It is commonly believed that a concrete floor feels cold, whereas a wood floor feels warm. It is not clear however, under what conditions this statement is supposed to be valid, if, in fact, it is true at all. Nevertheless, one supposes that it applies certainly to walking barefoot across the floor; and it is believed by many to apply also when shoes are worn. In common usage, however, no attempt is made to eliminate the factor of surface temperature.

Campylobacter jejuni/coli strains from 164 chickens were serotyped by the methods previously described by Penner et al. and Lior et al. The chickens were sampled during breeding from hatching to the age of 42 weeks. The birds were housed, in two separate groups, under different environmental conditions, (for comparison of the effect of hygienic precautions on the transmission of the bacteria during breeding). In the group where the hygienic conditions could be controlled to a greater extent, the chickens became colonized later in the breeding chain and with only one single campylobacter strains.

The relation of salmonella isolation efficiency and the size of inoculum introduced from a buffered peptone water culture of sewage polluted water into strontium chloride B medium was investigated. Two separate studies were made, one using enrichment at 37°C, the other at 43°C. From these trials, two inocula suitable for efficient salmonella isolation were determined. Using this information, strontium chloride B medium was compared with modified Rappaport's broth (R25). The inoculum used with R25 was 0·005 ml, determined in an earlier study. Two incubation temperatures were employed with strontium chloride enrichment (37 and 43°C). Rappaport's medium was incubated at 37°C only. Elevated temperature enrichment at 43°C improved the performance of strontium chloride B, but Rappaport's broth still gave significantly better results. This supports earlier studies on simplification of salmonella isolation and standardization of routine technique on a single enrichment medium: Rappaport broth (R25) incubated at 37°C.

Two hundred and twenty-two infants and fifty-one staff were examined for carriage of Staphylococcus pyogenes and Gram-negative bacilli, and the presence of these bacteria in the ward environment was also investigated. Staphylococci were phage-typed and tested for sensitivity to antibiotics. Assessment of clinical infection caused by these bacteria was made.

Infant carriage of Staphylococcus pyogenes was maximal on the sixth day, 73·1 % of umbilical swabs yielding significant growth. Carriage of Gram-negative bacilli was maximal on the fifth day, 31·7% of umbilical swabs being positive. Where special nursing was enforced, i.e. premature baby unit, isolation of Gram-negative bacilli was very infrequent.

The low nasal carriage of staphylococci seen in infants and nursing staff is attributed to traces of penicillinase-resistant penicillins in the ward air.

Staphylococcus pyogenes was recovered from 23 % of ward surfaces, and constituted 0·7% of the air-borne flora. In contrast, Gram-negative bacilli were recovered from 4·7 % of surfaces, and composed only 0·15% of the air-borne flora.

Phage group I constituted 73·0, 44·9 and 41·2% of strains from infants, staff and ward environment respectively.

Antibiograms were grouped into three categories, A, B and C. Category A (sensitive to chloramphenicol, erythromycin and methicillin but penicillin-resistant) composed 79·0% of infants' strains, being found mostly in group I, but was rare among staff strains.

Of 54 specimens taken from 40 infants showing evidence of infection, Staphylococcus pyogenes was isolated from 16, of which 14 were category A. Gram-negative bacilli were isolated 7 times. Only 21 infants required antibiotic therapy (9·3%) and none were infected with Gram-negative bacilli—this contrasts with the frequency of these bacilli in nursery infection today.

Ward air is considered to be the main depot of Staphylococcus pyogenes. Infant ‘dispersers’ are probably the principal source of the air-borne staphylococci. Infants and staff abstract from the air those staphylococci which become their colonizing strains. No transfer is thought to occur from the staff to the infants. Transmission of Gram-negative bacilli is similar in that the infants are the principal source and the air the main depot of these bacteria. Nasal colonization by Gram-negative bacilli is low, this is possibly due to poor colonizing properties. Infant umbilical carriage almost certainly results from endogenous faecal spread.

We are grateful to Dr J. C. Gould, Director, Central Microbiological Laboratories, Edinburgh, for his continued interest and advice, and to Mr J. C. Ferguson and Mrs M. M. Winton for skilled technical assistance. This study would not have been completed without the co-operation of Sisters McCartney and Struthers and their nursing staff.

A prospective study of hepatitis that began in 1968 and continues to include more than half the dialysis units in the United Kingdom shows that type B infection has been completely controlled in such units since the last outbreak ended in 1973. Though occasionally a single patient has developed hepatitis B surface antigenaemia in the course of dialysis or after transplantation, the infection has not spread to other patients or staff in the survey units.

A detailed analysis of the results in 1974–75 shows clustering of patients with raised aminotransferase levels in about one-fifth of the units but, unlike past outbreaks of hepatitis B, these clusters are not accompanied by clinical hepatitis among staff. The possibility that some of the clusters are caused by hepatitis viruses other than type A or B is discussed. It is concluded that, when reliable tests for type non-A non-B infections become available, the continued existence of the survey will allow prompt assessment of any viral hepatitis problems that may still exist in UK units.

The number of bacteria on the hands of nurses using 2 % hexachlorophene soap intermittently was compared with the numbers of bacteria on the hands of nurses using ordinary soap. No significant differences were observed.

This study would not have been possible without the whole-hearted co-operation of the Matron, Miss M. Schurr, the Deputy Matron, Miss G. Davies and the Sisters and Nursing Staff of Fulham Hospital.

We are also indebted to Mr T. Ridgewell, Mr T. F. Fletcher and Miss Julia Fisher for technical assistance, and to Messers Bibby and Co. For their generous gift of soap.

The blood picture in rubella is characterised by the presence of numerous plasma and Türk cells and by the absence of toxic changes in the neutrophilic leucocytes.

Plasma cells occur also in scarlatina and in measles but with less regularity and, as a rule, in smaller numbers, but these diseases are always associated with “toxic” changes in the neutrophilic cells.

Such haematological features must be considered in relation with the clinical findings because plasma cells and toxic changes in the neutrophiles may occur in entirely different conditions, e.g. in association with the lympho cytosis following almost any acute infective malady.

The haematological method would probably find its greatest application in those cases in which the characters of the rash are not sufficiently well developed to enable a diagnosis to be made in the usual way.

Acknowledgments. My investigations were carried out at the Institute of Pathology of Charing Cross Hospital Medical School, and I am much indebted to the Director, Dr Piney, for assistance and advice, and to Dr Whittaker of the Metropolitan Asylums Board for access to clinical material. Moreover, financial assistance has been afforded by The Virol Research Scholarship which I hold.

Using a set of statistical methods and HIV mathematical models applied on nationally representative Demographic and Health Survey data, we characterized HIV serodiscordancy patterns and HIV transmission dynamics in stable couples (SCs) in four countries: Cambodia, the Dominican Republic, Haiti, and India. The majority of SCs affected by HIV were serodiscordant, and about a third of HIV-infected persons had uninfected partners. Overall, nearly two-thirds of HIV infections occurred in individuals in SCs, but only about half of these infections were due to transmissions within serodiscordant couples. The majority of HIV incidence in the population occurred through extra-partner encounters in SCs. There is similarity in HIV epidemiology in SCs between these countries and countries in sub-Saharan Africa, despite the difference in scale of epidemics. It appears that HIV epidemiology in SCs may share similar patterns globally, possibly because it is a natural ‘spillover’ effect of HIV dynamics in high-risk populations.

The recent reinforcement of CoV surveillance in animals fuelled by the COVID-19 pandemic provided increasing evidence that mammals other than bats might hide further diversity and play critical roles in human infectious diseases. This work describes the results of a two-year survey carried out in Italy with the double objective of uncovering CoV diversity associated with wildlife and of excluding the establishment of a reservoir for SARS-CoV-2 in particularly susceptible or exposed species. The survey targeted hosts from five different orders and was harmonised across the country in terms of sample size, target tissues, and molecular test. Results showed the circulation of 8 CoV species in 13 hosts out of the 42 screened. Coronaviruses were either typical of the host species/genus or normally associated with their domestic counterpart. Two novel viruses likely belonging to a novel CoV genus were found in mustelids. All samples were negative for SARS-CoV-2, with minimum detectable prevalence ranging between 0.49% and 4.78% in the 13 species reaching our threshold sample size of 59 individuals. Considering that within-species transmission in white-tailed deer resulted in raising the prevalence from 5% to 81% within a few months, this result would exclude a sustained cycle after spillback in the tested species.

An enzyme-linked immunosorbent assay (ELISA) incorporating the sensitive biotin-streptavidin system was developed to detect IgG antibodies to tetanus toxoid in human serum. Serum samples obtained from 557 normal persons aged 1–65 years from different areas in New Zealand were tested. The proportion of those immune ranged from 60–93% in males, and from 46–86% in females. In the 1–9 years age group 85% were immune. The indirect ELISA is suitable for serological surveys as it is simple to perform, economical and reproducible.

Patients with a clinical diagnosis of dengue but negative by serological testing were studied for rubella infection. Paired sera were obtained from 69 patients during an outbreak in Yucatán, México. The presence of specific anti-viral IgM in the acute sera was considered as diagnostic for rubella infection. The immunoglobulin was determined by measuring the difference in the inhibition of hemagglutination between the non-reduced and the reduced fractionated sera. Immunoglobulins were separated by sucrose density centrifugation. Acute rubella infection was found in 7 (10·1%) of the patients. These results demonstrate active rubella infection in patients clinically diagnosed as dengue.

A study of the distribution of subtypes ad and ay among sera from hepatitis B antigen-positive subjects in North West England and North Wales revealed a marked contrast between symptomless carriers among whom ad predominated and patients with acute hepatitis the majority of whom were ay. Those with hepatitis associated with drug addiction or other forms of ‘needle transmission’ were almost all of subtype ay. On the other hand in cases of ‘sporadic’ hepatitis without evidence of parenteral exposure subtypes ad and ay are about equally distributed.

These findings are similar to those reported from other countries in Northern Europe and North America. Although geographical and social factors clearly affect the distribution of the two subtypes it is suggested that the virus of subtype ay may be more readily transmitted than subtype ad by parenteral routes involving small amounts of blood.

1. The effects of morphine upon the small intestine are an increase in the tone and peristaltic movements. The frequency of peristaltic movements is slightly increased at first, but later decreased. The frequency of the rhythmical contractions remains more or less constant while their amplitude is increased. The tone and movements of the ileo-colic sphincter are increased.

2. Atropine modifies the effects of morphine by producing a decrease in tone and movements of the intestine, for varying periods of time. The subsequent injection of morphine during the period of inhibition produces, however, a further increase in tone and movements. Adrenalin causes a temporary inhibition of tone and movements after morphine.

3. Diacetylmorphine and dihydromorphinone produce similar effects; but are more active than morphine. Dihydromorphinone is approximately 10 times more active, and diacetylmorphine 11/2 times more active than morphine.

4. Dihydrocodeinone, codeine and dihydro-oxycodeinone produce similar effects to morphine but are much weaker, especially in so far as the production of increased tone is concerned. Regarding relative activities dihydrocodeinone lies between morphine and codeine, while dihydro-oxycodeinone is placed after codeinone.

The Middle East respiratory syndrome coronavirus (MERS-CoV) is caused by a novel coronavirus discovered in 2012. Since then, 1806 cases, including 564 deaths, have been reported by the Kingdom of Saudi Arabia (KSA) and affected countries as of 1 June 2016. Previous literature attributed increases in MERS-CoV transmission to camel breeding season as camels are likely the reservoir for the virus. However, this literature review and subsequent analysis indicate a lack of seasonality. A retrospective, epidemiological cluster analysis was conducted to investigate increases in MERS-CoV transmission and reports of household and nosocomial clusters. Cases were verified and associations between cases were substantiated through an extensive literature review and the Armed Forces Health Surveillance Branch's Tiered Source Classification System. A total of 51 clusters were identified, primarily nosocomial (80·4%) and most occurred in KSA (45·1%). Clusters corresponded temporally with the majority of periods of greatest incidence, suggesting a strong correlation between nosocomial transmission and notable increases in cases.

A conjunctivitis outbreak affecting more than 200 individuals occurred on a university campus in Evanston, Illinois, USA, in spring 2002. An investigation was conducted jointly by the Evanston Department of Health and the Illinois Department of Public Health. A combination of e-mail and traditional telephone-based surveys demonstrated that wearing contact lenses was a risk factor for any conjunctivitis and bilateral conjunctivitis, whereas using glasses was protective. Laboratory and epidemiological evidence suggested that the outbreak was caused by a viral pathogen that eluded characterization despite extensive culture and PCR-based laboratory testing. Enhanced laboratory surveillance could help clinicians and public-health officials to identify relevant secular changes in the spectrum of causes of conjunctivitis. During institutional outbreaks, e-mail surveys can help public-health officials to efficiently access information not easily collected by traditional case-control studies, and can provide an effective conduit for providing prevention recommendation, such as the need for improved hand and contact-lens hygiene during outbreaks.

Detailed screening of the patients and staff in a unit specializing in liver disease was carried out over a year to ascertain whether transmission of the serum hepatitis virus was occurring and whether the situation was comparable in any way to that found in a Renal Haemodialysis Unit. Of the 154 patients with liver disease tested on admission, 6% were found to have Australia antigen in the serum and throughout the year there were rarely less than two patients in the ward at any one time with positive serum. No instances of clinical hepatitis were detected in the other patients following their stay in the ward or in their attendant medical, nursing and lay staff. Six staff members were found to have Australia antigen in their serum. In four of these, all nurses, it was present in the first sample tested and so the infection may have been acquired earlier. Temporary elevations in both plasma bilirubin and serum aspartate aminotransferase levels were found in another five staff members whose serum was negative for Australia antigen and who clinically were well. In a further eight and apparently healthy staff members, an isolated but persistent elevation of the plasma bilirubin was noted. In both groups these changes could represent the spread of subclinical infectious hepatitis and it is recommended that in units dealing with ‘liver patients’ not only should considerable care be taken during diagnostic and therapeutic procedures but the medical and nursing staff should be screened at regular intervals.

Physiologists have recognized for a long time that stuffiness in a close atmosphere is not due to diminution of oxygen or excess of carbon dioxide in the air breathed, or to any other impurity in the air. Such feelings are now shown to be due to the effect of longer infra-red rays on the skin, and are accompanied by a reflex narrowing of the air-ways of the nose and lungs. These effects are set aside by cool air acting on the skin and in many people also by shorter infra-red rays from bright sources of heat. This is why some people are much more comfortable with a bright source of heat than with a dark or dull red one. When people go out of doors to get a “breather”, or stand before an open window during physical exercises, they are instinctively using the stimulus of cold to widen their air-tubes. In open air treatment, and when sleeping with an open window, the same effect is obtained.

All rooms should be adequately ventilated with cool air to prevent stuffy feelings, and keep the air-ways open. Such ventilation will, at the same time, sweep away infection spread by “carriers”.

Partial obstruction of the air-tubes hinders the passage of blood through the lungs; it is this which causes failure of breathing when the obstruction is considerable.

Bleeding is of value because it relieves to a certain extent the impeded circulation.

Breathing through a narrow tube can be used as a test of fitness. An airway gauge has been designed for making such a test.

Circulation of methicillin-resistant Staphylococcus aureus (MRSA) outside hospitals could alter the impact of hospital-based control strategies. We investigated two groups of cases (each matched to controls with MRSA): 61 ‘community cases’ not in acute hospital in the year before MRSA isolation; and 21 cases with ciprofloxacin-sensitive (CipS) MRSA. Multi-locus sequence typing, spa-typing and Panton–Valentine leukocidin gene testing were performed and demographics obtained. Additional questionnaires were completed by community case GPs. Community cases comprised 6% of Oxfordshire MRSA. Three community cases had received no regular healthcare or antibiotics: one was infected with CipS. Ninety-one percent of community cases had healthcare-associated sequence type (ST)22/36; CipS MRSA cases had heterogeneous STs but many had recent healthcare exposure. A substantial minority of UK MRSA transmission may occur outside hospitals. Hospital strains are becoming ‘feral’ or persisting in long-term carriers in the community with regular healthcare contacts; those with recent healthcare exposure may nevertheless acquire non-hospital epidemic MRSA strains in the community.

In June 1935, certain problems arose concerning the fumigation of houses with hydrogen cyanide for the destruction of bedbugs. Workmen reconditioning houses in Rochester, which had been given the customary 24 hr. aeration after fumigation with hydrogen cyanide “disks”, had complained of sickness during their work. The walls, cavities and floor spaces of some of these houses had been tested by Mr Topping, the Chief Sanitary Inspector of Rochester, who, using benzidine acetate-copper acetate paper, had obtained a strong positive reaction indicative of the presence of hydrogen cyanide after 24 hr. aeration.

A bacteriological survey was made on the distribution and occurrence of coliforms and pathogenic indicators of pollution within the surf-zone and near-shore waters along a section of the Natal Coast, prior to the use of submarine outfalls. The distance covered measured approximately 47 miles. The waters sampled and assessed ranged from ‘clean’ beaches to heavily polluted areas; a single short run off an Eastern Cape coastal region was included for comparative purposes. In all cases, the bacteriological picture was related to sanitary features on the shore. The method is based on Escherichia coli I counts, parasite units, staphylococci, salmonellas and salinity, and provides an objective approach to the assessment of any future changes in water quality consequent on development.