The carriage of Staphylococcus aureus was studied in a group of 28 men living in a totally isolated environment for a year. Initially, nasal, axillary and perineal swabs were taken at weekly intervals, but from week 24 throat swabs were taken from known nasal carriers. Several attempts were made during the study to eradicate S. aureus. Eight subjects consistently carried their own phage type throughout the study, despite the application of antibacterial agents. In three subjects strains were isolated late in the study of a phage type which had either not been isolated before in this study, or had not been found for a prolonged period. Nine of the 12 nasal carriers also yielded S. aureus from the throat. It is apparent that following attempted eradication, S. aureus may seem to disappear, only to reappear some time later; ‘eradication’ in this case would be an erroneous appellation.

It is suggested that bovine enteroviruses (BEV) are involved in the aetiology of enteric infections, respiratory disease, reproductive disorders and infertility. In this study, bovine faecal samples collected in different Brazilian states were subjected to RNA extraction, reverse transcription-polymerase chain reaction analysis and partial sequencing of the 5′-terminal portion of BEV. One hundred and three samples were tested with an overall positivity of 14.5%. Phylogenetic analysis clustered these BEV Brazilian samples into the Enterovirus F clade. Our results bring an important update of the virus presence in Brazil and contribute to a better understanding of the distribution and characterisation of BEV in cattle.

1. Bacteriological examination from the tonsils and post-nasal space in forty-six cases of acute and sub-acute rheumatism resulted in streptococci alone being isolated.

2. The streptococci isolated fell into three groups, S. mitis, S. salivarius, and eleven strains of S. cardioarthritidis.

3. Comparison of the strains of S. cardioarthritidis with strains isolated in America show them to be closely related.

4. No evidence was found of an exotoxin.

5. Evidence was found of the presence of an endotoxin or lysate which produces an antitoxin.

6. Intravenous inoculation of the lysate into rabbits appears definitely to affect the heart muscle and lungs, and to some extent the liver and kidneys.

Outbreaks of norovirus-associated gastroenteritis have been reported in schools in recent decades in China. For early warning and response to infectious disease outbreaks, the Shanghai Infectious Diseases Bud Event Surveillance System (IDBESS) was established in 2016. Bud event is a term used for the early sign of a potential infectious disease outbreak in public settings when the first few cases appear. This study aimed to describe the epidemiological characteristics of Norovirus-associated gastroenteritis bud events from June 2016 to December 2017 and to understand factors influencing the severity of events. Data were extracted from the IDBESS, supplemented by field investigations and school absence surveillance. In total, 189 bud events of Norovirus-associated gastroenteritis were reported in schools and kindergartens, affecting 3827 individuals and 52.38% happened in primary schools. The attack rate of Norovirus-associated gastroenteritis was 3.82% on average in students in the affected schools. In each event, case numbers varied between 5 and 148, with a median of 16. The duration of bud events lasted for 2 days on average. School absence happened in 47.93% (1797/3749) of affected students and the average duration of absence was 3.07 days. It was found that a longer delay before reporting was associated with a longer-lasting duration of bud event (OR = 2.25, 95% CI: 1.65, 3.07). In conclusion, ascribed to the sensitive threshold for alerting and the timely field investigation, the surveillance of bud events of Norovirus-associated gastroenteritis is effective in the control of Norovirus infection among preschool children and students in Shanghai.

DNA- fingerprints (Hind III) of Streptococcus uberis field isolates from New York State and Europe showed substantial homogeneity, but were different to those of the type strain of the newly proposed psychrophilic species S. parauberis. S. uberis strains had major SDS-heat extracted antigens of molecular masses (Mr) < 14, 40–41, 42–43, 59–61, 80–86 and 118–122 kDa following immunoblotting with rabbit hyperimmune sera. Bovine sera and milk reacted with the 40–41 and 118–122 kDa antigens. Variations in the Mr of particular bands were too unevenly distributed to permit formation of subgroups. Although cross reactive, the sizes of the antigens of S. parauberis strain NCDO 2020 were substantially different to those of S. uberis, the most prominent antigen having a Mr of 50 kDa. The antigenic and genetic data therefore strongly support the introduction of S. parauberis as a distinct species. S. uberis strains reacted with antiserum to Lancefield groups B, E, G and P, their grouping reactions showing no correlation with DNA and immunoblot fingerprints. Lancefield grouping of S. uberis therefore appears to have little value in identification.

The Cambridge University Health Service started work in October 1948. So far it has been restricted to preventive measures and has been confined to new entrants to the University on an entirely voluntary basis. The Service provides a clinical examination and a chest X-ray. A general survey of the scope of the Service and the results obtained have been given in the annual reports of the Senior Health Service Officer, Sir Alan Rook (1950, 1951). In addition to the original clinical records a Hollerith punched-card record system has been used since the inception of the Service to facilitate detailed investigations. In Appendix I to the first annual report mentioned above (Rook, 1950) I gave a few preliminary results on various physical measurements for the first 900 men examined. It has now been possible to complete a much more extensive investigation, the results of which are given in the present paper. In some cases this has been based on the completed records for the year 1948–9, while in others the records for the two years 1948–50 have been utilized. I have already given a brief summary of the contents of this paper in Appendix I to the second annual report (Rook, 1951).

Three human volunteer experiments were performed in which river water expected to contain campylobacter organisms was ingested. Despite the ingestion of over 44000 organisms in one experiment, the subject did not suffer any symptoms, nor were campylobacter organisms excreted, nor was an antibody response to the ingested strains detected. The campylobacter organisms ingested resembled Campylobacter jejuni on colonial and microscopic morphology but were hippurate negative, and were distinct from C. coli. These environmental campylobacter strains appear to be non-pathogenic, however they may be mistaken for C. Jejuni or C.coli if they are not fully identified.

An analysis is given of the serological tests performed over a period of 15 months with viral, rickettsial and leptospiral antigens. The analysed material is made up of about 9400 tests performed on 4036 samples of serum obtained from 2430 patients and 536 animals.

The incidence of the various diseases, the distribution of the positive results according to diseases, and the height of the specific titres, as well as the height of the residual titres found in the material, are discussed and analysed in detail.

The procedure for the preliminary screening of the material, as well as the methods used in performing the different serological tests, are described and discussed.

A few examples of possible double infections are quoted, namely atypical virus pneumonia with influenza, and influenza A with B.

An analysis of the results of 1723 tests performed with influenza antigens on 909 samples of sera is presented.

The results obtained from testing about 1000 sera for cold agglutinins and 482 sera for MG agglutinins are discussed in detail.

Some cases of liver affections showed a marked rise in titre both of cold agglutinins and of MG agglutinins.

The serum samples, numbering about 1050, drawn from normal persons or patients suffering from infections other than Q-fever, all gave titres lower than 1/64 when tested with Q-fever antigen, except the sera of four persons who were probably cases of recent inapparent infection.

The geometrical mean of the titres found in sera drawn from acute Q-fever patients between the 29th and 60th days of their illness was 1/355. Of the 500 sera from various animals, 100 from sheep and eight from cows had titres of 1/8 to 1/64 against the Q-fever antigen.

Thirty-four sera have been positive when tested with the soluble antigen of both the epidemic and the murine types of typhus but no serum has given a higher titre with the murine type antigen than with the epidemic type antigen. Of the thirty-four sera tested with both antigens the titres obtained with the epidemic antigen were higher than with the murine antigen in 28.

The results obtained with 417 sera tested with the mumps antigen, and with the 222 sera tested with the lymphocytic choriomeningitis antigen are reported and discussed in detail.

Great individual variation has been observed in the time of appearance and rise and fall of the Paul-Bunell titres. Consequently, it is advised that early and frequent blood samples should be obtained from patients who are suspected to be suffering from infectious mononucleosis. On the basis of the results of 316 Paul-Bunnell tests it is suggested that a titre of 1/20, if preceded or followed by a negative serum sample, should be taken as conclusive evidence of infectious mononucleosis.

3080 human and 164 animal sera have been investigated for the presence of antibodies to various types of leptospirae. In both human and animal sera antibodies have been found most frequently against L. sejroe and L. pomona.

The results of a few tests performed with toxoplasma antigen are mentioned briefly.

We wish to express our gratitude to all our colleagues in Belgrade and other parts of the country who have provided us with information and additional samples of blood when requested, in particular Prof. K. Todorowich of the Infectious Diseases Hospital, Belgrade, and Drs Lj. Vuksich, M. Morelj, B. Arsich, D. Mehl and R. Papo of the Army Medical School, Belgrade.

We wish to thank Dr R. Djorich of the Infectious Diseases Hospital, Belgrade, for the supply of material for testing for atypical virus pneumonia and aseptic meningitis, and Dr Ž. Perishich for help with our cases of infectious mononucleosis. Mrs Martha Milivojevich gave valuable assistance with the complement-fixation tests and with the compilation of material for this report.

Salmonella enterica serotype Abortusovis, an ovine host-specific serotype, rare in most countries, is responsible for epidemic abortion episodes in Spain. With the aim of surveillance and detection of the spread of specific clones, 55 Abortusovis isolates collected during 1996–2001 from flocks in 11 provinces, were studied using XbaI–PFGE. Despite the fact that the strains were geographically and spatially related, PFGE demonstrated an epidemiologically acceptable discriminating power, identifying 20 clones (similarity, 52–96%). Clones Sabv6, 1, 5 were disseminated in seven, five and two areas respectively, while another 17 clones appeared in single places. Clones from nearby geographic regions showed a high relatedness (one band of difference in the PFGE profile) Sabv1-2-3, Sabv5-6, Sabv7-8, and Sabv13-14, suggesting a common ancestor. Co-isolation in the same flock (Sabv5-6, Sabv1-3, Sabv1-6) was detected. PFGE surveillance detected the predominance and widespread distribution of clone Sabv6 in 21 out of the 55 Abortusovis serotype episodes studied in Spain.

A cluster of Legionnaires' disease (LD) with 10 confirmed, three probable and four possible cases occurred in August and September 2016 in Dendermonde, Belgium. The incidence in the district was 7 cases/100 000 population, exceeding the maximum annual incidence in the previous 5 years of 1.5/100 000. Epidemiological, environmental and geographical investigations identified a cooling tower (CT) as the most likely source. The case risk around the tower decreased with increasing distance and was highest within 5 km. Legionella pneumophila serogroup 1, ST48, was identified in a human respiratory sample but could not be matched with the environmental results. Public health authorities imposed measures to control the contamination of the CT and organised follow-up sampling. We identified obstacles encountered during the cluster investigation and formulated recommendations for improved LD cluster management, including faster coordination of teams through the outbreak control team, improved communication about clinical and environmental sample analysis, more detailed documentation of potential exposures obtained through the case questionnaire and earlier use of a geographical information tool to compare potential sources and for hypothesis generation.

In rapidly growing and high-burden urban centres, identifying tuberculosis (TB) transmission hotspots and understanding the potential impact of interventions can inform future control and prevention strategies. Using data on local demography, TB reports and patient reporting patterns in Dhaka South City Corporation (DSCC) and Dhaka North City Corporation (DNCC), Bangladesh, between 2010 and 2017, we developed maps of TB reporting rates across wards in DSCC and DNCC and identified wards with high rates of reported TB (i.e. ‘hotspots’) in DSCC and DNCC. We developed ward-level transmission models and estimated the potential epidemiological impact of three TB interventions: active case finding (ACF), mass preventive therapy (PT) and a combination of ACF and PT, implemented either citywide or targeted to high-incidence hotspots. There was substantial geographic heterogeneity in the estimated TB incidence in both DSCC and DNCC: incidence in the highest-incidence wards was over ten times higher than in the lowest-incidence wards in each city corporation. ACF, PT and combined ACF plus PT delivered to 10% of the population reduced TB incidence by a projected 7%–9%, 13%–15% and 19%–23% over five years, respectively. Targeting TB hotspots increased the projected reduction in TB incidence achieved by each intervention 1.4- to 1.8-fold. The geographical pattern of TB notifications suggests high levels of ongoing TB transmission in DSCC and DNCC, with substantial heterogeneity at the ward level. Interventions that reduce transmission are likely to be highly effective and incorporating notification data at the local level can further improve intervention efficiency.

IgM antibodies specific for cytomegalovirus (CMV) were demonstrated in 15 (2.6%) of 575 umbilical cord sera obtained from newborns in Kuwait. Some 93% and 50% of these CMV-IgM positive cord sera displayed markedly raised (more than normal mean + 2 S.D.) content of total IgM and IgA respectively. In contrast, only 0.2 and 1.8% of the CMV-IgM negative cord sera had elevated total IgM and IgA. respectively. Rheumatoid factor (RF) was demonstrable. at concentrations of 30 IU/ml or more, in 67% of the CMV-IgM positive as compared with 3.2% of the CMV-IgM negative sera whereas interferon alpha was found in the serum of only one of these infants. These results indicate that raised total immunoglobulin. in particular IgM. concentrations and the detection of RF in cord blood are useful non-specific markers for the identification of congenital CMV infection.

Serum proteins adsorbed from the culture medium were detected in Mycoplasma bovis antigens, the number and type of proteins depending on the serum used in the medium. The α-globulins cross-reacted with α-globulins from different types of sera but the γ-globulins did not. The removal of non-specific medium antibodies by absorption showed that they affected the gel diffusion and growth precipitation tests, producing cross-reactions between M. bovis and M. bovigenitalium, but that the complement fixation, tube agglutination, and growth inhibition tests were not similarly affected. The presence of serum proteins in the antigens changed their specific reactivity in all the tests. The production of antibodies to serum proteins was increased by the use of an adjuvant, but it appeared that production of specific antibodies to the mycoplasmas was not.

We examined the uptake of HIV testing in black Africans living in England before the introduction of national testing guidelines. Analyses were conducted using data from an anonymous self-completed questionnaire linked to oral fluid samples to establish HIV status in black Africans attending community venues in England in 2004. Of 946 participants, 44% had ever been tested for HIV and 29% had been tested in the previous 24 months. Of those with undiagnosed HIV, 45% had previously had a negative HIV test. Almost a third of people tested in the UK had been at general practice. Uptake of HIV testing was not associated with perceived risk of HIV. These findings highlight the need for the implementation of national HIV testing guidelines in the UK, including the promotion of testing in general practice. Regular testing in black Africans living in the UK should be promoted regardless of their HIV test history.

We hope that this summary of our researches will be sufficient to make clear the nature of the danger spoken of at the beginning of this article. We see that certain bodies, not poisons in themselves in the usual sense of the word, can provoke physiological disorders and organic lesions, the etiology of which remains generally unnoticed, when they are absorbed daily for months and years. Such products are most certainly responsible for many illnesses, the frequence of which augments with the alimentary conditions imposed upon us by modern civilisation in a manner inexplicable beforehand.

Our object will have been attained if we succeed in attracting the attention of physicians and hygienists to certain problems, the study of which is perhaps not very attractive but the solution of which is of considerable practical interest.

Reducing the risk of human immunodeficiency virus type 1 (HIV-1) transmission is still a public health priority. The development of effective control strategies relies on the quantification of the effects of prophylactic and therapeutic measures in disease incidence. Although several assays can be used to estimate HIV incidence, these estimates are limited by the poor performance of these assays in distinguishing recent from long-standing infections. To address such limitation, we have developed an assay to titrate p24-specific IgG3 antibodies as a marker of recent infection. The assay is based on a recombinant p24 protein capable to detect total IgG antibodies in sera using a liquid micro array and enzyme-linked immunosorbent assay. Subsequently, the assay was optimised to detect and titrate anti-p24 IgG3 responses in a panel of sequential specimens from seroconverters over 24 months. The kinetics of p24-specific IgG3 titres revealed a transient peak in the 4 to 5-month period after seroconversion. It was followed by a sharp decline, allowing infections with less than 6 months to be distinguished from older ones. The developed assay exhibited a mean duration of recent infection of 144 days and a false-recent rate of ca. 14%. Our findings show that HIV-1 p24-specific IgG3 titres can be used as a tool to evaluate HIV incidence in serosurveys and to monitor the efficacy of vaccines and other transmission control strategies.

High-throughput sequencing technologies now allow for rapid cost-effective surveys of multiple pathogens in many host species including rodents, but it is currently unclear if the organ chosen for screening influences the number and identity of bacteria detected. We used 16S rRNA amplicon sequencing to identify bacterial pathogens in the heart, liver, lungs, kidneys and spleen of 13 water voles (Arvicola terrestris) collected in Franche-Comté, France. We asked if bacterial pathogen assemblages within organs are similar and if all five organs are necessary to detect all of the bacteria present in an individual animal. We identified 24 bacteria representing 17 genera; average bacterial richness for each organ ranged from 1·5 ± 0·4 (mean ± standard error) to 2·5 ± 0·4 bacteria/organ and did not differ significantly between organs. The average bacterial richness when organ assemblages were pooled within animals was 4·7 ± 0·6 bacteria/animal; Operational Taxonomic Unit accumulation analysis indicates that all five organs are required to obtain this. Organ type influences bacterial assemblage composition in a systematic way (PERMANOVA, 999 permutations, pseudo-F4,51 = 1·37, P = 0·001). Our results demonstrate that the number of organs sampled influences the ability to detect bacterial pathogens, which can inform sampling decisions in public health and wildlife ecology.

1. Methods for the estimation of iodine in natural products are described.

2. Common sea weeds on the Pacific coast of Otago have an iodine content of the same order as similar species on the Pacific coast of British Columbia.

3. In Cystophora retroflexa, which contains over 0·1 per cent, of iodine, 70–80 per cent, of the iodine appears to be in inorganic or loosely bound combination. Precipitation and colour tests indicate that di-iodotyrosine is also present.

4. Observations are recorded of the iodine content of kelp-feeding and other fish.

5. Administration of anaesthetics produces fluctuations in the concentration of blood iodine in rabbits, the effect persisting after removal of the thyroid gland. Experiments in vitro suggest that only in the case of inorganic iodine could a redistribution of iodine between tissues and serum be brought about by the direct action of anaesthetics.

6. New Zealand cabbage possesses goitrigenous properties for rabbits but in a much smaller degree than American cabbage.

7. The urinary excretion of Samoans is compared with that of inhabitants of Christchurch Mental Hospital.

8. The incidence and course of development of goitre at Christchurch Mental Hospital is discussed.

9. Values are given for the iodine content of Otago pigs' thyroids.

This study evaluated the roles of multiple factors in hepatitis C virus (HCV) infection, with emphasis on the modification of various individual characteristics on the risk associated with percutaneous exposure to blood. Serum samples taken from 4869 men in Taiwan within a cohort study were tested for HCV antibody. The overall positive rate of anti-HCV was 1·6 %. In a logistic regression, factors positively associated with anti-HCV positivity were previous blood transfusion (odds ratio [OR] = 7·28; 95 % confidence interval [CI] = 4·26–12·45), a history of surgery (OR = 2·06; 95 % CI = 1·23–3·46), and lower educational levels (OR = 1·94; 95 % CI = 1·14–3·32). The anti-HCV positive rate was significantly lower in hepatitis B surface antigen (HBsAg) carriers than in non-carriers (OR = 0·60; 95 % CI = 0·37–0·95). Ageing, lower educational levels, O blood group, and Taiwanese ethnicity enhanced the likelihood of HCV infection through blood transfusion/surgery, whereas HBsAg status, cigarette smoking, and habitual alcohol drinking reduced it.

Natal, which has been considered of recent years to be a malaria-free country, has been visited in the past six months by an extensive epidemic of this disease.