Plasmid profiles have been established for 68 isolates of Staphylococcus aureus from 13 episodes of epidemic spread in hospital wards between 1958 and 1962. Despite the original lack of care in preservation of strains the profiles give, in general, the same epidemiological patterns as were established originally on the basis of phage type, antibiotic sensitivity, ward and date of isolation.

Evolutionary studies on Dengue virus (DENV) in endemic regions are necessary since naturally occurring mutations may lead to genotypic variations or shifts in serotypes, which may lead to future outbreaks. Our study comprehends the evolutionary dynamics of DENV, using phylogenetic, molecular clock, skyline plots, network, selection pressure, and entropy analyses based on partial CprM gene sequences. We have collected 250 samples, 161 in 2017 and 89 in 2018. Details for the 2017 samples were published in our previous article and that of 2018 are presented in this study. Further evolutionary analysis was carried out using 800 sequences, which incorporate the study and global sequences from GenBank: DENV-1 (n = 240), DENV-3 (n = 374), and DENV-4 (n = 186), identified during 1944–2020, 1956–2020, and 1956–2021, respectively. Genotypes V, III, and I were identified as the predominant genotypes of the DENV-1, DENV-3, and DENV-4 serotypes, respectively. The rate of nucleotide substitution was found highest in DENV-3 (7.90 × 10−4 s/s/y), followed by DENV-4 (6.23 × 10−4 s/s/y) and DENV-1 (5.99 × 10−4 s/s/y). The Bayesian skyline plots of the Indian strains revealed dissimilar patterns amongst the population size of the three serotypes. Network analyses showed the presence of different clusters within the prevalent genotypes. The data presented in this study will assist in supplementing the measures for vaccine development against DENV.

In December 1917, Lieut.-Col. MacGilchrist of the Indian Medical Service published a paper on the necrosis produced by intra-muscular injections of strong solutions of quinine salts. It might be an advantage to quote the first few lines of this communication: “Advocates of intra-muscular injections of strong solutions of quinine salts for the treatment of malaria seldom omit to state that no local ill-effects are produced”. He records a case of tissue necrosis following on the intra-muscular injection of eleven grains of quinine bi-hydrochloride in thirty-four minims of water. Death supervened thirteen hours later. MacGilchrist especially noted, owing to rapid tissue necrosis, that the track of the needle remained patent. He regards as an established fact that most of the quinine injected is precipitated and probably chemically combined with serum proteins in the necrosed tissues and for this reason intramuscular injections of concentrated solutions of quinine salts are not to be recommended for cases of emergency. Very dilute solutions of quinine salts are, in his opinion, rapidly and completely absorbed whether employed subcutaneously or by the intra-muscular route. If the views which MacGilchrist puts forward in this and other communications are to be accepted without reserve then intra-muscular injections of strong solutions of quinine should no longer be employed. It was for this reason that Major-General Sir M. P. C. Holt, K.C.B., K.C.M.G., D.M.S., B.S.F., asked me to carry out an experimental enquiry on animals as to the effects produced by intra-muscular injections of strong solutions of quinine.

Presence of antimicrobial resistance (AMR) genes in Escherichia coli inhabiting anthropogenic rivers is an important public health concern because plasmid-mediated AMR genes can easily spread to other pathogens by horizontal gene transfer. Besides β-lactams, quinolones and aminoglycosides are the major antibiotics against E. coli. In the present study, we have investigated the presence of plasmid-mediated quinolone resistance (PMQR) and aminoglycoside resistance genes in E. coli isolated from a major river of northern India. Our results revealed that majority of the strains were phenotypically susceptible for fluoroquinolones and some aminoglycosides like amikacin, netilmicin, tobramycin and gentamicin. However, 16.39% of the strains were resistant for streptomycin, 8.19% for kanamycin and 3.30% for gentamicin. Of the various PMQR genes investigated, only qnrS1 was present in 24.59% of the strains along with ISEcl2. Aminoglycoside-resistance genes like strA-strB were found to be present in 16.39%, aphA1 in 8.19% and aacC2 in only 3.30% of the strains. Though, no co-relation was observed between phenotypic resistance for fluorquinolones and presence of PMQR genes, phenotypic resistance for streptomycin, kanamycin and gentamicin exactly co-related with the presence of the genes strA-strB, aphA1 and aacC2, respectively. Moreover, all the AMR genes discerned in aquatic E. coli were found to be situated on conjugative plasmids and, thus easily transferrable. Our study accentuates the importance of routine surveillance of urban rivers to curtail the spread of AMR genes in aquatic pathogens.

The object of this portion of the investigation was to determine

(a) Whether the amount of immune-body present in the sera of cases of pulmonary tuberculosis, bore any constant relation to the stage of the disease and the condition of the patient.

(b) Whether well-marked clinical phenomena, e.g. periods of fever, attacks of pleurisy etc., were associated in any definite manner with variations in the amount of immune-body in the serum.

(c) Whether gradual definite and sustained improvement or deterioration in a patient's condition was accompanied by increase or decrease of the specific immune-body in the serum.

It is well known that severe neutropenia, as usually seen in patients with acute leukaemia, aplastic anaemia or secondary to aggressive chemotherapy, predisposes to infections with Gram-negative enteric bacilli, Pseudomonas aeruginosa, Staphylococcus aureus, and to fungal infections. Infection with anaerobes, in contrast, is rare in patients with haematologic malignancy [1]. The spectrum of bacterial pathogens in this patient population has recently broadened, and now includes coagulase-negative staphylococci, viridans group streptococci, and, occasionally, coryneforms and other rather unusual opportunistic organisms. All these microorganisms originate either from the patient's own microflora, especially from the digestive tract, or from the hospital environment after having colonized the patient during the hospital stay [2]. Studies have shown that the incidence of fever during periods of severe neutropenia approaches 100%, and most of these fever episodes actually represent bacterial infection. For more than 20 years, methods for the prevention of bacterial and fungal infections have been under investigation in patients with profound neutropenia. These included decontamination trails, oral or systemic antimicrobial prophylaxis, strict reverse isolation and maintenance of germ-free conditions [3–8], prophylactic granulocyte transfusions [9], and, more recently, the application of haemopoietic growth factors [10, 11]. The method which remains the most widely used is oral antimicrobial prophylaxis, especially with agents for so-called selective decontamination of the intestinal tract.

1. Sera and antisera when kept in the dark at room temperature sealed in glass tubes occasionally give specific reactions after a period of 12 years. In most cases, however, negative results were obtained with the antisera, whilst in others the reactions were non-specific.

2. Fowl blood will still give specific complement fixation and precipitin reactions after being in the alimentary canal of either Argas persicus or Ornithodorus moubata for at least 23 months. The gut contents of Pediculus vestimenti fed on man three days previously, also will give specific reactions with human antisera.

Two distinct measles outbreaks, unrelated from the epidemiological point of view but caused by genetically related strains, occurred in the Friuli Venezia Giulia region of northeastern Italy. Forty-two cases were reported during the period April–May 2008. In the first outbreak the index case was a teacher who introduced the virus into the Pordenone area, involving eight adolescents and young adults. The other concomitant outbreak occurred in the city of Trieste with 33 cases. The containment of the epidemics can be explained by the high MMR vaccine coverage in an area where the first dose was delivered to 93·4% and the second dose to 88·3% of the target children. Phylogenetic analysis of 14 measles virus strains showed that they belonged to a unique D4 genotype indistinguishable from the MVs/Enfield.GBR/14.07 strain, probably introduced from areas (i.e. Piedmont and Germany) where this genotype was present or had recently caused a large epidemic.

The European rabbit flea was first released in Victoria in August 1969 at Werribee. Releases were made on five different land forms. At one site the first flea was recovered 2 weeks after release. Fleas were recovered between 4 and 6 weeks after release at the other sites. Differences in establishment and spread on the different land forms were due to physically restricted movement of some rabbit populations. By June 1971 80% of rabbits were infested but an occasional young uninfested rabbit was still found in August 1978. Infestation numbers were higher than in the Mallee region especially on pregnant does.

A group of 20 990 children in Uganda was examined for leprosy over a period of 8 years. There was no evidence that the incidence of leprosy varied according to a child's genetic relationship to a leprosy patient, once allowance had been made for the grade of physical contact.

Swaziland has the highest prevalence of human immunodeficiency virus (HIV) in the world. Attrition (loss to follow-up and mortality) in people living with HIV/AIDS (PLWHA) already on treatment is a major challenge, undermining achievements of the antiretroviral treatment (ART) programme in Swaziland. The contributing factors to attrition in the Swazi context are unclear. This study aims to (1) estimate attrition from the ART programme 12 months after ART initiation in Swaziland, and (2) determine the predictors of attrition in PLWHA treated with ART in Swaziland. A retrospective cohort study using national baseline data was conducted. A competing-risk Cox proportional hazard regression was used to determine the predictors of attrition. We estimated 10·3% (95% confidence interval 10·1–10·6) attrition in 16 423 participants that initiated ART in 2012. Attrition was significantly associated with sex, age, district, treatment supporter at initiation, co-infection of HIV and TB, functional status, WHO clinical stage, and ownership of facility. Our study can form a base of policies, plans, and service delivery strategies for preventing and controlling attrition in Swaziland.

Ten years ago the writer (Graham-Smith, 1929) called attention to the relation of the decline in the number of horse-drawn vehicles, and consequently of the urban breeding grounds of flies, to the fall in the death-rate from summer diarrhoea in children under one year of age.

1. A comparative study of alcoholized and phenolized T.A.B. vaccines has been made.

2. No difference could be detected in the immunological potency of the two vaccines.

3. The contentions of Felix and others that the reactions with alcoholized vaccine are less severe and ‘Vi’ response greater than with phenolized vaccine are confirmed.

4. The change over of large scale production in the Sudan from phenolized to alcoholized vaccine is not considered justifiable.

I wish to record my grateful thanks to Dr E. S. Horgan, Assistant Director Research, Sudan Medical Service, for the help and advice given in the carrying out of these experiments and preparation of this paper and also to Col. H. T. Findlay for his helpful criticism and permission to quote the conclusions of his preliminary experiments.

The Mahoney, Type I, poliomyelitis virus undergoes two ‘cycles’ of multiplication in the CNS of suckling mice—the first within 48 hr. after intracerebral inoculation, and the second approximately 10 days later. The former may not be associated with paralysis whilst the latter usually is.

By to-and-fro passage in suckling mouse brain and monkey kidney-tissue culture there is a gradual increase in the amount of virus obtained during the early multiplication cycle in suckling mouse brains and associated with this is the occurrence of early paralysis in 80% or more of these mice. The virus capable of causing early paralysis in infant mice is gradually lost by direct mouse-to-mouse passage.

The occurrence of two variants is postulated, one of these apparently nonparalytic and multiplying selectively in suckling brains.

The author would like to thank the late Prof. M. van den Ende for his stimulating discussions and advice, Dr P. K. Olitsky of New York for his constant interest, and Mr T. C. Norcott for his able technical assistance.

The present method of analysis of data from comparative field trials of acuterodenticides was compared with two alternative methods of analysis, using computer simulation techniques. One of the proposed alternative analyses, the use of post-treatment census takes as a percentage of pre-treatment census takes in an analysis of variance, was found to be more accurate, to avoid a theoretical difficulty associated with the present method, and is computationally much simpler.

Since early detection of pathogens and their virulence factors contribute to intervention and control strategies, we assessed the enteropathogens in diarrhoea disease and investigated the link between toxigenic strains of Escherichia coli from stool and drinking-water sources; and determined the expression of toxin genes by antibiotic-resistant E. coli in Lagos, Nigeria. This was compared with isolates from diarrhoeal stool and water from Wisconsin, USA. The new Luminex xTAG GPP (Gastroplex) technique and conventional real-time PCR were used to profile enteric pathogens and E. coli toxin gene isolates, respectively. Results showed the pathogen profile of stool and indicated a relationship between E. coli toxin genes in water and stool from Lagos which was absent in Wisconsin isolates. The Gastroplex technique was efficient for multiple enteric pathogens and toxin gene detection. The co-existence of antibiotic resistance with enteroinvasive E. coli toxin genes suggests an additional prognostic burden on patients.

Towards the end of October 1900 the Sanitary Authorities of Cambridge and Chesterton found themselves face to face with a serious outbreak of diphtheria; the first official notification had been on October 14th, and by October 23rd eleven cases had been notified, of which four terminated fatally, on October 15th, 21st, 22nd and 26th respectively. These four were all children attending the Infants' Department of a certain Higher Grade School, and the other seven cases were either children of this school or persons closely associated with them.

Although much work on the epidemiology of plague has been done in many parts of the world since the discovery of the Bacillus pestis in 1894, the origin of the outbreaks in Eastern and Southern Russia has, until a short time ago, remained obscure. Transbaikalia, together with extensive areas of Northern Manchuria and North-east Mongolia that are conterminous with it, and, again, the region in Southern Russia which includes the Kirghese and Kalmuck steppes and especially that portion of it which lies between the lower reaches of the rivers Volga and Ural have long been known to contain endemic foci of plague, and have been the source of considerable outbreaks of pneumonic plague. Thus, in the winter of 1878–79, an outbreak of this type at Vetlianka, a Cossack village on the right bank of the Volga, caused alarm in Western Europe. Competent epidemiologists–British, French and German–visited the village after the event, and examined the circumstances that favoured the spread of the infection. Their observations were brought together and analysed by Netten Radcliffe (1881) in his memorandum on plague, which gives the first adequate description of a pneumonic plague epidemic. The more recent epidemics of pneumonic plague, namely, those of Manchuria in 1910–11 with 50,000 deaths, Middle China in 1917–18 with 15,000 deaths, and Manchuria in 1920–21 with 9000 deaths, owed their origin to ill-defined centres of infection in the immense tract of land which includes Transbaikalia and which is contiguous to the north-west boundary of China.

In the autumn of 1934 I received from Dr A. R. D. Adams, Superintendent of the Bacteriological Laboratory at Mauritius, 163 cultures of organisms. These had been isolated by him from the faeces of the inmates of the Beau Bassin Prison and Reformatory in a research on the intestinal flora and fauna of the general population in that island. In the course of the bacteriological examination the specimens of faeces had been cultured on plates of Endo's medium and incubated for 24 hours, at the end of which time non-lactose-fermenting organisms were picked off. A number of these strains were identified by Dr Adams as belonging to the typhoid, paratyphoid, or dysentery groups. One hundred and sixty-three strains which did not fall into these groups were sent to me for investigation.

Crimean-Congo haemorrhagic fever (CCHF) is an emerging zoonotic disease in India which is prevalent in neighbouring countries. CCHF virus (CCHFV) is a widespread tick-borne virus which is endemic in Africa, Asia, Eastern Europe and the Middle East. In the present study, samples of clinically suspected human cases from different areas of northern-western India were tested for the presence of CCHFV by RT–PCR through amplification of nucleocapsid (N) gene of CCHFV. Positive samples were sequenced to reveal the prevailing CCHFV genotype(s) and phylogenetic relatedness. A phylogenetic tree revealed the emergence of diverse strains in the study region showing maximum identity with the Pakistan, Afghanistan and Iran strains, which was different from earlier reported Indian strains. Our findings reveal for the first time the emergence of the Asia 1 group in India; while earlier reported CCHFV strains belong to the Asia 2 group.