Subclinical infection and asymptomatic carriage of gastrointestinal zoonoses: Occupational exposure, environmental pathways, and the anonymous spread of disease

Asymptomatic carriage of gastrointestinal zoonoses is more common in people whose profession involves them working directly with domesticated animals. Subclinical infections (defined as an infection in which symptoms are either asymptomatic or sufficiently mild to escape diagnosis) are important within a community as unknowing (asymptomatic) carriers of pathogens do not change their behaviour to prevent the spread of disease; therefore the public health significance of asymptomatic human excretion of zoonoses should not be underestimated. However, optimal strategies for managing diseases where asymptomatic carriage instigates further infection remain unresolved, and the impact on disease management is unclear. In this review we consider the environmental pathways associated with prolonged antigenic exposure and critically assess the significance of asymptomatic carriage in disease outbreaks Although screening high-risk groups for occupationally acquired diseases would be logistically problematical, there may be an economic case for identifying and treating asymptomatic carriage if the costs of screening and treatment are less than the costs of identifying and treating those individuals infected by asymptomatic hosts

Lack of Serologic Evidence of Neospora caninum in Humans, England

Retrospective testing of 3,232 serum samples from the general population and 518 serum samples from a high-risk group showed no evidence of human exposure to Neospora caninum in England. Results were obtained by using immunofluorescence antibody testing and ELISA to analyze frequency distribution

Q Fever Outbreak in Industrial Setting

An outbreak of Q fever was likely caused by renovation work that aerosolized contaminated straw board

Hazards of Healthy Living: Bottled Water and Salad Vegetables as Risk Factors for Campylobacter Infection

Campylobacter is the most common cause of bacterial gastroenteritis worldwide, yet the etiology of this infection remains only partly explained. In a retrospective cohort study, we compared 213 sporadic campylobacter case-patients with 1,144 patients with negative fecal samples. Information was obtained on food history, animal contact, foreign travel, leisure activities, medical conditions, and medication use. Eating chicken, eating food from a fried chicken outlet, eating salad vegetables, drinking bottled water, and direct contact with cows or calves were all independently associated with infection. The population-attributable fractions for these risk factors explained nearly 70% of sporadic campylobacter infections. Eating chicken is a well-established risk factor, but consuming salad and bottled water are not. The association with salad may be explained by cross-contamination of food within the home, but the possibility that natural mineral water is a risk factor for campylobacter infection could have wide public health implications

Toxoplasma and coxiella infection and psychiatric morbidity: A retrospective cohort analysis

BACKGROUND: It has been suggested that infection with Toxoplasma gondii is associated with slow reaction and poor concentration, whilst infection with Coxiella burnetii may lead to persistent symptoms of fatigue. METHODS: 425 farmers completed the Revised Clinical Interview Schedule (CIS-R) by computer between March and July 1999 to assess psychiatric morbidity. Samples of venous blood had been previously collected and seroprevalence of T. gondii and C. burnetii was assessed. RESULTS: 45% of the cohort were seropositive for T. gondii and 31% were positive for C. burnetii. Infection with either agent was not associated with symptoms reflecting clinically relevant levels of concentration difficulties, fatigue, depression, depressive ideas or overall psychiatric morbidity. CONCLUSIONS: We do not provide any evidence that infection with Toxoplasma gondii or Coxiella burnetii is associated with neuropsychiatric morbidity, in particular with symptoms of poor concentration or fatigue. However, this is a relatively healthy cohort with few individuals reporting neuropsychiatric morbidity and therefore the statistical power to test the study hypotheses is limited

Cassini observations reveal a regime of zonostrophic macroturbulence on Jupiter

In December 2000, the Cassini fly-by near Jupiter delivered high-resolution images of Jupiter’s clouds over the entire planet in a band between 50°N and 50°S. Three daily-averaged two-dimensional velocity snapshots extracted from these images are used to perform spectral analysis of jovian atmospheric macroturbulence. A similar analysis is also performed on alternative data documented by Choi and Showman (Choi, D., Showman, A. [2011]. Icarus 216, 597–609), based on a different method of image processing. The inter-comparison of the products of both analyses ensures a better constraint of the spectral estimates. Both analyses reveal strong anisotropy of the kinetic energy spectrum. The zonal spectrum is very steep and most of the kinetic energy resides in slowly evolving, alternating zonal (west–east) jets, while the non-zonal, or residual spectrum obeys the Kolmogorov–Kraichnan law specific to two-dimensional turbulence in the range of the inverse energy cascade. The spectral data is used to estimate the inverse cascade rate ∊ and the zonostrophy index Rβ for the first time. Although both datasets yield somewhat different values of ∊, it is estimated to be in the range 0.5–1.0 × 10−5 m2 s−3. The ensuing values of Rβ ≳ 5 belong well in the range of zonostrophic turbulence whose threshold corresponds to Rβ ≃ 2.5. We infer that the large-scale circulation is maintained by an anisotropic inverse energy cascade. The removal of the Great Red Spot from both datasets has no significant effect upon either the spectra or the inverse cascade rate. The spectral data are used to compute the rate of the energy exchange, W, between the non-zonal structures and the large-scale zonal flow. It is found that instantaneous values of W may exceed ∊ by an order of magnitude. Previous numerical simulations with a barotropic model suggest that W and ∊ attain comparable values only after averaging of W over a sufficiently long time. Near-instantaneous values of W that have been routinely used to infer the rate of the kinetic energy supply to Jupiter’s zonal flow may therefore significantly overestimate ∊. This disparity between W and ∊ may resolve the long-standing conundrum of an unrealistically high rate of energy transfer to the zonal flow. The meridional diffusivity Kϕ in the regime of zonostrophic turbulence is given by an expression that depends on ∊. The value of Kϕ estimated from the spectra is compared against data from the dispersion of stratospheric gases and debris resulting from the Shoemaker-Levy 9 comet and Wesley asteroid impacts in 1994 and 2009 respectively. Not only is Kϕ found to be consistent with estimates for both impacts, but the eddy diffusivity found from observations appears to be scale-independent. This behaviour could be a consequence of the interaction between anisotropic turbulence and Rossby waves specific to the regime of zonostrophic macroturbulence

Vero Cytotoxin–Producing Escherichia coli O157 Gastroenteritis in Farm Visitors, North Wales

An outbreak of Vero cytotoxin–producing Escherichia coli O157 (VTEC O157) gastroenteritis in visitors to an open farm in North Wales resulted in 17 primary and 7 secondary cases of illness. E. coli O157 Vero cytotoxin type 2, phage type 2 was isolated from 23 human cases and environmental animal fecal samples. A case-control study of 16 primary case-patients and 36 controls (all children) showed a significant association with attendance on the 2nd day of a festival, eating ice cream or cotton candy (candy floss), and contact with cows or goats. On multivariable analysis, only the association between illness and ice cream (odds ratio [OR]=11.99, 95% confidence interval [CI] 1.04 to 137.76) and cotton candy (OR=51.90, 95% CI 2.77 to 970.67) remained significant. In addition to supervised handwashing, we recommend that foods on open farms only be eaten in dedicated clean areas and that sticky foods be discouraged

Persistent frequent attenders in primary care: costs, reasons for attendance, organisation of care and potential for cognitive behavioural therapeutic intervention

<p><b>Abstract</b></p> <p>Background</p> <p>The top 3% of frequent attendance in primary care is associated with 15% of all appointments in primary care, a fivefold increase in hospital expenditure, and more mental disorder and functional somatic symptoms compared to normal attendance. Although often temporary if these rates of attendance last more than two years, they may become persistent (persistent frequent or regular attendance). However, there is no long-term study of the economic impact or clinical characteristics of regular attendance in primary care. Cognitive behaviour formulation and treatment (CBT) for regular attendance as a motivated behaviour may offer an understanding of the development, maintenance and treatment of regular attendance in the context of their health problems, cognitive processes and social context.</p> <p>Methods/design</p> <p>A case control design will compare the clinical characteristics, patterns of health care use and economic costs over the last 10 years of 100 regular attenders (≥30 appointments with general practitioner [GP] over 2 years) with 100 normal attenders (6–22 appointments with GP over 2 years), from purposefully selected primary care practices with differing organisation of care and patient demographics. Qualitative interviews with regular attending patients and practice staff will explore patient barriers, drivers and experiences of consultation, and organisation of care by practices with its challenges. Cognitive behaviour formulation analysed thematically will explore the development, maintenance and therapeutic opportunities for management in regular attenders. The feasibility, acceptability and utility of CBT for regular attendance will be examined.</p> <p>Discussion</p> <p>The health care costs, clinical needs, patient motivation for consultation and organisation of care for persistent frequent or regular attendance in primary care will be explored to develop training and policies for service providers. CBT for regular attendance will be piloted with a view to developing this approach as part of a multifaceted intervention.</p

The association between bullying and early stages of suicidal ideation in late adolescents in Greece

<p>Abstract</p> <p>Background</p> <p>Bullying in schools has been associated with suicidal ideation but the confounding effect of psychiatric morbidity has not always been taken into account. Our main aim was to test the association between bullying behavior and early stages of suicidal ideation in a sample of Greek adolescents and to examine whether this is independent of the presence of psychiatric morbidity, including sub-threshold symptoms.</p> <p>Methods</p> <p>5614 pupils 16-18 years old and attending 25 senior high schools were screened in the first phase and a stratified random sample of 2431 were selected for a detailed interview at the second phase. Psychiatric morbidity and suicidal ideation were assessed with the revised Clinical Interview Schedule (CIS-R) while bullying was assessed with the revised Olweus bully/victim questionnaire.</p> <p>Results</p> <p>Victims of bullying behavior were more likely to express suicidal ideation. This association was particularly strong for those who were bullied on a weekly basis and it was independent of the presence of psychiatric morbidity (Odds Ratio: 7.78; 95% Confidence Interval: 3.05 - 19.90). In contrast, being a perpetrator ("bullying others") was not associated with this type of ideation after adjustment. These findings were similar in both boys and girls, although the population impact of victimization in the prevalence of suicidal ideation was potentially higher for boys.</p> <p>Conclusions</p> <p>The strong cross-sectional association between frequent victimization and suicidal ideation in late adolescence offers an opportunity for identifying pupils in the school setting that are in a higher risk for exhibiting suicidal ideation.</p

A full transit of v 2 Lupi d and the search for an exomoon in its Hill sphere with CHEOPS

The planetary system around the naked-eye star v2 Lupi (HD 136352; TOI-2011) is composed of three exoplanets with masses of 4.7, 11.2, and 8.6 Earth masses (M⊕). The TESS and CHEOPS missions revealed that all three planets are transiting and have radii straddling the radius gap separating volatile-rich and volatile-poor super-earths. Only a partial transit of planet d had been covered so we re-observed an inferior conjunction of the long-period 8.6 M⊕ exoplanet v2 Lup d with the CHEOPS space telescope. We confirmed its transiting nature by covering its whole 9.1 h transit for the first time. We refined the planet transit ephemeris to P = 107.13610.0022+0.0019 days and Tc = 2459009.77590.0096+0.0101 BJDTDB, improving by ~40 times on the previously reported transit timing uncertainty. This refined ephemeris will enable further follow-up of this outstanding long-period transiting planet to search for atmospheric signatures or explore the planet s Hill sphere in search for an exomoon. In fact, the CHEOPS observations also cover the transit of a large fraction of the planet s Hill sphere, which is as large as the Earth s, opening the tantalising possibility of catching transiting exomoons. We conducted a search for exomoon signals in this single-epoch light curve but found no conclusive photometric signature of additional transiting bodies larger than Mars. Yet, only a sustained follow-up of v2 Lup d transits will warrant a comprehensive search for a moon around this outstanding exoplanet