Campylobacteriosis associated with the consumption of unpasteurised milk: findings from a sentinel surveillance site.

Campylobacteriosis is the most common notifiable disease in New Zealand. While the risk of campylobacteriosis has been found to be strongly associated with the consumption of undercooked poultry, other risk factors include rainwater-sourced drinking water, contact with animals and consumption of raw dairy products. Despite this, there has been little investigation of raw milk as a risk factor for campylobacteriosis. Recent increases in demand for untreated or 'raw' milk have also raised concerns that this exposure may become a more important source of disease in the future. This study describes the cases of notified campylobacteriosis from a sentinel surveillance site. Previously collected data from notified cases of raw milk-associated campylobacteriosis were examined and compared with campylobacteriosis cases who did not report raw milk consumption. Raw milk campylobacteriosis cases differed from non-raw milk cases on comparison of age and occupation demographics, with raw milk cases more likely to be younger and categorised as children or students for occupation. Raw milk cases were more likely to be associated with outbreaks than non-raw milk cases. Study-suggested motivations for raw milk consumption (health reasons, natural product, produced on farm, inexpensive or to support locals) were not strongly supported by cases. More information about the raw milk consumption habits of New Zealanders would be helpful to better understand the risks of this disease, especially with respect to increased disease risk observed in younger people. Further discussion with raw milk consumers around their motivations may also be useful to find common ground between public health concerns and consumer preferences as efforts continue to manage this ongoing public health issue.

Legionella longbeachae detected in an industrial cooling tower linked to a legionellosis outbreak, New Zealand, 2015; possible waterborne transmission?

A legionellosis outbreak at an industrial site was investigated to identify and control the source. Cases were identified from disease notifications, workplace illness records, and from clinicians. Cases were interviewed for symptoms and risk factors and tested for legionellosis. Implicated environmental sources were sampled and tested for legionella. We identified six cases with Legionnaires' disease and seven with Pontiac fever; all had been exposed to aerosols from the cooling towers on the site. Nine cases had evidence of infection with either Legionella pneumophila serogroup (sg) 1 or Legionella longbeachae sg1; these organisms were also isolated from the cooling towers. There was 100% DNA sequence homology between cooling tower and clinical isolates of L. pneumophila sg1 using sequence-based typing analysis; no clinical L. longbeachae isolates were available to compare with environmental isolates. Routine monitoring of the towers prior to the outbreak failed to detect any legionella. Data from this outbreak indicate that L. pneumophila sg1 transmission occurred from the cooling towers; in addition, L. longbeachae transmission was suggested but remains unproven. L. longbeachae detection in cooling towers has not been previously reported in association with legionellosis outbreaks. Waterborne transmission should not be discounted in investigations for the source of L. longbeachae infection.

Isolation and characterisation of a novel Bohle-like virus from two frog species in the Darwin rural area, Australia.

Twelve captive magnificent tree frogs Litoria splendida and 2 green tree frogs L. caerulea on a property in the Darwin rural area (Northern Territory, Australia) either died or were euthanased after becoming lethargic or developing skin lesions. Samples from both species of frog were submitted for histopathology and virus isolation. An irido-like virus was cultured from tissue samples taken from both species and was characterised using electron microscopy, restriction enzyme digests and nucleic acid amplification and sequencing. The isolates were determined to belong to the genus Ranavirus, were indistinguishable from each other and shared a 98.62% nucleotide similarity and a 97.32% deduced amino acid homology with the Bohle iridovirus over a 1161 bp region of the major capsid gene. This is the first isolation of a ranavirus from amphibians in the Northern Territory and the first report of natural infection in these 2 species of native frog. The virus is tentatively named Mahaffey Road virus (MHRV).

Pathology of a Bohle-like virus infection in two Australian frog species (Litoria splendida and Litoria caerulea).

Gross and histopathological examination was performed on seven captive magnificent tree frogs (Litoria splendida) and one green tree frog (Litoria caerulea) that had died or been humanely destroyed while naturally infected with Mahaffey Road virus, a Bohle iridovirus-like ranavirus. Necropsy examination revealed skin lesions consisting of multiple small pale or haemorrhagic papules and ulcers in most frogs. Other common gross findings were perineural haemorrhage affecting the spinal nerves, hydrocoelom, hepatomegaly and splenomegaly with pinpoint pale foci throughout the parenchyma. On histological examination, vasculitis with prominent endothelial necrosis was found in a wide range of tissues. Widespread lymphoid necrosis and fibroblast necrosis were usual findings. Multifocal epithelial cell necrosis in the epidermis, liver and pancreas was found commonly. Non-suppurative meningoencephalitis, myelitis and ganglioneuritis were present variably. Intracytoplasmic basophilic inclusion bodies were found variably in hepatocytes, renal tubular epithelium and keratinocytes. Immunohistochemistry demonstrated ranavirus antigen in endothelial cells, fibroblasts, macrophages, lymphocytes and epithelial cells in a wide range of tissues. The finding of widespread venous and lymphatic endothelial necrosis and demonstration of abundant endothelial antigen suggests that endothelial tropism of the virus plays a significant role in the pathogenesis of the infection.

Arboviruses recovered from sentinel cattle using several virus isolation methods.

A group of 20 sentinel steers was bled weekly for 5 months in 1986 and the blood samples were examined for arboviruses by inoculation firstly into embryonated chicken eggs (ECE), baby mice, Aedes albopictus cells and BHK21 monolayers. A second group of cattle was similarly examined for virus in 1987, except that baby mice were not used. Viruses were recovered from 26% of the 878 weekly bleeds. The viruses identified consisted of 14 types belonging to the bluetongue, epizootic haemorrhagic disease (EHD), Palyam and Simbu groups with a single isolation of bovine ephemeral fever virus. The ECE system was found to be the best for isolating bluetongue and Simbu viruses, though the eggs were not usually killed by the inoculum. The ECE and A. albopictus systems were equally sensitive for recovering EHD viruses, while Palyam group viruses were most efficiently isolated in BHK21 monolayers.

Arboviruses recovered from sentinel livestock in northern Australia.

Over 700 arboviruses were recovered between 1981 and 1987 from the blood of sentinel livestock near Darwin. Twenty-three isolates were made from sheep, goats, swamp buffalo (Bubalus bubalis) and horses, and the remainder were from cattle. The isolates have been typed as 27 separate viruses belonging to the bluetongue, epizootic haemorrhagic disease, Palyam, Simbu, bovine ephemeral fever, Tibrogargan and alphavirus groups. Ten of these viruses have not been isolated elsewhere in Australia and four have been isolated only in Darwin. Considerable annual variations in virus activity and in the durations of detectable viraemia were observed.

EHDV-1, a new Australian serotype of epizootic haemorrhagic disease virus isolated from sentinel cattle in the Northern Territory.

In 1992, a virus (DPP2209) isolated from sentinel cattle located at Coastal Plains Research Station, latitude 12 degrees 39'S, longitude 131 degrees 20'E, approximately 60 km east of Darwin, Northern Territory. This virus was identified as a serotype of epizootic haemorrhagic disease (EHD) of deer virus previously undescribed in Australia. An additional 17 isolation of this virus were made from eight animals during the period February to May. Electron microscopic studies showed the presence of orbivirus-like structures. Serogrouping ELISA, indirect immunofluorescence assay and the serogrouping plaque reduction neutralisation test indicated the virus was a member of the epizootic haemorrhagic disease serogroup. Serotype specific plaque reduction neutralisation tests, indicated the virus was a member of the epizootic haemorrhagic disease serogroup not previously isolated in Australia. Analysis of the VP3 gene confirmed this observation. Cross neutralisation testing of the isolate with known epizootic haemorrhagic disease serotype viruses including endemic Australian and exotic strains identified isolate DPP2209 as epizootic haemorrhagic disease virus serotype 1.

Demonstration of herpes simplex type 2 in the cerebrospinal fluid of two patients with recurrent lymphocytic meningitis.

AIMS: To investigate the aetiology of recurrent lymphocytic meningitis in two patients with a past history of recurrent genital herpes simplex infection. METHODS: Cerebrospinal fluid (CSF) obtained from two patients during an acute recurrent episode of lymphocytic meningitis was analysed by polymerase chain reaction for the presence of herpes simplex DNA. RESULTS: In both patients, the acute CSF was positive for herpes simplex type 2 DNA. A second CSF obtained 2 weeks later from one patient was negative for HSV DNA: CONCLUSIONS: Herpes simplex type 2 may be an important cause of recurrent lymphocytic meningitis. Available evidence suggests that viral DNA is cleared from the CSF between episodes and supports active viral replication as the pathological mechanism. The recurrences of meningitis need not coincide with clinical recurrences of genital herpes.

Therapeutic day programs in the treatment of adolescents with mental illness.

OBJECTIVES: This study aims to assess the effectiveness of day programs against other treatment modalities in adolescents with mental illnesses (including substance abuse). It also aims to identify patient and program factors associated with favourable outcomes for adolescents with mental illness treated in therapeutic day programs. METHOD: An extensive database search of published literature was conducted, supplemented by hand-searching of references of retrieved articles, and a search by author. There was no restriction by study design. Relevant studies were identified and appraised using standardised criteria. RESULTS: Of the 231 studies identified in the search, 26 were relevant to this review. The majority of studies identified day programs as effective. There was a lack of adequate comparisons between day programs and other organisational arrangements. CONCLUSIONS: The quality of the studies identified was low. Twenty-two of the 26 studies did not have an adequate control group. Higher-quality research is required in the evaluation of the effectiveness of day programs, and the identification of other factors promoting successful outcome in the treatment of adolescent mental illness.

Bluetongue virus does not persist in naturally infected cattle.

Studies were designed to test if observations by Takamatsu et al. in 2003 were applicable to natural infection of cattle with bluetongue virus (BTV). These observations suggested that ovine gamma delta T-cells could become persistently infected and subsequent midge feeding could induce virus replication. Skin biopsies and blood were collected from 28 cattle naturally infected with BTV-1. Blood samples were processed for virus isolation by embryonated chicken egg inoculation and for serology by BTV competitive enzyme-linked immunosorbent assay and BTV-1 virus neutralisation. BTV-1 was isolated from the blood of all animals and serology confirmed infection with BTV-1. A total of 288 skin biopsies were collected and cultured in the presence of interleukin 2 and epidermal growth factor. Sampling commenced as soon as either serology or virus isolation indicated infection with BTV and continued at weekly intervals for at least eight weeks then monthly for another two months. The natural viraemias in this experiment ranged from one to five weeks. BTV-1 was isolated from only one skin biopsy sample. This sample was collected during the week in which the animal was viraemic. These findings provide compelling evidence that BTV does not persist in gamma delta T-cells in the skin of naturally infected cattle.