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PubMed2004

Antimicrobial susceptibility of invasive isolates of Streptococcus pneumoniae in Ireland.

Between January 1999 and June 2002, 646 invasive isolates of Streptococcus pneumoniae were collected in Ireland. MICs of penicillin, ciprofloxacin, cefotaxime, moxifloxacin and linezolid were determined by Etest methodology. Eighty-seven (13.5%) isolates showed intermediate resistance to penicillin, while seven (1.1%) showed high-level resistance. Eighty-seven (13.5%) isolates were resistant to erythromycin, but all isolates were susceptible to cefotaxime, moxifloxacin and linezolid. The prevalence of pneumococcal isolates non-susceptible to penicillin in Ireland is worryingly high, but currently there are alternative agents available to treat invasive infection.

Adolescent↗

PubMed1976

Major central nervous system malformations notified in Northern Ireland, 1969 to 1973.

In Northern Ireland, during the years 1969 to 1973, there were 485 notifications of anencephalus, 525 of spina bifida and 328 of hydrocephalus in a population of 157,725 (live and still) births. The data were based on the voluntary notification system for congenital malformations which has been operating in Northern Ireland and in England and Wales sine 1964. The malformation rates per 1000 (live and still) births were 3-1 for anencephalus, 3-3 for spina bifida and 2-1 for hydrocephalus. Secular trends in these data indicate a decrease in the incidence of all three major central nervous system malformations, but this is significant only in relation to anencephalus. Spina bifida was more common in female births than in male births, and 79 per cent of affected infants were liveborn. Indirect evidence suggests that some 40 per cent of the total number of live and stillborn infants having spina bifida at birth will survive to one year of age.

Anencephaly↗

PubMed1990

The prevalence of schizophrenia in three counties in Ireland.

This article reports a study of the prevalence of schizophrenia in 3 counties in Ireland based on case-register data and using a standardized diagnostic instrument--the Present State Examination. The estimate of prevalence varies depending on the criteria of schizophrenia employed. A middle-range estimate of 3.9 per 1000 population does not differ substantially from previous estimates of prevalence obtained elsewhere. Over 60% of all schizophrenic prevalence patients and over half of schizophrenic inpatients did not score as cases, suggesting that the continued hospitalization of symptomatically recovered cases has given rise to the mistaken impression that the prevalence of schizophrenia is unduly high in Ireland. The work reported here indicates substantial differences between the results of case ascertainment by hospital admission data compared with those arrived at by standardized interview diagnostic techniques.

Adolescent↗

PubMed1991

Knowledge, attitudes and behaviour in relation to dental health of adults in Belfast, Northern Ireland.

The aim was to investigate the knowledge, attitudes and behaviour related to dental health of adults living in two neighbouring areas in Belfast, Northern Ireland. 81 adults aged 30 yr or over from two neighbouring residential areas in South Belfast completed a structured interview. The responses of those who retained natural teeth were very different from those who were edentulous. Those in the higher socioeconomic status groups had clearer knowledge, more positive attitudes and more appropriate behaviour related to dental health than those in lower socioeconomic status groups. The differences between the residents of the two areas were less obvious than those noted between the different socioeconomic status groups. It was concluded that the results revealed misconceptions amongst adults in Northern Ireland regarding the causes of dental disease and how it might be prevented both in themselves and in their children.

Adult↗

PubMed1992

Prevalence of enamel defects/fluorosis in fluoridated and non-fluoridated areas in Ireland.

Water fluoridation was introduced in Ireland in 1964 and in recent years the availability of fluoride from other sources had increased. As part of a National Survey of Children's Health in Ireland Dean's and the DDE indices were used to determine the prevalence of enamel fluorosis/defects in 8- and 15-yr-old children in fluoridated and non-fluoridated areas. Over 94% of the children examined in all areas were regarded as having normal enamel, as defined by Dean's index, the remainder showing evidence of either questionable, very mild or mild fluorosis. Between 52% and 63% of the children had one or more teeth affected by enamel defects when measured by the DDE index. The prevalence of enamel fluorosis/defects was similar in children living in fluoridated and non-fluoridated areas but the prevalence of diffuse opacities (DDE) was higher in the fluoridated areas.

Adolescent↗

PubMed1991

The biochemical systematics of red and sika deer (genus Cervus) in Ireland.

Twenty enzyme loci were investigated using starch gel electrophoresis in managed populations of red deer (Cervus elaphus) and sika deer (C. nippon) from Ireland. The red deer, which originated from several European countries, were polymorphic (%P) at 25% of the loci examined and exhibited a mean heterozygosity (H) of 0.025. The sika, originally from Japan, were introduced to Ireland in very limited numbers. Here, %P was 5% and H was 0.006. Mean genetic distance (D) between these taxa was 0.160. Because Scottish red deer, the source of much of the Irish herd, had previously been investigated for 16 of the same enzyme loci, it was possible to merge the present data with results from that earlier study, which also included North American wapiti (C. elaphus canadensis). The resulting phenogram based on genetic distance demonstrates that sika are twice as distantly related to red deer and wapiti, than the latter are to each other and suggests that sika-like forms are ancestral. Also, the demonstration of absolute mobility differences in the products of two enzyme loci in red deer and sika has many practical applications.

Animals↗

PubMed2005

Severe food-allergic reactions in children across the UK and Ireland, 1998-2000.

AIM: Medical and lay concerns about food allergy are increasing. Whilst food allergy may be becoming more common, fatal reactions to food in childhood are very rare and their rate is not changing. We sought to establish how common severe reactions are. METHODS: Prospective survey, 1998 to 2000, of hospital admissions for food-allergic reactions-conducted primarily through the British Paediatric Surveillance Unit, covering the 13 million children in the United Kingdom and Ireland. RESULTS: 229 cases reported by 176 physicians in 133 departments, yielding a rate of 0.89 hospital admissions per 100,000 children per year. Sixty-five per cent were male, 41% were under 4 y and 60% started at home. Main allergens were peanut (21%), tree nuts (16%), cow's milk (10%) and egg (7%). Main symptoms were facial swelling (76%), urticaria (69%), respiratory (66%), shock (13%), gastrointestinal (4%). Fifty-eight cases were severe. Three were fatal, six near fatal, and 8 of these 9 had asthma with wheeze being the life-threatening symptom. Three near-fatal cases received excess intravenous epinephrine. None of the non-fatal reactions resulted in mental or physical impairment. Seven of 171 non-severe and 6/58 severe cases might have had a worse outcome if epinephrine auto-injectors had been unavailable. Six of the severe cases might have benefited if auto-injectors had been more widely prescribed. CONCLUSION: In the United Kingdom and Ireland, the incidence of severe reactions is low. The study highlights that: asthma is a strongly significant risk factor for a severe reaction and therefore warrants optimal management; severe wheeze is a prominent feature of severe reactions and warrants optimal management; intravenous epinephrine should be used with great care if needed. Epinephrine auto-injectors do not always prevent death, but our study design and data do not allow a definite statement about whether overall they are beneficial.

Adolescent↗

PubMed1999

Changes in male:female ratio among newborn infants in Ireland.

Trends in the male proportion of live births in Ireland were examined by extracting the numbers of male and female live births from Registrar General's Reports (1864-1952) and Department of Health Annual Reviews (1953-1996), and subjecting them to statistical analysis. Except for 10 years (1947-1956) the proportion of male births has risen, significantly so since 1957. The global fall in male proportion of live births in recent decades has not been seen in Ireland, even though the country has undergone progressive industrialisation. It would be prudent not to assume that the same environmental factors alter sex ratio and cause pathological changes in male reproductive organs.

Birth Rate↗

PubMed1996

The results of water fluoridation in Ireland.

The visit of Dr. Trendley Dean to Dublin in the mid-1950s helped accelerate the decision to introduce water fluoridation as a public health measure in the prevention of caries in the Republic of Ireland. A challenge to the constitutional validity of the Health (Fluoridation of Water Supplies) Act 1960 failed and in 1964 the water supplies of Dublin city were fluoridated. Over the next seven to eight years all the major urban communities in the Republic of Ireland were fluoridated. Currently, 67 percent of the 3.5 million people in the country reside in fluoridated communities. Studies conducted over the last 20 years show that residents of fluoridated communities have better dental health than those in nonfluoridated communities--the mean dmft is lower in children and the number of natural teeth present in adults is higher.

Adolescent↗

PubMedDate not supplied

Cleft lip and/or palate in the west of Ireland, 1980-1996.

The aim of this study was to identify and investigate care for children born, over a 17-year period (1980-1996), with cleft lip and/or palate (CL/P) in the Western Health Board region of Ireland. One hundred and six cleft-affected children were identified. The incidence was 1.14 per thousand (1:871) live births. Epidemiological findings in relation to cleft type, gender, family history, and location followed international trends. The establishment of a national Register with mandatory reporting of children with CL/P in Ireland would ensure greater consistency in data collection and may help improve co-ordination of care.

Age Factors↗

PubMed2006

Use of pulsed-field gel electrophoresis for comparison of similar but distinguishable isolates of Shigella sonnei collected in Ireland and Italy.

Comparison of pulsed-field gel electrophoresis patterns (generated with XbaI and BlnI) of Shigella sonnei isolates from Ireland and Italy suggests that two possibly distantly related lineages are present in both countries. Smaller, more closely related groups, including isolates from Ireland and Italy, were also noted. These groups raise the possibility that the dissemination of clonal groups of S. sonnei may have occurred in recent years.

Dysentery, Bacillary↗

PubMed1999

VP4 and VP7 genotyping of rotavirus samples recovered from infected children in Ireland over a 3-year period.

Between September 1995 and August 1998, the incidence and diversity of the main human rotavirus genotypes (G1, G2, G3, and G4 and P[8], P[4], P[6], and P[9]) among Irish children were determined by using established and adapted reverse transcriptase PCR-based genotyping methods. From a total of 193 rotavirus-positive specimens collected from nine hospitals we successfully identified the P type in 182 (94%) of the samples and the G type in 165 (85.5%) of the samples. Only four samples could not be assigned a G or P type. Two P types existed in Ireland, P[8] (78%) and P[4] (16%), and their relative incidence varied over the 3 years of this study. No P[6] or P[9] types were detected. G1 was the most predominant G type (55%), and the incidences of G2, G3, and G4 isolates were 15.5, 1, and 11%, respectively. Three percent of the samples tested had a mixed G type. A P and G type was assigned to 158 (81.8%) of samples. Of the typeable samples, G1 P[8] was the most prevalent (65%), whereas G2 P[4] (17%), G3 P[8] (1%), G4 P[8] (12%), and mixed types (all G1/ G4 P[8]) (4%) were detected less frequently. In the third year a significant genotypic shift from G1 P[8] to G2 P[4] and G4 P[8] was observed. During the study, we noticed that the inclusion of random primers during cDNA synthesis greatly increased the specificity of the PCR typing assays. No correlation was seen between the contributing hospitals and a specific genotype. In conclusion, the coverage of infection given by the recently licensed tetravalent vaccine would be significantly high in Ireland, although future monitoring of genotypic changes among Irish isolates should be encouraged.

Antigens, Viral↗

PubMed2006

Complications associated with the bacille Calmette-Guérin vaccination in Ireland.

INTRODUCTION: BCG vaccination is currently recommended for all newborns in Ireland except where specifically contraindicated. This paper describes a marked increase in the number of referrals of patients with localised complications after vaccination to two Dublin paediatric hospitals. This increase coincided with the introduction of a new strain of BCG vaccine METHODS: A population surveillance study was undertaken to determine the frequency and spectrum of complications associated with the new strain of BCG vaccine introduced in Ireland. Patients were identified though review of the infectious disease service case records and microbiology laboratory culture reports for the two year period from August 2002 to July 2004. Prospectively gathered data were supplemented by retrospective chart review. All infants who had inoculation site abscesses, suppurative adenopathy, or non-suppurative adenopathy with nodes > or =2 cm were included. RESULTS: Fifty eight patients presented a median of 13 weeks post-inoculation: 32 with suppurative adenitis, 17 with inoculation site abscess, three with both inoculation site abscess and suppurative adenitis, and six with non-suppurative adenopathy. The overall complication rate was estimated at 1/931 vaccinees with 1/1543 developing suppurative adenitis. Twenty six infants required surgery. DISCUSSION: This series illustrates the role of hospitals in sentinel surveillance and highlights the importance of having a well functioning and responsive system of adverse event reporting. These events raise a serious question as to the suitability of this vaccine strain for use in a national immunisation programme in a country where the prevalence of tuberculous disease is 10.4/100,000.

Abscess↗

PubMed2006

Prospective surveillance study of severe hyperbilirubinaemia in the newborn in the UK and Ireland.

OBJECTIVES: To determine the incidence of severe hyperbilirubinaemia in the newborn, and to identify associated clinical and demographic variables, and short-term outcomes. DESIGN: Prospective, population-based study. SETTING: UK and Republic of Ireland, between 1 May 2003 and 31 May 2005. PARTICIPANTS: Infants in the first month of life with severe hyperbilirubinaemia (maximum unconjugated serum bilirubin >/=510 micromol/l). RESULTS: 108 infants met the case definition, 106 from the UK and 2 from the Republic of Ireland. The UK incidence of severe hyperbilirubinaemia was 7.1/100 000 live births (95% CI 5.8 to 8.6). Only 20 cases presented in hospital; 88 were admitted with severe jaundice. 64 (60.4%) cases were male, and 56 (51.8%) were of ethnic minority origin. 87 (80.5%) cases were exclusively breast fed. Co-morbidity included haemolysis, dehydration, infection and bruising. 14 infants showed evidence of bilirubin encephalopathy, of whom 3 died. The UK incidence of bilirubin encephalopathy was 0.9/100 000 live births (95% CI 0.46 to 1.5). CONCLUSIONS: This is the first large, prospective, population-based study of the incidence of severe hyperbilirubinaemia in the newborn. The clinical and demographic associations, and short-term outcomes identified, are the same as those reported recently in North America and Europe.

Bilirubin↗

PubMed2000

Active surveillance of hepatitis C infection in the UK and Ireland.

AIM: To investigate the prevalence, distribution, and clinical details of paediatric hepatitis C virus (HCV) infection in the UK and Ireland. METHODS: Active monthly surveillance questionnaire study coordinated through the British Paediatric Surveillance Unit, to all consultant paediatricians in 1997 and 1998. RESULTS: A total of 182 HCV infected children were reported from 54 centres and by paediatricians from eight different specialties. In 40 children HCV was acquired through mother to child transmission (MTC children); 142 were infected by contaminated blood products (n = 134), organ transplantation (n = 2), needles (n = 4), or unknown risk factor (n = 2). Intravenous drug use was the risk factor for 35 mothers of MTC children. Twelve children were coinfected with HIV and four with HBV. Recent serum aspartate aminotransferase or alanine aminotransferase values were at least twofold greater than the upper limit of normal in 24 of 152 children; this occurred in five of 11 HIV coinfected children. Liver histology, available in 53 children, showed normal (7%), mild (74%), moderate (17%), or severe (2%) hepatitis. Twenty eight children had received therapy with interferon alfa. CONCLUSION: Most current paediatric HCV infection in UK and Ireland has been acquired from contaminated blood products, and most children are asymptomatic. There is a need for multicentre trials to inform clinical practice and development of good practice guidelines in this area. Long term follow up of this cohort of HCV infected children is planned to help determine the natural history over the long term of HCV acquired during infancy and childhood.

Child↗

PubMed2003

Variations in initial assessment and management of inflammatory bowel disease across Great Britain and Ireland.

BACKGROUND: There are no published data from Great Britain and Ireland detailing the initial management of children with inflammatory bowel disease (IBD). AIMS: To prospectively record the initial investigation and treatment of children aged less than 16 years with newly diagnosed IBD. METHODS: For 13 months, between June 1998 and June 1999, 3247 paediatricians, adult gastroenterologists, and surgeons across the UK and Ireland were prospectively surveyed each month and asked to report every newly diagnosed case of childhood IBD. Reporters subsequently completed a postal questionnaire about each case. RESULTS: A total of 739 new IBD cases were reported from 172 institutions. Significant variations were observed in the investigation and treatment of these cases, when examined by number of cases reported per institution, or by the specialists providing care. There were wide regional variations in the proportion of children having access to paediatric gastroenterology services. Overall, one third of children received care from an adult service, and a tenth care exclusively from an adult gastroenterologist. Children with Crohn's disease who had some or all of their care from adult services were more likely to receive systemic steroids and less likely to receive dietary therapy; those with ulcerative colitis were more likely to receive rectal steroids and to have surgery. Height and weight were also less likely to be recorded in those whose care involved adult services. CONCLUSION: Current specialist provision, and initial investigation and treatment of IBD, is heterogeneous. Optimisation of care is likely to be achieved by greater access to specialist paediatric gastroenterology services for all those with suspected IBD.

Adolescent↗

PubMed1997

Primary association of HLA-B51 with Behçet's disease in Ireland.

AIMS/BACKGROUND: While a primary association of HLA-B51 with Behçet's disease (BD) in Japanese and Mediterranean patients supports an immunogenetic predisposition, this link is unclear in north western Europe. This study assessed HLA associations with BD, and HLA-B51 with certain clinical characteristics, in the Republic of Ireland, which has an ethnically homogeneous population. METHODS: HLA-A, HLA-B, and HLA-DR typing was performed in 24 BD patients, conforming to International Study Group criteria, and in blood donors, as controls. Patient records were retrospectively reviewed and patients reassessed clinically. RESULTS: A highly significant HLA-B51 association (corrected exact p value = 0.002, relative risk = 6.3) with BD was determined, despite a low B51 prevalence (25%) in patients. No other HLA type was associated. There was a significant B51 link with male sex in BD patients but no association with age at first manifestation/diagnosis, eye involvement, cyclosporin A therapy, or poor visual acuity was determined. CONCLUSIONS: This study supports a HLA-B51 immunogenetic predisposition, similar to Japanese patients, in Irish BD in an ethnically homogeneous population in north western Europe. However, owing to a low prevalence of B51 positivity in BD patients in Ireland, a multifactorial pathogenesis is suggested.

Adult↗

PubMed1984

Possible method of identifying spotter practices in a health board in Northern Ireland.

We examined the notification of infectious diseases, including measles, by general practitioners over 18 months, which included a measles epidemic in the area covered by the Southern Health and Social Services Board in Northern Ireland. Of the 156 general practitioners who provided services in the area, 27 (17.3%) had a pattern of notification which might render them acceptable as "spotter" practices, a system which at present does not exist in Northern Ireland, although it is used in the rest of the United Kingdom. In future we hope to be able to; (i) predict impending epidemics of infectious disease; (ii) mobilise Health Service resources to minimise the effects of such epidemics; (iii) monitor the effects of improving the level of uptake of measles vaccine.

Communicable Disease Control↗