The effects of radiation from the surroundings on the impressions of freshness of 106 men and 39 women members of the staff of the Building Research Station were investigated during the first 6 months of 1948. Subjects were exposed to three types of environment: (1) where the walls were cooler than the air, (2) where the walls and air were at the same temperature, and (3) where the walls were warmer than the air. The tests were carried out in calm air.

It was found that the difference between the mean radiant temperature and the air temperature affected freshness impressions, but the effect was relatively slight. Environments which felt cool tended to feel fresh, yet a rise in the mean radiant temperature—which would increase the warmth of the environment—tended to produce an impression of greater freshness. At a given equivalent temperature, environments with the surroundings warmer than the air were found to be definitely fresher than cold- and neutral-wall environments. This was thought to be mainly due to the fact that the humidity of the air in the warm-wall environment was lower than that in the other two environments. Changes in humidity insufficient to affect sensations of warmth affect impressions of freshness. Under the conditions of these experiments, and to keep freshness impressions constant, a rise of 1° F. in the temperature of calm air must be compensated by a fall of about 5% in the relative humidity.

The subjects had a distinct preference for the warm-wall environment; 73% of them found it pleasanter than either the cold- or the neutral-wall environment.

Freshness impressions are considered to be related to transient fluctuations in the rate of heat loss from the head.

Respondent-driven sampling (RDS) is widely used to estimate HIV prevalence in men who have sex with men (MSM). Mathematical models that are calibrated to these data may be compromised if they fail to account for selection biases in RDS surveys. To quantify the potential extent of this bias, an agent-based model of HIV in South Africa was calibrated to HIV prevalence and sexual behaviour data from South African studies of MSM, first reweighting the modelled MSM population to match the younger age profile of the RDS surveys (age-adjusted analysis) and then without reweighting (unadjusted analysis). The model estimated a median HIV prevalence in South African MSM in 2015 of 34.6% (inter-quartile range (IQR): 31.4–37.2%) in the age-adjusted analysis, compared with 26.1% (IQR: 24.1–28.4%) in the unadjusted analysis. The median lifetime risk of acquiring HIV in exclusively homosexual men was 88% (IQR: 82–92%) in the age-adjusted analysis, compared with 76% (IQR: 64–85%) in the unadjusted analysis. These results suggest that RDS studies may under-estimate the exceptionally high HIV prevalence rates in South African MSM because of over-sampling of younger MSM. Mathematical models that are calibrated to these data need to control for likely over-sampling of younger MSM.

In skim milk obtained from susceptible cows after intramammary and intravenous inoculation (primary infected milk), foot-and-mouth disease (FMD) virus type 01 was slower inactivated by heat treatment than virus that had been added to pre-exposure skim milk.

Residual virus infectivity in heated primary infected milk was more efficiently detected in bovine thyroid cell cultures than in secondary pig kidney (PK2) cell cultures.

Untreated primary infected milk was found to inhibit both FMD-virus and vesicular stomatitis virus plaque formation in PK2 cells, suggesting the presence of interferon. The results of further tests confirmed that the interfering activity in unheated primary infected milk was indeed caused by an interferon.

Interferon excretion in primary infected milk was investigated using a series of milk samples from three cows. Maximum interferon titres were found after 24 h, coinciding with or shortly after the first virus excretion peak. The results are discussed with particular reference to the use of primary infected milk in studies of the thermal inactivation of FMD-virus.

Between April and September 2000, 60 injecting drug users in Scotland died or were hospitalized with severe illness. Laboratory investigations suggested that Clostridium novyi and other bacteria were important aetiological agents. To determine associated environmental/behavioural factors a case-control study was undertaken with 19 ‘definite’ and 32 ‘probable’ cases in Glasgow, Scotland. For every deceased case (n=19), up to three proxy individuals were interviewed. Three controls were identified for each case. Multivariate logistic regression analyses compared (i) all cases and controls; (ii) definite cases and matched controls; (iii) probable cases and matched controls. In all three analyses injecting into muscle or skin and injecting most of the time with a filter used by someone else were the variables most strongly associated with illness. Comparing only muscle-injecting cases and controls, cases were significantly more likely to have injected larger amounts of heroin per average injection than were controls. The findings make an important epidemiological contribution to the understanding of the public health and clinical implications of the contamination of illicit drugs by histotoxic clostridia.

This study set out to identify and analyse trends and seasonal variations of monthly global reported cases of the Middle East respiratory syndrome coronavirus (MERS-CoV). It also made a prediction based on the reported and extrapolated into the future by forecasting the trend. Finally, the study assessed contributions of various risk factors in the reported cases. The motivation for this study is that MERS-CoV remains among the list of blueprint priority and potential pandemic diseases globally. Yet, there is a paucity of empirical literature examining trends and seasonality as the available evidence is generally descriptive and anecdotal. The study is a time series analysis using monthly global reported cases of MERS-CoV by the World Health Organisation between January 2015 and January 2018. We decomposed the series into seasonal, irregular and trend components and identified patterns, smoothened series, generated predictions and employed forecasting techniques based on linear regression. We assessed contributions of various risk factors in MERS-CoV cases over time. Successive months of the MERS-CoV cases suggest a significant decreasing trend (P = 0.026 for monthly series and P = 0.047 for Quarterly series). The MERS-CoV cases are forecast to wane by end 2018. Seasonality component of the cases oscillated below or above the baseline (the centred moving average), but no association with the series over time was noted. The results revealed contributions of risk factors such as camel contact, male, old age and being from Saudi Arabia and Middle East regions to the overall reported cases of MERS-CoV. The trend component and several risk factors for global MERS-CoV cases, including camel contact, male, age and geography/region significantly affected the series. Our statistical models appear to suggest significant predictive capacity and the findings may well inform healthcare practitioners and policymakers about the underlying dynamics that produced the globally reported MERS-CoV cases.

Rapidly growing mycobacteria (RGM) are environmental organisms that have emerged as significant human pathogens. RGM infections show remarkable geographic variations. In this study, based on data from Houston, Texas, RGM were isolated from clinical cultures year-round, although peaks in the summer and autumn correlating with the seasonal variation of temperature and rainfall also were noted. These results may offer some explanation for the summer occurrence of RGM outbreaks at diverse locations.

There are limited data examining whether outcomes of methicillin-resistant Staphylococcus aureus (MRSA) healthcare-associated infections (HAIs) are worse when caused by community-associated (CA) strains compared to HA strains. We reviewed all patients’ charts at our institution from 1999 to 2009 that had MRSA first isolated only after 72 h of hospitalization (n = 724). Of these, 384 patients had a MRSA-HAI according to CDC criteria. Treatment failure was similar in those infected with a phenotypically CA-MRSA strain compared to a phenotypically HA-MRSA strain (23% vs. 15%, P = 0·10) as was 30-day mortality (16% vs. 19%, P = 0·57). Independent risk factors associated with (P < 0·05) treatment failure were higher Charlson Comorbidity Index, higher APACHE II score, and no anti-MRSA treatment. These factors were also associated with 30-day mortality, as were female gender, older age, MRSA bloodstream infection, MRSA pneumonia, and HIV. Our findings suggest that clinical and host factors, not MRSA strain type, predict treatment failure and death in hospitalized patients with MRSA-HAIs.

Over a period of 9 years in general practice temporary enlargement of the spleen was found in 29 episodes of pharyngitis or tonsillitis, in 2 episodes of acute upper respiratory tract infection other than pharyngitis and in 6 episodes of acute cervical lymphadenitis. In five patients more than one episode of illness associated with splenomegaly was recorded.

In 26 of the 37 episodes a possible aetiology was identified. Evidence only of infection with group A streptococci was found in 14 episodes, adenoviruses or coxsackie B viruses were isolated alone in 4 episodes and in 4 episodes the only finding was the presence in the blood of more than occasional atypical mononuclear cells; in 4 episodes there was evidence of both streptococcal and viral infection. Episodes with evidence of streptococcal infection only tended to be of shorter duration and to be more evenly distributed over the year than were episodes without such evidence. Temporary splenomegaly was noted also in two children with varicella (one of whom also had streptococcal infection) and in an adult with probable rubella.

A detailed investigation of the possible role of wild mammals, other than badgers, in the maintenance of Mycobacterium bovis in an area on the South Downs of East Sussex was carried out over 3 years. Estimates of population sizes were made where possible and minimum sample sizes were selected to be 95 % certain of including at least one infected animal if the prevalence was at least 5 %. Samples of wild mammals were taken from populations which had the highest potential direct or indirect contact rate with known infected badgers. M. bovis was not isolated from any of the 15 species of wild mammals.

It was concluded that badgers are able to maintain M. bovis in an area independently of other species, and that in the area studied other species were not a source of infection for the cattle herds.

More than 25 years have passed since the last rubella epidemic in the United States. The rubella pandemic of 1964–5 demonstrated clearly the extraordinary teratogenic potential of the rubella virus. In the United States alone, it is estimated that more than 12500000 cases of rubella occurred during the winter and spring of 1964–5. Congenital rubella infection occurred in an estimated 30000 pregnancies, 10000 resulting in fetal death or therapeutic abortion and 20000 resulting in infants born with congenital rubella syndrome (CRS) [1]. In contrast, during 1988, only 225 cases of rubella were reported to the Centers for Disease Control (CDC) in Atlanta, the lowest annual total since rubella became a nationally notifiable disease in 1966 [2]. However, in 1989, this downward trend of reported cases was interrupted, with the number of reported rubella cases in the United States increasing nearly twofold, and in 1990, the total increased another threefold (to more than 1000 cases) [3]. Although the 1990 reports represent the highest total since 1982, the overall incidence of rubella in the United States has still declined by more than 98% since 1969, the year rubella vaccine was licensed (Fig. 1).

A single inoculation of pseudomonas vaccine protected mice against a 1 LD 100 challenge by nine different serotypes of Pseudomonas aeruginosa, 4 days after vaccination. Three inoculations of the same vaccine, given on consecutive days, protected mice for a longer time, against challenge by a wide range of Ps. aeruginosa serotypes, than the single inoculation of vaccine. The amount of vaccine inoculated only marginally influenced the non-specific response. F1 vaccines from eight serotypes of Ps. aeruginosa each induced protection against a different range of serotypes.

With increasing knowledge of the effects of inhaled dusts upon the lungs has come an increase in the number of cases of Workmen's Compensation in which pulmonary disease is attributed to exposure to this form of risk during employment. Where a post-mortem examination has been made, and the opinion of a pathologist is sought, no difficulty is encountered in those cases of silicosis in which the disease is well developed, since the lesions are characteristic and easily recognised. The position, however, is by no means so easy where lesser degrees of pulmonary fibrosis are present and, in particular, where it becomes necessary to try to assess the bearing which these may have upon the susceptibility to, and the progress of, intercurrent pulmonary disease—for example lobar pneumonia. In these difficult circumstances recourse is frequently had to the chemical estimation of the quantity of silica recoverable from samples of lung. Certain standards have been set up, and the presence of silica in quantities in excess of the “normal” forms valuable corroborative evidence that a pulmonary fibrosis is attributable to its influence, where the subject in question has been exposed to this risk in his employment, and on the other hand the absence of an excess of silica is evidence that any pathological condition in the lung is due to other causes.

It is important to assess the suitability of sentinel sites for human disease; however, there have been few publications documenting the process of formal evaluation. We describe an approach to examining the representativeness of a single sentinel site employed for campylobacteriosis surveillance and source attribution, utilizing a selection of data sources and statistical comparisons of demographic, epidemiological and pathogen genotyping data across selected regions of New Zealand. Our findings showed that while this region captured the national variability in many variables, for example by containing sizable urban and rural populations, the relative frequency of these features did vary from other regions of New Zealand. We discuss the value of choosing a sentinel site that represents the national distribution of key variables, compared to a site that captures the broad features of the wider population, but provides greater power for the monitoring of sub-populations.

Human papillomavirus (HPV) types 6 and 11 are the aetiological agent of recurrent respiratory papillomatosis (RRP). The complete genome of an HPV6 isolate with a 170 base pair (bp) duplication identified within the long control region (LCR) from a patient with aggressive recurrent respiratory papillomatosis was determined. The promoter sequence from the HPV LCR including the 170 bp duplication was placed upstream of a heterologous reporter gene and the activity of the reporter gene product determined using transfected cells. In total, mutations were observed at 157 nucleotide positions of the complete genome and included nucleotide substitutions, deletions and insertions, resulting in amino acid changes at 43 residue positions. Reporter gene activity using an HPV-derived LCR region with a 170 bp duplication was significantly higher than that using an HPV-derived LCR region with no duplication within this region. The results suggest that novel HPV variants warrant further investigation for potential biomarkers of aggressive disease.

Summary Surface waters in 14 selected sites were examined for the presence of salmonella using modified Moore's swabs. The sites included an upland impounding reservoir, 3 rivers and 10 streams within Lancashire and Cheshire, selected because of their accessibility to farm livestock. Salmonellas were isolated from 22 out of the 57 swabs examined representing 10 sites. The probable source of pollution was shown to be sewage or farm effluent and an examination of sites over a wider area may be expected to produce similar results.

The significance of these findings is discussed in relation to the epidemiology of salmonella infections and the possible disinfection of effluent discharges.

Botulism has rarely been reported in Africa. In October 2008, botulism was reported in three Ugandan boarding-school students. All were hospitalized and one died. A cohort study was performed to assess food exposures among students, and clinical specimens and available food samples were tested for botulinum toxin. Three case-patients were identified; a homemade, oil-based condiment was eaten by all three. In the cohort study, no foods were significantly associated with illness. Botulinum toxin type A was confirmed in clinical samples. This is the first confirmed outbreak of foodborne botulism in Uganda. A homemade, oil-based condiment was the probable source. Consumption of homemade oil-based condiments is widespread in Ugandan schools, putting children at risk. Clinicians and public health authorities in Uganda should consider botulism when clusters of acute flaccid paralysis are seen. Additionally, schools should be warned of the hazard of homemade oil-based condiments, and take steps to prevent their use.

Already during the present war an extensive literature has grown up on the subject of the bacteriology of septic wounds. It was thought that a detailed study of the coliform organisms met with in these wounds might yield results of interest, and be a useful addition to some of the more general bacteriological contributions.

Acute gastroenteritis (AGE) remains a common condition in both low- and high-income countries. In Belgium, however, there is currently a lack of information on the societal health and economic impact of AGE. We conducted a retrospective study using mortality and cause-of-death data, hospital data, primary care data, health interview survey data and other published data. We estimated the burden of illness during a 5-year period (2010–2014) in Belgium in terms of deaths, patients admitted to hospitals, patients consulting their general practitioner (GP) and cases occurring in the community. We further quantified the health impact in terms of disability-adjusted life years (DALYs) and the economic impact in terms of cost-of-illness estimates. We estimated 343 deaths, 27 707 hospitalised patients, 464 222 GP consultations and 10 058 741 episodes occurring in the community (0.91 cases/person) on average per year. AGE was associated with 11 855 DALYs per year (107 DALY per 100 000 persons). The economic burden was estimated to represent direct costs of €112 million, indirect costs of €927 million (90% of the total costs) and an average total cost of €103 per case and €94 per person. AGE results in a substantial health and economic impact in Belgium, justifying continued mitigation efforts.

Groups of guinea-pigs were passively immunized against diphtheria toxin with homologous antitoxic serum so that their sera contained, at the start of the experiment, 1·0, 0·1, 0·01 or 0·001 unit/ml, respectively. They were then actively immunized with one, or two spaced, injections of 0·1 Lf of A.D.F. Two control groups were included, one passively immunized only and the other actively immunized only.

Passively produced serum titres of 0·01 and 0·001 unit/ml. did not interfere with active immunization in any demonstrable way.

A titre of 0·1 unit/ml. did interfere with active immunization, markedly 4 weeks after the primary, slightly 2 weeks after the secondary, and markedly 14 weeks after the secondary, stimulus.

A titre of 1·0 unit/ml. interfered with active immunization, markedly 4 weeks after the primary, and 2 and 14 weeks after the secondary, stimulus. This titre, however, did not completely annul the effect of the primary stimulus. The highest observed serum titre was obtained at the 32nd, instead of at the 4th week, as in the guinea-pigs actively immunized only.

In large measure the results confirm those of Barr and her colleagues who found that, in human babies, an initial ‘passive’ titre of 0·04 unit/ml. serum did not interfere with active immunization, whereas a titre of 0·1 unit/ml, led to unsatisfactory immunization.

Between June 1976 and August 1977 faeces were collected from 599 wild British birds caught during ringing operations at two sewage treatment works in south-east England. Samples were incubated with selenite-F broth to detect the presence of Salmonella. Salm. anatum was isolated from one bird, a Dunnock Prunella modularis an incidence of O.17 % of the total birds examined and 3.23 % of the Dunnocks. Comparisons are drawn with previously reported studies and it is suggested that sewage treatment works play little part in the transmission of Salmonella infections to wild birds feeding there.