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Dive into the research topics where Helen Maguire is active.

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Featured researches published by Helen Maguire.


Sexually Transmitted Diseases | 2005

The re-emergence of syphilis in the United Kingdom: the new epidemic phases.

Ian Simms; Kevin A. Fenton; Matthew Ashton; Katherine Mary Elizabeth Turner; Emma E. Crawley-Boevey; Russell Gorton; Daniel Rh Thomas; Audrey Lynch; Andrew J Winter; Martin J. Fisher; Lorraine Lighton; Helen Maguire; Maria Solomou

Objective: The objective of this study was to characterize the resurgence of infectious syphilis in the United Kingdom between 1997 and 2003. Study: The authors conducted a retrospective analysis of routine surveillance data from genitourinary medicine clinics and data collected through enhanced surveillance. Results: Between 1997 and 2002, diagnoses of primary, secondary, and early latent syphilis made at genitourinary medicine clinics increased by 213% in heterosexual males, 1412% in men who have sex with men (MSM), and 22% in females. These increases have been driven by a series of outbreaks, the largest of which were seen in Manchester (528) and London (1222) up to the end of October 2003. All the outbreaks have been geographically localized and the majority of cases occurred in MSM. A high percentage of concurrent HIV infection was reported, and oral sex was often reported as a route of transmission. Conclusions: Syphilis has re-emerged in response to behavior change, probably driven by changes in the HIV epidemic. The future course of the epidemic is difficult to predict and control remains elusive.


Sexually Transmitted Infections | 2008

Increase in diagnosed newly acquired hepatitis C in HIV-positive men who have sex with men across London and Brighton, 2002–2006: is this an outbreak?

Isabelle Giraudon; Murad Ruf; Helen Maguire; Andre Charlett; Fortune Ncube; Joanna Turner; Richard Gilson; Martin Fisher; Sanjay Bhagani; Margaret Johnson; Simon Barton

Objectives: To determine the incidence of diagnosed newly acquired hepatitis C virus (HCV) in HIV-positive men who have sex with men (MSM) across London and Brighton in order to inform public health interventions. Methods: Cases were defined as MSM attending London and Brighton HIV/genitourinary medicine clinics from January 2002 to June 2006, with HCV PCR RNA or antibody positive, and a negative HCV test in the previous three years. The yearly number of cases and HCV screening policy in MSM were examined. A negative binomial regression model was used to estimate HCV incidence density rate ratio and 95% CI. Results: 20 out of 38 clinics provided information, covering 84% of the HIV-positive MSM workload in London and 100% in Brighton. The estimated overall incidence was 9.05 per 1000 HIV-positive MSM patient-years. It increased from 6.86 per 1000 in 2002 to 11.58 per 1000 during January–June 2006. Incidence at clinics ranged from 0 to 15.4 (median 6.52) per 1000 HIV-positive MSM patient-years. There was some evidence of difference in the incidence and trend (p = 0.02) in each clinic. The average annual rise in incidence of HCV was 20% (95% CI 4% to 39%, p = 0.001). There was little evidence of such transmission among MSM with negative or unknown HIV status. Conclusions: HCV incidence clearly increased among HIV-positive MSM in London and Brighton during January 2002 to June 2006. Prospective enhanced surveillance of HCV in MSM, including HIV status and behavioural risk factors, is recommended to help inform control measures and better determine the frequency of transmission in all MSM.


Pediatric Infectious Disease Journal | 2001

Evidence base of incubation periods, periods of infectiousness and exclusion policies for the control of communicable diseases in schools and preschools.

Martin Richardson; David Elliman; Helen Maguire; John Simpson; Angus Nicoll

Background. The optimal control of communicable diseases requires accurate information on incubation periods, periods of infectiousness and the effectiveness of exclusion. We collected the available evidence for a wide range of infections and infestations and produced evidence-based guidelines for their control in schools and preschools. Methods. A thorough MEDLINE literature search was conducted on the incubation period, period of infectiousness and effectiveness of exclusion for 41 infections. The quality of the information obtained was indicated by levels of evidence. The information was used to produce guidelines on exclusion, and the recommendations were graded according to the levels of evidence available. Grades A, B and C represented strongly, reasonably and poorly evidence-based recommendations, respectively. Results. The quality of data obtained was highly variable. Information on incubation periods was obtained for all 41 infections and was generally of good quality. Information on periods of infectiousness and effectiveness of exclusion was of a lesser quality and was found for only 11 and 4 conditions, respectively. There were 3 Grade A, 17 Grade B and 21 Grade C recommendations on exclusion. Examples of exclusion periods include: 5 days for chickenpox, measles, mumps, rubella, pertussis and scarlet fever; and 24 h from the cessation of diarrhea for most gastrointestinal diseases. In contrast to existing guidelines exclusion was not recommended for school age children with hepatitis A. Conclusions. We have been able to present the best available data on the incubation periods and periods of infectiousness of 41 childhood infections. It was possible to produce strongly or reasonably evidence-based guidelines on exclusion periods for approximately one-half of the infections.


BMJ | 2003

Delay in the diagnosis of pulmonary tuberculosis, London, 1998-2000: analysis of surveillance data

Alison Rodger; Shabbar Jaffar; Stuart Paynter; Andrew Hayward; Jacqui Carless; Helen Maguire

Noted cases of tuberculosis each year have doubled in London since 1987. In 2000, 12.9 cases per 100 000 population in England and Wales were recorded compared with 40.3 cases in London.1 A delay in the diagnosis of tuberculosis increases the risk of poor clinical outcome—including death and transmission of tuberculosis. 2 3 Understanding which factors influence this delay is crucial for controlling tuberculosis. Only one small study has previously investigated delays in the diagnosis of pulmonary tuberculosis in the United Kingdom.4 Using surveillance data from London, we estimated the delays in diagnosis of tuberculosis and investigated the factors independently associated with delays. We analysed surveillance data collected by doctors (1999-2000) and an anonymised national survey (1998) for cases of tuberculosis in London from 1998 to 2000. We calculated the delay in …


BMJ | 2007

Public information needs after the poisoning of Alexander Litvinenko with polonium-210 in London: cross sectional telephone survey and qualitative analysis

G. James Rubin; Lisa Page; Oliver Morgan; Richard J. Pinder; Paul Riley; Stephani L. Hatch; Helen Maguire; Mike Catchpole; John Simpson; Simon Wessely

Objectives To identify public perceptions of the risk to health after the poisoning of Alexander Litvinenko with polonium-210 (210Po) in London and to assess the impact of public health communications. Design Cross sectional telephone survey and qualitative interviews. Setting London, United Kingdom. Participants 1000 people completed the cross sectional survey and 86 potentially exposed people completed the qualitative interviews. Main outcome measures Perception of risk to personal health after the 210Po incident. Qualitative interviews were analysed with an emphasis on information needs. Results 11.7% of the survey sample (n=117) perceived their health to be at risk. Aside from personal variables the main predictors of perceived risk to health were believing that the incident was related to terrorism (odds ratio 2.7, 95% confidence interval 1.5 to 4.6) rather than to espionage, that it was targeted at the wider public rather than one person (5.9, 3.2 to 10.9), and that it could affect people who had not been in the contaminated area (3.2, 2.1 to 5.1). Participants in the qualitative interviews were generally satisfied with the information they had received, although they would have preferred more information about their individual risk of exposure, the results of their urine tests, and the health implications of the incident. Conclusions Perceptions of the public that the 210Po incident in London in 2006 was related to espionage helped to reassure them that the risks to personal health were low. In the event of future incidents it is important to ensure that detailed, comprehensible information about the risks of any exposure is available.


BMJ | 2009

Monitoring the emergence of community transmission of influenza A/H1N1 2009 in England: a cross sectional opportunistic survey of self sampled telephone callers to NHS Direct

Alex J. Elliot; Cassandra Powers; Alicia Thornton; Chinelo Obi; Caterina Hill; Ian Simms; Pauline Waight; Helen Maguire; David Foord; Enid Povey; Tim Wreghitt; Nichola Goddard; Joanna Ellis; Alison Bermingham; Praveen Sebastianpillai; Angie Lackenby; Maria Zambon; David W. Brown; G. E. Smith; O Noel Gill

Objective To evaluate ascertainment of the onset of community transmission of influenza A/H1N1 2009 (swine flu) in England during the earliest phase of the epidemic through comparing data from two surveillance systems. Design Cross sectional opportunistic survey. Study samples Results from self samples by consenting patients who had called the NHS Direct telephone health line with cold or flu symptoms, or both, and results from Health Protection Agency (HPA) regional microbiology laboratories on patients tested according to the clinical algorithm for the management of suspected cases of swine flu. Setting Six regions of England between 24 May and 30 June 2009. Main outcome measure Proportion of specimens with laboratory evidence of influenza A/H1N1 2009. Results Influenza A/H1N1 2009 infections were detected in 91 (7%) of the 1385 self sampled specimens tested. In addition, eight instances of influenza A/H3 infection and two cases of influenza B infection were detected. The weekly rate of change in the proportions of infected individuals according to self obtained samples closely matched the rate of increase in the proportions of infected people reported by HPA regional laboratories. Comparing the data from both systems showed that local community transmission was occurring in London and the West Midlands once HPA regional laboratories began detecting 100 or more influenza A/H1N1 2009 infections, or a proportion positive of over 20% of those tested, each week. Conclusions Trends in the proportion of patients with influenza A/H1N1 2009 across regions detected through clinical management were mirrored by the proportion of NHS Direct callers with laboratory confirmed infection. The initial concern that information from HPA regional laboratory reports would be too limited because it was based on testing patients with either travel associated risk or who were contacts of other influenza cases was unfounded. Reports from HPA regional laboratories could be used to recognise the extent to which local community transmission was occurring.


Emerging Infectious Diseases | 2011

School Closures and Student Contact Patterns

Charlotte Jackson; Punam Mangtani; Emilia Vynnycky; Katherine Fielding; Aileen Kitching; Huda Mohamed; Anita Roche; Helen Maguire

To determine how school closure for pandemic (H1N1) 2009 affected students’ contact patterns, we conducted a retrospective questionnaire survey at a UK school 2 weeks after the school reopened. School closure was associated with a 65% reduction in the mean total number of contacts for each student.


Vaccine | 2009

Factors associated with incomplete vaccination of babies at risk of perinatal hepatitis B transmission: a London study in 2006.

Isabelle Giraudon; Nadia Permalloo; Grainne Nixon; Andre Charlett; Sandra Cohuet; Sema Mandal; Mary Ramsay; Bharat C. Patel; Helen Maguire

We measured the hepatitis B (HB) vaccination uptake in 249 London babies born in 2004 to HBsAg positive mothers. Two thirds (69%) received three vaccinations and half (49%, 95% CI 43-56) received a complete course (four doses). Complete immunization was associated with sector of delivery (p<0.001), recording of the GP details in case notes, having booked for antenatal care, having a good command of English, and receipt of written information on HB. A third of the babies (33%) had a post-vaccination test; when the mother had other children, 39% of the oldest children were vaccinated; information on partners vaccination was available for 12%. This study highlights that appropriate counseling and information should be provided to the mothers, and the importance in London of arrangements for integrated care across acute and primary care services.


Emerging Infectious Diseases | 2006

Shigella sonnei Outbreak among Homosexual Men, London

Oliver Morgan; Paul D Crook; T. Cheasty; Brian Jiggle; Isabelle Giraudon; Harriett Hughes; Stephen-Morris Jones; Helen Maguire

To the Editor: In the summer of 2004, genitourinary medicine clinics in London reported cases of Shigella sonnei with a novel phage type pattern (later designated PTQ). Outbreak case finding involved local laboratories and genitourinary medicine physicians in London, as well as the national reference laboratory. A case was considered confirmed if S. sonnei PTQ was isolated from January 2004 through April 2005, and the patient had not traveled outside the country the week before illness. Possible cases were defined as for confirmed cases but were so designated when patient had a history of foreign travel in the week before illness or when travel history was unknown. From October 2004, when we became aware of the outbreak, until December 2004, we conducted telephone interviews with newly identified case-patients. For cases that occurred before October 2004, and from January 2005 through April 2005, information was obtained from laboratory records only. Strains were phage typed by using the scheme described by Hammerstrom, Kallings, and Sjoberg, according to a protocol supplied by R. Wollin (1,2). The scheme consists of 11 phages and is based on the typing of the rough phase II variant of S. sonnei. The scheme comprises defined phage types (PT) 1–100 and provisional PTs A–P. Cultures were grown overnight on MacConkey agar, and a rough colony was placed in nutrient broth and grown for 18 hours at 37°C. The broth culture was then used to flood a nutrient agar plate and, once dry, spotted with the 11 phages and incubated at 37°C for 5 hours. The patterns of lysis were recorded and compared with those indicated on the typing chart. All isolates were screened for resistance to a panel of antimicrobial agents by an agar incorporation method with Iso-Sensitest agar (Oxoid, Basingstoke, UK). We identified 16 confirmed and 54 possible cases. Specimens from all 70 patients had the same unique pattern of lysis when phage typed, had the same profile when examined by pulsed-field gel electrophoresis, and were resistant to ampicillin, streptomycin, spectinomycin, sulfonamides, tetracyclines, and trimethoprim. Cases occurred at a low frequency during the first half of 2004, followed by a large increase in August, September, and October (Figure). All case-patients (N = 48) were men, mean age 37 years (range 18–58 years). Five persons designated possible case-patients had traveled abroad in the week before illness (United States, France, Vietnam, Turkey, and 1 unknown destination). Of patients for whom HIV status information was available, nearly all were HIV positive (n = 30/32). Figure Confirmed and possible cases of Shigella sonnei PTQ by earliest recorded date, London, January 2004–April 2005. From October 2004 through December 2004, we identified 20 case-patients and interviewed 17 (85%). All were men who had sex with men (MSM). Reported symptoms were diarrhea (n = 15), abdominal pain (n = 14), fever (n = 10), blood in stools (n = 7), and vomiting (n = 6). In the week before illness, 15 reported sex with another man, about half with a casual partner, and mostly with 1 (9/15) or 2 (3/15) different men. No common sex venue was identified. Most (12/15) reported participation in oral and anal sex, and 6 reported oral-anal contact. Three patients recalled that their partner had had diarrhea around the time of sexual intercourse. Of 7 respondents who were asked, 3 reported using a condom during anal intercourse, and none reported using any barrier during oral intercourse. That all cases were men, and many were HIV-positive MSM, who reported having sex the previous week, strongly suggests that male homosexual sex was the mode of transmission. The shape and timeframe of the epidemic curve indicates person-to-person transmission and rules out foodborne transmission linked to a gay venue. The predominance of HIV-positive homosexual men in the outbreak may be due to more symptomatic disease (from compromised cell-mediated immunity or achlorhydria [3]), more unprotected sex with other HIV-positive men (4), and greater likelihood of seeking healthcare. Sexual transmission of shigellosis between MSM was first reported in the United States during the 1970s (5), and recent outbreaks have been reported in San Francisco (6), Canada (7), Australia (8), and Germany (9). The London outbreak coincided with an outbreak of S. sonnei in Berlin, Germany (10). Of the 17 Berlin case-patients, 14 were MSM. Isolates from 10 Berlin patients were subsequently tested by the same reference laboratory in London and confirmed to also be PTQ, which suggests a link between these 2 outbreaks, even though none of the London interviewees reported travel to Berlin. Although the earliest identified case occurred in January 2004, S. sonnei PTQ may have been circulating among the MSM community for a longer period. The discovery of an outbreak of a novel phage type underlines the importance of prompt strain-typing for public health investigations and the benefit of good links between local clinicians, laboratories, and public health professionals. Additionally, local gay media and voluntary organizations were valuable partners for disseminating preventative health messages across London when the outbreak was in the early stages. This outbreak raises the possibility that the mobility and increased high-risk sexual practices among MSM in Europe (4) might facilitate mixing between sexual networks, thus causing potential for international outbreaks of sexually transmitted infection.


Journal of Public Health | 2010

High rate of transmission among contacts in large London outbreak of isoniazid mono-resistant tuberculosis

F. Neely; Helen Maguire; F. Le Brun; A. Davies; David Gelb; S. Yates

BACKGROUND For a continuing London outbreak of isoniazid mono-resistant tuberculosis (TB), we aimed to determine transmission rates and risk factors for contacts of early cases, in order to inform future guidance on contact tracing. METHODS Paper-based proformas were completed by TB nurses, and then analysed using EpiInfo/SAS statistical software. RESULTS Forty community contacts (11%) became cases, 45 (13%) were recommended chemoprophylaxis and 270 (76%) were discharged clear of infection. The highest transmission rate was among contacts exposed to two or more cases (29% became cases) and close contacts of sputum smear-positive cases (22%). Other risk factors were being male and exposure to drug-using cases or cases with prison links. The number needed to be screened (NNS) to detect one case was lowest [5 (95% CI: 4-8)] for contacts of sputum smear-positive pulmonary cases, although the NNS was still only 20 (95% CI:8-72) for casual contacts of smear-positive cases. CONCLUSIONS Transmission of disease to contacts was high (11%) compared with other documented outbreaks (0.7-2%). The results support recommended guidelines for contact tracing but also provide grounds to recommend, for outbreak cases, screening of casual contacts of smear-positive cases and contacts exposed to more than one case, drug users or prisoners.

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Andre Charlett

Health Protection Agency

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Andrew Hayward

University College London

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Mike Catchpole

Public health laboratory

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C Smith

University College London

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