The toxic effect of certain products of Pseudomonas aeruginosa on guinea-pig alveolar macrophages has been studied in an attempt to account for the apparent infrequency with which certain strains of this species are associated with respiratory infection. Tests were carried out on strains derived from the respiratory tract, strains from infection at other sites, and strains from the inanimate hospital environment which were believed not to have been responsible for infection (‘environmental’ strains).

Haemolysin, pigments, enzyme-containing fractions, slime and cell-wall fraction all exhibited toxic activity against macrophages in an in vitro system, although for any given strain of Ps. aeruginosa the haemolysin was by far the most potent factor. The activity of this factor against macrophages was directly proportional to its haemolytic activity against human erythrocytes. The haemolysin fractions of environmental strains, which have previously been found to have little activity on erythrocytes, were also less active against macrophages than haemolysin preparations from ‘infective’ strains.

It is therefore postulated that the ability of a strain of Ps. aeruginosa to initiate respiratory infection may be related to the degree of haemolysin production. The activity of other fractions against macrophages is more variable, but they may contribute in different ways to the development of infection once entry into the lung has been achieved.

The study was conducted to determine whether pre-enrichment would increase sensitivity of detecting Streptococcus (Str.) aqalactiae, Staphylococcus (S.) aureus, and mycoplasma in bovine milk. Two procedures were followed, one involving direct inoculation of milk on bovine blood agar, and the other involving preenrichment in broth followed by inoculation on agar. Logistic regression was used to predict the probability of isolation as a function of culture procedure and two additional covariates. the California Mastitis Test (CMT) score of the milk and the type of sample (indicating sample storage temperature and herd mastitis status). A total of 13778 milk samples was cultured for each of the three bacteria. By using results of both direct inoculation and pre-enrichment, the probability of isolation compared to use of direct inoculation only and adjusted for effects of other variables was increased 3·6-fold for Str. agalactiae, 1·6-fold for S. aureus and 1·7- fold for mycoplasma. The probability of isolation for all three bacteria increased as the CMT score increased. For Str. agalactiae, there was a statistical interaction predicting that enrichment improved the odds of isolation more from milk with high CMT scores than from milk with low scores. Results indicate that preenrichment can substantially increase the sensitivity of bacteriological screening of dairy cows for mastitis caused by Str. agalactiae, S. aureus, and mycoplasma.

The principal data which form the basis of the present paper were tabulated by the writer for the Annual Report of the Chief Inspector of Factories for 1899, and were obtained as a result of an enactment in the Factories and Workshops Act of 1895. This enactment requires every medical practitioner attending on or called in to visit a patient whom he believes to be suffering from lead poisoning, contracted in a factory or workshop, to notify the case forthwith to the Chief Inspector of Factories at the Home Office; and a similar obligation is imposed on the occupier of a factory or workshop to send written notice of every such case to the Certifying Surgeon and Inspector of Factories for the district.

Since 2015, the incidence of invasive meningococcal disease (IMD) caused by serogroup W (MenW) has increased in Sweden, due to the introduction of the 2013 strain belonging to clonal complex 11. The aim of this study was to describe the clinical presentation of MenW infections, in particular the 2013 strain, including genetic associations. Medical records of confirmed MenW IMD cases in Sweden during the years 1995–2019 (n = 113) were retrospectively reviewed and the clinical data analysed according to strain. Of all MenW patients, bacteraemia without the focus of infection was seen in 44%, bacteraemic pneumonia in 26%, meningitis in 13% and epiglottitis in 8%, gastrointestinal symptoms in 48% and 4% presented with petechiae. Phylogenetic analysis was used for possible links between genetic relationship and clinical picture. The 2013 strain infections, particularly in one cluster, were associated with more severe disease compared with other MenW infections. The patients with 2013 strain infections (n = 68) were older (52 years vs. 25 years for other strains), presented more often with diarrhoea as an atypical presentation (P = 0.045) and were more frequently admitted for intensive care (P = 0.032). There is a risk that the atypical clinical presentation of MenW infections, with predominantly gastrointestinal or respiratory symptoms rather than neck stiffness or petechiae, may lead to delay in life-saving treatment.

The annual incidence in 14 361 campylobacteriosis cases reported in Finland in 2002–2005 varied between 61 and 76/100 000 population. The mean incidence was highest (148/100 000) in the 25–29 years age group and lowest (range 21–24/100 000) in children aged 5–14 years and patients aged ⩾75 years. The number of domestic cases was low in winter and peaked in summer. A total of 622 strains isolated from domestic infections and 785 foreign travel-related strains were serotyped. Serotypes Pen 3 and Pen 37 had the strongest association with travel-related infections (96%, P<0·001), and Pen 6,7, Pen 12 and Pen 27 were significantly associated with domestic infections (>70% domestic within each serotype, P<0·001). Pen 2 and Pen 1,44 were less common in older than in younger patients. Of domestic strains, a higher proportion of Pen 2 strains was isolated in winter (18%) compared to the other serotypes (0–10%).

In order to identify and assess recent risk factors for sporadic human infections with Salmonella enterica, we conducted a case-control study in Lower Saxony, Germany. The data collection was based on standardized telephone interviews with 1017 cases and 346 controls aged >14 years. Odds ratios were calculated in single-factor and multi-factor analyses for Salmonella cases and two different control groups, i.e. population controls and controls with rotavirus infection. Multi-factor analysis revealed associations between sporadic Salmonella infections for two exposures by both sets of controls: consumption of raw ground pork [adjusted odds ratio (aOR) 2·38, 95% confidence interval (CI) 1·27–4·44] and foreign travel (aOR 2·12, 95% CI 1·00–4·52). Other exposures included consumption of food items containing eggs (aOR 1·43, 95% CI 0·80–2·54), consumption of chicken meat (aOR 1·77, 95% CI 1·26–2·50), outdoor meals/barbecues (aOR 3·96, 95% CI 1·41–11·12) and taking gastric acidity inhibitors (aOR 2·42, 95% CI 1·19–4·92), all were significantly associated with respect to one of the two control groups. The impact of consuming food items containing eggs or chicken meat was lower than expected from the literature. This might be a consequence of Salmonella control programmes as well as increased public awareness of eggs and chicken products being a risk factor for salmonellosis. Efforts to reduce Salmonella infections due to raw pork products should be intensified.

Two DNA clones were obtained from faecal specimens containing a parvovirus-like small round virus from a 1977 outbreak of gastroenteritis, and their nucleotide sequences were determined and found to be essentially identical with parts of the published sequence of serum parvovirus B19 and with a B19 isolate (JB) partially sequenced in this study. The clones corresponded mainly to genome regions coding for non-structural proteins, but also include a sequence of some 160 bp coding for structural proteins. Southern blotting experiments with a full-length B19 probe revealed a virion-sized 5·5 kbp DNA band in specimens from gastroenteritis cases in both 1977 and 1986. Thus the nucleotide sequence and hybridization results suggest that the virus seen in these studies is very similar to B19. Further work is necessary to clarify the antigenic relationship of these viruses.

Pour thousand two hundred and forty six samples of retail processed food were examined for the presence of Escherichia coli. Overall 12% of samples contained this organism, cakes and confectionery being more frequently contaminated (28%) than meat and meat based products (9%). Contamination was more frequent in the summer months than in the colder weather and 27% of the contaminated foods contained > 103E. coli/g. E. coli from meat and meat based products were more commonly resistant to one or more antibiotics (14%) than were confectionery strains (1%). The significance of these findings in relation to the E. coli population of the human bowel is discussed.

Methicillin-resistant Staphylococcus aureus (MRSA) is a major public health concern associated with residence in a long-term care facility (LTCF). The aim of this prospective study was to characterize MRSA isolated from residents over a 1-year period and their physical environment over a 2-year period. MRSA was recovered from 17/64 residents (R) of a LTCF and from 42 environmental (E) sites. All isolates carried the mecA gene and lacked the mecC and Panton–Valentine leukocidin (PVL) genes. Thirteen spa types were identified with t032 being the most frequent (41% of total; n = 8R, 16E), followed by t727 (22% of total; n = 13E), and t8783 (10% of total; n = 6E). Five spa types were each represented by single isolates. Thirty-nine isolates were of spa types associated with the multilocus sequence type ST22 (t032, 41%; spa-CC22, 68%) and reflect the predominance of ST22 in Irish hospitals. The uncommon spa types t727, t8783, t1372, t3130, t10038 were present in the environment but not detected in residents and are infrequently observed in Ireland.

We conducted an epidemic investigation to discover the route of transmission and the host factors of an outbreak of post-injection abscesses. Of the 2984 patients who visited a single clinic, 77 cases were identified and 208 age- and sex-matched controls were selected for analysis. Injected medications per se were not found to be responsible, and a deviation from safe injection practice suggested the likelihood of diluent contamination. Therefore the injected medications were classified according to whether there was a need for a diluent, and two medications showed a statistically significant association, i.e. injection with pheniramine [adjusted odds ratios (aOR) 5·93, 95% confidence interval (CI) 2·97–11·87] and ribostamycin (aOR 47·95, 95% CI 11·08–207·53). However, when considered concurrently, pheniramine lost statistical significance (aOR 8·71, 95% CI 0·44–171·61) suggesting that normal saline was the causative agent of this outbreak. Epidemiological evidence strongly suggested that this post-injection outbreak was caused by saline contaminated with Mycobacterium massiliense without direct microbiological evidence.

Four groups of sows were inoculated, either once or twice, with O1BFS 1860 foot and mouth disease oil-emulsion vaccine during pregnancy and samples of serum. for analysis, were collected at intervals for > 300 days.

The pregnant sows responded well to vaccination regardless of their state of gestation. Single vaccination produced protective levels of antibody (> 1·53 log10SN50) in 3 out of 4 sows while double vaccination produced protective levels in all 6 sows tested. Anti-FMD IgM antibodies could be detected for 40–60 days after vaccination or revaccination. Anti-FMD IgG antibodies appeared within 10 days of vaccination and persisted, in each sow, for the duration of the study. The anti-FMD IgA response observed was less easy to characterize due to significant animal to animal variation. Although there was no evidence of a fall in the neutralizing antibody titres over one year post vaccination the anti-FMD IgG antibody population did show signs of a change in its heterogenity and avidity.

In 2015, the Belgian National Reference Centre for Bordetella analyzed 4110 respiratory samples by qPCR and 4877 serum samples by serology. Whereas about 50% of respiratory samples were from infants and children below the age of five, serum samples were distributed among all age categories. A total of 394 (9·6%) cases was diagnosed as positive for Bordetella pertussis by qPCR and 844 (17·3%) cases were diagnosed as acute infection by serology (anti-pertussis toxin (PT) IgG > 125 IU/ml). Another 1042 (21·4%) sera had anti-PT IgG between 55 and 125 IU/ml reflecting a vaccination or pertussis infection during the last 1–2 years. Seventy per cent of the pertussis cases diagnosed by qPRC were in infants and children younger than 14 years old, whereas the highest number of sera with anti-PT levels >125 IU/ml was in the age group of 10–14 years old. Based on the limited data of the last vaccination (reported for only 15% of the samples), recent booster vaccination in the teenager group may have contributed only minimally to these elevated anti-PT levels. The highest number of sera with anti-PT titers between 55 and 125 IU/ml was found in the age category 50–59 years old. It is clear that pertussis continues to be a problem in Belgium and that other vaccination strategies (maternal vaccination, cocoon vaccination) and ultimately better vaccines will be needed to control this highly infectious respiratory disease.

This report presents the parasitological, bacteriological, mycological and physicochemical data obtained from both surface water and beach sand of a lake used for water sports. These show that the lake is contaminated in both winter and spring by water which overflows from the River Maine, and is self-purified by a mechanism of ‘lagunage’. In summer signs of pollution are at their lowest level although use of the complex is at its peak. Conversely, the amoebic flora, which is independent of the usual criteria of pollution, predominates in summer, and serves as a marker for the need for increased surveillance. The sand of the beaches does not appear to show any infectious hazard. Environmental pressure will doubtless change these data over a period of time, and it is planned to monitor this.

Susceptibilities to amphotericin B and fluconazole of 628 clinical yeast strains collected from 22 hospitals in Taiwan were determined. A total of 53 isolates (8·4%) were resistant to fluconazole. Each hospital had different resistance rate to fluconazole ranging from 0% to 24%. None of the 186 isolates from eight of the 22 hospitals was resistant to fluconazole. In contrast, isolates from nine of the remaining 14 hospitals had greater than 10% resistance rate to fluconazole. Consistently, 88·9% (8/9) fluconazole-resistant C. albicans isolates were from hospitals having a high resistance rate to fluconazole. The prevalence of various Candida spp. in each hospital was different. A positive association was found between the prevalence of C. tropicalis and the resistance rate to fluconazole for individual hospitals. Although only three isolates (0·5%) were resistant to amphotericin B, a co-resistance to both amphotericin B and fluconazole was observed, which highlights the emerging problem of drug resistance.

The efficacy of three anticoagulant rodenticides for use against the Indian field mouse, Mus booduga, was evaluated in the laboratory. The poisons, namely warfarin, bromadiolone and brodifacoum, were all found to be toxic enough at the concentrations normally used against other commensal and field rodents. With brodifacoum (0·00125%), bromadiolone (0·005%) and warfarin (0·025%), 83% of the animals died respectively after 1, 1 and 6 days' feeding. It is suggested that brodifacoum and bromadiolone might be more economical than warfarin for use in practical rodent control.

An epidemiologic investigation was conducted to characterize and evaluate the possibility of a viral aetiology of an outbreak of acute vertigo in Hot Springs Country, Wyoming, during autumn 1992. Case-finding identified Hot Springs County residents who sought medical attention for new onset vertigo during 1 August, 1992–31 January 1993. Thirty-five case-patients and 61 matched controls were interviewed and serum specimens were obtained during January 1993. Case-patients were more likely than controls to report symptoms (e.g. fatigue, sore throat, fever, diarrhoea) of antecedent acute illness. Case-patients did not have a significantly greater prevalence or mean titre of IgG antibodies to respiratory syncytial virus, parainfluenza viruses, Epstein–Barr virus, and cytomegalovirus than controls. Serologic evidence of recent enterovirus infection (IgM antibodies) was found for 74% of case-patients compared with 54% of controls (P < 0·05), suggesting a possible association between vertigo and enterovirus infection. Future studies are needed to define the role of enteroviruses in inner-ear diseases.

A report is made of a total of 438 simultaneous blood serum and milk ring tests, and an attempt made to evaluate the milk ring test as a diagnostic aid in individual animals.

The ring test has been used to test the bulk milk from some 370 herds providing the greater part of the raw milk supply for Edinburgh.

The incidence of viable Br. abortus in raw milk samples taken in the Edinburgh area has been studied together with the ring test reaction of such samples.

The survey has shown that:

(1) The ring test is correct in some 93 % of cases in detecting cows whose blood serum will be found positive to the brucella agglutination test.

(2) The ring test, if carefully carried out, is a simple time-saving and accurate screening test for detecting herds possibly infected with brucella.

(3) A high proportion of herd milks (53 %) giving a positive reaction to the ring test is disclosed, and the probable effect of vaccination with strain 19 in giving rise to this figure is noted.

(4) The relatively high incidence (at least 10·5%) of Br. abortus in Edinburgh milk supplies is noted.

Thanks are tendered to Dr Bruhn of the Veterinary School, and Dr Bendtsen, Veterinary State Serum Institute, both of Copenhagen and to Dr Stableforth of the Ministry of Agriculture and Fisheries Laboratory at Weybridge, for providing samples of stained antigen. Thanks are also due to the Bacteriology Department, Edinburgh University, for providing material from guinea-pigs and for relevant information; to J. Norval, Esq., M.R.C.V.S., for permission to obtain samples from the slaughterhouse, and also to the dairies and farmers who granted facilities for taking samples and to Miss Elma Chapman for assistance in the laboratory studies and in taking samples.

Indonesia has reported the most human infections with highly pathogenic avian influenza (HPAI) A(H5N1) virus worldwide. We implemented enhanced surveillance in four outpatient clinics and six hospitals for HPAI H5N1 and seasonal influenza viruses in East Jakarta district to assess the public health impact of influenza in Indonesia. Epidemiological and clinical data were collected from outpatients with influenza-like illness (ILI) and hospitalized patients with severe acute respiratory infection (SARI); respiratory specimens were obtained for influenza testing by real-time reverse transcription–polymerase chain reaction. During October 2011–September 2012, 1131/3278 specimens from ILI cases (34·5%) and 276/1787 specimens from SARI cases (15·4%) tested positive for seasonal influenza viruses. The prevalence of influenza virus infections was highest during December–May and the proportion testing positive was 76% for ILI and 36% for SARI during their respective weeks of peak activity. No HPAI H5N1 virus infections were identified, including hundreds of ILI and SARI patients with recent poultry exposures, whereas seasonal influenza was an important contributor to acute respiratory disease in East Jakarta. Overall, 668 (47%) of influenza viruses were influenza B, 384 (27%) were A(H1N1)pdm09, and 359 (25%) were H3. While additional data over multiple years are needed, our findings suggest that seasonal influenza prevention efforts, including influenza vaccination, should target the months preceding the rainy season.

The aim of this study was to examine the population structure, transmission and spatial relationship between genotypes of Shiga toxin-producing Escherichia coli (STEC) and Campylobacter jejuni, on 20 dairy farms in a defined catchment. Pooled faecal samples (n = 72) obtained from 288 calves were analysed by real-time polymerase chain reaction (rtPCR) for E. coli serotypes O26, O103, O111, O145 and O157. The number of samples positive for E. coli O26 (30/72) was high compared to E. coli O103 (7/72), O145 (3/72), O157 (2/72) and O111 (0/72). Eighteen E. coli O26 and 53 C. jejuni isolates were recovered from samples by bacterial culture. E. coli O26 and C. jejuni isolates were genotyped using pulsed-field gel electrophoresis and multilocus sequence typing, respectively. All E. coli O26 isolates could be divided into four clusters and the results indicated that E. coli O26 isolates recovered from calves on the same farm were more similar than isolates recovered from different farms in the catchment. There were 11 different sequence types of C. jejuni isolated from the cattle and 22 from water. An analysis of the population structure of C. jejuni isolated from cattle provided evidence of clustering of genotypes within farms, and among groups of farms separated by road boundaries.

The stability of IS6110 restriction fragment length polymorphism (RFLP) pattern was determined in 31 isolates from patients with multidrug-resistant tuberculosis (MDR-TB). These patients were in actual chains of transmission and they referred to the National Institute of Tuberculosis and Lung Diseases, Tehran, Iran. Susceptibility testing against first- and second-line drugs were performed by the proportional method on Lowenstein–Jensen culture media. Thereafter, DNA fingerprinting by IS6110 with direct repeat (DR) region as a probe was performed by standard protocols. The rate of IS6110 changes was 16%, although, no variation was found in the DR region, in a time-span of 1–63 months. The strains with unstable IS6110 patterns were resistant to all drugs tested, and the majority of them (60%) were collected from HIV-positive patients. The results demonstrated that for a reliable interpretation of strain typing, it is better to use an additional marker along with IS6110 RFLP.