Of 629 fresh fish (sixty-five species) and forty-two samples of fish-washings obtained from a fish-market in Colombo, and investigated bacteriologically for the presence of Salmonella, thirty-nine fish (twenty-four species) and five samples of washings were found to be harbouring the organisms.

Of fifteen salmonella types found, all except Salm. chittagong and Salm. oranienberg had been previously isolated from human and animal sources in Ceylon.

The presence of Salmonella in the intestines of fresh fish examined suggested that the organisms had entered the live fish, whilst their isolation from the gills and fish-washings was evidence that the fish could have been contaminated post-mortem.

The significance of these findings in relation to hazard to health is discussed.

Risk factors and prevalence of pulmonary nontuberculous mycobacterial (NTM) diseases were retrospectively evaluated in 1208 suspected pulmonary TB patients seeking care at the Affiliated Hospital of Hangzhou Normal University between July 2018 and December 2018. Further analysis of 390 culture-positive cases demonstrated that 358 (358/390, 91.8%) were infected with Mycobacterium tuberculosis (MTB), 24 (24/390, 6.2%) with NTM and eight (8/390, 2.0%) with both MTB and NTM. M. intracellulare was the most prevalent NTM isolated (16/24, 66.7%), followed by M. abscessus (3/24), M. kansasii (2/24), M. avium (1/24), M. szulgai (1/24) and M. fortuitum (1/24). The difference between NTM and TB case rates for the ⩾65-year-old age group significantly exceeded the difference for the reference group (patients aged 25–44 years) (OR (95% CI): 4.63 (1.03–20.90)). Pulmonary NTM diseases incidence positively correlated with prior TB history (OR (95% CI): 12.92 (3.24–31.82)). Moreover, pulmonary NTM patients were significantly more likely to exhibit underlying bronchiectasis than pulmonary TB patients (OR (95% CI): 18.89 (7.54–47.88)). In conclusion, approximately one-tenth of culture-positive suspected pulmonary TB patients are infected with NTM (most frequently M. intracellulare) in Zhejiang Province, China. The elderly and those with bronchiectasis or a history of TB are at the greatest risk of contracting pulmonary NTM disease.

Five large outbreaks of food poisoning are described in which clinical, epidemiological or laboratory data indicated Clostridium perfringens as the causative organism. The foodstuff common to all incidents was boiled salmon served cold as an hors d'oeuvre. In all cases the fish had been subject to a long period of cooling or storage between boiling and consumption. It is thought that multiplication of the organism occurred during this time.

Recommendations are made for the avoidance of further similar incidents.

Ventilation of vessels varying widely in size was found to preserve the toxic effect of open-air factor(s). There was a correlation between the minimum rates of ventilation required and the ratios of the surface area of the vessels to their volumes. The data obtained allowed an estimate to be made of the diffusion coefficient of open-air factor(s) and gave an indication that the molecular weight range of the open air factor(s) was from 50 to 150.

The diseases caused by non-tuberculous mycobacteria (NTM), in both AIDS and non-AIDS populations, are increasingly recognized worldwide. Although the American Thoracic Society published the guidelines for diagnosis of NTM pulmonary disease (NTM-PD), the diagnosis is still difficult. In the first part of the study, we collected data on NTM isolates in the Mycobacteriology Laboratory of Careggi Hospital (Florence, Italy) and analysed the epidemiological data of NTM isolates. Then, to analyse the risk factors associated to NTM-PD, we studied the presence of ATS/IDSA criteria for NTM-PD in patients who had at least one positive respiratory sample for NTM and were admitted to the Infectious Disease Unit and the Section of Respiratory Medicine. We selected 88 patients with available full clinical data and, according to ATS/IDSA criteria, classified 15 patients (17%) as NTM-PD cases and 73 as colonized patients (83%). When comparing colonized and NTM-PD patients we did not find significant differences of age, gender and comorbidity. We observed that Mycobacterium avium and M. intracellulare were statistically associated with NTM-PD (P = 0·001) whereas M. xenopi was statistically associated with colonization. Although the number of studied patients is limited, our study did not identify risk factors for NTM-PD that could help clinicians to discriminate between colonization and disease. We underline the need of close monitoring of NTM-infected patients until the diagnosis is reasonably excluded. Further larger prospective studies and new biological markers are needed to identify new useful tools for the diagnosis of NTM-PD.

High-risk human papillomaviruses (HPVs) are highly prevalent worldwide, and HPV genotype distribution varies regionally. Molecular surveys of HPVs are important for effective HPV control and prevention. Fifteen high-risk HPV strains (16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68) and six low-risk HPV strains (HPV6, 11, 42, 43, 44, CP8304) were detected by cervical cytology from 10 501 subjects. High-risk HPVs, low-risk HPVs, and both high- and low-risk HPVs were detected in 14·5%, 2·8%, and 2·4% of cases, respectively. Of 1782 subjects with high-risk HPV infection, 75·5%, 18·1%, and 6·4% were infected with one, two, and ⩾3 strains of high-risk HPVs, respectively. HPV52, HPV16, and HPV58 were the top three most dominant high-risk HPV genotypes in our population with positivity rates of 23·0%, 17·7% and 16·9%, respectively. Multiple infection was common, with significantly higher co-infection rates of HPV58/HPV33 (12·9%) and HPV58/HPV52 (11·3%). Further data comparisons showed that HPV genotype distribution varied markedly between domestic and international regions. In conclusion, a monolithic vaccination strategy is obviously impractical, and regional HPV surveillance is essential to optimize current HPV control and prevention.

The objectives were to present three approaches for calculating antimicrobial (AM) use in pigs that take into account the rearing period and rearing site, and to study the association between these measurements and phenotypical resistance and abundance of resistance genes in faeces samples from 10 finisher batches. The AM use was calculated relative to the rearing period of the batches as (i) ‘Finisher Unit Exposure’ at unit level, (ii) ‘Lifetime Exposure’ at batch level and (iii) ‘Herd Exposure’ at herd level. A significant effect on the occurrence of tetracycline resistance measured by cultivation was identified for Lifetime Exposure for the AM class: tetracycline. Furthermore, for Lifetime Exposure for the AM classes: macrolide, broad-spectrum penicillin, sulfonamide and tetracycline use as well as Herd Unit Exposure for the AM classes: aminoglycoside, lincosamide and tetracycline use, a significant effect was observed on the occurrence of genes coding for the AM resistance classes: aminoglycoside, lincosamide, macrolide, β-lactam, sulfonamide and tetracycline. No effect was observed for Finisher Unit Exposure. Overall, the study shows that Lifetime Exposure is an efficient measurement of AM use in finisher batches, and has a significant effect on the occurrence of resistance, measured either by cultivation or metagenomics.

We conducted prospective, community-wide surveillance for acute respiratory illnesses (ARIs) in Rochester, NY and Marshfield, WI during a 3-month period in winter 2011. We estimated the incidence of ARIs in each community, tested for viruses, and determined the proportion of ARIs associated with healthcare visits. We used a rolling cross-sectional design to sample participants, conducted telephone interviews to assess ARI symptoms (defined as a current illness with feverishness or cough within the past 7 days), collected nasal/throat swabs to identify viruses, and extracted healthcare utilization from outpatient/inpatient records. Of 6492 individuals, 321 reported an ARI within 7 days (4·9% total, 5·7% in Rochester, 4·4% in Marshfield); swabs were collected from 208 subjects. The cumulative ARI incidence for the entire 3-month period was 52% in Rochester [95% confidence interval (CI) 42–63] and 35% in Marshfield (95% CI 28–42). A specific virus was identified in 39% of specimens: human coronavirus (13% of samples), rhinovirus (12%), RSV (7%), influenza virus (4%), human metapneumovirus (4%), and adenovirus (1%). Only 39/200 (20%) had a healthcare visit (2/9 individuals with influenza). ARI incidence was ~5% per week during winter.

Samples of Fermi, Semple, modified Semple, Duck embryo and tissue culture rabies vaccine were inoculated by different routes and in different doses into rabbits, mice and hamsters. The vaccines induced neither detectable interferon nor immediate protection against lethal challenge with CVS rabies virus.

Under similar conditions, high but transient levels of interferon were induced in control animals of the same species with the polynucleotide complex Poly I.C. Hamsters but not mice were protected by Poly I.C.-induced interferon.

No autointerference by vaccine with challenge virus was established. Vaccineinduced protection in mice was directly related to immune response.

Of 303 children hospitalized with acute non-bloody, non-mucoid diarrhoea, 69 (22·8%) had polymicrobial infection, including 52 (17·2%) multiple viral infection and 17 (5·6%) viral and bacterial co-infection. Rotavirus had the most important role in both categories; thus the control of rotavirus infection is crucial for maintaining children's health in Taiwan.

Campylobacters isolated from human, animal and environmental sources during the investigation of a milk-borne outbreak, an incident involving goats' milk and an outbreak associated with puppies were serotyped using the Penner and Lior schemes and biotyped using the Preston scheme. Application of these three methods to the incident strains demonstrated that heterogenicity amongst similar strains exists. This study has confirmed the need to use at least two typing methods when investigating epidemiologically-related strains and we suggest that a combination of a serotyping scheme and an extended biotyping scheme is the most useful.

Classification, by agglutinogens, of 634 isolates of Bordetella pertussis collected from 1941 to 1968 in Great Britain demonstrated that a change from a predominantly 1,2,0,4 serotype (75% of those examined during 1941–4) to a predominantly 1,0,3,0 serotype (73% of those examined during 1966–8) occurred sometime after 1953. Furthermore, evidence from the examination of isolates collected between 1941 and 1953 suggests that the change may have been gradual. Isolates of serotype 1,2,3,4 made up 20–30% of the total of our cross-country selection for the periods 1941–4, 1946–9, 1950–3 and 1966–8, but over shorter periods in individual areas the percentage varied from negligible to as high as half of those isolated. Results from other countries show a similar drift towards a 1,0,3 serotype but more often from a 1,2,3 than from 1,2,0 serotype.

The value, in epidemiological studies, of extended information obtained by monospecific typing sera to all six, rather than only two or three agglutinogens, and confirmation of the results by agglutinin production is demonstrated: for instance not all 1,0,3 isolates were identical.

During June–August 2013, 25 US states reported 631 cyclosporiasis cases including Nebraska and Iowa where a regional investigation implicated common-source imported salad mix served in two chain restaurants. At least two common-origin growing fields were likely sources of contaminated romaine lettuce. Using producer- and distributor-provided data, we conducted a grower-specific traceforward investigation to reveal exposures of ill US residents elsewhere who reported symptom onset during 11 June–1 July 2013, the time period established in the Nebraska and Iowa investigation. Romaine lettuce shipped on 2–6 June from one of these Mexico-origin growing fields likely caused cyclosporiasis in 78 persons reporting illness onsets from 11 June to 1 July in Nebraska, Texas, and Florida. Nationwide, 97% (314/324) of persons confirmed with cyclosporiasis with symptom onset from 11 June to 1 July 2013 resided in 11 central and eastern US states receiving approximately two-thirds of romaine lettuce from this field. This grower's production practices should be investigated to determine potential sources of contamination and to develop recommendations to prevent future illnesses.

Serotyping, subtyping and genotyping are important tools for epidemiological studies of group B streptococci (GBS). We investigated the genotype distribution of 353 GBS isolates originating from vaginal or rectal carriage to identify capsular serotypes and subtypes based on the surface protein genes of the alpha-like protein (Alp) family. GBS were recovered from 30% of 1176 pregnant women during the period 2007–2009, with a predominance of capsular genotypes III (35%), Ia (20%), V (17%), II (15%), Ib (8%) and IV (5%). The most common Alp gene was epsilon (26%), followed by rib (22%), alp2 (21%), bca (17%) and alp3 (14%). Several protein genes were significantly associated (G2=249·635, P<0·0001) with particular serotypes: epsilon with Ia, Ib, IV; bca with Ib, II; rib with II, III; alp3 with V; alp2 with III. High genetic diversity within GBS strains was observed using DNA macrorestriction. Serotypes Ib, II and III demonstrated the greatest genetic heterogeneity and serotype V the lowest heterogeneity (relative frequency coefficient ⩾0·03 vs. −0·46, respectively). Macrolide-resistant strains with serotype V and alp3 gene, showed higher uniformity in genetic profile. The distribution of serotypes and surface proteins of GBS strains are necessary data to inform the design and formulation of new GBS vaccines for use in Poland and other countries.

1. Rats taken from mixed stock diet and fed synthetic diet containing an excess of magnesium carbonate developed urinary calculi in a large number of cases.

2. The incidence of calculi was much higher in the females.

3. Addition of excess of calcium carbonate to the diet prevented the formation of calculi.

4. Rats previously fed for a short time on the synthetic diet and normal salt mixture did not develop calculi, but suffered from severe catharsis.

5. Rats on mixed stock diet had a more acid caecum and colon than those on synthetic diet.

6. No significant alterations were found in the Ca, Mg or inorganic P of the blood on any of the diets.

7. Extra magnesium, or calcium, or sodium carbonate lowered the urinary phosphate excretion.

8. Extra magnesium or calcium had little effect upon the urinary excretion of the other, but tended in each case to lower the output.

9. Changes in the sex organs brought about by excessive intake of magnesium are described.

The writer wishes to thank Miss V. E. Leader for her watchful care of the rats.

We investigated a measles outbreak in the Jerusalem district in 2007–2008 (992 cases). Most cases (72·6%) were aged <15 years, 42·9% aged <5 years, and 12·8% were infants aged <1 year. The peak incidence rate was in infants aged 6–12 months (916·2/100 000). This represents a significant shift from former outbreaks in 2003–2004, where the peak incidence was in the 1–4 years age group. Of children aged <5 years the proportion aged 6–12 months tripled (7·7% vs. 25·6%). In a case-control study (74 cases, 148 controls) children who developed measles were less likely to be registered in a well-baby clinic and had lower overall immunization coverage. The differences in proportions for registration, DTaP3 and MMR1 coverage were 35·1%, 48·6% and 80·8%, respectively (all P<0·001). Rising birth order of cases and their siblings was associated with non-registration and non-compliance with MMR immunization. The vulnerability of young infants and the risk markers noted above should be taken into account in planning intervention programmes.

Inclusion of live varicella vaccine in the routine occupational health vaccination schedule requires knowledge of the natural immunity to varicella zoster virus (VZV) among high-risk occupations. This study aims were to evaluate VZV antibody positivity among health-care workers (HCWs) and day-care-centre workers (DCWs) and to assess its association with potential risk factors. Three groups of workers were tested for VZV antibody positivity: hospitals and community clinic HCWs (n=335), DCWs (n=117) and blue-collar workers as controls (n=121). The total VZV antibody positivity was 94·4%. There was no significant difference in VZV antibody positivity among study groups. DCWs had the lowest VZV seroprevalence (90·9%, 95% CI 85·7–96·1) and controls the highest (96·6%, 95% CI 93·2–99·9). This high VZV antibody positivity suggests that no special occupational measures are indicated in health-care or day-care occupational settings in Israel. On-going monitoring of the natural immunity to VZV is necessary to detect trends over time.

Bloodstream infection (BSI) is a serious complication in immunocompromised hosts. This study compares epidemiological, clinical and microbiological characteristics of BSI among children with haematological malignancies (HM) and solid tumours (ST). The study was conducted from October 2012 through to November 2015 at a referral hospital for cancer care and included the first BSI episode detected in 210 patients aged 18 years or less. BSI cases were prospectively detected by daily laboratory-based surveillance. The Centers for Disease Control and Prevention definitions for primary or secondary BSI were used. A higher proportion of use of corticosteroids (P = 0.02), chemotherapy (P = 0.01) and antibiotics (P = 0.05) before the BSI diagnosis; as well as of neutropenia (P < 0.001) and mucositis (P < 0.001) at the time of BSI diagnosis was observed in patients with HM than with ST. Previous surgical procedures (P = 0.03), mechanical ventilation (P = 0.01) and bed confinement (P < 0.001) were more frequent among children with ST. The frequency of use of temporary (P = 0.01) and implanted vascular lines (P < 0.01) was significantly higher in children with ST than with HM while the tunnelled line (P = 0.01) use was more frequent in children with HM as compared to ST. Most (n = 181) BSI cases were primary BSI. BSI associated with a tunnelled catheter was more frequent in children with HM (P < 0.01), whereas BSI associated with an implanted (P < 0.01) or temporary central line (P < 0.02) was more common in patients with ST. BSI associated with mucosal barrier injury was more frequent (P = 0.01) in children with HM. Indication for intensive care was more frequent in children (P = 0.05) with ST. Mortality ratio was similar in children with ST and HM, and length of hospital stay after BSI was higher in patients with HM than with ST (median of 19 vs. 13 days; P = 0.02). Infection caused by Gram-negative bacteria (P = 0.04) and polymicrobial infections (P = 0.05) due to Gram-positive cocci plus fungus was more common in patients with HM. These findings suggest that the characteristics of BSI acquisition and mortality can be cancer-specific.

1. The course of an epizootic of plague in thirty-four colonies of gerbils (Tatera brantsi) was observed by counting, at 4-weekly intervals, the number of burrows which, when they had been closed on one day, were found open on the next. One gerbil could open an average of eight burrows in one night.

2. Regular censuses on the twenty-one colonies which survived until the last phase of the epizootic showed that the gerbil population fell from about 420 at the end of June 1940 to none at the end of January 1941. From May 1941 to August 1942, 3-monthly counts revealed some recolonization, but field officers reported that between 1942 and 1951 the gerbils sometimes died from plague, and the population never regained its former level.

3. During 1940, two to four colonies died out every 4 weeks. The time of year seemed not to influence the course of the epizootic.

4. Pasteurella pestis was detected in some gerbil colonies 4–6 months before they died out.

5. Plague-infected gerbil fleas were found which had been immured in blocked deserted burrows for periods of up to 120 days.

6. The passage of infection was traced from the reservoir in gerbils to other wild rodents (Otomys irroratus, Rattus (Mastomys) natalensis), to house rats (Rattus rattus) and to man.

1. A historical survey is given of work upon the Eijkman method.

2. A total of 104 water samples were examined by methods I and III. These yielded 602 cultures obtained from the 44 and 37° C. presumptive series, and of these 357 were 44° C.-positive. The only types capable of fermenting lactose at 44° C. were Bact. coli type I and Irregular type II, with the addition of three cultures of intermediate type I and two of aerogenes type I.

3. The relative efficiencies in the detection of Bact. coli of the 44° C. method by direct inoculation and of the 37° C. presumptive test with plating and differentiation were compared. Out of 104 samples, sixty-eight were shown to contain faecal Bact. coli, and in 19% of these the 44° C. method detected Bact. coli when it was not recovered at 37° C. The converse was true in only 13% of samples.

4. The results obtained by other workers in regard to the specificity of incubation at 44° C. and to the various methods hitherto proposed for employing it have been collected and discussed; technical advantages and disadvantages have also been considered.

5. It is concluded: (1) That false positives at 44° C. are a negligible quantity for practical purposes. (2) That the best all-round method to use is Wilson's method IV. (3) That 48 hr. incubation should be given, but that 24 hr. is sufficient when rapidity is desired. (4) That the test should be officially recognized and standards laid down for use with it.

6. Cellobiose was found to be inferior to citrate for the identification of the I.A.C. group.