, 2003b; Shinkai, unpublished results). The results of the present study, which employed

both mono- and co-culture studies, strongly support this possibility. None of the S. ruminantium isolates could independently digest fiber as previously reported (Kingsley & Hoeniger, 1973; Scheifinger & Wolin, 1973), whereas the addition of S. ruminantium to a culture of F. succinogenes significantly improved fiber digestion with a concomitant increase in propionate production. This synergy GSK126 clinical trial could be caused by cross-feeding between the two species. Thus, F. succinogenes degrades cellulose to produce succinate and cello-oligosaccharides, while S. ruminantium decarboxylates succinate to propionate (Scheifinger & Wolin, 1973; Strobel HKI-272 research buy & Russell, 1991) and utilizes cello-oligosaccharides, some of which are known to function as feedback inhibitors of F. succinogenes cellulase (Huang & Forsberg, 1990; Maglione et al., 1997). More importantly, the extent of this synergy between F. succinogenes and S. ruminantium might depend on the phylotype of S. ruminantium, because clade I isolates were found to be more potent than clade II isolates in terms of increasing fiber digestion and propionate production. This result

could be explained by the superior ability of clade I isolates in succinate conversion, cello-oligosaccharide consumption or special niche formation, or by other unknown factors. It is therefore a priority to define the metabolic and ecologic advantages of clade I isolates that lead to their enhanced synergy with F. succinogenes compared with clade II isolates. This synergy between F. succinogenes and S. ruminantium this website for fiber digestion only occurred on orchardgrass hay and rice straw but not on alfalfa. Although the reason for this difference is not apparent, it may depend on structural and chemical differences between fiber sources such as grasses and legumes (Akin et al., 1993). Indeed, S. ruminantium has often been found in bacterial 16S rRNA gene clones retrieved from ruminally incubated orchardgrass hay but has never found in clones

retrieved from ruminally incubated alfalfa hay (Koike et al., 2003b). However, Fibrobacter and Treponema species may synergize for the digestion of alfalfa as described by Stanton & Canale-Parola (1980), because ruminally incubated alfalfa yields several clones that show high similarity with Treponema (Koike et al., 2003b). Overall, clades I may be better symbionts for F. succinogenes in terms of grass fiber digestion. The S137 isolate (clade I) showed the highest synergy with F. succinogenes, which is in good agreement with a previous report regarding combinations of S. ruminantium and R. flavefaciens (Sawanon & Kobayashi, 2006). Active decarboxylation of succinate to produce propionate, which was previously demonstrated for the combination of S. ruminantium and R.

In addition to virulence-related phenotypes, the presence of prophages

confers superinfection immunity to related phages. Pectobacterium atrosepticum (Pa– formerly Erwinia carotovora ssp. atroseptica) is an important potato pathogen, and due to the widespread cultivation of this food crop, Pa infections have significant EGFR inhibitor financial implications. In common with other soft rot bacteria, the primary virulence determinants are multiple, secreted plant cell wall-degrading enzymes, although a vast array of proteins contributes to maximal pathogenicity (Corbett et al., 2005; Pemberton et al., 2005; Liu et al., 2008). Disease progression is dependent on appropriate environmental conditions. For example, anaerobic conditions inhibit oxygen-dependent host resistance mechanisms, such as phytoalexin and free radical production, as well as cell wall lignification (Perombelon, 2002). Analysis of the Pa SCRI1043 genome KU-57788 clinical trial sequence indicated the presence of 17 horizontally acquired islands (HAIs) (Bell et al., 2004). Indeed, three-quarters of the

Pa coding sequences are shared by the animal-pathogenic enterobacteria, and the plant-specific lifestyle of Pa is thought to be due in large part to the presence of these islands (Toth et al., 2006). Two of the HAIs are complete prophages (named ECA29 and ECA41 – representing HAI-9 and HAI-17, respectively), and are the subject of this study. The other HAIs impact on bacterial physiology and virulence Cediranib (AZD2171) in multiple ways. HAI-5, for example, contains the rfb cluster, and a mutation in rfbI has been shown to result in altered lipopolysaccharide biosynthesis, reduced motility and decreased virulence (Evans et al., 2010). Mutants unable to synthesize the phytotoxin coronafacic acid (encoded on HAI-2) show markedly reduced disease on potato plants than the wild type (Bell et al., 2004). Erwinia tasmaniensis strain Et1/99

is a nonpathogenic epiphyte that is thought to compete with phytopathogenic bacteria, including other members of the Erwiniae. The 17 HAIs present in Pa are almost entirely absent from E. tasmaniensis (Kube et al., 2008). While not all virulence determinants are found on obvious HAIs (plant cell wall-degrading enzymes are not), this absence underscores the contribution of laterally transmitted genetic material to the evolution of pathogens. However, HAIs do not always play discernable roles in the virulence of phytopathogens. When two islands that encode Type III secretion systems in Erwinia amylovora were ablated, no attenuation in the ability of these strains to cause disease on pears was observed (Zhao et al., 2009). Of the 17 putative HAIs in Pa, the two prophages had not been investigated. In this study, we characterized these prophages and assessed their contribution to the pathogenicity of this economically important phytopathogen.

0, whereas the pKa values of most protein Cys-SH residues are higher than 8.0. Proteins such as cysteine proteases (e.g. caspases) are known to contain an essential Cys-SH with a low pKa at their active sites (Ischiropoulos, 1998), and are thus potential candidates for reversible oxidation by intracellularly generated H2O2 (Rhee, 1999). Interestingly, H2O2 exposure activated Xcg caspase-3 activity in vitro. Two sites of electron leakage lead to ROS formation in the mitochondrial electron transport chain (Blackstone et al., 2004): site 1 on complex I [NADH-ubiquinone oxidoreductase]

and site 2 at the interface between the mobile lipid-soluble carrier, ubiquinone, and complex III (ubiquinone-cytochrome c oxidoreductase). Leakage of electrons during ETC is considered

to be an important route of free radical generation selleck compound in obligate aerobic learn more organisms (Flecha & Demple, 1995). The uncoupler DNP was used in this study to examine this possibility. Uncouplers abolish the link between oxidation and phosphorylation, allowing electron transport to proceed without coupled ATP synthesis (Brand, 2000). DNP is a lipid-soluble weak acid that can cross the membrane barrier in both protonated and unprotonated form, and sets up a catalytic cycle that dissipates the proton-motive force and thus results in the decrease in ROS generation during ETC. At high proton-motive force, respiration slows; hence, electron would accumulate on ubiquinone instead of passing down the ETC to oxygen. This would increase the steady-state concentration of QH•, leading to an increase in the rate of ROS production (Brand, 2000). Interestingly, in the Xcg cells grown in PIM in the presence of DNP, no H2O2 could be detected by the scopoletin assay. Additionally, when Xcg cells were grown in PIM fortified with DNP, the cell survival was found to be increased by one log cycle. Thus, the free radical generation in PIM-growing Xcg cells seems to be mediated through the electron leakage during ETC. This could result in the formation

of Baricitinib superoxide radical (O2•−) upon incomplete reduction of oxygen, which could subsequently lead to the generation of other ROS such as H2O2 and the hydroxyl radical (OH•), eventually causing oxidative stress in the medium. Nalidixic acid, when used in sublethal concentrations, was found to inhibit PCD significantly. Nalidixic acid affects gyrase activity and could consequently reduce the rate of DNA replication and cell multiplication by maintaining DNA superhelicity. This ultimately may reduce the metabolic stress, leading to the inhibition of PCD (Crumplin & Smith, 1975; Syed, 1998). The role of gyrase in PCD has also been reported elsewhere (Hayes, 2003). Thus, while growing in a nutritionally rich PIM, Xcg cells acquire reducing potential, leading to the generation of ROS.

e. characterization of pMMO and sMMO, and acquisition and handling of copper by methanobactin. However, the recent findings of the large complement of c-type cytochromes in

M. capsulatus Bath, their unusual cellular surface localization, and copper-dependent expression and their putative roles in the copper homeostasis and metabolic flexibility, post-translational modifications (exemplified by the formation of kynurenine in MopE), open new fields of research on this model methanotroph. Importantly, searches for surface exposed c-type cytochromes in a broader range of methanotrophic bacteria may aid addressing these emerging questions. For example, is such redox active Small molecule library clinical trial surface enzymes important for cells to survive in methanotrophic communities distributed in several different redox conditions? Is the presence of such enzymes in methanotrophs linked to the bioavailability of copper, due to the likely limiting copper availability at lower redox conditions which may result in insoluble copper complexes? It has also been shown that c-type cytochromes are involved in the siderophore biosynthesis in other

bacteria (Yip et al., 2011), and it is at present an open question if such enzymes are involved in the maturation of methanobactin in M. capsulatus Bath. Furthermore, several protein families and proteins (e.g. cytochrome c553o family proteins, ‘MCA0445’, ‘MCA0446’ and ‘MCA0347’ and others) still appear to be unique to this bacterium and of unknown function. Importantly, several of these findings indicate a hitherto unrecognized plasticity of the metabolic pathways in M. capsulatus Bath. This plasticity may be essential to the bacterium to efficiently buy BMS-354825 adapt to a wide variety in copper conditions. In our opinion, many of these observations warrant further research, and have the potential to reveal unanticipated properties important to fully understand the biology and potentials of methanotrophy. This work was supported by the Norwegian Research Council (grant no. 101742). We would like to acknowledge Professor

Johan Lillehaug at the University of Bergen for interesting and useful discussions. “
“Methanotrophs this website are a group of phylogenetically diverse microorganisms characterized by their ability to utilize methane as their sole source of carbon and energy. Early studies suggested that growth on methane could be stimulated with the addition of some small organic acids, but initial efforts to find facultative methanotrophs, i.e., methanotrophs able to utilize compounds with carbon–carbon bonds as sole growth substrates were inconclusive. Recently, however, facultative methanotrophs in the genera Methylocella, Methylocapsa, and Methylocystis have been reported that can grow on acetate, as well as on larger organic acids or ethanol for some species. All identified facultative methanotrophs group within the Alphaproteobacteria and utilize the serine cycle for carbon assimilation from formaldehyde.

Therefore, the confirmation of ALA is based on laboratory diagnostic methods: serological tests are the most helpful especially in an emergency context, thanks to rapid and specific E histolytica antibody Angiogenesis inhibitor tests.[1, 4] A 27-year-old French male had returned 6 months

earlier from a 6-month journey through Nepal and had spent 6 months in Senegal 2 years previously. He was complaining of night and day sweats and lower-thoracic pain for the previous 7 days. His physical examination only revealed a body temperature of 37.5°C. Laboratory studies of blood showed elevated white blood cell (WBC) count, 35,000/μL (85% neutrophils), an inflammatory syndrome, and alkaline phosphatase level at 1.5 times the normal value. Blood culture remained sterile. An abdominal computerized tomography (CT) scan revealed a single hypodense

lesion in the right lobe of the liver (diameter 9.2 cm) consistent with a hepatic abscess. An amebic etiology was suspected, but latex agglutination test (LAT) (Bichro-Latex Amibe, Fumouze, Levallois-Perret, France) on serum was negative on day 1 (threshold at 1 : 5). The patient was given a first standard course of empiric intravenous antibiotherapy against pyogenic organisms and ameba: co-amoxiclav (3 g/day) and metronidazole (1.5 g/day). Because of risk of spontaneous rupture, drainage of the liver abscess was performed as an emergency (Figure 1). Microscopic examination of the chocolate brown aspiration fluid revealed neither cysts and trophozoites of Entamoeba check details oxyclozanide sp. nor bacteria after Gram coloration. Quantitative indirect hemagglutination assay test (IHAT) (Amibiase HAI, Fumouze)

and immunofluorescence assay test (IFAT) (Amoeba-Spot IF, bioMérieux) for the detection of antibodies to E histolytica were both positive: IHAT 1 : 640 (threshold at 1 : 320) and IFAT 1 : 640 (threshold at 1 : 160). The negative result with LAT was confirmed by a new analysis done with a new lot of the same kit and a prozone phenomenon was excluded. Serology was controlled on day 6. The results of serological tests on day 6 compared with day 1 in the same run were respectively 0 (day 1) and 1 : 20 (day 6) for LAT, 1 : 640 and >1 : 2560 for IHAT, and 1 : 320 and 1 : 640 for IFAT. The result of real-time polymerase chain reaction (PCR) to detect E histolytica DNA directly in pus was positive. Co-amoxiclav was stopped, metronidazole was maintained for 10 days and tiliquinol was added for 10 days. The patient left the hospital on day 7. Three weeks after his arrival in Tchad, a 45-year-old French male suffered from a sudden pain in the right hypochondrium, hyperthermia (40°C), and cholestatic jaundice. Abdominal ultrasound revealed a liver abscess compressing bile ducts. Empiric parenteral antibiotherapy was started (day 1): cefotaxim (3 g/day), gentamicin (200 mg/day), and metronidazole (1.5 g/day). On day 10, the patient was repatriated back to France.

This study highlights new roles of PP1 in regulating timing-dependent constraints on the expression of synaptic plasticity that may correlate with memory processes, and together PP1 and the spacing of stimulation protocols

provide mechanisms to regulate the expression of synaptic plasticity at CNS synapses. “
“Specialized hypothalamic neurons responding to rising extracellular glucose via increases or decreases in their electrical activity [glucose-excited (GE) and glucose-inhibited (GI) cells, respectively] have been reported in the hypothalamic arcuate, ventromedial and lateral nuclei. The hypothalamic paraventricular nucleus (PVN) is an important neurosecretory and preautonomic output Selleckchem GSK3 inhibitor nucleus. We tested whether parvocellular PVN neurons also possess glucosensing properties, using patch-clamp recording and immunocytochemistry. Putative neurosecretory (p-NS) and preautonomic (p-PA) cells were identified electrophysiologically. Although parvocellular neurons were insensitive to transitions

from 10 to 2.5 mm glucose, approximately 68% of p-PA cells responded directly to glucopenia (mimicked by a step to 0.2 mm glucose) with an increased membrane conductance. Of these, approximately FLT3 inhibitor 24% hyperpolarized (accompanied by an outward current) and thus were GE, approximately 26% depolarized (with an inward current, thus GI) and approximately 18% did not change membrane potential. The concentration dependence of the glucose response was similar for both GE and GI cells (EC50 of 0.67–0.7 mm), but was steep, with Hill slopes of 3–4. The KATP channel blockers glibenclamide and tolbutamide did not prevent, while the KATP channel opener diazoxide did not mimic, the effects of low glucose on GE neurons. Moreover, the KATP sulfonylurea receptor SUR1 was not

detected in glucosensitive neurons. We conclude that the PVN contains previously unknown Niclosamide GE and GI cells that could participate in regulation of autonomic functions. GE neurons in the PVN sense ambient glucose via a unique mechanism, probably independent of KATP channels, in contrast to neurons in other hypothalamic nuclei. “
“M6a is a neuronal membrane glycoprotein whose expression diminishes during chronic stress. M6a overexpression in rat primary hippocampal neurons induces the formation of filopodial protrusions that could be spine precursors. As the filopodium and spine motility has been associated with synaptogenesis, we analysed the motility of M6a-induced protrusions by time-lapse imaging. Our data demonstrate that the motile protrusions formed by the neurons overexpressing M6a were more abundant and moved faster than those formed in control cells.

7 years. Slightly over half (55.0%) of the patients were male. The prevalence of cardiovascular risk factors was relatively low (Table 1). The most common risk factors were low HDL (36.3%), abdominal obesity (30.6%) and hypercholesterolaemia (23.8%). The prevalence of high cardiovascular risk scores (≥10% risk of CHD in 10 years) was low (Table 1). This prevalence was 78 (9.9%), 16 (2.1%) and six (0.8%) by the Framingham, Rama-EGAT and D:A:D scoring systems, respectively. Only eight subjects (1.0%) had a history of CHD. The

mean CD4 count was 569 cells/μL. Most participants had HIV RNA<50 HIV-1 RNA copies/mL (90.2%) after a GSK-3 inhibition mean of 7.7 years of ART. Almost half (47.3%) had a history of lipodystrophy and almost two-thirds (63.2%) had a history of d4T use. Mean duration since HIV diagnosis was 10.0 years. Bland–Altman plots revealed that the Framingham equation predicted higher CHD risk as compared with the Rama-EGAT and D:A:D equations (Fig. 1a and b). On average, the Framingham risk score was 1.4% (SD 3.9%) higher than the Rama-EGAT score TSA HDAC price and 1.5% (SD 3.7%) higher than

the D:A:D score. The limits of agreement showed that the Framingham score could be as high as 9.1% above or as low as 6.4% below the Rama-EGAT score, and as high as 8.9% above or as low as 5.9% below the D:A:D score. The 95% confidence limits (i.e. upper and lower values of the 95% confidence intervals for the limits of agreement) were −9.5% and 6.9% for the Rama-EGAT Benzatropine and −9.4% and 6.4% for the D:A:D, when each was compared with the Framingham. The Bland–Altman plot comparing the D:A:D and Rama-EGAT equations (Fig. 1c) demonstrated better agreement between these two scoring systems. The average difference was smaller (−0.16%) and limits of agreement narrower (−3.9% and 3.6% with 95% confidence limits −4.1% and 3.8%). Differences among all three risk scores were most pronounced for subjects with higher average risk scores. No HIV-related variables were significantly associated with a high Rama-EGAT score, except for history of d4T use, which reached marginal significance (χ2df=1=4.0, P=0.047). Longer ART duration (χ2df=1=8.4, P=0.015) and current viral suppression (χ2df=1=7.1, P=0.008) were significantly associated

with a high Framingham score in the univariate analysis, but lost statistical significance in the multivariate analysis (Wald P>0.05). In terms of missing data, only 2.3% of subjects had missing Rama-EGAT or D:A:D risk scores, while 100% of subjects had Framingham risk scores calculated. Overall, 30.7% of subjects were missing some data, mostly duration since HIV diagnosis (19.9%), ART duration (4.1%) and family history data (3.9%). However, in a sensitivity analysis there were no significant differences in average risk scores of subjects with complete vs. missing data (data not shown). In this cohort of Thai subjects with stable HIV infection on long-term ART, we found low overall cardiovascular risk, as predicted by the Framingham, Rama-EGAT and D:A:D risk equations.

3; Table 3). The anterior intraparietal sulcus

is a core component of the putative human mirror neuron system (Grafton & Hamilton, 2007). It is thought to contribute to the understanding of ‘immediate’ action goals, such as grasping to eat vs. to place in macaque monkeys (Fogassi et al., 2005), or taking a cookie vs. a diskette in humans (Hamilton & Grafton, 2006). In monkeys, the anterior bank of the intraparietal sulcus changes its connectivity and response patterns when the animals train to use tools (Hihara et al., 2006), enabling an integration of visual and somatosensory stimuli. This is argued to support tool use see more through assimilation of the tool into the monkey’s body schema (Maravita & Iriki, 2004), such that ‘tools become hands’ (Umiltàet al., 2008). However, human left anterior inferior parietal check details lobule displays a specific response to observed tool use (as opposed to unassisted manual prehension) that is absent in monkeys (Peeters et al., 2009). This suggests that hominoid anterior inferior parietal cortex may be evolutionarily derived

to play a new role in coding the distinct functional properties of hand-held tools (Johnson-Frey et al., 2005; Peeters et al., 2009; Jacobs et al., 2010; Povinelli et al., 2010). The centre of anterior inferior parietal cortex activation reported here is somewhat posterior (−50, −36, 42 vs. −52, −26, 34) to that of Peeters et al. (2009); however, extraction of the volume of interest used by Peeters et al. (coordinates from Orban, pers. comm.) confirms that the same effect of stimulus is indeed present in this region. This response to increasingly complex Paleolithic toolmaking is consistent with the hypothesis that human technological evolution was supported, at least in part, by the emergence of enhanced neural mechanisms for representing the causal properties of hand-held tools (Johnson-Frey, 2003; Wolpert, 2003; Peeters Bumetanide et al., 2009). The main effect in the prefrontal cortex was centred on the inferior frontal sulcus. In macaques, this region is heavily interconnected with the anterior

inferior parietal lobule (Pandya & Seltzer, 1982) and the parietal operculum (Preuss & Goldman-Rakic, 1989), in keeping with the co-activation observed here, and suggesting involvement in the integration of visuospatial and somatosensory information. In an fMRI study with macaques, there was activation in this area during the observation of actions (Nelissen et al., 2005). In contrast to more the posterior premotor cortex (F5c) where mirror neurons were originally recorded, the ventral prefrontal cortex also responded to abstract or context-free stimuli, including isolated hands, robotic hands and shapes (Nelissen et al., 2005), indicating representation and integration of actions at a relatively high level.

These cases were communicated by A.A. Movsesyants, Head of Rabies Department at the

L. A. Tarassevich State Research Institute for Standardization and Control of Medical Biological Preparations in Moscow, Russian Federation. Three of these patients were bitten by stray or aggressive domestic dogs, and one was bitten by a fox. Exposures occurred in the Ukraine, Azerbaijan, Kazakhstan, or Kyrgyzstan. None of the Ion Channel Ligand Library screening male Russian patients, age 21 to 58 y, sought medical attention and all died (Table 1). An 11-y-old boy from Georgia, as described by PROMED, who received post-exposure prophylaxis after being bitten by a dog in Azerbaijan, died later in Georgia, probably because of an inappropriate interval between exposure and treatment. Based on literature review and personal communications,

we collected the most complete set of reports of imported rabies cases available to date. We reviewed 42 human deaths due to imported rabies, which we defined as rabies that was contracted outside the country where death occurred. We found that the risk for an individual traveler to contract rabies was small relative to the number of people traveling to such areas. For example, over 45 million international travelers went to Africa mTOR inhibitor in 2009.40 We report 14 fatalities in travelers to Africa; however, there may be substantial underreporting. Interestingly, we only found published cases that had occurred in the United States, Europe, and Japan, countries where scientific

publishing is very common. Of the 14 fatalities from Africa, 13 travelers came from Europe and 1 from the United States. To determine whether more human rabies cases occur in travelers within Asia or Africa would require further investigation by other means. Given that once symptoms of rabies are evident, the disease is expected to be fatal in virtually all cases, it is important to consider rabies prophylaxis and vaccination as a vital preparation Oxymatrine to ensure the safety of those planning to visit areas with high rabies incidence.1,2,8–12 A striking finding in this review of cases was that in 38 of the 39 cases where the animal cause of rabies was known or strongly suspected, the patient had exposure to a member of the family Canidae.13–38 Given that contact with dogs is known to represent the highest risk for contracting rabies in humans, this finding is not surprising.1,2,8 Travelers to areas with a high prevalence of rabies in the animal population should be cautious when approaching dogs, including puppies. Healthcare providers should be trained prospectively when advising travelers, and those who seek advice at travel clinics or their general practitioner should be informed about the risk of contracting rabies and the very high mortality rate. Travelers who do not routinely seek medical advice could also be reached through travel agencies or the media.

These cases were communicated by A.A. Movsesyants, Head of Rabies Department at the

L. A. Tarassevich State Research Institute for Standardization and Control of Medical Biological Preparations in Moscow, Russian Federation. Three of these patients were bitten by stray or aggressive domestic dogs, and one was bitten by a fox. Exposures occurred in the Ukraine, Azerbaijan, Kazakhstan, or Kyrgyzstan. None of the see more male Russian patients, age 21 to 58 y, sought medical attention and all died (Table 1). An 11-y-old boy from Georgia, as described by PROMED, who received post-exposure prophylaxis after being bitten by a dog in Azerbaijan, died later in Georgia, probably because of an inappropriate interval between exposure and treatment. Based on literature review and personal communications,

we collected the most complete set of reports of imported rabies cases available to date. We reviewed 42 human deaths due to imported rabies, which we defined as rabies that was contracted outside the country where death occurred. We found that the risk for an individual traveler to contract rabies was small relative to the number of people traveling to such areas. For example, over 45 million international travelers went to Africa click here in 2009.40 We report 14 fatalities in travelers to Africa; however, there may be substantial underreporting. Interestingly, we only found published cases that had occurred in the United States, Europe, and Japan, countries where scientific

publishing is very common. Of the 14 fatalities from Africa, 13 travelers came from Europe and 1 from the United States. To determine whether more human rabies cases occur in travelers within Asia or Africa would require further investigation by other means. Given that once symptoms of rabies are evident, the disease is expected to be fatal in virtually all cases, it is important to consider rabies prophylaxis and vaccination as a vital preparation Galeterone to ensure the safety of those planning to visit areas with high rabies incidence.1,2,8–12 A striking finding in this review of cases was that in 38 of the 39 cases where the animal cause of rabies was known or strongly suspected, the patient had exposure to a member of the family Canidae.13–38 Given that contact with dogs is known to represent the highest risk for contracting rabies in humans, this finding is not surprising.1,2,8 Travelers to areas with a high prevalence of rabies in the animal population should be cautious when approaching dogs, including puppies. Healthcare providers should be trained prospectively when advising travelers, and those who seek advice at travel clinics or their general practitioner should be informed about the risk of contracting rabies and the very high mortality rate. Travelers who do not routinely seek medical advice could also be reached through travel agencies or the media.