ANNEX VIII
(Para 11.8 refers) |
| |
| CENTRAL
SCOTLAND E.COLI PROJECT RESEARCH
GROUP: SUGGESTED TOPICS FOR RESEARCH BASED ON CENTRAL
SCOTLAND OUTBREAK DATA |
| |
| Clinical |
| |
| Estimation
of factors predisposing to, or predictive of,
deterioration, eg age, concomitant disease, length of
incubation, serological response. |
| |
| Evaluation
of clinical regimes (eg plasma exchange) by comparison of
different treatment groups. |
| |
| Documentation
of outcome by long term follow up eg: stool culture for
estimation of length of convalescent E.coli excretion;
estimation of long term stool and serum antibody response
to infection; evaluation of long term gastrointestinal
and extra-gastrointestinal complications, including late
mortality. |
| |
| Linkage with
other research groups to elucidate wider issues, eg:- |
| a. with the
Newcastle group on genetics of renal disease; |
| b. with the
Edinburgh group on blood group secretion and the
development of serious infection or complications; and |
| c. with the
Manchester group on monoclonal antibodies. |
| |
| Microbiological |
| |
| 1. A
quantitative study of toxin levels in E.coli O157
positive stool samples at various stages of the disease,
and in patients with varying presentations and disease
severity. |
| |
| 2. An
evaluation of the specificity of serology for antibodies
to E.coli O157 by immunoblotting, compared to
conventional and dynabead culture, and exploration of the
possibility for cross reactions in other enteric
infections eg campylobacter spp. |
| |
| 3.
Evaluation of the sensitivity of conventional E.coli O157
stool culture at first line laboratories, compared with
immunomagnetic separation: retrospectively at the
reference laboratory and prospectively at first line
laboratories. |
| |
| 4. A
quantitative study of IgM and IgA in sera (paired where
available) obtained from cases, and asymptomatic
excreters, identified in the course of the outbreak. |
| |
| Epidemiological,
environmental, economic, and social |
| |
| 1. Study of
the determinants of secondary spread. |
| |
| 2.
Assessment of the relative importance of
cross-contamination and the asymptomatic food handler in
the Central Scotland and similar outbreaks. |
| |
| 3. Full
socio-economic appraisal of the Central Scotland
outbreak, its consequences, and the costs and benefits of
the public health intervention. |
| |
| 4. Appraisal
of the public perception of the outbreak. |
| |
| 5.
Evaluation of the effectiveness of communications of risk
to public. |
| |
| 6.
Assessment of the role of the media. |
