We conducted a survey during the period from 1974 to 1976, to determine the distribution of Plesiomonas shigelloides in human faeces, the intestinal contents of cattle, swine, poultry, dogs, cats, fresh water fish, and river water and sludge from wet riverbeds in the vicinity of Tokyo. Isolation of the organisms was performed by using Salmonella-Shigella (SS) agar and deoxycholate-hydrogensulphide-lactose (DHL) agar plates.

P. shigelloides was isolated from 3 (0·0078%) of 38454 healthy Tokyoites, 37 (3·8%) of 967 dogs, 40 (10·3%) of 389 cats, 25 (10·2%) of 246 fresh water fish, 64 (12·8%) of 497 river water samples, and 2 of 19 (10·5%) sludge samples.

Of 302 strains isolated, from dogs, cats, fresh water fish, river water and healthy carriers, 196 were typed to 50 serovars. Most of the serovars were found to be similar to strains isolated from patients with gastroenteritis due to P. shigelloides.

1. Four β-haemolytic strains of Streptococcus, suspended in normal saline, showed progressive increase in mortality, as the pHwas lowered from 7·5 to 5·0; below pH 5·0 the mortality was greatly accentuated.

2. Ether and alcohol extracts of human skin and its appendages were powerfully, saline extracts more weakly and inconstantly, lethal to the haemolytic Streptococcus and to certain other organisms.

3. The long chain fatty acids and soaps are the chief, if not the only, bactericidal constituents of skin and its appendages.

4. Experiments are described illustra ting the streptococcocidal effect of various acids occurring in animal fats.

5. Cystein and blood inhibit the streptoeoccocidal activity of skin fats and certain fatty acids. Ultra-violet light may increase this activity, or abolish, the inhibition exercised by cystein.

6. The mechanism of the sterilizing power of fatty acids and soaps, the influence exerted by cystein, blood, and ultra-violet light on the sterilizing power, of skin fats and fatty acids, and the relationship of skin fatty acids to lysozyme are discussed.

A cross-sectional study based on a questionnaire survey was conducted to determine the distribution of lumpy skin disease (LSD) and associated risk factors in three main agro-climatic zones of Ethiopia. A total of 330 questionnaire surveys were collected from 44 peasant associations (PA) distributed in 15 districts. Across agro-climate zones, herd-level LSD prevalence in the midland agro-climate was significantly higher 55·2% [95% confidence interval (CI) 47·5–62·6] than in highland and lowland agro-climate zones. Overall observed LSD prevalence at animal-level was 8·1% (95% CI 7·3–8·9) and observed mortality was 2·12% (95% CI 1·73–2·6). The odds ratio (OR) of LSD occurrence in midland vs. highland and lowland vs. highland zones was 3·86 (95% CI 2·61–5·11) and 4·85 (95% CI 2·59–7·1), respectively. Significantly high risk of LSD occurrence was associated with communal grazing and watering management (OR 4·1, 95% CI 2·02–6·18) and introduction of new cattle (OR 8·5, 95% CI 6·0–11·0). Our findings describe the distribution of LSD in different agro-climates in Ethiopia along with associated risk factors, and can help shed light on the epidemiology of LSD in other African countries suffering from the disease.

Vibrio alginolyticus causes soft tissue and bloodstream infection; little systematically collected clinical and epidemiological information is available. In the USA, V. alginolyticus infections are reported to the Cholera and Other Vibrio Illness Surveillance system. Using data from 1988 to 2012, we categorised infections using specimen source and exposure history, analysed case characteristics, and calculated incidence rates using US Census Bureau data. Most (96%) of the 1331 V. alginolyticus infections were from coastal states. Infections of the skin and ear were most frequent (87%); ear infections occurred more commonly in children, lower extremity infections more commonly in older adults. Most (86%) infections involved water activity. Reported incidence of infections increased 12-fold over the study period, although the extent of diagnostic or surveillance bias is unclear. Prevention efforts should target waterborne transmission in coastal areas and provider education to promote more rapid diagnosis and prevent complications.

Examination of neck skin and caecal samples taken at a commercial processing plant from 15 randomly chosen poultry flocks showed that all flocks were contaminated initially with thermophilic Campylobacter spp., even in the apparent absence of caecal carriage. During processing, numbers of campylobacter on skin samples were reduced by between 10 and 1000-fold.

To improve hygiene control generally, chlorinated-water sprays were used to limit microbial contamination on equipment and working surfaces. In addition, chlorine concentrations in process water were increased and any unnecessary carcass contact surfaces in the processing plant were removed. When comparing flocks before and after the changes, it was found that numbers of campylobacter on packaged carcasses were significantly lower after the changes had been made (P 0·001). In practice, however, the reduction would be likely to have little impact on consumer exposure to campylobacter infection.

A number of outbreaks of food poisoning attributed to Bacillus cereus have been reported recently and all have been associated with cooked rice usually from Chinese restaurants and ‘take-away’ shops.

Tests were made to assess the heat resistance of B. cereus spores in aqueous suspension, the growth of the organism in boiled rice stored at temperatures in the range 4–55° C., and the effect of cooking and storage on the growth of the organism in boiled and fried rice. The spores of B. cereus survived cooking and were capable of germination and outgrowth. The optimum temperature for growth in boiled rice was between 30° and 37° C. and growth also occurred during storage at 15° and 43° C.

To prevent further outbreaks it is suggested that rice should be boiled in smaller quantities on several occasions during the day, thereby reducing the storage time before frying. After boiling the rice should either be kept hot (> 63° C.) or cooled quickly and transferred to a refrigerator within 2 hr. of cooking. Boiled or fried rice must not be stored under warm conditions especially in the range 15–50° C.

This systematic review–meta-analysis appraises and summarizes all the available research (128 papers) on the zoonotic potential of Mycobacterium avium ssp. paratuberculosis. The latter has been debated for a century due to pathogenic and clinical similarities between Johne's disease in ruminants and Crohn's disease (108 studies) in humans and recently for involvement in other human diseases; human immunodeficiency virus (HIV) infection (2), sarcoidosis (3), diabetes mellitus type 1 (T1DM) (7) and type 2 (3), multiple sclerosis (5) and Hashimoto's thyroiditis (2). Meta-analytical results indicated a significant positive association, consistently across different laboratory methods for Crohn's disease [odds ratio (OR) range 4·26–8·44], T1DM (OR range 2·91–9·95) and multiple sclerosis (OR range 6·5–7·99). The latter two and the thyroiditis hypothesis require further investigation to confirm the association. Meta-regression of Crohn's disease studies using DNA detection methods indicated that choice of primers and sampling frame (e.g. general population vs. hospital-based sample) explained a significant proportion of heterogeneity. Other epidemiological studies demonstrated a lack of association between high-risk occupations and development of Crohn's disease. Due to knowledge gaps in understanding the role of M. paratuberculosis in the development or progression of human disease, the evidence at present is not strong enough to inform the potential public health impact of M. paratuberculosis exposure.

Relapse of Clostridium, difficile-associated diarrhoea occurs in 15–20% of patients; however, whether relapse is due to an endogenous source of the organism or reinfection from the environment remains unclear. Restriction enzyme analysis (REA) of chromosomal DNA was used to type multiple isolates from ten patients who had experienced apparent relapses. More than half the relapses were due to infection with a new strain of C. difficile. The remaining patients were infected with the same strain, but whether this strain was acquired from the environment or from endogenous sources could not be determined. Relapses with a different strain of C. difficile could occur if an individual harboured more than one strain in their gastrointestinal tract. To investigate this possibility ten other patients were assessed for carriage of multiple strains. Ten colonies from a primary culture plate from each patient were typed by REA and tested for their ability to produce cytotoxin. All isolates from the same patient were identical by both methods, indicating that multiple carriage of strains may be a rare event.

Many countries plan to close schools during a future influenza pandemic, although the potential impact is poorly understood. We apply a model of the transmission dynamics of pandemic influenza to consultation, serological and clinical data from the United Kingdom from the 1957 (Asian) influenza pandemic, to estimate the basic reproduction number (R0), the proportion of infected individuals who experience clinical symptoms and the impact of school/nursery closures. The R0 for Asian influenza was about 1·8 and 60–65% of infected individuals were estimated to have experienced clinical symptoms. During a future pandemic, closure of schools/nurseries could reduce the epidemic size only by a very small amount (<10%) if R0 is high (e.g. 2·5 or 3·5), and modest reductions, e.g. 22% might be possible if it is low (1·8) and schools are closed early, depending on assumptions about contact patterns. Further data on contact patterns and their dependence on school closures are needed.

An investigation into two cases of post-operative Bacillus cereus meningitis revealed that hospital linen laundered by a batch continuous washing machine was heavily contaminated by B. cereus spores. The washing machine, detergents, other chemical additives and the water supply were eliminated as the source of contamination.

It was found that the linen introduced into the washing machine had a high B. cereus spore content and that this was still present after the wash process. The spores were not killed by either the heat disinfection stage of the wash or the addition of chemical disinfectants and were not removed by the dilution in the process.

The multiplication of B. cereus was thought to have occurred on used, damp linen stored in plastic bags, particularly when ambient temperatures were high. An increase in the water flow through the washing machine was the only measure associated with a decrease in B. cereus on laundered linen.

Epidemiological data accompanying reports of more than 1000 outbreaks of food poisoning have been studied to determine the factors which most frequently contributed to the outbreaks. Preparation of food in advance of needs combined with improper storage and inadequate cooking, cooling and reheating were the most common factors. Infected food handlers did not play a significant role except in instances of S. aureus food poisoning.

In England and Wales human salmonellosis is a major public health problem and, although mortality is low, the disease has important social and economic consequences. All surveillance indicators suggest that an epidemic of unprecedented proportions is occurring. Between 1081 and 1980 the number of strains received for serotyping by the Public Health Laboratory Service (PHLS) Division of Enteric Pathogens has increased by 60% (Table 1). This is predominantly due to strains of Salmonella typhimurium and S. enteritidis. Smaller but significant increases have occurred in the numbers of S. virchow and S. Stanley. With the exception of the latter serotype, which seems to come from a bovine reservoir, the indications aro that poultry is the main source of the increase in infections.

This study aims to identify the risk factors associated with mortality and survival of COVID-19 cases in a state of the Brazilian Northeast. It is a historical cohort with a secondary database of 2070 people that presented flu-like symptoms, sought health assistance in the state and tested positive to COVID-19 until 14 April 2020, only moderate and severe cases were hospitalised. The main outcome was death as a binary variable (yes/no). It also investigated the main factors related to mortality and survival of the disease. Time since the beginning of symptoms until death/end of the survey (14 April 2020) was the time variable of this study. Mortality was analysed by robust Poisson regression, and survival by Kaplan–Meier and Cox regression. From the 2070 people that tested positive to COVID-19, 131 (6.3%) died and 1939 (93.7%) survived, the overall survival probability was 87.7% from the 24th day of infection. Mortality was enhanced by the variables: elderly (HR 3.6; 95% CI 2.3–5.8; P < 0.001), neurological diseases (HR 3.9; 95% CI 1.9–7.8; P < 0.001), pneumopathies (HR 2.6; 95% CI 1.4–4.7; P < 0.001) and cardiovascular diseases (HR 8.9; 95% CI 5.4–14.5; P < 0.001). In conclusion, mortality by COVID-19 in Ceará is similar to countries with a large number of cases of the disease, although deaths occur later. Elderly people and comorbidities presented a greater risk of death.

Human cases of Q fever appear to be common in Northern Ireland compared to the rest of the British Isles. The purpose of this study was to describe the seroepidemiology of Coxiella burnetii infection in cattle in Northern Ireland in terms of seroprevalence and determinants of infection. A total of 5182 animals (from a stratified systematic random sample of 273 herds) were tested with a commercial C. burnetii phase 2 IgG ELISA. A total of 6·2% of animals and 48·4% of herds tested positively. Results from a multilevel logistic regression model indicated that the odds of cattle being infected with Q fever increased with age, Friesian breed, being from large herds and from dairy herds. Large dairy herd animal prevalence was 12·5% compared to 2·1% for small beef herds. Preliminary seroprevalence in sheep (12·3%), goats (9·3%), pigs (0%) rats (9·7%) and mice (3·2%) using indirect immunofluorescence is reported.

ELISA techniques developed for the veterinary diagnosis of Rabbit Haemorrhagic Disease (RHD) in domestic rabbits were used for studying the epidemiology of RHD in Australian wild rabbits. The combination of ELISA techniques that distinguished IgA, IgG and IgM antibody responses and a longitudinal data set, mainly based on capture-mark-recapture of rabbits, provided a reliable basis for interpreting serology and set the criteria used to classify rabbits' immunological status. Importantly, young with maternal antibodies, immune rabbits and rabbits apparently re-exposed to RHD were readily separated. Three outbreaks of RHD occurred in 1996–7. The timing of RHD outbreaks was mainly driven by recruitment of young rabbits that generally contracted RHD after they lost their maternally derived immunity. Young that lost maternal antibodies in summer were not immediately infected, apparently because transmission of RHDV slows at that time, but contracted RHD in the autumn when conditions were again suitable for disease spread.

We describe an Escherichia coli O157[ratio ]H7 outbreak associated with a fresh water lake at a county park. Campers were surveyed for diarrhoeal illness within 10 days of their visit, and a case-control study of day visitors was conducted. A confirmed case was a symptomatic person with a stool culture positive for E. coli O157[ratio ]H7 and a probable case was a person with bloody diarrhoea. Clinical isolates of E. coli O157 were subtyped by pulsed field gel electrophoresis (PFGE). In the camper survey, 12 (38%) of 32 swimmers had a diarrhoeal illness (relative risk [RR]=12·4; 95% confidence interval [RR]=1·7–89·7). For the case-control study, the 12 cases were more likely than controls to have purposefully ingested lake water (odds ratio [OR]=6·9, 95% CI=0·9–55·8). The PFGE patterns of six clinical isolates were indistinguishable. This report further demonstrates that contaminated fresh-water lakes can be the source of community outbreaks of E. coli O157[ratio ]H7.

Thirty-three volunteers were inoculated intranasally with coronavirus 229 E, and their responses monitored by antibody rises, symptomatology and virus excretion. These were related to their pre-trial immune status as indicated by concentrations of specific antibodies and non-specific proteins in serum and nasal washings. Both circulating and local specific antibodies were associated with protection from infection and disease, but only specific IgA antibodies of either type appeared to shorten the period of virus shedding. Although total secretory IgA was significantly associated only with reduction of symptoms, total protein in nasal washings appeared to protect against infection also, indicating that other locally produced proteins, not identified, may be associated with resistance.

Two of the many factors which may affect the concentration of circulating and local protective proteins and thus influence the outcome of virus inoculation, namely, sex of the volunteer and the interval since the previous cold, were examined. Male volunteers or volunteers who had had evidence of a recent respiratory infection were less likely to be infected, but if they were infected, they had lower clinical scores and stopped shedding virus earlier than the rest. These groups possessed higher concentrations of specific antibodies and non-specific proteins in their pre-challenge sera and/or nasal washings. The significance of these findings is discussed.

A case control study of foal diarrhoea in the United Kingdom was carried out over a 3-year period. Clostridium perfringens was significantly associated with foal diarrhoea (Odds Ratio (OR) = 3·0), being isolated from 57% of 421 animals with diarrhoea but from only 27% of 223 healthy foals. Also, C. perfringens was significantly associated with fatal diarrhoea (OR = 4·5). About half of diarrhoea with a fatal outcome was attributable to this organism.

The other pathogens significantly associated with diarrhoea were rotavirus (OR = 5·6), Cryptosporidium spp. (OR = 3·2) and the nematode Strongyloides westeri, which was significant only when present in large numbers (> 2000 eggs/g of faeces: OR = 6·1). Salmonella spp. (OR = 14·2) and Cryptosporidium spp. (OR = 3·0) were the only other pathogens associated with fatal illness.

Overall, C. perfringens, rotavirus, and large numbers of Cryptosporidium spp. or S. westeri were isolated from 80% of foals with diarrhoea. Thermophilic Campylobacter spp., Yersinia enterocolitica, Escherichia coli and other parasites were not associated with diarrhoea. Carriage of C. perfringens, rotavirus and Cryptosporidium spp. was significantly greater in healthy foals in contact with cases of diarrhoea than in foals that were not in contact with diarrhoea (P < 0·05). There were no statistical interactions between any of the pathogens associated with diarrhoea although separate cases from one location often involved more than one pathogen.

The contamination of gowns and uniforms worn in a burns unit and the transfer of patient's staphylococci by means of nurses' uniforms was investigated. The median values of staphylococci found on gowns and jackets worn during a routine nursing procedure were 3·0 × 104 and 1·4 × 103 respectively. From the results of model nursing experiments it appeared as if the fraction of staphylococci transferred from a patient's room to the air in a receiving room was 4 to 10 times less when protective gowns were worn than when no gowns were worn. The corresponding transfer directly to the model ‘patient’ was 100 times less. The protection afforded by a gown seemed mainly to be due to protection against contamination of the uniform worn underneath when nursing a burned patient. The discrepancy between the transfer of an airborne particle tracer and Staph. aurats-carrying particles earlier found in the ward could be explained by the dispersal of Staph. aureus from nurses' clothing.

Equine influenza vaccines containing inactivated whole virus and Carbomer adjuvant stimulated higher levels and longer lasting antibody to haemagglutinin in ponies than vaccines of equivalent antigenic content containing aluminium phosphate adjuvants. Five months after the third dose of vaccine containing Carbomer adjuvant, ponies were protected against clinical disease induced by an aerosol of virulent influenza virus (A/equine/Newmarket/79, H3N8). In contrast ponies which received vaccine containing aluminium phosphate adjuvant were susceptible to infection and disease. There was an inverse correlation between prechallenge levels of antibody detected by single radial haemolysis (SRH) and duration of virus excretion, pyrexia and coughing. All ponies with antibody levels equivalent to SRH zones of ≥ 154 mm2 were protected against infection and all those with levels ≤ 85 mm2 were protected from disease.