Rapid and wide dispersal of passengers after flights makes investigation of flight-related outbreaks challenging. An outbreak of Salmonella Heidelberg was identified in a group of Irish travellers returning from Tanzania. Additional international cases sharing the same flight were identified. Our aim was to determine the source and potential vehicles of infection. Case-finding utilized information exchange using experts' communication networks and national surveillance systems. Demographic, clinical and food history information was collected. Twenty-five additional cases were identified from Ireland, The Netherlands, Norway, USA and Canada. We conducted a case-control study which indicated a significant association between illness and consumption of milk tart (OR 10.2) and an egg dish (OR 6) served on-board the flight. No food consumed before the flight was associated with illness. Cases from countries other than Ireland provided supplementary information that facilitated the identification of likely vehicles of infection. Timely, committed international collaboration is vital in such investigations.
This 2003 book offers a distinctive overview of the internal and external pressures responsible for the making of modern Japan. L. M. Cullen argues that Japanese policies and fears have often been caricatured in western accounts which have viewed the expansion of the west in an unduly positive light. He shows that Japan before 1854, far from being in progressive economic and social decay or political crisis, was on balance a successful society led by rational policymakers. He also shows how when an external threat emerged after 1793 the country became on balance more open rather than more oppressive and that Japan displayed remarkable success in negotiation with the western powers in 1853–68. In the twentieth century, however, with the 1889 constitution failing to control the armed forces and western and American interests encroaching in Asia and the Pacific, Japan abandoned realism and met her nemesis in China and the Pacific.
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