Nana Infection Research Articles

Prevalence of intestinal protozoan infestation among primary school children in Urban and peri-urban communities in Kumasi, Ghana

Introduction- Intestinal protozoan infections continue to remain a global public health challenge, particularly in developing countries. Children are greatly prone to these infections via the ingestion of food, water or soil contaminated with the infective stage of these parasites. Objectives- This study focused on establishing the prevalence of intestinal protozoan infection among primary school children aged 5 to 12 years from six communities in the Kumasi metropolis of Ghana. Methods- A total of 2400 children were randomly selected sampled. Stool samples collected from the children were analyzed using the formol-ether concentration technique. The modified Ziehl-Neelsen staining technique was employed in the identification of Cryptosporidium parvum. Results- The overall prevalence of intestinal protozoan identified among the studied school children was 42.9%. Prevalence was significantly higher in males than females with rates of 51.0% (604/1162) and 30.8% (381/1238) respectively. The highest protozoan infestation was Giardia lamblia with a prevalence of 16.8% (195/1162) and 7.8 % (97/1238) in males and females respectively. Three pathogenic strains (Giardia lamblia, Entamoeba histolytica/dispar and Cryptosporidium parvum) and four non-pathogenic species (Entamoeba coli, Endolimax nana, Chilomastix mesnili and Iodamoeba butschlii) were identified in the study. Giardia lamblia and Cryptosporidium parvum recorded prevalence rates of 12.2% and 8.5% respectively. Prevalence was however proportional to age with respect to Endolimax nana and Iodamoeba butschlii infections. Conclusion- There is relatively high prevalence of intestinal protozoan infection among the studied children. This obviously suggests that there are possible household, school based and behaviour oriented risk factors which predispose the children to these parasites.

Extending Helminth Control beyond STH and Schistosomiasis: The Case of Human Hymenolepiasis

Similarly to schistosomiasis, a single dose of PZQ eliminates the vast majority of Hymenolepis egg excretion [10–12]. However, it is likely that a PZQ gap exists in many communities being targeted by MDA in that the geographical location of Hymenolepis infections may not necessarily overlap with that of schistosomiasis. Guiding PZQ delivery solely on the basis of the distribution of schistosomiasis may miss communities endemic to Hymenolepis infection also in need of PZQ. This means that the populations at risk of hymenolepiasis may need to also be identified so that PZQ delivery can be extended to those areas. In order to test our proposition, we have analysed data from a parasitic disease survey of 2,168 children aged #15 years, including 1,098 girls and 1,070 boys in the Dande municipality in Northern Angola. Previous analysis of this dataset revealed that children were at significantly increased risk of H. nana infection (prevalence of 6.2% [95% CI: 4.9–7.8%] in preschool children and 7.3% [95% CI: 5.8–9.0%] in school-age children) compared to adults (prevalence of 1.9% [95% CI: 1.1–3.1%]) [13]. Using these data, we aimed to describe the epidemiology of H. nana infection by quantifying the role of individual and household factors and the physical environment (land surface temperature, distance to irrigation canals and rivers) in H. nana infection; quantify the role of H. nana infection on morbidity outcomes such as anaemia, diarrhoea, abdominal pain, and growth; quantify the geographical variation in H. nana infection prevalence in children aged #15 years; generate the first high-resolution H. nana infection map; and compare this map with a preexisting S. haematobium

National intestinal helminth survey among schoolchildren in Tajikistan: Prevalences, risk factors and perceptions

Solid evidence regarding the epidemiology of intestinal helminth infections in Tajikistan is currently lacking. As such information is essential for the evidence-based design, implementation and evaluation of control interventions, a national intestinal helminth survey was conducted with the following objectives: (i) to assess the prevalence of intestinal helminth infections among school-aged children nationally and stratified by region; (ii) to identify locally relevant risk factors for infection; and (iii) to better understand the children's knowledge and perception of intestinal helminth infections, and asses their haemoglobin status. Standard field and laboratory procedures including the Kato-Katz thick smear and tape test were employed. Complete data was obtained for 1642 children from 33 randomly selected primary schools from different parts of the country. Across the country, prevalences of E. vermicularis, A. lumbricoides, H. nana and T. trichiura were 26.5%, 16.9%, 15.5% and 2.7% respectively. The prevalence of common soil-transmitted helminth (A. lumbricoides and T. trichiura) infections was 19.4%. No hookworm infections were detected, and prevalences of various infections differed significantly between administrative districts (all P<0.05). Hand washing after toilet usage (OR=0.78; P=0.047) and handling animals (OR=0.66; P=0.009) were identified as significant protective factors against E. vermicularis infections. H. nana infection was associated with a 2.85g/L decrease in haemoglobin levels (P<0.001) despite already low average haemoglobin levels. The proportions of children with knowledge about intestinal helminths and protective hygiene practices varied significantly between regions (both P<0.001). Mass albendazole administration to school-aged children and women of child-bearing age against intestinal helminths has been conducted in Tajikistan in spring 2012, followed by mass albendazole and praziquantel distribution to school-aged children in autumn 2012. In the longer term, an integrated approach including chemotherapy, provision of safe water and proper sanitation as well as targeted health education will be necessary to achieve sustainable control.

EFFICACY OF MYRRH TOTAL OIL EMULSION AGAINST HYMENOLEPIS NANA IN RATS

The study aims investigating the efficacy of Myrrh Total Oil (MTO), formulated as emulsion, in treating naturally acquired Hymenolepis nana infection in rats. White albino male rats were used and different treatment regimens were studied using praziquantel as a reference compound. MTO dose of 834 mg/kg for 3 days, cured the infection in 75% of the rats, while lower doses exhibited less success. The number of worms was around 24 when the infected rats received a dose of 333 mg/kg for one day or for 3 successive days. Increasing dosing duration to 4 days, the mean number of worms decreased to 2 worms. Praziquantel produced a 100% cure of all infected rats in the assigned group. MTO emulsion proved to be effective against Hymenolepis nana. Although the results indicate the superiority of praziquantel, nevertheless the data obtained is promising for the interest of using natural products and warrants further investigation.

FLOTAC for the diagnosis of Hymenolepis spp. infection: proof-of-concept and comparing diagnostic accuracy with other methods

Hymenolepis nana is the most common cestode parasitizing humans, yet it is under-diagnosed. We determined the optimal flotation solution (FS) for the diagnosis of this intestinal parasite with the FLOTAC method, and compared its diagnostic accuracy with an ether-concentration technique and the Kato-Katz method. Zinc sulphate (specific gravity 1.20) proved to be the best-performing FS. Using this FS, we detected 65 H. nana infections among 234 fixed fecal samples from Tajik and Sahrawi children (prevalence 27.8 %). The ether-concentration technique detected 40 infections (prevalence 17.1 %) in the same samples. Considering the combined results as a reference, the sensitivities of FLOTAC and ether-concentration were 95.6 % and 58.8 %, respectively. The Kato-Katz method resulted in a prevalence of only 8.7 %. In terms of eggs per gram of stool, a significantly (P <0.05) higher value was obtained with the FLOTAC and Kato-Katz techniques compared to ether-concentration. In another study carried out in China, the FLOTAC method detected six Hymenolepis diminuta infections in 302 fecal samples, whereas five samples were found positive with the Kato-Katz technique. We conclude that FLOTAC is an accurate coprodiagnostic technique for H. nana and H. diminuta, two species which join a growing list of intestinal parasites that can be reliably diagnosed by this technique.

Mebendazole in the treatment of Hymenolepis nana infections in the captive ring-tailed lemur (Lemur catta), China

The present study was conducted to evaluate the effectiveness of mebendazole in the treatment of Hymenolepis nana infection in ring-tailed lemurs (Lemur catta). Ten (L. catta) from the Chengdu Zoological Garden in China, which were naturally infected with H. nana, were treated with mebendazole (10 mg/kg for 5 days). A posttreatment fecal examination was conducted 10 and 20 days after the start of treatment. All treatments resulted in a decrease in the number of eggs per gram in the posttreatment sample compared with the pretreatment sample. Reduction of mean egg count was 97.6% and 100% on days 10 and 20, respectively. The results indicated that mebendazole has marked efficacy against H. nana infections in L. catta.

Schistosoma mansoni infection among prenatal attendees at a secondary-care hospital in central Sudan

Objective To investigate the epidemiology of Schistosoma mansoni infection among pregnant women in a secondary-care hospital in Geizera state, Sudan. Method Between August and September 2010, a cross-sectional study was conducted and questionnaires were administered to obtain basic sociodemographic and obstetric characteristics of pregnant women attending prenatal care at Araba Waeshreen Hospital. Stool samples were investigated for helminth infection via formol–ether concentration and Kato–Katz techniques. Results Of 292 pregnant women, 38 (13.0%) had S. mansoni infections. Hymenolepis nana and hookworm infections were present in 5 (1.7%) and 1 (0.3%) women, respectively. The intensity of the S. mansoni infection was light, moderate, and high in 13 (34.2%), 21 (55.3%), and 4 (10.5%) women, respectively. In multivariate analyses, parity, gestational age, and occupation were not associated with S. mansoni infection, unlike maternal age less than 20 years (odds ratio [OR] 9.8; 95% confidence interval [CI], 1.5–16.3; P = 0.01) and no education (OR 6.2; 95% CI, 2.8–12.9; P < 0.001). Conclusion There was a high level of S. mansoni infection among pregnant women in the present setting, especially among younger women and those with no education. Control and preventive measures should be used in the area.

Intestinal parasitic infections among under-five children and maternal awareness about the infections in Shesha Kekele, Wondo Genet, Southern Ethiopia

Background: Few studies have reported the magnitude of intestinal parasitic infections among under-five children in tropical countries. Moreover, there is little information on maternal awareness about intestinal parasitosis.Objective: To determine the prevalence of intestinal parasitosis among under-five children, and assess maternal awareness about it in Shesha Kebkele, Wondo Genet, Southern Ethiopia.Methods: A cross-sectional study involving 288 under-five children was conducted and stool samples were collected and examined for intestinal parasites using Kato-Katz and formol-ether concentration methods. In addition, a total of 130 mothers of under-five children were interviewed regarding their awareness about intestinal parasitic infections.Results: Of the 288 children, 245 (85.1%) were found infected with one or more intestinal parasites. The prevalence of Trichuris trichiura, Schistosoma mansoni and Ascaris lumbricoides, hookworm, and Hymenolepis nana infections as determined by Kato-Katz were 74.7%, 37.2%, 25.7%, 5.9%, and 4.5%, respectively. On the other hand, theprevalence of Strongyloides stercoralis, Giardia lamblia, Entamoeba histolytica/dispar, and Entamoeba coli infections as determined by formol-ether concentration method were 0.69%, 13.2%, 0.35%, and 2.1%, respectively. Most mothers were reasonably aware of the mode of transmission of ascariasis, amoebiasis and giardiasis while they hadvery limited knowledge of bilharzia and hookworm transmission. Almost all of the respondents reported that infections with intestinal parasites could cause retardation of growth and death in children unless treated.Conclusion: Intestinal parasitic infections were prevalent in varying magnitude among under-five children in Wondo Genet area, Southern Ethiopia. Mothers in the study area had a fairly good knowledge of the impact of infections but limited knowledge of the mode of transmission of intestinal parasitic infections. Improvement of sanitation and healtheducation are required besides preventive chemotherapy to control worms (except for schistosomiasis in under-five which need treatment on an individual basis) and other intestinal parasitic infections in the area.

Computational characterization of molecular mechanism of surface receptor binding with alpha-enolase of Trichomonas vaginalis

Results: We investigated 64 institutionalized children aged 2 to 12 years. Parasitic infections were identified in 44 cases (68.7%). Hymenolepis nana (31.2%), Giardia lamblia (28.1%), Blastocytis hominis (7.8%), Entamoeba coli (4.7%), Ascaris lumbricoides (4.7%), and Trichuris trichiura (3.1%) were diagnosed. We have determined associations of two (45.4%) and more than two parasites (18.2%) among the infected children; of the 20 with hymenolepiasis, 11 (55%) had multiple parasitic infections. Clinical and laboratory examinations were conducted to investigate the presence of symptoms and eosinophilia in patients with parasitic infections. Diarrhoea (38.6%), weight loss (47.7%), abdominal pain (25%), nervous disorders (34.1%), cutaneous manifestations (22.7%), fever (9.1%) and respiratory infections (59.1%) were reported in the infected children. Eosinophilia was noted in 27 (61%) of the 44 patients with parasitosis. High eosinophil values were mostly observed among those diagnosed with helminth infections. Conclusion: Hymenolepis nana infection was reported with an increased frequency among Romanian institutionalized children. The majority of the patients with hymenolepiasis were diagnosed with multiple parasitic infections.

Effect of Hymenolipes nana infection on some blood parameters in some definitive host

The aim of this study is to determine the effect of Hymenolepis nana infection in some bloodparameters of some final host ( rats &amp; mice ) by experimental infection of 15 rats and 48 mice . Theresults showed that the prepatant period between 12-14 days and the shape of eggs spherical &amp; slightlyellipsoid in mean 40.92 X 35.96 microne &amp; the numbers of eggs in feaces increased with the severityof the infection .The infection which effected on the blood parameters by decreasing the means of packed cell volume ,total white blood count , lymphocytes , while increased the means of neutrophils , monocytes ,eosinophils &amp; basohpils in infected group

Hymenolepis nana infection of the colon in an adult male

Hymenolepis nana infection of the colon in an adult male

Desenvolvimento e distribuição de Rodentolepis nana em Meriones unguiculatus

Com o objetivo de avaliar o desenvolvimento e a distribuição de Rodentolepis nana em Meriones unguiculatus, vinte animais receberam um inóculo oral de 100 ovos do parasito. A metade desses roedores recebeu, por via subcutânea, inóculo diário de dexametasona (DMS) (10mg/Kg). Aos 7 e 15 dias após a infecção (DPI), cinco animais de cada grupo foram sacrificados para a recuperação dos parasitos. Em M. unguiculatus não tratados, foram recuperados parasitos somente no 7o DPI, em início de maturação e distribuídos principalmente pela porção distal do intestino delgado desse roedor. Nesta mesma data, os parasitos recuperados em M. unguiculatus, que receberam DMS, estavam possivelmente no mesmo estádio que os encontrados em M. unguiculatus não tratados, porém distribuídos pelas porções média e distal do intestino delgado. Aos 15 DPI, os helmintos recuperados em M. unguiculatus que receberam DMS estavam completamente desenvolvidos, apresentando proglotes maduras e grávidas, distribuídos principalmente pela porção média, e, secundariamente, pela porção distal do intestino delgado. Conclui-se que M. unguiculatus tem reduzido potencial como reservatório deste cestóide e sua resistência à infecção pelo R. nana tem um importante componente inflamatório, sensível à ação da DMS.

Cytokine production in Hymenolepis nana infection.

Although many experimental studies provide convincing evidence that type II immunity is protective against helminths, recent data in mice demonstrate that Th1 is also important in some cestodes like Hymenolepis nana. To identify the role of Th1 and Th2 lymphocytes in immunity against H. nana, the levels of IL-12, IFNgamma, IL-5, and IL-13 were determined in serum of humans infected with this cestode. A total of 31 patients (case) with H. nana infection and 30 clinically healthy individuals (control) was included in this study. Measurements of IL-12, IFNgamma, IL-13 and IL-5 in serum samples were performed by solid-phase sandwich enzyme linked immunosorbant assay. Differential leukocyte count was also done. T test, Mann Whitney U test and Wilcoxan W test were used for data analysis. The mean concentrations of IFNgamma, IL-12 and IL-5 in the sera of patients with H. nana infection were higher than the control group, but only the differences between the concentrations of IFNgamma (P<0.001) and IL-13 (P<0.05) in the two groups were significant. There was an increase in the percentage of monocytes, eosinophils and lymphocytes in patients when compared to the controls, but this increase was not significant. Results from the present study in humans are in agreement with experimental studies in animals in which both Th1 and Th2 responses occur in H. nana infection.

Induction of indoleamine 2,3-dioxygenase in small intestine of mouse infected with parasitic helminth, Hymenolepis nana

Abstract. One hundred and fifty crushed eggs of Hymenolepis nana were administrated to 5–6 week old ddY mice, and the animals were killed at 0, 7, 14, 21 or 28 days post-infection (dpi). The small intestines were recovered, and both halves, proximal and distal, were examined, observed for immunohistochemistry, and assayed on enzyme activity of IDO. Enzyme activity of IDO was increased by H. nana infection, and was parallel to a decrease of recovered worms. The expression pattern of IDO-positive cells in the proximal intestine was also the same as those of IDO activity with a little change earlier. Furthermore, IDO-positive cells coincided with goblet cells, but not all goblet cells were IDO-positive. Present findings apparently suggest that IDO might be involved in the mucous excretion process in the expulsion of worms.

Chronic urticaria caused by Hymenolepis nana in an adopted girl

AllergyVolume 62, Issue 7 p. 821-822 Chronic urticaria caused by Hymenolepis nana in an adopted girl G. L. Marseglia, Corresponding Author G. L. Marseglia Dipartimento di Scienze Pediatriche - Fondazione IRCCS Policlinico San Matteopiazzale Golgi 227100 Pavia ItalyTel: +390382502583Fax: +390382527976E-mail: gl.marseglia@smatteo.pv.itSearch for more papers by this authorA. Marseglia, A. MarsegliaSearch for more papers by this authorA. Licari, A. LicariSearch for more papers by this authorA. M. Castellazzi, A. M. CastellazziSearch for more papers by this authorG. Ciprandi, G. CiprandiSearch for more papers by this author G. L. Marseglia, Corresponding Author G. L. Marseglia Dipartimento di Scienze Pediatriche - Fondazione IRCCS Policlinico San Matteopiazzale Golgi 227100 Pavia ItalyTel: +390382502583Fax: +390382527976E-mail: gl.marseglia@smatteo.pv.itSearch for more papers by this authorA. Marseglia, A. MarsegliaSearch for more papers by this authorA. Licari, A. LicariSearch for more papers by this authorA. M. Castellazzi, A. M. CastellazziSearch for more papers by this authorG. Ciprandi, G. CiprandiSearch for more papers by this author First published: 15 June 2007 https://doi.org/10.1111/j.1398-9995.2007.01362.xCitations: 6 Hymenolepis nana: an unusual cause of chronic urticaria in an adopted Bolivian girl Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume62, Issue7July 2007Pages 821-822 RelatedInformation

Comparative evaluation of Western Blotting in hepatic and pulmonary cystic echinococcosis

Many serological tests are widely used in the diagnosis of cystic echinococcosis (CE), caused by the larval stages of Echinococcus granulosus. The present study was carried for differentiation between hepatic and pulmonary cystic echinococcosis by Western Blotting (WB). A total of 121 sera from patients with hepatic CE (37), pulmonary CE (31) and controls (53; consisting of six healthy, seven Hymenolepis nana infection, 20 hepatic and 20 pulmonary diseases other than CE) were examined. In all of the CE patients, E. gronulosus infection was confirmed by surgical intervention. Sera were previously tested using IHA and ELISA to detect the E. gronulosus specific antibodies. Sera from hepatic cases of CE reacted with 16 polypeptides of 6-116 kDa and sera from pulmonary cases of CE reacted with 14 polypeptides of 4-130 kDa by Western Blotting. The WB test enabled the detection of antibodies in the hepatic CE samples for proteins of 24, 32 34, 44-46 and 52-54 kDa in molecular weight in 78.4%, 75.7%, 78.4% and 89.2% of the patients, respectively. In the pulmonary CE samples sera WB test enabled the detection of antibodies 24, 44-46, 100, 110, 116 and 120 124 kDa in molecular weight in 81.3%, 75.0%, 87.5%, 71.9%, 84.4% and 65.6% of the patients, respectively. We indicated that the antigenic components of high molecular weight can be good candidates for differentiation of hepatic CE from pulmonary CE.

Hymenolepis nana infection: symptoms and response to nitazoxanide in field conditions

A matched case-control study on clinical symptoms of Hymenolepis nana and an open trial of nitazoxanide treatment were conducted in a village on the northern coast of Peru. Interview data were obtained from 25 individuals with hymenolepiasis only and 46 matched controls. Individuals with other intestinal helminths or giardiasis were excluded. Twenty nitazoxanide-treated cases were followed with stool examination a month later. There were no significant differences between groups in the prevalence of symptoms except headache, which was less frequent in the cases. Treatment efficacy was 75%. Hymenolepiasis in this community did not have significant impact on specific symptoms.

The association of Blastocystis hominis and Endolimax nana with diarrheal stools in Zambian school-age children

To determine the prevalence of endoparasites and their association with diarrhea, a survey was conducted in the Southern Province of Zambia that used conventional and molecular techniques applied to stool and urine samples from school-age children (n = 93). Almost half of the stools (49.5%) were diarrhetic. The overall prevalence of Endolimax nana, Schistosoma haematobium, Blastocystis hominis, Giardia lamblia, Cryptosporidium parvum, Encephalitozoon intestinalis, and Strongyloides stercoralis was 64.3, 59.1, 53.8, 19.4, 8.6, 8.6, and 1.1%, respectively. Only the associations between infection with B. hominis and E. nana with diarrhea were statistically significant. Although B. hominis and E. nana are considered to be nonpathogenic organisms, this study demonstrated that they can be associated with diarrhea in children when they occur at high prevalence and intensity. This survey supports the recent evidence that B. hominis and E. nana infections are associated with deficient sanitation and low hygiene standards and can contribute to diarrhea in children in developing countries.

Albendazole: a review of anthelmintic efficacy and safety in humans

This comprehensive review briefly describes the history and pharmacology of albendazole as an anthelminthic drug and presents detailed summaries of the efficacy and safety of albendazole's use as an anthelminthic in humans. Cure rates and 0% egg reduction rates are presented from studies published through March 1998 both for the recommended single dose of 400 mg for hookworm (separately for Necator americanus and Ancylostoma duodenale when possible), Ascaris lumbricoides, Trichuris trichiura, and Enterobius vermicularis and, in separate tables, for doses other than a single dose of 400 mg. Overall cure rates are also presented separately for studies involving only children 2-15 years. Similar tables are also provided for the recommended dose of 400 mg per day for 3 days in Strongyloides stercoralis, Taenia spp. and Hymenolepis nana infections and separately for other dose regimens. The remarkable safety record involving more than several hundred million patient exposures over a 20 year period is also documented, both with data on adverse experiences occurring in clinical trials and with those in the published literature and/or spontaneously reported to the company. The incidence of side effects reported in the published literature is very low, with only gastrointestinal side effects occurring with an overall frequency of just >1% . Albendazole's unique broad-spectrum activity is exemplified in the overall cure rates calculated from studies employing the recommended doses for hookworm (78% in 68 studies: 92%, for A. duodenale in 23 studies and 75% for N. americanus in 30 studies), A. lumbricoides (95% in 64 studies), T. trichiura (48% in 57 studies), E. vermicularis (98% in 27 studies), S. stercoralis (62% in 19 studies), H. nana (68% in 11 studies), and Taenia spp. (85% in 7 studies). The facts that albendazole is safe and easy to administer, both in treatment of individuals and in treatment of whole communities where it has been given by paramedical and nonmedical personnel, have enabled its use to improve general community health, including the improved nutrition and development of children.

Immunosuppressive and antiparasitic effects of cyclosporin A on Hymenolepis nana infection in mice

The effect of cyclosporin A, which is known to act both as an immunosuppressant and as an antiparasitic drug in many host-parasite systems, was examined in a mouse- Hymenolepis nana system. When BDF 1 mice were injected s.c. with cyclosporin A (100 mg kg −1 day −1) every 48 h from 11 days p.i. with eggs, expulsion of the adult worms from the intestines of mice was prevented completely until at least 30 days p.i. Worm burden, dry weight and the number of gravid proglottids were not significantly reduced. By contrast, in untreated mice most of the worms were eliminated by 19 days p.i. The drug also completely abolished acquired resistance to a challenge infection with eggs when mice were injected s.c. with cyclosporin A (100 mg kg −1 day −1) around the time of challenge infection (Days −2, −1, 0, 1 and 2 relative to challenge). Such immunosuppressive effects of cyclosporin A on worm expulsion and protective immunity to reinfection were similar to those of another immunosuppressant, cyclophosphamide. As for the antiparasitic action of cyclosporin A against H. nana, a smaller number of cysticercoids developed from eggs in mice given cyclosporin A (100 mg kg −1 day −1) for 5 days beginning 1 day before infection, than in untreated controls.