Disease In Great Britain Research Articles

Ancient dental calculus reveals oral microbiome shifts associated with lifestyle and disease in Great Britain.

The prevalence of chronic, non-communicable diseases has risen sharply in recent decades, especially in industrialized countries. While several studies implicate the microbiome in this trend, few have examined the evolutionary history of industrialized microbiomes. Here we sampled 235 ancient dental calculus samples from individuals living in Great Britain (∼2200 BCE to 1853 CE), including 127 well-contextualized London adults. We reconstructed their microbial history spanning the transition to industrialization. After controlling for oral geography and technical biases, we identified multiple oral microbial communities that coexisted in Britain for millennia, including a community associated with Methanobrevibacter, an anaerobic Archaea not commonly prevalent in the oral microbiome of modern industrialized societies. Calculus analysis suggests that oral hygiene contributed to oral microbiome composition, while microbial functions reflected past differences in diet, specifically in dairy and carbohydrate consumption. In London samples, Methanobrevibacter-associated microbial communities are linked with skeletal markers of systemic diseases (for example, periostitis and joint pathologies), and their disappearance is consistent with temporal shifts, including the arrival of the Second Plague Pandemic. This suggests pre-industrialized microbiomes were more diverse than previously recognized, enhancing our understanding of chronic, non-communicable disease origins in industrialized populations.

Early childhood lower respiratory tract infection and premature adult death from respiratory disease in Great Britain: a national birth cohort study

Lower respiratory tract infections (LRTIs) in early childhood are known to influence lung development and lifelong lung health, but their link to premature adult death from respiratory disease is unclear. We aimed to estimate the association between early childhood LRTI and the risk and burden of premature adult mortality from respiratory disease. This longitudinal observational cohort study used data collected prospectively by the Medical Research Council National Survey of Health and Development in a nationally representative cohort recruited at birth in March, 1946, in England, Scotland, and Wales. We evaluated the association between LRTI during early childhood (age <2 years) and death from respiratory disease from age 26 through 73 years. Early childhood LRTI occurrence was reported by parents or guardians. Cause and date of death were obtained from the National Health Service Central Register. Hazard ratios (HRs) and population attributable risk associated with early childhood LRTI were estimated using competing risks Cox proportional hazards models, adjusted for childhood socioeconomic position, childhood home overcrowding, birthweight, sex, and smoking at age 20-25 years. We compared mortality within the cohort studied with national mortality patterns and estimated corresponding excess deaths occurring nationally during the study period. 5362 participants were enrolled in March, 1946, and 4032 (75%) continued participating in the study at age 20-25 years. 443 participants with incomplete data on early childhood (368 [9%] of 4032), smoking (57 [1%]), or mortality (18 [<1%]) were excluded. 3589 participants aged 26 years (1840 [51%] male and 1749 [49%] female) were included in the survival analyses from 1972 onwards. The maximum follow-up time was 47·9 years. Among 3589 participants, 913 (25%) who had an LRTI during early childhood were at greater risk of dying from respiratory disease by age 73 years than those with no LRTI during early childhood (HR 1·93, 95% CI 1·10-3·37; p=0·021), after adjustment for childhood socioeconomic position, childhood home overcrowding, birthweight, sex, and adult smoking. This finding corresponded to a population attributable risk of 20·4% (95% CI 3·8-29·8) and 179 188 (95% CI 33 806-261 519) excess deaths across England and Wales between 1972 and 2019. In this prospective, life-spanning, nationally representative cohort study, LRTI during early childhood was associated with almost a two times increased risk of premature adult death from respiratory disease, and accounted for one-fifth of these deaths. National Institute for Health and Care Research Imperial Biomedical Research Centre, Royal Brompton and Harefield National Health Service (NHS) Foundation Trust, Royal Brompton and Harefield Hospitals Charity and Imperial College Healthcare NHS Trust, UK Medical Research Council.

Multilayer network analysis unravels haulage vehicles as a hidden threat to the British swine industry.

When assessing the role of live animal trade networks in the spread of infectious diseases in livestock, attention has focused mainly on direct movements of animals between premises, whereas the role of haulage vehicles used during transport, an indirect route for disease transmission, has largely been ignored. Here, we have assessed the impact of sharing haulage vehicles from livestock transport service providers on the connectivity between farms as well as on the spread of swine infectious diseases in Great Britain (GB). Using all pig movement records between April 2012 and March 2014 in GB, we built a series of directed and weighted static multiplex networks consisting of two layers of identical nodes, where nodes (farms) are linked either by (a) the direct movement of pigs and (b) the shared use of haulage vehicles. The haulage contact definition integrates the date of the move and the duration that lorries are left contaminated by pathogens, hence accounting for the temporal aspect of contact events. For increasing , descriptive network analyses were performed to assess the role of haulage on network connectivity. We then explored how viruses may spread throughout the GB pig sector by computing the reproduction number Our results showed that sharing haulage vehicles increases the number of contacts between farms by >50% and represents an important driver of disease transmission. In particular, sharing haulage vehicles, even if <1day, will limit the benefit of the standstill regulation, increase the number of premises that could be infected in an outbreak, and more easily raise above 1. This work confirms that sharing haulage vehicles has significant potential for spreading infectious diseases within the pig sector. The cleansing and disinfection process of haulage vehicles is therefore a critical control point for disease transmission risk mitigation.

Estimating the impact on food and edible materials of changing scrapie control measures: The scrapie control model

Multiple controls established during the bovine spongiform encephalopathy (BSE) epidemic were not solely applied to BSE in cattle, but were implemented for scrapie in sheep and goats due to concerns over the occurrence of BSE in sheep. In the absence of BSE in sheep being observed, control measures for prion diseases are now being evaluated to ensure they remain proportionate to risk. This risk assessment, aims to estimate, by use of stochastic simulation, the impact of reducing controls for Specified Risk Materials (SRM) from sheep at abattoir. Three scenarios have been included: 1) current list of SRM; 2) brain and spinal cord of adult sheep; and 3) the brain of adult sheep.Results indicate the total amount of infectivity passing through British abattoirs is highest for atypical scrapie with nearly 3,500,000 Ovine Oral (OO) ID50 per year. The majority of this infectivity enters Category 1 waste for incineration, with only 13,000 OO ID50 per year within edible products. Under Scenario 2, an additional 4000 OO ID50 per year would be classified as edible products from the lifting of restrictions on the distal ileum of adult sheep. However, if SRM removal was limited to brain, an additional 110,000 OO ID50 per year would be permitted into edible products with the lifting of restrictions on the spinal cord of adult sheep.For classical scrapie, there is a mean estimate of infectivity of 30,000 OO ID50 per year at abattoir. This is lower than for atypical scrapie due to the lower occurrence of this disease in Great Britain. However, more infectivity is destined to reach the food chain as the disease is peripherally distributed in the carcase. The highest contributor to the total amount of infectivity consumed per year is the intestines (duodenum and jejunum). If SRM removal is limited to the brain and spinal cord of sheep over 12 months of age, there is an approximate mean increase from 19,000 to 21,000 OO ID50 per year diverted to edible products. If the SRM list is restricted to brain only, this increases to over 23,000 OO ID50 per year.For the potential of sheep-BSE, there is a very low estimate of 29 OO ID50 per year in total from carcases entering abattoir, due to the potential very rare occurrence of this disease. Given changes in SRM regulations there is a change of an additional 4 OO ID50 per year being diverted to edible products.

Chest physician-reported, work-related, long-latency respiratory disease in GreatBritain.

Much of the current burden of long-latency respiratory disease (LLRD) in Great Britain is attributed to historical asbestos exposure. However, continuing exposure to other agents, notably silica, also contributes to disease burden. The aim of this study was to investigate the incidence of work-related LLRD reported by chest physicians in Great Britain, including variations by age, gender, occupation and suspected agent.LLRD incidence and incidence rate ratios by occupation were estimated (1996-2014). Mesothelioma cases by occupation were compared with proportional mortality ratios.Cases were predominantly in men (95%) and 92% of all cases were attributed to asbestos. Annual average incidence rates (males) per 100 000 were: benign pleural disease, 7.1 (95% CI 6.0-8.2); mesothelioma, 5.4 (4.8-6.0); pneumoconiosis, 1.9 (1.7-2.2); lung cancer, 0.8 (0.6-1.0); chronic obstructive pulmonary disease (COPD), 0.3 (0.2-0.4). Occupations with a particularly high incidence of LLRD were miners and quarrymen (COPD), plumbers and gas fitters (asbestosis), and shipyard and dock workers (all other categories). There was a clear concordance between cases of SWORD mesothelioma and proportional mortality ratios by occupation.Occupationally caused LLRD continues to contribute to a significant disease burden. Many cases are attributable to past exposure to agents such as asbestos and silica, but the potential for occupational exposures persists.

G355 Presenting phenotype of ulcerative colitis (uc) in children 2010–13: Abstract G355 Table 1

Aims There has been a two-fold increase in the incidence of paediatric-onset UC over the last 20 years; there are few recent reports of the presenting phenotype – symptoms, inflammatory markers and disease extent. We report the presenting features of a defined cohort and compare to previous data. Methods Patients diagnosed with UC at University Hospitals Southampton from 2010–2013 were identified from an in-house database. Data were obtained from note review using a standardised proforma and compared to previous UK data. 1 Weight and height at diagnosis are presented as median SDS (95% CI). Results 49 children were included. Median age 13.18 (Range 1.59–16.24 years), 27 male. The most common presenting features are seen in Table 1. Weight loss (36.7%) and lethargy (36.7%) were less common. The majority of patients presented with pancolitis (68.1%). A significant number of patients present with normal inflammatory markers (percentage with normal CRP 69.4%, normal ESR 34.9%). Median CRP 3.0 mg/L (0.0–12–9), ESR21.5 mm/hr (15.2–26.8)). Weight SDS was 0.14 (–0.20 to 0.48). Seventeen patients (39.5%) were greater than 1 SD above the median. Seven patients (15.9%) were between –1 and –2 SD. Height SDS at diagnosis was 0.5315 (0.19 to 0.87). Thirty percent were overweight (BMI >1 SD above the median) at diagnosis. Positive family history (3 rd degree relative or closer) of IBD was seen in 26.5%. Conclusion Growth delay and raised inflammatory markers are seen in a minority of cases of UC at presentation. The majority of patients present with the classical triad of blood in stools, diarrhoea and abdominal pain however this is not invariable and absence does not preclude a diagnosis of UC. Reference Sawczenko A. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child. 2003;88(11):995–1000

G371(P) Presenting phenotype of crohn’s disease (cd) in children 2010–13: Abstract G371(P) Table 1

Aims There has been at least a two-fold increase in the incidence of paediatric-onset CD over the last 20 years; there are few recent reports of the presenting phenotype – symptoms, inflammatory markers and disease extent. We report the presenting features of a defined cohort and compare to previous data. Methods Patients diagnosed with CD at University Hospitals Southampton from 2010–2013 were identified from an in-house database. Data were obtained from note review using a standardised proforma and compared to previous UK data. 1 Weight and height at diagnosis are presented as median SDS (95% CI). Results 106 children were included. Median age 13.80 (Range 4.40–17.32 years), 79 male. The most common presenting features are seen in Table 1. The majority of patients presented with ileocolonic disease (51%) or isolated colonic disease (32%). Twenty-eight patients (26.4%) had perianal signs (5.7% abscesses/fistulae). Inflammatory markers were raised at diagnosis-median CRP 18.0 mg/L (8.9–27.1), ESR24.0 mm/hr (19.6–28.4); however normal inflammatory markers were frequently seen-normal CRP 26.4%, ESR 18.2%. Weight SDS was –1.088 (–1.35 to –0.83), 52% patients were below –1 standard deviation (SD). Height SDS was –0.366 (–0.60 to –0.14). 26.5% of patients were between –1 and –2 SD from the median and 4.8% were below –2 SD. Family history (3 rd degree relative or closer) of IBD was seen in 27.6%. Conclusion Despite an increase in incidence of CD there does not appear to be an accrual of milder cases of disease. A significant number of patients will present with both normal growth and normal inflammatory markers. Reference Sawczenko A. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child. 2003;88(11):995–1000

Mycobacterial disease in cats in Great Britain: I. Culture results, geographical distribution and clinical presentation of 339 cases

This study investigated 339 cases of feline mycobacterial disease from cats with cutaneous lesions or masses found at exploratory laparotomy. Tissue samples were submitted to the Veterinary Laboratories Agency for mycobacterial culture over a 4-year period to December 2008. The study assessed which species of culturable mycobacteria were involved, where the cats lived, and their clinical presentation (physical findings, serum biochemistry, radiography, feline leukaemia virus and feline immunodeficiency virus status). Mycobacterium microti was cultured from 19%, Mycobacterium bovis 15%, Mycobacterium avium 7%, non-M avium non-tuberculous mycobacteria 6%, with no growth in 53% of samples. M microti, M bovis and M avium were found in almost mutually exclusive clusters within Great Britain (GB) (ie, M bovis in South-West England/Wales/Welsh Border, M avium in eastern England and M microti south of London and in South-West Scotland). While differences were seen in the clinical presentation and distribution of lesions caused by the different infections, these were not sufficiently different to be diagnostic. Cats commonly presented with single or multiple cutaneous lesions (74%), which were sometimes ulcerated or discharging, located most frequently on the head (54%). Lymph nodes were usually involved (47%); typically the submandibular nodes. Systemic or pulmonary signs were rarely seen (10-16%). When a cat is suspected of having mycobacteriosis, accurate identification of the species involved helps to determine appropriate action. Our findings show that knowing the cat's geographic location can be helpful, while the nature of the clinical presentation is less useful. Most cases of feline mycobacterial disease in GB are cutaneous.

Correction: A Review of Exotic Animal Disease in Great Britain and in Scotland Specifically between 1938 and 2007

Correction: A Review of Exotic Animal Disease in Great Britain and in Scotland Specifically between 1938 and 2007

Correction: A Review of Exotic Animal Disease in Great Britain and in Scotland Specifically between 1938 and 2007

Correction: A Review of Exotic Animal Disease in Great Britain and in Scotland Specifically between 1938 and 2007

A review of exotic animal disease in Great Britain and in Scotland specifically between 1938 and 2007.

BackgroundIncursions of contagious diseases of livestock into disease-free zones are inevitable as long as the diseases persist elsewhere in the world. Knowledge of where, when and how incursions have occurred helps assess the risks, and regionalize preventative and reactive measures.MethodologyBased on reports of British governmental veterinary services, we review occurrence of the former OIE List A diseases, and of Aujeszky's disease, anthrax and bovine tuberculosis (bTB) in farm-animals in Great Britain (GB) between 1938 and 2007. We estimate incidence of each disease on GB agricultural holdings and fraction of susceptible farm-animals culled to control the disease each year. We then consider the frequency and incidence of the diseases in Scotland alone. The limitations of available data on historical disease occurrence and denominator populations are detailed in Text S2.ConclusionsThe numbers of livestock and poultry farmed in GB grew over the years 1938–2007; the number of agricultural holdings decreased. An amalgamation of production on larger holdings took place from the 1940s to the 1980s. The maximum annual incidence of a reviewed disease in GB 1938–2007 was reported for bTB, 1.69% of holdings in 1961. This was followed by Newcastle disease, 1.50% of holdings in 1971, and classical swine fever, 1.09% of holdings in 1940. The largest fractional cull of susceptible livestock in a single year in each of the four decades 1950s–1980s was due to a viral disease primarily affecting swine. During the periods 1938–1949 and 2000–2007 this was due to outbreaks of foot and mouth disease. In the absence of incursions of the former OIE List A diseases in the 1990s, this was due to bTB. Over the 70 years, the diseases were reported with lower frequency and lower annual incidence in Scotland, as compared to when these statistics are considered for GB as a whole.

The Outbreaks of Foot and Mouth Diseases in Great Britain, Korea and Japan Recently

The Outbreaks of Foot and Mouth Diseases in Great Britain, Korea and Japan Recently

The role of routine versus random movements on the spread of disease in Great Britain

Mathematical models of infectious disease spread are important tools for assessing the threat of a novel pathogen and offer the best information for mitigating an outbreak. Here we present a metapopulation model of disease spread in Great Britain defined at the level of electoral wards. Using data from the United Kingdom 2001 census and the National Travel Survey to define the amount of travel performed by individuals between wards, we examine the effect of assumptions on the regularity of travel. Routine, daily commuter-type movements, characteristic of the working population are shown to lead to a slower epidemic spread compared to movements with random destinations. We demonstrate that routine movements slow down the epidemic spread compared to a standard metapopulation setting by up to 25%. We also show that spurious long distance movements present in the census data do not have a significant impact on the development of a potential epidemic in Great Britain.

The effect of climate change on the occurrence and prevalence of livestock diseases in Great Britain: a review

SummaryThere is strong evidence to suggest that climate change has, and will continue to affect the occurrence, distribution and prevalence of livestock diseases in Great Britain (GB). This paper reviews how climate change could affect livestock diseases in GB. Factors influenced by climate change and that could affect livestock diseases include the molecular biology of the pathogen itself; vectors (if any); farming practice and land use; zoological and environmental factors; and the establishment of new microenvironments and microclimates. The interaction of these factors is an important consideration in forecasting how livestock diseases may be affected. Risk assessments should focus on looking for combinations of factors that may be directly affected by climate change, or that may be indirectly affected through changes in human activity, such as land use (e.g. deforestation), transport and movement of animals, intensity of livestock farming and habitat change. A risk assessment framework is proposed, based on modules that accommodate these factors. This framework could be used to screen for the emergence of unexpected disease events.

Estimating the hidden number of scrapie affected holdings in Great Britain using a simple, truncated count model allowing for heterogeneity

None of the current surveillance streams monitoring the presence of scrapie in Great Britain provide a comprehensive and unbiased estimate of the prevalence of the disease at the holding level. Previous work to estimate the under-ascertainment adjusted prevalence of scrapie in Great Britain applied multiple-list capture-recapture methods. The enforcement of new control measures on scrapie-affected holdings in 2004 has stopped the overlapping between surveillance sources and, hence, the application of multiple-list capture-recapture models. Alternative methods, still under the capture-recapture methodology, relying on repeated entries in one single list have been suggested in these situations. In this article, we apply one-list capture-recapture approaches to data held on the Scrapie Notifications Database to estimate the undetected population of scrapie-affected holdings with clinical disease in Great Britain for the years 2002, 2003, and 2004. For doing so, we develop a new diagnostic tool for indication of heterogeneity as well as a new understanding of the Zelterman and Chao’s lower bound estimators to account for potential unobserved heterogeneity. We demonstrate that the Zelterman estimator can be viewed as a maximum likelihood estimator for a special, locally truncated Poisson likelihood equivalent to a binomial likelihood. This understanding allows the extension of the Zelterman approach by means of logistic regression to include observed heterogeneity in the form of covariates—in case studied here, the holding size and country of origin. Our results confirm the presence of substantial unobserved heterogeneity supporting the application of our two estimators. The total scrapie-affected holding population in Great Britain is around 300 holdings per year. None of the covariates appear to inform the model significantly.

A survey of horse owners in Great Britain regarding horses in their care. Part 2: Risk factors for recurrent airway obstruction

Recurrent airway obstruction (RAO) is a commonly encountered respiratory condition of horses. Despite this, the epidemiology of this predominately manageable and reversible disease in Great Britain has been largely ignored. To estimate the prevalence of RAO in the general horse population of Great Britain and to investigate possible risk factors for RAO associated with management or early life. Horse owners were surveyed using a self-administered postal questionnaire that contained a risk-screening questionnaire (RSQ) designed to identify horses with RAO. These owners were randomly selected, following geographical stratification, using 2-stage cluster sampling of veterinary practices and their clients. Multilevel, multivariable logistic regression models were used to investigate risk factors for RAO in the selected horse population. The estimated true prevalence of RAO in the selected horse population was 14.0% (95%CI 10.7-17.4%). Risk factors for RAO identified in a general horse management logistic regression model included increasing age and exposure to an urbanised environment. Recurrent airway obstruction has long been associated with mature horses while the association with an urbanised environment could be related to different management practices in these areas or possibly air pollution could be involved. The second model associated exposure to hay and respiratory infection in early life with a horse having RAO in later life. Challenges to the respiratory system in early life may be involved in the development of this disease. Recurrent airway obstruction is a significant health problem in the horse population of Great Britain. This form of epidemiological investigation highlights potential risk factors for the disease.

The Development of an Efficient Test Automation and Sample Tracking System in a High-Throughput Veterinary Laboratory to Improve the Emergency Response to Outbreaks of Highly Infectious Disease in Great Britain

Serological surveillance testing for bovine brucellosis, Enzootic Bovine Leukosis, and Warble fly reaches approximately 1.7 million tests every year in the UK. An automated system was developed to improve the quality of data handling for all three surveys. The objectives were to make improvements in efficiency, sample tracking, and test reporting and to develop an epidemiological database. The developed system of bar-coded samples and test plates processed on automated equipment capable of scanning barcodes and transferring information across a computer network met the data objectives. Consolidating and automating the highly repetitive liquid-handling steps met the cost objectives. To reduce the impact of temporary bottlenecks in the system, a philosophy of ‘islands of automation’ was adopted to maximize the throughput. The creation of this system was driven largely by the need to have in place an effective emergency response capability to handle the serological needs of an outbreak of an acute and highly infectious veterinary disease such as Foot and Mouth Disease (FMD) in the UK.

Simple model for tuberculosis in cattle and badgers.

As an aid to the study of bovine tuberculosis (TB), a simple model has been developed of an epidemic involving two species, cattle and badgers. Each species may infect the other. The proportion of animals affected is assumed relatively small so that the usual nonlinear aspects of epidemic theory are avoided. The model is used to study the long-run and transient effect on cattle of culling badgers and the effect of a period without routine testing for TB, such as occurred during the 2001 epidemic of foot-and-mouth disease in Great Britain. Finally, by examining the changes in cattle TB over the last 15 years, and with some other working assumptions, it is estimated that the net reproduction number of the epidemic is approximately 1.1. The implications for controlling the disease are discussed.

Costs of the major endemic diseases of sheep in Great Britain and the potential benefits of reduction in disease impact

AbstractThe costs of three major endemic sheep diseases in Great Britain, gastro-intestinal (GI) parasites, footrot and scab, were estimated and compared with costs for other diseases from another study. Disease costs include lost performance, preventive measures and treatment of affected animals. The most costly disease, of those studied, for the British sheep industry is infestation with GI parasites, with estimated annual costs of £84 million. Annual costs for the other two diseases are £24 million for footrot and £8 million for sheep scab. This compares with literature estimates of £20 million for Chlamydial abortions and £12 million for toxoplasmosis. For sheep scab most costs are for preventive measures, therefore, short of eradication, a reduction in incidence will have a limited effect on costs. For GI parasites, costs are linearly related to the severity of the infestation and a reduction of the disease will have a proportional effect on the costs to the industry. For footrot about half the costs are for preventive measures, the other half is for lost production and treatment. A reduction in the incidence of footrot has a proportional effect on the £10 million associated with loss of production and treatment of infected animals. It is concluded that gastro-intestinal parasites and footrot are two sheep diseases in Britain for which a reduction of severity or incidence will have a large impact on costs of production.

Updated Estimates of the Costs Associated with Thirty Four Endemic Livestock Diseases in Great Britain: A Note

This Note outlines the further development of a system of models for the estimation of the costs of livestock diseases first presented by Bennett (2003). The models have been developed to provide updated and improved estimates of the costs associated with 34 endemic diseases of livestock in Great Britain, using border prices and including assessments of the impact of diseases on human health and animal welfare. Results show that, of the diseases studied, mastitis has the highest costs for cattle diseases, enzootic abortion for sheep diseases, swine influenza for pig diseases and salmonellosis for poultry diseases.