A summer camp was followed by an outbreak of illness involving around 90 children. Investigations included individual questionnaires, inspection of the camp facilities, and laboratory analysis of water and clinical samples. Contamination of drinking and swimming water was demonstrated. An enterovirus was detected by polymerase chain reaction (PCR) and/or culture in 4/4 cerebrospinal fluid samples, 9/15 (60%) stool samples from symptomatic children and 2/9 (22%) stool samples from asymptomatic children. The virus was identified as an echovirus 3 by sequencing and phylogenetic analysis of a short 5′ non-coding region (NCR) PCR product. Viruses from the outbreak clustered closely and an echovirus 3 from a temporally associated non-outbreak case could be readily distinguished. Despite the lack of a standardized approach, direct molecular detection and identification of enteroviruses is an efficient epidemiological tool. Here the 5′-NCR was successfully used for both detection and ‘serotyping’, and the close genetic relatedness of isolates was proven.

The Darwin region in northern Australia has experienced rapid population growth in recent years, and with it, an increased incidence of melioidosis. Previous studies in Darwin have associated the environmental presence of Burkholderia pseudomallei, the causative agent of melioidosis, with anthropogenic land usage and proximity to animals. In our study, we estimated the occurrence of B. pseudomallei and Burkholderia spp. relatives in faecal matter of wildlife, livestock and domestic animals in the Darwin region. A total of 357 faecal samples were collected and bacteria isolated through culture and direct DNA extraction after enrichment in selective media. Identification of B. pseudomallei, B. ubonensis, and other Burkholderia spp. was carried out using TTS1, Bu550, and recA BUR3–BUR4 quantitative PCR assays, respectively. B. pseudomallei was detected in seven faecal samples from wallabies and a chicken. B. cepacia complex spp. and Pandoraea spp. were cultured from wallaby faecal samples, and B. cenocepacia and B. cepacia were also isolated from livestock animals. Various bacteria isolated in this study represent opportunistic human pathogens, raising the possibility that faecal shedding contributes to the expanding geographical distribution of not just B. pseudomallei but other Burkholderiaceae that can cause human disease.

It has been found that antigens suitable for routine tests for complement-fixing or precipitating antibodies in the sera of suspected cases of chickenpox or zoster can be readily prepared from tissue cultures of human amnion infected with zostervaricella virus.

Useful antigens were obtained when infected cells were incubated at 36°–38° C. in bovine amniotic fluid diluted with an equal volume of Hanks' solution.

Virus strains gave a good yield of antigen after two or more passages in tissue culture but one strain in its fiftieth passage did not.

Harvested culture fluids require 5- to 20-fold concentration for complement-fixation tests and 100- to 200-fold for precipitation tests; concentration of culture fluids was readily effected by drying from the frozen state after removal of salts by dialysis. Tissue culture antigens gave results by complement-fixation tests which were comparable to those given by a good vesicle fluid.

Some evidence was obtained that the antigens responsible for precipitation were not identical with those fixing complement with convalescent sera.

Pneumonia in well known to be extremely fatal at both extremes of life. In 1923 it was the cause of 3671 deaths per million living at ages under 5 years; between ages 5–24 the death-rate fell to 177 and rose to 376 at ages 25–44. after 45 the increase was rapid and the death-ate reached 2279 per million living for the ago group 65–74 and 4100 for all ages over 75 years.

Herpes simplex virus type 1 (HSV-1) infection is a lifelong infection that is acquired primarily orally and during childhood. We aimed to characterise HSV-1 epidemiology in Australia and New Zealand. HSV-1-related data as recent as 6 December 2021 were systematically reviewed, synthesised and reported, following PRISMA guidelines. Pooled mean seroprevalence and proportions of HSV-1 detection in genital ulcer disease (GUD) and in genital herpes were calculated using random-effects meta-analyses. Meta-regressions were also conducted. HSV-1 measures were retrieved from 21 eligible publications. Extracted HSV-1 measures included 13 overall seroprevalence measures (27 stratified) in Australia, four overall proportions of HSV-1 detection in clinically diagnosed GUD (four stratified) in Australia, and ten overall proportions of HSV-1 detection in laboratory-confirmed genital herpes (26 stratified) in Australia and New Zealand. Pooled mean seroprevalence among healthy adults in Australia was 84.8% (95% confidence interval (CI) 74.3–93.1%). Pooled mean seroprevalence was 70.2% (95% CI 47.4–88.7%) among individuals <35 years of age and 86.9% (95% CI 79.3–93.0%) among individuals ≥35 years. Seroprevalence increased by 1.05-fold (95% CI 1.01–1.10) per year. Pooled mean proportion of HSV-1 detection in GUD was 8.2% (95% CI 0.4–22.9%). Pooled mean proportion of HSV-1 detection in genital herpes was 30.5% (95% CI 23.3–38.3%), and was highest in young individuals. Proportion of HSV-1 detection in genital herpes increased by 1.04-fold (95% CI 1.00–1.08) per year. Included studies showed heterogeneity, but 30% of the heterogeneity in seroprevalence and 42% of the heterogeneity in proportion of HSV-1 detection in genital herpes were explained in terms of epidemiological factors. HSV-1 seroprevalence is higher in Australia than in other Western countries. HSV-1 epidemiology in Australia and New Zealand appears to be transitioning towards less oral acquisition in childhood, but more genital acquisition among youth.

The use of gauze swabs in drains or sewers to clarify the path followed by a salmonella from source to human host has been reviewed in the light of experience gained in Cardiff over 15 years. This period has seen a marked change in attitudes to salmonella epidemiology in that infected food is now regarded as of greater importance than infected food handlers. In these 15 years, butchers, abattoirs and knackers' yards, markets and bakehouses have been monitored. In the bakehouse survey the existence of staff infection was demonstrated by sewage examination. Sewage investigation has also been used to show frequent entry of salmonellas into households in a residential estate. The estate was carefully chosen to exclude salmonellas from industrial sources and shops. The frequent finding of infection in this sewage implies that a commonly consumed heavily infected food item is involved. The wide range of serotypes isolated suggests an animal usually fed on infected animal feed. Poultry and pigs are put forward as animals liable to spread salmonellosis to man.

It is hoped that clarification of the salmonella pathway may eventually lead to measures likely to prevent the transmission of infection to man. It is also suggested that swabs placed in abattoir drains serve as an economical method of obtaining warning of a persistent build-up of contamination. The persistence of a serotype in an abattoir is not infrequently followed by human infection.

Meningococci are regarded as being unlikely to survive outside of their human host although this has possibly been more assumed than demonstrated. Seven strains of meningococci were tested for their ability to survive on glass or plastic while retaining expression of their capsule and important outer membrane proteins. A known number of colony-forming units of each strain were dried onto glass and onto plastic and tested for viability over time. Survival on glass was significantly better than on plastic (P<0·0001). Isolates of the New Zealand epidemic strain, B:4:P1.7-2,4 survived better on glass than all other strains tested. Recovered isolates still expressed their capsules and outer membrane proteins. These findings raise the question of whether meningococci can be transferred from person to person via fomites contaminated with oropharyngeal secretions containing meningococci.

A trial of an experimental live influenza B vaccine has been described.

The virus it contained was active and produced infections, antibody rises and clinical reactions.

Second and third vaccinations had much less effect than the first. Resistance to revaccination was only partially reflected in the serological response.

It seems that another factor, probably local antibody, exerts a considerable influence on resistance to infection with influenza viruses.

We are greatly indebted to Dr P. G. Higgins of the Public Health Laboratory, Cirencester, who went to much trouble to provide us with specimens from patients with influenza; to Dr H. G. Pereira of the National Institute for Medical Research for the antigenic analysis of the vaccine virus; to Messrs Sankey Ltd., Bilston, Wolverhampton, for their unfailing courtesy and forbearance throughout the trial; to the volunteers for their enthusiastic co-operation in the face of some discom forts; and to Messrs Pfizer Ltd., Sandwich, for originally providing facilities for the preparation of the vaccine.

In particular we wish to record our gratitude for the invaluable technical help of Miss Pamela Ball of the Common Cold Research Unit, Mrs Maria Gregory of the Bacteriology Department of Liverpool University, Mrs L. Johnson of the Virus Laboratory of New Cross Hospital, Wolverhampton, and Mr A. Westoby, an assistant in the practice of Dr Tyler.

Norovirus (NoV) is a major cause of acute gastroenteritis (AGE). In this study, we investigated the genetic diversity of NoV strains identified in children under 5 years of age with AGE in four provinces of Angola. Faecal samples from 343 children were screened for NoV by an in house real-time PCR assay and genotyping was performed by partial capsid gene sequencing. NoV was detected in 17.4% (58/334) of the samples, with high detection rates in children <6 months old (19%) and in children aged 12–24 months (23%). Genotype diversity was large, as demonstrated by the 11 identified genotypes. GII.4 was the predominant genotype (20% of all NoV-positive samples), followed by GII.6 (15%), GI.3 (12%), GII.7 (10%) and by other genotypes to a lesser extent. Two GII.4 variants, New Orleans 2009 and Sydney 2012, were detected and several genetic clusters were observed for genotypes GI.3, GII.6 and GII.7. The present study shows high detection rates and genetic diversity of circulating NoV genotypes in paediatric AGE samples from Angola. This information emphasises the importance of continuous assessment of NoV burden and evolution in the target population.

Although rabies incidence in humans in Western Europe is low, the repeated importation of rabid animals from enzootic areas threatens the rabies-free status of terrestrial animals and challenges the public health systems in this area. Most rabid animals imported into the European Union (EU) in recent years came from Morocco. The aim of this study was to develop a probabilistic risk assessment model to estimate the probability of rabies introduction, which was applied to the risk to the EU from dogs coming from Morocco. The mean annual probability of rabies introduction was 0·21 (90% CI 0·02–0·65). The pathways that contributed the most to this probability were: (a) EU citizens who adopted a dog in Morocco (59% of the total probability) and (b) EU citizens who travelled with their dog to Morocco by ferry (34% of the total probability). The model showed a marked seasonality in the risk of rabies with almost 40% of the annual probability occurring during the months of July and August. The application of stricter border controls (assuming 100% compliance) would result in a >270-fold reduction in the likelihood of rabies introduction into the EU from Morocco.

Recently, two independent research teams reported evidence of infection with SARS-like coronaviruses in insectivorous horseshoe bats (genus Rhinolophus) in China [1, 2]. SARS emerged in China in 2002, and eventually infected over 8000 people around the world, killing about 10% of them. Early epidemiological studies suggested that the human disease may have originated in Chinese live-animal food markets, and the hunt for a source of the virus quickly identified apparently healthy Himalayan palm civets (Paguma larvata) as prime suspects [3]. Other studies, however, failed to find any evidence of widespread infection in civets [4] or a variety of other animals traditionally used as food in China. Rather, palm civets, like human beings, seem to be only accidental hosts of the virus, becoming infected, again like people, when mixed with other species in markets. More structured hunts for the reservoir continued, although not before thousands of palm civets had been slaughtered.

The faecal survival of Salmonella typhimurium orally administered to restrained American cockroaches maintained on an antibiotic diet was investigated. Significant reductions in median numbers of total aerobic faecal microorganisms were noted in insects fed antibiotics daily, and when Salmonella was introduced to this modified micro-environment, it persisted for 44 days in all specimens. Multiplication of the pathogen was also observed in these insects, with numbers often exceeding 103 times that of the initial input. This differs significantly from our previous results showing that the pathogen is unable to multiply in conventional cockroaches. Attempts to restore the normal flora by feeding a faecal suspension from untreated cockroaches resulted in a decrease in numbers of Salmonella excreted, but did not result in their elimination. Carcasses of infected cockroaches retained viable Salmonella for at least 60 days post mortem, or 104 days after the infective meal.

Between March and June 2008, 12 cases of hepatitis A were notified in Winchester. Cases were from a primary school and a nursery school with no direct linkage. Hepatitis A virus (HAV) RNA sequenced from nine cases confirmed the strain in both schools to be identical. The outbreak could have affected three other schools and a maternity unit and was controlled by immunization and screening of neonates in the maternity unit by dried blood spots. No neonates were infected and no further cases were reported until 5 months later when the index case's mother became infected with same strain of virus associated with the outbreak despite vaccination. Neither the source of the outbreak or the subsequent infection of the index case's mother was identified; however, with the timing of the cases continued transmission in the community by children with asymptomatic infection or a recurrent source cannot be ruled out.

Plasmid analysis of Salmonella enteritidis isolates from human gastroenteritis cases and from two commercial egg-producing poultry flocks was performed to determine if the poultry flocks were the source of the human infections. The plasmid profile and restriction fragment pattern (fingerprint) of five S. enteritidis isolates from human cases matched those of nine isolates from internal organs of egg-laying hens in one flock which was the source of eggs consumed by the cases. Another commercial flock was epidemiologically associated as the source of eggs consumed by affected persons in four separate gastroenteritis outbreaks from which S. enteritidis isolates were available. Five S. enteritidis isolates from human cases in these four outbreaks had the same profile and fingerprint, and they all matched those of the 24 isolates from hens in this flock. These results provide further documentation of egg-borne transmission of S. enteritidis to humans.

The unexpected appearance of fatal encephalitis in six elderly people living in New York in 1999, heralded the re-birth of arbovirology in the United States of America. The subsequent rapid spread through North America and impact of the disease on humans, birds, horses and a wide range of other species including alligators and frogs, has brought West Nile virus (WNV) to the attention of governments and the media, worldwide. The response of the public in the United Kingdom has not been hysterical, despite being fuelled by press reports that scientists have demonstrated the presence of WNV antibodies in birds in the UK. Nevertheless, concern has been expressed by government bodies either directly or indirectly connected with the potential health problems that could arise if WNV was introduced and caused the same degree of morbidity and mortality as that seen in the USA. Is the concern justified and are we likely to see significant health problems associated with WNV if this virus is confirmed to be present and circulating amongst birds in the UK? In this review I shall try to put the virus in its true context and assess the risks that WNV might pose both to animals and humans in the United Kingdom.

A cross-sectional study into risk factors for Salmonella was undertaken using data gathered from 252 fattening turkey flocks in the UK. The data was derived from the EU baseline survey conducted during 2006 and 2007, in addition to a voluntary questionnaire. Multivariate logistic regression models identified significant risk factors for Salmonella spp. and Salmonella Typhimurium. A decreased risk of Salmonella spp. infection was associated with a history of intestinal illness in the sampled flock (OR 0·17), the use of wood shavings as litter (OR 0·21), use of disinfectant in the cleaning process (OR 0·25), incineration of dead birds on farm (OR 0·29), seasonal production (OR 0·31), farm staff also working with cattle (OR 0·31), and the presence of pigs on neighbouring farms (OR 0·38). The risk of isolating Salmonella spp. varied according to the company from which the poults were sourced. A reduced risk of S. Typhimurium infection was associated with the use of wax blocks to control rodents (OR 0·09), using mains water (OR 0·19) and having a Salmonella test programme (OR 0·23). An increased risk of S. Typhimurium infection was associated with storage of items around the turkey house (OR 5·20), evidence of mice (OR 4·71) and a soil surface surrounding the turkey house (OR 2·70). This study therefore identifies a number of important practical measures which can be implemented by farmers and veterinarians within the turkey industry to assist in the control of salmonellosis at the farm level.

The clinical impact of antimicrobial resistance on the outcome of pneumococcal bacteraemia has remained unclear. This study aimed to evaluate risk factors for mortality and determine the impact of antimicrobial resistance on clinical outcomes. A total of 150 adult patients with pneumococcal bacteraemia were identified over a period of 11 years at Seoul National University Hospital. Of the 150 patients, 122 (81·3%) had penicillin-susceptible (Pen-S) strains and 28 (18·7%) penicillin-non-susceptible (Pen-NS) strains; 43 (28·7%) had erythromycin-susceptible (EM-S) strains and 107 (71·3%) erythromycin-non-susceptible (EM-NS) strains. On multivariate analysis, elevated APACHE II score [odds ratio (OR) 1·24, 95% confidence interval (CI) 1·14–1·34, P<0·001) and presence of solid organ tumour (OR 2·99, 95% CI 1·15–7·80, P=0·025) were independent risk factors for mortality. Neither erythromycin resistance nor penicillin resistance had a significant effect on clinical outcomes. However, for the 76 patients with pneumococcal pneumonia, the time required for defervescence was significantly longer in the EM-NS group than in the EM-S group (5·45±4·39 vs. 2·93±2·56, P=0·03 by log rank test). In conclusion, antimicrobial resistance does not have an effect on mortality in adult patients with pneumococcal bacteraemia.

One hundred and eighty–one stool specimens from patients with various types of diarrhoea (135 patients) or from non-diarrhoeal controls (23 acute medical patients, 23 inflammatory bowel disease in remission) were investigated using a colony–blot DNA hybridization assay for the presence of Verocytotoxin–producing (VTEC), enteroaggregative (EAggEC) and diffusely adherent (DAEC) Escherichia coli. Twelve patients had probe–positive EAggEC in the stool and 8 of these had diarrhoea, 6 following recent travel. Eight patients had DAEC, 7 of whom had travellers diarrhoea. Six of 10 (60%) travellers with gastroenteritis, but without a recognized enteric pathogen, were positive for EAggEC (4) or DAEC (2). Five of 10 (50%) travellers with gastroenteritis related to a recognized enteric pathogen also had DAEC identified in their stool. Of the 23 acute medical control patients 11 had been abroad, 4 of these were immigrants and had EAggEC. VTEC were not found and, with one exception, immunoassays for antibodies to E. coli O 157 and O 2 lipopolysaccharides were negative.

In a 1-year survey at a university hospital we found that 20·6% (81/392) of patients with antibiotic associated diarrohea where positive for C. difficile. The most common PCR ribotypes were 012 (14·8%), 027 (12·3%), 046 (12·3%) and 014/020 (9·9). The incidence rate was 2·6 cases of C. difficile infection for every 1000 outpatients.

The burden of pneumococcal carriage is largest in developing countries from which, however, detailed studies on pneumococcal transmission are missing. In this study we followed nasopharyngeal carriage in Bangladeshi infants (n=99) from birth, with 2-week sampling intervals until age 4 months, and monthly thereafter until age 1 year, and also their family members at the same intervals. We assessed the dependence of pneumococcal acquisition rates on age, serotype, serotype-specific exposure (i.e. transmission) and current state of carriage (yes/no). A statistical model of pneumococcal transmission, taking into account incompletely observed data, was applied to estimate rates of acquisition and clearance for a large number of serotypes at the same time. Serotypes that were common in the study population were more often acquired from the community than rarer serotypes. However, when conditioning on serotype-specific exposure within the family, transmission rates were similar between different serotypes. Exposure within families signified more than tenfold increase in the rate of acquisition.