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Biomedical subjects

A D Green

Publications and source records attributed to A D Green.

At least 19 recordsLinked to original sources
PubMed2006

Helminth infections in British troops following an operation in Sierra Leone.

One hundred and fifty-three British soldiers and 86 Royal Air Force (RAF) personnel were deployed on a hostage rescue operation in Sierra Leone. For 3 days they were exposed to various infection risks and 6 weeks later some of the soldiers presented with gastrointestinal complaints. Both groups were screened with structured questionnaires, blood investigations and (where indicated) faecal microscopy and charcoal culture for helminths. Definite and probable cases of helminth infection were treated with albendazole and all soldiers were screened again after 3 months. Among the soldiers investigated, 73/145 (50%) reported gastrointestinal symptoms and 70/139 (50%) had eosinophilia. Among these, 17/66 (26%) had hookworm infection, 6/66 (9%) had Strongyloides stercoralis infection and 1/66 (2%) had Giardia lamblia infection. Eosinophilia was most strongly associated with entering the enemy camp and being in the platoon that attacked the area around the camp latrines. Among RAF personnel, who were not involved in activities on the ground, 3/86 (3%) had borderline eosinophilia. Treatment of 105/153 (69%) soldiers with albendazole was well tolerated and, on follow-up screening 3 months later, 23/124 soldiers (19%) had gastrointestinal symptoms and 18/121 (15%) had eosinophilia. Faecal investigations and schistosomiasis serology tests were all negative at this stage.

Albendazole↗
PubMed2005

Detection of multiple enteric virus strains within a foodborne outbreak of gastroenteritis: an indication of the source of contamination.

An outbreak of acute gastroenteritis of suspected viral aetiology occurred in April 2003 in the British Royal Fleet Auxiliary ship (RFA) Argus deployed in the Northern Arabian Gulf. There were 37 cases amongst a crew of 400 personnel. Of 13 samples examined from cases amongst the crew, six enteric viruses were detected by reverse transcriptase polymerase chain reaction (RT-PCR). Five different viruses were identified including, three norovirus genotypes, a sapovirus and a rotavirus. No multiple infections were detected. A common food source was implicated in the outbreak and epidemiological analysis showed a statistically significant association with salad as the source of the outbreak, with a relative risk of 3.41 (95% confidence interval of 1.7-6.81) of eating salad on a particular date prior to the onset of symptoms. Faecal contamination of the salad at source was the most probable explanation for the diversity of viruses detected and characterized.

Disease Outbreaks↗
PubMed2003

A malaria outbreak following a British military deployment to Sierra Leone.

OBJECTIVES: To describe a malarial outbreak amongst a British military force deployed to Sierra Leone in May 2000. METHODS: A case-control study was conducted that investigated possible risk or protective factors affecting the population. RESULTS: All bite avoidance measures (use of insecticide-treated bed nets and insecticide-treated clothes and use of thermal fogging/knockdown insecticide sprays) offered some degree of protection, although only use of clothes and nets was significant at the 5% level. Use of 3 or 4 protection measures was significantly protective, as was the cumulative protective effect when using multiple protective measures. CONCLUSION: Professionals giving travel advice must continue to advice travellers that they can significantly improve their levels of malarial protection by using multiple protection measures.

Adult↗
PubMed2000

Recent trends in infectious diseases for travellers.

In the early 1970s medicine was considered to have conquered infectious diseases. The following three decades have shown this optimism to be misplaced, with both traditional infections increasing in prevalence and novel diseases appearing. Many of these diseases have become major problems in developing countries, and coupled with the exponential growth in international traffic now pose a significant risk to the traveller. The threat to the package tourist differs greatly from that to the businessman, soldier or backpacker. The latter groups may have little control over their food and water supplies and be exposed to vector-borne and zoonotic infections normally restricted to remote locations. However the package holidaymaker may be involved in mass outbreaks of food poisoning with novel pathogens or acquire unusual infections from close proximity to other tourists. All groups may be susceptible to diseases transmitted during travel, and these may be more common than is presently recognised. The common factor is that all such infections may be transported around the world within their incubation period, and that any disease can now present to any doctor. Today more than ever before it is incumbent on any practitioner to ask not only 'where have you been?' but also 'what were you doing there?'

Communicable Diseases↗
PubMed2000

Effectiveness of the meningococcal vaccination programme for British Armed Forces recruits.

After several clusters of meningococcal disease arose among recruits to the British Armed Forces, vaccination against A + C meningococcal disease was introduced for military recruits in 1992. From 1993 onwards, no further clusters of group C infection were reported and incidence of meningococcal disease among trained soldiers fell, but there was no significant reduction in the overall incidence of meningococcal disease in recruits.

Humans↗
PubMed1995

Erysipeloid infection in a sheep farmer with coexisting orf.

Erysipeloid is a rarely reported zoonotic infection caused by Erysipelothrix rhusiopathiae. We report a case of coexisting erysipeloid and orf infections in a sheep farmer, an association not previously recorded to our knowledge.

Administration, Oral↗
PubMed1995

Immunisation of armed service medical personnel against hepatitis B infection.

Clinical and laboratory staff of the Army and RAF medical services at risk of acquiring infection with hepatitis B were immunised against the virus with a recombinant vaccine. Vaccine was administered in Service hospitals and medical centres located throughout the world. After a primary course of vaccine, 73% of personnel developed anti-HBs titres > or = 100 IU/L to hepatitis B surface antigen and were considered protected; 11% were non-responders (anti-HBs < 10 IU/l). A significantly higher proportion of females than males, and vaccinees under 40 years of age, produced a good response. Among those achieving a good response, antibody titres were higher in the younger age group and in females. After a fourth (booster) dose of vaccine, 87.2% of the poor responders and 37% non-responders, developed anti-HBs titres > or = 100 IU/L.

Adolescent↗
PubMed1995

Runway malaria in a British serviceman.

'Runway malaria' is a clinical entity first described in 1990 and refers to a patient who has contracted malaria, in whom the only possible exposure has been when the aircraft in which they were travelling has landed transiently in a malarious zone. We describe such a case in a British Serviceman travelling from the South Atlantic to Germany, who acquired malaria in West Africa.

Adult↗
PubMed1994

The AO unreamed tibial nail: a 14-month follow-up of the 1992 TT experience.

This paper reports early experiences with the immediate use of the AO unreamed tibial nail, the immediate complications and the 14 months follow-up of 13 patients with Gustilo grades I, II and IIIa open tibial fractures. The nail insertion technique was found to be clear and quickly acquired by the surgeons unfamiliar with it. There were two equipment complications associated with insertion and one early compartment syndrome. Two patients needed a split skin graft and one other patient required hyperbaric oxygen therapy with a split skin graft to bring about impact wound closure. At 14 months two nails had been electively removed. There had been four cases of locking bolt failure leading to metalwork exchange in two cases, metalwork exchange and bone graft in one case and nail removal in one cases. Two patients had undergone bone graft with nail removal or exchange. Five patients had undergone no further bony procedures. Four patients had not achieved bony union. There were no cases of early or late bone or soft-tissue infection. The authors suggest that the unreamed nail principle has a valuable place in the early management of open tibial fractures.

Adolescent↗
PubMed1994

Prevalence of immunity to hepatitis A in recruits to the British Army and Royal Air Force.

Between 1989 and 1992, 92% of a sample of 2790 Service recruits aged between 17 and 35 years (mean age 19 years 7 months) were found not to be immune to infection by hepatitis A virus. The proportion of males with immunity was consistently greater than that for females. There was a significantly increased probability of immunity if individuals originated from Northern England, the Midlands and Scotland, in particular the suburbs. Among male recruits there were significantly increased probabilities of immunity associated with travel to Southern and Eastern Europe or to the Tropics, and for females with travel to North West Europe or to Southern and Eastern Europe.

Adolescent↗
PubMed1994

Sexually transmitted diseases in transient British forces in the tropics.

OBJECTIVE: To compare the incidence of sexually transmitted diseases (STD) in British troops in the tropics with that in a standard population. DESIGN: Retrospective analysis of STD clinic records over one calendar year. SETTING: A British Military Hospital in the Tropics serving 1441 resident personnel. SUBJECTS: All patients attending a STD clinic. MAIN FINDINGS: 815 cases of STD were recorded during the study period, giving incidence rate of 56,558 per 100,000 population per year. When compared with a matched population from England and Wales, the age standardised relative risk for STD amongst tropical troops was 25.0 (95% confidence interval 24.9 to 25.1). Thirty nine percent of cases reported prostitute contact as a source of their disease. Of patients questioned about condom usage, 70% reported that they did not normally use a condom. CONCLUSIONS: British troops spending short periods of time in a tropical environment are significantly more likely to acquire a STD than men in the same age groups in England and Wales. The proportions of cases who reported that they did not use condoms and the number who cited prostitute contact as a source of infection indicate that even greater sexual education of troops on deployment overseas may be required.

Adolescent↗