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An outbreak of meningococcal disease in Stonehouse: planning and execution of a large-scale survey
- J. M. Stuart, K. A. V. Cartwright, D. M. Jones, N. D. Noah, R. J. Wall, C. Caroline Blackwell, A. E. Jephcott, I. R. Ferguson
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- Journal:
- Epidemiology & Infection / Volume 99 / Issue 3 / December 1987
- Published online by Cambridge University Press:
- 19 October 2009, pp. 579-589
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- Article
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In November 1986 a large-scale survey was undertaken in the Gloucestershire town of Stonehouse during an outbreak of meningococcal disease due to group B type 15 subtype Pl. 16 sulphonamide-resistant strains. There were 15 cases in Stonehouse residents during the 4 years from April 1983, an annual attack rate of 56·5 per 100000. Four secondary cases occurred despite rifampicin prophylaxis. The objectives of this community survey were to investigate patterns of meningococcal carriage, transmission and immunity and to determine the proportion of non-secretors of blood group antigens in the Stonehouse population find amongst meningococcal carriers. A total of 6237 subjects participated including 75% of the 6635 Stonehouse residents. Over 97% of the participants provided all three of the requested specimens – nasopharyngeal swabs, saliva and blood samples.
The co-operation between the many organizations involved in the detailed preliminary planning was instrumental in the success of the survey; in particular the value of effective collaboration between Departments of Community Medicine and Microbiology and of the Public Health Laboratory Service network of laboratories in undertaking investigations of this size and type was clearly demonstrated.
11 - Blood group phenotypes and infectious diseases
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- By C. Caroline Blackwell, Discipline of Immunology and Microbiology and Hunter Immunology Unit, University of Newcastle, Newcastle, Australia; Institute for Scientific Evaluation of Naturopathy, University of Cologne, Cologne, Germany, Donald M. Weir, Department of Medical Microbiology, The Medical School, University of Edinburgh, Abdulhamid M. Alkout, Department of Medical Microbiology, The Medical School, University of Edinburgh, Omar R. Elahmer, Department of Medical Microbiology, The Medical School, University of Edinburgh, Doris A. C. MacKenzie, Department of Medical Microbiology, The Medical School, University of Edinburgh, Valerie S. James, Department of Medical Microbiology, The Medical School, University of Edinburgh, J. Matthias Braun, Department of Medical Microbiology, The Medical School, University of Edinburgh; Institute for Scientific Evaluation of Naturopathy, University of Cologne, Cologne, Germany, Osama M. Almadani, Department of Medical Microbiology, The Medical School University of Edinburgh; Forensic Medicine Unit, Edinburgh, Scotland, United Kingdom, Anthony Busuttil, Forensic Medicine Unit, The Medical School University of Edinburgh, Edinburgh, Scotland, United Kingdom
- Edited by Richard Bellamy, Kintampo Health Research Centre, Ghana
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- Book:
- Susceptibility to Infectious Diseases
- Published online:
- 14 August 2009
- Print publication:
- 22 December 2003, pp 309-336
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Summary
INTRODUCTION
The first observations on associations between blood groups and infectious diseases were made in the 1950s, but the underlying mechanisms were not elucidated for many years. This could have been due to limited explanations for the epidemiological findings or to conflicting reports of associations between different blood groups with the same disease. An example of the latter is the large numbers of papers on Helicobacter pylori and ABO or Lewis blood groups/secretor status during the past few years which have reported inconsistent or conflicting results. Because determination of blood groups is a relatively simple and inexpensive procedure, many investigators have used it for quick “simple” studies without consideration of possible confounding factors. For all studies on blood groups and infection, the following points (gained with the experience of hindsight) need to be considered in planning or assessment of surveys:
The disease or organism under investigation needs to be clearly defined. Severity of the symptoms should be also be considered, e.g., differentiation of cases of Escherichia coli O157 infection between patients with uncomplicated diarrhoeal disease and those that develop haemolytic uraemic syndrome (HUS) (Blackwell et al., 2002).
It should be made clear that the investigation examined an outbreak or defined epidemic due to a particular strain in contrast to sporadic cases which could be due to strains with different antigenic characteristics or virulence factors.
Different populations express different quantities of antigens such as H, Lewisa, or Lewisb.
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