The inhibitory influence of cyanuric acid on the virucidal effect of chlorine was studied. The time required for 99·9% inactivation of ten enteroviruses and two adenoviruses by 0·5 mg/l free available chlorine at pH 7·0 and 25○C was prolonged approximately 4·8–28·8 times by the addition of 30 mg/l cyanuric acid. Comparative inactivation of poliovirus 1 by free available chlorine with or without cyanuric acid revealed the following. The inactivation rate by 1·5 mg/l free available chlorine with 30 mg/l cyanuric acid or by 0·5 mg/l free available chlorine with 1 mg/1 cyanuric acid was slower than by 0·5 mg/1 free available chlorine alone. Temperature and pH did not affect the inhibitory influence of cyanuric acid on the disinfectant action of chlorine. In the swimming-pool and tap water, cyanuric acid delayed the virucidal effect of chlorine as much as in the ‚clean’ condition of chlorine-buffered distilled water. The available chlorine value should be increased to 1·5 mg/l when cyanuric acid is used in swimming-pool water.

Twenty-one strains of Haemophilus ducreyi were analysed by Western blotting using two antisera produced in mice. Common antigens of molecular weights 58, 46, 41, 28, 22 and 16 kDa were detected in all the strains. The antigens were protein in nature, since they could not be detected in whole-cell lysates which had been treated with proteinase K. The H. ducreyi strains showed antigenic cross-reactivity with strains of H. influenzae and H. parainfluenzae, but showed minimal or no cross-reactivity with seven other species of bacteria.

Six patients developed local infection after being bitten or groed by swine. Wounding was often deep and occurred characteristically on the posterior aspect of the thigh. Severity of infection caried from simple wound infection with discharge and slouth to cellulitis and abscess formation; pathogens included haemolytic streptococci, pasteurellae, Bacterodies sp., Proteussp. and Escherichia coli and were usually isolated in mixed culture. A patient with Pasteurella aerogences infection apperars to be the first reported in England. A seventh patient developed Streptococcus milleri septicaemia after wounding himself while cutting teeth from piglets. It is suggested that a course of broad-spectrum antibiotics should be given as part of the initial treatment when patients present with the more servere pig bite injuries.

This paper examines the sensitivity and specificity of two ELISA assays for IgM antibodies to Mycobacterium leprae, one employing natural phenolic glycolipid and the other employing a synthetic disaccharide glycoconjugate as antigen. Estimates of sensitivity and specificity are derived, based on a panel of sera from leprosy cases in Malawi and various non-leprosy controls from the UK. Though both assays were able to identify a high proportion of multibacillary patients, neither was able to detect a high proportion of paucibacillary patients without considerable loss of specificity. The implications of the inverse relationship between sensitivity and specificity are discussed with reference to the predictive value of such tests in such areas as Malawi, where the large majority of cases are paucibacillary.

A comparison was made of different culture media and procedures for detection of Serratia marcescens from faecal, pharyngeal and ocular swabs collected from 213 neonates. MacConkey agar and MacConkey agar with sorbitol (1%) and/or colistin (200 i.u./ml) were used both for primary isolation and after enrichment using Mossel Enterobacteriaceae broth with colistin (200 i.u./ml). The use of MacConkey agar supplemented with colistin for primary isolation improved considerably the isolation rate of S. marcescens from faecal swabs but not from pharyngeal swabs; the number of ocular isolations were insufficient to demonstrate differences between procedures. Moreover the enrichment procedures consistently increased the number of S. marcescens isolates especially from pharyngeal and ocular swabs. Use of sorbitol made detection of S'. marcescens from clinical specimens easier and time– and cost–efficient.

A sterile suspension containing 950 mouse LD50 per ml of type C botulinum toxin was exposed for various periods to different temperatures. The time required for the 99% (hundred-fold) reduction of toxicity was more than 5 years at -70°C or -20°C, 6 montha at +5 °C, 3 weeks at +20 °C, 2 weeks at +28 °C, 2 days at +37 °C, 9h at +42°C, less than 30 min at 56 °C, less than 20 min at +60 °C, and below 5 min at +80 °C. The results suggest that Clostridium botulinum type C toxin, if produced in an ecosystem of the mild climatic zone, might persist there over the winter season and cause the intoxication of vertebrates next carly spring in the absence of further microbial toxigenesis.

From January 1983 until December 1985, 35 cases of sporadic nosocomial legionella pneumonia, all caused by Legionella pneumophila, were diagnosed in a university hospital. L. pneumophila serogroup (SG) 1 was cultured from 12 of the 35 cases and compared to corresponding L. pneumophila SG 1 isolates from water outlets in the patients' immediate environment by subtyping with monoclonal antibodies. The corresponding environmental isolates were identical to 9 out of 12 (75%) of those from the cases. However, even in the remaining three cases identical subtypes were found distributed throughout the hospital water supply. From the hospital water supply four different subtypes of L. pneumophila SG 1 were isolated, three of which were implicated in legionella pneumonia. Of 453 water samples taken during the study 298 (65.8%) were positive for legionellae. Species of Legionella other than L. pneumophila have not been isolated. This may explain the exclusiveness of L. pneumophila as the legionella pneumonia-causing agent. Our results suggest that the water supply system was the source of infection.

Ticks of the Ornithodoros moubata complex were collectedfrom domestic pig sties and dwelling houses, and from a warthog habitat, and tested for the presence of African swine fever (ASF) virus. Collections were made in 9 of the 24 districts of Malawi, these being primarily the districts in which O. moubata is most numerous. ASF virus was isolated from ticks collected in both domestic pig sties and houses in certain villages in Mchinji district where ASF outbreaks had recently occurred. Mchinji district is in the centre of a large ASF enzootic area which stretches into other districts of Malawi and also into Zambia and Mozambique. The high titre of virus in some of the ticks demonstrates that O. moubata can act as a virus reservoir and potential vector of disease in the field situation in Malawi.

Using DNA probes specific for the genes encoding Vero cytotoxins 1 and 2 in hybridization experiments on faecal samples. Vero cytotoxin-producing Escherichia coli (VTEC) of serogroup 0 157 were detected in 21 of 63 cases of haemorrhagic colitis, 9 of 31 cases of non-bloody diarrhoea and 14 of 68 cases of haemolytic uraemic syndrome. Compared with these results sorbitol-MacConkey agar in conjunction with a specific 0 157 antiserum gave a sensitivity of 62% in haemorrhagic colitis, 56% in non-bloody diarrhoea and 57% in haemolytic uraemic syndrome.The specificity of this method was 100% in all three groups. This demonstrates that sorbitol-MacConkey agar is a useful screening method for the detection of VTEC of serogroup O 157 when used in conjunction with a specific homologous antiserum. However, this method does not detect VTEC belonging to other serogroups and such strains were found, particularly in cases of haemolytic uraemic syndrome.

The prevalence of cardiac morbidity due to Change' disease was assessed in a rural community in Central Bolivia. Sixty-nine of 104 persons (66%) were seropositive to Trypanosoma cruzi by two serological methods. Two of 35 (6%) seronegative individuals presented with modest ECG alterations (left anterior hemiblock), but 21 of 69 (30%) seropositives showed modest and severe abnormalities (6 complete right bundle branch block. 2 polyfocal or frequent extrasystoles, 9 ischaemic ST alterations). A high percentage (56%) of domiciliary Triatoma infestans was infected with T. cruzi. There was a significant association between seropositivity and substandard housing. Priority preventive measures should thus include house improvement (to reduce bug infestation) and health education.

A simple and sensitive M antibody-capture radioimmunoassay (MACRIA) is described which utilizes crude commercial VZV antigen and a single monoclonal anti-VZV antibody. This was compared to the immunofluorescence (IF) test for IgM antibody and was used to study IgM responses in sera from 261 patients with varicella and 220 patients with herpes zoster.

With MACRIA, IgM antibodies were detected in all patients with varicella. The IgM antibodies appeared shortly after onset of rash, reached peak levels between 1 and 4 weeks after onset and then declined to low or undetectable levels in most, though not all, patients after 3 months. IgM antibodies were also detected in 98·2% of patients with herpes zoster, but the levels of IgM were significantly lower than after varicella and there was wider individual variation both in magnitude and duration of the IgM responses, in some cases only lasting 2–3 weeks.

Comparison between MACRIA and IF showed good agreement in the detection of IgM antibodies following varicella. Discordant results were obtained with 13% of sera. of which 81% were taken either early or late after onset of rash and contained very low IgM levels. In contrast, 62 (28%) of the 220 sera from patients with zoster gave discordant results in the two tests, all except five being MACRIA positive but IF-negative. The largest proportion of discordant results were obtained with sera taken more than 3 months after onset of rash, but 18 (29%) contained high IgM levels and were taken during the period of peak IgM responses. The diagnostic applications of the VZV MACRIA are discussed.

During the 10-year period 1978–87 there were 48 outbreaks of food poisoning in Scottish hospitals affeeting a total of 2287 persons of whom 12 died. This compared with 50 outbreaks during the previous 5 years (1973–77) when over 1500 persons and 7 deaths were recorded. Although the incidence of outbreaks has decreased the average number of persons affected in outbreaks has increased. A marked reduction was seen in the incidence of outbreaks due to Clostridium perfringens, in contrast to foodborne salmonellosis which remains a problem. Thirty-four hospitals, of which 10 reported two or more outbreaks, were involved. The type of hospitals most frequently affected were general (14), psychiatric (13), geriatric (9) and hospitals for the mentally subnormal (7). Meat, including poultry meat, was incriminated in over 90% of outbreaks where a food vehicle was identified. In modern or re-equipped kitchens cooking in advance with subsequent reheating is being progressively discontinued as more food is being cooked on the day of consumption, a practice which may readily explain the decreasing incidence of outbreaks due to Cl. perfringens. Bacterial cross-contamination from poultry-meat and other raw foods, compounded by inadequate temperature control, however, continues to be a problem in some hospitals. It is too early as yet to determine whether the removal of Crown immunity will have any effect on the future incidence of hospital ‘food poisoning’.

The pH of the rument contents of cattle was recorded at slaughter; pH ranged from 5.5 to 7–8 and was not correlated with the period from saleyard to slaughter. Volatile fatty acids (VFA) were measured in 43 rumen samples; acetic, propionic and butyric were the major acids present, and the total VFA ranged from 75·9 mM/1 for samples between pH 6–7, to 7·1 mM/1 for samples of pH 8–9. Ten Salmonella strains belonging to 8 serotypes were grown in these 43 rumen samples. Where acid levels of these samples were high and pH low, most Salmonella sp. were inhibited: as the pH rose (pH 7–8) all Salmonella serotypes grew, some vigorously; as the total acid declined and pH continued to rise, growth of salmonella ceased. Serotypes and strains of the same serotype differed in their ability to grow in rumen contents, particularly when the pH was low.

Direct and indirect antigen capture enzyme immunoassays (Ag-EIA) have been developed for the detection of Mycoplasma pneumoniae in nasopharyngeal aspirates or sputum from respiratory infection. The sensitivity of the two Ag-EIA were similar, but the indirect method using polyclonal rabbit and guinea-pig antisera was more convenient. The Ag-EIA had a detection limit of 104–4·5 colony-forming units/ml of sample. It was specific for M. pneumoniae and gave a low level response with M. genitalium. There were no cross-reactions with 10 other species of mycoplasmas. Tests with a wide range of bacteria and chlamydia group antigen, representing agents sometimes found in the respiratory tract, were also negative. At the current level of development, the Ag-EIA detected about 90% of specimens that were also positive for culture; 43% of specimens from culture-negative-seropositive patients gave a positive result. The overall pattern of results indicated that while antigen detection is a quick and effective substitute for the slow culture method, serological examination for specific IgM antibody is also necessary to give a complete diagnostic coverage.

The specificity of human antibodies for the two major sidechain determinants of the type II group B streptococcal (GBS) polysaccharide was examined in 90 pairs of maternal and cord sera. Using an ELISA system, total antibody was measured against the complete (sialylated) type II antigen and the proportion of antibody against the galactose determinant was estimated by inhibition with free β–methylgalactopyranosided. Mothers colonized by type II or by other GBS types had higher levels of total specific antibody (means, 33 and 4–7 µg/ml, respectively) than those not colonized (mean, 2–2 µg/ml). Cord sera averaged 1–2 µg/ml lower than maternal sera. Colonization with GBS was also associated with higher levels against the galactose determinant (mean, 1.5&µg/ml, compared to 0–7µg/ml for those not colonized). The distribution of specificities favoured antibodies against the sialic acid determinant in maternal but not cord sera. Specificity as well as antibody level may play a role in the epidemiology of GBS type II.

The investigation of an outbreak of cryptosporidiosis in a hospital day-care centre is reported. Twenty-eight (27%) children and one member of the staff were infected. Most of the cases were symptomatic and the major presenting symptom was watery diarrhoea. Shedding of oocysts continued for a mean of 12 days after diarrhoea had subsided and most of the cases were still excreting oocysts when the first follow-up sample was examined. Intermittent shedding or a carrier state were not seen in any of the cases. Giardia intestinalis cysts were detected in 19 children, 7 of whom showing mixed infection with Cryptosporidium sp., but this association was not statistically significant. All cases recovered without specific therapy. No definite proof could be found to demonstrate the source of the outbreak or the route of transmission but some observations suggesting person-to-person transmission are discussed.

The efficiency of the direct detection of Mycoplasma pneumoniae in respiratory exudates by an antigen capture, indirect enzyme immunoassay (Ag-EIA), has been compared with its detection with a cDNA probe (‘Gen-Probe assay’) directed against the specific ribosomal RNA sequences of the organism (‘Mycoplasma pneumoniae Rapid Diagnostic System’, Gen-Probe, San Diego, California).

Both assays showed excellent specificity against a range of mycoplasma species suspended in negative nasopharyngeal aspirates; only M. pneumoniae and M. genitalium reacted. In experiments with graded doses of viable M. pneumoniae cells suspended in negative nasopharyngeal aspirate, the Gen-Probe assay was more sensitive than Ag-EIA; detection limits were respectively 2 × 103 c.f.u./ml (3·2 × 105 genomes) and 2·5 × 104 c.f.u./ml (4 × 106 genomes); detection levels 10–100 times less sensitive than culture.

The two assays were also tested on nasopharyngeal aspirates or sputum specimens from 90 patients with respiratory infection; 67 of these were culture-or seronegative for M. pneumoniae and 23 were culture-or seropositive. Ag-EIA detected 21 (91%) of the latter but the Gen-Probe assay detected only 5 (22%). Both assays were negative with the 67 culture-/sero-negatives; there were no Gen-Probe assay positive/Ag-EIA negatives.

Overall, it is concluded that although Ag-EIA and the Gen-Probe assay are effective substitutes for culture as a diagnostic procedure, there is a significant problem with samples which are culture-negative and from patients who have good serological evidence of current infection. Possible reasons for the disparity between the two assays are advanced.