Vaccination remains a mainstay of companion animal population health. However, how vaccine use at a population level complies with existing guidelines is unknown. Here we use electronic health records to describe vaccination in dogs, cats and rabbits attending a large sentinel network of UK veterinary practices. In total, 77.9% (95% CI: 77.6–78.1) of animals had recorded vaccinations. The percentage of animals with recorded vaccinations was higher in dogs, neutered animals, in insured dogs and cats and in purebred dogs. Vaccination rates varied in different regions of Great Britain in all species. Dogs and cats belonging to owners living in less deprived areas of England and Scotland were more likely to be recorded as vaccinated. In the vaccinated population, cats received more core vaccines per year of life (0.86) than dogs (0.75), with feline leukaemia vaccines almost as frequent as core vaccines. In dogs, leptospira vaccines were more frequent than core vaccines. This descriptive study suggests a substantial proportion of animals are not benefiting from vaccine protection. For the first time, we identify potential factors associated with variations in recorded vaccination frequency, providing a critical baseline against which to monitor future changes in companion animal vaccination and evidence to inform future targeted health interventions.

Silicic acid in its polymerized form is toxic to leucocytes in tissue culture and depresses leucocyte respiration, effects which appear to be paralleled by its inhibition of the cytochrome oxidase enzyme system. There is evidence that silicic acid acts on this system by combining with and inactivating cytochrome c and it is suggested that its effect in vivo may have a similar basis. The inhibitory effect of silicic acid on the two other respiratory enzyme systems studied is considerably less intense and probably non-specific.

1. A review has been made of literature on the ecology of different types of coliform bacteria. The main object of the review has been to consider whether there is evidence to support the view that Bact. aerogenes and the intermediate types live normally on plants or in the soil and not in the intestines of man and other animals.

2. There is ample evidence that Bact. coli is by far the most common type of coliform in normal human faeces. On the other hand, there is evidence that Bact. aerogenes or intermediate types are usually present in faeces, may sometimes be present in greater numbers than Bact. coli, and on rare occasions may be the only type present. Both quantitatively and qualitatively the coliform flora of the faeces of an individual person may vary from day to day. There is insufficient evidence on the numbers of Bact. aerogenes and intermediate types in faeces to justify any more definite statement, but limited data suggest that such types may be absent or may be present in numbers of the order of a million per gram.

3. When fresh faeces are stored there is first a multiplication of such bacteria as will grow on ordinary laboratory media, including the coliform types. The rate of multiplication, as with the flora of soil, water, and milk, increases with an increase in the incubation temperature to 37° C, but the period of multiplication becomes shorter. In the literature consulted no evidence can be found to show which groups are prominent in the multiplication. Results are in agreement that on further storage the ratio of the numbers of Bact. coli to those of Bact. aerogenes and intermediates decreases, the typical Bact. coli flora dying off more rapidly than other conform types. The rapidity of decrease appears to depend partially at least upon the temperature of the environment, and the decrease may be accelerated by intense sunlight.

4. In urine from patients suffering from genito-urinary infections the dominant types of coliform are usually either Bact. aerogenes or intermediates. No data on the number of such organisms in urine have been obtained from the works consulted.

5. There is no-evidence that coliform bacteria multiply on fresh grasses or grains. Few quantitative data on this question have been found. In some of the older work it is doubtful whether a large proportion of the cultures isolated were actually coliform bacteria or whether they were species of other genera capable of fermenting lactose at 30° C. but not at 37° C. In the decomposition of grasses and legumes during ensilage, a process involving a considerable increase in temperature, it would appear that multiplication of conform bacteria may take place and counts may for a time equal those found in fresh faeces. No indication has been found that this multiplication is confined to Bact. aerogenes or intermediates.

6. Most workers who have studied the coliform bacteria in soil have ignored the quantitative aspects and no counts at intervals over long periods of coliform bacteria in any undisturbed soil appear to have been made. No evidence of any multiplication of coliform bacteria in soil has been found. Results, however, are in agreement that where pollution of the soil by animal excreta has taken place, the heavier the pollution the greater is the number of coliform bacteria; soils relatively free from human or other animal pollution either contain no coliform bacteria or only small numbers. It is generally agreed that the ratio of the numbers of Bact. coli to those of Bact. aerogenes and intermediates decreases with the increase of time which has elapsed since pollution of the soil. This change is similar to that which occurs in faeces during storage.

7. There is insufficient evidence to justify the definite statement often made that Bact. aerogenes and intermediates are normal inhabitants of soils, grasses, and grains.

The relative frequency of salmonella strains isolated from hospitalized and non-hospitalized patients in Southern Israel changed during the period, 1994–6. Salmonella enterica serotype Typhimurium definitive phage-type 104 (DT104) appeared in Israel in 1994 and became the most prevalent strain in 1996. An outbreak of enteritis due to Salmonella enterica serotype Agona occurred in Israel, in October 1994 and lasted for 4 months. The relative frequency of Salmonella enterica serotype Enteritidis remained almost constant during these years, with seasonal fluctuations only.

The importance of the increase in the prevalence of Typhimurium DT104 has been the epidemic spread of a multiresistant strain of R-type ACT (A, ampicillin; C, chloramphenicol; T, tetracycline) belonging to this phage-type. Since 1995 the frequency of Typhimurium DT104 isolates that possess, in addition to the above R-type, a chromosomally encoded resistance to the quinolone drug, nalidixic acid, increased tenfold. In 1996, 27% of the Typhimurium DT104 isolates were of R-type ACTN. S. Enteritidis exhibited over 95% susceptibility to at least eight of the most commonly used antibiotic drugs, and none of the isolates was resistant to quinolone or fluoroquinoline.

1. Treatment of washed sheep erythrocytes with dilute solutions of tannic acid rendered them capable of adsorbing diphtheria toxin from solution. Diphtheria toxoid was not adsorbed under similar conditions.

2. Cells thus sensitized with diphtheria toxin were agglutinable by a proportion of children's sera and human cord sera; sera of rabbits, mice and horses, immunized with soluble or adsorbed diphtheria toxoid, also agglutinated sensitized cells, as did also the sera of children suffering from diphtheria and treated with antitoxic serum. Clear-cut results were usually obtained, but the end-point of titrations on horse sera was, in some cases, difficult to determine.

3. Using intradermal toxin neutralization tests, a highly significant linear relationship was demonstrated between the haemagglutinating titres of children's sera for the sensitized red cells, and the antitoxin content of their sera. The antitoxin content corresponding to the smallest detectable amount of haemagglutinating antibody was 0·008 unit per ml. serum.

4. The haemagglutinating titre was an accurate measure of the mean antitoxin level of a group of sera and a close measure of the antitoxin content of most specimens in individual tests.

The method of path analysis is described in detail. Application of this analytical technique in the interpretation of causal relationships in complex biological systems is demonstrated using data from an epidemiological study of echinococcosis in New Zealand. The results identified the major causal pathways determining Echinococcus granulosus prevalence in dogs, based on multiple regression analysis of a linear causal model constructed from prior biological and epidemiological knowledge. Only ethnic and sheep husbandry variables had important direct effects on prevalence in the North Island of New Zealand, with some climatic factors (maximum temperature and relative humidity) and soil porosity acting indirectly through animal husbandry practices. It is suggested that path analysis, by permitting interaction between epidemiological theory and statistical analysis, provides a valuable additional tool to epidemiologists for the study of causal relationships among variables in multivariate systems.

Seasonal respiratory illnesses present a major burden on primary care services. We assessed the burden of respiratory illness on a national telehealth system in England and investigated the potential for providing early warning of respiratory infection. We compared weekly laboratory reports for respiratory pathogens with telehealth calls (NHS 111) between week 40 in 2013 and week 29 in 2015. Multiple linear regression was used to identify which pathogens had a significant association with respiratory calls. Children aged <5 and 5–14 years, and adults over 65 years were modelled separately as were time lags of up to 4 weeks between calls and laboratory specimen dates. Associations with respiratory pathogens explained over 83% of the variation in cold/flu, cough and difficulty breathing calls. Based on the first two seasons available, the greatest burden was associated with respiratory syncytial virus (RSV) and influenza, with associations found in all age bands. The most sensitive signal for influenza was calls for ‘cold/flu’, whilst for RSV it was calls for cough. The best-fitting models showed calls increasing a week before laboratory specimen dates. Daily surveillance of these calls can provide early warning of seasonal rises in influenza and RSV, contributing to the national respiratory surveillance programme.

Geographically widespread outbreaks involving commonly isolated organisms and where the vehicles of infection are commonly eaten foodstuffs pose particular difficulties at a technical and organizational level.

An outbreak of Salmonella typhimurium infection, affecting 39 people, spread over a wide area in North West England and North Wales in April and May 1991, was detected thanks to the practice of sending specimens to the national reference laboratory where phage typing and characterizing of antibiotic resistance patterns enabled the identification of a cluster of distinctive isolates (S. typhimurium DT193 resistant to sulphonamides, trimethoprim and furazolidone). An investigation, involving twenty environmental health departments in addition to health authorities and the Public Health Laboratory Service, showed an association between the illness and eating loose sliced cooked ham (P = 0.004). Detailed tracing of the chain of supply of the ham showed this to be particularly cooked ham originating from a single small local producer (P = 0.00003). Further investigation of that producer revealed that a batch of ham distributed on one day in early April was undercooked due to a malfunction in cooking equipment.

In countries maintaining national hepatitis C virus (HCV) surveillance systems, a substantial proportion of individuals report no risk factors for infection. Our goal was to estimate the proportion of diagnosed HCV antibody-positive persons in Scotland (1991–2010) who probably acquired infection through injecting drug use (IDU), by combining data on IDU risk from four linked data sources using log-linear capture–recapture methods. Of 25 521 HCV-diagnosed individuals, 14 836 (58%) reported IDU risk with their HCV diagnosis. Log-linear modelling estimated a further 2484 HCV-diagnosed individuals with IDU risk, giving an estimated prevalence of 83. Stratified analyses indicated variation across birth cohort, with estimated prevalence as low as 49% in persons born before 1960 and greater than 90% for those born since 1960. These findings provide public-health professionals with a more complete profile of Scotland's HCV-infected population in terms of transmission route, which is essential for targeting educational, prevention and treatment interventions.

Norovirus is the leading cause of acute gastroenteritis in the USA. Although secondary household transmission of norovirus is frequently reported in outbreaks, little is known about specific risk factors for susceptibility and infectiousness in the household. Three norovirus outbreaks were investigated and data were collected on individuals exposed in the primary outbreak setting and their household members. Potential individual- and household-level risk factors for susceptibility and infectiousness were assessed using univariate and multivariate generalised linear mixed models. In the univariate models, the secondary attack rate (SAR) was significantly higher when living in a household with two or more primary cases (incidence rate ratio (IRR) = 2·1; 95% confidence interval (CI) 1·37–3·29), more than one primary case with vomiting (IRR = 1·9; CI 1·11–3·37), and at least one primary case with diarrhoea (IRR = 3·0; CI 1·46–6·01). After controlling for other risk factors in the multivariate models, the SAR was significantly higher among those living in a household with two or more primary cases (adjusted IRR = 2·0; CI 1·17–3·47) and at least one primary case with diarrhoea (adjusted IRR = 2·8; CI 1·35–5·93). These findings underscore the importance of maintaining proper hygiene and isolating ill household members to prevent norovirus transmission in the household.

Enzyme immunoassays (EIA) for IgG and IgM antibodies against influenza A and B virus are described. One hundred and seven subjects with a clinical diagnosis of acute respiratory infection (influenza, bronchitis or pneumonia) were selected for this study during two epidemics of influenza A which occurred in Finland in 1983 and 1985. Paired sera and nasopharyngeal secretions were obtained from all subjects. The sera were tested for influenza A and B antibodies by IgG and IgM EIAs and by complement fixation tests. The nasopharyngeal secretions were tested by an indirect EIA for influenza A and B antigens.

The IgG EIA was found to be better than complement fixation for the diagnosis of influenza A infections: only 22% of the significant increases detected by this test were also positive by complement fixation. The additional contribution of the IgM EIA to the number of positives was minimal.

It was also found that testing a single 1/1000 dilution of serum for influenza A and 1/100 dilution for influenza B in the IgG EIA gave as many positives as the conventional method of testing several dilutions.

With the rapid rise in the prevalence of non-tuberculous mycobacteria (NTM) diseases across the world, the microbiological diagnosis of NTM isolates is becoming increasingly important for the diagnosis and treatment of NTM disease. In this study, the clinical presentation, species distribution and drug susceptibility of patients with NTM disease visiting the Chongqing Public Health Medical Centre during March 2016–April 2019 were retrospectively analysed. Among the 146 patients with NTM disease, eight NTM species (complex) were identified. The predominant NTM species in these patients were identified to be Mycobacterium abscessus complex (53, 36.3%), M. intracellulare (38, 26%) and M. fortuitum (17, 11.7%). In addition, two or more species were isolated from 7.5% of the patients. Pulmonary NTM disease (142, 97.3%) showed the highest prevalence among the patients. It was observed that 40.1% of the patients with pulmonary NTM disease had chronic pulmonary obstructive disease and bronchiectasis, while 22.5% had prior tuberculosis. Male patients showed more association with the conditions of cough and haemoptysis than the female patients. In an in vitro antimicrobial susceptibility testing, most of the species showed susceptibility to linezolid, amikacin and clarithromycin, while M. fortuitum exhibited low susceptibility to tobramycin. In conclusion, the prevalence of NTM disease, especially that of the pulmonary NTM disease, is common in Southwest China. Species identification and drug susceptibility testing are thus extremely important to ensure appropriate treatment regimens for patient care and management.

Two models estimating the proportion of Escherichia coli O157[ratio ]H7 cases not reported in the Ontario notifiable diseases surveillance system are described. The first model is a linear series of adjustments in which the total number of reported cases is corrected by successive under-reporting coefficients. The structure of the second model is based on a relative difference in the proportion of E. coli O157[ratio ]H7 cases which are hospitalized between the surveillance database and the underlying population.

Based on this analysis, the rate of under-reporting of symptomatic cases of E. coli O157[ratio ]H7 infection in Ontario ranges from 78 to 88% corresponding to a ratio of 1 reported case for approximately 4–8 symptomatic cases missed by the surveillance system. This study highlights the need to increase awareness among public health workers of the potential biases that may exist in the interpretation of routine surveillance data.

This study investigates neighbourhood variation in rates of pneumococcal bacteraemia and community-level factors associated with neighbourhood heterogeneity in disease risk. We analysed data from 1416 adult and paediatric cases of pneumococcal bacteraemia collected during 2005–2008 from a population-based hospital surveillance network in metropolitan Philadelphia. Cases were geocoded using residential address to measure disease incidence by neighbourhood and identify potential neighbourhood-level risk factors. Overall incidence of pneumococcal bacteraemia was 36·8 cases/100 000 population and varied significantly (0–67·8 cases/100 000 population) in 281 neighbourhoods. Increased disease incidence was associated with higher population density [incidence rate ratio (IRR) 1·10/10 000 people per mile2, 95% confidence interval (CI) 1·0–1·19], higher percent black population (per 10% increase) (IRR 1·07, 95% CI 1·04–1·09), population aged ⩽5 years (IRR 3·49, CI 1·8–5·18) and population aged ⩾65 years (IRR 1·19, CI 1·00–1·38). After adjusting for these characteristics, there was no significant difference in neighbourhood disease rates. This study demonstrates substantial small-area variation in pneumococcal bacteraemia risk that appears to be explained by neighbourhood sociodemographic characteristics. Identifying neighbourhoods with increased disease risk may provide valuable information to optimize implementation of prevention strategies.

High rates of immigration from endemic countries contribute to the high chronic hepatitis B (HBV) prevalence in New York City (NYC) compared to the United States overall, i.e. about 1 million individuals. We describe the impact of HBV infection on mortality and specific causes of death in NYC. We matched surveillance and vital statistics mortality data collected from 2000 to 2011 by the New York City Department of Health and Mental Hygiene (DOHMH) and analysed demographics and premature deaths (i.e. whether death occurred at <65 years) in persons with and without chronic HBV or HIV infection (excluding those with hepatitis C). From 2000 to 2011, a total of 588 346 adults died in NYC. Of all decedents, 568 753 (97%) had no report of HIV or HBV, and 4346 (0·7%) had an HBV report. Of HBV-infected decedents, 1074 (25%) were HIV co-infected. Fifty-five percent of HBV mono-infected and 95% of HBV/HIV co-infected decedents died prematurely. HBV disproportionately impacts two subgroups: Chinese immigrants and HIV-infected individuals. These two subgroups are geographically clustered in different neighbourhoods of NYC. Tailoring prevention and treatment messages to each group is necessary to reduce the overall burden of HBV in NYC.

The purpose of this study was to determine the magnitude and distribution of acute gastrointestinal illness (GI) in the Chilean population, describe its burden and presentation, identify risk factors associated with GI and assess the differences between a 7-day, 15-day and a 30-day recall period in the population-based burden of illness study design. Face-to-face surveys were conducted on 6047 randomly selected residents in the Metropolitan region, Chile (average response rate 75·8%) in 2008. The age-adjusted monthly prevalence of GI was 9·2%. The 7-day recall period provided annual incidence rate estimates about 2·2 times those of the 30-day recall period. Age, occupation, healthcare system, sewer system, antibiotic use and cat ownership were all found to be significant predictors for being a case. This study expands on the discussion of recall bias in retrospective population studies and reports the first population-based burden and distribution of GI estimates in Chile.

1. The use of Esch. coli alone as an index of faecal pollution for shellfish, and the correlation between the 44° C. MacConkey test and citrate tests are discussed.

2. The mercury-toluene thermo-regulator used in these experiments, which gives a maximum variation of ± 0.1° C., is discussed briefly and illustrated.

3. Experiments are described in which 522 colonies from polluted shellfish were isolated, inoculated into MacConkey's broth and incubated at temperatures of 37° C. and at successive 1° intervals from 41 to 46° C., in accurately controlled water-baths. An almost perfect negative correlation was found to exist between 44° C. incubation and the citrate test.

4. It appeared that temperatures above 44° C. are detrimental to the growth of Esch. coli.

5. Certain cultures of citrate-negative lactose fermenters at 37° C., which were inhibited at 44° C., were found on further investigation to be mostly intermediate types.

Fifty volunteers, treated with an inactivated trivalent influenza vaccine containing A/Bangkok/1/79 (H3N2), A/Brazil/11/78 (H1N1) and B/Singapore/222/79 virus, were subdivided according to the estimated first exposure to influenza in their lifetime (priming) and the presence of antibodies against the vaccine components in the pre-vaccination sera. The isotypic antibody response (IgG, IgA, IgM) was determined by means of an antibody capture haemadsorption immunosorbent technique. For all three vaccine components, previously seropositive subjects produced antibodies of the IgG- and IgA-class more frequently than previously seronegative persons. Subjects primed to one of the influenza A subtypes showed more IgG and IgA responses in comparison with those unprimed (prime-effect). In contrast, IgM antibodies occurred in only 19 and 11% of primed, but in 59 and 54% of unprimed subjects, for A (H3N2) and A (HlNl), respectively. The incidence of IgM titre rises was not influenced by the prevaccination state. However, the mean magnitude of anti-A(H1N1)-IgM titre rises was greater in those previously seronegative. The concepts of primary and reinfection and of ‘original antigenic sin’ are discussed, and it is suggested that age and, if possible, serological state prior to antigen-exposure should be taken into account when studying isotypic antibody responses after influenza infection or vaccination.

Dog treats might be contaminated with Salmonella. In Canada and the USA, outbreaks of human salmonellosis related to exposure to animal-derived dog treats were reported. Consequently, surveillance data on Salmonella contamination of dog treats have been gathered in many countries, but not in Japan. In the current study, we investigated whether dog treats in Japan were contaminated with Salmonella. Overall, 303 dog treats (of which 255 were domestically produced) were randomly collected and the presence of Salmonella investigated. Seven samples were positive for Salmonella enterica subsp. enterica. Among these isolates, three were identified as serovar 4,5,12:i:–; two were serovar Rissen; and two were serovar Thompson. All serovar 4,5,12:i:– and Thompson isolates were resistant to one or more drugs. Two serovar Rissen isolates were fully susceptible to all tested antimicrobial agents. All Salmonella isolates were susceptible to cefotaxime, ciprofloxacin and nalidixic acid. The gene blaTEM was detected in two serovar 4,5,12:i:– isolates. The blaCTX−M and blaCMY genes were not detected in any isolates. This study demonstrated that dog treats in Japan could constitute a potential source of dog and human Salmonella infections, including multidrug-resistant Salmonella isolates.

Campylobacteriosis is the commonest cause of bacterial enteritis in England yet the epidemiology of apparently sporadic cases is not well understood. Here we evaluated the feasibility of applying a space-time cluster detection method to routine laboratory surveillance data in the North East of England by simulating prospective weekly space-time cluster detection using SaTScan as if it had been performed for 2008–2011. From the 209 simulated weekly runs using a circular window, 20 distinct clusters were found which contained a median of 30 cases (interquartile range 15–66) from a median population of ∼134 000 persons. This corresponds to detection of a new cluster every 10 weeks. We found significant differences in age, sex and deprivation score distributions between areas within clusters compared to those without. The results of this study suggest that space-time detection of Campylobacter clusters could be used to find groups of cases amenable to epidemiological investigation.