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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.18 (PDF file, 798 KB)

Archives | News Archives 2006: Page 1| 6 May 2005

News Archives: | 2006 | 2005 | 2004 | 2003

 

Infectious intestinal disease associated with farm visits

 

Following a large outbreak of cryptosporidiosis associated with a local zoo in Tayside Scotland (1), a number of outbreaks of infectious intestinal disease (IID) associated with farm visits in England have been reported recently to the Health Protection Agency Centre for Infections.

In an outbreak of cryptosporidiosis, four people were ill after feeding lambs at an open farm in County Durham. Furthermore, in an outbreak of Vero cytotoxin-producing Escherichia coli (VTEC) O157 infection, five people were ill following contact with a number of different animals at an open farm in Cambridgeshire.

Outbreaks of IID associated with contact with animals on farms are common at this time of year. Of 28 outbreaks of IID associated with animal contact on farms reported to national surveillance between 1992 and 2004, more outbreaks occurred in April compared with any other month (figure). Outbreaks of cryptosporidiosis occurred more often in springtime whereas outbreaks of VTEC O157 infection occurred more often in mid to late summer, especially in August.

Figure General outbreaks of IID associated with animal contact on farms, England and Wales: 1992-2004

 

Associations between cryptosporidiosis in spring and contact with lambs have been reported previously (2). The recent outbreaks reinforce the need for careful attention to hygiene and supervision of children when visiting farms, and the need for the provision of appropriate facilities, such as those for handwashing. Despite the two separate seasonal peaks of infection, care should be exercised throughout the year. Guidance on the control of VTEC O157 infections for farms open to the public (3) applies equally to most gastrointestinal pathogens.

References

 

1.Health Protection Scotland. HPS weekly report [serial online]26 April 2005 [cited 4 May 2005]; 39(16). Available at: <http://www.show.scot.nhs.uk/scieh/PDF/weekly_report.pdf>.


2.HPA. Cryptosporidiosis associated with farm visits. Commun Dis Rep CDR Wkly 2004 [cited 27 April 2005]; 4(16):News. Available at
<http://www.hpa.org.uk/cdr/archives/CDR94/CDR1694.PDF>.

3.Subcommittee of the PHLS Advisory Committee on Gastrointestinal Infections. Guidelines for the control of infection with Vero cytotoxin producing Escherichia coli (VTEC). Subcommittee of the PHLS Advisory Committee on Gastrointestinal Infections. Comm Dis Public Health; 3(1):14-23. Available at: <http://www.hpa.org.uk/cdph/issues/CDPHVol3/no1/CDPHv3n1.htm>.

 

 

New legislation to control avian influenza in poultry in Europe proposed by Commission

 

The European Commission (EC) has proposed legislation to prevent and control outbreaks of avian influenza in poultry in Europe. If approved, the legislation would require European Union member states to introduce or reinforce surveillance and control measures against these viruses which are generally of low pathogenicity (1,2).

This proposed Directive would replace existing legislation from 1992 (3), which enforces control measures for highly pathogenic influenza viruses only. Evidence from outbreaks since 1997, however, suggests that highly pathogenic viruses might develop from viruses with lower pathogenicity, as was demonstrated most recently during the A/H7N3 outbreak in Canada (4). If such a virus then developed the characteristics to transmit from birds to humans, and also transmit efficiently from human to human, and the general population had little or no immunity to the virus subtype, it might be able to cause an influenza pandemic.

The new legislation would require surveillance and control measures in domestic poultry, although viruses of low pathogenicity cannot be eradicated from wildfowl such as ducks and geese. It is hoped that this would reduce the occurrence of low pathogenic avian influenza in poultry and thereby the chances of the emergence of highly pathogenic avian influenza virus. The Community Reference Laboratory for Avian Influenza at the Veterinary Laboratories Agency in the United Kingdom would collate all serological and virological results of surveillance, and the Commission and member states would revise surveillance plans based on the laboratory’s findings.

Both protective and emergency vaccination are covered extensively in the proposed legislation. Vaccination would be strictly monitored, and strategies would allow differentiation between vaccinated and unvaccinated flocks, and it is hoped that the impact on trade of birds and eggs would be minimal. Funding for the new measures is expected to come from the EU Veterinary Fund, and if approved, the Directive will come into force in January 2007, replacing the current Directive.

The EC continues to provide emergency technical and financial support to the Asian countries in coordination with the World Health Organization, the Food and Agriculture Organization of the United Nations and the World Organisation for Animal Health (OIE), although eradication of avian flu in Asia is not currently a realistic short-term objective.

References

 

1.European Commission. Proposal for a COUNCIL DIRECTIVE on Community measures for the control of Avian Influenza. Proposal for a COUNCIL DECISION amending Council Decision 90/424/EEC on expenditure in the veterinary field (presented by the Commission) {SEC(2005)549}. Brussels: Commission of the European Communities, 28 April 2005. Available at <http://europa.eu.int/comm/food/animal/diseases/controlmeasures/avian/directive_avian_en.pdf>.

2.European Commission. Avian Influenza: commission proposes updated measures aimed at preventing epidemics. (Press release) IP/05/501. Brussels: European Commission, 28 April 2005. Available at <http://europa.eu.int/rapid/pressReleasesAction.do?reference=IP/05/501&format=
HTML&aged=0&language=EN
>.

 

3.European Commission. Council Directive 92/40/EEC of 19 May 1992 introducing Community measures for the control of avian influenza. Official Journal of the European Communities 1992; L 167: 1-16. Available at <http://europa.eu.int/eur-lex/lex/LexUriServ/LexUriServ.do?uri=CELEX:31992L0040:EN:HTML>.

4.Hirst M, Astell CR, Griffith M, Coughlin SM, Moksa M, Zeng T, et al. Novel avian influenza H7N3 strain outbreak, British Columbia. Emerg Infect Dis 2004; 10(12): 2192-5. Available at <http://www.cdc.gov/ncidod/EID/vol10no12/04-0743.htm>.

 

 

 Xenotransplantation – WHO advisers stress need for adequate controls and surveillance of microbial risks in all   countries

 

An advisory group of international experts met recently at the World Health Organization (WHO) to discuss progress made in xenotransplantation (1).

Recent experiments have shown that the transplantation of organs from genetically modified pigs into baboons can yield moderate to good results and has raised hopes of future success of xenotransplantation (i.e. the transplant of animal organs, tissues, or cells into humans).

Treatments for diabetes or neurodegenerative disorders such as Parkinson's disease have also produced some potentially promising results. Only a few simple established procedures such as the treatment of severe burns with human skin cells cultured with mouse cells are currently in clinical use, and all other uses of xenotransplantation are still in research stages.

It has been recognised for many years that the major risk associated with xenotransplantation (assuming the risks to the recipient of rejection of the transplant can be adequately managed) is the transmission of diseases, and that sensitive global surveillance systems are needed (2,3). Once a pathogen (possibly benign in the donor animal species) is introduced into a human recipient, it may cause disease in the recipient, and may spread from that individual to cause disease in the general population. For pig to human transplants, the many porcine endogenous retroviruses (PERVs) constitute a particular threat.

The potential for such risks led the member states of WHO to adopt a resolution addressing xenotransplantation in 2004. The resolution urged member states ”to allow xenotransplantation only when effective national regulatory control and surveillance mechanisms overseen by National Health Authorities are in place”.

The WHO advisory group and experts have reviewed practice and concluded that xenotransplantation performed in some countries may pose unacceptable infectious public health risks, and that stronger measures need to be put in place to stop the illegal performance of xenotransplantation and to promote harmonized quality and safety controls. International oversight and cooperation was highlighted as of paramount importance in ensuring high standards for xenotransplantation globally, and protection of all populations from the associated risk of emerging infections.

A revised action plan has been proposed to assist member states to implement the WHO resolution by:

• updating a compendium of guidelines and recommendations for national health authorities and regulatory bodies to deal with xenotransplantation;
• improving methods for the collection and dissemination of information on xenotransplantation practices – successes and potential risks;
• raising greater awareness among national health authorities and promoting high ethical standards and well regulated practices.

References

 

1.WHO. Animal to human transplantation — future potential, present risk (press release). Geneva: WHO, 2 May 2005. Available at:
<http://www.who.int/mediacentre/news/notes/2005/np08/en/index.html>.

2.WHO, CSR [online]. Guidance on xenogeneic infection/disease surveillance and response: a strategy for international cooperation and coordination. WHO/CDS/CSR/EPH/2001.2. Geneva: WHO, February 2001. Available at
<http://www.who.int/emc-documents/zoonoses/whocdscsreph20012c.html#english%20contents>.

3.WHO. OECD/WHO consultation on xenotransplantation surveillance: summary report WHO/CDS/CSR/EPH/2001.1. Geneva: WHO, January 2001. Available at:
<http://www.who.int/emc-documents/zoonoses/docs/whocdscsreph20011.pdf>.