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L R Ward

Publications and source records attributed to L R Ward.

At least 55 records · Page 3Linked to original sources
PubMed1996

International epidemiological and microbiological study of outbreak of Salmonella agona infection from a ready to eat savoury snack--I: England and Wales and the United States.

OBJECTIVES: To identify the source of an international outbreak of food poisoning due to Salmonella agona phage type 15 and to measure how long the underlying cause persisted. DESIGN: Case-control study of 16 primary household cases and 32 controls of similar age and dietary habit. Packets of the implicated foodstuff manufactured on a range of days were examined for salmonella. All isolates of the epidemic phage type were further characterised by pulsed field gel electrophoresis. RESULTS: 27 cases were identified, of which 26 were in children. The case-control study showed a strong association between infection with S agona phage type 15 and consumption of a peanut flavoured ready to eat kosher savoury snack imported from Israel. S agona phage type 15 was isolated from samples of this snack. The combined food sampling results from the United Kingdom, Canada, the United States, and Israel showed that contaminated snacks were manufactured on at least seven separate dates during a four month period between October 1994 and February 1995. Voluntary recalls of the product successfully interrupted transmission. CONCLUSIONS: Rapid international exchanges of information led to the identification of the source of a major outbreak of S agona in Israel and of associated cases in North America. The outbreak showed the value of the Salm-Net surveillance system and its links outside Europe, both for increasing case ascertainment and for improving the information on the duration of the fault at the manufacturing plant.

Case-Control Studies↗
PubMed1996

Epidemiological application of differentiating multiresistant Salmonella typhimurium DT104 by plasmid profile.

Human isolates of multiresistant Salmonella typhimurium definitive phage type (DT) 104 in England and Wales are currently second in number only to those of S. enteritidis phage type 4. Differentiation of strains is essential in epidemiological investigations and the value of one method, plasmid profile typing, has been assessed in a study of 600 isolates of S. typhimurium DT 104 with multiresistant antibiograms (R-types) ACSSuT, ACSSuTCp and ACSSuTTm from humans, food animals, human food, pets, and animal feed made in England and Wales from January 1990 to April 1996. Twenty plasmid profile (PP) types have been identified in isolates of R-type ACSSuT and ACSSuTCp. One profile type, with a single plasmid of 60 megadaltons-PP type A-has predominated, but identification of PP type has proved useful in some epidemiological investigations. A further four PP types have been identified in isolates of DT 104 R-type ACSSuTTm, in which resistance to trimethoprim is encoded by a plasmid of 4.6 megadaltons and the two commonest PP types are related to those also common in DT 104 R-type ACSSuT. Methods of differentiating within the commonest profile type are now needed.

Animals↗
PubMed1996

Outbreaks of salmonellosis in hospitals in England and Wales: 1992-1994.

Data from the surveillance scheme of general outbreaks of infectious intestinal disease in England and Wales were used to describe the epidemiology of outbreaks of salmonellosis in hospitals from 1992-1994. Outbreaks of infectious intestinal disease in hospitals accounted for 15% (189/1275) of all outbreaks. A salmonella was the implicated pathogen in 12% (22/189). The mode of transmission was described as mainly person to person in 12 outbreaks, mainly foodborne in eight and equal or unknown proportions of foodborne and person to person in two. The most common strain involved was Salmonella enteritidis PT4 (11 outbreaks). The mean duration of outbreaks was 16 days. The mean attack rate in patients was 25% but varied from 2-67%. Illness was reported in 260 patients, of whom 130 had a laboratory confirmed infection. Eight hundred and twenty-six asymptomatic patients were tested, 31 of whom were positive. The salmonella infection was believed to have contributed to the deaths of five patients. Ill staff (115) were tested and 68 were positive; 1508 well staff were tested and 33 were positive. Outbreaks of salmonellosis in hospitals are preventable. Attack rates can be high and outbreaks are often prolonged, with high morbidity and associated disruption of hospital services. There is need for effective infection control policies, appropriate training of staff, simple surveillance systems and readily available expert advice to ensure outbreaks are rapidly controlled.

Cross Infection↗
PubMed1996

Salmonella virchow PT 26 infection in England and Wales: a case control study investigating an increase in cases during 1994.

An increase in the number of human isolates of Salmonella virchow phage type (PT) 26 in England and Wales during 1994 was investigated. A national case control study was conducted which included 88 cases and 182 controls. The cases were mostly young adults (median age 26) and 13 (15%) were admitted to hospital. Acquisition of S. virchow PT 26 was associated with the consumption of any chicken (OR 2.5, CI 1.1-5.8), of chicken curry from restaurants and take aways (OR 2.9, CI 1.4-6.1), and of some other diverse types of pre-prepared chicken (OR 3.8, CI 1.9-7.6). Halal chicken was associated (P = 0.006) with illness in a subset. There were negative associations with contact with animals (OR 0.47, CI 0.23-0.95) and with the consumption of chicken cooked whole (OR 0.37, CI 0.21-0.66). The increase in S. virchow PT 26 may be due to changing epizoology and may be an indicator of what will become the dominant salmonella strain in poultry in future years. The increasing incidence of S. virchow PT 26 is of particular concern because of its association with more invasive disease in humans.

Adolescent↗
PubMed1996

Plasmid characterization and pulsed-field electrophoretic analysis demonstrate that ampicillin-resistant strains of Salmonella enteritidis phage type 6a are derived from Salm. enteritidis phage type 4.

Plasmid incompatibility studies have demonstrated that strains of Salmonella enteritidis phage type (PT) 6a resistant to ampicillin possess a 36 megadalton incompatibility group (Inc) X plasmid coding for resistance to ampicillin which is capable of converting strains of Salm. enteritidis belonging to PTs 1 and 4 to PT 6a, and PT 8 to PT 13. However, pulsed-field gel electrophoresis (PFGE) has demonstrated that all clinical isolates of PT 6a have a characteristic XbaI pulsed-field profile which is distinct from that of PT 1 and which can only be differentiated from that of PT 4 by the presence of plasmid-associated fragments of less than 45 kb. It is concluded that ampicillin-resistant strains of Salm. enteritidis PT 6a are derived from strains of Salm. enteritidis PT 4 by acquisition of an Inc X ampicillin resistance plasmid.

Ampicillin↗
PubMed1995

Chaos under canvas: a Salmonella enteritidis PT 6B outbreak.

An outbreak of Salmonella enteritidis PT 6B food poisoning, the first reported of this recently described phage type, resulted in illness among 46 of 49 members of a camping group in North Wales, 33 of whom were hospitalized. Epidemiological evidence (P < 0.0001) indicated that a lemon meringue pie was the vehicle of infection. Fresh shell eggs, stored after purchase at ambient temperature, appear to be the most likely source of infection, with multiplication during preparation and subsequent storage of the pie a significant contributory factor. Campers may be at greater risk than others and should consider the use of cold boxes for the transport and storage of eggs, and avoid the preparation of lightly cooked egg products under these basic conditions.

Abdominal Pain↗
PubMed1995

Salmonella typhimurium DT 193: differentiation of an epidemic phage type by antibiogram, plasmid profile, plasmid fingerprint and salmonella plasmid virulence (spv) gene probe.

Of over 2000 isolates of Salmonella typhimurium DT 193 from humans examined in the 2 year period 1991-92, 93% were antibiotic-resistant with the most common R-types being ASSuT (38%) and T (29%). Fourteen plasmid profiles were identified in DT 193 R-type ASSuT with the majority of isolates being characterized by a single plasmid of 80 MDa (pDEP 34) which in addition to coding for ASSuT, also hybridized with a spv gene probe prepared from the 50 MDa Salm. dublin serovar-specific plasmid. On the basis of restriction fragment length polymorphisms, two variant lines of pDEP 34-like plasmids were identified and a third line which had lost the genes coding for resistance to ampicillin, streptomycin and sulphonamides, was recognized. Although 18 plasmid profile types were identified in DT 193 R-type T, all isolates carried a high mol. wt plasmid which coded for tetracycline resistance only. Further discrimination was achieved on the basis of hybridization of tetracycline resistance plasmids with the spv gene probe and restriction enzyme fingerprinting. These results demonstrate that Salm. typhimurium DT 193 can be rapidly subdivided by antibiogram and that further subdivision can be achieved on the basis of plasmid profile, plasmid fingerprint and hybridization with a spv gene probe.

Animals↗
PubMed1995

Chronic carriage of multidrug resistant Salmonella typhimurium in a cat.

Gastroenteritis caused by a multidrug-resistant Salmonella typhimurium was diagnosed in a 12-week-old kitten. Although the kitten recovered from the acute episode after seven days, it continued to shed salmonella in its faeces for a further 12 weeks. Carriage was finally cleared by administering a 14-day course of treatment with parenteral enrofloxacin. The public health implications of an infection and subsequent carriage in a cat of a salmonella strain known to cause illness in humans is discussed.

Animals↗
PubMed1994

A case control study of infection with an epidemic strain of multiresistant Salmonella typhimurium DT104 in England and Wales.

Laboratory reports of a multiresistant strain of Salmonella typhimurium definitive type (DT) 104 rose in 1993; this led the Public Health Laboratory Service to investigate cases and identify possible risk factors for infection. Information derived from questionnaires, and details of previous isolations of S. typhimurium DT104 from food and animals, were used to design an unmatched case control study. Eighty-three cases whose isolations were of the same plasmid profile type (the 'epidemic strain') and 235 controls were included in the analysis. Illness was independently associated with the consumption of several food items and contact with animals, particularly ill farm animals. The number of isolations of this organism continues to rise, and control measures may include reducing infection in animals used for food, reducing the risk of contamination at all stages of the food chain, and raising awareness of measures to prevent food poisoning among food handlers and the general public.

Adolescent↗
PubMed1994

Salmonella enteritidis phage types in Germany.

In order to monitor the epidemiological situation of S. enteritidis in Germany, in 1990-91 1138 isolates from more than 180 locations in West Germany were phage typed. 1124 strains (98.8%) from all sources were typeable, belonging to 21 different phage types (PT). PT4 strains were isolated most frequently (70.8%). In addition, PT7, 25, 34 and 8 were of epidemiological relevance with incidences of 7.2 to 4.5%. The comparison of data shows that in Germany, like in other parts of Europe, PT4 predominates. This phage type is, however, infrequent in North America, where PT8 has the highest incidence.

Animals↗
PubMed1994

Insertion sequence IS200 fingerprinting of Salmonella typhi: an assessment of epidemiological applicability.

When Pst I-generated digests of genomic DNA from each of the type strains of 49 of the Vi phage types of Salmonella typhi were probed with a PCR-amplified IS200 gene probe, all strains were found to possess at least 11 IS200 elements carried on fragments in the range 24.2-1.2 kb. Fourteen fingerprints were identified but two patterns designated IS200Sty1 and IS200Sty2 predominated. In one strain, a plasmid-mediated IS200 element was identified. When IS200 fingerprinting was applied to epidemiologically-unrelated strains of S. typhi isolated in Ecuador, 3 patterns were identified in 10 strains belonging to 9 different phage types. It is concluded that Vi phage typing remains the method of choice for the primary differentiation of S. typhi but that IS200 fingerprinting may be of limited use in laboratories which do not have access to phage typing.

Bacteriophage Typing↗
PubMed1994

Plasmid profile typing provides a method for the differentiation of strains of Salmonella enteritidis phage type 4 isolated in Turkey.

Five phage types have been identified in 38 strains of Salmonella enteritidis isolated in Turkey in the 20-month period June 1992-January 1994. Strains belonging to phage type 4 predominated. Within phage type 4, plasmid profile typing has proved a useful method of strain discrimination and has confirmed the identity of a putative outbreak involving canteen workers in an industrial complex.

Bacteriophage T4↗