Human respiratory tract chlamydial infections have been studied in Cambridge-shire for many years, but until recently we have been unable to distinguish between infection with Chlamydia psittaci Or Chlamydia pneumoniae (TWAR). In this study, we have employed the micro-immunofluorescence (micro-IF) test for this purpose and to look for the relative incidence of C. psittaci and C. pneumoniae infections in Cambridgeshire. Among 50 patients with community-acquired respiratory tract symptoms whose serum samples had Chlamydia complement fixation test titres ≥ 64, 25 had evidence of recent C. psittaci or C. pneumoniae infection. Nineteen (76%) of the 25 patients had evidence of recent C. psittaci infection and of these 16 (84%) had recently had contact with birds. Six patients (24%) had evidence of recent C. pneumoniae infection, and of these, only two (33% had recently had contact with birds). While C. psittaci was grown from several of the birds associated with human C. psittaci infection, it was not cultured from any of the birds in contact with the two human C. pnemoniae cases.

Faecal samples of 2660 domestic animals from 116 farms and 956 samples of food were examined for the presence of Shiga toxin-producing Escherichia coli (STEC). STEC was recovered from 126 (15·3%) cattle, 135 (11·3%) pigs, 135 (66·8%) sheep, 31 (73·8%) goats, 4 (1%) chicken, and 15 (1·6%) food samples. Of all STEC isolates, 21·5, 25·8 and 15% produced enterohaemolysin, α-haemolysin, and aerobactin respectively, 1·6% displayed localized adherence (LA) to HEp-2 cells, 27·6% were sorbitol negative, and 30% were resistant to antibiotics. Only 14 (3·1%) of the STEC isolates belonged to human infection-associated serogroups (O26, O55, O111, O128 and O157), designated as enterohaemorrhagic E. coli (EHEC). This study revealed that STEC are prevalent in domestic animals, and to a lesser extent in food of animal origin in Serbia, but the absence of a EHEC phenotypic profile (characteristic serogroup, LA, enterohaemolysin production) in most animal STEC strains may explain the low incidence of human STEC infection in this part of the world.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, first notified in China, has spread around the world causing high morbidity and mortality, which is due to factors such as the subversion of the immune response. The aims of the study are to summarise and present the immunopathological relationship of COVID-19 with innate immunity. This is a systematic review conducted by the National Library of Medicine – National Institutes of Health, USA (PUBMED), Latin American and Caribbean Literature on Health Sciences (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE) and Scientific Electronic Library Online (SCIELO) databases with clinical trials, in vitro assays, case-controls, cohort studies, systematic reviews and meta-analyses between February 2020 and July 2021. The version 2 of the Cochrane risk-of-bias tool for RCTs (RoB 2), Joana Briggs Institute (JBI) Critical Appraisal (for the review articles) and the Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) tools were used to evaluate the quality and the risk of bias of the studies included in this review. The innate immune response through the generation of interferons, alternative pathways and complement system lectins and the joint action of innate immune cells and cytokines and chemokines lead to different clinical outcomes, taking into account the exacerbated inflammatory response and pathogenesis. Then, in addition to interacting as a bridge for adaptive immunity, the innate immune response plays an essential role in primary defense and is one of the starting points for immune evasion by SARS-CoV-2.

In September 2016, an imported case of measles in Edinburgh in a university student resulted in a further 17 confirmed cases during October and November 2016. All cases were genotype D8 and were associated with a virus strain most commonly seen in South East Asia. Twelve of the 18 cases were staff or students at a university in Edinburgh and 17 cases had incomplete or unknown measles mumps rubella (MMR) vaccination status. The public health response included mass follow-up of all identified contacts, widespread communications throughout universities in Edinburgh and prompt vaccination clinics at affected campuses. Imported cases of measles pose a significant risk to university student cohorts who may be undervaccinated, include a large number of international students and have a highly mobile population. Public health departments should work closely with universities to promote MMR uptake and put in place mass vaccination plans to prevent rapidly spreading measles outbreaks in higher educational settings in future.

Indian Ocean islands are endemic areas for human and animal leptospirosis. Maintenance host species for Leptospira spp. have still not been completely elucidated, and recently the role of cats (Felis catus) has been questioned. This cross-sectional study aims to determine whether cats are part of the maintenance community of different strains of Leptospira spp. in Reunion Island. The prevalence of Leptospira infection in an opportunistic sample of stray and domestic cats (n = 92) from Reunion Island has been studied using serological (microagglutination test) and molecular detection (polymerase chain reaction (PCR)). The results revealed a seroprevalence of 37.0% (34/92) (cut-off 1:40) without a significant difference in the living conditions of animals. The predominant serogroup was Icterohaemorrhagiae, but Ballum, Cynopteri and Australis were also detected. Using PCR, 28.6% (12/42) of stray cats were tested positive. Leptospiral DNA was detected in renal tissue, urine and blood of respectively 14.3% (6/42), 10.3% (4/39) and 11.9% (5/42) of stray cats, but 0% (0/3), 0% (0/50) and 0% (0/36) of domestic cats (P = non-applicable, P = 0,038, P = 0,058 respectively). Partial rrs gene (16S rRNA) sequencing identified Leptospira interrogans in all PCR-positive samples. Our study confirms that renal carriage and urinary shedding are possible, positioning cats, and especially stray cats as potential actors within the maintenance community of L. interrogans in Reunion Island.

This study was conducted to determine the seroprevalence of anti-Neospora caninum antibodies and to investigate the risk factors related to seroprevalence in dogs from urban and rural areas with distinct economic activities (milk and coffee production) in Minas Gerais state, Brazil. For this purpose, blood samples from 703 dogs were collected and questionnaires addressing epidemiological aspects were completed by dog-owners. The sera were analysed for anti-N. caninum antibodies by indirect fluorescent antibody tests (IFAT ⩾ 1:50). Association between epidemiological aspects and seropositivity in dogs was evaluated with multivariate logistic regression models. A total of 80 (11·4%) dogs tested positive for N. caninum. In the multivariate logistic regression models, dogs aged >4 years, dogs used as guard dogs, dogs that spontaneously hunt, and history of bovine abortion were found to be greater risk factors for canine N. caninum infection. When we considered only dogs from rural areas, an association with seroprevalence was seen for milk farms, dogs not fed with commercial food, dogs that hunt, and dogs used as guard dogs.

A prospective longitudinal study of diseases of lambs born in December and January and housed through to slaughter was carried out on three flocks (A, B and C) between 1989 and 1991. In the first year of the investigation (1989–90) three cohorts of approximately 80 lambs were examined in detail on a regular (weekly or fortnightly) basis. This involved over 2000 examinations and at least one clinical abnormality was observed in each lamb. In the second year (1990–1) the farmers were asked to present sick lambs for treatment on the farm. Farmers from flocks A and B participated in this part of the study; a total of 97/1295 lambs that were slaughtered received at least one treatment.

The carcases and visceral organs of lambs from each flock were observed after slaughter. There was no association between the abnormalities observed during routine examination of the cohort lambs (year 1) and those observed at post mortem meat inspection. However, in year 2, in lambs from flock A, there was a significant association between lambs treated for arthritis or pneumonia on the farm and the presence of arthritic or pleuritic lesions, respectively, post mortem. In both years of the study lambs which were older when slaughtered were significantly more likely to have pleuritic, pneumonic or arthritic lesions at meat inspection.

It was concluded that routine examination of groups of lambs is an inefficient and possibly ineffective method to identify lambs with lesions at slaughter. However, lambs which have been treated for disease, and the older lambs in a flock, had an increased prevalence of lesions post mortem and hence more detailed inspection of these animals would increase the efficiency of meat inspection.

The presence of different Campylobacter jejuni serotypes in Swedish patients with diarrhoea and in Mexican patients with or without diarrhoea was investigated with special reference to repeated isolations during the course of infection and to symptomatic and asymptomatic episodes. The study included 136 C. jejuni isolates from 62 Mexican children and 173 isolates from 68 Swedish patients. The bacteria were serotyped for heat-stable (HS) and heat-labile (HL) antigen.

A set of 723 diagnostic sera from human patients, submitted for the microscopic agglutination test (MAT) for antibodies to a group of 6 leptospiral serovars, was also tested by MAT for antibodies to the recently-discovered Leptospira fainei serovar hurstbridge. MAT titres of [ges ]128 to serovar hurstbridge were detected in 13·4% of these sera, and titres of [ges ]512 in 7·2%. In contrast, none of 62 sera obtained from a control population of laboratory staff gave titres of [ges ]128. The difference between the number of titres of [ges ]128 given by the two groups of sera was highly significant (P<0·01). The titres observed may have been due to cross-reactions with other leptospiral serovars, but this could not be demonstrated. An alternative explanation is that serovar hurstbridge is present in the human population.

An infusion of E. coli endotoxin (10 μg) into the mammary gland of the cow 16 h before experimental infection with St. agalactiae prevented the establishment of mastitis. A clinical examination of the affected gland did not reveal signs of inflammation, all organisms were eliminated from the milk by 36 h after infection. Mammary glands not pretreated with endotoxin, and injected with the same number of viable streptococci, showed signs of severe inflammation, the milk yield was reduced and the injected pathogen could be isolated from the gland for up to 14 days when sampling was discontinued. The injection of endotoxin alone produced a rapid increase in the cell count of the milk, there were some signs of inflammation and 80% of the cells in the milk were neutrophils. The cell counts in the milk remained above normal for 7–10 days. Untreated control quarters appeared to be unaffected by the injection of E. coli endotoxin into an adjacent quarter, on the other hand the injection of St. agalactiae into the adjacent quarter on the same side of the udder produced a cell response which reached a peak after 2 days and returned to preinoculation levels by the fourth day. No inflammation was observed in these control quarters and no streptococci were isolated from the milk.

Simulation models are used widely in pharmacology, epidemiology and health economics (HEs). However, there have been no attempts to incorporate models from these disciplines into a single integrated model. Accordingly, we explored this linkage to evaluate the epidemiological and economic impact of oseltamivir dose optimisation in supporting pandemic influenza planning in the USA. An HE decision analytic model was linked to a pharmacokinetic/pharmacodynamics (PK/PD) – dynamic transmission model simulating the impact of pandemic influenza with low virulence and low transmissibility and, high virulence and high transmissibility. The cost-utility analysis was from the payer and societal perspectives, comparing oseltamivir 75 and 150 mg twice daily (BID) to no treatment over a 1-year time horizon. Model parameters were derived from published studies. Outcomes were measured as cost per quality-adjusted life year (QALY) gained. Sensitivity analyses were performed to examine the integrated model's robustness. Under both pandemic scenarios, compared to no treatment, the use of oseltamivir 75 or 150 mg BID led to a significant reduction of influenza episodes and influenza-related deaths, translating to substantial savings of QALYs. Overall drug costs were offset by the reduction of both direct and indirect costs, making these two interventions cost-saving from both perspectives. The results were sensitive to the proportion of inpatient presentation at the emergency visit and patients’ quality of life. Integrating PK/PD–EPI/HE models is achievable. Whilst further refinement of this novel linkage model to more closely mimic the reality is needed, the current study has generated useful insights to support influenza pandemic planning.

In the summer of 2001 an outbreak of Escherichia coli O157 gastroenteritis affected staff and residents of a care home for the elderly in the West Midlands, UK. E. coli O157 phage type 2 was isolated from faeces in eight patients and 12 staff members. Thirty-five staff and 40 residents met the case definition for clinical gastrointestinal infection. Serological testing identified a further 14 possible cases of infection amongst asymptomatic staff and residents. The outbreak was atypical, as the disease seemed to be milder than has been observed in past outbreaks in similar settings. The index case, a member of staff, developed bloody diarrhoea and haemolytic–uraemic syndrome (HUS), but only one resident developed bloody diarrhoea and required hospitalization. No deaths occurred, despite the high-risk nature of the affected population. The source of the outbreak could not be identified. The prolonged nature of the outbreak and observed lapses in infection control practices indicated that person-to-person spread was the likely route of transmission. This outbreak illustrates the importance of observing appropriate infection control measures in the institutions providing residential and nursing care to the elderly.

Five rubella antigens were evaluated in an antiglobulin enzyme-linked immunosorbent assay for rubella-specific IgG subclass antibody. One monoclonal anti-human IgG subclass antibody was used for each of IgG1, IgG2 and IgG4, but two were compared for IgG3. A total of 101 sera were tested from cases of rubella in the distant past and from cases of primary rubella, reinfection and following immunization. Only one serum gave a discrepant result for specific IgG1, being positive with only one rubella antigen, a commercially prepared antigen coated on to microtitre wells (Enzygnost; Behringwerke). No sera contained detectable specific IgG2. Only four sera contained specific IgG4, and this was detectable only with Enzygnost antigen. For specific IgG3 little difference was observed between the two monoclonal anti-human IgG3 subclass antibodies; only two very weakly positive sera gave discrepant results. However, varying results were obtained for specific IgG3 with the different antigens. Enzygnost gave more positive results for specific IgG3 with most categories of sera.

It is concluded that the differences between various reports of the rubella-specific IgG subclass profile cannot be explained entirely by the use of different rubella antigens.

Knowledge of epidemiological mechanisms and parameters underlying scrapie transmission in sheep flocks remains very limited at present. Here we introduce a method for fitting stochastic transmission models to outbreak data to estimate bounds on key transmission parameters. We apply this method to data describing an outbreak of scrapie in a closed flock of Romanov sheep. The main findings are that the relative infectiousness of infected animals in this outbreak becomes appreciable early into disease incubation and that the mean incubation period is less than 1·5 years. We also find that the data are consistent with a broad range of values for the basic reproduction number R0 and describe how the boundaries of this range depend on assumptions about the mean incubation period and the contribution to transmission of a long-lived environmental reservoir of infectivity.

Cervical cancer is the second most frequent cancer in women in French Guiana. Studies have shown that populations living in the remote areas of the interior have early sexual debut and that multiple sexual partnerships are common. The objective of the present study was thus to determine the prevalence of human papillomavirus (HPV) infection in these areas. A study was conducted in women aged 20–65 years with previous sexual activity. Women were included on a voluntary basis after using local media and leaders to inform them of the visit of the team. HPV infection was defined by the detection of HPV DNA using the Greiner Bio-One kit. In addition to HPV testing cytology was performed. The overall age-standardized prevalence rate was 35%. There was a U-shaped evolution of HPV prevalence by age with women aged >50 years at highest risk for HPV, followed by the 20–29 years group. Twenty-seven percent of women with a positive HPV test had normal cytology. Given the high incidence of cervical cancer in French Guiana and the high prevalence of HPV infections the present results re-emphasize the need for screening for cervical cancer in these remote areas. Vaccination against HPV, preferably with a nonavalent vaccine, also seems an important prevention measure. However, in this region where a large portion of the population has no health insurance, this still represents a challenge.

The incidence of bacteraemia has increased considerably during the last decades. This may be related to population ageing, increased use of invasive procedures, and increased ascertainment of bacteraemia. Generalized additive and generalized linear models were used to analyse the impact of four successive improvements in blood culture methodology on the recovery of prevalent blood culture isolates while simultaneously controlling for underlying time trend and seasonal variation. Between 1981 and 2006, 20 091 bacteraemias comprising 22 800 blood culture isolates were diagnosed. The changes in methodology increased the recovery of some bacterial groups; the greatest impact was observed for Enterobacteriaceae, pneumococci and Staphylococcus aureus whereas recovery of β-haemolytic streptococci, Pseudomonas aeruginosa, other Gram-negative aerobes, and fungi was not affected. Changes in blood culture methodology should be taken into account when assessing time trends of bacteraemia.

The rapid rise in syphilis cases has prompted a number of public health campaigns to assist men who have sex with men (MSM) recognize and present early with symptoms. This study aimed to investigate the temporal trend of the duration of self-report symptoms and titre of rapid plasma reagin (RPR) in MSM with infectious syphilis. Seven hundred and sixty-one syphilis cases in MSM diagnosed at the Melbourne Sexual Health Centre (MSHC) from 2007–2013 were reviewed. Median duration of symptoms and RPR titres in each year were calculated. The median durations of symptoms with primary and secondary syphilis were 9 [interquartile range (IQR) 6–14] days and 14 (IQR 7–30) days, respectively. The overall median titre of RPR in secondary syphilis (median 128, IQR 64–256) was higher than in primary syphilis (median 4, IQR 1–32) and in early latent syphilis (median 32, IQR 4–64). The median duration of symptoms for primary syphilis, secondary syphilis and titre of RPR level did not change over time. Public health campaigns were not associated with a significant shorter time from onset of symptoms to treatment. Alternative strategies such as more frequent testing of MSM should be promoted to control the syphilis epidemic in Australia.

Wild Norway rats (Rattus norvegicus) from several habitats were tested for their susceptibility and resistance to warfarin. Animals were fed 0·005% warfarin in ground oatmeal for periods varying from 1 to 12 days. Rats having no prior exposure to anticoagulants were shown to be susceptible, none having survived a 6-day feeding period. Resistant rats were found on two farms where anticoagulant materials had been used intensively for about 20 years.

In August 2012, an outbreak of gastroenteritis occurred among 88 persons attending a wedding reception at a resort/activity centre in Ylöjärvi, Finland. Of 39 interviewed guests, 23 met the case definition. Two persons were hospitalized. Epidemiological, laboratory and environmental investigations were conducted to characterize the outbreak and to recommend control measures. Investigation confirmed the presence of a new strain of norovirus GII.4 Sydney variant in stool specimens obtained from two wedding guests and on several environmental surfaces in the centre. In the questionnaire study, none of the foods or beverages served during the reception were significantly associated with the illness. Additional cases of gastroenteritis that occurred at the centre before and after the wedding reception supported the hypothesis of environmental transmission of norovirus. After thorough cleansing and disinfection and 1 week's quarantine, no new cases with symptoms typical for norovirus infection were identified at the centre.

A mathematical model was used to estimate malaria transmission rates based on serological data. The model is minimally stochastic and assumes an age-dependent force of infection for malaria. The transmission rates estimated were applied to a simple compartmental model in order to mimic the malaria transmission.

The model has shown a good retrieving capacity for serological and parasite prevalence data.