In this paper the pathological and the bacteriological findings in ten instances of naturally acquired tuberculosis in ten different species of animals are recorded. The tubercle bacilli obtained in culture from five species (bat, bear, bison, hedgehog and mink), all cases of fatal tuberculosis, were of the bovine type. The bacilli from a case of localised glandular tuberculosis in a goat and one of tuberculosis of the pancreas in a kangaroo were of the avian type. The bacilli from a case of generalised retrogressive tuberculosis in a horse, of minimal thoracic tuberculosis in a calf and cutaneous and glandular tuberculosis in a parrot were of the human type. These results amplify the evidence already published which shows that each of the three types of tubercle bacilli (bovine, human and avian) is able to cause natural tuberculosis in many different species of animals other than that which is its normal habitat.

The bovine bacillus which is transmitted to animals almost exclusively by tuberculous bovines is responsible for the greater part, especially the generalised and fatal forms, of the tuberculous disease occurring naturally in farm and domestic mammals and for a not inconsiderable amount of tuberculosis in human beings.

The avian bacillus whose natural host is the domestic fowl can infect casually many species of mammals, namely the pig, the ox, the sheep, the goat, the horse, the guinea-pig and the rabbit and in Zoological Gardens several marsupial species. Instances of its transmission to the different species of farm mammals are rare, except in the case of the pig, and the disease produced is usually limited and confined to the glands adjacent to the points of entry of the bacilli. This type of bacillus may however cause severe generalised and fatal disease in the pig, sheep, rabbit and marsupials.

The human bacillus has a narrower range of pathogenicity than either the bovine or the avian bacillus. This type can infect the pig, the calf and the horse, but does not produce progressive tuberculosis in these species. It causes cutaneous tuberculosis in parrots and is one cause of tuberculosis in the dog and in various species of animals kept in captivity, namely the guinea-pig, monkey, gnu, antelope, peccary, etc., in which species infection is followed by generalisation and progression of the disease.

The evidence accumulated regarding the susceptibility of various species of animals to the three types of tubercle bacilli under farm and domestic conditions and in captivity may be summed up as follows.

All three types of bacilli can infect the ox, pig, horse, guinea-pig and rabbit.

Two types of bacilli have been found in the following species; viz. bovine and avian in the sheep, the goat and Australian marsupials; bovine and human in the domestic dog and in the ape, monkey and Ungulata in captivity; human and avian in the parrot.

Only one type of bacillus has so far been obtained from domestic fowls (the avian), the domestic cat, hedgehog, mink and ferret (the bovine) and members of several species in captivity.

An immunofluorescence test for detecting parvovirus B19 IgG was developed by infecting insect cells with recombinant baculovirus expressing the capsid protein VP1. The test was used to study the prevalence of antibodies in 725 healthy children and young adults living in Santiago, Chile. In total, 248 sera were taken in 1990 and 477 in 1996. The seroprevalence was low in children less than 5 years old (3% in 1990 and 21% in 1996). It rose during school age to a prevalence around 50%, reaching 60% in young adults. No differences were found between genders. There was a statistically significant higher seroprevalence in the low socio-economic status group in 1990 samples, but this was not observed in 1996. The higher prevalence observed in children less than 5 years of age in 1996 compared with 1990 could be explained by the occurrence of intervening epidemics of parvovirus B19 infection.

Urban slum environments in the tropics are conducive to the proliferation and the spread of rodent-borne zoonotic pathogens to humans. Calodium hepaticum (Brancroft, 1893) is a zoonotic nematode known to infect a variety of mammalian hosts, including humans. Norway rats (Rattus norvegicus) are considered the most important mammalian host of C. hepaticum and are therefore a potentially useful species to inform estimates of the risk to humans living in urban slum environments. There is a lack of studies systematically evaluating the role of demographic and environmental factors that influence both carriage and intensity of infection of C. hepaticum in rodents from urban slum areas within tropical regions. Carriage and the intensity of infection of C. hepaticum were studied in 402 Norway rats over a 2-year period in an urban slum in Salvador, Brazil. Overall, prevalence in Norway rats was 83% (337/402). Independent risk factors for C. hepaticum carriage in R. norvegicus were age and valley of capture. Of those infected the proportion with gross liver involvement (i.e. >75% of the liver affected, a proxy for a high level intensity of infection), was low (8%, 26/337). Sixty soil samples were collected from ten locations to estimate levels of environmental contamination and provide information on the potential risk to humans of contracting C. hepaticum from the environment. Sixty percent (6/10) of the sites were contaminated with C. hepaticum. High carriage levels of C. hepaticum within Norway rats and sub-standard living conditions within slum areas may increase the risk to humans of exposure to the infective eggs of C. hepaticum. This study supports the need for further studies to assess whether humans are becoming infected within this community and whether C. hepaticum is posing a significant risk to human health.

Staphylococcus aureus has been recognised as one of the important zoonotic pathogens. However, knowledge about the epidemiology and genetic characteristics of S. aureus in rabbits was limited. The aim of this study was to determine the characteristics of 281 S. aureus isolated from dead rabbits of nine rabbit farms in Fujian Province, China. All the isolates were characterised by multi-locus sequencing typing, detection of virulence factors and antimicrobial susceptibility test. The results showed that the 281 isolates were grouped into two sequence types, ST121 (13.52%, 38/281) and ST398 (86.48%, 243/281). Surprisingly, the ST121 strains were only recovered from the lung samples from one of the nine rabbit farms studied. In the 281 isolates, the virulence genes of nuc, hla, hlb, clfA, clfB and fnbpA were positive, whereas the sea, seb, tsst, eta and etb genes were negative. Notably, the 38 ST121 isolates carried the pvl gene. All the 281 isolates were methicillin-susceptible S. aureus, and the isolates were susceptible to most of the used antibiotics, except for streptomycin, kanamycin, azithromycin and penicillin, and the resistance rates of which were 23.84%, 19.57%, 16.01% and 11.03%, respectively. This study first described the epidemiology and characteristics of S. aureus in rabbits in Fujian Province, which will help in tracking the evolution of epidemic strains and preventing the rabbit–human transmission events.

A cross-sectional study was performed among 2494 adults not living or working on a farm to assess prevalence of Clostridium difficile (CD) colonization and risk factors in a livestock dense area. CD prevalence was 1·2%. Twenty-one persons were colonized with a toxigenic strain and nine with a non-toxigenic strain. CD-positive persons did not live closer to livestock farms than individuals negative for CD. Antibiotic exposure in the preceding 3 months was a risk factor for CD colonization (odds ratio 3·70; 95% confidence interval 1·25–10·95).

Duplicate specimens were taken with cotton-wool swabs from the upper tarsal conjunctiva of 63 patients living in Gambian villages in which trachoma is endemic and from 34 infants with ophthalmia neonatorum (ON) attending an outpatient clinic in The Gambia. The detection of Chlamydia trachomatis by direct immunofluorescence (IF) using a conjugated monoclonal antibody to its principal outer membrane protein was compared with isolation in cycloheximide-treated McCoy cells. For trachoma, the sensitivity and specificity of the immunofluorescent technique were 62% and 100% respectively if ten elementary bodies (EBs) was taken as the minimum requirement for positivity by IF. If all cases with one or more EB were considered positive, the sensitivity was 81% and the specificity 85%. For ON the sensitivity and specificity were 100% and 95% respectively, regardless of which criterion was used. In view of its simplicity and easy applicability to field conditions it seems likely that direct IF using monoclonal antibodies may be a useful technique for the detection of C. trachomatis in the conjunctival epithelium of patients with trachoma.

We reviewed measles surveillance data for 1993–2002 to determine the impact of Australia's measles control initiatives. The introduction of a second dose of measles–mumps–rubella (MMR) vaccine for 10- to 16-year-olds in 1993 was followed by marked reductions in measles notifications and hospitalizations, especially in the targeted age group. Further rate reductions were achieved following the Measles Control Campaign (MCC) in 1998, which involved a catch-up campaign for primary-school-aged children and lowering the age for the second dose of MMR vaccine to 4 years. Since the MCC, outbreaks have continued to occur, but most had a source case who was infected overseas, which suggests that indigenous transmission has been interrupted. In addition, a greater proportion of cases have been in adults although infants aged <5 years still had the highest rates. In conclusion, Australia is making good progress towards measles elimination. However, as in other countries, this progress can be sustained only by maintaining high vaccination coverage with the routine childhood vaccination schedule.

Indirect haemagglutination (IHA), agglutination and complement fixation tests (CFT) for Bordetella pertussis antibodies were compared on paired sera from 52 suspected cases of whooping cough and single sera from 83 children with no recent history of whooping cough. All three tests detected serotype antibodies 1, 2 and 3, but the IHA test was the most sensitive; in seven cases it was the only test to show a rise in titre. It is recommended, particularly with vaccinated children, that the serological diagnosis of whooping cough should be based upon a rise in titre. There should be a gap of at least 2–4 weeks between serum samples, depending on the age and vaccination state of the child. The CFT appears to detect a different antibody from that detected by the other two tests, and in three cases it was the only test to show a rise in titre.

A mathematical model is described which determines the impact of a schedule of vaccination on the time course of a certain class of diseases. The data are the demographic variables and parameters and age-dependent non-fatal and fatal case rates. Given the age- and time-dependent rates of vaccination including coverage and corresponding efficacies, various schedules may be distinguished by either the absolute numbers of cases and deaths avoided or the numbers of cases and deaths avoided per dose of vaccine. The model was applied to meningo-coccal serogroup C disease in France. The outcomes of six different vaccination schedules were examined. In absolute terms, a schedule in which all individuals aged between 2 and 20 years were vaccinated performed best, but this schedule and that in which only 1-year olds were vaccinated performed equally and best in terms of cases prevented, but not lives saved, per dose.

In the preceding paper the morphology of the parasites found in the peripheral circulation and in the organs of eleven dogs experimentally infected with Canine Piroplasmosis has been described. In the following pages will be considered the morbid lesions found in hese dogs, and the proportions of the variously infected red corpuscles to one another, both in the organs and in the blood.

Visceral leishmaniasis (VL) is an endemic parasitic disease transmitted by the bite of sand flies. To describe trends and demographics of reported VL cases, we reviewed surveillance data from 1990–2009. Reported VL incidence per 100 000 population was 2·6 in 2007, 3·1 in 2008, and 4·8 in 2009, mostly in children aged <5 years. The number of cases varied greatly in step with prevailing economic and security conditions, raising concerns about the completeness and quality of surveillance data. Nevertheless, we conclude that VL remains an important endemic disease in Iraq and that surveillance system is recovering the capacity to detect cases as the country experiences greater stability. We recommend conducting formal entomological investigations, and evaluating existing control measures.

To determine the time to appearance of antibody against hepatitis B surface antigen (anti-HBs) after clearance of hepatitis B surface antigen (HBsAg) in chronically infected individuals, we followed up 3963 cases with positive antibody against hepatitis B e antigen (anti-HBe) from 1991 to 2014. Of these, 101 (67 males, 34 females) lost HBsAg. These serocleared cases were checked every 6-month interval regarding HBsAg, anti-HBs, liver function tests, and liver sonography. Hepatitis B virus DNA was assessed at the time of seroclearance or the appearance of anti-HBs. The mean age of these patients at entry to this study was 34·4 ± 13 years. The mean follow-up duration until seroclearance of HBsAg was 6·6 ± 4·3 years. After the mean follow-up of 43·7 ± 45 months, anti-HBs appeared in 64 (63·4%) cases. The cumulative probabilities of anti-HBs appearance for 2, 5 and 10 years were 24·3%, 58% and 78·2%, respectively. The appearance of anti-HBs was associated with age ⩾35 years and seroclearance of HBsAg (hazard ratio 1·96, 95% confidence interval 1·32–3·38, P = 0·016) but not with sex. The results show that anti-HBs may develop in 78·2% of cases within 10 years of HBsAg clearance. Age ⩾35 years at HBsAg loss was associated with earlier development of anti-HBs.

In low vaccination coverage regions (LVR) in The Netherlands people often reject participation in the National Immunization Programme for religious reasons. During a rubella epidemic in 2004–2005, 32 pregnant women were notified with rubella, and 11 babies were born with defects related to maternal infection. This study presents a cost-utility analysis of a screening and vaccination programme for rubella focusing on three scenarios: (1) screening non-vaccinated pregnant women in LVR; (2) screening all pregnant women in LVR; (3) screening all non-vaccinated pregnant women in The Netherlands (including pregnant first-generation non-Western immigrant women). Cost-utility was estimated over a 16-year period which included two rubella outbreaks. Observed complications from the 2004–2005 epidemic were used to estimate average cost savings and quality-adjusted life-years (QALY) gained. The programme would be cost-effective (€1100/QALY gained) when assuming an acceptability of vaccination of 20% in women belonging to orthodox protestant risk groups.

In a recent survey of trimethoprim resistance. 357 Gram-negative aerobic organisms were isolated from healthy volunteers from rural and urban populations in South Africa. Trimethoprim resistance did not transfer to an Escherichia coli J62–2 recipient strain by conjugation in a liquid mating in 161 (45·1%) of the isolates. These isolates which did not transfer their resistance were probed with intragenic oligonucleotide probes for the types Ia. Ib. IIIa. V. VI. VII. VIII. IX. X and XII dihydrofolate reductase genes. Contrary to all previous data, the most prevalent dihydrofolate reductase gene in this group of non-transferable isolates which hybridized, was the type VII (38%) followed by the type Ia (25%). Ib (12%). V (1·7%) and VIII (1·2%). None of the strains hybridized to the types IIIa. VI. XI. X and the XII dihydrofolate reductase probes. Southern blots of plasmid and chromosomal DNA from selective isolates revealed that the type VII dihydrofolate reductase genes were located on the chromosome and were associated with the integrase gene of Tn21. However, the type Ib and V dihydrofolate reductase genes were all found on plasmids which could not be mobilized. The type Ia dihydrofolate reductase genes were found on both non-transferable plasmids and on the chromosome. The nature of the genetic structures associated with a dihydrofolate reductase gene strongly affects the means of spread of the gene in a population.

In this paper, the results of a pilot study of willingness to pay (WTP) to avoid poultry-borne illness are reported. Through this, the problems of devising an economic measure of the ‘intangible’ benefits of prevention of food-borne risk are explored. The study is the first to allow those against a prevention policy (irradiation of poultry-meat) to register their WTP not to have the policy implemented. The study demonstrates that it is feasible to obtain answers to WTP questions from a self-selected sample. Future studies should ensure greater representativeness of respondents, that better information about benefits is provided to respondents and that an appropriate method of aggregation of benefits is used.

Studies were made of a 14-room isolation ward in which the bedrooms were provided with individual ventilation units to provide a slight positive pressure within the rooms. Airborne staphylococci were detected with sedimentation plates.

The median count of Staphylococcus aureus in the occupied bedrooms was 4·6 col. per 14 cm. plate exposed for 24 hr. or 13 col./m.2 hr. When the air count was high virtually all the staphylococci proved to be of the phage type harboured by the patient in the room; with low counts a substantial proportion were apparently derived from patients in other rooms.

The apparent rate of acquisition of S. aureus in the nose of the patients was between 2·7 and 4·2 per 100 patient weeks at risk. This is substantially lower than has commonly been observed in open wards.

We are very graetful to Miss M. A. Adams, Sister in charge of the Almroth-Wright isolation Ward, and all her staff for all their help and co-operation during this study, which was supported by funds provided to St Mary's Hospital by the Ministry of Health for clinical research.

The reconstruction of the ward was designed by Mr A. Stableford, Group Engineer to St Mary's Hospital; the ventilation units were designed and supplied by White Bays and White Ltd., London.

Bartonella spp. are endemic in wild rodents in many parts of the world. A study conducted in two northern California counties (Sonoma and Yolo) sampling California ground squirrels (Otospermophilus beecheyi) and four other rodent species (Peromyscus maniculatus, P. boylii, P. truei and Neotoma fuscipes) led to the isolation of small Gram-negative bacilli which were identified as Bartonella spp. based on colony morphology, polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) and partial gene sequencing. Overall, Bartonella spp. were isolated from the blood of 71% (32/45) of the ground squirrels and one third (22/66) of the other rodents. PCR–RFLP analysis of the gltA and 16S rRNA genes yielded seven unique profiles, four for the ground squirrels and three for the other rodents. Isolates from each PCR–RFLP profiles were submitted for partial sequencing. Ground squirrel isolates were most closely related to B. washoensis, whereas the other rodent isolates were closest to B. vinsonii subsp. vinsonii and B. vinsonii subsp. arupensis. Two of these three species or subspecies are known zoonotic agents.

Persons who develop tuberculosis (TB) may have subtle immune defects that could predispose to other intracellular bacterial infections (ICBIs). We obtained data on TB and five ICBIs (Chlamydia trachomatis, Salmonella spp., Shigella spp., Yersinia spp., Listeria monocytogenes) reported to the Tennessee Department of Health, USA, 2000–2011. Incidence rate ratios (IRRs) comparing ICBIs in persons who developed TB and ICBIs in the Tennessee population, adjusted for age, sex, race and ethnicity were estimated. IRRs were not significantly elevated for all ICBIs combined [IRR 0·87, 95% confidence interval (CI) 0·71–1·06]. C. trachomatis rate was lowest in the year post-TB diagnosis (IRR 0·17, 95% CI 0·04–0·70). More Salmonella infections occurred in extrapulmonary TB compared to pulmonary TB patients (IRR 14·3, 95% CI 1·67–122); however, this appeared to be related to HIV co-infection. TB was not associated with an increased risk of other ICBIs. In fact, fewer C. trachomatis infections occurred after recent TB diagnosis. Reasons for this association, including reduced exposure, protection conferred by anti-TB drugs or macrophage activation by Mycobacterium tuberculosis infection warrant further investigation.

This study aimed to determine current seroprevalence of hepatitis A virus (HAV) antibody in subjects aged 0–30 years in Shanghai. A total of 5515 subjects were recruited through random clustering sampling in 2009. Basic clinical and demographic information and records of HAV vaccination were acquired by questionnaire interviews and review of immunization records. Serum samples were collected and tested for anti-HAV IgM and total anti-HAV. The overall seroprevalence of total anti-HAV was 52·9%. Subjects aged 20–24 years had the lowest (34·4%) anti-HAV seropositivity and subjects aged 5–9 years had the highest (74·6%) positivity. Seroprevalence was significantly greater in subjects from suburban areas than in subjects from urban areas. Subjects who had HAV immunizations had significantly greater seropositivity for total anti-HAV. Previous hepatitis A immunization policies had a significant impact on the presence of anti-HAV seroprevalence in a population aged 0–30 years from Shanghai.

Experiments were carried out on rabbits, guinea-pigs and monkeys to test the immunity produced by vaccinia virus killed with heat, phenol or formalin. Before use, the vaccines were rigorously tested for their inactivity by a method of inoculation and triple passage in series. The test of immunity was quantitative.

The rabbit experiments gave equivocal results but indicated that a slight immunity was produced in some cases. In guinea-pigs more success was obtained: they could be protected against one to ten minimal infecting doses and showed a partial immunity to stronger tests. Monkeys were only tried in one experiment in which a weak vaccine was used. This did not protect them.

The superiority of guinea-pigs for this kind of work is discussed as also the bearing of the results obtained with them on the nature of immunity to vaccinia virus.