Surveillance for new and re-emerging animal diseases in England and Wales is based on post-mortem and syndromic analysis of laboratory data collated in a central database by the Animal Health and Veterinary Laboratories Agency (AHVLA), with the aim of providing early warning of disease events prior to clinical diagnosis. Understanding the drivers for participation in such systems is critical to the success of attempts to improve surveillance sensitivity. The aim of this study was to investigate the decision-making process governing the submission of biological samples on which this surveillance system is based by use of questionnaires. Data extracted were used to structure and parameterize scenario trees modelling the probability of generating an entry in the surveillance database. The mean probability for database entry per case ranged from 0·085 for neurological disorders to 0·25 for enteric disease. These findings illustrate the importance of on-farm decision making to the generation of surveillance data.

Neisseria meningitidis is transmitted through the inhalation of large human respiratory droplets, but the risk from contaminated environmental surfaces is controversial. Compared to Streptococcus pneumoniae and Acinetobacter baumanni, meningococcal viability after desiccation on plastic, glass or metal surfaces decreased rapidly, but viable meningococci were present for up to 72 h. Encapsulation did not provide an advantage for meningococcal environmental survival on environmental surfaces.

This nationwide population-based cohort study investigated the risk of tuberculosis (TB) in patients with end-stage renal disease (ESRD) and receiving dialysis. The evaluations included 4131 incident ESRD patients receiving dialysis and 16 524 age- and gender-matched controls, recruited between 1998 and 2009. We used Cox proportional hazards regression analysis to measure the association between TB and ESRD. Compared to the controls, the ESRD cohort had a significantly higher risk of TB within 1 year [incident rate ratio (IRR) 4·13], and 1–2 years (IRR 2·12), of occurrence of ESRD. The Cox proportional hazards model revealed that ESRD [hazard ratio (HR) 2·40], age >65 years (HR 2·41), male sex (HR 1·94), diabetes mellitus (HR 1·36), silicosis (HR 7·70) and chronic obstructive pulmonary disease (HR 1·61) are independent risk factors for TB. Patients with ESRD are associated with an increased risk of TB, and should thus be monitored more carefully for TB, especially within 2 years of onset of ESRD.

In countries maintaining national hepatitis C virus (HCV) surveillance systems, a substantial proportion of individuals report no risk factors for infection. Our goal was to estimate the proportion of diagnosed HCV antibody-positive persons in Scotland (1991–2010) who probably acquired infection through injecting drug use (IDU), by combining data on IDU risk from four linked data sources using log-linear capture–recapture methods. Of 25 521 HCV-diagnosed individuals, 14 836 (58%) reported IDU risk with their HCV diagnosis. Log-linear modelling estimated a further 2484 HCV-diagnosed individuals with IDU risk, giving an estimated prevalence of 83. Stratified analyses indicated variation across birth cohort, with estimated prevalence as low as 49% in persons born before 1960 and greater than 90% for those born since 1960. These findings provide public-health professionals with a more complete profile of Scotland's HCV-infected population in terms of transmission route, which is essential for targeting educational, prevention and treatment interventions.

Group B streptococcus (GBS) is a leading cause of neonatal sepsis and meningitis. We determined the distribution of serotypes and surface protein encoding genes of GBS strains from pregnant and non-pregnant women in Egypt. Vaginal swabs from 364 women were screened by culture and 100 (27·4%) yielded GBS. Serotype V was the most predominant (33%), followed by serotypes II (17%), III (15%), Ia (14%), VI (12%), Ib (8%) and IV (1%). The most common surface protein genes were epsilon (27%), alp3 (26%), bca (18%), rib (16%) and alp2 (10%). Two isolates were negative for surface protein genes. The distribution of serotypes and surface proteins was similar to reports from other parts of the world but the relatively high frequency of serotype VI was a notable feature of the strains from women in Egypt.

Data obtained from genitourinary medicine clinics through a comprehensive surveillance system were used in a Bayesian mixed-effects Poisson regression model to explore socio-demographic individual and ecological risk factors for gonorrhoea in London, as well as its spatial clustering. The spatial analysis was performed at the Middle-layer Super Output Area level (median population size 7200). A total of 12452 individuals were diagnosed during the 2-year study period (2009–2010). The study confirmed the presence of ‘core areas’ of high incidence, and identified ‘core’ high-risk groups, in particular young adults (16–29 years), males, black Caribbeans and more deprived areas. The individual (age, sex, ethnicity) and area-level (deprivation, teenage pregnancies, students) model covariates accounted for 48% of the variance. Most of the remaining variance was explained by the spatial effect, thus capturing other spatially distributed factors associated with gonorrhoea, such as local sexual networks. These findings will be useful in identifying areas for targeted interventions, such as STI testing and health promotion.

Daptomycin-non-susceptible enterococci (DNSE) are emerging pathogens. We have previously reported de novo DNSE isolates in patients with agricultural activities and exposure to livestock. We studied the geographical distribution of the residencies of 34 patients with DNSE infections described in a tertiary centre over a 5-year period in an effort to explore the association between patients’ residential locations and agricultural and farm lands. Nine patients had no prior exposure to daptomycin (de novo) and seven of these lived in areas with animal or crop operations. Of those living near an animal or crop operation, the mean number of operations in the proximity of the residence of patients with daptomycin-exposed DNSE was 13·8 (range 1–67) compared to 98·6 (3–529) for those patients with de novo DNSE (P = 0·0486). These data are consistent with previous reports that the transport of daptomycin resistance genes between animals and humans may be a possible mechanism for development of de novo daptomycin resistance in enterococci.