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At least 1,009 records · Page 56Linked to original sources
PubMed1998

Studies of the presence of verocytotoxic Escherichia coli O157 in bovine faeces submitted for diagnostic purposes in England and Wales and on beef carcases in abattoirs in the United Kingdom.

A survey of beef carcases in abattoirs in the UK was carried out in order to estimate the prevalence of contamination with verocytotoxin-producing Escherichia coli (VTEC) serogroup O157. Contamination with verocytotoxin-producing E. coli (VTEC) O157 was confirmed in 0.47% of the 4067 (95% confidence limits 0.22-1.00%) of neck muscle samples. A significant tendency for carcases present in the same abattoir on the same day to have similar results was found, thus suggesting cross contamination. VTEC O157 was found in 0.83% of 6495 bovine faeces samples routinely submitted for diagnostic purposes to Veterinary Investigation Centres in England and Wales. Of the samples from cattle less than 6 months old, 3.7% of 68 samples from animals without gastrointestinal disease were positive for E. coli O157, in contrast to 0.75% of 2321 samples from cases of gastrointestinal disease. No association with season or herd type (beef or dairy) was found.

Abattoirs↗
PubMed1998

Surveillance of small round structured virus (SRSV) infection in England and Wales, 1990-5.

Data from the national surveillance scheme for general outbreaks of intestinal disease, and the national laboratory reporting scheme were used to describe the epidemiology of small round structured virus (SRSV) infections in England and Wales. Between 1990 and 1995, there were 7492 laboratory reports of SRSV. Rates of reported illness were highest among infants, young children and the elderly. During 1992-5, some 707 SRSV outbreaks were reported. Outbreaks in hospital wards and residential facilities for the elderly accounted for 76% of the total, and annual numbers increased more than sixfold over the study period. There were wide regional variations in the numbers of SRSV outbreaks and laboratory reports. Both sporadic cases and outbreaks in the community are likely to be underestimated, but these passive surveillance systems provide an insight into the burden of SRSV infection among the institutionalized elderly.

Adolescent↗
PubMed1998

A community outbreak of invasive and non-invasive group A beta-haemolytic streptococcal disease in a town in South Wales.

An increase in the incidence of invasive and non-invasive infections caused by group A beta-haemolytic streptococci (GAS) was noted in and around the town of Glynneath (population approx. 4000) in West Glamorgan, South Wales between 1 January and 30 June 1995. A total of 133 cases was ascertained with 127 (96%) occurring between 1 March and 30 June 1995. Six patients had invasive disease (one died) and all presented at the peak of the outbreak. There were 127 non-invasive cases of whom 7 were hospitalized. The outbreak was investigated to determine its extent and whether it was caused by a single M-serotype of GAS. Serotyping showed that 13 different M-serotypes were involved with the M1 serotype predominating. The overall incidence of GAS invasive disease in West Glamorgan (population 365,000) increased sevenfold from a crude incidence of 0.5/10(5) per year in 1994 to 3.5/10(5) per year in 1995, but fell back to 0.75/10(5) per year in 1996. Eighty-two (80%) out of 102 individuals affected by GAS replied to a health questionnaire; sore throat was the commonest symptom reported (97%). Thirty-nine of these index cases identified at least one other member of their household who had experienced similar symptoms. The interval between the onset of illness in members of a single household was 0-83 days with a mean of 22 days. The mean duration of illness was 13.5 days and 61% of patients were treated with penicillin V for a mean duration of 9.3 days. Twenty-one per cent of GAS isolates were erythromycin-resistant and the M4 and M6 serotypes were especially resistant to erythromycin (87.5 and 100% resistance, respectively). Penicillin V failed to eradicate GAS from the throats of 25% of assessable patients. In this community, an outbreak of non-invasive disease caused by GAS was linked in time and place with an outbreak of serious invasive disease.

Adolescent↗
PubMed1999

Acute hepatitis B infection in England and Wales: 1985-96.

Confirmed acute hepatitis B infections are reported to the Public Health Laboratory Service Communicable Disease Surveillance Centre by laboratories in England and Wales. These reports have been used to monitor trends in the incidence of hepatitis B virus (HBV) infection over time, and between exposure categories and age groups. Between 1985 and 1996 a total of 9252 cases of acute HBV infection were reported; the number of reports fell from 1761 in 1985 to 581 in 1996. Most infections were reported in adults aged 15-44 years [n = 7365 (80%)], and infections were more commonly reported in males [n = 6490 (70%)] than females [n = 2658 (29%)]. The probable means of acquisition was known for just over half of all adult cases [4827/8956 (54%)]. Injecting drug use was the most common exposure [n = 1901 (21%)], followed by sex between men and women [n = 1140 (13%)] and sex between men [n = 1025 (11%)]. The number of infections in injecting drug users fell in the late 1980s, but increased again from 1991 onwards. In children aged under 15 years, infections acquired by mother to baby transmission accounted for 35/170 (21%) of the total. Surveillance indicates that the incidence of acute hepatitis B infection fell in the late 1980s, probably reflecting changed behaviour in injecting drug users. An increase in the number of infections in injecting drug users since 1993 may indicate ongoing transmission that has not been contained by the introduction of needle exchange schemes or by selective vaccination.

Acute Disease↗
PubMed1998

Indirect methods for estimating prevalent HIV infections: adults in England and Wales at the end of 1993.

Two indirect methods were used to estimate the point prevalence of HIV infection in England and Wales at the end of 1993 using data on diagnosed HIV infections, AIDS cases, HIV-related deaths and HIV testing behaviour from unlinked anonymous surveys. The methods estimated the proportion of all prevalent HIV infections that diagnosed infections represented. Most of those exposed to HIV infection through injecting drug use or sexual intercourse between men had had their infections diagnosed compared to less than half of those exposed through heterosexual intercourse. The total estimated number of prevalent infections was 22,350 for the diagnosis interval method and 20,540 for the test history method, and about 56-57% of these were in homo/bisexual men. These indirect methods are cheap and simple applications of surveillance data which provide estimates that compare favourably with those produced by more complex methods.

England↗
PubMed1999

Bordetella pertussis surveillance in England and Wales: 1995-7.

Available data sources on disease due to Bordetella pertussis, including notifications, hospital admissions, deaths, and an enhanced laboratory-based surveillance system commenced in January 1994, were reviewed for the period 1995-7. Pertussis notifications continued their approximately 3-year cycle although at historically reduced levels. A slight seasonal increase in late summer/early autumn existed over and above a relatively constant background rate. Over time, the proportion of pertussis cases in younger, unvaccinated children, and to a lesser extent, adolescents and young adults, is increasing. There is a continuing significant and underreported mortality associated with pertussis in the very young age group. Disease due to serotype 1,2 is on the increase despite persistent high vaccination levels and this serotype causes more severe disease. The provision of preventative antibiotics prior to disease onset reduced the severity of the disease but its use remains uncommon in England and Wales. While overall levels of pertussis notifications have declined in recent times, vaccination efficacy wanes with increasing age, and pertussis remains a significant cause of mortality and severe morbidity in the very young. This could be reduced by timely booster vaccination and increased recognition of mild disease in older cases followed by early antibiotic therapy for the very young household contacts.

Adolescent↗
PubMed2000

Hepatitis A in New South Wales, Australia from consumption of oysters: the first reported outbreak.

Between 22 January and 4 April 1997, 467 hepatitis A cases were reported to the New South Wales Health Department, Australia. To identify the cause of the outbreak, we conducted a matched case-control study, and an environmental investigation. Among 66 cases and 66 postcode-matched controls, there was a strong association between illness and consumption of oysters (adjusted odds ratio 42; 95 % confidence interval 5-379). More than two-thirds of cases reported eating oysters, including one third of cases and no controls who reported eating oysters in the Wallis Lake area. A public warning was issued on 14 February, and Wallis Lake oysters were withdrawn from sale. Hepatitis A virus was subsequently identified in oyster samples taken from the lake. Hepatitis A virus poses a special risk to consumers who eat raw oysters because it can survive for long periods in estuaries and cause severe disease.

Adult↗
PubMed2000

A secondary school outbreak of mumps following the childhood immunization programme in England and Wales.

Since the introduction of routine measles, mumps and rubella immunization for children in England and Wales in 1988, the incidence of mumps has declined steadily. We describe an outbreak of mumps in 1996 attacking 34 of a cohort of 98 schoolchildren born in 1982 and 1983. This is the largest outbreak in the UK since the introduction of the vaccine into the childhood immunization schedule. Salivary IgM assay was used as a simple, minimally invasive test to confirm the diagnosis. The occurrence of the outbreak demonstrates that British children who were just too old to receive mumps immunization in 1988 continue to be at risk of this disease as a result of diminished natural exposure. Further cases and outbreaks in this cohort are to be expected. Cohorts born before 1982 appear to be at less risk, presumably because of naturally acquired infection before the introduction of immunization.

Adolescent↗
PubMed2000

Population estimates of persons presenting to general practitioners with influenza-like illness, 1987-96: a study of the demography of influenza-like illness in sentinel practice networks in England and Wales, and in The Netherlands.

Incidence data by age of new episodes of influenza-like illness reported by sentinel general practice networks in England and Wales and in The Netherlands over a 10-year period were examined to provide estimates of the consulting population during influenza epidemic periods. Baseline levels of recording in each age group were calculated from weeks in which influenza viruses were not circulating and the excess over baseline calculated to provide the population estimates during influenza epidemics. Influenza A/H3N2 epidemics were associated with higher population estimates for consultations than influenza B, especially in the age groups 0-4 and 65 years and over. In the intervening age groups, population estimates were more consistent regardless of the virus type. Both networks reported simultaneous peaking of incidence rates in all of the age groups. There were substantial increases in the number of persons reporting other respiratory illnesses during influenza epidemics. Population estimates of the consulting population provide the only secure basis for which health services resource utilization during influenza epidemics can be estimated.

Adolescent↗
PubMed2003

Environmental costs of freshwater eutrophication in England and Wales.

Eutrophication has many known consequences, but there are few data on the environmental and health costs. We developed a new framework of cost categories that assess both social and ecological damage costs and policy response costs. These findings indicate the severe effects of nutrient enrichment and eutrophication on many sectors of the economy. We estimate the damage costs of freshwater eutrophication in England and Wales to be $105-160 million yr(-1) (pound 75.0-114.3 m). The policy response costs are a measure of how much is being spent to address this damage, and these amount to $77 million yr(-1) pound 54.8 m). The damage costs are dominated by seven items each with costs of $15 million yr(-1) or more: reduced value of waterfront dwellings, drinking water treatment costs for nitrogen removal, reduced recreational and amenity value of water bodies, drinking water treatment costs for removal of algal toxins and decomposition products, reduced value of nonpolluted atmosphere, negative ecological effects on biota, and net economic losses from the tourist industry. In common with other environmental problems, it would represent net value (or cost reduction) if damage was prevented at source. A variety of effective economic, regulatory, and administrative policy instruments are available for internalizing these costs.

Costs and Cost Analysis↗
PubMed2002

Mapping the distribution of DDT residues as DDE in the soils of the irrigated regions of northern New South Wales, Australia using ELISA and GIS.

An enzyme-linked immunosorbent assay (ELISA) specific for DDE [1,1-dichloro-2,2-bis(4-chlorophenyl)ethylene] has been used to map DDT [1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane)] residues in the top 10 cm of soil in three river valleys of northern New South Wales, Australia. Despite being almost 20 years since DDT was last applied for cotton growing in these areas, the relationship between sites of greatest application and current residue levels was strong. DDE concentrations in the range 0-2 ppm were found, although most the 389 soil samples examined contained less than 0.2 ppm of DDE. Although some relationship between mode of land use and current residue levels was apparent, this varied from valley to valley and may have reflected different farming practices and times of application. The study demonstrates that the combination of ELISA and geographical information system (GIS) analysis provides an effective means of displaying levels of soil contamination by a pesticide and the possible need for remediation.

Agriculture↗
PubMed1999

Epidemiological features of parainfluenza virus infections: laboratory surveillance in England and Wales, 1975-1997.

Hospital laboratory reports of parainfluenza virus (PIV) infections from England and Wales between 1975 and 1997 were analysed with regard to PIV type and seasonality, and in addition, those between 1985 1997 with regard to age, sex and clinical features. Laboratory-based surveillance data highlight striking differences in the seasonality of different PIV types. PIV-3 reports demonstrated a clear annual epidemic cycle, with a peak usually occurring in late spring or summer, whereas peaks of PIV-1 and PIV-2 occurred at one or two year intervals, in the late autumn or early winter. PIV-4 also occurred most frequently in the late autumn or early winter, but a clear epidemic cycle could not be identified. Laboratory surveillance data also provide insight into the age and disease distribution of PIV infection in children and indicate severity of PIV infection in immunosuppressed adults. Of 8221 PIV reports received between 1985-1997, PIV-3 accounted for 70.8%, PIV-1 for 17.2%, PIV-2 for 7.5%, and PIV-4 for 1.1%; 64.1% of reports came from infants under one year, 24.4% from children aged 1-4 years and 7.2% from individuals aged 5 years or older, with an excess of males in all age groups. Bronchiolitis, croup and pneumonia occurred in association with all PIV types. In children under 1 year, PIV-2 infections were more likely to be associated with bronchiolitis than infections with other PIV types. In children under 15 years, croup was more frequently associated with PIV-1 and PIV-2 than with PIV-3 or PIV-4. In 392 (7.2%) of the reported PIV infections between 1989 and 1997 an underlying condition was implicated, which included immunosuppression or chronic cardiac or pulmonary disease. Considerable morbidity is associated with PIV infections in infants and young children and would make the widescale use of a vaccine a valuable public health intervention. Surveillance information is essential to guide the development and use of preventive measures as well as to monitor their effectiveness.

Adolescent↗
PubMed2003

Soil ingestion by sheep grazing the metal enriched floodplain soils of mid-Wales.

Floodplain soils within and downstream from the mineralised and mined areas of mid-Wales, are contaminated by metals, especially Pb, because of historical and contemporary fluvial pollution. Rates of soil ingestion by sheep grazing these sites have been quantified to establish the relative importance of the soil-plant-animal and soil-animal pathway of metals. The highest rates of soil ingestion occurred during the winter/spring period. During March, soil ingestion exceeded 30% of the D.M. intake at 2 of the 11 sites investigated. The total daily intake of metals by sheep reflects the degree of soil metal enrichment, and is elevated during the winter/spring period, coincident with the higher rates of soil ingestion and the generally higher pasture herbage metal concentrations. Because the soil-plant transfer of Pb is low, ingested soil is often the major pathway of this metal to sheep. This is especially evident in March and May when on average 80.0 and 82.9%, respectively of the Pb intake was via soil ingestion. At one site in May, 97% of the Pb intake was attributable to ingested soil. Even when soil-plant transfers are not so low, as found for Cu and Zn, ingested soil can occasionally supply greater than 60% of these metals to the animal. However, despite the potential importance of soil ingestion, little is known about the availability to and absorption of soil-borne metals by animals.

Adsorption↗
PubMed2003

Effectiveness of pertussis vaccination in New South Wales, Australia, 1996-1998.

Pertussis notifications have increased over the past decade in Australia and other industrialised countries. This study estimates the effectiveness of pertussis vaccination in one Australian State (New South Wales, NSW) among children aged less than 14 years, during a period when an Australian whole-cell pertussis vaccine was in routine use. Cases notified with pertussis between 1996 and 1998 and pertussis vaccine coverage estimates from the Australian Childhood Immunisation Register were used. Vaccine effectiveness (VE) was calculated using the screening method, with adjustment for age group, year of disease onset and area of residence. VE was highest (91%) in the youngest age group (8-23 months) and lowest (78%) in the oldest age group (9-13 years). Pertussis vaccination is highly effective at preventing pertussis in NSW children, as measured by notified cases. Ongoing monitoring will be important to evaluate VE following Australia's change to an acellular vaccine based program.

Adolescent↗
PubMed2004

Mammography screening and breast cancer mortality in New South Wales, Australia.

OBJECTIVE: To investigate the relationship between utilisation of service mammography screening and breast cancer mortality in New South Wales (NSW) women. Setting : Population-based biennial mammography screening was progressively introduced in NSW from 1988, with active recruitment and re-invitation for women aged 50-69 years, and reached full geographic coverage by 1996. Biennial mammography screening participation has varied widely over time and by municipality. METHODS: Breast cancer mortality by age, period and municipality was obtained from the NSW Central Cancer Registry. Biennial mammography screening rates for the same strata were obtained from the BreastScreen NSW database. Temporal changes in breast cancer mortality for NSW were summarised as annual average declines using Poisson regression. Breast cancer mortality for 1997-2001 was examined in relation to lagged biennial screening rates by municipality, adjusted for age, area socio-economic and geographic indicators, and breast cancer incidence, also using Poisson regression. RESULTS: For the 50-69 year age group, the mean annual breast cancer mortality decline was 0.8% (not significant) for 1988-1994, and 4.4% (p < 0.0001) for 1995-2001. Statistically significant negative associations between breast cancer mortality in 1997-2001 and lagged biennial screening rates were found with the highest significance at a four-year lag for women aged 50-69 years ( p = 0.0003) and also for women aged 50-79 years (p c = 0.0002). From the regression coefficient, a 70% biennial screening rate is associated with 32% lower breast cancer mortality (compared to zero screening). CONCLUSIONS: The effect of population-based mammography screening on breast cancer mortality in NSW inferred using this method is consistent with results of trials and other service studies. This suggests that population-based mammography screening programs can achieve significant reductions in breast cancer mortality with adequate participation.

Aged↗
PubMed2004

The 23-valent pneumococcal polysaccharide vaccine. Part II. A cost-effectiveness analysis for invasive disease in the elderly in England and Wales.

The 23-valent pneumococcal polysaccharide vaccine (PPV) has been available for a number of years and is recommended for high-risk categories. Relatively immunocompetent elderly people are not included in this group, although their probability of getting invasive pneumococcal infection is high. The objective of this study was to assess whether vaccinating all elderly people over 65 years of age was a cost-effective policy for England and Wales. The analysis was performed comparing the cost and health effects produced by vaccination, to what would have been occurred if vaccination were not introduced. A decision analysis model was used in order to predict health outcomes under different vaccination scenarios. Unit costs were applied to the outcome and the cost per life-year gained was calculated. Sensitivity analysis was performed to allow for uncertain parameters to vary. The current UK recommendation does not appear to be the most cost-effective strategy due to the low level of efficacy of the vaccine in high-risk groups (HRG) and their shorter life expectancy. Routine vaccination of all elderly appears to be more cost-effective. These results are, nevertheless, very much dependent on the uncertainties around vaccine efficacy estimates, which appear to be still present, especially in HRG, and on the number of hospitalisations and deaths attributable to invasive pneumococcal disease (IPD).

Aged↗
PubMed2004

Seroepidemiology of group C rotavirus infection in England and Wales.

A total of 3199 serum samples collected in 1993--1994 from two population cohorts from England and Wales were tested for the prevalence of IgG antibodies specifically directed against group C rotavirus VP6. Seroprevalence was 39% (95% confidence intervals: 37.0-40.4%). Seroprevalence was highest (46.0%) in the oldest age group (61-70 years of age). Infection with group C rotaviruses occurred at an earlier age and with higher incidence in rural than in urban populations. These results may suggest transmission from animals to humans, however further work is required to identify the reservoir of group C rotavirus for human infection.

Adolescent↗
PubMed2003

The death of offenders in England and Wales.

The death of offenders in the community has received considerably less attention than the death of prisoners, although limited research suggests that community offenders may be even more vulnerable to death than prisoners. This study compared the nature and extent of death among prisoners (n = 236) and offenders serving community sentences or ex-prisoners receiving postcustodial supervision by the Probation Service (n = 1,267) in England and Wales in 1996 and 1997. Information contained in death certificates was used to code for mode of death. Prisoners and community offenders were found to be reasonably similar in vulnerability to suicide/self-inflicted death; however, the risk of accidental death and homicide was greater for community offenders, and drugs and alcohol played a bigger part in their deaths. The policy implications of the findings are discussed.

Adolescent↗