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C L Bartlett

Publications and source records attributed to C L Bartlett.

At least 19 recordsLinked to original sources
PubMed2003

The Communicable Disease Surveillance Centre 1977-2002: an overview.

The Communicable Disease Surveillance Centre (CDSC) is now firmly established within the new Health Protection Agency (HPA), which was inaugurated on 1st April 2003. In 2002, CDSC celebrated its 25th anniversary. Its achievements over those 25 years, a period when it evolved from a small unit with three staff to an international centre of excellence with over 250 staff, are recalled in this paper. The development of the Centre is reviewed, as are the ways in which it identified and responded to changing patterns of communicable disease over the quarter century. The considerable benefits of placing CDSC within the Public Health Laboratory Service are demonstrated through several examples. The fact that the expansion of CDSC took place during an era when public expenditure was constrained indicates that government valued the service it provided. The elements required and put in place for effective control and prevention of communicable diseases are highlighted and several themes emerge including the close working relationship needed between the various agencies and disciplines, particularly those between epidemiologists, microbiologists and clinicians. Another theme is the commitment to training, (which is necessary to ensure that work is practiCed to the highest standards), as well as to innovation through research and development. A rigorous approach to field investigation is essential, not just to enable the most appropriate control measures to be applied but to increase the knowledge base on infections and the means of prevention. Good surveillance and reference microbiology stand out as the vital components needed to produce the timely and precise information required to influence practice and policy.

Cholera↗
PubMed2000

Risk factors for community-acquired pneumonia diagnosed by general practitioners in the community.

The purpose of this study was to identify risk factors for pneumonia diagnosed in the community by general practitioners, using a case control study in 29 general practices in Nottingham, U.K. Patients with radiographically confirmed pneumonia were compared with adults randomly selected from electoral registers corresponding to the catchment areas of the general practices taking part in the study. Sixty-six cases and 489 controls participated. Significant risk factors in univariate analysis included age, chronic obstructive pulmonary disease, congestive heart failure and lifetime consumption of cigarettes. Multiple logistic regression analysis of these four variables showed that age [adjusted odds ratio = 2.69 (for 30 year increment), 95%CI = 1.66-4.35] and chronic obstructive pulmonary disease (adjusted odds ratio= 1.99, 95%CI = 1.15-3.45) were independent risk factors. Only age and chronic obstructive pulmonary disease were independent risk factors for pneumonia in this study. Since cigarette smoking is the major cause of chronic obstructive pulmonary disease, these data suggest that cigarette smoking is the main avoidable risk factor for community-acquired pneumonia in adults.

Adolescent↗
PubMed2000

Risk factors for community-acquired pneumonia diagnosed upon hospital admission. British Thoracic Society Pneumonia Study Group.

A case-control study of risk factors for community-acquired pneumonia in adults admitted to hospital is reported. Cases were surviving patients (n = 178) admitted to 14 hospitals in England. Controls were individuals (n = 385) randomly selected from the electoral registers of the areas served by the hospitals. The two groups were compared with regard to risk factors for pneumonia using a standardized postal questionnaire. Independent risk factors associated with cases in log-linear regression analysis were age, heart disease (as indicated by congestive heart failure and/or digitalis treatment), lifetime smoking history, chronic airway disease (chronic bronchitis and/or asthma), occupational dust exposure, pneumonia as a child, single marital status and unemployment. Corticosteroid and bronchodilator therapy were also independent risk factors in the log-linear regression analysis, but may reflect the severity of underlying lung disease for which these drugs were prescribed. These data suggest that cigarette smoking is the major avoidable risk factor for acute pneumonia in adults.

Adolescent↗
PubMed1999

Legionnaires' disease in residents of England and Wales: 1998.

Two hundred and twenty-six cases of legionnaires' disease who acquired infection in 1998 have been reported to the PHLS Communicable Disease Surveillance Centre. Twenty-five cases (11%) were reported to have died. One hundred and fifteen cases were associated with travel, either abroad or in the United Kingdom, three cases acquired infection in hospital, and the remaining 108 were presumed to have acquired infection in the community. Thirty-five cases were linked to industrial or community associated outbreaks in England and Wales, 22 cases to outbreaks or clusters abroad, and the remaining 169 cases (75%) were reported as single cases. The proportion of cases diagnosed by detection of urinary antigen has continued to increase; in 1998 it contributed to the diagnosis of 117 cases.

Adult↗
PubMed1998

Legionnaires' disease in residents of England and Wales: 1997.

Two hundred and twenty-six residents of England and Wales who developed legionnaires' disease with onset of infection in 1997 were reported to the PHLS Communicable Disease Surveillance Centre. Twenty-eight cases (12%) were reported to have died. Half of the reported cases (114) were associated with travel, either abroad or in the United Kingdom. Six cases acquired infection in hospital and the remaining 106 were presumed to have acquired infection in the community. Nineteen cases were linked to industrial or community associated outbreaks or clusters in England, two cases to a hospital outbreak, and 25 cases to outbreaks or clusters abroad. The remaining 180 cases (80%) were reported as single cases. The proportion of cases diagnosed by detection of urinary antigen has continued to increase. In 1997 this method of diagnosis was included for 60% of confirmed cases and in 46% of all cases.

Adolescent↗
PubMed1997

Legionnaires' disease in residents of England and Wales: 1996.

Two hundred and one cases of legionnaires' disease were reported to the PHLS Communicable Disease Surveillance Centre in 1996. Twenty-four cases (12%) were known to have died. One hundred and one cases were associated with travel, either abroad or in the United Kingdom. Two cases acquired infection in hospital, the smallest number ever reported, and the remaining 98 were presumed to have acquired infection in the community. Fifty-five (27%) of the 201 cases were linked to outbreaks or clusters and the remaining 146 (73%) were reported as single cases. Six outbreaks were associated with industrial premises. Twenty-two of the travel associated cases were part of three travel outbreaks and six clusters. The proportion of cases diagnosed by detection of urinary antigen has continued to increase and in 1996 this method of diagnosis was used for 43% of the cases.

Adolescent↗
PubMed1996

International epidemiological and microbiological study of outbreak of Salmonella agona infection from a ready to eat savoury snack--I: England and Wales and the United States.

OBJECTIVES: To identify the source of an international outbreak of food poisoning due to Salmonella agona phage type 15 and to measure how long the underlying cause persisted. DESIGN: Case-control study of 16 primary household cases and 32 controls of similar age and dietary habit. Packets of the implicated foodstuff manufactured on a range of days were examined for salmonella. All isolates of the epidemic phage type were further characterised by pulsed field gel electrophoresis. RESULTS: 27 cases were identified, of which 26 were in children. The case-control study showed a strong association between infection with S agona phage type 15 and consumption of a peanut flavoured ready to eat kosher savoury snack imported from Israel. S agona phage type 15 was isolated from samples of this snack. The combined food sampling results from the United Kingdom, Canada, the United States, and Israel showed that contaminated snacks were manufactured on at least seven separate dates during a four month period between October 1994 and February 1995. Voluntary recalls of the product successfully interrupted transmission. CONCLUSIONS: Rapid international exchanges of information led to the identification of the source of a major outbreak of S agona in Israel and of associated cases in North America. The outbreak showed the value of the Salm-Net surveillance system and its links outside Europe, both for increasing case ascertainment and for improving the information on the duration of the fault at the manufacturing plant.

Case-Control Studies↗
PubMed1996

Legionnaires' disease surveillance: England and Wales, 1995.

One hundred and sixty cases of legionnaires' disease were reported to the PHLS Communicable Disease Surveillance Centre in 1995. Twenty cases (13%) were known to have died. Ninety cases (56%) were associated with travel (in the United Kingdom or abroad), four were associated with a stay in hospital, and the remaining 66 were presumed to have acquired infection in the community. One hundred and twenty-three cases (77%) occurred sporadically. Three community outbreaks and one outbreak at an industrial site were detected in England and Wales. One outbreak and five clusters were detected among visitors to Turkey, Spain, and Italy. Seven cases and one outbreak of nonpneumonic legionellosis were also reported. Cases of travel associated legionnaires' disease continue to account for the largest proportion of the total reported in 1995 and the number of hospital acquired cases continues to decline. A cause for concern in 1995 was a fall in the proportion of cases diagnosed by culture of the organism (from 16% in 1994 to only 9% in 1995). This corresponded with a small increase in the proportion of cases diagnosed solely by detection of antigen to L. pneumophila serogroup 1 in urine.

Adult↗
PubMed1995

Legionnaires' disease surveillance: England and Wales 1994.

One hundred and sixty cases of legionnaires' disease in England and Wales were reported to the PHLS Communicable Disease Surveillance Centre in 1994, a rate of 3.1 cases per million population. Twenty-seven cases died. Eighty-nine cases (56%) were associated with travel, either in the United Kingdom (UK) or abroad, and six with a stay in hospital; the remaining cases were presumed to have acquired infection in the community. Seven outbreaks were detected in England and Wales: one was associated with a holiday centre, one with a hotel in London, two with industrial sites, and three occurred in the community. A further four clusters were associated with travel abroad: Spain, Ibiza, the Channel Islands, and a Mediterranean cruise. One hundred and twenty-eight of the 160 cases (79%) were sporadic--that is, not known to be associated with outbreaks--43 of which (34%) were not associated with travel nor acquired in hospital.

Adult↗
PubMed1994

Legionnaires' disease surveillance: England and Wales, 1993.

One hundred and twenty-nine cases of legionnaires' disease were reported in England and Wales in 1993. Twenty-two of the cases died. Sixty-six cases (51%) were associated with travel (in the United Kingdom or abroad), six were associated with a stay in hospital, and the remaining 57 were thought to have acquired infection in the community. Two community and two hospital outbreaks were recognised in England and Wales and four outbreaks were detected in travellers from the United Kingdom to Spain, Greece, and the United States. One hundred and six cases (82%) were not known to have been associated with outbreaks, and 51 (40%) of these were not associated with travel or hospitals.

Cross-Sectional Studies↗
PubMed1994

Nosocomial Legionnaires' disease in England and Wales, 1980-92.

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 non L. pneumophila serogroup 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.

Adolescent↗
PubMed1993

AIDS predictions.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1993

An evaluation of surveillance methods for detecting infections in hospital inpatients.

Eight selective surveillance methods were compared with a reference method for their ability to detect hospital infections in patients was also assessed. In the reference method, case records were reviewed three times a week, and during the 11-month period of study, 668 infections were identified amongst 3326 patients. Three hundred and thirty-eight were community acquired infections (CAI) and 330 were hospital acquired infections (HAI). The time for data collection was 18.1 h per 100 beds per week. Of the selective surveillance methods, those based on the review of treatment and temperature charts detected the highest proportion (70%) of CAI; and the review of microbiology reports with regular ward liaison identified the highest proportion (71%) of HAI. The time for data collection in the eight methods ranged from 1.2 h per 100 beds per week to 6.5 h per 100 beds per week. After considering the sensitivity for identifying patients with HAI and time for data collection, the review of microbiology reports with regular ward liaison was judged to be an effective and efficient method of surveillance.

Cross Infection↗
PubMed1993

Introduction of laboratory based ward liaison surveillance of hospital infection into six district general hospitals.

A previous study demonstrated that laboratory based ward liaison surveillance (LBWLS) of hospital infection was an effective and efficient method. The method involved the follow-up of positive microbiology reports by the review of patient records and liaison with ward nursing staff to consider whether any patients had infection. Here we report the introduction of LBWLS into six district general hospitals to determine whether it is feasible to use this method on an everyday basis. The time required for data collection was assessed and the method was compared with a reference method in one hospital to check its ability to detect infections. To assess reproducibility two infection control nurses (ICNs) performed LBWLS independently, but concurrently, for 5 weeks. The method could be used in all hospitals studied; however, the time for data collection ranged from 3.0 to 6.8 h/100 beds per week. In comparison with the reference method, LBWLS detected 15/41 (37%) of community acquired infections and 30/43 (70%) of hospital acquired infections. In the reproducibility assessment 72 patients were identified by both ICNs. There was agreement about the infected/non-infected status of 65 of these patients. The mean pair agreement and Kappa statistic were 0.88 and 0.72. Laboratory based ward liaison was readily used in all hospitals and was reproducible.

Adolescent↗