We analysed the serotypes and antibiotic susceptibility of 1560 human and 1505 non-human Salmonella isolated in New Zealand (NZ) between 2002 and 2007. The most common serotypes in humans were Salmonella enterica serovar Typhimurium, S. Enteritidis, S. Brandenburg and S. Infantis. Over the 6-year period human cases due to S. Agona and S. Enteritidis increased and cases due to S. Typhimurium decreased. The most common serotypes from non-human sources were S. Typhimurium, S. Brandenberg, S. Hindmarsh and S. Infantis, and there were no significant changes over time. More isolates were non-susceptible to streptomycin than to any other antibiotic. Almost all isolates were susceptible to ciprofloxacin and gentamicin. There were significant trends of increasing non-susceptibility to streptomycin and sulfonamides in isolates from human and non-human sources, while ampicillin, tetracycline and multidrug non-susceptibility also increased in human isolates. Despite these increases, rates of antibiotic non-susceptibility in Salmonella in NZ are still lower than in many international settings.

More organisms were found on the paralysed hands of hemiplegic patients than on their unaffected ones. However, both showed considerably higher bacterial counts than did geriatric patients without paralysis. An infection rate for Cl. welchi of 15% was found in the paralysed hands.

Data are rare on influenza outbreaks spreading through a workplace, but such transmission dynamics would be useful for comparison with the spread of the infection in other settings. We collected and compared infection data from two settings, a workplace and a university campus, during the 2009 pandemic influenza A(H1N1)pdm09 outbreak in a geographically contained community. Trajectories of infection were markedly alike in both settings. This suggests that transmission behaviour was similar in individuals in the two environments, despite the condition that individuals can leave the workplace setting in order to avoid transmission.

1. Refection occurs as a rule in rats receiving diets containing raw potato starch.

2. Rats were maintained for one year on a diet deficient in the vitamin B complex and containing raw potato starch. Two of them attained a weight of almost 300 grm. and made sustained gains at a rate of almost 4 grm. daily.

3. Rapid decline, symptoms of vitamin B1 and B2 deficiency and death were observed in these rats after their diet had been steamed.

4. Steaming under identical conditions does not alter the vitamin B (complex) content of other diets.

The purpose of these papers was:

(i) To ascertain the standardized death-rates for tuberculosis among the urban Chinese of Hong Kong.

(ii) To review the more important articles dealing with tuberculosis among the chinese.

(iii) To compare the data obtained in (ii) with those found in this survey of urban Chinese in Hong Kong.

Topical medicaments used in the treatment and prevention of pressure sores in patients in three hospitals were examined for Pseudomonas aeruginosa and Staphylococcus aureus contamination. Contamination rates were found to vary between hospitals and were affected by differences in the packaging of the product and in the method of application used by the nursing staff.

A large-scale mass vaccination campaign was carried out in Java, Indonesia in an attempt to control outbreaks of highly pathogenic avian influenza (HPAI) in backyard flocks and commercial smallholder poultry. Sero-monitoring was conducted in mass vaccination and control areas to assess the proportion of the target population with antibodies against HPAI and Newcastle disease (ND). There were four rounds of vaccination, and samples were collected after each round resulting in a total of 27 293 samples. Sampling was performed irrespective of vaccination status. In the mass vaccination areas, 20–45% of poultry sampled had a positive titre to H5 after each round of vaccination, compared to 2–3% in the control group. In the HPAI + ND vaccination group, 12–25% of the population had positive ND titres, compared to 5–13% in the areas without ND vaccination. The level of seropositivity varied by district, age of the bird, and species (ducks vs. chickens).

With economic development, non-communicable diseases replace infectious diseases as the leading cause of death; how such transition occurs for infectious diseases with long latency has rarely been considered. We took advantage of a Chinese population with rapid economic development in the mid-20th century to study changing patterns of infection-related cancers. We used sex-specific Poisson regression to estimate age, period and cohort effects on adult deaths 1976–2005 from eight infection-related cancers in Hong Kong. Cervical, head and neck, and oesophageal cancers, associated with sexually transmitted infections, decreased for the first birth cohorts with sexual debut in a more developed environment. Leukaemia and non-Hodgkin's lymphoma, associated with vertically transmitted infections, decreased for the first cohorts born into a more developed environment. Birth cohort patterns were unclear for nasopharyngeal, stomach and liver cancers. Mortality rates for cancers related to early infections may depend on population history, with delayed reductions for some infection-related cancers.

1. Of 318 Polish refugees now living in this country 30% gave a history of typhus fever; nearly half of these had complement-fixing antibodies to a titre of 1–5 or more to epidemic typhus. A further 12% without such a history similarly had these antibodies making a total of 22% of 318 refugees. None of the 174 British born controls had antibodies up to this titre.

2. Brill-Zinsser disease may occur from time to time among immigrants or visitors from typhus endemic areas to this country, but it is unlikely to be a serious problem.

3. The clinical diagnosis of Brill-Zinsser disease may not be easy because the characteristic rash is not always to be seen. Any patient of Eastern European origin or who has a history of typhus complaining of fever and severe headache should be examined serologically by the rickettsial agglutination or the complement-fixation test for specific epidemic typhus antibodies. The Weil-Felix reaction may be positive, but a negative result will not exclude a diagnosis of Brill-Zinsser disease.

We acknowledge with gratitude the help, interest and advice of Dr E. S. Murray, of the School of Public Health, Harvard University and Dr Janet Niven and also the technical assistance of Mr J. P. Brooks, FIMLT. We have to thank Messrs Lederle for their kindness in supplying the rickettsial antigens and in addition those who helped us to obtain the specimens and the volunteers who supplied them.

Jamestown Canyon and snowshoe hare viruses are two emerging human pathogens associated with cases of neuroinvasive disease in North America. This study aimed to identify environmental and individual risk factors for seropositivity to these arboviruses in humans and pet dogs from Québec, Canada, 2012–2014. In humans, areas with moderate densities of white-tailed deer (Odocoileus virginianus) were associated with higher odds of seropositivity compared with areas with low densities of white-tailed deer (OR 2.50, P = 0.009) and odds of seropositivity were higher in males than in females (OR 2.03, P = 0.016). Among humans reporting more than 10 mosquito bites weekly, the odds of being seropositive were 4.44 times higher (P = 0.004) for people living in hardwood forested areas. Exposure to areas with coniferous forests was identified as the main environmental risk factor for seroconversion in dogs (OR 2.39, P = 0.04). These findings may help target further public health research, diagnostic and surveillance efforts in Canada.

Birds play a central role in the epidemiology of several flaviviruses of concern for public and veterinary health. Seabirds represent the most abundant and widespread avifauna in the western Indian Ocean and may play an important role as host reservoirs and spreaders of arthropod-borne pathogens such as flaviviruses. We report the results of a serological investigation based on blood samples collected from nine seabird species from seven islands in the Indian Ocean. Using a commercial competitive enzyme-linked immunosorbent assay directed against the prototypic West Nile flavivirus, antibodies against flaviviruses were detected in the serum of 47 of the 855 seabirds tested. They were detected in bird samples from three islands and from four bird species. Seroneutralization tests on adults and chicks suggested that great frigatebirds (Fregata minor) from Europa were infected by West Nile virus during their non-breeding period, and that Usutu virus probably circulated within bird colonies on Tromelin and on Juan de Nova. Real-time polymerase chain reactions performed on bird blood samples did not yield positive results precluding the genetic characterization of flavivirus using RNA sequencing. Our findings stress the need to further investigate flavivirus infections in arthropod vectors present in seabird colonies.

Prevention of secondary household transmission of Shiga toxin-producing Escherichia coli (STEC) is important in outbreak settings. We examined factors contributing to secondary household transmission during STEC outbreaks in daycare centres in Japan. Suspected STEC outbreaks in daycare centres were identified by the National Epidemiological Surveillance of Infectious Diseases. Questionnaires were sent to local health centres that responded to outbreaks. Secondary household transmission rates were calculated, and factors affecting secondary household transmission rate were analysed by multilevel analysis. The secondary household transmission rates in 16 outbreaks ranged from 0% to 34·4% (median 4·4%). The highest rate (23·0%) was observed in siblings aged 6–9 years, and the infection rate was significantly higher for mothers than for fathers and grandparents (P < 0·05). Using multilevel analysis, the following variables were selected in the best model: information provided face-to-face (vs. letter or telephone) to families of children in daycare centres (at initial response), STEC type and lag time (days) between onset and providing information. Early response and hygiene education by visiting local health centre staff may be effective measures to prevent secondary household transmission in STEC outbreaks. Hygiene education should be emphasized for children aged 6–9 years, as well as for younger children.

The problem as to the frequency with which multiple cases of, or deaths from, a disease may be expected to occur in the same house has been attacked by Troup and Maynard (1911–12), Karl Pearson (1911–12, 1911–12 a, 1913), McKendrick (1911–12), Greenwood and Yule (1920), Greenwood (1910, 1931) and others. Troup and Maynard obtained a general expression for the frequency of occurrence, and the standard deviation of the frequency, of s casesin a house when n cases of a disease occur in a town with m houses, assumingeach house to contain the same number of persons, all equally liable to contract it. Karl Pearson (1911–12) considered the problem as analogous to throwing balls at random into equally accessible pigeon-holes, and showed that since the chance that any one case will fall into any one house is , and that it will not is , the numbers of houses having 0, 1, 2, 3, ... cases should be given by the successive terms of the binomial . In a later paper (1913) he showed that the correspondence between the observed andexpected frequencies could be measured by applying the ordinary X2 test to the frequencies, omitting the houses having no cases.

There is limited information on the roles of different age groups in propagating pertussis outbreaks, and the temporal changes in those roles since the introduction of acellular pertussis vaccines. The relative roles of different age groups in propagating the 2010 and the 2014 pertussis epidemics in California were evaluated using the relative risk (RR) statistic that measures the change in the group's proportion among all detected cases before vs. after the epidemic peak. For the 2010–11 epidemic, evidence for a predominant transmission age group was weak, with the largest RR estimates being 1.26 (95% CI 1.08–1.46) (aged 11–13 years); 1.19 (1.01–1.4) (aged 9–10 years); 1.17 (0.86–1.59) (aged 14–15 years); 1.12 (0.86–1.46) (aged 16–19 years) and 1.1 (0.89–1.36) (aged 7–8 years). The 2014 epidemic showed a strong signal of the role of older adolescents, with the highest RR estimate being in those aged 14–15 years (RR = 1.83, 1.61–2.07), followed by adolescents aged 16–19 years (RR = 1.41, 1.24–1.61) and 11–13 years (RR = 1.26, 1.12–1.41), with lower RR estimates in other age groups. As the time following introduction of acellular pertussis vaccines in California progressed, older adolescents played an increasing role in transmission during the major pertussis outbreaks. Booster pertussis vaccination for older adolescents with vaccines effective against pertussis transmission should be considered with the aim of mitigating future pertussis epidemics in the community.

Limited information is available on the prevalence of hepatitis C virus (HCV) in the general population in China. A community-based epidemiological study was conducted in three counties in eastern China. A total of 149 175 individuals were investigated in 60 communities in three counties in Jiangsu province, eastern China, of whom 1175 subjects [0·79%, 95% confidence interval (CI) 0·74–0·83] were HCV antibody positive. The prevalence was low in children (0·09%, 95% CI 0·04–0·17), but increased progressively from adolescents (0·20%, 95% CI 0·15–0·28) to adults aged ⩾21 years (95% CI 0·15–1·64). Women had a higher prevalence of HCV infection than men in most age groups. In a multilevel regression analysis, age, sex, education, occupation, blood transfusion [odds ratio (OR) 2·91, 95% CI 1·09–5·37], invasive testing (OR 1·28, 95% CI 1·14–1·61), and dental therapy (OR 2·27, 95% CI 1·41–3·42) were associated with HCV infection. In conclusion, although the prevalence of HCV in this population was lower than reported from national levels, the total reservoir of infection is significant and warrants public health measures, such as health education to limit the magnitude of the problem.

The properties of pyriminyl (N-3-pyridylmethyl-N′-p-nitrophenyl urea) as a rodenticide against the lesser bandicoot rat (Bandicota bengalensis) in Rangoon, Burma, were investigated in the laboratory. The acute LD 50 and LD 95 dose of orally administered pyriminyl for B. bengalensis were found to be 6·7 mg/kg and 23·0, mg/kg of body weight respectively. When caged bandicoots were given a choice between plain and poisoned baits, the optimum rodenticidal concentration in the bait was found to be 0·25–0·5%. Symptoms of pyriminyl poisoning appear from 1 to 4 h after feeding starts, giving individual animals time to consume from 2 to over 30 LD 50 doses of 0·5% pyriminyl before feeding stops. Deaths occurred from 4 to 96 h after either oral dosing or free-choice feeding. There appeared to be no significant aversion to the poison at 0·25% or 0·5% concentration in foods. The potential hazards and use of pyriminyl as a field bait against populations of B. bengalensis are discussed.

The distribution of phage types was studied among 577 strains of Salmonella typhi from Indonesia. Chemotype, colicinogeny, and tetrathionate reductase activity were also studied for most of these strains. The current phage type formula for Java was determined to be: A, D2, D6, E1a, E2, M1, and 46, but two other large groups of strains were also found, I +IV and degraded Vi + strains. Significant differences in S. typhi strain distributions were noted between two localities on Java with respect to phage type and tetrathionate reductase activity. Comparisons were made with past phage typing studies in Jakarta as well as with more recent studies in other parts of south-east Asia. Phage types A, Dl, D2, and El persisted at a rather steady level in Jakarta for 28 years. Evidence was found for epidemiological links to European and Asian areas. Antibiotic resistance among these Indonesian S. typhi strains was rare.

1. Experience of 4½ years of intravenously administered scarlatinal antitoxin, in 1204 cases, confirms the tentative conclusions reached in 1928, viz. that the acute stage of the disease can generally be arrested in 12–24 hours, complications almost wholly prevented, and the period of morbidity reduced to a little over a fortnight.

2. These effects were obtained in hospital wards where over 50 per cent, of the cases, generally about 75 per cent, and including all the worst, were so treated, and it is possible that the reduction of mass infection obtained in the wards by this means is an essential condition for obtaining such results. Under such conditions relapses and cross-infections were very rare.

3. Some evidence was obtained that intravenous antitoxin administered in the acute stage of scarlet fever largely prevents the onset of septic complications, including the late septic type itself, scarlatina anginosa; and that it may be of striking benefit in the treatment of the septic type, even at a late stage.

4. The importance of proved clinical potency and freedom from dangerous reactions of each individual batch of serum to be employed, is stressed.

5. Indications and contra-indications are stated.

6. Certain precautions and details of technique are recommended.

Spatial–temporal patterns of measles incidence reflect the spatial distribution of human hosts. The heterogeneous spatial distribution of communities has been shown to introduce spatially dependent temporal lags in the timing of measles incidence. Incidence patterns reflect internal dynamics within a community and coupling of communities through the movement of infectious individuals. The central role of human movement in coupling dynamics in separate communities suggests that physical geographic barriers to movement should reduce spatial–temporal correlation. We examine measles dynamics in Maryland and Pennsylvania during the period of 1917–1938. The central feature of interest is the Chesapeake Bay, which separates Maryland into two distinct regions. We find that correlation of measles incidences in communities separated by the bay is reduced compared to communities not separated by the bay, suggesting the bay acted as a barrier to human movement during this time sufficient to decouple measles dynamics in Maryland counties.

Healthcare-associated infection (HAI) is a major cause of morbidity, mortality and cost, which vary widely by region and hospital. In this case-control study, we calculated losses attributable to HAI in central China. A total of 2976 patients in 10 hospitals were enrolled, and the incidence rate of HAI (range, 0.88–4.15%) was significantly, but negatively associated with the cost per 1000 beds of its prevention (range, $24 929.76–$53 146.41; r = −0.76). The per capita economic loss attributable to HAIs was $2047.07 (interquartile range, $327.63–$6429.17), mainly from the pharmaceutical cost (median, $1044.39). The HAIs, which occurred in patients with commercial medical insurance, affected the haematologic system and caused by Acinetobacter baumannii, contributed most to the losses (median, $3881.55, $4734.20 and $9882.75, respectively). Furthermore, the economic losses attributable to device-associated infections and hospital-acquired multi-drug resistant bacteria were two to four times those of the controls. The burden attributable to HAI is heavy, and opportunities for easing this burden exist in several areas, including that strengthening antibiotic stewardship and practicing effective bundle of HAI prevention for patients carrying high-risk factors, for example, elders or those with catheterisations in healthcare institutions, and accelerating the medical insurance payment system reform based on diagnosis-related groups by policy-making departments.