There is limited information on percent expenditure of household income due to childhood diarrhoea especially in rural Bangladesh. A total of 4205 children aged <5 years with acute diarrhoea were studied. Percent expenditure was calculated as total expenditure for the diarrhoeal episode divided by monthly family income, multiplied by 100. Overall median percent expenditure was 3·04 (range 0·01–94·35). For Vibrio cholerae it was 6·42 (range 0·52–82·85), for enterotoxigenic Escherichia coli 3·10 (range 0·22–91·87), for Shigella 3·17 (range 0·06–77·80), and for rotavirus 3·08 (range 0·06–48·00). In a multinomial logistic regression model, for the upper tertile of percent expenditure, significant higher odds were found for male sex, travelling a longer distance to reach hospital (⩾median of 4 miles), seeking care elsewhere before attending hospital, vomiting, higher frequency of purging (⩾10 times/day), some or severe dehydration and stunting. V. cholerae was the highest and rotavirus was the least responsible pathogen for percent expenditure of household income due to childhood diarrhoea.

A total of 241 group A rotavirus-positive stool samples collected from diarrhoeic patients in Thailand between July 1988 and June 1991 were characterized for their serotypes by enzyme-linked immunosorbent assay (ELISA) using serotype-specific monoclonal antibodies and by a polymerase chain reaction (PCR). In July 1988–June 1989, serotype 1 was the most prevalent (63·4%), followed by serotype 4 (11·0%) and serotype 2 (8·5%). In July 1989–June 1990, 59·8% were serotype 1, 24·3% were serotype 2, and 6·1 % were serotype 3. In contrast, in July 1990–June 1991, serotype 3 was detected in the highest frequency (40·5%), 29·9% were serotype 1, and 27·3% were serotype 2. Thus, a distinct yearly change of serotype distribution of rotavirus in Thailand was observed in the three consecutive years. In particular, it was of note that the prevalence of serotype 3 greatly increased, in contrast to the previous studies in which almost no serotype 3 rotaviruses were detected in the years 1983–8 in Thailand.

The response of Meriones shawi to seven rodenticides was investigated in laboratory feeding tests. The species proved to be much less susceptible to anticoagulants than most other species of rodent pests. Brodifacoum (at 0·005%), although giving complete mortality after only 8 days' continuous feeding, was more toxic than warfarin (0·025%), coumatetralyl (0·0375%), difenacoum (0·005%) and bromadiolone (0·005%). Calciferol (0·1%), though toxic, was significantly unpalatable. Zinc phosphide (5·0%) presented for 2 days in a choice test against unpoisoned food gave 80% mortality and appears to be the most suitable of these compounds for the control of M. shawi in the field.

Ever since the World Health Organization (WHO) declared the new coronavirus disease 2019 (COVID-19) as a pandemic, there has been a public health debate concerning medical resources and supplies including hospital beds, intensive care units (ICU), ventilators and protective personal equipment (PPE). Forecasting COVID-19 dissemination has played a key role in informing healthcare professionals and governments on how to manage overburdened healthcare systems. However, forecasting during the pandemic remained challenging and sometimes highly controversial. Here, we highlight this challenge by performing a comparative evaluation for the estimations obtained from three COVID-19 surge calculators under different social distancing approaches, taking Lebanon as a case study. Despite discrepancies in estimations, the three surge calculators used herein agree that there will be a relative shortage in the capacity of medical resources and a significant surge in PPE demand if the social distancing policy is removed. Our results underscore the importance of implementing containment interventions including social distancing in alleviating the demand for medical care during the COVID-19 pandemic in the absence of any medication or vaccine. The paper also highlights the value of employing several models in surge planning.

Suriname is ranked as high-risk country for cervical cancer, but recent national data of HPV prevalence and distribution in cervical cancer is scarce. In a retrospective cross-sectional study, cervical cancer incidence, HPV prevalence and HPV-type-specific distribution were investigated in all cervical cancer cases (n = 111), diagnosed in two consecutive years. HPV presence and type-specific prevalence were determined in paraffin-embedded biopsies utilizing master-nested multiplex PCR assays, targeting 14 HPV types. The age-standardized incidence rate of cervical cancer was 22·4/100 000 women, justifying revision of the current international ranking of Suriname. Eleven HPV types were detected, with the most common types in descending order of frequency: 16, 18, 45, 66, 58/52/35. HPV16 was predominant, although with markedly low presence (25%). HPV16 or 18 infections were detected in 43% of the cases, while 28% were untyped, implicating a divergent HPV-type distribution in Suriname with significant variation in the prevalence of less common high-risk virus types and/or presence of HPV16 variants. HPV-type distribution differed between ethnic groups. A vaccination efficacy of just 28–30% was anticipated, next to an uneven vaccination impact in different ethnic groups, cautioning Suriname and other multi-ethnic countries to tailor the information presented to different ethnic communities.

Surveys of arbovirus activity in Fiji were conducted over a 10-year period from December 1959 to December 1969. No arboviruses were isolated from over 200,000 mosquitoes, 9000 ticks, or 575 serum samples. Eight thousand human and 1117 bird, bat and animal sera were tested for haemagglutination-inhibiting arbovirus antibody using a variety of group A, group B and Bunyamwera group antigens. Only a small number of low-titre reactions were found among the non-human sera, but 14% of all human sera were found to contain Group B antibody. The antibody prevalence increased with increasing age, from less than 1 % for persons born since 1950, to 70% for persons born before 1900. The age differences in prevalence could be used to estimate the time and size of previous epidemics. Differences were found in antibody prevalence between the sexes, between ethnic groups and between persons from different regions. These differences could be explained in terms of climate, location and custom.

Historical and serological evidence both suggest that all the antibody detected was due to past exposure to dengue virus. The very high proportion of the population with no dengue antibody makes Fiji a high-risk area for a further dengue epidemic. Dengue virus is known to be active in the Pacific and South-East Asia.

We observed an outbreak of Q fever in a prison population. Overall, 65 of the 600 prison inmates developed the disease. The location of the prison cells had no apparent effect on the risk of infection. The outbreak was probably due to exposure to dust contaminated by a passing flock of sheep, which at the time of the outbreak was engaged in lambing. These findings highlight the possible emergence of Q fever in settings and populations not normally thought of as being at risk of exposure to the infection.

Recently, a changing pattern of hepatitis A epidemiology has been reported in the Indian population indicating a rise in the rate of hepatitis A infection among adults. The study's objective was to assess anti-HAV prevalence in voluntary blood donors from middle and high socioeconomic strata. Serum samples collected from voluntary blood donors from Pune city and its suburbs in the years 2002 and 2004–2005 were tested for anti-HAV IgG antibodies. Serum samples collected during 2004–2005 were examined for anti-HAV IgM antibodies. Positive samples were tested for HAV-RNA. Agewise anti-HAV positivity was significantly low in adults aged 18–25 years (90·4%) compared to those aged >25 years (97·4%) (P<0·01). A decline in anti-HAV prevalence was significant in 2004–2005 compared to that in 2002 (96·5% vs. 92·1%) (P<0·01). Overall, in both adult age groups, the proportion of anti-HAV positivity was remarkably low in the high socioeconomic group (HSG) (88·96%) compared to that of the middle socioeconomic group (MSG) (95·86%) (P<0·01). Anti-HAV IgM positivity was not significant (~1%), however, presence of HAV-RNA in one of the samples indicated the possibility of horizontal transmission of HAV. Increase in seronegativity to HAV in HSG implicates a rise in the susceptible pool and indicates the need for vaccination against hepatitis A.

The objective of our analysis was to describe the aetiology, clinical features, and socio-demographic background of adults with diarrhoea attending different urban and rural diarrhoeal disease hospitals in Bangladesh. Between January 2010 and December 2011, a total of 5054 adult diarrhoeal patients aged ⩾20 years were enrolled into the Diarrhoeal Disease Surveillance Systems at four different hospitals (two rural and two urban) of Bangladesh. Middle-aged [adjusted odds ratio (aOR) 0·28, 95% confidence interval (CI) 0·23–0·35, P < 0·001] and elderly (aOR 0·15, 95% CI 0·11–0·20, P < 0·001) patients were more likely to present to rural diarrhoeal disease facilities than urban ones. Vibrio cholerae was the most commonly isolated pathogen (16%) of the four pathogens tested followed by rotavirus (5%), enterotoxigenic Escherichia coli (ETEC) (4%), and Shigella (4%). Of these pathogens, V. cholerae (19% vs. 11%, P < 0·001), ETEC (9% vs. 4%, P < 0·001), and rotavirus (5% vs. 3%, P = 0·013) were more commonly detected from patients presenting to urban hospitals than rural hospitals, but Shigella was more frequently isolated from patients presenting to rural hospitals than urban hospitals (7% vs. 2%, P < 0·001). The isolation rate of Shigella was higher in the elderly than in younger adults (8% vs. 3%, P < 0·001). Some or severe dehydration was higher in urban adults than rural adults (P < 0·001). Our findings indicate that despite economic and other progress made, conditions facilitating transmission of V. cholerae and Shigella prevail in adults with diarrhoea in Bangladesh and further efforts are needed to control these infections.

Chlamydia trachomatis (CT) infection has been a major public health threat globally. Monitoring and prediction of CT epidemic status and trends are important for programme planning, allocating resources and assessing impact; however, such activities are limited in China. In this study, we aimed to apply a seasonal autoregressive integrated moving average (SARIMA) model to predict the incidence of CT infection in Shenzhen city, China. The monthly incidence of CT between January 2008 and June 2019 in Shenzhen was used to fit and validate the SARIMA model. A seasonal fluctuation and a slightly increasing pattern of a long-term trend were revealed in the time series of CT incidence. The monthly CT incidence ranged from 4.80/100 000 to 21.56/100 000. The mean absolute percentage error value of the optimal model was 8.08%. The SARIMA model could be applied to effectively predict the short-term CT incidence in Shenzhen and provide support for the development of interventions for disease control and prevention.

Poultry contact is a risk factor for zoonotic transmission of non-typhoidal Salmonella spp. Salmonella illness outbreaks in the United States are identified by PulseNet, the national laboratory network for enteric disease surveillance. During 2020, PulseNet observed a 25% decline in the number of Salmonella clinical isolates uploaded by state and local health departments. However, 1722 outbreak-associated Salmonella illnesses resulting from 12 Salmonella serotypes were linked to contact with privately owned poultry, an increase from all previous years. This report highlights the need for continued efforts to prevent backyard poultry-associated outbreaks of Salmonella as ownership increases in the United States.

Arguments in favour of biotyping of Enterobacteriaceae excreted in the faeces of isolated patients, as a method of investigating the efficiency of the isolation procedures, are presented as well as a technical outline of the procedure. The study included three kidney transplantation patients, five acute myeloid leukaemia patients and four healthy persons as controls.

The results show, apart from new colonizations during isolation, a difference in the mean number of contaminations and colonizations with different Enterobacteriaceae biotypes. It is concluded from these results, that the isolation procedures were not completely effective and that the AML patients studied had a decreased colonization resistance of their digestive tract. This was less evident in the kidney transplant group.

The degerming effect of a 3 min handwash with 2% triclosan, or 4% chlorhexidine, in detergent and enhanced efficacy of either antiseptic in isopropyl alcohol, was evaluated in volunteers. Handwashing with either antiseptic preparation reduced the normal flora by a factor of 10; alcohol rubbing by approximately a factor of 1000. Both regimens eliminated Micrococcus roseus, artificially inoculated before every procedure. The sustained action of the same detergent preparations was further studied in gloved and ungloved hands by the Vinson's ‘finger imprint test’. In the gloved hand both antiseptics inhibited Staphylococcus epidermidis for 4 h. In the ungloved hand however, triclosan remained active longer than chlorhexidine. Whilst the activity of chlorhexidine was short-lived against a clinical isolate of S. aureus, particularly in the ungloved hand, the sustained effect of triclosan against the same strain persisted for 4 h on either hand.

Ross River virus (RRV) is the most common vector-borne disease in Australia. It is vitally important to make appropriate projections on the future spread of RRV under various climate change scenarios because such information is essential for policy-makers to identify vulnerable communities and to better manage RRV epidemics. However, there are many methodological challenges in projecting the impact of climate change on the transmission of RRV disease. This study critically examined the methodological issues and proposed possible solutions. A literature search was conducted between January and October 2012, using the electronic databases Medline, Web of Science and PubMed. Nineteen relevant papers were identified. These studies demonstrate that key challenges for projecting future climate change on RRV disease include: (1) a complex ecology (e.g. many mosquito vectors, immunity, heterogeneous in both time and space); (2) unclear interactions between social and environmental factors; and (3) uncertainty in climate change modelling and socioeconomic development scenarios. Future risk assessments of climate change will ultimately need to better understand the ecology of RRV disease and to integrate climate change scenarios with local socioeconomic and environmental factors, in order to develop effective adaptation strategies to prevent or reduce RRV transmission.

Catheter-related bloodstream infection (CRBSI) caused by coagulase-negative staphylococci (CNS) is common in haematological patients with febrile neutropenia. As the clinical signs of CRBSI are usually scarce and it is difficult to differentiate from blood culture contamination, we tried to confirm CRBSI by molecular typing of CNS isolated from paired blood cultures (one from a peripheral vein and another from the central venous catheter hub). Blood cultures were positive in 59 (36%) out of 163 patients. CNS were isolated in 24 (40%) patients; in 14 from paired blood cultures (28 isolates) and in 10 from a single blood culture. CNS from paired blood cultures were identified as Staphylococcus epidermidis. Antimicrobial susceptibility was determined and bacteria were typed by pulsed-field gel electrophoresis (PFGE) of bacterial genomic DNA. In 13 patients, the antibiotic susceptibility of isolates was identical. The PFGE patterns from paired blood cultures were identical or closely related in 10 patients, thus confirming the presence of CRBSI. In the remaining four patients they were unrelated, and suggested a mixed infection or contamination. Since CNS isolates from three patients had identical PFGE patterns, they were probably nosocomially spread amongst them.

Antibody to hepatitis B surface antigen was detected by radioimmunoprecipitation in 74 (5·5%) of 1336 staff members in a large general hospital in Edinburgh, in 14 (2·9%) of 480 volunteer blood donors in the area, and in 12 (6·1%) of 197 pregnant women attending for the first time at the ante-natal clinic in the hospital. Rates of antibody prevalence rose with age in the sample of hospital staff and in that of the blood donors, particularly among males. On the other hand, in the ante-natal patients antibody prevalence declined with age.

The rates in hospital staff were higher than those in blood donors of comparable age and sex, and high titres of antibody were more common in the staff group. However, no association was found between antibody prevalence and a history of clinical hepatitis, blood transfusion, or recognized contact with cases of hepatitis. Staff who had previously worked in an infectious disease hospital did not show increased antibody prevalence, indicating that simple isolation measures have been adequate to minimize exposure to hepatitis B.

No particular prevalence of infection was seen in physicians and surgeons, in the nursing staff, or in workers in clinical diagnostic laboratories, hospital administration or other areas. One group clearly showing increased antibody prevalence was staff currently working, or who had worked, in the Haemodialysis Unit; this correlated with the outbreak of dialysis-associated hepatitis in 1969–70. However, no evidence suggested that significant dissemination of infection had occurred to other defined groups of hospital staff. Elevated rates were also observed in a small sample of kitchen and portering staff, and in obstetric medical and nursing staff; the latter observations indicate a need for further investigation to identify unsuspected exposure to hepatitis B virus.

The response of Acomys cahirinus to three anticoagulant rodenticides was investigated in the laboratory. In contrast to the other commensal rodents Rattus rattus and R. norvegicus, this species appears to be naturally very resistant to warfarin, difenacoum and brodifacoum. It is considered unlikely that anticoagulant poisons would be effective in the field for the control of A. cahirinus.

The work described in this paper is based, very largely, on the work of Dean and Webb (1926), and the methods used in the various experiments are similar to those described by them. The results are discussed in two parts. The first is concerned with the mixture of different specimens of anti-horse serum, and with the relationship of the antibody in one specimen to the antibody in another. The second part deals with the nature of the reaction between antigen and antibody in the serum precipitation reaction. The two parts are dependent on each other, and the subject of the second suggested itself whilst the work on the first was in progress. The order in which the work is described is mostly that in which it was done. Nevertheless, conclusions arrived at in one part are, in one or two cases, of importance in the consideration of the other part, and vice versa. A question as to the possibility of strengthening the ratio of an antiserum by the addition of another antiserum led to the earlier experiments.

Ninety-eight samples of pig slurry from 54 farms were examined for the presence of salmonellas, porcine enteropathogenic strains of haemolytic Escherichia coli and mycobacteria. Salmonellas were isolated from 12 farms (22 %) and enteropathogenic E. coli from 13 farms (24%). Pathogenic mycobacteria were not isolated.

Salmonellas were isolated from 7 of 16 farms (44%) stocked with ‘minimal disease’ pigs compared with only 5 of 38 farms (13%) stocked with conventionally reared pigs. Conversely enteropathogenic coliforms were isolated from 3 of 16 farms (19%) stocked with ‘minimal disease’ pigs compared with 10 of 38 farms (26%) stocked with conventionally reared pigs.

Epizootics of various Fish-diseases due to bacteria have been described by several observers, but most of these have affected coarse fish only, such as carp, tench and perch and the bacilli, which have been described as the causative organisms, have been quite different in their characters from those constantly found in the epizootic now under consideration.