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S J O'Brien

Publications and source records attributed to S J O'Brien.

At least 37 records · Page 2Linked to original sources

A European outbreak of Salmonella enterica serotype Typhimurium definitive phage type 204b in 2000.

OBJECTIVE: To describe the clinical, epidemiologic and microbiological features of a large outbreak of infection with a multiresistant Salmonella enterica serotype Typhimurium definitive type DT204b infection involving at least 392 people in five European countries. METHODS: Icelandic public-health doctors responded to a report on an Internet news site of an outbreak of infection with a multiresistant strain of Typhimurium DT104 in England by contacting the Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC). An international alert was sent out through Enter-net. All strains from England & Wales, The Netherlands, Scotland and Germany, and 17 of the outbreak isolates from Iceland, were phage-typed, screened for antimicrobial resistance, and subjected to molecular typing. Hypothesis-generating interviews were conducted, followed by case-control studies performed in Iceland and England. RESULTS: Isolates from cases in Iceland, England and Wales, The Netherlands, Scotland and Germany were identified as Typhimurium DT204b. The antimicrobial resistance pattern was ACGNeKSSuTTmNxCpL. All strains tested displayed an identical plasmid profile. Strains from five cases in England & Wales and five cases in Iceland possessed identical pulsed-field profiles. Although a common source was suspected, only Iceland implicated imported lettuce as a vehicle, with an analytic epidemiologic study (OR = 40.8; P = 0.005; 95% CI 2.7-3175). CONCLUSION: The identification of international outbreaks, necessary for investigation and control, can be facilitated by standardized phage-typing techniques, the electronic transfer of molecular typing patterns, formal and informal links established through international surveillance networks, and the early reporting of national outbreaks to such networks.

Adolescent↗

General outbreaks of infectious intestinal disease (IID) in hospitals, England and Wales, 1992-2000.

Between 1992 and 2000, 26.6% (1,396/5,257) of all general outbreaks of infectious intestinal disease (IID) reported to the Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC) occurred in hospitals. Over 29,000 patients and staff were affected and the mortality risk was higher than for outbreaks in other settings [relative risk 2.00 (95% CI: 1.52-2.63) P<0.001]. Person-to-person spread was the predominant mode of transmission. The mortality risk was highest in foodborne disease outbreaks [relative risk 3.22 (95% CI: 1.41-7.36); P=0.003]. Most outbreaks occurred between November and April. The pathogens most frequently reported were Norwalk-like virus (NLV) (54%) and Clostridium difficile (12.6%). These findings emphasize the public health importance of outbreaks of IID in hospitals, especially during the winter when pressures on hospitals are at their height.

Caliciviridae Infections↗

What can analysis of calls to NHS direct tell us about the epidemiology of gastrointestinal infections in the community?

OBJECTIVES: Most gastrointestinal (GI) illness within the UK goes undetected by routine surveillance. A national telephone helpline for health advice (NHS Direct) offers a new source of data on GI infection. We aim to describe NHS Direct calls suggestive of GI infection and the outcome of these calls. METHODS: Details of over 150000 telephone calls were collected from NHS Direct over a 6-month period. Calls about 'diarrhoea', 'vomiting' or 'food poisoning' were defined as GI calls and described according to the age of the patient and call outcome. RESULTS: Gastrointestinal calls accounted for 10.3% of total calls ('diarrhoea'=4.9%, 'vomiting'=5.1%). GI calls as a proportion of total calls were significantly high in children under 1 year (23.5%) and aged 1-4 years (21.5%). Call outcomes which resulted in further NHS care being recommended accounted for 72.3% of total calls and 54.5% of GI calls. CONCLUSIONS: A high proportion of NHS Direct calls were about GI symptoms especially for children under 5 years. When compared with all NHS Direct calls, GI calls were less likely to result in further NHS care being recommended. Analysis of NHS Direct calls provides further insight into GI infection in the community.

Adolescent↗

Radiation hybrid mapping of 304 novel microsatellites in the domestic cat genome.

Effective utilization of the domestic cat as an animal model for hereditary and infectious disease requires the development and implementation of high quality gene maps incorporating microsatellites and conserved coding gene markers. Previous feline linkage and radiation hybrid maps have lacked sufficient microsatellite coverage on all chromosomes to make effective use of full genome scans. Here we report the isolation and genomic mapping of 304 novel polymorphic repeat loci in the feline genome. The new loci were mapped in the domestic cat radiation hybrid panel using an automated fluorescent TAQ-Man based assay. The addition of these 304 microsatellites brings the total number of microsatellites mapped in the feline genome to 580, and the total number of loci placed onto the RH map to 1,126. Microsatellites now span every autosome with an average spacing of roughly one polymorphic STR every five centimorgans, and full genome coverage of one marker every 2.7 megabases. These loci now provide a useful tool for undertaking full-genome scans to identify genes associated with phenotypes of interest, such as those relating to hereditary disease, coat color, patterning and morphology. These resources can also be extended to the remaining 36 species of the cat family for population genetic and evolutionary genomic analyses.

Animals↗

Point source outbreaks of Campylobacter jejuni infection--are they more common than we think and what might cause them?

Despite being the commonest bacterial cause of infectious intestinal disease (IID) in England and Wales, outbreaks of campylobacter infection are rarely reported. However, data from the Campylobacter Sentinel Surveillance Scheme suggested that outbreaks might be more common than was previously suspected, since a high proportion of cases reported other illness in the home or in the community at the same time as their illness. To identify factors that might lead to these apparent outbreaks, the exposures of cases of Campylobacter jejuni infection reporting other illness, either in the home or the community, were compared with those for cases not reporting other illness using case-case methodology. Illness in the home was associated with consuming organic meats in the winter, having contact with a pet suffering from diarrhoea or visiting a farm in the 2 weeks before the onset of symptoms. Illness in the community was associated with the consumption of foods in restaurants or drinking unpasteurized milk. Prevention of campylobacter infection requires that better methods of outbreak detection and investigation are developed, which in turn should lead to a better understanding of risk factors.

Adolescent↗

Milkborne general outbreaks of infectious intestinal disease, England and Wales, 1992-2000.

From 1 January 1992 to 31 December 2000, 27 milkborne general outbreaks of infectious intestinal disease (IID) were reported to the Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC). These outbreaks represented a fraction (2%) of all outbreaks of foodborne origin (N = 1774) reported to CDSC, but were characterized by significant morbidity. Unpasteurized milk (52%) was the most commonly reported vehicle of infection in milkborne outbreaks, with milk sold as pasteurized accounting for the majority of the rest (37%). Salmonellas (37%), Vero cytotoxin-producing Escherichia coli (VTEC) O157 (33%) and campylobacters (26%) were the most commonly detected pathogens, and most outbreaks were linked to farms (67%). This report highlights the importance of VTEC O157 as a milkborne pathogen and the continued role of unpasteurized milk in human disease.

Animals↗

Public health implications of campylobacter outbreaks in England and Wales, 1995-9: epidemiological and microbiological investigations.

Although campylobacter has been the most commonly recognized bacterial cause of gastrointestinal infection in England and Wales since 1981, there are few reported campylobacter outbreaks. Of the 2374 general outbreaks of infectious intestinal disease reported to CDSC between 1995 and 1999, for which an aetiological agent was identified, campylobacter accounted for only 50 (2%). Foodborne transmission was identified in 35 outbreaks and the majority took place in commercial catering establishments; waterborne transmission was responsible for a further four outbreaks. Isolates of Campylobacter jejuni were referred for typing from 25 outbreaks. In 13 outbreaks all isolates were the same subtype, as defined by serotype and phage type, while in the remainder more than one campylobacter subtype was involved.

Adolescent↗

Surveillance of foodborne outbreaks of infectious intestinal disease in England and Wales 1992-1999: contributing to evidence-based food policy?

Between 1992 and 1999, a total of 1426 general outbreaks of infectious intestinal disease reported to the Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC) were described as foodborne. Where the evidence base to support the conclusions drawn was provided (66.3% of outbreaks) a combination of microbiological and analytical evidence was reported in 4% of outbreaks (60/1426); microbiological evidence alone in 10% of outbreaks (149/1426); analytical evidence alone in 23% of outbreaks (322/1426); microbiological evidence in combination with descriptive epidemiology in 3% of outbreaks (46/1426) and descriptive epidemiology alone in 26% of outbreaks (365/1426). Information supplied to CDSC by local investigators appears to be of varying quality and depth and may be influenced by the individual characteristics of outbreaks such as size and duration, outbreak setting, causative organism, vehicles of infection and time of year. These findings have implications for the use of these surveillance data in developing evidence-based food policy.

Communicable Diseases↗

Faecal genetic analysis to determine the presence and distribution of elusive carnivores: design and feasibility for the Iberian lynx.

Noninvasive methods using genetic markers have been suggested as ways to overcome difficulties associated with documenting the presence of elusive species. We present and assess a novel, reliable and effective molecular genetic technique for the unequivocal genetic identification of faeces from the endangered Iberian lynx (Lynx pardinus). From mitochondrial DNA (mtDNA) cytochrome b and D-loop region sequences, we designed four species-specific primers (for products 130-161 bp long) that were considered to be likely to amplify degraded DNA. We compared two DNA extraction methods, various DNA amplification conditions and the robustness and specificity of the primer pairs with 87 lynx samples from 5 potentially different lynx populations and with 328 samples of other carnivore species. The utility of the identification technique was tested with faeces of different ages, with faeces from controlled field experiments, and with faeces collected from locales with possible lynx populations from throughout the state of Andalusia, Spain (8052 km2). Faecal mtDNA extraction was more efficient using PBS wash of the faeces instead of a faeces homogenate. Our assay increased from 92.6 to 99% efficiency with a second amplification and a reduction in template concentration to overcome polymerase chain reaction (PCR) inhibition. Our assay never produced false positives, and correctly identified all lynx faeces. Of 252 faeces samples of unknown species collected throughout Andalusia, 26.6% (from three different areas) were classified as Iberian lynx, 1.4% showed evidence of PCR inhibition and 1.2% were of uncertain origin. This method has proven to be a reliable technique that can be incorporated into large-scale surveys of Iberian lynx populations and exemplifies an approach that can easily be extended to other species.

Animals↗

Trends in indigenous foodborne disease and deaths, England and Wales: 1992 to 2000.

BACKGROUND: Commitment to food safety is evidenced by high profile governmental initiatives around the globe. To measure progress towards targets, policy makers need to know the baseline from which they started. AIM: To describe the burden (mortality, morbidity, new presentations to general practice, hospital admissions, and hospital occupancy) and trends of indigenous foodborne disease (IFD) in England and Wales between 1992 and 2000. METHODS: Routinely available surveillance data, special survey data, and hospital episode statistics were collated and arithmetic employed to estimate the burden and trends of IFD in England and Wales. Adjustments were made for underascertainment of disease through national surveillance and for foreign travel. The final estimates were compared with those from the USA. RESULTS: In 1995 there were an estimated 2,365,909 cases, 21,138 hospital admissions, and 718 deaths in England and Wales due to IFD. By 2000 this had fallen to 1,338,772 cases, 20,759 hospital admissions, and 480 deaths. In terms of disease burden the most important pathogens were campylobacters, salmonellas, Clostridium perfringens, verocytotoxin producing Escherichia coli (VTEC) O157, and Listeria monocytogenes. The ratio of food related illness in the USA to IFD in England and Wales in 2000 was 57:1. Taking into account population rates, this ratio fell to 11:1 and converged when aetiology and disease severity were considered. CONCLUSION: Reducing IFD in England and Wales means tackling campylobacter. Lowering mortality rates however also requires better control and prevention of salmonellas, Cl perfringens, L monocytogenes, and VTEC O157.

Campylobacter Infections↗

General outbreaks of infectious intestinal disease linked with salad vegetables and fruit, England and Wales, 1992-2000.

Between 1992 and 2000, 1,518 foodborne general outbreaks of infectious intestinal disease (IID) were reported to the Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC), of which 83 (5.5%) were associated with the consumption of salad vegetables or fruit (SVF). The pathogens most frequently reported were salmonellas (41.0%) and Norwalk-like virus (NLV) (15.7%). In total 3,438 people were affected; 69 were admitted to hospital and one person died. Most outbreaks were linked to commercial catering premises (67.5%). Three community outbreaks, of Salmonella enterica serovar Typhimurium Definitive Phage Type (DT) 104, S. Typhimurium DT 204b and Shigella sonnei infection, were found to be associated with lettuce contaminated at source, and these accounted for 501 (14.6%) cases. The latter two outbreaks were international, involving several European countries. This demonstrates how contamination of SVF during production/processing can result in major, geographically widespread, outbreaks of infection with serious public health consequences.

Disease Outbreaks↗

Collaborative investigation of an outbreak of Salmonella enterica serotype Newport in England and Wales in 2001 associated with ready-to-eat salad vegetables.

In June 2001, as part of a microbiological study of bagged, ready-to-eat salad products, Salmonella enterica serotype Newport was isolated from a sample of pre-packed green salad distributed by a major supermarket retailer. The strain was characterised by phage typing, plasmid profile typing and pulsed-field gel electrophoresis. Other isolates of S. Newport from cases of human infection in England and Wales in the first six months of 2001 were similarly characterised. Of 60 strains from cases of human infection, 19 were found to be indistinguishable from that isolated from the salad product. This study highlights the benefits of an integrated approach to outbreak investigations, involving the various elements of the PHLS and the Food Standards Agency, and acknowledges the full co-operation of the retailer in ensuring the rapid withdrawal of the contaminated product.

Disease Outbreaks↗

Resolution of the early placental mammal radiation using Bayesian phylogenetics.

Molecular phylogenetic studies have resolved placental mammals into four major groups, but have not established the full hierarchy of interordinal relationships, including the position of the root. The latter is critical for understanding the early biogeographic history of placentals. We investigated placental phylogeny using Bayesian and maximum-likelihood methods and a 16.4-kilobase molecular data set. Interordinal relationships are almost entirely resolved. The basal split is between Afrotheria and other placentals, at about 103 million years, and may be accounted for by the separation of South America and Africa in the Cretaceous. Crown-group Eutheria may have their most recent common ancestry in the Southern Hemisphere (Gondwana).

Africa↗

Considering genetic profiles in functional studies of immune responsiveness to HIV-1.

Over the last two decades HIV-1 has spread worldwide and has now surpassed malaria as the leading cause of infectious disease mortality in adults (http://www.who.int/infectious-disease-report/pages/ch1text.html). The clinical course and outcome of HIV-1 infection are highly variable among individuals. Most individuals infected with HIV develop AIDS within 10 years. However about 1-5% remain relatively healthy for 15 years or more (long-term nonprogressors), while others progress to AIDS within the first 2-3 years after infection (rapid progressors). A small number of individuals are resistant to infection, while some individuals appear to eliminate the virus. Factors that influence susceptibility to infection and rate of disease progression are a combination of viral, host, and environmental determinants. With few exceptions, genetic resistance to infectious diseases is likely to involve a complex array of host genetic effects involving variants that have very subtle, but significant consequences on gene expression or protein function. We have gained considerable insight into the genetic effects on HIV-1 disease, yet we likely have uncovered only a fraction of the total picture. The greater our knowledge of various effects on HIV disease, the more likely we will be able to predict disease outcome on an individual-by-individual basis. While this may seem obvious, there is no standard practice of taking into account the genetic profile (i.e. genotypes at loci known to associate with rate of AIDS progression) of subjects used in functional studies of immune responsiveness to HIV-1. Here, we propose an approach for assessing overall genetic risk on an individual basis, and suggest that this information be considered when selecting comparison groups in studies of immune responses to HIV and/or in the interpretation of data derived from such studies.

Acquired Immunodeficiency Syndrome↗

Genetic evidence for two species of elephant in Africa.

Elephants from the tropical forests of Africa are morphologically distinct from savannah or bush elephants. Dart-biopsy samples from 195 free-ranging African elephants in 21 populations were examined for DNA sequence variation in four nuclear genes (1732 base pairs). Phylogenetic distinctions between African forest elephant and savannah elephant populations corresponded to 58% of the difference in the same genes between elephant genera Loxodonta (African) and Elephas (Asian). Large genetic distance, multiple genetically fixed nucleotide site differences, morphological and habitat distinctions, and extremely limited hybridization of gene flow between forest and savannah elephants support the recognition and conservation management of two African species: Loxodonta africana and Loxodonta cyclotis.

Africa↗