A new type of pathogenic Salmonella for the fowl has been described. Its somatic “O” antigen corresponds with factors VI, VII of potsdam. It occurs only in the specific phase, but its flagellar “H” antigen contains at least two distinct and separate antigenic complexes, which commonly occur in organisms that are not even remotely related. The one complex (the first, en-, antigen, α phase of Kauffmann and Mitsui) contains factors enx, which represent also the factors of the specific phase of abortus-equi. The other complex (the second, d-, antigen, β phase of Kauffmann and Mitsui) contains factor d, which comprises the type phase of stanley, muenchen and typhi.

Single cells containing factors enx on multiplying constantly yield variants containing factor d as well as offspring that retain antigenic complex enx. In the same way single cells containing apparently only specific factor d will bring forth new cells, most of which retain the parental antigenic structure, but a small proportion of the progeny will acquire specific factors enx instead of d.

When a broth culture of amersfoort in either the enx or d phase in an apparently pure form, as judged by the agglutination test, using heterologous sera which contain agglutinins either against factors enx (or en) or d, is used for the preparation of sera, agglutinins of approximately the same titre for both variants are produced in the sera.

As a result of the information given above the following antigenic structure is proposed for Salmonella amersfoort:

Somatic “O” antigen—VI, VII.

Flagellar “H” antigen—

(1) α phase of Kauffmann and Mitsui—enx.

(2) β phase of Kauffmann and Mitsui—d.

One hundred and thirty-three vanilla slices, purchased from shops in the West Yorkshire Metropolitan County, were examined to determine the numbers and types of bacteria present at the time of purchase. The surface colony count at 37 °C was > 103/g in 67/133 (50%) of the samples examined, Bacillus cereus being found at that concentration in 21·8%, coliform bacilli including E. coli in 5·3%, Staphylococcus aureus in 3·0% and Streptococcus faecalis in 0·8%. Thirty-four strains of B. cereus were serotyped and 11 (32%) of these were typable with the sera available.

Preparation of custard mixes in the laboratory suggests that the milk or milk powder used in the mix may be the major source of B. cereus in the final product. Many of the present methods of manufacture, distribution and storage allow organisms present in the custard at manufacture the opportunity to multiply and possibly reach numbers which present a risk of food poisoning.

Experiments on the bactericidal properties of mists were performed in a closed room of 850 cu. ft. capacity. The test organism was sprayed into the room through an Atmozon nebulizer operated from a mechanically driven Austin diaphragm compressor; the pressure was maintained at 7 lb./sq. in. Air to the compressor was taken through rubber tubing from an adjoining room to avoid accidental admixture of antiseptics into the air used to atomize the bacteria. The output of the nebulizer was 0·22 c.c./min. In the majority of the experiments the test organism was sprayed for 2 min. To ensure that an adequate mist was being emitted, the culture was nebulized in the dark against a dark background, and examined frequently with a light beam. Even distribution of the mist in the room was ensured by convection currents from a large hot-water pipe which ran along the length of two walls about 2 ft. from the floor, and by a small electrically driven fan placed immediately behind the nebulizer.

Of 485 persons who replied to a questionnaire after attending a European Congress in September 1974, diarrhoea was experienced by 4 of 143 British residents and 2 of 342 visitors to the United Kingdom. This extremely low incidence of travellers' diarrhoea contrasts with the high incidence reported in travellers from countries with cool climates and north European standards of hygiene to countries where these conditions do not hold.

Twenty-six isolates of the newly designated M90 serotype group A Streptococcus (GAS) from a large food-borne outbreak of pharyngitis in Greece and six M90 sporadic isolates from UK, were typed by pulsed-field gel electrophoresis (PFGE). Twenty-four outbreak isolates were identical and two closely related. The Greek isolates were possibly related with one UK isolate, while other sporadic isolates exhibited distinct PFGE profiles from the former isolates.

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%.

To elucidate the epidemic pattern of a dengue outbreak in southern Taiwan during 1987–8, antibody prevalence rates were investigated in paired sera collected in both epidemic (Kaohsiung) and non-epidemic (Tainan) areas. In Kaohsiung, the IgG prevalence rate in 1989 was significantly higher (9·23%) than that in 1988 (5·29%) suggesting that new infections continuously appeared after the first bleeding in 1988. Although IgG antibody persisted in most infected blood samples, waning of antibody occurred in 6/355 (1·69%) of Kaohsiung sera. IgM antibody was only detected in Kaohsiung sera, suggesting that Tainan was not involved in the outbreak. Because IgG antibody was present in some samples collected in 1989, but not in 1988, from the non-epidemic area, sporadic infections perhaps occurred. Additionally, 4/355 (1·13%) of Kaohsiung sera showed IgM antibody positive in both 1988 and 1989. In turn, secondary infections may have occurred because of circulation of multiple-types of the virus. The possible relationship between low levels of dengue haemorrhagic fever (DHF) and the loss of IgG antibodies over time is also discussed.

In a previous paper on Bird Trypanosomes it was pointed out that these organisms grew readily in the test-tube on blood agar and that the resulting forms resembled the flagellates which Schaudinn found in the gut of mosquitoes which had fed on owls infected with Halteridium and with H. Ziemanni. In other words, the position taken was that the flagellates observed in the mosquitoes did not represent stages in the life-history of intracellular parasites but were actually cultures in vivo of trypanosomes present in the blood of the birds used. In confirmation of this position it was desirable to show that trypanosomes could actually grow and multiply in the gut of mosquitoes and that such forms actually did correspond to those which would be obtained in vitro.

In a previous paper (Brodie, 1977) the value of the Widal test in the diagnosis of typhoid fever was shown to be limited. Evaluation of possible alternative tests showed that:

(1) the sensitivity of the anti-human globulin (Coombs') test appeared greater than that of the agglutination test but the length of time (48 h) before results were available rendered it of little value in rapid diagnosis;

(2) the complement fixation test offered no particular help towards diagnosis;

(3) immunized and non-immunized typhoid fever patients developed fimbrial antibodies, as also did immunized healthy individuals. In this latter group, however, those immunized with alcoholized TAB vaccine had higher antibody titres to fimbrial antigen than those immunized with heat-killed phenolized vaccine.

(1) There are two methods of examining industrial material for anthrax spores, viz. agar plate cultures and the inoculation of guinea-pigs.

(2) Though no worker has yet made a large series of examinations of equal portions of the same material by both methods simultaneously, yet the available evidence indicates that animal inoculation is superior, provided that guinea-pigs, not mice, are employed.

(3) It is better to inoculate two guinea-pigs than one, and to use the centrifuged deposit of the watery extract, though this practice may also increase the mortality from pathogenic anaerobes.

(4) The inoculation of guinea-pigs is more successful than plate cultures mainly on account of the larger quantity of watery extract usually tested, which more than counterbalances the disadvantage that some of the animals died from anaerobes before they develop anthrax.

(5) If plate cultures are employed it is essential to examine the superficial colonies after a short incubation, probably 12 to 16 hours is the most suitable.

(6) Anthrax spores have been demonstrated by the inoculation method in 21·3 % of 141 samples of industrial material, supposed to have produced anthrax in Liverpool amongst those who handled them. Of these samples 28·6 % were from hides, 22·2 % from wool, 20·6 % from hair and 7·1 % from bones. The largest proportion of infected samples came from Singapore.

(7) Anthrax spores have been demonstrated in one sample of hair “ disinfected ” with 5 % fluid of high coefficient at 100° C. and in two out of six samples of hair disinfected in Germany probably by steam at 105° C. It is practically impossible to completely sterilise certain industrial materials without seriously damaging them; yet partial disinfection should on no account be abandoned, because the perfect method has not yet been discovered.

(8) Anthrax appears to be steadily increasing among domestic animals, and consequently a larger number of agriculturalists are becoming infected. The reason for this dissemination amongst animals is still obscure.

(9) We have found B. anthracis in a sample of pea meal used for feeding cattle confined to a shippon, one of which died of anthrax. The meal was probably infected from the sack.

(10) Anthrax is preventible among men and domestic animals, and its ultimate suppression depends largely upon the certainty with which bacteriologists can demonstrate the presence or absence of bacilli in suspected industrial food, or other materials.

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.

Examination of the records of a large number of quantitative Wassermann tests has suggested a new and simple criterion of a positive reaction. This is based upon a comparison of the amounts of complement giving complete lysis with any given serum, and with the negative control, respectively. Reasons are given for regarding this criterion as more satisfactory than that in common use. Details are given of the methods employed for the selection of a negative control serum, the estimation of degrees of lysis, and the provision of a suitable range of amounts of complement.

1. The population as a whole is exposed to Brucella infection by the consumption of infected milk. This does not appear to be a very potent source of infection as relatively few clinical cases of brucellosis occur, nor are many latent infections discovered by the agglutination reaction.

2. Those exposed to contact with infected animals or meat, as are farm workers, slaughterers and butchers, run a greater risk of contracting infection. The risk is not, however, markedly increased when the contact is limited to the handling of carcasses or meat, milking or ordinary animal husbandry.

3. Members of the veterinary profession, who assist in calving and remove placentas from infected cows are exposed to the greatest risk of infection. They come in contact with the greatest natural concentration of Br. abortus through the most dangerous route, the skin. Clinical brucellosis is not common among them, but many contract latent infection. 58·3% of post-graduate and 10·8% of undergraduate veterinary students were found to have agglutinins for Br. abortus in their serum. This should be borne in mind when a diagnosis of undulant fever is considered in a member of the veterinary profession.

Continued monitoring of the seriousness of influenza viruses is a public health priority. We applied time-series regression models to data on cardio-respiratory mortality rates in Hong Kong from 2001 to 2011. We used surveillance data on outpatient consultations for influenza-like illness, and laboratory detections of influenza types/subtypes to construct proxy measures of influenza activity. In the model we allowed the regression coefficients for influenza to drift over time, and adjusted for temperature and humidity. The regression coefficient for influenza A(H3N2) increased significantly in 2005. The regression coefficients for influenza A(H1N1) and B were relatively stable over the period. Our model suggested an increase in seriousness of A(H3N2) in 2005, the year after the appearance of the A/Fujian/411/2002(H3N2)-like virus when the drifted A/California/7/2004(H3N2)-like virus appeared. Ongoing monitoring of mortality and influenza activity could permit identification of future changes in seriousness of influenza virus infections.

The first reported New Zealand-acquired case of murine typhus occurred near Auckland in 1989. Since then, 72 locally acquired cases have been recorded from northern New Zealand. By 2008, on the basis of the timing and distribution of cases, it appeared that murine typhus was escalating and spreading southwards. To explore the presence of Rickettsia typhi in the Waikato region, we conducted a seroprevalence study, using indirect immunofluorescence, Western blot, and cross-adsorption assays of blood donor samples. Of 950 human sera from Waikato, 12 (1·3%) had R. typhi antibodies. The seroprevalence for R. typhi was slightly higher in northern Waikato (1·4%) compared to the south (1·2%; no significant difference, χ2P = 0·768 at P < 0·05). Our results extend the reported southern range of R. typhi by 140 km and indicate it is endemic in Waikato. Evidence of past Rickettsia felis infections was also detected in six sera. Globally, R. felis is an emerging disease of concern and this pathogen should also be considered when locally acquired rickettsiosis is suspected. If public health interventions are to be implemented to reduce the risk of rickettsioses as a significant public health problem, improvements in rickettsial diagnostics and surveillance will be necessary.

Another large outbreak of mumps occurred in Lothian from October 2017, which coincided with the commencement of the higher education term. During this period 324 cases were notified, most of whom were aged 18–22 years old. Although previous outbreaks had a focus in student populations, 43% of current cases reported that they were not a student. There has been increases in private student housing where students from all universities live, which may have contributed to the wide spread of the outbreak and complicated outbreak control. Information on vaccination status was available for 244 cases (75%), of whom the majority (75.8%) reported having two MMR doses. To investigate potential waning vaccine immunity the mean length of time since last mumps containing vaccine was calculated as 14.3 years. The outbreak was declared over in May 2018 after case numbers returned to background levels. This outbreak highlighted that mumps outbreaks occur cyclically coinciding with new cohorts of susceptible students entering the Lothian population. The lessons from this outbreak are to encourage students to have two MMR doses and also be prepared for mumps outbreaks in the near future. In future outbreaks the utility of a third MMR for outbreak control could be examined.

Sixty-three samples of the more solid material (sludge) separated from the effluent plants of dairy factories were examined for the presence of salmonellas and brucellas. Salmonellas were isolated from two samples (S. heidelberg. [1]; S. indiana [1]). No brucellas were isolated. None of the samples supported the growth of S. dublin. Salmonellas added to effluent sludge at a concentration of 106 organisms/ml, survived less than 70 days.

The sludge from dairy factory effluent plants does not appear to be a source for the spread of salmonellosis or brucellosis.