Browse publications by year: 1999

Plant reproductive phenology over four years including an episode of general flowering in a lowland dipterocarp forest,Sarawak, Malaysia

Sakai S, Momose K, Yumoto T, Nagamitsu T, Nagamasu H, Hamid AA, et al.

Am J Bot, 1999 Oct;86(10):1414-36.
PMID: 10523283

The first systematic observation of a general flowering, a phenomenon unique to lowland mixed-dipterocarp forests in Southeast Asia, is presented. During general flowering, which occurs at irregular intervals of 3-10 yr, nearly all dipterocarp species together with species of other families come heavily into flower. We monitored reproductive phenology of 576 individual plants representing 305 species in 56 families in Sarawak, Malaysia. Observations continued for 53 mo from August 1992 and covered one episode of a general flowering cycle. Among 527 effective reproductive events during 43 mo, 57% were concentrated in the general flowering period (GFP) of 10 mo in 1996. We classified 257 species into flowering types based on timing and frequency of flowering. The most abundant type was "general flowering" (35%), which flowered only during GFP. The others were "supra-annual" (19%), "annual" (13%), and "sub-annual" (5%) types. General flowering type and temporal aggregation in reproductive events were commonly found among species in various categories of taxonomic groups, life forms, pollination systems, and fruit types. Possible causes for general flowering, such as promotion of pollination brought about by interspecific synchronization and paucity of climatic cues suitable for flowering trigger, are proposed, in addition to the predator satiation hypothesis of Janzen (1974).

MeSH terms: Cues; Fruit; Malaysia; Plants; Reproduction; Satiation; Flowers; Pollination; Forests
Fulltext Temporal trends and ethnic variations in asthma mortality in Singapore, 1976-1995

Ng TP, Tan WC

Thorax, 1999 Nov;54(11):990-4.
PMID: 10525557

BACKGROUND: A study was undertaken to examine temporal trends and ethnic differences in the asthma mortality rate in Singapore.
METHODS: Asthma mortality rates in Singapore were estimated from vital data for the years from 1976 to 1995. Trends in sex and age specific (5-14, 15-34, 35-59, 60+ years) rates were obtained for four periods (1976-80, 1981-85, 1986-90, 1991-95) and for Chinese, Malay, and Indian subjects for the years when these data were available (1989-95).
RESULTS: An increase in asthma mortality was observed in children aged 5-14 years from 0.21 per 100,000 person years in 1976-80 to 0.72 per 100,000 person years in 1991-95. No increases were noted in the other age groups but a small decrease was observed in the 1991-95 period for the 35-59 year age group. Marked ethnic differences in mortality rates were observed. In the group aged 5-34 years the asthma mortality rates were 0.5 per 100,000 in Chinese subjects, 1.3 per 100,000 in Indians, and 2.5 per 100,000 in Malay subjects. Similar 2-4 fold differences were observed in all other age groups.
CONCLUSIONS: Apart from genetic factors, environmental exposures and medical care factors which influence asthma prevalence and severity are most likely to be the causes of the observed temporal trends and ethnic differences in the asthma mortality rate in Singapore, but further studies are needed to elucidate these more fully.

MeSH terms: Adolescent; Adult; Aged; Asthma/ethnology*; Asthma/mortality*; Child; Child, Preschool; China/ethnology; Female; Humans; India/ethnology; Malaysia/ethnology; Male; Middle Aged; Singapore; Asian Continental Ancestry Group; Oceanic Ancestry Group
Knowledge, attitudes and preventive efforts of Malaysian medical students regarding exposure to environmental tobacco and cigarette smoking

Frisch AS, Kurtz M, Shamsuddin K

J Adolesc, 1999 Oct;22(5):627-34.
PMID: 10527534 DOI: 10.1006/jado.1999.0258

A longitudinal study was conducted to determine changes in knowledge, attitudes and preventive efforts of Malaysian medical students concerning cigarette smoking and environmental exposure to tobacco smoke from their first pre-clinical year in medical school until their final clinical year. There were significant improvements in knowledge about cigarette smoking and in knowledge, attitudes and efforts concerning environmental exposure to tobacco smoke. Overall attitudes concerning cigarette smoking did not change over this period. The same pattern was found for male non-smokers. Women improved on all five scales; male smokers improved on none over the 3-year period. Male non-smokers had better scores on these scales than male smokers in both beginning and ending years. Women excelled in comparison to male non-smokers on smoking attitudes in the pre-clinical year and on all scales except preventive efforts in the final clinical year.Although medical students experienced no changes in the amount of pressures not to smoke from family and friends, there was a significant increase in the amount of prohibition on smoking from their teachers. Male non-smokers alone accounted for this increase. Women experienced more pressure than men not to smoke from their teachers in both years, but the male smokers and non-smokers did not differ in teacher pressure for either year.

MeSH terms: Adult; Female; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Male; Peer Group; Students, Medical*; Tobacco Smoke Pollution*
Molecular detection of enteroviruses from an outbreak of hand, foot and mouth disease in Malaysia in 1997

Abubakar S, Chee HY, Shafee N, Chua KB, Lam SK

Scand. J. Infect. Dis., 1999;31(4):331-5.
PMID: 10528868

Enterovirus 5'UTR sequences were detected by RT-PCR in 22 out of 47 suspected hand, foot and mouth disease (HFMD) patients during an outbreak of the disease with incidences of fatal brainstem encephalomyelitis in Malaysia in 1997. Genetic and phylogenetic analyses of the isolates 5'UTR sequences suggest the presence of predominantly enteroviruses with high sequence similarities to Echovirus 1 and Coxsackievirus A9 in the Malaysian peninsula. No fatal cases, however, were associated with these isolates. The remaining isolates, including all (4/4) isolates of the fatal cases from the Malaysian peninsula and Sarawak shared very high sequence identity with enterovirus 71MS (EV71). These findings suggest that several enteroviruses were circulating in Malaysia during the outbreak period, with only EV71 causing fatal infections.

MeSH terms: Base Sequence; Disease Outbreaks*; Enterovirus/classification; Enterovirus/isolation & purification*; Female; Hand, Foot and Mouth Disease/epidemiology*; Hand, Foot and Mouth Disease/virology*; Humans; Malaysia/epidemiology; Male; Molecular Sequence Data; Phylogeny; Sensitivity and Specificity; Reverse Transcriptase Polymerase Chain Reaction*
Malignant paraganglioma of frontoethmoidal region

Sharma HS, Madhavan M, Othman NH, Muhamad M, Abdullah JM

Auris Nasus Larynx, 1999 Oct;26(4):487-93.
PMID: 10530746

Nonchromaffin paragangliomas are unusual tumours arising from widely distributed paraganglionic tissues probably of neural crest origin. In the head and neck region they are usually seen as carotid body or jugulotympanic tumours. Other rarely reported sites in the head and neck region are the orbit, nose and larynx. This report deals with a case of sinonasal paraganglioma which was initially treated with surgery and radiotherapy. Twenty two years later the tumour recurred and showed a rapid growth due to malignant transformation which we believe is late effect of radiotherapy. The clinical features, histopathology and role of radiotherapy in sinonasal paragangliomas together with a review of the medical literature have been discussed.

MeSH terms: Adult; Combined Modality Therapy; Ethmoid Sinus/pathology*; Ethmoid Sinus/surgery; Frontal Sinus/pathology*; Frontal Sinus/surgery; Humans; Magnetic Resonance Imaging; Male; Paraganglioma/pathology*; Paraganglioma/therapy; Paranasal Sinus Neoplasms/pathology*; Paranasal Sinus Neoplasms/surgery; Tomography, X-Ray Computed; Fatal Outcome
Candida biotypes isolated from clinical specimens in Malaysia

Ng KP, Madasamy M, Saw TL, Baki A, He J, Soo-Hoo TS

Mycopathologia, 1999 10 26;144(3):135-40.
PMID: 10531679

The distribution of Candida species was examined using 1114 yeasts isolated from various clinical specimens. The isolates were identified by germ tube test, hyphal/pseudohyphae and chlamydoconidia production and carbohydrate assimilation test using ten carbohydrates (glucose, sucrose, trehalose, cellobiose, arabinose, galactose, mannitol, raffinose, lactose and maltose). Among the 1114 isolates studied, 9 species of Candida were identified and the relative frequency of isolation was C. albicans (44.2%), C. parapsilosis (26.0%), C. tropicalis (17.7%), C. glabrata (9.6%), C. krusei (1.2%), C. rugosa (0.6%), C. guilliermondii (0.2%), C. lusitaniae (0.08%) and C. kefyr (0.08%). Non-C. albicans was the most common Candida species isolated from blood, respiratory system, urine and skin. The isolate from vaginal swabs was predominantly C. albicans. 82.2% of C. glabrata and 64.2% of C. krusei isolated in this study were from vaginal swabs.

MeSH terms: Candida/classification*; Candida/growth & development; Candida/isolation & purification*; Candida albicans/classification; Candida albicans/growth & development; Candida albicans/isolation & purification; Candidiasis/microbiology; Female; Humans; Malaysia; Male; Mycology/methods; Species Specificity
A novel complex mutation of the OTC (ornithine transcarbamylase) gene in a Malaysian pedigree

Khoo AS, Balraj P, Rachedi A, Chin CN, Volpi L

Hum Mutat, 1999 Nov;14(5):448.
PMID: 10533073
MeSH terms: Humans; Infant, Newborn; Malaysia; Male; Molecular Sequence Data; Ornithine Carbamoyltransferase/genetics*; Polymerase Chain Reaction; Frameshift Mutation
Massive pleural effusions in cryptococcal meningitis

Wong CM, Lim KH, Liam CK

Postgrad Med J, 1999 May;75(883):297-8.
PMID: 10533638

Cryptococcal infection uncommonly presents with pulmonary manifestations and even more rarely so as massive bilateral effusions. Pleural involvement is usually associated with underlying pulmonary parenchymal lesions and is unusual while on antifungal therapy. We report a patient with cryptococcal meningitis who, while on intravenous 5-flucytosine and amphotericin B, developed life-threatening bilateral massive pleural effusions with evidence of spontaneous resolution, consistent with prior hypothesis of antigenic stimulation as the cause of pleural involvement.

MeSH terms: Adult; Amphotericin B/therapeutic use; Antifungal Agents/therapeutic use; Cryptococcosis; Female; Flucytosine/therapeutic use; Humans; Pleural Effusion/etiology*; Meningitis, Cryptococcal/complications*; Meningitis, Cryptococcal/drug therapy
Evaluation of the first international teleconference in ophthalmology

Papakostopoulos D, Williams A, Ramani V, Hart CJ, Dodson K, Papakostopoulos S

J Telemed Telecare, 1999;5 Suppl 1:S17-20.
PMID: 10534828

The First International Teleconference in Ophthalmology was held during March 1998 between five sites in the UK, USA, Greece and Malaysia. ISDN transmission at 128 kbit/s was used to reduce costs while maintaining the clarity of the presented material. Specialized lecture theatres were not available at all sites and conventional halls had to be adapted for videoconferencing. For this reason initial point-to-point testing was carried with Bristol to simplify problem solving. Thereafter, a multipoint bridge was used to connect all sites together. During the conference a number of individual presentations were given, all followed by extensive discussion periods. Special instructions were given beforehand on the production of slide material, with particular reference to font sizes and colour combinations. Full use was made of various presentation media, including slides, videos and live demonstrations. The conference was attended by over 500 delegates, all of whom were specialists in ophthalmology. The technology employed was ideal for teaching purposes. However, if used in a clinical field, it should be kept in mind that the choice of transmission rate makes certain features not easily apparent in images but they become clearer when pointed out by the presenter.

MeSH terms: Computer Communication Networks; Costs and Cost Analysis; Evaluation Studies as Topic; Great Britain; Greece; Humans; International Cooperation*; Malaysia; Ophthalmology/methods*; United States; Telemedicine/economics; Telemedicine/methods*
Geographical variation of the skull morphology of the common tree shrew (Tupaia glis)

Endo H, Cuisin J, Nadee N, Nabhitabhata J, Suyanto A, Kawamoto Y, et al.

J Vet Med Sci, 1999 Sep;61(9):1027-31.
PMID: 10535508

Geographical variation was examined morphologically in the common tree shrew (Tupaia glis) in some Indochinese and Malayan regions. Osteometrical examination and principal component analysis elucidated the morphological differences among various populations. The populations from southern and western Thailand were distinguished morphologically from the other populations. Variation in males from south Thailand and Kuala Lumpur suggests that the Isthmus of Kra may have an influence on the variation of skull morphology. However, the Isthmus of Kra was not completely considered as a factor of geographical separation in this species, because we could not confirm the separation in skull size and shape between the localities at least in females. While, the Kanchanaburi population in western Thailand was significantly smaller than the other population in skull size, and constituted the morphologically separable group in our study.

MeSH terms: Animals; Borneo; Female; Malaysia; Male; Skull/anatomy & histology*; Thailand; Tupaiidae/anatomy & histology*
Intrahepatic biloma: an unusual complication of cholangiocarcinoma treated endoscopically

Ranjeev P, Goh KL, Rosmawati M, Tan YM

Gastrointest Endosc, 1999 Nov;50(5):711-3.
PMID: 10536338
MeSH terms: Aged; Bile Duct Neoplasms/complications*; Bile Duct Neoplasms/therapy; Cholangiopancreatography, Endoscopic Retrograde; Female; Humans; Rupture, Spontaneous; Tomography, X-Ray Computed; Stents; Cholangiocarcinoma/complications*; Cholangiocarcinoma/therapy
Effect of rocuronium compared with succinylcholine on intraocular pressure during rapid sequence induction of anaesthesia

Chiu CL, Jaais F, Wang CY

Br J Anaesth, 1999 May;82(5):757-60.
PMID: 10536557

We have compared the effect of rocuronium and succinylcholine on intraocular pressure (IOP) during rapid sequence induction of anaesthesia using propofol and fentanyl, in a randomized double-blind study. We studied 30 adult patients, allocated to one of two groups. Anaesthesia was induced with fentanyl 2 micrograms kg-1 and propofol until loss of verbal response. This was followed by succinylcholine 1.5 mg kg-1 (group S; n = 15) or rocuronium 0.9 mg kg-1 (group R; n = 15). Laryngoscopy was performed 60 s later. IOP, mean arterial pressure (MAP) and heart rate (HR) were measured before induction, immediately before intubation and every minute after intubation for 5 min. A Keeler Pulsair air impulse tonometer was used to measure IOP and the mean of two readings obtained in the right eye at each measurement time was recorded. Intubating conditions were evaluated according to a simple scoring system. IOP in the succinylcholine group was significantly greater than that in the rocuronium group (mean 21.6 (SEM 1.4) mm Hg vs 13.3 (1.4) mm Hg; P < 0.001). Intubating conditions were equally good in both groups. We conclude that with rapid sequence induction of anaesthesia using propofol and fentanyl, rocuronium did not cause as great an increase in IOP as succinylcholine and may be an alternative in open eye injury cases.

MeSH terms: Adolescent; Adult; Androstanols/pharmacology*; Anesthesia, Intravenous; Blood Pressure/drug effects; Neuromuscular Nondepolarizing Agents/pharmacology*; Double-Blind Method; Female; Heart Rate/drug effects; Humans; Intraocular Pressure/drug effects*; Male; Middle Aged; Neuromuscular Depolarizing Agents/pharmacology*; Succinylcholine/pharmacology*
Transcatheter closure of multiple muscular ventricular septal defects using Gianturco coils

Latiff HA, Alwi M, Kandhavel G, Samion H, Zambahari R

Ann Thorac Surg, 1999 Oct;68(4):1400-1.
PMID: 10543517

A 10-month-old boy underwent operation to close a large secundum atrial septal defect and multiple muscular ventricular septal defects. Closure of the ventricular septal defects was unsuccessful and led to worsening cardiac failure and inability to wean the patient from mechanical ventilation. Transcatheter closure of the ventricular septal defects using Gianturco coils was undertaken. This technique is an effective alternative for closure of multiple muscular ventricular septal defects in infants and small children.

MeSH terms: Embolization, Therapeutic/instrumentation*; Cardiac Catheterization/instrumentation*; Heart Septal Defects, Ventricular/radiography; Heart Septal Defects, Ventricular/therapy*; Humans; Infant; Male; Postoperative Complications/radiography; Treatment Outcome
Anthraquinones from hedyotis herbacea

Permana D, Lajis NH, Othman AG, Ali AM, Aimi N, Kitajima M, et al.

J Nat Prod, 1999 Oct;62(10):1430-1.
PMID: 10543909

A new anthraquinone, 2-hydroxymethyl-10-hydroxy-1,4-anthraquinone (1), was isolated from Hedyotis herbacea along with three other known derivatives: 1,4-dihydroxy-2-hydroxymethylanthraquinone (2); 2, 3-dimethoxy-9-hydroxy-1,4-anthraquinone; and 1,4-dihydroxy-2, 3-dimethoxyanthraquinone. The structure of 1 was determined based on analysis of its spectroscopic data.

MeSH terms: Anthraquinones; Coloring Agents; Spectrum Analysis; Hedyotis
An outbreak of acute eosinophilic myositis attributed to human Sarcocystis parasitism

Arness MK, Brown JD, Dubey JP, Neafie RC, Granstrom DE

Am J Trop Med Hyg, 1999 Oct;61(4):548-53.
PMID: 10548287

Seven members of a 15-man U.S. military team that had operated in rural Malaysia developed an acute illness consisting of fever, myalgias, bronchospasm, fleeting pruritic rashes, transient lymphadenopathy, and subcutaneous nodules associated with eosinophilia, elevated erythrocyte sedimentation rate, and elevated levels of muscle creatinine kinase. Sarcocysts of an unidentified Sarcocystis species were found in skeletal muscle biopsies of the index case. Albendazole ameliorated symptoms in the index case; however, his symptoms persisted for more than 5 years. Symptoms in 5 other men were mild to moderate and self-limited, and 1 team member with laboratory abnormalities was asymptomatic. Of 8 team members tested for antibody to Sarcocystis, 6 were positive; of 4 with the eosinophilic myositis syndrome who were tested, all were positive. We attribute this outbreak of eosinophilic myositis to accidental tissue parasitism by Sarcocystis.

MeSH terms: Acute Disease; Adult; Alanine Transaminase/blood; Animals; Aspartate Aminotransferases/blood; Biopsy; Disease Outbreaks*; Eosinophilia/epidemiology; Eosinophilia/parasitology*; Eosinophilia/pathology; Erythrocyte Count; Humans; L-Lactate Dehydrogenase/blood; Malaysia/epidemiology; Male; Military Personnel*; Myositis/epidemiology; Myositis/parasitology*; Myositis/pathology; Recurrence; Rural Health; Sarcocystis/pathogenicity*; Sarcocystosis/epidemiology*; Sarcocystosis/pathology; United States; Cohort Studies; Muscle, Skeletal/parasitology*; Muscle, Skeletal/pathology; Parasitemia
Rapid serologic diagnosis of pediatric typhoid fever in an endemic area: a prospective comparative evaluation of two dot-enzyme immunoassays and the Widal test

Bhutta ZA, Mansurali N

Am J Trop Med Hyg, 1999 Oct;61(4):654-7.
PMID: 10548305

We evaluated the diagnostic sensitivity and specificity of two dot-enzyme-linked immunoassays (Typhidot and Typhidot-M; Malaysian Biodiagnostic Research SDN BHD, Kuala Lumpur, Malaysia), assessing IgG and IgM antibodies against the outer membrane protein (OMP) of Salmonella typhi, and the Widal test in comparison with blood culture in a consecutive group of children with suspected typhoid fever. Of 97 children with suspected typhoid fever, the disease was confirmed bacteriologically in 46 (47%), whereas 25 (26%) were considered to have typhoid fever on clinical grounds. An alternative diagnosis was made in 26 (27%). The Typhidot and Typhidot-M were superior to the Widal test in their diagnostic sensitivity and specificity, although values (sensitivity = 85-94% and specificity = 77-89%) were significantly lower than in other regional reports. The lower specificity of the Typhidot in our series may represent regional differences in the genomic structure and plasticity of the OMP of S. typhi and merits further evaluation of these tests in diverse geographic locations.

MeSH terms: Agglutination Tests; Antibodies, Bacterial/blood; Bacterial Outer Membrane Proteins/immunology; Child; Child, Preschool; Female; Humans; Immunoenzyme Techniques*; Male; Pakistan; Predictive Value of Tests; Prospective Studies; Reagent Kits, Diagnostic; Salmonella typhi/immunology; Salmonella typhi/isolation & purification*; Sensitivity and Specificity; Typhoid Fever/diagnosis*
Risk factors for early death in acute ischemic stroke and intracerebral hemorrhage: A prospective hospital-based study in Asia. Asian Acute Stroke Advisory Panel

Wong KS

Stroke, 1999 Nov;30(11):2326-30.
PMID: 10548666

BACKGROUND AND PURPOSE: In Asia, there has been no international study to investigate the risk factors for early death in patients with ischemic stroke and intracerebral hemorrhage.
METHODS: We conducted a prospective study of consecutive patients with acute stroke who were admitted to 36 participating hospitals in China, India, Indonesia, Korea, Malaysia, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. With the use of a simple identical data sheet, we recorded the demographics and cardiovascular risk factors of each patient. Early death was defined as death on discharge from the acute hospital.
RESULTS: We enrolled 2403 patients with ischemic stroke and 783 patients with intracerebral hemorrhage. Among patients with ischemic stroke, previous use of antiplatelet drugs (adjusted odds ratio [OR] 0.53; 95% confidence interval [CI] 0. 30 to 0.95) and relatively young age group 56 to 75 years (OR 0.65; 95% CI 0.42 to 1.00) were protective factors; atrial fibrillation (OR 2.23; 95% CI 1.40 to 3.57), ischemic heart disease (OR 2.03; 95% CI 1.37 to 3.05), diabetes (OR 1.52; 95% CI 1.04 to 2.22), and ex-smoker status (OR 2.18; 95% CI 1.18 to 4.05) were risk factors for early death. Among patients with intracerebral hemorrhage, hypertension (OR 0.56; 95% CI 0.38 to 0.82) and young age group 56 to 75 years old (OR 0.55; 95% CI 0.34 to 0.87) were associated with lower death rate, whereas diabetes (OR 1.74; 95% CI 1.01 to 2.98) was a risk factor for early death.
CONCLUSIONS: In Asian patients with stroke, previous use of antiplatelet drugs nearly halved the risk of early death in patients with ischemic stroke, whereas atrial fibrillation, ischemic heart disease, diabetes, and ex-smoker status were risk factors for early death. Among patients with intracerebral hemorrhage, diabetes was associated with early death, whereas young age group and hypertension were associated with lower death rates, though no clear explanation for the hypertension association could be discerned from the data available.

MeSH terms: Acute Disease; Age Factors; Asia, Southeastern/epidemiology; Atrial Fibrillation/epidemiology; Cerebral Hemorrhage/mortality*; Brain Ischemia/mortality*; China/epidemiology; Demography; Diabetes Mellitus/epidemiology; Female; Heart Diseases/epidemiology; Humans; Hypertension/epidemiology; India/epidemiology; Male; Middle Aged; Platelet Aggregation Inhibitors/therapeutic use; Prospective Studies; Risk Factors; Smoking/epidemiology; Confidence Intervals; Odds Ratio; Myocardial Ischemia/epidemiology; Stroke/mortality*
An unusual cause of antepartum haemorrhage

Soh EB, Lim JM

Aust N Z J Obstet Gynaecol, 1999 Aug;39(3):389-90.
PMID: 10554965

This is a rare case of antepartum haemorrhage arising from the nonpregnant uterus in a woman with uterine didelphys. The bleeding and subsequent passage of a decidual cast did not have any adverse effect on the ongoing pregnancy.

MeSH terms: Adult; Decidua; Female; Humans; Pregnancy; Pregnancy Complications/etiology*; Pregnancy Complications/therapy; Uterine Hemorrhage/etiology*; Uterine Hemorrhage/therapy; Uterus/abnormalities*; Vagina/abnormalities*
Seroprevalence of human herpesvirus-8 (HHV-8) in countries of Southeast Asia compared to the USA, the Caribbean and Africa

Ablashi D, Chatlynne L, Cooper H, Thomas D, Yadav M, Norhanom AW, et al.

Br. J. Cancer, 1999 Nov;81(5):893-7.
PMID: 10555764

Seroprevalence of HHV-8 has been studied in Malaysia, India, Sri Lanka, Thailand, Trinidad, Jamaica and the USA, in both healthy individuals and those infected with HIV. Seroprevalence was found to be low in these countries in both the healthy and the HIV-infected populations. This correlates with the fact that hardly any AIDS-related Kaposi's sarcoma has been reported in these countries. In contrast, the African countries of Ghana, Uganda and Zambia showed high seroprevalences in both healthy and HIV-infected populations. This suggests that human herpes virus-8 (HHV-8) may be either a recently introduced virus or one that has extremely low infectivity. Nasopharyngeal and oral carcinoma patients from Malaysia, Hong Kong and Sri Lanka who have very high EBV titres show that only 3/82 (3.7%) have antibody to HHV-8, demonstrating that there is little, if any, cross-reactivity between antibodies to these two gamma viruses.

MeSH terms: Adolescent; Adult; Africa/epidemiology; Aged; Aged, 80 and over; Burkitt Lymphoma/epidemiology; Child; Female; Herpesviridae Infections/epidemiology*; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms/epidemiology; Sarcoma, Kaposi/epidemiology*; United States/epidemiology; Seroepidemiologic Studies; Caribbean Region/epidemiology; Herpesvirus 8, Human/immunology*
Molecular epidemiology and evolution of enterovirus 71 strains isolated from 1970 to 1998

Brown BA, Oberste MS, Alexander JP, Kennett ML, Pallansch MA

J Virol, 1999 Dec;73(12):9969-75.
PMID: 10559310

Enterovirus 71 (EV71) (genus Enterovirus, family Picornaviridae), a common cause of hand, foot, and mouth disease (HFMD), may also cause severe neurological diseases, such as encephalitis and poliomyelitis-like paralysis. To examine the genetic diversity and rate of evolution of EV71, we have determined and analyzed complete VP1 sequences (891 nucleotides) for 113 EV71 strains isolated in the United States and five other countries from 1970 to 1998. Nucleotide sequence comparisons demonstrated three distinct EV71 genotypes, designated A, B, and C. The genetic variation within genotypes (12% or fewer nucleotide differences) was less than the variation between genotypes (16.5 to 19.7%). Strains of all three genotypes were at least 94% identical to one another in deduced amino acid sequence. The EV71 prototype strain, BrCr-CA-70, isolated in California in 1970, is the sole member of genotype A. Strains isolated in the United States and Australia during the period from 1972 to 1988, a 1994 Colombian isolate, and isolates from a large HFMD outbreak in Malaysia in 1997 are all members of genotype B. Although strains of genotype B continue to circulate in other parts of the world, none have been isolated in the United States since 1988. Genotype C contains strains isolated in 1985 or later in the United States, Canada, Australia, and the Republic of China. The annual rate of evolution within both the B and C genotypes was estimated to be approximately 1.35 x 10(-2) substitutions per nucleotide and is similar to the rate observed for poliovirus. The results indicate that EV71 is a genetically diverse, rapidly evolving virus. Its worldwide circulation and potential to cause severe disease underscore the need for additional surveillance and improved methods to identify EV71 in human disease.

MeSH terms: Amino Acid Sequence; Base Sequence; Disease Outbreaks*; DNA, Viral; Enterovirus/classification; Enterovirus/genetics*; Enterovirus/isolation & purification; Hand, Foot and Mouth Disease/epidemiology*; Hand, Foot and Mouth Disease/virology*; Humans; Molecular Sequence Data; Sequence Homology, Nucleic Acid; United States/epidemiology; Sequence Homology, Amino Acid; Molecular Epidemiology; Evolution, Molecular*; Capsid Proteins

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