Evaluation of the continuing professional development scheme of the Institute of Biomedical Science.

As part of a review of the Continuing Professional Development (CPD) scheme of the Institute of Biomedical Science (IBMS), 10 years after it started, a survey was conducted. A questionnaire was distributed to all Institute members in July 2002. By the end of September, replies had been received from 777 biomedical scientists, representing a range of ages, grades and disciplines, and working for a variety of employers throughout the UK and overseas. The majority of respondents (n = 687) were current participants in the IBMS CPD scheme, but 74 replies were received from members who had not previously taken part. Half the respondents who were both scheme participants and Associate members of the IBMS and one-third of participating Fellows had yet to claim a diploma. The results showed that the IBMS CPD scheme was well respected among biomedical scientists, but many reported some difficulties in obtaining study leave and financial support to attend credited activities. Although respondents felt that an individual's own time should not be spent on CPD, activities that are performed when off duty (e.g., journal-based learning) are popular, especially among staff in younger age groups and among junior biomedical scientist grades. Respondents suggested that the scheme could be improved by provision of more resources at departmental level to allow regular participation for individual biomedical scientists. They also recommended inclusion of competency testing within CPD and a simplified diploma system. The IBMS scheme has been well received and has the potential to evolve into a good scheme to serve the profession's needs into the 21st century.

Fatal echovirus 7 infection during an outbreak in a special care baby unit.

A case of fatal echovirus 7 infection in a neonate which was probably acquired from the symptomatic mother and an outbreak of infection in a neonatal unit are described. The baby who died had extensive haemorrhagic necrosis of the brain, liver, adrenal glands and kidneys as well as disseminated intravascular coagulation. Three other babies and one member of staff were found to be infected. No other babies died. Human normal immunoglobulin was administered to all babies on the unit.

False positive latex tests negative by ELISA for toxoplasma IgG.

An enzyme linked immunosorbent assay (ELISA) kit for detecting IgG class antibody to T gondii was compared with the latex agglutination test to determine the specificity as a screening method in 12 patients who had undergone heart transplantation (recrudescence of T gondii infection n = 3, donor acquired infection n = 3; acute cytomegalovirus infection n = 6). The latex agglutination test detected antibodies to primary T gondii infection much earlier in the infection than the ELISA, but the ELISA method was useful for detecting previous infection. It is concluded that the ELISA technique is more complex to perform than the latex agglutination test but the use of IgM and IgG assays combined could reduce the number of samples sent to the reference laboratory and thus reduce the time taken to obtain a final result.

Risk factors for the spread of AIDS in rural Africa: evidence from a comparative seroepidemiological survey of AIDS, hepatitis B and syphilis in southwestern Uganda.

Before commencing rational control programmes for AIDS in Africa it is desirable to determine the relative importance of heterosexual and various non-sexual modes of transmission. We investigated this by comparing the seroepidemiologies of AIDS, hepatitis B and syphilis at two rural hospitals in southwest Uganda. During August 1986, 3% of 357 outpatients, reflecting the age and sex composition of the general population, were anti-HIV positive. Anti-HIV seropositivity, both in the outpatients and among 36 suspected prostitutes and 14 suspected AIDS cases, was confined to individuals aged 20 or over. For men, seropositivity was associated with sexual contact with prostitutes (a risk factor for 61% of young men in the study). In the prostitute group, 25% were anti-HIV positive and 46% were positive on the Treponema pallidum haemagglutination (TPHA) test for syphilis. The risk factors for HIV, but not hepatitis B, were the same as for having a history of sexually transmitted disease (STD). However, there was, surprisingly, an association between a history of STD and seropositivity for hepatitis B virus but not for HIV infection. The geographical and age distributions of seropositivity for HIV and hepatitis B virus were also quite different. Finally, blood transfusions, scarification and exposure to mosquitoes (as assessed by a history of malaria) were not evident risk factors for either HIV or hepatitis B virus. AIDS in rural Africa seems to differ in its epidemiology from hepatitis B and appears to be spread predominantly by pre-existing patterns of heterosexual activity responsible for high rates of other sexually transmitted diseases.

PIP: AIDS in rural Africa seems to differ in its epidemiology from hepatitis B and appears to be spread predominantly by preexisting patterns of heterosexual activity responsible for high rates of other sexually transmitted diseases. The authors compared the seroepidemiologies of AIDS, hepatitis B, and syphilis at 2 rural hospitals in southwest Uganda. During August 1986, 3% of 357 outpatients, reflecting the age and sex composition of the general population, were anti-HIV positive. Anti-HIV seropositivity, both in the outpatients and among 36 suspected prostitutes and 14 suspected AIDS cases, was confined to individuals aged 20 or over. For men, seropositivity was associated with sexual contact with prostitutes (a risk factor for 61% of young men in the study). In the prostitute group, 25% were anti-HIV positive and 46% were positive on the Treponema pallidum hemagglutination (TPHA) test for syphilis. The risk factors for HIV, but not hepatitis B, were the same as for having a history of sexually transmitted disease (STD). However, there was, surprisingly, an association between a history of STD and seropositivity for hepatitis B virus but not for HIV infection. The geographical and age distributions of seropositivity for HIV and hepatitis B virus were also quite different. Finally, blood transfusions, scarification, and exposure to mosquitoes (as assessed by a history of malaria) were not evident risk factors for either HIV or hepatitis B virus.

A comparison of two ELISAs for detecting HBe markers.

A new enzyme-linked immunosorbent assay (ELISA) kit (Wellcozyme HBeAg/anti-HBe; Wellcome Diagnostics) for detecting hepatitis Be antigen and antibody, the markers by which the infectivity of persons with hepatitis B surface antigenaemia may be inferred, has been compared with the ELISA obtained from the Division of Microbiological Reagents and Quality Control (Public Health Laboratory Service, London U.K.) currently used in this laboratory. The new test may be completed within 2 h compared with about 19 h for the current test. There was agreement between the two assay kits with 106/109 (97%) samples tested. The new test is acceptably sensitive and specific as well as being straightforward to perform.

Hepatitis B in the Cambridge dialysis and transplant unit 1966-1983.

The results of hepatitis B surveillance of the Cambridge dialysis and transplant units from June 1969 to July 1983 are reported. On admission 34/528 (6.44%) haemodialysis patients had anti-HBc. Preadmission screening excluded 19 HBs Ag carrier patients and two carrier staff. Eight patients became antigenaemic after admission and two others were found to be antigenaemic post-transplantation but pretransplant sera were not available from them. These two had active hepatitis and of the others, seven had asymptomatic carriage and one had acute hepatitis during haemodialysis. Two infected patients were admitted temporarily and one antigenaemic organ donor identified retrospectively. No cross infection occurred on the unit and the only instance of accidental infection of a member of staff was from an outpatient.

Tonometer disinfection and viruses.

Tonometer disinfectants in current use are frequently inactive against viruses and enable transfer of infection between patients. We selected sodium hypochlorite as a readily available alternative which is active against viruses and bacteria. At 500 p.p.m. it destroys herpes simplex, adenovirus 8, and enterovirus 70 within 10 minutes. A simple technique is described which is clinically acceptable and has been in daily use for one year.