During the decade to 1999, the incidence of human infections with the zoonotic pathogen verocytotoxin-producing Escherichia coli O157 (VTEC O157) increased in England and Wales. This paper describes the results of a survey of 75 farms to determine the prevalence of faecal excretion of VTEC O157 by cattle, its primary reservoir host, in England and Wales. Faecal samples were collected from 4663 cattle between June and December 1999. The prevalence of excretion by individual cattle was 4.2 per cent (95 per cent confidence interval [CI] 2.0 to 6.4) and 10.3 per cent (95 per cent CI 5.8 to 14.8) among animals in infected herds. The within-herd prevalence on positive farms ranged from 1.1 to 51.4 per cent. At least one positive animal was identified on 29 (38.7 per cent; 95 per cent CI 28.1 to 50.4) of the farms, including dairy, suckler and fattening herds. The prevalence of excretion was least in the calves under two months of age, peaked in the calves aged between two and six months and declined thereafter. The phage types identified most widely were 4, 34 and 2, which were each found on six of the 29 positive farms.
Anthrax is extremely rare in the western world but is endemic to areas of south and central Asia. In early 2010 an outbreak was identified in heroin-injecting intravenous drug users in the United Kingdom and Europe. Afghanistan is currently the principal source of heroin which reaches the United Kingdom. When anthrax occurs, cutaneous disease accounts for over 95% of cases. At least 47 cases with 13 deaths have been confirmed so far. We present three cases presenting during this time with marked swelling, one resulting in compartment syndrome but all with an absence of the expected cutaneous appearances. We suggest that rather than cutaneous anthrax, these patients represent a new subcutaneous presentation of anthrax.
The clinical signs, treatments used and spread of psoroptic mange in cattle from October 2007 until March 2011 are described. The disease was first diagnosed in South West Wales, having not been reported in Great Britain since the 1980s. The likely source was identified as a farm that had imported two animals from mainland Europe in the summer of 2006. Since that time, disease has been diagnosed on a further 22 premises, the majority in South West Wales but also in South East and Mid Wales and on one farm in England. Bought in animals harbouring the Psoroptes species mite but not showing clinical signs were considered the greatest risk of introducing the infestation into a herd. This, together with the difficulties of treatment to eliminate the parasite, means that it is unlikely that this outbreak has been controlled. There is also a continuing threat of importing the disease from abroad. The disease is not notifiable in the UK.
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