Eurosurveillance weekly releases

Syphilis transmission in homo/bisexual men : New outbreak in London, continuing outbreak in
Dublin
Salmonella newport infection in England associated with the consumption of ready to eat salad
Cases of legionnaires' disease in the UK and Sweden linked with a London site
Behavioural intervention does not reduce incidence of sexually transmitted diseases in
homosexual men

Syphilis transmission in homo/bisexual men : New outbreak in London, continuing outbreak in
Dublin

In the past eight weeks, 18 cases of infectious syphilis have been diagnosed in homo/bisexual
men attanding sexually transmitted infection clinics in North, East and South East London (1).
Fifteen of the cases are in men who are known to be infected with HIV, including some who are
known to have been HIV-infected for a considerable period of time. Local surveillance has been
intensified. Outbreak control measures have been instituted, including increased syphilis
testing in known HIV-infected patients and increased health promotion activities in venues
frequented by homo/bisexual men.
The enhanced syphilis surveillance in Ireland has ascertained over 10 cases of primary and
secondary syphilis each month since the beginning of 2001, including 17 cases in March and 13
cases in April (2). Of the 109 cases reported since January 2000, 106 are associated with the
outbreak in Dublin (3). Four-fifths of the cases are in homo/bisexual men.

These syphilis outbreaks in homo/bisexual men in London and Dublin follow the large outbreak
reported recently from Antwerp (4), and earlier outbreaks in Paris (5) and Oslo (6), and in
Manchester and Brighton in England (7).


References :
PHLS CDSC (London). News Bulletin 25/01, week beginning June 18th 2001.
Domegan L, Cronin M. Enhanced surveillance of syphilis. EPI-INSIGHT 2001; 2 (June):4.
NDSC. Update: Syphilis outbreak. EPI-INSIGHT 2001; 2 (April):1.
De Schrijver K. Syphilis outbreak in Antwerp, Belgium. Eurosurveillance weekly 2001; 5: 010510.
Doherty L, Fenton K, O'Flanagan D, Couturier E. Evidence for increased transmission of syphilis
among homosexual men and heterosexual men and women in Europe. Eurosurveillance Weekly 2000; 4:
001214.
Blystad H, Nilsen Ø, Aavitsland P. An outbreak of syphilis among homosexual men in Oslo,
Norway. Eurosurveillance Weekly 1999; 3: 991118.
Fenton K. Syphilis continues in gay men in Greater Manchester, England. Eurosurveillance Weekly
2001; 5: 010419.
Reported by Noel Gill, (ngill@phls.org.uk), Public Health Laboratory Service, Communicable
Disease Surveillance Centre, London.


Salmonella newport infection in England associated with the consumption of ready to eat salad

Nine human cases of infection with Salmonella newport with a possible link to a salad item have
been identified in England. The cases were identified following the isolation of S. newport
from a salad item as part of the PHLS/LACOTS survey of retail prepared pre-packed ready-to-eat
salad vegetables in the United Kingdom (1).
Cases range in age from 4 to 74 years (median 33 years) and are distributed throughout England.
Onset dates of illness range from June 2nd to 8th. Salad consumption has been confirmed in six
cases and food histories are awaited from the other two. The two cases from one area (who are
not related to each other) are known to have consumed the implicated salad item three and six
days prior to the onset of illness. One of the six cases from whom a food history has been
obtained, is known to be a vegetarian. None of the cases travelled abroad during the incubation
period.

Isolates from the salad item and the nine cases exhibit an unusual reaction with the PHLS
Laboratory of Enteric Pathogens phage typing scheme for S. newport. Additional molecular work
has shown that isolates from the salad and five of the human cases have a unique plasmid
profile. The salad isolate and three of the human isolates are also indistinguishable using
pulsed field gel electrophoresis. Examination of the remaining human isolates using molecular
methods is underway.

On June 22nd an urgent request for information was sent to all participants in the Enter-net
(http://www.Enter-net.org.uk) surveillance network (2). Of the seven countries that had replied
by June 28th, none reported an increase in human cases of S. newport in recent weeks. Several
countries reported on foodstuffs contaminated with this serotype, but these were predominantly
strains from poultry samples, and a few strains had been isolated from reptiles.

Salmonellosis associated with the consumption of salad items is relatively uncommon, although
two notable outbreaks occurred last year. In a widespread outbreak of multiresistant S.
typhimurium DT104 infection in England, where 361 people were affected and one person was known
to have died, illness was epidemiologically linked to the consumption of lettuce away from home
in the three days prior to the onset of illness. Investigations in Iceland into a Europe-wide
outbreak of multiresistant S. typhimurium DT204b (which included 125 cases in England and
Wales) revealed an association between illness and the consumption of imported iceberg lettuce
(3).


References :
LACOTS/PHLS co-ordinated Food Liaison Group Studies: microbiological examination of retail
prepared pre-packed ready-to-eat salad vegetables; sampling protocol. Available to subscribers
online at (<http://www.LACOTS.com>.)
IST Fisher on behalf of the Enter-net participants. The Enter-net international surveillance
network - how it works. Eurosurveillance1999; 4: p 52-5.
(http://www.eurosurveillance.org/euro...n5/en33-22.htm)
PHLS. Outbreaks of Salmonella typhimurium DT204b infection in England and Wales and elsewhere
in Europe. Commun Dis Rep CDR Wkly 2000; 10 (39): 349.
http://www.phls.co.uk/publications/CDR00/cdr3900.pdf)

Reported by Sarah O'Brien (sobrien@phls.org.uk), Public Health Laboratory Service Communicable
Disease Surveillance Centre, and Ian Fisher, Enter-net scientific co-ordinator,
(ifisher@phls.org.uk), London, England.


Cases of legionnaires' disease in the UK and Sweden linked with a London site

Three confirmed cases of legionnaires' disease have been associated with central London, in
particular the area of Portman Square. The cases are all men aged between 31 and 61 years in
whom illness onsets were 22 May, 25 May, and 3 June. Two cases had worked in the area. The
third case was reported to the PHLS Communicable Disease Surveillance Centre (CDSC) by the
Swedish collaborator in the European Surveillance Scheme for Travel Associated Legionaires'
Disease (1). This case had visited London and been in the Portman Square area before the onset
of his illness. All cases were diagnosed in their admitting hospital by urinary antigen
detection. Legionella pneumophila serogroup1 infection has been confirmed in the two British
cases by the Respiratory and Systemic Infection Laboratory at the PHLS Central Public Health
Laboratory.
An outbreak control team has been convened and possible environmental sources of infection
within a 500 metre radius of Portman Square are being investigated. L. pneumophila serogroup 1
has been identified in water systems and cooling towers in three buildings in the vicinity.
Control measures have been taken at all three sites and further investigations are in hand.

All Consultants for Communicable Disease Control in England and Wales have been alerted to the
outbreak. Information has been disseminated in Europe through the European Surveillance Scheme
for Travel Associated Legionnaires' Disease and in the United States via the Centers for
Disease Control and Prevention (CDC). CDSC would be grateful for information on any other
suspected cases of legionnaires' disease who became ill during May or June that might be
associated with this incident. Please contact Carol Joseph, European legionella surveillance
scheme project co-ordinator (tel: 0208 200 6868 ext 4497; email cjoseph@phls.org.uk).

Information on the European surveillance scheme for travel associated legionnaires' disease can
be obtained from its website www.ewgli.org

Reported by Carol Joseph, (cjoseph@phls.org.uk), Public Health Laboratory Service, Communicable
Disease Surveillance Centre, London.

Behavioural intervention does not reduce incidence of sexually transmitted diseases in
homosexual men

The need for effective HIV prevention strategies based on reducing sexual risk behaviour
remains important. A study reported in the BMJ found, however, that even a carefully designed,
brief, behavioural intervention did not reduce the risk of participants acquiring new sexually
transmitted infections (STIs) as a proxy for unprotected anal intercourse (1).
The researchers conducted a randomised controlled trial with 12 months' follow up. Participants
were 343 gay men attending a sexual health clinic in London from September 1995 to November
1997 who presented with an acute STI, reported having had unprotected anal intercourse in the
past year, or expressed concern about their sexual practices.

All participants received standard management consisting of a 20 minute one to one counselling
session about sexual risk behaviour. Contact tracing was offered to those with a newly
diagnosed infection; and participants could also be referred to clinic-based or community-based
education on HIV prevention and counselling services. Additionally, participants assigned to
the intervention were invited to a one-day workshop.

Behavioural outcomes were followed up by using postal questionnaires. Clinic and laboratory
databases were reviewed to identify new STIs diagnosed at the clinic. Attendance at other
clinics in greater London was determined by matching individuals to a regional database.
Re-attendance at the clinic was not required by the protocol.

Self reported changes in sexual behaviour were modest, but generally there was more improvement
in the intervention group, where the proportion of men engaging in unprotected anal intercourse
in the past month decreased from 37% (63/172) at baseline to 24% (32/136) at 6 months and 27%
(31/114) at 12 months. In the control group the proportion changed little: from 30% (50/166) at
baseline to 32% (44/139) at 6 months and 32% (39/124) at 12 months. After adjusting for
infections and unprotected anal intercourse at baseline, differences in these proportions
between the arms of the trial were not significant (P=0.07 at 6 months and P=0.31 at 12
months). Findings were similar for the proportions having unprotected anal intercourse in the
past 12 months (61% (106/174) in the intervention group and 63% (104/166) in the control group
at baseline, compared with 50% (58/116) and 59% (76/128) respectively at 12 months).

However, 31% (38/123) of the intervention group and 21% (35/168) of controls had had at least
one new STI diagnosed at the clinic. Considering only men who requested a check up for STIs,
the proportion diagnosed with a new infection was 58% (53/91) for men in the intervention group
and 43% (35/81) for men in the control group (adjusted odds ratio 1.84, 95% confidence interval
0.99 to 3.40). The higher risk of acquiring a STI among participants in the intervention arm
was unexpected, at odds with the data on sexual behaviour, and clearly a cause for concern.

Despite its promise and acceptability, the brief cognitive intervention aimed at gay men at
high risk of STI did not reduce their risk of acquiring new infections. Even carefully
formulated behavioural interventions should not be assumed to bring benefit. It is important to
evaluate their effects in randomised trials by using clinical end points wherever possible.


References :
Imrie J, Stephenson JM, Cowan FM, Wanigaratne S, Billing ton AJP, Copas AJ, et al. A cognitive
behavioural intervention to reduce sexually transmitted infections among gay men: randomised
trial BMJ 2001;322:1451-6. (http://www.bmj.com/cgi/content/full/322/7300/1451)
Reported by Birte Twisselmann (btwisselmann@phls.org.uk), Eurosurveillance editorial office.

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Citation style for articles

- Article 1 : Gill O. Syphilis transmission in homo/bisexual men: New outbreak in London,
continuing outbreak in Dublin . Eurosurveillance Weekly [1812-075X]. 2001 Jun 28;6(26) 010628.
Available from: http://www.eurosurveillance.org/ew/2001/010628.asp#1

- Article 2 : Fisher I, O'Brien S. Salmonella newport infection in England associated with
the consumption of ready to eat salad . Eurosurveillance Weekly [1812-075X]. 2001 Jun 28;6(26)
010628. Available from: http://www.eurosurveillance.org/ew/2001/010628.asp#2

- Article 3 : Joseph C. Cases of legionnaires' disease in the UK and Sweden linked with a
London site . Eurosurveillance Weekly [1812-075X]. 2001 Jun 28;6(26) 010628. Available from:
http://www.eurosurveillance.org/ew/2001/010628.asp#3

- Article 4 : Twisselmann B. Behavioural intervention does not reduce incidence of sexually
transmitted diseases in homosexual men . Eurosurveillance Weekly [1812-075X]. 2001 Jun 28;6(26)
010628. Available from: http://www.eurosurveillance.org/ew/2001/010628.asp#4




Neither the European Commission nor any person acting on the behalf of the Commission is
responsible for the use which might be made of the information in this journal. The opinions
expressed by authors contributing to Eurosurveillance do not necessarily reflect the opinions
of the European Commission, the European Centre for Disease Prevention and Control ( ECDC ),
the Institut de veille sanitaire ( InVS ), the Health Protection Agency ( HPA ) or the
institutions with which the authors are affiliated

Eurosurveillance [ISSN] - ©2006. Tous droits réservés. All rights reserved.

" Death" <Death@yourdoor.net> wrote in message
newsb4fh.2254$V07.1812@bignews4.bellsouth.net...
Bloody faggots can't keep them zippers up ... of course, considering
that syphilis comes from fucking sheep, the more power to them!

"Tossed salad", anyone?

Fags can't stop fuckin, suckin and eatin each others butts.

Trying to spread the wealth.

Nasty business, this.

On Wed, 13 Dec 2006 23:27:09 -0500, "Life" <Life@life.com> wrote:

LOL...fred, you ARE a faggot.

And many gay men are no more promiscuous than heterosexual men.

So that just a Goebbels-like lie from the resident bully, coward and
liar.

"GMCarter" <fiar@verizon.net> wrote in message
December 13, 2006
Circumcision Reduces Risk of AIDS, Study Finds
By DONALD G. McNEIL Jr.

Circumcising African men may cut their risk of catching AIDS in half, the National Institutes
of Health said today as it stopped two clinical trials in Africa, when preliminary results
suggested that circumcision worked so well that it would be unethical not to offer it to
uncircumcised men in the trials.

AIDS experts immediately hailed the result, saying it gave the world a new way to fight the
spread of AIDS, and the directors of the two largest funds for fighting the disease said they
would now consider paying for circumcisions.

"This is very exciting news," said Daniel Halperin, an H.I.V. specialist at Harvard's Center
for Population and Development, who has argued in scientific journals for years that
circumcision slows the spread of AIDS in the parts of Africa where it is practiced.

In an interview from Zimbabwe, Mr. Halperin added: "I have no doubt that, as word of this gets
around, millions of African men will want to get circumcised and that will save many lives."

But experts also cautioned that circumcision is no cure-all. It only lessens the chances that a
man will catch the virus, it is expensive compared to condoms, abstinence or other methods, and
the surgery has serious risks if performed by folk healers using dirty blades, as often happens
in rural Africa.

Sex education messages to young men need to make it clear that "this does not mean that you
have an absolute protection," said Dr. Anthony S. Fauci, an AIDS researcher and director of the
National Institute of Allergy and Infectious Diseases, which sponsored the trials. Circumcision
should be added to other prevention methods, not replace them, he said.

The two trials were carried out among nearly 3,000 men in Kisumu, Kenya, and nearly 5,000 men
in Rakai, Uganda. None were infected with H.I.V., the virus that causes AIDS; they were divided
into circumcised and uncircumcised groups. They were given safe sex advice - although many
presumably did not take it - and retested regularly.

The trials were stopped by the National Institutes of Health's Data Safety and Monitoring Board
this week after data showed that the Kenyan men had a 53 percent reduction in new H.I.V. cases
and the Ugandan men a 48 percent reduction.

In Kenya, 22 of the 1,393 circumcised young men in the study caught the disease, compared with
47 of the 1,391 uncircumcised men.

Those results echo the finding of a trial completed last year in the town of Orange Farm, South
Africa, financed by the French government, which demonstrated a reduction of 60 percent among
circumcised men.

Two agencies, one under the State Department and the other financed by a number of countries,
said they now would be willing to pay for circumcisions, which they have not before, citing a
lack of hard evidence that it works.

Dr. Richard G. A. Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis
and Malaria, said that if a country seeking money submitted plans to conduct safe, sterile
circumcisions, "I think it's very likely that our technical panel would approve it."

Ambassador Mark Dybul, executive director of the $15 billion President's Emergency Plan for
AIDS Relief in the State Department, said his agency "will support implementation of safe
medical male circumcision for HIV/AIDS prevention."

He too warned that it was only one new weapon.

"Prevention efforts must reinforce the ABC approach - abstain, be faithful and correct and
consistent use of condoms," he said.

Uncircumcised men are thought to be more susceptible to AIDS because the underside of the
foreskin is rich in Langerhans' cells, which attach easily to the virus. The foreskin may also
suffer small tears during intercourse, making it more susceptible to infection.

Researchers have long noted that parts of Africa where circumcision is practiced - particularly
in the Muslim countries of West Africa - had much lower AIDS rates. But it was unclear whether
other factors, such as religion or polygamy, played important roles.

Outside Muslim regions, circumcision is spotty. In South Africa, for example, the Xhosa people
circumcise teen-age boys, while Zulus, whose traditional homeland abuts theirs, do not. AIDS is
common in members of both tribes.

In recent years, as word has spread that circumcision might be protective, many African men
have sought it out. A Zambian hospital offered $3 circumcisions last year, and Swaziland
trained 60 doctors to give them at $40 each after its waiting lists grew.

"Private practitioners also do it," Dr. Halperin said. "In some places, it's $20, in others,
much more. Lots of the wealthy elite have already done it. It prevents STD's, it's seen as
cleaner, sex is better, women like it. I predict that a lot of men who can't afford private
clinics will start clamoring for it."

"GMCarter" <fiar@verizon.net> wrote in message
news:8rf2o2ls497bpm2i564o7g2q10uvpnjvdk@4ax.com...
I don't care why you think I am someone named "fred", but you
are as paranoid as you are wrong.

A lie. There is no comparison between the two groups - gay men
exhibit borderline-psychotic sexual tendencies and compulsions
which are virtually unseen among heterosexual males - at least
outside of prisons or institutions.

Another lie from the resident "gay" idiot and Bronx heroin junkie: George
Mary Carter.

" Death" <Death@yourdoor.net> wrote in message
news:5ndgh.1083$DJ4.842@bignews7.bellsouth.net...
Castration works even better, thus the ethical rule must compel castration
of
all African men - that would certainly thin the diseased herd.

"Life" <Life@life.com> wrote in message
I'm all for it.
That would work equally well in the US of A.

On Sat, 16 Dec 2006 16:10:30 -0500, "Life" <Life@life.com> wrote:

Yeah, right.