The pandemic due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged as a serious global public health issue. Since the start of the outbreak, the importance of hand-hygiene and respiratory protection to prevent the spread of the virus has been the prime focus for infection control. Health regulatory organisations have produced guidelines for the formulation of hand sanitisers to the manufacturing industries. This review summarises the studies on alcohol-based hand sanitisers and their disinfectant activity against SARS-CoV-2 and related viruses. The literature shows that the type and concentration of alcohol, formulation and nature of product, presence of excipients, applied volume, contact time and viral contamination load are critical factors that determine the effectiveness of hand sanitisers.

1. Examination of several hundred eggs suggests that a high proportion (98%) of the whites of fresh eggs, and a slightly smaller proportion of the yolks (93%), are sterile.

2. The shell of the egg is heavily infected with a heterogeneous flora, including Proteus and Pseudomonas bacteria capable of producing rotting.

3. The rots found in imported New Zealand and Australian eggs, and in English stored eggs, may be grouped into black rot, red rot, green rot, and a miscellaneous group.

4. Black rot is brought about chiefly by strains of Proteus, but some species of Pseudomonas cause some blackening. Red and green rots are due to infection with particular strains of Pseudomonas.

5. A “fishy” odour is developed during the multiplication of certain atypical coliform organisms in the white, and a strong “cabbage-water” smell is often found after the growth of Pseudomonas species.

6. Washing eggs under clean conditions has no effect on immediate bacterial penetration. Washing removes a protective coating so that if the eggs are subsequently soaked in a bacterial suspension, much more penetration of bacteria occurs than with untreated controls.

7. Detailed descriptions of the coliform and Proteus organisms isolated are given. It is shown that the strains of Proteus from the eggs here investigated are antigenically not related to P. melanovogenes found by Miles and Hainan to be the cause of black rot in South African eggs.

8. It does not at present seem possible to assign specific names to the organisms isolated. The utilization of carbon sources by the species of Pseudomonas obtained from eggs, and by certain stock strains, and the possibility of a grouping on that basis, is discussed.

It is generally accepted that Professor Ignaz Semmelweis was the first to identify the mode of transmission of puerperal sepsis. However no appropriate statistical analysis of Semmelweis's data supporting his theory has been reported. Mean annual percent maternal mortality rates for the Allgemeines Krankenhaus and Dublin Maternity Hospitals (1784–1858) were analysed. The introduction of pathological anatomy at the Allgemeines Krankenhaus in 1823 was associated with increased mortality. After 1840 maternal mortality was higher in Clinic 1 which was staffed by male obstetricians and medical students who, unlike the midwives in Clinic 2, attended autopsies. The introduction of chlorine washing of the male clinicians’ hands in Clinic 1 by Semmelweis in 1847 reduced mortality, whereas the cessation of handwashing after Semmelweis left Vienna in 1850 was associated with increased mortality. This statistical analysis supports Semmelweis's hypothesis that ‘the cadaveric particles adhering to the hand had … caused the preponderant mortality in the first Clinic’.

Fifteen cohorts of healthy bathers were recruited at four Lake Leman beaches between 3 July and 23 August 1996 to assess the public health importance of cercarial dermatitis in Geneva, Switzerland. Telephone follow-up interviews were carried out after 2–7 days. Overall, 153 bathers out of 555 reported probable cercarial dermatitis at follow-up. Median daily attack rate was 27·7% (2·2–57·7%). Of the cases, 11·1% noticed more than 30 skin lesions, 19·6% described severe itching, 50·3% used a drug treatment, 3·9% visited a doctor and 15% claimed they would reduce their bathing activities. History of cercarial dermatitis, time spent in the water, hour of the day, barometric pressure and maximum daily atmospheric temperature predicted disease occurrence in multivariate analysis. While a benign disease, cercarial dermatitis may have a negative impact on the local water recreation industry. The identification of risk factors for the disease may help produce better preventive recommendations for the bathers.

In an outbreak of cryptosporidiosis in Warrington. a town in North-West England. 47 cases were recorded between November 1992 and February 1993. most within the first month. There was a strong statistical association between cases and residence in an area supplied from two groundwater sources. In a case-control study, a strong association between having drunk unboiled tap water from these sources, and a dose-response relationship were found. Oocysts were not detected in the water supply. During very heavy rainfall one source of water was found to drain surface water directly from a field containing livestock faeces, thereby bypassing natural sandstone filtration. Exceptionally heavy rainfall occurred at the probable time of infection. After withdrawal of the original water supply, the outbreak rapidly subsided. It was concluded that there was very strong evidence that this outbreak was waterborne. This, the second documented outbreak of cryptosporidiosis attributable to a groundwater supply, demonstrates that infection can be transmitted from a disinfected groundwater source despite apparently satisfactory treated water quality. We recommend that guidelines for protection of groundwater are implemented, raw groundwater should be routinely monitored for microbiological contamination, and the structure of all sources and waterworks should be assessed in risk surveys of water catchment areas.

The natural reservoir of Borna disease virus (BDV) is unknown. In this paper, we show that mallards (Anas platyrhyncos) and jackdaws (Corvus monedula) can be subclinically infected carriers of this virus. From faecal samples collected at a bird pond, we were able to amplify fragments of the BDV p24 and p40 genes. Following cloning and sequencing, a phylogenetic analysis revealed that these birds carry strains of BDV closely related to but distinct from the reference strains BDV V and He/80. To our knowledge, this is the first confirmed finding of BDV in wild birds.

Several outbreaks of hepatitis A in men who have sex with men (MSM) were reported in the 1980s and 1990s in Australia and other countries. An effective hepatitis A virus (HAV) vaccine has been available in Australia since 1994 and is recommended for high-risk groups including MSM. No outbreaks of hepatitis A in Australian MSM have been reported since 1996. In this study, we aimed to estimate HAV transmissibility in MSM populations in order to inform targets for vaccine coverage in such populations. We used mathematical models of HAV transmission in a MSM population to estimate the basic reproduction number (R0) and the probability of an HAV epidemic occurring as a function of the immune proportion. We estimated a plausible range for R0 of 1·71–3·67 for HAV in MSM and that sustained epidemics cannot occur once the proportion immune to HAV is greater than ~70%. To our knowledge this is the first estimate of R0 and the critical population immunity threshold for HAV transmission in MSM. As HAV is no longer endemic in Australia or in most other developed countries, vaccination is the only means of maintaining population immunity >70%. Our findings provide impetus to promote HAV vaccination in high-risk groups such as MSM.

To assess the sensitivity of the Swedish surveillance system, four notifiable communicable diseases in Sweden were examined during 1998–2002 with the two-sources capture–recapture method, based on parallel clinical and laboratory notifications. The sensitivity (proportion of diagnosed diseases actually being notified) was highest for salmonellosis (99·9%), followed by meningococcal infection (98·7%), and tularaemia (98·5%). For penicillin-resistant pneumococci, introduced as a notifiable disease in 1996, the overall sensitivity was 93·4% – increasing from 86·5% in 1998 to 98·5% in 2002. The system benefited from parallel reporting, with a sensitivity of clinical and laboratory notifications alone (all diseases combined) of 91·6% and 95·9% respectively. The sensitivity of both clinical and laboratory notifications was markedly higher in counties using the national electronic reporting system, SmiNet. Thus, sensitivity was higher for diseases with a long tradition of reporting, and there is a run-in period after a new disease becomes notifiable.

Seasonal peaks in both human campylobacter infections and poultry isolates have been observed in several European countries but remain unexplained. We compared weekly data on human campylobacter infections with thermophilic Campylobacter isolation rates from fresh, retail chicken samples (n=514) purchased weekly in Wales between January and December 2002. Human isolates (n=2631) peaked between weeks 22 and 25 (early June) and chicken isolates (n=364) between weeks 24 and 26 (late June). In the absence of a temporal association, we postulate that the seasonal rise in humans is not caused by a rise in isolation rates in poultry but that both are more likely to be associated with a common, but as yet unidentified, environmental source.

To facilitate the isolation of anaerobes from cultures in which swarming organisms were present Roux flasks were adapted to provide anaerobic conditions. Using these flasks, five species of anaerobes were isolated from the caecum of mice resistant to colonization with Escherichia coli and other Gram-negative organisms. These species accounted for the majority of organisms seen in films of caecal material. No aerobes were isolated and the flora of these mice apparently consisted of a limited number of anaerobes representing part of the intestinal flora of conventional mice. Three of the species were clostridia and another was identified as Propionibacterium acnes. One species resembled Catenabacterium but was not identified. One of the Clostridium species could only be isolated when the medium was supplemented with yeast extract and vitamins. This species sporulated on media with ammonium phosphate as the source of nitrogen; tryptone completely suppressed sporulation.

Antimicrobial-resistant bacteria in dogs can be transmitted to humans and close contact between dogs and people might foster dissemination of resistance determinants. The aim of our study was to describe the antimicrobial resistance (AMR) pattern of the major causative agents of canine otitis – one of the most common diseases in dogs – isolated in France. Data collected between 2012 and 2016 by the French national surveillance network for AMR, referred to as RESAPATH, were analysed. Resistance trends were investigated using non-linear analysis (generalised additive models). A total of 7021 antibiograms were analysed. The four major causative agents of canine otitis in France were coagulase-positive staphylococci, Pseudomonas aeruginosa, Proteus mirabilis and streptococci. Since 2013, resistance to fluoroquinolones has been on the decrease in both P. aeruginosa and Staphylococcus pseudintermedius isolates. For P. aeruginosa, 19.4% of isolates were resistant to both enrofloxacin and gentamicin. The levels of multidrug resistance (acquired resistance to at least one antibiotic in three or more antibiotic classes) ranged between 11.9% for P. mirabilis and 16.0% for S. pseudintermedius. These results are essential to guide prudent use of antibiotics in veterinary medicine. They will also help in designing efficient control strategies and in measuring their effectiveness.

Mucormycosis is a fairly rare fungal infection caused by ubiquitous fungi of the order Mucorales and primarily affects immunocompromised hosts. A series of 16 cases of invasive mucormycosis admitted to three referral centres in Beirut, Lebanon between 1981 and 1999 is described. It includes 12 patients with rhinocerebral, three with cutaneous, and one with pulmonary infection. Onset of symptoms occurred in the summer and autumn in 15 out of 16 patients, showing a statistically significant seasonal variation (P=0·007) A recent report of 19 patients from Tel Aviv describes a strikingly similar seasonal pattern. Studies on atmospheric concentration of Mucorales spores in the Eastern Mediterranean are lacking. Weather pattern analysis in Beirut revealed clustering of onset of invasive mucormycosis at the end of a dry, warm period, which begins around May and ends in October. Mucormycosis incidence appears to be seasonal in the Eastern Mediterranean.

Despite the adoption of strategies to prevent and treat multidrug-resistant tuberculosis (MDR-TB) over the past decade, Latvia continues to have one of the highest rates of MDR-TB in the world. It is important to identify modifiable factors that may impact on MDR-TB patient outcomes. A study was conducted to elucidate the association between nutritional status and clinical presentation, clinical course, and mortality in 995 adult patients treated for MDR-TB from 2000 to 2004. Twenty percent of patients were underweight, defined as a body mass index <18·5, at the time of diagnosis. These patients were significantly more likely to have clinical evidence of advanced disease, and had a greater risk of experiencing ⩾3 side-effects [adjusted odds ratio 1·5, 95% confidence interval (CI) 1·1–2·1] and death (adjusted hazard ratio 1·9, 95% CI 1·1–3·5) compared to patients who were normal or overweight. Interventions aimed at these high-risk patients, including nutritional supplementation as an adjunct to anti-TB therapy, should be considered and evaluated by TB programmes.

Toxoplasmosis caused by the protozoan parasite, Toxoplasma gondii, is a worldwide zoonosis. In this paper published information on toxoplasmosis in humans and other animals in Ethiopia is reviewed. Limited data indicate that the prevalence of T. gondii in humans in Ethiopia is very high, up to 41% of children aged 1–5 years were reported to be seropositive. There is little information on seroprevalence data in pregnant women and no data on congenital toxoplasmosis in children. About 1 million adults in Ethiopia are considered to be infected with HIV with less than one-third likely receive highly active antiviral therapy. Based on a conservative T. gondii seroprevalence of 50%, thousands might die of concurrent opportunistic infections, including toxoplasmosis. However, exact figures are not available, and most serological surveys are not current. Serological surveys indicate up to 79% of goats and sheep have T. gondii antibodies. However, there is no information on losses due to toxoplasmosis in livestock or the presence of viable T. gondii in any host in Ethiopia.

Scabies outbreaks can be disruptive in institutional settings, and are associated with considerable but under-researched morbidity, especially in vulnerable populations. In this paper, we describe key findings from a retrospective review of scabies outbreaks reported in the literature over the past 30 years. We undertook this review to gain insights into the impact of institutional outbreaks, the burden in terms of attack rates, economic costs, treatment trends, the types of index cases and outbreak progression. We found 84 reports over 30 years, with outbreaks most frequently reported in aged care facilities (n = 40) and hospitals (n = 33). On average, scabies outbreaks persisted for 3 months, and the median attack rate was 38%. While 1% lindane was once the most commonly employed acaricide, 5% permethrin and oral ivermectin are increasingly used. Crusted scabies represented the index case for 83% of outbreaks, and scabies was misdiagnosed in 43% outbreaks. The frequency of reported scabies outbreaks has not declined consistently over time suggesting the disease is still highly problematic. We contend that more research and practice emphasis must be paid to improve diagnostic methods, surveillance and control, health staff education and management of crusted scabies to prevent the development of scabies outbreaks in institutional settings.

Chlorine dioxide, bromine chloride and iodine were compared with chlorine as virucidal agents. Under optimal conditions all disinfectants were effective at low concentrations, but each disinfectant responded differently to acidity and alkalinity. Disinfection by chlorine was impaired by the presence of ammonia, but the other disinfectants retained much of their potency. Disinfection of poliovirus by iodine resulted in structural changes in the virions as seen by electron microscopy, but the other disinfectants were able to inactivate poliovirus without causing any apparent structural changes.

Experimental arbovirus infections of mice provide a convenient model to study factors which determine the occurrence or severity of encephalitis following ex-traneural infection with certain neurotropic viruses. Varying doses of West Nile or Powassan viruses were inoculated by intraperitoneal or intramuscular routes into mice of varing ages; individual variables were manipulated to influence the outcome of infection. Three patterns of pathogenesis were delineated: (1) Fatal encephalitis, preceded by early viraemia, and invasion of the central nervous system. (2) In-apparent infection, with no detectable viraemia and no evidence of central nervous system invasion. (3) Subclinical encephalitis, usually preceded by trace viraemia, with minimal transient levels of virus in the brain. In this latter type of subclinical infection with a potentially lethal virus, the immune response probably plays an important role in recovery.

Experiments were carried out to assess the reduction rate of two salmonella strains (S. eastbourne and S. typhimurium) in chocolate bars. After artificial contamination of chocolate, after ‘conching’, with about 106S. eastbourne/g. this organism was still recovered after 9 months storage. The strain of S. typhimurium was less resistant. Both serotypes died off more rapidly in bitter chocolate than in milk chocolate.

After contamination with a smaller dose (about 103/g.) with these two serotypes, similar differences were observed.

1. Histological methods show four layers in the intact shell of the hen's egg, namely, cuticle, spongy layer, mammillary layer, and inner shell membrane. Distinct channels or pores may be found in the spongy layer, but these tend to disappear in the mammillary layer in which only a network of much finer channels can be observed.

2. Viscometric measurements of the passage of water and air through the shell show that

(a) shells vary widely in their porosity, even when taken on successive days from the same hen;

(b) there is no correlation between porosity so determined and the number of pores counted by staining methods;

(c) the rate of flow is slower from the interior to the exterior than vice versa, and the pore count by staining methods also less on the inside than on the outside.

3. A rough correlation exists between porosity as determined viscometri-cally and the evaporation of water during storage.

4. If the temperature of the egg is higher than a fluid containing bacteria in which it is immersed, the latter are readily drawn through the shell by simple suction as the egg cools down, a point of great significance in the washing of eggs.

An epidemiological study on Campylobacter jejuni enterocolitis was performed in an urban Swedish community. The study included 55 patients gathered during a six-month period. Forty-one of the 55 patients (75%) were infected outside Sweden. Campylobacter enterocolitis was rare among children within the country. Patients infected in Sweden had eaten chicken significantly more often than a corresponding control group. Seven out of nine chicken consuming campylobacter patients also had prepared the fresh chicken alone, and none of their family members became ill. Thus the preparation of food contaminated with Campylobacter seems to elevate the risk for contracting the disease. Sick household pets transmitted the campylobacter infection to two patients. Forty-six of the patients had a total of 85 close household members. Three definite secondary cases were found. There was no evidence of transmission of Campylobacter by food prepared by two cooks who were working while still being asymptomatic excreters. Clinical reinfection with Campylobacter was observed in one patient. No patients became long-term carriers of Campylobacter.