Vaccination and monitoring strategies for epidemic prevention and detection in the Channel Island fox (Urocyon littoralis).

Disease transmission and epidemic prevention are top conservation concerns for wildlife managers, especially for small, isolated populations. Previous studies have shown that the course of an epidemic within a heterogeneous host population is strongly influenced by whether pathogens are introduced to regions of relatively high or low host densities. This raises the question of how disease monitoring and vaccination programs are influenced by spatial heterogeneity in host distributions. We addressed this question by modeling vaccination and monitoring strategies for the Channel Island fox (Urocyon littoralis), which has a history of substantial population decline due to introduced disease. We simulated various strategies to detect and prevent epidemics of rabies and canine distemper using a spatially explicit model, which was parameterized from field studies. Increasing sentinel monitoring frequency, and to a lesser degree, the number of monitored sentinels from 50 to 150 radio collared animals, reduced the time to epidemic detection and percentage of the fox population infected at the time of detection for both pathogens. Fox density at the location of pathogen introduction had little influence on the time to detection, but a large influence on how many foxes had become infected by the detection day, especially when sentinels were monitored relatively infrequently. The efficacy of different vaccination strategies was heavily influenced by local host density at the site of pathogen entry. Generally, creating a vaccine firewall far away from the site of pathogen entry was the least effective strategy. A firewall close to the site of pathogen entry was generally more effective than a random distribution of vaccinated animals when pathogens entered regions of high host density, but not when pathogens entered regions of low host density. These results highlight the importance of considering host densities at likely locations of pathogen invasion when designing disease management plans.

Mortalities, amyloidosis and other diseases in free-living red squirrels (Sciurus vulgaris) on Jersey, Channel Islands.

Between 2007 and 2014, 337 free-living red squirrels (Sciurus vulgaris) on Jersey, Channel Islands, were examined post mortem as part of a mortality and disease surveillance scheme. Road traffic accidents (RTAs) were attributable for 50.7 per cent (171/337) of the casualties, 34.4 per cent (116/337) succumbed to diseases including fatal exudative dermatitis (FED), 7.1 per cent (24/337) to predation, 6.5 per cent (22/337) to other trauma and 1.2 per cent (4/337) to suspected poisoning. Cat predation accounted for 5 per cent (17/337) of mortalities. Pathologies were diverse and individual animals were often identified with more than one disease process. Squirrelpox virus (SQPV) particles were not detected in selected cases examined by transmission electron microscopy (TEM). Amyloid was identified in 19.3 per cent (65/337) of squirrels, often in conjunction with inflammatory lesions like hepatic capillariasis. A consistent cause of amyloid accumulation was not identified, although there was a significant association of amyloidosis with hepatic capillariasis and FED. In addition to RTAs, amyloidosis and FED have been identified as important causes of squirrel morbidity and mortality on Jersey, while the underlying aetiology and predisposing factors for these two disease complexes are presently unclear. Disease, fragmented woodlands, an increasingly suburban habitat, along with various anthropogenic factors, may jeopardise the long-term viability of this island red squirrel population.

The Epidemiology of Community Clostridium difficile Infection: A Five-Year Population-Based Study on the Bailiwick of Jersey, Channel Islands.

We studied healthcare-associated and community-associated Clostridium difficile infection (CDI) in Jersey, Channel Islands (2008-2012). The Island's stable population has reliable denominator data, a clearly defined at-risk population, and healthcare contact that is easily followed. The vast majority of CDI cases had had recent healthcare contact, and true community-associated disease is extremely rare.Infect Control Hosp Epidemiol 2018;39:603-607.

High incidence of skin cancer in the Channel Islands.

BACKGROUND: Previous studies looking at rates of malignant melanoma (MM) and nonmelanoma skin cancer (NMSC) in the UK have documented one of the highest rates in the southwest of England; however, the incidence of these tumours in Guernsey and Jersey, two of the Channel Islands, has not previously been reported. AIMS: To determine the incidence of cutaneous MM and NMSC in the Channel Islands. METHODS: Data for the period 2005-2009 were obtained from clinical and histopathological records for all MMs excised in the Channel Islands, and from the South-west Cancer Registry for MMs excised in the southwest of England and for NMSCs in both areas. The age-standardized incidence rate (ASRs) per 100,000 of the population in the Channel Islands were compared with those with the southwest of England, the UK and the rest of Europe where available. The MM characteristics of the Channel Islands were then compared with the southwest of England using standardized incidence ratios (SIRs). RESULTS: The ASR/100,000 for cutaneous MM for 2005-2009 was 30 for the Channel Islands (31.3 for Jersey, 28.2 for Guernsey), 20.3 for the southwest of England, and 15.6 for the UK. Comparison with the rest of Europe indicated that the incidence of MM in the Channel Islands is one of the highest in Europe. The highest incidence of MM was in the over 65 years age group on both Guernsey and Jersey, and when divided into 5-year age bands, the 70-74 years age group had the highest rate. This suggests that this particular age group may have previously received greater exposure to some environmental factor that promotes MM development. The ASR/100,000 for NMSC was also higher for the Channel Islands (263.3) than for the southwest of England (174.6) for 2005-2009, and for the UK in 2009 (104.9). CONCLUSIONS: This study indicates that the Channel Islands have a high incidence of skin cancer (both MM and NMSC). In addition, the data show that the ASRs in older people in this population group differ from those in mainland UK, showing higher rates in the over 65 years age group.

Cardiovascular disease in a cohort exposed to the 1940-45 Channel Islands occupation.

BACKGROUND: To clarify the nature of the relationship between food deprivation/undernutrition during pre- and postnatal development and cardiovascular disease (CVD) in later life, this study examined the relationship between birth weight (as a marker of prenatal nutrition) and the incidence of hospital admissions for CVD from 1997-2005 amongst 873 Guernsey islanders (born in 1923-1937), 225 of whom had been exposed to food deprivation as children, adolescents or young adults (i.e. postnatal undernutrition) during the 1940-45 German occupation of the Channel Islands, and 648 of whom had left or been evacuated from the islands before the occupation began. METHODS: Three sets of Cox regression models were used to investigate (A) the relationship between birth weight and CVD, (B) the relationship between postnatal exposure to the occupation and CVD and (C) any interaction between birth weight, postnatal exposure to the occupation and CVD. These models also tested for any interactions between birth weight and sex, and postnatal exposure to the occupation and parish of residence at birth (as a marker of parish residence during the occupation and related variation in the severity of food deprivation). RESULTS: The first set of models (A) found no relationship between birth weight and CVD even after adjustment for potential confounders (hazard ratio (HR) per kg increase in birth weight: 1.12; 95% confidence intervals (CI): 0.70-1.78), and there was no significant interaction between birth weight and sex (p=0.60). The second set of models (B) found a significant relationship between postnatal exposure to the occupation and CVD after adjustment for potential confounders (HR for exposed vs. unexposed group: 2.52; 95% CI: 1.54-4.13), as well as a significant interaction between postnatal exposure to the occupation and parish of residence at birth (p=0.01), such that those born in urban parishes (where food deprivation was worst) had a greater HR for CVD than those born in rural parishes. The third model (C) found no interaction between birth weight and exposure to the occupation (p=0.43). CONCLUSION: These findings suggest that the levels of postnatal undernutrition experienced by children, adolescents and young adults exposed to food deprivation during the 1940-45 occupation of the Channel Islands were a more important determinant of CVD in later life than the levels of prenatal undernutrition experienced in utero prior to the occupation.

The impact of the Occupation of Guernsey 1940-1945 on breast cancer risk factors and incidence.

To examine the impact of the German Occupation of Guernsey (1940-1945) on breast cancer risk factors and incidence. Under study were 1019 women who stayed, or whose mothers had stayed, in Guernsey, and 1358 women evacuated or born to evacuated mothers. Amongst those born 1926-1934 who remained in Guernsey, the secular trend of earlier menarche disappeared: menarche was delayed by 12 months for those born in 1930. By March 2006, 97 breast cancers had been diagnosed, 37 in the occupied group. Unusually, higher age at menarche appeared to be associated with increased risk of breast cancer (>or=14 years vs.

District nurses' involvement and attitudes to mental health problems: a three-area cross-sectional study.

AIMS AND OBJECTIVES: The main aims of this study were to obtain information on the extent of staff contact and input with mental health problems and to determine their experience, training and attitudes to such problems. BACKGROUND: Historical changes and policy shifts have resulted in primary care providers playing an increasing role in the care of mental health problems. Such problems are common within community settings and a major cause of suffering and disability. District nurses in particular are likely to encounter a high level of psychological co-morbidity in their patients. Information is lacking on their involvement, attitudes and specific training for this area of their work. DESIGN AND METHODS: A cross-sectional study was conducted of the staff of district nursing services in three areas, Jersey (Channel Islands), Lewisham and Hertfordshire, using a postal questionnaire. RESULTS: Questionnaires were sent to 331 staff; 66% responded. Community and district nurses estimated a 16% prevalence of mental health problems among their patients, most commonly dementia, depression and anxiety disorders. Staff noted participation in a wide range of psychological care activities, but identified a lack of training for this aspect of their role (three-quarter of nurses had received no such training during the past five years). They reported a willingness to develop their understanding and skills by means of educational programmes. Attitude measures revealed generally optimistic views concerning depression treatment, a rejection of deterministic attitudes about this condition and confidence in the role of district nursing staff in managing such problems. CONCLUSIONS: The need for primary care mental health training is widely noted and based upon consistent evidence of the limited detection and treatment of these problems. This study has employed quantitative methods to clarify the extent and nature of district nursing staff involvement in this area of practice and indicates that training needs are acknowledged by community nurses from geographically distinct settings. RELEVANCE TO CLINICAL PRACTICE: Staff are interested in developing knowledge and skills pertinent to the psychological problems of their patients and their views reveal a consensus that the most important areas for learning are recognition of mental disorders, anxiety management, crisis intervention and pharmacological treatments for depression.

Growth of Jersey schoolchildren during the 1940-1945 German occupation: comparison with schoolchildren on mainland Britain.

The 1940-45 German occupation of the Channel Islands was accompanied by a gradual deterioration in food availability and culminated in a nine-month siege with severe food shortages after supplies from France were cut off following the liberation of Normandy in 1944. The aim of this study was to compare the growth rates of schoolchildren resident on one of the Channel Islands (Jersey) with children growing up on mainland Britain. Secondary analyses were conducted on published data describing the growth of approximately 3500 schoolchildren resident on Jersey throughout the occupation, 10,000-15,000 London schoolchildren, and about 5000 children evacuated from mainland cities to "residential camp schools" in rural areas. A comparison of age- and sex-adjusted average annual growth rates between 1940 and 1943 confirmed that 8 1/2 - 12 1/2-year-old children on Jersey gained 28.2-33.1% less weight and 23.6-26.5% less height per year than children on the mainland. Because food shortages on Jersey intensified after 1943 (when the mid-occupation growth measurements had been recorded), growth rates toward the end of the occupation (in 1944 and early 1945) are likely to have been even worse than those observed between 1940 and 1943. As such, these analyses provide a somewhat conservative estimate of the decline in childhood growth rates that occurred on Jersey during the 1940-45 German occupation.

The dental caries experience of 14-year-old children in England and Wales. Surveys co-ordinated by the British Association for the Study of Community Dentistry in 2002/2003.

OBJECTIVE: This paper reports the results of standardised clinical caries examinations of 77,693 14-year-old children from across England, Wales, Jersey and the Isle of Man. These 2002/3 coordinated surveys are the latest in a series which seeks to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating health authorities and boards and caries was diagnosed at the caries into dentine (D3) threshold using a visual method without radiography or fibre-optic transillumination. RESULTS: These demonstrated, once again, a wide variation in prevalence across the area surveyed, with mean values for D3MFT for the current English government offices (of the National Health Service) and the local Health Boards in Wales ranging from 0.99 in the South East to 2.10 in Wales (2.41 in the Isle of Man). The mean value for across England and Wales was 1.48 (D3T=0.56, MT=0.10, FT=0.82). Overall 49 per cent of 14-year-old children in England and Wales had evidence of dentinal caries experience (D3MFT>0), the regional/country means ranged between 37 per cent (South-East) and) and 60 percent in Wales (65 per cent, Isle of Man). The mean D3MFT for those with disease at this threshold was 3.03. Trends over time demonstrate an improvement of 4% in overall D3MFT for England and Wales, there has been only small improvement in mean MT since 1994/95, while FT and care index have fallen. The number of fillings provided in 2002/3 and thus the care index, remains low, on average across England and Wales, only 55% of the dentinal caries experience identified by survey examinations of permanent teeth was seen as fillings (range in individual areas: 28% to 83%). CONCLUSION: These findings demonstrate a modest overall improvement in oral health, but a continuing need for more effective preventive strategies and treatment services for permanent teeth in this important age group. An average of half of the 14 year old children examined being affected by dentinal decay and a mean of three permanent teeth decayed into dentine for those children affected at this level of diagnosis is a poor start to charting oral health in the 21st Century in England and Wales.

The incidence of childhood leukaemia around the La Hague nuclear waste reprocessing plant (France): a survey for the years 1978-1998.

BACKGROUND: A previous study has suggested an increased incidence rate of leukaemia from 1978 to 1992 in people aged 0 to 24 years and living in the vicinity of the La Hague nuclear waste reprocessing plant without considering age and cytological type. SETTING: The Nord Cotentin region (France) and the island of Alderney (United Kingdom). STUDY OBJECTIVE: To describe the occurrence of leukaemia for each age group and cytological type from 1978 to 1998 in the same area, using accurate reference incidence rates and adequate estimation of the at risk population. DESIGN: A geographical study of incidence using three zones defined according to their distance from the site (0 to 10 km: Beaumont-Hague electoral ward, 10 to 20 km and 20 to 35 km) has been conducted. The risk of leukaemia was estimated from the standardised incidence ratio (SIR) of the number of cases observed to the number expected. Exact 95% confidence intervals (CI) have been computed. PARTICIPANTS: All people under the age of 25 years living in the study region between 1978 and 1998. MAIN RESULTS: The observed number of cases of leukaemia in the study region as a whole was consistent with the expected value (SIR=1.03; 95%CI: 0.73, 1.41). No cases were observed on Alderney. The SIR in the Beaumont-Hague electoral ward was 2.17 (95%CI: 0.71, 5.07). The highest SIR was observed in the 5 to 9 years age group (SIR=6.38; 95%CI: 1.32, 18.65). This consists in acute lymphoblastic leukaemia cases. CONCLUSION: This study indicates an increased incidence of leukaemia in the area situated at less than 10 km from the plant. Monitoring and further investigations should be targeted at acute lymphoblastic leukaemia occurring during the childhood incidence peak (before 10 years) in children living near the La Hague site and may be other nuclear reprocessing plants.

Is childhood allergy more common amongst an island population?

A rise in the prevalence of childhood asthma has been reported in both the UK and in several overseas countries during recent years. Wide geographical variations have also been demonstrated in the distribution of hay fever, atopic eczema and other allergic symptoms. It is the impression of many parents and some clinicians that allergic symptoms may be even higher amongst children in an island environment compared with a similar population on the mainland. To test this hypothesis, Guernsey and Jersey in the Channel Islands, and the Isle of Man in the Irish Sea participated as an independent arm in the International Study of Asthma and Allergy in Childhood (ISAAC). This entailed self-completion of a 38-part pretested and validated questionnaire in a classroom setting under standardised conditions. A total of 3,772 secondary students in school years eight and nine living in the three islands were compared with 27,507 students of similar age in 93 British secondary schools enrolled in the larger UK study. There are a number of demonstrable differences in climate, home environment and lifestyle factors between the islands and mainland UK. Although results were generally above the UK mean, they were comparable with the reference region of South West England and invariably below the UK maximum. For instance, the prevalence of 'ever wheezed?', 'wheezed in last twelve months?', 'wheezed with exercise?' and 'diagnosis of asthma' were a mean of 50.5%, 34.5%, 31% and 19.7% in the islands compared with a UK prevalence of 48.8%, 33.3%, 28.5% and 20.7%, whilst the prevalence of 'runny nose ever?' and 'runny nose in last twelve months?' was a mean of 46.6% and 36.7% in the islands, compared with 47.1% and 37.9% in the UK mean. These differences were not statistically significant. This information will be reassuring to parents of island children, and also demonstrates that services for the management of asthma and other allergic conditions should not be a higher public health priority in these locations than on the mainland of Britain.

Pseudotuberculosis in marmosets, tamarins, and Goeldi's monkeys (Callithrichidae/Callimiconidae) housed at a European zoo.

Yersinia pseudotuberculosis is an insidious bacterial infectious agent distributed worldwide and endemic to European countries. It has caused several animal deaths and may threaten the effectiveness of breeding projects for endangered species. In this retrospective study, we examine the prevalence of pseudotuberculosis in Jersey Zoo (Channel Islands, U.K.) over a period of 16 yr to obtain information that can be applied to prevent the infection. The efforts made to control the disease through vaccination are also explored. Our results show that pseudotuberculosis has been endemic to Jersey Zoo since 1979 and is responsible for significant animal loss in the Callithrichidae/Callimiconidae group. Mortality due to Y. pseudotuberculosis was seasonal; a high percentage of deaths occurred during wet and cold seasons. No significant difference was found in mortality rates of vaccinated versus nonvaccinated animals. Although the efficacy of vaccination has not been confirmed, we believe that an improved vaccination program could be an important tool in controlling outbreaks of infection in marmosets and tamarins.

The effect of HFE mutations on serum ferritin and transferrin saturation in the Jersey population.

High frequencies of the haemochromatosis-related HFE C282Y mutation have been reported in North European populations, in which a high proportion of patients with the disease are homozygotes. However, the degree of penetrance of this genotype is unknown. We determined the HFE C282Y and H63D genotypes of 411 consenting volunteer blood donors on Jersey, and the serum ferritin and transferrin saturation levels of 204 of these volunteers. The C282Y allele frequency was found to be 8.3% in 822 chromosomes, indicating a homozygote frequency of 1/145. Consistent with this, four C282Y homozygotes were detected in 411 volunteers. As there are only 18 patients presently receiving treatment for haemochromatosis on Jersey, out of a total population of about 85000, there is a large discrepancy between the number of haemochromatosis patients and the number of C282Y homozygotes in this population. In a preliminary study of 204 consenting volunteers we found a correlation between transferrin saturation and HFE H63D/ C282Y genotype (P=0.017) and between serum ferritin and genotype (P = 0.056). We also observed elevated values of transferrin saturation in the two C282Y homozygotes assayed. These results suggest that a large proportion of the many undetected C282Y homozygotes on Jersey and in similar populations could be in the preclinical stages of haemochromatosis, and warrant investigation. However, there may be a wide variation in the expression of the condition, and a more extensive study of the level of disease penetrance encompassing a large number of hitherto undetected C282Y homozygotes is therefore imperative.

The association of height, weight, menstrual and reproductive events with breast cancer: results from two prospective studies on the island of Guernsey (United Kingdom).

The association with breast cancer of menstrual and reproductive events, family history of breast cancer, and body size have been studied on two cohorts of 6,706 volunteers on the island of Guernsey (United Kingdom), 168 of whom had breast cancer detected during follow-up. The median follow-up time of the non-cases was 21 years in the first study and 10 years in the second. A time-dependent Cox regression model was fitted to the data with age as the time-dependent variable in order to represent the effect of changing menopausal status. Other variables examined in the model were age at menarche, parity, age at first birth, family history of breast cancer, height, weight (both directly measured), relative weight (weight [kg]/height[m]), and Quetelet's body mass index (weight[kg]/height[m]2). Interactions between age and all other covariates also were examined. Family history was found to be the most important risk factor for women aged less than 51 years (relative risk [RR] = 3.5, 95 percent confidence interval [CI] = 2.0-6.0), and intervals between menarche and first birth longer than 14 years were found to increase significantly the risk of breast cancer in women older than 61 years (RR = 2.4, CI = 1.3-4.4). Height was the only indicator of body size which was associated significantly with risk of breast cancer, the estimated regression coefficient indicating an increase in risk of about 70 percent for women on the 90th centile of height relative to those on the 10th centile. A survey of the literature showed that the association between risk of breast cancer and height was found in those studies which used direct measurements of height but not in others which used self-reported values.

Snoring, asthma and sleep disturbance in Britain: a community-based survey.

A questionnaire was sent to a random sample of adults in eight locations throughout Britain, to investigate the prevalence of snoring, asthma and sleep complaints in community-based British adult. Of the 1,478 respondents (831 females, 647 males; mean +/- SD age 45 +/- 18 yrs), 37% reported snoring at least occasionally, and 11% reported snoring on at least four nights per week (frequent snorers). Frequent snorers reported spending less time asleep at night, falling asleep accidentally during the day more often, taking planned daytime naps, and falling asleep whilst driving or operating machinery more often than the other respondent. Using ordinal logistic regression analysis to allow for the age and sex of the respondents, both accidental daytime sleep and planned daytime naps were commoner in frequent snorers than other respondents. Six percent of all respondents and 6% of those aged under 40 yrs reported that they had asthma (asthmatics). Seven percent of respondents aged less than 40 yrs reported wheezing on three or more occasions per year, and had been prescribed oral or inhaled bronchodilators (young wheezers). More than 80% of the asthmatic respondents of all ages, and young wheezers, reported waking at night with wheeze at least occasionally, and more than 30% of each group reported this symptom frequently. A larger proportion of asthmatics and young wheezers reported that their night-time sleep was unrefreshing, and that they had too little sleep at night than the other respondents.(ABSTRACT TRUNCATED AT 250 WORDS)

Hazards of commercial fishing.

The nature of their work exposes commercial fishermen, and their families, to exceptionally high risks of accident and illness. Increased efforts should be made to improve the health and safety record of the world's fishing industry.

Some mortality data for Grimsby "lumpers" and fishermen.

All death certificates supplied to Grimsby District Health Authority for the years 1967-1980 were examined. Certificates showing the occupation on fisherman (or similar term) or lumper were extracted. Brief analysis of the data on the age and cause of death stated on those certificates is presented. There was no indication that the mortality pattern differed significantly between the two groups or from that of the community from which the lumpers and fishermen came.