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.

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.

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.

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.

The distribution of three putative adhesin genes in 123 Shiga toxin-producing (STEC) strains was determined by PCR. The STEC strains were isolated from human patients (n=90) and food (n=33) and were characterized by serogroup, virulence markers (eae, stx1, stx2) and adherence factors (efa1, lpfAO157, saa) genes. Serogroups O157 (64·4%) and O26 (28·8%) were the most frequent among human strains and the majority (60·6%) of food strains were serologically non-typable. The adhesin genes efa1 (90%) and lpfAO157 (73·3%) were the most common in humans strains and saa (45·5%) in food strains. The presence of these genes in addition to eae in STEC from different sources may suggest a relevant role in their pathogenesis.

During the 3-year period 1985–7, all strains of Shigella sonnei isolated in Catania, Sicily, showed a high level of resistance to trimethoprim (Tp) which was invariably associated with resistance to other antibiotics.

Plasmid analysis showed 18 different electropherotypes: 35 of 37 strains harboured a plasmid of 70 Megadaltons (MDa), and 29 of 37 strains a plasmid of 130 MDa.

Restriction endonuclease fingerprinting of purified 70 MDa plasmid DNA from different strains demonstrated that these plasmids were similar but not identical.

In some strains with transferable Tp resistance, DNA hybridization analysis demonstrated the presence of genes coding for the production of dihydrofolate reductase (DHFR) type V. In contrast, there was no detectable hybridization with DNA probes specific for genes coding for DHFR types I, II and IV. This is the first report of the DHFR type V gene outside Sri Lanka.

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.

Introduction of antiretroviral therapy (ART) has dramatically reduced the incidence of infectious ocular diseases in human immunodeficiency virus (HIV)-infected individuals. However, the effects of long-term ART and chronic HIV infection on the eye are ill-defined. This study determined the occurrence and severity of ocular diseases among 342 participants in a rural South African setting: HIV-naïve (n = 105), HIV-infected ART-naïve (n = 16), HIV-infected on ART for <12 months (short-term ART; n = 56) and HIV-infected individuals on ART for >36 months (long-term ART; n = 165). More HIV-infected participants presented with an external eye condition, in particular blepharitis, than HIV-naïve individuals (18% vs. 7%; age-adjusted odds ratio (aOR) = 2·8, P < 0·05). Anterior segment conditions (particularly keratoconjunctivitis sicca and pterygium) were also more common (50% vs. 27%; aOR = 2·4; P < 0·01). Compared with individuals on short-term ART, participants receiving long-term ART were more likely to have clinically detectable cataract (57% vs. 38%; aOR = 2·2, P = 0·01) and posterior segment diseases, especially HIV retinopathy (30% vs. 11%; aOR = 3·4, P < 0·05). Finally, long-term ART was significantly associated with presence of HIV retinopathy (P < 0·01). These data implicate that ocular disease is more common and of more diverse etiology among HIV-infected individuals, especially those on long-term ART and suggest that regular ophthalmological monitoring of HIV-infected individuals on ART is warranted.

The inactivation kinetics of CELO virus were studied in the presence of 1/4000 formaldehyde. Inactivation of the virus by formaldehyde at 4° C. was not complete after 14 days incubation. Formaldehyde inactivation at 36° C., however, was rapid and no virus was detected after 24 hr. incubation.

Neutralizing antibody to CELO virus was detected in 20–88% of sera tested from five flocks of hens. This suggested dissemination of the virus in England and Scotland. However, no CELO virus neutralizing antibody at a serum dilution of 1/8 was detected in 142 normal human sera or in 229 sera from persons who had been immunized with egg grown, inactivated influenza virus vaccine.

We would like to thank Professor C. H. Stuart-Harris and Drs J. E. Wilson, D. A. Martin and D. Breeze for their help and their criticisms of the manuscript.

Dr G. C. Schild kindly supplied a number of the human sera used in the study. The study was financed in part by the National Fund for Research in Poliomyelitis and other Crippling Diseases and by the British Empire Cancer Campaign.

During 9th December 2016 and 12th February 2017, 149-chickenpox cases were reported in a tribal and industrial zone of Rakholi (n = 80) and Surangi (n = 69) villages from Union Territory of India. An epidemiological investigation was performed to assess the characteristics and determinants of the chickenpox outbreak. Overall, the attack rate per 100 population in Rakholi village (n = 1757) was 4.5% and 19.1% in Surangi village (n = 360). Ages of the cases were ranged from 6 months to 55 years and there were 53 females and 96 males. For the laboratory investigations, 25 serum samples, three urine specimens, three throat swabs and six blister/skin swabs were collected from 37-suspected chickenpox cases. Altogether, 30-suspected cases were laboratory confirmed by either IgM EIA or varicella zoster virus (VZV) DNA PCR. Both VZV-specific IgM and IgG antibodies were detected in 19-suspected cases. Two suspected cases showed the presence of VZV-specific IgG antibodies but not IgM antibodies. On the contrary, three suspected cases showed VZV-specific IgM but not IgG antibodies. Overall, 31 of 37-suspected cases (including one equivocal case) were laboratory confirmed. The partial sequencing of ORF-28 gene of VZV revealed circulation of clade-1 viruses. In conclusion, this investigation provides detail information about the chickenpox outbreak in the tribal and industrial setting from India. Furthermore, the study emphasises the need to investigate more chickenpox outbreaks in different parts of India.

In this study we determined the presence of IgM/IgG antibodies to Toxoplasma gondii in sera of 155 and 300 pregnant women from Lisbon (Portugal) and Luanda (Angola), respectively, and evaluated the potential risk factors associated with this infection. DNA detection was performed by PCR assays targeting T. gondii regions (RE/B1). Overall, 21·9% (10·9% IgG, 10·9% IgG/IgM) of the Lisbon women and 27·3% (23·7%, IgG, 2% IgM, 1·7% IgG/IgM) of the Luanda women had antibodies to T. gondii. Single variable and binary logistic regression analyses were conducted. Based on the latter, contacts with cats (family/friends), and having more than two births were identified as risk factors for Toxoplasma infection in Lisbon women. In Luanda, the risk factors for T. gondii infection suggested by the single variable analysis (outdoor contact with cats and consumption of pasteurized milk/dairy products) were not confirmed by binary logistic regression. This study shows original data from Angola, and updated data from Portugal in the study of infection by T. gondii in pregnant women, indicating that the prevalence of anti-Toxoplasma antibodies is high enough to alert the government health authorities and implement appropriate measures to control this infection.

In 2015–2016, simultaneous circulation of dengue, Zika and chikungunya in the municipality of Rio de Janeiro (Brazil) was reported. We conducted an ecological study to analyse the spatial distribution of dengue, Zika and chikungunya cases and to investigate socioeconomic factors associated with individual and combined disease incidence in 2015–2016. We then constructed thematic maps and analysed the bivariate global Moran indices. Classical and spatial models were used. A distinct spatial distribution pattern for dengue, Zika and chikungunya was identified in the municipality of Rio de Janeiro. The bivariate global Moran indices (P < 0.05) revealed negative spatial correlations between rates of dengue, Zika, chikungunya and combined arboviruses incidence and social development index and mean income. The regression models (P < 0.05) identified a negative relationship between mean income and each of these rates and between sewage and Zika incidence rates, as well as a positive relationship between urban areas and chikungunya incidence rates. In our study, spatial analysis techniques helped to identify high-risk and social determinants at the local level for the three arboviruses. Our findings may aid in backing effective interventions for the prevention and control of epidemics of these diseases.

This study assessed the seroprevalence of brucellosis and its risk factors in migratory nomads in the Fars province of Iran. Active brucellosis was defined as the combination of clinical symptoms, including fever, chills, night sweats, headache, low back pain, arthralgia, or myalgia, and positive laboratory testing, including either a serum agglutination test (SAT) ⩾1:80 with a 2-mercaptoethanol (2-ME) test ⩾1:40, or a SAT <1:80 combined with a positive Coombs Wright test (CWT) at a titre of at least threefold higher than SAT titre results. For the 536 participants, the female (316, 59%) to male (220, 41%) ratio was 1·4 and the participants' mean age was 32·4 ± 18·9 (range 1–96) years. Of all participants, 325 (60·6%) showed clinical symptoms; in symptomatic participants, the Rose Bengal plate test was positive in 33 (6·1%) cases, the SAT was positive in 18 (3·3%) cases, and the 2-ME test was positive in 30 (5·5%) cases. Positive SAT and 2-ME results were seen in 18 (3·3%) cases, but a negative SAT and a positive CWT were found in 36 (6·7%) cases. As a result, active brucellosis was detected in 54 cases, indicating a prevalence of 10% (95% confidence interval 8–12). In conclusion, we determined that brucellosis is a prevalent yet neglected disease in this nomadic population. Brucellosis control is not possible as long as these high-risk populations remain neglected.

During the summer and autumn of 1964, echovirus 4 was found widely distributed in northern Japan; this virus was associated with localized outbreaks of iaseptic meningitis in many regions. The evidence that the echovirus was aetio-logically related to aseptic meningitis was shown by the virus isolation from cerebrospinal fluids and faeces and the serodiagnosis of paired sera in many patients: Age-specific sero-immunity and morbidity rate suggested that echovirus 4 had spread extensively in about 1954. The strains of echovirus 4 isolated in the 1964; epidemic were similar to the prototype strain, Pesascek, in biological characteristics.

(1) The energy cost of static effort.

From previous work it appears that the metabolic cost of maintaining a given tension varies directly as the load, provided no new muscles are brought into play as the result of fatigue or local strain. There is conflict of opinion as to the relation of cost to tension; some workers find a linear relation, while others find a non-linear one.

In the present observations contractions, which were virtually isometric, were made against a powerful spring, while in a standing position.

With constant tension the oxygen cost per contraction varied directly as the duration of the contraction. With constant time and increasing tension the oxygen cost increased more rapidly than the tension.

The duration of contraction varied from ½ to 30 sec., and the tension from 30 to 165 Ib. Over the whole range the oxygen cost per contraction is adequately described by the equation

Q = T1·37 (0·0117 + 0·01090t),

where Q is the oxygen cost per contraction, T is the tension, and t is the duration of contraction.

(2) The effect of static effort on the respiration.

As a measure of hyper-ventilation the ratio of ventilation to oxygen intake is used. It is shown that in dynamic work this ratio falls below the resting value, whereas in static effort of whatever severity the ratio increases considerably above the resting value if the effort is sufficiently prolonged. The rise in the ventilation ratio runs parallel with the feelings of strain which are associated with static effort. Pain causes such a rise in the ratio, and the rise which occurs in static effort is ascribed to the influence of painful sensations of strain.

Observations were made in which the posture alternated between sitting and standing every 40 sec. The change of posture altered the distribution of the strain, and thus the subjective sensations were not so marked as in the experiments with posture unchanged. In consequence of the postural change the ventilation ratio did not rise sensibly above the resting value, and the maximum strength of pull was increased by 6–16 per cent.

Studies from developing countries suggest that persons with household-acquired (HA) measles are at greater risk of severe illness than persons with community acquired (CA) infection. Reported measles cases occurring among Milwaukee residents from May 1989 to June 1990 were used to assess whether household acquisition was a risk factor for severe measles in the United States. A case was classified as HA if onset of rash occurred 7–18 days after onset of rash in another case in the same household. Hospitalization rates were similar for 128 patients with HA measles (27%) and for 1004 patients with CA measles (26%). Multiple logistic regression was used to evaluate the association between hospitalization and household-acquisition after controlling for socioeconomic status, measles vaccination history, age, race, and date of onset of rash. Patients with HA measles were no more likely to be hospitalized than patients with CA measles (odds ratio 0·9, 95% confidence interval 0·6, 1·5). HA measles cases were not more severe than CA measles cases during this urban outbreak in the United States.

(1) At present no public authority possesses legal power to deal with the question of the contamination of shellfish.

(2) It is not sufficient to test shellfish exposed for sale in a market or shop. These may have been contaminated subsequent to removal from the fishery; and multiplication of the contained bacteria may have taken place. The results of such analyses may lead to unjustifiable condemnation of a laying. It is essential that a topographical examination should be made and that samples for analysis should be taken from the laying itself.

(3) In the case of natural shellfish beds there is so much variability in the conditions with regard to the susceptiblity to pollution that a fairly large number of the animals must be examined. The labour of the analyses is therefore so great that the development of some simple routine test for faecal contamination is most desirable. Since most desirable. Since most natural shellfish layings are situated within the “sewage zone”, and therefore contain B. coli, quantitative results are essential.

(4) There are considerable differences in practial routine work in regard to the methods of isolation of intestinal organisms from shellfish; and aslo with respect to the number and nature of the reactions necessary for the identification of B. coli. It is desirable that some generally recognised series of tests should be uniformly adopted by bacteriologists engaged in such work. Further, different micro-organisms, possibly of varying degrees of significance as indicators of faecal contamination, may have been confused. There is possibly some variation in cultural characters in B. coli, and investigation of this variability is desirable. Investigation of the changes in cultural reactions undergone by intestinal organisms when entering the sea, or the tissues of marine shellfish, is also very desirable.

(5) Remedial measures other than the simple closure of a contaminated laying might be suggested. It is possible to subject the shellfish to treatment which will cause them to clean themselves of contained sewage bacteria. The source of the pollution may be removed; and sterilisation of the shellfish may be practised.

The characteristics of Gram-negative organisms and some of the underlying reasons for their adjuvant action with diphtheria toxoid are described.

The adjuvant effect was shown by an earlier production of antitoxin, with a maintained differential advantage over controls, but with the usual decline in titre with passage of time. The adjuvant effect only occurred with a primary stimulus. There was no adsorption between toxoid and vaccine and mixture of the two was not necessary, but the vaccine had to be given simultaneously with or within 24 hr. following injection of the toxoid. There was evidence for believing that these adjuvants decreased the minimal stimulating dose of antigen and caused hyperplasia of antibody-producing cells. No direct link could be found between the characteristic stress symptoms caused by lipopolysaccharides and their ability to enhance antibody formation.