The mumps resurgence has frequently been reported around the world in recent years, especially in many counties mumps vaccines have been widely used. This study aimed to describe the spatial epidemiological characteristics of mumps in Jiangsu, and provide a scientific basis for the implementation and adjustment of strategies to prevent and control mumps. The epidemiological characteristics were described with ratio or proportion. Spatial autocorrelation, Tango's flexible spatial scan statistics, and Kulldorff's elliptic spatiotemporal scan statistics were applied to identify the spatial autocorrelation, detect hot and cold spots of mumps incidence, and aggregation areas. A total of 172 775 cases were reported from 2004 to 2020 in Jiangsu. The general trend of mumps incidence is declining with a bimodal seasonal distribution identified mainly in summer and winter, respectively. Children aged 5–10 years old are the main risk group. A migration trend of hot spots from southeast to northwest over time was found. Similar high-risk aggregations were detected in the northwestern parts through spatial-temporal analysis with the most likely cluster time frame around 2019. Local medical and health administrations should formulate and implement targeted health care policies and allocate health resources more appropriately corresponding to the epidemiological characteristics of mumps.

The distribution of adenovirus types in faecal samples of patients with suspected viral gastroenteritis from South Australia was determined during the 12-month period, July 1991–June 1992. There were 3299 samples tested and 226 (6·9%) were positive for adenovirus by enzyme immunoassay. Of these 226 samples. 154 (68%) were typed directly using virus DNA extracted from the faecal samples according to the Sma I, Hind III and BstEII restriction patterns and Southern hybridization analysis with pooled viral genomic DNA probes. In this group, 86% of the samples were from patients who were < 3 years of age. Enteric adenovirus types 40 and 41 accounted for 20 and 40% respectively, of these samples, and types 1, 2, 3, 5, 6, 7 and 31 comprised the remainder. Type 40 was detected mainly in the winter and spring periods, and type 41 predominated in the autumn period. The majority of the non-enteric types were found during the late winter and spring periods.

A better understanding of physician practices in requesting stool samples for patients with acute gastroenteritis (AG) is needed to more accurately interpret laboratory-based surveillance data. A survey was conducted in General Practitioners (GPs) between August 2013 and July 2014 to estimate the proportion of stool samples requested for patients with AG and to identify factors associated with GP requests for a stool sample. National health insurance (NHI) data together with surveillance data from a French Sentinel GP network were also used to estimate the proportion of stool samples requested. This proportion was estimated at 4·3% in the GP survey and 9·1% (95% confidence interval 8·7–9·6) using NHI data. Multivariate analysis indicated that the ratio of stool samples requested was almost five times higher in patients with bloody diarrhoea and 10–20 times higher in patients with a long duration of illness before consultation. Laboratory-based surveillance data underestimates the actual burden of disease as fewer than one in 10 AG cases consulting their GP will be requested to submit a stool sample for laboratory testing. This underestimation varies by pathogen as stool samples are more frequently requested for severe illness.

Zoonotic diseases are a significant health threat for humans and animals. To better understand the epidemiology, etiology, and pathology of infectious agents affecting humans and animals combined approaches are needed. Here we describe an epidemiological investigation conducted by physicians and veterinarians after a reported case of psittacosis. Upon admission suffering from respiratory distress syndrome in a hospital and with a history of bird contact, a female patient was serologically diagnosed with psittacosis. After the case notification, veterinarians were able to investigate the source of infection by detecting Chlamydia psittaci in her pet cockatiel. The bird was hospitalized and successfully treated. In addition, the establishment where the pet bird was purchased was traced and through molecular techniques other birds intended to be sold as pets tested positive for C. psittaci. As a result, sanitary measures were applied and the establishment then was closed down. The birds intended for the pet commerce were treated and retested with negative molecular results for C. psittaci, thus avoiding disease propagation. Reliable data about zoonotic diseases can only be generated through the application of multidisciplinary approaches which take into account the epidemiological factors and interactions of humans, animals and their environments as an integrated system.

Brucella abortus infection in the bitch, associated with an aborted bovine fetus, is described. Clinical signs were absent, but the organism was isolated from many sites in the body, including the urine, after death. The response of the dog to B. abortus infection and its possible role as a vector of the disease is discussed.

We examined the impact of the neonatal hepatitis B immunization programme, first provided to all neonates born to mothers screened positive for hepatitis B surface antigen (HBsAg) in late 1983, on the age-specific prevalence of HBsAg carriage in teenage mothers managed in 1998–2008. HBsAg carriage was found in 2·5%, 2·7%, 8·8% and 8·0% of mothers aged ⩽16, 17, 18, and 19 years, respectively (P = 0·004), which was also correlated with advancing age (P = 0·011). While neither difference nor correlation with age was found in mothers born before 1984, the prevalence of 1·2%, 1·5%, 7·1% and 8·3%, respectively, was significantly different among (P = 0·008) and correlated with (P = 0·002) age in mothers born 1984 onwards. Regression analysis indicated there was a significantly higher incidence of HBsAg carriage from age 17 onwards (adjusted odds ratio 2·55, 95% confidence interval 1·07–6·10, P = 0·035), suggesting that the protective effect of the vaccine declined in late adolescence.

Six hundred and thirteen fresh diarrhoeal faeces were inoculated on Skirrow blood agar (SK), on Preston blood free agar (PBF), and in Campy-thioglycolate broth (CT). After 24 h of storage at 4 °C, specimens were again inoculated on SK and PBF, and in Campylobacter enrichment broth (CEB). CT tubes were placed overnight at 4 °C. Plates and CEB tubes were incubated at 43 °C in microaerophilic conditions. A total of 68 specimens was positive for campylobacter on direct plating. Sixty-four of them were also recovered after subculturing from CT, and only 51 from CEB. Delayed inoculation of plates after storage of samples at 4 °C yielded 57 isolates. The storage of faeces at 4 °C for 24 h significantly reduces the number of campylobacter isolates. When samples are not plated immediately we recommend inoculating a CT tube maintained at 4 °C overnight as a holding medium.

1. Immuno-conglutinin production by auto-stimulation was attempted in guinea-pigs, pigs, donkeys, rats and mice by the intravenous injection of a suspension of Gram-negative bacteria. The attempt was successful in rats and mice.

2. Experiments were carried out to elucidate the lack of response in guinea-pigs.

The author would like to thank Mr N. H. Hole of the Ministry of Agriculture Veterinary Laboratories at Weybridge, who inoculated and bled the donkeys used in these experiments.

Rabies is a prevalent and re-emerging disease in South Africa particularly in rural areas with high human densities. Outbreaks are frequently reported in the north and eastern parts of this country, probably an indication of inadequacy in the control of the disease. Following the 2005/2006 outbreak in Limpopo, we undertook an analysis of case surveillance data and genetically characterized 18 rabies viruses, all recovered from domestic dogs. Although rabies prevalence gradually declined annually from 2007, dog rabies still remains a public and veterinary health hazard in this region. Sylvatic rabies cycles are maintained by the black-backed jackal species in specific ecological conditions in the northwest of the province (Waterberg area), unlike in the north and east (Vhembe and Mopani districts, respectively), where spillover of infection between dogs and jackals is likely to predominate. Genetic analysis demonstrated that the rabies virus strain currently circulating within dog populations in Limpopo province is the same variant responsible for the 2005/2006 rabies outbreak. However, residual foci probably exist hence the observed sporadic outbreaks. These data further underline the value of continuous and sustainable dog immunization in controlling rabies.

A swabbing technique was compared with an excision and maceration technique for bacteriological sampling of pig carcass skin surfaces. Total viable counts at 37 °C obtained by swabbing were 46% of those obtained by maceration. At 21 °C, swabbing gave total viable counts which were 54% of the counts obtained from excision samples. Escherichia coli counts showed wide variation with both sampling methods. Neither method was more efficient than the other in recovering E. coli, although excision sampling gave generally higher counts. Both methods were equally effective at recovering salmonellac from carcass surfaces. There was no significant difference between the methods in recovering particular Salmonella serotypes.

On 13 November 2009, the authorities of Flemish Brabant, Belgium, received an alert concerning a potential outbreak of Shigella sonnei at a public institution. A study was conducted to assess the extent, discover the source and to implement further measures. We performed a matched case-control study to test an association between shigellosis and canteen-food consumption. Water samples and food handlers' faecal samples were tested. The reference laboratory characterized the retrospectively collected Shigella specimens. We found 52 cases distributed over space (25/35 departments) and time (2 months). We found a matched odds ratio of 3·84 (95% confidence interval 1·02–14·44) for canteen-food consumption. A food handler had travelled to Morocco shortly before detection of the first laboratory-confirmed case. Water samples and food handlers' faecal samples tested negative for Shigella. Confirmed cases presented PFGE profiles, highly similar to archived isolates from Morocco. Foodborne transmission associated with the canteen was strongly suspected.

Twenty–four cultures comprising 20 clinical isolates of ‘Klebsiella aerogenes’ from two hospitals, a reference strain of ‘K. aerogenes’ and the type strains of three other Klebsiella species, were characterized by one–dimensional sodium dodecyl sulphate–polyacrylamide gel electrophoresis (SDS–PAGE) of whole–cell proteins. The protein patterns were highly reproducible and were used as the basis of a numerical analysis which divided the clinical isolates into 12 protein types. Comparison with established typing methods indicated that the level of discrimination of SDS–PAGE was similar to that achieved with conventional typing methods but the strains were grouped differently. Protein typing sub–divided five serotype K3 isolates that could also be distinguished by phage typing. Conversely, three strains of protein type 11 were clearly distinguishable by both serotyping and phage typing. We conclude that high–resolution SDS–PAGE of proteins provides an effective adjunct to other methods for typing isolates of ‘K. aerogenes’.

Serological markers and peak serum alanine aminotransferase (ALT) values of 140 in-patients with acute hepatitis, either type A (n = 90), or type B (n = 50) were prospectively assessed. In 23 out of the 90 patients with acute hepatitis A, evidence of previous experience with hepatitis B virus (HBV) was found, whereas 35 out of the 50 patients with acute hepatitis B had past contact with hepatitis A virus (HAV). The mean peak ALT values [S.D.] were significantly higher in hepatitis A patients with previous experience with HBV (1413 [704] i.u./l), when compared to those without such experience (842 [464] i.u./l, P < 0·001). Such a difference was not evident between acute hepatitis B patients, whether or not they had previous contact with HAV. We conclude that when acute hepatitis A is superimposed on past HBV infection an augmented transaminaemia, indicative of enhanced liver cell necrosis, takes place although a definite explanation is lacking. We suggest that individuals with markers of HBV infection should be early candidates for HAV immunization.

The seroepidemiology of Cryptosporidium infection was investigated in a representative sample of a normal population in the State of Sao Paulo, Brazil using a recombinant form of the immunodominant 27-kDa sporozoite antigen. IgG seropositivity was low in infants following loss of maternal antibody but quickly increased to ~60% by 5 years, then 80% by the age of 10 years, after which prevalence remained constant. The broad range of antibody concentrations is consistent with previous reports that the IgG response to C. parvum is short-lived. There is also evidence that average antibody concentrations increase with age. Results suggest that the recombinant antigen may be a more sensitive method of measuring seroprevalence than the native antigen in Western blot. Although cross-sectional studies can provide an insight into the epidemiology of C. parvum in normal populations, further studies investigating the dynamics of the humoral immune responses to Cryptosporidium and the use of serology in epidemiological studies are required.

This study assessed the incidence and risk factors for dengue virus (DENV) infection among children in a prospective birth cohort conducted in the city of Recife, a hyperendemic dengue area in Northeast Brazil. Healthy pregnant women (n = 415) residing in Recife who agreed to have their children followed were enrolled. Children were followed during their first 24 months of age (May/2011–June/2014), before the 2015 Zika virus outbreak. DENV infection was detected by reverse-transcriptase polymerase chain reaction and/or serology (anti-DENV IgM/IgG). The incidence rates per 1000 person-years (py) and its association with risk factors by age bands (0–12, >12–30 months) were estimated through Poisson regression models. Forty-nine dengue infections were detected; none progressed to severe forms. The incidence rates were 107·6/1000py (95% CI 76·8–150·6) and 93·3/1000py (95% CI 56·1–154·4) in the first and second years of age, respectively. Male children (risk ratios (RR) = 2·33; 95% CI 1·09–4·98) and those born to DENV-naïve mothers (RR = 2·42; 95% CI 1·01–5·80) were at greater risk of infection in the first year of age. In the second year, children born to Caucasian/Asian descent skin colour mothers had a threefold higher risk of infection (RR = 3·34; 95% CI: 1·08–10·33). These data show the high exposure of children to DENV infection in our setting and highlight the role of biological factors in this population's susceptibility to infection.

The prevalence and epidemiological traits of human immunodeficiency virus (HIV)/hepatitis B virus (HBV) infections in high-risk populations (HRPs) remained unclarified in Japan. We determined the prevalence of HIV, HBV and Treponema pallidum (TP) and the viral genotypes in HRPs who attended primary sexually transmitted infection (STI) clinics in Osaka province during 2006–2011. Of 7898 specimens, 133 (1·7%) were HIV positive, which was significantly higher than the figures reported by Japanese Red Cross (0·0019%) and public health centres (0·27%) in Japan. The frequency of HIV-1 subtype B was 88·7%, followed by CRF01_AE (2·3%) and C (0·8%), which were almost identical to the national trend. HBV seroprevalence was surprisingly high in the HIV-positive group (63·2%), which was significantly higher than that in the HIV-negative group (25·6%). By contrast, there was no statistical correlation between HIV and TP infection. Interestingly, the distinct HBV genotypes Ae and G were prevalent in the HIV-positive population (60·0% and 20·0%, respectively), although both were rarely detected during nationwide surveillance. The transmission of HIV and HBV appeared to occur largely within a closed community early in life. Of note, about one-quarter of HIV-positive cases would have remained untested if health professionals had not motivated individuals to undergo HIV testing. This is the first evidence-based assessment of HIV positivity and HIV/HBV co-infection in HRPs at primary STIs in Japan and the effect of the involvement of health professionals in the diagnosis of HIV infections in asymptomatic carriers. The genotyping of HBV provided valuable information for understanding HIV epidemical traits.

We analysed associations between exposure to nightlife businesses and severe acute respiratory syndrome coronavirus 2 PCR test results at a tertiary hospital in Tokyo between March and April 2020. A nightlife group was defined as those who had worked at or visited the businesses. We included 1517 individuals; 196 (12.9%) were categorised as the nightlife group. After propensity score matching, the proportion of positive PCR tests in the nightlife group was significantly higher than that in the non-nightlife group (nightlife, 63.8%; non-nightlife, 23.0%; P < 0.001). An inclusive approach to mitigate risks related to the businesses needs to be identified.

The growth of eight strains of Newcastle disease virus in chick embryo chorioallantoic membranes was studied by comparing, at different times after infection, the amounts of haemagglutinin released into the allantoic fluid (extracellular haemagglutinin) with that associated with the membrane (cell-associated haemagglutinin). The virulence of the strains examined differed in that some killed chick embryos more rapidly than others. All strains released similar amounts of extracellular haemagglutinin and maximum titres were achieved about 12 hr. after infection. With virulent strains cell-associated haemagglutinin titres increased exponentially until the death of the host and maximum titres were much higher than those of extracellular haemagglutinin. With avirulent strains cell-associated haemagglutinin titres increased exponentially for only a limited time and titres were always lower than the titres of extracellular haemagglutinin.

Similar results were obtained when the titres of neuraminidase and viral ribonucleoprotein were measured during the growth of two virulent and two avirulent strains. Virulence appears to be associated with the continued intracellular accumulation of viral antigens.

During outbreaks of hospital-acquired influenza-like illness (HA-ILI) healthcare workers (HCWs), patients, and visitors are each a source of infection for the other. Quantifying the effects of these various exposures will help improve prevention and control of HA-ILI outbreaks. We estimated the attributability of HA-ILI to: (1) exposure to recorded or unrecorded sources; (2) exposure to contagious patient or contagious HCW; (3) exposure during observable or unobservable contagious period of the recorded sources; and, (4) the moment of exposure. Among recorded sources, 59% [95% credible interval (CrI) 34–83] of HA-ILI of patients was associated with exposure to contagious patients and 41% (95% CrI 17–66) with exposure to contagious HCWs. Exposure during the unobservable contagiousness period of source patients accounted for 49% (95% CrI 19–75) of HA-ILI, while exposure during the unobservable contagiousness period of source HCWs accounted for 82% (95% CrI 51–99) of HA-ILI. About 80% of HA-ILIs were associated with exposure 1 day earlier. Secondary cases of HA-ILI might appear as soon as the day after the detection of a primary case highlighting the explosive nature of HA-ILI spread. Unobservable transmission was the main cause of HA-ILI transmission suggesting that symptom-based control measures alone might not prevent hospital outbreaks. The results support the rapid implementation of interventions to control influenza transmission.

In this study, we estimate the burden of foodborne illness (FBI) caused by five major pathogens among nondeployed US Army service members. The US Army is a unique population that is globally distributed, has its own food procurement system and a food protection system dedicated to the prevention of both unintentional and intentional contamination of food. To our knowledge, the burden of FBI caused by specific pathogens among the US Army population has not been determined. We used data from a 2015 US Army population survey, a 2015 US Army laboratory survey and data from FoodNet to create inputs for two model structures. Model type 1 scaled up case counts of Campylobacter jejuni, Shigella spp., Salmonella enterica non-typhoidal and STEC non-O157 ascertained from the Disease Reporting System internet database from 2010 to 2015. Model type 2 scaled down cases of self-reported acute gastrointestinal illness (AGI) to estimate the annual burden of Norovirus illness. We estimate that these five pathogens caused 45 600 (5%–95% range, 30 300–64 000) annual illnesses among nondeployed active duty US Army Service members. Of these pathogens, Norovirus, Campylobacter jejuni and Salmonella enterica non-typhoidal were responsible for the most illness. There is a tremendous burden of AGI and FBI caused by five major pathogens among US Army Soldiers, which can have a tremendous impact on readiness of the force. The US Army has a robust food protection program in place, but without a specific active FBI surveillance system across the Department of Defence, we will never have the ability to measure the effectiveness of modern, targeted, interventions aimed at the reduction of specific foodborne pathogens.