Previous reports had described satisfactory halogenations on the sugar moiety mediated by fluorinase and chlorinase (O’Hagan et al., 2002; Eustaquio et al., 2008). However, these enzymes cannot introduce the halogen into the base moiety. Biosynthesis of purine nucleoside analogues by transglycosylation has been extensively studied (Sinisterra et al., 2010). However, there have been few reports about obtaining pyrimidine nucleosides halogenated on the base moiety using whole cells. In

all cases, conversion rates were < 50% (Pal & Nair, 1997). Microorganism immobilization is a good way to carry out the bioprocess under preparative conditions. Cell entrapment techniques are the most widely used for whole cell immobilization (Trelles et al., 2004). The main advantages of RAD001 research buy this methodology are high operational stability, easy upstream separation, and bioprocess scale-up feasibility. The aim of this study was to obtain 5-halogenated 2′-deoxynucleosides with potential antitumoral activity using a smooth, cheap, and environmentally friendly methodology. We have been able to develop a bioprocess for 5-fluoro and 5-chloro-2′-deoxyuridine Selleck GDC 0449 production using immobilized Aeromonas salmonicida ATCC 27013. Nucleosides and nucleobases were purchased from Sigma Chem. Co. (Brazil). Culture media compounds were obtained from Britania S.A. (Argentine). Chemicals were from Sigma Chem. Co. and Britania S.A. HPLC

grade solvents used were from Sintorgan S.A. (Argentine). Most of the microorganisms were kindly supplied by the ‘Colección Española de Cultivos Tipo (CECT)’, Universidad de Valencia (Spain). Microorganisms were grown until stationary phase in LB medium (5 g L−1 meat extract, 10 g L−1 peptone, and 5 g

L−1 NaCl in deionized water adjusted to pH 7). Cells were harvested by centrifugation for 10 min at 17 500 g, were then washed once with potassium phosphate buffer (30 mM, pH 7), and finally recentrifuged and stored at 4 °C until use. A taxonomic screening with bacterial strains was performed using the following Dapagliflozin genera: Aeromonas (10), Bacillus (8), Citrobacter (3), Chromobacterium (1), Enterobacter (6), Escherichia (7), Klebsiella (2), Micrococcus (3), Serratia (4), Proteus (7), and Xanthomonas (4). All microorganisms assayed were non pathogenic for humans. The reaction to select the microorganisms was performed with 1 × 1010 CFU, 10 mM 5-fluorouracil and 2.5 mM thymidine or uridine in 1 mL of potassium phosphate buffer (30 mM, pH 7). Reactions were performed at 30 °C and 200 r.p.m. Samples were taken at 1, 3, 6, and 24 h and centrifuged at 17 500 g during 5 min. Reactions were performed at 30 °C with 1 × 1010 CFU, 2.5 mM 5-fluorouracil and 10 mM thymidine at different phosphate concentration (20–40 mM), pH values (6–8), and shaking speed (100–300 r.p.m.). Reactions were carried out with 1 × 1010 CFU, 2.

The two recommended NRTI options for treatment of naïve patients with wild-type HIV alone are abacavir/3TC and tenofovir/FTC [124]. Although 3TC is a potent www.selleckchem.com/products/GDC-0449.html anti-HBV agent [131], monotherapy is associated

with a high likelihood of HBV resistance in coinfected persons (M204 V develops at a rate of 25%/year) and hence therapy with this drug, or FTC, without a second anti-HBV active drug is not recommended [132,133]. 3TC/FTC-resistant strains will normally respond to tenofovir [118–123,134–137] Tenofovir is effective at suppressing HBV DNA and may induce HBeAg seroconversion although, as for other antivirals in coinfection, this may be less likely than in an HIV-negative person [127,134–136]. Resistance is

rare and combination with 3TC or FTC has been demonstrated to be effective at suppressing HBV DNA and may induce HBeAg seroconversion. Combining 3TC/FTC with tenofovir may reduce the risk of breakthrough [137]. If renal toxicity precludes the use of tenofovir, entecavir is an option that can be used along with a fully active antiretroviral regimen [137]. If AC220 clinical trial genotypic HIV resistance to tenofovir and/or 3TC/FTC is present or develops, but HBV DNA suppression is maintained, tenofovir and 3TC/FTC should be continued in addition to an effective new antiretroviral regimen. The presence of mutations conferring 3TC resistance affects the fitness of both viruses which potentially slows down HBV progression and therefore continuing this drug should be considered [131]. ART may lead to an immune reconstitution flare when commenced, and a viral escape inflammatory flare if drugs with medroxyprogesterone anti-HBV activity are stopped, both of which may be severe, particularly in persons with cirrhosis [138,139]. 4.3.2.3 Recommendations for patients with a CD4≥500 cells/μL • No HBV therapy is recommended for patients who are HBsAg and HBV DNA negative but HBcAb positive (I). 4.3.2.4 Recommendations for patients with a CD4<500 cells/μL • Patients

with HBV coinfection who have a CD4 count of <500 cells/μL should commence HAART (II). The only exception to this may be the patient with a CD4 count of 350–500 cells/μL, an HBV DNA level of <2000 IU/mL, a normal ALT and no evidence of fibrosis or hepatic inflammation: in this situation, close monitoring is essential. 4.3.2.5 Goals of therapy. As in HBV monoinfection, the long-term goal is to prevent cirrhosis and primary hepatoma by sustained suppression of viral replication to the lowest possible level [140]. Seroconversion from HBeAg positive to HBeAg negative and normalization of ALT are endpoints that indicate success of therapy in monoinfected patients and allow consideration for discontinuation of treatment.

The presence of the HLA B*5701 variant was associated with increased risk of HSR development, which was confirmed

in numerous studies [6–9]. Prospective screening was found to significantly reduce the number of HSRs noted, with HLA B*5701 testing having an overall positive prognostic value for clinically diagnosed HSRs of 61.2%, while the negative prognostic value was 95.5% [6]. Many countries introduced prospective HLA B*5701 testing as the standard of care for HIV-infected patients, selleck compound and this has been particularly successful in Australia and the United Kingdom, allowing reductions in the number of adverse reactions observed, improvements in adherence to therapy and reductions in the number of abacavir discontinuations [10,11]. Testing is cost effective, especially in populations with higher frequencies of the HLA B*5701 allele (e.g. Caucasian populations), allowing reductions in costs related to HSR treatment [12]. For such populations, on average, only 14 tests would result in the prevention of one case of abacavir HSR [13]. HLA B*5701 testing is included in the European AIDS Clinical Society guidelines for clinical management

and treatment of HIV-infected adults in Europe, with abacavir contraindicated I-BET-762 nmr if an individual tests positive for this variant (available online at http://www.eacs.eu). To avoid costly and time-consuming high-resolution sequencing, screening can be based on the sequence-specific amplification technique. This approach reduces both

the cost of the test and the time needed to obtain results [14]. As validated tests become available, it might be expected that this field will develop Unoprostone rapidly in the near future. In this study, we tested the HLA B*5701 allele frequency in a cohort of 200 HIV-positive individuals from the West Pomeranian region of Poland by means of sequence-specific primer (SSP) polymerase chain reaction (PCR) technology. The aim of the study was not only to provide allele frequency data for this group but also to determine the feasibility of widespread clinical implementation of genetic testing for this pharmacogenetic factor in Poland. The study group consisted of 234 randomly selected patients with confirmed HIV infection attending the Clinic for Acquired Immunodeficiency Treatment, Department of Infectious Diseases and Hepatology, Szczecin, Poland. Most of the individuals tested were male [male, 169 (72%); female, 65 (28%)]. The mean age (±standard error) of the studied individuals was 40.9±9.5 years (median 39 years). As the majority of patients attending the clinic are of Caucasian origin (99.9%), for this study only Caucasians were selected. All participants voluntarily consented to participate in the study. Genomic DNA was extracted using the QIAamp DNA Blood Mini Kit (Qiagen, Hilden, Germany) from whole blood samples previously collected in tubes containing ethylenediaminetetraacetic acid (EDTA) anticoagulant.

Ascospores, which are formed within the perithecia and forcibly discharged into the air, are known to be the primary inocula of the disease (Fernando et al., 1997; Trail et al., 2005). Filamentous fungi can utilize various compounds as nitrogen sources. Such metabolic versatility implies that numerous metabolic enzymes and permeases are required under certain growth conditions (Kudla et al., 1990). The advantages of efficient regulation of gene expression are apparent in fungi. Regulation of nitrogen metabolism has been studied extensively in Aspergillus

nidulans and Neurospora crassa (Marzluf, 1997). In these fungi, simple nitrogen sources (ammonium and glutamine) GSK2118436 research buy are preferentially utilized over other sources, such as nitrate and proteins (Arst & Cove, 1973; Kudla et al., 1990). When the favored nitrogen CHIR-99021 solubility dmso sources are limiting, the expression of metabolic enzymes and permeases required for utilization of secondary nitrogen sources is increased. In A. nidulans and N. crassa, those genes are activated by the global regulators AreA and NIT2, respectively (Caddick et al., 1986; Fu & Marzluf, 1990). Loss-of-function

mutations of areA result in an inability to utilize nitrogen sources other than ammonium and glutamine, which indicates that many metabolic enzymes and permeases are under the control of AreA (Arst & Cove, 1973; Kudla et al., 1990). The GATA transcription factor AreA/NIT2 contains the zinc finger region Cys-X(2)-Cys-X(17)-Cys-X(2)-Cys, which recognizes and binds to the consensus DNA sequence, 5′-HGATAR-3′ (Ravagnani et al., 1997; Starich et al., 1998). Orthologues of AreA/NIT2 have been identified in Fusarium spp., including AREA-GF in Gibberella fujikuroi (Tudzynski

et al., 1999), FNR1 in Fusarium oxysporum (Divon et al., 2006), and AREA in Fusarium verticillioides (Kim & Woloshuk, 2008). Mutants where areA/nit2 orthologue genes were disrupted in those species were unable to utilize nitrogen sources other than ammonium and glutamine. In addition, AreA/NIT2 orthologues are required for the expression of structural genes involved in the biosynthesis of secondary metabolites, such as gibberellin in G. fujikuroi and fumonisin B1 in F. verticillioides Baf-A1 nmr (Mihlan et al., 2003; Kim & Woloshuk, 2008). In F. oxysporum, FNR1 mediates adaptation to nitrogen-limiting conditions in planta by regulating nitrogen utilization genes (Divon et al., 2006). It has been proposed that nitrogen availability during in planta growth is a limiting factor for virulence of fungal pathogens (Coleman et al., 1997; Snoeijers et al., 2000; López-Berges et al., 2010). In addition, the precise and global regulation of nitrogen metabolism is a prerequisite for vegetative growth, toxin production, and sexual development under nitrogen-limiting conditions. Therefore, AreA orthologue in G.

For example, when prehypertensive men and women (mean age 49 years) were randomized to receive an angiotensin II receptor antagonist (ARB) or placebo for 2 years, hypertension developed in 40% of the placebo recipients, and only 14% of the active drug recipients (66% PF-02341066 mouse relative risk reduction). When the active drug was discontinued and participants were followed

for an additional 2 years, those who originally received ARB maintained significantly lower systolic (−2 mmHg) and diastolic (−1.1 mmHg) blood pressures, and maintained their lower relative risk for developing hypertension (15%) than the placebo recipients. This suggests that even small decrements in systolic and diastolic blood pressure that can be maintained for prolonged periods can postpone the progression of hypertension. In another cohort study [46], normotensive men and women (<120/80 mmHg) with modest coronary artery disease who controlled their blood pressures using either an angiotensin-converting enzyme inhibitor or a calcium-channel blocker had the largest decrease in coronary atheroma volume (using intravascular ultrasound) after 2 years, while participants with baseline pre-hypertension or hypertension had no significant reduction or an increase in atheroma volume. This suggests that early anti-hypertensive

interventions, even in people with normal blood pressures, effectively reduce the progression of atherogenesis. In HIV-infected people with pre-hypertension and other cardiometabolic risk factors (e.g. tobacco use, Mitomycin C concentration central adiposity and dyslipidaemia) it seems prudent to recommend lifestyle modifications (including yoga) to reduce blood pressures. Randomized trials and observational studies are consistent in that a 10 mmHg reduction in systolic blood pressure and a 5 mmHg reduction in diastolic blood pressure predict ∼50–60% lower risk for death from stroke,

and ∼40–50% lower risk for death from coronary artery (or other vascular) disease [40,42]. In the current study, average reductions in systolic/diastolic blood pressures were 5/3 mmHg. Assuming that HIV-infected people respond similarly to the general population, our findings suggest that the risk of death from stroke was reduced by 25–30% and the risk of death from coronary artery disease was reduced by 20–25% by this yoga intervention. Progesterone Yoga was selected as the intervention because complementary and alternative medicine advocates believe that yoga’s approach to synchronizing breath inhalation, exhalation or held breath to movement in conjunction with focusing the mind on a specific region of the body optimizes the interaction between the autonomic nervous system and endocrine system [16,47,48]. We hypothesized that yoga would reduce body fat because energy expenditure during Hatha/Ashtanga yoga averaged 2.5 METS (3 kcal/min) and peak energy expenditure was 11 METS (14 kcal/min) [49,50]; however, fat loss was not observed.

A negative HCV RNA test 4 weeks into therapy is defined as a rapid virological response (RVR) and is associated BTK inhibitor with an increased likelihood of SVR [194,195]. The early virological response (EVR) is defined as a negative HCV RNA or reduction of >2 log10 in HCV viraemia after 12 weeks of therapy [195]. Therapy should be stopped in patients who do not achieve an EVR or where there is detectable viraemia at

24 weeks [194,195]. In the AIDS Pegasys Ribavirin International Co-infection Trial (APRICOT) study, patients treated with peginterferon and ribavirin had a mean CD4 count decrease of 140 cells/μL [196] and there have been previous case reports of interferon-treated patients developing opportunistic infections following an interferon-associated CD4 count decline. Ideally, therefore, patients should have a CD4 count of at least 200 cells/μL and undetectable HIV RNA. CD4 percentage should also be taken into account when making the treatment decision. Patients with low CD4 count (<300 cells/μL at baseline) will require more detailed monitoring. In patients being evaluated for both antiretroviral

and HCV treatment it is advisable to stabilize the patient on ART in the first instance (see above). It has been shown that the immune restoration associated with ART can limit the progression of HCV-associated disease so that even if they do not respond to HCV therapy there may be some long-term indirect benefit from ART [172,197–199]. The liver disease should also be staged both clinically and with either noninvasive tests/biomarkers such as hepatic elastography (see Selleckchem Bortezomib General section) or liver biopsy. Consider liver biopsy particularly for those with genotype 1 or 4 infection where the see more results of HCV therapy remain disappointing [198,200,201]. The risk–benefit of liver biopsy

should be considered in the individual patient. The patient’s age should also be taken into account as there is some evidence that response diminishes with increasing age [202]. It is particularly important to establish whether the patient has cirrhosis as: (a) HCV therapy can be potentially dangerous in those with severe liver disease, particularly cirrhosis Child–Pugh stage B/C, as deaths have occurred [201,203,204]. Overall, the SVR rates in coinfected patients are approximately 60% of those seen in HCV-monoinfected patients [194–196,200–202,205]. It is reasonable, therefore, to treat patients with genotype 2 or 3 infection without performing a baseline liver biopsy if there is no evidence of advanced liver disease clinically, or by using noninvasive tests/biomarkers. In those with genotype 1 or 4 infection, or where there is clinical concern regarding co-existent liver disease such as haemochromatosis, or alcohol-related or other liver disease, a biopsy can be helpful in staging the liver disease(s) and determining the need for HCV therapy [194–196,200–202,205,206].

Hence, nutrient conditions influence the biosynthesis of M(IP)2C in yeast. Autophagy is a catabolic membrane-trafficking phenomenon that occurs in response to drastic changes in the nutrients available to yeast cells, for example during starvation for nitrogen (N) or carbon (Abeliovich & Klionsky, 2001). Although both autophagy and the M(IP)2C content of yeast membranes seem to be responsive to nutritional stress, a direct link between these processes has not been investigated in yeast to date. Selleck ERK inhibitor Hence, the question arises as to whether Δipt1 or Δskn1 single and double deletion mutants

are characterized by an altered autophagic response as compared with the corresponding wild type (WT). Therefore, in this study, we used N starvation to assess differences in the autophagic response of the different Δipt1 and/or Δskn1 deletion mutants as compared with WT, as well as their sphingolipid profiles and putative induction of apoptosis, which has previously been linked to autophagy (Maiuri et al., 2007; Scott

et al., 2007). Because overexpression of autophagy-related protein 1, Atg1, in Drosophila was previously shown to induce autophagy and to cause cell death accompanied by increased DNA fragmentation (Scott et al., 2007), we further assessed DNA fragmentation upon N starvation in all mutants and WT. The yeast strains used are Saccharomyces cerevisiae BY4741 (MATa his3Δ1 leu2Δ0 met15Δ0 ura3Δ0) and the corresponding Δipt1, Δskn1 (Invitrogen, Carlsbad, selleck products CA) mutants and the double Δipt1Δskn1 deletion mutant (Thevissen et al., 2005), the pho8Δ60∷pho8 pho13Δ∷kan-lox STK38 strain (WT, YTS158) (Noda et al., 1995) and the corresponding Δatg1, Δipt1, Δskn1 and Δipt1Δskn1 mutants. Overnight cultures in YPD medium (1% yeast extract; 2% peptone, 2% glucose) were transferred to SD medium [0.8 g L−1 complete amino acid supplement mixture (Bio 101 Systems); 6.5 g L−1 yeast nitrogen base (YNB); 20 g L−1 glucose] at a start OD600 nm=0.2, grown to the exponential phase till

OD600 nm=0.8, washed twice with SD-N medium (0.17% YNB w/o ammonium sulfate and amino acids, 2% glucose) and shifted to SD-N medium for 4 h. As a control, cells were also shifted to SD medium after reaching the exponential phase. For monitoring bulk autophagy, the alkaline phosphatase activity of Pho8Δ60 was carried out as described previously (Noda et al., 1995; Klionsky, 2007). The percentage of autophagy of the different mutants was relative to the WT autophagy level under the different conditions. After challenge with SD-N medium, cell numbers were measured (using CASY cell counter), ROS levels were determined (via staining with dihydroethidium) and phosphatidylserine externalization of the yeast cultures (via staining with fluorescein isothiocyanate-labeled annexin V in combination with propidium iodide) was quantified using flow cytometry and bd facsdiva software (Madeo et al., 1997; Büttner et al.

bovis/BCG narK2X promoter inactive. To confirm that no other trans-acting factor (e.g. repressor) contributed to the loss of promoter activity in M. bovis/BCG, the pnarK2 plasmid (harbouring the M. tb WT narK2 promoter) was introduced into M. bovis and BCG strains and the GFP reporter assay was performed under hypoxic conditions. The M. tb WT narK2X promoter was well induced and to the same level in M. bovis and BCG as in M. tb (Table 3), which suggests that the −6TC mutation, and not a trans-acting negative regulator, is responsible for the absence

of narK2X promoter activity in M. bovis and BCG. To further validate that the M. tb narK2X promoter behaves similarly in M. bovis/BCG and M. tb, two additional truncated narK2X promoter Selleck HSP inhibitor Navitoclax order GFP reporter constructs pnarK2Δdown and pnarK2Δup (described in Chauhan & Tyagi,

2008a) were also assessed for GFP fluorescence in M. bovis and BCG under hypoxic conditions. In pnarK2Δdown, the so-called ‘downstream inhibitory region’ is removed (+14 to +57 with respect to M. tb narK2X TSP), whereas in pnarK2Δup, the so-called ‘upstream activating region’ (described by Hutter & Dick, 2000) is deleted (−122 to −220 relative to M. tb narK2X TSP). A similar level of hypoxic induction was observed for both promoter constructs in all three strains (Table 3), demonstrating that the M. tb narK2X promoter has similar activity in M. tb, M. bovis and BCG. These results suggest that all the trans-acting (including DevR) and cis elements that control the narK2X promoter are functionally conserved in M. tb, M. bovis and BCG, except for the −6T/C SNP. A putative −10 element was recognized upstream of the experimentally detected TSP of narK2 that was reported previously (Chauhan & Tyagi, 2008a). In the present study, it was functionally characterized by individually mutating additional nucleotides at −4, −5, −7 and −8 positions with respect to the TSP (Fig. 1).

Both −4AC Paclitaxel nmr and −5TC mutations significantly or completely reduced the promoter activity and demonstrated the importance of these nucleotides in promoter function. Taken together, the results of mutation analysis indicate that ‘ATT’ nucleotides present at −4, −5 and −6 positions are essential for promoter activity and likely to be recognized by the transcriptional machinery. Note that the −5TC mutation was reported to be present in BCG by Hutter and Dick (2000), and the introduction of this mutation significantly reduced inducible promoter activity by ∼7-fold, but did not abolish it (Fig. 1). The −7GC or −8GT mutations, which also altered the overlapping putative SigC −10 sequence, did not adversely affect narK2X promoter activity. Although the −10 element of the narK2X promoter showed only a modest resemblance (2/6) to the SigA consensus sequence (Unniraman et al.

another. A key distinction between these studies of within-modality switches and our between-modality study is that the two tasks are typically afforded by the same stimuli in the former,

whereas in the current design the participants switch between both the task and the stimuli affording those tasks. When one switches between auditory and visual inputs, the suppression of the potentially distracting sensory inputs can putatively be achieved by a relatively LEE011 order indiscriminate suppression of a large swath of cortex, probably involving early sensory regions. On the other hand, when both tasks are afforded by the same object (e.g. the printed words in a Stroop task), then the suppression mechanisms would need to target much more specific, feature-level representations. In a recent study, we assessed this issue by asking individuals to switch between a color and a motion task, where the two features were afforded by the same random dot field arrays (Snyder & Foxe, 2010). Consistent CH5424802 manufacturer with a feature-based suppression account, we found that alpha power increased within dorsal visual regions when

motion was to be suppressed (i.e. when color was the relevant feature), whereas alpha power increased in ventral visual regions when color was irrelevant. One could certainly argue that, in the current experiment, the auditory and visual inputs to be acted upon had no natural relationship to each other. Thus, although they are presented simultaneously and compete for resources, they may be perceived as separable objects, and the this website level of competition between them would probably then be less than if the tasks were afforded by features of the same object. It may be of considerable interest, in future work, to employ audiovisual stimuli where there is a clear semantic relationship between the constituent inputs (e.g. animals and their related vocalisations; Molholm et al., 2004, 2007; Fiebelkorn et al., 2010). We observed clear behavioral mixing costs in a cued audiovisual task, but no apparent switching costs, suggesting that preparatory processes during the cue-target period allowed for the entirely successful

resolution of competition among the two task-sets. We argue that, within our design, the competing tasks are held in close states of readiness, and then ‘tipped’ in favor of one or the other of the tasks by neural biasing mechanisms. Our findings support the contention that one of these mechanisms very probably involves the distribution of alpha oscillations among relevant cortical regions. Further work is required to fully tease apart the contribution of alpha synchronisations and desynchronisations to task-set reconfigurations. This work was primarily supported by a grant from the U.S. National Science Foundation (NSF) to J.J.F. (BCS1228595). The authors thank Mr Jason Adler and Ms Sarah Walkley for help with initial data collection and analysis. Additional support for the work of J.J.F.

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 AZD1208 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 MycoClean Mycoplasma Removal Kit 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.