An outbreak of Salmonella typhimurium DT170 associated with kebab meat and yogurt relish.

During July 1995, an outbreak of Salmonella typhimurium definitive type (DT) 170, an unusual strain, occurred in South Wales. A case-control study found that illness was associated with eating kebabs (odds ratio undefined, P = 0.002), doner kebabs (odds ratio 7.9, 95 % confidence interval 1.5-20.5, P = 0.02) and kebabs with yoghurt based relish (odds ratio undefined, P = 0.009) but not with eating kebabs with mayonnaise-based relish (odds ratio 2.4, 95 % confidence interval 0.4-13.9, P = 0.53). Environmental investigations discovered a complex web of producers and wholesale suppliers. Kebab meat and yoghurt had been supplied to the two main implicated outlets by a single wholesaler. Samples of raw minced lamb and several environmental swabs taken at the wholesaler were positive for S. typhimurium DT170. Blood-stained, unsealed yoghurt pots were observed to be stored under a rack of raw lamb. Investigators of food poisoning outbreaks linked to takeaway food should consider cross-contaminated relishes and dressings as well as undercooked meat as potential vehicles of infection.

Travel brochures need to carry better health advice.

Most people travelling abroad on holiday from the United Kingdom consult a travel brochure and book with a travel agent. Travel brochures are therefore potentially an important source of travel health advice. We assessed the quantity and quality of health advice of 143 travel brochures for 1994/5 winter and 1995 summer seasons available from a high street travel agent. Only 11% carried health information in a prominent location, 64% put health information at the end (often in small print), and 25% contained no health information at all. Much advice was superficial, and only a minority mentioned safe drinking water (24%), safe food (22%), or safe sex (3%). Better health advice more prominently displayed is needed in travel brochures. Public health practitioners should collaborate with travel companies and travel agents to improve the quality and quantity of health information provided to travellers.

Reasons for non-uptake of measles, mumps, and rubella catch up immunisation in a measles epidemic and side effects of the vaccine.

OBJECTIVE: To investigate the reasons for poor uptake of immunisation (non-immunisation) and the possible side effects of measles, mumps, and rubella vaccine in a catch up immunisation campaign during a community outbreak of measles. DESIGN: Descriptive study of reasons for non-immunisation and retrospective cohort study of side effects of the vaccine. SETTING: Secondary schools in South Glamorgan. SUBJECTS: Random cluster sample of the parents of 500 children targeted but not immunised and a randomised sample of 2866 of the children targeted. MAIN OUTCOME MEASURES: Reasons for non-immunisation; symptoms among immunised and non-immunised children. RESULTS: Immunisation coverage of the campaign was only 43.4% (7633/17,595). The practical problems experienced included non-return of consent forms (6698/17,595), refusal of immunisation (2061/10,897 forms returned), and absence from school on day of immunisation (1203/8836 children with consent for immunisation). The most common reasons cited for non-immunisation were previous measles infection (145/232), previous immunisation against measles (78/232), and concern about side effects (55/232). Symptoms were equally common among immunised and non-immunised subjects. However, significantly more immunised boys than non-immunised boys reported fever (relative risk 2.31 (95% confidence interval 1.36 to 3.93)), rash (2.00 (1.10 to 3.64), joint symptoms (1.58; 1.05 to 2.38), and headache (1.31 (1.04 to 1.65)). CONCLUSIONS: Many of the objections raised by parents could be overcome by emphasising that primary immunisation does not necessarily confer immunity and that diagnosis of measles is unreliable. Measles, mumps, and rubella vaccine is safe in children aged 11-15.