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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.20 (PDF file, 952 KB)

Archives | News Archives 2006: Page 1| 19 May 2005

News Archives: | 2006 | 2005 | 2004 | 2003

Lymphogranuloma venereum in the UK - an update

 

The Health Protection Agency launched an initiative to raise awareness and improve the diagnosis and surveillance of Lymphogranuloma venereum (LGV) in men who have sex with men (MSM) in England in October 2004 (1). This was extended to include the rest of the United Kingdom in January 2005, following publication of the initial results from enhanced surveillance (2,3). A UK Incident Group was also established at this time.

Since January 2005 the number of confirmed cases has continued to rise. To date, 72 cases have been confirmed in MSM, all serovar L2. Cases have mainly been diagnosed in London (51). Other regions with cases include the South East (10), North West (3), West Midlands (2), South West (1), and East of England (1). There were also four cases in Scotland . Although enhanced data remain provisional, there are various features of the current outbreak that are of note:

Preliminary reports suggest HIV infection (two cases) and hepatitis C infection (one case) may have been acquired at the same time as LGV. With numbers continuing to rise it is an opportune time for local Health Protection Units to establish or build on their working relationships with genitourinary clinics, gastroenterologists, and other clinicians in their regions. This will help to ensure a high index of suspicion is maintained and LGV cases are detected, treated, and reported promptly. Lymphogranuloma venereum is a sexually transmitted disease caused by a specific type of Chlamydia trachomatis (serovars L1, L2, and L3). The symptoms oF LGV vary according to the site of infection.



References

 

1.HPA. Enhanced surveillance of Lymphogranuloma Venereum starts in England . Commun Dis Rep CDR Wkly [serial online] 2004 [cited 17 May 2005]; 14 (41): News. Available at <http://www.hpa.org.uk/cdr/archives/2004/cdr4104.pdf>.

2.Initial results of enhanced surveillance for lymphogranuloma venereum in England . Commun Dis Rep CDR Wkly [serial online] 2005 [cited 17 May 2005]; 15 (4): News. Available at <http://www.hpa.org.uk/cdr/archives/2005/cdr0405.pdf>.

3.Health Protection Scotland (McMillan A). Lymphogranuloma venereum proctitis in Edinburgh . HPS Weekly Report 2005; 39 (6): 37. Available at <http://www.show.scot.nhs.uk/scieh/PDF/pdf2005/0506.pdf>.

 

 

Report published on the benefits of vaccination to children's health

 

The Health Protection Agency has published a report, Protecting the health of England 's children: the benefit of vaccines. This is the Agency's first national report on the current status of universal vaccine programmes in the United Kingdom , which aim to protect children against a variety of common childhood infectious diseases including measles, mumps, rubella, and meningitis. The report was produced by the Immunisation Department, based at the Centre for Infections (CfI).

The report in intended to be an important source of information for both the public and healthcare professionals on the monitoring and control of vaccine preventable diseases and the introduction of new vaccines.

The report aims to:

The report is available on the HPA website at: <http://www.hpa.org.uk/hpa/publications/publications.htm>.

For further details about this report contact the CfI Immunisation Department, email: <immunisationreport@hpa.org.uk>.

 

 

The prevalence of proline iminopeptidase negative N. gonorrhoeae throughout England and Wales

 

The enzyme proline iminopeptidase (Pip) is used in clinical microbiology as a marker for the detection of N. gonorrhoeae , with all commercially available biochemical test kits requiring the presence of this enzyme for the unambiguous identification of this pathogen. Although previous reports have highlighted the presence of Pip-negative N. gonorrhoeae isolates, the overall prevalence of these strains was unknown.

A total of 2056 representative isolates from 26 centres throughout England and Wales were submitted to the Sexually Transmitted Bacteria Reference Laboratory for testing. Upon receipt, identity was confirmed using N. gonorrhoea e specific monoclonal antibodies and Pip status was established using the Gonochek II kit (Key Scientific).

The overall prevalence of Pip negative N. gonorrhoeae was found to be 4.52%, with significant geographical variation observed in the frequency of Pip negative isolates submitted from centres outside of London (p <0.001). The highest prevalence of Pip-negative isolates is in Cambridge , Brighton, and Bristol . In contrast, no Pip negative isolates were submitted from eight outer London centres including: Cardiff , Gloucester , Luton, Newcastle , Newport , Northampton , Reading , and Wolverhampton . Interestingly, prevalence variation was also observed within London , between the nine different submitting centres (p < 0.025), to a lesser but still significant degree.

The high prevalence and widespread distribution of Pip-negative N. gonorrhoeae is a very serious cause for concern. It is essential that laboratories using biochemical test kits which rely solely on the presence of the Pip enzyme ( eg , Neisseria Preformed Enzyme test and Gonochek II) ensure that any negative cultures examined, are followed up using an alternative method, preferable immunological such as Phadebact Monoclonal GC Test (Boule), MicroTrak N. gonorrhoeae Culture Confirmation Test (Trinity Biotech plc). GonoGen II Test . Any questions regarding these isolates please contact the Sexually Transmitted Bacteria Reference Laboratory (020 8327 6464 or stbrl@hpa.org.uk ).

 

Creation of the new Travel and Migrant Health Section

 

Migration and travel play a key role in determining and changing the epidemiology of infectious diseases. In May 2005, the Travel Health Surveillance section of the Centre for Infections (CfI) (set up in 2003 as part of the National Travel Health Network and Centre) has expanded to form the Travel and Migrant Health section. This change is in response to a perceived need for more information about migrant health and the recognised overlap between travel and migration.

The broad ethos of the Travel and Migrant Health section is to contribute to the health of British travellers, and migrants to the England , Wales and Northern Ireland , through surveillance, information, advocacy, teaching, and research. The new section is headed by a consultant epidemiologist, Jane Jones, and includes a travel scientist, Joanne Lawrence and migration scientist, Ruth Gilbert. Administrative support for the section is provided by Carol Taylor.

Many departments at the CfI and throughout the Health Protection Agency collect data on diseases that may affect both travellers and the migrant population. For the last two years, the Travel Health Surveillance section has worked closely with these departments and other external agencies to produce regular and timely reports on travel health. The expanded Travel and Migrant Health section aims to further develop and extend these existing collaborative links and to additionally report on migrant health. It will also examine ways to improve surveillance of infections in travellers and migrants, and develop other approaches to understanding their health needs. An advisory steering committee will ensure that the work undertaken by the section is in keeping with the aims and needs of the organisation, and facilitate effective collaboration with other relevant parts of the Health Protection Agency. The section can be contacted at <TMHS@hpa.org.uk>.

Preliminary virological investigations have also identified differences between influenza H5N1 genes from affected areas, suggesting that they are becoming increasingly antigenically diverse. WHO stated that, as yet, these findings are not fully clear, although they do indicate that the viruses are evolving and are continuing to pose a potentially growing pandemic threat. In response to the concern generated by these findings, they have recommended that steps be taken to complete pandemic preparatory actions in all countries and accelerate the control of avian influenza in poultry in those countries affected.

WHO's full assessment of the current situation can be found at:

<http://www.who.int/csr/disease/avian_influenza/H5N1%20Intercountry%20Assessment%20final.pdf>.

 

Changes in influenza A (H5N1) epidemiology discussed by World Health Organization

 

The World Health Organization (WHO) has organised an inter-country consultation in Manila to discuss the implications of an apparent change in the epidemiology of Influenza A (H5N1) infection in Asia . These changes became apparent during investigations into cases of human infection in northern Viet Nam earlier this year. Concerns were raised as these changes are consistent with those expected when recently emerging influenza viruses become increasingly infectious for humans.


The observed changes included the following:

Preliminary virological investigations have also identified differences between influenza H5N1 genes from affected areas, suggesting that they are becoming increasingly antigenically diverse. WHO stated that, as yet, these findings are not fully clear, although they do indicate that the viruses are evolving and are continuing to pose a potentially growing pandemic threat. In response to the concern generated by these findings, they have recommended that steps be taken to complete pandemic preparatory actions in all countries and accelerate the control of avian influenza in poultry in those countries affected.

WHO's full assessment of the current situation can be found at:

<http://www.who.int/csr/disease/avian_influenza/H5N1%20Intercountry%20Assessment%20final.pdf>.