Search

ABSTRACTShigellais a leading cause of diarrhea among children globally and of diarrheal deaths among children under 5 years of age in low- and middle-income countries. To date, no licensed Shigellavaccine exists. We review evidence that serum IgG antibodies to ShigellaLPS represent a good correlate of protection against shigellosis; this could support the process of development and evaluation of Shigellavaccine candidates.Case-control and cohort studies conducted among Israeli soldiers serving under field conditions showed significant serotype-specific inverse associations between pre-exposure serum IgG antibodies to ShigellaLPS and shigellosis incidence. The same serum IgG fraction showed a dose–response relationship with the protective efficacy attained by vaccine candidates tested in phase III trials of young adults and children aged 1–4 years and in Controlled Human Infection Model studies and exhibited mechanistic protective capabilities. Identifying a threshold level of these antibodies associated with protection can promote the development of an efficacious vaccine for infants and young children.

The aim of the study was to examine the prevalence of Helicobacter pyloriinfection among Israeli children from different backgrounds and to assess potential interactions between ethnicity, socioeconomic status (SES), and H pyloriseroprevalence. The present sero-epidemiologic study was conducted among 0- to 20-year-old children seeking medical attention, not specifically gastrointestinal symptoms, using sera collected between 2000 and 2001 from 575 Israeli Arab children, 584 Jewish children from the general population, and sera that were obtained between 1997 and 2007 from 464 children of an ultraorthodox Jewish community. An enzyme-linked immunosorbent assay was used to measure H pyloriserum immunoglobulin G antibodies and seropositivity to H pyloriCagA strains. H pyloriseropositivity was 22.9% (95% confidence interval [CI] 19.7–26.5) among Jewish children from the general population, 25.2% (95% CI 21.5–29.4) among ultraorthodox Jewish children, and 45.6% (95% CI 41.5–49.7) among Arab children. H pyloriseroprevalence increased significantly with age in the 3 study groups, but it was consistently higher in Arab children. Compared with Jewish participants from high SES and controlling for age and sex, the odds ratio for H pyloriseropositivity was 2.03 (95% CI 1.31–3.12) in Jewish children from intermediate SES, 2.42 (95% CI 1.29–4.53) in Arab children from intermediate SES, 2.26 (95% CI 1.52–3.36) in Jewish children from low SES, and 5.72 (95% CI 3.89–8.42) in Arab children from low SES. CagA seropositivity was 40.8% and 45.0% among Jewish and Arab children, respectively (P= 0.59), and it was highest among subjects of lower SES. Socioeconomic factors may not totally explain the ethnic differences in H pyloriprevalence.

AbstractEnterotoxigenic Escherichia coli(ETEC) is a major cause of diarrhea among infants and children in developing countries, as well as among travelers to these areas. The major virulence factors of ETEC are the colonization factor antigens (CFAs) and a heat-labile enterotoxin (LT) and/or a heat-stable enterotoxin (ST). Among Israeli recruits serving under military field conditions, 107 of all examined isolates expressed LT or ST, and CFAs could be characterized in 68% of the isolates, in which CFAs of the CFA/II group and CS6 were the most prevalent. Additionally, 31% of the 107 ETEC isolates showed resistance to three or more of the antimicrobial agents examined, and the percentage of resistant isolates expressing LT was significantly higher than those expressing ST or LT+ST. These results may be important for development of an effective vaccine and for facilitation of an empirical choice of antibiotic treatment or prophylaxis for traveler's diarrhea in this area.

We conducted a community‐based study among 159 healthy Israeli Arab children aged 3 to 5 years old to examine the validity of the HpELISA kit (URINELISA, Otuska Phamaceuticals Co, Ltd, Tokyo, Japan) for detection Helicobacter pyloriIgG antibodies in urine. The polyclonal H. pyloristool antigen test (Premier HpSA) served as the gold standard. The sensitivity, specificity, positive and negative predictive values of the URINELISA kit were 34.2%, 96.3%, 90% and 60%, respectively. Using a cutoff value calculated based on the receiver operating characteristic curve (0.066), the corresponding figures were 65.8%, 87.5%, 83% and 72%, respectively. These data indicate that the usefulness of the URINELISA test in epidemiological studies in healthy young children is limited.