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Biomedical subjects

J Cowden

Publications and source records attributed to J Cowden.

15 recordsLinked to original sources
PubMed2003

Investigation of an outbreak of Escherichia coli O157 infection caused by environmental exposure at a scout camp.

In May 2000 a scout camp was held on an agricultural showground in New Deer, Aberdeenshire. There were 337 campers at the event, comprising 233 cubs, scouts, and venture scouts, and 104 adults. The event was abandoned early because of heavy rainfall. Twenty campers who became ill between 28 May and 3 June were confirmed as having E. coli O157 infection. Preliminary investigation did not suggest a food vehicle but did indicate environmental exposure at the camp as a risk factor. Subsequent investigations supported the hypothesis that transmission of E. coli O157 was from the environment to cases by contaminated hands, either directly from hand to mouth, or via food. As a result of the investigation the Aberdeenshire Council and the Scout Association jointly prepared interim guidelines to reduce the risk of E. coli O157 infection at scout camps.

Adolescent↗
PubMed2003

A national outbreak of infection with Salmonella enteritidis phage types 5c and 6a associated with Chinese food businesses in Scotland, summer 2000.

An outbreak of salmonellosis, involving cases of infection with Salmonella enteritidis phage types (PT) 5c and 6a, occurred across Scotland between May and August 2000. In total, 70 outbreak cases were microbiologically confirmed. Preliminary investigation suggested that consumption of food, especially chicken dishes, from Chinese restaurants or take-aways (food businesses) was a risk factor for infection. A matched case-control study demonstrated a statistically significant association (OR 22.4, P=0.0024) between infection and consumption of food from Chinese food businesses. A cohort study of novel design suggested that chicken was an important vehicle of infection. However the result did not reach statistical significance (OR 1.7, P=0.3). Extensive environmental investigation was unable to identify the source of the suspected contaminated chicken.

Animals↗
PubMed2002

The seasonal distribution of campylobacter infection in nine European countries and New Zealand.

In all temperate countries campylobacter infection in humans follows a striking seasonal pattern, but little attention has been given to exploring the epidemiological explanations. In order to better characterize the seasonal patterns, data from nine European countries and New Zealand have been examined. Several European countries with weekly data available showed remarkably consistent seasonal patterns from year to year, with peaks in week 22 in Wales, week 26 in Scotland, week 32 in Denmark, week 30 in Finland and week 33 in Sweden. In Europe, the seasonal peak was most prominent in Finland and least prominent in Scotland and Austria. In New Zealand the seasonality was less consistent since the peak was more prolonged. Possible explanations for the seasonal peaks are discussed. Research into the causes of campylobacter seasonality should help considerably in elucidating the sources of human infection.

Campylobacter Infections↗
PubMed2001

The evaluation of a new standard data set on reported cases of intestinal infectious disease in Scotland, and recommendations for the future.

A national survey of local authorities was carried out to ascertain what information they collected on reported cases of intestinal infectious disease and why. As a result of the survey, and a review of national objectives, two data collection forms designed to satisfy both local and national objectives were piloted. One of the forms was four pages long, and sought much less data than the second form, which was 10 pages long. The outcomes of these investigations were established, and assessed, to see if they could have led to the achievement of the stated local and national objectives. Neither data collection form was entirely successful in fulfilling all local objectives, although the four-page form was no less successful than the ten page form. Neither form succeeded in fulfilling national objectives. The study has shown that our best efforts at fulfilling local and national objectives by the universal administration of either the four-page, or the 10-page form are of limited value. We recommend that the universal collection of such information from reported cases of intestinal infectious disease be discontinued. We recommend a risk-based approach to identify cases whose follow up is more likely to achieve more realistic objectives.

Data Collection↗
PubMed1995

A pilot study of infectious intestinal disease in England.

Pilot studies to test methods to determine the incidence, agents, risk factors and socioeconomic costs of infectious intestinal disease (IID) in England were carried out as recommended by the Committee on the Microbiological Safety of Food (the Richmond Committee) by eight general practices. There were case control and enumeration studies of patients presenting to general practice with IID, a population-based prospective cohort study, and a survey of socioeconomic costs of cases of IID. Information on risk factors was obtained by questionnaire (self-administered compared with interview) and a stool sample was requested on all cases and controls. Response rates in the GP case control study were 75% for case questionnaires and 74% for stools; for controls the figures were 70% and 68% respectively. The acceptance rate into the cohort study was 49%; this was significantly higher where phone contact was made. The rate was similar if recruitment was by individual or household. Follow-up of the cohort by negative reporting was complete for up to 6 months. Direct postage by subject was required to obtain fresh stool specimens. Estimates were obtained of presentation rates of IID and the distribution of risk factors which were used to plan the main study. The pilot study demonstrated that it is possible to undertake a national study based in general practice to determine the incidence of IID in the population and presenting to GPs and its agents, risk factors and costs.

Adolescent↗
PubMed1993

An outbreak of Salmonella mikawasima associated with doner kebabs.

During October 1992 an increase in the number of isolates of Salmonella mikawasima, a rare serotype, was noted including a cluster of nine cases in the South West Thames region. A case control study was conducted and univariate analysis showed a statistical association between illness and eating at take-away A for cases compared with household controls (P = 0.003) and with neighbourhood controls (P = 0.0245). Cases were also more likely to have eaten kebabs than were controls or average take-away A customers, implicating doner kebabs as the most likely vehicle of infection. Plasmid profile analysis of the nine cases' isolates showed them to be indistinguishable and to be characterized by a single plasmid of approximately 60 MDa. The original source of the Salmonella mikawasima contamination was not determined, but food preparation practices for kebabs at take-away A were insufficient to protect against illness if contaminated. This outbreak was only recognized because of the unusual serotype, but could be an indication of a more widespread problem with doner kebabs.

Adolescent↗
PubMed1992

An outbreak of Salmonella dublin infection in England and Wales associated with a soft unpasteurized cows' milk cheese.

An outbreak of Salmonella dublin infection occurred in England and Wales in October to December 1989. Forty-two people were affected, mainly adults, and most lived in south-east England. Microbiological and epidemiological investigations implicated an imported Irish soft unpasteurized cows' milk cheese as the vehicle of infection. A case-control study showed a statistically significant association between infection and consumption of the suspect cheese (p = 0.001). Salmonella dublin was subsequently isolated from cheeses obtained from the manufacturer's premises. Initial control measures included the withdrawal of the cheese from retail sale and a Food Hazard Warning to Environmental Health Departments, as well as a press release, from the Department of Health. Subsequently, a decision was taken by the manufacturer to pasteurize milk used in the production of cheese for the UK market and importation of the cheese resumed in June 1990.

Adolescent↗
PubMed1990

An outbreak of Salmonella saint-paul infection associated with beansprouts.

In March 1988, there was an outbreak of infection by a strain of Salmonella saint-paul with a distinctive antigenic marker. A total of 143 reports were received between 1 March and 7 June. Preliminary investigations suggested that raw beansprouts were a possible source of infection and a case-control study confirmed the association. S. saint-paul of the epidemic type was isolated from samples of beansprouts on retail sale in different cities in the United Kingdom and from mung bean seeds on the premises of the producer who was most strongly associated with cases. In addition, Salmonella virchow PT34 was isolated from samples of raw beansprouts and was subsequently associated with seven cases of infection. Four other serotypes of salmonella were also isolated from beansprouts. On 8 April the public were advised to boil beansprouts for 15 seconds before consumption, and the premises of the one producer associated with many cases were closed. As a result of these actions there was a significant decrease in the number of infections with S. saint-paul.

Adolescent↗
PubMed1990

Management of institutional outbreaks of Salmonella gastroenteritis.

The number of reports of outbreaks of salmonella gastroenteritis in hospitals has decreased since 1984 but the number of outbreaks in institutions such as old peoples' homes have increased during 1988. Foods, particularly chickens, remain a source of salmonellae and particular attention has to be paid to training and practices in food preparation areas. Staff who are convalescent are very unlikely to be sources of salmonella and do not need to be excluded unless they handle food that receives no further cooking. Outbreaks that do occur can usually be controlled by patient isolation and good control-of-infection measures and an effective Major Outbreak Control Plan is necessary. In some large old hospitals cross infection outbreaks may continue despite good control-of-infection measures. Antibiotics have been contraindicated in the treatment of salmonella gastroenteritis, but the new 4-quinolone antibiotics have demonstrated potential. Ciprofloxacin was used successfully in two outbreaks of salmonella gastroenteritis at a dose of 500 mg bd orally for seven days. Relapses did not occur and resistance did not develop. Ciprofloxacin should be considered as a therapeutic adjunct to control of infection measures in cross infection outbreaks in these situations.

Anti-Bacterial Agents↗
PubMed1981

Radial keratotomy: an analysis of the American experience.

A total of 223 patients with bilateral nonprogressive myopia ranging from - to - 11 D underwent partial-thickness radial keratotomy (400 eyes). Topical anesthesia was used for all surgery and all patients had 16 radial incisions from a preset central optical zone, determined by table and/or formula. Neither corneal diameter or scleral rigidity was taken into account in these groups. Substantial reduction of myopia resulted immediately in all cases, with Group 1 showing a 44% regression of the myopia with stabilization occurring at three months. Group 2 showed a 14% regression of effect. In Group 1, 28% attained an unaided visual acuity (postoperatively) of 20/40 or better for most of the day, while 61% of Group 2 attained the same result. Night glare was present in both groups, usually subsiding in three months. Fluctuation was reported in both groups. Side effects were mild. The comparison of the two groups shows that incisions carried almost to Descemet's membrane and deepened in the periphery resulted in much greater reduction of the myopia and a more permanent and stable effect following surgery. New methods of measuring corneal curvature are necessary and a more satisfactory blade needs to be developed for surgery. Corneal thickness measurements have been made more accurate by the development of the ultrasonic pachymeter.

Adolescent↗