Maternal TB is potentially dangerous for the fetus and newborn O

Maternal TB is potentially dangerous for the fetus and newborn. Only five well-matched comparative studies detailing perinatal effects of maternal TB could be identified worldwide. These comparative

studies from India,7,8 Mexico12,13 and Taiwan22 clearly suggested that infants born to tuberculous mothers are smaller than in healthy controls (Table 1). This is evident Ku-0059436 chemical structure by higher risks of low-birthweight (LBW) and small-for-gestational-age (SGA) babies in tuberculous mothers.46 The risks for prematurity, though inconsistent (a twofold rise in Indian7 and Mexican13 cohorts, but no change in Taiwan22), alone cannot explain birthweight reduction in women with TB. A significant birthweight reduction (215 g in pulmonary TB and 277 g in extrapulmonary TB in India, and 240 g in a combined group in Mexico) is most likely due to fetal growth restriction, which might have been superimposed on a higher prematurity rate.7,13 In our experience from northern India, pulmonary TB is associated with an approximately twofold increase in fetal distress during labor (relative risk [RR] 2.4; 95% confidence interval [CI] 1.2–4.7), and SGA (RR 2.6; 95%CI 1.4–4.6), preterm (RR 2.1;

95%CI 1.2–3.4), find protocol and LBW (RR 2.1; 95%CI 1.4–3.1) neonates when compared with the healthy controls.7 Similarly, extrapulmonary TB (except tuberculous lymphadenitis) is also associated with adverse perinatal outcomes.8 More importantly, perinatal mortality is approximately fivefold higher in both pulmonary and extrapulmonary TB.7,8,46 These perinatal effects were even more pronounced in cases with late diagnosis, incomplete or irregular drug treatment,

and in those with advanced pulmonary lesions.7 Therefore, antenatal and intrapartum care may be modified according to severity of disease, Sulfite dehydrogenase and associated obstetric complications. As incomplete and irregular treatment of TB remains a major challenge in pregnant women, any strategy to promote adherence to TB treatment requires overcoming barriers at three levels – health system, social and family, and personal levels.47 Removal of these barriers for pregnant women with TB remains a daunting task. In contrast, Tripathy and Tripathy reported overall good perinatal outcome among 111 women with pulmonary/extrapulmonary TB over a period of 16 years (1986–2001) from eastern India.9 Unfortunately, this study only had a 41% follow-up rate (original cohort of 271 patients). This might have introduced a bias, because the defaulters in the TB cohort could represent a relatively worse/severe spectrum of the disease and outcome. Furthermore, lack of follow up in the study was mostly attributed to non-compliance to medication and regular check-up, which has remained a major concern in South Asian countries.18 In this study, extreme prematurity, LBW, and neonatal mortality were more common among pregnant women with TB, who started treatment late in pregnancy.

All the primers used in this study are listed in Table 1 The vir

All the primers used in this study are listed in Table 1. The virulence of Xcc to cabbage was estimated after bacteria were introduced into the leaves by leaf clipping as described previously (Qian et al., 2005), and the lesion length was measured 14 days postinoculation. For measurements

of exopolysaccharide production, strains grown overnight in NYGB medium were washed and resuspended in 10 mM MgCl2 (OD600 nm=0.1). Aliquots (5 μL) of these bacterial suspensions were then added to 50 mL of TGM medium (1% tryptone, 0.5% yeast extract, 2% glycerol, 1% glucose, 0.07% K2HPO4 and 0.025% MgSO4·7H2O) Selleck NVP-BEZ235 and shaken for 48 h at 250 r.p.m. Exopolysaccharides were precipitated from culture supernatants by ethanol, dried and weighed as reported previously (Vojnov et al., 1998). Strains grown overnight in NYGB medium were washed and resuspended in 10 mM MgCl2 (OD600 nm=0.1). learn more To analyze swimming motility, 0.3% swimming agar TYGS (0.1% tryptone, 0.05% yeast extract, 0.1% NaCl and 1% glucose) plates were inoculated with 2-μL bacterial suspensions (OD600 nm=0.1) and incubated for 24 h. Agar (0.6%) plates were used to analyze swarming motility and were inoculated for 72 h. The diameters of the colony were measured 24 h or 72 h after incubation on swimming or swarming plates, respectively. The promoter of the gum gene cluster was

amplified by PCR using the primers listed in Table 1. The PCR product was cloned into pGEM-T Easy (Promega, Madison, WI) for sequence verification. It was then cloned into the upstream region of the βGUS (uidA) gene of the broad-host-range vector pL6GUS (Wang et al., 2007) digested with HindIII and BamHI. The plasmid was transformed into Xcc strain 8004 wild type and the ΔvemR mutant. The resulting strains were grown overnight in NYGB medium. Cells were collected by centrifugation and β-GUS

gene activity was assayed Gemcitabine as described elsewhere (Jefferson, 1987). The ability of Xcc to secrete extracellular enzymes was tested as described previously (Yang et al., 2009). Briefly, 2 μL of cells (OD600 nm=0.1) were inoculated onto NYGB plates containing skim milk (1%), starch (0.2%) or carboxymethylcellulose (0.5%) and incubated for 48 h. Protease activity was assessed by the appearance of clear zones surrounding the colonies on milk plates. Starch plates were stained with I2/KI (0.08 M/3.2 M) for 2 min, rinsed with water and clear zones were observed. Carboxymethylcellulose plates were stained with 0.1% Congo red for 5 min, rinsed with water and then washed twice with 1.0 M NaCl. To investigate whether VemR plays a role in Xcc pathogenesis, we created an in-frame deletion mutant ΔvemR in Xcc strain 8004. We then tested virulence in the ΔvemR mutant strain by measuring the lesion length by leaf clipping. The results showed that the ΔvemR mutant had significantly reduced virulence (Fig. 1b and c).

As an IVI antigen identified in a previous study using IVIAT meth

As an IVI antigen identified in a previous study using IVIAT method, the regulation of YncD expression usually can be induced in certain conditions encountered in vivo. In the genome of S. Typhi, the yncD gene is adjacent to the yncE gene but it has the opposite transcriptional orientation. The yncE gene is induced under iron restriction through the action of the global iron regulator Fur in E. coli; however, the regulator and the iron restriction did not affect the transcription of the yncD gene (McHugh et al., 2003). Upstream of the yncD gene, a possible PmrAB-box sequence, cattttcttaacttaat, was found, which indicated that the

expression of the yncD gene may be regulated by the PmrAB system (Marchal et al., Ivacaftor molecular weight 2004). In agreement with this anticipation, acidic pH, a main activation signal of the PmrAB system, was proved to induce the expression of yncD gene in the present study. The acid

condition is an ecological niche that pathogens usually encounter in vivo. Enteric pathogens share an oral route of infection (Gorden & Small, 1993; Maurer et al., 2005). During the initial infection, enteric bacteria PARP inhibition encounter low pH stresses in the human digestive tract (Drasar et al., 1969). Successful colonization requires survival through the stomach at pH 1–2 or the intestinal tract at pH 2–7 (Dressman et al., 1990). The bacteria respond to low pH stresses by regulating gene expression, which maintains internal pH homeostasis (Gorden & Small, 1993). Moreover, low pH is an important inducing factor of virulence genes as well. Low pH enhances the expression of numerous virulence factors, such as the ToxR-ToxT virulence regulon in Vibrio cholerae (Behari et al., 2001) and the phoP-phoQ regulon of Salmonella enterica (Bearson et al., 1998). It also enhances expression of genes for flagellar Epothilone B (EPO906, Patupilone) motility and catabolism (Maurer et al., 2005). Due to lack of information, the exact function of YncD remains unclear. However, our study showed that YncD plays a role

in the in vivo survival of S. Typhi. As the yncD gene knockout significantly reduces bacterial virulence and the attenuated strain shows an effective immunoprotection, the yncD gene is undoubtedly a good candidate gene for the construction of attenuated vaccine strains. This study was supported by the National Natural Science Foundation of China (Grant No. 30500435). We gratefully acknowledge Victor de Lorenzo of the Centro Nacional de Biotecnologia CSIC, Spain, for providing the Mini-Tn5 plasmid. K.X. and Z.C. contributed equally to this work. Please note: Wiley-Blackwell is not responsible for the content or functionality of any supporting materials supplied by the authors. Any queries (other than missing material) should be directed to the corresponding author for the article.

Unfortunately the authors did not report performance measures on

Unfortunately the authors did not report performance measures on the tasks, so the modulations of oscillatory

activity cannot be interpreted accordingly. Nonetheless, there is striking similarity between the physiological effects they report and those of the current study. The modulation of alpha-band activity over parieto-occipital scalp as a function of task switches vs. repeats has also been addressed in studies in which both tasks were performed on visual stimuli (i.e. within-modality). In one such study, for example, participants were free to choose which of a pair of tasks to perform on a set of geometric shapes (either a location or a color task; Poljac & Yeung, 2014). Performance measures made it clear that the location task Galunisertib proved easier in that participants were both faster and more accurate on this task. What these authors found was that alpha desynchronisations were equivalent preceding switches to both tasks, whereas there was a distinct increase in synchronisation preceding repeats of the easier location task, an effect not seen for repeats of the more challenging color task. Similar to the differences seen here for switch vs. repeat visual trials, these data suggest

that equally vigorous desynchronisations were employed to switch to each visual task, regardless of difficulty, but that once a switch had been made and the participants were ‘locked onto’ the task at hand, resources could be withdrawn from the Selleckchem GDC0068 easier location task. More vigorous alpha desynchronisations over

parieto-occipital scalp preceding switch vs. repeat trials in purely within-modality visual task-switching designs have now been reported by a number of groups (Sauseng et al., 2006). This issue of differential oscillatory suppression as a function of task difficulty was also recently addressed in a study in non-human primates (Buschman et al., 2012). Recording from prefrontal cortex, P-type ATPase monkeys were required to switch between performing a color discrimination task and a line orientation discrimination task. Saccadic RTs were significantly slowed by a switch away from the orientation task to the color task, but not vice versa. This pattern led Buschman and colleagues to consider the orientation task as ‘dominant’ over the color task. Performing the ‘non-dominant’ color task was accompanied by an increase in alpha coherence in neuronal populations showing selectivity for the orientation task, whereas performance of the dominant orientation task did not result in increased alpha coherence in neurons selective for the color task.

It will outline how, to move policy and practice forward, it is i

It will outline how, to move policy and practice forward, it is important that there is a good understanding of the pharmacy team, which allows working together effectively, for the

benefit of patients. Finally, regulation needs to be fit-for-purpose, supportive of practitioners in all sectors and enabling practice innovation. Research is not a lone activity, and undertaking high quality research which has the potential to inform and impact practice relies on working with a great team, and I have been fortunate to have worked with many truly inspirational http://www.selleckchem.com/products/ipilimumab.html colleagues. My research has particularly benefitted from working with not just pharmacists but many social scientists, who have challenged my perspective, approach or way of thinking. Furthermore, none of my research would have been possible without the pharmacists, pharmacy staff, students, and indeed patients who have participated by completing surveys, agreeing to be interviewed, observed or otherwise involved. Their views are what make practice research check details rich, insightful and relevant. (1) Schafheutle EI, David TJ, Hall J, Noyce PR, Silverthorne J, Tully MP (2009 January

23). MPharm Student Code of Conduct: A Literature Review. www.rpsgb.org/pdfs/ccpharmstudentslitrev.pdf (accessed 4 January 2011). (2) Schafheutle EI, David TJ, Hall J, Noyce PR, Silverthorne J, Tully MP (2009 January 23). Fitness to Practise Procedures for Pharmacy Students in UK Universities: A Literature Review. www.rpsgb.org/pdfs/studftpsoplitrev.pdf (accessed 11 June 2009 Jun 11). (3) Schafheutle EI, Hassell K, Ashcroft DM, Hall J, Harrison S. How do UK pharmacy students learn professionalism? Int J Pharm Pract 2012; 20: 118–128. (4) Schafheutle EI, Hassell K, Ashcroft N-acetylglucosamine-1-phosphate transferase DM, Harrison S. Organizational philosophy as a new perspective on understanding the learning of professionalism. Am J Pharm Educ 2013; 77: Article 214. (5) Elvey R, Hassell K, Lewis P, Schafheutle E, Willis S, Harrison S.

Patient-centred professionalism in pharmacy: values and behaviours. Journal of Health Organization and Management 2014 (in press). (6) Elvey R, Lewis P, Schafheutle EI, Willis S, Harrison S, Hassell K. Patient-Centred Professionalism Among Newly Registered Pharmacists. London: Pharmacy Practice Research Trust, 2011. (7) Jee S. The process of professional socialisation and development of professionalism during pre-registration training in pharmacy. The University of Manchester, 2014 (PhD Thesis). (8) Schafheutle EI, Jee SJ, Hassell K, Noyce PR. What could the NHS appraisal system contribute to revalidation in pharmacy? Pharm J 2011; 286: 82. (9) Jee SD, Jacobs S, Schafheutle EI, Elvey R, Hassell K, Noyce PR. An exploration of the utility of appraisals for the revalidation of pharmacy professionals in community pharmacy in Great Britain. Res Soc Admin Pharm 2013; 9: 155–165.

These are due to large conformational rearrangements of certain r

These are due to large conformational rearrangements of certain residues away from the packing interactions. A disruption of this hydrophobic packing would result in serious structural

consequences and thus prevent the correct folding of the molecule, affecting the toxin-inclusion formation, the resistance to proteases and a loss in protein activity. The poor accumulation of the two mutants in B. thuringiensis cells as typical crystals could be the reason for their accessibility to the endogenous proteases and thus their rapid degradation, especially in the case of Cry1Ac′3, which is rapidly converted to a 90-kDa stable form. Bacillus thuringiensis proteases were identified belonging to enzymes of the cysteine, metallo- and serine families (Oppert, 1999). Some researchers have described this type of endogenous protease activity on their mutants or recombinant proteins (Coux et al., 2001; Roh et al., 2004). Together selleck chemical with the toxicity data, structural investigation of the residues Y229 and F603 and their positions indicates a structural

and functional role for the two conserved residues. This work was supported by grants from the Ministère Antidiabetic Compound Library chemical structure de l’Enseignement Supérieur, de la Recherche Scientifique et de la Technologie. “
“The diversity of the equine fecal bacterial community was evaluated using pyrosequencing of 16S rRNA gene amplicons. Fecal samples were obtained from horses fed cool-season grass hay. Fecal bacteria were characterized by amplifying the V4 region of bacterial 16S rRNA gene. Of 5898 mean unique sequences, a mean of 1510 operational taxonomic units were identified in the four fecal samples. Equine fecal bacterial

richness was higher than that reported in humans, but lower than that reported in either cattle feces or soil. Bacterial classified sequences were assigned to 16 phyla, of which 10 were present in all samples. The largest number of reads belonged to Firmicutes (43.7% of total bacterial sequences), Verrucomicrobia (4.1%), Proteobacteria (3.8%), and Bacteroidetes (3.7%). The less abundant Actinobacteria, Cyanobacteria, and TM7 phyla presented here have not been previously described in the gut contents or feces of horses. Unclassified Urease sequences represented 38.1% of total bacterial sequences; therefore, the equine fecal microbiome diversity is likely greater than that described. This is the first study to characterize the fecal bacterial community in horses by the use of 16S rRNA gene amplicon pyrosequencing, expanding our knowledge of the fecal microbiota of forage-fed horses. The horse is a nonruminant herbivore where the hindgut (cecum and colon) is a fermentative chamber for a complex and dynamic microbial population. Gut microorganisms serve the host through energy extraction, immune stimulation, pathogen exclusion, and detoxification of toxic compounds.

For each strain, one cosmid carrying hiC6 was analyzed by physica

For each strain, one cosmid carrying hiC6 was analyzed by physical mapping and sequencing. For construction of physical maps,

cosmids were digested by single or double restriction enzymes, and the sizes of restricted fragments this website were calculated based on their migration distances in agarose gel electrophoresis. hiC6 genes were localized to restriction fragments by PCR. For sequencing of the hiC6 region in the NJ-7 cosmid, a library of 2–4 kb Sau3AI DNA fragments (partial digestion) was constructed by insertion into the BamHI site of pUC19. hiC6-containing subclones were selected by PCR screening and sequenced. The sequence of the NJ-7 hiC6 region was assembled from overlapping subclone sequences. With the reference of the NJ-7 sequence, XL184 research buy PCR fragments were generated for the hiC6 region of UTEX259 and sequenced. In addition, restriction fragments of this region in the UTEX259 cosmid were cloned and sequenced. The whole sequence of the UTEX259 hiC6 region was assembled from those of PCR and restriction fragments. In each case, the sequence was confirmed by

a series of PCRs using genomic DNA as the template. DNA sequences were deposited in the NCBI GenBank under accession numbers JF333588 (NJ-7 hiC6 genes) and JF333589 (UTEX259 hiC6 genes). Genomic DNA of C. vulgaris was extracted using the cetyltrimethylammonium bromide (CTAB) method (Murray & Thompson, 1980). A 10-μg aliquot of DNA was digested completely with one or two restriction enzymes. Separation of digested DNA with 0.7% agarose electrophoresis and capillary transfer of the separated DNA fragments onto Immobilon-Ny+ membrane (Millipore) were performed as standard methods (Sambrook et al., 1989). The digoxigenin (DIG)-labeled hiC6 probe for hybridization was prepared by PCR using hiC6-5 and hiC6-6 as primers and genomic DNA of NJ-7 as the template. Labeling,

hybridization and detection were performed with DIG High Prime DNA Labeling and Detection Starter Amisulpride kit I (Roche) according to the manufacturer’s recommendations. Total RNA was extracted using Trizol reagent (Invitrogen) from C. vulgaris strains according to manufacturer’s instructions, separated by agarose/formaldehyde gel electrophoresis and blotted onto Immobilon-Ny+ membranes by capillary transfer. The hiC6 transcripts were probed by a PCR-generated 322-bp fragment overlapping the 3′-end of hiC6-3/4 cDNA (nt.380-701) of NJ-7. NJ-7 and UTEX259 were grown at 20 °C for 7 days and exposed to 4 °C for 24 h. Total RNA extracted from the algal cells with or without exposure to 4 °C was treated with RNase-free DNase I to remove residual DNA until no DNA could be detected by PCR, and then converted into cDNA using M-MLV reverse transcriptase (Promega). The transcription of each hiC6 gene was shown with RT-PCR with gene-specific primers listed in Supporting Information, Table S1.

fatigans larvae collected from the drains around

Chirala

fatigans larvae collected from the drains around

Chirala in Andhra Pradesh, India (Rao & Mahajan, 1990). The standard strains of B. sphaericus, 1593 and 2362, were obtained from the Pasteur Institute, Paris, France. All bacterial cultures were maintained on a standard nutrient broth (NB) medium supplemented with 0.3% sugar cane molasses (NB medium). A single colony suspension was heat shocked at 80 °C for 12 min to synchronize the culture. This culture was first inoculated in a sterile 50 mL NB medium and incubated as a static culture at room temperature for 16 h. The 5% v/v inoculum from the static culture was transferred to 250 mL NB medium and incubated at 28±2 °C on a rotary shaker at 180 r.p.m. (Orbitek, Sciegenics, Chennai, India). The culture was harvested JAK pathway when it showed >90% sporulation as observed by phase-contrast microscopy

(Axioscop-40, Carl Zeiss, Göttingen, Germany). The culture usually reached a spore count of 1–2 × 109 spores mL−1 at the time of harvest. The pellet was washed twice with sterile-distilled water and lyophilized. The lyophilized powder was stored in an airtight container for further use. The cultures of Culex quinquefasciatus, Culex tritaeniorhynchus, Aedes aegypti and Aedes albopictus were maintained at 28±2 °C and 85% relative humidity in our laboratory. The adults were reared separately in closed cages and fed with a chicken bloodmeal. Eggs were collected and allowed to hatch in plastic bowls containing 1 L of tap water supplemented with 0.13 g of sterilized larval food (13 : 6 : 1 of wheat flour, chickpea flour and yeast extract) (Hadapad et al., 2008). Anti-infection Compound high throughput screening For all bioassays, third-instar larvae of the same age and size were used. The total viable counts (TVC) of all the strains were determined from lyophilized powder as described in Hire et al. (2006). Statistically significant differences between different means were calculated using Fisher’s least significant difference multiple comparison test (spss 12.0 for Windows). For preliminary screening

of the larvicidal activity, the stock suspensions of all B. sphaericus strains were prepared in sterile-distilled water and tested against the third-instar larvae of C. quinquefasciatus. Lck Different concentrations of all these strains, along with the control, were tested in 100 mL tap water containing 20 larvae in each beaker (150 mL), with four replications for each concentration. Based on the preliminary bioassay studies, ISPC-8 was found to be highly toxic and was hence selected to determine the spectrum of larvicidal activity against different mosquito species. The different concentrations of ISPC-8 were tested against third-instar larvae of C. tritaeniorhynchus, A. aegypti and A. albopictus. All the experiments were repeated three times on different days. The total larval mortality was scored after 48 h of treatment.

This finding is corroborated by the fact that the genome of A ni

This finding is corroborated by the fact that the genome of A. niger contains a locus (An16g04160; galE) with obvious similarity to other fungal galactokinases (Flipphi et al., 2009). Northern analysis performed with the respective gene as a probe showed that the gene was transcribed on all carbon sources investigated. Expression on d-galactose was higher than on d-glucose or glycerol, however, lower than on l-arabinose or d-xylose (Fig. 3a). The finding that galactokinase was active prompted us to study whether a full Leloir pathway is operating

in A. niger. In silico data revealed that the A. niger genome contains orthologs for each gene of this pathway (Flipphi et al., 2009). Expression studies showed that they are all expressed selleck screening library in a fashion similar to galactokinase, for example, transcripts Y-27632 mw were formed on all carbon sources studied, but their transcript levels were higher on pentoses (l-arabinose, d-xylose) and on d-galactose (Fig. 3a). The reason for the higher expression of Leloir pathway genes on l-arabinose and d-xylose than on d-galactose remains unclear at this point and will require further study. Most

notably, however, results obtained from conidiospores formed on glycerol or d-glucose showed that while all transcripts of the Leloir pathway genes were also present in conidiospores, galE (encoding a galactokinase) and galD (encoding an UTP-galactose-1-phosphate uridylyltransferase) were very poorly expressed (Fig. 3b), indicating that the potential to convert d-galactose into an intermediate of the EMP pathway may be dependent on the growth stage of the fungus. Aspergillus niger

has a prominent position amongst microorganisms employed in industrial biotechnology, thus it is not surprising that numerous studies have been devoted to its biology (Andersen et al., 2011). However, its metabolic relationship with d-galactose remained obscure, although this hexose is a major component of hemicelluloses and pectin, whose enzymatic hydrolysis is subject to considerable industrial interest. In this article, we have provided evidence that the d-galactose-negative Digestive enzyme phenotype of A. niger is growth stage dependent, being complete in the conidiospores but only partial in mycelia germinated on any other carbon source. This result required that a d-galactose transporter system needs to be present in A. niger. In the yeast Kluyveromyces lactis, d-galactose and lactose transport are mediated by the same protein (Baruffini et al., 2006), while in the related species A. nidulans, transport of these two sugars are independent (E. Fekete, M. Flipphi and L. Karaffa, unpublished data). Galactose permeases from A.

The basis

The basis LGK-974 nmr of travel medicine was to try to decrease the risks of disease and injury for individual travelers when visiting environments perceived as having excess health risks compared to the home country. Owing to economic growth in large parts of Asia, the number of outbound travelers from this region is dramatically increasing. In 1990, only 50 million Asians traveled abroad, while this number reached 100 million in the year 2000 and 190 million in 2010.[1] The outbound tourism growth rate among Asian travelers is the highest in

the world. Thus, travelers from Asia are becoming a major proportion of world tourism. In 1980 less than 10% of international travelers were from Asia. This proportion doubled in 2010 and it is expected to reach

30% in 2030, equal to 500 million.[1] So far, the concept of travel medicine is not well known in Asia among both travelers and health care professionals. Only 21% to 40% of Asian travelers sought pre-travel health information before their trip;[2-4] this proportion being far lower as compared to 60% to 80% in “Western” travelers.[5, 6] Recent evidence is even more concerning; only 4% of Chinese travelers who traveled to high malaria risk areas visited a travel clinic before their trip,[7] and only 5% of Japanese travelers who traveled to developing Vincristine in vitro countries received hepatitis A vaccine.[2] These rates were far lower than among European travelers.[6] Using the clinic directory of the International Society of

Travel Medicine (ISTM) as a crude indicator, very 3-mercaptopyruvate sulfurtransferase few travel medicine services have been established in Asia. While one travel clinic in North America serves 220,000 people, in Asia it may have to serve up to 45 million people. It should be noted that the European data are partly misleading, as many countries have highly developed national travel health associations and thus few travel clinic staff apply for membership in ISTM. However, this does not apply to North America, Australia, or Asia. There may be several reasons for the apparent lack of awareness and interest of travelers or health professionals in regard to travel health risks in Asia: The perception of risk. Pre-travel medicine in “Western” countries is mainly focused on diseases that may have become rare, have been eradicated or never existed in their home countries, but remain endemic in large parts of Asia, such as malaria, typhoid, hepatitis A, hepatitis B, dengue, rabies, and Japanese encephalitis (JE). Doctors and travelers from Asia who are familiar with these diseases usually consider that there is no additional risk for these diseases when traveling within Asia.