Pertussis diagnosis among adults is primarily based on serology. In this study, receiver operation characteristics (ROC) analysis was utilized to evaluate three IgA, IgM and IgG ELISAs based on B. pertussis whole-cell sonicate (WC), pertussis toxin (PT), or combined PT-filamentous haemagglutinin (FHA) antigens in a healthy adult population and in adults suffering from symptoms consistent with pertussis. The assays were compared to a PT and FHA reference ELISA. The reference assay showed high correlation with PT- and PT-FHA-based ELISAs but low correlation was found with the WC-based ELISA. However, ROC analysis indicated that all the assays enabled fine differentiation between healthy subjects and subjects suffering from symptoms suggestive of pertussis. The WC IgA ELISA showed the best diagnostic performance [highest specificity (98·8%) with highest sensitivity (53·8%)]. We conclude that despite a low correlation between the various assays they all carry good diagnostic capability for an adult population.

Fever is a common adverse event following measles vaccination, more frequent among older children and those receiving Measles-Mumps-Rubella-Varicella vaccine vs. Measles-Mumps-Rubella vaccine, two factors associated with a better antibody response. However, the role of fever in the immunogenicity of measles-containing vaccines (MCV) is unclear. We performed a post-hoc pooled analysis of data of 5 216 11 to 22 month-old children receiving MCV from 2004 to 2012 in Europe and USA to evaluate the association between post-immunisation fever and antibody response, measured by geometric mean concentrations (GMCs). We further evaluated fever as an effect modifier or a mediator in the associations between the type of MCV or the age at first vaccination and vaccine immunogenicity. After the first dose, fever was associated with 60% higher GMCs (95% CI 1.51–1.68). For children vaccinated at ⩾12 months, the fever did not modify and minimally mediated (2% to 3%) the association between age and antibody response. Fever mediated 18% of the association between type of MCV and GMCs. In a model including fever, age and type of vaccine, fever was the strongest predictor of GMCs. These results suggest that fever is associated with a stronger measles antibody response independently of age and type of MCV.

The cell membrane of Mycoplasma gallisepticum was isolated by lysing the cells with digitonin. Chemical and density-gradient analyses and electron microscopy showed the isolated membranes to be relatively free of cytoplasmic contaminants. The density of the membranes exceeded that of other mycoplasma membranes, indicating a higher protein content. Small vesicular extensions seen in the sectioned membranes were interpreted as empty blebs.

The isolated membranes, but not the cytoplasmic fraction, elicited in chickens the production of growth-inhibiting, agglutinating and haemagglutination-inhibition antibodies to M. gallisepticum in titres resembling those obtained by injection of whole cells. The peak of the serological response varied with the serological test employed. The rapid slide-agglutination test became positive as early as 3 days after the first injection of only 50 μg. of membrane protein. The haemagglutination-inhibition antibody titre reached its peak at about 10 days after the first injection, while that of the growth-inhibiting antibodies was reached only at about 25 days. The addition of adjuvant to the membrane antigen did not improve the production of the growth-inhibiting antibodies in chickens, but it produced some improvement in rabbits. Our results support the thesis that the chief immunogens of M. gallisepticum reside in the cell membrane of this organism.

Significant ethnic and socio-economic disparities exist in infectious diseases (IDs) rates in New Zealand, so accurate measures of these characteristics are required. This study compared methods of ascribing ethnicity and socio-economic status. Children in the Growing Up in New Zealand longitudinal cohort were ascribed to self-prioritised, total response and single-combined ethnic groups. Socio-economic status was measured using household income, and both census-derived and survey-derived deprivation indices. Rates of ID hospitalisation were compared using linked administrative data. Self-prioritised ethnicity was simplest to use. Total response accounted for mixed ethnicity and allowed overlap between groups. Single-combined ethnicity required aggregation of small groups to maintain power but offered greater detail. Regardless of the method used, Māori and Pacific children, and children in the most socio-economically deprived households had a greater risk of ID hospitalisation. Risk differences between self-prioritised and total response methods were not significant for Māori and Pacific children but single-combined ethnicity revealed a diversity of risk within these groups. Household income was affected by non-random missing data. The census-derived deprivation index offered a high level of completeness with some risk of multicollinearity and concerns regarding the ecological fallacy. The survey-derived index required extra questions but was acceptable to participants and provided individualised data. Based on these results, the use of single-combined ethnicity and an individualised survey-derived index of deprivation are recommended where sample size and data structure allow it.

1. A typical uncomplicated case of silicosis with fatal outcome in a porcelain turner is described.

2. Microscopic examination of lung tissue and of ashes therefrom showed numerous mineral needles resembling those found in kaolin from his factory.

3. The findings in this case are taken to support in part the theory advanced by W. R. Jones, that silicosis can be produced by fibrous minerals.

We are indebted to Mr Bögvad, M.S., for valuable aid in the mineralogical diagnosis.

In developed countries the majority of hepatitis C virus (HCV) infections occur in injecting drug users (IDUs) with prevalence in IDUs often high, but with wide geographical differences within countries. Estimates of local prevalence are needed for planning services for IDUs, but it is not practical to conduct HCV seroprevalence surveys in all areas. In this study survey data from IDUs attending specialist services were collected in 52/149 sites in England between 2006 and 2008. Spatially correlated random-effects models were used to estimate HCV prevalence for all sites, using auxiliary data to aid prediction. Estimates ranged from 14% to 82%, with larger cities, London and the North West having the highest HCV prevalence. The methods used generated robust estimates for each area, with a well-identified spatial pattern that improved predictions. Such models may be of use in other areas of study where surveillance data are sparse.

Inactivated vaccinia virus vaccines were prepared from purified virus inactivated by either formalin, hydroxylamine or heat. The immunogenicity of these vaccines was assessed in rabbits by measurement of virus neutralizing antibody following each of two inoculations. It was concluded that inactivated vaccinia virus stimulates the production of neutralizing antibody and that the most important single factor in this immunogenicity is the concentration of virus in the vaccine. Vaccines prepared from virus suspensions containing 107 to 108 pfu/ml. before inactivation give variable antibody responses.

Transmission of acute respiratory infections (ARI) and acute gastroenteritis (AGE) often occurs in households. The aim of this study was to assess which proportion of ARI and AGE is introduced and transmitted by children in German households with children attending child care. We recruited families with children aged 0–6 years in Braunschweig (Germany), for a 4 months prospective cohort study in the winter period 2014/2015. Every household member was included in a health diary and used nasal swabs for pathogen identification in case of ARI. We defined a transmission if two persons had overlapping periods with symptoms and used additional definitions for sensitivity analyses. In total, 77 households participated with 282 persons. We observed 277 transmission events for ARI and 23 for AGE. In most cases, the first infected person in a household was a child (ARI: 63%, AGE: 53%), and the risk of within-household transmission was two times higher when the index case was a child. In 26 ARI-transmission events, pathogens were detected for both cases; hereof in 35% (95% confidence interval (17–56%)) the pathogens were different. Thus, symptomatic infections in household members, apparently linked in time, were in 2/3 associated with the same pathogens.

1. Straight-chain α-amino-acids are all equally effective in causing the lysis of Bact. coli.

2. Various modifications of this structure always result in a decrease of this lytic activity.

3. The optical isomers of α-amino-acids are equally effective in causing lysis.

4. There is a correlation between the lytic and the bactericidal powers of the amino-acids and their derivatives.

A new serological method, the platelet aggregation (PA) test, was used to study Group B arbovirus infections, which are often associated with thrombocytopenia. The method is based on the interaction of antigen-antibody complexes with platelets. The PA test was nearly as good as the haemagglutination-inhibition (HI) test for epidemiological studies of tick-borne encephalitis (16 out of 18 HI positive sera) and was superior to the complement-fixation test which was positive in 10 out of 18 HI positive sera. The PA test could be used in the serological diagnosis of Group B arbovirus infection. The titres with the PA test were of the same magnitude as the HI titres, and about ten times higher than the CF titres. Two pairs of dengue haemorrhagic fever sera showed high initial PA titres. The role of immune complexes in the pathogenesis of haemorrhagic fevers is discussed.

Historical outbreaks can be an important source of information in the understanding of norovirus evolution and epidemiology. Here, we revisit an outbreak of undiagnosed gastroenteritis that occurred in Shippensburg, Pennsylvania in 1972. Nearly 5000 people fell ill over the course of 10 days. Symptoms included diarrhea, vomiting, stomach cramps, and fever, lasting for a median of 24 h. Using current techniques, including next-generation sequencing of full-length viral genomic amplicons, we identified an unusual norovirus recombinant (GII.Pg/GII.3) in nine of 15 available stool samples from the outbreak. This particular recombinant virus has not been reported in recent decades, although GII.3 and GII.Pg genotypes have been detected individually in current epidemic strains. The consensus nucleotide sequences were nearly identical among the four viral genomes analysed, although each strain had three to seven positions in the genome with heterogenous non-synonymous nucleotide subpopulations. Two of these resulting amino acid polymorphisms were conserved in frequency among all four cases, consistent with common source exposure and successful transmission of a mixed viral population. Continued investigation of variant nucleotide populations and recombination events among ancestral norovirus strains such as the Shippensburg virus may provide unique insight into the origin of contemporary strains.

Norovirus is detected in one in five diarrhoea episodes in children, yet little is known about environmental risk factors associated with this disease, especially in low-income settings. The objective of this study was to examine environmental risk factors, and spatial and seasonal patterns of norovirus diarrhoea episodes in children in León, Nicaragua. We followed a population-based cohort of children under age 5 years for norovirus diarrhoea over a 1-year period. At baseline, characteristics of each household were recorded. Households were geocoded and spatial locations of garbage dumps, rivers, and markets were collected. In bivariate analysis we observed younger children and those with animals in their households were more likely to have experienced norovirus episodes. In adjusted models, younger children remained at higher risk for norovirus episodes, but only modest associations were observed with family and environmental characteristics. We next identified symptomatic children living in the same household and within 500 m buffer zones around the household of another child infected with the same genotype. Norovirus diarrhoea episodes peaked early in the rainy season. These findings contribute to our understanding of environmental factors and norovirus infection.

Threads were infected with the spores of four species of bacteria and put inside rubber gloves which were sealed into plastic bags and irradiated with electrons or gamma rays. A dose of 1·5 Mrad. killed approximately 99·99% of the spores of each species and a dose of 2·5 Mrad. appeared to give an adequate margin of safety for sterilization. Spores were similarly killed inside plastic tubing and within the lumen of hypodermic needles.

The tensile strength of the gloves decreased with increasing doses of radiation so that the rough, solution-dipped gloves tested were significantly weaker after 8·0 Mrad., but the smooth gloves tested still complied with the British Standard after 30 Mrad. When vacuum-packed before irradiation, rough gloves were still satisfactory after 16 Mrad., and smooth gloves were apparently unaffected by 30 Mrad.; they could, therefore, be sterilized six and twelve times, respectively.

Radiation gives dependable sterilization of rubber gloves, and the use of a sealed plastic package obviates subsequent contamination. The possibility of using disposable radiation-sterilized gloves is discussed, the use of a plastic radiation indicator suggested and the practical applications of radiation sterilization in the hospital considered.

In order to obtain cultures of aerobic bacteria from single cells it is hardly necessary to insist that a method of isolation should be employed which can be relied on to ensure that one organism, and one only, is the starting point for inoculation of the first subculture. Unfortunately, for technical reasons which will be explained, no such method is at present available.

The so-called SC (small colony) and LC (large colony) strains of Mycoplasma mycoides subsp. mycoides are said to be indistinguishable by the in vitro serological tests generally used in mycoplasmology. In mice the immunity given by a single dose of killed LC-strain vaccine against challenge with SC strains is – unlike that given by SC-strain vaccine – only partial.

When multiple doses of killed or living vaccines were given, the majority of 13 LC strains still failed to immunize completely against a SC strain. This suggests that, although some protective antigens are shared between both types of strain, at least one of importance is present in the SC strains but absent from the majority of LC strains. The difference between the protective-antigen content of SC and most LC strains is thus qualitative, and not merely quantitative.

New Zealand has a strategy of eliminating SARS-CoV-2 that has resulted in a low incidence of reported coronavirus-19 disease (COVID-19). The aim of this study was to describe the spread of SARS-CoV-2 in New Zealand via a nationwide serosurvey of blood donors. Samples (n = 9806) were collected over a month-long period (3 December 2020–6 January 2021) from donors aged 16–88 years. The sample population was geographically spread, covering 16 of 20 district health board regions. A series of Spike-based immunoassays were utilised, and the serological testing algorithm was optimised for specificity given New Zealand is a low prevalence setting. Eighteen samples were seropositive for SARS-CoV-2 antibodies, six of which were retrospectively matched to previously confirmed COVID-19 cases. A further four were from donors that travelled to settings with a high risk of SARS-CoV-2 exposure, suggesting likely infection outside New Zealand. The remaining eight seropositive samples were from seven different district health regions for a true seroprevalence estimate, adjusted for test sensitivity and specificity, of 0.103% (95% confidence interval, 0.09–0.12%). The very low seroprevalence is consistent with limited undetected community transmission and provides robust, serological evidence to support New Zealand's successful elimination strategy for COVID-19.

Although true meningococci are represented in serum 1, as shown by the high agglutination figure reached with serum 1 in the case of subculture 8, it appears that the antigenic value of strain 1, as represented in serum 1, finds its chief expression in “giant” forms, the morphological equivalent of films 3, 14, 17, 23, 31 A, from the subcultures which give the highest readings with serum 1 (except 8), being mainly that of “giant” forms in various stages of development. As I showed in 1916 “giant” forms may be either large, small or intermediate in size, and can at once be distinguished from true meningococci on the warm-stage by the fact that they often multiply by unequal binary fission, and by the further fact that they often undergo in addition endo-chromatinolysis, giving rise directly to meningococci which then divide in the ordinary vegetative manner. These fertile “giant” forms are readily distinguishable form forms undergoing genuine involutionary changes, both by the sterility of the latter when observed on the warm stage and by their feebly-staining properties.

Unpurified and purified smallpox vaccines were prepared from calf dermal pulp, or chorioallantoic membrane (CAM) of hen eggs infected with vaccinia virus, and freeze-dried. The protective effect of various suspending media was investigated both in the course of the freeze-drying and in the period of subsequent storage of the dried product at different temperatures, including 100° C.

Single media consisting of either sodium glutamate or peptone were effective in the preservation of both unpurified and purified vaccines prepared from calf dermal pulp or CAM. It was shown that there was an optimal concentration of sodium glutamate for the preservation of the vaccine preparations, especially of the purified vaccine.

Combined media, consisting of soluble starch, polyvinylpyrrolidone or sodium carboxymethyl cellulose with sodium glutamate, were effective with the purified vaccine when the concentration of sodium glutamate exceeded the optimum necessary for preservation.

Streptococcus pneumoniae is an important cause of community-acquired pneumonia and pneumococcal conjugate vaccines (PCVs) may reduce this burden. This study's goal was to analyse trends in lower respiratory tract infections (LRTI) hospitalisations before and during a routine vaccination programme targeting all newborns with PCV was started in the province of Quebec, Canada in December 2004. The study population included hospital admissions with a main diagnosis of LRTI among 6–59 month-old Quebec residents from April 2000 to December 2014. Trends in proportions and rates were analysed using Cochran-Armitage tests and Poisson regression models. We observed a general downward trend in all LTRI hospitalisations rate: from 11·55/1000 person-years in 2000–2001 to 9·59/1000 in 2013–2014, a 17·0% reduction, which started before the introduction of PCV vaccination. Downward trends in hospitalisation rates were more pronounced for all-cause of pneumonia (minus 17·8%) than for bronchiolitis (minus 15·4%). There was also a decrease in the mean duration of hospital stay. There was little evidence that all-cause pneumonia decreased over the study period due mainly to the introduction of PCVs. Trends may be related to changes in clinical practice. This study casts doubt on the interpretation of ecological analyses of the implementation of PCV vaccination programmes.

Orthobunyaviruses, tri-segmented, negative-sense RNA viruses, have long been associated with mild to severe human disease in Africa, but not haemorrhagic fever. However, during a Rift Valley fever outbreak in East Africa in 1997–1998, Ngari virus was isolated from two patients and antibody detected in several others with haemorrhagic fever. The isolates were used to identify Ngari virus as a natural Orthobunyavirus reassortant. Despite their potential to reassort and cause severe human disease, characterization of orthobunyaviruses is hampered by paucity of genetic sequences. Our objective was to obtain complete gene sequences of two Bunyamwera virus and three Ngari virus isolates from recent surveys in Kenya and to determine their phylogenetic positioning within the Bunyamwera serogroup. Newly sequenced Kenyan Bunyamwera virus isolates clustered closest to a Bunyamwera virus isolate from the same locality and a Central African Republic isolate indicating that similar strains may be circulating regionally. Recent Kenyan Ngari isolates were closest to the Ngari isolates associated with the 1997–1998 haemorrhagic fever outbreak. We observed a temporal/geographical relationship among Ngari isolates in all three gene segments suggesting a geographical/temporal association with genetic diversity. These sequences in addition to earlier sequences can be used for future analyses of this neglected but potentially deadly group of viruses.