A prevalence study was conducted on German sheep flocks including goats if they cohabitated with sheep. In addition, a novel approach was applied to identify an infection at the herd-level before lambing season with preputial swabs, suspecting venereal transmission and ensuing colonisation of preputial mucosa with Coxiella (C.) burnetii. Blood samples and genital swabs were collected from breeding males and females after the mating season and were analysed by enzyme-linked immunosorbent assay (ELISA) and quantitative polymerase chain reaction (qPCR) respectively. In total, 3367 animals were sampled across 71 flocks. The true herd-level prevalence adjusted for misclassification probabilities of the applied diagnostic tests using the Rogan-Gladen estimator for the prevalence estimate and a formula by Lang and Reiczigel (2014) for the confidence limits, ranged between 31.3% and 33% (95% confidence interval [95% CI] 17.3–45.5) detected by the ELISA and/or qPCR. Overall 26–36.6% (95% CI 13–56.8) were detected by ELISA, 13.9% (95% CI 4.5–23.2) by the qPCR and 7.9–11.2% (95% CI 0.08–22.3) by both tests simultaneously. The range of results is due to data obtained from literature with different specifications for test quality for ELISA. Among eight farms with females shedding C. burnetii, three farms (37.5%) could also be identified by preputial swabs from breeding sires. This indicates less reliability of preputial swabs if used as a single diagnostic tool to detect C. burnetii infection at the herd-level.

The objective of this study was to model the age–time-dependent incidence of hepatitis B while estimating the impact of vaccination. While stochastic models/time-series have been used before to model hepatitis B cases in the absence of knowledge on the number of susceptibles, this paper proposed using a method that fits into the generalized additive model framework. Generalized additive models with penalized regression splines are used to exploit the underlying continuity of both age and time in a flexible non-parametric way. Based on a unique case notification dataset, we have shown that the implemented immunization programme in Bulgaria resulted in a significant decrease in incidence for infants in their first year of life with 82% (79–84%). Moreover, we have shown that conditional on an assumed baseline susceptibility percentage, a smooth force-of-infection profile can be obtained from which two local maxima were observed at ages 9 and 24 years.

A method of titrating influenza virus-neutralizing antibodies is described. This method is based on the technique for cultivating virus in fragments of chick chorio-allantoic membrane using a special plastic tray with cups for 100 replicates. The neutralization test cannot be made directly by adding the antiserum to the cups in which the virus is growing in the membrane fragments because there is a significant non-specific inhibitory effect. Therefore, use is made of the observation that virus added to the cups is rapidly fixed by the membrane so that, after a short time, the membrane may be washed and transferred to a fresh cup which will later be found to contain the new virus released from the membrane.

In the neutralization test the membrane fragments are exposed to virus-serum mixtures for 18 hr. and then transferred to other cups without serum to determine which pieces have become infected. The titre of neutralizing antibodies is defined as the serum dilution which will protect from infection with 100 ID 50 of virus, half of a large number of replicate pieces of membrane.

The neutralization technique has been applied to the antigenic comparison of six strains of influenza virus. The results support the relationships disclosed between the six strains by a complement-fixation technique. It is suggested, however, that the neutralization technique, because of its greater specificity, and because of its dependence on the infectivity of the strain, is not as satisfactory as the complement-fixation test for strain comparisons. Apart from its use for titrating neutralizing antibodies, the technique may also be of value for proving the virtual identity of two virus strains and in the selection of strains for a vaccine.

It is a pleasure to acknowledge the help given by Dr Isaacs of the WHO Influenza Centre. Not only did he provide many of the virus strains and antisera, but he also undertook the purification of the WS strain.

Staphylococcus aureus has been recognised as one of the important zoonotic pathogens. However, knowledge about the epidemiology and genetic characteristics of S. aureus in rabbits was limited. The aim of this study was to determine the characteristics of 281 S. aureus isolated from dead rabbits of nine rabbit farms in Fujian Province, China. All the isolates were characterised by multi-locus sequencing typing, detection of virulence factors and antimicrobial susceptibility test. The results showed that the 281 isolates were grouped into two sequence types, ST121 (13.52%, 38/281) and ST398 (86.48%, 243/281). Surprisingly, the ST121 strains were only recovered from the lung samples from one of the nine rabbit farms studied. In the 281 isolates, the virulence genes of nuc, hla, hlb, clfA, clfB and fnbpA were positive, whereas the sea, seb, tsst, eta and etb genes were negative. Notably, the 38 ST121 isolates carried the pvl gene. All the 281 isolates were methicillin-susceptible S. aureus, and the isolates were susceptible to most of the used antibiotics, except for streptomycin, kanamycin, azithromycin and penicillin, and the resistance rates of which were 23.84%, 19.57%, 16.01% and 11.03%, respectively. This study first described the epidemiology and characteristics of S. aureus in rabbits in Fujian Province, which will help in tracking the evolution of epidemic strains and preventing the rabbit–human transmission events.

Diarrhoeal management practices are unsatisfactory in India especially in the slum areas. Dearth of information regarding physicians' diarrhoea-related knowledge and practice in India ncessitated this cross-sectional study of allopathic practitioners in the slums of Kolkata, to assess the distribution and interrelationship between physicians' characteristics, knowledge and practice regarding diarrhoea. A total of 264 randomly selected consenting practitioners were interviewed using a field-tested questionnaire. Nineteen percent had good overall knowledge, 49% and 80% prescribed antibiotics to diarrhoea and cholera patients, respectively, and 55% advised stool examination for every case. Qualified and Government physicians had better knowledge regarding diarrhoea [MBBS: odds ratio (OR) 5·96, P < 0·001; postgraduates: OR 9·33, P < 0·001; Government physicians: OR 11·49, P < 0·0001] and were less likely to prescribe antibiotics for all diarrhoea cases (MBBS: OR 0·30, P = 0·002; postgraduates: OR 0·20, P < 0·001; Government physicians OR 0·24, P < 0·029). Better knowledge was associated with a lower likelihood of prescribing antibiotics for diarrhoea (OR 0·72, P < 0·001), cholera (OR 0·78, P = 0·027) and investigative procedure (OR 0·85, P = 0·028). In the slums of Kolkata, diarrhoea-related knowledge and practice were poor with the exception of qualified physicians, hence an improvement in the knowledge of pharmacists and unqualified practitioners is necessary for the overall improvement of diarrhoeal management in these slums.

In this paper the pathological and the bacteriological findings in ten instances of naturally acquired tuberculosis in ten different species of animals are recorded. The tubercle bacilli obtained in culture from five species (bat, bear, bison, hedgehog and mink), all cases of fatal tuberculosis, were of the bovine type. The bacilli from a case of localised glandular tuberculosis in a goat and one of tuberculosis of the pancreas in a kangaroo were of the avian type. The bacilli from a case of generalised retrogressive tuberculosis in a horse, of minimal thoracic tuberculosis in a calf and cutaneous and glandular tuberculosis in a parrot were of the human type. These results amplify the evidence already published which shows that each of the three types of tubercle bacilli (bovine, human and avian) is able to cause natural tuberculosis in many different species of animals other than that which is its normal habitat.

The bovine bacillus which is transmitted to animals almost exclusively by tuberculous bovines is responsible for the greater part, especially the generalised and fatal forms, of the tuberculous disease occurring naturally in farm and domestic mammals and for a not inconsiderable amount of tuberculosis in human beings.

The avian bacillus whose natural host is the domestic fowl can infect casually many species of mammals, namely the pig, the ox, the sheep, the goat, the horse, the guinea-pig and the rabbit and in Zoological Gardens several marsupial species. Instances of its transmission to the different species of farm mammals are rare, except in the case of the pig, and the disease produced is usually limited and confined to the glands adjacent to the points of entry of the bacilli. This type of bacillus may however cause severe generalised and fatal disease in the pig, sheep, rabbit and marsupials.

The human bacillus has a narrower range of pathogenicity than either the bovine or the avian bacillus. This type can infect the pig, the calf and the horse, but does not produce progressive tuberculosis in these species. It causes cutaneous tuberculosis in parrots and is one cause of tuberculosis in the dog and in various species of animals kept in captivity, namely the guinea-pig, monkey, gnu, antelope, peccary, etc., in which species infection is followed by generalisation and progression of the disease.

The evidence accumulated regarding the susceptibility of various species of animals to the three types of tubercle bacilli under farm and domestic conditions and in captivity may be summed up as follows.

All three types of bacilli can infect the ox, pig, horse, guinea-pig and rabbit.

Two types of bacilli have been found in the following species; viz. bovine and avian in the sheep, the goat and Australian marsupials; bovine and human in the domestic dog and in the ape, monkey and Ungulata in captivity; human and avian in the parrot.

Only one type of bacillus has so far been obtained from domestic fowls (the avian), the domestic cat, hedgehog, mink and ferret (the bovine) and members of several species in captivity.

It has not yet been possible to breed hedgehogs in laboratory cages, but they have been bred and reared successfully in pens in the open, twenty-seven young being produced by five females in seven litters. The methods adopted in breeding and maintaining this stock are described.

A Spanish household was identified through a Public Health follow up on a Shiga toxin-producing Escherichia coli (STEC)-positive 14-month-old girl reporting bloody diarrhoea, with the four household members experiencing either symptomatic or asymptomatic STEC and/or atypical enteropathogenic E. coli (aEPEC) shedding. In total, two different O76:H19 STEC strains and six aEPEC strains belonging to multiple serotypes were isolated and characterized in the household during a 5-month period. Prolonged asymptomatic shedding of O76:H19 STEC and O51:H49 aEPEC was detected in two family members. Although there was no conclusive evidence, consumption of vegetables fertilized with sheep manure was the suspected source of infection. This study highlights the risk of cross-infections posed by prolonged asymptomatic carriage and close household contact between family members, and illustrates the importance of molecular epidemiology in understanding disease clusters.

1. A group of rats has been fed on a poor human dietary supplemented with milk and green food. A further group has been given the same dietary supplemented with Ca and P as salts, equivalent in amount to that present in the milk and green food. The experiment has been continued over three generations.

2. The diet supplemented with Ca and P salts has been found to be as effective as that containing milk and green food in promoting reproduction, calcification and tooth formation; it has induced growth as effectively in the first generation of rats but is unable to maintain this growth rate as effectively over several generations. It is obvious that Ca and P are of the chief deficiencies in the poor diet. The addition of these elements greatly increases the nutritive value of this diet, but they are inferior in this respect to milk and green food supplements.

3. Under conditions of Ca and P lack, tooth formation is much less adversely affected than is skeletal ossification.

In August 2013, a nationwide vaccination campaign with bivalent oral polio vaccine (bOPV) was initiated after isolation of wild-type poliovirus type 1 (WPV-1) in routine sewage surveillance in Israel. The campaign started in the Southern district and later extended to the entire country. This study examined the association between socioeconomic status (SES), and compliance with bOPV vaccine during the campaign. Nationwide data relating to SES by geographical cluster were correlated with vaccine coverage rates in the same areas. All analyses were conducted separately for Jews and Arabs. Coverage with the bOPV vaccination campaign in the Arab population (92·4%) was higher than in the Jewish population (59·2%). This difference was consistently present in all SES clusters. In the Jewish population there was an inverse correlation between SES and vaccination coverage rates (R = −0·93, P < 0·001). Lower vaccination coverage with supplemental vaccine activities in higher SES groups is a challenge that needs to be addressed in future public health events and emergencies in order to achieve satisfactory protection rates for the public.

Investigating whether high-risk human papillomavirus (HR-HPV) types tend to become grouped in a particular way and whether factors are associated with such grouping is important for measuring the real impact of vaccination. In total, 219 women proving positive for HPV as detected by real-time PCR were included in the study. Each sample was analysed for detecting and quantifying six viral types and the hydroxymethylbilane synthase gene. Multiple correspondence analysis led to determining grouping patterns for six HR-HPV types and simultaneous association with multiple variables and whether viral load was related to the coexistence of other viral types. Two grouping profiles were identified: the first included HPV-16 and HPV-45 and the second profile was represented by HPV-31, HPV-33 and HPV-58. Variables such as origin, contraceptive method, births and pregnancies, educational level, healthcare affiliation regime, atypical squamous cells of undetermined significance and viral load were associated with these grouping profiles. Different socio-demographic characteristics were found when coinfection occurred by phylogenetically related HPV types and when coinfection was due to non-related types. Biological characteristics, the number of viral copies, temporality regarding acquiring infection and competition between viral types could influence the configuration of grouping patterns. Characteristics related to women and HPV, influence such interactions between coexisting HPV types reflecting the importance of their evaluation.

The aim of this study was to determine the potential association between housing type and multiple drug resistance (MDR) in Escherichia coli and Enterococcus faecalis isolates recovered from 283 laying-hen flocks. In each flock, a cloacal swab from four hens was collected and produced 1102 E. coli and 792 E. faecalis isolates. Broth microdilution was used to test susceptibility to antimicrobials. Country and housing type interacted differently with the MDR levels of both species. In the E. coli model, housing in a raised-floor system was associated with an increased risk of MDR compared to the conventional battery system [odds ratio (OR) 2·12, 95% confidence interval (CI) 1·13–3·97)]. In the E. faecalis model the MDR levels were lower in free-range systems than in conventional battery cages (OR 0·51, 95% CI 0·27–0·94). In Belgium, ceftiofur-resistant E. coli isolates were more numerous than in the other countries.

In recent years, the control or eradication of scrapie and any other transmissible spongiform encephalopathies (TSEs) possibly circulating in the sheep population has become a priority in Britain and elsewhere in Europe. A better understanding of the epidemiology of scrapie would greatly aid the development and evaluation of control and eradication strategies. Here we bound the range of key epidemiological parameters using a combination of relatively detailed pathogenesis and demography data, more limited data on susceptibility and incubation times, and recent survey data on scrapie incidence in Great Britain. These data are simultaneously analysed using mathematical models describing scrapie transmission between sheep and between flocks. Our analysis suggests that occurrence of scrapie in a flock typically provokes changes in flock management that promote termination of the outbreak, such as the adoption of selective breeding, and that a large fraction of cases (possibly over 80%) goes undetected. We show that the data analysed are consistent with the within-flock reproduction number of scrapie lying in the range 1·5–6, consistent with previous epidemiological studies.

The effect of penicillin alone, and with sulphonamide upon various Gram-negative bacteria, has been investigated.

S. typhi, S. paratyphi B and strains of Proteus vulgaris were inhibited by penicillin in concentrations of 8–20 units/c.c. Certain coliforms were inhibited by 30–128 units.

Organisms which were inhibited to some extent by penicillin and sulphonamide acting separately were inhibited under experimental conditions at lower concentrations when both agents acted together. The mechanism of this reaction has been discussed.

A proportion of the insensitive coliform strains were identified as penicillinase producers.

d-Tartrate dehydrase of Salmonella java is an oxygen-sensitive enzyme active in cultures incubated under the poorly aerated conditions of static culture but not in fully aerated shaken cultures nor on plates incubated aerobically. On plates of d-tartrate minimal agar incubated anaerobically the enzyme or the degradation products of d-tartrate are exported from d-tartrate-positive cells and are available to d-tartrate-negative bacteria. This may give misleading growth results when d-tartrate-positive and d-tartrate-negative strains are tested for growth on the same plate of d-tartrate minimal agar.

The lead-acetate test terminated at 24 h, the 24 h turbidity test and the ability to grow on d-tartrate minimal agar within 48 h differentiated 53 S. paratyphi B strains that were negative in each of the three tests from 76 S. java that were positive in each of the tests. An intermediate group of eight strains utilized d-tartrate in Difco bacto-peptone water to give a positive lead acetate reaction at 2 days, were stimulated to a varying degree by d-tartrate in Oxoid peptone water within the same period of incubation and grew poorly on d-tartrate minimal agar. These latter strains may be deficient in a permease controlling uptake of d-tartrate or export of d-tartrato dehydrase.

Inability to utilize d-tartrate is unlikely to be the single character accountable for the reputed enhanced pathogenicity of S. paraptyphi B when compared with S. java. Indications for the existence of an enzyme, complementary to and mutually exclusive with d-tartrate dehydrase, that has a positive correlation with pathogenicity are discussed.

In recent years the number of pregnant women susceptible to rubella has increased markedly. In the West Midlands the proportion has risen from 1·4% in 2004 to 6·9% in 2011. Locally, the proportion of non-immune women ranges from 1·6% in those born prior to 1976 to 17·8% in those born since 1986. The latter group comprises those given MMR in their second year with no further booster doses. The number of non-immune women will continue to rise as a consequence of low MMR uptake in the late 1990s. Repeat testing of samples with values <10 IU/ml and the need to vaccinate women postnatally have increased the workload of laboratory and maternity units. Screening for rubella in pregnancy has no advantages for the current pregnancy and it may be time to review the universal MMR vaccination programme which in turn would remove the need for continuing this practice.

A total of 592 people reported gastrointestinal illness following attendance at Street Spice, a food festival held in Newcastle-upon-Tyne, North East England in February/March 2013. Epidemiological, microbiological and environmental investigations were undertaken to identify the source and prevent further cases. Several epidemiological analyses were conducted; a cohort study; a follow-up survey of cases and capture re-capture to estimate the true burden of cases. Indistinguishable isolates of Salmonella Agona phage type 40 were identified in cases and on fresh curry leaves used in one of the accompaniments served at the event. Molecular testing indicated entero-aggregative Escherichia coli and Shigella also contributed to the burden of illness. Analytical studies found strong associations between illness and eating food from a particular stall and with food items including coconut chutney which contained fresh curry leaves. Further investigation of the food supply chain and food preparation techniques identified a lack of clear instruction on the use of fresh uncooked curry leaves in finished dishes and uncertainty about their status as a ready-to-eat product. We describe the investigation of one of the largest outbreaks of food poisoning in England, involving several gastrointestinal pathogens including a strain of Salmonella Agona not previously seen in the UK.

An outbreak of typhoid caused by Salmonella typhi of the same Vi-phage type (D1) and of the same antibiogram was reported in a large psychiatric institution in Singapore. A total of 95 (4·8%) of the 1965 inmates were infected, 47 with symptoms and 48 asymptomatic. Transmission was through close person-to-person contact and not through contaminated food or water. The source of infection could not be established. The outbreak was brought under control by maintaining a high standard of environmental sanitation, active search for fever and diarrhoeal cases, identification of asymptomatic cases by rectal swabbing, and isolation of those found to be infected. Mass immunization with two doses of heat-phenol inactivated typhoid vaccine was also carried out concurrently. The vaccine was found to have an efficacy of 65·8% in preventing clinical illness.

Despite the availability of inexpensive antimicrobial treatment, syphilis remains prevalent worldwide, affecting millions of individuals. Furthermore, syphilis infection is suspected of increasing both susceptibility to, and tendency to transmit, HIV. Development of a syphilis vaccine would be a potentially promising step towards control, but the value of dedicating resources to vaccine development should be evaluated in the context of the anticipated benefits. Here, we use a detailed mathematical model to explore the potential impact of rolling out a hypothetical syphilis vaccine on morbidity from both syphilis and HIV and compare it to the impact of expanded ‘screen and treat’ programmes using existing treatments. Our results suggest that an efficacious vaccine has the potential to sharply reduce syphilis prevalence under a wide range of scenarios, while expanded treatment interventions are likely to be substantially less effective. Our modelled interventions in our simulated study populations are expected to have little effect on HIV, and in some scenarios lead to small increases in HIV incidence, suggesting that interventions against syphilis should be accompanied with interventions against other sexually transmitted infections to prevent the possibility that lower morbidity or lower perceived risk from syphilis could lead to increases in other sexually transmitted diseases.

The epidemiology of infectious diseases depends on many characteristics of disease progression, as well as the consistency of these processes across hosts. Longitudinal studies of infection can thus inform disease monitoring and management, but can be challenging in wildlife, particularly for long-lived hosts and persistent infections. Numerous tortoise species of conservation concern can be infected by pathogenic mycoplasmas that cause a chronic upper respiratory tract disease (URTD). Yet, a lack of detailed data describing tortoise responses to mycoplasma infections obscures our understanding of URTDs role in host ecology. We therefore monitored Mycoplasma agassizii infections in 14 captive desert tortoises and characterised clinical signs of disease, infection intensity, pathogen shedding and antibody production for nearly 4 years after initial exposure to donor hosts. Persistent infections established in all exposed tortoises within 10 weeks, but hosts appeared to vary in resistance, which affected the patterns of pathogen shedding and apparent disease. Delays in host immune response and changes to clinical signs and infection intensity over time resulted in inconsistencies between diagnostic tools and changes in diagnostic accuracy throughout the study. We discuss the implications these results have for URTD epidemiology and past and future research assessing disease prevalence and dynamics in tortoise populations.