Fifteen term babies born to 12 HIV-1 antibody positive Filipino CSW have been m onitored for signs and sym ptom s of HIV-1 infection. Eleven babies were enrolled in the study within the first 6 months after birth; 4 others were enrolled at 4, 9, 11 and 21 months of age respectively. Every 3 months after enrolm ent, each baby received a physical examination, serum was tested for HIV-1 antibodies and p24 antigen and peripheral blood mononuclear cells were cultured for isolation of virus. After a m ean follow-up period of 39.3 months (range 7-72 months), virus isolation and serum p24 antigen assays confirmed that 2 babies have been infected with HIV1. If the 4 babies less than 18 months of age were excluded, the vertical transmission rate was 18.2%. Seven babies who have been monitored for a minim um of 25 months (range 31-60 m onths) lost their maternal antibodies but 6 of them subsequently developed indeterm inant Western blots (WB); reactivity to p24 and/or gp120/160 but no reactivity to gp41. Of the remaining 6 babies, still less than 25 months of age (range 7-24 months), 2 lost their maternal antibodies within one year. The other 4 continued to recognize either p24 or gp120/160 well after the accepted 15-month period for loss of maternal antibody. Although a diagnosis could not be established upon the basis of these laboratory findings, clinical observations (failure to thrive, anergy, persistent generalized lymphadenopathy and recurrent pneumonias) mimicked HIV-1 infection. However, because these clinical features are common among m any babies in the developing world, their usefulness in supporting a diagnosis of perinatal HIV-1 infection is limited.

Fish from lagoons in Northern Luzon, Philippines, have been shown experimentally to be intermediate hosts of Capillaria philippinensis. Eggs ingested by the fish hatch in the intestines and the larvae double in size in 3 weeks. When fed to monkeys, Mongolian gerbils and birds, the larvae develop into adults and reproduce. Fish from the lagoons or purchased from the market were fed to gerbils and the animals developed patent infections, demonstrating natural transmission of the parasite. Philippine and Thailand populations have the habit of eating uncooked freshwater and brackish water fish and some have been experimentally infected with C. philippinensis. These countries report the largest number of cases of intestinal capillariasis. Fish-eating birds are now considered natural hosts for the parasite, fish the intermediate hosts, and humans accidentally become infected by eating infected fish.

Annual surveillance studies were initiated in 1985 to determine the incidence and prevalence of HIV-1 infection in female prostitutes registered through the Social Hygiene Clinic System of the Philippine Department of Health. All of the confirmed HIV-1 seropositive women detected in the above surveys who could be contacted were followed up about every three months to monitor their clinical and immunological status. Since we regularly interviewed and examined these HIV-1 seropositive women, we were able to note the occurrence of pregnancies following HIV diagnosis. By September 1990, 54 HIV-1 seropositive women (aged 18-35) detected from the above surveys had been interviewed and examined. Twenty-six of these HIV-1 positive women had a total of 37 pregnancies. Eight were pregnant at the time of HIV diagnosis: three term deliveries, one premature delivery (PD) at eight months, three abortions, and one lost to follow-up while still pregnant. Five of these eight had repeat pregnancies: two term deliveries, two abortions, and one lost to follow-up while pregnant. Eighteen other women became pregnant one or more times after HIV diagnosis: seven term deliveries, 13 abortions, two PDs, one ectopic pregnancy terminated, one currently pregnant, and one lost to follow-up during pregnancy. There was no clear indication from clinical examinations and CD4+ cell counts that pregnancy exacerbated the course of HIV-1 related disease in these women. One of the 12 term infants has died and eight have developed non-specific findings that are suggestive but not diagnostic of HIV infection.2+ strongly seropositive by both ELISA and Western blot assay at 16 months.

Between 1985 and 1987, examinations for human immune deficiency virus (HIV) antibody were done on 25,392 prostitutes working in 64 cities throughout the Philippines. The country-wide seropositivity rate among prostitutes based on this sample was 0.8/1,000. Of the HIV cases, 85% were working in just two cities whose prostitute populations comprised 50% of the total sample. The average incidence rate for the same two cities after 1 year was 2.3/1,000. HIV antibody-positive women were enrolled in a case-control study to determine demographic and epidemiologic risk factors. This study involving 34 HIV-positive prostitutes and 61 randomly selected negative control prostitutes did not reveal any risk factors related to sexual or other types of behavior. A history of genital warts, a history of abnormal vaginal discharge, and cytomegalovirus antibody were significantly more frequent in the HIV-positive cases than in the controls; however, by logistic regression analysis, only an abnormal vaginal discharge was independently associated with HIV infection. Absence of any evidence of transmission by blood transfusion or i.v. drug abuse suggests that HIV was introduced by the heterosexual route.

A study of female prostitutes in Manila who tested positive for human immunodeficiency virus (HIV) antibody ascertained demographic and sexual behavior information following diagnosis. Counselling alone did not appear to have a major impact on the sexual behavior of the HIV positive women since most continued to work as prostitutes. Switching from high risk to low risk jobs in bars is not effective in preventing HIV positive women from engaging in prostitution. Revoking work permits is only effective if enforced with adequate follow up. Alternative job training programs may offer a viable approach.

In the Philippines a total of 46 female prostitutes were found seropositive for the antibodies of HIV as of July 31 1987. A total of 53376 tests were performed among these women and repeated positive tests by enzyme-linked immunosorbent assay (ELISA) were confirmed by the Western blot test. 40 of the cases were found in the Angeles City and Olongapo areas adjacent to military bases and they were detected from among 34998 blood examinations for an overall HIV antibody positivity rate of 1.1/1000. In the MetroManila area 4 prostitutes were found positive from among 10549 tested yielding an antibody positivity rate of 0.4/1000. The Department of Health tested 867 male homosexuals and found only 1 individual seropositive. 3 other infections were reported by private sources 2 of them in male homosexuals. No infection was detected in 3200 blood donors or in 12000 overseas workers. A total of 9 cases of AIDS were reported and all contracted the disease abroad. 7 were Filipinos: 4 homosexual/bisexual men 1 elderly woman got it via blood transfusion and 2 other undisclosed persons. The Philippines AIDS control plan for the period from July 1987 to December 1990 estimated about 500 cases of HIV infection in 1987 which could progress to 150 cases of AIDS by 1992. A total of 4000 cases of HIV infection by 1990 could result in approximately 1000 cases of AIDS by 1995. The AIDS Committee projected 300 cases by 1990. The strategy of AIDS control is to block the 3 main routes of transmission: sexual activity contaminated blood supply and infected mother to child. Control activities concern surveillance (high-risk behavior groups during the next 3 years) and laboratory testing education personnel development (counseling clinical management research) and organization of local AIDS committees in Angeles City Olongapo and Manila.

Albendazole or Zentel a benzimidazole derivative, was used to treat intestinal capillariasis in hospitalized patients seen in Northern Luzon in the Philippines. In initial studies, four patients responded satisfactorily to the drug in dosages of 400 mg/day in divided doses for 20 days. This is the same dosage used for mebendazole, which has been the drug of choice in treating the parasitosis. In further studies, 16 patients with Capillaria philippinensis, were treated with 400 mg/day of the drug for 10 days, and 15 were completely cured. The one treatment failure was found to be passing eggs of the parasite three months later, and was retreated with the standard mebendazole regimen of 400 mg/day for 20 days. Side effects attributed to albendazole were not reported in any of the patients. Albendazole, 400 mg/day in two divided doses, is now the recommended drug of choice in Northern Luzon in the Philippines.

Vaginal specimens obtained from 1,284 hospitality girls and 87 expectant mothers were examined for Trichomonas vaginalis by first examining material collected from vaginal swabs and after incubation in Feinberg and Whittington culture medium. Twenty-four percent of the specimens examined, shortly after the cotton-tip swab was placed into 1 ml culture medium, were positive by direct microscopic examination and 37% positive following 3 to 5 days incubation at 37 degrees C. Only 3 of the specimens from mothers were positive after the first examination and 4 positive after culture. These high prevalence rates are expected among hospitality girls and are the highest rates thus far reported from the Philippines. These results provide convincing evidence of the value of using cultural methods in determining prevalence rates for Trichomonas vaginalis infections in females.

Leptospirosis was first isolated in the Philippines from one of the human cases of Weil's Disease in 1932 and from then up to 1970 a total of 65 cases were studied sporadically. From 1971 up to 1973 a total of 390 cases were studied out of which 82 (21.02%) were found positive by isolation and serological examination. An outbreak of leptospirosis was followed up from 1976 to 1983 in a penal farm in Sablayan, Mindoro. At the time of the outbreak, 31% of the sera from patients and those with complaints reacted to one or more antigen pools with 40% of these reactors reacting to only one antigen pool. Only one percent of prisoners and residents without complaints reacted to one or more antigen pools, with 80% of these reactors reacting to pool 3 alone. Three and half years later, a first follow-up was done in which 9.07% reacted to one or more pools. Of these, 42% reacted to pool 2 and 82% to pool 3 alone or in combination with other pool. Ninety five percent of those reacting to Pool 2 reacted to L. pyrogenes and 88% of those that reacted to Pool 3 reacted to L. autumnalis. More than three years later after the first follow-up, a second follow up was done. This time 2.29% reacted to one or more pools. Most reacted specifically to L. autumnalis. The residents outside the penal farm were all non-reactive. Sampling from another penal colony and in four agricultural areas revealed no significant reactivity.(ABSTRACT TRUNCATED AT 250 WORDS)

The sera of 5,684 pregnant women were tested for HBsAG and 432 (7·6%) were found positive. Positive HBsAG sera were then tested for the e antigen and of 413 tested, 115 or 27·8% were positive. The over-all prevalence rate of e antigen was 2·03%. All women were asymptomatic. Six of 13 HBsAG-HBeAg-positive mothers delivered infants who became HBsAg-positive within two years of age for a rate of 46%. The findings support earlier studies on the importance of the e antigen as an index of perinatal transmission. Also, they support evidence of unusually high rates of transmission among Asian ethnic groups.

Etude de la prevalence de l'antigene Hbs Ag des anticorps. Etude du virus de l'hepatite B et de l'hepatome. Etude des marqueurs epidemiologiques de Hbs Ag et Hbe Ag chez les femmes enceintes. Taux de positivite de Hbs Ag au cours de la schistosomiase. Resolution des problemes

Attempts to reduce the standard treatment of intestinal capillariasis of 200 mg mebendazole twice daily for 20 days were not successful. Two of 13 patients given mebendazole at single daily dosages of 500 mg per day for 16 days relapsed 3 to 6 months after treatment. Attempts to reduce the treatment to 14 days were even less satisfactory in that 4 of 8 patients treated experienced relapses 2 to 9 months later. Since intestinal capillariasis can be fatal it is recommended to continue the use of the standard schedule of 400 mg mebendazole daily for 20 days for new cases and 30 days for relapsed cases until a more effective drug is available.

Capillaria philippinensis larvae from fish and adult and larval forms of the parasite from gerbil intestines established parent infections when given a stomach tube to several species of birds from Taiwan. Adult males, oviparous and larviparous females and larval stages were found in Nycticorax nycticorax, Bubulcus ibis, Ixobrychus sinensis, Gallinula chloropus and Amaurornis phoenicurus. C. philippinensis also developed in pigeons, Rostratula benghalensis, a few Anas spp. and chickens. Some birds died of the infection while others recovered; most could not be re-infected after repeated exposure. Autoinfection also occurred in most birds. Eggs from an egret hatched and the larvae developed in fish intestines. This is the first group of animals indigenous to the endemic area that could be infected with C. philippinensis and although no naturally infected birds have been found in the area, fish-eating birds should be suspected as potential reservoir hosts. A fish-bird life-cycle is thought to be occurring throughout Asia but intestinal capillariasis is reported only in areas where the human population eats raw freshwater fish.

Japanese encephalitis virus was isolated from Culex tritaeniorhynchus, Culex bitaenorhynchus and Anopheles annularis mosquitoes collected from San Jose, Nueva Ecija, South Central Luzon in the Philippines. This is the second report of the isolation of the virus from mosquitoes in the Philippine Islands.

A total of 33,274 mosquitoes was collected from Tagudin, Ilocos Sur Province, Philippines during July 1977. Isolates made from one pool of Culex tritaeniorhynchus and one pool of C. vishnui were identified as Japanese encephalitis virus (JEV) by a micro-neutralization test using reference hyperimmune mouse ascitic fluids. This is the first known isolation of JEV from the Philippines.

A biomedical survey was carried out in North Samar Province, Philipines to update information on the prevalence of parasitic and other infectious diseases. A total of 1,394 stool specimens, 1,859 blood smears and 1,274 sera were collected from persons living in 8 barrios. Stools were examined for intestinal parasites, bloods smears for malaria and filariasis and sera tested for antibodies to Schistosoma japonicum, Entamoeba histolytica, Toxoplasma gondii, influenza A and B, and Japanese encephalitis virus. The prevalence rates for intestinal parasites were: Trichuris trichiura 90%, Ascaris lumbricoides 78%, hookworm 65%, Schistosoma japonicum 15%, Strongyloides stercoralis 1%, Entamoeba coli 16%, Endolimax nana 6%, entamoeba histolytica 5%, Giardia lamblia 3%, Entaemoeba hartmanii 1%, Chilomastix mesnili 1%. No malaria was found but microfilariae of Wuchereria bancrofti were detected in 4% of the blood smears; the MfD50 was 12.9. The circumoval precipitin test (COPT) was used to detect antibodies to Schistosoma japonicum and 65% of 994 sera was considered positive. The indirect hemagglutination test (IHA) was used for detecting antibodies to Entamoeba histolytica and Toxoplasma gondii and 5% and 3% of 1,274 sera tested were positive at titers equal to or greater than 1:128 and 1:256, respectively. Hemagglutination inhibition tests (HI) were used to detect antibodies to Influenza A2HK68, Influenza A2HK68, Influenza B2T62 and Japanese encephalitis virus and 72%, 12% and 78%, respectively, of 1201 sera were considered positive at titers equal to or greater than 1:20.

(1977). Amoebiasis and intestinal parasitic infections in a population on Cebu Island, the Philippines. Annals of Tropical Medicine & Parasitology: Vol. 71, No. 4, pp. 435-441.