BACKGROUND: The zoonotic disease Q fever is caused by Coxiella burnetii and usually affects high-risk human populations. We conducted a serological survey of dairy cattle farmers in Korea to determine seroreactivity and identify risk factors for C. burnetii infection. METHODS: This cross-sectional study included 1,824 of 7,219 dairy cattle farms (25.3%) in the study region. The selected dairy cattle farmers visited the nearest public health centers or branches with completed questionnaires. Serum samples from the farmers were tested using an indirect immunofluorescence assay to detect phase II C. burnetii immunoglobulin (Ig) G or M antibodies. RESULTS: A total of 1,222 dairy cattle farmers from 784 dairy cattle farms (43.0%) participated in this study, and 11.0% (134/1,222) exhibited seroreactivity, defined as a phase II antigen IgG or IgM titer ≥ 1:16. In the multivariate analysis, male sex, residence in Gyeonggi Province, a larger herd size, and ocular/oral contact with birth products during calf delivery were significantly associated with a higher risk of C. burnetii infection. Furthermore, the risk was significantly lower among farmers who always wore protective gloves while cleaning cattle excretion, compared to those who sometimes or rarely wore protective gloves. CONCLUSION: Dairy cattle farmers should exercise caution by avoiding ocular/oral contact with birth products during calf delivery and by using protective equipment (including gloves).
Agriculture ; Animals ; Antibodies ; Cattle* ; Coxiella burnetii* ; Coxiella* ; Cross-Sectional Studies ; Farmers* ; Fluorescent Antibody Technique, Indirect ; Gloves, Protective ; Gyeonggi-do ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Korea* ; Male ; Multivariate Analysis ; Parturition ; Public Health ; Q Fever* ; Risk Factors* ; Serologic Tests ; Zoonoses

OBJECTIVES: Q fever is a zoonotic disease that occurs worldwide; however, little is known about its prevalence in South Korea. We attempted to determine the prevalence of Q fever seroreactivity among Korean slaughterhouse workers and the risk factors for seroreactivity according to the type of work. METHODS: The study was conducted among 1503 workers at a total of 73 slaughterhouses and 62 residual-product disposal plants. During the study period, sites were visited and surveys were administered to employees involved in slaughterhouse work, and serological tests were performed on blood samples by indirect immunofluorescence assays. Serological samples were grouped by job classification into those of slaughter workers, residual-product handlers, inspectors and inspection assistants, and grading testers and testing assistants. Employee risk factors were analyzed according to the type of work. RESULTS: Out of 1481 study subjects who provided a blood sample, 151 (10.2%) showed reactive antibodies. When these results were analyzed in accordance with the type of work, the result of slaughter workers (11.3%) was similar to the result of residual-product handlers (11.4%), and the result of inspectors and assistants (5.3%) was similar to the result of grading testers and assistants (5.4%). Among those who answered in the affirmative to the survey question, “Has there been frequent contact between cattle blood and your mouth while working?” the proportions were 13.4 and 4.6%, respectively, and this was identified as a risk factor that significantly varied between job categories among slaughterhouse workers. CONCLUSIONS: This study found a Q fever seroreactivity rate of 10.2% for slaughterhouse workers, who are known to be a high-risk population. Contact with cattle blood around the mouth while working was the differential risk factor between job categories among slaughterhouse workers.
Abattoirs* ; Animals ; Antibodies ; Cattle ; Classification ; Coxiella burnetii ; Fluorescent Antibody Technique, Indirect ; Korea* ; Mouth ; Prevalence ; Q Fever* ; Risk Factors ; Serologic Tests ; Zoonoses

Severe fever with thrombocytopenia syndrome (SFTS) is caused by the SFTS virus (SFTSV). The SFTSV appears to have a wide host range, as SFTSV-positive ticks have been isolated from both farm animals and wild rodents. Therefore, it is important to monitor SFTSV-positive animals to prevent the transmission of SFTSV from animals to humans. Previously, we developed a competitive enzyme-linked immunosorbent assay (cELISA) to detect SFTSV-specific antibodies from field animals and compared the cELISA results to those from an indirect immunofluorescence assay (IFA). In this study, cELISA results were compared to and evaluated against the results from both an IFA and a virus neutralization (VN) test of 193 bovine serum samples (including two bovine positive control sera) and 70 horse serum samples. The consistency (98.9%) between cELISA and VN results was higher than that (97.4%) between cELISA and IFA for the bovine serum samples. Similarly, for the horse serum samples, the consistency (88.6%) between cELISA and VN results was higher than that (84.3%) between the cELISA and IFA. These findings indicate that our newly developed cELISA can be used for surveillance or epidemiological studies of SFTSV in animals.
Animals ; Animals, Domestic ; Antibodies ; Enzyme-Linked Immunosorbent Assay* ; Epidemiologic Studies ; Fever* ; Fluorescent Antibody Technique, Indirect ; Horses ; Host Specificity ; Humans ; Neutralization Tests* ; Rodentia ; Thrombocytopenia* ; Ticks

We report a rare case of bullous scabies with bullous pemphigoid in a 59-year-old male patient. He presented with a 9-month history of exhibiting multiple, variable-sized, red-to-brown, pruritic cutaneous patches, and papules with tense bullae on his whole body. A direct smear of the bullous lesions was performed and was negative for scabies mites. Histopathologic findings (hematoxylin and eosin staining) revealed Sarcoptes scabiei in the stratum corneum. There were sub-epidermal blisters with massive eosinophil and lymphocyte infiltration in the epidermis and upper dermis. Direct immunofluorescence microscopy showed linear deposition of IgG at the dermo-epidermal junction. Indirect immunofluorescence microscopy of samples acquired for the salt-split skin test showed linear IgG deposition in the epidermis. Skin lesions improved after the patient was treated with an anti-scabietic and steroids.
Blister ; Dermis ; Eosine Yellowish-(YS) ; Eosinophils ; Epidermis ; Fluorescent Antibody Technique, Direct ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoglobulin G ; Lymphocytes ; Male ; Microscopy ; Middle Aged ; Mites ; Pemphigoid, Bullous* ; Sarcoptes scabiei ; Scabies* ; Skin ; Skin Tests ; Steroids ; Transcutaneous Electric Nerve Stimulation

Autoimmune neutropenia of infancy (AIN) is caused by increased peripheral destruction of neutrophils as a result of antibodies in patients' blood that are directed against their own neutrophils. Due to non-specific symptoms, benign clinical courses, and cumbersome diagnostic tests, AIN are commonly undetected. Antineutrophil antibody test for diagnosis of AIN has recently become available. Compared to its relatively lower absolute neutrophil count (ANC), the clinical course of AIN is mostly benign. Therefore, although treatment is not usually necessary for AIN, it is applicable in order to rule out other significant diseases, such as severe congenital neutropenia (SCN), which can be transformed to myelodysplastic syndrome or acute myelocytic leukemia. For this reason, several treatments can be used for neutropenia: granulocyte-colony stimulating factor (G-CSF) for SCN, trimethoprim and sulfamethoxazole (TMP-SMX) for prophylaxis. Here we report on two cases of AIN confirmed by indirect immunofluorescence test using flow cytometry.
Antibodies ; Diagnostic Tests, Routine ; Flow Cytometry ; Fluorescent Antibody Technique, Indirect ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes ; Neutropenia ; Neutrophils ; Sulfamethoxazole ; Trimethoprim

OBJECTIVETo establish a method of indirect immunofluorescence (IIF) to measure DNA (mDNA)-associated autoantibodies to cell membrane, and to evaluate diagnostic value of the anti-mDNA antibodies in patients with juvenile systemic lupus erythematosus (SLE) in comparison with anti-dsDNA antibody.

METHODSForty-four children with SLE were enrolled in this study. As a control group, 30 children with other rheumatic diseases were also enrolled. Anti-mDNA and anti-dsDNA antibodies were measured by IIF. Anti-smooth muscle (Sm) antibodies were measured by immuno-double diffusion (ID) and IIF.

RESULTSOut of 44 juvenile SLE patients, 34 (77.27%) were seropositive for anti-mDNA, which was significantly higher than that of patients with other rheumatic diseases (20.00%, P<0.05). The sensitivity and specificity of anti-mDNA for juvenile SLE diagnosis were 77.27% and 80.00%, respectively. The positive predictive value and negative predictive value were 85.00% and 70.59%, respectively. The positive rate of anti-mDNA in SLE lacking of anti-dsDNA and anti-Sm antibodies were 68.00% (17/25) and 79.49% (31/39), respectively.

CONCLUSIONThe detection of anti-mDNA antibodies is useful for diagnosis of juvenile SLE, especially in patients who are negative for anti-dsDNA antibodies and anti-Sm antibodies.

Adolescent ; Antibodies, Antinuclear ; analysis ; Case-Control Studies ; Cell Membrane ; immunology ; Child ; Female ; Fluorescent Antibody Technique, Indirect ; methods ; Humans ; Lupus Erythematosus, Systemic ; immunology ; Male ; Predictive Value of Tests ; Sensitivity and Specificity

OBJECTIVETo evaluate the sensitivity and the specificity of Anti-M2-3E ELISA for the detection of IgG- and IgA-specific isotypes of antimitochondrial antibody (AMA), and to investigate the significance of antimitochondrial IgA and IgG in the diagnosis of primary biliary cirrhosis (PBC).

METHODSSera were collected from 107 PBC patients, 87 disease controls and 26 healthy controls, and the antimitochondrial antibodies (IgG and IgA) were detected using indirect immunofluorescence (IFL), Anti-PDC ELISA and Anti-M2-3E ELISA.

RESULTSThe AMA IgG positive rate in PBC patients was 90.6% detected by Anti-M2-3E ELISA, which is significantly higher than that (81.3%) detected by IFL(t = 4.32, P < 0.05) and that (72.9%) detected by Anti- PDC ELISA (t = 6.03, P < 0.05). The AMA IgA was positive in 59 of the 107 PBC patients, and 99 of the 107 patients were positive for AMA IgG or/and IgA. 9 of the 20 IFL-negative patients were positive for AMA IgG as indicated by Anti-M2-3E ELISA, 11 of the 20 IFL-negative patients were positive for AMA IgG or/and IgA as indicated Anti-M2-3E ELISA. Compared to patients negative for IgG AMA, patients positive for IgG AMA had more severe histopathology and higher levels of ALP, IgG, and IgM.

CONCLUSIONThe IgG and IgA Anti- M2-3E ELISAs are more sensitive for the AMA detection than IFN and the Anti-PDC ELISA. The presence of AMA IgG is the characteristics of severe PBC.

Adult ; Aged ; Autoantibodies ; blood ; Biomarkers ; blood ; Biopsy, Needle ; Enzyme-Linked Immunosorbent Assay ; methods ; Female ; Fluorescent Antibody Technique, Indirect ; Hepatitis, Autoimmune ; blood ; diagnosis ; immunology ; Humans ; Immunoglobulin A ; blood ; Immunoglobulin G ; blood ; Liver Cirrhosis, Biliary ; blood ; diagnosis ; immunology ; Liver Function Tests ; Male ; Middle Aged ; Mitochondria, Liver ; immunology ; Sensitivity and Specificity

BACKGROUND: Anti-mitochondrial antibodies (AMA) are a hallmark of primary biliary cirrhosis (PBC); however, low titers of AMA are also detected in some patients without PBC. We evaluated the clinical value of commercial rat kidney/stomach sections and an additional biochip coated with mitochondrial antigen M2 (pyruvate dehydrogenase complex). METHODS: A total of 124 patients who had been tested for AMA were evaluated. Results of AMA, antibodies to M2, and antinuclear antibody were reviewed retrospectively and searched for clinical and laboratory data to diagnose PBC. AMA and M2 antibody were assayed by an indirect immunofluorescence assay using EUROPLUS kit (Euroimmun, Luebeck, Germany). RESULTS: In 10 of the 124 patients, a diagnosis of PBC was established by AMA, liver function test or liver biopsy. The sensitivity and specificity of rat kidney/stomach section, M2 antibody, and coarse cytoplasmic fluorescent pattern of HEp-2 cell were 80.0, 75.0, 88.9% and 97.4, 98.2, 97.3%, respectively; however, these differences were not statistically significant. Six patients with coarse cytoplasmic pattern of HEp-2 cell at 1: 320 dilution were positive for both rat kidney/stomach sec-tion and M2 antibody. Two of five patients with coarse cytoplasmic pattern at below 1: 80 dilution were diagnosed as PBC, yet all of them were negative for M2 antibody. CONCLUSIONS: M2 biochip test would be convenient to test simultaneously with rat kidney/stomach section and it provided results similar to those of the preexisting serological tests for PBC.
Animals ; Antibodies ; Antibodies, Antinuclear ; Biopsy ; Cytoplasm ; Diagnosis ; Fluorescent Antibody Technique, Indirect ; Humans ; Liver ; Liver Cirrhosis, Biliary ; Liver Function Tests ; Oxidoreductases ; Rats ; Retrospective Studies ; Sensitivity and Specificity ; Serologic Tests

A virus strain, showing cytopathic effect in Vero cell, was isolated from plasma of a fattening pig in Gyeonggi province, Korea in October 1999. The evaluation of physicochemical/biological properties of the isolate showed that the virus, KV1899, inoculated suckling mouse showed paralysis and died within 7 days post-inoculation, the mouse brain suspension had hemagglutinating activity with goose RBC. Pathogenicity of isolate was carried out by intracranial and intraperitoneal inoculation of 3-4 weeks mice. The mice inoculated with isolate showed 10 4.5 LD50/ 0.03 ml and 10 3.0 LD50/0.5 ml according to the inoculation route. The isolate was identified as RNA and enveloped virus using IUDR and chloroform sensitivity test. The virus particles within the infected Vero cell were measured to be 40-50 nm in size by electron microscopy. The isolate was further characterized by immuno-fluorescence assay using Japanese encephalitis virus (JEV) specific monoclonal antibodies. Reverse transcription polymerase chain reaction (RT-PCR) revealed the presence of JE specific conserved sequences in this isolate. The artificially inoculated pigs had HI titer of 320 to 2,560 against JEV at 14 to 42 days post inoculation. We confirmed this isolate as Japanese encephalitis virus. It was the second isolation of JEV in pigs in Korea.
Animals ; Antibodies, Viral/analysis ; Cercopithecus aethiops ; Cytopathogenic Effect, Viral ; Encephalitis Virus, Japanese/*classification/*isolation & purification/ultrastructure ; Encephalitis, Japanese/pathology/*veterinary/virology ; Fluorescent Antibody Technique, Indirect/veterinary ; Hemagglutination Inhibition Tests/veterinary ; Hemagglutination Tests/veterinary ; Korea ; Mice ; Microscopy, Electron/veterinary ; RNA, Viral/analysis ; Reverse Transcriptase Polymerase Chain Reaction/veterinary ; Swine ; Swine Diseases/pathology/*virology ; Vero Cells/virology

OBJECTIVEAntineutrophil cytoplasmic antibody (ANCA) associated small vasculitides (ASV) are rare in children and often complicated in clinical manifestations and have very poor prognosis. In order to deepen our understanding of ANCA-associated small vasculitis (ASV) in children, the present study aimed to characterize their clinical manifestations, serum ANCA and renal histopathological findings and outcomes in Chinese children.

METHODSSerum ANCA was qualitatively tested with indirect immunofluorescence microscopy and anti-proteinase 3 (PR(3)) and anti-myeloperoxidase (MPO) activity were quantitated by enzyme-linked immunosorbent assays (ELISA), and renal biopsies were done to investigate the pathological changes. The clinical manifestation, serum ANCA and renal histopathological findings and outcome were characterized in 5 children with ANCA associated small vasculitis.

RESULTS(1) Five children with ANCA associated small vasculitis only accounted for 1.20% of children in whom renal biopsy was performed and 0.25% of hospitalized children with renal diseases during the same period. The age of onset of the 5 children with ASV was between 8 to 12 years with mean age 10.5 years. All ASV children were female. (2) All ASV children were negative for C-ANCA and showed normal anti-proteinase 3 activities, but positive for P-ANCA with high anti-myeloperoxidase activities between 98 to 242 kEU/L. The mean value of MPO-ANCA was 154.5 kEU/L (normal range < 12.7 kEU/L). (3) All ASV in the children was microscopic polyarteritis with wide-spread glomerular crescents formation and capillary tuft fibrinoid necrosis. Variety of complement C3 deposits and weak immunoglobulin deposits were noted in all ASV but one child who showed relatively strong deposits of IgA and IgM. The electronic dense deposits were mainly located in subendothelial space but were also found in the glomerular basement membrane in one child. (4) Three children with ASV died within one year after diagnosis, and two got remission and restored renal function after combined pulse therapy with methylprednisolone and cyclophosphamide (CTX), but remained to have hematuria and small amount of proteinuria after 1 and 5 year follow-up, respectively.

CONCLUSIONChildhood ASV was female and P-ANCA predominant, more vulnerable to progress to renal failure and poorer in prognosis than adult cases. Qualitative and quantitative ANCA measurement and renal biopsy were key to the diagnosis of ASV in children.

Antibodies, Antineutrophil Cytoplasmic ; blood ; Biopsy ; Child ; Enzyme-Linked Immunosorbent Assay ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Kidney ; pathology ; Kidney Function Tests ; Myeloblastin ; Peroxidase ; metabolism ; Prognosis ; Renal Insufficiency ; etiology ; pathology ; Serine Endopeptidases ; metabolism ; Vasculitis ; blood ; complications ; therapy