The characters of the Aronson Streptococcus from Prof. Neufeld's laboratory at the “Robert Koch” Institute in Berlin have been described. This coccus resembles the pneumococcus in many respects, viz. the appearance of the colonies on the surface of horse blood agar, its virulence and capsule production in mice and rabbits, the production of a specific precipitable substance in the peritoneal washings of infected mice, the formation of firm clumps and masses when mixed with homologous antiserum, the ease of production of active and passive immunity in mice and rabbits by intraperitoneal and intravenous inoculation, the alteration in the morphology of colonies, i.e. the appearance of R forms, associated with attenuation of virulence. It differs from the pneumococcus in the following features: the round shape of the cocci, bile-insolubility and the absence of autolysis in surface colonies, the beta haemolysis of deep colonies in horse blood agar, the production of a soluble haemolysin in broth cultures, the difficulty of producing active immunity in mice by the subcutaneous injection of heat-killed vaccines.

I have obtained the Aronson Streptococcus (Neufeld type), which Lance-field places in a group containing chiefly streptococci of bovine origin, from human throats, but there was no evidence in any instance that it was producing disease, and it seems probable that it is not pathogenic for man.

The results of my investigation of this strain are in agreement with those of Yoshioka (1923), Killian (1924) and Lancefield (1933, 1934).

There are in existence other laboratory strains designated Aronson Streptococcus. These have been found to exhibit specific characters identifying them with the Str. pyogenes. It is proposed that the name Streptococcus Aronson should be confined to strains possessing the characters of Aronson N above described.

Parasitic infections have been reported to be relatively common among the Southeast Asian labourers in Taiwan. This study, conducted in 1992–6, was designed to determine the temporal changes of the prevalence. Faecal specimens were examined by the formalin-ethyl acetate sedimentation technique and blood samples screened using the quantitative buffy coat technique and confirmed by Giemsa stained blood smear. The overall prevalence of intestinal parasitic infections was 10·3%. The annual prevalence decreased from 33·3% in 1992–3 to 4·6% in 1995–6. The Thai (12·0%) and Indonesian (11·1%) had a higher prevalence than the Malaysian (6·7%) and Filipinos (5·9%). Opisthorchis viverrini was the most important parasite in the Thai and Trichuris trichiura in the remaining groups. Moreover, no blood parasites were found in the labourers. The dramatic temporal decline in the intestinal parasitic infections suggests that limiting the entry of infected persons, periodic follow-ups, and immediate treatment of sporadic cases are necessary in preventing transmission of non-indigenous parasites through large population change.

Pulsed field gel electrophoresis (PFGE) of the genomic DNA of penicillin resistant serotype 19B Streptococcus pneumoniae was carried out. Thirteen strains form the Nagasaki area and 12 strains from other areas in Japan were examined. Twenty-three strains were resistant to erythromycin, tetracycline and trimethoprim/sulfamethoxazole but susceptible to chloramphenicol. Eight strains were resistant to ceftriaxone. All strains were multiply resistant. Five strains isolated from Nagasaki were indistinguishable from each other by using restriction enzymes Apa I and Sma I. Two strains isolated from other areas were indistinguishable from the above five strains. We could classify 13 Nagasaki strains into 3 groups and the total of 25 Japanese strains into 6 groups. These results suggest that the increasing prevalence of multiply drug resistant S. pneumoniae serotyped 19B in Japan is not due to a single clone, but at least one clone has spread widely in Japan.

We investigated and quantified the factors which may affect the prevalence of cystic echinococcosis caused by Echinococcus granulosus in Rangtang County using a multidisciplinary approach. From a previously performed field survey, epidemiological data were linked with environmental data. Altitude and land surface temperature were extracted from remote-sensing images. Cumulative logistic regression models were used to identify and quantify the potential risk factors. The multiple regression models confirmed that yaks (χ 2 = 4·0447, P = 0·0443), dogs (χ 2 = 8·3455, P = 0·0039) and altitude (χ2 = 7·6223, P = 0·0058) were positively correlated with the prevalence of cystic echinococcosis, while land surface temperature may have a negative association. The findings showed that dogs and yaks play the most important role in the transmission of cystic echinococcosis, while altitude and land surface temperature may also be involved in the transmission.

Yersinia enterocolitica infection is a zoonosis with worldwide distribution, gastroenteritis being by far the most common clinical manifestation of human infection. In Gipuzkoa, northern Spain, human Y. enterocolitica infections increased from the mid-1980s to the beginning of the 21st century (from 7·9 to 23·2 annual episodes per 100 000 population) to decrease to 7·2 annual episodes per 100 000 population in the last years of the study. The hospital admission rate due to yersiniosis during the last 15 years of the study was 7·3%. More than 99% of isolates were serotype O:3. Infection affected mainly children under 5 years of age (average rate: 140 episodes per 100 000 population). The incidence in adults was low but hospitalisation increased with age, exceeding 50% in people over 64 years old.

Respiratory syncytial virus (RSV) is the most common cause of documented viral respiratory infections, and the leading cause of hospitalization, in young children. We performed a retrospective time-series analysis of all patients aged <18 years with laboratory-confirmed RSV within a network of multiple affiliated academic medical institutions. Forecasting models of weekly RSV incidence for the local community, inpatient paediatric hospital and paediatric intensive-care unit (PICU) were created. Ninety-five percent confidence intervals calculated around our models' 2-week forecasts were accurate to ±9·3, ±7·5 and ±1·5 cases/week for the local community, inpatient hospital and PICU, respectively. Our results suggest that time-series models may be useful tools in forecasting the burden of RSV infection at the local and institutional levels, helping communities and institutions to optimize distribution of resources based on the changing burden and severity of illness in their respective communities.

Isolates from 3903 cases of invasive pneumococcal disease (IPD) were referred to the national reference laboratory over the 8 years, 1998–2005, as part of the laboratory-based surveillance of this disease in New Zealand. All isolates were serotyped and their antimicrobial susceptibility was tested. The incidence of IPD was highest in young children, with an average annual incidence of 100·8/100 000 in infants aged <2 years. There were changes in the prevalence of several of the serotypes during the 8-year period. Overall the seven serotypes included in the 7-valent pneumococcal conjugate vaccine, 4, 6B, 9V, 14, 18C, 19F and 23F, were the most common serotypes and accounted for 80·9% of the disease in infants aged <2 years. There was no overall change in penicillin resistance or non-susceptibility during the 8 years, and rates were 7·1% and 17·1%, respectively, in 2005. In contrast, cefotaxime and erythromycin resistance increased to reach 3·1% and 12·2%, respectively, by 2005.

Making a distinction between facial palsy due to Lyme neuroborreliosis (LNB) and idiopathic facial palsy (IFP) is of importance to ensure timely and adequate treatment. The study objective was to assess incidence and patient characteristics of facial palsy due to LNB. Hospital records were reviewed of adult patients with facial palsy visiting the departments of neurology and/or otorhinolaryngology of Gelre hospitals between June 2007 and December 2017. Gelre hospitals are located in an area endemic for Lyme borreliosis. Patients with LNB had pleocytosis and intrathecal antibody production or pleocytosis with positive IgG serology. Patients with IFP had negative serology. Clinical characteristics were compared between patients with LNB and patients with IFP. Five hundred and fifty-nine patients presented with facial palsy, 4.7% (26) had LNB and 39.4% (220) IFP. The incidence of facial palsy due to LNB was 0.9/100 000 inhabitants/year. Over 70% of patients with facial palsy due to LNB did not report a recent tick bite and/or erythema migrans (EM). Patients with facial palsy due to LNB presented more often in July to September (69.2% vs. 21.9%, P < 0.001), and had more often headache (42.3% vs. 15.5%, P < 0.01). To reduce the risk of underdiagnosing LNB in an endemic area, we recommend testing for LNB in patients with facial palsy in summer months especially when presenting with headache, irrespective of a recent tick bite and/or EM.

In a herd affected with bovine mastitis, dwarf colony variants of Staphylococcus aureus, auxotrophic for Ca-pantothenate, were isolated from the milk of four cows with mastitis. From one of these cows, a dwarf variant with an unknown metabolic disorder was isolated during the same period. Infections with auxo trophic staphylococci were always chronic and proved to be refractory to anti biotic treatment, though the causative micro-organism was highly susceptible to the drugs used as judged by in vitro tests.

The authors acknowledge with appreciation the skilful help of Miss Nili Abramova.

Staphylococcus aureus strains of type 95 in Denmark have increased to a frequency of 20% of the total S. aureus population. A clonal origin and possible subdivision of these strains have been discussed. In the present investigation 35 epidemiologically unrelated S. aureus strains of type 95 as well as reference strains of other types have been analysed by other typing techniques including lectintyping, multilocus enzyme electrophoresis and pulsed-field gel electrophoresis of genomic restriction fragments. No subdivision could be achieved based on any of these methods and a clonal origin seems therefore possible.

Long-chain fatty acids are not appreciably bactericidal to tubercle bacilli at neutral pH, but become so even in slightly acid solution. In this way tubercle bacilli, normally resistant to 0·1 N hydrochloric acid (pH 1·0), are rapidly killed at this pH if traces of fatty acid are present, such as can be found inside test tubes that have been plugged with cotton wool and sterilized by dry heat.

The lethal effect is largely prevented by non-ionic, cationic, and to a lesser extent anionic detergents, which probably take up the fatty acid into the micelles so that it can no longer attack the bacilli.

The various fatty acids identified in the deposit from heated cotton wool were tested individually and found to be bactericidal. They comprised the usual C12 to C18 saturated acids and also oleic acid. The latter, however, showed no particular lethal toxicity in excess of that shown by, for example, palmitic acid. Shorter chained fatty acids than those represented in the deposit were less lethal.

We wish to thank Dr A. T. James for the chromatographic analyses and for advice; Dr R. J. W. Rees for carrying out counts of total acid-fast bacilli in two experiments; Messrs. Robinson & Sons Ltd, Chesterfield, for information on the industrial processes involved in the preparation of cotton wool; Mr E. J. Latham for advice on preparing glassware; and Dr J. Marks for helpful criticism of the manuscript.

This investigation was designed to determine the prevalence of Corynebacterium suis in the preputial diverticulum of pigs of various age groups, located in different parts of the U.K., and to demonstrate whether the organism is transmissible between male pigs.

C. suis was isolated from almost 90% of 224 adult males, distributed among 25 pig units in widely separated regions of the country and in 96 % of 66 pigs aged 5–6 months originating from six different herds in East Anglia. The rate of isolation of C. suis from younger pigs depended, at least in part, on the system of husbandry practised. Thus, in one herd, A, in which young pigs were maintained in comparative isolation, none of 26 pigs aged 5–8 weeks harboured C. suis; however, in the same herd, the organism was isolated from 77 % of 64 pigs aged 9–15 weeks which were in close contact with male pigs aged up to 6 months. In another herd, B, in which individual litters were housed in the same pen from birth to 5 months of age, C. suis was isolated once from only one of 36 pigs in the age range 5–17 weeks, sampled on two occasions, with an interval of 5 weeks between each sampling. In a third herd, C, in which adult males had never been present, C. suis was not isolated from any of 26 pigs aged 4 months.

In each of two herds at the Royal Veterinary College colonization of the preputial diverticulum by C. suis was shown to have occurred by the age of 5 weeks in all of 38 pigs examined in a Large White herd and in all of 29 pigs in a Göttingen miniature pig herd.

Transmission experiments clearly demonstrated the ease and rapidity with which the preputial diverticulum became colonized with C. suis when non-infected pigs were placed in close contact with pigs which harboured the organism.

The toxicity and efficacy of the acute rodenticide scilliroside was evaluated in the laboratory against the lesser bandicoot rat, Bandicota bengalensis. The acute oral LD50 and LD 95 doses for males were 0·8 mg/kg and 2·5 mg/kg respectively, and for females were 0·5 mg/kg and 1·6 mg/kg, respectively. When caged bandicoots were given a choice between plain and poison baits, the optimum concentration of scilliroside was found to be 0·05%. Symptoms of poisoning appear from 22 to 34 min after feeding starts and the latency pattern indicated an abrupt ceasing to feed at these points. Death occurred from 2 h to as long as 6 days after poisoning, following prolonged convulsive seizures. There appears to be aversion to scilliroside at all concentrations in food baits. Maximum mortality attained on free-choice feeding on scilliroside was 90%. Despite these disadvantages, the material may have merit as an alternative rodenticide to zinc phosphide where acute toxicants are to be used.

Hepatitis E virus (HEV) is a well-known cause of acute hepatitis. Immunocompromised subjects, including liver transplant recipients, are considered to be at risk for HEV infection, which occasionally follows a chronic course. The diagnosis of HEV infection in these patients must be based on HEV RNA testing, as serology has variable performance. The aim of this study was to assess the prevalence of HEV infection in liver transplant recipients in Greece by means of HEV RNA testing. Liver transplant recipients followed in the sole transplant centre in Greece were prospectively included. HEV RNA was detected by real-time RT-PCR. Positive samples were further analysed using a nested reverse transcription RT-PCR kit, which amplifies a 137-nucleotide sequence within the ORF2/ORF3 overlapping region to detect the HEV genotype and perform phylogenetic analysis. The mean age of the included patients (n = 76) was 54 years. The most common indication for liver transplantation was viral hepatitis (57%). The majority of the patients (75%) received a calcineurin inhibitor as part of their immunosuppressive regimen and had normal liver enzymes. HEV RNA was found positive in only 1/76 (1.3%) patient. Phylogenetic analysis showed that the sequence clustered into the HEV genotype 3 clade. This patient experienced an acute hepatitis flare, which nonetheless did not become chronic. The prevalence of HEV infection in liver transplant recipients in Greece is similar (1.3%) to that reported previously in other countries. Transplant physicians should be aware of this condition and its associated consequences.

Mosquito-borne Sindbis virus (SINV) causes rash-arthritis syndrome in Finland. Major outbreaks with approximately 7-year cycles have caused substantial burden of illness. Forest dwelling grouse are suspected to be amplifying hosts, with the infection transmitted to humans by mosquito bites. SINV infection surveillance data for 1984–2010 were used to create a negative binomial hurdle model, with seasonality, long-term cycles, climatic, ecological and socioeconomic variables. Climatic factors during early summer and amount of snow in April described the occurrence and incidence of SINV infections. Regulated water shore and hatch-year black grouse density described the occurrence, while population working in agriculture, agricultural land (negative) and income (negative) described the incidence of the disease. The prediction for 2009 was 85 cases (95% prediction interval 2-1187), while the actual occurrence was 106. We identified novel and known risk factors. The prevention of SINV infections in regulated water areas by infected mosquito populations should be targeted.

The incidence of bacteraemia has increased considerably during the last decades. This may be related to population ageing, increased use of invasive procedures, and increased ascertainment of bacteraemia. Generalized additive and generalized linear models were used to analyse the impact of four successive improvements in blood culture methodology on the recovery of prevalent blood culture isolates while simultaneously controlling for underlying time trend and seasonal variation. Between 1981 and 2006, 20 091 bacteraemias comprising 22 800 blood culture isolates were diagnosed. The changes in methodology increased the recovery of some bacterial groups; the greatest impact was observed for Enterobacteriaceae, pneumococci and Staphylococcus aureus whereas recovery of β-haemolytic streptococci, Pseudomonas aeruginosa, other Gram-negative aerobes, and fungi was not affected. Changes in blood culture methodology should be taken into account when assessing time trends of bacteraemia.

This paper examines the sensitivity and specificity of two ELISA assays for IgM antibodies to Mycobacterium leprae, one employing natural phenolic glycolipid and the other employing a synthetic disaccharide glycoconjugate as antigen. Estimates of sensitivity and specificity are derived, based on a panel of sera from leprosy cases in Malawi and various non-leprosy controls from the UK. Though both assays were able to identify a high proportion of multibacillary patients, neither was able to detect a high proportion of paucibacillary patients without considerable loss of specificity. The implications of the inverse relationship between sensitivity and specificity are discussed with reference to the predictive value of such tests in such areas as Malawi, where the large majority of cases are paucibacillary.

The aim of our study is to describe the prevalence of the different HPV types in women with pre-neoplastic lesions of the cervix in Greece. Cervical scrapes from 841 women were obtained for both cytological evaluation and analysis for the presence of HPV DNA. PCR was performed on specimens from these 841 women. The Pap test results were normal or showed benign cellular changes in 45·8% of the women, atypical squamous cells of undeterminated significance (ASCUS) in 23·2%, low-grade squamous intra-epithelial lesion (LSIL) in 27·9% and high-grade squamous intra-epithelial lesion (HSIL) in 3·1%. HPV DNA was demonstrated in 23·6% of cytologically normal women. We detected HPV in 60% of the total samples. Of these, HPV-16 was the most common HPV DNA detected. Interestingly, HPV-58 was inversely correlated with positive cytological findings. A clear pattern of decreasing prevalence of HPV with age was also observed. Our results indicate that HPV infections, especially those with HPV-16, represent a significant public health concern in Greece.

The antibiotic susceptibility pattern of Vibrio cholerae O139, Bengal, an emerging intestinal pathogen has been determined by the Kirby Bauer technique and the MIC values of some antibiotics against these strains by agar dilution technique. All the strains were susceptible to tetracycline, norfloxacin, ciprofloxacin and a majority was susceptible to gentamicin (95·7%) and nalidixic acid (82·9%). Only 51% were susceptible to cefotaxime and most strains were resistant to furazolidone (95·7%), ampicillin (87·3%) and co-trimoxazole (91·5%). The study shows the importance of judicious use of antibiotics in cholera cases and the need for monitoring the susceptibility status of these strains particularly because of their ability to cause extra-intestinal infections like septicaemia.

A link between infection, inflammation, neurodevelopment and adult illnesses has been proposed. The objective of this study was to examine the association between infection burden during childhood – a critical period of development for the immune and nervous systems – and subsequent systemic inflammatory markers and general intelligence. In the Avon Longitudinal Study of Parents and Children, a prospective birth cohort in England, we examined the association of exposure to infections during childhood, assessed at seven follow-ups between age 1·5 and 7·5 years, with subsequent: (1) serum interleukin 6 and C-reactive protein (CRP) levels at age 9; (2) intelligence quotient (IQ) at age 8. We also examined the relationship between inflammatory markers and IQ. Very high infection burden (90+ percentile) was associated with higher CRP levels, but this relationship was explained by body mass index (adjusted odds ratio (OR) 1·19; 95% confidence interval (CI) 0·95–1·50), maternal occupation (adjusted OR 1·23; 95% CI 0·98–1·55) and atopic disorders (adjusted OR 1·24; 95% CI 0·98–1·55). Higher CRP levels were associated with lower IQ; adjusted β = −0·79 (95% CI −1·31 to −0·27); P = 0·003. There was no strong evidence for an association between infection and IQ. The findings indicate that childhood infections do not have an independent, lasting effect on circulating inflammatory marker levels subsequently in childhood; however, elevated inflammatory markers may be harmful for intellectual development/function.