Biomedical subjects
Publications and source records attributed to K A Cartwright.
Epidemiological evidence is summarized for associations of ABO blood group and secretor status with susceptibility to invasive disease due to capsulate organisms responsible for the majority of bacterial meningitis. Host-parasite interactions that might underly these findings are proposed and evidence to support or refute them provided.
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Gastroenteritis due to Salmonella montevideo occurred amongst guests attending two social functions held within 24 h, food for both having been provided by the same catering firm. Salmon was the most likely vehicle of infection in each case, although cross-contamination of other foods occurred. There were no deaths; four patients were admitted to hospital, one of whom underwent appendicectomy. A review of salmon-associated food-poisoning outbreaks suggests that fresh salmon is an infrequent cause of food poisoning in the United Kingdom. The two outbreaks described here resulted from a failure of simple kitchen hygiene measures at a time of high ambient temperatures. Some current cooking instructions for salmon are inadequate.
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In November 1986 a large-scale survey was undertaken in the Gloucestershire town of Stonehouse during an outbreak of meningococcal disease due to group B type 15 subtype P1.16 sulphonamide-resistant strains. There were 15 cases in Stonehouse residents during the 4 years from April 1983, an annual attack rate of 56.5 per 100,000. Four secondary cases occurred despite rifampicin prophylaxis. The objectives of this community survey were to investigate patterns of meningococcal carriage, transmission and immunity and to determine the proportion of non-secretors of blood group antigens in the Stonehouse population and amongst meningococcal carriers. A total of 6237 subjects participated including 75% of the 6635 Stonehouse residents. Over 97% of the participants provided all three of the requested specimens-nasopharyngeal swabs, saliva and blood samples. The co-operation between the many organizations involved in the detailed preliminary planning was instrumental in the success of the survey; in particular the value of effective collaboration between Departments of Community Medicine and Microbiology and of the Public Health Laboratory Service network of laboratories in undertaking investigations of this size and type was clearly demonstrated.
A total of 6234 nasopharyngeal swabs was collected during a survey of the population of Stonehouse, Gloucestershire in November 1986 as part of an investigation into an outbreak of meningococcal disease. The overall meningococcal carriage rate was 10.9%. The carriage rate rose with age from 2.1% in the 0- to 4-year-olds to a peak of 24.5% in the 15- to 19-year-olds, and thereafter declined steadily with age. Male carriers outnumbered female carriers of meningococci by 3:2. Group B (or non-groupable) type 15 sulphonamide-resistant strains which had caused the outbreak were isolated from 1.4% of subjects. The age distribution of carriers of these strains was similar to that of other meningococci apart from an additional peak in the 5-9-year age group and a more rapid decline in carriage with increasing age. Variations in the carriage rates of the outbreak strain were seen in children attending different schools and in the residents of different areas of the town. The low carriage rate of these strains in a community during a prolonged outbreak supports the hypothesis that these organisms are less transmissible but more virulent than other strains of pathogenic meningococci. Carriage of Neisseria lactamica, which is thought to be important in the development of meningococcal immunity, was most frequent in children under the age of 5 years and was six times commoner in this age group than carriage of Neisseria meningitidis. In older children and adults female carriers of N. lactamica increasingly outnumbered males in contrast to the male preponderance observed with meningococcal carriage.
Meningococci continue to cause outbreaks of disease throughout the world. The UK is currently experiencing an upsurge due to organisms of groups B and C. There is substantial under-reporting of meningococcal disease, only meningitis currently being notifiable. All significant meningococcal strains should be typed by a reference laboratory. New approaches to vaccine development permit cautious optimism for the future.
Between October, 1981, and March, 1986, there were 65 cases of meningococcal infection, about five times the expected number, in Gloucester Health District. The cases, mainly in teenagers and young adults, were clustered in the Stroud district and in the southern part of Gloucester City, and most were caused by a sulphonamide-resistant group B type 15 meningococcus. 2 patients died. Only 57% of meningitis cases were formally notified. 7 (11%) patients had septicaemia without meningitis, not a notifiable disease. All meningococcal disease should be made notifiable and meningococci should be serotyped routinely so that the epidemiology of the disease can be monitored before the introduction of suitable vaccines.
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Explore the source record for details and available documents.