Meningococcal meningitis is a major public health problem in the African Belt. Despite the obvious seasonality of epidemics, the factors driving them are still poorly understood. Here, we provide a first attempt to predict epidemics at the spatio-temporal scale required for in-year response, using a purely empirical approach. District-level weekly incidence rates for Niger (1986–2007) were discretized into latent, alert and epidemic states according to pre-specified epidemiological thresholds. We modelled the probabilities of transition between states, accounting for seasonality and spatio-temporal dependence. One-week-ahead predictions for entering the epidemic state were generated with specificity and negative predictive value >99%, sensitivity and positive predictive value >72%. On the annual scale, we predict the first entry of a district into the epidemic state with sensitivity 65·0%, positive predictive value 49·0%, and an average time gained of 4·6 weeks. These results could inform decisions on preparatory actions.

Population-based seroprevalence studies on coronavirus disease 2019 (COVID-19) in low- and middle-income countries are lacking. We investigated the seroprevalence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) antibodies in Sergipe state, Northeast Brazil, using rapid IgM−IgG antibody test and fluorescence immunoassay. The seroprevalence was 9.3% (95% CI 8.5–10.1), 10.2% (95% CI 9.2–11.3) for women and 7.9% (IC 95% 6.8–9.1) for men (P = 0.004). We found a decline in the prevalence of SARS-CoV-2 antibodies according to age, but the differences were not statistically significant: 0–19 years (9.9%; 95% CI 7.8–12.5), 20–59 years (9.3%; 95% CI 8.4–10.3) and ≥60 years (9.0%; 95% CI 7.5–10.8) (P = 0.517). The metropolitan area had a higher seroprevalence (11.7%, 95% CI 10.3–13.2) than outside municipalities (8.0%, 95% CI 7.2–8.9) (P < 0.001). These findings highlight the importance of serosurveillance to estimate the real impact of the COVID-19 outbreak and thereby provide data to better understand the spread of the virus, as well as providing information to guide stay-at-home measures and other policies. In addition, these results may be useful as basic data to follow the progress of COVID-19 outbreak as social restriction initiatives start to be relaxed in Brazil.

Despite considerable efforts to control tuberculosis (TB) among Ethiopian immigrants in Israel, an outbreak of TB among second-generation Ethiopian immigrants that involved native Israelis occurred between January 2011 and December 2019. The aim of this article is to report on this outbreak and discuss the patient and health system barriers that led to its propagation. Overall, 13 culture-positive TB patients were diagnosed in this outbreak. An additional 36 cases with identical mycobacterium tuberculosis genotypes were identified through cross-checking with the National TB Laboratory Registry. Among the 32 close contacts of the index case, 18 (56.3%) reported for screening and treatment of latent TB infection (LTBI) was recommended for 11 (61.1%) of them. However, none completed treatment and eight eventually developed TB. Of the 385 close contacts identified in this outbreak, 286 (74.3%) underwent contact investigation, 154 (53.8%) were recommended LTBI treatment, but only 26 (16.9%) completed the treatment. Routine contact investigation and treatment practice measures failed to contain the cascade of infection and disease, leading to the spread of the infecting strain of TB. This report highlights the challenges to identify the high-risk group and address barriers to care among such a vulnerable population.

Over a four-year period 878 samples of faeces were collected from five species of small wild rodents and two species of shrews at sites in England, Scotland and Wales. A search was made for Salmonella in these samples but no isolations of this genus were made. Several other genera of Enterobacteriaceae were identified.

Trimethoprim-resistance genes of Shigella dysenteriae 1 strains, isolated from a different location of six different countries of Asia over a 5-year period were characterized by using three different dihydrofolate reductase (DHFR) gene probes. The trimethoprim-resistant (TMPR) strains hybridized only with the type I DHFR gene probe by colony hybridization. None of the strains hybridized with types II and III DHFR gene probes. Southern blot experiments using plasmid DNA extracted from these resistant strains indicated that the type I DHFR genes were either on a 20 MDa plasmid or might be located on the chromosome. None of the other plasmids present in S. dyysenteriae 1 strains hybridized with the probe. This indicates that the TMP resistance in these S. dysenteriae 1 strains are mediated by type I DHFR enzyme, and there may be transposition of this type I DHFR gene occurs between the 20 MDa plasmid and the chromosome in this serotype of shigella.

Recovery of Yersinia enterocolitica and related strains from faecal samples enriched in 1% buffered peptone water (pH 7·2) and incubated at 4 °C for 17–21 days was compared with recovery from 1% peptone water buffered to pH 8·0 and incubation over the temperature range 4–26°C. Best recovery was obtained by use of the alkaline medium incubated at 9°C. Greatest recovery was obtained after incubation for 10–14 days, but most strains (> 75%) were recovered after 1 week.

After encouraging results of the mass vaccination programme in Iran, in which 5 million children in rural areas were vaccinated with the Japanese Sugiyama strain at its 82nd passage in baby calf kidney, and a progressive decrease in the incidence of measles as well as a reduction of excessive infant mortality, a further attenuated vaccine, produced with the same strain, cloned in Japan, was compared in a field trial with the parent vaccine. The new strain caused fewer reactions than the original strain. Seroconversion with a geometric mean antibody titre of 6·1 was observed in 95% of susceptible children.

An investigation is reported into sepsis due to Staphylococcus aureus in the maternity unit of a provincial hospital and in domiciliary midwifery in the same town.

In the hospital Staph. aureus infections of mother or infant occurred 123 times per 1000 live births in one ward and 116 per 1000 in another, but the use of hexachlorophane powder on the infants in one ward reduced the sepsis rate in that ward to 34 cases per 1000 live births, thus confirming the reports by two teams in Bristol hospitals. Sepsis was more frequent in both mothers and infants after Caesarean delivery than after normal labour. Reasons are given for thinking that ‘sticky eyes’ are usually not caused by the bacteria isolated when the eyes are swabbed.

The rate of infection in domiciliary cases was 39 per 1000 live births. As all these were normal deliveries the sepsis rate cannot be directly compared with that occurring among complicated cases in hospital.

No evidence was found that hospital Staph. aureus strains carried home by newly born infants were causing a significant amount of sepsis among their home contacts within 28 days of delivery.

The importance of nurses as sources of infecting strains of Staph. aureus in maternity work is discussed. The infant-to-infant route of transmission has been stressed in the literature but reasons are given for believing that nurse-to-infant infection in the labour room may also be important under certain circumstances.

I am greatly indebted to Dr V. P. Randall Martin, formerly Senior Medical Officer in the Hampshire County Health Department, who organized the follow-up of patients after leaving hospital and after home delivery, and also to the County Medical Officer Dr I. A. MacDougall for his help.

I am also grateful to Messrs P. R. Mitchell and G. T. Hammond for permission to investigate their wards and to Sister D. M. Carter and her staff, and to the County midwives and Health Visitors, for their co-operation.

Dr G. J. G. King kindly undertook the phage-typing of a large number of strains of Staph. aureus at the Bournemouth Public Health Laboratory, for which I am most grateful.

I am also grateful to Dr W. A. Gillespie for information in advance of publication, and for advice, about the hexachlorophane regimen of which he and his Bristol colleagues were the pioneers.

Tremendous advancements in syndromic surveillance strategies over the last two decades, and specifically from prior mass gatherings, have been incorporated into day-to-day healthcare analysis worldwide and have left a lasting indirect impact since their inception. Mass gatherings are a daily occurrence worldwide and provide a scenario ripe for public health aims and objectives utilising syndromic surveillance. Europe is less than a decade away from hosting a colossal worldwide gathering (2024 Summer Olympics) in likely a time when the global agreement is in flux. A call to arms is needed for additional surveillance strategies incorporating mobile application symptom checker data, telemedicine, social media and social data sensing. There remains a need for an optimal combination of real-time data sensing that captures the whole population, but to reach that goal we must incorporate new advancements into baseline epidemiologic data monitoring, otherwise we will be tracking real-time mass gathering events on top of inaccurate baseline epidemiologic data.

Two variants of Listeria monocytogenes were isolated from blood cultures from each of two patients with listeriosis. Each variant displayed a two-band difference in DNA profile from the other by pulsed-field gel electrophoresis. Although this difference in profile is insufficient to distinguish clearly between the variants, the possibility of co-infection with different strains of L. monocytogenes needs to be considered. We suggest that more than one colony should be selected for molecular typing to aid interpretation during investigation of the sources and routes of Listeria infection.

We conducted a matched case-control (MCC), test-negative case-control (TNCC) and case-cohort study in 2016 in Lusaka, Zambia, following a mass vaccination campaign. Confirmed cholera cases served as cases in all three study designs. In the TNCC, control-subjects were cases with negative cholera culture and polymerase chain reaction results. Matched controls by age and sex were selected among neighbours of the confirmed cases in the MCC study. For the case-cohort study, we recruited a cohort of randomly selected individuals living in areas considered at-risk of cholera. We recruited 211 suspected cases (66 confirmed cholera cases and 145 non-cholera diarrhoea cases), 1055 matched controls and a cohort of 921. Adjusted vaccine effectiveness of one dose of oral cholera vaccine (OCV) was 88.9% (95% confidence interval (CI) 42.7–97.8) in the MCC study, 80.2% (95% CI: 16.9–95.3) in the TNCC design and 89.4% (95% CI: 64.6–96.9) in the case-cohort study. Three study designs confirmed the short-term effectiveness of single dose OCV. Major healthcare-seeking behaviour bias did not appear to affect our estimates. Most of the protection among vaccinated individuals could be attributed to the direct effect of the vaccine.

To control hepatitis A spread by vaccination, accurate estimation of transmissibility is vital. Regan et al. (2016) proposed a model of hepatitis A virus (HAV) transmission and used least squares to calibrate model to the 1991/1992 HAV outbreak in men who have sex with men (MSM) in Sydney, Australia. Based on the estimate of R0, they obtained the critical immunity of 70% and showed that when the proportion immune <70%, there is a definite chance for outbreaks to take place. The immunity level from previous surveys ranges from 32% to 64% after 1996 while no outbreaks in Australian MSMs have been reported since 1996. Further noticing the ill-distributed parameters, we argue that their estimate of R0 is not accurate. In this study, we revisited their model by Bayesian inference, which has privilege over least squares. We obtained the appropriate posterior distributions of parameters and the estimate of R0 ranges from 1.38 to 2.89, indicating a critical immunity of 65%. The reduction in critical immunity and outbreak probabilities predicts the absence of outbreaks in Australian MSMs since 1996. Our study shows the importance of using appropriate methods to provide reliable and accurate estimates of the model parameters especially the transmissibility.

Big data has been reported widely to facilitate epidemic prevention and control in health care during the coronavirus disease 2019 (COVID-19) pandemic. However, there is still a lack of practical experience in applying it to hospital prevention and control. This study is devoted to the practical experience of design and implementation as well as the preliminary results of an innovative big data-driven COVID-19 risk personnel screening management system in a hospital. Our screening system integrates data sources in four dimensions, which includes Health Quick Response (QR) code, abroad travelling history, transportation close contact personnel and key surveillance personnel. Its screening targets cover all patients, care partner and staff who come to the hospital. As of November 2021, nearly 690 000 people and 5.79 million person-time had used automated COVID-19 risk screening and monitoring. A total of 10 376 person-time (0.18%) with abnormal QR code were identified, 242 person-time with abroad travelling history were identified, 925 person-time were marked based on the data of key surveillance personnel, no transportation history personnel been reported and no COVID-19 nosocomial infection occurred in the hospital. Through the application of this system, the hospital's expenditure on manpower and material resources for epidemic prevention and control has also been significantly reduced. Collectively, this study has proved to be an effective and efficient model for the use of digital health technology in response to the COVID-19 pandemic. Based on the data from multiple sources, this system has an irreplaceable role in identifying close contacts or suspicious person, and can significantly reduce the social burden caused by COVID-19, especially the human resources and economic costs of hospital prevention and control. It may provide guidance for clinical epidemic prevention and control in hospitals, as well as for future public health emergencies.

The incidence of Industrial Lead Poisoning is closely related to those sections of the manufactures which involve the production of dust. In white-lead works, paint-grinding shops, litharge grinding, electrical accumulator works, etc., the dust takes the form of minute particles of the special compound of lead manipulated by the workman. In smelting, desilverising, trimming metals and in file cutting, finely divided metallic lead, or a lead oxide, is present in the workshop air.

Circulation of methicillin-resistant Staphylococcus aureus (MRSA) outside hospitals could alter the impact of hospital-based control strategies. We investigated two groups of cases (each matched to controls with MRSA): 61 ‘community cases’ not in acute hospital in the year before MRSA isolation; and 21 cases with ciprofloxacin-sensitive (CipS) MRSA. Multi-locus sequence typing, spa-typing and Panton–Valentine leukocidin gene testing were performed and demographics obtained. Additional questionnaires were completed by community case GPs. Community cases comprised 6% of Oxfordshire MRSA. Three community cases had received no regular healthcare or antibiotics: one was infected with CipS. Ninety-one percent of community cases had healthcare-associated sequence type (ST)22/36; CipS MRSA cases had heterogeneous STs but many had recent healthcare exposure. A substantial minority of UK MRSA transmission may occur outside hospitals. Hospital strains are becoming ‘feral’ or persisting in long-term carriers in the community with regular healthcare contacts; those with recent healthcare exposure may nevertheless acquire non-hospital epidemic MRSA strains in the community.

A bacteriological survey was made on the distribution and occurrence of coliforms and pathogenic indicators of pollution within the surf-zone and near-shore waters along a section of the Natal Coast, prior to the use of submarine outfalls. The distance covered measured approximately 47 miles. The waters sampled and assessed ranged from ‘clean’ beaches to heavily polluted areas; a single short run off an Eastern Cape coastal region was included for comparative purposes. In all cases, the bacteriological picture was related to sanitary features on the shore. The method is based on Escherichia coli I counts, parasite units, staphylococci, salmonellas and salinity, and provides an objective approach to the assessment of any future changes in water quality consequent on development.

During the last year further investigations of germicidal mists, especially those produced by heat-volatilization of phenols, have been carried out. We are primarily interested in continuous disinfection of the air in the presence of man, and all our original experimental results appeared to show that a small quantity of the higher phenols in the mist form was more potent to bacteria than when in the vapour form. Thus, persistence as a mist long enough to ensure a duration of lethal effectiveness covering the time taken for at least one air turn-over was considered to be a desirable characteristic of a germicide to be used for our purpose.

An important aspect of the investigation of bacterial metabolism is the study of the substrate and its changes and of the resulting products; together with an examination of the rate of change. The present report deals with the influence of certain carbohydrates in modifying the action of one species of bacteria upon the protein molecule.

It is commonly believed that a concrete floor feels cold, whereas a wood floor feels warm. It is not clear however, under what conditions this statement is supposed to be valid, if, in fact, it is true at all. Nevertheless, one supposes that it applies certainly to walking barefoot across the floor; and it is believed by many to apply also when shoes are worn. In common usage, however, no attempt is made to eliminate the factor of surface temperature.

The culture representing the new type to be described was obtained by one of us (S. H. W.) under rather unusual circumstances. Three fatalities occurred at intervals of 4 and 6 months among the children of one family living in Ashington, Northumberland, a coal-mining town of 30,000 population; in each case death was due to acute gastro-enteritis and supervened within 24 hours of their falling ill. On the death of the third child a bacteriological examination was made post-mortem and S. aertrycke found in abundance in the organs. The suggestion was made at the inquest that a carrier must exist in the stricken family and specimens of faeces from the surviving members were examined by S. H. W. From the mother's specimen a Salmonella was isolated agglutinating with the sera not only of S. paratyphi B, but also of S. enteritidis (Gaertner). This Salmonella, which we propose to call S. newcastle, was obviously different from the strain of S. aertrycke obtained from the fatal case, and the suggestion that the mother had been a carrier infecting her family should almost certainly be dropped; she had had no suspicious illness at any time. The probability is rather that conditions in the house and habits of the inmates were responsible for the succession of cases, though no evidence could be obtained as to possible infection of food by rodents, or consumption of food likely to be specifically infected; the sanitation was of poor quality (privy midden).