Foodborne Snow Mountain Agent Gastroenteritis in a School Cafeteria

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 559-563
Author(s):  
Charles Guest ◽  
Kenneth C. Spitalny ◽  
H. Paul Madore ◽  
Katherine Pray ◽  
Raphael Dolin ◽  
...  

In 1984, an outbreak of gastroenteritis occurred at a school with 1,860 students in Brooklyn, NY. In a single-stage cluster sample of 375 students, 129 (34%) had illnesses that met our case definition of vomiting or diarrhea. The mean incubation period was 26 hours, and the mean illness duration was 24 hours. All case students had eaten in the cafeteria on at least one day between Nov 13 and 16, compared with 174/214 (81%) noncase students (P = 10-8, Fisher exact test). Foods implicated were french fries (relative risk 1.7, 95% confidence limits 1.4, 2.0) and hamburgers (relative risk 1.6, 95%, confidence limits 1.2, 2.1). Two cafeteria employees had served those foods while affected by diarrhea. By a recently developed blocking enzyme-linked immunosorbent assay, six of 11 (55%) case students showed fourfold antibody increases between acute-and convalescent-phase serum samples for Snow Mountain agent, a Norwalk-like virus, compared with one of ten (10%) noncase students (P = .04, Fisher exact test). We strongly suspect, but cannot document conclusively, that the Snow Mountain agent was spread to students on a vector of hot foods contaminated by ill food handlers. Implicated foods conferred low relative risks and could only have accounted for 74% of cases of illness. The strong association between cafeteria exposure and illness, therefore, suggests that additional modes of spread occurred.

2020 ◽  
Vol 14 (1) ◽  
pp. 47-52
Author(s):  
Md Shariful Alam Jilani ◽  
Tang Thean Hock ◽  
Sraboni Mazumder ◽  
Fahmida Rahman ◽  
Md Mohiuddin ◽  
...  

Background and objectives: Several types of Burkholderia pseudomallei antigens have been used to determine the antibody response in acute and asymptomatic cases. In the present study, we have detected immunoglobulin G (IgG) antibody to recombinant truncated flagellin antigen (RTFA) of B. pseudomallei in the sera of acute melioidosis cases and healthy individuals from melioidosis endemic areas of Bangladesh by indirect enzyme-linked immunosorbent assay (ELISA). In parallel, IgG antibody to sonicated whole cell antigen (SWCA) of B. pseudomallei was determined to compare with anti-RTFA antibody. Methodology: Serum samples from culture confirmed melioidosis cases and from healthy individuals aged 21 years and above residing in melioidosis endemic rural areas were included in the study. Serum IgG antibody to RTFA and SWCA of B. pseudomallei was determined by indirect ELISA. Results: Out of 8 culture confirmed acute melioidosis cases, 7 (87.5%) and 8 (100%) were positive for anti-B. pseudomallei IgG antibodies by RTFA and SWCA methods respectively. Among 361 healthy individuals, the rate of seropositivity by RTFA-ELISA was significantly less than that of SWCA-ELISA (16.1% versus 26.8%; p = 0.001). The mean optical density (OD) of RTFA-ELISA of positive cases was significantly less than that of SWCA-ELISA in both melioidosis and healthy individuals (0.79±0.11 versus 2.4±0.08, p = 0.0001; 0.67±0.01 versus 1.27±0.02, p = 0.0001). The sensitivity and specificity of RTFA-ELISA were 88.9% and 100% respectively. Conclusion: Findings of the study suggest that multiple or combination of antigens should be used to study the seroprevalence of B. pseudomallei infection in a community. Also, prospective study is necessary to find out the duration of persistence of antibodies to different antigenic components of B. pseudomallei after exposure. Ibrahim Med. Coll. J. 2020; 14(1): 47-52


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Liss ◽  
M Kuczynska ◽  
A Knight ◽  
K Lukaszuk

Abstract Study question To evaluate the correlation between the serum level of stem cell factor (s-SCF) during the stimulation and results of embryo culture. Summary answer The serum SCF concentration at the stimulation stage may be a potential predictor of IVF outcome in endometriosis patients. What is known already Stem cell factor (SCF) is a pleiotropic cytokine that affects the target cells via the c-kit receptor, a tyrosine kinase receptor. Recent evidence indicates that SCF and c-kit may play a role in regulation and growth of ovarian follicular function. It is unclear whether endometriosis primarily affects in vitro fertilization outcomes via oocyte quality. SCF is produced during the human follicular phase, immediately before the ovulatory phase, and may play an important role in folliculogenesis and in the mechanism of ovulation. It may reflect a successful stimulation with ample follicle maturation. Study design, size, duration This was a prospective case-control study and consisted four group of patients: 10 with endometriosis, 24 PCOs, 20 with normal (AMH 1.2–4.0 ng/ml) and 11 with lower (AMH<1.2 ng/ml) ovary reserve who were undergoing IVF treatment with the assessment of serum SCF concentration between August 2019 and March 2020 at INVICTA Fertility Centre, Poland. The age of the patients ranged from 22 to 42 years (median 34 years). Participants/materials, setting, methods s-SCF was measured in duplicate by enzyme-linked immunosorbent assay (ELISA) kit in 195 serum samples collected during ovarian stimulation on days 1 and 8 and on the day of oocyte retrieval. We analysed correlation between s-SCF level and formation of top quality (TQ) blastocysts on day 5 formation in the study groups. Main results and the role of chance We have compared mean level of s-SCF within each group dividing the patients into two subgroups – those with at least one TQ blastocyst (TQ) on day 5 vs. those with no TQ blastocysts (no-TQ). There were no significant differences in mean s-SCF level on day 1 of stimulation between no-TQ and TQ patients in PCOs, normal and lower ovary reserve groups (41.1 pg/ml vs. 40.9 pg/ml; 34.8 pg/ml vs. 38.9 pg/ml and 32.3pg/ml vs. 28.7 pg/ml respectively). The mean level of s-SCF in endometriosis patients was higher in case of no-TQ compared to the TQ subgroup and were 41.1 pg/ml and 29.1 pg/ml respectively. Also no significant differences were also observed in the mean level of s-SCF in the no-TQ and TQ subgroups on the 8 day of stimulation and pick-up in PCOs, normal and lower ovary reserve patients. However, again in the case of endometriosis patients, the mean level of s-SCF was significantly lower on the 8 day of stimulation (28.1 pg/ml vs. 49.1 pg/ml; p < 0.05) and pick-up day (33.4 pg/ml vs. 50.4 pg/ml; p < 0.005) in samples from patients who had at least one TQ blastocysts on day 5 of culture. Limitations, reasons for caution More data are required to confirm the corelation of s-SCF level and presence of top quality blastocysts in patients with endometriosis. Wider implications of the findings: Our study suggests that the level of serum SCF during ovarian stimulation in patients with endometriosis of less 30 pg/ml may potentially be a predictor for the chance of obtaining at least one top quality blastocyst on day 5 and thus a chance to successful treatment. Trial registration number Not applicable


1970 ◽  
Vol 2 (1) ◽  
pp. 35-38 ◽  
Author(s):  
E Shrestha

Introduction: Seasonal hyper-acute panuveitis (SHAPU) is a sight-threatening disease and its management is challenging. Objective: To study the profile and evaluate the visual outcome of the patients of clinicallydiagnosed cases of SHAPU after treatment. Subjects and methods: A retrospective interventional hospital-based study was carried out involving 21 subjects with clinically-diagnosed SHAPU. The data were retrieved from the record section of the hospital and analyzed. The variables studied were demographic pattern, clinical condition, duration of presentation and visual acuity before and after the treatment. Statistics: The data were analyzed using Epi Info version 2000. Percentage prevalence, mean values with standard deviation, relative risk, 95% CI and p value were calculated. P value of < 0.05 was considered to be significant. Results: Among the 21 cases, the numbers of male and female were 11 (52.4 %) and 10 (46.7 %) respectively. A comparative analysis of gender in children and adults did not show any significant difference (RR=0.47, 95% CI = 0.22 - 1.01, Fisher exact test: p = 0.14). The mean for all ages was 7 ± 12.68 years, while the mean age in pediatric cases was 4.5 ± 3.91 years. Thirteen (61.9%) cases occurred in children below fifteen years. Fifteen (71.4 %) cases reported during September and October. Presenting visual acuity of all cases was less than 3/60. All of them received medical treatment. By the end of the 4th week, seven (33.3 %) patients regained vision to 6/18. Conclusion: SHAPU is more prevalent in pediatric age group. It is equally prevalent among males and females. The visual acuity can improve with early medical treatment. Keywords: SHAPU; panuveitis; steroid; phthisis bulbi DOI: 10.3126/nepjoph.v2i1.3702 Nep J Oph 2010;2(1) 35-38


Blood ◽  
2009 ◽  
Vol 114 (24) ◽  
pp. 4928-4932 ◽  
Author(s):  
Huei-Ting Tsai ◽  
Neil E. Caporaso ◽  
Robert A. Kyle ◽  
Jerry A. Katzmann ◽  
Angela Dispenzieri ◽  
...  

AbstractImmune-related deficiencies are well-known complications of chronic lymphocytic leukemia (CLL). Although recent data indicate that almost all CLL patients are preceded by a monoclonal B-cell lymphocytosis precursor state, patterns of immune defects preceding CLL diagnosis are unclear. We identified 109 persons who developed CLL from the prospective and nationwide Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial with 77 469 participants, with serially collected prediagnostic serum samples. We assayed monoclonal (M)–proteins, κ/λ free light chains (FLCs) in prediagnostic obtained up to 9.8 years before CLL diagnosis. The prevalence of an abnormal FLC ratio, M-protein, and hypogamma-globulinemia before CLL diagnosis was 38% (95% confidence interval, 29%-47%), 13% (7%-21%), and 3% (1%-8%), respectively. M-proteins and abnormal FLC ratios were detected up to 9.8 years before CLL diagnosis in a total of 48 persons (44%). Hypogammaglobulinemia was not present until 3 years before the diagnosis of CLL. Among 37 patients with information on tumor cell immunophenotype, an association between immunophenotype and involved FLC (P = .024, Fisher exact test) was observed. Among 61 persons with a normal FLC ratio and without an M-protein, 17 had elevated κ and/or λ FLC levels, indicating polyclonal B-cell activation in 17 of 109 (16%) patients. These findings support a role for chronic immune stimulation in CLL genesis.


Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5119-5119
Author(s):  
Rachid Baz ◽  
Steven M. Fruchtman ◽  
Jerome B. Zeldis ◽  
Esteban Walker ◽  
Mohamad A. Hussein

Abstract Background: Erythropoietic agents (EPO) have recently been implicated with higher rates of thromboembolic events (VTE) in multiple myeloma (MM) patients receiving lenalidomide (R) and dexamethasone (Knight et al. NEJM 2006). Uncontrolled erythrocytosis, a recognized risk factor for VTE, may complicate therapy with EPO, but was not evaluated as a causative factor for VTE in the above report. We sought to evaluate the putative interactions between erythrocytosis, immunomodulator therapy, EPO and VTE. Patients and Methods: We retrospectively reviewed patients’ records from 2 studies of anthracycline-based chemotherapy with immunomodulators: pegylated liposomal doxorubicin, vincristine, dexamethasone and thalidomide (T) (study A) or lenalidomide (study B) in MM. Demographic variables, aspirin therapy, EPO therapy, immunomodulator therapy (T vs R), as well as laboratory variables (which included all hemoglobin values while on study) were reviewed. Results: From August 2001 to December 2005, 184 multiple myeloma patients with active disease were treated on study A (105) and B (79). The median age for patients was 63 and 62 years on study A and B respectively. Aspirin prophylaxis (81mg daily) was administered for all patients on study B and for all but 19 patients on study A. Among all patients, 113 patients (61%) received EPO. Twenty-six patients on study A and 7 patients on study B developed a VTE. Treatment with EPO was not associated with a higher rate of VTE compared to no treatment with EPO (19% versus 22%, Fisher exact test, p=0.8). The mean peak hemoglobin for patients with a VTE was not statistically different from patients without a VTE (14.2 vs. 13.8 g/dL, p=0.3). Similarly, the mean on study hemoglobin was not different among patients with a VTE and those without a VTE (11.7 vs. 11.6 g/dL, p=0.8). The mean hemoglobin at the time of the VTE was 12.0 g/dL (S.D. 1.5g/dL). Conclusion: Our results do not indicate an association between EPO and VTE in MM patients receiving anthracycline-based chemotherapy with an immunomodulator and aspirin prophylaxis. Uncontrolled erythrocytosis does not appear to be associated with VTE in this patient population. Of note, target hemoglobins were not commonly exceeded. Low dose Aspirin (81mg) is an effective prophylaxis for VTE in multiple myeloma patients receiving anthracycline based therapy with thalidomide or lenalidomide in conjunction with the use of erythropoietin therapy.


Author(s):  
Daniel Muasya ◽  
George Karuoya Gitau ◽  
Thaiyah Gitau Andrew ◽  
Daniel Waweru Gakuya ◽  
John Vanleeuwen ◽  
...  

Bovine tuberculosis (BTB) is an important zoonotic disease which has remained persistent in many areas of the World. Control and eradication has proved problematic due to the challenges in effective screening and diagnosis. Limited information on the status of BTB in Kenya presents a need to investigate its occurrence in cattle population. The study was carried out using an indirect antibody Enzyme Linked Immunosorbent Assay (ELISA-IDEXX-USA) to assess the agreement with Comparative Intradermal Tuberculin Test (CITT) test results between August and December 2013 in Laikipia County. The study also determined the apparent prevalence of cattle BTB antibodies in Laikipia County. A total of 276 bovine serum samples were tested using MPB70 and MPB83 recombinant proteins as capture antigens in the ELISA kit. Data were recorded in Microsoft Excel and exported to SPSS 16.0 for analysis. Apparent prevalence was calculated as a proportion at 95% CI, Kappa statistics computed, and test of significance assessed by Chi-square and Fisher exact test.  The results showed an individual animal apparent prevalence of 3.9% (11/276) and a herd prevalence of 58.3% (7/12). There was no significant association between BTB infection and both animal level factors, breed and sex. Kappa agreement test between ELISA test and TST showed a good agreement at K= 0.65. This study reported the prevalence of BTB in cattle for the first time in Laikipia County Kenya using the IDEXX ELISA. The ELISA test was comparable to the tuberculin test which is used as the gold standard for screening TB on live animals. The two tests can be used alongside for series or parallel interpretation to achieve desirable diagnostic sensitivity and specificity in disease control programs.


2017 ◽  
Vol 8 (1) ◽  
pp. 585
Author(s):  
Radita Ikapratiwi ◽  
Indah Rahmawati ◽  
Joko Mulyanto

Tuberculosis (TB) is considered as the leading killer among infectious diseases because of bacteria resulted in a high number ofmorbidity and mortality world wide. One risk factor for tuberculosisis diabetes mellitus (DM). The prevalence of TB and DM jump together globally, especially in developing countries, including Indonesia. Early and accurate diagnosis of TB cases in the enforcement is sputum smear examination. Monitoring of TB seen through sputum conversion. The purpose of this studyis to determine the duration of sputum conversion difference new case smear positive pulmonary TB patients with and without DM in hospital Prof. Dr.Margono Soekarjo (RSMS) Purwokerto. Thestudy design is observational analytic with cohort retrospective study. Sample of this study was patients who checked their health in Lung Clinis of RSMS Purwokerto obtained total sample of 44 people, consisting of 22 patients clinically diagnosed new cases smear-positive pulmonary TB with DM and 22 patients without DM in 2009 until 2012.Results of this study were analyzed using Fisher Exact Test. pvalues obtainedof 0.000 (p <0.05) (95% CI = 0,288-0,718) with relative risk 0,455. The conclusion is there were significant differences in sputum conversion time between the group of patients suffering from pulmonary uberculosis with and without DM. The conversion of sputum in patients with pulmonary tuberculosis who suffered DM is longer than patients without DM. Relative risk value which is equal to 0.455 which means that patients with DM have pulmonary tuberculosis risk by 0.455 times more likely to experience delays in sputum conversion than TB patients without DM


PEDIATRICS ◽  
1987 ◽  
Vol 79 (3) ◽  
pp. 487-487
Author(s):  
JOSEPH OREN ◽  
DOROTHY H. KELLY ◽  
DANIEL C. SHANNON

In Reply.— Dr Cummins' letter raises two questions regarding the statistical analysis in our report and we forward the following explanations. First, we agree that the Fisher exact test is superior to the χ2 statistic in analyzing associations between small subgroups. However, as we have already shown, in response to Dr Leblanc's letter (Pediatrics 1986;78:957), the results of the Fisher exact test are in good agreement with the published values using χ2 analysis. Second, in Figs 1 and 2 the ordinate depicts the 95% confidence interval of the relative risk and not the relative risk per se.


2014 ◽  
Vol 49 (4) ◽  
pp. 486-492 ◽  
Author(s):  
Viviana Bompadre ◽  
Thomas M. Jinguji ◽  
N. David Yanez ◽  
Emma K. Satchell ◽  
Kaiulani Gilbert ◽  
...  

Context: The Lystedt law requires high school athletes who have sustained a concussion to be removed from practice and play and not to be allowed to return until cleared by a medical professional. Objective: To determine the effect of the Lystedt law on injury and concussion documentation in the Seattle public high schools. Design: Cross-sectional study. Setting: Seattle public high schools. Patients or Other Participants: The numbers of students, aged 13 to 19 years in the 2008–2009, 2009–2010, and 2010–2011 school years, were 4348, 4925, and 4806, respectively. Main Outcome Measure(s): All injuries documented in SportsWare by athletic trainers in Seattle public high schools. We evaluated all injuries, including concussions recorded during the 2008–2009 school year, before the Lystedt law, and during the 2 school years after the law took effect (2009–2010 and 2010–2011). Incidence rates before and after the law were estimated and compared. Results: The concussion rate was −1.09% in 2008–2009, 2.26% in 2009–2010, and 2.26% in 2010–2011. A comparison of relative risks showed that the incidence rates of concussions were different before and 1 year after the Lystedt law (relative risk = 2.10; 95% confidence interval [CI] = 1.50, 2.93) and 2 years after the law (relative risk = 2.10; 95% CI = 1.49, 2.93). Overall, the mean number of days out of play after 2008–2009 was almost 7 days greater after the law took effect (difference = 6.9 days; 95% CI = 0.70, 13.1). For females, the mean number of days out of play after 2008–2009 was more than 17 days in 2009–2010 (difference = 17.2 days; 95% CI = 4.81, 29.5) and was more than 6 days in 2010–2011 (difference = 6.3 days; 95% CI = 1.62, 11.0). Conclusions: The number of documented concussions more than doubled after the institution of the Lystedt law, which may be attributed to heightened awareness and closer monitoring.


2009 ◽  
Vol 19 (9) ◽  
pp. 1516-1520 ◽  
Author(s):  
Anita Olejek ◽  
Aleksandra Damasiewicz-Bodzek ◽  
Piotr Bodzek ◽  
Tomasz Wielkoszyński ◽  
Jacek Zamłyński ◽  
...  

Introduction:Heat shock proteins (Hsp) are highly expressed in many malignant human tumors, including tumors of the genital tract. One of the Hsps strongly associated with the process of cancerogenesis is Hsp27. The presence of Hsp27 and anti-Hsp27 in the sera of patients with ovarian carcinoma is still a new research field, and papers contain contradictory results. The aim of this work was to study the concentrations of anti-Hsp27 immunoglobulin G antibodies in the sera of women with ovarian cancer at different clinical stages and with different histopathological types of this cancer.Methods:Serum samples from 158 patients with ovarian carcinoma and 80 healthy women were investigated. The concentrations of anti-Hsp27 antibodies were determined by the enzyme-linked immunosorbent assay technique.Results:The mean concentration of anti-Hsp27 antibodies in the patients with ovarian carcinoma was significantly higher than that in the control group. Analysis in relation to the stage of clinical progression showed that the less advanced the cancerogenesis process, the higher the concentration of the anti-Hsp27 antibodies is. The mean concentrations of the anti-Hsp27 antibodies in the patients with ovarian carcinoma were not significantly different in relation to the histological type of the cancer. The use of chemotherapy as a primary anticancer treatment in ovarian carcinoma did not cause a significant decrease in the concentration of anti-Hsp27 antibodies.Conclusions:An immunological response to Hsp27 is increased in women with ovarian carcinoma. Although the diagnostic concentrations of anti-Hsp27 antibodies have not been precisely defined yet, we believe that this may be a helpful diagnostic parameter particularly to detect early stages of clinical advancement of the disease.


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