scholarly journals Cross-border investigation of a Shigella sonnei outbreak in a group of Norwegian tourists after a trip to Russia

2007 ◽  
Vol 12 (4) ◽  
pp. 9-10 ◽  
Author(s):  
B Schimmer ◽  
H Meldal ◽  
N G Perederij ◽  
L Vold ◽  
M A Petukhova ◽  
...  
Keyword(s):  
Public Health ◽  
Gastrointestinal Symptoms ◽  
Food Samples ◽  
Shigella Sonnei ◽  
Epidemiological Surveillance ◽  
Cross Border ◽  
Cured Meat ◽  
Food And Beverage ◽  
Stool Samples ◽  
E Mail

In early September 2006, the Norwegian Institute of Public Health was alerted to an outbreak of Shigella sonnei infections (shigellosis) among 23 Norwegian passengers who had taken a bus tour from Kirkenes, Norway to Murmansk, Russia. The trip lasted from 27 to 31 August, and the group stayed in various hotels and visited several restaurants in both Kirkenes and Murmansk during this period. Stool samples from three ill passengers yielded S. sonnei; an additional 10 passengers had gastrointestinal symptoms with diarrhoea or loose stools with abdominal pain. An investigation was initiated in collaboration with the department of epidemiological surveillance in Murmansk. We sent a questionnaire to the work e-mail addresses of all passengers asking about symptoms and exposures. Two restaurants and a hotel visited by the Norwegian tourists in Murmansk were inspected and sampled. Of all the food and beverage items mentioned in the questionnaire, only cured meat consumed in restaurant A in Murmansk on 28 August was associated with the risk of developing illness. Inspections of the restaurants in Murmansk identified some hygienic shortcomings and inadequate routines. However, S. sonnei could not be isolated from food samples or the personnel. Improved routines were implemented.

Multiple Outbreaks of Gastroenteritis That Were Associated with 16 Funerals and a Unique Caterer and Spanned 6 Days, 2011, Québec, Canada

2013 ◽  
Vol 76 (9) ◽  
pp. 1582-1589 ◽  
Author(s):  
COLETTE GAULIN ◽  
SOULYVANE NGUON ◽  
MARIE-ANDREE LEBLANC ◽  
DANIELLE RAMSAY ◽  
SOPHIE ROY
Keyword(s):  
Public Health ◽  
Food Samples ◽  
Viral Gastroenteritis ◽  
Epidemiological Investigation ◽  
Food Handlers ◽  
Duration Of Symptoms ◽  
Causative Agents ◽  
Stool Samples ◽  
The Mean ◽  
Over Time

In January 2011, multiple acute gastroenteritis outbreaks that spanned many days and were related to attendance at funerals were reported to public health units in Quebec. An epidemiological investigation was initiated to identify the source of the contamination and to explain the extent of the contamination over time. Thirty-one cohorts of individuals attended different funerals held between 14 and 19 January. All attendees were served a cold buffet made by the same caterer. Of these 31 cohorts, 16 (with a total of about 800 people) contained individuals who reported being ill after the funeral. Symptoms were mainly diarrhea (89 to 94% of individuals), vomiting (63 to 90%,) and fever (26 to 39%), with a median incubation period of 29 to 33 h and a median duration of symptoms of 24 to 33 h, suggesting norovirus-like infection. Among the 16 cohorts, 3 were selected for cohort studies. Among those three cohorts, the mean illness rate was 68%. Associations were found between those who fell ill and those who had consumed pasta salad (relative risk [RR] = 2.4; P = 0.0022) and ham sandwiches (RR = 1.8; P = 0.0096). No food handlers reported being sick. No stool samples were provided by individuals who became ill. Environmental and food samples were all negative for causative agents. Although the causative agent was not clearly identified, this investigation raised many concerns about the importance of preventing foodborne transmission of viral gastroenteritis and generated some recommendations for management of similar outbreaks.

scholarly journals An outbreak of Salmonella Saintpaul in a Scottish childcare facility: the influence of parental under-reporting

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Rachel M. Thomson ◽  
Hazel J. Henderson ◽  
Alison Smith-Palmer
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Gastrointestinal Symptoms ◽  
Control Measures ◽  
Incident Management ◽  
Reference Laboratory ◽  
Public Health Department ◽  
Water Tank ◽  
Stool Samples ◽  
Childcare Facility

Abstract Background Salmonella outbreaks in childcare facilities are relatively rare, most often occurring secondary to contaminated food products or poor infection control practices. We report an outbreak of Salmonella Saintpaul at a pre-school facility in Ayrshire, Scotland with atypical clinical and epidemiological features. Methods Following notification of the initial two cases, the multi-disciplinary Incident Management Team initiated enhanced active case finding and two environmental inspections of the site, including food preparation areas. Parent and staff interviews were conducted by the Public Health department covering attendance, symptomatology and risk factors for all probable and confirmed cases. Microbiological testing of stool samples and the facility water tank was conducted. Whole Genome Sequencing (WGS) was performed for positive stool samples at the national reference laboratory. Infection control measures were introduced iteratively due to the atypical progression of the outbreak. Results There were 15 confirmed cases and 3 children admitted to hospital during the outbreak. However, 35.7% of cases reported extremely mild symptoms. The attack rate was 15.2%, and age of affected children ranged from 18 to 58 months (mean 35 months). All cases were the same Multilocus Sequence Type (MLST50). Epidemiological investigation strongly suggested person-to-person spread within the facility. Existing infection control practices were found to be of a high standard, but introduction of additional evidence-based control measures was inadequate in halting transmission. Facility staff reported concerns about lack of parental disclosure of gastrointestinal symptoms, particularly where these were mild, with 50.0% of cases having attended while symptomatic against public health advice. Voluntary two-week closure of the facility was implemented to halt transmission, following which there were no new cases. WGS results were unavailable until after the decision was taken to close the facility. Conclusions This is the first reported instance of a Salmonella Saintpaul outbreak at a childcare facility, or where person-to-person transmission is indicated. Clinicians should consider the influence of parental under-reporting on gastrointestinal outbreaks in childcare settings, particularly where perceived severity is low and financial or social pressures to attend work may reduce compliance. WGS cannot yet replace conventional microbiological techniques during short, localised outbreaks due to delays receiving results.

scholarly journals Cryptosporidium parvuminfections in a cohort of veterinary students in Sweden

2015 ◽  
Vol 143 (13) ◽  
pp. 2748-2756 ◽  
Author(s):  
P. KINROSS ◽  
J. BESER ◽  
K. TROELL ◽  
C. SILVERLÅS ◽  
C. BJÖRKMAN ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Relative Risk ◽  
Cryptosporidium Parvum ◽  
Gastrointestinal Symptoms ◽  
Hand Washing ◽  
Veterinary Students ◽  
Veterinary Student ◽  
Stool Samples ◽  
Epidemiological Link

SUMMARYIn March 2013, a veterinary student tested positive forCryptosporidium; four classmates reported similar gastrointestinal symptoms. We aimed to identify source(s) and risk factors forCryptosporidiuminfection in university persons symptomatic between 21 January and 14 April 2013. Sixty-four (79%) students from a cohort of 81 fourth-year veterinary students completed questionnaires, identifying 13 cases; four wereCryptosporidium parvumGP60 subtype IIaA16G1R1b, two were IIdA24G1, seven did not submit stool samples. Thirteen cases attended the university's field clinic before symptom onset (13/37 attendees, 35%); 11 visited at least one of four farms where students recalled seeing calves with diarrhoea.C. parvumsubtype IIaA16G1R1b was identified in calves at one of the farms. Entering pens of calves with diarrhoea [relative risk (RR) 7·6, 95% confidence interval (CI) 1·7–33·5] and eating in clinic cars (RR 9·1, 95% CI 1·3–65·8) were associated with being a case. Washing hands at least twice per farm visit (0 cases,P= 0·03) was protective. This outbreak investigation was notable for rapid and effective collaboration between public health, veterinary and environmental sectors, leading to swift identification of a microbiological and epidemiological link between cases, infected calves and their farms. We recommend frequent hand-washing using proper technique and dissuasion from eating in clinic cars to minimize possible exposure to contaminated surfaces.

scholarly journals Parasitic infections in Swiss children: Are we overtesting?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Corinne Légeret ◽  
Céline Rüttimann ◽  
Hans Fankhauser ◽  
Henrik Köhler
Keyword(s):  
Retrospective Study ◽  
Positive Result ◽  
Pediatric Patients ◽  
Intestinal Parasites ◽  
Gastrointestinal Symptoms ◽  
International Travel ◽  
Parasitic Infections ◽  
Stool Samples ◽  
Stool Specimens

Abstract Background A wide variation of causes can lead to gastrointestinal symptoms in children- an infection with parasites is one of them. The expansion of international travel might lead to an increase in testing children for a correspondent infection. Currently there are no guidelines available, which patients should be tested for a possible parasitical infection. The aim of the study was to characterize Swiss children suffering from intestinal parasites, in order to provide more knowledge for the clinician who should be tested. Methods This is a retrospective study of Swiss pediatric patients, whose stools have been tested for parasites and helminths. Results A total of 1855 stool samples, belonging to 572 different children with an average age of 7.9 years, were tested within a 10-year period. The prevalence of a positive result was 4.2%, of which all were positive for Blastocystis, and 12.5% had a co-infection with Endolimax nana. Conclusion Immigrants, immune compromised children with diarrhea and pediatric patients with bloody or protracted diarrhea should have 2 different stool specimens examined for a possible parasitical infection.

scholarly journals Seasonal Differences in Cyclospora cayetanensis Prevalence in Colombian Indigenous People

2021 ◽  
Vol 9 (3) ◽  
pp. 627
Author(s):  
Hagen Frickmann ◽  
Juliane Alker ◽  
Jessica Hansen ◽  
Juan Carlos Dib ◽  
Andrés Aristizabal ◽  
...  
Keyword(s):  
Indigenous People ◽  
Rainy Season ◽  
Gastrointestinal Symptoms ◽  
Dry Season ◽  
Seasonal Effects ◽  
Chain Reaction ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
Stool Samples ◽  
Polymerase Chain

Fecal-orally transmitted cyclosporiasis is frequent in remote resource-limited settings in Central and South America with poor hygiene conditions. In this study, we aimed at assessing seasonal effects on the epidemiology of colonization or infection with C. cayetanensis in Colombian indigenous people living under very restricted conditions. In the rainy season between July and November and in the dry season between January and April, stool samples from indigenous people with and without gastrointestinal symptoms were collected and screened for C. cayetanensis applying in-house real-time polymerase chain reaction (PCR). In the rainy season and in the dry season, positive PCR results were observed for 11.8% (16/136) and 5.1% (15/292), respectively, with cycle threshold (Ct) values of 30.6 (±3.4) and 34.4 (±1.6), respectively. Despite higher parasite loads in the rainy season, fewer individuals (2/16, 12.5%) reported gastrointestinal symptoms compared to the dry season (6/15, 40%). In conclusion, considerable prevalence of C. cayetanensis in Colombian indigenous people persists in the dry season. Low proportions of gastrointestinal symptoms along with higher parasite loads make colonization likely rather than infection.

Epidemiological surveillance and performance assessment: the two roles of health indicators during the COVID-19 pandemic

2021 ◽  
Vol 17 (2) ◽  
pp. 186-203
Author(s):  
Nathan Genicot
Keyword(s):  
Public Health ◽  
Performance Assessment ◽  
Health Indicators ◽  
Health Policies ◽  
Epidemiological Surveillance ◽  
Public Health Policies ◽  
History Of ◽  
And Performance ◽  
The One ◽  
Massive Development

AbstractThe COVID-19 pandemic has given rise to the massive development and use of health indicators. Drawing on the history of international public health and of the management of infectious disease, this paper attempts to show that the normative power acquired by metrics during the pandemic can be understood in light of two rationales: epidemiological surveillance and performance assessment. On the one hand, indicators are established to evaluate and rank countries’ responses to the outbreak; on the other, the evolution of indicators has a direct influence on the content of public health policies. Although quantitative data are an absolute necessity for coping with such disasters, it is critical to bear in mind the inherent partiality and precarity of the information provided by health indicators. Given the growing importance of normative quantitative devices during the pandemic, and assuming that their influence is unlikely to decrease in the future, they call for close scrutiny.

scholarly journals “No Entry into New South Wales”: COVID-19 and the Historic and Contemporary Trajectories of the Effects of Border Closures on an Australian Cross-Border Community

Land ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 610
Author(s):  
Dirk H. R. Spennemann
Keyword(s):  
Public Health ◽  
Economic Impact ◽  
New South ◽  
Community Integration ◽  
New South Wales ◽  
The State ◽  
Cross Border ◽  
Health Measures ◽  
Border Community ◽  
South Wales

Given its intensity, rapid spread, geographic reach and multiple waves of infections, the COVID-19 pandemic of 2020/21 became a major global disruptor with a truly cross-sectoral impact, surpassing even the 1918/19 influenza epidemic. Public health measures designed to contain the spread of the disease saw the cessation of international travel as well as the establishment of border closures between and within countries. The social and economic impact was considerable. This paper examines the effects of the public health measures of “ring-fencing” and of prolonged closures of the state border between New South Wales and Victoria (Australia), placing the events of 2020/21 into the context of the historic and contemporary trajectories of the border between the two states. It shows that while border closures as public-health measures had occurred in the past, their social and economic impact had been comparatively negligible due to low cross-border community integration. Concerted efforts since the mid-1970s have led to effective and close integration of employment and services, with over a quarter of the resident population of the two border towns commuting daily across the state lines. As a result, border closures and state-based lockdown directives caused significant social disruption and considerable economic cost to families and the community as a whole. One of the lessons of the 2020/21 pandemic will be to either re-evaluate the wisdom of a close social and economic integration of border communities, which would be a backwards step, or to future-proof these communities by developing strategies, effectively public health management plans, to avoid a repeat when the next pandemic strikes.

scholarly journals External Quality Assessment in the Evaluation of Laboratory Performance of Faecal Culture

2017 ◽  
Vol 10 ◽  
pp. 117863611769125
Author(s):  
Salla J Kiiskinen ◽  
Tarja Ojanen ◽  
Yvonne Björkman ◽  
Harri Laitinen ◽  
Anja Siitonen
Keyword(s):  
Public Health ◽  
Quality Control ◽  
External Quality Assessment ◽  
False Negative ◽  
The Other ◽  
Epidemiological Surveillance ◽  
External Quality Control ◽  
External Quality ◽  
Faecal Culture

In Finland, all laboratories carrying out diagnostics of infectious diseases in humans are approved by the Regional State Administrative Agencies and are obligated to participate in External Quality Assurance rounds. Performance in these rounds is thought to reflect the quality of laboratory work. In the 6-year study period, 17 Finnish laboratories received 48 simulated faecal specimens for the culturing of diarrhoeal pathogens, yielding altogether 586 faecal culture External Quality Control specimens and 581 reports. The results were correct in 92% of all reports and in 67% of all specimens. False-negative Salmonella results were given for 2 of the 18 specimens, one with biochemically atypical Salmonella strain and the other with a low count of Salmonella cells. False-negative Shigella report was given for 6 of the 7 specimens in some participating laboratory. Detection of all common faecal pathogens is especially relevant to patient safety, public health, and epidemiological surveillance.

scholarly journals Experience in the implementation of epidemiological surveillance of West Nile fever in the Volgograd region

2015 ◽  
Vol 20 (1) ◽  
pp. 49-55
Author(s):  
M. V Monastyrskiy ◽  
N. V Shestopalov ◽  
V. G Akimkin ◽  
Yu. V Demina
Keyword(s):  
Public Health ◽  
Epidemiological Surveillance ◽  
West Nile Fever ◽  
Management Decisions ◽  
West Nile ◽  
Epidemic Process ◽  
Volgograd Region ◽  
Necessary And Sufficient ◽  
Epidemiological Situation

West Nilefever (WNF) is the most important arbovirus infectionfor the Volgograd region. The observed decrease in the WNF incidence from 2001 to 2006, in 2008 and2009, the reducing the number ofsevere forms ofdiseases only give evidence ofa temporary regression of the epidemic process in the territory of the Volgograd region. In the territory of the Volgograd region there are prerequisites and harbingers of the complication of epidemiological situation on West Nile fever. The aim of the performed in the Volgograd region epidemiological surveillance for WNF is to provide the information necessary and sufficient for the analysis of the epidemiological situation, as well as to determine the direction of policy and activities in public health and in making management decisions.

scholarly journals Molecular characterization of hookworm spp. isolated from food handlers, Khartoum, Sudan: A cross-sectional study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 662
Author(s):  
Tarig A. Gamar ◽  
Hassan H. Musa ◽  
Hisham N. Altayb ◽  
Mohamed H. Mohamed ◽  
Adam D. Abakar
Keyword(s):  
Public Health ◽  
Molecular Characterization ◽  
Molecular Probe ◽  
Hookworm Infection ◽  
Food Handlers ◽  
The Public ◽  
Necator Americanus ◽  
Link Type ◽  
Stool Samples

Background: Hookworms infect the intestines, cause an itchy rash, respiratory and gastrointestinal problems, and eventually iron deficiency (anaemia) due to the ongoing loss of blood. The objectives of this study were to assess the prevalence and molecular characterization of hookworms isolated from food handlers attending the Public Health Laboratories in Khartoum state, Sudan, for annual check-ups, and to assess the efficiency of PCR as molecular probe for hookworm infection. Methods: A total of 350 foods handlers’ participant's stool samples who were not suspected to be infected with hookworms were studied. Conventional methods were applied to make an early diagnosis. Stool samples were collected from public health laboratories (the public health lab in the Medical Commission) of Khartoum State; Omdurman locality, Khartoum North locality and Khartoum locality between October 2016 and April 2017. Specific identification was made by PCR on specimens identified as positive by Baermann’s technique, which were then sequence and genotyped Results: The prevalence of hookworms in the stool samples of food-handlers was 1.43%. One larval specimen recovered by Baermann’s technique was confirmed to be Necator americanus by PCR. PCR also confirmed that Necator americanus was the common species isolated from four further specimens. The results of DNA sequencing for Necator americanus were deposited in NCBI GenBank under the following accession numbers: sample 91, MH035824; sample 92, MH035825; sample 294, MH035826; and sample 319 MH035827. Conclusion: PCR was found to be effective for confirmation of the diagnosis of hookworm infection and can aid the clinician in initiating prompt and appropriate antiparasite therapy.

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