In order to mitigate the spread of COVID-19, in the early stages of the pandemic outbreak, postponing elective procedures was recommended all around the world. Outpatient care and dental care were limited to telephone advice and emergency services. Dental staff is particularly vulnerable to SARS-CoV-2 contraction, because of the inevitable contact with patients’ body fluids during aerosol-generating procedures. The implementation of diagnostic tests among ambulatory patients could improve the occupational safety among outpatient care personnel. The aim of this review was to introduce information regarding COVID-19 diagnostics with a particular focus on the methods which can be utilized in an outpatient and dental care setting. An online PubMed database review of articles on COVID-19 diagnostics, published on February 12–May 15, 2020, was conducted. Reverse transcription polymerase chain reaction is the gold standard in COVID-19 diagnostics, which determines if a person has an active infection. Unfortunately, its utilization in outpatient care is limited. Serological enzyme-linked immunosorbent assays identify people who were infected, including those who have had an asymptomatic infection, but they do not give sufficient information about the acute infection. Rapid serological assays developed to facilitate testing outside of laboratories, especially in dental offices, are not recommended by the World Health Organization to be used outside research settings, and they should not constitute the basis for clinical decision-making because of frequent false-negative results which may consequently contribute to personnel infections. Out of all available COVID-19 diagnostic methods, rapid serological assays seemed to be a method of choice in outpatient medical care. Unfortunately, their results turned out to be unreliable. The best methods to ensure the occupational safety of medical staff and to avoid cross-infections in outpatient care facilities include a thorough epidemiological interview, temperature measurement to rule out patients with an active infection, and the implementation of strict infection control procedures.
One of the main approaches to monitoring the welfare of wild mammal populations in the wild is animal health estimation based on an analysis of their physiological parameters. To assess that for the natural felid populations, we analyzed adrenal activity level, white blood cells (WBC) counts and occurrence of seropositive reactions to different diseases. The first study was conducted in the Southwest Primorye, in natural habitats of Far Eastern leopard. Unevenly cold and snowy winters in 2010 and 2011 provided extreme natural conditions for overwintering mammals across the Russian Far East. Adrenocortical activity of leopards was significantly higher in 2011 (fecal cortisol level was 712.7 ± 92.4 ng g-1) than in 2010 (361.4 ± 80.5 ng g-1). We suggest that abundance and availability of weakened deer and carcasses could facilitate hunting for leopards and help them to avoid starvation. In the second study we used WBC counts as a health index for three felid species: Pallas cat (Daursky State Nature Biosphere Reserve, 2010), Far Eastern leopard (Southwestern Prymorie, 2011), Siberian tiger (Ussuriskii Reserve, 2010-2011). The ratio of neutrophils to lymphocytes (N:L) was used as an indicator of stress and/or disease state. Occurrence of seropositive reactions to 12 different pathogens was analyzed in all the animals after the hematological analysis. Pallas cats had the lowest N:L ratio (1.0 ± 0.1), significantly differing from leopards (42.8 ± 16.0) and tigers (24.5 ± 9.2). The N:L ratio correlated with the occurrence of seropositive reactions but not with the pathogen diversity. Pallas cats had the lowest occurrence of positive reactions to 4 pathogens: Toxoplasma gondii (12.5%), Mycoplasma sp. (12.5%), influenza A (7.1%), and feline leukemia virus (8.3%). Leopards had the highest N:L and occurrence of seropositive reactions only to 2 infections: T. gondii (16.6%) and Candida sp. (100%). On the contrary, tigers had positive responses to 6 pathogens, including canine distemper (7.7%), feline immunodeficiency virus (8.3%) and Aujeszky's disease (31%), which were not found in other cats. Values of N:L depended also on the time spent to get blood samples. In the big felid species effects of glucocorticoids on the WBC ratio (neutrophilia) were obtained in blood samples from anesthetized animals, taken more than 2 hours after capture. In Pallas cats blood samples were collected within 13 ± 2 min without anesthesia. Thus the high N:L ratio in big felids can be explained by several reasons: stress of capture, immunosuppression and a high diversity of detected infections. The present findings may have important implications for creation of effective conservation strategies of rare felid species in the wild.
Background: The aim of the study is to assess the incidence of Lyme disease, established diagnosis based on medical history and clinical symptoms, serology, duration of exposure in the workplace and occupational disease certification among forestry workers in selected districts of the Warmia and Mazury region. Material and Methods: The study consisted of annual screening of 332 employees in 6 forest districts under the supervision of the Health Center Medica in Ostróda. Serological tests were performed in all serum samples and IgG and IgM antibodies were determined by ELISA test. Positive results were confirmed by Western-blot test. Diagnosis was made based on medical history and clinical symptoms. Results were presented by the division of selected forest districts, gender, duration of exposure in the workplace and genospecies of spirochete Borrelia responsible for the disease development. Results: Lyme disease incidence was found in all selected forest districts. Positive results in Western-blot test were determined in 120 people (63.1% of all the surveyed). However, after taking a detailed medical history of the patients Lyme disease was diagnosed in 91 people which makes 27.4% of all the examined. Among patients with diagnosed disease, IgG antibodies were found in 76 people, IgM in 25 people, while both IgM and IgG in 10 people. There was also variation in the involvement of genospecies generating the disease; spirochete B. afzeli – 46% for IgG antibodies, whereas spirochete B. burgdorferi – 50% of all cases for IgM antibodies. At the same time the relationship between the extended duration of occupational exposure to tick bites and the increased incidence of Lyme disease was confirmed, indicating the group of workers employed for at least 25 years. Conclusions: Forestry districts of the Warmia and Mazury region, creates extremely dangerous occupational conditions because of exposure to tick bites. At the same time the duration of employment significantly increases the risk of Lyme. The analysis of serological tests results indicated differences in the reactivity of IgG and IgM classes and confirmed the correlation between clinical symptoms of Lyme disease and the variation of genospecies inducing the disease. Med Pr 2014;65(3):335–341
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Wstęp: Celem prezentowanej pracy jest ocena występowania boreliozy, ustalonej diagnozy na podstawie wywiadu, objawów klinicznych i badań serologicznych, okresu narażenia w miejscu pracy oraz orzecznictwa o chorobie zawodowej wśród pracowników wybranych nadleśnictw województwa warmińsko-mazurskiego. Materiał i metody: Corocznym badaniom przesiewowym poddano 332 pracowników 6 nadleśnictw, objętych opieką profilaktyczną przez Centrum Zdrowia Medica w Ostródzie. U wszystkich osób wykonano badania serologiczne, a poziomy przeciwciał klasy IgG oraz IgM w próbkach surowicy krwi oznaczono testem ELISA. Wynik dodatni kwalifikował pacjenta do wykonania testu potwierdzającego Western-blot oraz ewentualnego ustalenia rozpoznania boreliozy na podstawie wywiadu i objawów klinicznych choroby. Dane przedstawiono z uwzględnieniem podziału na wybrane nadleśnictwa, płeć, okres narażenia w miejscu pracy oraz genogatunki krętków Borrelia wywołujące chorobę. Wyniki: We wszystkich nadleśnictwach objętych badaniem stwierdzono zachorowania na boreliozę. Ogółem dodatnie wyniki badań Western-blot ustalono u 120 osób (63,1% badanych), jednak rozpoznanie boreliozy po szczegółowym wywiadzie i badaniu przedmiotowym ustalono u 91 pacjentów (27,4% badanych). W grupie pacjentów z rozpoznaną chorobą obecność przeciwciał w klasie IgG stwierdzono u 76 osób, w klasie IgM u 25 osób, z czego u 10 osób – w obu klasach. Wykazano także zmienności w udziale genogatunków wywołujących chorobę, z czego 46% stanowiły krętki B. afzeli dla przeciwciał IgG, natomiast w klasie IgM krętki z rodzaju B. burgdorferi stanowiły 50% wszystkich przypadków. Jednocześnie potwierdzono zależność między wydłużeniem okresu narażenia w miejscu pracy na ukąszenia przez kleszcze a zwiększoną zachorowalnością na boreliozę, która wskazała na grupę z ponad 25-letnim stażem pracy. Wnioski: Praca zawodowa w leśnictwie stwarza szczególnie niebezpieczne warunki ekspozycji na ukąszenia przez kleszcze, a jednocześnie długość stażu pracy znamiennie zwiększa ryzyko zachorowania na boreliozę. Analiza wyników badań serologicznych wskazuje na różnice reaktywności klas przeciwciał IgG oraz IgM w stosunku do badanych antygenów, potwierdzając tym samym korelację objawów klinicznych boreliozy względem rozpoznanych genogatunków krętków Borrelia. Med. Pr. 2014;(65):335–341
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