In May 2000, public health authorities in Dublin, Ireland, identified a cluster of unexplained severe illness among injecting drug users (IDUs). Similar clusters were also reported in Scotland and England. Concurrent investigations were undertaken to identify the aetiology and source of the illnesses. In Dublin, 22 IDUs were identified with injection-site inflammation resulting in hospitalization or death; eight (36%) died. Common clinical findings among patients with severe systemic symptoms included leukaemoid reaction and cardiogenic shock. Seventeen (77%) patients reported injecting heroin intramuscularly in the 2 weeks before illness. Of 11 patients with adequate specimens available for testing, two (18%) were positive by 16S rDNA PCR for Clostridium novyi. Clinical and laboratory findings suggested that histotoxic Clostridia caused a subset of infections in these related clusters. Empiric treatment for infections among IDUs was optimized for anaerobic organisms, and outreach led to increased enrolment in methadone treatment in Dublin. Many unique legal, medical, and public health challenges were encountered during the investigation of this outbreak.

The results of typing of 121 strains in the Mycobacterium tuberculosis complex by PFGE are presented. Every isolate from patients in Scotland over a 3-month period for M. tuberculosis and for 1 year for M. bovis were included along with several laboratory strains including those of BCG. The PFGE results suggest that the population structure of all the strains in this complex is distinctly simple with limited genetic diversity and also suggest that M. bovis is not a distinct species.

Outbreaks of myxomatosis during the winter or spring have coincided with the establishment of the European rabbit flea in the Mallee region. The severity of these outbreaks has varied from causing complete suppression of the normal spring increase in rabbit numbers to being completely ineffective in a year in which late spring rains allowed rabbit breeding to extend into the early summer.

In 1973 and 1974 effective spring myxomatosis caused heavy mortality in kittens before they emerged from the warrens. The age of the population increased as the result of few young rabbits coming into the population and of the lessened stress on old rabbits in a low summer-autumn population. This effect was reversed in the late-breeding year, 1976, when flea numbers were apparently too low to maintain a spring outbreak and rabbit numbers increased rapidly.

So-called LC strains of Mycoplasma mycoides subsp. mycoides and, where appropriate, SC strains, were examined, together with M. mycoides subsp. capri strains, by growth, fermentation, and antibiotic-sensitivity tests.

Growth curves in BVF-OS medium showed that, from the 6th until at least the 19th day of incubation, strain Mankefår 2833 had a viable count strikingly higher than that of any other LC strain. Its robust growth properties may explain its ability – unusual among LC strains – to produce mycoplasmaemia readily in mice. Strain 143–A66 Conn, also shown by earlier experiments in mice to possess unusual properties, lost viability more rapidly than any other LC strain between the 13th and 19th days of incubation. The viable count of a subsp. capri strain was considerably lower than that of any LC strain for much of the period between days 6 and 19.

In fermentation tests with 27 substrates and sensitivity tests with 11 antibiotics the strains gave results that, in all but the following respects, were uniform. Sorbitol was fermented to varying degrees by all the LC and subsp. capri strains tested but was unaffected by the SC strains. The LC and subsp. capri strains were in general more resistant than the SC strains to streptomycin. The growth of the LC strains, much more than that of the other strains, was greatly stimulated by the presence of fermentable substrate.

Oxoid dehydrated MacConkey broth was compared with laboratory-prepared Gray's improved formate lactose glutamate medium and with two dehydrated versions of it, by participants in ten laboratories. A variety of chlorinated and unchlorinated water samples was used. The superiority of the glutamate media over MacConkey broth for the detection of coliform organisms in water was again confirmed. The minerals-modified version, either dehydrated or laboratory-prepared, gave the best results and is the medium recommended for use in water examination. Care should be taken to ensure that the final pH after sterilization is 6·7.

A procedure for combining evidence from different biological assays is shown to be equivalent both to generalized least-squares and to maximum-likelihood estimation. By appropriate nesting of hypotheses, the likelihood function can be used to test the agreement between the assays and to obtain probability limits for the combined estimate of potency. The properties of these limits are examined, with particular reference to the situation, unusual but not impossible in practice, in which the values of relative potency that they define consist of several disjoint segments instead of a single interval. The connexion with general theory of estimating linear functional relations is pointed out.

Pulsed-field gel electrophoresis (PFGE) of SmaI–DNA digests and serotyping was performed on 15 colonies of Streptococcus agalactiae (GBS) from each of 30 vaginal–rectal colonized women. Five distinct GBS serotypes were observed among the 30 specimens (Ia, Ib, II, III and V). In 29 of the 30 samples, the same serotype was observed among all 15 colonies; in the remaining specimen, the 15 colonies yielded two serotypes (II and V). The PFGE profiles of all colonies in 27 of the 30 subjects were indistinguishable within each subject. In the remaining women, different DNA profiles were identified among the colonies in each specimen, one of whom carried two different serotypes. Furthermore, strains of the same serotype belonging to different women were genetically heterogeneous.

With increasing knowledge of the effects of inhaled dusts upon the lungs has come an increase in the number of cases of Workmen's Compensation in which pulmonary disease is attributed to exposure to this form of risk during employment. Where a post-mortem examination has been made, and the opinion of a pathologist is sought, no difficulty is encountered in those cases of silicosis in which the disease is well developed, since the lesions are characteristic and easily recognised. The position, however, is by no means so easy where lesser degrees of pulmonary fibrosis are present and, in particular, where it becomes necessary to try to assess the bearing which these may have upon the susceptibility to, and the progress of, intercurrent pulmonary disease—for example lobar pneumonia. In these difficult circumstances recourse is frequently had to the chemical estimation of the quantity of silica recoverable from samples of lung. Certain standards have been set up, and the presence of silica in quantities in excess of the “normal” forms valuable corroborative evidence that a pulmonary fibrosis is attributable to its influence, where the subject in question has been exposed to this risk in his employment, and on the other hand the absence of an excess of silica is evidence that any pathological condition in the lung is due to other causes.

In this study 197 strains of Escherichia coli isolated from cowpats and the faeces of healthy humans were examined for the presence of enterotoxins. Six strains representing five different serotypes were found to be enterotoxigenic. Four of these strains produced the heat labile enterotoxin and two, the Vero cell cytotoxin.

Heating at 37° C. for 5 days completely abolished the capacity of a trachoma/inclusion conjunctivitis (TRIC) vaccine to protect baboons against conjunctival infection. Treatment with formalin also impaired or abolished immunogenicity.

The rate of inactivation of TRIC agent by ultraviolet light was exponential, and was about 7 times faster than that of a suspension of vaccinia virus of comparable turbidity. By contrast with vaccinia, irradiation of TRIC agent with twice the dose of ultraviolet light needed to destroy infectivity resulted in loss of immunogenicity.

The deleterious action of these inactivation procedures on the potency of TRIC vaccines may be explained in terms of damage to a protective antigen; alternatively, live vaccines may be more immunogenic because TRIC agents are capable of multiplying within primate hosts after parenteral injection.

Unlike the same type of variant of another strain of inclusion conjunctivitis, the ‘fast-killing’ variant of MRC-4 was still pathogenic for the baboon conjunctiva.

Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus colonization of the adenoids and nasopharynx in 103 preschool children who underwent adenoidectomy for recurrent upper respiratory tract infections was examined. Bacterial interactions and risk factors for bacterial colonization of the nasopharynx and adenoids, separately, were analysed statistically. The prevalence of simultaneous isolation from both anatomical sites was 45·6% for S. pneumoniae, 29·1% for H. influenzae, 15·5% for M. catarrhalis and 18·4% for S. aureus. Three pathogens were significantly more frequent together from adenoid samples; nasopharyngeal swabs more often yielded a single organism, but without statistical significance. M. catarrhalis and S. aureus significantly more frequently co-existed with S. pneumoniae and H. influenzae than with each other and a positive association of S. pneumoniae and H. influenzae in adenoid samples was evident. Several differences between risk factors for nasopharyngeal and adenoid colonization by the individual pathogens were observed. We conclude that the adenoids and nasopharynx appear to differ substantially in colonization by pathogenic microbes but occurrence of H. influenzae and S. pneumoniae in the nasopharynx could be predictive of upper respiratory tract infections.

The bactericidal effect of ultra-violet radiation on dried films of β-haemolytic streptococci has been shown to be dependent both on the relative humidity and on the nature of the suspending medium from which the films are prepared. In particular, while the bactericidal action is most often more repaid under dry conditions, films prepared from suspensions in dust extract culture show a similar behaviour to that of naturally occurring dust flora and are most resistant to the effects of radiation under dry conditons.

B. dysenteriae (Sonne Type III) may be separated from the dispar group by the fact that it is indol negative and zylose negative. It is usually inagglutinable when freshly isolated but will remove all agglutinins from a Sonne serum. B. dysenteriae (Sonne Type III) is a serological entity and can readily be distinguished from B. dysenteriae Flexner and from the dispar group. Eleven strains of B. dysenteriae (Sonne Type III) have been isolated and examined, along with standard cultures of this group of organisms.

As the literature on Haemophilus ducreyi and clinical chancroid is reviewed, it becomes obvious that many significant findings have been forgotten over the years. As a result, from the time of Ducrey's original description of the organism in 1890 until about 1977, both clinical and laboratory experts in the United Kingdom believed that H. ducreyi infections were rare, generally acquired abroad, and almost impossible to confirm in the routine laboratory! In consequence it was a common view that it was not worth looking for H. ducreyi until all other possible causes of genital ulceration had been excluded. Moreover, the search for such an infection stopped as soon as any other cause for the patient's lesions had been found.

A decision to ignore this ‘rule’ in Sheffield led to our looking for H. ducreyi in specimens from an unselected series of patients with genital ulceration including a number with herpes genitalis infections. The surprise finding of H. ducreyi in circumstances suggesting that it was a secondary invader made us re-examine the whole question of H. ducreyi infections and chancroid and wonder if the same organism can act as a primary pathogen and as a secondary invader. An account of the media and methods we used and of the characteristics of the organism is presented. In an attempt to find out more about the characteristic coherent colonies of H. ducreyi we studied them with the scanning electron microscope. It is clear that the whole subject of H. ducreyi infections has been neglected in the United Kingdom, but we believe that interest has now been aroused and progress will surely follow. Some areas for further investigation are suggested.

This study was undertaken to detect Trypanosoma evansi infection in clinically ill cattle, buffaloes and horses that were suspected of ‘surra’ infection. Various diagnostic tests were utilized in order to assess the prevalence of infection in the clinically ill and ‘suspected’ animals. Animals in the Eastern Region of India were systematically studied for T. evansi infection, which had not been tested for previously. Examination of Giemsa-stained blood smears detected 5·3%, 9·4% and 40·6% infections; the mouse inoculation test detected 18·4%, 15·6% and 46·9% infections whereas an in-house ELISA detected anti-trypanosomal antibodies in 42·1%, 43·8% and 65·6% infections in clinically ill buffaloes, cattle and horses, respectively. It can be concluded that T. evansi is prevalent in cattle, buffaloes and horses in the Eastern Region of India.

Cross-reactions of 17 members of the family Legionellaceae were studied by four different serological techniques: immunofluorescence (IF), slide agglutination (SA), microagglutination (MA) and immunodiffusion (ID), using antigens and rabbit antisera prepared in our laboratory. Results obtained corresponded closely with those described by other authors, especially for IF and SA.

The 17 antigens were further tested by IF with a panel of sera previously diagnosed as positive for legionella. A high number of positive reactions with several of the antigens tested were found, half of them being positive for Legionella pneumophila serogroup 1, usually in combination with other serogroups or species. The remaining sera presented a great variety of patterns combining different antigens.

A Bayesian Belief Network (BBN) for assessing the potential risk of dengue virus emergence and distribution in Western Australia (WA) is presented and used to identify possible hotspots of dengue outbreaks in summer and winter. The model assesses the probabilities of two kinds of events which must take place before an outbreak can occur: (1) introduction of the virus and mosquito vectors to places where human population densities are high; and (2) vector population growth rates as influenced by climatic factors. The results showed that if either Aedes aegypti or Ae. albopictus were to become established in WA, three centres in the northern part of the State (Kununurra, Fitzroy Crossing, Broome) would be at particular risk of experiencing an outbreak. The model can also be readily extended to predict the risk of introduction of other viruses carried by Aedes mosquitoes, such as yellow fever, chikungunya and Zika viruses.

The following is an account of the bacteriological examinations for diphtheria bacilli made by me at the University Pathological Laboratory, from October 23, 1900 to Jan. 5, 1901; a period which includes all but the first week of the outbreak described in the preceding paper.

Attempts were made to discover the source of strains of haemolytic Escherichia coli infecting weaned pigs on a piggery. The organisms were not detected in the faeces of sows in the farrowing house, or in the in the faeces or intestinal tracts of slaughtered bacon pigs or sows. Sows held in a quarantine unit, and their offspring born in the unit, did not excrete haemolytic E. coli until after they were returned to the piggery.

The environment of the piggery was the most likely source of infection for weaned pigs, and routine cleaning and disinfection of the accommodation did not prevent infection. Unweaned pigs were however able to transfer haemolytic E. coli to a newly built, previously unused weaning house, and establish a cycle of infection.

Rapidly growing mycobacteria (RGM) are environmental organisms that have emerged as significant human pathogens. RGM infections show remarkable geographic variations. In this study, based on data from Houston, Texas, RGM were isolated from clinical cultures year-round, although peaks in the summer and autumn correlating with the seasonal variation of temperature and rainfall also were noted. These results may offer some explanation for the summer occurrence of RGM outbreaks at diverse locations.