB), and amniotic fluid (AF) tested by polymerase chain reaction (PCR) and culture, and fetuses monitored by ultrasonography.

Comparison of the effectiveness of five different antibiotic regimens on infection with Rickettsia typhi: therapeutic data from 87 cases.

This study estimated the clinical effectiveness of five different antibiotic regimens (doxycycline, chloramphenicol, ciprofloxacin, doxycycline plus chloramphenicol, and doxycycline plus ciprofloxacin) administered for infection with Rickettsia typhi in terms of the duration of the fever. Eighty-seven patients with endemic typhus were hospitalized between 1993 and 1998 at the General Hospital of Chania in Chania, Crete, Greece. The mean time to defervescence was 2.

Prevalence of nosocomial infections after surgery in Greek hospitals: results of two nationwide surveys.

Objective: To determine the frequency and type of nosocomial infections (NIs) (especially surgical-site infections [SSIs]), risk factors, and the type and duration of antibiotic use among surgical patients in Greek hospitals.

Design: Two point-prevalence studies.

Setting: Fourteen Greek hospitals.

Ochrobactrum anthropi bacteraemia in immunocompetent children.

Ochrobactrum anthropi is an emerging pathogen in immunocompromised patients but infections with the bacterium have very rarely been documented in normal hosts. We report the characteristics of O. anthropi bacteraemia in 11 immunocompetent children, aged 2 months to 7 y, hospitalized in a general hospital during a 5-y period.

Prognostic value of quantitative blood cultures for the outcome of central venous catheters in children.

Quantitative blood cultures have been used in order to define catheter-related bloodstream infection (CRBI) in pediatric patients with malignancy and central venous catheters (CVCs). We prospectively followed 32 patients with a total of 38 CVCs for a period of 4 y (14,068 catheter-days). Of a total of 35 cases of bacteremia, 9 were considered to be CRBI (25%).