TOOLS FOR THE FIELD, TESTING AND TRACEABILITY IN THE DISTRIBUTION OF FOOD INGREDIENTS

Food Consumption/Nutrition/Food Safety,

The epidemiology of infectious diseases and an outbreak in Queensland

Epidemiological study (Chapter 2) In Australia, influenza vaccination is recommended for all pregnant women. Evidence to date suggests influenza vaccination has not been associated with adverse birth outcomes, however there are still concerns about safety and risks of receiving a vaccine during pregnancy. This chapter describes a nested retrospective cohort study comprising 7,121 mother-infant pairs in Australia from 2012-2014. The study focussed on whether mothers who had received an influenza vaccination during pregnancy had poorer birth outcomes compared to unvaccinated women in pregnancy. Birth outcomes examined were infant birthweights and prematurity. I found there were no differences in birth outcomes between the vaccinated and unvaccinated groups. This was the first Australian study examining birth outcomes of influenza vaccination during pregnancy and as such, results will make an important contribution to the literature on this topic. Analysis of a public health dataset (Chapter 3) Morbidity and mortality of pertussis is highest in infants under six months of age. Control efforts focus on preventing disease in this age group by minimizing exposure by other infected cases. This project presents results from a retrospective case series analysis of all valid and probable pertussis notifications in Queensland from 1997-2014 by age group. Over this 18 year observation period, amongst children less than three years of age, notifications of pertussis were most common amongst infants <4 months of age. Increases in pertussis notifications from 2009 coincided with a substantial increase in the number of cases diagnosed by PCR. The results in this case series are consistent with that of overseas literature. It will important to monitor the outcomes of the implementation of the Queensland maternal pertussis vaccination program which commenced on 01 August 2014 regarding pertussis notifications in infants less than four months of age. Outbreak investigation (Chapter 4) This chapter describes an outbreak investigation of 85 confirmed cases of Salmonella Typhimurium (MLVA 03-12-11-12-524 and MLVA 03-13-11-12-524) in South-East Brisbane in January 2015. Cases experienced gastrointestinal illness following the consumption of Kim Bap (Korean style sushi). The descriptive study involved epidemiological, laboratory and environmental investigations. Twenty-two cases were hospitalised, seven of these (32%) were children. The likely vehicle of transmission of infection for this outbreak (Kim Bap sushi) was distributed by one producer to multiple food retail outlets in South-East Brisbane. Once supply of this product had ceased there were no further reported cases of illness. I was unable to determine any associations between food exposures and illness due to the absence of a comparison group. Evaluation of a surveillance system (Chapter 5) Hepatitis A virus (HAV) in Australia remains a nationally notifiable disease and control is considered to be a high public health priority. This evaluation of the current surveillance system for HAV in Queensland examined acceptability and timeliness. A detailed retrospective case series data analysis and genotype analysis was also conducted to determine sensitivity, representativeness and data quality. Age and sex data were complete, however risk factor data were largely incomplete. Data quality for travel history, post exposure prophylaxis vaccination, Indigenous status, mechanism of infection and hospitalisations were poor. Most cases of HAV are now acquired as a result of overseas travel or exposure to a returning overseas traveller. The timeliness of all aspects of the current system is reassuring however there needs to be a sustained improvement in completeness of data at every step, particularly for identification of Aboriginal and Torres Strait Islander people and for risk factor data

Baseline incidence of adverse birth outcomes and infant influenza and pertussis hospitalisations prior to the introduction of influenza and pertussis vaccination in pregnancy: a data linkage study of 78 382 mother-infant pairs, Northern Territory, Australia, 1994-2015

We conducted probabilistic data linkage of three population datasets for the Northern Territory (NT), Australia, to describe the incidence of preterm births, stillbirths, low birthweight and small for gestational age (SGA) per 1000 NT births; and influenza and pertussis hospitalisations per 1 00 000 NT births in infants <7 months of age, in a pre-maternal vaccination era. The Perinatal Trends dataset (1994–2014) formed the cohort of 78 382 births. Aboriginal mother–infant pairs (37%) had disproportionately higher average annual rates (AR) for all adverse birth outcomes compared to their non-Aboriginal counterparts; rate ratios: preterm births 2.2 (AR 142.4 vs. 64.7); stillbirths 2.3 (AR 10.8 vs. 4.6); low birthweight 2.9 (AR 54 vs. 19); and SGA 1.7 (AR 187 vs. 111). Hospitalisation (2000–2015) and Immunisation Register datasets (1994–2015), showed that influenza hospitalisations (n = 53) and rates were 42.3 times higher in Aboriginal infants (AR 254 vs. 6); and that pertussis hospitalisations (n = 37) were 7.1 times higher in Aboriginal infants (AR 142.5 vs. 20.2) compared to non-Aboriginal infants. These baseline data are essential to assess the safety and effectiveness of influenza and pertussis vaccinations in pregnant women from the NT. Remote living Aboriginal women and infants stand to benefit the most from these vaccines.This study was funded by a National Health and Medical Research Council (NHMRC) Project Grant (APP1091491). LMc was supported by an Australian Postgraduate Award scholarship provided by Charles Darwin University of the Northern Territory and an Enhanced Living scholarship provided by Menzies as part of the Doctor of Philosophy (PhD) program. TS holds a Career Development Fellowship from the NHMRC (GNT 1111657). MJB was supported by an NHMRC Early Career Fellowship (GNT1088733)

Passive sampling as a screening tool in Ireland for new and emerging chemicals

The challenges of monitoring our waters for compliance with WFD and the expansion of the list of organic chemicals that are to be added for monitoring, provides impetus for investigation of alternative monitoring approaches such as passive sampling. The work being carried out represents an important collaboration between two research centres (DCU & MI) together with agency (EA UK and Inland Fisheries Ireland) and industry (TelLab) to assess the potential of passive sampling in monitoring priority pollutants in Ireland. This work is underpinned by a some studies carried out in Ireland already by the Marine Institute and a vast array of literature in the area of priority pollutant monitoring. The impact of this study may lie in the establishment of a capability to utilise passive sampling in the monitoring programme in Ireland for WFD. This project pilots the use of passive sampling technology (PDMS and POCIS) combined with biota monitoring to assess the presence of priority substances in Irish surface waters. The project focuses in particular on new pollutants earmarked as candidates for the Annex X priority substances list under the EU Water Framework Directive e.g. E2 and EE2, pharmaceuticals, pesticides, PFOS etc. This considers the implications for compliance with current and proposed EQS and investigates the potential for incorporating passive sampling and biota testing in future compliance, investigative and trend monitoring. Results of water, biota and passive sampling will be presented together with an outline of the project over the next 12 months. Keywords: passive sampling, surface waters, coastal waters, WFD

Catchment approach to passive sampling of Irish waters

The challenges of monitoring our waters for compliance with WFD and the expansion of the list of organic chemicals that are to be added for monitoring, provides impetus for investigation of alternative monitoring approaches such as passive sampling. The work being carried out represents an important collaboration between two research centres (DCU & MI) together with agency (EA UK and Inland Fisheries Ireland) and industry (TelLab) to assess the potential of passive sampling in monitoring priority pollutants in Ireland. The impact of this study may lie in the establishment of a capability to utilise passive sampling in the monitoring programme in Ireland for WFD. This project pilots the use of passive sampling technology (PDMS and POCIS) combined with biota monitoring to assess the presence of priority substances in Irish surface waters. The project focuses in particular on new pollutants earmarked as candidates for the Annex X priority substances list under the EU Water Framework Directive e.g. E2 and EE2, pharmaceuticals, pesticides, PFOS etc. This considers the implications for compliance with current and proposed EQS and investigates the potential for incorporating passive sampling and biota testing in future compliance, investigative and trend monitoring. . Results of water, biota and passive sampling will be presented together for samples collected in the Dublin catchment. A separate study on the occurrence of the pyrethroid pesticide cypermethrin was also conducted. Several sites along the River Liffey, Dublin, were sampled for pharmaceutical as well as other organic pollutants. A POCIS device was deployed at each location and water samples were collected at T-0 and T-4weeks. There are a number of potential point sources of pollution to this catchment with 3 wastewater treatment plants in the area. Pyrethroids have a low toxicity relative to other pesticides (specifically the organochlorines) so have recently been used in place of more toxic pesticides. Cypermethrin has been shown to accumulate in passive sampling devices. This study involved collection of water samples alongside PDMS and SPMD samplers. Cypermethrin was detected in high levels in the water and PDMS samplers. Passive sampling devices can be a useful supporting technique in a ‘toolbox’ for monitoring within the WFD and other environmental programs. From the investigation of work to date it is clear that passive sampling can play an important role in screening of waters for emerging contaminants, especially for hydrophobic subtances where they could be incorporated into a risk based approach to monitoring. Also, passive sampling has demonstrated that it has a role to play in trend monitoring to illustrate where waters are improving in quality over time, thereby offering the WFD monitoring programme a valuable tool. Keywords: passive sampling, surface waters, coastal waters, WFD

Stability of methylation markers in head and neck squamous cell carcinoma

BackgroundAs cancer progresses, methylation patterns change to promote the tumorigenic phenotype. However, stability of methylation markers over time and the extent that biopsy samples are representative of larger tumor specimens are unknown. This information is critical for clinical use of such biomarkers.MethodsNinety‐eight patients with tumor specimens from 2 timepoints were measured for DNA methylation in the promoter regions across 4 genes.ResultsThere were no significant differences in overall methylation of CCNA1 (cyclin A1), NDN (necdin), deleted in colorectal carcinoma (DCC), and cluster of differentiation 1a (CD1A) within paired specimens (p values = .56, .17, .66, and .58, respectively). All genes showed strong correlations between paired specimens across time. Methylation was most consistent for CCNA1 and NDN over time.ConclusionThis report provides the first evidence that methylation markers measured in biopsy samples are representative of gene methylation in later specimens and suggests that biopsy markers could be representative biomarkers for use in defining personalized treatment utilizing epigenetic changes. © 2015 Wiley Periodicals, Head Neck 38: E1325–E1331, 2016Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137576/1/hed24223.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137576/2/hed24223_am.pd

Inequity of antenatal influenza and pertussis vaccine coverage in Australia: the Links2HealthierBubs record linkage cohort study, 2012–2017

Background: Pregnancy and early infancy are increased risk periods for severe adverse effects of respiratory infections. Aboriginal and/or Torres Strait Islander (respectfully referred to as First Nations) women and children in Australia bear a disproportionately higher burden of respiratory diseases compared to non-Indigenous women and infants. Influenza vaccines and whooping cough (pertussis) vaccines are recommended and free in every Australian pregnancy to combat these infections. We aimed to assess the equity of influenza and/or pertussis vaccination in pregnancy for three priority groups in Australia: First Nations women; women from culturally and linguistically diverse (CALD) backgrounds; and women living in remote areas or socio-economic disadvantage. Methods: We conducted individual record linkage of Perinatal Data Collections with immunisation registers/databases between 2012 and 2017. Analysis included generalised linear mixed model, log-binomial regression with a random intercept for the unique maternal identifier to account for clustering, presented as prevalence ratios (PR) and 95% compatibility intervals (95%CI). Results: There were 445,590 individual women in the final cohort. Compared with other Australian women (n = 322,848), First Nations women (n = 29,181) were less likely to have received both recommended antenatal vaccines (PR 0.69, 95% CI 0.67–0.71) whereas women from CALD backgrounds (n = 93,561) were more likely to have (PR 1.16, 95% CI 1.10–1.13). Women living in remote areas were less likely to have received both vaccines (PR 0.75, 95% CI 0.72–0.78), and women living in the highest areas of advantage were more likely to have received both vaccines (PR 1.44, 95% CI 1.40–1.48). Conclusions: Compared to other groups, First Nations Australian families, those living in remote areas and/or families from lower socio-economic backgrounds did not receive recommended vaccinations during pregnancy that are the benchmark of equitable healthcare. Addressing these barriers must remain a core priority for Australian health care systems and vaccine providers. An extension of this cohort is necessary to reassess these study findings

Exposure to the antimicrobial peptide LL-37 produces dendritic cells optimized for immunotherapy

Immunization of patients with autologous, ex vivo matured dendritic cell (DC) preparations, in order to prime antitumor T-cell responses, is the focus of intense research. Despite progress and approval of clinical approaches, significant enhancement of these personalized immunotherapies is urgently needed to improve efficacy. We show that immunotherapeutic murine and human DC, generated in the presence of the antimicrobial host defense peptide LL-37, have dramatically enhanced expansion and differentiation of cells with key features of the critical CD103 + /CD141 + DC subsets, including enhanced cross-presentation and co-stimulatory capacity, and upregulation of CCR7 with improved migratory capacity. These LL-37-DC enhanced proliferation, activation and cytokine production by CD8 + (but not CD4 + ) T cells in vitro and in vivo. Critically, tumor antigen-presenting LL-37-DC increased migration of primed, activated CD8 + T cells into established squamous cell carcinomas in mice, and resulted in tumor regression. This advance therefore has the potential to dramatically enhance DC immunotherapy protocols