Miloslav Salavec

A repeated syphilis infection imported from Thailand in an HIV positive couple of men-who-have-sex-with-men in Czech Republic

Coinfection by HIV and syphilis has become a growing problem due to the re-appearance of unsafe sexual practices in the era of potent anti-retroviral drugs. We describe a repeated import of syphilis by a couple of men-who-have-sex-with-men from Thailand to Czech Republic likely due to non-adherence of the patients to physician recommendations. Such cases can become foci for dissemination of once locally rare infections and present a danger for the community.

GENOTYPING OF VARICELLA-ZOSTER VIRUS (VZV) WILD-TYPE STRAINS ISOLATED IN THE CZECH REPUBLIC

OBJECTIVES Monitoring of the varicella-zoster virus is becoming an important tool for analysis of the circulation of individual strains of VZV which differ not only at the genomic level, but show a variability in their clinical and epidemiological characteristics. Such data are not available on a large scale from the Czech population and could help understanding the epidemiological and evolutionary characteristics of the virus, as well as its potential for reinfection and increased pathogenesis in the population groups at higher risk for complications. The main aim of this study was detection and monitoring of wild-type or vaccine VZV strain isolates in the region of Eastern Bohemia and genotypic characterization of these isolates. MATERIAL A total of 273 clinical samples were obtained from patients exhibiting symptoms of varicella zoster virus (VZV) infection manifested as chickenpox or herpes zoster (HZ) treated in the Faculty Hospital of Charles University, Medical School in Hradec Kralove, Czech Republic. METHODS Characterization of individual short VZV DNA sequences was performed utilizing restriction fragment length polymorphisms (RFLPs), PCR and sequencing. Single nucleotide polymorphisms (SNP) in open reading frames (ORF) 21, 22 and 50 were used to identify individual VZV strains. RESULTS All clinical isolates (97 from varicella, 176 from herpes zoster) were VZV positive wild-type strains. Sequencing analysis showed that 89 isolates were of the European E1 genotype, 180 were of the European E2 genotype and 2 were identified as the Mosaic M1 strain. In addition, for the first time in this region two unusual genotypes were identified, both representing a combination of E1 and M2 strain specific SNPs. CONCLUSION Our prospective VZV genotyping study which is the first to monitor the VZV epidemiological situation in the Czech Republic using such a large set of clinical specimens, has provided valuable epidemiological data and identified two unique VZV recombinants.

EVIDENCE CELOROČNÍHO VÝSKYTU GENOTYPIZOVANÝCH DIVOKÝCH KMENŮ VARICELLA ZOSTER VIRU (VZV) U DĚTÍ A DOSPĚLÝCH V KLIMATICKÝCH PODMÍNKÁCH MÍRNÉHO PÁSU ČESKÉ REPUBLIKY

1 Katedra epidemiologie, Fakulta vojenského zdravotnictví, Univerzita obrany, Hradec Králové 2 Klinika nemocí kožních a pohlavních, Fakultní nemocnice Hradec Králové 3 Klinika infekčních nemocí, Lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Hradec Králové 4 Přírodovědecká fakulta, Univerzita Hradec Králové 5 Centrum pro základní a aplikovaný výzkum, Fakulta informatiky a managementu, Univerzita Hradec Králové 6 Katedra organizace vojenského zdravotnictví a managementu, Fakulta vojenského zdravotnictví, Univerzita obrany, Hradec Králové

AN UNUSUAL CASE OF MULTI-RECURRENT HERPES ZOSTER (HZ): A CASE REPORT

AIMS We report a case of multi-recurrent herpes zoster in a 53-year-old Caucasian woman treated repeatedly at the Faculty Hospital Hradec Kralove, Czech Republic over the years 2009 - 2011. METHODS Specific PCR methods targeting single nucleotide polymorphisms (SNPs) in open reading frames (ORF) 38, 54 and 62 were utilized to determine vaccine or wild type varicella-zoster (VZV) strains followed by SNPs analysis using two amplicons in ORF 22 and/or ORF 21/ORF 50. Additional genotyping in ORF 1, 6, 9 and 28 was subsequently performed due to the unusual results. RESULTS Three sets of clinical specimens from one patient (from hospital visits 2, 3 and 4) were analyzed and the presence of an unusual wild-type strain of VZV was discovered. The VZV strain isolated from the lesions bears a combination of markers characteristic both for Mosaic 2 (M2) and European 1 (E1) wild-type VZV strains. CONCLUSION This is the first report of atypical wild-type VZV strain circulating currently in Czech Republic.