Rabbit polyclonal hyperimmune antibodies to Yersinia pestis, and a mouse monoclonal antibody against the capsular antigen fraction 1 (F1) were compared in immunofluorescence (IF) tests. Fluorescent antibody conjugates were prepared from polyclonal antisera to four F1 positive Y. pestis strains; the conjugated antibody to strain A1122 gave the strongest IF staining of F1 positive and F1 negative Y. pestis strains. Indirect assays were rejected in favour of direct assays utilizing polyclonal and monoclonal reagents because the increased background staining reduced the effective contrast of bacterial visualisation. Polyclonal conjugates gave fairly homogeneous staining of Y. pestis bacterial populations, but in monoclonal assays a skew distribution of fluorescence intensity was observed, the majority of bacteria being poorly stained. The proportion of cells stained well by the monoclonal sufficed for easy identification of Y. pestis of the F1 positive phenotype however, and staining was not affected by washing the bacteria or treating them with formaldehyde. Y. pestis strains of the F1 positive genotype reacted with the monoclonal if bacteria were grown at 37 °C but not if the growth temperature was reduced to 25°C thus preventing capsule production. The polyclonal conjugate reacted with bacteria of these strains that had been grown at either temperature. Strains of F1 negative genotype grown at either temperature. Strains of F1 negative genotype grown at either temperature reacted with the polyclonal conjugate but not with the monoclonal. Cross reactions between the polyclonal reagents and Y. enterocolitica biovar 2, serovar O 8 could not be removed by selective absorption; however, the monoclonal antibody gave no cross reaction.

The F1 phenotypic status of bacterial preparations was verified by ELISA measurement of the fraction 1 antigen concentration. Antigen levels for F1 positive and F1 negative phenotypes differed by about three logs for suspensions of Y. pestis harvested from solid media.

The polyclonal and monoclonal direct IF tests applied to spleen and blood smears of laboratory mice infected with Y. pestis were able to differentiate between lethal infection with an F1 positive strain carrying all four classical virulence determinants, an F1 positive vaccine strain, and an F1 negative strain.

Surveillance of acute hepatitis B in England is necessary to estimate incidence, determine routes of transmission and inform public health actions. Here we describe an automated process to extract information on testing for markers of hepatitis B infection in English sentinel laboratories between 2002 and 2008. The resulting data were used to identify individuals with acute infections, describe their characteristics and estimate the incidence of infection. Two-thirds of acute infections were in males. Heterosexual exposure and injecting drug use were the main risks reported. Annual incidence was estimated at 1·3/100 000 person-years overall (1·7 and 0·6 for males and females, respectively) and declined each year. Automated extraction of hepatitis B markers, including quantitative results where available, can help to classify HBV status more accurately for surveillance. HBV incidence in England is at its lowest level in recent years.

The history of the Brown Animal Sanatory Institution was intended originally to be published in book form, and was therefore divided into chapters. For the sake of convenience this division has been continued, even though it is unusual for the term to be employed in scientific periodicals. The history will be published serially in four consecutive issues of the Journal of Hygiene. References have presented a difficulty. In two instances the title of the paper referred to has had to be omitted, because no copy of the original journal in which the article appeared has been obtainable. More important, however, is the failure to give references, beyond the date, to a number of statements in the text, because the information in question has been abstracted from sources that are not available to the general reader.

The sialic acid content and the cell-surface hydrophobicity index of 40 group B streptococci (GBS) strains were assessed. GBS isolated from invasive infections (virulent strains) presented an increased level of sialic acid content (1.4%) when compared with GBS isolated from asymptomatic patients (0.53%). Treatment of GBS strain 85634 with neuraminidase resulted in a decrease (about 25%) in the net negative surface charge as assessed by cell electrophoresis. This finding suggests that sialic acid residues are important anionogenic groups exposed on GBS cell surface. N-acetylneuraminic acid was the only sialic acid derivative characterized in the strain 85634 as evaluated by gas-liquid chromatography. GBS from different serotypes presented a hydrophobic index mean value of 0.9. Even though the sialic acid contributed effectively to the negative charge on GBS cell surface, no difference was observed in the hydrophobic index when virulent and avirulent strains were compared.

During the last week of May 1986, a 1-week prospective study on antibiotic utilization in surgical patients was held in 104 (42%) of the 247 Belgian acute care hospitals. All surgical patients with a post-operative stay of at least 3 days were studied, involving 3112 patients. Each patient was observed for 7 days, starting from the day before surgery. Antibiotics were administered to 71·9% of all patients; 21·9% received therapeutic antibiotics and 52·9% prophylactic antibiotics; 2·9% received both. Of the 1285 patients undergoing a surgical procedure with no indication for antimicrobial prophylaxis, 50·7% nevertheless received prophylaxis; 92·8% of patients with a generally recognized indication for prophylaxis received antibiotic prophylaxis. Less than one fifth (17·1 %) of all prophylactic courses were stopped on the day of the intervention whilst 26·3% were continued up to the fifth post-operative day or beyond. The most frequently prescribed drugs for this indication included first and second generation cephalosporins and nitroimidazoles. The number of different generic drugs utilized per hospital ranged from 1 to 18 (mean: 7·7).

1. The virulence of S. typhi strains Ty 2 and O 901 injected intra-abdominally into white mice was examined. The lethal dose of strain Ty 2 grown in vivo was lower than that of the corresponding culture grown in vitro, while the lethal doses of the in vivo- and in vitro-grown strain O 901 were almost identical.

2. The extracts of infected livers and spleens were not toxic, but acted as infection-promoting substances. Extracts from normal organs exerted similar but weaker effects. Glycogen together with sodium taurocholate were powerful infection-promoting substances. The highest increases of virulence were observed when spleen-grown bacteria together with extracts from infected organs were injected.

3. Extracts from infected spleen, pancreas, stomach and lower intestines, spleen-grown S. typhi, other spleen-grown Enterobacteriaceae, and bacteria taken from the intestines of normal and diseased animals, exhibited high DPN-ase activity.

4. The extracts from infected organs contained soluble bacterial antigens. Their presence was demonstrated by tube precipitation, agar gel precipitation and antibody production after immunization of rabbits with extracts from infected organs with addition of adjuvants.

5. Spleen-grown bacteria were able to absorb host antigens and to produce, in addition to the known agglutinating antibodies, anti-spleen precipitins.

Birth cohort has been shown to be related to morbidity and mortality from other diseases and conditions, yet little is known about the potential for birth cohort in its relation to pneumonia and influenza (P&I) outcomes. This issue is particularly important in older adults, who experience the highest disease burden and most severe complications from these largely preventable diseases. The objective of this analysis is to assess P&I patterns in US seniors with respect to age, time, and birth cohort. All Medicare hospitalizations due to P&I (ICD-9CM codes 480-487) were abstracted and categorized by single-year of age and influenza year. These counts were then divided by intercensal estimates of age-specific population levels extracted from the US Census Bureau to obtain age- and season-specific rates. Rates were log-transformed and linear models were used to assess the relationships in P&I rates and age, influenza year, and cohort. The increase in disease rates with age accounted for most of the variability by age and influenza season. Consistent relationships between disease rates and birth cohorts remained, even after controlling for age. Seasonal associations were stronger for influenza than for pneumonia. These findings suggest that there may be a set of unmeasured characteristics or events people of certain ages experienced contemporaneously that may account for the observed differences in P&I rates in birth cohorts. Further understanding of these circumstances and those resulting age and cohort groups most vulnerable to P&I may help to target health services towards those most at risk of disease.

Fourteen cases of enzootic pneumonia, nearly all of which had presented diagnostic difficulties using the metabolic-inhibition test, were re-examined using specific pig antisera in the passive haemagglutination test (PHA). All proved positive for Mycoplasma suipneumoniae, indicating that the test, used in this manner, might be particularly valuable for routine diagnosis.

The PHA test was also used to demonstrate antibody to M. suipneumoniae in pneumonic tissue and the associated bronchial lymph nodes.

To allay our concern that cross-reactions might interfere with this and other serological tests—the complement-fixation test (CF) and precipitation in agar-gel—the specificity of our reagents and the antigenic relationships of Mycoplasma hyorhinis, Mycoplasma granularum, mycoplasmaB3, Mycoplasma hyopneumoniae and three strains of M. suipneumoniae (including cloned and uncloned isolates of the J strain) were studied in various ways. Antibodies to medium constituents occurred in rabbit antiserum but did not present a problem with pig antisera. These antibodies were successfully absorbed from the rabbit antisera but it was not possible to remove medium constituents from the antigens used to produce antisera in rabbits by repeated washing.

By all these tests, the main species of mycoplasmas studied seemed to be anti-genically distinct. No major antigenic differences between the three strains of M. suipneumoniae were revealed by the PHA test and the CF test; a slight difference in the precipitation lines of one of these strains (MG) in agar-gel might have indicated an antigenic variation or been a measure of some other factor.

The concomitant occurrence of a case of haemolytic–uraemic syndrome (HUS) and 62 cases of mild gastroenteritis in schools of a small rural community in southern Italy induced the health authorities to suspect a foodborne outbreak of shiga-toxin-producing Escherichia coli (STEC) infection. The schools were closed and the catering service involved was investigated. However, STEC were not isolated from the HUS case or from the 56 cases of gastroenteritis examined, and the HUS case and the outbreak of gastroenteritis were probably just coincidental. A retrospective cohort study failed to show any correlation with consumption of school meals and suggested that the outbreak probably started outside the school setting and then spread within the schools by person-to-person transmission. All the cases examined were negative for common enteric pathogens and the responsible agent for the cases of gastroenteritis was not identified. The concern raised in the small community by the occurrence of a severe case of HUS and the lack of a rapid epidemiological assessment excluding the occurrence of a STEC outbreak, turned an epidemic episode of mild gastroenteritis into a public health emergency with relevant socioeconomic consequences. Prompt intervention in outbreaks following timely and effective risk communication are crucial for taking the most appropriate control measures and avoiding the spread of fear and panic in the community.

An area of the laboratory bench on which slide agglutinations were performed in the diagnosis of salmonella and shigella infection was examined for these organisms. Impression plates and broth-moistened swabs were used for sampling. Both techniques gave satisfactory results, but the contact plates provided positive results a day earlier than the swabs. Suitable precautions to minimize contamination of the bench surface are discussed.

From an outbreak of very mild “typhus-like disease” in Pretoria, which strongly resembled the cases of “sporadic” or “mild” typhus occasionally occurring in that town, a virus was isolated which was studied in guinea-pigs and rabbits, and was found to belong to the typhus-group.

This virus in cross-immunity experiments with virus of South African louse-typhus and South African tick-bite fever and also in other respects behaved exactly like the typhus-like virus the authors on a previous occasion isolated from rats in a South African town where cases of “mild” or “ sporadic ” typhus have been known to occur regularly for many years.

This constitutes evidence that South African “mild” or “sporadic” typhus comes from rats and is communicated to man by rat-fleas.

In southern Africa, therefore, one has to reckon with three typhus-like diseases: tick-bite fever, flea-typhus from rats, and louse-typhus. Tick-bite fever has a primary sore, the tick-bite, as a pathognomic symptom, the other two can only be differentiated satisfactorily from one another by cross-immunity tests.

Agglutination reactions and cross-immunity tests show that South African louse-typhus and South African rat- or flea-typhus are not identical with similar diseases in other parts of the world.

Tick-bite fever is a mild typhus-like disease extending from the Cape to South Rhodesia.

The typhus-like disease of Kenya is not tick-bite fever, and seems to be identical with fièvre boutonneuse.

Tick-borne encephalitis is a serious arboviral infection with unstable dynamics and profound inter-annual fluctuations in case numbers. A dependable predictive model has been sought since the discovery of the disease. The present study demonstrates that four superimposed cycles, approximately 2·4, 3, 5·4, and 10·4 years long, can account for three-fifths of the variation in the disease fluctuations over central Europe. Using harmonic regression, these cycles can be projected into the future, yielding forecasts of sufficient accuracy for up to 4 years ahead. For the years 2016–2018, this model predicts elevated incidence levels in most parts of the region.

To examine the pathogenesis of USA300 MRSA infection in long-term care residents, we performed a retrospective cohort study of 1691 adult residents of two extended-care facilities from 2003 to 2007 to assess whether the risk of subsequent MRSA infection is higher in USA300 MRSA-colonized residents compared to non-colonized residents or non-USA300 MRSA colonized residents. Six per cent of residents were colonized with USA300 MRSA; 12% of residents were colonized with non-USA300 MRSA; and 101 residents developed MRSA infection. The risk of infection was twofold higher in residents colonized with USA300 MRSA compared to residents not colonized with MRSA [adjusted hazard ratio 2·3, 95% confidence interval (CI) 1·1–4·5]. The risk of infection in USA300 MRSA-colonized residents was similar to USA300 MRSA non-colonized residents (relative risk 1·1, 95% CI 0·5–2·3). Our findings show that colonization with USA300 MRSA increases the risk of MRSA infection suggesting a similar pathogenesis.

1. The lysis of Bact. coli by glycine is inhibited completely by various treatments: (a) by heating the bacteria at 65 or 100° C.; (b) by the action of Cr, Fe, and Al salts at concentrations which cause agglutination of the organisms, (c) by various heavy metals, including particularly Hg and Ag salts, at low concentrations (d) by lethal concentrations of formaldehyde and phenol.

2. The lysis is not inhibited by sodium fluoride, potassium cyanide, or sodium monoiodoacetate at concentrations which suppress the action of certain enzymes.

3. This evidence on the whole supports the rejection of the view that a simple physical process is responsible for lysis by glycine, but does not yet enable us to distinguish between the other possible mechanisms of the lysis because the treatments used might equally interfere either with the structural proteins of the bacteria, or with the hypothetical enzymes which might be concerned in producing the lysis.

Human infection with antimicrobial-resistant Campylobacter species is an important public health concern due to the potentially increased severity of illness and risk of death. Our objective was to synthesise the knowledge of factors associated with human infections with antimicrobial-resistant strains of Campylobacter. This scoping review followed systematic methods, including a protocol developed a priori. Comprehensive literature searches were developed in consultation with a research librarian and performed in five primary and three grey literature databases. Criteria for inclusion were analytical and English-language publications investigating human infections with an antimicrobial-resistant (macrolides, tetracyclines, fluoroquinolones, and/or quinolones) Campylobacter that reported factors potentially linked with the infection. The primary and secondary screening were completed by two independent reviewers using Distiller SR®. The search identified 8,527 unique articles and included 27 articles in the review. Factors were broadly categorised into animal contact, prior antimicrobial use, participant characteristics, food consumption and handling, travel, underlying health conditions, and water consumption/exposure. Important factors linked to an increased risk of infection with a fluoroquinolone-resistant strain included foreign travel and prior antimicrobial use. Identifying consistent risk factors was challenging due to the heterogeneity of results, inconsistent analysis, and the lack of data in low- and middle-income countries, highlighting the need for future research.

The Ebola virus disease (EVD) outbreak in West Africa may affect healthcare attendance. We describe, in the Guinean prefecture of Guéckédou, trends in attendance of public healthcare structures and the main reported diagnoses over the year following the EVD outbreak notification (March 2014). Monthly numbers of visits and main diagnoses such as malaria, schistosomiasis and measles reported by Guéckédou health centres and health posts were described from January 2012 to March 2015. The median number of visits was 15 724/month. From 1 April to 30 September 2014 (EVD outbreak peak), 90 947 visits were reported, representing decreases of 4·8% and 7·4% compared to 2013 and 2012, respectively. Following December 2014 (last EVD notification in Guéckédou), visits increased from 12 540 in January to 16 032 in March 2015. Malaria seasonality was observed in 2014 with 22 519 notifications from 1 April to 31 July. No seasonality was observed for intestinal schistosomiasis (median 485 cases/month); however, a peak was notified in March 2014 (824 cases). Over the study period, all measles cases were notified in 2015 (183 cases). Reduction in healthcare attendance in Guéckédou was modest during the EVD outbreak. Enhanced infectious disease surveillance is a challenge in this context, due to the impact of EVD on traditional prevention programmes.

A material (LS) analogous to that described by Craigie & Wishart (1936a) has been detected in extracts of vaccinia-infected rabbit dermis. Gel-diffusion tests on this material support the view that it is a single substance possessing two distinct serologically reactive sites. The tests also show that under some conditions rabbit LS may give two lines of precipitation against suitable antisera and that this is not due usually to the dissociation of LS into discrete L and S substances.

A study of vaccinia-infected sheep dermis failed to give evidence of a single LS substance. Instead two chemically different substances were isolated, one having the serological specificity of L, the other that of S. The physical, chemical and quantitative serological properties of sheep S were such that it could not have arisen by degradation of an LS material similar to that found in vaccinia-infected rabbit dermis. On this evidence it is suggested that vaccinia virus is not necessarily synthesized in the same way in different host tissues.

Streptococcus pneumoniae strains causing invasive pneumococcal disease (IPD) in the elderly population of England and Wales during the winter of 2003/2004 (1 November 2003 to 30 April 2004) were characterized by serotyping and genotyping in order to determine their population structure in the elderly. Serotyping and multilocus sequence typing (MLST) were carried out on 542 invasive isolates referred to the Respiratory and Systemic Infection Laboratory. Pneumococci were distributed among 32 serotypes and 144 MLST sequence types. A high genetic diversity was observed within the major serotypes. Genetic relatedness varied with regard to serotype. Isolates within serotypes 3, 7F and 8 were the most genetically related whereas serotypes 6A and 19F comprised isolates originating from unrelated ancestors. There was indirect evidence that some pneumococci were derived from clones that had undergone capsular switching in the past. Interestingly one case of IPD was caused by a pneumococcus originating from a clone that had undergone capsular switching from serotype 18C, a serotype included in 7-valent pneumococcal conjugate vaccine (PCV) to serotype 1 (serotype not included in PCV) suggesting that virulent clones with the potential ability to evade PCV existed in the pneumococcal population prior to the routine introduction of this vaccine. Isolates from 28 cases of apparent 23-valent pneumococcal polysaccharide vaccine (PPV) failure were included but there was no evidence of the emergence of particular clones associated with vaccine failures. Longitudinal studies based on serotypic and genetic characterization of pneumococci are fundamental to understanding the impact of both PPV and PCV on the genetic structure of pneumococcal populations.

This study aimed to determine the prevalence of serological markers for HIV-1/2, HBV, HCV, Treponema cruzi and T. pallidum infections. The association of these infections with risk factors in a population from Salvador, Bahia, Brazil was also analysed. Of the 780 enrolled individuals, 545 (70%) were female and 235 (30%) were male. Seroprevalence of 0·8% (6/702), 1·3% (9/678), 1·5% (10/684), 3·5% (23/663) and 11·5% (77/668) for HIV-1/2, HBV, HCV, T. cruzi and T. pallidum infections, respectively, was observed. The seroprevalence of T. pallidum was higher in males 20% (43/210) than in females 7% (34/458) (P < 0·01). An association between age and seroprevalence for T. cruzi (P = 0·02) and T. pallidum (P < 0·01) was observed. HBsAg was associated with having tattoos (3/37 vs. 6/623, P = 0·01) and not having a steady sexual partner (5/141 vs. 4/473, P = 0·04), while anti-HIV-1/2 was associated with having tattoos (2/39 vs. 4/647, P = 0·04); however, larger studies are needed to categorically state the relationship of these risk factors with infectious agents. The prevalence of serological markers for HIV-1/2, HBV, HCV and T. cruzi was consistent with other studies.

Salmonella enterica commonly colonizes the intestinal tract of cattle and is a leading cause of foodborne illness. A previously described investigation into the prevalence of S. enterica on a dairy farm revealed an 8-year-long asymptomatic S. enterica epidemic caused by serotypes Cerro and Kentucky in the lactating herd. To investigate the source of the S. Kentucky strains, the genomes of two S. Kentucky isolates were sequenced; one collected prior to the epidemic (2004) and one collected during the epidemic (2010). Comparative genomic analysis demonstrated significant polymorphisms between the two strains. PCR primers targeting unique and strain-specific regions were developed, and screening of the archived isolates identified the index case of the asymptomatic S. Kentucky epidemic as a heifer that was raised off-site and transported onto the study farm in 2005. Analysis of isolates collected from all heifers brought onto the farm demonstrated frequent re-introduction of clones of the epidemic strain suggesting transmission of pathogens between farms might occur repeatedly.