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Immunological monitoring of cystic hydatid patients undergoing medico-surgical management has revealed that it is possible to assess individual host responses throughout therapy and subsequently be guided by the results obtained. The analysis has involved the demonstration of variation in haemagglutination antibodies, specific IgG and IgM immunoglobulins and circulating immune complexes before, during, and months after albendazole therapy.

A. A comparative study of a simplified radioimmunoassay (RIA) technique with the indirect haemagglutination (IHA) test in the diagnosis of 72 patients with hydatid disease indicated the greater sensitivity of the former. Both methods had an equal specificity in 60 control patients. RIA will serve as a useful addition to tests already available in hydatid serology.B. A comparison of the (RIA) technique with the fluorescent antibody test (FAT) in the diagnosis of 33 patients with early, active trichinosis and 30 healthy controls indicated an equal sensitivity and specificity of both methods. The adoption of RIA as an easier method is recommended.This study of a simplified radioimmunoassay technique for the diagnosis of hydatid disease and trichinosis in man is presented in two sections.

Co-trimoxazole (trimethoprim-sulphamethoxazole combination) was effective in the control of the acute infection in 60 patients with proven enteric fever. The mean interval between initiating treatment and defervescence was similar to that observed with a comparable group of 38 patients treated with chloramphenicol. Both co-trimoxazole and chloramphenicol were well tolerated and no serious adverse reactions, attributed to either drug, were noted. Two patients treated with chloramphenicol relapsed. No relapses were noted in the co-trimoxazole treated group. Although the evidence available at present is inadequate for drawing final conclusions regarding the relative efficacy of these two therapeutic agents in enteric fever, co-trimoxazole should be considered as an alternative drug, particularly when encountering salmonella strains resistant to chloramphenicol and ampicillin.

Brood capsules were obtained from freshly collected cysts of equine and ovine strains ofEchinococcus granulosus. Protoscoleces were freed from brood capsules either by mechanical disruption or pepsin-HCl digestion. Preparations of protoscoleces studied included: mechanically released protoscoleces without further treatment, or incubated either in HCl pH 2·0 or in evaginating solution (containing Na taurocholate) for 24 h; pepsin-HCl released protoscoleces without further treatment or incubated in evaginating solution for 24 h or 7 days. Half of each preparation of ovine protoscoleces was fixed in absolute methanol.All fresh preparations of protoscoleces lysed rapidly when incubated in normal human serum. Studies with a fluorescein isothiocyanate (FITC) labelled sheep anti-human C3antiserum revealed the presence of C3on the surface of lysing protoscoleces. Antibody could not be detected on the surface of any of the preparations of fresh or methanol-fixed protoscoleces using direct or indirect fluorescent antibody tests suggesting that the classical pathway of complement activation was not involved in the lytic process. Strong evidence for lysis by the alternate pathway of complement activation was the lysis of protoscoleces which had been treated with pepsin-HCl and lysis of protoscoleces in guinea-pig serum deficient in C4component of complement.

There is evidence that the yearly incidence rate of hydatid disease may be increasing in endemic areas and in regions of the world hitherto free of the infection. The availability of an accurate method of detection in both man and other animals would facilitate understanding of the global epidemiology. The diagnostic procedures in use in human hydatidosis have often given inconclusive results in animal infections. The following tests are discussed and their usefulness appraised: intradermal, complement fixation, haemagglutination, latex agglutination, indirect fluorescent antibody, immunoelectrophoresis, counter immunoelectrophoresis, enzyme linked immunosorbent assay, radio-immuno assay and lymphocyte transformation.

In the summer and early autumn of 1974, flies were trapped in the Beirut districts of Ashraffiyah, Burj, Burj-Hammoud, Quarantine, the New Slaughter House, Ras Beirut, American University Campus, and the suburbs of Chiyah and Mreyjieh. Musca domestica, Muscina stabulans, Calliphora vicina, Phormia regina, Phaenicia sericata, Sarcophagidae spp. and Fannia canicularis were identified. The rural areas of Mreyjieh and Chiyah had higher densities of Musca domestica while higher densities of Calliphoridae spp. were found in the Slaughter House, Quarantine and Burj-Hammoud districts. Twenty-nine isolates, ten of Shigella spp. and 19 of Salmonella spp. were obtained from the bacteriological studies of 72 batches of Muscidae spp. and 84 Calliphoridae spp. These results indicate the hyperendemicity of salmonellosis and shigellosis in the areas under study, due to the prevalent poor sanity conditions and high fly infestation. It is suggested that in countries where valid health statistics are not available, bacteriological studies of flies may provide essential epidemiological information.

Summary Blood samples collected from human and rat population of Lebanon were tested for the presence of residual antibodies to typhus rickettsiae. Of 454 human serum samples tested, 76 (16.74%) were positive in CF and 37 (8.15%) in HA tests. Of 51 rat serum samples tested 18 (35.3%) were positive in CF tests. In the human population there was a stepwise increase of the rates of infections towards older age groups. This suggested a slow but continuous level of exposure to the disease. The findings of other investigators, indicating the superiority of CF over the HA test for detection of residual antibodies to typhus, was confirmed. The epidemiology of typhus fever in Lebanon and other Middle Eastern countries was briefly disscussed.

Summary By the employment of complement fixation and indirect hemagglutination tests 50 serum samples obtained from patients with hydatid disease and other conditions were tested. Of the 16 serum samples collected from hydatid disease patients positive results were obtained in 13 (81.25%) in indirect hemagglutination tests and in 11 (68.75%) in complement fixation tests. Of the 34 serum samples obtained from patients with other than hydatid disease the number of positive reactors was zero in indirect hemagglutination tests, and 2 (5.88%) in complement fixation tests. The results of the limited number of determinations indicate that indirect hemagglutination is a more sensitive and more specific serologic diagnostic procedure for hydatid disease than is complement fixation. Furthermore, it is easier to run than the complement fixation test and is less expensive.

(1960). A Simple Haemagglutination Drop Test for Human Hydatidosis. Annals of Tropical Medicine & Parasitology: Vol. 54, No. 2, pp. 233-235.

An early rise in serum IgE levels was observed in five of seven patients with acute primary trichinosis. Parallel increases in the total IgG, IgM and IgA levels, as well as specific IgG and IgM antibody titres to Trichinella spiralis larval antigen, were detected in two. The elevated levels persisted long after the clinical recovery of the patients.

• A strain of Bacillus laterosporus was isolated from the aqueous and vitreous humors of a patient with endophthalmitis that developed after a penetrating injury of the cornea. Intravitreal inoculation of the isolate into rabbits produced severe panophthalmitis, corneal perforation, orbital cellulitis, and even meningitis. These observations suggest that B laterosporus , hitherto classified as nonpathogenic, is an opportunist that can cause disease when conditions are favorable. ( Arch Ophthalmol 95:2187-2189, 1977)

With the use of an indirect fluorescent antibody (IFA) test and freeze-dried antigens, circulating antibody titres of 1 in 100 or above to Leishmania tropica leptomonad forms were detected in 66-6% and 76-2% of 18 patients with active and 21 patients with healed cutaneous leishmaniasis, respectively. Cross-reactivity was observed with L. donovani and Trypanosoma cruzi antigens. Five out of 15 patients with active pulmonary tuberculosis had antibodies to L. tropica major, suggesting a possible cross-reactivity between the two agents.