PhD thesis - University of Hertfordshire Research Archive

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1931a; Jones & Little, 1931b). Demonstrating the absence of other potentially causative microorganisms, pathogenicity and antigenic- relatedness which was distinct from the vibrios causing vibrionic abortion, they proposed along with Orcutt the name Vibrio jejuni to reflect the focus of infection (Jones, Orcutt, & Little, 1931). Whilst investigating the cause of swine dysentery in 1944, Doyle noted that, of a number of organs tested, only the colonic wall from a diseased pig was capable of inducing disease when fed to susceptible pigs (Doyle, 1944). He subsequently isolated vibrios from the colon of a dysenteric hog which was later termed Vibrio coli (Doyle, 1948). Human diarrhoeal disease due to a vibrio was first reported by Levy in 1946 (Levy, 1946). Investigating a large outbreak of milkborne gastroenteritis affecting 357 inmates in two prisons in Illinois, he observed vibrio-like microorganisms in mucous from faeces submitted by acutely ill patients. Their significance was at first disregarded as they could not be cultured, however their presence in samples from 31 patients stimulated further study, and 16 of 306 stool samples taken three weeks into the outbreak were visually positive for the organism. Morphologically-similar vibrios were isolated from blood samples from 13 of 39 patients, and were observed to resemble those of the V. fetus described by Smith, and more closely those of V. jejuni described by Jones and colleagues. The next major development occurred in 1957 and arose from combining findings from human and veterinary medicine. Elizabeth King examined in detail the cultural, biochemical, and serological characteristics of 32 human and 13 veterinary vibrio isolates and compared these to the disease presentation and the available epidemiological information (King, 1957). These studies demonstrated the existence of a group of „related vibrios‟ which were physiologically (they grew best at 42°C) and antigenically distinct from V. fetus, and were prone to cause diarrhoeal disease in children, rather than the systemic or abortive disease caused by V. fetus in predisposed humans. 17
The application of veterinary techniques to human medicine was to provide the technical breakthrough which allowed the isolation of the bacteria from faeces. Having isolated related vibrios from the blood of one of two linked cases of diarrhoea in Belgium in 1972, Jean-Paul Butzler approached a veterinary colleague for assistance in examining the patients‟ stool samples. Dekeyser diluted, homogenised and centrifuged the samples, and vibrios isolated from the filtered supernatants were antigenetically similar to each other and that from the blood sample (Dekeyser et al., 1972). Examination of 1000 „pathogen-negative‟ stool samples by this method resulted in the isolation of 35 strains of related vibrios, suggesting a significant role for these bacteria in the human gastrointestinal tract. The following year Butzler extended this work by demonstrating that the pathogen was more prevalent in diseased children (5%) and adults (4%) than in children without diarrhoea (1.3%) (Butzler et al., 1973). Inexplicably the findings of Dekeyser and Butzler did not receive the deserved attention, and it was not until Skirrow reported similar findings in the United Kingdom (UK) in 1977 that the importance of campylobacters was established (Skirrow ,1977). 18
Page 1 and 2: Population-Based Sentinel Surveilla
Page 3 and 4: The research carried out by the can
Page 5 and 6: Dedication. This thesis is dedicate
Page 7 and 8: 7. Results (the published work). ..
Page 9 and 10: Statement identifying the degree fo
Page 11 and 12: Paper Reference Page 6 Gillespie IA
Page 13 and 14: Statement of the candidate’s cont
Page 15 and 16: Declaration form. I, Iain Andrew Gi
Page 17: 2. History. In contrast to other co
Page 21 and 22: The incidence of laboratory-confirm
Page 23 and 24: were elderly or had a pre-existing
Page 25 and 26: they would for other bacterial gast
Page 27 and 28: papers (Pearson et al., 1977; Bruce
Page 29 and 30: Studies were most frequently conduc
Page 31 and 32: The content of peer-reviewed public
Page 33 and 34: infection. An approximation of the
Page 35 and 36: hypotheses a „blank canvas‟ app
Page 37 and 38: 6. Materials and methods. Regional
Page 39 and 40: presentation and severity, foreign
Page 41 and 42: together, etc). The results of the
Page 43 and 44: and improve response during the stu
Page 45 and 46: The published work. 7.1 Epidemiolog
Page 47 and 48: community illness was more common a
Page 49 and 50: north west England and in Yorkshire
Page 51 and 52: community was no different from oth
Page 53 and 54: provide useful insights into the ep
Page 55 and 56: Cases in case-control studies of la
Page 57 and 58: 8. Discussion. The research carried
Page 59 and 60: The sentinel health authorities wer
Page 61 and 62: fundamentally flawed. Since the app
Page 63 and 64: control studies. The potential role
Page 65 and 66: Campylobacter spp. from cattle farm
Page 67 and 68: Cameron, S., Ried, K., Worsley, A.,
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Doyle, L. P. 1948, "The etiology of
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other industrialised countries," in
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Hanel, C. M. & Atanassova, V. 2007,
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Hudson, S. J., Lightfoot, N. F., Co
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Kessel, A. S., Gillespie, I., O'Bri
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costs-of-illness, Rijksinstituut vo
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Department of Health and Human Serv
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Potter, R. C., Kaneene, J. B., & Ha
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Siemer, B. L., Harrington, C. S., N
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Sopwith, W., Birtles, A., Matthews,
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Campylobacter infection: a general
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The published work 90
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Table A1.1: Notable events in the h
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Year Human medicine Veterinary medi
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Levy, A. J. 1928, "A gastro-enterit
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Appendix 2. An assessment of the ro
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compare the period after 2000 with
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condition was significantly associa
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Deaths/100,000 cases 600 500 400 30
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Table A2.1: Factors affecting the u
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Appendix 3. An analytical review of
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to indigenously acquired infection
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susceptibility to Campylobacter inf
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year demonstrated that only the num
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Table A3.1 Reported epidemiological
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Table A3.3 Selected reported risk f
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Table A3.5. The effect of various r
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Deming, M. S., Tauxe, R. V., Blake,
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Harris, N. V., Weiss, N. S., & Nola
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Kist, M. & Rossner, R. 1985a, in Ca
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Oosterom, J., den Uyl, C. H., Banff
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Severin, W. P. J. 1982, "Epidemiolo
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Appendix 4. The Campylobacter Senti
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