Search

Background More than 700 UK residents were tested for possible contamination with polonium-210 (210Po) following the alleged poisoning of Mr Alexander Litvinenko in London in November 2006. This paper describes the epidemiology of internal contamination with the radionuclide in this group. Methods 11 locations in London had been identified as sufficiently environmentally contaminated with 210Po to present a health risk to people associated with them. Public health consultant teams identified individuals at risk and offered 24-h urine testing for 210Po excretion. Prevalence of internal contamination was estimated, and a retrospective cohort analysis was completed for each location. Results Overall 139 individuals (prevalence 0.19 (95% CI 0.13 to 0.27)) showed evidence of internal contamination with 210Po, although none with uptakes likely to cause adverse health effects. Substantial prevalence was seen among specific hotel service staff, customers, staff and other users of a hotel bar, office and hospital staff, staff of one restaurant and residents of and visitors to the family home. Increased risks of contamination were seen for a hotel bar in association with occupational, behavioural and temporal factors. Occupational and guest exposure to contaminated areas of hotels were also associated with increased contamination risk. Nurses were more likely to become contaminated than other staff involved in direct patient care. Conclusions Uptake of trace amounts of radionuclide in this incident was frequent. Occupational, behavioural and temporal gradients in contamination risk were mostly consistent with a priori site risk assessments. Utility of the investigation methods and findings for future accidental or deliberate environmental contamination incidents are discussed. [ABSTRACT FROM AUTHOR]

The article discusses the conditions necessary to foster photovoltaic (PV) technologies deployment within the UK electricity sector. It explores the incentives to invest in PV technologies by assessing the financial viability of PV system investments in the UK. The analysis focuses on a set of target PV technologies and applications for the domestic sector. First, it provides a picture of profitability and incentives to invest in the targeted PV systems under current UK market, technical, and regulatory conditions. Then, the analysis looks at the role of policy and potential future technological development by exploring the impact of alternative policy instruments and technology cost reductions on the financial viability of investing in PV. The analysis shows that domestic PV investments are generally not profitable under current cost, market, and regulatory conditions. The initial capital costs are too high and the current policy framework is not enough to make PV systems financially viable. The introduction of high-enough feed-in tariffs, as well as the achievement of target cost reductions, would make PV systems financially attractive and would likely increase PV deployment in the UK. [ABSTRACT FROM AUTHOR]

Cost-effectively decarbonising the power sector and household energy use using variable renewable energy will require that electricity consumption becomes much more flexible and responsive to constraints in supply and the distribution network. In recent years residential demand response (DR) has received increasing attention that has sought to answer, based on current evidence, questions about how much consumers will engage with DR. This paper critically reviews the evidence base for residential consumer engagement with DR and draws out several important limitations in it. We argue for a more action-oriented focus on developing practical strategies to enable and unlock greater loadshifting and consumer engagement with DR within a changing technology and regulatory context. A number of recommendations are put forward for accelerating UK consumer engagement with DR, presented under three broad strategies: (a) promote awareness of smart tariffs, smart meters and storage and automation behind-the-meter devices as mutually-supportive components within a common 'DR technology cluster'; (b) deliver targeted support for adoption of electric vehicles and other storage and automation technologies; (c) enable and support informed adoption of DR-enabling products and services through 'smarter' digital comparison tools (DCTs), data portability, and faster, simpler switching. The interdependency between components within this DR technology cluster delivers efficiency but also poses a risk that one delayed component (e.g., smart metering) will hold-up policy and industry support for other components. The urgency of decarbonisation goals makes it necessary to push forward as many of these elements as possible rather than the pace being set by the slowest. • Findings and limitations of the evidence base for residential DR are drawn out. • Smart meters, TOU and smart storage should be promoted as a DR 'technology cluster'. • Support EV adoption to drive greater engagement with smart meters and DR. • Enable adoption of DR products and services with smarter Digital Comparison Tools. • Support for each element of the DR technology cluster should be urgently pursued. [ABSTRACT FROM AUTHOR]

In a three year study of children under 16 years with haemolytic uraemic syndrome faecal samples were examined for the presence of Verocytotoxin producing Escherichia coli (VTEC) using DNA probes and for free neutralisable Verocytotoxin in a Vero cell assay with specific antisera. There was evidence of VTEC infection in 58 of 185 (31%) samples. A total of 53 VTEC was identified from patients with haemolytic uraemic syndrome. Thirty eight VTEC belonged to serotype O157:H7 or O157:H-, 34 produced VT2 only, and four strains produced both VT1 and VT2. The remaining 15 VTEC belonged to nine different O serogroups; three strains produced VT1, 10 produced VT2, and two were positive for VT1 and VT2. Three control groups of patients without haemolytic uraemic syndrome were also examined. There was evidence of VTEC infection in 8%, 6%, and 4% of specimens from individuals with bloody diarrhoea, those with diarrhoea only, and healthy controls respectively. VTEC from the bloody diarrhoeal and diarrhoeal controls were O157:H7 but those from the healty controls could not be O serogrouped. This study confirms the association of VTEC, and particularly strains of O157:H7, with haemolytic uraemic syndrome. Strains producing VT1, VT2, or both toxins were isolated, although over 94% of VTEC produced VT2 alone or together with VT1.

Two hundred and thirty-two strains of Escherichia coli belonging to infantile enteropathogenic serotypes isolated in the United Kingdom during 1980 and 1981 were tested for resistance to 10 antimicrobial drugs. Resistance to one or more drugs was found in 134 (57.8%) of the strains, with resistance to sulphonamides, streptomycin, tetracycline, and ampicillin occurring most commonly. Resistance was transferable in 65 out of 104 resistant strains. These findings are a cause for concern because they indicate that the choice of treatment for severe illness is limited and suggest that a large pool of drug-resistant organisms exists in the community.

A point source outbreak of haemorrhagic colitis due to Escherichia coli O 157.H7 producing verocytotoxin (VT), took place following a christening party in Birmingham in June 1987. Twenty-six people were affected, six were admitted to hospital and one developed haemolytic uraemic syndrome: there were no deaths. VT + E. coli O 157.H7 was isolated from 13 (57%) of 23 faecal specimens from affected people and from 3 (9%) of 33 specimens from asymptomatic people. Free VT was detected in the faeces of one further asymptomatic person. Illness was associated with eating turkey-roll sandwiches (P less than 0.001) suggesting that cold meats might be an important source of infection.

Altogether 411 cultures of Escherichia coli isolated from blood and 60 from cerebrospinal fluid (CSF) of patients in the United Kingdom were identified biochemically and serologically. They were tested for the presence of K1 antigen by an antiserum-agar method using horse meningococcus group B antiserum and by slide agglutination using E. coli 07.K1.H-antiserum. In total 71 cultures from blood (17%) and 29 from CSF (48%) gave positive results by both methods and were considered to possess the K1 antigen. Among the cultures from patients less than 3 years of age the K1 antigen was found significantly more often in those isolated from CSF (53%) than in those from blood (29%). The K1 antigen was found significantly more frequently in cultures isolated from the blood of patients less than 3 years old (29%) than in those from the blood of older patients (13%). Cultures which gave negative results in the slide agglutination test also gave negative results by the antiserum-agar method but positive results obtained by slide agglutination were not always confirmed using the antiserum-agar technique. Slide agglutination was considered to be valuable for the elimination of K1 negative cultures, but positive results required confirmation using the antiserum-agar method.

Vero-cytotoxin (VT) producing Escherichia coli serogroup O157 have been isolated from patients with diarrhoea, haemorrhagic colitis (HC) and haemolytic uraemic syndrome (HUS). A phage-typing scheme developed in Canada has been used to type 155 VT+ E. coli O157 serogroup isolated from sporadic infections in the UK since 1983, and 48 strains from HC or HUS outbreaks. Twelve phage types were identified of which three, types 49, 51 and 52, have not been found in North America. All strains carried a 60 x 10(6) plasmid and most VT1+VT2+ strains also had a 5 x 10(6) plasmid coding for colicin D production. The majority of strains producing both VT1 and VT2 belonged to phage type 1, or the related types 4, 8 and 14. Most strains producing only VT2 belonged to types 2 or 49. Four outbreaks were included in the survey. Three had strains of a single phage type while strains from the fourth outbreak were more variable. The distribution of phage types throughout the UK showed no marked geographical variations.

For many years strains of Escherichia coli belonging to particular serotypes (EPEC) were a common cause of outbreaks of infantile enteritis in Europe and North America. E. coli 0142.H6 was first isolated from infants with diarrhoea in Indonesia in 1960 and a further outbreak occurred in Mexico in 1965. Between 1967 and 1972 outbreaks of infantile enteritis caused by E. coli 0142 were reported in hospitals in Scotland, England, Northern Ireland and Eire. Sporadic cases occurred in Canada in 1972 and a further outbreak occurred in Arizona, U.S.A. in 1975. Strains from all these incidents were examined by biochemical and serological methods. Their resistance to antimicrobial drugs was determined and their resistance plasmids characterized; their plasmid profiles were visualized by agarose gel electrophoresis. The cumulative evidence suggests that strains isolated in the British Isles all belonged to a single clone and were related to those isolated in Indonesia, the U.S.A. and Canada. However, the strains from Mexico appeared to be unrelated. This study demonstrates that single clones of enteropathogenic E. coli may spread throughout the world, causing outbreaks of diarrhoeal disease and acquiring resistance to antimicrobial drugs.

Faecal specimens from 66 children with haemolytic uraemic syndrome in the United Kingdom were examined for strains of Escherichia coli producing Vero cytotoxin (VT). Initially, conventional bacteriological methods were used to identify colonies of E. coli which were then tested for VT production. Subsequently, specific DNA probes for VT1 and VT2 were used in hybridisation tests to detect VT-producing E. coli (VTEC). VTEC strains were isolated from 19 cases and in 15 they belonged to serogroup O157. Fourteen of these O157 strains possessed the flagellar antigen H7 and one was non-motile. The VTEC strains from the remaining four cases belonged to serotypes O26:H11, O104:H2, O153:H25, and O163:H19 together with a rough VT+ strain with flagellar antigen H51. The O157 strains hybridised with either the VT2 probe or both VT1 and VT2 probes. The other VTEC strains hybridised with either the VT1 or VT2 probe. Confirmation of the production of VT1 and VT2 in vivo was obtained by the neutralisation of faecal VT with specific antisera raised against these two cytotoxins.

Enteropathogenic strains of Escherichia coli (EPEC) that caused 10 outbreaks of infant diarrhoea in the U.K. between 1968 and 1986 were studied. All gave localised adherence (LA) to HEp-2 cells, HeLa cells and Intestine 407 cells in culture. All hybridised with the EPEC adherence factor (EAF) probe. The hybridising sequences were carried on plasmids ranging in size from 26 to 76 MDa. EPEC from sporadic cases of infant diarrhoea occurring between 1979 and 1986 that belonged to the same serotypes as the outbreak strains were also studied. All strains of serotypes O111ab.H2, O114.H2, O119.H6, O127.H6 and O142.H6 gave LA and were EAF-positive. In other serotypes, non-adhering strains or strains giving diffuse adherence were found also. In addition, strains of serotype O128.H2 which gave LA but did not hybridise with the EAF probe were identified. The strains isolated from sporadic cases of diarrhoea in the U.K. were similar, with respect to adhesion and hybridisation, to those isolated from sporadic cases of diarrhoea in developing countries.

Three test systems were used to study enterotoxin production by epidemic strains of Escherichia coli from cases of infantile enteritis in well-documented outbreaks in the U.K. The tests used were the Y1-mouse-adrenal-cell test and the Chinese-hamster-ovary-cell (C.H.O.) test for the detection of heat-labile enterotoxin and the infant-mouse test for the detection of heat-stable enterotoxin. All 6 outbreaks had been studied using full serotyping techniques and the results had been published. In each outbreak the epidemiological studies clearly implicated a particular serotype of E. Coli as the epidemic strain and cultures of that serotype were tested for enterotoxin production. Although a control strain validated by other workers was positive in all three systems, the epidemic strains from infantile enteritis were negative. It seems that the three enterotoxin tests used in this study are of little value in recognising strains of E. coli causing epidemics of infantile enteritis in the U.K.