Turkey is the only country in Europe where urban dog-mediated rabies persists. Control measures in recent decades have reduced the burden of rabies to relatively low levels but foci of disease still persist, particularly in urban areas. Occasional human cases result from this persistence although the source of these appears to be both dog and wildlife reservoirs. This review considers the current state of rabies in Turkey including current control measures, the varying epidemiology of the disease throughout this country and the prospects for rabies elimination.

We utilized Medline to perform a systematic review of the literature to quantify the aetiology of cellulitis with intact skin. Of 808 patients with cellulitis, 127–129 (15·7–16·0%) patients had positive needle aspiration and/or punch biopsy cultures from intact skin. Of the patients with positive cultures, 65 (50·4–51·2%) had cultures positive for Staphylococcus aureus, 35 (27·1–27·6%) for group A streptococcus, and 35–37 (27·1–29·1%) for other pathogens. The most common aetiology of cellulitis with intact skin, when it can be determined, is S. aureus, outnumbering group A streptococcus by a ratio of nearly 2:1. Given the increasing incidence of community-associated methicillin-resistant S. aureus infections, our findings may have critical therapeutic implications.

The phage types and antimicrobial susceptibilities of 226 isolates of Salmonella enterica serovar Typhi from imported cases in Japan between 2001 and 2006 were investigated. Most (93·8%) had travelled to Asian countries, particularly South East Asia. Twenty-one phage types were identified with E1 (30·5%), UVS (15·9%) and B1 (9·3%) being the most common. The frequency of multidrug-resistant strains reached 37·0% in 2006 with phage types E1 and E9 predominating. Almost half (48·2%) of the isolates were resistant to nalidixic acid and two isolates displayed high-level fluoroquinolone resistance. Three mutations, two in gyrA and one in parC, were identified in both isolates.

We analysed the serotypes and antibiotic susceptibility of 1560 human and 1505 non-human Salmonella isolated in New Zealand (NZ) between 2002 and 2007. The most common serotypes in humans were Salmonella enterica serovar Typhimurium, S. Enteritidis, S. Brandenburg and S. Infantis. Over the 6-year period human cases due to S. Agona and S. Enteritidis increased and cases due to S. Typhimurium decreased. The most common serotypes from non-human sources were S. Typhimurium, S. Brandenberg, S. Hindmarsh and S. Infantis, and there were no significant changes over time. More isolates were non-susceptible to streptomycin than to any other antibiotic. Almost all isolates were susceptible to ciprofloxacin and gentamicin. There were significant trends of increasing non-susceptibility to streptomycin and sulfonamides in isolates from human and non-human sources, while ampicillin, tetracycline and multidrug non-susceptibility also increased in human isolates. Despite these increases, rates of antibiotic non-susceptibility in Salmonella in NZ are still lower than in many international settings.

The objective of this study was to estimate the sensitivity of three different sampling/testing methodologies for the detection of Salmonella Enteriditis in commercial egg-laying flocks relative to the within-flock prevalence. The following methods were compared on 21 farms: (1) The European Union (EU) baseline survey method (five faecal and two dust samples); (2) an in-house method that involved collecting 10 dust and 10 faecal samples into jars with buffered peptone water, and (3) a method involving single samples of pooled faeces and dust that has been adopted as a monitoring method for the National Control Programme across the EU (the NCP method). Testing of individual bird ovaries/oviduct and caeca was carried out on each flock, and the sensitivity of each sampling method was estimated relative to the within-flock prevalence using Bayesian methods. Results showed that the sensitivity of all the sampling methods increased as the within-flock prevalence increased, and that all were more efficient than individual bird sampling for detection of S. Enteriditis in commercial flocks. The in-house method was the most sensitive of the methods compared, with a 98% power to detect a 0·1% prevalence, and the NCP method the least sensitive, with a 93% power to detect a prevalence of 20%.

From 1996 to 2004, the incidence of Salmonella Javiana infections increased in FoodNet, the U.S. national active foodborne disease surveillance programme. Contact with amphibians and consumption of tomatoes have been associated with outbreaks of S. Javiana infection. To generate and test hypotheses about risk factors associated with sporadic S. Javiana infections, we interviewed patients with laboratory-confirmed S. Javiana infection identified in Georgia and Tennessee during August–October 2004. We collected data on food and water consumption, animal contact, and environmental exposure from cases. Responses were compared with population-based survey exposure data. Seventy-two of 117 identified S. Javiana case-patients were interviewed. Consumption of well water [adjusted odds ratio (aOR) 4·3, 95% confidence interval (CI) 1·6–11·2] and reptile or amphibian contact (aOR 2·6, 95% CI 0·9–7·1) were associated with infection. Consumption of tomatoes (aOR 0·5, 95% CI 0·3–0·9) and poultry (aOR 0·5, 95% CI 0·2–1·0) were protective. Our study suggests that environmental factors are associated with S. Javiana infections in Georgia and Tennessee.

During epidemics of cholera in two rural sites (Bakerganj and Mathbaria), a much higher proportion of patients came for treatment with severe dehydration than was seen in previous years. V. cholerae O1 isolated from these patients was found to be El Tor in its phenotype, but its cholera toxin (CT) was determined to be that of classical biotype. Whether the observed higher proportion of severe dehydration produced by the El Tor biotype was due to a shift from El Tor to classical CT or due to other factors is not clear. However, if cholera due to strains with increased severity spread to other areas where treatment facilities are limited, there are likely to be many more cholera deaths.

The relationship between flock management and histomoniasis, a re-emergent infection in poultry, was investigated by statistical techniques used in veterinary epidemiology to deal with various problems including: multicollinearity, confounding, interaction or sample size. Associations between the variables describing flock management were examined by multivariate descriptive analysis to reduce the number of independent variables, prior to investigating associations with the disease. No homogenous groups of farms were found in the 44 free-range turkey flocks sampled in France. Histomonas meleagridis was identified in 26/38 flocks and histomoniasis was confirmed in 19 flocks. Cleanliness of the building, wet litter and diarrhoea were linked with H. meleagridis and severity of histomoniasis. Sharing outdoor fields simultaneously with chickens was related to serious macroscopic lesions determined by post-mortem examinations. Contrary to general belief, acidification of drinking water with organic acid had consistent association with the presence of H. meleagridis in turkey caeca. These results confirm previous findings and provide several new hypotheses on the effects of hygiene and water management on H. meleagridis and histomoniasis.

An innovative and well-adapted statistical method, called multiblock redundancy analysis, is proposed for a complex health-event analysis to account for the thematic block organization of variables. The outcome block contained the condemnation rates of 404 broiler chicken flocks, distinguishing infectious and traumatic condemnation categories. Explanatory variables were organized in blocks related to the different production stages (farm structure and routine husbandry practices; on-farm flock history and characteristics; catching, transport and lairage conditions; slaughterhouse and inspection features). The aim was to determine risk factors for both condemnation categories, and the relative impact of the different production stages on the whole condemnation rate. Results showed that significant factors were either specific to one condemnation category or related to both categories, and each of the explanatory blocks was involved in the explanation of infectious and traumatic condemnation rates. On-farm flock information explained 40% of the overall condemnation process whereas the other explanatory blocks had similar relative impacts.

During a recent large tularemia outbreak in Bulgaria we found several cases that were remote from the main focus. One case had an unusual mode of transmission. A hunter acquired tularemia through a nail scratch from a buzzard (Buteo buteo) and consequently developed a typical ulceroglandular form of the disease. The diagnosis was confirmed by serological methods and successful cultivation. Comparative strain typing was performed by high-resolution multi-locus variable-number tandem repeat analysis (MLVA). The isolated strain was identical to one of the outbreak genotypes. We consider that this case represents a bird-to-human transmission of F. tularensis.

Dirofilaria immitis is the causal agent of canine and feline cardiopulmonary dirofilariasis. Moreover, the existence of canine dirofilariasis implies a risk for human populations living in an endemic area in which, the parasite can cause pulmonary dirofilariasis. The Spanish epidemiological situation is not well understood, lacking data from many central and Northern provinces. In our study, epidemiological data on canine and human dirofilariasis for La Rioja (Northern Spain) have been obtained for the first time. The overall prevalence of D. immitis in dogs was 12% (9% of patent and 3% of occult infections), being 11·6% the seroprevalence of human residents in this province. The geographic distribution of both canine and human D. immitis infections in La Rioja is restricted to humid and irrigated areas near the Ebro Valley River, being absent in the rest of the province where hills and mountains predominate.

The risk of classical scrapie in sheep is associated with polymorphisms in the prion protein (PrP) gene. In recent years, large-scale selective breeding programmes for sheep at lower risk of disease have been undertaken across the European Union. We analysed large-scale datasets on scrapie and sheep demography to investigate additional effects of sheep breed on scrapie risk. There was evidence for variation between certain breeds in the scrapie risk of some PrP genotypes, which could be caused by innate breed differences or distinct scrapie strains circulating within them. While the PrP genotypes of cases are generally consistent across breeds, some exceptions provide evidence that scrapie strain may influence affected PrP genotypes to a greater extent than innate breed differences. There was a significant association between the breed-level incidence of scrapie and the frequency of susceptible PrP genotypes in breeds. Our results lend support to selective breeding programmes which aim to reduce the frequency of high-risk PrP genotypes with measures not varying by sheep breed.

We estimated the extent of undiagnosed hepatitis C virus (HCV) infection in injecting drug users (IDUs) in Scotland. We used record-linkage to determine HCV diagnosis status for 41 062 current/former IDUs attending drug treatment and support services between 1 April 1995 and 31 March 2006; the extent of undiagnosed HCV infection was estimated by comparing the number HCV-diagnosed to the number HCV-infected (estimated from an unlinked anonymous testing survey of 2141 current/former IDUs). In all, 9145 IDUs (22%) were diagnosed HCV antibody-positive since first attendance at drug services (diagnosis rate of 33·6/1000 person-years, 95% CI 32·7–34·4). By 31 March 2006, of the 19 632 current/former IDUs who had attended drug services and were determined to be living with HCV, an estimated 58% (95% CI 45–62) had not been HCV-diagnosed. It is essential that the deployment of resources for identifying at-risk IDUs with a view to offering antiviral therapy is guided by evidence.

A cross-sectional study was carried out in injecting drug users (IDUs) from Greece to assess the seroprevalence of human herpesvirus 8 (HHV-8) and to identify potentially associated risk factors. A total of 288 IDUs were tested for K8.1 antibodies to HHV-8 lytic antigen. Associations between HHV-8 serostatus and potential risk factors were examined using univariate and multivariate logistic regression analysis. Seroprevalence of HHV-8 was 24·3% (95% CI 19·5–29·7), increasing with age from 19·4% in those aged <30 years to 52·9% in those aged ⩾40 years (P for trend=0·003). No statistically significant associations between HHV-8-positive status and gender, educational level, age at first drug injection, needle sharing, number of imprisonments, complications from drug overdose, HIV and HCV were observed. In the multivariate logistic regression analysis, older age (⩾40 vs. <40 years, OR 3·30, 95% CI 1·14–9·56) and report of septicaemia/abscess (yes vs. no, OR 1·80, 95% CI 1·01–3·18) were each independently associated with higher HHV-8 seroprevalence. HHV-8 is highly prevalent in the IDU population in Greece. The independent association between HHV-8 and reported abscess or septicaemia supports the hypothesis that poor hygiene conditions in the setting of drug injection may contribute to HHV-8 transmission.

Although many studies have investigated bacteria on the hands of health-care workers and caregivers, few have looked at microbiological contamination on the hands of the general adult public. This study investigated faecal bacteria on the hands of commuters in five UK cities. Of the 404 people sampled 28% were found to have bacteria of faecal origin on their hands. A breakdown by city showed that the proportion of people with contaminated hands increased the further north the city of investigation (P<0·001), an effect which was due in large part to a significant trend in men but not in women. Bus users were more contaminated than train users. The results of this exploratory study indicate that hand hygiene practices in the UK may be inadequate and that faecal indicator bacteria on hands may be used to monitor the effect of hand-washing promotion campaigns.

We report on a measles outbreak originating in an anthroposophic community in Austria, 2008. A total of 394 (94·9%) cases fulfilled the outbreak case definition including 168 cases affiliated to the anthroposophic community. The source case was a school pupil from Switzerland. The Austrian outbreak strain was genotype D5, indistinguishable from the Swiss outbreak strain. A school-based retrospective cohort study in the anthroposophic school demonstrated a vaccine effectiveness of 97·3% in pupils who had received a single dose of measles-containing vaccine and 100% in those who had received two doses. The vaccination coverage of the cases in the anthroposophic community was 0·6%. Of the 226 outbreak cases not belonging to the anthroposophic community, the 10–24 years age group was the most affected. Our findings underline the epidemiological significance of suboptimal vaccination coverage in anthroposophic communities and in older age groups of the general population in facilitating measles virus circulation. The findings of this outbreak investigation suggest that the WHO European Region is unlikely to achieve its 2010 target for measles and rubella elimination.

Comparing pertussis epidemiology over time and between countries is confounded by differences in diagnostic and notification practices. Standardized serological methods applied to population-based samples enhance comparability. Population prevalence of different levels of pertussis toxin IgG (PT IgG) antibody, measured by standardized methods, were compared by age group and region of Australia between 1997/1998 and 2002. The proportion of 5- to 9-year-olds with presumptive recent pertussis infection (based on IgG levels ⩾62·5 ELISA units/ml) significantly decreased in 2002, consistent with notification data for the same period and improved uptake of booster vaccines following the schedule change from whole-cell to acellular vaccine. In contrast, recent presumptive infection significantly increased in adults aged 35–49 years. Population-based serosurveillance using standardized PT IgG antibody assays has the potential to aid interpretation of trends in pertussis incidence in relation to vaccine programmes and between countries.

To characterize the association between county-level risk factors and the incidence of mumps in the 2006 Iowa outbreak, we used generalized linear mixed models with the number of mumps cases per county as the dependent variable. To assess the impact of spring-break travel, we tested for differences in the proportions of mumps cases in three different age groups. In the final multivariable model, the proportion of Iowa's college students per county was positively associated (P<0·0001) with mumps cases, but the number of colleges was negatively associated with cases (P=0·0002). Thus, if the college students in a county were spread among more campuses, this was associated with fewer mumps cases. Finally, we found the proportion of mumps cases in both older and younger persons increased after 1 April (P=0·0029), suggesting that spring-break college travel was associated with the spread of mumps to other age groups.

In an epidemiological survey from South India, 936 serum samples were tested for IgG against recombinant baculovirus-expressed VP6 proteins from human group A and group C rotaviruses. The overall seroprevalence for group A was 100% and for group C was 25·32% (95% CI 22·64–28·21). The lowest seroprevalence for group C was in children aged <10 years (16·79%). An age-related rise in seroprevalence in group C, but not group A, suggests different patterns of exposure. Seroprevalence was similar in rural and urban subjects, unlike the higher prevalence in rural subjects in studies elsewhere.