Data on the impact of the recently recommended maternal pertussis vaccination are promising, but still insufficient to universalise this approach. We thus compared the epidemiological data prior to the implementation of this vaccination strategy in Argentina (2012) with the figures reported after 2012. During that 2010–2016 period, two outbreaks occurred, one in 2011 and another in 2016. In the former, the incidence was 6.9/100 000 inhabitants and the case-fatality rate 2.6%. Thereafter, a decline in incidence was detected until 2014. During 2015 and 2016 an increase in the incidence transpired, but this rise was fortunately not accompanied by one in the case fatality ratio. Indeed, in 2016 the case fatality ratio was the lowest (0.6%). Moreover, during the 2016 outbreak, the incidence (3.9/100 000 inhabitants) and the case severity detected in the most vulnerable population (infants 0–2 months) were both lower than those in 2011. Consistent with this pattern, in 2016, in the most populated province of Argentina (Buenos Aires), the case percentage with laboratory-positive results indicating a high number of symptoms (59.1% of the total cases) diminished compared with that detected in the 2011 outbreak without maternal immunisation (71.9%). Using the mathematical model of pertussis transmission we previously designed, we assessed the effect of vaccination during pregnancy on infant incidence. From comparisons between the epidemiological data made through calculations, emerged the possibility that vaccinating women during pregnancy would benefit the infants beyond age 2 months, specifically in the 2–12-month cohort.

1. Both in Bombay city and in the Amritsar district of the Punjab there is a distinct seasonal variation in the number of rat fleas.

2. In these places this seasonal variation of rat fleas corresponds directly in a general way with the plague mortality. During the season when plague is epidemic the average number of fleas per rat is above the mean, while during the non-epidemic season it is below the mean. The height of the epidemic corresponds fairly closely with the season of maximum flea prevalence.

Social network characteristics of people who inject drugs (PWID) have previously been flagged as potential risk factors for HCV transmission such as increased injection frequency. To understand the role of the injecting network on injection frequency, we investigated how changes in an injecting network over time can modulate injecting risk behaviour. PWID were sourced from the Networks 2 Study, a longitudinal cohort study of PWID recruited from illicit drug street markets across Melbourne, Australia. Network-related correlates of injection frequency and the change in frequency over time were analysed using adjusted Cox Proportional Hazards and Generalised Estimating Equations modelling. Two-hundred and eighteen PWID followed up for a mean (s.d.) of 2.8 (1.7) years were included in the analysis. A greater number of injecting partners, network closeness centrality and eigenvector centrality over time were associated with an increased rate of infection frequency. Every additional injection drug partner was associated with an increase in monthly injection frequency. Similarly, increased network connectivity and centrality over time was also associated with an increase in injection frequency. This study observed that baseline network measures of connectivity and centrality may be associated with changes in injection frequency and, by extension, may predict subsequent HCV transmission risk. Longitudinal changes in network position were observed to correlate with changes in injection frequency, with PWID who migrate from the densely-connected network centre out to the less-connected periphery were associated with a decreased rate of injection frequency.

1. The influence of temperature on the germicidal power of selected disinfectants has been studied, and it has been found that germicides may be classified broadly into three main groups, viz.

Germicidal power (a) unaffected by rise in temperature: chiefly chemical substances, possessing reducing properties;

(b) approximately doubled by rise in temperature from 20 to 37°C.—phenol, alcohol;

(c) increased as much as 10 or 20-fold by the same temperature rise: oxidising agents.

2. The effect of temperature on bactericidal action is different for B. coli and B. fluorescens, thus causing very complex changes in selective action, which are discussed in this paper.

3. The temperature coefficient for the process of protein-precipitation by phenol is 2·2 per 10°C. rise in temperature, and thus similar in magnitude to the coefficient for disinfection by phenol. This supports the view that the germicidal action of phenol is associated with its denaturating effect on the cell-proteins.

4. Previous experimental work had suggested that the bactericidal action of the quinones was due to their chemical reactivity with the simple cell-constituents, e.g. the amino-acids, rather than with the complex colloids. The temperature coefficient of the reaction between benzoquinone and glycine is, however, the normal one, viz. 2 for 10° C. rise, for chemical action, although the germicidal action of the quinones may be actually 20 times more effective at 37° than at 20° C. The presence of certain inorganic cell-constituents accelerates the velocity of reaction between quinone and glycine, but does not increase the temperature coefficient.

5. The bactericidal power of picric acid and potassium permanganate, as well as the quinones, is greatly increased by rise in temperature: and there would appear to be some other factor common to all these disinfectants associated with their high temperature coefficient.

1. An investigation of ninety-eight cases of aseptic meningitis admitted to hospital resulted in the isolation of ECHO virus Type 6 from fifty-one patients.

2. The viruses were cultivated in both human embryonic skin-muscle tissue and human amniotic cell tissue. The latter was found to be more satisfactory.

3. Forty-eight strains were isolated from the stools of patients, six from the cerebrospinal fluid and four from throat-washings.

4. Serological examination of patients from whom the virus was isolated showed that a significant proportion of patients exhibited a specific antibody response. This included three out of six patients with the virus in their cerebrospinal fluid.

5. The clinical picture of aseptic meningitis from which cases ECHO virus was isolated cannot be distinguished from that caused by other known viruses.

6. The evidence presented supports the claim that ECHO virus Type 6 is one of the causes of aseptic meningitis.

Grateful appreciation is acknowledged to Prof. P. M. Holst (Oslo), Prof. Johs. Böe (Bergen), Dr B. Helland-Hanssen (Molde), Dr O. Römcke (Drammen), Dr R. Tingstad (Namsos), and Dr A. H. Brinchmann (Bærum), for providing specimens and case records. I am also grateful to Mrs B. Zapffe and Mrs L. Kohmann for expert technical assistance.

Many contradictory articles on the infectivity of non-culturable Campylobacter jejuni can be found. We studied the effect of non-culturable C. jejuni in an in vitro assay. To prevent the potential effect of a few culturable bacteria in the non-culturable suspension, INT-407 cells, which mimic the outer cell layer in the small intestines, were exposed to culturable C. jejuni suspensions with or without non-culturable C. jejuni. The number of bacteria adhering to and/or invading INT-407 cells and the IL-8 secretion were measured. No differences were found between bacterial suspensions with or without non-culturable C. jejuni added. These findings show that non-culturable C. jejuni do not adhere to or invade INT-407 cells and do not induce an immune response. As previous studies showed a correlation between the used in vitro assays and the effect in vivo, our study strongly suggests that culturability is a good indicator of the risk for C. jejuni infection.

This study investigated the carriage of antimicrobial resistant Haemophilus influenzae in 582 healthy children attending kindergarten or elementary school at four intervals over a 9-month period in Seoul, Korea. Diverse colonization patterns and a lower level of long-term persistent carriage by H. influenzae status were evident in this study. Colonizing H. influenzae isolates showed a high rate of resistance to β-lactams including ampicillin (51·9%), cefaclor (52·1%), and amoxicillin/clavulanate (16·3%). Based on the ampicillin resistance mechanism, H. influenzae isolates were categorized as β-lactamase-negative, ampicillin-susceptible (BLNAS) (48·1%), β-lactamase-positive, ampicillin-resistant (BLPAR) (22·6%), β-lactamase-negative, ampicillin-resistant (BLNAR) (22·8%), and β-lactamase-positive, amoxicillin/clavulanate-resistant (BLPACR) strains (6·5%). This study provides the first evidence of a high prevalence (22·8%) of BLNAR strains of H. influenzae nasal carriage in healthy children attending kindergarten or the first 2 years of elementary school in Korea. The high carriage of these resistant strains in overcrowded urban settings may create reservoirs for development of H. influenzae-resistant strains.

Twenty-five cultures comprising 18 clinical isolates of Serratia marcescens from two hospitals, the type strain of S. marcescens, two reference strains of S. marinorubra, the type or a reference strain of three other Serratia species and a reference strain of undetermined 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 of a numerical analysis which divided the clinical isolates into eight protein types. Comparison with O-serotyping indicated that the level of discrimination by SDS–PAGE was similar. As with O-serotyping, a secondary scheme, such as phage typing, is necessary to differentiate strains of the same protein type. We conclude that high-resolution SDS–PAGE of proteins provides an effective adjunct to other methods for typing isolates of S. marcescens.

We know, since the time of Pasteur, that repeated passage of rabies street virus from rabbit to rabbit after intracerebral inoculation, leads to a modification of its effect and the appearance of mutative characters. This takes place at a variable period of time depending upon the strain employed. The irreversibility and the permanence of these characters has led to the name of “fixed virus” once the street virus has become adapted for the rabbit.

Despite national guidance recommending testing and vaccination of household contacts of hepatitis B-infected pregnant women, provision and uptake of this is sub-optimal. The aim of this study was to evaluate the use of in-home dried blood spot (DBS) testing to increase testing and vaccination of household contacts of hepatitis B-infected pregnant women as an alternative approach to conventional primary-care follow-up. The study was conducted across two London maternity trusts (North Middlesex and Newham). All hepatitis B surface antigen-positive pregnant women identified through these trusts were eligible for inclusion. The intervention of in-home DBS testing for household contacts was introduced at North Middlesex Trust from November 2010 to December 2011. Data on testing and vaccination uptake from GP records across the two trusts were compared between baseline (2009) and intervention (2010–2011) periods. In-home DBS service increased testing uptake for all ages (P < 0·001) with the biggest impact seen in partners, where testing increased from 30·3% during the baseline period to 96·6% during the intervention period in North Middlesex Trust. Although impact on vaccine uptake was less marked, improvements were observed for adults. The provision of nurse-led home-based DBS may be useful in areas of high prevalence.

In late 2002, health professionals from the ministries of health and academia of Jordan, the Palestinian Authority and Israel formed the Middle East Consortium on Infectious Disease Surveillance (MECIDS) to facilitate trans-border cooperation in response to infectious disease outbreaks. The first mission of MECIDS was to establish a regional, laboratory-based surveillance network on foodborne diseases. The development of harmonized methodologies and laboratory capacities, the establishment of a common platform of communication, data sharing and analysis and coordination of intervention steps when needed were agreed upon. Each of the three parties selected the microbiological laboratories that would form the network of sentinel laboratories and cover the different districts of each country and also designated one laboratory as the National Reference Laboratory (NRL). Data analysis units have been established to manage the data and serve as a central point of contact in each country. The MECIDS also selected a regional data analysis unit, the Cooperative Monitoring Centre (CMC) located in Amman, Jordan, and established a mechanism for sharing data from the national systems. Joint training courses were held on interventional epidemiology and laboratory technologies. Data collection started in July 2005 with surveillance of salmonellosis as the first target. This network of collaboration and communication established in an area of continuous dispute represents an important step towards assessing the burden of foodborne diseases in the region and is expected to be fundamental for coordination of public health interventions and prevention strategies.

The injection of the small amount of diphtheria toxin used in the Schick test may act as a secondary stimulus.

A Schick test may therefore cause a great and rapid increase in the immunity of the animals tested.

Examples are quoted of six rabbits and twelve guinea-pigs in Tables II to VII.

2. A fraction of a Schick dose may act as a secondary stimulus. Rabbit G 23 quoted in Table IV, injected with 1/10 of a Schick dose, showed an immunity response, the antitoxic content of its blood rising from 1/50 to nearly 1/10 unit per c.c. in six days.

3. The action of a Schick dose as a secondary stimulus may cause an animal to give a negative reaction when tested seven days or more after the first positive reaction.

This is illustrated by rabbits G 7 in Table III, G 31 in Table II, G 32 and G 34 in Table V and four guinea-pigs in Table VI.

4. The antigenic value of a Schick dose of toxin as a secondary stimulus may be as high as that of a reasonable dose of a toxin-antitoxin mixture suitable for human immunisation. Examples are given comparing the results of the injection of a Schick dose of toxin and of a toxin-antitoxin mixture in the same rabbit in Table III, in different rabbits, G 20 and G 22 in Table IV and reference is made to the companion rabbits to those quoted in Table V.

5. The antigenic value of a Schick dose as a secondary stimulus can be demonstrated:

A. In animals which have not produced a detectable quantity of antitoxin (that is less than 1/2000 of a unit per c.c.) as the result of a primary stimulus.

See both rabbits in Table II, rabbit G 20 in Table IV, both rabbits in Table V, and guinea-pig FF 19. v in Table VII. The four guinea-pigs in Table VI probably come under the same heading.

B. In animals whose actively produced antitoxin has fallen below a de tectable level.

See rabbit G 7 in Table III.

(These results add further confirmation to the phenomenon reported in the paper “Active immunity to diphtheria in the absence of detectable antitoxin” (Glenny and Allen, 1922).

6. A Schick dose of toxin which gives a positive reaction may, by acting as a secondary stimulus, produce a rapid increase in the antitoxic value of animals already containing some actively produced antitoxin.

See guinea-pig LL 17. vi in Table VII.

7. A Schick dose of toxin which causes no reaction may, by acting as a secondary stimulus, produce a rapid increase in the antitoxic value of animals already containing some actively produced antitoxin.

See guinea-pigs in Table VII.

8. A Schick dose of toxin may fail as a secondary stimulus if the antitoxic content at the time of injection is comparatively high.

See rabbit G 21 in Table IV.

1. 656 samples of sera taken at random from natives in Southern Rhodesia were examined for the presence of typhoid Vi agglutinins.

2. Forty-nine or 7·47% were shown to contain Vi agglutinins in titres of 1 in 5 to 1 in 12·5.

3. Samples of faeces and urine from twenty-six of the positive Vi reactors were cultured for Bact. typhosum, which was isolated from only one individual who was shown to be a chronic urinary carrier.

4. The significance of these findings is discussed.

One of the fundamental features of Ehrlich's method of standardising diphtheria antitoxic serum is the recognition of the so-called Lo and L+ limits, the L+ dose being the quantity of a toxin which when mixed with one unit of antitoxin and injected subcutaneously into a guinea-pig leaves sufficient excess of toxin free to cause the death of the animal about the fifth day after injection, the Lo dose being the largest quantity which when similarly mixed with one unit of antitoxin fails to produce a local reaction. In the region between the two doses, the so-called “ Differential-Region ” of Ehrlich, one can obtain a series of mixtures which, while they kill the guinea-pig later than the fifth day or not at all, cause local reactions of varying severity increasing as the L+ limit is reached.

The prevalence of blood-borne viruses in injecting drug users (IDUs) in Tayside, Scotland was determined by testing serum samples from IDUs who underwent attributable HIV antibody testing during 1993–7. The prevalence of antibodies to HIV was 29/802, (3·6%); to hepatitis C virus (HCV) 451/691, (65·3%); and to human T-cell leukaemia/lymphoma viruses type 1 and 2 (HTLV) 0/679, (0·0%). The prevalence of HIV and HCV antibodies were higher in subjects over the age of 25 (P=0·03 and P=0·001, respectively). During 1993–7 the prevalence of HCV fell only in younger female IDUs (P<0·01). HIV prevalence has declined dramatically since 1985, when a rate of 40% was recorded in similar populations. Harm reduction measures have failed to control HCV the spread of infection among IDUs in Tayside, as indicated by the high proportion of antibody positive IDUs, particularly males under the age of 25. Future studies should address the nature and effective reduction of continuing risk taking among IDUs in Tayside.

1. Highly milled parboiled rice was found to be rich in the antineuritic vitamin B1, while roughly milled raw rice was deficient. In estimating the content of vitamin B1 the method of Chick and Roscoe was used.

2. Exact comparison was made of the vitamin B1 potency of two samples of rice, the one raw, the other parboiled, after similar degrees of milling. The vitamin value of the unmilled samples was equal, but when each was highly milled to an equal degree, as judged by weight of polishings removed in a hand rice mill, the parboiled sample retained the vitamin while the raw sample did not.

3. Polishings from parboiled rice were found to contain less vitamin B1 than those from raw rice.

4. Parboiled rice contains more P2O5 than raw rice milled to the same degree.

5. It is probable that when rice is steamed in the process of parboiling, the vitamin B1 and some of the phosphate contained in the germ and pericarp diffuse through the endosperm.

6. The P2O5 content of raw rice is a good index of vitamin B1 value, but in parboiled rice a low percentage of phosphate is compatible with the presence of the vitamin.

Thanks are due to Miss L. M. B. Patterson who kindly made the phosphate estimations recorded in the paper. I am indebted to the Director of Agriculture, British Guiana, for a number of rice samples. The rice mill used was kindly lent by Jackson and Son, 30, Mincing Lane, E.C. 3. I am grateful to Miss Chick for her continued interest in these experiments.

To understand the dynamics of transmission of Shiga toxin-producing Escherichia coli O157:H7 (STEC O157) in beef calves, serum samples were obtained from calves in a beef cow-calf herd approximately every 6 weeks from birth until weaning for three consecutive years. The presence of specific anti-O157 antibodies in these serum samples was detected using a blocking ELISA assay incorporating an anti-O157 monoclonal antibody. Using seroconversion data, the basic reproduction ratio (R0) was estimated for each of the three years as well as in aggregate using both deterministic and Martingale methods. R0 for STEC O157 infection in range beef calves by deterministic methods varied from 2·9–5·6, with an average of 4·3 (95% CI 2·8–5·9). Martingale estimates of R0 ranged from 3·5–7·4, or 5·3 (95% CI 3·9–6·6), for data from all three years. Given the above estimate of R0, it is predicted that 65–86% of a herd of calves must be effectively vaccinated, or must be rendered non-susceptible through other means, to eliminate STEC O157 infection from a herd.

Twelve grade school and junior high school students had oral exposures to hepatitis B surface antigen (HBsAg) positive saliva via contact with contaminated musical instruments. The 12 exposed students and 18 students who served as age and sex matched controls were tested for the presence of HBsAg and antibody to the hepatitis surface antigen (anti-HBs) at 2 weeks, 8 weeks and 6 months after exposure. All students were negative for HBsAg and anti-HBs on all dates tested and reported no illness during that time suggestive of viral hepatitis. There was no evidence of viral hepatitis, type B transmission from the exposure. The students probably experienced the maximum possible oral exposure from direct or fomites contact, since there was no cleaning of the musical instruments between use by the students and teacher. Based on these results, the risk of transmission of viral hepatitis, type B from oral contact with fomites is unlikely.

Commercially available kits for detection of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) by enzyme immunoassay (EIA) were evaluated in American Samoa during a public health programme to eliminate the transmission of hepatitis B. The first 19184 serum specimens obtained, representing 68% of the total cooperating population, were initially tested for anti-HBs, and those without detectable antibody were tested for HBsAg. All the antigen-positive serum samples, and a selection of the antigen-and antibody-negative specimens were tested by radioimmunoassay (RIA) for detection of both markers. Compared with the standard tests, the EIA kits for anti-HBs and HBsAg performed well; sensitivity and specificity were 90·3 and 96·0%, respectively, for antibody, and 97·8 and 97·9% respectively for antigen. Substantial disagreement between the EIA and RIA tests for HBsAg was found only for specimens considered weakly reactive by EIA. Few differences were found between three EIA method options for follow-up HBsAg testing of weakly reactive serum specimens; each option contributed about equally to improved test specificity for these ‘borderline’ specimens. Based on their demonstrated equivalence to the standard RIA tests, we conclude that the EIA kits for anti-HBs and HBsAg detection are suitable for use in hepatitis B control programmes in open populations.