Antibiotic residues in milk samples obtained from cows after treatment for papillomatous digital dermatitis.

OBJECTIVE: To determine whether there would be detectable antibiotic residues in milk obtained from dairy cattle with papillomatous digital dermatitis (PDD) after topical treatment with oxytetracycline. DESIGN: Randomized controlled clinical trial. ANIMALS: 28 lactating Holstein cows with PDD. PROCEDURE: Cows were assigned to 2 treatment groups. Treatment 1 (n = 16) consisted of spraying of PDD lesions with 15 ml of a solution containing 100 mg of oxytetracycline/ml; lesions were sprayed twice daily for 7 days, using a garden sprayer. Treatment 2 (n = 12) consisted of a one-time application of a bandage that consisted of cotton soaked with 20 ml of a solution containing 100 mg of oxytetracycline/ml. Milk samples were obtained before and after treatment and assayed for tetracycline content by use of high-performance liquid chromatography and a commercially available tetracycline screening test. RESULTS: None of the cows in either treatment group had violative residues of oxytetracycline in milk samples. CONCLUSIONS AND CLINICAL RELEVANCE: Producers treating lactating cows that have PDD, via topical application of oxytetracycline solution at the concentrations reported in this study, have a low risk of causing violative antibiotic residues in milk.

Travel health: perceptions and practices of travel consultants.

BACKGROUND: The global increase in international travel puts travelers at risk of travel-related morbidity and mortality. Prior to travel, most travelers have contact with a travel agency, thereby providing an opportunity for intervention. With this in mind we aimed to determine some of the travel-related health knowledge, practices and needs of travel consultants. METHODS: A cross sectional study was undertaken in which one travel consultant from each of 166 Western Australian travel agencies was asked to complete a self-administered questionnaire. RESULTS: One hundred and forty-five travel agencies (87%) agreed to participate in the study. Fifty-six percent indicated that they "usually" gave broad travel-related health guidelines and recommended their clients consult a medical practitioner. Almost all travel consultants reported discussing travel health insurance; very few provided information on sexually transmissible diseases, the risks associated with drug use, or first aid kits. Over 80% responded correctly to statements eliciting their knowledge on yellow fever, malaria, and food safety; the majority incorrectly answered questions on dengue fever and altitude sickness. Fifty-six percent of respondents thought that there was "not enough" readily accessible travel health information; 52% said they would like to be more involved in providing health information to their clients. CONCLUSIONS: Contact between travelers and travel agents offers an opportunity to promote awareness of travel-related health hazards. While travel consultants' health knowledge on some topics is adequate, in other areas it is inconsistent. Many travel consultants in Western Australia expressed a willingness to be involved in future health promotion activities. This participation may be best nurtured by providing travel consultants with: (1) better health education so they are able to identify high-risk travelers and destinations for medical referral; and, (2) health information in a format they feel comfortable distributing to their clients.

New guidelines for management and prevention of meningococcal disease in Australia. Meningococcal Disease Working Party of the National Health and Medical Research Council.

The incidence of invasive meningococcal disease in Australia has increased over the past decade, and in April 1997 the National Health and Medical Research Council published guidelines for management of patients with meningococcal disease and their contacts. These guidelines emphasise the need for immediate intravenous antibiotic treatment of patients with suspected meningococcal disease, before transfer to hospital or lumbar puncture. When possible, blood for culture should be collected before antibiotic therapy, if this does not delay treatment.

Acute symptoms and sequelae of Ross River virus infection in South-Western Australia: a follow-up study.

BACKGROUND: Unusually high tides along the south-west coast of Western Australia (WA) during the spring and summer of 1988-89 provided ideal breeding conditions for mosquito vectors of Ross River virus (RRV). This was followed by the biggest outbreak of RRV infection ever documented in WA (330 notified cases). OBJECTIVES: To describe the nature and duration of symptoms of RRV infection in WA, and associated functional disability; to determine the perceived effectiveness of treatments; to determine the usefulness of available information on RRV infection. STUDY DESIGN: A retrospective study of all cases of RRV infection reported from South West WA during the 1988-89 outbreak, using a self-administered patient questionnaire. RESULTS: The most common symptoms were arthralgia, tiredness and lethargy, and joint stiffness and swelling. In patients with joint manifestations, the knees, wrists and ankles were almost always affected. Non-steroidal anti-inflammatory agents, rest, simple analgesics and hydrotherapy were subjectively the most helpful treatments. Only 27% of patients had recovered completely within 6 months of onset of symptoms. Three years after the outbreak, up to 57% still experienced at least intermittent joint symptoms. Less than one-third of people reported that the available information adequately explained the consequences of RRV infection. CONCLUSIONS: Compared with patients elsewhere in Australia, people infected with RRV in the South West of WA experience a slightly different spectrum of clinical symptoms, with a longer period of disability. This may be related to the presence of a different topotype of the virus to that found elsewhere in Australia. Better information for doctors and patients on the likely course of the illness is needed. Future studies should examine the economic cost associated with RRV infection, and evaluate treatments to shorten the period of disability.

Epidemic gonococcal conjunctivitis in central Australia.

OBJECTIVES: To describe an epidemic of gonococcal conjunctivitis in central Australian Aboriginal children, the responsible phenotypes of Neisseria gonorrhoeae, factors facilitating spread and treatment efficacy. DESIGN: Prospective study of patients with laboratory confirmed or clinical gonococcal conjunctivitis diagnosed from January to July 1991. SETTING: The Alice Springs and Barkly Tablelands Health Districts of the Northern Territory, the Anangu Pitjantjatjara Lands of South Australia and the Ngaanyatjarra Homelands of Western Australia. METHODS: Cases were identified from surveillance data and laboratory notifications, and by active case finding. A community survey explored risk factors. MAIN OUTCOME MEASURES: Age-specific attack rates, auxotype/serovar characterisation of isolates, and clinical response to single dose treatment. RESULTS: We identified 432 cases. The highest attack rate was in the 0-4 year age group (86 per 1000), and the risk of conjunctivitis decreased with age. The odds ratio of secondary infection in household compared with community contacts was 14.5 (P < 0.002; 95% CI, 1.8-120.0). Disease was less common in children with clean faces and hands. The outbreak occurred after unseasonable rains and large community gatherings. Isolates were predominantly IA serovars, less common among central Australian serovars. CONCLUSIONS: The trigger for nonsexually transmitted gonococcal conjunctivitis epidemics remains obscure. Age is a significant risk factor and social and ecological factors may also contribute. Active case finding within affected households and treatment with a suitable penicillin is effective in stopping transmission.

Rubella vaccination and congenital rubella syndrome in Western Australia.

OBJECTIVE: To review the incidence of congenital rubella syndrome (CRS) and the acceptance of schoolgirl rubella vaccination in Western Australia (WA), and to determine whether any groups in the community are at increased risk of having a child affected by CRS. DESIGN: Review of records of the WA Birth Defects Registry for cases of CRS; survey of obstetricians for terminations of pregnancy for maternal rubella infection; survey of schoolgirls eligible for the 1991 annual rubella vaccination campaign; review of Perth Immunisation Clinic and rural community and child health records; review of the rubella immune status of women tested antenatally. MAIN OUTCOME MEASURES: The incidence rate of CRS per 10,000 live births in WA 1980-1990; the incidence of rubella-associated terminations of pregnancy during 1990 and 1991; trends in rubella vaccine acceptance among WA schoolgirls between 1971 and 1991; and the proportion of women attending antenatal clinics who showed satisfactory immunity against rubella, stratified by country of birth. RESULTS: The incidence rate of CRS in WA remains below 2 cases per 10,000 live births. Approximately 86% of Perth schoolgirls have been vaccinated against rubella. Rubella vaccine acceptance fell in some country areas during the late 1980s, but is now returning to acceptable levels. Women born in Asia are at greater risk of having a baby affected by CRS than women born in Australia. Babies with CRS may be born to women who have previously been vaccinated against rubella. CONCLUSIONS: The incidence of CRS has fallen dramatically since the introduction of the schoolgirl vaccination program, but there is still a need for mechanisms to identify and vaccinate non-immune women.

A case of human melioidosis originating in south-west Western Australia.

OBJECTIVE: To report the first human case of autochthonous melioidosis in temperate Australia (latitude 31 degrees 10'S) and to describe the extent of the presence of the causative agent, Pseudomonas pseudomallei, in southwest Western Australia. CLINICAL FEATURES: A 45-year-old man living on a hobby farm was admitted to hospital for investigation of lung lesions, weight loss and low grade fevers. P. pseudomallei was cultured from material from an aspiration biopsy of a mediastinal mass. INTERVENTION AND OUTCOME: The patient was successfully treated with a regimen of ceftazidime and trimethoprim-sulfamethoxazole. A review of epidemiological data showed that, since 1967, P. pseudomallei has been cultured from animals and soil in a region 50-250 km north-west of Perth, Western Australia, and that pockets of endemicity are found in the districts of Toodyay (where our patient's farm was), Chittering, Ballidu, Gidgegannup, Badgingarra, and Wongan Hills. CONCLUSION: The persistence of the bacterium in animals and soil in south-west Western Australia demonstrates abundantly that P. pseudomallei can exist opportunely beyond its traditional tropical habitat. It is likely that there will be further clinical cases of melioidosis originating in this region, and that the boundaries of endemicity in Australia will expand further.

Effects of graded levels of dietary copper on copper and iron concentrations in swine tissues.

In a dose-response study, 120 weanling, crossbred pigs were used to determine the effect of 7.5, 15, 30, 60, 120 and 240 ppm total dietary Cu on animal performance and Cu and Fe stores in selected tissues. Pigs were killed at 56 or 91 kg average body weight. Average daily gain was not affected by dietary treatment. Dietary Cu concentrations of 7.5, 15, 30 and 60 ppm had no appreciable effect on Cu and Fe concentrations in liver and kidney of pigs slaughtered at 91 kg. However, 120 and 240 ppm dietary Cu increased (P less than or equal to .01) liver Cu 4.5- and 16-fold and decreased (P less than or equal to .05) liver Fe by 50 and 60%, respectively, compared with the other dietary treatments. A fit of liver Cu and Fe data to linear plateau models resulted in an inflection point of approximately 60 ppm dietary Cu. Kidney Cu was also increased (P less than or equal to .05) by 120 and 240 ppm dietary Cu, but the magnitude of the change was smaller than that of liver Cu. Muscle Cu and Fe were not significantly affected by dietary Cu.

Herd health status of animals exposed to polybrominated biphenyls (PBB).

The health status of 16 herds of dairly cattle exposed to low levels of polybrominated bipenyl (PBB) was compared with that of 15 control herds. Milk production of the contaminated herds was not significantly changed in 1972, 1973, and 1974 and was not significantly different from that of control herds in the same years. Mortality of adult cows and calves, the percentages of cows culled from the herds because of old age and low production, disease, or sterility, and the general health conditions were similar in the two groups. Serum concentrations of calcium, glucose, and cholesterol in contaminated herds were significantly different from those of the control herds, but the relationship to PBB exposure needs further investigation.