Encephalitis lethargica (EL) was first reported in 1917 in central Europe. It became epidemic in the winter of 1918/1919 concurrently with the pandemic of influenza, and by then had reached Russia and North America. It spread throughout the world in epidemic form, mainly in the succeeding winters, up to 1927. By then about 65 000 cases had been reported, although the true number worldwide can only be guessed at. EL mortality was about 30% in the acute stage, and similar during recurrences. Half of the survivors had persistent or recurrent neuro-psychiatric illness, with Parkinsonism a frequent end stage. Most contemporary observers attributed EL to a virus and some believed it was specifically a post-influenzal complication. The epidemiology of EL mostly points to an infective cause, e.g. a seasonal respiratory or gastrointestinal virus with infrequent encephalitic expression but the ability to persist, flare and progressively damage the brain. However, any link with the influenza virus strain of 1918/1919 remains hypothetical. The aetiological theories that have been applied to EL are reviewed and the question is raised whether broader laboratory investigation might now reveal a continuing low endemicity of EL and identify its cause.

Q fever has been associated with exposure to domesticated livestock and the agricultural industry. However large population-based studies examining the relationship are lacking. This report sought to describe the association between Coxiella burnetii infection and participation in agricultural work in the 2003–2004 National Health and Nutrition Examination Survey. Adjusted logistic regression analysis showed that agricultural workers were six times more likely to have antibody evidence of C. burnetii infection than those employed in other occupations (odds ratio 6·5, 95% confidence interval 1·7–25·3). These findings suggest that agricultural workers may experience greater C. burnetii infection and emphasize an important need for more detailed study of people engaged in this work.

The factors influencing the rate of progress in Echinococcus granulosus control in New Zealand were analysed by hydatid control area using stepwise multiple regression techniques. The results indicated that the rate of progress was related positively to initial E. granulosus prevalence in dogs and the efficiency with which local authorities implemented national control policy, and negatively to the Maori proportion in the local population and the number of dogs per owner. Problems in analysis of the New Zealand data are discussed and improved methods of monitoring progress in hydatid disease control programmes are described.

The epidemiology and transmission dynamics of sheep scrapie is as yet poorly understood. Here we present a theoretical analysis of the transmission dynamics within a sheep flock, concentrating on how persistence properties depend on transmission scenario and flock size. Patterns of disease persistence and extinction are studied analytically using branching-process approximations and numerically using stochastic model simulations. For a given basic reproduction number, disease extinction is most likely when late-stage infected animals are responsible for most of the transmission. This effect can be understood in terms of aggregation in the distribution of the number of secondary infections arising from a single primary infection. The presence of an environmental reservoir reduces the probability of extinction.

A survey of the coverage, distribution and the factors associated with use of influenza and pneumococcal vaccines among general practitioners (GPs) in primary care and in hospital settings was carried out in 53 general practices in Scotland taking part in the ‘Continuous Morbidity Recording’ (CMR) programme. The annual vaccine distribution increased substantially among 53 general practices from 1993 to 1999 and in Scotland as a whole from 1984 to 1999. From the questionnaire, overall coverage was 43% (95% CI 38–48) for influenza vaccine in the 2000–1 season and 13% (95% CI 9–16) for pneumococcal vaccine in the last 5 year period, in high-risk patients recommended for these vaccines by the Department of Health (DoH). Influenza vaccine coverage was highest in the elderly (65 years of age and above) at 62% (95% CI 59–74). Although pneumococcal vaccination is not currently recommended for all elderly, coverage of this vaccine was also higher in this group (22%, 95% CI 16–29). In the majority of patients (influenza vaccine, 98% and pneumococcal vaccine, 94%), vaccination was carried out in general practice. Only 2% of patients had received pneumococcal vaccination in a hospital setting. The level of influenza and pneumococcal vaccination varied with the level of deprivation. Most GPs considered that the responsibility for influenza and pneumococcal vaccination lay with them. Forty-five percent of GPs reported having a written policy with set target for influenza vaccination and 11% for pneumococcal vaccination.

The effectiveness of calciferol (vitamin D2) against Rattus norvegicus was investigated in field trials on twenty-three farms with rat infestations partly resistant to warfarin. At 0·01% combined with warfarin at 0·025% no rodenticidal effect of the calciferol was discernible. At 0·025% with warfarin at the same concentration, results were better, but not appreciably better than is often obtained with warfarin alone against resistant rat populations. When the concentration of calciferol was stepped up to 0·1%, four out of five treatments in which the poison was applied directly gave complete control. The fifth may have partly failed because of poison shyness caused by under-baiting. Five out of six more treatments done after ‘pre-baiting’ were also successful. The sixth failed for reasons unconnected with the choice of poison.

Six further infestations that were not responding adequately to warfarin treatments were quickly controlled when, in three instances, calciferol at 0·1% was used instead and, in three more, it was used together with warfarin. It is concluded that calciferol at 0·1% is an effective poison against R. norvegicus either combined with warfarin or not, but that because at 0·1% its effect is subacute rather than chronic, there may be a case in some environments for using it only after pre-baiting.

Coliforms were readily obtained from many soils. In samples taken from sites exposed to animal contamination Bact. coli type I occurred predominantly. A large number of samples taken from grassy banks, only remotely exposed to contamination, were found to contain intermediates. It was found that the greater the probable degree of contamination of the soil the higher was the proportion of Bact. coli type I, and that the less the probable degree of contamination the higher was the proportion of intermediates. It is difficult to explain this merely on the basis of the prolonged survival of intermediates in soil, and it would appear obvious that the source of these intermediates lay elsewhere than in animal faeces. The numbers in which they were found in soil, however, were not of the order expected of bacteria living in their natural environment, and consequently it was equally difficult to conclude that these intermediates were actively established in soil.

In North America, the raccoon-associated variant of rabies virus (RRV) is of special concern, given its relatively rapid spread throughout the eastern USA and its potential public health impact due to high raccoon host densities in urban areas. Northward expansion of this epizootic included an outbreak in the Canadian province of Quebec in 2006–2009 due to trans-border spread from the State of Vermont. To inform a more proactive approach to future control efforts, this study uses phylogenetic analyses to explore the role of geography and alternative carnivore hosts in the dynamics of RRV spread within Vermont. Specifically, we sought to examine whether striped skunks, a species frequently infected by RRV, could be part of the maintenance host community. Whole genome sequencing of 160 RRV samples from Vermont and neighbouring US states were used for fine-scale phylogeographic analyses. Results, together with the complete surveillance record of raccoon rabies since its entry into Vermont in 1994, document incursions by two distinct viral lineages and identify topographical features of the landscape which have significantly influenced viral spread, resulting in a complex distribution pattern of viral variants throughout the state. Results of phylogenetic cluster analysis and discrete state reconstruction contained some evidence of skunk-to-skunk and skunk-to-raccoon transmission but overall failed to support a role for skunks as alternative maintenance hosts.

UNAIDS established fast-track targets of 73% and 86% viral suppression among human immunodeficiency virus (HIV)-positive individuals by 2020 and 2030, respectively. The epidemiologic impact of achieving these goals is unknown. The HIV-Calibrated Dynamic Model, a calibrated agent-based model of HIV transmission, is used to examine scenarios of incremental improvements to the testing and antiretroviral therapy (ART) continuum in South Africa in 2015. The speed of intervention availability is explored, comparing policies for their predicted effects on incidence, prevalence and achievement of fast-track targets in 2020 and 2030. Moderate (30%) improvements in the continuum will not achieve 2020 or 2030 targets and have modest impacts on incidence and prevalence. Improving the continuum by 80% and increasing availability reduces incidence from 2.54 to 0.80 per 100 person-years (−1.73, interquartile range (IQR): −1.42, −2.13) and prevalence from 26.0 to 24.6% (−1.4 percentage points, IQR: −0.88, −1.92) from 2015 to 2030 and achieves fast track targets in 2020 and 2030. Achieving 90-90-90 in South Africa is possible with large improvements to the testing and treatment continuum. The epidemiologic impact of these improvements depends on the balance between survival and transmission benefits of ART with the potential for incidence to remain high.

We examined the prevalence of mumps antibodies in the Israeli population in relation to mumps vaccination policy and past and subsequent incidence of disease. The levels of specific IgG antibodies against mumps were tested in 3330 residual sera collected during 1997–1998 from an age-stratified population sample. Against the background of a consistent MMR vaccination coverage of >90%, the age- and sex-adjusted seropositivity to mumps was 77·0%. No significant differences between genders were found. Seropositivity in the 10–13 years age group, born just before the introduction of the MMR vaccine, was the lowest (59%). These birth cohorts were the target of an outbreak of mumps in 2005 that occurred among high-school students and military recruits. A trend of waning immunity was observed between the first and second vaccine doses. The seroepidemiological data demonstrate that immunity levels below the herd immunity threshold, along with social mixing and crowded conditions facilitated the occurrence of mumps outbreaks. Periodical serosurveys are an essential component in the evaluation of the vaccination policy against mumps.

We have been able to confirm all the experimental results of Felix and his collaborators in regard to the Vi antigen and its significance in mouse infections. In the interpretation of some of the findings we are, however, not quite in agreement with Felix.

When large doses of living V forms of typhoid bacilli are injected into the mouse they cause acute intoxication followed by death within 2 days—if the animals die. Surviving animals are clinically healthy after this time, often earlier, but they are nevertheless found to be massively infected in the organs and blood for several days.

When smaller, non-intoxicating, doses are used it is not possible to demonstrate any difference between the V form and the W form of the same strain in regard to the severity of the infection they cause; so that we may conclude that the Vi antigen plays no part in the virulence of the typhoid bacillus in the mouse. (Remember in this connexion that the dysentery bacillus is also very toxic for mice injected in large doses, while its virulence, i.e. the ability to grow in the mouse is = 0; but when rapidly fatal doses are used a massive growth of dysentery bacilli can also be demonstrated here, the cause being that the natural immunity has become partly neutralized by the intoxication.)

Like Felix we find that only the V form can be used both for active vaccination and the production of sera which protect against lethal doses of V forms in mouse experiments. We consider that this is due to the antitoxic effect. Our experiments show that the anti-bacterial effect in vaccination experiments differs little whether the V or the W form is used as vaccine, so long as the vaccinal effect is tested with non-toxic doses of bacilli. As shown in earlier experiments, the bactericidal effect in actively vaccinated animals is often a relatively slow process.

Only the Vi antibody containing sera can protect prophylactically with certainty against the toxic effect of living typhoid bacilli. On the other hand; the bactericidal effect prophylactically of 0 and 0 + Vi sera is very similar when tested against non-toxic doses of “virulent” typhoid bacilli.

The therapeutic value of potent Vi sera under the experimental conditions given was nil.

Following an outbreak of 2009 pandemic influenza A (H1N1) at a residential summer camp for boys aged 10–16 years, we assessed secondary household transmission of the novel virus after their return home. Of 212 study participants who attended camp, 49 had confirmed or probable influenza for a primary attack rate of 23%. Of 87 exposed household contacts who did not attend camp, only three instances of probable transmission were observed, for a household secondary attack rate of 3·5%. All secondary cases occurred in households where the ill camp attendee returned home 1 day after onset of illness, with an attack rate of 14·3% in household contacts in this category. Returning home after peak infectivity to others and advanced warning prior to reintegration of sick individuals into the household probably contributed to the overall low secondary attack rate observed.

The occurrence of extended-spectrum β-lactamase producing enterobacteria (ESBLE) has been prospectively surveyed in a neurosurgical intensive care unit (ICU). Of the 47 patients examined, 8 were identified as faecal carriers, and 2 of them developed a subsequent urinary tract infection. ESBLE were also detected in the immediate environment of five colonized and/or infected patients. All isolates were Klebsiella pneumoniae of a particular biotype which exhibited a similar antibiotype and produced an SHV-4 type β-lactamase. However, plasmid profiling and ribotyping revealed that strains isolated from seven patients of hall A were a single epidemic clone, whereas strains isolated from the eighth patient of hall B were different. Comparison between the characteristics of patients who carried an ESBLE during the surveillance period, and control patients who did not, showed that a recent surgery, and the length of ICU stay were significantly associated with the acquisition of ESBLE.

The association between opportunistic infection (OI) and anaemia among HIV-infected patients remains to be studied. We investigated the prevalence and risk factors of anaemia in hospitalised HIV-infected patients to reveal the association between OI and anaemia. We conducted a retrospective study of HIV-positive hospitalised patients from June 2016 to December 2017 in Mengchao Hepatobiliary Hospital of Fujian Medical University. Patients’ information on socio-demographic and clinical characteristics were carefully collected. The comparison of anaemia prevalence between groups was conducted with χ2 test. A logistic regression model was carried out to analyse the predictors of anaemia. The total prevalence of anaemia in hospitalised HIV-infected patients was 55.15%. The prevalence of mild, moderate and severe anaemia was 41.42%, 11.08% and 2.64%, respectively. Predictors independently associated with anaemia were: CD4 counts <50 cells/μl (odds ratio (OR): 6.376, 95% confidence interval (CI) = 1.916–21.215, P = 0.003), CD4 counts 50–199 cells/μl (OR: 6.303, 95% CI = 1.874–21.203, P = 0.003), co-infection with tuberculosis (TB) (OR: 2.703, 95% CI = 1.349–5.414, P = 0.005) or Penicillium marneffei (PM) (OR: 7.162, 95% CI = 3.147–15.299, P < 0.001). In Fujian, China, more than half inpatients with HIV were anaemic, but severe anaemia is infrequent. Lower CD4 counts, co-infection with TB or PM were independent risk factors for anaemia. Chinese HIV patients especially with TB, PM infection and low CD4 level should be routinely detected for anaemia to improve therapy.

Forty-two cultures of pseudomonas comprising 28 clinical isolates from a pseudo-outbreak on a Special-Care Baby Unit and 14 reference strains, including 9 type strains, of various Pseudomonas species, were characterized by one-dimensional sodium dodecyl sulphate–polyacrylamide gel electrophoresis (SDS–PAGE) of whole-cell proteins. The protein patterns were highly reproducible and were used as the basis for a numerical analysis which divided the strains into 9 phenons. Two of the 28 clinical isolates were identified by biochemical tests as P. pickettii and their identification was confirmed by SDS–PAGE as they fell in the same phenon as the type strain of the species. The remaining 26 isolates, which could not be identified on phenotypic tests, fell in the same phenon as three reference strains of ‘P. thomasii’. The protein patterns provided the first clear evidence that P. pickettii and ‘P. thomasii’ were separate taxa and that the ‘outbreak’ was polymicrobial in origin, in line with the probable aqueous source of contamination. We conclude that high-resolution SDS–PAGE of proteins provides an effective method of identifying and differentiating pseudomonads, especially where this cannot be done adequately using conventional biochemical tests.

The growth of vaccinia and cowpox in RK13 cells was studied by measurement of infective virus production, gel diffusion and haemagglutination. The effects of virus growth inhibitors on the normal course of infection were then followed. Although the results with the two viruses were essentially similar some differences were detected between them. Inhibitors of DNA synthesis permitted production of many virus-specific soluble antigens. Compounds which inhibit DNA function and compounds that affected energy-yielding reactions had more dramatic effects. The different results obtained suggested that the synthesis of virus-specific materials was sequential and a possible part of the sequence is suggested.

The nature of the ringworm flora of Birmingham over 17 years was investigated and tabulated by species, geographical distribution and concentration.

The rise and fall of such outbreaks as occurred has been charted.

The persistent preponderance of zoophilic species, in spite of the recent decline in over-all incidence, has been demonstrated.

We have analysed data on respiratory syneytial (RS) and parainfiuenza type 3 (PF3) viruses reported to the Communicable Disease Surveillance Centre. London, over the period 1978–87. These confirm the annual winter epidemic of RS virus and show that, in England and Wales, PF3 is a summer infection with regular yearly epidemics.

The anticoagulant rodenticide flocoumafen was evaluated against Rattus rattus and Bandicota bengalensis, In no-choice 24 h feeding tests 100% mortality occurred at 0·00125% concentration of the poison in the bait in the case of B. bengalensis and at 0·00375% in R. rattus. Feeding of 0·0025% poison bait in 1-day, no-choice and 2-day choice tests resulted in 60% and 75% mortality of R. rattus, respectively, and 100% of B. bengalensis. The differences between the consumption of plain food in the pretreatment period and of poison bait in no-choice tests were non-significant, except in one case. The rodents consumed significantly more (P < 0·01) poison bait than the plain alternative in the choice trials. Median period of survival and its 95% confidence limits of R. rattus and B. bengalensis, at the 100% mortality dose levels of the poison, were 6·3 (5·04–7·88) and 6·2 (4·92–7·81) days respectively.

Using Moore's swabs in four abattoirs, six strains of subgenus III salmonellas were isolated—four diphasic strains belonging to one serotype and two monophasic strains belonging to another. The serotypes differed in the length of time needed to ferment lactose. There was some evidence that the diphasic serotype could have had an ovine origin.