Valerie Delpech

Increasing Pneumocystis Pneumonia, England, UK, 2000–2010

After an increase in the number of reported cases of Pneumocystis jirovecii pneumonia in England, we investigated data from 2000–2010 to verify the increase. We analyzed national databases for microbiological and clinical diagnoses of P. jirovecii pneumonia and associated deaths. We found that laboratory-confirmed cases in England had increased an average of 7% per year and that death certifications and hospital admissions also increased. Hospital admissions indicated increased P. jirovecii pneumonia diagnoses among patients not infected with HIV, particularly among those who had received a transplant or had a hematologic malignancy. A new risk was identified: preexisting lung disease. Infection rates among HIV-positive adults decreased. The results confirm that diagnoses of potentially preventable P. jirovecii pneumonia among persons outside the known risk group of persons with HIV infection have increased. This finding warrants further characterization of risk groups and a review of P. jirovecii pneumonia prevention strategies.

A SALMONELLOSIS OUTBREAK LINKED TO INTERNALLY CONTAMINATED PORK MEAT

In August 1995, we investigated an outbreak of salmonellosis among patrons who attended a church camp in southern Sydney. Of the 73 attendees interviewed, 22 reported a gastroenteritis illness within two days of the conclusion of the camp, with one attendee hospitalised. Two stool specimens, one from each of two attendees, were both positive for Salmonella typhimurium phage type 9. A cohort study of 68 attendees established a statistically significant association between illness and the consumption of de‐boned roast pork (estimated relative risk infinite, p=0.03) and between illness and the degree of cooking of the pork meat (x2 for trend 5.8, p<0.02). The outbreak was most likely caused by consumption of roast pork that had been internally contaminated during the de‐boning process. Meat and meat products that may be internally contaminated, such as de‐boned meats, should be thoroughly cooked. Guidelines about minimum cooking temperatures of meats liable to internal contamination should be developed for commercial food handlers in Australia.