The present study attempted to analyse human papillomavirus (HPV) genotype distribution and its association with cervical cytology results in women in western China. The present retrospective analysis was performed in 1089 female outpatients with a positive HPV test result who had undergone a cervical cytology test at the gynaecological clinic, West China Second Hospital, Sichuan University, China, between January 2014 and December 2016. Of the 1089 patients with HPV infection, multiple HPV genotypes were detected in 220 patients (20.20%). Among the 1368 HPV genotypes detected, 1145 (83.70%) were high-risk subtypes. The most common genotypes were HPV-52 (18.64%), HPV-16 (16.59%), HPV-58 (13.23%), HPV-18 (6.80%), HPV-56 (5.56%) and HPV-59 (5.56%). Cervical cytology revealed abnormal cells in 430 (39.49%) patients. The most common diagnoses were atypical squamous cells of undetermined significance (ASC-US; 236 cases, 54.88%), low-grade squamous intraepithelial lesions (LSIL; 151 cases, 35.12%), high-grade squamous intraepithelial lesions (HSIL; 63 cases, 14.65%) and atypical glandular cells (AGC; 21 cases, 4.88%). HPV-66 was significantly associated (P = 0.037) with ASC; HPV-52 and HPV-56 were significantly associated with LSIL (P = 0.009 and 0.026, respectively); HPV-16 (P < 0.001), HPV-33 (P = 0.014) and HPV-58 (P = 0.003) were significantly associated with HSIL; and HPV-16 (P = 0.005) was significantly associated with AGC. HPV-16, HPV-52 and HPV-58 are associated with different diagnoses in patients with positive cervical cytological findings.

These animal experiments corroborate the findings in the blood of anilin and nitro-benzine workers and enable us to follow the sequence of events, which appear to be the same in cases of poisoning by either of these bodies, though they are much more marked in the case of the latter.

These bodies may gain access to the body either by (1) inhalation of their vapours; (2) absorption through the skin; (3) absorption from the alimentary canal after being swallowed.

Probably the first method occurs most commonly, since cases of poisoning are much more frequent in hot close weather than during the colder seasons of the year. No matter how they are absorbed these bodies appear to have the same action on the blood, which is as follows:

They first convert the oxy-haemoglobin of the red corpuscles into met-haemoglobin, this is followed by haemolysis, degeneration of cytoplasm and escape of haemoglobin into the plasma.

If a considerable amount of met-haemoglobin is present in the blood, the respiratory capacity of the red corpuscles is diminished, the patient becomes cyanosed and the colour of the blood is changed to a chocolate brown. This fact renders the estimation of haemoglobin by the ordinary colour standards impossible, as they are based on the colour of pure oxy-haemoglobin, which is quite different from that of met-haemoglobin.

In the less severe cases of poisoning in which met-haemoglobin is not present in sufficient amount to be detected spectroscopically, the changes which may be found in the blood are sufficiently characteristic to enable a diagnosis of anilin or nitro-benzine poisoning to be made.

These consist in:

(1) A decrease in the percentage of haemoglobin as estimated from the specific gravity of the blood of from 5% to 50%.

(2) A decrease in the number of red corpuscles if the amount of poison absorbed is considerable; if the dose is very small this decrease is not found, blood formation apparently keeping pace with blood destruction.

(3) Degeneration and imperfect development of the red corpuscles as shown by the occurrence of basophil granulations, polychromasia, poikilocytosis, and variations in size.

(4) The presence of nucleated red corpuscles in severe cases.

(5) A decrease in leucocytes rapidly followed by an increase; the increase being principally due to the number of lymphocytes.

The simultaneous occurrence of all or several of these signs in the blood enables a diagnosis of poisoning by anilin or nitro-benzine to be made in quite mild cases.

Cessation from work for a short time enables the blood to recover rapidly from the effects of poisoning.

The best treatment in any severe case of poisoning by these bodies appears to be inhalation of oxygen.

Haldane, Makgill, and Mavrogordato found that mice could be kept alive in oxygen at a pressure of two atmospheres even when 90% of their blood had been converted into met-haemoglobin by injection of sodium nitrite. They also showed that animals showing severe symptoms of di-nitro-benzol poisoning recovered rapidly when placed in oxygen, and that as other substances besides met-haemoglobin are produced by the decomposition of the haemoglobin, the absence of a met-haemoglobin band is no evidence that the symptoms are not due to oxygen asphyxia.

Permission to publish this paper has kindly been given by Mr H. L. Samuel, Chairman of the Home Office Committee on Industrial Diseases.

Corynebacterium ulcerans (toxigenic C. ulcerans) produces the diphtheria toxin, which causes pharyngeal and cutaneous diphtheria-like disease in people, and this bacterium is commonly detected in dogs and cats that are reared at home. It is considered dangerous when a carrier animal becomes the source of infection in people. To investigate the carrier situation of toxigenic C. ulcerans of cats bred in Japan, bacteria were isolated from 37 cats with a primary complaint of rhinitis in 16 veterinary hospitals in Osaka. Toxigenic C. ulcerans was detected in two of the cats. By drug sensitivity testing, the detected bacterium was sensitive to all investigated drugs, except clindamycin. It appears necessary to create awareness regarding toxigenic C. ulcerans infection in pet owners because this bacterium is believed to be the causative organism for rhinitis in cats.

Estimating the case fatality ratio (CFR) for COVID-19 is an important aspect of public health. However, calculating CFR accurately is problematic early in a novel disease outbreak, due to uncertainties regarding the time course of disease and difficulties in diagnosis and reporting of cases. In this work, we present a simple method for calculating the CFR using only public case and death data over time by exploiting the correspondence between the time distributions of cases and deaths. The time-shifted distribution (TSD) analysis generates two parameters of interest: the delay time between reporting of cases and deaths and the CFR. These parameters converge reliably over time once the exponential growth phase has finished. Analysis is performed for early COVID-19 outbreaks in many countries, and we discuss corrections to CFR values using excess-death and seroprevalence data to estimate the infection fatality ratio (IFR). While CFR values range from 0.2% to 20% in different countries, estimates for IFR are mostly around 0.5–0.8% for countries that experienced moderate outbreaks and 1–3% for severe outbreaks. The simplicity and transparency of TSD analysis enhance its usefulness in characterizing a new disease as well as the state of the health and reporting systems.

Vulnerability to coronavirus disease (COVID)-19 varies due to differences in interferon gamma (IFNγ) immunity. We investigated whether a key modifiable interferon precursor, interleukin-18, was related to COVID-19, overall and by severity, using Mendelian randomisation. We used four established genome-wide significant genetic predictors of interleukin-18 applied to the most recent genome-wide association study of COVID-19 (June 2021) to obtain Mendelian randomisation inverse variance weighted estimates by severity, i.e. any (cases = 112 612, non-cases = 2 474 079), hospitalised (cases = 24 274, non-cases = 2 061 529) and very severe (cases = 8779, non-cases = 1 001 875) COVID-19. To be comprehensive, we also conducted an exploratory analysis for IFNγ and two related cytokines with less well-established genetic predictors, i.e. interleukin-12 and interleukin-23. Genetically predicted interleukin-18 was associated with lower risk of any COVID-19 (odds ratio (OR) 0.96 per standard deviation, 95% confidence interval (0.94–0.99, P-value 0.004)) and of very severe COVID-19 (OR 0.88, 95% CI 0.78–0.999, P-value 0.048). Sensitivity analysis and a more liberal genetic instrument selection gave largely similar results. Few genome-wide significant genetic predictors were available for IFNγ, interleukin-12 or interleukin-23, and no associations with COVID-19 were evident. Interleukin-18 could be a modifiable target to prevent COVID-19 and should be further explored in an experimental design.

The anticipated worldwide surge in urban environments is generating ever-greater interest in the study of host–pathogen interactions in this specific type of habitat. We investigated the potential of city-inhabiting rodents to serve as the main Lyme borreliosis agents (Borrelia spp.) reservoir. We also tried to verify if anthropogenic disturbances changing the vertebrate species community composition may also alter the scheme of Borrelia spp. circulation. A total of 252 Apodemus mice (A. agrarius, A. flavicollis, A. sylvaticus) were captured in Warsaw (Poland), at sites classified into different zones of anthropogenic disturbance, ranging from suburban forests to municipal parks strictly in the city centre. Borrelia spp. infection, ascertained based on bacterium DNA presence in the rodents’ blood, was found only in A. agrarius and A. flavicollis (7.6 and 6%, respectively). Only one species from the Borrelia genus – the mammal-associated species B. afzelii – was found in the mice studied. We found no statistical evidence of a correlation between infection in Apodemus mice and the zone of anthropogenic disturbance where the mice were caught. Non-homogeneous concentrations of Borelia spp. infected specimens within the strict city centre area suggest a lack of contact between members of particular mice subpopulations, and their responsibility for relatively high, but local Borrelia spp. infection.

Salmonellosis is an internationally important disease of mammals and birds. Unique epidemics in New Zealand in the recent past include two Salmonella serovars: Salmonella enterica subsp. enterica serovar Typhimurium definitive type (DT) 160 (S. Typhimurium DT160) and S. Brandenburg. Although not a major threat internationally, in New Zealand S. Typhimurium DT160 has been the most common serovar isolated from humans, and continues to cause significant losses in wildlife. We have identified DNA differences between the first New Zealand isolate of S. Typhimurium DT160 and the genome-sequenced strain, S. Typhimurium LT2. All the differences could be accounted for in one cryptic phage ST64B, and one novel P22-like phage, ST160. The majority of the ST160 genome is almost identical to phage SE1 but has two regions not found in SE1 which are identical to the P22-like phage ST64T, suggesting that ST160 evolved from SE1 via two recombination events with ST64T. All of the New Zealand isolates of DT160 were identical indicating the clonal spread of this particular Salmonella. Some overseas isolates of S. Typhimurium DT160 differed from the New Zealand strain and contained SE1 phage rather than ST160. ST160 was also identified in New Zealand isolates of S. Typhimurium DT74 and S. Typhimurium RDNC-April06 and in S. Typhimurium DT160 isolates from the USA. The emergence of S. Typhimurium DT160 as a significant pathogen in New Zealand is postulated to have occurred due to the sensitivity of the Salmonella strains to the ST160 phage when S. Typhimurium DT160 first arrived.

Group B Streptococcal isolates (n = 235) from the South of Ireland were characterised by serotyping, antimicrobial susceptibility and determination of the phenotypic and genotypic mechanisms of resistance. Resistance to erythromycin and clindamycin was observed in 21·3% and 20·4% of the total population, respectively. The c-MLSB phenotype was the most common phenotype detected (62%), with ermB being the predominant genetic determinant, present in 84% of resistant isolates. The rare L phenotype was observed in 2·9% (n = 7) of isolates, four of which harboured the lsaC gene responsible for clindamycin resistance. Serotypes Ia, III and II were the most common amongst the entire study population (28·1%, 24·7% and 14%, respectively). Four of the seven L phenotype isolates were serotype III and two of these strains were confirmed as the hypervirulent clone, ST-17 and harboured the hvgA gene. This is the first documented case of the L phenotype in Ireland to date and the study findings emphasise the need for continued monitoring of antibiotic resistance and serotype distribution in GBS isolates from Ireland.

An investigation of Salm. saint-paul infection in England and Wales in 1959 is described. In one-third of the human incidents the infection was attributed to home-produced meat coming from two infected abattoirs.

Animal infection was demonstrated and was probably due to contaminated imported animal feedingstuffs.

The clinical histories of 55 of the 89 cases reported during the year were studied. There was one death. In ten patients the illness commenced with fever and malaise and diarrhoea was absent or did not occur until 24–48 hr. later. One patient developed meningitis and another an abdominal abscess.

Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is lasting for more than 1 year, the exposition risks of health-care providers are still unclear. Available evidence is conflicting. We investigated the prevalence of antibodies against SARS-CoV-2 in the staff of a large public hospital with multiple sites in the Antwerp region of Belgium. Risk factors for infection were identified by means of a questionnaire and human resource data. We performed hospital-wide serology tests in the weeks following the first epidemic wave (16 March to the end of May 2020) and combined the results with the answers from an individual questionnaire. Overall seroprevalence was 7.6%. We found higher seroprevalences in nurses [10.0%; 95% confidence interval (CI) 8.9–11.2] than in physicians 6.4% (95% CI 4.6–8.7), paramedical 6.0% (95% CI 4.3–8.0) and administrative staff (2.9%; 95% CI 1.8–4.5). Staff who indicated contact with a confirmed coronavirus disease 2019 (COVID-19) colleague had a higher seroprevalence (12.0%; 95% CI 10.7–13.4) than staff who did not (4.2%; 95% CI 3.5–5.0). The same findings were present for contacts in the private setting. Working in general COVID-19 wards, but not in emergency departments or intensive care units, was also a significant risk factor. Since our analysis points in the direction of active SARS-CoV-2 transmission within hospitals, we argue for implementing a stringent hospital-wide testing and contact-tracing policy with special attention to the health care workers employed in general COVID-19 departments. Additional studies are needed to establish the transmission dynamics.

We aimed to explore Campylobacter genotype-specific risk factors in Australia. Isolates collected prospectively from cases recruited into a case-control study were genotyped using flaA restriction fragment-length polymorphism typing (flaA genotyping). Exposure information for cases and controls was collected by telephone interview. Risk factors were examined for major flaA genotypes using logistic and multinomial regression. Five flaA genotypes accounted for 325 of 590 (55%) cases – flaA-6b (n=129), flaA-6 (n=70), flaA-10 (n=48), flaA-2 (n=43), flaA-131 (n=35). In Australia, infections due to flaA-10 and flaA-2 were found to be significantly associated with eating non-poultry meat (beef and ham, respectively) in both case-control and inter-genotype comparisons. All major genotypes apart from flaA-10 were associated with chicken consumption in the case-control comparisons. Based on several clinical criteria, infections due to flaA-2 were more severe than those due to other genotypes. Thus genotype analysis may reveal genotype-specific niches and differences in virulence and transmission routes.

Knowledge of carriage and population dynamics of Staphylococcus aureus is crucial for infection risk assessment and to reveal transmission patterns of strains. We report the prevalence and molecular epidemiology of S. aureus in elderly people (n = 290) living in nursing homes in three cities in the south of Sweden. The overall carriage prevalence rate was 48% when results from nares (31%) and throat (34%) samples were combined. Common spa types were equally distributed but a frequent type, t160, was found only in one of the regions. Carriage of different spa types was detected in 23% of individuals and antimicrobial resistance rates were higher in S. aureus isolates from those carrying more than one spa type. Five of the 21 individuals who carried different spa types were colonized simultaneously with resistant and non-resistant strains. Seventeen per cent of the individuals carried S. aureus of the same spa type on all occasions. Methicillin resistance was not detected. In conclusion we found a high prevalence of S. aureus in this elderly population with a high rate of dual colonization with different spa types. We also found signs of institutional spread of one strain.

When ten cats were infected orally with undiluted or a 10−1 dilution of virulent feline infectious enteritis (panleucopaenia) virus, all developed severe leucopaenia followed by the development of demonstrable antibody, but none died. Eighteen of 29 cats given a 10−2 dilution of virus died of the disease. Three of the survivors had white blood cell counts of less than 4000 and three had counts between 4000 and 6000 cells. Although the remaining five animals never had individual counts of less than 6000 cells, the geometric means of these counts showed that a marked depression in the leucocyte counts had occurred. All surviving cats developed antibody.

Among the ten cats dosed with either 10−3 or 10−4 dilution of virus, four died of feline infectious enteritis and three developed antibody after falls in the leucocyte counts. It is suspected that low dilutions of feline infectious enteritis virulent virus in cats produce a phenomenon similar to that reported by von Magnus (1954) with influenza virus in eggs.

Leucopaenia is commonly defined as less than 4000 white blood cells/mm.3 of blood. Counts lower than this are usual in cats which either die of the disease or have received large doses of virus; they are less common in cats surviving after administration of diluted virus. Challenge of cats with pre-existing antibody did not provoke a depression in the leucocyte counts.

A comparison of neutralizing and immunofluorescent (IF) IgG antibody tests in 18 sera from 10 cases of hand, foot and mouth disease (HFMD) showed a variety of responses but all sera taken more than one week after infection had both neutralizing and IF IgG antibodies.

A survey of IF IgG antibody in 80 paediatric and 80 adult non-HFMD case sera gave antibody detection rates of 47·5% and 11·3% respectively. This difference could be attributed to a decline in IF IgG antibody with time after infection. Three point nine per cent of 2G sera from possible adult carditis cases had IF antibody suggesting that coxsackie A16 virus was not a common cause of adult carditis. Forty-eight point three per cent of 29 sera from cases of spontaneous abortion had detectable IF antibody, a rate similar to the paediatric sera and significantly greater than that in adult male (7·9%) and other adult female (13%) sera tested. This interesting observation requires further study.

An autoradiographic method to trace the dissemination in water of radioactive bacteria is reported. It has been tested for accuracy and sensitivity and a field trial has been performed. The method appears suitable for practical use and permits the study of environmental effects on the spreading bacteria.

In August 2011, we investigated an outbreak of Escherichia coli O157 in Plymouth, England, utilizing a case-control study and food traceback. Nine cases, eight laboratory-confirmed with E. coli O157 phage type 21/28 verocytotoxin 2 and one epidemiologically linked, had onsets from 30 July 2011 to 15 August 2011. We compared cases (n = 8) with controls (n = 28) of similar age and sex (median age 61 vs. 55 years, females 75% vs. 61%). Cases were 58 times more likely to have eaten crab (88% vs. 11%; odds ratio 58, 95% confidence interval 4-2700). Eight cases consumed crab sourced from the same supplier who was not registered with the local authority. This outbreak pointed to crab as a possible vehicle of E. coli O157 infection. We ensured the withdrawal of crab meat sourced from unregistered suppliers from food venues by 25 August 2011. We also emphasized the importance of only using registered suppliers to the food venues. Since then no further associated cases have been reported.

1. The recovery, after poisoning, of the rat population of eight sewer systems was measured by the bait-census method.

2. In three of the systems the mean rate of increase was of the order of 3% per week. This is attributed solely to breeding and is regarded as typical for rats in sewers.

3. Higher rates of increase (up to 11·8%) were also recorded but are believed to have been partly due to immigration or to have been only apparent (as a result of census difficulties).

4. The consequences for control of a rate of increase as low as 3% per week are discussed.

Our thanks are due to eight Local Authorities, their Chief Public Health Officers and members of their staffs, without whose help the work would have been impossible, and to a number of colleagues, especially Mr J. H. Greaves, who helped with much of the census work.

Understanding seasonal changes in age-related incidence of infections can be revealing for disentangling how host heterogeneities affect transmission and how to control the spread of infections between social groups. Seasonal forcing has been well documented in human childhood diseases but the mechanisms responsible for age-related transmission in free-living and socially structured animal populations are still poorly known. Here we studied the seasonal dynamics of Bordetella bronchiseptica in a free-living rabbit population over 5 years and discuss the possible mechanisms of infection. This bacterium has been isolated in livestock and wildlife where it causes respiratory infections that rapidly spread between individuals and persist as subclinical infections. Sera were collected from rabbits sampled monthly and examined using an ELISA. Findings revealed that B. bronchiseptica circulates in the rabbit population with annual prevalence ranging between 88% and 97%. Both seroprevalence and antibody optical density index exhibited 1-year cycles, indicating that disease outbreaks were seasonal and suggesting that long-lasting antibody protection was transient. Intra-annual dynamics showed a strong seasonal signature associated with the recruitment of naive offspring during the breeding period. Infection appeared to be mainly driven by mother-to-litter contacts rather than by interactions with other members of the community. By age 2 months, 65% of the kittens were seropositive.

A high proportion of young men in this country suffer from premature baldness. Alopecia is not a disease entity but one of the outstanding features of chronic fluorine poisoning (fluorosis). It is frequently associated with dystrophies of other organs of ectodermal origin, namely, those of the skin and its other appendages, the teeth and nails. Since all these organs are regulated by the parathyroid glands, it is concluded that alopecia, too, is produced by fluorine acting through the medium of these endocrine glands. By its ability to precipitate the calcium content of the body, fluorine may lay the foundation for alopecia already in intra-uterine life, or produce it at any time after birth.

The action of fluorine is closely similar to that of thallium. There is ample evidence to show that in both fluorosis and chronic thallium poisoning the vegetative nervous system is vitally involved.

Toxic alopecia due. to fluorine is preventable.

In order to determine whether infection with Schistosoma japonicum is related to a higher rate of infection with hepatitis B virus and/or to a higher probability of HBsAg chronic carriage, a population based survey was carried out in China in which HBV markers were studied in 112 subjects with long-lasting S. japonicum infection, and 93 subjects with no S. japonicum infection 37·5% of the cases and 40·9% of controls showed no markers of HBV infection. The prevalence rate of HBsAg was 12·5% in the cases and 12·9% in the controls. For anti-HBc and anti-HBs the figures were 59·8% and 59·8%, and 27·9% and 35·0%, respectively. These data do not support the hypothesis of an interaction between infection with hepatitis B virus and S. japonicum.