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J Giesecke

Publications and source records attributed to J Giesecke.

At least 19 recordsLinked to original sources
PubMed2006

Coverage of hepatitis B vaccination in Swedish healthcare workers.

The aim of this study was to assess how well the guidelines on vaccination against hepatitis B had been implemented among healthcare workers (HCWs) at risk for blood exposure. A point-prevalence survey was conducted in six departments of a university hospital in Sweden: the emergency room, intensive care unit, postoperative unit, surgical theatre, department of anaesthesiology and the laboratory for blood chemistry. All HCWs who worked in these departments during the 24h of the survey were asked to complete a questionnaire. In total, 369 questionnaires were analysed. Seventy-nine percent (293/369) of HCWs had received at least one dose of vaccine, but only 40% (147/369) reported that they were fully vaccinated and 21% (76/369) had not been vaccinated at all. The majority of unvaccinated HCWs (72/76, 95%) stated that they would accept vaccination if offered. The main barrier to better compliance with the guidelines is not lack of acceptance among the employees but the failure of the employer to ensure that policies are implemented.

Adult↗
PubMed2006

Description of a new all cause mortality surveillance system in Sweden as a warning system using threshold detection algorithms.

A warning system has been set up to detect unusual weekly clusters of deaths by age group and municipality using all-cause Swedish death registry data. The technique for monitoring deaths by age group (<1, 1-24, 25-44, 45-64 and 65 plus) and week uses a compound smoothing technique, which calculates a baseline of expected events from retrospective data. Due to insufficient baseline data for the geographical component of the system a different algorithm, based on the Poisson distribution, was chosen to calculate expected weekly number of deaths per municipality, adjusting for municipalities with inherently higher mortality rates. This system was designed and tested during 2004 and implemented from the beginning of 2005. Threshold settings have been adjusted to provide a realistic number of weekly alerts. An evaluation of the system will be performed prospectively from the beginning of 2005 due to the lack of a gold standard for retrospective performance evaluation.

Adolescent↗
PubMed2006

A case-cohort study to investigate concomitant waterborne outbreaks of Campylobacter and gastroenteritis in Söderhamn, Sweden, 2002-3.

Increased domestic, laboratory confirmed, Campylobacter notifications were reported in Siderhamn municipality, December 2002 and January 2003. Concurrently, during preliminary investigations a large outbreak of acute gastroenteritis was detected. Simultaneously, two studies were completed to identify risk factors for infection with Campylobacter and acute gastrointestinal infection (AGI): (1) a case-cohort study using Campylobacter cases (N = 101) with a large random sample from the municipal population as referents (N = 1000) and (2) a retrospective cohort study for the outcome AGI using the same sample. A postal questionnaire was used to collect demographic, clinical, water and food consumption data. Measures of association (risk ratio (RR), odds ratio (OR)) and 95% confidence intervals (CI) were calculated. Stool, environmental and water samples were tested by standard methods at Gävle Hospital and SMI laboratories respectively. In the case-cohort study, Camplylobacter cases were more likely than referents to consume communal water (OR = 12.6 (95% CI 1.7-92.3)). In the cohort study, risk of gastroenteritis was 2.3 times higher in those who consumed water (AR = 27.3%) than others (AR = 12%). Risk of illness was associated with the amount of water consumed in both studies. Campylobacter was detected in stools and Escherichia coli (E. coli) from routine communal water (CW) samples. Results suggest both Söderhamn outbreaks of Campylobacter and AGI were associated with consumption of CW. The method used strengthened epidemiological evidence and was efficient in the use of time and resources.

Adolescent↗
PubMed2005

Patients unaware of their HIV infection until AIDS diagnosis in Sweden 1996-2002--a remaining problem in the highly active antiretroviral therapy era.

Our objective was to analyse the characteristics of patients who were unaware of their HIV infection until they developed AIDS, in the period after introduction of highly active antiretroviral therapy. The complete national register of HIV and AIDS cases reported to the Department of Epidemiology at the Swedish Institute for Infectious Disease Control 1996-2002 was searched for cases diagnosed with HIV less than three months before AIDS diagnosis (so-called "late testers"). Of a total of 487 patients with AIDS, reported during the seven-year period, 219 (45%) were late testers. Their proportion of all AIDS cases increased from 22% in 1996 to 58% in 2002. Heterosexual route of transmission, age greater than 40 years, and foreign origin were all significant risk factors for being a late tester. Intravenous drug users were associated with a highly significant reduced risk. The group without previously known HIV infection represents an increasing part of all cases of AIDS. From a disease control and from a medical perspective, it is important to study this group further and discover what measures are needed for earlier identification and access to medical care.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Pulmonary tuberculosis in two remand prisons (SIZOs) in St Petersburg, Russia.

The tuberculosis (TB) situation in the Russian penitentiary system has received much attention. We performed a descriptive epidemiological study of TB in two St Petersburg remand prisons (SIZOs). The medical databases of the TB divisions in these prisons were searched for all diagnosed cases of TB from 1 January 2000 to 31 December 2002. The main diagnostic method was chest x ray. The total number of reported TB cases in these two remand prisons during this three-year period was 876. Out of these, 432 were diagnosed at entry to prison, and 444 developed the disease during incarceration, with the proportion diagnosed during incarceration increasing over time. The majority of cases were aged under 30 years. TB incidence in Russian remand prisons is still very high and needs to be monitored closely.

Adolescent↗
PubMed2005

An outbreak of mumps in Sweden, February-April 2004.

Between 24 February and 26 April 2004, Västra Götaland county in Sweden reported 42 cases of suspected mumps. A descriptive study of the cases was undertaken. A questionnaire was administered by telephone and vaccine effectiveness was calculated using the screening method. Seventy four per cent (31/42) of the suspected cases were interviewed by telephone. Eight out of the 42 serum samples were positive or equivocal for mumps IgM by ELISA. Mumps virus genome was identified in 21/42 (50%) saliva samples. Eleven were selected for sequencing and all were confirmed to be mumps virus. Cases were predominantly from 2 small towns. Eighteen out of 19 cases that developed bilateral swelling could be linked to one small town. The median age of interviewed cases was 43 years (range 5 to 88). Six cases were admitted to hospital, 5 of which were older than 30 years. The highest incidence occurred in the 35 to 44 years age group. Vaccine effectiveness was estimated to be 65% for 1 dose and 91% for 2 doses. This descriptive study shows the increasing age of mumps cases with increasing vaccine coverage. Vaccine effectiveness was particularly high for 2 doses. Second-dose uptake must be ensured, as primary vaccine failure is well documented in mumps. Stronger precautions must be taken to avoid pools of susceptible older individuals accumulating due to the increased risk of complications.

Adolescent↗
PubMed2005

'Did you have flu last week?' A telephone survey to estimate a point prevalence of influenza in the Swedish population.

Sentinel surveillance usually underestimates the true burden of influenza in a population, as individuals must present to medical establishments to be included in the surveillance system. We carried out a telephone survey to estimate the national burden of influenza in the Swedish population for one week during the 2004/05 influenza season. Fixed-line telephone numbers were randomly sampled and households interviewed concerning influenza illness between 14-20 February 2005 (Week 7 of 2005). Questions regarding seasonal influenza vaccination status, symptoms and the impact of illness on daily life were also included. A self-defined influenza prevalence of 7.7% in week 7 of 2005 was estimated. On applying a case definition of 'cough and fever and muscle pain' for influenza like illness, the prevalence decreased to 3.6%. The survey provided insight into the burden of illness in the population further to that estimated through the sentinel surveillance system.

Adolescent↗
PubMed2004

Association between environmental risk factors and campylobacter infections in Sweden.

Campylobacter sp. is the most common cause of acute bacterial gastroenteritis in Sweden and the incidence has been increasing. Case-control studies to identify risk factors have been conducted in several countries, but much remains unexplained. The geographical distribution of campylobacter infections varies substantially, and many environmental factors may influence the observed pattern. Geographical Information Systems (GIS) offer an opportunity to use routinely available surveillance data to explore associations between potential environmental risk factors showing a geographical pattern and disease incidence, complementing traditional approaches for investigating risk factors for disease. We investigated associations between campylobacter incidence and environmental factors related to water and livestock in Sweden. Poisson regression was used to estimate the strength of the associations. Positive associations were found between campylobacter incidence and average water-pipe length per person, ruminant density, and a negative association with the percentage of the population receiving water from a public water supply. This indicates that drinking water and contamination from livestock may be important factors in explaining sporadic human campylobacteriosis in Sweden, and that contamination occurring in the water distribution system might be more important than previously considered.

Animals↗
PubMed2004

Detection of Mycobacterium tuberculosis in gastric aspirate and sputum collected from Ethiopian HIV-positive and HIV-negative children in a mixed in- and outpatient setting.

AIM: To investigate, through a prospective study, the detection rate of Mycobacterium tuberculosis in sputa and gastric aspirate from tuberculous children in a low-income country with high prevalence of tuberculosis and an increasing HIV epidemic. METHODS: Gastric aspirates and/or sputum samples were collected from 355 children with pulmonary tuberculosis as follows: from 136 children under 5 y only gastric aspirate was taken, for 159 children aged 5 to 9 y both methods were used, and for 60 children over 10 y only sputum was analysed. The diagnosis of tuberculosis was based on clinical data, tuberculin test and chest radiography. All children were tested for HIV infection. RESULTS: Direct microscopy for acid-fast bacilli was positive for 55 (15%) and mycobacterial culture for 183 (52%) children. The proportion of positive cultures was similar in all age groups. Among the 5 to 9 year-old children who could produce a sputum sample, sputum gave just as good culture yield of M. tuberculosis as gastric aspirate. Of the clinical or radiological findings only weight loss was associated with a higher yield. Repeat gastric aspirate increased the culture yield by 6%. Mycobacterial culture from HIV-positive children gave lower yield compared with HIV-negative children. CONCLUSION: Our data suggest that one gastric aspirate for children less than 6 y and three sputum samples for the older children collected at an outpatient TB clinic, is enough to provide a close to 50% yield of M. tuberculosis available for culture and further analyses. However, with an increasing prevalence of HIV, this detection rate may be reduced.

Adolescent↗
PubMed2003

Febrile gastroenteritis after eating on-farm manufactured fresh cheese--an outbreak of listeriosis?

An outbreak of febrile gastroenteritis affected consumers of on-farm manufactured dairy products from a summer farm in Sweden. Symptoms included diarrhoea, fever, stomach cramps and vomiting in 88, 60, 54 and 21% of cases identified. The median incubation period was 31 h. A cohort study with 33 consumers showed an attack rate of 52% and an association between the total amount of product eaten and illness (P=0.07). Twenty-seven of 32 (84%) stool samples cultured for Listeria monocytogenes tested positive, although there was no association between clinical disease and the isolation of L. monocytogenes. In addition, gene sequences for VTEC and ETEC were detected in 6 and 1 subjects, respectively. Bacteriological analysis of cheese samples revealed heavy contamination with L. monocytogenes and coagulase positive staphylococci in all of them and gene markers for VTEC in one of them. Molecular profiles for L. monocytogenes isolated from dairy products, stool samples and an abscess from 1 patient who developed septic arthritis were identical. Results of both microbiological and epidemiological analyses point to L. monocytogenes as the most likely cause of this outbreak. The finding of markers for VTEC in some humans and cheese samples means that a mixed aetiology at least in some cases cannot be conclusively ruled out.

Adolescent↗
PubMed2003

A norwalk-like virus waterborne community outbreak in a Swedish village during peak holiday season.

An outbreak of gastroenteritis due to Norwalk-like virus (NLV) affecting approximately 500 people occurred in a Swedish ski resort during February-March 2002. Epidemiological investigations were performed on cohorts of schoolchildren, permanent residents and skiers visiting the area. Attack rates were respectively 39.7, 29.9 and 38.5%. Drinking un-boiled water originating from one of the three communal water systems was a significant risk factor for all groups. For schoolchildren, the risk of illness increased with increasing amount of water consumed. Nine of 12 stool samples of patients analysed tested positive for NLV. The water tested negative for indicator bacteria and results of NLV tests were inconclusive. In the absence of microbiological findings, the environmental authorities were reluctant to act based on the epidemiological analysis alone, and intervention was delayed until mid-April, following the discovery of a crack in a sewage pipe 10 m from the well.

Adolescent↗
PubMed2001

Clinical spectrum and transmission characteristics of infection with Norwalk-like virus: findings from a large community outbreak in Sweden.

A large foodborne outbreak caused by Norwalk-like virus (NLV) among children and staff at 30 day care centers provided an opportunity to study symptomatology and attack rates among patients in different age groups, as well as secondary transmission rates in centers and households. A retrospective cohort study of 775 subjects from 13 randomly chosen centers was performed. Diarrhea was more common in adults than in children (P=.001), whereas the reverse was noted with regard to vomiting (P=.003). The primary attack rate was 27% (142 of 524 subjects): 54% of adults versus 19% of children (P<.001). The mean incubation time for foodborne cases of infection was 34 hours. The secondary attack rate was 17%. Risk factors for spread into households were the primary case being a child (relative risk [RR], 3.8; 95% confidence interval [CI], 1.9-7.6) and vomiting (RR, 2.4; 95% CI, 1.0-5.5). The incubation time for person-to-person transmission was approximated by a mean serial interval of 52 hours. This is the first reported outbreak of NLV infection in which secondary transmission into households by individuals has been studied.

Adolescent↗
PubMed2001

Incidence of Guillain-Barré syndrome following infection with Campylobacter jejuni.

Evidence of recent or ongoing Campylobacter jejuni infection has been found in approximately one out of every four cases of Guillain-Barré syndrome (GBS). It is increasingly accepted that C. jejuni infection is an important causal factor for GBS. However, the likelihood of GBS' occurring following an episode of C. jejuni gastroenteritis has not been measured. The authors measured the incidence of GBS in a large cohort of persons with laboratory-confirmed C. jejuni infection. Cases of C. jejuni infection were derived from the Swedish national laboratory reporting system for the years 1987--1995. Follow-up for GBS was carried out using the Swedish national hospital inpatient register. Nine cases of GBS were detected in the cohort, which comprised 29,563 cases of C. jejuni infection--a rate of 30.4 per 100,000 (95% confidence interval: 13.9, 57.8). This compares with an expected incidence of 0.3 per 100,000 in a 2-month period in the general population. GBS is an important but rare complication of C. jejuni infection. The risk of developing GBS during the 2 months following a symptomatic episode of C. jejuni infection is approximately 100 times higher than the risk in the general population.

Adult↗
PubMed2001

A new MRI technique for imaging scoliosis in the sagittal plane.

The purpose of the present study was to introduce a new magnetic resonance imaging (MRI) procedure showing the whole spine in a coronal and sagittal plane, and to study the assessment of sagittal Cobb angle measurements using this technique. Prospectively we studied 32 patients (average age 14.8 years) with idiopathic scoliosis (mean thoracic Cobb angle 33 degrees on radiograph) and 18 patients (average age 14.5 years) without scoliosis. The MRI investigation was carried out in a standard supine position. The cervical and upper thoracic spine and the lower thoracic and lumbar spine were measured on a 1.5-T Gyroscan ACS-NT Powertrak 6000 system. An algorithm was developed to combine the results of the cranial and caudal scans into a coronal and a sagittal image of the whole spine (MR total spine imaging). Measurement of the sagittal Cobb angle conducted ten times by four independent investigators revealed an intraobserver variance of 1.6 degrees and an interobserver variance of 1.8 degrees. In the group with scoliosis the mean sagittal Cobb angle from T4 to T12 was 12 degrees (range -3 degrees to 24 degrees) and in the group without scoliosis 22 degrees (range 16 degrees to 30 degrees), which was a significant difference. MR total spine imaging makes it possible to image scoliosis in the sagittal plane. On these MR projections, idiopathic thoracic scoliosis was identified by a reduced sagittal Cobb angle. MR total spine imaging would allow monitoring of scoliosis in the sagittal plane, which can reveal relevant clinical data without radiation exposure.

Adolescent↗
PubMed2001

A controlled estimate of the risk of HIV infection in Ethiopian children with tuberculosis.

To quantify the risk of human immunodeficiency virus (HIV) infection in children with tuberculosis (TB) a hospital-based, 1-year prospective, case-control study was performed in Addis Ababa, Ethiopia. Children with TB were compared to a control group of children admitted for elective surgery. The control group was also compared to a recent census of the background population. The crude odds ratio for HIV infection was 8.6 (95 % CI 2.2-73). After adjustment for possible confounders in a multivariate regression model, the odds ratio for HIV infection in children with TB was found to be 12.7 (95% CI 2.9-55). Of several independent determinants of TB assessed in the study, this association was the strongest. Until HIV transmission has reached its peak, an increasing burden of dual infection among Ethiopian children is to be expected.

Adolescent↗
PubMed2001

Risk factors for human immunodeficiency virus infection in Ethiopian children with tuberculosis.

BACKGROUND: Separate risk factors for HIV infection and for tuberculosis (TB) are well-studied, but it is unclear whether these risk factors still apply in the new epidemiologic situation of dual infection. This study examines risk factors associated with seropositivity for HIV in Ethiopian children with clinical TB. METHODS: A prospective, controlled study of children with TB diagnosed in Addis Ababa from December 11, 1995, to January 28, 1997, in which HIV-positive children were compared with HIV-negative children with regard to sociodemographic background, previous medical history and vaccination. RESULTS: HIV prevalence among children with clinical TB was 11.2%. High educational status of mothers, low age, loss of one or two parents and earlier Calmette-Guérin bacillus (BCG) vaccination of the child were factors independently related to HIV infection. CONCLUSION: Factors associated with HIV infection among children with clinical TB include higher education of parents, higher income and better living conditions. The HIV epidemic might thus modify traditional risk factors for tuberculosis. It might also decrease the overall effect of BCG vaccination given that BCG did not provide protection in children infected with HIV. An expected increase of dually infected children who are younger, more in need of hospitalization and often lacking one or both parents will put an additional burden on the Ethiopian health care system.

Adolescent↗