A recent outbreak in Aukland belies the fact that rates of hepatitis A in New Zealand are low. In fact, since 2000 incidence figures for all forms of viral hepatitis in this country have even been exceeded by those of leptospirosis and rheumatic fever [1] – see graph [2]:

During the same period, rates of hepatitis A among the six major English-speaking countries have been decreasing, and continue to be surprisingly similar – see graph:

Only one country in this group, the United States, employs routine vaccination against Hepatitis A. Two other countries, Canada and Australia, administer the vaccine to high-risk populations only. [2]

References:
1. Berger SA. Infectious Diseases of New Zealand, 2012. 413 pp, 136 graphs, 1534 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-new-zealand/
2. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps
3. Berger SA. Hepatitis A: Global Status, 2012. 166 pp, 181 graphs, 1189 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hepatitis-a-global-status/

Note featured in ProMED

The incidence of Lyme disease has been increasing in the United Kingdom since reporting began, with highest rates in Scotland. In the following graph I’ve contrasted these rates with those of the Uhnited States. [1]

Reference:
1. Gideon graph tool at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

Reports of campylobacteriosis in the United Kingdom have increased since the 1990′s, and continue to exceed the combined incidence of all other reportable gastrointestinal pathogens [1,2]: see graph [3] .

Campylobacteriosis rates in Scotland are similar to those of England and Wales, while those of Northern Ireland more closely resemble rates reported by the Irish Republic. [1,2] See graph [3] :

References:
1. Berger SA. Infectious Diseases of the United Kingdom, 2011. 992 pp, 786 graphs, 2594 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-kingdom/
2. Berger SA. Campylobacteriosis: Global Status, 2011. 94 pp, 93 graphs, 717 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/campylobacteriosis-global-status/
3. Gideon graph tool tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps )

Note reproduced by ProMED

Of historic interest, rates of scarlet fever in the United Kingdom decreased by a factor of 3 to 20 following the advent of antibiotics [1,2] See graph

References:
1. Berger SA. Infectious Diseases of the United Kingdom, 2011, 992 pp. Gideon e-book series, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-kingdom/
2. Berger SA. Rheumatic Fever and Scarlet Fever: Global Status, 2011, 96 pp. Gideon e-book series, http://www.gideononline.com/ebooks/disease/rheumatic-fever-and-scarlet-fever-global-status/

Recent reports from Cornwall remind us that autothonous cases of Hepatitis E are increasingly reported in Europe. In fact, reported rates in England and Wales are somewhat higher than those of other regional countries.

The following background data on Hepatitis E in the United Kingdom are abstracted from the Gideon e-book series. [1,2] Primary references are availale on request.

Only one autochthonous case (in 1999) of Hepatitis E was reported during 1994 to 2000 – all others were either imported or source unknown.
– 10 autochthonous cases had been reported as of 2006.
– 186 cases were reported during 1996 to 2003 – including 17 autochthonous cases.
– 100 confirmed and presumed indigenous infections were reported in 2005 (30.4% of total cases, 70% above age 55 years).
– 181 cases were confirmed during January to June, including 25 autochthonous cases.

21 autochthonous cases were documented in southwestern England during a 7-year period (2007 publication). 5 ; 28 in Cornwall and Devon during 2005 to 2006.
- A series of 24 cases of non-travel associated Hepatitis E infection was treated at a hospital in south Wales during a 25-month period (2010 publication)
- 13 cases were confirmed in South Hampshire during a 13-month period (2005 to 2006)

Prevalence surveys:
5% to 35% of pigs on farms in the Yorkshire Humberside area (2008 publication)

Seroprevalence surveys:
16% of blood donors, 13% of patients with chronic liver disease and 25% in individuals over 60 years (southwestern England, 2008 publication)
13% of persons in England (1991 to 2004)
3.9% (native-born) to 8.8% (foreign-born) of persons in inner city London (1996 publication)
2.4% of farming industry workers (2009 publication) 13

Human infection by a porcine strain of Hepatitis E virus has been documented.

Notable outbreaks:
2008 – An outbreak (33 cases) was reported among passengers on a British round-the-world cruise ship.

References:
1. Berger SA. Infectious Diseases of the United Kingdom, 956 pp, 2010. Gideon e-book series. http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-kingdom/
2. Berger SA. Hepatitis D, E and G: Global Status, 89 pp, 2010. http://www.gideononline.com/ebooks/disease/hepatitis-d-e-and-g-global-status/

Update: Posted in ProMED

Recent cross-border oubreaks belie the fact that salmonellosis activity in the United Kingdom has actually declined in recent years. In fact, since 1997, reporting rates for England, Scotland and Wales have been similar to the lower figures which had existed in Ireland and Northern Ireland. The following data are extracted from the Gideon e-book series. [1-3]

The following chronlogy of earlier international salmonellosis outbreaks (not including clusters among tourists) is extracted from reference [4]:

Outbreaks involving two or more countries (primary references available on request)
1973 (publication year) – An international outbreak of Salmonella agona infection was reported.
1973 to 1974 – An outbreak (80 cases in the U.S. and 39 in Canada) of Salmonella Eastborne infection was caused by contaminated chocolate.
1982 – An outbreak (245 cases) of Salmonella napoli infection in England and Wales was caused by contaminated chocolate bars imported from Italy.
1991 – An outbreak (400 cases or more) of Salmonella poona infection in the United States and Canada was caused by contaminated American and Central American cantaloupe.
1995 – An outbreak (27 cases in the U.K.) of Salmonella agona infection was caused by a savoury snack imported from Israel.
1995 – An outbreak ( 242 cases, approximate) in the United States and Finland of Salmonella serotype Stanley infection was traced to Alfalfa sprouts.
1996 to 1997 – An outbreak (22 cases) of S. enterica serotype Anatum infection was caused by contaminated dried formula milk – resulting in 13 cases in England, 4 Scotland, 4 France and 1 Belgium.
1997 – An outbreak of S. livingstone infection was reported in Western Europe – several of the cases were acquired abroad, notably in Tunisia.
1997 – An outbreak (24 cases) of Salmonella serogroup Saphra infection in California was associated with imported Mexican cantaloupe.
1997 to 1998 – An outbreak of Salmonella Newport infection associated with contaminated cured ham was reported in the United Kingdom and Finland.
1998 – Outbreaks of Salmonella blockley infection were reported in Germany, Austria, Belgium, Sweden, Finland and the United Kingdom – smoked eel implicated in some countries.
1999 – An outbreak (275 cases) of Salmonella paratyphi B infection was reported among European tourists who visited Turkey during the summer of 1999.
1999 – An outbreak (400 cases or more, 21 hospitalized) of Salmonella muenchen infection from orange juice affected 25 U.S. states and two Canadian provinces (22 cases).
2000 – Outbreaks of Salmonella typhimurium DT204b infection (total 396 cases) which may have been related occurred in Iceland, England and Wales, the Netherlands, Scotland and Germany. Contaminated lettuce was implicated.
2000 to 2001 – An outbreak (168 cases, total) of S. enteritidis phage type 30 infection (157 cases in Canada, 11 in the United States) was caused by contaminated raw almonds.
2000 to 2002 – Outbreaks (148 cases, total) of Salmonella poona infection (47 cases in 2000, 50 in 2001, 58 in 2002) from imported Mexican cantaloupe were reported in multiple American states and Canada.
2001 – Outbreaks of Salmonella typhimurium DT 104 infection caused by a batch of imported Turkish halvah were reported in Australia and Sweden. Contaminated halvah was also identified in Germany, Norway and the United Kingdom.
2001 – An outbreak (99 total cases) of Salmonella Stanley infection in Australia (60 cases) and Canada (33 cases) was associated with contaminated peanuts imported from China.
2001 – An outbreak of Salmonella oranienburg due to contaminated German chocolate affected several European countries.
2001 – An outbreak (303 cases) of Salmonella enteritidis anaerogenic PT 14b infection was reported among Norwegian, Finish and Swedish tourists returning from Crete and Karpathos. The probable source was contaminated poultry.
2001 – An outbreak of Salmonella Schwarzenground infections in Denmark and the United States was traced to contaminated chickens in Thailand.
2003 – Outbreaks of Salmonella Montevideo infection in Australia and New Zealand were caused by contaminated sesame seed products (Tahini and Halva) imported from Egypt and Lebanon.
2004 – Raw almonds contaminated with Salmonella enteritidis were recalled by the manufacturer from China, Taiwan, Democratic Republic of Korea, France, Italy, Japan, Malaysia, Mexico and the United Kingdom.
2004 – Ruccola lettuce contaminated with Salmonella Thompson was identified in Norway, Sweden and the United Kingdom.
2005 – An outbreak (5 cases, total) of Salomonella enterica serotype Thompson infection (3 cases in Canada and 2 in United States) was caused by handling contaminated pet treats.
2005 – An outbreak (48 cases, total) of Salmonella stoubridge infection in Sweden (6 cases), Switzerland (3), Germany (2), Austria (5), United Kingdom (3) and France (27) was caused by unpasteurized French soft cheese.
2005 – An outbreak (178 cases) of Salmonella Goldcoast infection in Majorca affected tourists from Scotland (37), Ireland (6), Sweden (6), Norway (8), Denmark (3), Germany (20) and Finland (4).
2005 – An outbreak (22 cases) of Salmonella typhimurum DT 104 infection in Denmark was caused by raw beef carpacio imported from Italy.
2006 – An outbreak (13 cases) of Salmonella typhimurium infection in Sweden was caused by contaminated salami imported from Italy.
2007 – An outbreak (10 cases) of Salmonella typhimurium infection in Denmark (6 cases) and Norway (4 cases) was caused by imported Spanish sausage.
2007 – An outbreak (63 cases) of Salmonella senftenberg infection in England and Wales (51 cases), Denmark (11) and the Netherlands (2) was ascribed to contaminated basil imported from Israel. Subsequent testing of local batches of basil failed to demonstrate the organism.
2007 – An outbreak (45 cases, total) of Salmonella Weltevreden infections in Norway (19 cases), Denmark (19 cases) and Finland (7 cases) was associated with alfalfa sprouts distributed from Denmark. 2007 – An outbreak (354 cases) of Salmonella paratyphi B variant Java (Salmonella Java) infection in Netherlands (12 cases), Sweden (172), Norway (25), Ireland (9), Hungary (3), Finland (9), Denmark (40) and Austria (2) was ascribed to contaminated baby spinach.
2008 – An outbreak (59 cases) of Salmonella Litchfield infection in 16 American states (50 cases) and Canada (9 cases) was caused by contaminated melon from Honduras.
2008 – An outbreak (141 cases) of Salmonella serotype Agona infection in England (80 cases), Wales (10), Ireland (11) , Northern Ireland (1) , Scotland (31) Sweden (2), France (1) and Finland (1) was ascribed to contaminated commercial sandwiches.
2008 – An outbreak (74 cases) of Salmonella enterica serotype poona infection included 26 cases in Canada and 48 in the United States.
2008 – An outbreak (49 cases) of Salmonella enterica serotype typhimurium U288 infection from contaminated pork products included 37 cases (4 fatal) in Denmark, 10 in Norway and 2 in Sweden.
2008 to 2010 – An outbreak (400 cases) of Salmonella typhimurium DT 191a infections in England, Wales, Northern Ireland and Ireland was related to pet reptiles which were fed with contaminated frozen mice. Subsequent outbreak cases (34) were reported in multiple American states in 2010.
2009 – An outbreak (137 cases) of Salmonella oranienburg infection included 38 cases in the United Kingdom, 85 in the United States, 7 in Canada and 7 in Scotland.
2009 – An outbreak (124 cases in the United States and 12 in Canada) of Salmonella enterica serotype typhimurium infections was ascribed to possible contamination of shredded lettuce.
2010 – An outbreak (14 cases) of Salmonella urbana infection included cases in in Finland, the Czech Republic and Latvia.

1. Berger SA. Infectious Diseases of the United Kingdom, 956 pp. 2010. Gideon e-book series. http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-kingdom/
2. Berger SA. Infectious Diseases of Ireland and Northern Ireland, 433 pp. 2010. Gideon e-book series. http://www.gideononline.com/ebooks/country/infectious-diseases-of-ireland-and-northern-ireland/
3. Berger SA. Salmonellosis: Global Status, 237 pp. 2010. Gideon e-book series. http://www.gideononline.com/ebooks/disease/salmonellosis-global-status/
4. Berger SA. Infectious Diseases of the World, 929 pp. 2010. Gideon e-book series. http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-world/

Recently, a British woman died of leptospirosis acquired from the scratch of a rodent. Few people realize that leptospirosis is not uncommon in the United Kingdom. In fact, 18 fatal cases were reported in England and Wales during 1988 to 2006. In the following graph, I’ve contrasted disease rates for the region with those of the United States.

Update: Also quoted in ProMED