National policies for chemoprophylaxis after single cases of meningococcal disease in day-care or nursery settings vary across Europe. We carried out a multi-national retrospective study to compare the effectiveness of different policies. Countries were divided into those recommending chemoprophylaxis only to close contacts (policy A, close) and those recommending chemoprophylaxis for all children in the same nursery (policy B, mass). Country-specific relative risk (RR) of a cluster was defined as the ratio of the number of clusters observed to the number of clusters expected by chance. In total, 37 clusters were identified between 1 January 1993 and 31 December 2002. After adjusting for marked heterogeneity in RR by country, the ratio of RR between countries suggested possible benefit from mass prophylaxis (RR ratio 3·8, 95% CI 0·7–22·0), although the difference was not statistically significant (P=0·22). The costs of this approach and the low risk of clustering need to be taken into account when deciding national policy.

The hepatitis E virus (HEV) has been described in humans and various animal species in different regions of the world. However, the knowledge on natural HEV infection in non-human primates and the corresponding risk of zoonotic transmission is scarce. To determine whether primates in captivity are affected by HEV infection, we investigated 259 individual sera of clinically healthy non-human primates of 14 species from nine German zoos. Using a commercial double-antigen-sandwich ELISA and a commercial IgG ELISA, 10 animals (3·9%) reacted positive in at least one assay. Three ape species and one Old World monkey species were among the seropositive animals: bonobo (Pan paniscus), gorilla (Gorilla gorilla gorilla), lar gibbon (Hylobates lar) and drill (Mandrillus leucophaeus). Testing for anti-HEV-IgM antibodies by commercial ELISA and for viral RNA by reverse-transcription real-time polymerase chain reaction resulted in negative results for all animals indicating the absence of acute HEV infections. In the past, no clinical signs of hepatitis were recorded for the seropositive animals. The results suggest that non-human primates in zoos can get naturally and subclinically infected with HEV or related hepeviruses. Future studies should evaluate potential sources and transmission routes of these infections and their impact on human health.

The present paper contains the results of an enquiry into the differentiation of certain organisms of varying source, which present characters more or less closely allied to those of the “mannite” or “Flexner” type of the dysentery bacillus.

Rabies in cattle is a viral disease with mandatory notification in Brazil, transmitted by Desmodus rotundus, which causes an invariably fatal acute encephalitis. To understand the dynamics of this disease in Tocantins state, Brazil, an analysis of the time series of rabies cases in cattle between 2006 and 2019 was carried out to describe the pattern of its occurrence, aiming to subsidise the Official Veterinary Service (OVS) with relevant information to enable the improvement of control actions provided for in the guidelines of the National Program for the Control of Rabies in Herbivores (NPCRH). The statistical analyses of the time series under study were performed using the R Studio software, version 1.1.463, in which the existence of trend, cyclicality and seasonality of rabies cases in cattle was assessed. These analyses showed that this disease is endemic in Tocantins state, with epidemic outbreaks that can occur every 3 or 4 years, without a seasonality pattern. The autoregressive integrated by moving average (ARIMA(4,1,4)) model predicted the approximate occurrence of 38 rabies cases in cattle in 2022 and all monthly records of this disease remained within the predicted confidence interval (95% CI) in 2020 and 2021, demonstrating it has a good predictive capacity and allowing OVS to intervene in the present processes to achieve better control of this disease.

Ribotyping performed with six restriction endonucleases was used to study the molecular epidemiology of shigellosis in Asturias, Spain. The series included Shigella sonnei from 34 sporadic cases, 3 outbreaks and 3 reference strains, and S. flexneri from 13 sporadic cases and 1 reference strain. The S. sonnei strains were grouped into 5 ribotypes with Sal I, 4 with Hind III and Pvu II, 3 with Bgl II and EcoR I and 2 with Hinc II (Discriminatory Index (DI) between 0·54 and 0·14); the S. flexneri into 5 ribotypes with Sal I, Hinc II and Hind III, and 4 with the other enzymes (DI = 0·71–0·63). The combination of results for 2 or more enzymes facilitated an additional discrimination, the highest values in S. sonnei were for the 6 enzymes (16 types, DI = 0·91) and in S. flexneri for some combinations of 3 or more enzymes (7 types, DI = 0·81). Ribotypes with the 6 enzymes defined 16 clonal lines in S. sonnei and 7 in S. flexneri, which showed a different degree of genetic heterogeneity, and all the lines of each species falling into a different cluster. No line appeared as clearly endemic in the bowels of Asturian people.

There seems to be considerable evidence in favour of the view that the immediate cause of this acute infective fever is an organism in the form of a streptococcus although there does not yet appear to be unanimity as to the specific characteristics of the latter. With regard to the secondary or indirect or predisposing causes of the complaint, the agencies which influence favourably the development and activity of the organism and consequently the prevalence of the disease, there has been a definite tendency in recent years not only to abandon the hitherto prevailing opinion on the influence of certain meteorological factors, namely, that increase in the amount of rainfall and decrease in the temperature are generally associated with increased incidence of the disease but even to assert that the action of these factors is the reverse of this.

Like the skin and its appendages, the teeth, nails and hair, so also other tissues of ectodermal origin are here shown to be affected by fluorine. The action of fluorine consists in lowering the level of the calcium in the blood and tissues. The epithelia of the mouth and the salivary glands, of the nasopharynx, the conjunctivae and the lachrymal glands may be affected. Signs and symptoms are thus produced which are closely similar to those usually attributed primarily to infection. It is suggested that an infection accompanying chronic fluorine poisoning is of a secondary nature, and that it is brought about by the loss of calcium in the body.

Coronavirus disease 2019 (COVID-19) has had a tremendous impact in China and abroad since its onset in December 2019 and poses a major threat to human health. Healthcare workers (HCWs) are at the forefront of the response to outbreaks. This study reviewed literature data and found that HCWs were at high risk of infection during the COVID-19 pandemic, especially at the early stage of the epidemic, and many factors greatly affected their occupational safety. Although SARS-CoV-2 transmission was controlled in China, the Chinese experience can help protect HCWs from COVID-19 and other respiratory diseases.

Healthcare workers (HCWs) reporting no history of varicella frequently receive varicella vaccination (vOka) if they test varicella-zoster virus (VZV) immunoglobulin G (IgG) negative. In this study, the utilities of VZV-IgG time-resolved fluorescence immunoassay (VZV-TRFIA) and a commercial VZV-IgG purified glycoprotein enzyme immunoassay (gpEIA) currently used in England for confirming VZV immunity have been compared to the fluorescent-antibody-to-membrane-antigen assay (FAMA). A total of 110 HCWs received two doses of vOka vaccine spaced 6 weeks apart and sera collected pre-vaccination (n = 100), at 6 weeks post-completion of vaccination (n = 86) and at 12–18 months follow-up (n = 73) were analysed. Pre-vaccination, by FAMA, 61·0% sera were VZV IgG negative, and compared to FAMA the sensitivities of VZV-TRFIA and gpEIA were 74·4% [95% confidence interval (CI) 57·9–87·0] and 46·2% (95% CI 30·1–62·8), respectively. Post-completion of vaccination the seroconversion rate by FAMA was 93·7% compared to rates of 95·8% and 70·8% determined by VZV-TRFIA and gpEIA, respectively. At 12–18 months follow-up seropositivity rates by FAMA, VZV-TRFIA and gpEIA were 78·1%, 74·0% and 47·9%, respectively. Compared to FAMA the sensitivities of VZV-TRFIA and gpEIA for measuring VZV IgG following vaccination were 96·4% (95% CI 91·7–98·8) and 74·6% (95% CI 66·5–81·6), respectively. Using both FAMA and VZV-TRFIA to identify healthy adult VZV susceptibles and measure seroconversion showed that vOka vaccination of HCWs is highly immunogenic.

Twenty-three pre- and post-treatment isolates of Helicobacter pylori from the antral mucosa of eight patients with dyspepsia and gastritis were compared using 1-D SDS PAGE of proteins. The protein patterns were highly reproducible and were used as the basis for two numerical analyses. The first, based on the total protein patterns, showed that a number of the strains did not cluster with their respective patient set. This was thought to be due to differences in both mobility and intensity of proteins in the major band region. The second analysis, based on partial patterns, excluding the major band region (51–68 kDa), divided the clinical isolates into clearly defined groups corresponding to the patient sets. Although there was a degree of heterogeneity with respect to protein pattern between the pre- and post-treatment isolates of some patients, there was nonetheless clear evidence that each patient was harbouring strains of only a single type. These results suggested that patients were not being reinfected with a different strain but that there was recrudescence of the pre-treatment strain. Protein ‘fingerprints’ provided a precise and reproducible means of strain differentiation, and revealed that in each patient the same strain persisted after drug therapy even though there was marked patient-to-patient strain variation.

A technique is presented for the titration of the virus of foot-and-mouth disease in culture in surviving epithelial tissue from the tongues of cattle. The cultures are incubated in cups on Perspex plates, and the detection of virus multiplication is by a complement-fixation test made on the culture in each cup.

On the basis of comparative titrations in culture and in cattle, the method has been found to be as sensitive for the detection of virus as the titration by intradermal inoculation of the tongue of cattle. The method can also be applied in the detection of antibody in neutralization tests.

We wish to record our thanks to Messrs E. Scoates and P. Mitchell for their technical assistance, and to Messrs H. M. Smith, R. H. Compton and R. L. Jackson for their part in the design and fabrication of various bottle rotators, plate shakers, Perspex lids and the inoculating box.

Aquatic wild birds are often carriers of low-pathogenic avian influenza viruses (LPAIVs). If H5 and H7 LPAIVs are transmitted to poultry and have the opportunity to circulate, a highly pathogenic AIV may arise. Contact with aquatic wild birds is one of the most important ways in which these LPAIVs can be introduced into poultry flocks. In this study, the transmissibility of a duck-originated H5 LPAIV between ducks and chickens was analysed in a series of animal experiments, using different transmission routes. Results indicate that the outcome of virus intake by chickens exposed to infectious ducks depends on the way the virus is presented. Faecally contaminated drinking water proved to be the most efficient route by which the virus can be transmitted to chickens. The results from this study also suggest that some duck-originated H5 LPAIVs may be introduced to poultry but do not have the potential to become established in poultry populations.

Neonatal listeriosis is rare and detecting more than one case together would be unlikely without a causal link. Thirty-five instances of neonatal listeriosis where cross-infection occurred in the UK and Ireland were reviewed together with 29 other similar episodes reported elsewhere. All instances comprised an infant who was ill at or within one day of delivery and who had direct or indirect contact with a second infant, or in the minority, two or more infants, who then usually developed meningitis 6 to 12 days later. In most instances, the infants were nursed on the same day in obstetric units or new-born nurseries and consequently, staff and equipment were common: hence, the likely route of transmission was via direct or indirect neonate to neonate contact. In one instance, a stethoscope was used on both infants nursed in different parts of the same hospital. In a further incident, the mother of the early-onset infant cuddled a baby from an adjacent bed who developed meningitis 12 days later. The largest outbreak occurred in Costa Rica where nine neonatal listeriosis cases resulted after bathing in mineral-oil shortly after birth which had been contaminated from the early-onset index case.

When mice were injected intracerebrally with doses of Bordetella pertussis vaccine greater than 5 ImD50 and challenged intracerebrally 14 days later with virulent B. pertussis there was an immediate reduction in the numbers of organisms. An analysis of this in vivo bactericidal effect has shown that large doses of an unrelated vaccine, Salmonella typhosa, equivalent in cell mass to about 50 ImD 50 of B. pertussis vaccine can achieve this effect, so for such doses the effect must be partly non-specific. This action is not maintained and so is not ultimately protective. Local immunoglobulin was also demonstrable 14 days after 300 ImD 50 of B. pertussis vaccine but following smaller doses of 10–20 ImD 50 it could not be found until after the mice had been infected and the blood–brain barrier impaired.

A similar immediate reduction in the numbers of infecting organisms inoculated 1 day after vaccination has been shown to follow very small, non-protective doses of vaccines unrelated to B. pertussis and to be achieved with lipopolysaccharide and endotoxin isolated from B. pertussis. Brains were not sterilized and only in mice receiving protective B. pertussis vaccine was the lowering of infection maintained beyond 2 days and the brains eventually sterilized.

The antibody passively protecting mice against intracerebral infection was found in the 19 S and 11 S globulin fractions of the serum of once-vaccinated mice and in the 11 S and 7 S fractions of the serum of rabbits and ascitic fluid of mice receiving repeated doses of vaccine. The IgM probably eliminated infections by immediate sterilization but had to be present locally to do so since it was unable to pass from the circulation into the brain, and was therefore inactive when injected intraperitoneally. The IgA and IgG were not so restricted and both the 11 S and 7 S globulins were capable of exerting an immediate suppressive effect on infecting organisms. The 7 S globulin was also capable of a maintained or delayed suppressive effect.

Lymphocytes from fully protected once-vaccinated mice, transferred 2–3 weeks after intraperitoneal vaccination, were able to confer some protection when injected intraperitoneally or intracerebrally into recipient mice infected 2 weeks after transfer. Homologous, non-concentrated antiserum from once-vaccinated mice, injected intraperitoneally 1 hr. before infection sometimes augmented the transferred immunity, whereas alone it was inactive.

In March 2008, the Health Protection Agency in England conducted a retrospective case-control study to investigate the cause of 179 cases of the newly recognized, fully antimicrobial-sensitive Salmonella Typhimurium PT U320. Forty-three symptomatic laboratory-confirmed case-patients and 84 asymptomatic location-matched controls were interviewed by telephone about exposures in the 3 days prior to illness or interview. Multivariate logistic analysis indicated consumption of pre-packaged egg sandwiches (odds ratio 3·29, 95% confidence interval 1·19–9·09) was independently associated with illness. Eight of the 15 case-patients who consumed egg sandwiches did so from retail chain A (53·3%) whereas none of the eight controls consumed similar sandwiches (χ2=7·20, P⩽0·01). A review of the pre-packaged egg sandwich ingredients suggested this outbreak was probably caused by exposure to an ingredient common to pre-packaged sandwiches and prepared salads but we established a definitive epidemiological link with only the former. Short shelf-life, product diversity and investigation lag hinder epidemiological investigations of such popular products, providing continued challenges for food safety enforcement of freshly prepared produce.

41·7 per cent. of the rats in the Oxford district were found to carry Leptospira icterohaemorrhagiae in their kidneys. The percentage infection increases until the animals are mature, reaching a maximum of 56 per cent. among one class of the population, but is less among the oldest rats. There is evidence that the organism is acquired comparatively early in life, and that immunity is obtained after a long period of infection.

Estimating the spread of SARS-CoV-2 infection in communities is critical. We surveyed 2244 stratified random sample community members of the Gardena valley, a winter touristic area, amidst the first expansion phase of the COVID-19 pandemic in Europe. We measured agreement between Diasorin and Abbott serum bioassay outputs and the Abbott optimal discriminant threshold of serum neutralisation titres with recursive receiver operating characteristic curve. We analytically adjusted serum antibody tests for unbiased seroprevalence estimate and analysed the determinants of infection with non-response weighted multiple logistic regression. SARS-CoV-2 seroprevalence was 26.9% (95% CI 25.2–28.6) by June 2020. The bioassays had a modest agreement with each other. At a lower threshold than the manufacturer's recommended level, the Abbott assay reflected greater discrimination of serum neutralisation capacity. Seropositivity was associated with place and economic activity, not with sex or age. Symptoms like fever and weakness were age-dependent. SARS-CoV-2 mitigation strategies should account for context in high prevalence areas.

The aim of this paper is to describe the prevalence of Mycoplasma genitalium and Trichomonas vaginalis in patients who visited general practitioners in the Netherlands. Additionally, we describe the prevalence of M. genitalium resistance to azithromycin and moxifloxacin. We used data from 7,411 consecutive female patients who were screened for Chlamydia trachomatis, Neisseria gonorrhoeae, M. genitalium, and T. vaginalis and data from 5,732 consecutive male patients screened for C. trachomatis, N. gonorrhoeae, and M. genitalium. The prevalence of M. genitalium and T. vaginalis in female patients was 6.7% (95% CI: 6.2 to 7.4) and 1.9% (95%CI: 1.6 to 2.2%), respectively. M. genitalium prevalence in male patients was 3.7% (3.3 to 4.3). M. genitalium co-occurred with C. trachomatis in 1.4% (0.3 to 0.6%) of female and in 0.7% (0.5 to 0.9) of male patients. Macrolide resistance gene mutations and fluoroquinolone resistance gene mutations were detected in 73.8% and 9.9%, respectively. We concluded that M.genitalium is relatively infrequently found in a large general practitioner population in the Netherlands. It can co-occur with C. trachomatis, and is often resistant to azithromycin. Therefore, when treating sexually transmitted infections, these prevalence and resistance data should be taken into account.

The study identified the common aetiological agents and prominent clinical features of dysentery cases in children aged <5 years and compared this to non-dysentery diarrhoeal cases from the same population. From January 2010 to December 2011, 2324 children aged <5 years received treatment at Kumudini Hospital, of which 682 (29%) presented with dysentery. Of the dysenteric children, aetiology could not be determined for over half (61%). Shigella spp. accounted for 32% of dysentery cases. Significant associations were found between presence of blood in stool and: child age (24–59 months) [odds ratio (OR) 2·21, 95% confidence interval (CI) 1·49–3·27], no treatment of drinking water at home (OR 2·00, 95% CI 1·09–3·67), vomiting (OR 0·19, 95% CI 0·14–0·25), abdominal pain (OR 4·68, 95% CI 3·24–6·77), straining (OR 16·45, 95% CI 11·92–22·69), wasting (OR 1·66, 95% CI 1·15–2·41), and presence of Shigella in stool (OR 6·25, 95% CI 4·20–9·29) after controlling for confounders. This study makes it clear that appropriate public health strategies are needed to reduce the burden of dysentery in Bangladesh.

Normal bovine milk and whey was mycoplasmacidal for 6 of the 13 strains of bovine T-mycoplasmas examined. The in vitro assay used also demonstrated no killing of the human, canine and simian T-mycoplasma strains after 4 hr. incubation. However, there appeared to be some cow-to-cow variation in possession of this activity, and following E. coli endotoxin stimulation of the mammary gland the activity was considerably reduced.

Whey from three normal cows was fractionated on a Bio-Gel A 1·5 m. column and the mycoplasmacidal activity of the resulting five peaks assayed. Only the second peak, peak B, contained activity and was characterized as the only peak containing bovine IgA. The active component in whey, however, was found to be heat stable at 60° C. for 60 minutes and to pass through a dialysis membrane. This is inconsistent with it being immunoglobulin.