Projecting social contact matrices in 152 countries using contact surveys and demographic data.

Heterogeneities in contact networks have a major effect in determining whether a pathogen can become epidemic or persist at endemic levels. Epidemic models that determine which interventions can successfully prevent an outbreak need to account for social structure and mixing patterns. Contact patterns vary across age and locations (e.

HIV testing in black Africans living in England.

We examined the uptake of HIV testing in black Africans living in England before the introduction of national testing guidelines. Analyses were conducted using data from an anonymous self-completed questionnaire linked to oral fluid samples to establish HIV status in black Africans attending community venues in England in 2004. Of 946 participants, 44% had ever been tested for HIV and 29% had been tested in the previous 24 months.

Fidaxomicin: a new option for the treatment of Clostridium difficile infection.

The two drugs currently recommended for the treatment of Clostridium difficile infection (CDI), namely vancomycin and metronidazole, are both associated with high rates of recurrence of infection. Hence there is a need for new treatment options. The novel oral macrocyclic antibiotic fidaxomicin (previously known as PAR-101, OPT-80 and difimicin) was recently approved in the USA and in Europe for the treatment of CDI.

A new method to assign country of HIV infection among heterosexuals born abroad and diagnosed with HIV.

Objective: To apply a new method to ascertain likely place of HIV infection among persons born abroad and diagnosed with HIV in the United Kingdom (UK).

Design: Analyses of heterosexual adults born abroad, diagnosed with HIV in the UK between 2004 and 2010, and reported to the national HIV diagnoses database.

Methods: Year of infection was ascertained by applying an estimated rate of CD4 cell count decline between an individual's CD4 cell count at diagnosis and estimates of CD4-cell count at infection.

Mortality caused by influenza and respiratory syncytial virus by age group in England and Wales 1999-2010.

Background: The mortality burden caused by influenza cannot be quantified directly from death certificates because of under-recording; therefore, the estimated number of influenza deaths has to be obtained through statistical modelling.

Objective: To estimate the number of deaths caused by influenza and respiratory syncytial virus (RSV) in England and Wales between 1999 and 2010 using a multivariable regression model.

Methods: Generalised linear models were used to estimate weekly deaths by age group (<15, 15-44, 45-74 and 75+ years) as a function of positive influenza and RSV isolates.

Safe travels? HIV transmission among Britons travelling abroad.

Objectives: The aim of the study was to identify and describe the characteristics of persons born in the UK who acquire HIV infection abroad.

Methods: Analyses using case reports and follow-up data from the national HIV database held at the Health Protection Agency were performed.

Results: Fifteen per cent (2066 of 13 891) of UK-born adults diagnosed in England, Wales and Northern Ireland between 2002 and 2010 acquired HIV infection abroad.

Effectiveness of trivalent and pandemic influenza vaccines in England and Wales 2008-2010: results from a cohort study in general practice.

Estimation of influenza vaccine effectiveness (VE) is complicated by various degrees of mismatch between circulating and vaccine strains each season. We carried out a cohort study to estimate VE of trivalent (TIV) and pandemic influenza vaccines (PIV) in preventing various respiratory outcomes among general practice (GP) patients in England and Wales between 2008 and 2010. Dates of consultations for influenza-like illness (ILI), acute respiratory tract infection (ARTI), lower respiratory tract infection (LRTI) and nasopharyngeal swabs were obtained from the patient-level electronic records of the 100 practices enrolled in a national GP network.

Recruiting individuals into the HTLV cohort study in the United Kingdom: clinical findings and challenges in the first six years, 2003 to 2009.

Human T-lymphotropic virus (HTLV) infection is rare in the United Kingdom (UK) and few studies are available worldwide. Following introduction of blood donation testing in 2002, a cohort of individuals could be identified and prospectively recruited to describe progression and onset of disease. Here we describe baseline characteristics of participants, and evaluate recruitment into the UK HTLV National Register over the first six years, from July 2003 to June 2009.

Comparison of diagnostic sensitivity and specificity of seven Cryptosporidium assays used in the UK.

To compare the diagnostic sensitivity and specificity of seven Cryptosporidium diagnostic assays used in the UK, results from 259 stool samples from patients with acute gastrointestinal symptoms were compared against a nominated gold standard (real-time PCR and oocyst detection). Of the 152 'true positives', 80 were Cryptosporidium hominis, 68 Cryptosporidium parvum, two Cryptosporidium felis, one Cryptosporidium ubiquitum and one Cryptosporidium meleagridis. The Cryptosporidium spp.

Hepatitis C prevalence in England remains low and varies by ethnicity: an updated evidence synthesis.

Background: Previous evidence synthesis estimates of Hepatitis C Virus (HCV) in England did not consider excess HCV risk in ethnic minority populations. We incorporate new information on HCV risk among non-injectors by ethnic group, and additional information on injecting prevalence in order to generate new and updated estimates of HCV prevalence risk in England for 2005.

Methods: Bayesian evidence synthesis was used to combine multiple sources of data that directly or indirectly provide information on the populations at risk, or prevalence of HCV infection.

The role of the interferon gamma release assay in assessing recent tuberculosis transmission in a hospital incident.

In 2007, an extensive contact screening investigation into onward transmission of tuberculosis was instigated at a hospital in Northern Ireland following diagnosis of pulmonary multi-drug resistant TB in a healthcare worker. Interferon gamma release assays (IGRAs) were used to test 333 patients and 98 staff. We investigated for evidence of onward transmission and recent infection based on analysis of clinical, demographic and IGRA data.

Investigation of the population structure of Legionella pneumophila by analysis of tandem repeat copy number and internal sequence variation.

The population structure of the species Legionella pneumophila was investigated by multilocus variable number of tandem repeats (VNTR) analysis (MLVA) and sequencing of three VNTRs (Lpms01, Lpms04 and Lpms13) in selected strains. Of 150 isolates of diverse origins, 136 (86 %) were distributed into eight large MLVA clonal complexes (VACCs) and the rest were either unique or formed small clusters of up to two MLVA genotypes. In spite of the lower degree of genome-wide linkage disequilibrium of the MLVA loci compared with sequence-based typing, the clustering achieved by the two methods was highly congruent.

Molecular typing methods for outbreak detection and surveillance of invasive disease caused by Neisseria meningitidis, Haemophilus influenzae and Streptococcus pneumoniae, a review.

Invasive disease caused by the encapsulated bacteria Neisseria meningitidis, Haemophilus influenzae and Streptococcus pneumoniae remains an important cause of morbidity and mortality worldwide, despite the introduction of successful conjugate polysaccharide vaccines that target disease-associated strains. In addition, resistance, or more accurately reduced susceptibility, to therapeutic antibiotics is spreading in populations of these organisms. There is therefore a continuing requirement for the surveillance of vaccine and non-vaccine antigens and antibiotic susceptibilities among isolates from invasive disease, which is only partially met by conventional methods.

Mumps complications and effects of mumps vaccination, England and Wales, 2002-2006.

We analyzed data from hospital admissions and enhanced mumps surveillance to assess mumps complications during the largest mumps outbreak in England and Wales, 2004-2005, and their association with mumps vaccination. When compared with nonoutbreak periods, the outbreak was associated with a clear increase in hospitalized patients with orchitis, meningitis, and pancreatitis. Routine mumps surveillance and hospital data showed that 6.

Hepatitis B and residual risk of infection in English and Welsh blood donors, 1996 through 2008.

Background: Globally, of all infections that donations are tested for, hepatitis B has the highest residual risk of transfusion transmission, despite donor selection criteria and advances in testing. Every blood donation in England and Wales is tested for hepatitis B surface antigen. Knowledge of infections being detected can inform donor selection and testing strategies.

Assessing the effect of foreign travel and protection by BCG vaccination on the spread of tuberculosis in a low incidence country, United Kingdom, October 2008 to December 2009.

The contribution of travel to high incidence countries and the impact of the discontinuation of universal Bacillus Calmette–Guérin (BCG) vaccination to there cent rise in tuberculosis (TB) in the United Kingdom remain unclear. An outbreak in a college presented an opportunity to assess these. A cohort of students answered a questionnaire assessing risk factors for TB.

Excess mortality monitoring in England and Wales during the influenza A(H1N1) 2009 pandemic.

We present the results from a novel surveillance system for detecting excess all-cause mortality by age group in England and Wales developed during the pandemic influenza A(H1N1) 2009 period from April 2009 to March 2010. A Poisson regression model was fitted to age-specific mortality data from 1999 to 2008 and used to predict the expected number of weekly deaths in the absence of extreme health events. The system included adjustment for reporting delays.

Investigating transmission of Mycobacterium bovis in the United Kingdom in 2005 to 2008.

Due to an increase in bovine tuberculosis in cattle in the United Kingdom, we investigated the characteristics of Mycobacterium bovis infection in humans and assessed whether extensive transmission of M. bovis between humans has occurred. A cross-sectional study linking demographic, clinical, and DNA fingerprinting (using 15-locus mycobacterial interspersed repetitive-unit-variable-number tandem-repeat [MIRU-VNTR] typing) data on cases reported between 2005 and 2008 was undertaken.

A novel real-time polymerase chain reaction for identification of Salmonella enterica subspecies enterica.

Salmonella enterica subspecies enterica (subspecies I) causes the majority of infections in humans and homeothermic animals. We present a real-time polymerase chain reaction assay targeting the hilA gene that demonstrates 97.9% specificity and 99.

Hepatitis C and B testing in English prisons is low but increasing.

Background: Prisons are important settings for blood-borne virus control because of the high prevalence of hepatitis C and B viral infections (HCV and HBV), and behaviours associated with transmission among prisoners.

Methods: Data from sentinel laboratories in England were used to identify testing for hepatitis C (anti-HCV) and hepatitis B [hepatitis B surface antigen (HBsAg) and anti-hepatitis B core antigen (HBc)] among male and female prisoners between 2005 and 2008.

Results: Between 2005 and 2008, 10 723 prisoners from 39 prisons in England were tested for anti-HCV, anti-HBc and/or HBsAg.

Mycoplasma pneumoniae infection in primary care investigated by real-time PCR in England and Wales.

Real-time PCR was employed to detect a conserved region of the P1 cytadhesin gene of Mycoplasma pneumoniae in combined nose and throat swabs collected from patients attending GP surgeries during 2005-2009 with symptoms of respiratory tract infection (RTI). Samples were collected as part of an annual winter epidemiological and virological linked study in England and Wales. A total of 3,987 samples were tested, 65 (1.

Estimation of the rate of pelvic inflammatory disease diagnoses: trends in England, 2000-2008.

Background: Pelvic inflammatory disease (PID) is difficult to define and diagnose; therefore, a standardized methodology for identifying and monitoring PID diagnoses is required. We estimated the rate of PID in general practice in England, and investigated variations by definition of PID, time, age, and geographical area.

Methods: We analyzed the United Kingdom General Practice Research Database between 2000 and 2008.

Wet cooling systems as a source of sporadic Legionnaires' disease: a geographical analysis of data for England and Wales, 1996-2006.

Background: The source of infection for most sporadic cases of Legionnaires' disease remains unknown. This study aims quantify the relationship between cases and wet cooling systems (WCS), a potential source of aerosolised legionella bacteria.

Methods: The study analysed data on 1163 sporadic, community-acquired cases of Legionnaires' disease in England and Wales with onset between 1996 and 2006, and 11630 postcode controls randomly sampled in proportion to population size and matched on region, age group and sex.

No effect of 2008/09 seasonal influenza vaccination on the risk of pandemic H1N1 2009 influenza infection in England.

This study reports effectiveness of trivalent influenza vaccine (TIV) against confirmed pandemic influenza infection in England using a retrospective test-negative case-control study. Cases and controls were frequency matched by age, swabbing-week and region. On univariable and multivariable analysis adjusted for underlying clinical risk factors, cases were no more or less likely than controls to be vaccinated with 2008-09 or 2007-08 season TIV.