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Biomedical subjects

H A Kelly

Publications and source records attributed to H A Kelly.

18 recordsLinked to original sources
PubMed1999

Fifth disease in a small rural community. What are the consequences?

OBJECTIVE: To characterise the implications of an outbreak of human parvovirus in a small community. METHOD: A community survey was conducted over a period of 18 months in a small rural town in Western Australia with a population of approximately 4300 people. Outbreak cases were assessed by the single general practice in the town. Notification of the survey was placed in both the schools and by advertisement in the local paper. Survey questionnaires distributed to community members were returned on a voluntary basis. After 12 months repeat surveys were sent to all adults who had responded to the initial survey. RESULTS: Eighty-eight definite and 14 equivocal cases were identified as part of the outbreak, which occurred between late July 1994 and February 1995. Serological testing which confirmed human parvovirus B19 infection was available for 29% of cases. The highest attack rate was in the 5-9 year age group. One-third of cases were adults and 9% of them developed symptoms lasting longer than 6 months. Transient anaemia almost certainly due to parvovirus infection was identified in one adult women during the course of the outbreak. No pregnant woman suffered any adverse fetal outcome as a result of human parvovirus infection. CONCLUSION: In an outbreak of parvovirus, children will be most commonly affected although adults can develop polyarthralgia/arthritis which may persist for several months and some may suffer transient anaemia. Pregnant women are potentially at risk of the development of fetal hydrops and fetal death, but advice to them can be based on the estimate of a less than 1% risk of adverse fetal outcome due to parvovirus infection.

Adolescent↗
PubMed1998

The immunological response of llamas (Lama glama) following experimental infection with Mycobacterium bovis.

Llamas were experimentally infected with Mycobacterium bovis in order to evaluate the axillary skin test and the ELISA as diagnostic procedures for tuberculosis in llamas (Lama glama). Six llamas were given a single intratracheal challenge with 1 of 2 doses of a recent field isolate of M. bovis and 2 llamas were left as noninfected controls. This resulted in a progressive disease in some animals with 1 mortality as early as 68 d post-infection (PI). The tuberculin skin test, at the axillary site, was positive in 4 of 5 infected llamas at 80 d PI. At 143 d PI, all 3 surviving lamas were positive, including the one which had not responded at 80 d PI. The application of skin and serological tests throughout the course of this experiment adds support for the need to further evaluate the skin test and its anamnestic effect on serodiagnosis since serological responses were generally not observed in the absence of skin testing or antibiotic treatment. The wide variation in M. bovis antigens recognized by the serological response would indicate that a diagnostic panel should include multiple antigens such as MPB70 and lipoarabinomannan (LAM). While skin testing or serology alone may be of limited value to diagnose tuberculosis in llamas, together they may offer an enhanced potential for immunodiagnosis of tuberculosis.

Animals↗
PubMed1996

A cluster of murine typhus cases in Western Australia.

Measures to control rodents have resulted in a decreased incidence of murine typhus, but it is also likely that it is being underdiagnosed because many medical practitioners do not include it in their differential diagnosis of pyrexia of unknown origin. Four recent cases are described, and historical aspects of this disease in Australia are presented.

Adult↗
PubMed1994

Dramatic increase in incidence of insulin dependent diabetes mellitus in Western Australia.

OBJECTIVES: To document and suggest possible reasons for a dramatic increase in the incidence of insulin dependent diabetes mellitus (IDDM) in Western Australia in 1992. PATIENTS: Children aged 0-14 years with IDDM diagnosed in Western Australia from 1985 to 1992 inclusive. DESIGN: A population-based register in Western Australia, using name-identified data from two separate ascertainment sources, provided numerator data. Denominator data were estimated from census figures collected in 1986 and 1991 by the Australian Bureau of Statistics. The completeness of case ascertainment was estimated by the capture-recapture method. RESULTS: Case ascertainment for 1985-1992 was estimated as 99.6% complete. Between 1985 and 1991 the incidence of IDDM in the 0-14 year age group varied between 11.8 and 15.5 per 100,000 person-years without a significant increase. In 1992, however, based on the previous seven years, 52 cases would have been expected but 84 cases were observed, an incidence of 22.2 per 100,000 person-years. The increase in incidence occurred across all age groups and in both sexes. Place of residence at diagnosis, the prevalence of islet cell antibody positivity at diagnosis and the proportion of new cases with a first degree relative with IDDM were no different in 1992 than in preceding years. CONCLUSION: This is the first report of a significant increase in the incidence of IDDM in Australia. It appears to be a period, rather than a cohort, effect and provides further evidence for environmental antigens as disease triggers.

Adolescent↗
PubMed1992

Incidence of IDDM in Western Australia in children aged 0-14 yr from 1985 to 1989.

OBJECTIVE: To document the incidence of insulin-dependent diabetes mellitus (IDDM) in Western Australia in children aged 0-14 yr between 1985 and 1989 and to test for differences in incidence by year of diagnosis, age of diagnosis, and sex. RESEARCH DESIGN AND METHODS: A population-based register that used a primary source of case ascertainment (diabetes clinics at teaching hospitals and direct approach to general practitioners and general physicians) and a secondary source (Western Australian Hospital Morbidity Data System) established numerator data. Denominator data were obtained from the Australian Bureau of Statistics. RESULTS: From 1985 to 1989 inclusive, 235 children in the 0- to 14-yr age-group were diagnosed with IDDM in Western Australia. Case ascertainment was estimated at 99% complete. The mean age-adjusted (developed-world population) annual incidence of IDDM was 13.2 per 100,000 person-yr and there was no evidence of an increasing incidence over the 5 yr. However, girls were more likely than boys to be diagnosed with IDDM in this period (P = 0.006). CONCLUSIONS: The incidence of IDDM in Western Australia is in the middle range of IDDM incidence in countries throughout the world. The unexpected finding of an increased incidence of IDDM in girls compared with boys needs to be confirmed in a future study.

Adolescent↗
PubMed1991

Ear disease in three aboriginal communities in Western Australia.

Surveys of ear disease amongst Aboriginal people in two isolated bush communities (Wiluna and La Grange) and one urban community (Kwinana) in Western Australia were undertaken in 1988 or 1989. The age-adjusted prevalence odds ratio (relative risk) of perforations of the tympanic membrane for Wiluna compared with Kwinana was 5.0 (95% confidence interval [CI] 2.7-12.2) and 6.8 (95% CI 3.5-13.9) for La Grange compared with Kwinana. The relative risk of mild hearing loss, in comparison with Kwinana, was 2.5 (95% CI 1.5-4.3) for Wiluna and 3.2 (95% CI 2.0-5.0) for La Grange. There was no significant difference in the relative risk of moderate or severe hearing loss or impedance pattern B, usually interpreted as "glue ear", in any of the three communities. Overall, the urban Aboriginal community had less ear disease and hearing loss than either of the isolated bush communities, but even this community did not approach the much lower levels of prevalence in Australia as a whole.

Acoustic Impedance Tests↗
PubMed1990

Measuring the HIV epidemic: the Western Australian experience.

Previous discussion about sources of error in measuring the human immunodeficiency virus (HIV) epidemic has tended to emphasise errors which underestimated the number of HIV infected persons. Data are provided from Western Australia illustrating potential errors which may result in overestimating the size of the epidemic. Duplication of persons notified in more than one State and multiple notifications by doctors and laboratories of single cases may give rise to substantial errors in over-estimation.

Contact Tracing↗
PubMed1989

Properties and partial genetic characterization of Nepean phage and other lytic phages of Brucella species.

Nepean (Np), a new brucellaphage, was associated with atypical Brucella abortus strains from Ontario cattle. Carriage of Np was associated with loss of smooth lipopolysaccharide, changes in some protein bands in acrylamide gel electrophoresis profiles, increased susceptibility to colistin, and increased resistance to ultraviolet killing. Nepean (Np) was compared with brucellaphages Tb, Fi, Wb, Iz and R/C. All were morphologically identical, with icosahedral capsids (50-65 nm diameter) and short tails (15-25 nm long), but Np had a more restricted host range, replicating only in smooth strains of B. abortus. All six brucellaphages were generally similar in resistance to chemical and physical agents. Brucellaphage DNA was double stranded and unmethylated; its molecular size was 38 kilobase pairs. The DNAs of Tb, Fi, Wb, Iz and R/C could not be differentiated by restriction endonuclease digest profiles produced by BgII, EcoRI, HindIII or PvuII. Nepean (Np) DNA was very similar to that of the other brucellaphages, but with every enzyme used its profile differed in the number and/or position of at least one fragment. However, there was complete cross-hybridization of Tb and Np DNAs. Hybridization techniques failed to detect Brucella DNA in Dp or Tb phages, or phage DNA in Brucella cells. Extrachromosomal plasmid DNA was not detected.

Animals↗
PubMed1986

Evaluation of determination of theophylline concentrations by Seralyzer.

Determination of theophylline concentrations by Seralyzer in 28 paired serum and plasma samples disclosed almost identical results. Comparison of determinations by Seralyzer and enzyme-multiplied immunoassay in 31 paired serum samples disclosed significant underestimation by Seralyzer when recalibrated whenever results of analysis of a 15-micrograms/mL control exceeded limits of +/- 3 micrograms/mL. Determinations by Seralyzer did not differ significantly from enzyme-multiplied immunoassay with narrower limits of 15 +/- 2 micrograms/mL for Seralyzer calibration for 18 paired samples. Seralyzer results are sufficiently reliable for clinical use if the instrument is recalibrated whenever analysis of the 15-micrograms/mL control falls outside limits of +/- 2 micrograms/mL.

Child↗