HTLV-1 is a significant global health problem but remains largely confined to endemic areas and risk groups. However, increasing migration may mean that the virus will be encountered more frequently in areas traditionally thought of as virtually free of HTLV-1. In this review we discuss the epidemiology, transmission, clinical features, diagnosis and treatment of HTLV-1, focussing specifically on the neurological manifestations. We highlight the circumstances in which HTLV-1 should be suspected and outline the current understanding of HTLV-1-associated myelopathy and other neurological presentations.

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STs) previously reported in China (ST1, ST2, ST4, ST9, ST22, ST47), but also eight novel lineages, were detected. Only some quinolone-resistant isolates had amino acid substitutions in ParC (Ser83Leu in UPA) and ParE (Val417Thr in UPA and the novel Thr417Val in UUA), whereas the mechanism (s) for the remaining strains remains unclear. Although several isolates were nonsusceptible to macrolides, mutations in 23S rRNA or substitutions in L4/L22 were not detected. Conclusion This is the first study analysing susceptibility of Ureaplasma spp. isolates detected in Switzerland and the clonal distribution outside China. Resistance rates are low compared to other surrounding countries, but the empirical use of quinolones is compromised. We hypothesise that some hyperepidemic STs (e.g., ST4) spread worldwide via sexual intercourse. Large combined microbiological and clinical studies should address this important aspect.