Influenza A outbreak in a community hospital.

In January 2005, the Department of Public Health, HSE Eastern Region, received notification of an outbreak of influenza-like illness (ILI) in a community hospital for elderly patients. Influenza A (H3N2 subtype) was isolated in 12 of 18 (66%) throat swabs sent to the National Virus Reference Laboratory (NVRL). An outbreak control team was convened. Infection control measures were put in place. Immunisation clinics were organised for non-immunised staff. The epidemic curve confirmed peak onset of illness from 14th-17th January. Attack rates were high among patients (37/74: 50%). Mortalities were also reported. A high percentage of cases occurred in patients who had been immunised (19/34: 55.6%). Seventeen of 94 healthcare workers (HCWs) became ill (18.1%), of whom only 3 (3.2%) had been immunised. A questionnaire circulated to staff identified reasons for non-immunisation. In accordance with the National Institute of Clinical Excellence (NICE) guidelines and microbiological advice, antiviral medication was recommended for patients and non-immunised HCWs as treatment or chemoprophylaxis. This outbreak highlights the importance of immunisation of HCWs against influenza.

Dead cattle, lead and child health.

This study was carried out as part of a larger interagency investigation in response to concerns about human health following the death of three cattle from lead poisoning in an old lead mining area in Silvermines, Tipperary. Its aim was to screen for lead toxicity in the local child population. Screening consisted of measurement of blood lead concentrations and the completion of questionnaires regarding exposure to lead and general health. Pre-school and primary school children resident in four surrounding district electoral divisions (DEDs) were specifically targeted. One out of 334 (0.3%) children screened had an elevated blood lead concentration. The geometric mean lead concentration was 2.6 microg/dl which is below the intervention lead concentration of 10 microg/dl recommended by the CDC. The mean lead concentration in those aged under three years was statistically significantly higher than in those aged three years and over (3.4 microg/dl vs 2.5 microg/dl; p=0.000581). No specific health problems were identified by the questionnaires. This study concluded that the elevated environmental lead levels which were demonstrated by other agencies involved in this investigation are not currently being transferred to children. It recommends further blood screening of children in the area and ongoing education to minimise the risk of lead toxicity in the area in the future.

An outbreak of Norwalk-like viral gastroenteritis in holidaymakers travelling to Andorra, January-February 2002.

A retrospective cohort study was conducted to investigate an outbreak of Norwalk-like viral gastroenteritidis that occurred in Irish holidaymakers visiting Andorra, in January-February 2002. Preliminary results showed the risk exposure was higher for tourists who stayed in Soldeu and consumed ice cubes in their drinks (OR = 2.5, 95% CI [1.3-4.6)], after logistic regression and adjusting for sex and water consumption).