Subject(s)
Immunization , Vaccination , Child , Humans , Academies and Institutes , Risk Assessment , India , Immunization ScheduleABSTRACT
The recent high-profile death of a British Olympic rower from leptospirosis has raised awareness to this uncommon but potentially fatal disease. The re-emergence of the disease abroad is well documented in the literature, but less is known about cases in the UK. The increase in participation in water sports, foreign travel and often a combination of the two, has increased the exposure of tourists subsequently returning to the UK from areas of high prevalence. Leptospirosis is a zoonotic infection. The bacteria are shed in the urine of animals to the environment from where humans are infected by incidental hosts. There is a wide spectrum of severity of symptoms, from a self-limiting febrile illness to fatal pulmonary haemorrhage, renal or liver failure. It is thought that cases remain unrecognized every year in the UK, largely due to the mild nature of symptoms and the wide differential for febrile illness and partly due to lack of awareness among clinicians. This review examines the epidemiology of leptospirosis in the UK, over the period 2006-10, the clinical features, diagnostic techniques and treatment.
Subject(s)
Leptospirosis/diagnosis , Leptospirosis/epidemiology , Weil Disease/diagnosis , Weil Disease/epidemiology , Adolescent , Adult , Aged , Animals , Child , Female , Humans , Leptospirosis/transmission , Male , Middle Aged , Rats/urine , Rats/virology , United Kingdom/epidemiology , Weil Disease/transmission , Young Adult , ZoonosesABSTRACT
AIM: To determine the effectiveness of serial influenza vaccination. SCOPE: Studied in a Scottish GP population, the overall seroresponse rate increased with annual influenza vaccinations and after 5 years it increased from 45.1% to 93.3% for influenza virus A (H1) and from 48.4% to 98.3% for influenza virus A (H3). However, there was little boosting effect with further doses after becoming a seroresponder. The pre-vaccination titres were significantly higher in previous year's seroresponders compared to non-responders. CONCLUSIONS: The policy of annual vaccination is supported by our data in order to increase the disappointing response rate after one dose. However, the lack of a boosting response with subsequent doses and the significant residual immunity after becoming a seroresponder suggests a prior serological immunity check in order to better direct the vaccine supply (in the years of no antigenic drift), to those who need it most.
