Vitamin E-deficient rats, as well as normal and vitamin E-deficient chicks, failed to discriminate between two diets which were identical in all respects except that in one there was a deficiency of vitamin E and in the other there were adequate levels of vitamin E.

Grateful thanks are due to G. Crook for assistance in the care and management of the experimental animals.

The purpose of surveys of amoebae or other organisms is the estimation of the carrier rate in a population, that is, of the proportion of persons who carry a given parasite. As a rule, the tests do not infallibly detect the presence of the organism in a known carrier. Thus simple estimation from a single examination of each member of a sample is not applicable.

Particle concentration in patient rooms at various ventilation rates and with differing methods of air supply has been investigated experimentally in a specially built test room. The size of the test room corresponded to an ordinary bedroom for two patients. Air was supplied isothermally to this test room, either through induction units or through a perforated ceiling, and the number of air changes per hour varied from 1 to 16. When the air was supplied by means of induction units, tests with different airflow patterns in the room were also carried out. The principle of the measurements was to estimate the decrease in particle concentration at certain points when the initial concentration was uniform all over the room and no generation took place during the measuring period. Talc powder was used as test dust, and the particle concentration was measured at up to six points in the room with a particle counter.

The cases which from the subject of the following note occurred in the district of Dr Chas. Jackson, M.O.H., of Fulham, and I am greatly indebted to him for so kindly furnishing me with their histories and with samples of the patients' serum.

Nasal colonization with Staphylococcus aureus occurred in 18% of babies leaving a maternity unit and had risen to 40% by 6 weeks after birth. S. aureus was first acquired by 34·5% of babies after discharge. Female infants were more likely to be colonized than males. Colonization was not significantly different between babies receiving standard postnatal care and those nursed on the Special Care Baby Unit.

Crystal violet (CV) tests showed that purple-reacting isolates accounted for approximately 60% of strains, whether first detected at hospital discharge or subsequently acquired. Purple-reacting strains, once acquired, were significantly better able to persist than non purple-reacting strains and formed a cumulatively higher proportion of the strains isolated at 6 weeks after birth than at hospital discharge. CV purple-reactions were significantly associated with lysis by phages of groups III and I and non-purple-reactions were significantly associated with lysis by phages of group II and/or 94/96.

Maternity units remain a significant route whereby strains of S. aureus with some characteristics associated with a hospital origin gain access to the community.

Knowing the burden of severe disease caused by influenza is essential for disease risk communication, to understand the true impact of vaccination programmes and to guide public health and disease control measures. We estimated the number of influenza-attributable hospitalisations in Spain during the 2010–2011 to 2019–2020 seasons – based on the hospitalisations due to severe acute respiratory infection (SARI) in Spain using the hospital discharge database and virological influenza information from the Spanish Influenza Sentinel Surveillance System (SISSS). The weekly numbers of influenza-attributable hospitalisations were calculated by multiplying the weekly SARI hospitalisations by the weekly influenza virus positivity, obtained from the SISSS in each season, stratified by age group and sex. The influenza-related hospitalisation burden is age-specific and varies significantly by influenza season. People aged 65 and over yielded the highest average influenza-attributable hospitalisation rates per season (615.6 per 100,000), followed by children aged under 5 (251.2 per 100,000). These results provide an essential contribution to influenza control and to improving existing vaccination programmes, as well as to the optimisation and planning of health resources and policies.

In order to assess the HIV prevalence in healthcare workers (HCWs) in Burkina Faso, we conducted a national survey in 97 health facilities from urban and rural areas. Of 1570 HCWs who agreed to participate, 1013 (64·5%) provided a urine sample for HIV testing. The crude prevalence of HIV in HCWs was 3·5% (95% CI 2·3–4·6). HIV prevalence was 0·7% in students and trainees, 3·8% in nurses and midwives, 4·5% in administrative workers, and 4·6% in laboratory workers. After age and area standardization, men from the Demographic Health Survey (DHS) had a similar HIV prevalence (2·3%, 95% CI 1·4–2·9) as male HCWs (2·5%, 95% CI 1·1–4·0), while female HCWs were more infected (4·5%, 95% CI 2·5–6·0) than women from the DHS (2·1%, 95% CI 1·3–2·4). A voluntary counselling and testing (VCT) programme should be specifically implemented and adapted for female HCWs.

A split-product influenza A vaccine which contained an influenza B strain (B/Hong Kong/8/73) and two influenza A strains, antigenically identical with A/Fort Dix/741/76 (HswlNl) and A/Victoria/3/75 (H3N2), was offered to personnel of the CPHL. Changes in the antibody status were followed with serum samples collected from 153 participants on the day of vaccination and 1, 13 and 18 months thereafter. During the two epidemic seasons in the trial period there were only four serological influenza A infections (2·6%) among the vaccinees. This is one eighth of the corresponding infection rate (22%) in the general population estimated on the basis of other indices.

The vaccinees' antibody response was strongly influenced by the age of the individual subjects. During the trial period the decrease in the antibody titres slowed down. The geometric mean titres of homologous HI antibodies were still substantially higher at the end of the period than at the beginning. This also applied to heterologous antibodies against H1N1 viruses in persons born between 1926 and 1952. In participants born after 1952, the vaccine was not able to evoke these antibodies, and in participants born in or before 1925 the boosting effect was poor.

Mice given an intraperitoneal injection of 0.5 mg. Corynebacterium parvum (dry weight) before vaccination with heat-killed (HK) or acetone-killed (AK) Salmonella typhimurium vaccine and later challenged intraperitoneally with S. typhimurium strain 1566, showed a statistically significant increase in mortality when compared with mice that had received only C. parvum but no vaccine. They also showed a higher mortality rate than mice receiving only HK or AK vaccine or mice that had received no vaccine before challenge. Prior administration of C. parvum to mice that are vaccinated with HK or AK vaccine appears to make them more susceptible to an intraperitoneal challenge with S. typhimurium. This was more apparent with HK vaccine than with AK vaccine.

In a study of the distribution of e-antigen and anti-e in subjects whose blood was positive for hepatitis B surface antigen (HBsAg), patients with acute hepatitis B who were tested during the incubation period were all e-antigen-positive but after the onset of illness e-antigen was detected in only 11%. Persistence, and in some instances reappearance of e-antigen in those who became long-term carriers of HBsAg was associated with high titres of HBsAg. There was a high incidence of e-antigen in those conditions in which cell-mediated immunity may be depressed, including Down's syndrome and chronic renal failure.

The majority of HBsAg carriers identified as sources of infection were e-antigen-positive. A positive reaction for e-antigen is evidently associated with a defective immune response to hepatitis B virus infection which permits continued replication of virus in liver cells accompanied by high titres of HBsAg, numerous Dane particles and detectable DNA polymerase in the blood with consequently a greater likelihood of transmitting infection.

Although it cannot be assumed that anti-e positive carriers of HBsAg are not infective, it may be necessary, in the assessment of passive or active immunization for the control of hepatitis B, to take into account the e-antigen/antibody status of possible sources of infection.

Animals protected from fleas by means of a sufficiently broad layer of “tangle-foot” and placed in plague-infected houses do not contract plague, but the control animals, not so protected, on several occasions (24 per cent.) developed the disease. Out of 247 fleas caught on the “tangle-foot,” 60 p.c. were human, 34 p.c. were rat and 6 p.c. were cat fleas. Plague-like bacilli were demonstrated in the stomach contents of one out of 85 human fleas dissected, and of 23 out of 77 rat fleas.

Ankylostomiasis was first discovered in men working in Cornish mines in October, 1902 (this Journal, Vol. III. p. 95), though there had been many cases of illness clearly referable to this cause for some eight years previously. The number of men who were too ill to do their ordinary work was greater about two years before the cause of “Dolcoath anaemia” was identified. These men had either stopped at home or had been employed on the surface instead of underground: in this way they had avoided further infections, and in many cases had progressed towards a spontaneous cure. At the time therefore of our first enquiry the number of sick men was less than it had been. Anaemic miners were, however, still very numerous and, without anything like an exhaustive search among the 750 underground hands at Dolcoath mine, we found 14 men with less than 50 p.c. haemoglobin and 19 more with less than 75 p.c. The general pallor prevalent among the men on looking at a shift as a whole was very striking, and complaints of shortness of breath on climbing the ladders were frequent. The disease, in short, was at that time a meterial hindrance in carrying on the work of the mine.

Four outbreaks of food-poisoning are described in which over 100 cases in all of gastro-enteritis occurred, one being fatal. In each outbreak the infecting bacteria were indistinguishable culturally and in serological behaviour from the “G” strain of B. suipestifer.

The reasons are given for following Andrewes and Neave and classifying these as B. suipestifer. (sub-group II).

Following the emergence of SARS-CoV-2, early outbreak response relied on behavioural interventions. In the USA, local governments implemented restrictions aimed at reducing movements and contacts to limit viral transmission. In Pennsylvania, restrictions closed schools and businesses in the spring of 2020 and interventions eased later through the summer. Here we use passive monitoring of vehicular traffic volume and mobile device-derived visits to points of interest as proxies for movements and contacts in a rural Pennsylvania county. Rural areas have limited health care resources, which magnifies the importance of disease prevention. These data show the lowest levels of movement occurred during the strictest phase of restrictions, indicating high levels of compliance with behavioural intervention. We find that increases in movement correlated with increases in reported SARS-CoV-2 cases 9–18 days later. The methodology used in this study can be adapted to inform outbreak management strategies for other locations and future outbreaks that use behavioural interventions to reduce pathogen transmission.

Compared to cervical cancer, little is known about human papillomavirus (HPV)-driven oropharyngeal cancer and their cofactors. Here, we investigated potential associations between Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) with oral HPV and HPV persistence, which are known cofactors in cervical carcinogenesis, and also play a role in HPV-driven oropharyngeal cancer. Saliva samples (n = 547) from 312 people were tested for CT and NG and whom had previously been tested for oral HPV infection in a longitudinal study. Eight participants were positive for CT (2.6%) and one for NG (0.3%). Six of these nine participants were also positive for oral HPV in at least one of their samples. We found no significant associations between HPV, CT, or NG infection in the saliva samples analyzed. These preliminary data suggest CT and NG have little influence on oral HPV-positivity and persistence in a general population. However, larger studies focusing on ‘at risk’ population cohorts are necessary to assess potential associations between oral sexually transmissible infections and oral HPV infections, and their outcomes.

The incidence of reported infections of non-typhoid Salmonella is affected by biases inherent to passive laboratory surveillance, whereas analysis of blood sera may provide a less biased alternative to estimate the force of Salmonella transmission in humans. We developed a mathematical model that enabled a back-calculation of the annual seroincidence of Salmonella based on measurements of specific antibodies. The aim of the present study was to determine the seroincidence in two convenience samples from 2012 (Danish blood donors, n = 500, and pregnant women, n = 637) and a community-based sample of healthy individuals from 2006 to 2007 (n = 1780). The lowest antibody levels were measured in the samples from the community cohort and the highest in pregnant women. The annual Salmonella seroincidences were 319 infections/1000 pregnant women [90% credibility interval (CrI) 210–441], 182/1000 in blood donors (90% CrI 85–298) and 77/1000 in the community cohort (90% CrI 45–114). Although the differences between study populations decreased when accounting for different age distributions the estimates depend on the study population. It is important to be aware of this issue and define a certain population under surveillance in order to obtain consistent results in an application of serological measures for public health purposes.

The objective of this study was to determine the optimal number of respiratory samples per outbreak to be tested for institutional respiratory outbreaks in Ontario. We reviewed respiratory samples tested for respiratory viruses by multiplex PCR as part of outbreak investigations. We documented outbreaks that were positive for any respiratory viruses and for influenza alone. At least one virus was detected in 1454 (85·2%) outbreaks. The ability to detect influenza or any respiratory virus increased as the number of samples tested increased. When analysed by chronological order of when samples were received at the laboratory, percent positivity of outbreaks testing positive for any respiratory virus including influenza increased with the number of samples tested up to the ninth sample, with minimal benefit beyond the fourth sample tested. Testing up to four respiratory samples per outbreak was sufficient to detect viral organisms and resulted in significant savings for outbreak investigations.

Group B streptococcus (GBS) is a major global cause of neonatal, infant, and maternal infections. In Japan, national guidelines based on Centers for Disease Control and Prevention recommendations mandate culture-based screening and intrapartum antibiotic prophylaxis (IAP) for GBS-positive pregnant women. Despite initial reductions in GBS infections, the incidence has plateaued, and there are notable limitations in current prevention methods. Approximately 15% of pregnant women are not screened for GBS, and intermittent colonization undermines screening accuracy, contributing to early-onset disease. IAP does not prevent late-onset disease, the incidence of which is increasing in Japan. This study reviewed maternal and neonatal GBS colonization using polymerase chain reaction, evaluated capsular type distributions, and explored late-onset disease infection routes. Among 525 mother-neonate pairs, the study found a higher detection rate of GBS via polymerase chain reaction compared to culture methods and identified significant discrepancies between antepartum and intrapartum colonization. GBS was detected in 3.5% of neonates from initially negative mothers at 4 days of age. Capsular types varied between mothers and neonates, indicating potential horizontal transmission. This study underscores the need for improved rapid diagnostic tests and highlights the potential of maternal GBS vaccination as a future prevention strategy.

This paper gives an abbreviated account of part of a research programme which followed the Aberdeen typhoid outbreak of 1964. Chloramphenicol, the main antibiotic used in treatment, was shown to have a minimum inhibitory concentration (MIC) of between 5 and 2.5 μg./ml. for the S. typhi phage type 34 of the outbreak. The MIC for methacycline was between 2.5 and 2 μg./ml. Whereas the deep and shallow broth techniques used gave similar results with these antibiotics, the MIC for ampicillin, and also cephaloridine, was less in the deep than in the shallow broths.

Serum assays in patients given ampicillin or cephaloridine yielded abnormally high concentrations of both antibiotics when S. typhi phage type 34 was the test organism whereas, with other test organisms, the concentrations were within expectation. These abnormally high values fell within expected values when the sera under investigation had first been heated to 56° C. for 30 min. before assay against the S. typhi of the outbreak.

The findings with ampicillin suggested that dosages given were satisfactory. With cephaloridine the concentrations found in patients' sera seemed to show that twice daily doses of 0.5 g. fell short of adequacy.