Bluetongue (BT) is a disease of ruminants caused by bluetongue virus (BTV), which is spread between its hosts by Culicoides midges. Vaccination is the most effective way to protect susceptible animals against BTV and was used reactively to control the recent northern European outbreak. To assess the consequences of using vaccination pre-emptively we used a stochastic, spatially explicit model to compare reactive and pre-emptive vaccination strategies against an incursion of BTV serotype 1 (BTV-1) into Great Britain. Both pre-emptive and reactive vaccination significantly reduced the number of affected farms and limited host morbidity and mortality. In addition, vaccinating prior to the introduction of disease reduced the probability of an outbreak occurring. Of the strategies simulated, widespread reactive vaccination resulted in the lowest levels of morbidity. The predicted effects of vaccination were found to be sensitive to vaccine efficacy but not to the choice of transmission kernel.

Faecal specimens collected from 2101 patients with acute gastroenteritis from three cities (Pune, Alappuzha, Belgaum) in India during 1994–1995 and 2004–2010 were tested for group B rotavirus (RVB) by amplification of the NSP2 gene using RT–PCR. Seventy-five (3·6%) specimens were shown to contain RVB RNA. The positivity rate in Pune, Alappuzha and Belgaum was 4·1%, 7·3% and 4·1%, respectively, in the 2000s which was not significantly different from the detection rate in the 1990s in Pune (2·5%, P>0·05). RVB infections prevailed in adolescents and adults (62/1082, 5·7%) compared to children (13/1019, 1·3%, P<0·001) and were detected throughout the year. Phylogenetically, all strains clustered in an NSP2 lineage together with Indian-Bangladeshi RVB strains belonging to VP7 genotype G2. The study confirmed the occurrence of RVB infections in western India and reported for the first time circulation of RVB strains in southern India, suggesting that an increased awareness and monitoring for RVB infections is necessary in India.

The value of Google Flu Trends (GFT) remains unclear after it overestimated the proportion of physician visits related to influenza-like illness (ILI) in the United States in 2012–2013. However, GFT estimates (%GFT) have not been examined nationally in Canada nor compared with positivity for respiratory viruses other than influenza. For 2010–2014, we compared %GFT for Canada to Public Health Agency of Canada ILI consultation rates (%PHAC) and to positivity for influenza A and B, respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and rhinoviruses. %GFT correlated well with %PHAC (ρ = 0·77–0·90) and influenza A positivity (ρ = 0·64–0·96) and overestimated the 2012–2013 %PHAC peak by 0·99 percentage points. %GFT peaks corresponded temporally with peaks in positivity for influenza A and rhinoviruses (all seasons) and RSV and hMPV when their peaks preceded influenza peaks. In Canada, %GFT represented traditional surveillance data and corresponded temporally with patterns in circulating respiratory viruses.

The emergence of Vibrio cholerae O139 in 1992 and reports of an increasing number of other non-O1 serogroups being associated with diarrhoea, stimulated us to characterize V. cholerae non-O1 non-O139 strains received at the National Institute of Infectious Diseases, Japan for serotyping. Ribotyping with the restriction enzyme BglI of 103 epidemiological unrelated mainly clinical strains representing 10 O-serotypes yielded 67 different typing patterns. Ribotype similarity within each serotype was compared by using the Dice coefficient (Sd) and different levels of homogeneity were observed (serotypes O5, O41 and O17, Sd between 82 and 90%; serotypes O13 and O141 Sd of 72; and O2, O6, O7, O11, O24 Sd of 62–66%). By cluster analysis, the strains were divided into several clusters of low similarity suggesting a high level of genetic diversity. A low degree of similarity between serotypes and ribotypes was found as strains within a specific serotypes often did not cluster but clustered with strains from other serotypes. However, epidemiological unrelated O5 strains showed identical or closely related ribotypes suggesting that these strains have undergone few genetic changes and may correspond to a clonal line. Surprisingly, 10 of 16 O141 strains studied contained a cholera toxin (CT) gene, including 7 strains recovered from stool and water samples in the United States. This is to our knowledge the first report of CT-positive clinical O141 strains. The closely related ribotypes shown by eight CT-positive strains is disturbing and suggest that these strains may be of a clonal origin and have the potential to cause cholera-like disease. Despite the low degree of correlation found between ribotypes and serotypes, both methods appears to be valuable techniques in studying the epidemiology of emerging serotypes of V. cholerae.

Over the recent years, potential associations between Toxoplasma gondii (T. gondii) infection and cancer risk have attracted a lot of attention. Nevertheless, the association between T. gondii infection and oral cancer remains relatively unexplored. We performed a case–control study of 861 oral cancer patients and 861 control subjects from eastern China with the aim to detect antibodies to T. gondii by enzyme-linked immunosorbent assay (ELISA) in these patients. The results showed that oral cancer patients (21.72%, 187/861) had a significantly higher seroprevalence than control subjects (8.25%, 71/861) (P < 0.001). Among them, 144 (16.72%) oral cancer patients and 71 (8.25%) control subjects were positive for IgG antibodies to T. gondii, while 54 (6.27%) oral cancer patients and 9 (1.05%) controls were positive for IgM antibodies to T. gondii. In addition, multiple logistic analysis showed that T. gondii infection in oral cancer patients was associated with blood transfusion history, keeping cats at home, and oyster consumption. To our knowledge, this is the first study that provided a serological evidence of an association between T. gondii infection and oral cancer patients. However, further studies are necessary to elucidate the role of T. gondii in oral cancer patients.

This study aimed to assess and compare the epidemiology of faecal carriage of extended spectrum β-lactamase-producing enterobacteria (ESBL-E) in Hepatology departments of two hospitals specializing in liver diseases, Theodor Bilharz Research Institute (TBRI) in Cairo (Egypt) and Beaujon Hospital (Bj) in Clichy (France). CTX-M groups were identified by PCR, and TEM and SHV derivatives with the check-point system. Phylogenetic groups of E. coli were determined by multiplex PCR, and clone ST131 by PCR of gene pabB. Prevalence of ESBL-E was 77·6% (45/58) in TBRI and 6·5% (13/199) in Bj (P < 10−7). Previous hospitalization was more common (P = 0·003) in Bj patients (93%) than in TBRI patients (45%) suggesting high prevalence of ESBL-E in the Egyptian community. The presence of E. coli B2 ST131 among ESBL-E faecal E. coli in Egypt confirms its pervasiveness in the community and raises concern regarding this highly virulent and resistant clone.

1. An examination by bacteriological methods has been made of the antigens present in the washed bacilli of smooth Shiga strains and certain derived variants, including the rough type.

2. The washed formol-killed smooth bacilli kill mice only in massive doses of the order of 5000 millions, suggesting death from protein shock; no protection against a fatal issue is afforded by antibacterial sera. This finding is discussed in relation to recently acquired information obtained by chemical methods on the occurrence of a specific enterotropic toxin in the smooth bacilli, as distinct from the enterotropic toxin present together with a neurotoxin in autolysates of smooth and rough bacilli.

3. Antibacterial sera prepared by immunization with the smooth antigen have high protective value against infection with the living smooth bacilli but not against pure toxin, whereas purely antitoxic sera have no value against infection with the living smooth bacilli.

4. From experiments so far performed, protection against infection with the living rough bacilli has been afforded only by sera prepared from formol-killed rough bacilli and from acetone-killed rough bacilli.

5. From findings reported in (3) inferences are drawn with regard to improvements in the manufacture of dysentery serum for use in man, both prophylactically and therapeutically.

6. The presence of two distinct antigens in the Shiga bacillus has been clearly demonstrated, since the protective values of their corresponding antisera are sharply defined, and do not overlap. The existence of the neurotoxin as a separate entity, unrelated to the smooth ‘endotoxin’, has also been shown by its derivation from a completely ‘rough’ strain, but though the smooth somatic antigen gives rise to a highly protective antiserum, in these experiments it has not been shown, per se, to be a specific toxin.

The writer wishes to thank Sir John. Ledingham and Dr G. F. Petrie for their advice and criticism during this work, and Dr D. W. Henderson, by whom the experiments were first suggested.

Results from clinical isolations confirmed that mercury resistance is common among antibiotic-resistant strains of Staphylococcus aureus present in a large general hospital although the correlation is not as high as that found by Moore (1960).

The distribution of mercury-resistant strains among infections and carriers in surgical, medical, obstetric and geriatric patients and staff was studied. Attention was directed to the distribution among carriers since there are fewer extraneous factors operating among them, and a statistical analysis was made on the total number of mercury-resistant strains and the number of non-endemic strains; this latter figure was obtained by subtracting the dominant type 80/81, which is nearly always mercury-resistant and antibiotic-resistant, from the total. Analysis showed the geriatric patients to have a significantly higher proportion of mercury-resistant strains in both cases, and obstetric patients to have a significantly lower proportion when the total number of mercury-resistant strains was considered. Among the surgical, medical and staff categories, no significant difference in proportions could be found although a trend, in that order, of decreasing proportions of mercury-resistant strains present was noted.

In those cases infected on admission with tetracycline-resistant strains, although mercury-resistant strains still predominate, mercury-sensitive strains make a sizeable contribution. This is a reflexion of their dominance in the non-hospital environment.

The incidence of antibiotic resistant strains of Sh. sonnei isolated in the London area is described. Strains were tested for their ability to transfer resistance to Most strains were resistant to sulphonamide and this resistance was transferable.

An increasing proportion of strains was resistant to 800 µg./ml. of streptomycin, but transferable streptomycin resistance was less common and often associated with tetracycline resistance.

The proportion of strains resistant to tetracycline fluctuated but this resistance was always transferred.

Ampicillin resistance was common; only those strains resistant to 500µg./ml. transferred this resistance.

Resistance to other antibiotics was very rare.

In New Zealand Campylobacter infection rates have increased steadily since 1980, reaching a peak in 2003 (396/100 000 population). Compared to other nations, disease rates are unfavourably high (e.g. Australia 117/100 000 population, UK 85/100 000 population, USA 13/100 000 population). This ecological study investigated spatial variations in Campylobacter infection rates across New Zealand's Territorial Local Authorities (TLAs, n=73) for the period 1997–2005. Applying multiple linear regression, we examined whether geographical factors such as socio-demographic characteristics, climate, land use, water and the food environment were associated with local differences in the occurrence of Campylobacter infection rates. The results suggested significant variations in campylobacteriosis across TLAs (average annual rates ranging from 97 to 526/100 000 population), with higher rates in the South Island. Disease rates were associated with lower socio-economic deprivation (P<0·01), the proportion of the population aged 25–44 years (P<0·01) and fresh food outlet density (P<0·76). The results underline the role of area-level characteristics in explaining the spatial distribution of campylobacteriosis in New Zealand. In particular, the findings draw attention to the relatively unexplored role of fresh food outlets as a potential risk factor for increased Campylobacter notifications.

Limited studies exist regarding whether incorporating micronutrient supplements during tuberculosis (TB) treatment may improve cell-mediated immune response. We examined the effect of micronutrient supplementation on lymphocyte proliferation response to mycobacteria or T-cell mitogens in a randomized trial conducted on 423 patients with pulmonary TB. Eligible participants were randomly assigned to receive a daily dose of micronutrients (vitamins A, B-complex, C, E, and selenium) or placebo at the time of initiation of TB treatment. We found no overall effect of micronutrient supplements on lymphocyte proliferative responses to phytohaemagglutinin or purified protein derivatives in HIV-negative and HIV-positive TB patients. Of HIV-negative TB patients, the micronutrient group tended to show higher proliferative responses to concanavalin A than the placebo group, although the clinical relevance of this finding is not readily notable. The role of nutritional intervention in this vulnerable population remains an important area of future research.

The labile Vi antigens of Salmonella typhi, Salm. paratyphi A and B, and of Salm. typhi-murium were compared, especially in their response to various chemical and physical agents.

1. Inactivation by dilute acid:

(a) The TVi antigen is the most resistant to acid treatment, the BVi antigen is most readily inactivated and the AVi antigen holds an intermediate position.

(b) Pure Vi sera may be obtained by absorption with acid-treated bacilli, but this technique gives irregular results.

(c) Contrary to Kauffmann's statements, the TVi antigen is not ‘destroyed’ by acid treatment.

2. Inactivation by dilute alkali:

(a) All the Vi antigens so far tested are susceptible to dilute alkali.

(b) Complete inactivation, or extraction, of the Vi antigens is ensured when the yield of alkali-treated bacteria represents no more than 25% of the original bacterial count.

(c) The most reliable method of preparing a pure Vi serum is by absorption of the Vi + O serum with alkali-treated organisms of the same strain as that employed in immunization.

(d) Immunization with alkali-treated bacilli results in the elaboration of pure 0 antisera entirely devoid of Vi antibody.

3. Inactivation by heat (in aqueous suspensions):

(a) The TVi antigen is the one most readily inactivated, the BVi antigen is the one most resistant and the AVi antigen holds an intermediate position.

(b) These differences are only of minor significance, since similar differences have been established for the TVi antigen itself when it is contained in the two varieties of Vi strain of Salm. typhi.

4. Treatment with alcohol:

(a) Most of the properties of the three Salmonella Vi antigens remain unimpaired by alcohol treatment.

(b) The physico-chemical behaviour of alcohol-treated or heated bacilli, as exemplified by agglutinability by pure Vi antiserum, depends on the presence of other constituents of the bacterial cell.

5. Treatment with formalin:

(a) The Vi agglutinability of the different Salmonella is preserved undamaged for long periods of time. The 0 inagglutinability of Salm. typhi is also well maintained.

(b) It is not yet known whether formolized AVi and BVi antigens undergo an alteration that leads to ‘functional deficiency’ of the corresponding antibody similar to that of the altered T Vi antibody.

6. Treatment with phenol produces a reversible inactivation of the agglutinogenic activity of the T Vi antigen but not of the A Vi and B Vi antigens.

7. The inadequacy of the symbols employed by Kauffmann for expressing the changed reactivity of differently treated antigens is emphasized.

Mortality from influenza and pneumonia during the 1918–1919 pandemic was compared between subgroups of civilian and military populations from states in Australia and the USA. Exposures to crowded environments before and during the pandemic were used as proxies for exposure to respiratory infections. In three separate datasets, civilian mortality from influenza and pneumonia was higher in urban than rural populations. In contrast soldiers from these same urban backgrounds had significantly lower mortality than their rural counterparts. This suggests the lower mortality in rural civilians was due to the rural environment, probably due to the relative social isolation in rural areas. This is encouraging for pandemic planning, as it suggests social distancing interventions have the potential to reduce mortality in future pandemics. Soldiers recruited before 1918 had significantly lower mortality than those recruited in 1918, and this effect was separate from the protection given by urban origin to soldiers. Both these effects substantially reduced mortality in soldiers. Further research to identify the mechanisms of these separate protective effects may yield important evidence to inform pandemic planning strategies.

Amongst 1267 healthy children 6 months to 4.5 years of age in Adelaide, the pneumococcal carriage rate from a single nasal swab sampling was 29% in the period 1980–1. Of 269 children, sampled monthly on five occasions, 91% carried a pneumococcus on one or more occasions: 55% carried a single type, 33% carried two types, 2% carried three types and 1% carried four types; 18% carried a pneumococcus on either 4 or 5 occasions. The commonest types encountered were types 6, 19 and 23 in that order, and these three types constituted 57% of the total: other common types(> 5% of the total) were types 14, 15 and 11, and the six commonest types constituted 77% of the total. Of these, types 6, 14, 19 and 23 commonly cause systemic disease in children; on the other hand types 11 and 15 cause disease infrequently. The number of strains showing antimicrobial drug resistance was low: on quantitative testing 0.7%of 291 isolates examined showed relative resistance to benzylpenicillin and 0.7% were resistant to tetracycline; 10.9% of 230 isolates examined showed resistance to co-trimoxazole; dual or multiple drug resistance was not detected, and all isolates tested were susceptible to chloramphenicol, erythromycin, lincomycin and rifampicin.

Partial nucleotide sequence at the 3′ end of 1D (VP1-encoding) gene of 90 foot-and-mouth disease virus type O isolates recovered from field outbreaks in India between 1993–9 were determined. The sequences were compared with each other and reference viruses. The published sequences of 15 type O isolates recovered from different parts of Asia and one isolate (O1BFS) from Europe and one from Egypt (O1/Sharquia/Egypt/72) were also included in the analysis for comparison. On the basis of phylogenetic analysis the viruses could be grouped into four distinct genotypes (genotypes I–IV). All 90 isolates from India were genotype-I, as were the reference isolates from Bangladesh, China, Egypt, Iran, Saudi Arabia, Syria and Turkey. Genotype-I isolates were further subdivided into 16 sub-genotypes. The Indian isolates were found to be extremely heterogeneous in nature and clustered into 12 different genetic groups. In genotype-I, the nucleotide sequence difference seen between the isolates was 0–11·6%, while among the Indian isolates it is 0–8·8%. Viruses of similar genetic groups are circulating in India, Bangladesh and countries of the Middle East. Genotype-II and -III are represented by isolates from Lebanon (O1/South Lebanon) and Europe (O1-BFS), respectively. Genotype-IV is formed by isolates from China, Hong Kong and Taiwan. The present study reveals the occurrence of viruses belonging to multiple genetic groups over a short period of time and persistence of single genetic group in the same geographical area over several years. This is consistent with the endemic nature of the disease in the country.

Summarising our results, and considering their probable significance, we should draw the following conclusions.

Our observations do not suggest that the dissemination of a bacteriophage is likely to have been the cause of the sudden decrease in the excretion rate of B. aertrycke, which was observed among the population at risk during the epidemic previously recorded (Topley, Ayrton and Lewis, 1924).

Our results are completely at variance with those recorded by d'Herelle in the case of fowl typhoid, a disease which shows many points of similarity to enteric infection in mice. The observations we have recorded do not suggest that the presence of the bacteriophage will, in itself, prevent the epidemic spread of infection, check an epidemic when it has once started, or appreciably reduce the mortality among the population at risk. In the light of these results we cannot share d'Herelle's optimism as to the probable results of the wholesale administration of the lytic principle in a public water supply. We do not suggest that the Twort-d'Herelle phenomenon has no significance in the epidemic spread of disease, but it does not appear to us that the problem is the simple and straightforward one envisaged by d'Herelle.

The results of the last experiment of this series are in substantial agreement with d'Herelle's experiments on barbone in cattle, so far as they concern the action of the lytic filtrate in causing an immunising response, though we have not obtained such strikingly uniform and satisfactory results.

We would note, in conclusion, that we have not yet tested the effect of the administration of the lytic principle, by injection, during the course of an experimental epidemic.

A simple solid-phase enzyme immunoassay is described for the detection of antibody classes showing activity against foot-and-mouth disease (FMD) virus in bovine sera. The assay achieves a preliminary separation of the specific class of antibody from other serum proteins through immuno-adsorption to class-specific immunoglobulin-coated wells of micro-titre plates. The specific antibody is reacted with FMD virus, which is then detected by an enzyme-labelled anti virus IgG.

Twenty-two gentamicin-resistant urinary isolates of Escherichia coli and five gentamicin-resistant urinary isolates of Klebsiella pneumoniae from a Dublin hospital were examined for resistance to the veterinary aminoglycoside antibiotic apramycin. Five isolates of E. coli and one isolate of K. pneumoniae were found to be resistant. The apramycin-resistant isolates, which were also resistant to the veterinary anthelmintic agent hygromycin B, hybridized with a DNA probe for the gene encoding the enzyme 3-N-aminoglycoside acetyltransferase type IV (AAC(3)IV). Resistance to apramycin and hygromycin B was co-transferable in four of the five isolates of E. coli and the isolate of K. pneumoniae. In one isolate of E. coli apramycin resistance was not transferable. On the basis of their restriction enzyme digestion profiles and the antimicrobial resistance traits encoded, the transferable plasmids encoding resistance to apramycin and hygromycin B comprised three distinct types. Genetic linkage between the gene encoding AAC(3)IV and genes encoding resistance to ampicillin and either tetracycline or trimethoprim, means that the relatively widespread use of these antimicrobial agents provides a selective pressure for the persistence of resistance to apramycin and gentamicin even in the absence of bacterial exposure to aminoglycosides.

1. The more recent literature on the experimental methods employed in variola or alastrim-vaccinia variation is reviewed and briefly discussed.

2. An account is given of attempts to produce a vaccinia variant from variola of the virulent type and a successful result, by employing the method of intratesticular passage, has been described.

3. The reasons for accepting this as a genuine variation and not a vaccinial contamination are discussed.

4. An attempt has been made to analyse some possible factors underlying the discrepancies in the literature, and a plea is made for more co-operation in future work on the subject.

In the near future, the inactivated enterovirus 71 (EV71) vaccine is expected to become available on the market in China. Since EV71 is a major cause of hand, foot and mouth disease (HFMD), the vaccine is expected to significantly reduce the number of cases, as well as the detrimental economic effect of the disease. However, for a national vaccination strategy to be developed, policy-makers need more information on the socioeconomic burden of EV71 HFMD infection. Based on the 2011 population data, we estimated the clinical and economic effect of EV71 HFMD infection in children aged 0–9 years in Shanghai, China. The annual cost related to HFMD is >US$7.66 million for a population of 1·42 million children aged 0–9 years with an average cost of US$208.2/case. The extrapolated cost for EV71 HFMD infection was US$3.53 million, comprising 46·1% of the overall cost associated with HFMD. Around 97% of all of the HFMD-related expenses were paid for by the families creating a considerable economic burden. Our findings could provide the necessary recommendations on the most effective national EV71 vaccine implementation, as well as a baseline data for assessing the cost-effectiveness of the vaccine in China.