The outcome of contact tracing (partner notification) for Chlamydia trachomatis in a district general hospital during the 5-year period between 1991-1995 was surveyed. During the 5-year period 1027 cases of C. trachomatis were diagnosed. The health adviser saw 928 (90%) of cases who reported 1132 (1.2) sexual contacts. Out of 682 sexual contacts sought by the health adviser, 472 (69.5%) were seen. Following a consultation with the health adviser, over two-thirds (86%) of index cases chose to inform their contacts themselves. Over two-thirds (71%) of contacts informed by these index cases were seen. A higher proportion of regular and first or most immediate contacts were seen as a result of contact tracing. A significantly higher proportion of partners of index cases who themselves returned for test of cure were seen. A consultation with the health adviser facilitated uptake of partner notification by the index patients. Patient referral led to a majority of contacts being seen in a genitourinary medicine (GUM) clinic. Follow-up visits by index patients may improve outcome of contact tracing and should continue irrespective of need for test of cure.
The purpose of the study was to describe the results of follow up of human contacts of bovine tuberculosis. The bovine tuberculosis cases occurred on farms in North Staffordshire between 1993 and 1997. A total of 162 people were identified as having close contact with cattle diagnosed as having bovine tuberculosis, or who had drunk unpasteurized milk from a herd with bovine tuberculosis. A retrospective review of chest clinic notes was performed. One hundred and thirty-eight people attended for follow up, and Heaf test results, necessity for chest X-ray and further clinical follow-up are described. No case of human Mycobacterium bovis infection was identified. It is suggested that follow-up of human contacts is limited to those with close contact with herds who have bovine tuberculosis and cattle with visible pulmonary lesions or evidence of udder infection. Children on the farms with affected cattle should also be offered BCG in advance of the routine school's programme.
It is reasonable to advocate expeditious surgery but not by cutting corners at the expense of safety. I would suggest that not closing the parietal peritoneum may have been a significant factor in the haemoperitoneum that occurred. We should reconsider nonclosure of the peritoneum.
A. S. Clark
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