We analysed the reactivity of enterovirus-specific human IgM and IgG antibodies with the structural proteins of different enteroviruses by the immunoblot technique. In general, all immunoglobulin G antibodies of the tested sera reacted with capsid polypeptide VP 1 of the viruses tested (echoviruses 9 and 11, coxsackievirus B3 and poliovirus 2). In contrast, enterovirus specific immunoglobulin M antibodies of adults reacted with capsid polypeptides VP 1, VP 2, and/or VP 3 of the viruses mentioned above. The reactions with VP 2 and/or VP 3 were often stronger than with VP 1. IgM antibodies from sera of newborns infected by echovirus 11 reacted with VP 1 and VP 2/3 of echovirus 11 and also with VP 2 and VP 3 of poliovirus 2. Preabsorption experiments indicate that cross-reactive IgG antibodies react with epitopes of VP 1 not present on the surface of intact virus particles. The results from the immunoblot technique were compared to data from microneutralization tests and M-antibody capture radioimmunoassays.

This cross-sectional prevalence study investigates meningococcal carriage for the first time in a Southeast Asian population. Posterior pharyngeal swabs were collected between August 2013 and March 2014 from 937 healthy Filipinos aged 5–24 years attending school or university in Manila. Of these, 35 were found to be carriers giving an overall carriage prevalence of 3·7% [95% confidence interval (CI) 2·6–5·2]. Carriage was associated with age (P < 0·001) and was highest (9·0%, 95% CI 5·5–13·8) in subjects aged 10–14 years, but was comparatively low (<3%) in all other age groups considered. This suggests that an immunization programme in the Philippines designed to reduce carriage acquisition and induce herd immunity may require a vaccine dose before the age of 10 years. Serogroup B was most commonly carried (65·7%, 95% CI 47·8–80·9), with a small number of carriers for serogroups C, Y and W also present. Two individuals (5·7%, 95% CI 0·7–19·2) who were simultaneously carrying multiple serogroups were identified. This exploratory study provides valuable insight into the asymptomatic carriage of Neisseria meningitidis in a healthy subset of the Filipino population and illustrates the importance of generating local carriage data.

Campylobacter species such as C. jejuni and C. coli are recognized as major causes of acute gastroenteritis world-wide. Although C. jejuni and C. coli are usually non-pathogenic in birds and animals, they cause enteric disease in humans and the source of infection is often the consumption of contaminated foodstuffs. In this paper we report on the development and use of a multiplex PCR of C. jejuni genomic DNA which yielded a PCR product with a unique polymorphic site that can be used to quickly and accurately identify and group C. jejuni isolates from any source including DNA, cell culture, skin washings and faecal samples. The test is simple and sensitive and can detect purified DNA from a single bacterium 102 cells from crude lysates, 103 cells in seeded faeces and 120 cells/ml of washing of 1 cm2 skin fragments of chicken skin.

The disease known as equine piroplasmosis is one possessing great importance to the farming community of certain portions of Cape Colony, especially to importers, for the reason that recently imported horses sometimes develop a very acute and often fatal form of this malady. A similar disease attacks mules. The recently reported outbreak of piroplasmosis amongst donkeys in the Transvaal, if not identical, is probably very closely allied to the malady affecting horses and mules. A great mortality amongst donkeys at Lydenburg was due to piroplasmosis. Equine piroplasmosis requires further investigation, it being unknown how the disease is disseminated, although most authorities consider that the parasite is transmitted by the agency of a tick.

Mice, rats, guinea-pigs and rabbits were inoculated with isolates of Streptococcus suis type 2. An isolate cultured from the tonsils of a healthy pig, produced disease in rabbits after intravenous inoculation but not in mice, rats or guinea-pigs. An isolate of S. suis type 2, that was pathogenic for pigs and had been cultured from a human patient with clinical disease, produced signs of neurological disease in mice, rats and rabbits following intravenous inoculation. There was an apparent dose response in mice with 31 % of mice receiving more than 106 organisms developing clinical disease, whilst mice receiving less than this did not develop disease. There were no detectable histopathological lesions in the brains or meninges of mice with nervous signs. It is proposed that the disease in mice may mimic that reported in humans and that mice may be a useful indicator species for determining the virulence of isolates cultured from pigs.

Serum samples were obtained from 281 heifers vaccinated with Brucella abortus strain 19, and from 50 heifers that had received two injections of killed B. abortus strain 45/20 adjuvant (K45/20A) vaccine. The serological response measured by the brucellosis radioimmunoassay (RIA) was compared with responses measured by other tests.

The serological responses of cattle during the first weeks after strain 19 vaccination were found to give little guide to the frequency of persistent reactions.

In the case of strain 19, persistent reactions were considered to be those occurring 12 or more months after vaccination. In heifers vaccinated at the recommended age, small numbers of persistent reactions were given by the RIA (four in 374 sera), the complement fixation test using warm fixation (CFTW) (six in 383) and cold fixation (one in 185), the serum agglutination test (two in 222) and the indirect haemolysis test (IHLT) (two in 369). The Rose Bengal plate test gave 74 persistent reactions in 374 sera.

Five of the 50 heifers gave particularly prolonged responses to K45/20A vaccine. In these animals the RIA and IHLT remained positive for longer than the CFTW.

The identification of specific environments sustaining emerging arbovirus amplification and transmission to humans is a key component of public health intervention planning. This study aimed at identifying environmental factors associated with West Nile virus (WNV) infections in southern Quebec, Canada, by modelling and jointly interpreting aggregated clinical data in humans and serological data in pet dogs. Environmental risk factors were estimated in humans by negative binomial regression based on a dataset of 191 human WNV clinical cases reported in the study area between 2011 and 2014. Risk factors for infection in dogs were evaluated by logistic and negative binomial models based on a dataset including WNV serological results from 1442 dogs sampled from the same geographical area in 2013. Forested lands were identified as low-risk environments in humans. Agricultural lands represented higher risk environments for dogs. Environments identified as impacting risk in the current study were somewhat different from those identified in other studies conducted in north-eastern USA, which reported higher risk in suburban environments. In the context of the current study, combining human and animal data allowed a more comprehensive and possibly a more accurate view of environmental WNV risk factors to be obtained than by studying aggregated human data alone.

We aimed to assess the performance of active surveillance for hospitalized childhood encephalitis in New South Wales (NSW) using the Paediatric Active Enhanced Disease Surveillance (PAEDS) network to inform methodology for the nationwide Australian childhood encephalitis (ACE) study. We piloted active surveillance for suspected encephalitis from May to December 2013 at the Children's Hospital at Westmead, Sydney, NSW. Cases were ascertained using four screening methods: weekday nurse screening of admission records (PAEDS), cerebrospinal fluid (CSF) microscopy records, magnetic resonance imaging (MRI) reports, and pharmacy dispensing records. Comprehensive clinical data were prospectively collected on consented participants and subsequently reviewed by an expert panel. Cases were categorized as confirmed encephalitis or ‘not encephalitis’; encephalitis cases were sub-categorized as infectious, immune-mediated or unknown. We performed an ICD-10 diagnostic code audit of hospitalizations for the pilot period. We compared case ascertainment in the four screening methods and with the ICD code audit. Forty-eight cases of suspected encephalitis were identified by one or more methods. PAEDS was the most efficient mechanism (yield 34%), followed by MRI, CSF, and pharmacy audits (yield 14%, 12%, and 7% respectively). Twenty-five cases met the criteria for confirmed encephalitis. PAEDS was the most sensitive of the mechanisms for confirmed encephalitis (92%) with a positive predictive value (PPV) of 72%. The ICD audit was moderately sensitive (64%) but poorly specific (Sp 9%, PPV 14%). Of the 25 confirmed encephalitis cases, 19 (76%) were sub-categorized as infectious, three (12%) were immune-mediated, and three (12%) were ‘unknown’. We identified encephalitis cases associated with two infectious disease outbreaks (enterovirus 71, parechovirus 3). PAEDS is an efficient, sensitive and accurate surveillance mechanism for detecting cases of childhood encephalitis including those associated with emerging infectious diseases. Active surveillance significantly increases the ascertainment of encephalitis cases compared with passive approaches.

A catalogue of dates and places of major outbreaks of epidemic diseases, that occurred in the Chinese Empire between 243 b.c.e. and 1911 c.e., combined with corresponding demographic data, provides a unique opportunity to explore how the pressure of epidemics grew in an agrarian society over 2000 years. This quantitative analysis reveals that: (1) the frequency of outbreaks increased slowly before the 12th century and rapidly thereafter, until 1872; (2) in the first millennium of our era, the people of China lived for decades free of major epidemics; in the second millennium, major outbreaks occurred every couple of years, but were localized; (3) in the more recent centuries, these outbreaks were as common, but disseminated to more places. This evolution, closely matching the demographic growth, was similar in the north and south of China, and therefore may have been similar in other regions of the world.

Livestock herbivores are at risk of inter- and intra-specific exposure to parasites/pathogens via the faecal–oral route during grazing. Each contact between livestock and faeces in the environment is a potential parasite/pathogen transmission event. Cattle grazing contact with faeces varies in relation to the species depositing the faeces and the distribution of the faeces. We used a foraging model to simulate the grazing behaviour of beef cattle in two grazing systems to compare the relative inter-specific and intra-specific exposure risks to parasites/pathogens. Overall, there is a greater level of intra- vs. inter-specific risk via the faecal–oral route. However, under certain conditions, particularly for microparasite infections, e.g. paratuberculosis in rabbits and bovine tuberculosis in badgers, wildlife may pose a significant exposure risk to parasites/pathogens. These risks can be enhanced when cattle are first turned out onto pasture and in situations where intra-specific variations in wildlife behaviour result in more dispersed defecation patterns.

Among pathogens shed by cattle, Escherichia coli O157 ranks highest in those causing human illness. To date, prevalence and risk factors for O157 shedding have been assessed in feedlot, but not dairy cattle. The study aimed to determine prevalence levels and risk factors for O157 atypical enteropathogenic E. coli (aEPEC) and enterohaemorrhagic E. coli (EHEC) shedding in dairy cattle. Dairy cattle (n = 899) within the first 21 days of lactation were sampled monthly over the course of 1 year, on three dry lot dairies surrounding Fort Collins, CO. During visits multiple factors were measured (disease history, pharmaceutical use, climate measures, etc.), and cattle faeces were collected and assessed for presence of O157 and virulence genes. Logistic regression analysis was performed using O157 outcomes and measured factors. Prevalence of O157 aEPEC was 3·7%, while EHEC was 3·0%. Many potential risk factors were highly correlated, and used to build separate multivariable models. An increase in humidity was positively associated with aEPEC, while fluid faeces and history of disease showed a negative association. Meanwhile, an increase in temperature and antibiotic treatment was positively associated with EHEC, while more days in milk, higher hygiene score and cow contact were negatively associated. These results may guide mitigation strategies that reduce O157 shedding, and contamination of the human food chain.

From 1985 to 1988, a total of 2496 swine sera from 60 farms in the Tohoku District of the Honshu Island of Japan were examined for antibodies to swine haemagglutinating encephalomyelitis virus (HEV), human coronavirus (HCV) and bovine coronavirus (BCV) by haemagglutination-inhibition (HI) test. Antibodies to HEV 67N strain and HCV OC43 strain were highly prevalent with positivity rates of 82·1 and 91·4%, respectively, while seropositivity rate to BCV Kakegawa strain was 44·2%. No clinical signs of HEV infection were noticed in any farms including farms with relatively high seropositivity. The results suggested that HCV or antigenitically related virus(es) as well as HEV might be perpetuated in swine in the Tohoku District.

The subject of the following remarks is the mode of spread of bubonic plague in epidemic form as deduced from observations made during the outbreak at Sydney. The nature of the disease, and the whole of the circumstances which accompanied its appearance, having been described at length in my official report, only those points which have a direct bearing on the subject just defined are here mentioned; but a brief preliminary statement of certain local conditions is necessary.

In the routine laboratory examination of specimens of faeces and urine, from time to time certain Gram-negative bacilli belonging to many different groups are encountered, which morphologically show no appreciable differences from the Gram-negative bacilli of the coli-typhoid group, but which however ferment the usual carbohydrate media employed in differentiation with the formation of acid only. Some ferment lactose quickly, others more slowly, and many not at all, but as with the other media no gas is formed. These organisms might be considered as belonging to the so-called B. coli anaerogenes group— a somewhat loose term which might include many different strains, some perhaps related to the colon group, others belonging to and related to the group of dysentery bacilli, and others showing no relationship to either.

The air of a subdivided surgical ward was sampled by the exposure of culture plates for 12 hr. periods 5 days a week.

A number of ‘broadcasts’ of airborne Staphylococcus aureus were observed; many of these were of very short duration. A single person could be recognized as responsible for 22 of the 33 broadcasts; in all cases dispersal seemed to be from carrier sites rather than from infected lesions.

There was little spread of the staphylococci between the 4 rooms of the ward. The frequency of nasal carriage of tetracycline-resistant S. aureus increased from 6·2% in patients examined during their 1st week to 13·2% in those examined in their 4th week in the ward; the rate for all S. aureus declined from 31·3 to 26·4%.

It is suggested that the long-period exposure of culture plates for the collection of airborne staphylococci may be useful in monitoring some aspects of hospital hygiene.

The efficacy of iodophor germicides containing different concentrations of available iodine against transient (inoculated) bacteria and the natural hand microflora was compared with chlorhexidine gluconate (2 and 4%) liquid detergent (Hibitane), non-germicidal soap and a tap water rinse. The tap water rinse was ineffective compared with all other treatments. Only 4% chlorhexidine gluconate liquid detergent and iodophor containing 0·75% available iodine were significantly better than the non-germicidal soap for reduction of transient bacteria, Escherichia coli and Pseudomonas fluorescens, that had been inoculated onto hands. These agents also caused a significant reduction in the number of ‘natural’ micro-organisms released from hands after a standard 15 s hand wash. The low-concentration iodophor products and the product containing 2% chlorhexidine gluconate failed to give results significantly better than the non-germicidal control soap. Baird-Parker medium and standard aerobic plate counts were highly correlated (r = 0·82), so that for studies of Gram-negative bacteria inoculated onto hands as a transient microflora, counts on Baird-Parker medium give a reasonable indication of the natural (residual) hand microflora.

This is a surveillance study of the antimicrobial resistance of the S. flexneri group in the context of its serotype diversity. It includes 1422 isolates, which were sent to the National Shigella Reference Centre (NSRC) by hospitals and outpatient clinics in Israel during a 3-year period (2000–2002). The strains were identified and classified according to the prevalence and antigenic structure of their serotypes. All samples were checked for resistance to ampicillin (AMP), trimethoprim–sulphamethoxazole (TMP–SMX), ceftriaxone (CRO), tetracycline (TE), nalidixic acid (NAL), and chloramphenicol (C) by the disk diffusion method of Bauer et al. There were significant differences in their resistance to the individual antimicrobials with resistance to AMP, TE and C being lower among the strains of serotype 6 than among those of serotypes 2a and 1b. The resistant phenotypes were also serotype-specific. The similarities both in individual and in phenotype resistance between the rare and the prevalent serotypes (but not serotype 6) may be attributed to their antigenic relatedness. The serospecificity of the antimicrobial resistance was not affected by external factors such as seasonality and source (hospital or outpatient laboratory) of the isolates, and the age and sex of the patients. The serotype-specific approach can assist in properly assessing the problem of the antimicrobial resistance of the Shigella flexneri group and may prove useful for the empirical therapy of shigellosis. The observed interdependency between resistance and the antigenic specificity and relatedness of the S. flexneri serotypes requires additional investigation.

An indoor system designed for the study of survival of airborne micro-organisms in closed conditions has been successfully modified to allow the effect of open air to be measured. It was found that the unidentified open-air factors which are toxic for many species of microbes and rapidly lost when enclosed in conventional laboratory apparatus could be retained in the system by continuous ventilation at an adequate rate. The rate required allowed examination of Escherichia coli in aerosols generated from small amounts of material because of the short periods of ventilation required for appreciable viable decay to occur.

The validity of the system was tested by comparing the survival of E. coli in true aerosols with its survival when the droplets were held on microthread. An investigation of the role of relative humidity in open-air toxicity was included.

After instituting laboratory screening for Escherichia coli O157. H7, a Connecticut hospital isolated the organism from four persons in September 1993. As a result, an outbreak of E. coli O157.H7 associated with a country club was detected. The club had served hamburger from the same shipment at two picnics. Attendees of two picnics were interviewed, stool cultures were obtained from symptomatic persons, and the remaining hamburger was cultured. Twenty (22%) of 89 persons who ate hamburger became ill, compared with 1 of 60 who did not eat hamburger (relative risk = 13·5, 95% confidence interval 3·2–56·3). Among persons who ate hamburgers, illness was strongly associated with eating hamburger that was not thoroughly cooked (P < 0·001). All 20 samples from 5 remaining boxes of patties yielded E. coli O157.H7. Isolates from hamburger and case-patients were indistinguishable by pulsed-field gel electrophoresis. Heightened surveillance can rapidly identify outbreaks and may mitigate their impact. However, continued review of food safety issues is necessary if E. coli O157.H7 outbreaks are to be prevented.

To evaluate measles incidence and its relevant changes over a 14-year period (2000–2014), we analysed data from the regional hospital discharge database on children and adults hospitalized in Tuscany, Italy. A total of 181 paediatric and 413 adult cases were identified. Despite all the efforts towards regional measles elimination, we observed that the overall measles hospitalization rates for children and adults living in Tuscany globally increased from 0·45 to 0·85/100 000 during the study period (P = 0·001) showing fluctuations due to periodic measles outbreaks. Data stratified by age group showed that the hospitalization rate significantly increased in young adults over the study period, confirming an increase in susceptibility to measles in this subpopulation. Conversely, no statistically significant difference was observed in the hospitalization rate in the other age groups. However, children aged <1 year still exhibit the highest hospitalization rate. Pneumonia represented the most common complication in both the adult and children subsets. No death was reported. Measles still represents a public health problem, and national strategies should be implemented, focusing on emergent susceptible subsets, such as infants and young adults.