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J S Cheesbrough

Publications and source records attributed to J S Cheesbrough.

At least 19 recordsLinked to original sources
PubMed2000

Widespread environmental contamination with Norwalk-like viruses (NLV) detected in a prolonged hotel outbreak of gastroenteritis.

A protracted outbreak of Norwalk-like virus (NLV)-associated gastroenteritis occurred in a large hotel in North-West England between January and May 1996. We investigated the pattern of environmental contamination with NLV in the hotel during and after the outbreak. In the ninth week, 144 environmental swabs taken from around the hotel were tested for NLV by nested RT-PCR. The sites were categorized according to the likelihood of direct contamination with vomit/faeces. The highest proportion of positive samples were detected in directly contaminated carpets, but amplicons were detected in sites above 1.5 m which are unlikely to have been contaminated directly. The trend in positivity of different sites paralleled the diminishing likelihood of direct contamination. A second environmental investigation of the same sites 5 months after the outbreak had finished were all negative by RT-PCR. This study demonstrates for the first time the extent of environmental contamination that may occur during a large NLV outbreak.

Caliciviridae Infections↗
PubMed2000

The serodiagnosis of infection with Salmonella typhi.

BACKGROUND/AIMS: The serodiagnosis of infection with Salmonella typhi, using the Widal agglutination assay, relies on patients' antibodies to the O = 9,12 lipopolysaccharide (LPS) antigens, H = d flagellar antigens, and the Vi capsular antigens. A Vi agglutination titre of > 1/40 has traditionally been regarded as indicative of recent infection with S typhi. In this study, 91 sera were used to assess the reliability of the Widal agglutination assay based on antibodies to the Vi antigens. METHODS: The Widal agglutination assay was carried out using protocols established by the Central Public Health Laboratory, Colindale. Antibodies to the Vi capsular antigen were detected using a standard preparation of S typhi, ViI Bhatnagar variant strain (S typhi, ViI). Sera used in the study comprised 73 from patients who were culture positive for S typhi, 10 from patients who were culture positive for other species of Salmonella not expressing a Vi antigen (namely, S javiana, S enteritidis, S typhimurium, S stanley, S saint paul, S bareilly, or S mbandaka), and eight from healthy blood donors. RESULTS: Agglutination titres of > or = 1/40 were detected to S typhi ViI in 69 of 73 sera from patients with typhoid, although 27 of these also agglutinated an unrelated control antigen. The Widal assay also detected significant amounts of agglutinating antibodies to S. typhi ViI in all eight control sera and seven sera from patients infected with S bareilly, S enteritidis, S javiana, S mbandaka, S saint paul, and S stanley. CONCLUSIONS: Agglutinating antibodies to the Vi antigen can be detected by the Widal assay, but even with the appropriate control antigens the results were unreliable. The serodiagnosis of infections with S typhi should be based on the detection of antibodies to both the O = 9,12 LPS antigen and the H = d flagellar antigen by immunoblotting, and should not use the Vi antigen-based Widal assay. Conclusions should be made in the light of patients' clinical details and any knowledge of previous immunisation for typhoid.

Agglutination Tests↗
PubMed1997

Clinical definition for invasive Salmonella infection in African children.

BACKGROUND: Invasive salmonellosis is common among children in tropical Africa, typically presenting as a nonspecific febrile illness that is difficult to distinguish clinically from malaria. This study examines the performance of a clinical definition devised to aid its recognition among children ages 1 to 15 years presenting to a mission hospital in rural Zaire. METHODS: Invasive salmonellosis was defined by: (1) illness requiring admission to hospital in the opinion of an experience pediatrician; (2) history of fever for 5 or more days; (3) no focus of infection on clinical examination; and (4) negative or only scanty positive thick film for malarial parasites. Children fulfilling all these criteria were treated with ciprofloxacin after culture of blood and feces. The primary outcome measure was blood culture-confirmed salmonellosis. Secondary measures were final clinical diagnosis and serologic evidence of recent salmonellosis. RESULTS: Of 120 children fulfilling the definition, 55 (46%) were bacteremia; in 46 (38%) Salmonella species were isolated. In the majority of the nonbacteremic children no definite cause for the fever could be found. Salmonella serology supported invasive salmonellosis as the diagnosis in 62% of the nonbacteremic children. CONCLUSION: Salmonella serology suggested that invasive salmonellosis without detectable bacteremia was common. The addition of blood culture-proved and serologically diagnosed cases indicates that the definition has a specificity of at least 60%.

Adolescent↗
PubMed1997

Serological response of patients infected with Salmonella typhi.

AIMS: To evaluate a rapid immunoblotting procedure for providing evidence of infection with Salmonella typhi using 73 sera from patients infected with S typhi. METHODS: A sodium dodecyl sulphatepolyacrylamide gel electrophoresis (SDS-PAGE)/immunoblotting procedure using lipopolysaccharide (LPS, O = 9,12) and flagellar (H = d) antigens was used. RESULTS: Seventy two of 73 sera contained antibodies to LPS, 40 sera also contained antibodies to H = d flagellar antigens. Analysis of acute and convalescent sera showed that only 62% of patients produced antibodies to flagellar antigens. CONCLUSIONS: The SDS-PAGE/immunoblotting procedure provided a rapid method for providing serological evidence of infection with S typhi.

Acute Disease↗
PubMed1997

Atypical eumycetoma caused by Phialophora parasitica successfully treated with itraconazole and flucytosine.

Phialophora species are occasional pathogens causing subcutaneous and invasive disease. We report the first case of eumycetoma caused by P. parasitica in an otherwise healthy U.K. resident who visited India. She failed to respond to surgical excision and itraconazole, 400 mg daily, but responded to itraconazole, 400 mg daily, and flucytosine, 1 g three times daily, for 12 months. In vitro susceptibility testing predicted a response.

Adult↗
PubMed1995

Meningococcal meningitis and carriage in western Zaire: a hypoendemic zone related to climate?

An analysis of bacteria recovered from cerebrospinal fluid over a 16-year period at a rural hospital in western Zaire showed that Neisseria meningitidis accounted for only five (2.2%) isolates. A survey of naso-pharyngeal colonisation with N. meningitidis in 378 healthy children was undertaken to distinguish whether this low frequency was due to lack of carriage or, by inference, lack of the co-factors necessary to permit invasive disease. N. meningitidis was recovered from only three (0.78%) of the children. All isolates were non-typable strains of low pathogenicity. A review of studies examining the aetiology of bacterial meningitis and the geographical location of epidemics of meningococcal meningitis in and around Zaire reveals a 'hypoendemic zone', the limits of which correlate well with the area in which mean absolute humidity remains above 10 g m-3 of air throughout the year. Continuous high absolute humidity appears to reduce the transmission of meningococci.

Adolescent↗
PubMed1993

Salmonella bacteraemia among young children at a rural hospital in western Zaire.

An analysis of 206 cases of extra-intestinal Salmonella infection among children up to 60 months of age admitted to a rural hospital in western Zaire was undertaken. Most children presented with fever but without any focus of infection which was difficult to distinguish clinically from falciparum malaria. The majority (83%) of the infections were due to serotypes other than S. typhi. Infection with these serotypes was clinically indistinguishable from S. Typhi infection and was associated with a comparably high case fatality rate of 23%. Death was significantly associated with age under 6 months (relative risk 1.7), meningitis (RR 4.7), jaundice (RR 2.5), severe anaemia (RR 1.8), contracting disease in the late wet season when malnutrition peaks (RR 2.6) and infection with a chloramphenicol-resistant isolate (RR 3.2). The increasing prevalence of antibiotic resistance and HIV infection will complicate the management of this disease in the future.

Age Factors↗
PubMed1990

Metastatic pneumococcal endophthalmitis: report of two cases and review of literature.

Two patients with pneumococcal bacteraemia complicated by endophthalmitis are described. While this condition appears to have been relatively common in the preantibiotic era, a review of the literature since 1950 only identified six additional case reports. Analysis of these eight cases reveals two patterns: unilateral disease in six patients and bilateral disease with simultaneous onset in two patients. The potential pathogenic mechanisms--direct bacterial invasion or immunologically mediated processes--are discussed in relation to these clinical presentations. The critical importance of seeking ophthalmological advice early in the course of the disease is emphasised, as the risk of visual loss with systemic antimicrobials alone is very high, particularly if the infective process involves the vitreous humour.

Ampicillin↗