156 Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
Results: Most of larval water types were man-made artificial
sites, and belonged to 10 water container or habitat categories
for different uses (average productivity: 83.9±103.6 larva/site,
5.4±7.4 pupa/site). SNPs and NJ analyses of single and concate-
nated marker sequences identified different molecular haplotypes
unique to Saudi Arabian Ae. aegypti populations and numerous hap-
lotypes shared with Ae. aegypti from other zoogeographic regions.
Microsatellite loci showed that Ae. aegypti from Saudi Arabia is most
closely-related to Asian populations, although they are genetically
distinct. These results indicate the presence of considerable genetic
variation among the studied Ae. aegypti populations from Saudi
Arabia and other world zoogeographic regions.
Conclusion: This is the first report on Ae. aegypti phylogenetics
from the Arabian Peninsula, the most eastern part of the Afrotrop-
ical zone, and bordering the Palaearctic and Oriental zones. These
results are important for better understanding of dengue trans-
mission and implementation of control programmes at both the
national and global levels.
http://dx.doi.org/10.1016/j.ijid.2016.11.380
20.197
First molecular identification of Dirofilaria spp.
(Onchocercidae) in mosquitoes from Serbia
K. Kurucz a , A. Kepner b , B. Krtinic c , B. Zana a , F.
Földes a , K. Banyai d , M. Oldal a , F. Jakab a,∗ , G.
Kemenesi a
a 1, 2000 and December 31, 2015 were enrolled. O. Tsutsugamushi
University of Pécs, Szentágothai Research Centre,
Virological Research Group, Pécs/HU
b University of Pécs, Institute of Biology, Faculty of
Sciences, Pécs/HU
c Ciklonizacija, Novi Sad/RS
d Hungarian Academy of Sciences, Centre for
Agricultural Research, Institute for Veterinary
Medical Research, Budapest/HU
Purpose: Dirofilariosis is a common and widespread veterinary
health issue in several European countries with notable zoonotic
potential. The causative agents are Dirofilaria immitis and Dirofi-
laria repens nematoda species which are transmitted by different
mosquito vectors. Similar to other mosquito-borne infections, the
knowledge about mosquito species involved in disease transmis-
sion is crucial for the complex understanding of local transmission
cycles.
Methods & Materials: Since there is no available data on
mosquito species, potentially involved in disease transmission
from Serbia, 6369 female mosquito individuals representing 11
species were retrospectively tested for Dirofilaria nematodes, col-
lected within the framework of a municipal mosquito monitoring
programme from 13 localities in Vojvodina province, Serbia, in
2013. After species identification by morphological taxonomic
keys, nucleic acid extractions from mosquito homogenates were
tested for Dirofilaria repens and Dirofilaria immitis using molecular
biological technics.
Results: Altogether, 8.33% of tested pools showed positivity,
composed of five mosquito species, mainly, Culex pipiens and Aedes
vexans the most abundant species of the area. Dirofilaria immitis
(80% of infected mosquitoes) and Dirofilaria repens (20%) were both
detected from multiple localities (n = 6, both urban and rural areas),
during the whole period of mosquito breeding season (from May to
August with a maximum rate in July), which provides the first data
on local transmission characteristics regarding mosquitoes from
the Balkans.
Conclusion: Since urban territories were found to be posi-
tive also, our results need to be concerned by veterinary and
human health professionals as well and call increased attention
to the importance of mosquito surveillance, particularly in human-
associated areas.
http://dx.doi.org/10.1016/j.ijid.2016.11.381
20.198
Meningitis and meningoencephalitis associated
with Orientia tsutsugamushi infection
H.S. Lee a,∗ , J.-S. Sunwoo b , S.-J. Ahn a , J. Moon a ,
J.-A. Lim a , J.-S. Jun a , W.-J. Lee a , S.-T. Lee a , S.K.
Lee a , K. Chu a
a Seoul National University Hospital, Neurology,
Seoul/KR
b Soonchunhyang University Seoul Hospital,
Neurology, Seoul/KR
Purpose: O. Tsutsugamushi is a rare entity of central ner-
vous system infection but can result in life-threatening conditions
and requires timely treatment. We investigated the clinical and
laboratory findings of patients with O. Tsutsugamushi-related
meningitis/meningoencephalitis and their outcome.
Methods & Materials: Patients diagnosed with meningi-
tis/meningoencephalitis who were admitted to the Department
of Neurology, Seoul National University, Korea, between January
infection was diagnosed with serologic testing. Clinical and labo-
ratory information was obtained by the electronic medical records
of Seoul National University Hospital.
Results: Sixteen cases were identified, of whom ten were diag-
nosed with meningitis and six with meningoencephalitis. Thirteen
patients (82%) had headaches and nine patients (56%) had fever,
though six out of the ten patients with meningitis only reported
headaches without febrile illness. Eschar was found in two of
the patients with meningoencephalitis but none in patients with
meningitis. Cerebrospinal fluid (CSF) WBC counts were higher in
patients with meningitis (mean ± S.E.M., 384.2 ± 132.8/•) than
in patients with meningoencephalitis (44.8 ± 36.0/•) (p-value =
0.020). Four out of the six patients with meningoencephalitis
showed no or mild (≤10/•) pleocytosis. One patient showed no WBC
in the CSF on the day of admission despite dysarthria and personal-
ity change occurred 6 days earlier but showed delayed pleocytosis
(16/•) 2 days after admission. Critical care was needed in 1 patient
due to hemorrhagic fever with renal syndrome accompanied with
scrub typhus. All patients were treated with doxycycline and recov-
ered to normal without significant neurologic deficits.
Conclusion: O. Tsutsugamushi should be suspected as an eti-
ology of meningitis/meningoencephalitis in endemic areas and
empirical treatment should be started on clinical suspicion despite
the lack of CSF pleocytosis, especially in cases of meningoencephali-
tis. Repeated CSF studied may show delayed pleocytosis supporting
the evidence of meningoencephalitis. A considerable proportion
of patients only reported headaches, therefore the lack of febrile
illness should not delay the diagnosis of meningitis. Neurologic
recovery is excellent with minor sequelae if treated rapidly and
systemic infection is well-controlled.
http://dx.doi.org/10.1016/j.ijid.2016.11.382