bluuebunny/crossref_metadata_2025 huggingface dataset:
The epidemiology ofHaemophilus influenzaetype b disease in the Republic of Ireland
Authors: Fogarty J. , Moloney A. C. , Newell J. B.
Published: May 2009

A 2-year case-control study was conducted to describe the epidemiology ofHaemophilus influenzaetype b (Hib) and investigate Hib disease risk factors in the Republic of Ireland. Between October 1991 and September 1993, 149 laboratory confirmed incident cases were matched with community controls. Annual Hib disease incidence was 25·4 per 100000 children under 5 years, with peak incidence (65·8 per 100000) in the 6–11 months age-group. Meningitis was the predominant clinical condition. Twenty-four (16·1%) isolates were resistant to ampicillin. Crèche or day-care attendance and the presence of chronic illness emerged as risk factors for Hib disease. Empirical first line treatment for suspected Hib infection warrants alternatives to ampicillin such as cefotaxime. Completed immunization with Hib conjugate vaccine by 6 months of age is required for maximum disease prevention. Until all children are receiving Hib vaccine on schedule, those who are crèche or day-care attendees and those with chronic illness should be prioritized for timely immunization.
Feasibility study for identifying adverse events attributable to vaccination by record linkage
Authors: Nash J. Q. , Chandrakumar M. , Farrington C. P. , Williamson S. , Miller E.
Published: May 2009

To investigate the feasibility of using a record linkage method for identifying vaccine attributable adverse events, computerized hospital admissions and vaccination records from South East Kent district were linked and checked for accuracy. Records for 90% of children under 2 years of age admitted to hospital over a 2-year period were matched with vaccination records using a computer algorithm based on name, date of birth, sex, and post-code supplemented by visual inspection. Relative to this gold standard, matching on date of birth, sex and postcode alone had a sensitivity of 60% and an incorrect match rate of 0·2% after matches to more than one vaccine recipient were excluded. Manual checking of a sample of admissions showed that only 4% had been assigned incorrect International Classification of Disease (ICD) codes. Routine record linkage of ICD admission codes to vaccination records therefore yields data of good quality which may be used for surveillance purposes.
Serological studies of influenza viruses in pigs in Great Britain 1991–2
Authors: Brown I. H. , Harris P. A. , Alexander D. J.
Published: May 2009

Samples from a sow serum bank representative of the pig population of Great Britain collected during 1991–2, were examined for antibodies to influenza A, B and C viruses, using viruses which had been isolated from a variety of hosts. For influenza A viruses there was evidence of the continued circulation of ‘classical swine’ H1N1 virus (26%) seroprevalence), and human H3N2 viruses (39%) which are antigenically most closely-related to A/Port Chalmers/1/73 virus. In addition antibodies were detected to A/swine/England/201635/92 (8%), a strain of H3N2 virus which appears to have arisen by antigenic drift from conventional H3N2 swine strains. Specific antibodies (2%) were detected to an H1N1 virus (A/swine/England/195852/92) related most closely to avian H1N1 strains. In tests with human H1N1 and H3N2 viruses, excluding isolates from pigs, the highest seroprevalence was detected to the prevailing strains from the human population. Serological tests with avian H4 and H10, human H2, equine 1 and 2 influenza A viruses were all negative. Seven pigs seropositive by haemagglutination-inhibition, virus neutralization and immunoblotting assays for antibody to influenza B virus, were randomly distributed geographically suggesting that influenza B viruses may be transmitted to pigs but fail to spread. The seroprevalence to influenza C viruses was 9·9% indicating that these viruses are widespread in pigs. These results provide further evidence that the pig can be infected by a number of influenza viruses, some of which may have significance in the epidemiology of human influenza.
Foodborne outbreaks caused by salmonella in Italy, 1991–4
Authors: Scuderi G. , Fantasia M. , Filetici E. , Anastasio M. P.
Published: May 2009

This report summarizes studies on 1699 foodborne outbreaks, in Italy, reported to theIstituto Superiore di Sanità(ISS) (the National Institute of Health of Italy, Rome) during the period 1991–4. The most frequently reported foodborne outbreaks were caused by salmonellae (81%), in particular bySalmonella enteritidisand non-serotyped group D salmonella (34% and 33% of the total salmonella outbreaks, respectively). A vehicle was implicated in 69% of the salmonella outbreaks; eggs were implicated in 77% of the outbreaks for which a vehicle was identified or suspected. Salmonella strains isolated in 54 outbreaks were studied for phenotypic and genotypic characteristics. The isolates belonged toS. enteritidis(50 outbreaks),S. typhimurium(three outbreaks) andS. hadar(one outbreak). In theS. enteritidisoutbreaks, phage type 4 was most frequently isolated (64·8%), followed by phage type 1 (14·8%). The virulence plasmid of 38 megadaltons was found in many different phage types ofS. enteritidis.
Changing epidemiology of cholera due toVibrio choleraeO1 and O139 Bengal in Dhaka, Bangladesh
Authors: Faruque A. S. G. , Fuchs G. J. , Albert M. J.
Published: May 2009

At the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B) Dhaka we studied the trends in cholera for the period January 1992 to May 1995.Vibrio choleraeO139 Bengal emerged as a second aetiologic agent of cholera in Dhaka in January 1993. In 1993, the majority of cholera cases was due toV. choleraeO139, withV. choleraeO1 accounting for a small proportion of cases. During the latter part of the study period (Jan 1994–May 1995),V. choleraeO1 re-emerged as the predominant cholera strain. The predominant age group affected in endemic cholera due toV. choleraeO1 was children 2–9 years old, and the organism was isolated from more females than from males at all ages. In contrast, cholera due toV. choleraeO139 caused disease mostly in adults 15 years and older, which indicated that this organism was new in this population. As withV. choleraeO1,V. choleraeO139 was isolated from more females than males. The initial rapid emergence and predominance ofV. choleraeO139 was considered possibly to herald the start of the eighth pandemic of cholera. However, just after a year, the prevalence ofV. choleraeO139 decreased dramatically withV. choleraeO1 resuming the role of the dominant cholera strain. The factor(s) contributing to the dramatic decline in prevalence ofV. choleraeO139 is not well understood.
Phage typing and drug resistance ofShigella sonneiisolated in England and Wales
Authors: Bentley C. A. , Frost J. A. , Rowe B.
Published: May 2009

Phage typing ofShigella sonneihas been used to examine isolates from the 1991–2 sonnei dysentery outbreak in England and Wales and compare them with strains isolated during and following a widespread foodborne outbreak in 1994 which was associated with consumption of imported lettuce. The distribution of phage types was different in the three periods studied with PT 3 predominating during 1991–2, PT 2 during the ‘lettuce’ outbreak in the summer months and PT 6 during the subsequent months. PT 6 was frequently associated with travel outside the UK. Variation was also seen in the distribution of drug resistance patterns.
A school outbreak of parvovirus B19 infection investigated using salivary antibody assays
Authors: Rice P. S. , Cohen B. J.
Published: May 2009

An outbreak of parvovirus B19 infection at a primary school was investigated using saliva samples. Antibody capture immunoassays for salivary B19 IgG and IgM were developed using a recombinant B19 antigen and monoclonal antibody to B19 virus. Evaluation of the salivary IgG assay using paired serum and saliva samples from 43 staff at St Thomas' Hospital showed that it had a sensitivity of 100% and a specificity of 95%. Evaluation of the salivary B19 IgM assay using 87 paired blood and saliva samples from a study of general practitioner rubella notifications showed it had a sensitivity of 60% and a specificity of 98%. Using the salivary assay the level of B19 IgG within 2 weeks of the start of the outbreak ranged from 5–33% in children and 29% in staff. By detecting salivary B19 IgM and/or B19 IgG seroconversions, attack rates of 8–50 % in children in different classes and 47 % in staff were observed. Household transmission was also studied and an attack rate of 45 % was recorded in 11 susceptibles. After the outbreak, the level of B19 IgG in children with the highest attack rates was 60–70%, similar to that seen in adults in the UK. This study highlights the risk of B19 infection in an institutional setting and shows that saliva samples are a useful alternative to blood.
Outbreaks of Norwalk-like virus-associated gastroenteritis traced to shellfish: coexistence of two genotypes in one specimen
Authors: Sugieda M. , Nakajima K. , Nakajima S.
Published: May 2009

We determined the nucleotide sequences of Norwalk-like viruses in 10 PCR products from stool or oyster specimens obtained from four outbreaks of gastroenteritis in which shellfish was suspected as the cause in Shizuoka prefecture in Japan between 1987–94. The sequences were determined from nucleotide positions 4561–852 (292 bp) in the polymerase region. Two types of sequences were detected. One (genotype 1) had 87% sequence homology with the prototype Norwalk virus, and the other (genotype 2) had 59 % sequence homology. The sequences from isolates belonging to the same genotype were almost the same regardless of the year of isolation. Because sequences of 2 genotypes were detected in 2 of the 4 outbreaks, nested PCR was performed with genotype-specific primers to detect the presence of 2 genotypes in the same specimen. In 5 of 10 specimens, PCR bands were detected with both genotype-specific primers, indicating the coexistence of 2 genotypes in 1 specimen. We also detected two genotypes of Norwalk-like virus in an oyster from a sample implicated in one of the outbreaks which may provide direct evidence of oysters as the cause of the gastroenteritis.
Investigation of tick-borne viruses as pathogens of humans in South Africa and evidence of Dugbe virus infection in a patient with prolonged thrombocytopenia
Authors: Burt F. J. , Spencer D. C. , Leman P. A. , Patterson B. , Swanepoel R.
Published: May 2009

In the course of investigating suspected cases of viral haemorrhagic fever in South Africa patients were encountered who had been bitten by ticks, but who lacked evidence of infection with Crimean–Congo haemorrhagic fever (CCHF) virus or non-viral tick-borne agents. Cattle sera were tested by enzyme-linked immunoassay to determine whether tick-borne viruses other than CCHF occur in the country. The prevalence of antibody in cattle sera was 905/2116 (42·8%) for CCHF virus, 70/1358 (5·2%) for Dugbe, 21/1358 (1·5%) for louping ill, 6/450 (1·3%) for West Nile, 7/1358 (0·5%) for Nairobi sheep disease, 3/625 (0·5%) for Kadam and 2/450 (0·4%) for Chenuda. No reactions were recorded with Hazara, Bahig, Bhanja, Thogoto and Dhori viruses. The CCHF findings confirmed previous observations that the virus is widely prevalent within the distribution range of ticks of the genusHyalomma, while antibody activity to Dugbe antigen was detected only within the distribution range of the tickAmblyomma hebraeum. Cross-reactivity for the nairoviruses, Hazara, Nairobi sheep disease and Dugbe, was detected in serum samples from 3/72 human patients with confirmed CCHF infection, and serum from 1/162 other patients reacted monospecifically with Dugbe antigen. The latter patient suffered from febrile illness with prolonged thrombocytopenia.
An abattoir-based study of the prevalence of subclinical Johne's disease in adult cattle in south west England
Authors: Çetinkaya B. , Egan K. , Harbour D. A. , Morgan K. L.
Published: May 2009

The prevalance of subclinical Johne's disease was estimated in adult cattle slaughtered at three major abattoirs in south west England. A polymerase chain reaction (PCR) based on IS900 was used to detectMycobacterium paratuberculosisin intestinal lymph nodes of 1553 cattle. Culture was also carried out on all PCR positive and inconclusive samples. The prevalence of subclinical disease in adult cattle was 3·5% (95% confidence intervals (CI) 2·6–4·7) by PCR and 2·6% (CI 1·8–3·6) by culture. The proportion of the disease in each month ranged from 1·6% (CI 0·2–5·5) in April to 4·6% (CI 2·8–6·9) in November, but the difference was not significant (P> 0·05). The proportion of PCR positive lymph nodes in each abattoir ranged from 2·8% (CI 1·6–4·6) to 4·9% (CI 2·9–7·6), this difference was not significant either (P> 0·05). The prevalence in young cattle was 2·0% (CI 0·6–4·5). The difference between age groups was not statistically significant (P> 0·05).
The haematological values of European badgers (Meles meles) in health and in the course of tuberculosis infection
Authors: Mahmood K. H. , Stanford J. L. , Machin S. , Watts M. , Stuart F. A. , Pritchard D. G.
Published: May 2009

Captive, healthy, adult badgers have blood containing haemoglobin at 13·3 g/dl, and 8·4×1012/l red cells with an MCV of 46·2 f1 and an MCH of 15·6 pg. They have 5·1×109 white cells/1 of which 3·29×109 are polymorphs, 1·49×109 are lymphocytes, 0·26×109 are monocytes, 0·07×109 are eosinophils and 0·01×109 are basophils. These values are somewhat less in adult animals just trapped from the wild, and are lower still in wild cubs.

Changes associated with tuberculosis are a rise, and then a fall in red blood count and white blood count, an increase in the proportion of polymorphs and momocytes and a fall in lymphocytes late in the disease. This picture is similar to that seen in widespread, disseminated, tuberculin negative, tuberculosis in humans, a type of disease similar to that occurring in many badgers.

BCG vaccination of badgers did not produce any measurable change in the blood picture.
Food poisoning due to the consumption of red whelks (Neptunea antiqua)
Authors: Reid T. M. S. , Gould I. M. , Mackie I. M. , Ritchie A. H. , Hobbs G.
Published: May 2009

Two incidents of toxin-type food poisoning in N.E. Scotland associated with the consumption of red whelks (Neptunea antiqua) are described. Four patients developed symptoms within 1 h of consuming whole whelks. These included visual distrubances—double vision and difficulty in focusing-ingling of the fingers, prostration and in one subject nausea, vomiting, diarrhoea and ataxia. In all cases recovery was complete in 24 h. Using a newly developed analytical technique the concentration of the causative toxin, tetramine, in the salivary glands of the whelks consumed was estimated at 0.07%, equivalent to a content of 3.75mg/100g of the shellfish.
Maternally derived measles immunity in children of naturally infected and vaccinated mothers
Authors: Jenks P. J. , Caul E. O. , Roome A. P. C. H.
Published: May 2009

Measles antibody titres were established in three groups of infants: children of vaccinated mothers, children of unvaccinated mothers and neonates born after different gestational periods.
Listeria faecal carriage by renal transplant recipients, haemodialysis patients and patients in general practice: its relation to season, drug therapy, foreign travel, animal exposure and diet
Authors: MacGowan A. P. , Marshall R. J. , Mackay I. M. , Reeves D. S.
Published: May 2009

About 2·3% (16/700) of faecal specimens from renal transplant recipients and patients having home haemodialysis as well as patients attending their general practitioners with symptoms of gastroenteritis yieldedListeriaspecies 40% of positive faeces contained more than oneListeriaspecies or serovar. The proportion of positive specimens was similar in all three patient groups. Listeria were isolated from 5·6% (10/177) of renal transplant recipients on one or more occasions over the period of a year. The commonest species wasL. monocytogenesand type 4b the commonest serovar. Carriage was more common in July and August than other times of year, and less than 28 weeks in duration. In renal transplant recipients carriage was positively related to treatment with ranitidine, consumption of more than three types of cheese in the previous 20 months, and consumption of English cheddar cheese more than once per week.
Bacteriophage as models for virus removal from Pacific oysters (Crassostrea gigas) during re-laying
Authors: Humphrey T. J. , Martin K.
Published: May 2009

A study was undertaken to examine the feasibility of using naturally-occurring bacteriophages to assess the impact of re-laying on levels of viral contamination inCrassostrea gigas, the Pacific oyster. Two phages were chosen. One, male-specific (F+), was enumerated usingSalmonella typhimurium. The other, a somatic phage, was detected using an, as yet, uncharacterizedEscherichia coli. Investigations, using a variety of re-laying sites, demonstrated that numbers of F+ phage in oyster tissue declined more rapidly than those of somatic phage. For example, in oysters placed in commercially-used sea water ponds, F+ phage reached undetectable levels within 2–3 weeks, whereas somatic phage could still be detected 5 weeks after re-laying. The studies suggest that F+ phage may not be a suitable indicator for virus removal and that somatic phage may be better suited to this role.
Influenza immunization; vaccine offer, request and uptake in high-risk patients during the 1991/2 season
Authors: Nguyen-Van-Tam J. S. , Nicholson K. G.
Published: May 2009

Current levels of influenza vaccine uptake in patients considered to be at high risk have been determined by means of a questionnaire survey. During March–April 1992, information was sought from 624 patients in Leicestershire, UK with either chronic cardiovascular or respiratory disease, or diabetes; questions related to current health status and the request, offer and receipt of influenza vaccine in the current and three previous seasons. Ninety-eight percent of all offers of immunization were made in the primary care setting, and vaccine was well tolerated as judged by the fact that 86% of vaccinees between 1988/9–1990/1 returned for immunization in the following year. However in the 1991/2 season the overall level of vaccine uptake was only about 41% which is at variance with the stated policies and practices of general practitioners. Opportunities were missed, in both hospitals and general practices, to publicise and offer immunization to individuals with vaccine indications. Future attempts to improve vaccine uptake should focus on increasing the role of hospital staff in influenza prevention, in addition to promoting better vaccine delivery through primary care.
Intracellular growth ofLegionella pneumophilaserogroup 1 monoclonal antibody type 2 positive and negative bacteria
Authors: Edelstein P. H. , Edelstein M. A. C.
Published: May 2009

Epidemiological evidence suggests that monoclonal antibody type 2 positive (MAB 2+)Legionella pneumophilaserogroup 1 (LP1) more often causes disease than do MAB 2−isolates, and there is evidence that MAB 2−LP1 grow less well in cells than do MAB 2+bacteria. We tested the intracellular growth rates of ten randomly selected MAB 2−LP1 isolates, by using guinea-pig alveolar macrophages, and human monocyte-derived macrophages. Save a low virulence control, all ten MAB 2−isolates grew as well in cells as a virulent MAB 2+isolate. Heterogeneity of MAB 2−LP1 growth in cells exists, making poor intracellular growth an unlikely explanation for why MAB 2+LP1 appear to cause disease more often.
Genetic relationships between foot–and–mouth disease type Asia 1 viruses
Authors: Ansell D. M. , Samuel A. R. , Carpenter W. C. , Knowles N. J.
Published: May 2009

The sequence of 165 nucleotides at the 3´ end of the 1D (VP1) gene of foot-and-mouth disease (FMD) virus was determined for 44 type Asia 1 strains isolated from throughout Asia between 1954–92. Analysis of the relationships between the virus genomes showed epidemiological links not previously evident. The possible origin of the only outbreak of FMD Asia 1 to have occurred in Europe, in Greece in 1984, was identified because the nucleotide sequence of this virus was closely-related to the sequences of those present in the Middle East between 1983–5.

Variation in the region sequenced was not as great as that seen in the other FMDV serotypes and all viruses shared greater than 85% nucleotide identity. Thus all the virus isolates examined were considered to belong to a single genotype.

A database of Asia 1 virus sequences has been established which will facilitate the rapid analysis of new outbreaks strains.
The detection of antibodies against peste des petits ruminants virus in cattle, sheep and goats and the possible implications to rinderpest control programmes
Authors: Anderson J. , Mckay J. A.
Published: May 2009

Monoclonal antibody–based competitive ELISA (C–ELISA) have been used for the specific measurement of antibodies to both rinderpest and peste des petits ruminants (PPR) viruses in cattle, sheep and goats. Examination of serum samples from sheep and goats in Gambia, before and after vaccination with rinderpest vaccine, suggested that antibodies to PPR virus could prevent an immune response to the rinderpest vaccine. Cattle sera from Nigeria and Ghana showed a high prevalence of antibody against PPR virus which may explain the difficulty experienced in some countries in achieving high post-vaccination immunity levels against rinderpest. Because antibodies against PPR virus are both cross–neutralizing and cross-protective against rinderpest virus further vaccination in the presence of antibodies against PPR virus may be a waste of national resources. This paper presents serological evidence for the transmission of PPR virus from sheep and goats to cattle and highlights the need to include PPR serology in the sero-monitoring programme to give a better indication of national herd immunity.
Cell surface hydrophobicity and adherence to extra–cellular matrix proteins in two collections of methicillin–resistantStaphylococcus aureus
Authors: Cree R. G. A. , Aleljung P. , Paulsson M. , Witte W. , Noble W. C. , Ljungh A. , Wadström T.
Published: May 2009

Non-specific and specific mechanisms of adherence have been examined in two collections of methicillin–resistantStaphylococcus aureus(MRSA). Determination of hydrophobicity by salt aggregation, hydrophobicity indices and of adherence to the extra–cellular matrix proteins fibronectin, vitronectin, laminin and collagen type 1 have failed to reveal any correlation with phage-type, plasmid profile or antibiogram. Further, the strain collections, made over a period of years in two countries, differ markedly in their adherence characteristics; MRSA are heterogeneous in this respect. Such heterogeneity may explain the polarization of views on the epidemicity or ‘virulence’ of MRSA. With the exception of adherence to collagen a small group of methicillin sensitiveS. aureushad characteristics intermediate between the two groups of MRSA.
Antigenicity and immunogenicity of equine influenza vaccines containing a Carbomer adjuvant
Authors: Mumford J. A. , Wilson H. , Hannant D. , Jessett D. M.
Published: May 2009

Equine influenza vaccines containing inactivated whole virus and Carbomer adjuvant stimulated higher levels and longer lasting antibody to haemagglutinin in ponies than vaccines of equivalent antigenic content containing aluminium phosphate adjuvants. Five months after the third dose of vaccine containing Carbomer adjuvant, ponies were protected against clinical disease induced by an aerosol of virulent influenza virus (A/equine/Newmarket/79, H3N8). In contrast ponies which received vaccine containing aluminium phosphate adjuvant were susceptible to infection and disease. There was an inverse correlation between prechallenge levels of antibody detected by single radial haemolysis (SRH) and duration of virus excretion, pyrexia and coughing. All ponies with antibody levels equivalent to SRH zones of ≥ 154 mm2were protected against infection and all those with levels ≤ 85 mm2were protected from disease.
Cutaneous leishmaniasis in the Peruvian Andes: an epidemiological study of infection and immunity
Authors: Davies C. R. , Llanos-Cuentas E. A. , Pyke S. D. M. , Dye C.
Published: May 2009

A prospective longitudinal survey of cutaneous leishmaniasis (Leishmania peruviana) was carried out in Peru on a study population of 4716 persons living in 38 villages (Departments of Lima, Ancash and Piura). Demographic and clinical data were collected from all individuals, and a Montenegro skin test (MST) was carried out on 72% (3418) of the study population. Each household was revisited at 3-monthly intervals for up to 2 years to detect new leishmaniasis cases; 497 people received a second MST at the end of the study. Analysis of the epidemiological data indicated that (i) 17% (16/94) of all infections were subclinical, (ii) this percentage increased significantly with age, (iii) clinical infections led to 73·9 % protective immunity (95 % C.I. 53·0–85·5 %) and relatively permanent MST responsiveness (recovery rate = 0·0098/year; 95% C.I. 0·000–0·020/year), (iv) sub-clinical infections led to protective immunity, which was positively correlated with their MST induration size (increasing by 17·9% per mm; P < 0·0001), and a mean MST recovery rate of 0·114/year (4/421 man-months), and (v) recurrent leishmaniasis was dominated by reactivations, not by reinfections.
Predicting the impact of measles vaccination in England and Wales: model validation and analysis of policy options
Authors: Babad H. R. , Nokes D. J. , Gay N. J. , Miller E. , Morgan-Capner P. , Anderson R. M.
Published: May 2009

Measles incidence in England and Wales has fallen to an all-time low. Attention is now focused on preventing local outbreaks, and, in the long run, on the elimination of indigenous measles. A realistic age-structured (RAS) mathematical model of measles transmission is used to reconstruct the impact of measles vaccination in England and Wales from 1968 to the present and to evaluate the merits of future policy options. In general, the predictions of the model show good agreement with long-term age stratified case reports and seroprevalence surveys. The model underestimates the proportion of cases that are notified in 0–2-year-old children. However, recent work suggests a high degree of misdiagnosis in this age group. Projections on the basis of the existing vaccination strategy in the UK suggest that the present level of measles vaccine coverage will be insufficient to eliminate small seasonal outbreaks of measles. This result is, however, sensitive to the assumed level of vaccine efficacy. Explorations of a variety of changes to current vaccination strategy favour a 2-dose schedule with the second dose administered at age 4 years irrespective of vaccination history. A vaccination campaign in school-age children, to reduce deficits in herd immunity, would accelerate progress towards measles elimination.
Cryptosporidiosis reservoir in wild brown rats (Rattus norvegicus) in the UK
Authors: Webster J. P. , MacDonald D. W.
Published: May 2009

Rats (n= 73) were trapped from nine rural farms around Oxfordshire and faeces were examined using the auramine-phenol and the Modified Ziehl-Neelsen techniques.Cryptosporidium parvumoocysts were detected in the faeces from 46 (63%) rats. This suggests that wild rats represent a risk to human and livestock health through the carriage and transmission of this zoonotic protozoan.
Comparison of PFGE, ribotyping and phage-typing in the epidemiological analysis ofCampylobacter jejuniserotype HS2 infections
Authors: Gibson J. R. , Fitzgerald C. , Owen R. J.
Published: May 2009

In this study we have evaluated the ability of three typing methods, pulsed field gel electrophoresis (PFGE), phage-typing and ribotyping, to discriminate not only between strains of differing serotypes but also between strains within a single serotype, heat stable serotype 2 (HS2). Forty-five isolates derived from cases of campylobacter enteritis occurring in the Cardiff area were examined. These included 18, mostly HS2, strains associated with an outbreak. The typing results for these and a further 39 epidemiologically unrelated strains of serotype HS2 were compared. This is the first report documenting the use of PFGE in an epidemiological investigation ofCampylobacter jejuniin the UK. The results presented suggest that this technique is the most discriminatory of the three subtvping methods examined.
PCR-based characterization ofYersinia enterocolitica: comparison with biotyping and serotyping
Authors: Odinot P. T. , Meis J. F. G. M. , Van Den Hurk P. J. J. C. , Hoogkamp-Korstanje J. A. A. , Melchers W. J. G.
Published: May 2009

PCR-based DNA fingerprinting was used to characterize 48 clinical isolates ofYersinia enterocolitica. The samples were examined by random amplified polymorphic DNA (RAPD-PCR) and inter-repeat PCR (IR-PCR). IR-PCR with two enterobacterial repetitive intergenic consensus primers resulted in patterns which were poorly discriminated; 2 of 11 arbitrary primers (RAPD-PCR) provided sufficient discriminatory power. In comparisons with serotyping and biotyping, RAPD-fingerprinting was the most discriminatory technique and may therefore be a valuable epidemiological tool for the study ofY. enterocoliticainfections.
Analysis of methicillin-resistant and methicillin-susceptibleStaphylococcus aureusby a molecular typing method based on coagulase gene polymorphisms
Authors: Kobayashi N. , Taniguchi K. , Kojima K. , Urasawa S. , Uehara N. , Omizu Y. , Kishi Y. , Yagihashi A. , Kurokawa I.
Published: May 2009

A molecular typing method forStaphylococcus aureusbased on coagulase gene polymorphisms (coagulase gene typing) was evaluated by examining a total of 240 isolates which comprised 210 methicillin-resistantS. aureus(MRSA) and 30 methicillin-susceptibleS. aureus(MSSA) collected from a single hospital. ByAlulrestriction enzyme digestion of the PCR-amplified 3′-end region of the coagulase gene including 81-bp repeated units, the MRSA and MSSA isolates examined were divided into 6 and 12 restriction fragment length polymorphism (RFLP) patterns, respectively, whereas five patterns were commonly detected in MRSA and MSSA. MRSA isolates that showed a particular RFLP pattern were considered to be predominant in the hospital. Coagulase typing with type-specific antisera was also performed for allS. aureusisolates for comparison. Coagulase types II and VII were most frequently detected and included isolates with four and five differentAluIRFLP patterns, respectively, whereas each of the other coagulase types corresponded to a single RFLP pattern. These results indicated that RFLP typing was more discriminatory than serological typing, for typingS. aureusand demonstrated its utility in epidemiologic investigation ofS. aureusinfection in hospitals.
The speciation and subtyping of campylobacter isolates from sewage plants and waste water from a connected poultry abattoir using molecular techniques
Authors: Koenraad P. M. F. J. , Ayling R. , Hazeleger W. C. , Rombouts F. M. , Newell D. G.
Published: May 2009

In this study the distribution of phenotypes of campylobacter strains in sewage and surface waters was investigated by subtyping and by speciation of isolates from various aquatic environments. These environments included two municipal sewage plants (SPA and SPB) and waste water from a poultry abattoir (WWA). Both the sewage plants SPA and SPB collected domestic and industrial waste, and SPA received drain water from WWA. SPB received no waste water from any meat-processing plant. The isolates were speciated by PCR and subtyped by PCR/RFLP based on the flagellin PCR products.

From all three reservoirs, noCampylobacter lariwas isolated, and approximately 80% of the isolates could be identified asC. jejuniand the rest belonged to theC. colispecies. The PCR/RFLP typing technique has a high discrimination level and was reproducible between two separate laboratories. The 182 isolates tested yielded 22 distinctDdeI profiles. The results indicate that strains with profiles found in poultry are also detectable in waste water presumed to be solely from domestic and human sources. In addition some strains were unique to the known poultry-related sources, suggesting that avian-specific strains, non-pathogenic to man, may exist in the environment. In contrast some strains were unique to human waste indicating the potential importance of non-poultry sources of infection. No seasonality was observed in the profile distribution. So, at least in the Netherlands, it is unlikely that infections caused by contaminated surface waters contribute to the seasonality of human campylobacteriosis.
Study of the effectiveness of influenza vaccination in the elderly in the epidemic of 1989–90 using a general practice database
Authors: Fleming D. M. , Watson J. M. , Nicholas S. , Smith G. E. , Swan A. V.
Published: May 2009

The effectiveness of influenza vaccination in preventing serious illness and death was determined in an elderly population during the influenza epidemic of 1989–90. A retrospective cohort study was carried out using computerized general practitioner records on nearly 10000 patients aged 55 years and over. After adjustment for potential confounding factors, recent immunization was found to have a protective effect of 75% (95% confidence intervals: 21–92%) against death. Protection did not appear to vary with either age or the presence of underlying chronic disease. As the complications of influenza are most common in those with underlying chronic disease, the study findings are consistent with the recommended policy for the use of influenza vaccine in the UK. Further work is necessary to determine the cost-effectiveness of extending immunization to other groups.
An outbreak of cholera from food served on an international aircraft
Authors: Eberhart-Phillips J. , Bessser R. E. , Tormey M. P. , Feikin D. , Araneta M. R. , Wells J. , Kilman L. , Rutherford G. W. , Griffin P. M. , Baron R. , Mascola L.
Published: May 2009

In February 1992, an outbreak of cholera occurred among persons who had flown on a commercial airline flight from South America to Los Angeles. This study was conducted to determine the magnitude and the cause of the outbreak. Passengers were interviewed and laboratory specimens were collected to determine the magnitude of the outbreak. A case-control study was performed to determine the vehicle of infection. Seventy-five of the 336 passengers in the United States had cholera; 10 were hospitalized and one died. Cold seafood salad, served between Lima, Peru and Los Angeles, California, was the vehicle of infection (odds ratio, 11·6; 95% confidence interval, 3·3–44·5). This was the largest airline-associated outbreak of cholera ever reported and demonstrates the potential for airline-associated spread of cholera from epidemic areas to other parts of the world. Physicians should obtain a travel history and consider cholera in patients with diarrhoea who have travelled from cholera-affected countries. This outbreak also highlights the risks associated with eating cold foods prepared in cholera-affected countries.
Differing antibody responses toHaemophilus influenzaetype b after meningitis or epiglottitis
Authors: Johnson P. D. R. , Hanlon M. , Isaacs D. , Gilbert G. L.
Published: May 2009

Two common forms of invasive disease due toHaemophilus influenzaetype b (Hib) are epiglottitis and meningitis. It is not known why some children develop epiglottitis and others meningitis. To examine the hypothesis that epiglottitis occurs in children who may have been previously exposed to Hib, and who would therefore exhibit a more vigorous antibody response in convalescence, we measured levels of antibody to Hib capsule in 92 children. Geometric mean convalescent-phase IgG, IgA, IgM and total antibody levels were significantly higher in 45 children with epiglottitis than in 47 with meningitis, even after adjustment for age differences (mean total antibody, 95% confidence intervals: meningitis 0·38, 0·34–0·43; epiglottitis: 2·25, 2·0–2·54 μg/ml). However, contrary to previous reports, a poor antibody response was only observed in a minority of children with meningitis; the antibody response of the majority was indistinguishable from that observed in children with epiglottitis.
Impact of influenza and respiratory syncytial virus on mortality in England and Wales from January 1975 to December 1990
Authors: Nicholson K. G.
Published: May 2009

The effects of influenza A and B and RSV on mortality in England and Wales were assessed by regression analysis for the period 1975–90. Morbidity data from sentinel practices were used to calculate 4-weekly rates of aggregated upper respiratory tract infections (URTI); PHLS laboratory reports were used as indices of infection, and 4-weekly death rates from all causes, excluding childbirths, were used to study relationships with mortality. Deaths correlated strongly with influenza A and B reports, temperature, and interactions between aggregated URTI and temperature, and RSV outbreaks and temperature. Estimates of ‘seasonal’ 4-weekly mortality associated with URTI were made by substituting into primary regression models the mean of annual trough consultation rates for aggregated URTI and baseline values for RSV and influenza. Peak 4-weekly mortality associated with URTIs was estimated at c. 24000 and c. 28000 during combined influenza and RSV epidemics of 1975–6 and 1989–90 respectively. Secondary regression analysis was carried out with the estimated ‘seasonal’ 4-weekly deaths associated with URTI as dependant variable and laboratory data as regressors. Estimated excess mortality associated with influenza was considerable even during years without major epidemics. Overall during the 15 winters the estimated mortality associated with RSV was 60–80 % more than that associated with influenza. The modelling permits only a crude estimate of RSV associated mortality. None the less it suggests that RSV is an important cause of winter mortality.
An 18 year clinical review of septic arthritis from tropical Australia
Authors: Morgan D. S. , Fisher D. , Merianos A. , Currie B. J.
Published: May 2009

A retrospective study of 191 cases of septic arthritis was undertaken at Royal Darwin Hospital in the tropical north of Australia. Incidence was 9·2 per 100000 overall and 29·1 per 100000 in Aboriginal Australians (RR 6·6; 95% CI 5·0–8·9). Males were affected more than females (RR 1·6; 95% CI 1·2–2·1). There was no previous joint disease or medical illness in 54%. The commonest joints involved were the knee (54%) and hip (13%). Significant age associations were infected hips in those under 15 years and infected knees in those over 45 years. Seventy-two percent of infections were haematogenous. Causative organisms included Staphylococcus aureus (37%),Streptococcus pyogenes(16%) andNeisseria gonorrhoeae(12%). Unusual infections included three melioidosis cases. Polyarthritis occurred in 17%, withN. gonorrhoeae(11/23) more likely to present as polyarthritis than other organisms (22/168) (OR 6·0; 95% CI 2·1–16·7). Univariate and multivariate analysis showed the hip to be at greater risk forS. aureusthan other joints. Open arthrotomy was a more successful treatment procedure than arthroscopic washout or needle aspiration.
A foodborne outbreak of gastroenteritis involvingListeria monocytogenes
Authors: Salamina G. , Donne E. Dalle , Niccolini A. , Poda G. , Cesaroni D. , Bucci M. , Fini R. , Maldini M. , Schuchat A. , Swaminathan B. , Bibb W. , Rocourt J. , Binkin N.
Published: May 2009

An outbreak of gastroenteritis occurred in Italy among 39 persons who had attended a private supper. All guests were previously healthy, young, non-pregnant adults; 18 (46%) had symptoms, mostly gastrointestinal (78%), with a short incubation period. Four were hospitalized with acute febrile gastroenteritis, two of whom had blood cultures positive forListeria monocytogenes. No other microorganisms were recovered from the hospitalized patients' specimens. Epidemiological investigation identified rice salad as the most likely vehicle of the food-borne outbreak.L. monocytogeneswas isolated from three leftover foods, the kitchen freezer and blender. Isolates from the patients, the foods and the freezer were indistinguishable: serotype l/2b, same phage type and multilocus enzyme electrophoretic type. Eight (36%) of 22 guests tested were found to have antibodies againstL. monocytogenes, compared with none of 11 controls from the general population. This point source outbreak was probably caused by infection withL. monocytogenes. Unusual features included the high attack rate among immunocompetent adults and the predominance of gastrointestinal symptoms.
Experimental studies on the infectivity of non-culturable forms ofCampylobacterspp. in chicks and mice
Authors: Van De Giessen A. W. , Heuvelman C. J. , Abee T. , Hazeleger W. C.
Published: May 2009

The significance of non-culturable forms ofCampylobacterspp., especially with regard to the epidemiology of this organism in poultry flocks, was explored. Two different experiments were conducted to produce non-culturableCampylobacterspp. and test their ability to colonize the animal gut. In the first experiment a mixture of 28 different strains ofCampylobacterspp. from various sources was inoculated in both sterilized surface water and potassium phosphate buffer and stored at 4 °C. AfterCampylobacterspp. were no longer detectable by culture in the microcosms, the mixtures of non-culturable cells were used to challenge both chicks and mice. Recovery of non-culturableCampylobacterspp. from the animals was not successful at 4 weeks after administration. In the second experiment the survival of six individual strains ofCampylobacterspp. in sterilized surface water at 4 °C was studied and the resulting non-culturable cells were used to challenge chicks. None of the Campylobacter strains could be recovered from the chicks at 2 weeks after administration. We conclude that occurrence of non-culturable forms ofCampylobacterspp. capable of colonizing chicks is not a common phenomenon and that non-culturable forms ofCampylobacterspp. are likely to be insignificant for importantly to the epidemiology of the organism in Dutch broiler flocks.
Association ofChlamydia pneumoniaeIgA antibodies with recently symptomatic asthma
Authors: Hahn D. L. , Anttila T. , Saikku P.
Published: May 2009

To determine whether recently diagnosed adult–onset asthma is associated with serologic evidence of chronicChlamydia pneumoniaeinfection, we performed a case-control study in a primary care clinic of cases with asthma (25 adults reporting first symptoms of asthma within 2 years of enrollment) and 45 concurrently enrolled sex and age (±10 years) matched non-asthmatic controls with normal pulmonary function.C. pneumoniae-specific IgA, IgG and IgG4 antibodies, and circulating immune complexes (CIC) were measured by microimmunofluorescence testing. Results showed that frequencies of IgG litres>16 (92%), IgG4 litres>16 (20%) and CIC>4 (60%) in asthma patients were not significantly different from those of controls. However, asthmatics had a significantly higher prevalence ofC. pneumoniae-specific IgA litres>10 (72% of casesvs44% of controls,P< 0·05). After adjustment for the effects of age, sex and smoking, the odds ratio for an association of IgA and asthma was 3·7 (95% confidence interval 1·2–11·5). We conclude that recently symptomalic reversible airway obstruction in adults is associated with the presence ofC. pneumoniae-specific IgA antibodies, a proposed indicator of chronic respiratoryC. pneumoniaeinfection.
A study of maternally derived measles antibody in infants born to naturally infected and vaccinated women
Authors: Brugha R. , Ramsay M. , Forsey T. , Brown D.
Published: May 2009

Maternal, cord and infant measles antibody levels were measured and compared in a group of 411 vaccinated mothers and 240 unvaccinated mothers, and their babies, between 1983 and 1991. Maternal and cord sera were tested by haemagglutination inhibition and/or enzyme-linked immunosorbent assay, and plaque reduction neutralization tests were also used to test infant sera. Geometric mean litres were significantly higher in the unvaccinated than in the vaccinated mothers (P< 0·001). Infants born to mothers with a history of measles had higher antibody levels at birth than infants of vaccinated mothers and, although the difference narrowed over time, continued to have higher levels up to 30 weeks of age. Between 5 and 7 months of age significantly more of the children of vaccinated mothers had plaque reduction neutralization antibody levels below that which would interfere with vaccination. As the boosting effect of circulating natural measles disappears, earlier measles vaccination may need to be considered, perhaps as part of a two-dose policy.
Genotyping of hepatitis C virus isolates from Basque Country, Spain
Authors: Cilla G. , García-Bengoechea M. , Trallero E. Perez , Montalvo I. , Vicente D. , Arenas J. I.
Published: May 2009

The genotype of HCV was determined in 161 chronic HCV-infected patients. The patients were classified into three groups on the basis of the origin of the HCV infection: 50 patients had a history of intravenous drug use (IVDU) but no HIV infection; 41 patients had received blood transfusions, and 70 patients had no known exposure. The distribution of HCV genotypes was associated with the origin of infection and age of patients: genotype 1b was predominant among patients who had received blood transfusions and those without evidence of parenteral exposure (84·6% and 67·7%, respectively), whereas genotype 3a was present in 65·3% of IVDUs. Patients with genotype 1b were older than those with genotypes la or 3a: 50·3 ± 12 vs. 34·1±9·9 and 31 ± 5.4 years, respectively. These findings suggest that the pattern of HCV genotypes in our region is changing and that genotype 1b may be substituted by 3a as the dominant genotype in the future.
Trajectory analysis of winds and eastern equine encephalitis in USA, 1980–5
Authors: Sellers R. F. , Maarouf A. R.
Published: May 2009

Backward trajectories of winds were determined to identify possible sources of eastern equine encephalitis virus associated with isolation of virus from mosquitoes or birds or outbreaks in horses between 1980 and 1985 in Maryland, New Jersey, New York and Michigan, USA.

The results of the trajectory analyses suggested that eastern equine encephalitis virus could have been carried by infected mosquitoes on surface winds at temperatures 13 °C or higher from North Carolina north-eastwards along the Atlantic Coast to Maryland and New Jersey and thence to upstate New York and from western Kentucky to Michigan. Landing of mosquitoes was associated with the presence of a cold front and rain leading to variations in the location and timing of outbreaks from year to year. The mosquito responsible was most likely to have been Culiseta melanura, but Coquillettidia perturbans and Aedes sollicitans could also have been involved.

There may be a continual cycle of eastern equine encephalitis virus in mosquitoes and birds in south-eastern USA, from where the virus could be distributed by infected mosquitoes on the wind along the Gulf and Atlantic Coasts and up the Mississippi Valley.