bluuebunny/crossref_metadata_2025 huggingface dataset:
Hospital infections in Spain. I.Staphylococcus aureus(1978–91)
Authors: Vindel A. , Trincado P. , Nicolas MM. Martin De , Gomez E. , Bourgon C. Martin , Nieto J. A. Saez
Published: May 2009

This study was undertaken to determine the distribution of phage types ofStaphylococcus aureusisolates from hospital outbreaks or sporadic cases received in our laboratory during the past 14 years. The records for 15803 isolates from 55 Spanish hospitals have been analysed.

In relation to sporadic isolates we have been able to detect the predominance of phage group I and non-typable staphylococcal strains. Since 1989, we have observed a considerable increase in hospital infection caused by methicillin-resistantS. aureusstrains which we could differentiate in to two groups; one belonging to phage group III (6/47/54/75/77/84/85) and other groups of non-typable strains which could be classified as phage group I-III after heat treatment (29/77/84) and with similar patterns by reverse typing (6/47/53/54/75/83A/84/85/W57/1030/18042).

During 1990 and 1991, these strains have extended widely to at least six different autonomous regions creating an epidemic situation in Spain.
The contamination of paté byListeria monocytogenesin England and Wales in 1989 and 1990
Authors: Gilbert R. J. , McLauchlin J. , Velani S. K.
Published: May 2009

In July 1989, 1834 samples of paté (of which 1698 were from retail displays) were examined by the PHLS for the presence ofListeria monocytogenes. The survey was repeated in July 1990, when 626 paté samples on retail sale were examined. Between the two surveys there was a marked reduction in the proportions of patés contaminated (10% in 1989 and 4% in 1990) and in the numbers of samples from which > 103L. monocytogenes/gwere recovered. The higher rate of contamination detected in 1989 was largely due to paté from a single manufacturer. In both surveys, paté sold as loose slices had higher rates of contamination than those prepackaged. Temperature control had improved between the two surveys where 65% of samples in 1989 and 83% in 1990 were stored at ≤ 7 °C. Although contamination occurred at almost all temperatures,L. monocytogeneswas both quantitatively and qualitatively more common in samples stored at > 7 °C. The majority of patés had unexpired shelf lives of between 0 and 3 weeks. Although contamination occurred throughout the shelf life of these products, the proportion of samples whereL. monocytogeneswas recovered was higher in patés with expired sell by dates. There was an association between high total viable counts and the presence ofL. monocytogenes.
Campylobacter bacteraemia in England and Wales, 1981-91
Authors: Skirrow M. B. , Jones D.M. , Sutcliffe E. , Benjamin J.
Published: May 2009

Routine surveillance of infection in England and Wales detected 394 cases of campybacter bactermia in 11 years. This represented an average incidence of 1.5 per 1000 intestinal campllobacter infections, with range of 0.3/1000 in children aged 1–4 years to 5.9/1000 in patients aged 65 years or more. Definitive identification of 257 isolates showed that 89% wereCampylobacter jejuniorC. coli: other species wereC. fetus(8.6%).C. lari(0.8%),C. uspaliensis(0.8%). helicobacter (Campylobacter)fennlliae(0.8%), andHelicobacter (Camphlobacter) cinaedi(0.4%). Most (71%) of theC. jejuni/C. colibacteraemias were in pastients with acute enteritis. Of the patients withC. fetusbacteremias only 27% had diarrhoea: they were older than patients with diarrhoae: they were older than patients withC. jejuniorC. colibacteremia (54.1 r. 45.9 years) and proportionally more of them were male (M:F retio 2.7: 1 v. 1.9:1): 41% had endovascular pathology or cellulitis. There was a higher proportion ofC. jejuniserogroup O 4 (Penner) and O 18 strains among blood than faecal isolates. Which suggests that they were unsually serum resistant and/or invasive.
Genetic analysis ofEscherichia colifrom porcine postweaning diarrhoea
Authors: Hampson D. J. , Woodward J. M. , Connaughton I. D.
Published: May 2009

A total of 79 Australian isolates of beta-haemolyticEscherichia colifrom cases of porcine postweaning diarrhoea (PWD), and 18 isolates of serotype O 149:K91:K88 (F4) from unweaned pigs from Australia, Indonesia and Denmark, were examined by multilocus enzyme electrophoresis. These were divided into 57 electrophoretic types (ETs), with an overall mean genetic diversity per enzyme locus of 0·466. This value closely resembled that previously recorded for the whole species. Not only was the collection diverse, but there was considerable genetic heterogeneity amongst PWD isolates of the same serogroup. Isolates from serogroups O 8 and O 138 were most varied, whilst many from serogroups O 141 and O 149 were more closely related. In contrast, the isolates from the unweaned pigs all belonged to only one ET.
An outbreak ofEscherichia coliO157 associated with a children's paddling pool
Authors: Brewster D. H. , Brown M. I. , Robertson D. , Houghton G. L. , Bimson J. , Sharp J. C. M.
Published: May 2009

In May 1992. a small, circumscribed community outbreak of infection due to verotoxin-producingEscherichia coliO157 phage type 49 occurred in a semi-rural area of south-east Scotland. On the basis of stool cultures, six cases were identified, one of whom was asymptomatic. One child developed the haemolytic uraemic syndrome. Although the source of infection of the index case was not established nor could the extent of person-to-person spread be fully determined, the clinical, microbiological and epidemiological evidence available indicated that a children's paddling pool served as the focal point in the transmission of infection causing the outbreak.
Seroprevalence of leptospirosis in a rural flood prone district of Bangladesh
Authors: Morshed M. G. , Konishi H. , Terada Y. , Arimitsu Y. , Nakazawa T.
Published: May 2009

Leptospirosis is a worldwide zoonotic disease. In the present investigation, a total of 89 human sera from a flood prone district of Bangladesh was screened by a one-point microscapsule agglutination test (MCAT). MCAT-positive and-doubtful sera were further tested by microscopic agglutination test (MAT) against 16 reference serovars ofLeptospira interrogans. and the antibody titres determined. In MCAT, 34 sera were positive and 22 were doubtful. Among those positive and doubtful sera. 33 and 20. respectively were tested by MAT. Thirty-four out of 53 MCAT-screened samples were MAT-positive. The titres ranged from 20 to 1600 with antibodies to serovarscopenhageni, australis, cynopteriandicterohaemorrhagiaebeing the most prevalent. Eleven MCAT-positive samples failed to react with any strains used by MAT, suggesting the presence of new or untested serovars. Among the MAT-positive samples, the presence of antibody against two or more serovars was more common than that of a single serovar. The present study suggests that rural people in Bangladesh are at high risk to leptospiral infection.
Comparison in the immunological properties ofBorrelia burgdorferiisolates fromIxodes ricinusderived from three endemic areas in Switzerland
Authors: Hu C. M. , Leuba-Garcia S. , Kramer M. D. , Aeschlimann A. , Gern L.
Published: May 2009

Borrelia burgdorferiisolates were obtained fromIxodes ricinusfrom three sites in Switzerland. They were examined by SDS-PAGE and immunoblotting. The phenotypes, in respect of three outer surface proteins (Osp), differed between the sites of collection. In site 1, most isolates had an OspA of 31 kDa and an OspB of 34 kDa: in site 2, isolates presenting an OspA of 33 kDa dominated and in site 3, the isolates with an OspA of 32 kDa and an OspB of 35 kDa were most frequent. This distribution differed significantly. About half of the isolates from sites 1 and 3 reacted with anti-OspA monoclonal antibody H5332 compared to 29% from site 2. Site 1 isolates reacted significantly more frequently (81 %) with another anti-OspA monoclonal antibody LA-31 than isolates from site 3 (P< 0·0001). These findings have implications for the epidemiology of Lyme borreliosis, for the further development of serodiagnostic reagents and for the development of a vaccine.
Subtyping ofMycobacterium aviumcomplex (MAC) isolates by thin-layer chromatography – distribution of subtypes from patients with AIDS compared with clinically non-significant isolates
Authors: Chew W. , Sorrell T. C. , Gilbert G. L.
Published: May 2009

Thin-layer chromatography (TLC) was compared with seroagglutination for subtyping ofMycobacterium aviumcomplex (MAC) bacteria. Seventy-five significant MAC isolates from patients with AIDS were typed by both methods and 36 isolates, judged to be clinically non-significant, were examined by TLC only. Overall. 75% of isolates tested were typable by seroagglutination and 91% by TLC; the results correlated between the two except for minor discrepancies.

Serovars 1, 8 and 21 and mixed serovars 1–21 and 1–8–21 were common among isolates from AIDS patients and together represented 83 % of isolates compared with only 36% in the non-significant group (odds ratio 8·4; 95% confidence interval 3·4–23·3). This difference remained significant after exclusion of serovar 41 (M. scrofulaceum), which was the commonest isolate (28%) in the non-significant group but was not isolated from patients with AIDS.

TLC is useful to supplement seroagglutination for subtyping of MAC. Further study is required to determine whether apparent differences between isolates from patients with AIDS and from other sources reflect differences in virulence or in environmental prevalence of MAC subtypes.
Household-acquisition of measles and illness severity in an urban community in the United States
Authors: Butler J. C. , Proctor M. E. , Fessler K. , Hopfensperger D. J. , Sosin D. M. , Davis J. P.
Published: May 2009

Studies from developing countries suggest that persons with household-acquired (HA) measles are at greater risk of severe illness than persons with community acquired (CA) infection. Reported measles cases occurring among Milwaukee residents from May 1989 to June 1990 were used to assess whether household acquisition was a risk factor for severe measles in the United States. A case was classified as HA if onset of rash occurred 7–18 days after onset of rash in another case in the same household. Hospitalization rates were similar for 128 patients with HA measles (27%) and for 1004 patients with CA measles (26%). Multiple logistic regression was used to evaluate the association between hospitalization and household-acquisition after controlling for socioeconomic status, measles vaccination history, age, race, and date of onset of rash. Patients with HA measles were no more likely to be hospitalized than patients with CA measles (odds ratio 0·9, 95% confidence interval 0·6, 1·5). HA measles cases were not more severe than CA measles cases during this urban outbreak in the United States.
Distribution of bluetongue virus in Turkey, 1978–81
Authors: Taylor W. P. , Mellor P. S.
Published: May 2009

Information about the distribution of bluetongue in Turkey during 1978–81 has been obtained by serological surveys in cattle, sheep and goats. The group-specific immunodiffusion test was used to identify the presence of bluetongue virus (BTV) in a given province and the type-specific microneutralization test to decide which virus types had been in circulation. By drawing sera from accurately aged donor animals in May and August 1980. it was possible to draw up a general outline of the distribution of BTV in Turkey between early 1978 and mid 1980. By combining the same technique with spring and autumn field visits it became possible to make detailed inferences about the distribution of BTV serotypes in 1980 and 1981. The results support the conclusion that BTV was widespread in central and western Turkey for a number of years and suggests that overwintering can be a regular occurrence in that country. When compared with contemporaneous results from Syria and Jordan, a unifying and well-defined bluetongue virus ecosystem becomes apparent.
Application of pulsed-field gel electrophoresis to the epidemiological characterization ofStaphylococcus intermediusimplicated in a food-related outbreak
Authors: Khambaty F. M. , Bennett R. W. , Shah D. B.
Published: May 2009

An outbreak of food intoxication involving over 265 cases in western United States occurred in October 1991.Staphylococcus intermediuswas implicated as the aetiologic agent. Representative outbreak isolates (five clinical and ten from foods) produced type A enterotoxin. DNA fragments generated by four restriction endonucleases and analysed by pulsed-field gel electrophoresis (PFGE) provided definitive evidence that all isolates from nine different counties in California and Nevada were derived from a single strain. The PFGE pattern of these outbreak isolates was distinct from those of a heterogeneous collection of sevenS. intermediusstrains of veterinary origin and five unrelatedS. aureuslaboratory strains. The data show a significant PFGE pattern heterogeneity not only among members of differentStaphylococcusspecies but also within members of the same species and even the same enterotoxin type. The results indicate that PFGE is a valuable strain-specific discriminator for the epidemiological characterization ofS. intermedius. To our knowledge, this represents the first documented foodborne outbreak caused byS. intermedius. These findings suggest that the presence ofS. intermediusand other species such asS. hyicusin food should be reason for concern.
A school- and community-based outbreak of Mycobacterium tuberculosis in Northern Italy, 1992–3
Authors:   The Lodi Tuberculosis Working Group
Published: May 2009

In late 1992, three cases of smear-positive tuberculosis were diagnosed among secondary school students in Lodi, Italy. The three attended different schools but travelled on the same bus. Schoolmates, other bus riders, family members, and friends underwent tine testing and X-rays. Of the 3188 students tested, 277 (8·7 %) were reactors. Independent risk factors for tine reactivity among students included living in the same town (odds ratio [OR] = 4·8; 95% confidence intervals [CI] = 3·8–6·0); having classroom contact (OR = 4·4; 95% CI = 3·4–5·7); or riding the same bus (OR = 5·4; 95% CI = 4·3–6·7) as a smear-positive case. Twenty-four cases of pulmonary tuberculosis were identified. The index case was a student whose father had had cavitary tuberculosis. Despite being tine test positive in 1989, he was not given prophylaxis and was lost to follow-up. This large outbreak emphasizes the need for identification and prompt chemoprophylaxis of reactors, especially in vulnerable adolescent populations.
Prevalence of serum IgG antibodies to Puumala virus (haemorrhagic fever with renal syndrome) in Northern Sweden
Authors: Ahlm C. , Linderholm M. , Juto P. , Stegmayr B. , Settergren B.
Published: May 2009

A stratified and randomly-selected population sample was identified in 1990 in order to study the seroprevalence of nephropathia epidemica (haemorrhagic fever with renal syndrome) in Northern Sweden. Sera from 1538 subjects (750 men, 788 women), 25—64 years of age, were analysed for the presence of Puumala virus (PUV) specific-IgG by the indirect immunofluorescence antibody test. Specific IgG was detected in sera from 83 subjects (5·4%). Men and women had similar seroprevalence rates. The highest seroprevalences were found in subjects 55 years or older (8·0%) and among farmers and forestry workers (15·9%). The geographic distribution of seropositive individuals was uneven and there were significantly more seropositive persons in rural than in urban areas (P < 0·05).
Measurement of IgA responses following Norwalk virus infection and other human caliciviruses using a recombinant Norwalk virus protein EIA
Authors: Parker S. P. , Cubitt W. D.
Published: May 2009

An enzyme immunoassay employing recombinant Norwalk virus capsid protein was evaluated for the measurement of IgA responses. Tests on 23 volunteers and patients known to have been infected with Norwalk virus (NV) showed that 19 developed significant IgA responses, 2 had unchanging levels of IgA and 2 failed to respond. There was no evidence of IgA responses to NV following infection with Hawaii or Snow Mountain-like viruses.

Tests on sera from patients involved in outbreaks associated with eating contaminated shellfish suggest that some patients may have been infected with more than one strain of calicivirus. The use of the rNV EIA for measuring IgA and IgG responses in patients involved in a major outbreak of food poisoning affecting hospital staff indicated that the causative agent was probably NV.
The prevalence ofEscherichia coliO157.H7 in dairy and beef cattle in Washington State
Authors: Hancock D. D. , Besser T. E. , Kinsel M. L. , Tarr P. I. , Rice D. H. , Paros M. G.
Published: May 2009

Escherichia coliO157.H7 was found in 10 of 3570 (0·28%) faecal samples from dairy cattle in 5 of 60 herds (8·3%). Several tentative associations with manure handling and feeding management practices on dairy farms were identified. Faecal/urine slurry samples, bulk milk samples, and milk filters from dairy herds were negative forE. coli0157.H7.E. coli0157.H7 was also isolated from 10 of 1412 (0·71 %) faecal samples from pastured beef cattle in 4 of 25 (16%) herds. The prevalence ofE. coli0157. H7 excretion in feedlot beef cattle was 2 of 600 (0·33 %). The identification of cattle management practices associated with colonization of cattle byE. coli0157.H7 suggests the possibility that humanE. coliO157.H7 exposure may be reduced by cattle management procedures.
Municipal drinking water and cryptosporidiosis among persons with AIDS in Los Angeles County
Authors: Sorvillo F. , Lieb L. E. , Nahlen B. , Miller J. , Mascola L. , Ash L. R.
Published: May 2009

To assess unfiltered drinking water as a source of cryptosporidium infection in patients with the acquired immunodeficiency syndrome (AIDS) the prevalence of cryptosporidiosis among persons with AIDS in Los Angeles County was assessed by water service area. One water distributor, serving approximately 60% of the county's residents (area B), has consistently employed filtration. The other company, which serves the remainder of the county (area A), did not institute nitration until mid-December 1986. This difference provided a ‘natural experiment ’ in which to assess the effect of municipal water filtration on the level of cryptosporidiosis among persons with AIDS. The prevalence of cryptosporidiosis among AIDS patients was compared for the two water service areas for the time period (1983–6) preceding the implementation of filtration in area A. From 1983 to 1986 the age-standardized prevalence of cryptosporidiosis among AIDS patients was 32% lower in area A (4·2%), which received unfiltered water, than in area B (6·2%). Following addition of filtration in area A, the prevalence of cryptosporidiosis among AIDS patients decreased by 20%; however, a decline, of 47%, was also observed in area B. The similar baseline levels of cryptosporidiosis and the corresponding post-filtration decline in both areas suggest that filtration had no effect on levels of cryptosporidiosis among persons with AIDS. Thus it does not appear that municipal drinking water is an important risk factor for cryptosporidiosis in AIDS patients residing in Los Angeles County.
A review of the possible mechanisms for the persistence of foot-and-mouth disease virus
Authors: Woodbury E. L.
Published: May 2009

Foot-and-mouth disease (FMD) was the first animal disease to be attributed to a virus, and the second virus to be discovered [1]. It is a positive-sense, singlestranded RNA picornavirus and the sole member of the genus Aphthovirus. Each infectious virus particle contains a single strand of RNA approximately 8-5 kb long. This is translated into a single polypeptide which is then cleaved into the structural and non-structural virus proteins.
The distribution of serotype-specific plasmids among different subgroups of strains ofSalmonella entericaserotype Enteritidis: characterization of molecular variants by restriction enzyme fragmentation patterns
Authors: Rankin S. C. , Benson C. E. , Platt D. J.
Published: May 2009

Four hundred and thirty-four isolates ofSalmonella entericaserotype Enteritidis were studied. They were grouped into five subsets defined by either the collection criteria or the parameter which formed the basis for subsequent analysis. Seventy-seven per cent harboured the serotype-specific plasmid (SSP). In 55% of the isolates this was the sole plasmid. Molecular variation in the SSP was detected in 17 (5%) of the isolates on the basis of restriction enzyme fragmentation pattern (REFP) analysis usingPstI andSmaI. The SSP variants were further characterized using additional restriction enzymes chosen to optimize the information content and analysed using a coefficient of similarity.

A variant SSP designated pOG690 showed greater resemblance to the SSP ofSalmonella entericaserotype Typhimurium than Enteritidis; 89% and 68% respectively forPstI and 79% and 55% respectively forSmaI. In respect of thePstI data pOG690 shared at least 55 kb of DNA with the Typhimurium SSP and 37 kb with the SSP of Enteritidis. This variant was associated with poultry (duck, goose, chicken) and all isolates belonged to phage type 9b. Other variants were associated with phage types 4, 6, 6a, 9a, 11, 15 and 24. The epidemiological implications of these results are discussed.
Epidemiology ofPseudomonas aeruginosakeratitis in contact lens wearers
Authors: Stapleton F. , Dart J. K. G. , Seal D. V. , Matheson M.
Published: May 2009

This study evaluated the epidemiology ofPseudomonas aeruginosakeratitis in contact lens (CL) wearers; the relationships between CL storage case contamination and CL hygiene practice and between CL hygiene and the development of keratitis. Sixteen CL wearers with keratitis were compared with 44 asymptomatic controls. Lens hygiene practice was assessed and CL care materials, domestic water sites and endogenous sites were evaluated microbiologically. Poor CL hygiene was not associated withPs. aeruginosakeratitis. There was an association between keratitis and bacterial contamination of the CL and storage case (P < 0·0005). Lens and storage case contamination were not significantly associated with poor hygiene. No domestic or endogenous source forPs. aeruginosawas found. Causative organisms may be derived from other sources, but CLs and CL storage cases provide a favourable environment forPs. aeruginosacolonization. Changing the CL care environment to one less favourable forPs. aeruginosamay help to eliminate this problem.
Epidemiology ofCampylobacterspp. at two Dutch broiler farms
Authors: Jacobs-Reitsma W. F. , Van de Giessen A. W. , Bolder N. M. , Mulder R. W. A. W.
Published: May 2009

Broiler flocks on two Dutch poultry farms were screened weekly for the presence of Campylobacter in fresh caecal droppings during eight consecutive production cycles. Hatchery and fresh litter samples were taken at the start of each new cycle. Water, feed, insects, and faeces of domestic animals, present on the farms were also included in the sampling. Penner seretyping of isolates was used to identify epidemiological factors that contribute to Campylobacter colonization in the broiler flocks. Generally, broiler flocks became colonized with Campylobacter at about 3–4 weeks of age with isolation percentages of 100%, and stayed colonized up to slaughter. A similar pattern of serotypes was found within the various broiler houses on one farm during one production cycle. New flocks generally showed also a new pattern of serotypes. Most serotypes isolated from the laying hens, pigs, sheep and cattle were different from those isolated from the broilers at the same time. Campylobacter serotypes from darkling beetles inside the broiler houses were identical to the ones isolated from the broilers. No Campylobacter was isolated from any of the hatchery, water, feed or fresh litter samples. Conclusive evidence of transmission routes was not found, but results certainly point towards horizontal transmission from the environment. Horizontal transmission from one broiler flock to the next one via a persistent contamination within the broiler house, as well as vertical transmission from breeder flocks via the hatchery to progeny, did not seem to be very likely.
Restriction fragment length polymorphisms among the flagellar genes of the Lior heat-labile serogroup reference strains and field strains ofCampylobacter jejuniandC. coli
Authors: Burnens A. P. , Wagner J. , Lior H. , Nicolet J. , Frey J.
Published: May 2009

Several typing systems have been described forCampylobacter jejuniandC. coli, to assess the complex epidemiology of these important enteric pathogens. In the present study two typing methods, slide agglutination according to the Lior scheme, and the demonstration of restriction-fragment length polymorphisms (RFLP) of flagellar genes, have been used in parallel on a set of 194 strains. This set comprised 118 sero-reference strains ofC. jejuniandC. coliof the Lior scheme, as well as 76 clinical isolates. All isolates were serotyped and subjected to PCR for amplification of flagellar genes, and the PCR product was restricted withAluI. Flagellar genes could be amplified in 152 strains. Among 85 seroreference strains, 74 different RFLP patterns were observed, and among 67 clinical isolates, there were 36 patterns. There was only limited correlation between flagellar RFLP and the Lior serogroup, and the variability of patterns in serogroups HL2 and HL4 were as marked as the variability between serogroups. Flagellar gene RFLP patterns are shown to be stable, highly discriminatory epidemiologic markers.
VerotoxinogenicCitrobacter freundiiassociated with severe gastroenteritis and cases of haemolytic uraemic syndrome in a nursery school: green butter as the infection source
Authors: Tschäpe H. , Prager R. , Streckel W. , Fruth A. , Tietze E. , Böhme G.
Published: May 2009

A summer outbreak of severe gastroenteritis followed by haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopenic purpura in a nursery school and kindergarten is described. Sandwiches prepared with green butter made with contaminated parsley were the likely vehicle of infection. The parsley originated from an organic garden in which manure of pig origin was used instead of artificial fertilizers, Cornally identical VerotoxinogenicCitrobacter freundiiwere found as causative agents of HUS and gastroenteritis and were also detected on the parsley.
Sequence variation in the haemagglutinin-neuraminidase gene of human parainfluenza virus type 3 isolates in the UK
Authors: Collins K. R. , Easton A. J.
Published: May 2009

The sequence variation in a 934 base-pair region of the gene encoding the haemagglutinin-neuraminidase of five human parainfluenza virus type 3 (HPIV3) isolates was determined together with that of a prototype UK strain. All of the clinical isolates were from the Manchester area of the UK and were obtained in 1990. 1991 and 1993. The gene segment was amplified by the polymerase chain reaction using HPIVB-specific oligonucleotide primers. The nucleotide homology of the strains was high, around 99% and specific differences in the UK sequences when compared with that of the US prototype strain were identified. In addition, a number of isolate-specific differences were seen. No correlation was detected between the observed nucleotide mutations and the year of isolation, which supports the hypothesis that HPIV3 shows cocirculation of a heterogeneous population of viruses rather than varying with time in a linear fashion. However, the data suggested that geographically-defined genetic lineages of HPIV3 may exist.
Epidemic cholera in Guatemala, 1993: transmission of a newly introduced epidemic strain by street vendors
Authors: Koo D. , Aragon A , Moscoso V. , Gudiel M. , Bietti L. , Carrillo N. , Chojoj J. , Gordillo B. , Cano F. , Cameron D. N. , Wells J. G. , Bean N. H. , Tauxe R. V.
Published: May 2009

Epidemic cholera reached Guatemala in July 1991. By mid-1993, Guatemala ranked third in the hemisphere in reported cases of cholera. We conducted a case-control study with two age-, sex-, and neighbourhood-matched controls per patient in periurban Guatemala City. Twenty-six patients hospitalized for cholera and 52 controls were enrolled. Seven (47%) of 15 stool cultures obtained after admission yielded toxigenicVibrio choleraeOl. All seven were resistant to furazolidone, sulfisoxazole, and streptomycin, and differed substantially by pulsed-field gel electrophoresis from the Latin American epidemic strain dominant in the hemisphere since 1991. In univariate analysis, illness was associated with consumption of left-over rice (odds ratio [OR] = 7·0, 95% confidence interval [CI] = 1·4–36), flavored ices (‘helados’) (OR = 3·6, CI = 1·1–12), and street-vended non-carbonated beverages (OR = 3·8, CI = 1·2–12) and food items (OR = 11·0, CI = 2·3–54). Street-vended food items remained significantly associated with illness in multivariate analysis (OR = 6·5, CI = 1·4–31). Illness was not associated with drinking municipal tap water. Maintaining water safety is important, but slowing the epidemic in Guatemala City and elsewhere may also require improvement in street vendor food handling and hygiene.
Resistotyping of campylobacters: fulfilling a need
Authors: Ribeiro C. D. , Thomas M. T. , Kembrey D. , Magee J. T. , North Z.
Published: May 2009

A 9-month trial of a simple typing scheme for ‘thermophilic’ enteric campylobacter isolates at a large Public Health Laboratory is described. Resistotyping was performed with six agents in a method modified by Bolton and colleagues from an earlier scheme, and biotyping was performed by a modified Lior scheme involving three tests. Reproducibility was excellent in both schemes, with test variation < 2%. Five household clusters and one larger presumptive milk-borne outbreak were identified in this scheme, and confirmed in pyrolysis mass spectrometry. The 328 isolates from new patients, excluding duplication from these clusters, were divided into 35 resistotypes with the largest group comprising 22% of isolates. In combined bio- and resistotyping, 86 types were found, with the largest group comprising 9·5% of isolates. The results are contrasted with salmonella sero- and phage-typing, where, on the same basis, the 176 isolates in the same period were divided into 40 groups, with the largest comprising 45% of isolates. Resistotyping, with or without additional biotyping, proved to be a convenient, simple, rapid, highly discriminatory, reproducible and inexpensive method well suited to use in local laboratories. It is a strong candidate for first-line national and local surveillance of campylobacter infections, fulfilling a need for monitoring of this important cause of enteric disease.
Legionellosis linked with a hotel car park – how many were infected?
Authors: Bell J. C. , Jorm L. R. , Williamson M. , Shaw N. H. , Kazandjian D. L. J. , Chiew R. , Capon A. G.
Published: May 2009

An outbreak of legionellosis associated with a hotel in Sydney, Australia, and the subsequent epidemiological and environmental investigations are described. Four cases of Legionnaires' disease were notified to the Public Health Unit. A cross-sectional study of 184 people who attended a seminar at the hotel was carried out. Serological and questionnaire data were obtained for 152 (83%) of these. Twenty-eight (18%) respondents reported symptoms compatible with legionellosis. Thirty-three subjects (22%) had indirect fluorescent antibody (IFA) titres toLegionella pneumophilaserogroup 1 (Lp-1) of 128 or higher. The only site which those with symptoms of legionellosis and IFA titre ≥128 were more likely to have visited than controls was the hotel car park (adjusted odds ratio [OR] 14·7, 95% confidence interval [CI]: 1·8–123·1). Those with symptoms compatible with legionellosis, but whose IFA titres were < 128 were also more likely to have visited the hotel car park (adjusted OR 4·4, 95% CI: 1·5–12·9). Seroprevalence of Lp-1 antibodies was higher in those who attended the seminar than in a population sample of similar age. Findings suggested that the 4 cases represented a small fraction of all those infected, and highlighted difficulties in defining illness caused by Lp-1 and in interpreting serology.
Non-replicating expression vectors: applications in vaccine development and gene therapy
Authors: Limbach K. J. , Paoletti E.
Published: May 2009

This review presents experimental, preclinical and clinical data illustrating the multiple uses of recombinant non-replicating virus vectors in the fields of immunoprophylaxis and gene therapy.
Risk factors for recent toxoplasma infection in pregnant women in Naples
Authors: Buffolano W. , Gilbert R. E. , Holland F. J. , Fratta D. , Palumbo F. , Ades A. E.
Published: May 2009

Effective primary prevention of congenital toxoplasmosis requires up to date information on locally relevant risk factors for infection in pregnant women. In Naples, risk factors for toxoplasma infection were compared in recently infected women (as assessed by detection of specific IgM in serum) and susceptible, IgG negative women. Recent infection was strongly associated with frequency of consumption of cured pork and raw meat. Eating cured pork or raw meat at least once a month increased the risk of toxoplasma infection threefold.

This simple study design for determining locally relevant sources of toxoplasma infection is the first report of cured pork as a risk factor for infection. Further research is required to determine cyst viability in cured pork products. Our findings suggest that in southern Italy, cured pork and raw meat should be avoided by susceptible pregnant women.
The significance of wild birds(Larus sp.)in the epidemiology of campylobacter infections in humans
Authors: Whelan C. D. , Monaghan P. , Girdwood R. W. A. , Fricker C. R.
Published: May 2009

During much of the present century, the population of herring gulls in Britain has increased rapidly (Cramp, Bourne & Saunders, 1973; Chabrzyk & Coulson, 1976; Monaghan & Coulson, 1977). Accompanying this changes was an increased utilization by these birds of human waste as a food supply, particularly sewage and refuse emanating from our towns and cities (Monaghan, 1983; Hortonet al.1983). This, coupled with their habits of roosting on agricultural land and water storage reservoirs and of breeding on inhabited buildings, has given rise to concern over the role of these birds in the spread of disease to man and domestic animals (e.g. Fenlon, 1981; Reillyet al.1981; Butterfieldet al.1983; Monaghanet al.1985; Girdwoodet al.1986).
The characterization and pathological significance of gastric campylobacter-like organisms in the ferret: a model for chronic gastritis?
Authors: Tompkins D. S. , Wyatt J. I. , Rathbone B. J. , West A. P.
Published: May 2009

Gastric campylobacter-like organisms (CLO) were isolated from gastric tissues removed at sacrifice from 17 mature ferrets; all animals were colonized, but no macroscopic mucosal lesions or histological features of chronic gastritis were seen. The isolates resembledCampylobacter pyloriin many cultural and biochemical characteristics, and produced substantial urease activity, but there were sufficient differences fromC. pylorito suggest that ferret gastric CLO represents a separate species. Comparison of humanC. pyloriand ferret gastric CLO may help to clucidate the pathogenicity of the former in patients with gastritis, and the ferret may serve as a useful animal model for the study ofC. pyloriinfection.
Occurrence of H-antigen z66 of R phase in cultures of Salmonella serovar typhi originated from Indonesia
Authors: Tamura K , Sakazaki R , Kuramochi S , Nakamura A
Published: May 2009

Eighteen strains of Salmonella choleraesuis subsp. choleraesuis serovar Typhi (S. typhi) isolated from blood of patiens in Japan who had visited Indonesia and returned before the onset of typhoid fever were found to possess the H-antigen z66reported by Guinée et al. (1981) but had the naturally occuring H-antigen d. They were not lysed by any of the phages of the Vi phage typing system. After passage through semi-solid medium containing H-z66 antiserum, H-antigens of 11 of 18 cultures with H-z66 phage changed to H-j and those of 2 others to H-d, while the remaining 5 were immobilized. With cultures in the H-d or H-j phages, change of the H-antigens did not occur when they were cultured in semi-solid medium containing homologous H-antiserum. These phase induction experiments as well as colony examination of original cultures suggest that H-z66 phase is unstable and tends to change of H-antigen to H-d or H-j occured without difficulty probably represented a mixed population of cells in the H-z66 and H-d or H-j phases. Since none of 856 isolates from Japan or fromimported cases of typhoid fever from Southeast Asia other than Indonesia exhibited the H-z66 antigen, it was concluded that the focus of typhois fever caused by S. typhi in H–z66 phase was probably in Indonesia.
The use of sorbitol-MacConkey agar in conjunction with a specific antiserum for the detection of Vero cytotoxin-producing strains ofEscherichia coliO 157
Authors: Kleanthous H. , Fry N. K. , Smith H. R. , Gross R. J. , Rowe B.
Published: May 2009

Using DNA probes specific for the genes encoding Vero cytotoxins 1 and 2 in hybridization experiments on faecal samples. Vero cytotoxin-producingEscherichia coli(VTEC) of serogroup 0 157 were detected in 21 of 63 cases of haemorrhagic colitis, 9 of 31 cases of non-bloody diarrhoea and 14 of 68 cases of haemolytic uraemic syndrome. Compared with these results sorbitol-MacConkey agar in conjunction with a specific 0 157 antiserum gave a sensitivity of 62% in haemorrhagic colitis, 56% in non-bloody diarrhoea and 57% in haemolytic uraemic syndrome.The specificity of this method was 100% in all three groups. This demonstrates that sorbitol-MacConkey agar is a useful screening method for the detection of VTEC of serogroup O 157 when used in conjunction with a specific homologous antiserum. However, this method does not detect VTEC belonging to other serogroups and such strains were found, particularly in cases of haemolytic uraemic syndrome.
Water quality control trials: statistical tables for direct comparison between membrane filtration bacterial counts and the multiple tube method with a description of the bacteriological method
Authors: Tillett Hilary E. , Wright A. E. , Eaton Sheila
Published: May 2009

Experiments in the quality control of water samples are being conducted in the Public Health Laboratory Service and the water industry in the United Kingdom. The number of distributions which have been made is 7 and 92 laboratories are now participating. The methods used for preparing and distributing samples are described. Some participating laboratories use the multiple tube method and some use membrane filtration to assess the presence of coliforms and Escherichia coli. The results are, therefore, a mixture of estimated numbers and direct colony counts.
Bacterial contamination of weaning foods and drinking water in rural Bangladesh
Authors: Henry F. J. , Patwary Y. , Huttly S. R. A. , Aziz K. M. A.
Published: May 2009

The aim of this study was to determine what weaning foods and food preparation practices expose children to a high risk of diarrhoeal disease through exposure to a contaminated diet. Bacterial contamination of 897 food and 896 drinking water samples was assessed in a water and santitation intervention project.

The geometric mean of faecal coliforms per g or ml was 7·5 x 103 in left-over rice, 1·4 x 102 in other types of boiled rice, 2·5 x 102 in milk, 4·8 in household drinking water, and 3·5 in bread. Multiplication of faecal coliforms occurred when there was a delay of more than 4 h between preparation and consumption of food. All samples were more contaminated in the rainy than in the dry season. Strategies to reduce contamination should therefore focus on ‘wet’ foods, early consumption after preparation, and re–heating of left–over foods. Understanding the reasons for the faulty practices is also essential to the formulation of effective measures.
Bacteriological quality of on-farm manufactured goat cheese
Authors: Thaml W. A. , Hajdu L. J. , Danielsson–Thaml M. L. V.
Published: May 2009

The bacteriological quality of 198 ripened soft or semi-soft goat cheeses obtained from dairy farms and the retail trade was investigated. The cheeses were examined for total counts of aerobic bacteria, coliform bacteria (37 and 44 °C respectively), enterocoeci, coagulase positive staphylococci,Bacillus cereusandClostridium perfringens.Cheeses obtained from dairy-farms were also determined for pH value. In terms of all tests performed, cheeses made of heat-treated milk with starter culture had the best prospects for fulfilling the criteria for 'fit for consumption '. Cheeses made of raw milk without starter culture made up the most unsatisfactory group from a food-hygiene point of view. Bacteriological guidelines for on-farm manufactured goat cheese are suggested.
Immunogenicity of yeast-derived hepatitis B vaccine from two different producers
Authors: Dahl-Hansen E. , Siebke J. Chr. , Frøland S. S. , Degré M.
Published: May 2009

The immunogenicity and reactogenicity of two preparations of yeast-derived hepatitis B vaccinces were compared in healthy adult populations. The two groups were vaccinated in parallel, but they were not matched for age and sex. All subjects seroconverted, and 9 months after the first vaccine dose, all had anti HBs titres of at least 10 IU/1. The anti-HBs titres were higher in the group of subjects given 20μg vaccine antigen made by Smith Kline & RIT (GMT 2943 at 9 months) compared to those who received 10μg of vaccine made by Merck, S harp & Dohme (GMT 729 at 9 months). Adverse effects were recorded in 32·0 and 44·7% of the participants, but these were limited to minor local and general reactions. In the present study both preparations were safe and efficient.
Distribution ofSalmonella enteritidisphage types in Canada
Authors: Khakhria R. , Duck D. , Lior H.
Published: May 2009

The distribution ofSalmonella enteritidisphage types in Canada is described; 606 of 674 strains examined were of human origin. Typable strains of all sources, constituted 99·6% (671/674) of all strains examined, and were representative of 15 different phage types. Five phage types (8, 13, 4, 13a and 1) accounted for 92·4% of the total. Phage type 8 consistently showed the highest incidence in human (69·96%) and non-human (72·05%) sources and appeared to be the most common in North America. Phage type 4, the most prevalent in the UK, is infrequent in Canada (38/674). The distribution of phage types showed regional variation among infrequent phage types, whereas the common type, 8, was observed in different frequencies in all provinces. Examination of 29 outbreaks ofS. enteritidisrepresenting 254 isolates for humans revealed 5 different phage types, the highest number of outbreaks (11) were type 8. A study of these outbreaks and the animal-host-associations of the common phage types, 8 and 13, indicated that contaminated poultry appeared to be the most common source of human infection in Canada.
Teratogenicity of the Palyam serogroup orbiviruses in the embryonated chicken egg model
Authors: Whistler T. , Swanepoel R.
Published: May 2009

Embryonated chicken eggs were used as a model for assessing the teratogenic potential of several Palyam serogroup orbiviruses. Infection of 4-day-old embryonated chicken eggs via the yolk sac with eight of the viruses resulted in deaths or congenital deformities which included retarded development, arthrogryposis and reduced feathering. Statistical analysis showed that the viruses could be divided into three groups: those that caused death (Gweru virus isolates 866/77 and 1726/7776 and Apies River virus), those that caused deaths only when large amounts of virus were inoculated (Gweru isolate AR11869 and Marondera virus) and those that caused death and deformities (Abadina, Kasba, Nyabira, Petevo and Vellore viruses). Differences in pathogenic potential were noted between isolates identified as the same serotype by serological tests.
Mycobacterium bovis in the European badger (Meles meles): epidemiological findings in tuberculous badgers from a naturally infected population
Authors: Clifton-Hadley R. S. , Wilesmith J. W. , Stuart F. A.
Published: May 2009

This study investigates the course of tuberculosis in a naturally infected badger population, its impact on the population and the risk of spread to other species in the light of capture data and post-mortem findings from 47 tuberculous badgers, stratified by age group and sex, accrued since 1975. The findings are compared with those for 260 badgers from the same population in whom no evidence of infection was detected. Detailed estimates of seasonal variations in bodyweight for uninfected male and female cub, yearling and adult badgers are presented and compared to the weights at post-mortem examination of the tuberculous badgers, in whom poor condition and weight loss were the principal presenting signs. Lesions were seen especially in the lungs and associated lymph nodes, and in the kidneys. Organisms were detected intermittently in faeces, urine, sputum and discharging bite wounds. Infected animals could survive for nearly 2 years and produce cubs successfully.
Age-specific efficacy of pertussis vaccine during epidemic and non-epidemic periods
Authors: Ramsay M. E. B. , Farrington C. P. , Miller E.
Published: May 2009

A national survey was conducted of 3150 notified cases of whooping cough in order to determine age-specific pertussis vaccine efficacy by the ‘screening’ method. The cases were collected over two periods, one just prior to the start and one at the first peak of the whooping cough epidemic of 1989–90. Vaccination status was determined by a postal questionnaire to the reporting doctor and clinical data were also collected to provide efficacy estimates according to standardized case definitions. Overall, observed vaccine efficacy was high but differed between epidemic (87%) and non-epidemic (93%) periods (P = 0·03). Efficacy estimates were generally higher for typical or severe cases than for children with an atypical illness. Vaccine efficacy declined with age (P < 0·01) but estimates remained high up to the age of 8 years. This study will provide baseline data for comparison with efficacy observed from similar studies of children immunized at an accelerated schedule and from phase III studies of acellular pertussis vaccines performed elsewhere.
High prevalence of thermostable direct hemolysin (TDH)-like toxin inVibrio mimicusstrains isolated from diarrhoeal patients
Authors: Uchimura M. , Koiwai K. , Tsuruoka Y. , Tanaka H.
Published: May 2009

A total of 17 isolates ofVibrio mimicusfrom patients, 29 from environment and 2 from food was examined for toxigenicity. Sixteen (94%) clinical isolates and one (50%) from food produced TDH-like toxin, whereas none of the environmental isolates did so. The food from whichV. mimicuswith TDH-like toxin production was isolated, was one which had caused food poisoning. Only one environmental strain produced CT-like toxin, whilst ST-like toxin was not detected from any strains tested.
A miniaturized biotyping system for strain discrimination inEscherichia coli
Authors: Crichton P. B. , Logan J. M. J. , Old D. C.
Published: May 2009

A two-tier miniaturized scheme of eight tests was devised for biotyping strains ofEscherichia coliin microwell plates. Primary biotypes were defined by positive and negative reactions in tests for fermentation of raffinose, sorbose, dulcitol and 2-deoxy-D-ribose and for decarboxylation of ornithine when read after specified periods of incubation; subtypes were identified within primary biotypes according to results in secondary tests for rhamnose fermentation, lysine decarboxylation and motility. The method gave reproducible results on different occasions of testing.

Among 100E. colistrains from various sources, 26 of the 32 possible primary biotypes and 56 full biotypes, as defined by results in both primary and secondary tests, were identified, thus demonstrating a high index of strain discrimination (D = 0·98).

The scheme is recommended as a simple, reliable, inexpensive and efficient method of differentiating strains ofE. coli.