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PubMed1996

A waterborne outbreak of hepatitis E virus transmission in southwestern Vietnam.

A hepatitis outbreak affecting primarily adults occurred in southwestern Vietnam, along the Hau river bordering Cambodia, in June and July 1994. One month after the outbreak, sera and epidemiologic information were collected from 150 subjects: 50 patient cases, 50 matched, healthy community controls, and 50 geographic controls living 50 km upriver. The prevalence of immunoglobulin G (IgG) to hepatitis E virus (HEV) was significantly (P < 0.001) higher (76%) among cases than among the matched (38%) and geographic (38%) control populations. Immunoglobulin M to HEV was detected by enzyme-linked immunosorbent assay and Western blot in 16% of sera collected from patients one month after the outbreak. Hepatitis E virus RNA was detected with the polymerase chain reaction in 6% of sera from patients; RNA was not detected in either control group. These results indicate that HEV was the etiologic agent responsible for the outbreak. Children were under-represented among clinical cases. River water served as the principal source for drinking and bathing among most (96%) of the case and control study populations. Boiling of drinking water was negatively associated (P < 0.05) with IgG anti-HEV seropositivity. Unusually heavy rainfall likely contributed to conditions that favored the outbreak. This is the first recognized outbreak of epidemic HEV transmission in Indo-China.

Adolescent↗
PubMed1990

Rapid control of a chancroid outbreak: implications for Canada.

From June to November 1987 an outbreak of chancroid occurred in Winnipeg, the first in more than 10 years; 14 people (9 men, 5 women) were involved. Nine of the cases were confirmed through culture. A control strategy was implemented in November 1987 that included presumptive treatment of genital ulcer disease with single-dose antimicrobial therapy, intensive tracing of contacts and treatment of asymptomatic sexual contacts. The origin of the outbreak was not determined, and an epidemiologic link between all the patients could not be demonstrated. The isolates were found to contain the same plasmid; this suggested that a single clone of Haemophilus ducreyi was responsible for the outbreak.

Adult↗
PubMed1990

Chancroid: results from an outbreak in Houston, Texas.

A recent (and continuing) epidemic of chancroid in Houston has included morphologic variation in the disease, including so-called dwarf, classic, giant, transient, follicular, phagedenic, and pseudogranuloma inguinale types. Most cases were clearly acquired by unprotected sexual encounters with local prostitutes. The strain of Haemophilus ducreyi responsible for this outbreak was relatively easily cultured on routine media; unexpected sensitivity of this strain to vancomycin rendered the recommended "selective" growth medium much less optimal for isolation. Therapeutic success uniformly followed the use of intramuscular ceftriaxone sodium; one case responded to oral ciprofloxacin hydrochloride.

Administration, Oral↗
PubMed1995

Outbreaks of foodborne infectious intestinal disease in England and Wales: 1992 and 1993.

We have analysed data from the surveillance scheme of general foodborne outbreaks of infectious intestinal disease in England and Wales reported to, or otherwise identified by, the PHLS Communicable Disease Surveillance Centre in 1992 and 1993. Data were available about 458 outbreaks, 197 (43%) in commercial catering premises (restaurants, cafés, hotels, public houses, and canteens), 77 (17%) associated with food prepared in private houses, and 58 (13%) in hospitals and residential institutions. Salmonellas and Clostridium perfringens were responsible for 340 outbreaks (74%) and no pathogen was identified in 55 outbreaks (12%). Organisms associated with the highest mean attack rates were Staphylococcus aureus (66%) and C. perfringens (53%). Eleven thousand people were reported to be il and 362 were admitted to hospital. There were 15 deaths, 13 of which were associated with salmonellosis. A specified food was suspected to be the vehicle of infection in 204 outbreaks (45%). Possible contributory factors were identified in 277 (61%), most commonly inappropriate storage, cross contamination, and inadequate heat treatment. Reducing the incidence of food poisoning will depend on concerted action on farms, in abattoirs and food processing plants, in wholesale and retail outlets, and in kitchens.

Disease Outbreaks↗
PubMed1989

RNA-electrophoresis as a typing method for nosocomial rotavirus infection in a special-care baby unit.

During January and February 1988 an outbreak of nosocomial rotavirus infection occurred in a special-care baby unit (SCBU). Seven infants were affected, of whom five had symptoms of diarrhoea. Typing by RNA electrophoresis (electropherotyping) demonstrated that a single rotavirus strain was responsible for the outbreak. The epidemic electropherotype was introduced by an infant with diarrhoea admitted directly into the SCBU from the community. Eight other electropherotypes were identified during January and February in patients with community-acquired rotavirus diarrhoea on other paediatric wards, but the outbreak strain occurred only on the SCBU. Electropherotyping is a useful and rapid method for tracing the epidemiology of hospital-acquired rotavirus infection.

Communicable Disease Control↗
PubMed2005

What Internet services would patients like from hospitals during an epidemic? Lessons from the SARS outbreak in Toronto.

BACKGROUND: International health organizations and officials are bracing for a pandemic. Although the 2003 severe acute respiratory syndrome (SARS) outbreak in Toronto did not reach such a level, it created a unique opportunity to identify the optimal use of the Internet to promote communication with the public and to preserve health services during an epidemic. OBJECTIVE: The aim of the study was to explore patients' attitudes regarding the health services that might be provided through the Internet to supplement those traditionally available in the event of a future mass emergency situation. METHODS: We conducted "mask-to-mask" surveys of patients at three major teaching hospitals in Toronto during the second outbreak of SARS. Patients were surveyed at the hospital entrances and selected clinics. Descriptive statistics and logistic regression models were used for the analysis. RESULTS: In total, 1019 of 1130 patients responded to the survey (90% overall response rate). With respect to Internet use, 70% (711/1019) used the Internet by themselves and 57% (578/1019) with the help of a friend or family member. Of the Internet users, 68% (485/711) had already searched the World Wide Web for health information, and 75% (533/711) were interested in communicating with health professionals using the Internet as part of their ongoing care. Internet users expressed interest in using the Web for the following reasons: to learn about their health condition through patient education materials (84%), to obtain information about the status of their clinic appointments (83%), to send feedback to the hospital about how to improve its services (77%), to access screening tools to help determine if they were potentially affected by the infectious agent responsible for the outbreak (77%), to renew prescriptions (75%), to consult with their health professional about nonurgent matters (75%), and to access laboratory test results (75%). Regression results showed that younger age, higher education, and English as a first language were predictors of patients' interest in using Internet services in the event of an epidemic. CONCLUSION: Most patients are willing and able to use the Internet as a means to maintain communication with the hospital during an outbreak of an infectious disease such as SARS. Hospitals should explore new ways to interact with the public, to provide relevant health information, and to ensure continuity of care when they are forced to restrict their services.

Attitude to Health↗
PubMed1992

[Virologic diagnosis of an outbreak of epidemic hemorrhagic conjunctivitis by an indirect immunofluorescence technique. Cuba.1989].

The causative agent of an hemorrhagic conjunctivitis outbreak was assessed through the study of 18 conjunctival exudates using the indirect immunofluorescence technique and isolation in cell culture of human embryo fibroblasts. In addition, 395 paired serum samples were studied and Enterovirus 70 was found to be responsible for the outbreak.

Antibodies, Viral↗
PubMed2006

Pandemic preparedness: pigs, poultry, and people versus plans, products, and practice.

Influenza pandemic preparedness planning is critical for reducing human suffering and negative effects on the economy and society. The Centers for Disease Control and Prevention (CDC) is working to ensure a rapid, efficient, and successful response to an outbreak if, when, and where it appears. The CDC's context for strategic planning is based on experiences with seasonal influenza and what is known about past influenza pandemics. From a public health perspective, pandemic preparedness can be achieved with a plan that builds a network of shared responsibility from the local to the global level, with a focus on saving lives with vaccines, antiviral drugs, medical supplies, containment, and communication.

Animals↗
PubMed2005

Genetic characterization of wild type measles virus isolated in Croatia during the 2003-2004 outbreak.

Viral epidemiology is determined by the movement of infected people within and between geographical areas. The genetic characterization of wild-type isolates combined with standard epidemiological methods may enable the identification of the source and transmission pathways and permit differentiation between indigenous and imported viruses. We investigated the genetic characteristics of the wild-type measles virus isolated in Croatia during a 2003-2004 outbreak. The results of this study indicate the presence of the D4 measles virus genotype in Europe. The isolated virus is closely related to virus isolates from the India-like subgroup of the D4 measles virus genotype. The virus responsible for this outbreak differs in the hemagglutinin gene sequence from other virus strains belonging to the D4 genotype. The hemagglutinin gene sequence also differs when compared to viruses from other genotypes that are known to circulate in Europe and from vaccine strains.

Croatia↗
PubMed2000

An outbreak of Eltor cholera in Aizwal town of Mizoram, India.

During the months of May, June and through early part of July 1994, an unusual occurrence of severe dehydrating watery diarrhoea cases and deaths were reported from Aizwal town, the capital of Mizoram, a North-Eastern state of India. Vibrio cholerae 01 biotype Eltor, the causative agent responsible for this outbreak, was isolated from 50.0% of hospitalised cases. The disease affected older children and adults more (52.9%) than younger children below five years of age. Vibrio cholerae 01 strains isolated were uniformly resistant to furazolidone and co-trimoxazole, which are commonly advocated in the treatment of cholera specially in children of developing countries. Emergence of such resistant strain is alarming and is of great public health importance.

Adolescent↗
PubMed2003

The complete genome sequence and analysis of Corynebacterium diphtheriae NCTC13129.

Corynebacterium diphtheriae is a Gram-positive, non-spore forming, non-motile, pleomorphic rod belonging to the genus Corynebacterium and the actinomycete group of organisms. The organism produces a potent bacteriophage-encoded protein exotoxin, diphtheria toxin (DT), which causes the symptoms of diphtheria. This potentially fatal infectious disease is controlled in many developed countries by an effective immunisation programme. However, the disease has made a dramatic return in recent years, in particular within the Eastern European region. The largest, and still on-going, outbreak since the advent of mass immunisation started within Russia and the newly independent states of the former Soviet Union in the 1990s. We have sequenced the genome of a UK clinical isolate (biotype gravis strain NCTC13129), representative of the clone responsible for this outbreak. The genome consists of a single circular chromosome of 2 488 635 bp, with no plasmids. It provides evidence that recent acquisition of pathogenicity factors goes beyond the toxin itself, and includes iron-uptake systems, adhesins and fimbrial proteins. This is in contrast to Corynebacterium's nearest sequenced pathogenic relative, Mycobacterium tuberculosis, where there is little evidence of recent horizontal DNA acquisition. The genome itself shows an unusually extreme large-scale compositional bias, being noticeably higher in G+C near the origin than at the terminus.

Aged↗
PubMed2004

[Outbreaks of acute schistosomiasis in Anhui province in 2003].

OBJECTIVE: To analyze the outbreak patterns of acute schistosomiasis in Anhui province in 2003. METHODS: The criteria of emergency event for schistosomiasis issued by the Ministry of Health were applled in this study. Epidemiological data of acute schistosomiasis outbreak in Anhui province in 2003 were collected, checked and analyzed. RESULTS: In 2003, there were 6 episodes of acute schistosomiasis outbreaks in Anhui which had met the criteria of being emergency events, issued by the Ministry of Health. The preplanning was initiated in 5 outbreaks to respond to the outbreaks of acute schistosomiasis. All of the acute schistosomiasis cases received timing treatment, except those misdiagnosed cases coming from the non-endemic areas. There were no deaths or follow-up cases during the outbreaks. Health education, preventive treatment for people living in high risk villages were conducted in order to timely control the epidemics of schistosomiasis. CONCLUSION: The implementation of preplanning has played an important role in early cases-finding, timing report and response to the outbreaks of acute schistosomiasis.

Adolescent↗
PubMed2006

Molecular and antigenic characterization of a Mycoplasma bovis strain causing an outbreak of infectious keratoconjunctivitis.

An unusually high incidence of infectious keratoconjunctivitis followed by pneumonia and arthritis was observed in beef calves of a managed herd. No Moraxella spp. or bacteria other than Mycoplasma spp. were obtained from conjunctival and nasal swabs. A strategy was designed for characterization of bovine mycoplasmas at species and strain level on the basis of a combination of molecular tools and the immunoblotting method. The strategy made it possible to rapidly assign the bacterium responsible for this outbreak to one of the phylogenetic clusters of bovine mycoplasmas delineated in this study and then to identify it as Mycoplasma bovis. The strain, designated Sar 1, showed a 100% 16S rDNA sequence identity with two European strains (120/81 and MC3386) isolated in Germany and Ireland, respectively, and hosts a vsp gene analog to the vspA, vsp422-4, and vsp422-8 genes of the M. bovis reference strain PG45T and of the field strain 422. The use of a cross-reactive rabbit serum developed against the Mycoplasma agalactiae immunodominant antigen P48 confirmed the molecular findings. The immunological response of calves against M. bovis was also investigated. This is the first report on the occurrence of M. bovis on the Island of Sardinia (Italy).

Animals↗
PubMed1978

An apparent outbreak of rickettsial illness in Costa Rica, 1974.

A focal outbreak of highly fatal disease occurred in eastern Costa Rica in 1974. No rickettsial spotted fevers have previously been reported in Costa Rica. Nevertheless, the available evidence points to an unidentified rickettsial pathogen, probably of the spotted fever group, as the agent responsible for this outbreak.

Adolescent↗
PubMed1989

Outbreak of cholera in Berasia block of Bhopal District in Madhya Pradesh.

Bhopal district, Madhya Pradesh has been considered to be free of cholera. In an outbreak of gastro-enteritis in Berasia block of Bhopal district, Cholera vibrio Inaba and Ogawa were isolated from 17.64 per cent of stool samples collected. Extreme insanitary conditions, large aggregation of uncontrolled population and probably consumption of infected ice candies were responsible for the outbreak of cholera.

Adolescent↗
PubMed1984

Two epizootics of lymphocytic choriomeningitis virus occurring in laboratory mice despite intensive monitoring programs.

Two epizootics of lymphocytic choriomeningitis virus in mice occurred within two months in one research facility consisting of several widely separated rooms. These outbreaks developed despite intensive institutional monitoring policies designed to prevent introduction and spread of lymphocytic choriomeningitis virus. Evidence derived from serological and virological assays and interviews with the concerned investigators suggested that a single transplantable tumor carried in mice may have been responsible for spread of the virus. However, the tumor was not contaminated with lymphocytic choriomeningitis virus at the time of its introduction into the mouse facility. The origin of the virus responsible for the outbreaks was not definitively established although data supported an hypothesis that the virus was introduced into the research facility by a wild or feral mouse. Virus spread from infected mice to humans did not occur, as measured by serological tests. However, a large and valuable animal facility was depopulated for safety reasons. Absorption of sera with lymphocytic choriomeningitis virus antigen proved a necessary and reliable method for confirming specificity of lymphocytic choriomeningitis virus fluorescence-positive reactions.

Animals↗