1. Before undertaking a bacteriological survey of the waters of the Hooghly River and the associated canals a detailed epidemiological study over the past 20 years of cholera, as it affected the individual administrative wards of Calcutta, was undertaken. Sampling points were selected in accordance with the results of this study. Samples of water from the various points were collected at intervals extending from December 1958 to August 1959 in 2½–5 l. amounts. The whole sample in each case was filtered through special filter pads. The pads were first cultured in an enrichment medium from which plate cultures were subsequently made for colony isolation, serological and biochemical examination.

2. The sampling points on the canals were all adjacent to areas where the local endemicity was judged to be high; other points were by bathing ghats, etc. A total of eighty-nine samples covering all the sampling points were examined and Vibrio cholerae were isolated from twelve of these samples, eight of which came from twenty-six samples collected from two sampling points on the Chetla and Circular Canals, respectively.

3. The positive isolations were spread fairly evenly over the whole period of the study which covered both epidemic and non-epidemic periods including the monsoon. Although the incidence of cholera in Calcutta may fall to a low level during non-epidemic periods cases continue to occur throughout the year and the relationship of the maintenance of the infection in the city to the continuous potential infectivity of the open natural waters of Calcutta is discussed.

This study used statistical methods to investigate linkages in phenotypic resistance profiles in a population sample of 321 Salmonella Typhimurium isolates from sporadic salmonellosis cases in Lower Saxony, Germany, collected during 2008–2010. A resistance index was applied to calculate the conditional probability of resistance to one antimicrobial agent given the resistance to one or more other antimicrobial agent(s). A susceptibility index was defined analogously. A contingency plot, which visualizes the association between resistances to two antimicrobial agents, facilitated the interpretation. Linkages between minimum inhibitory concentrations (MIC) were analysed using Spearman's rank correlation coefficient and jittered scatter plots. Applying these methods provided a compact description of multi-resistance and linkages between resistance properties in large datasets. Moreover, this approach will improve monitoring of antimicrobial resistance dynamics of bacteria in human or animal populations by identifying linked resistance to antimicrobial agents (cross- or co-resistance) with a non-molecular method.

1. Breeding records are given of fourteen female Dutch rabbits reared and maintained without green food, and of twelve of their female offspring.

2. Fertility, average litter size at birth, and the percentage of young weaned, were good for the breed.

3. No difference in growth rate was found between the first and second generations of young.

4. With the dry pelleted diet, supplemented by drinking water, fresh green food is unnecessary for breeding rabbits, as it has already been shown to be unnecessary for growing animals (Bruce & Parkes, 1946).

I should like to thank Dr A. S. Parkes, F.R.S., for his help in the preparation of the manuscript.

More than 70% of reported human Salmonella infections in Norway are infected abroad. The Canary Islands and Thailand are two of the most popular charter tourist destinations for Norwegians. Using surveillance data for the years 1994–2008, and denominator data on travel to the Canary Islands 2000–2008 and to Thailand 1997–2008, we present the epidemiology and trends of Salmonella infections in Norwegian tourists to these destinations. We found a declining trend in risk of salmonellosis in tourists returning from the Canary Islands, and a change in serovar distribution in travellers to Thailand with more S. Enteritidis infections, similar to that observed in Western European countries. The use of denominator data is important when studying risk of travel-related disease, as surveillance data tend to reflect travel activity more than the risk. Infections among tourists do not always affect the local residents and therefore may not be detected by local public health authorities. Sharing knowledge on the epidemiology of infections in tourists could be useful for observation of changes in trends in the countries visited, and in future outbreak investigations.

In a group of 32 adult volunteers given subunit influenza virus vaccine containing 250 international units (i.u.) of A/Victoria/3/75, 250 i.u. of A/Scotland/ 840/74 and 300 i.u. of B/Hong Kong/8/73, there were substantial increases in the geometric mean homologous haemagglutination-inhibiting (HI) antibody titres. There was also substantial boosting of the antibodies to the earlier variants of the Hong Kong (H3N2) series and to a later variant of the Asian (H2N2) series. There was no boosting of antibodies to the A/FM/1/47 strain, a representative member of the H1N1 series, but two individuals showed substantial rises to A/PR/8/34 (H0N1).

There were increases in the HI titre of antibodies cross reactive with two recent isolations, A/Texas/1/77, and A/Victoria/35/77, but the majority of vaccinees failed to reach antibody titres likely to be protective against such strains.

From 2007 to 2010, the largest reported Q-fever epidemic occurred in the Netherlands with 4026 notified laboratory-confirmed cases. During the course of the epidemic, health-seeking behaviour changed and awareness among health professionals increased. Changes in laboratory workflows were implemented. The aim of this study was to analyse how these changes instigated adjustments of notification criteria and how these adjustments affected the monitoring and interpretation of the epidemic. We used the articles on laboratory procedures related to the epidemic and a description of the changes that were made to the notification criteria. We compared the output of a regional laboratory with notifications to the regional Public Health Service and the national register of infectious diseases. We compared the international notification criteria for acute Q-fever. Screening with ELISA IgM phase II and PCR was added to the diagnostic workflow. In the course of the epidemic, serology often revealed a positive IgG/IgM result although cases were not infected recently. With increasing background seroprevalence, the presence of IgM antibodies can only be suggestive for acute Q-fever and has to be confirmed either by seroconversion of IgG or a positive PCR result. Differences in sero-epidemiology make it unlikely that full harmonisation of notification criteria between countries is feasible.

When fresh urine from LCM tolerantly infected mice was applied to small areas of excoriated skin of guinea-pigs undiluted or diluted 10−1, a high LCM infectivity developed in the local dermal tissue within 3 days and quickly spread to the lymphatic system. The skin at this site of infection became erythematous 10–12 days after infection and a few days later a rash was often seen in the hairless skin around the mammary teats. A viraemia was first detected at about 8 days after infection and persisted for at least 8 days, during which time a high infectivity titre in skin not only at the infection site but also distal to it suggested that there was a generalized active infection of the dermis. Infectivity in the tongue was simultaneously high and probably associated with erosions of the tongue tip seen a day or two later than the teat rash.

In similar experiments in hamsters and rabbits, indications were again that lightly injured dermis was a primary site of virus replication. These observations should lead to the dermal route receiving greater attention as a potential route of infection of man when exposed to infectious excretions of reservoir hosts of arena-viruses.

1. For each case of streptococcal illness—sore throat, otitis, or other respiratory tract illness—observed in a 30-month study in a large children's home an attempt was made to enumerate the infected contacts from whom the infection might have been derived.

2. Of 459 illnesses, 10·5% seemed to be relapses of a previous illness, and in 10·0% the child was known to have been carrying streptococci for more than 7 days before sickening, so that the causal relation of the streptococcus is in doubt.

3. Of the 365 other illnesses, 31·5% could be attributed with varying degrees of confidence to infection from one specified carrier, 36·8% could have been derived from one or more recognized contacts although there was not sufficient evidence to specify one in particular. For 17·5% no infected contacts were recognized, but infection with the particular streptococcus was known to be present in the community; and for 9·3% there were no contacts and the streptococcus was not known to be present in the Village.

4. Of the ninety-four illnesses for which the source could be specified as one particular carrier, 66% were derived from heavy nasal, 19% from light nasal, and 15% from throat carriers. Persons incubating a streptococcal illness and healthy carriers were each responsible for 31% of the illnesses and convalescent carriers for 38%.

5. It seemed that at least 50% of all illnesses could have been contracted from contacts within the cottage; the proportion due to school infection was much more difficult to estimate but was at least 12%.

Under the title “Is Cancer Mortality increasing or decreasing?” Wolff (1935) has discussed a problem of world-wide interest. He comes to the conclusion that, in German-speaking countries the risk of dying from cancer is not increasing in the sense that the ordinary man attaches to the phrase. He enquires whether the undoubted absolute increase in cancer mortality may not be a mere function of the ageing of the population, a feature common to all civilised countries; and he concludes that, for Berlin, the altered age structure of the population has caused the increase in the general rate of mortality from cancer, and that—taking certain other factors also into con sideration—it may fairly be concluded that in Berlin the rate of mortality from cancer has declined.

Mother-to-child transmission (MTCT) is the leading cause of paediatric HIV-infection in Israel. This study aimed to assess MTCT rates and analyse temporal changes in relation to highly active antiretroviral therapy (HAART) introduction in 1996. This historical prospective study included all HIV-infected women who delivered in Israel between 1988 and 2011. Demographic, clinical, laboratory and therapy characteristics were compared between HIV-infected newborns with all others, and between infants born before and after 1996. Of all 796 infants born in Israel to HIV-infected women, 25 (3·1%) were infected. MTCT rates decreased significantly after HAART introduction compared with infants who were born before 1996 (16·3% vs. 1·7%). Mothers who infected vertically were more likely to be younger, Ethiopian-born, delivered trans-vaginally, not treated with HAART during pregnancy/labour and delivered before 1996 compared with mothers who did not transmit the HIV to their neonates. Newborns who did not receive antiretroviral therapy postpartum were more commonly HIV-infected and their mortality rate was higher. In conclusion, HAART during pregnancy/labour decreased MTCT significantly. Most MTCT in Israel was recorded among Ethiopian migrants, yet, in decreasing rates. Continuous efforts should be employed to encourage early HIV testing and allow effective HAART to pregnant women who belong to a key risk-group.

The screening of 2000 women of childbearing age in Cork between 2004 and 2006 produced 37 erythromycin-resistant group B streptococcus (GBS) isolates. PCR analysis was performed to determine the basis for erythromycin resistance. The ermTR gene was most frequently expressed (n=19), followed by the ermB gene (n=8). Four isolates harboured the mefA gene. Six isolates yielded no PCR products. Some phenotype–genotype correlation was observed. All isolates expressing the mefA gene displayed the M phenotype whilst all those expressing ermB displayed the constitutive macrolide resistance (cMLSB) phenotype. Of 19 isolates that expressed the ermTR gene, 16 displayed the inducible macrolide resistance (iMLSB) phenotype. Serotype analysis revealed that serotypes III and V predominated in these isolates. The identification of two erythromycin-resistant serotype VIII isolates among this collection represents the first reported finding of erythromycin resistance in this serotype. A single isolate was non-typable using two latex agglutination serotyping kits.

1. It seems to be the general opinion of veterinary contributors on the subject that infection of the udder with coliform organisms is rapidly followed by clinical symptoms of mastitis, and marked changes in the appearance of the secretion. There would therefore appear to be little danger of contamination of bulk milk from such sources except during the few hours between infection and the appearance of the clinical symptoms.

2. Injury to the teats or quarters may result in infection of milk with coliform organisms owing to the difficulty of thorough cleaning of the malformed tissue.

3. Several cases of infection of quarters in the entire absence of clinical or other symptoms of disease have been cited. There is no evidence that such cases can be classed as subclinical forms of the disease as is the case in streptococcic mastitis. The evidence in two cases cited indicates that milk drawn from a quarter can remain infected with coliform organisms for a considerable period with no apparent clinical or other symptoms of disease.

4. There is sufficient evidence to warrant the examination of quarter samples in cases where infection of bulk milk with coliform organisms from other more common sources appears to be unlikely.

Germany has been an officially bovine tuberculosis (bTB)-free (OTF) country since 1996. Gradually rising numbers of bTB herd incidents due to Mycobacterium bovis and M. caprae in North-Western and Southern Germany during the last few years prompted the competent authorities to conduct a nationwide bTB survey in 2013/2014. This led to the detection of a dairy herd in which as many as 55 cattle reacted positively to consecutive intra vitam testing. Test-positive animals lacked visible lesions indicative of bTB at necropsy. Extensive mycobacterial culturing as well as molecular testing of samples from 11 tissues for members of the M. tuberculosis complex (MTC) yielded negative results throughout. However, caseous lymphadenitis of Ln. mandibularis accessorius was observed during meat inspection of a fattening pig from the same farm at regular slaughter at that time. Respective tissue samples tested MTC positive by polymerase chain reaction, and M. tuberculosis T1 family were identified by spoligotyping. Four human reactors within the farmer's family were also found to be immunoreactive. As exposure of livestock to M. tuberculosis is not generally considered, its impact may result in regulatory and practical difficulties when using protocols designed to detect classical bTB, particularly in OTF countries.

1. The paper records, for the first time, the isolation of Bact. paratyphosum C in Egypt.

2. It has been isolated from the urine of nine patients and the faeces of two patients suffering from enteric fever during the summer of 1937 and the early part of the present year.

3. Its frequency is comparable with that of Bact. paratyphosum A, and may exceed that of Bact. paratyphosum B.

4. Its inclusion in prophylactic vaccines, along with the usual “T.A.B”. vaccine is worthy of serious consideration.

Swabs of rectal faeces were obtained daily for 28 days from 90 calves reared in five batches during the summer of 1983. The calves were purchased unweaned in markets and fed a milk-substitute diet. Salmonella typhimurium phage type DT204c was isolated from calves in four batches and Salmonella newport from one. When the data from the 90 calves were considered together the incidence of salmonellas, excretion rose to peak between 5 and 7 days after purchase before declining to low levels during the fourth week. Salmonella was isolated from 55 (61%) calves; 30 were positive on up to four occasions while 21 and 4 animals respectively were positive between 5 and 11 and 15 and 20 times. In the majority of animals infection was probably subclinical since treatment with antibacterial drugs and excretion of S. typhimurium coincided in four calves only.

The aim of this study was to determine the prevalence and risk factors for human papillomavirus (HPV) infection in the Southern region of the State of Bahia, evaluating the performance of alternative complementary methods for cervical lesion detection. Cervical samples from women who attended healthcare units were collected and diagnosed by visual inspection, cervical cytology and nested polymerase chain reaction (PCR). Moreover, hemi-nested PCR was performed to detect different HPV genotypes. The prevalence of HPV infection was 47·7%, with genotype 16 detected in most cases. Infection was associated with dyspareunia and bleeding (P < 0·001, odds ratio (OR) 5·6, 95% confidence interval (CI) 2·815–11·14) and hormonal contraceptive use (P = 0·007, OR 2·33, 95% CI 1·25–4·34). There was a positive correlation between positive PCR and positive visual inspection, cervical cytology and symptoms reported. Furthermore, visual inspection was twice as specific, and had a greater positive predictive value than cytology. We showed a high prevalence of HPV infection in Southern Bahia, with HPV 16 being the most common type, and visual inspection being most effective at detecting HPV lesions, corroborating the suggestion that it can be applied in routine gynecologic examinations for low-income populations.

Large datasets are often not amenable to analysis using traditional single-step approaches. Here, our general objective was to apply imputation techniques, principal component analysis (PCA), elastic net and generalized linear models to a large dataset in a systematic approach to extract the most meaningful predictors for a health outcome. We extracted predictors for Plasmodium falciparum infection, from a large covariate dataset while facing limited numbers of observations, using data from the People, Animals, and their Zoonoses (PAZ) project to demonstrate these techniques: data collected from 415 homesteads in western Kenya, contained over 1500 variables that describe the health, environment, and social factors of the humans, livestock, and the homesteads in which they reside. The wide, sparse dataset was simplified to 42 predictors of P. falciparum malaria infection and wealth rankings were produced for all homesteads. The 42 predictors make biological sense and are supported by previous studies. This systematic data-mining approach we used would make many large datasets more manageable and informative for decision-making processes and health policy prioritization.

An enzyme-linked immunosorbent assay (ELISA) was developed to detect IgG antibodies to diphtheria toxin in human serum. Serum samples obtained from 557 normal persons aged 1–65 years from different areas in New Zealand showed maximum antibody levels in the 1–9 years age group (95·1%) and the least in the 60–65 years age group (38·1%). The indirect ELISA is suitable for sero-epidemiological survey study as it is simple to perform, economical and precise.

Participation in European surveillance for bloodstream infection (BSI) commenced in Ireland in 1999 with all laboratories (n = 39) participating by 2014. Observational hand hygiene auditing (OHHA) was implemented in 2011. The aim of this study was to evaluate the impact of OHHA on hand hygiene compliance, alcohol hand rub (AHR) procurement and the incidence of sensitive and resistant Staphylococcus aureus and Enterococcus faecium and faecalis BSI. A prospective segmented regression analysis was performed to determine the temporal association between OHHA and outcomes. Observed hand hygiene improved from 74.7% (73.7–75.6) in 2011 to 90.8% (90.1–91.3) in 2016. AHR procurement increased from 20.1 l/1000 bed days used (BDU) in 2009 to 33.2 l/1000 BDU in 2016. A pre-intervention reduction of 2% per quarter in the ratio of methicillin sensitive Staphylococcus aureus BSI/BDU stabilized in the time period after the intervention (P < 0.01). The ratio of Methicillin resistant Staphylococcus aureus (MRSA) BSI/BDU was decreasing by 5% per quarter pre-intervention, this slowed to 2% per quarter post intervention, (P < 0.01). There was no significant change in the ratio of vancomycin sensitive (P = 0.49) or vancomycin resistant (P = 0.90) Enterococcus sp. BSI/BDU post intervention. This study shows national OHHA increased observed hand hygiene compliance and AHR procurement, however there was no associated reduction in BSI.