Although S. pneumoniae and H. influenzae have been described to reside together in the middle ear of children with OM [ 8, 31], interestingly these pathogens were never observed together in the same specimen (0 of 5 specimens) in our study.
Unfortunately, due to the unavailability of molecular data for P. toxica (the limu make o Hana from Hawaiian folklore), we could not determine its relationship to either the toxic specimens from our study or to P. heliodiscus, which available molecular data suggests our toxic specimens are.
However, since we did not study gut specimens in our study, this hypothesis deserves further study.
We are grateful to Beto Brandão (MZSP), Stefan Cover (MCZ), Ted Schultz (NMNH) and Heraldo Vasconcelos (UFU) for contributing specimens to our study.
The significantly higher proportions of subjects over 85 years with cross-reacting antibodies in pre-pandemic specimens in our study, are consistent with results of recent studies from England and Finland [21], [22].
Plagiognathus obscurus and species closely related to it showed patterns of sequence variation that conflicted with current taxonomic assignments (Fig. 4) although its taxonomy was recently revised [14] and the specimens in our study were identified to reflect this treatment.
Furthermore, the specimens in our study were macroscopically graded: only those with intact cartilage were included.
Futhermore, the specimens in our study were harvested from normal, mature porcine spines that lacked degeneration, instablity, and osteoporosis.
Also, the number of specimens in our study was small and generalization must therefore be done with caution.
However, no such overt evidence of EMT was seen in either LMD or HMD specimens in our study.
