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Vol 16 no 51 |
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Final Issue: Volume 16 Number 51 |
Published on: 21 December 2006 |
Final Issue in PDF |
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News Archives
Last updated: Volume 15, No.38 (PDF file, 161 KB)
Archives | News Archives 2006: Page 1| News Archives 2005 Page 2 | 22 September 2006
News Archives: | 2006 | 2005 | 2004 | 2003
Verotoxin-producing E.coli O157 (VTEC O157) at a school in the south Wales valleys
On Friday 16 September 2005, staff at Prince Charles Hospital, Merthyr Tydfil, Wales, reported nine cases of bloody diarrhoea that had presented at the hospital to the National Public Health Service for Wales and local authorities. There have now been 56 cases (defined as any people residing in south Wales presenting with bloody diarrhoea in September) of which 12 have been confirmed microbiologically as verotoxin-producing Escherichia coli O157 (VTEC O157).
Onset dates range from 10 to 20 September with all but one of the primary cases being in school age children from 26 different schools. Of 15 initial cases, all had eaten school meals and the adult case was a school meals supervisor. The early epidemiological investigation has focussed on the foods supplied to the school meals service, since 60% of pupils take school meals in the area and because of the widespread distribution of the cases among different schools in this part of Wales.
The number of cases, so far, is almost double the normal annual total for Wales, which is around 30. Parents have been advised to keep children out of school if they develop symptoms of gastroenteritis.
Control measures to remove ready-to-eat foods (as opposed to foods cooked on the school premises) and to curtail educational activities which might facilitate person-to-person spread have been put in place.
Further information on VTEC O157 is available from the Health Protection Agency website at:
<http://www.hpa.org.uk/infections/topics_az/ecoli/O157/menu.htm>.
The changing epidemiology of listeriosis in England and Wales
Between 1 January and 30 August 2005, a provisional total of 118 cases of Listeria monocytogenes infection were reported to the Health Protection Agency Centre for Infections (figure 1). This represents a continued increase in incidence compared to the same period in 1990 to 2002.
Figure 1 Eight monthly reports (January to August) of listeriosis cases in England and Wales: 1990 to 2005
Annual totals for the years 1990 to 2004 demonstrate that, while pregnancy-associated listeriosis has remained relatively stable, non pregnancy-associated listeriosis has risen dramatically between 2001 and 2004, especially in people aged 60 years and over (figure 2). This increase has occurred in most NHS regions and cannot be explained by seasonality, gender, underlying illness, or L. monocytogenes subtype.
Figure 2 Annual totals of listeriosis cases by patient category and age group, England and Wales: 1990 to 2004
Laboratories in England and Wales are requested to refer L. monocytogenes isolates from clinical and food samples to Kathie Grant, Centre for Infections, for confirmation and subtyping (telephone: 020 8327 6505; e-mail: kathie.grant@hpa.org.uk ) . Clinical and exposure questionnaires for the routine follow-up of all cases of L. monocytogenes infection have been developed and are available on the Health Protection Agency website at: <http://www.hpa.org.uk/infections/topics_az/listeria/questionnaires.htm> .
Please send copies of completed questionnaires to Iain Gillespie at the Centre for Infections (telephone: 020 8327 7486;
email: Iain.Gillespie@hpa.org.uk ).
Indonesia reports second laboratory-confirmed case of human influenza A (H5N1) infection
On 16 September 2005, a second fatal case of avian influenza infection was reported to the World Health Organization (WHO) by the Indonesian Ministry of Health (1). A woman aged 37 years from Jakarta died on 10 September 2005 after developing symptoms on 31 August 2005. The source of her infection has yet to be identified. The Indonesian government, assisted by WHO, is currently investigating those who had close contact with the woman, including the hospital staff that treated her. The woman lived in an area where contact with chickens and ducks could frequently occur and poultry samples have been taken by the agriculture authorities.
This is Indonesia’s second laboratory-confirmed case of influenza A (H5N1). The first laboratory confirmed case occurred in July 2005 in a man aged 38 years who tested positive for influenza A (H5N1) (2). Laboratory tests on samples from the man’s two daughters did not meet the criteria for acute influenza A (H5N1) infection. The Ministry of Health in Viet Nam has also retrospectively confirmed a case of influenza A (H5N1) infection in a male farmer aged 35 years from Ben Tre Province, who died on 31 July 2005 (3).
This case and that of the Indonesian woman brings the total number of fatal human infections since December 2003, to 59 from a total of 114 laboratory confirmed infections.
References
1.World Health Organization [online]. Communicable Disease Surveillance and Repsonse (CSR). Avian influenza-situation in Indonesia – update 29. Geneva: WHO, 16 September 2005 [accessed 20 September 2005]. Available at: <http://www.who.int/csr/don/2005_09_16/en/index.html>.
2.World Health Organization. [online]. Communicable Disease Surveillance and Repsonse (CSR) .Avian influenza-situation in Indonesia – update 25. Geneva: WHO, 21 July 2005 [accessed 20 September 2005]. Available at: <http://www.who.int/csr/don/2005_07_21a/en/index.html>.
3.World Health Organization. [online]. Communicable Disease Surveillance and Repsonse (CSR). Avian influenza-situation in Viet Nam – update 30. Geneva: WHO, 19 September 2005 [accessed 20 September 2005]. Available at: <http://www.who.int/csr/don/2005_09_19/en/index.html>.
Japanese encephalitis in India and Nepal
Since July 2005, there has been an outbreak of Japanese encephalitis (JE) occurring in northern India and Nepal which has so far affected over 5000 people, mainly children, with over 1000 deaths reported (1). The outbreak has affected the states of Uttar Pradesh (3551 cases, 764 deaths) and neighbouring Bihar (238 cases, 58 deaths) in India and most regions of Nepal (1540 cases, 259 deaths); western, mid-western, and far-western regions of Nepal have been most affected.
JE is transmitted by the bite of the Culex spp mosquito and is endemic in many parts of India. Thousands of cases are reported each year (2). Peak transmission season ( betwen May and October) in northern India occurs during and just after the monsoon season when major outbreaks coincide with heavy rains and flooding. Case numbers in the region are reported to be higher this year than in previous years.
The risk of JE for British travellers who stay for short periods in urban areas is low. All travellers to endemic areas should be advised to practice insect bite avoidance methods, particularly between dusk and dawn, when the mosquito vector is most active (3). There is vaccine available for prevention of JE in travellers in certain circumstances and further information about the prevention of JE in travellers is available from the National Travel Health Network and Centre at <http://www.nathnac.org/pro/factsheets/japanese_enc.htm>.
References
1.World Health Organization, Regional Office for South East Asia (SEARO). Japanese Encephalitis in India and Nepal, 2005 [online] [cited 20 September 2005]. Available at <http://w3.whosea.org/en/Section10/Section392_10316.htm>.
2.Kabilan L, Rajendran R, Arunachalam N, Ramesh S, Srinivasan S, Philip Samuel P, et al. Japanese encephalitis in India: An overview. Indian J Paediatr. 2004; 71(7): 609-15.
3.National Travel Health Network and Centre. Japanese encephalitis in India – update [online] 15 September 2005 [cited 21 September 2005]. Available at: <http://www.nathnac.org/pro/clinical_updates/JE_india_nepal_220905.htm>.
