bluuebunny/crossref_metadata_2025 huggingface dataset:
Isolation and characterization of motileAeromonasfrom human, food and environmental specimens
Authors: Nishikawa Yoshikazu , Kishi Teruhiko
Published: May 2009

From July 1985 to March 1987, the occurrence of motileAeromonassp. in stool, food and environmental specimens was investigated to assess their pathogenic significance and to determine sources and routes of infection. A total of 9366 stool specimens were examined;Aeromonaswas isolated from 11.1% of diarrhoeal stools and 2.2% of normal stools (P0.001).Aeromonascounts in food specimens, which included minced beef, pork and chicken, seafood and various vegetables and their products, were unexpectedly high suggesting that infection might be food–borne rather than water–borne. About 70% of the isolates from meat products were A.hydrophilaand A.sobria, while A.Caviaewas the most common in sea–fish, vegetables and their products. Most A.hydrophilaand A.sobriastrains produced haemolysin, but haemagglutinin was found more frequently in A.Sobria.
A two-year survey of the incidence of heat-labile enterotoxin-producingEscherichia coliand other enteric pathogens in travellers returning to the Sheffield area
Authors: Chapman P. A. , Mitchelmore Deborah L.
Published: May 2009

A case-controlled study of the incidence of heat-labile enterotoxin-producingEscherichia coli(LT+ETEC) and other enteric pathogens in travellers returning to the Sheffield area was conducted from May 1984 to April 1986. LT+ETEC were found in 35 (5.8%) of 600 travellers to developed countries (mainly popular Mediterranean holiday resorts), 36 (11.3%) of 320 travellers to less-developed countries, and 11 (0.9%) of 1282 control patients whose illness was not associated with recent travel abroad. A seasonal peak of LT+ETEC infection was observed only in travellers to developed countries, with infections being significantly commoner in August to October. There was no significant deviation from expected age/sex distribution of LT+ETEC infection. Strains of LT+ETEC from travellers produced more toxin than strains from control patients, strains from travellers to less-developed countries producing most of all.
Salmon as a food-poisoning vehicle-two successive salmonella outbreaks
Authors: Cartwright K. A. V. , Evans B. G.
Published: May 2009

Gastroenteritis due to Salmonella montevideo occurred amongst guests attending two social functions held within 24 h, food for both having been provided by the same catering firm. Salmon was the most likely vehicle of infection in each case, although cross-contamination of other foods occurred. There were no deaths; four patients were admitted to hospital, one of whom underwent appendicectomy.

A review of salmon-associated food-poisoning outbreaks suggests that fresh salmon is an infrequent cause of food poisoning in the United Kingdom. The two outbreaks described here resulted from a failure of simple kitchen hygiene measures at a time of high ambient temperatures. Some current cooking instructions for salmon are inadequate.
Campylobacters in man and the environment in Hull and East Yorkshire
Authors: Mawer S. L.
Published: May 2009

Campylobacter organisms isolated from water samples taken weekly from ponds and land-drains in the City of Hull were compared with isolates from humans. Of 314 campylobacter organisms isolated from patients, 237 (75.5%) of the strains were identified as typicalCampylobacter jejuni, whilst of 125 identified strains isolated from the water samples, 85 (68%) resembledC. jejuniin most respects but were hippurate hydrolysis negative by the Hwang and Ederer method. The ponds and land drains in the city were therefore not a source of campylobacteriosis in the people living near these water courses. The atypicalC. jejunistrains isolated from the environment may be mistaken for theC. jejunistrains which cause human infection. It is therefore essential that such strains are fully identified before attributing human and animal infections to their ingestion.
Methicillin-resistant Staphylococcus aureus: associated morbidity and effectivencess of control measures
Authors: Law M. R , Gill O. N , Turner A
Published: May 2009

The strain of methicillin-resistant Staphylococcus aureus (MRSA) prevalent in south-east England produced in one acute hospital in a year 40 infections (bacteraemia, pneumonia and surgical wound, skin and urinary tract infections) with three attributable deaths. Rigorous measures succeeded in controlling the outbreak despite its extent, but our results suggest that less stringent measures could fail to control outbreaks of this scale. Several subsequent localized outbreaks within the hospital, probably caused by separate re-introductions of MRSA from other hospitals, were controlled by re-instigation of control measures on individual wards. The overall success of the intervention was shown by the decline in the incidence of MRSA infections from 27 in the 6 months beforehand to 2 in the most recent 6 months, and by the decline in the prevalence of colonization among patients 10 or more days in hospital from 52% immediately before the intervention to 3% 7 months after it. The incidence of attributable morbidity and death without control measures warrants a concerted effort to tackle the epidemic in all affected hospitals in Britain.
The development and evaluation of a μ-capture ELISA detecting chlamydia-specific Igm
Authors: Wreghitt T. G. , Robinson V. J. , Caul E. O , Paul I. D. , Gatley S.
Published: May 2009

A μ-capture enzyme-linked immunosorbent assay (ELISA) for detecting chlamydia-specific IgM was developed by use of the heat stable, lipopolysaccharide group-specific antigen and an alkaline phosphatase-labelled anti-chlamydia group-specific monoclonal antibody conjugate. The test was used to study the serological response in chlamydial respiratory tract infection among patients with acute respiratory tract symptoms in Cambridgeshire during the past 7 years. Results were compared with those of the complement fixation test (CFT) in routine use as well as those of a whole inclusion indirect immunofluorescence (WIF) test for IgM. Correlation between results of the μ-capture ELISA and those of the WIF test was 87·5%.
Antibody level of New Zealand children immunized with the triple vaccine DTP (diphtheria-tetanus-pertussis)
Authors: Lau R. C. H
Published: May 2009

Enzyme-linked immunosorbent assay (ELISA) tests were used to measure IgG antibody levels in 2638 New Zealand children who had been immunized with the triple vaccine DTP. The percentage of children immune to diphtheria decreased with age. The percentage of children immune to tetanus varied from 67.1 to 55.0%. The percentage of children with measurable antibody to pertussis increased with age. The mean percentages of children with measurable antibody or immunity to one or more DTP components were 34.2% (with 3 components), 34.4% (2 components), and 78.1% (1 component). It appears the immunization strategy for diphtheria and tetanus is satisfactory for herd immunity in New Zealand children. However, the current pertussis strategy may not be providing adequate immunity to 5-year-olds in this country.
Association of intraspecific wounding with hantaviral infection in wild rats (Rattus norvegicus)
Authors: Glass G. E. , Childs J. E. , Korch G. W. , LeDuc J. W.
Published: May 2009

The potential for hantaviral transmission among wild Norway rats by wounding associated with aggressive interactions was evaluated using a prospective sero-epidemiological study coupled with a mark-release-recapture survey. There was a significant association between an animal's serological status and the presence of wounds. Longitudinal studies of marked and released animals showed sero-conversion between captures was associated with wounding between captures more often (33%) than expected by chance, while unwounded animals seroconverted less often (8%) than expected. Typically, less than a 5% difference was found when comparing the incidence of seroconversion with the predicted rate based on wounding and seroprevalence. Infection was highly associated with the onset of sexual maturity and aggression but decoupled from rat age and the length of environmental exposure. Seroconversions occurred at times most associated with aggressive encounters and least associated with amicable behaviours that could lead to aerosol transmission.
A prospective study of genital infections in a family-planning clinic: 1. Microbiological findings and their association with vaginal symptoms
Authors: Riordan T. , Macaulay M. E. , James J. M. , Leventhall P. A. , Morris E. M. , Neal B. R. , Rowland J. , Evans B. M.
Published: May 2009

A prospective study of genital infection was conducted in four inner-city family–planning clinics. Fifteen per cent of routine attenders had symptoms and signs of vaginal infection and many more women attended primarily because of symptoms. Among the women with both signs and symptoms, 70% had positive laboratory findings, Trichomonas vaginalis, Candida albicans and bacterial vaginosis being equally prevalent. Measurement of vaginal pH in the clinic was the single most useful clinical finding for directing empirical therapy. Among patients with a discharge confirmed on examination and an abnormally high pH, 72% had either T. vaginalis or bacterial vaginosis. Neisseria gonorrhoeae was isolated from 4% of women with, and 1% of those without, symptoms. We believe that it is worthwhile to investigate patients presenting to family-planning clinics with vaginal symptoms. No single specimen was found ideal for all pathogens, a cervical swab is better for gonococci and also for T. vaginalis but a vaginal swab is needed for Candida and bacterial vaginosis.
Development of a new set of phages as an epidemiological marker inStaphylococcus epidermidiscausing nosocomial infections
Authors: Martίn-De-Nicolás M. M. , Vindel A. , Sáez-Nieto J. A.
Published: May 2009

We describe the isolation of a new set of phages for typingStaphylococcus epidermidis. One hundred and eighty-two phages were obtained fromS. epidermidisstrains of human origin. Twelve phages were selected according to their potency and their lytic activity studied. Twenty phages of the Dean and Williams' set were also studied.

Phage-typing was undertaken at 100 × RTD, 1000 × RTD and after heat treatment at 48 °C. When the two sets of phages were compared separately similar figures were obtained. When the two typing sets wrere combined, the percentage of typability for the 182 bacterial strains increased to 29⋅1% using 1000 x RTD and to 75⋅3% after heat treatment.
Epidemiological study ofSalmonella enteritidisstrains of animal origin in Belgium
Authors: Pohl P. , Lintermans P. , Marin M. , Couturier M.
Published: May 2009

Since 1987, the number of cases of salmonellosis caused bySalmonella enteritidishas considerably increased in Western Europe. Comparison of endemic animal strains isolated in Belgium from 1976–84 with strains isolated from 1987 on shows that the strains which cause the current epidemic have no features distinguishing them from the previously–isolated strains and that furthermore, they do not constitute a bacterial clone. They belong to 13 different lysotypes and in most cases remain sensitive to antibiotics. Nevertheless, the lysotype 33 which belongs to the phage type 4 [1] has increased significatively. It encompasses 37 % of the animal strains isolated in Belgium from 1987–9, but only 7% of the strains isolated from 1976–84.

It is worth noting that the endemic as well as the epidemic strains contain a virulence plasmid sharing sequence similarities with the FIB and FIIA plasmid replicons and with the VirA and VirB virulence regions of theS. typhimuriumvirulent plasmid: pIP1350.
Variation in time and space of non–outbreak Legionnaires' disease in Scotland
Authors: Bhopal R. S. , Fallon R. J.
Published: May 2009

The main aim of this study was to measure and explain geographic variations in the incidence of Legionnaires' disease in Scotland, particularly to help understand the source of non–outbreak infection.

Between 1978 and 1986 the overall mean annual incidence rate was 7·9 per million (range 3·1–20·2), and for non–outbreak, non-travel cases it was 5·6. There were geographical variations by health board, by city and within cities, e.g. the mean annual incidence rate per million for non–travel, non–outbreak disease was 1·2 in Tayside Health Board, 3·7 in Lanarkshire, 5·6 in Lothian and 14·4 in Greater Glasgow. In Greater Glasgow Health Board non–travel cases lived in and around the city centre and in some postcode sectors there, the mean annual incidence rate exceeded 100. Travel–related cases lived in peripheral areas.

These variations could not be explained by differences in access to and use of diagnostic services, surveillance, or host susceptibility (as reflected by socio–economic status and frequency of other respiratory disease). The explanation probably lay in environmental factors, though differences in agent virulence were not excluded.

The two main conclusions are, that non–outbreak cases were not truly sporadic, and that the spacetime variations in incidence support the hypothesis that cooling towers were an important source of infection for not–nravel, non-outbreak cases. If so such infection is potentially preventable.
Absence of epidemicity of severe leptospirosis in Barbados
Authors: Bennett S. , Everard C. O. R.
Published: May 2009

The possibility of micro-epidemics of severe leptospirosis occurring on the island of Barbados was investigated by examining the space-time clustering of the disease in 212 laboratory-confirmed cases admitted to Queen Elizabeth Hospital, Bridgetown, over a 7-year period. A series of 109 patients with symptoms compatible with leptospirosis but shown to be otherwise by laboratory examination were also examined for comparison. No significant space-time clustering was found among the leptospirosis cases, indicating no evidence for micro-epidemics. By comparison, statistically significant clustering was apparent among the smaller non-leptospirosis series. Possible explanations for the absence of observed micro-epidemics of leptospirosis are discussed.
Outbreak of nosocomial infections with two different MRSA-strains involved: significance of genomic DNA fragment patterns in strains otherwise difficult to type
Authors: Cuny C. , Schassan H. -H. , Witte W.
Published: May 2009

Methicillin-resistantStaphylococcus aureusisolates from an outbreak of 17 cases of wound infection in a municipal hospital were typed by conventional methods, phage typing by three sets of phages, reverse phage typing and plasmid profiles, as well as by genomic DNA fragment patterns obtained afterSma-I digestion and pulsed-field electrophoresis. These isolates were non-typable by phages, only some were typable by reverse phage typing and were not uniform in plasmid profile. Only the genomic DNA fragment patterns resulted in a clear discrimination of 2 strains (12 isolates for the first and 7 isolates for the second). Both strains were disseminated in different wards of the same hospital and one strain had obviously spread to another clinic in the same city.
The haemagglutinins of influenza A (H1N1) viruses in the ‘O’ or ‘D’ phases exhibit biological and antigenic differences
Authors: Azzi A. , Bartolomei-Corsi O. , Zakrzewska K. , Corcoran T. , Newman R. , Robertson J. S. , Yates P. , Oxford J. S.
Published: May 2009

Influenza A (H1N1) viruses when initially isolated in mammalian cell cultures (MDCK cells) had different agglutination reactions with chicken and guinea-pig erythrocytes compared to the same viruses after passage. On first isolation the virus HA resembled the ‘O’ phase viruses described originally by Burnet and Bull and agglutinated mammalian but not avian erythrocytes. After passage, the virus HA resembled a classical ‘D’ phase virus and agglutinated both avian and mammalian erythrocytes. Monoclonal and polyclonal antisera detected antigenic differences between the HAs of the viruses in the ‘O’ and ‘D’ phases. The ‘O’ phase virus HA reacted preferentially with antibodies in post infection human antisera. Viruses in the ‘O’ phase replicated poorly in the allantoic cavity of embryonated hens' eggs whilst ‘D’ phase virus replicated in both MDCK cells and in embryonated hens' eggs. At least three distinguishable subpopulations of influenza A (H1N1) viruses may co-exist in clinical throat swab material, including viruses possessing HAs in the ‘O’ and ‘D’ phases and other ‘D’ phase viruses cultivable in embryonated hens' eggs but antigenically distinguishable from the corresponding ‘D’ phase virus in MDCK cells.
Plasmid analysis ofSalmonella enteritidisisolated from human gastroenteritis cases and from epidemiologically associated poultry flocks
Authors: Dorn C. R. , Silapanuntakul R. , Angrick E. J. , Shipman L. D.
Published: May 2009

Plasmid analysis ofSalmonella enteritidisisolates from human gastroenteritis cases and from two commercial egg-producing poultry flocks was performed to determine if the poultry flocks were the source of the human infections. The plasmid profile and restriction fragment pattern (fingerprint) of fiveS. enteritidisisolates from human cases matched those of nine isolates from internal organs of egg-laying hens in one flock which was the source of eggs consumed by the cases. Another commercial flock was epidemiologically associated as the source of eggs consumed by affected persons in four separate gastroenteritis outbreaks from whichS. enteritidisisolates were available. FiveS. enteritidisisolates from human cases in these four outbreaks had the same profile and fingerprint, and they all matched those of the 24 isolates from hens in this flock. These results provide further documentation of egg-borne transmission ofS. enteritidisto humans.
A quantitative polymerase chain reaction method for the detection in avian faeces of salmonellas carrying thespvRgene
Authors: Mahon J. , Lax A. J.
Published: May 2009

A quick, semi-quantitative method of detectingSalmonellaspecies which contain the virulence plasmid has been developed using the polymerase chain reaction (PCR). A pair of primers have been synthesized encompassing a 500 bp fragment of thespvRvirulence gene. Competitor DNA consisting of thespvRgene with a 94 bp deletion situated between the primer recognition sequences, was cloned into a plasmid vector. Co-amplification of the ‘unknown’ target salmonella DNA with known quantities of competitor DNA in the same reaction tube gave PCR products of 500 and 406 bp respectively. Visual assessment of the ratio of the two products on ethidium bromide stained agarose gels provided an estimate of the approximate number of salmonella cells present in avian faeces.

The technique could be applied to detect quantifiably any non-host DNA in clinical samples if a suitable DNA sequence for primer construction is available.
Malaria prevalence amongst Brazilian Indians assessed by a new mathematical model
Authors: Burattini M. N. , Massad E. , Coutinho F. A. B. , Baruzzi R. G.
Published: May 2009

An alternative way to estimate the endemic level of malaria amongst Brazilian indians is proposed. This is achieved by estimating the age-related “force of infection’ of malaria (the effective inoculation rate), applying a mathematical model, described elsewhere, to serological data. In addition we present a way to estimate the Basic Reproductive Rate of malaria in the same area. The results have shown a good degree of accuracy in describing the endemic pattern of malaria in the area, and also indicate some relevant aspects of its age distribution related to the design of control strategies.
Seasonal variations in the occurrence of Vibriovulnificusalong the Dutch coast
Authors: Veenstra J. , Rietra P. J. G. M. , Coster J. M. , Slaats E. , Dirks-Go S.
Published: May 2009

The seasonal variation in the occurrence ofV. vulnificusin relation to water temperature and salinity was studied along the Dutch coast. In two consecutive yearsV. vulnificusstrains could be isolated in August when the water temperature was highest. The indole-positive strains isolated from North Sea water samples were identical to most strains isolated from human disease and from the environment. However, strains isolated from four of five patients living in countries around the North Sea were different from the North Sea isolates in that they were indole-negative and have a lower NaCl tolerance.
Nosocomial Legionnaires' disease in England and Wales, 1980–92
Authors: Joseph C. A. , Watson J. M. , Harrison T. G. , Bartlett C. L. R.
Published: May 2009

Two hundred and eighteen nosocomial cases of Legionnaires' disease with 68 deaths were reported to the National Surveillance Scheme for Legionnaires Disease between 1980 and 1992, representing 15% of the reported infections acquired in England and Wales. Twenty–two nosocomial outbreaks accounted for 135 (62%) of these cases, the remainder occurring as single cases either in hospitals where other single cases or outbreaks had been reported in different years or as ‘sporadic’ cases in hospitals from which no other cases were reported. A clinical history prior to onset of Legionnaires' disease was available for 124 patients, 61 of whom had undergone recent transplant therapy or were immunosuppressed for other reasons.

Sixty cases (27%) were diagnosed by culture of the organism and isolates from 56 patients were typed; 25 (42%) were nonL. pneumophilaserogroup 1 infections.

Methods for prevention and control of nosocomial outbreaks are discussed, in particular the susceptibility to Legionnaires' disease of certain groups of hospital patients.
Phage conversion inSalmonella entericaserotype Enteritidis: implications for epidemiology
Authors: Rankin S. , Platt D. J.
Published: May 2009

A model system for the study of phage conversion ofSalmonella entericaserotype Enteritidis is reported. Temperate phages 1,2,3 and 6 from the phage typing scheme were used to convert several individually recognized phage types into others. Phage type 4 was converted to PT8, PT6a to PT4, PT6a to PT7, PT13 to PT13a and PT15 to PT11; some new phage lysis patterns were also detected.

This model was used to examine the relationships between phage types within a previously denned clonal lineage, SECLIII, to establish whether or not Enteritidis likeSalmonella entericaserotype Typhi andSalmonella entericaserotype Paratyphi B possessed type determining phages. We were able to convert PT1 to PT20, and PT15 to PT11.
Diversity and molecular variation among plasmids inSalmonella entericaserotype Dublin based on restriction enzyme fragmentation pattern analysis
Authors: Browning L. M. , Wray C. , Platt D. J.
Published: May 2009

Molecular variation within and between plasmids ofSalmonella entericaserotype Dublin was analysed. Such variation has been demonstrated in the serotype-specific plasmids (SSP's) of Typhimurium and Enteritidis. The two aims of this study were to determine the plasmid diversity in a host-adapted serotype and also the incidence of molecular variation in the SSP among strains of Dublin using restriction endonuclease fragmentation pattern (REFP) analysis withPst1,Sma1 andEcoRV. Sixty-five strains were examined from seven countries. Plasmid profile and REFP analysis showed that none of the strains was plasmid-free. Seventy-seveń percent of the strains possessed the 72 kb SSP either alone or in combination with another plasmid; 23 % harboured plasmids which were molecular variants of the SSP. Four of the variants were more closely related to each other than to the reference SSP and were harboured by Dublin isolated from both the USA and Europe. A further three were shown to be cointegrate plasmids and were similarly distributed. Thirty-two percent of strains possessed the SSP alone. None of the UK strains was resistant to any of the antimicrobial agents tested whereas 74 % of the remaining strains were resistant to between one and five antimicrobial agents. This study corroborates previous findings concerning the high degree of stability of the SSP and confirmed the clonal nature of Dublin. Co-resident plasmids provided evidence of sub-clones within localized geographical areas.
Control of infection with multiple antibiotic resistant bacteria in a hospital renal unit: the value of plasmid characterization
Authors: Reed C. S. , Barrett S. P. , Threlfall E. J. , Cheasty T.
Published: May 2009

An outbreak of infections due to multiple antibiotic-resistant bacteria took place over a period of approximately 18 months in a renal unit. Strains ofEscherichia coli, Enterobacter aerogenes, Klebsiella pneumoniae, Citrobacterspp. andPseudomonasspp. were involved, and a variety of antibiotic resistances was encountered. Closely related plasmids encoding resistance to aztreonam, ceftazidime and piperacillin, possibly derived from an archetypal plasmid of 105 kb were found in the majority of isolates examined. After limiting the use of aztreonam the incidence of new patient isolates of multiple-resistant organisms was greatly reduced. This study demonstrated how molecular studies can contribute to the control of an outbreak situation in a hospital unit by providing an impetus to reduce the use of specific antibiotics.
RAPD analysis of isolates ofBurkholderia pseudomalleifrom patients with recurrent melioidosis
Authors: Haase A. , Melder A. , Smith-Vaughan H. , Kemp D. , Currie B.
Published: May 2009

Twenty-seven isolates ofBurholderia pseudomallei(formerlyPseudomonas pseudomallei) from ten patients with recurrent melioidosis were analysed by RAPD. In two cases RAPD patterns in recurrent isolates differed from the original isolates; one was considered a likely reinfection while the other may represent relapse from one of two strains initially infecting the patient. In two cases where a change in antibiotic resistance had occurred between original and relapse isolates, slight changes in RAPD patterns were found with one of the four primers used. In the other six cases the relapse was clearly due to the original strain re-emerging unchanged, with identical RAPD patterns with all four primers.
Prevalence of hepatitis A antibody among disadvantaged gypsy children in northern Spain
Authors: Cilla G. , Perez-Trallero E. , Marimon J. M. , Erdozain S. , Gutierrez C.
Published: May 2009

The prevalence of antibody to hepatitis A virus (HAV) in a group of socially and economically disadvantaged Spanish gypsy children was compared to that of a group of non-gypsy middle-class children. The study included 438 children, 73 gypsies (38 girls and 35 boys, mean age 8·5 years, age range 2–16 years) and 365 non-gypsy controls, randomly selected by age. The presence of anti-HAV was investigated using ELISA.

Among the gypsy children, 82% had antibodies to HAV compared with 9·3% of the children in the control group. The unfavourable living conditions of the gypsy population (e.g. homes with poor sanitary conditions, overcrowding) may explain the high prevalence of HAV infection. These findings underline the need for specific action which targets disadvantaged populations.
Antigenic analysis of SAT 2 serotype foot-and-mouth disease virus isolates from Zimbabwe using monoclonal antibodies
Authors: Davidson F. L. , Crowther J. R. , Nqindi J. , Knowles N. J. , Thevasagayam S. J. , Van Vuuren C. J.
Published: May 2009

This paper compares strains of foot-and-mouth disease (FMD) serotype SAT (South African Territories) 2 viruses isolated from Zimbabwe and other African countries using monoclonal antibodies (MAb). A sandwich-ELISA was used to examine the relative binding of anti-SAT 2 MAb to the various viruses. The MAb-binding profiles of viruses isolated from field samples were compared using hierarchical cluster analysis. Viruses were obtained from game animals, mainly African buffalo (Syncerus caffer) which is the natural host and reservoir for SAT serotypes in Africa, and from cattle showing clinical signs of FMD, as well as from animals suspected of carrying the virus subclinically. Some isolates have been adapted for use as vaccine strains. The results showed that most of the Zimbabwe isolates collected between 1989 and 1992 were an antigenically closely-related group. Although differences were observed between Zimbabwe isolates collected between 1989 and 1992 and those collected in 1987, there was no correlation with the different MAb binding patterns within the 1987 group and the epidemiological information received from the field. Similar profiles were observed for many SAT 2 viruses, including viruses isolated over a 50-year period and from geographically distant areas. This indicates an inherent stability in antigenic profiles of SAT 2 viruses. The MAb panel was capable of assessing antigenic variation, since very different profiles were obtained for some isolates. The work also allowed comparison and characterization of anti-type SAT 2 MAb from different laboratories. The findings are discussed with reference to selection of vaccine strains.
Epidemiological investigation of an outbreak of meningococcal meningitis in Makkah (Mecca), Saudi Arabia, 1992
Authors: Al-Gahtani Y. M. , El Bushra H. E. , Al-Qarawi S. M. , Al-Zubaidi A. A. , Fontaine R. E.
Published: May 2009

During March and April of 1992, the health surveillance system began detecting increasing numbers of cases of meningococcal disease (MCD) in the Islamic holy city of Makkah (Mecca). We identified 102 bacteriologically confirmed cases (CC) and 80 suspected cases (SC) of MCD. Neisseria meningitidis was identified as Group A. III-1 clone. The ratio of male:female cases was 2·9:1. All age groups of males were affected. There was only one case among women aged 10–30; 50% of the adult female cases were 55 or older. The case-fatality ratio (CFR) was 14·7% among CC. Pakistanis, who comprised about one-third of the CC. had a CFR of 26·7%. Fifty-nine percent of CC were religious visitors. CC in residents were most common in persons living near the Holy Mosque (Haram), where the carriage rate reached 86%. A mass vaccination program against MCD was instituted, using AC bivalent meningococcal vaccine (MCV). An abrupt drop, from a mean of 15 CC per week to 2 CC per week (only in visitors), coincided with vaccinating 600000 persons over 2 weeks. Makkah residents who had been vaccinated against MCD were less likely to have contracted MCD (OR = 0·17, 95% CI: 0·06–0·50). MCV was of no significant protective value if it had been administered 5 years before the outbreak. The main reason for not being vaccinated as stated by both cases (71%) and controls (45%) was not knowing about the disease. The age and sex differences probably relate to differences in exposures to crowded conditions. Health education should illuminate the seriousness of the disease and the importance of vaccination.
Targeted vaccination with meningococcal polysaccharide vaccine in one district of the Czech Republic
Authors: Kriz P. , Vlckova J. , Bobak M.
Published: May 2009

Vaccination againstNeisseria meningitidisis not part of routine immunization schemes in any country; instead, targeted vaccination of groups at the highest risk is recommended during outbreaks and epidemics. After a long period of sporadic occurrence of meningococcal invasive disease, a new clone ofNeisseria meningitidisC: 2a: P1.2, ET-15/37, occurred in the Czech Republic, and caused local outbreaks in two neighbouring districts, Olomouc and Bruntal, in spring 1993. In Olomouc, a mass campaign was conducted during which 6191 students were vaccinated (5·6 % of the total population of this locality and 96% of all students in the age group 15–19) within 2 weeks in June 1993. In Bruntal district, no such campaign was organized. In Olomouc, the incidence of invasive disease caused byNeisseria meningitidisC in the age group 10–24 decreased from 57 to 0 per 100000 (P < 0·001) during the post-vaccination period (July 1993–August 1994), but no such decrease was observed in Bruntal. Although other factors can affect the frequency of disease, these results support the current recommendations of targeted vaccination in outbreaks of meningococcal disease.
The role of heightened surveillance in an outbreak ofEscherichia coliO157. H7
Authors: Roberts C. L. , Mshar P. A. , Cartter M. L. , Hadler J. L. , Sosin D. M. , Hayes P. S. , Barrett T. J.
Published: May 2009

After instituting laboratory screening forEscherichia coliO157. H7, a Connecticut hospital isolated the organism from four persons in September 1993. As a result, an outbreak ofE. coliO157.H7 associated with a country club was detected. The club had served hamburger from the same shipment at two picnics. Attendees of two picnics were interviewed, stool cultures were obtained from symptomatic persons, and the remaining hamburger was cultured. Twenty (22%) of 89 persons who ate hamburger became ill, compared with 1 of 60 who did not eat hamburger (relative risk = 13·5, 95% confidence interval 3·2–56·3). Among persons who ate hamburgers, illness was strongly associated with eating hamburger that was not thoroughly cooked (P< 0·001). All 20 samples from 5 remaining boxes of patties yieldedE. coliO157.H7. Isolates from hamburger and case-patients were indistinguishable by pulsed-field gel electrophoresis. Heightened surveillance can rapidly identify outbreaks and may mitigate their impact. However, continued review of food safety issues is necessary ifE. coliO157.H7 outbreaks are to be prevented.
Effect of changes in processing to improve hygiene control on contamination of poultry carcasses with campylobacter
Authors: Mead G. C. , Hudson W. R. , Hinton M. H.
Published: May 2009

Examination of neck skin and caecal samples taken at a commercial processing plant from 15 randomly chosen poultry flocks showed that all flocks were contaminated initially with thermophilicCampylobacterspp., even in the apparent absence of caecal carriage. During processing, numbers of campylobacter on skin samples were reduced by between 10 and 1000-fold.

To improve hygiene control generally, chlorinated-water sprays were used to limit microbial contamination on equipment and working surfaces. In addition, chlorine concentrations in process water were increased and any unnecessary carcass contact surfaces in the processing plant were removed. When comparing flocks before and after the changes, it was found that numbers of campylobacter on packaged carcasses were significantly lower after the changes had been made (P0·001). In practice, however, the reduction would be likely to have little impact on consumer exposure to campylobacter infection.
Measles vaccination policy
Authors: Williams B. G. , Cutts F. T. , Dye C.
Published: May 2009

Where immunization campaigns locally eliminate measles, it will be important to identify the vaccination policy most likely to prevent future epidemics. The optimum age for vaccination depends on the rate of decline of maternal antibody, because the presence of antibody reduces vaccine efficacy. The first part of this paper contains a quantitative reappraisal of the data on antibody decline and seroconversion rates by age. The decline in maternal antibody protection follows delayed exponentials, with delays of 2–4 months, and subsequent half-lives of 1–2 months. Using this result in an analytical mathematical model we find that the optimal age to administer a single dose of vaccine to children, which is independent of vaccine coverage, lies within the range 11–19 months. We also show that, where the optimal age cannot be met, it is better to err towards late rather than early vaccination. There are therefore two reasons why developing countries, which presently vaccinate during infancy because measles transmission rates are high should eventually switch to the second year of life. The possible gains from two-dose vaccination schedules are explored with respect to both coverage and efficacy. A two-dose schedule will be beneficial, in principle, only when there is a need to increase net vaccine efficacy, after coverage has been maximized with a one-dose schedule.
Epidemiological aspects of group B streptococci of bovine and human origin
Authors: Jensen N. E. , Aarestrup F. M.
Published: May 2009

Restriction fragment length polymorphism of the gene encoding rRNA (ribotyping) was used in combination with conventional epidemiological markers to study phenotypic variations amongStreptococcus agalactiaeof bovine origin and the possible epidemiological interrelationship between the bovine and human reservoirs ofStreptococcus agalactiae.

The bovine material constituted 53 strains (9 antigen combinations) isolated from 11 herds. Herds with a uniform as well as heterogenic antigenic pattern were included. Furthermore, strains isolated in the course of time from the same persistently infected quarters were examined. The human material constituted 16 strains, 4 each of 4 serotypes, isolated from healthy carriers. Finally, nine serotype- and the group reference strains were examined. All strains were serotyped by double diffusion in agarose gel, biotyped (lactose ±), and ribotyped using two restriction enzymes,HindIII andHhaI.

All isolates could be typed by ribotyping and seven ribotypes were identified among the reference strains. The restriction enzymes used alone or in combination gave typing results that allowed discrimination between and within serotype. Combined use of serotype,HindIII andHhaI ribotypes produced 11 types among the 16 human strains. Ribotype analysis discriminated between herds infected with the same serotype. Strains of varying antigenic patterns from the same herd had the same ribotype. Phenotypic variations in serotype observed in persistent intramammary infection were not related to genetic changes as monitored by ribotype. Two ribotypes were represented among both bovine and human strains. The discriminating capability of lactose fermentation was of limited value.
A milk-borne campylobacter outbreak following an educational farm visit
Authors: Evans M. R. , Roberts R. J. , Ribeiro C. D. , Gardner D. , Kembrey D.
Published: May 2009

After a nursery school trip to a dairy farm, 20 (53%) of 38 children and 3 (23%) of 13 adult helpers developed gastrointestinal infection. Campylobacter jejuni was isolated from 15 primary cases and from 3 of 9 secondary household cases. A cohort study of the school party found illness to be associated with drinking raw milk (relative risk 5·4, 95 % confidence interval 1·4–20·4, P = 0·001). There was a significant dose response relationship between amount of raw milk consumed and risk of illness (X2-test for linear trend 12·1, P = 0·0005) but not with incubation period, severity of symptoms or duration of illness. All 18 human campylobacter isolates were C. jejuni resistotype 02 and either biotype I (number 16) or biotype II (number 2). Campylobacter was also isolated from samples of dairy cattle and bird faeces obtained at the farm but these were of different resisto/biotypes. Educational farm visits have become increasingly popular in recent years and this outbreak illustrates the hazard of exposure to raw milk in this setting.
Plasmid profiles, restriction fragment length polymorphisms and O-serotypes amongVibrio anguillarumisolates
Authors: Pedersen K. , Tiainen T. , Larsen J. L.
Published: May 2009

A total of 279Vibrio anguillarumstrains were serotyped and examined for plasmid content. Plasmids were subjected to digestion with restriction enzymes. Most strains belonged to serogroup O1 (39%) and O2 (16%). In total 164 strains (53%) carried plasmids. Of the O1 and O2 isolates, 92% and 30%, respectively, carried one or more plasmids. Restriction fragment length polymorphism (RFLP) analysis of plasmid DNA indicated that plasmids belonged to several groups. Each group seemed to be restricted to a single O-serovar. The largest group was the pJM1-like plasmids among most serovar O1 strains. Most of these plasmids were about 67 kb like the pJM1 plasmid, but various derivatives ranged from 26–77 kb. RFLP studies of the 67 kb plasmids revealed 17 different restriction patterns. Some patterns were dominant among European strains whereas others were dominant among North American strains. The results confirmed the applicability of O-serotyping together with plasmid profile and restriction analysis of plasmids for typing ofV. anguillarum. They also indicated that plasmids among strains which belonged to the traditional fish pathogenic serogroups, O1 and O2, showed more homology than did strains from most other serogroups, that were usually non-pathogenic, environmental bacteria.
Tuberculosis outbreak in a Texas prison, 1994
Authors: Bergmire-Sweat D. , Barnett B. J. , Harris S. L. , Taylor J. P. , Mazurek G. H. , Reddy V.
Published: May 2009

In 1994 a Texas prison containing a population of mentally retarded inmates experienced a large tuberculosis outbreak. Fifteen cases of tuberculosis were identified (8 confirmed by positive cultures forMycobacterium tuberculosis) and more than 100 inmates became infected. The culture-confirmed patients were infected with an identical strain of tuberculosis as demonstrated by polymerase chain reaction (PCR) based DNA fingerprinting technique. The prison followed standard tuberculosis infection control policies, but these controls were inadequate to prevent tuberculosis transmission in this special population. Two hundred and thirty inmates (119 inmates showing evidence of new tuberculosis infection or active disease and 111 healthy controls) were enrolled in the investigation. Inmate cell assignments, job duties, and educational classes were identified and medical chart reviews were conducted on all inmates. Tuberculosis transmission was associated with residing on the D Wing of the prison (OR = 25·84,P< 0·01), attending school in Classroom A (OR = 8·34,P= 0·01) and working on the prison utility work crew (OR = 2·52,P< 0·01). The index case in the outbreak had been prescribed 6 months of isoniazid (INH) chemoprophylaxis in 1988.
Severe giardiasis and cryptosporidiosis in Scotland, UK
Authors: Robertson L. J.
Published: May 2009

Hospital discharge data from 1990–4 for 26 hospitals were used to estimate and compare the cost and describe the epidemiology of severe giardiasis and cryptosporidiosis in Scotland, UK. The incidence of severe cryptosporidiosis was almost double that of severe giardiasis and the median duration of hospitalization was longer for cryptosporidiosis than giardiasis. Impaired immunity was frequently listed as co-diagnosis with cryptosporidiosis and associated with extended hospitalization. Although both infections were associated with infants, the median age was lower for cryptosporidiosis (5 years compared with 30 years). Whereas hospitalization was not significantly longer for infants with cryptosporidiosis, hospitalization for this age group with giardiasis was longer (4 days compared with 3 days). Comparison with similar data for giardiasis from USA revealed various differences and similarities. These points are discussed in relation to the epidemiology of these infections and published data were used to estimate costs of hospitalization.
Trimethoprim resistance gene inShigella dysenteriae1 isolates obtained from widely scattered locations of Asia
Authors: Haider K. , Chatkaeomorakot A. , Kay B. A. , Talukder K. A. , Taylor D. N. , Echeverria P. , Sack D. A.
Published: May 2009

Trimethoprim-resistance genes ofShigella dysenteriae1 strains, isolated from a different location of six different countries of Asia over a 5-year period were characterized by using three different dihydrofolate reductase (DHFR) gene probes. The trimethoprim-resistant (TMPR) strains hybridized only with the type I DHFR gene probe by colony hybridization. None of the strains hybridized with types II and III DHFR gene probes. Southern blot experiments using plasmid DNA extracted from these resistant strains indicated that the type I DHFR genes were either on a 20 MDa plasmid or might be located on the chromosome. None of the other plasmids present inS. dyysenteriae1 strains hybridized with the probe. This indicates that the TMP resistance in theseS. dysenteriae1 strains are mediated by type I DHFR enzyme, and there may be transposition of this type I DHFR gene occurs between the 20 MDa plasmid and the chromosome in this serotype of shigella.
Vaccine prophylaxis of abattoir-associated Q fever: eight years' experience in Australian abattoirs
Authors: Marmion B. P. , Ormsbee R. A. , Kyrkou M. , Wright J. , Worswick D. A. , Izzo A. A. , Esterman A. , Feery B. , Shapiro R. A.
Published: May 2009

During the period 1981–8 a clinical trial of a Q fever vaccine (Q-vax; Commonwealth Serum Laboratories, Melbourne) has been conducted in abattoir workers and other at-risk groups in South Australia. Volunteers in four abattoirs and visitors to the abattoirs were given one subcutaneous dose of 30 μg of a formalin-inactivated, highly-purifiedCoxiella burnetiicells, Henzerling strain, Phase 1 antigenic state, in a volume of 0·5 ml.

During the period, over 4000 subjects have been vaccinated and the programme continues in the abattoirs and related groups. ‘Common’ reactions to the vaccine comprised tenderness and erythema, rarely oedema at the inoculation site and sometimes transient headache. Two more serious ‘uncommon’ reactions, immune abscess at the inoculation site, were observed in two subjects, and two others developed small subcutaneous lumps which gradually dispersed without intervention.

Protective efficacy of the vaccine appeared to be absolute and to last for 5 years at least. Eight Q fever cases were observed in vaccinees, but all were in persons vaccinated during the incubation period of a natural attack of Q fever before vaccine-induced immunity had had time (≥ 13 days after vaccination) to develop. On the other hand, 97 Q fever cases were detected in persons working in, or visiting the same abattoir environments.

Assays for antibody and cellular immunity showed an 80–82% seroconversion after vaccination, mostly IgM antibody to Phase 2 antigen, in the 3 months after vaccination. This fell to about 60%, mostly IgG antibody to Phase 1 antigen, after 20 months. On the other hand, 85–95% of vaccinees developed markers of cell mediated immunity as judged by lymphoproliferative responses withC. burnetiiantigens; these rates remained elevated for at least 5 years.

The Q fever vaccine, unlike other killed rickettsial vaccines, has the property of stimulating long-lasting T lymphocyte memory and this may account for its unusual protective efficacy as a killed vaccine.
Beyond Citizenship: American Identity After Globalization. By Peter J. Spiro. New York: Oxford University Press, 2008. 208p. $29.95.
Authors: Smith Jackie
Published: May 2009

Peter J. Spiro's timely and highly accessible book encourages readers to reflect upon the contemporary meaning of citizenship. It could not have come at a better time. As I read it, I watched the collapse of the global financial system, which may really be just an aftershock of even more devastating global climate, food, and energy crises. At the same time, rather than coming together in a shared effort to respond to these multiple crises, Americans were entering the most polarizing phase of the presidential election. Sarah Palin is probably the first vice presidential candidate to suggest publicly that some parts of the country are “un-American,” but her words clearly reflected the sentiments of a significant portion of the U.S. public. Although it stirred some late-night television ridicule, Palin's remarks sparked little outrage or thoughtful and sustained public reflection about the broader implications of her statement. We should hope that the aftermath of the election will afford us a chance for such a dialogue on the nature of our national political community and its relation to the wider, global community. Beyond Citizenship should be required background reading for such a conversation.