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A patient with respiratory toxigenic diphtheria in Greece after more than 30 years
- T. Georgakopoulou, K. Tryfinopoulou, A. Doudoulakakis, F. Nikolaou, I. Magaziotou, A. Flountzi, N. K. Fry, D. J Litt, M. Damala, I. Spiliopoulou, E. Liatsi-Douvitsa, E. Lebessi, G. Panayiotakopoulos, M. Tsolia, G. Saroglou, M. Theodoridou, S. Tsiodras, A. Efstratiou
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- Journal:
- Epidemiology & Infection / Volume 148 / 2020
- Published online by Cambridge University Press:
- 28 October 2020, e274
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- Article
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The introduction of treatment and systematic vaccination has significantly reduced diphtheria mortality; however, toxigenic strains continue to circulate worldwide. The emergence of an indigenous diphtheria case with fatal outcome in Greece, after 30 years, raised challenges for laboratory confirmation, clinical and public health management. Toxigenic Corynebacterium diphtheriae was isolated from an incompletely vaccinated 8-year-old boy with underlying conditions. The child passed away due to respiratory distress syndrome, before the administration of diphtheria antitoxin (DAT). All close contacts in family, school and hospital settings were investigated. Pharyngeal swabs were obtained to determine asymptomatic carriage. Chemoprophylaxis was given for 7 days to all close contacts and a booster dose to those incompletely vaccinated. Testing revealed a classmate, belonging to a subpopulation group (Roma), and incompletely vaccinated, as an asymptomatic carrier with an indistinguishable toxigenic strain (same novel multilocus sequence type, designated ST698). This case highlights the role of asymptomatic carriage, as the entry of toxigenic strains into susceptible populations can put individuals and their environment at risk. Maintenance of high-level epidemiological and microbiological surveillance, implementation of systematic vaccination in children and adults with primary and booster doses, availability of a DAT stockpile, and allowing timely administration are the cornerstone to prevent similar incidents in the future.
Grain-filling patterns and nitrogen utilization efficiency of spelt (Triticum spelta) under Mediterranean conditions
- S. D. KOUTROUBAS, S. FOTIADIS, C. A. DAMALAS, M. PAPAGEORGIOU
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- Journal:
- The Journal of Agricultural Science / Volume 152 / Issue 5 / October 2014
- Published online by Cambridge University Press:
- 31 May 2013, pp. 716-730
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The identification of factors determining the adaptation and nitrogen (N) utilization of spelt wheat is important for the successful introduction of the crop to a new environment. The present study was carried out to investigate the relative importance of grain-filling rate and duration of grain growth and to analyse the nitrogen utilization efficiency (NUtE) and biomass production efficiency of spelt under Mediterranean conditions. The performance of spelt was evaluated in relation to a well-adapted bread wheat cultivar. Three spelt cultivars (Ressac, Poème and Cosmos) and one bread wheat cultivar (Centauro) were grown for two growing seasons on a silty clay soil under two N levels (0 and 100 kg N/ha). Grain-filling parameters were estimated using the cubic polynomial model. This model provided good fit to the grain-filling data of spelt cultivars, with high coefficients of determination (R2) that ranged from 0·868 to 0·999. Cultivar differences were found for all grain-filling parameters studied, and these differences accounted for most of the variation observed within each particular grain-filling component in both years. Grain filling of spelt plants took place under adverse environmental conditions, mainly high temperatures, which led to a shortening of the grain-filling period. This fact was not fully compensated by the increase in the grain-filling rate, and eventually resulted in a reduction of the final spelt grain weight. Selection for early-flowering cultivars could be a successful strategy to moderate the influence of the environment on grain filling and improve the adaptation of spelt under Mediterranean conditions. The mean grain-filling rate was positively correlated with dry matter translocation, suggesting the crucial role of reserve assimilates in the vegetative tissues for the grain growth of spelt. The efficiency of N utilization to produce biomass was greater during the grain-filling period than the vegetative period. Averaged across N application rates, NUtE in spelt ranged from 20·1 to 29·5 g grain/g plant N. Cultivar differences in NUtE were observed in both years. Grain yield per unit grain N (grain DM/grain total N at maturity) contributed more to the total variation in NUtE among spelt cultivars compared with N harvest index (NHI). Spelt showed lower NUtE values, probably due to its higher grain N concentration and lower NHI compared with wheat. Low straw N concentration at maturity may be an indicator of improved NUtE in spelt, as evidenced by the negative relationship detected between the two variables. These results provide a better understanding of factors related with the adaptation and N utilization of spelt under Mediterranean conditions.