A high attack rate (17·3/100 000) of meningococcal disease in army recruits in Italy, with 95% of the cases due to serogroup C, constituted the motivating factors to make bivalent serogroup A + C meningococcal vaccination compulsory by law for army recruits starting January 1987. Because the vaccine was given only to the new recruits entering the army, full coverage was not achieved until January 1988. Nearly 900 000 subjects (300 000 yearly) were vaccinated between January 1987 and December 1989. There were no reports of any untoward reactions to the vaccine. Of the 300 000 recruits in service each year, 52, 21, 15, 5 and 4 cases of the disease occurred in 1985, 1986, 1987, 1988 and 1989, respectively (P < 0·001).

Of the 24 cases occurring since the start of the vaccination, only two (due to serogroup C) were attributable to vaccine failure. The remaining cases were in unvaccinated recruits (15 cases) or were due to serogroups other than A or C (7 cases). The cumulative incidence of meningococcal serogroup C in the 600 000 vaccinated recruits during the period 1988–89 was 0·2/100 000 (1 case amongst 600 000 recruits), while the corresponding figure in the 600 000 unvaccinatred recruits during the period 1985–6 was 11·3/100000 (68 cases amongst 600 000 recruits) (P < 0·001). The protective efficacy of the vaccine in 1987 was 91·2% (12 cases of meningococcal serogroup A and C disease from an average of 150 000 unvaccinated recruits observed for 1 year, and 1 case from the corresponding average of 150 000 vaccinated ones). In 1988 and in 1989 this figure could not be calculated because all recruits were vaccinated.

The incidence of meningitis caused by other serogroups of meningococci remained low, both before and after the mass vaccination campaign.

Four groups of pregnant sows were inoculated with type O1 foot and mouth disease (FMD) oil emulsion vaccine at various times before farrowing and samples of the sow's serum, colostrum and milk, and piglet's serum, collected during the first week after farrowing, were analysed for FMD virus neutralizing activity.

No FMD neutralizing antibodies were detectable in the piglets serum at birth but they were present 1·5 h after suckling and peak titres were reached 1–3 days later. There was no significant difference between the antibody titres of colostrum samples collected from different teats at farrowing. However, similar samples collected 3 days later showed significant (P < 0·005) fore to hind variation. The principal FMD virus neutralizing antibody class present in the sow's serum at farrowing and in their 3-day-old piglets was governed by the inoculation schedule employed. When the last vaccinations were given ≃ 30 days before farrowing (dbf) the predominant FMD virus neutralizing class was IgG. However, when the sows were vaccinated only ≃ 12 dbf the predominant class was IgM. A significant correlation was observed between the sow's serum titres and colostrum titres at farrowing (r = 0·90), and also between sows colostrum titres at farrowing and their 3-day-old piglets serum titres (r = 0·99).

Two events concerned with echo virus 14 infection were reported.

The first, which occurred in Sendai in 1962, was that the intestinal infection with the attenuated poliovirus 1 vaccine was possibly suppressed by naturally occurring infection with echovirus 14. Echovirus 14 was isolated 10 days after the vaccine feeding in six out of nine cases, but poliovirus in only two cases. Six of the vaccinated babies did not exhibit antibody response to the poliovirus 1, while a significant rise of antibody titre against echovirus 14 was seen in as many as eight babies 7 weeks after the vaccination.

The second was a small outbreak of aseptic meningitis due to echovirus 14 in Aomori in 1963. During August to October, echovirus 14 was isolated from the faeces of seven patients with aseptic meningitis. The virus was also isolated from the CSF in one case. The antibody titre against echovirus 14 was detected in all the patients from whom the virus was isolated. In addition, echovirus 14 antibody was detected in four out of fourteen patients with aseptic meningitis from whom no virus was recovered. The onset of serologically positive patients was limited to the months of August to October.

Acholeplasma axanthum sp. was isolated from the lung of swine with catarrhal pneumonia. Clinical symptoms of respiratory disease, gross and histological lesions of pneumonia, as well as serological response were produced by intranasal inoculation of ‘miniature pigs’ with the supernatant of lung suspension containing Acholeplasma axanthum and by a 48 hr. broth culture of the strain.

A similar picture of disease was observed in animals held in contact with the animals inoculated with untreated lung suspension. Acholeplasma axanthum was isolated from the nasal cavity, lung and peribronchial lymph nodes 7–41 days after inoculation. No lesions were observed after inoculation of pigs with the supernatant of lung suspension pretreated with oxytetracycline or chloroform, and no successful isolation of Acholeplasma axanthum could be achieved after this treatment.

Results are presented of the laboratory examination of faeces specimens from 20,273 patients with acute diarrhoea. These were household index cases seen in general practice in a London borough during the years 1953–68. An annual average of about 2% of households in the area were affected, but there was considerable fluctuation with year and season. Half the patients were children although only one-fifth of the population at risk was under 15 years of age. The greatest incidence of diarrhoea was among children under 5 years old. Male children, but female adults predominated.

Specimens were sent for laboratory diagnosis at the discretion of the general practitioner. The laboratory found some abnormality in nearly a third and there were indications that transmissible infection was involved in about one-fifth of patients. The most common diagnosis was Sonne dysentery (9%) which came in epidemic waves and made its greatest impact among young school children. Microscopy was useful, and giardiasis was diagnosed in 1·4% of index patients. Other parasites were less commonly found. Fatty globules characteristic of an infectious condition we have called ‘fatty diarrhoea’ were frequently observed by microscopy in stools from young children and occasionally from older persons. Blood or pus cells were seen in less than half the shigella and salmonella infections and in a much smaller proportion of the remainder. A test for occult blood performed on specimens from all patients of 40 years or older was positive, in the absence of visible red cells, in a tenth of these cases.

Other studies on the bacteriology of diarrhoea in general practice are referred to and some epidemiological comparisons made. The possible place of unidentified infective agents in the aetiology of undiagnosed diarrhoeas and of ‘fatty diarrhoea’ is discussed.

Serological evaluations of foot-and-mouth disease type SAT 2 viruses isolated in Kenya between 1979 and 1982 were performed using the two-dimensional microneutralization test. Nine field isolates of epizootiological significance were compared with four vaccine viruses. The results obtained identified Tan 5/68 as the most appropriate reference vaccine virus strain since it had the broadest serological spectrum. Potent Tan 5/68 vaccines would be expected to provide adequate protection against the contemporary SAT 2 field viruses. In the case of K 83/74, which also was shown to have a broad spectrum with viruses isolated in Kenya, the results show that the 1982 isolate from central Kenya was significantly divergent (r < 1·00 at P = 0·01) and warranted tactical revaccination for its control. The study highlighted the fact that strain R1215 which had been isolated from the oesophageal-pharyngeal swabs of asymptomatic carrier cattle had a narrow serological spectrum suggesting that such viruses could be unsuitable as vaccine for the national campaign.

The susceptibility of laboratory reared Zimbabwean Amblyomma hebraeum and A. variegatum ticks to infection with geographically distinct Cowdria ruminantium strains was investigated by feeding both species simultaneously on individual sheep infected with one of the four strains (Crystal Springs [Zimbabwe], Ball 3 [South Africa]. Gardel [Guadeloupe] and Nigeria [Nigeria]). A. hebraeum ticks demonstrated a high susceptibility to infection with all four C. ruminantium strains. In comparison. A. variegatum were less susceptible to infection with the Crystal Springs and Ball 3 strains (P < 0·001), but showed a similar susceptibility to the Gardel and Nigeria strains. The differences in susceptibility of A. variegatum to infection with the four strains of C. ruminantium correlated with the origin of these strains. The consistently higher susceptibility of A. hebraeum ticks to infection with geographically different C. ruminantium strains may be one explanation for the observation that heartwater is a more serious problem where A. hebraeiun is the vector of the disease.

The prevalence of sexually transmitted infection (STI) pathogens in Beijing, China, is rarely reported. In this study, 34 911 symptomatic outpatients with suspected genital infections who attended outpatient clinics in a tertiary care hospital were included to investigate the updated prevalence of Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and herpes simplex virus (HSV) from 1 January 2013 to 31 December 2016 in Beijing, China. Results indicated that a decrease trend (UU, CT, NG and HSV) in male and an increase trend (UU, CT and NG) in female were observed during the period. Patients aged 20–39 years old were mostly affected by these pathogens, while the prevalence in patients aged 20–29 years old was the highest, The prevalence of UU in male was significantly lower than in female (31.5% vs. 49.3%, P < 0.05), while the prevalence of NG in male was significantly higher than in female (2.5% vs. 0.8%, P < 0.05). In patients with co-infections, 60.6% of male and 71.4% of female were co-infected by UU + CT. In total, 11.9% and 88.1% of patients with HSV infections were confirmed to be infected by HSV-1 and HSV-2. This study could contribute to a better understanding of the current epidemiological features of UU, NG, CT and HSV among symptomatic patients attending an outpatient clinic in Beijing, China, and thus facilitate to develop more effective intervention, prevention and treatment of STI.

The exposure of indigenous humans and native fauna in Australia and the Wallacea zoogeographical region of Indonesia to exotic Salmonella serovars commenced during the colonial period and has accelerated with urbanization and international travel. In this study, the distribution and prevalence of exotic Salmonella serovars are mapped to assess the extent to which introduced infections are invading native wildlife in areas of high natural biodiversity under threat from expanding human activity. The major exotic Salmonella serovars, Bovismorbificans, Derby, Javiana, Newport, Panama, Saintpaul and Typhimurium, isolated from wildlife on populated coastal islands in southern temperate areas of Western Australia, were mostly absent from reptiles and native mammals in less populated tropical areas of the state. They were also not recorded on the uninhabited Mitchell Plateau or islands of the Bonaparte Archipelago, adjacent to south-eastern Indonesia. Exotic serovars were, however, isolated in wildlife on 14/17 islands sampled in the Wallacea region of Indonesia and several islands off the west coast of Perth. Increases in international tourism, involving islands such as Bali, have resulted in the isolation of a high proportion of exotic serovar infections suggesting that densely populated island resorts in the Asian region are acting as staging posts for the interchange of Salmonella infections between tropical and temperate regions.

A seroepidemiological survey was conducted on subjects who had received a full vaccination course with live attenuated poliovirus 2–16 years before. For strains 1 and 2 prevalence of seropositives and median values dropped gradually during the first 10 years; strain 3 showed a much earlier decline. Environmental displacement of wild poliovirus by the attenuated, less immunogenic strain might eventually induce a ‘gap’, should complacency hamper needed vaccination efforts.

Monitoring and evaluation (M&E) is an essential component of public health emergency response. In the WHO African region (WHO AFRO), over 100 events are detected and responded to annually. Here we discuss the development of the M&E for COVID-19 that established a set of regional and country indicators for tracking the COVID-19 pandemic and response measures. An interdisciplinary task force used the 11 pillars of strategic preparedness and response to define a set of inputs, outputs, outcomes and impact indicators that were used to closely monitor and evaluate progress in the evolving COVID-19 response, with each pillar tailored to specific country needs. M&E data were submitted electronically and informed country profiles, detailed epidemiological reports, and situation reports. Further, 10 selected key performance indicators were tracked to monitor country progress through a bi-weekly progress scoring tool used to identify priority countries in need of additional support from WHO AFRO. Investment in M&E of health emergencies should be an integral part of efforts to strengthen national, regional and global capacities for early detection and response to threats to public health security. The development of an adaptable M&E framework for health emergencies must draw from the lessons learned throughout the COVID-19 response.

Pertussis or whooping cough is a highly contagious community disease mainly caused by Bordetella pertussis and B. parapertussis. We report a minor outbreak of whooping cough (2009–2010) in symptomatic subjects from Bisham, near Swat, Khyber Pukhtoonkhawa province, Pakistan. Interestingly, our results show that all the culture-positive isolates (n = 21) collected from children (average age 3·46 years), were identified as B. parapertussis after routine identification tests and PCR IS481, IS1001 and IS1002. Furthermore, in the affected patients, none had received immunization with diphtheria-pertussis-tetanus (DTPw) vaccine. Therefore, the possibility of the re-emergence of the disease due to limitation of basic health services as a result of the political unrest due to the 9/11 situation is also examined. Moreover, we discuss the importance of vaccinating both adults and children with DTPwPaw vaccine containing both organisms for better protection.

The conditions for satisfactory fumigation with formaldehyde were investigated using suspensions of Staph. aureus and Ps. aeruginosa dried as drops on strips of polythene or after mixing with cotton dust. In laboratory experiments with controlled concentrations of formaldehyde and water vapour, satisfactory results were obtained at 86 % humidity, but at 32 % humidity the formaldehyde was virtually inactive.

Measurements under field conditions showed that the permanganate method of vaporizing formaldehyde did not vaporize enough water to produce optimum conditions for sterilization, and that great care was necessary in the sealing of rooms. When sterilization was incomplete the surviving organisms were not uniformly distributed within the room.

In the limited circumstances in which fumigation with formaldehyde is thought to be essential, the process should be controlled by estimating the formaldehyde and water vapour concentrations initially and after 3 hr.

Antimicrobial resistance (AR) is a growing problem worldwide and international travel, cross-border migration, and antimicrobial use may contribute to the introduction or emergence of AR. We examined AR rates and trends along the US–Mexico border by analysing microbiology data from eight US hospitals in three states bordering Mexico. Microbiology data were ascertained for the years 2000–2006 and for select healthcare and community pathogens including, three Gram-negative (Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae) and three Gram-positive (Staphylococcus aureus, Enterococcus, Streptococcus pneumoniae) pathogens and 10 antimicrobial–pathogen combinations. Resistance was highest in S. aureus (oxacillin resistance 45·7%), P. aeruginosa (quinolone resistance 22·3%), and E. coli (quinolone resistance 15·6%); six (60%) of the 10 antimicrobial–pathogen combinations studied had a significantly increasing trend in resistance over the study period. Potential contributing factors in the hospital and community such as infection control practices and antimicrobial use (prescription and non-prescription) should be explored further in the US–Mexico border region.

Despite a number of risk-factor studies in different countries, the epidemiology of Campylobacter colonization in broilers, particularly spatial dependencies, is still not well understood. A series of analyses (visualization and exploratory) were therefore conducted in order to obtain a better understanding of the spatial and temporal distribution of Campylobacter in the Danish broiler population. In this study, we observed a non-random temporal occurrence of Campylobacter, with high prevalence during summer and low during winter. Significant spatio-temporal clusters were identified in the same areas in the summer months from 2007 to 2009. Range of influence between broiler farms were estimated at distances of 9·6 km and 13·5 km in different years. Identification of areas and time with greater risk indicates variable presence of risk factors with space and time. Implementation of safety measures on farms within high-risk clusters during summer could have an impact in reducing prevalence.

This study compared the molecular characteristics of vancomycin-resistant Enterococcus faecium (VREF) isolates recovered from 20 non-tertiary-care hospitals (36 isolates) and three tertiary-care hospitals (26 isolates) in diverse geographical areas of Korea from October 2010 to April 2011. All isolates carried the vanA gene only, but 42% and 73% of non-tertiary and tertiary-care isolates expressed the VanB phenotype (teicoplanin minimum inhibitory concentration ⩽16 μg/ml). All isolates harboured insertion sequences, IS1542 and IS1216V, within Tn1546. The isolates from tertiary-care hospitals tended to have reduced Tn1546 lengths by deletion of sequences adjacent to IS elements. Multilocus sequence typing revealed eight sequence types within clonal complex 17 (CC17), but DNA fingerprinting by rep-PCR did not show clonal relatedness between the intra- and inter-hospital isolates. These results suggest that vanA, which has prevailed in tertiary-care hospitals of Korea since the 1990s, had been transferred horizontally to non-tertiary-care hospitals while the genetic rearrangement driven by evolutionary adaptation to adverse environments may have occurred in tertiary-care hospitals.

Specimens of human faeces were tested by a rapid strategy for detection of Campylobacter jejuni lineages by the presence of specific single nucleotide polymorphisms (SNPs) based on the C. jejuni multi locus sequence typing (MLST) scheme. This strategy was derived from analysis of the MLST databases to identify clonal complex specific SNPs followed by the design of real-time PCR assays to enable identification of six major C. jejuni clonal complexes associated with cases of human infection. The objective was to use the MLST SNP-based assays for the direct detection of C. jejuni by clonal complex from specimens of human faeces, and then confirm the accuracy of the clonal complex designation from the SNP-based assays by performing MLST on the cultured faecal material, this targeted at determining the validity of direct molecular specimen identification. Results showed it was possible to identify 38% of the isolates to one of the six major MLST clonal complexes using a rapid DNA extraction method directly from faeces in under 3 h. This method provides a novel strategy for the use of real-time PCR for detection and characterization beyond species level, supplying real-time epidemiological data, which is comparable with MLST results.

This study of 724 13-year-old schoolgirls in the County Borough of Reading showed that approximately 25% were susceptible to rubella. 96·1% of the 129 seronegative girls and significant numbers of girls with low rubella HAI antibody titres responded to subcutaneous vaccination with Wistar RA. 27/3 rubella vaccine. The incidence of most reactions after vaccination was similar in those who responded to vaccine and those who were initially immune but did not develop rising antibody titres, but rash, lymphadenopathy and headache occurred significantly more frequently in the susceptible group.

An investigation of the in vitro responsiveness of peripheral blood lymphocytes to tetanus toxoid was undertaken to determine the extent to which such reactivity might reflect in vivo reactions to tetanus toxoid immunization. It was found that lymphocyte transformation in the presence of tetanus toxoid, as measured by the uptake of tritiated thymidine, did not differ significantly for the group giving local or systemic reactions to tetanus toxoid and an immune control group. However, a striking inverse relation between lymphocyte reactivity to tetanus toxoid and age of the cell donors of both groups became clear. Such an age-related decline in the in vitro responsiveness of peripheral blood lymphocytes to a specific antigen has apparently not been reported previously in man.

A questionnaire survey was undertaken to determine the exposure of a study population to campylobacteriosis source risk factors (environmental, water, food) and results were stratified by age, population density and deprivation. Data were gathered using an exposure assessment carried out by telephone in the Grampian region of Scotland. Univariate analysis showed that children aged 5–14 years, living in low population density (0–44·4 persons/km2) and affluent areas had elevated exposure to environmental and water risk factors. Multivariate logistic regression analysis revealed that younger age groups and lower population density were significant indicators for most environmental risk factors. The results compared to reported disease incidence in Grampian showed that greater exposure to risk factors does not necessarily coincide with greater disease incidence for age groups, particularly for the 0–4 years age group. Further research is required to explain the relationship between exposure and disease incidence.