Epidemiological and clinical findings from 1162 serologically confirmed measles cases occurring in Buenos Aires, Argentina in 1997 and 1998 were retrospectively reviewed. From 90 hospitalized children, measles virus was detected by direct RT–PCR from nasopharyngeal secretions. Patients were grouped as follows: (i) not vaccinated: infants < 12 months; (ii) regularly vaccinated: children 1–4 years not covered by the last catch-up; (iii) catch-up vaccinated: patients 5–19 years immunized during the 1993 campaign. Most cases were recorded in non-vaccinated infants (54%), and the lowest in catch-up vaccinated children (16%). Mean age of the 90 hospitalized children was 11·3 months. Pneumonia was the major hospitalization cause followed by pneumonitis. Two children required intensive care and one died. The 1993 catch-up campaign seemed to reduce the number of cases in the 5- to 19-year-old group. Lack of timely follow-up probably led to the accumulation of susceptible individuals allowing measles re-emergence. Direct viral detection by RT–PCR proved to be a sensitive tool for molecular epidemiology surveillance.

Over 10% of acute rotavirus gastroenteritis (ARGE) requires hospitalization because of complications. The aggravating factors have been widely analysed, but in an isolated way. We aimed to explore the interrelationship between the clinical and epidemiological factors that characterize rotavirus hospitalizations in Spain using information from the Minimum Basic Data Set (MBDS). Using ICD-9-CM codes, we classified acute gastroenteritis (AGE) cases by principal diagnosis fields and then categorized their comorbidities, complications, and epidemiological features by secondary fields. A multivariable, logistic, step-wise regression model was then constructed. We identified 1657 ARGE cases from 17 415 cases of AGE. Rotavirus hospitalizations were associated with place of residence, age, and season (P < 0·0001), as well as with dehydration [odds ratio (OR) 12·44, 95% confidence interval (CI) 1·52–40·38], intravenous rehydration (OR 1·74, 95% CI 1·29–2·35), metabolic acidosis (OR 1·51, 95% CI 1·24–1·83), respiratory tract infections (RTIs) (OR 1·60, 95% CI 1·09–1·98), and concomitant AGE (OR 1·52, 95% CI 1·03–2·25). Dehydration was four times more likely in patients aged <5 years (OR 4·36, 95% CI 1·20–12·96) and was associated with acidosis when ARGE and RTI were present simultaneously (P < 0·0001). Specific co-infecting viruses may play a role in acute respiratory symptoms and aggravation of gastrointestinal manifestations of rotaviruses, thus leading to complications requiring hospitalization.

The effect of a community intervention programme of antibiotics and meningitis vaccine on pharyngeal carriage of Neisseria meningitidis was investigated. Carriage rates were determined in pupils at both secondary schools (ages 11–18 years) included in the community intervention programme and compared with two schools outside the area matched for socio-economic status. A total of 1869 pupils were studied 6 months after the programmes, and 2457 pupils after 11 months.

Six months after the programme was completed there was a 72% reduction in pharyngeal carriage of Neisseria meningitidis in pupils attending the schools in the intervention area compared with pupils in the control schools. After 11 months this difference persisted in the 11–14 age group but not in the 15–18 age group. No resistance to the antibiotics used in the programme was found.

A community intervention programme of antibiotics and vaccine for the control of meningococcal disease led to a long-term reduction in Neisseria meningitidis carriage in some age groups.

The social networks of 49 ethnic Vietnamese injecting drug users (IDUs) and 150 IDUs of other ethnicities recruited in Melbourne, Australia, were examined for ethnic differences in distribution of hepatitis C virus infection risk using social network analysis and molecular epidemiology. Vietnamese IDUs were more highly connected than non-Vietnamese IDUs, and more likely to be members of dense injecting sub-networks. More related infections were detected in IDUs with discordant ethnicities than were captured in the social network data; nonetheless, most dyads and most IDU pairs with related infections had matching ethnicity, confirming that mixing was assortative on that criterion. Mixing was not obviously dissortative by risk; low-risk Vietnamese IDUs injected more frequently than did correspondingly low-risk non-Vietnamese IDUs, but results for other measures were reversed or equivocal. Network measurements suggest that ethnic Vietnamese IDUs are at elevated risk of blood-borne infection, a conclusion supported by their relatively high HIV prevalence.

The National Institute for Water Research of the South African Council for Scientific and Industrial Research has been engaged on extensive research into the conservation of water supplies and into the reclamation of industrial and sewage effluents. Within the framework of this programme, a comparative study of the efficiency in the reduction of bacterial numbers by existing conventional sewage treatment plants has been carried out. The numerical decreases in bacterial populations after primary sedimentation, biological filtration, the activated sludge process, secondary sedimentation (humus tank), and final sand filtration have been compared with the reduction in bacterial numbers attained by the treatment of sand-filter effluent, humus tank effluent, and primary biological filter effluent in units for further biological purification.

Various types of units for this purpose have been investigated, and from available results it appears perfectly feasible to consider the suitability of effectively purified sewage effluents as sources for raw water supplies for industrial and domestic use. Sewage effluents after final further biological purification could be admitted for unrestricted discharge into rivers. The possibility of objections from the point of view of public health and future use is completely ruled out by the fact that the quality of the final effluent is as good as that of river water.

A variety of experimental units for further biological purification of sewage effluents have been studied, and a comparison of the results obtained from grass-plots, artificial vleis (a natural vlei in South Africa is a marshy or swampy depression in the ground in which water collects and which supports a standing vegetation), algal beds, artificial model rivers, and maturation or oxidation ponds have shown that maturation ponds, possibly a number of ponds in series, with an established microflora and microfauna of their own, may provide the final solution of the problem. Further biological purification will play an important role in the conservation of water supplies and will contribute to the raw water sources available for industrial and domestic use.

In parallel with these studies, the effect of the discharge of sewage effluents from conventional treatment plants into a river system has been investigated together with the fate of the sewage bacteria after admission to a natural environment. The manifestations of self-purification have been recorded, and the additional or superimposed effect of run-off and drainage from populated and unpopulated areas, as well as the admission of storm-water, have been considered together with the effects of seasonal variations due to climatic conditions.

The author wishes to express his gratitude to his assistants who bravely bore the burden of the routine work involved, and wishes to thank the S.A. Council for Scientific and Industrial Research for permission to publish this paper.

Bacteriostatic activity was measured in 244 specimens of milk collected during 1977 throughout lactation of up to one year from 78 mothers; the activity varied from very good to fair and only seven were inactive. There was a wider range of activity than was found previously in milk from English mothers. Activity usually fell slowly during lactation but some of the Gambian mothers produced milk of very high activity, like that of colostrum into the second week of lactation, and two mothers did so at six and nine months; other mothers produced good-activity milk throughout lactation. The bacteriostatic activity varied little with the season but slight decreases from that expectcd were found after the high incidence of infant diarrhoea towards the end of the rainy season.

The bacteriostatic activity of most of the milk tested could be prevented by iron salts but that of colostrum and some of the milks with high activity could not. Only these highly active colostra and milks were inhibitory in vitro when the inoculum was increased from 104 to 106 organisms per ml. These and less active milks were able to inhibit the smaller, standard inoculum for longer than 3 h with the addition of bicarbonate and extra iron-binding protein at the concentrations likely to be present in vivo. Both commensal and pathogenic E. coli were inhibited to a similar degree by these milks and there was no evidence of serotype specificity.

In nearly every case where canned meat or fish is condemned as unfit for human consumption, the action is based upon the physical features of the unopened tin, which are held to indicate decomposition of the contents. No studies of canned foods would therefore be complete without some detailed consideration as to the real harmfulness of such rejected foodstuffs.

Antibiotic-resistant Gram-negative bacteraemias (GNB) are increasing in incidence. We aimed to investigate the impact of empirical antibiotic therapy on clinical outcomes by carrying out an observational 6-year cohort study of patients at a teaching hospital with community-onset Escherichia coli bacteraemia (ECB), Klebsiella pneumoniae bacteraemia (KPB) and Pseudomonas aeruginosa bacteraemia (PsAB). Antibiotic therapy was considered concordant if the organism was sensitive in vitro and discordant if resistant. We estimated the association between concordant vs. discordant empirical antibiotic therapy on odds of in-hospital death and ICU admission for KPB and ECB. Of 1380 patients, 1103 (79.9%) had ECB, 189 (13.7%) KPB and 88 (6.4%) PsAB. Discordant therapy was not associated with increased odds of either outcome. For ECB, severe illness and non-urinary source were associated with increased odds of both outcomes (OR of in-hospital death for non-urinary source 3.21, 95% CI 1.73–5.97). For KPB, discordant therapy was associated with in-hospital death on univariable but not multivariable analysis. Illness severity was associated with increased odds of both outcomes. These findings suggest broadening of therapy for low-risk patients with community-onset GNB is not warranted. Future research should focus on the relationship between patient outcomes, clinical factors, infection focus and causative organism and resistance profile.

A descriptive study was performed between 1 January 2010 and 31 December 2011 to estimate the incidence of norovirus outbreaks in hospitals and nursing homes in Catalonia (Spain). Epidemiological surveys were done for each outbreak. Norovirus was confirmed using RT–PCR. The incidence of outbreaks/106 person-years by centre, and the attack rate, were calculated. Statistically significant differences were calculated using odds ratio (ORs) and 95% confidence intervals (CIs). Person-to-person transmission was responsible for 81·5% (22/27) of outbreaks. The incidence in the population was 156·7 outbreaks/106 person-years. The incidence by centre was 1·3% per year and was greater in hospitals (2·6%) than in nursing homes (0·9%) (OR 3·2, 95% CI 1·5–6·9). The global attack rate in residents and staff was 34·7% (816/2348). The mortality rate was 0·25% (2/816). Genogroup GII.4 caused 66·7% of outbreaks. Norovirus GII.4 outbreaks cause significant morbidity affecting both patients and staff.

The growth of an enterotoxin A producing strain of Staphylococcus aureus in corned beef was investigated. In the inoculated 6 lb. canned product the bacteria spread throughout the meat and attained high numbers. The rate of spread of the organisms was related to the temperature and length of storage of the cans and the numbers of bacteria inoculated. Cans which had been stored for more than four months showed high counts of the bacteria throughout the meat. It was noted that with the long term contaminated product counts of S. aureus on some selective media may give falsely low results.

Numbers of S. aureus on meat inoculated by handling after removal from the can were initially extremely variable. More uniform distribution and higher counts were attained only if the meat was exposed for some hours at ambient temperature or above. The significance of the results to the investigation of outbreaks of food poisoning suspected of being associated with canned corned beef is discussed.

Epidemiological analysis of Klebsiella strains from nosocomial infections needs a simple, stable and reproducible technique of typing. We have evaluated three bacteriocin typing methods for Kiebsiella spp. by means of 15 bacteriocin-producing strains, with special reference to stability and reproducibility.

With the three methods indicator strains and clinical strains were retyped on different days under constant test procedures. Stability of bacteriocins was tested by titration immediately after preparation and after 4 weeks of storage at –70°C. Thereafter, reproducibility of typing was tested by means of these freshly prepared bacteriocin lysates and of portions of the same lysates stored at –70 °C. A moderate reproducibility was obtained with one method after two typing experi ments: 79.2% and 61.3% for indicator strains and clinical strains respectively. The other two methods gave a much lower reproducibility of 38 .5% and 32.5 % for indicator strains and of 11.1% and 25.5% for clinical strains after two experiments.

The reproducibility decreased after retyping three, four or five times. These methods are simple to perform but their usefulness for epidemiological studies is doubtful. Possible causes of the lack of reproducibility of the methods are discussed.

A total of 50 duplicate Moore swabs were placed for 2 days, on five different dates, in 9–12 points of the Athens sewage disposal system.

Three methods of enrichment were used for the isolation of salmonellas. In the first method, one half of the duplicate swabs was incubated in Muller–Kauffmann's tetrathionate broth at 43° C. for one day. For the second method, a secondary enrichment was carried out in Rappaport's broth, made from the Muller–Kauffmann's broth and for the third method, the other half of the duplicate swab was cultured in Heart Infusion broth at 43° C. for 16–18 hr. after which a secondary enrichment was made in Rappaport's medium.

By use of these 3 enrichment procedures, 96% of the swabs were found to be positive for salmonellas. A total of 178 strains were isolated (an average of 3·7 strains per positive swab), belonging to 53 different serotypes (an average of 1·1 different serotypes per positive swab).

With the simple enrichment in Muller–Kauffmann's broth, only 72% of the swabs were found positive, and 68 strains of salmonellas belonging to 30 different serotypes were isolated. The secondary enrichment in Rappaport's medium made from the Muller–Kauffmann's broth produced 88% positive samples, and yielded 82 strains belonging to 34 different serotypes. Finally, with the secondary enrichment in Rappaport's broth made from the heart infusion broth, 92% of the swabs were positive and yielded 67 strains of salmonellas belonging to 27 different serotypes.

Although the last procedure yielded the greatest number of positive swabs, the method involving secondary enrichment in Rappaport's broth made from Muller–Kauffmann's broth led to the isolation of the greatest number of strains and different serotypes, while the other two procedures were approximately equal in this respect.

Of the 178 strains isolated, 110 were recovered only by the procedures involving secondary enrichment in Rappaport's broth. The most frequently isolated serotypes were Salmonella senftenberg (33 strains), S.typhimurium including var-copenhagen (18 strains), S.poona (11 strains), S.montevideo (10 strains), etc. The following 23 serotypes were isolated for the first time in Greece: S. adelaide, S. alachua, S. allerton, S. binza, S. bobo, S. butantan, S. gnesta, S. goelzau, S. haelsingborg, S. havana, S. hofit, S. ibadan, S. indiana, S. irumu, S. jodhpur, S. nienstedten, S. panama, S. pomona, S. poona, S. reading, S. schwarzengrund, S. stockholm, S. tournai. Moreover, a new serotype, S. athinai was described.

This study aims to evaluate the impact of non-pharmaceutical interventions (NPIs) on the prevalence of respiratory pathogens among hospitalised children with acute respiratory infections (ARIs) in Suzhou. Children with ARIs admitted to the Children’s Hospital of Soochow University between 1 September 2021 and 31 December 2022 and subjected to 13 respiratory pathogen multiplex PCR assays were included in the study. We retrospectively collected demographic details, results of respiratory pathogen panel tests, and discharge diagnostic information of the participants, and described the age and seasonal distribution of respiratory pathogens and risk factors for developing pneumonia. A total of 10,396 children <16 years of age, including 5,905 males and 4,491 females, were part of the study. The positive rates of the 11 respiratory pathogen assays were 23.3% (human rhinovirus (HRV)), 15.9% (human respiratory syncytial virus (HRSV)), 10.5% (human metapneumovirus (HMPV)), 10.3% (human parainfluenza virus (HPIV)), 8.6% (mycoplasma pneumoniae (MP)), 5.8% (Boca), 3.5% (influenza A (InfA)), 2.9% (influenza B (InfB)), 2.7% (human coronavirus (HCOV)), 2.0% (adenovirus (ADV)), and 0.5% (Ch), respectively. Bocavirus and HPIV detection peaked during the period from September to November (autumn), and MP and HMPV peaked in the months of November and December. The peak of InfA detection was found to be in summer (July and August), whereas the InfB peak was observed to be in winter (December, January, and February). HRSV and HRV predominated in the <3 years age group. HRV and HMPV were common in the 3–6 years group, whereas MP was predominant in the ≥6 years group. MP (odds ratio (OR): 70.068, 95%CI: 32.665–150.298, P < 0.01), HMPV (OR: 6.493, 95%CI: 4.802–8.780, P < 0.01), Boca (OR: 3.300, 95%CI: 2.186–4.980, P < 0.01), and HRSV (OR: 2.649, 95%CI: 2.089–3.358, P < 0.01) infections were more likely to develop into pneumonia than the other pathogens. With the use of NPIs, HRV was the most common pathogen in children with ARIs, and MP was more likely to progress to pneumonia than other pathogens.

Although the impact of diarrhoeal disease on paediatric health in Nigeria has decreased in recent years, it remains an important cause of morbidity and mortality in children under 5 years. Rotavirus is recognised as an important aetiological agent, but information on the contribution of intestinal protozoa to watery diarrhoea in this age group in Nigeria is scarce. In this cross-sectional study, faecal samples from children admitted to healthcare centres in Abakaliki, Nigeria with acute watery diarrhoea (N = 199) and faecal samples from age-matched controls (N = 37) were examined for Cryptosporidium and Giardia using immunofluorescent antibody testing and molecular methods. Cryptosporidium was identified in 13 case samples (6.5%) and no control samples. For three samples, molecular characterisation indicated C. hominis, GP60 subtypes IaA30R3, IaA14R3 and IdA11. Giardia was not detected in any samples. This contrast in prevalence between the two intestinal protozoa may reflect their variable epidemiologies and probably differing routes of infection. Given that these two parasitic infections are often bracketed together, it is key to realise that they not only have differing clinical spectra but also that the importance of each parasite is not the same in different age groups and/or settings.

The most widely used indicator of the sanitary quality of recreational waters is the coliform group of bacteria. Present techniques of coliform enumeration are imprecise, and this fact is too often overlooked in routine water quality surveys as well as in research efforts seeking quantitative relationships between coliform density and the health effects of recreational waters. To illustrate this point, three years of data gathered by the New York City Department of Health as part of their routine beach water sampling programme were re-analysed, taking the limited precision of each coliform estimate into account. Re-analysis showed 56·6% of the data were not significantly different (P > 0·05) from the standard being used. This large percentage of the data was of little value in determining the acceptability of the waters being sampled relative to the standard being used and thus represented a substantial waste of time and expense. Of the remaining data, half indicated acceptable water quality and half indicated unacceptable water quality relative to the standard. These three years of data, therefore, gave little information on the acceptability of the water quality at this location with respect to the standard being used. The data further suggest significant differences in coliform density within sample dates. It is recommended that in future water quality surveys, or in studies of the health effects of recreational waters as related to coliform density, emphasis should shift from maximizing the number of sample dates to maximizing the number of replicate determinations made per sample date.

Rotavirus (RV) infections affect young children, but can also occur in adults. We sought to identify risk factors for RV infections in adults aged ⩾18 years in Denmark, and to describe illness and genotyping characteristics. From March 2005 to February 2009, we recruited consecutive cases of laboratory-confirmed RV infection and compared them with healthy controls matched by age, gender and municipality of residence. We collected information on illness characteristics and exposures using postal questionnaires. We calculated univariable and multivariable matched odds ratios (mOR) with conditional logistic regression. The study comprised 65 cases and 246 controls. Illness exceeded 10 days in 31% of cases; 22% were hospitalized. Cases were more likely than controls to suffer serious underlying health conditions [mOR 5·6, 95% confidence interval (CI) 1·7–18], and to report having had close contact with persons with gastrointestinal symptoms (mOR 9·4, 95% CI 3·6–24), in particular young children aged <3 years and adults aged >18 years. Close contact with young children or adults with gastrointestinal symptoms is the main risk factor for RV infection in adults in Denmark. RV vaccination assessments should consider that RV vaccination in children may indirectly reduce the burden of disease in adults.

In May 2011, the Center for Disease Control and Prevention of a Chinese county found a rapid increase in the number of hepatitis A case notification; these were traced to an outbreak in an elementary school. Twenty-eight cases aged between 7 and 13 years with onset between 7 May and 8 June were serologically confirmed. Network method was conducted to reconstruct an outbreak network and to quantify the relative importance of those involved in the outbreak. A case-control study was used to study the association between the outbreak and putative risk factors. The network analysis suggested this was a disseminated outbreak originating from a 4-year-old boy with propagated spread. Evidence from the case-control study supported consumption of well water as a potential risk factor; however, this was unable to be established through field investigation. Outbreak networks can be used to identify the possible source of infectious disease outbreak, especially when the environmental investigation information is negative or not available.

Surveillance activities for ovine scrapie have expanded in the 21st century, following concerns about the potential for a hidden epidemic of bovine spongiform encephalopathy in European sheep populations. Large-scale surveys have been used to estimate the prevalence of scrapie infection. In this study we analyse data from the surveys in Great Britain between 2002 and 2004. When we estimate genotype-specific prevalences for each of the two screening tests used a difference is observed. One test underestimates the number of positive cases in genotypes classically considered to be at a low relative risk of developing clinical disease (ARR- and AHQ-containing genotypes). By comparison, the other test underestimates the number of positive cases in genotypes classically considered to be at an increased relative risk of developing clinical disease (VRQ-containing genotypes). These findings have implications for surveillance, disease control, and diagnostic test evaluation.

Clinical observations made by practitioners and reported using web- and mobile-based technologies may benefit disease surveillance by improving the timeliness of outbreak detection. Equinella is a voluntary electronic reporting and information system established for the early detection of infectious equine diseases in Switzerland. Sentinel veterinary practitioners have been able to report cases of non-notifiable diseases and clinical symptoms to an internet-based platform since November 2013. Telephone interviews were carried out during the first year to understand the motivating and constraining factors affecting voluntary reporting and the use of mobile devices in a sentinel network. We found that non-monetary incentives attract sentinel practitioners; however, insufficient understanding of the reporting system and of its relevance, as well as concerns over the electronic dissemination of health data were identified as potential challenges to sustainable reporting. Many practitioners are not yet aware of the advantages of mobile-based surveillance and may require some time to become accustomed to novel reporting methods. Finally, our study highlights the need for continued information feedback loops within voluntary sentinel networks.

1. The application of factorial design to. the testing of diets for breeding mice is described.

2. The use of a system of monogamous making, by which the females have a continuous series of pregnancies with concurrent gestation and lactation, is advocated for such tests.

3. Present indications are that a high wheat content or a high yeast content is desirable in the diet of breeding mice.

4. A diet containing a considerable proportion of full-cream milk was very effective for breeding mice, but it is not yet certain that this constituent is necessary.