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Final Issue: Volume 16 Number 51

Published on: 21 December 2006

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News Archives

Last updated: Volume 15, No.7 (PDF file, 598 KB)

Archives | News Archives 2006: Page 1| 17 February 2005

News Archives: | 2006 | 2005 | 2004 | 2003

Outbreak of Salmonella Typhimurium DT104 infection in Scotland, England, and Wales: January to February 2005

 

Since the begining of January 2005, the Scottish Salmonella Reference Laboratory and the Health Protection Agency Laboratory of Enteric Pathogens (LEP) have confirmed 96 cases of Salmonella Typhimurium definitive phage type (DT) 104 infection in Scotland (26), England (66), and Wales (4). This phage type is resistant to ampicillin, chloramphenicol, streptomycin, sulphonamides, spectinomycin, and tetracyclines (R-type ACSSuSpT). In the same period in 2004, the LEP reported on 30 human isolates of S.Typhimurium DT 104 R-type ACSSuSpT.

Most of the cases in Scotland (23/26) live in the Lothian and Borders Health Board areas, while nearly half of cases in England and Wales (34/70) live in the north east and south east of England.

Cases range in age from four months to 70 years (median 24 years) and more females (60%) are affected than males. Onset dates range between 17 December 2004 to 31 January 2005, with most cases ill between 4 and 21 January 2005 (figure 1). Eleven cases are known to have received hospital treatment for their illness. Few cases have reported foreign travel in the period before illness.

Figure 1 Epidemic curve of Salmonella Typhimurium DT104 (R-type ACSSuSpT) cases in Scotland, England, and Wales by onset of illness between December 2004 and February 2005

*Total number of cases is 96, 73/96 with known onset dates.

About 2000 cases of S. Typhimurium infection are confirmed in Scotland, England, and Wales each year (1,2), with DT104 being the most common phage type and ACSSuSpT the most common resistance pattern and a majority of these strains are also characterised by a distinctive pulsed-field gel electrophoresis profile. In 2000, a national outbreak of S. Typhimurium DT104 ACSSuSpT infection occurred in England and Wales (3). The implicated strain possessed a 2.0 megadalton (MDa) plasmid in addition to the 60MDa plasmid that is common to many strains of S. Typhimurium. This additional plasmid is absent from the current outbreak strain. Environmental and epidemiological investigations are currently underway to identify the cause of the outbreak.

Reference

 

Influenza vaccine composition for northern hemisphere winter season 2005/2006

 

The composition of the influenza vaccine for the 2005/2006 season (northern hemisphere winter) was announced by the World Health Organization (WHO) in Geneva on 12 February 2005. This annual review of vaccine composition is necessary to match the vaccine with the changing viruses that are predicted to circulate during the 2005/2006 season, if the normal pattern of seasonal influenza continues. The vaccine will contain:

1. an A/New Caledonia/20/99 (H1N1)-like virus;
2. an A/California/7/2004 (H3N2)-like virus ;
3. a B/Shanghai/361/2002-like virus .

The WHO base their annual vaccine composition recommendation on those influenza viruses isolated and characterised by the WHO/National Influenza Centres, which are located in more than 80 countries. Along with this recommendation the WHO also provides the vaccine manufacturing industry with prototype strains for the seasonal vaccine and materials to ensure that global vaccine standards are met.

If a new pandemic strain of influenza A emerges, different circumstances would apply and it is unlikely that this vaccine would be effective. WHO is currently finalising a draft plan, which will be available in the near future <http://www.who.int/topics/influenza/en/>.

 

 

  Two cases of polio in Saudi Arabia

 

The composition of the influenza vaccine for the 2005/2006 season (northern hemisphere winter) was announced by the World Health Organization (WHO) in Geneva on 12 February 2005. This annual review of vaccine composition is necessary to match the vaccine with the changing viruses that are predicted to circulate during the 2005/2006 season, if the normal pattern of seasonal influenza continues. The vaccine will contain:

1. an A/New Caledonia/20/99 (H1N1)-like virus;
2. an A/California/7/2004 (H3N2)-like virus ;
3. a B/Shanghai/361/2002-like virus .

The WHO base their annual vaccine composition recommendation on those influenza viruses isolated and characterised by the WHO/National Influenza Centres, which are located in more than 80 countries. Along with this recommendation the WHO also provides the vaccine manufacturing industry with prototype strains for the seasonal vaccine and materials to ensure that global vaccine standards are met.

If a new pandemic strain of influenza A emerges, different circumstances would apply and it is unlikely that this vaccine would be effective. WHO is currently finalising a draft plan, which will be available in the near future <http://www.who.int/topics/influenza/en/>.

 

 The national register of hepatitis C infections with a known date of acquisition – call for study proposals

 

There have been two cases of polio in Saudi Arabia with onset dates in late 2004. One case was in Jeddah in November in a Sudanese child who had arrived two days earlier from the Sudan. The other case was in Mecca in December in a Nigerian child who had been living in Saudi Arabia for at least two years. At the moment there does not appear to be any evidence of transmission during the annual Hajj pilgrimage to Mecca which took place around 18 January 2005.

The risk to individual pilgrims is probably low as most would be immune due to past immunisation. Local clinicians and laboratories should, however, be aware of the possibility of polio in travellers returning from Saudi Arabia, in particular pilgrims, who have symptoms compatible with polio. The standard investigation method for such cases is a viral culture from a stool sample, but a range of other methods may be helpful in confirming or refuting the diagnosis. Any isolates of enterovirus and samples for enterovirus PCR can be referred to the Health Protection Agency’s Enteric, Respiratory, and Neurological Virus Laboratory (ERNVL) for further analysis (tel: 0208 327 6017, email: ernvl@hpa.org.uk).

Travellers to endemic and re-infected areas should continue to be advised to ensure their polio immunisation is up-to-date <http://www.nathnac.org/>.


Reference


1.Harris HE, Ramsay ME, Heptonstall J, Soldan K, Eldridge KP. The HCV National Register: towards informing the natural history of hepatitis C infection in the UK. J Viral Hep 2000; 7:420-7.


2.Harris HE, Ramsay ME, Andrews N, Eldridge KP. Clinical course of hepatitis C virus during the first decade of infection: cohort study. BMJ 2002;324:450-3.

3.Chief Medical Officer. Hepatitis C and blood transfusion lookback [PL CMO (95) 1]. London: HMSO, 1995.

 

Streptococcus halichoeri: a novel Lancefield group B streptococcus isolated from grey seals

 

In 1998, a national register of hepatitis C virus (HCV) infections with a known date of acquisition was established (1). The register was set-up to help inform the natural history of HCV-related disease in the United Kingdom (UK) (2), and now contains anonymous data for one of the largest cohorts of individuals with known-date HCV infections, with over 1120 registered patients. The majority of infections in the register are those that were acquired following transfusion of HCV-infected blood that was issued before the introduction of routine screening of the blood supply for HCV (3), but other routes of acquisition are represented.

In order to get maximum benefit from this national resource, the register steering group invites clinical and epidemiological researchers to submit proposals to access data held in the register. It is envisaged that a variety of studies might benefit from linkage with or access to the register, and proposals from all specialties and institutions are welcomed. Such studies are urgently needed to help determine the current and future burden of HCV-related disease on health care services, and to assess the impact of currently available treatments as well as those that may become available in the future.

Any researchers interested in applying for access to information held within the national register should contact the register
co-ordinator for a list of available data, and an application form. No data will be released that could identify individual patients directly or via linkage to other data. Any study proposals should then be submitted to the register co-ordinator for consideration by the steering group by Thursday, 31 March 2005. Contact Helen Harris (register co-ordinator) or Shirley Cole (research assistant): Immunisation Department, Communicable Disease Surveillance Centre (CDSC), Health Protection Agency, Centre for Infections, 61 Colindale Avenue, London, NW9 6EQ; tel: 020 8200 6868 ext 7676 (Wed-Friday) or ext 7906 (Mon-Fri); fax: 020 8200 7868; email: <helen.harris@hpa.org.uk>; or <shirley.cole@hpa.org.uk>.

Reference

1.Lawson PA, Foster G, Falsen E, Davison N, Collins MD. Streptococcus halichoeri sp. nov., isolated from grey seals (Halichoerus grypus). Int J Syst Evol Microbiol 2004; 54:1753-6.