A5045995139- Escherichia coli research studies
- Viral gastroenteritis research and epidemiology
- Clostridium difficile and Clostridium perfringens research
- Malaria Research and Control
- Salmonella and Campylobacter epidemiology
- Viral Infections and Outbreaks Research
- Bacteriophages and microbial interactions
- Mosquito-borne diseases and control
- Vibrio bacteria research studies
- Travel-related health issues
- Viral Infections and Vectors
- HIV/AIDS Research and Interventions
- Listeria monocytogenes in Food Safety
- HIV Research and Treatment
- HIV, Drug Use, Sexual Risk
- Bacterial Identification and Susceptibility Testing
- Influenza Virus Research Studies
- Zoonotic diseases and public health
- Diphtheria, Corynebacterium, and Tetanus
- Animal Disease Management and Epidemiology
- Parasites and Host Interactions
- Toxin Mechanisms and Immunotoxins
- Virus-based gene therapy research
- Gut microbiota and health
- Enterobacteriaceae and Cronobacter Research
Public Health England
2015-2021
University of Warwick
2018
National Institute for Health Research
2018
London School of Hygiene & Tropical Medicine
2011-2017
Barts Health NHS Trust
2016
National Health Service
2016
University College London
2016
Health Protection and Research Organisation
2012-2016
European Centre for Disease Prevention and Control
2015
University of London
2012-2015
The use of whole genome sequencing (WGS) as a method for supporting outbreak investigations, studying Salmonella microbial populations and improving understanding pathogenicity has been well-described (1-3). However, performing WGS on discrete dataset does not pose the same challenges implementing routine, reference microbiology service public health surveillance. Challenges include translating data into useable format laboratory reporting, clinical case management, surveillance,...
<b>Objective</b> To assess the accuracy of malaria diagnosis and treatment at primary level clinics in Afghanistan. <b>Design</b> Prospective observational study. <b>Setting</b> 22 two Afghan provinces, one north (adjoining Tajikistan) east Pakistan); areas with seasonal transmission <i>Plasmodium vivax</i> falciparum</i>. <b>Participants</b> 2357 patients all ages enrolled if clinicians suspected malaria. <b>Interventions</b> Established (>5 years) microscopy (12 Afghanistan), newly...
In August 2015, Public Health England detected an outbreak of Shiga toxin-producing Escherichia coli (STEC) serotype O157:H7 caused by contaminated salad leaves in a mixed leaf prepacked product from national retailer. The implicated were cultivated at five different farms and the zoonotic source strain was not determined. March 2016, additional isolates new cases identified that shared recent common ancestor with strain. A case-case study involving 2016 revealed ovine exposures associated...
In England in 2015, Shigella sonnei isolates from men who have sex with produced extended-spectrum β-lactamases and exhibited macrolide resistance. Whole-genome sequencing showed a close relationship among the isolates, which harbored plasmid that was previously identified shigellosis outbreak this population but has acquired mobile element.
Whole-genome sequencing has enhanced surveillance and facilitated detailed monitoring of the transmission Shigella species in England. We undertook an epidemiological phylogenetic analysis isolates from all cases shigellosis referred to Public Health England between 2015 2018 explore recent strain characteristics dynamics species. Of 4,950 confirmed identified during this period, highest proportion was sonnei (54.4%), followed by S. flexneri (39.2%), boydii (4.1%), dysenteriae (2.2%). Most...
Background Chemsex, the use of select psychoactive drugs to enhance sexual experience, typically among men who have sex with (MSM), is associated behaviours higher STI risk. Understanding patterns chemsex MSM as well characteristics and health service engagement participants important for developing interventions. Methods Between 5/2016 5/2017, 3933 completed an online survey, recruited in clinics (SHCs) England (n=421) via four social networking/dating apps (n=3512). We described past year...
We investigated a large outbreak of Escherichia coli O157 in the United Kingdom (UK) with 165 cases between 31 May and 29 July 2016. No linked were reported other countries. Cases predominately female (n = 128) adult 150), 66 attended hospital nine had features haemorrhagic uraemic syndrome. A series epidemiological studies (case–control, case–case, ingredients-based venue-based studies) supply chain investigations implicated mixed salad leaves from Supplier as likely vehicle. Whole genome...
Improving access to parasitological diagnosis of malaria is a central strategy for control and elimination the disease. Malaria rapid diagnostic tests (RDTs) are relatively easy perform could be used in primary level clinics increase coverage diagnostics improve treatment malaria.A cost-effectiveness analysis was undertaken RDT-based public health sector facilities Afghanistan comparing societal costs RDTs versus microscopy clinical low moderate transmission areas. The effect measure...
In 2012, an ongoing outbreak of diphtheria in Indonesia was focused the province East Java. There a need to assess vaccine coverage and immunity gaps children.We conducted cross-sectional seroprevalence survey children 1-15 years age 2 districts Java: one high incidence (on island Madura) low mainland). From each district, we sampled 150 (10 per year age). Sera throat swabs were taken determine carriage status. Immunity defined as ≥0.1 international unit/mL antibody toxin.A total 297...
We used whole-genome sequencing to investigate the evolutionary context of an emerging highly pathogenic strain Shiga toxin-producing Escherichia coli (STEC) O157:H7 in England and Wales. A timed phylogeny sublineage IIb revealed that clone evolved from a STEC stx-negative ancestor ≈10 years ago after acquisition bacteriophage encoding toxin (stx) 2a, which turn had stx2c progenitor ≈20 ago. Infection with stx2a was significant risk factor for bloody diarrhea (OR 4.61, 95% CI 2.24-9.48;...
To assess the impact of rapid diagnostic tests on accuracy and treatment malaria non-severe fever in an Asian setting.Patient randomised trial primary level clinics.Two areas Afghanistan where Plasmodium vivax falciparum are endemic; one area with moderate transmission (eastern region) low (northern region).5794 patients all ages suspected enrolled by 80 clinicians 22 clinics.Malaria were compared clinical diagnosis no parasite test was available, longer established field microscopy,...
Since the 1970s, shigellosis has been reported as a sexually transmissible infection, and in recent years, genomic data have revealed breadth of Shigella spp. transmission among global networks men who sex with (MSM). In 2015, Public Health England (PHE) introduced routine whole-genome sequencing (WGS) to identify clusters. However, limited behavioural information for cases hampers interpretation. We investigated whether WGS can distinguish between clusters representing sexual MSM community...
The first documented British outbreak of Shiga toxin-producing Escherichia coli (STEC) O55:H7 began in the county Dorset, England, July 2014. Since then, there have been a total 31 cases which 13 presented with haemolytic uraemic syndrome (HUS). strain had toxin (Stx) subtype 2a associated an elevated risk HUS. This not previously isolated from humans or animals England. only epidemiological link was living having close links to two areas Dorset. Extensive investigations included testing and...
Accurate parasitological diagnosis of malaria is essential for targeting treatment where more than one species coexist. In this study, three rapid diagnostic tests (RDTs) (AccessBio CareStart (CSPfPan), PfPv (CSPfPv) and Standard Diagnostics Bioline (SDBPfPv)) were evaluated their ability to detect natural Plasmodium vivax infections in a basic clinic setting. The potential locally made evaporative cooling boxes (ECB) protect the from heat damage high summer temperatures was also...
In many malaria-endemic areas, including Afghanistan, overdiagnosis of malaria is common. Even when using parasite-based diagnostic tests prior to treatment, clinicians commonly prescribe antimalarial treatment following negative test results. This practice neglects alternative causes fever, uses drugs unnecessarily, and might contribute drug resistance. We undertook a qualitative study among health workers different methods in Afghanistan explore perceptions diagnosis. Health valued for...
Abstract In April 2018, Public Health England was notified of cases Shigella sonnei who had eaten food from three different catering outlets in England. The outbreaks were initially investigated as separate events, but whole-genome sequencing (WGS) showed they caused by the same strain. investigation included analyses epidemiological data, chain and microbiological examination samples. WGS used to determine phylogenetic relatedness antimicrobial resistance profile outbreak Ultimately, 33...
Abstract Recurrent outbreaks of haemolytic uraemic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli (STEC) serotype O55:H7 occurred in England between 2014 and 2018. We reviewed the epidemiological evidence to identify potential source(s) transmission routes pathogen, assess on-going risk public health. Over 5-year period, there were 43 confirmed three probable cases STEC O55:H7. The median age was 4 years old (range 6 months 69 old) over half all female (28/46, 61%). There...
To measure prevalence of prior/current Plasmodium vivax and falciparum (PV PF), Brucella spp. (BR), dengue virus (DENV), Leishmania donovani (visceral leishmaniasis; VL), Crimean-Congo hemorrhagic fever (CCHF) exposure among Afghan National Army (ANA) recruits.Randomly chosen, nationally representative serum samples from consenting men aged 18-40 years who were screened between February 2010 January 2011 tested, with ∼25 samples/province. Samples for PV PF antigens VL antibody rapid...
The World Health Organisation (WHO) recommends parasitological diagnosis of malaria before treatment, but use rapid diagnostic tests (mRDTs) by community health workers (CHWs) has not been fully tested within services in south and central Asia. mRDTs could allow CHWs to diagnose accurately, improving treatment febrile illness. A cluster randomised trial was undertaken Afghanistan. primary outcome the proportion suspected cases correctly treated for polymerase chain reaction (PCR)-confirmed...
The public health value of whole genome sequencing (WGS) for
In December 2015, six cases of Shiga toxin (Stx)-producing Escherichia coli (STEC) O157:H7 stx2a/stx2c phage type (PT) 24 were identified by the national gastrointestinal disease surveillance system at Public Health England (PHE). Frozen grated coconut imported from India was implicated as vehicle infection. Short and long read sequencing data interrogated for genomic markers to provide evidence that outbreak strain an source. The belonged a sub-lineage (IIa) rare in domestically acquired...
Shigella is a leading cause of gastroenteritis worldwide; however, data on clinical outcomes amongst adults are lacking. All adult cases (>16 years) diagnosed between January 2014 to December 2017 at an East London NHS Trust in the United Kingdom were included. Demographic, clinical, microbiological and whole genome sequencing (WGS) retrospectively collected. spp isolates from 169 identified: S. flexneri 90 (53.3%), sonnei 75 (44.9%) boydii 4 (2.0%). The median age was 34 years (IQR...
<h3>Background</h3> Chemsex, the use of select psychoactive drugs to enhance sexual experience, typically among men who have sex with (MSM), is associated STI risk behaviours. Understanding characteristics MSM engage in chemsex and their clinics important for developing interventions. <h3>Methods</h3> Between 5/2016-5/2017, 3,358 (aged≥15years; no known HIV infection) completed an online survey, largely via 4 gay social-networking apps. We described patterns differences demographics,...