The incidence of purulent staphylococcal infections at a large Swedish university hospital was followed during 3 years and has been described as an expression of the incidence of hospital infections.

A marked decrease in the relative number of infections was found. The decrease was most evident among infections with ‘80/81’ strains and other antibiotic resistant hospital strains and was parallel in all the departments investigated. This is taken as an evidence for the assumption that the lowering of the amount of staphylococcal infections was brought about by a factor that was active throughout the hospital, probably some hygienic preventive measure.

The study of the factors influencing the heat-denaturation of serum proteins has led us to change the technique of my method (1916) for concentrating antitoxic sera. These changes involve a considerable shortening of the process and therefore a brief description of our present method of procedure may be useful to those engaged in serum concentration in other laboratories.

Two batches of pooled antisera obtained from rabbits injected with crystalline egg albumin have been fractionated with ammonium sulphate in order to investigate the distribution of the antibody to this antigen in the serum proteins.

The albumin fractions contained no antibody.

All the globulin fractions examined contained antibody, and flocculated readily when mixed with appropriate dilutions of the antigen.

The distribution of antibody throughout the serum globulin was fairly uniform, the ratio of the antibody content to the protein concentration being the smallest in a fraction with a solubility in ammonium sulphate slightly lower than that of pseudoglobulin.

Fine resolution spatial variability in pneumonia hospitalization may identify correlates with socioeconomic, demographic and environmental factors. We performed a retrospective study within the Fairview Health System network of Minnesota. Patients 2 months of age and older hospitalized with pneumonia between 2011 and 2015 were geocoded to their census block group, and pneumonia hospitalization risk was analyzed in relation to socioeconomic, demographic and environmental factors. Spatial analyses were performed using Esri's ArcGIS software, and multivariate Poisson regression was used. Hospital encounters of 17 840 patients were included in the analysis. Multivariate Poisson regression identified several significant associations, including a 40% increased risk of pneumonia hospitalization among census block groups with large, compared with small, populations of ⩾65 years, a 56% increased risk among census block groups in the bottom (first) quartile of median household income compared to the top (fourth) quartile, a 44% higher risk in the fourth quartile of average nitrogen dioxide emissions compared with the first quartile, and a 47% higher risk in the fourth quartile of average annual solar insolation compared to the first quartile. After adjusting for income, moving from the first to the second quartile of the race/ethnic diversity index resulted in a 21% significantly increased risk of pneumonia hospitalization. In conclusion, the risk of pneumonia hospitalization at the census-block level is associated with age, income, race/ethnic diversity index, air quality, and solar insolation, and varies by region-specific factors. Identifying correlates using fine spatial analysis provides opportunities for targeted prevention and control.

HIV-1 molecular surveillance provides a new approach to explore transmission risks and targeted interventions. From January to June 2021, 663 newly reported HIV-1 cases were recruited in Zhaotong City, Yunnan Province, China. The distribution characteristics of HIV-1 subtypes and HIV-1 molecular network were analysed. Of 542 successfully subtyped samples, 12 HIV-1 strains were identified. The main strains were CRF08_BC (47.0%, 255/542), CRF01_AE (17.0%, 92/542), CRF07_BC (17.0%, 92/542), URFs (8.7%, 47/542), and CRF85_BC (6.5%, 35/542). CRF08_BC was commonly detected among Zhaotong natives, illiterates, and non-farmers and was mostly detected in Zhaoyang County. CRF01_AE was frequently detected among married and homosexual individuals and mostly detected in Weixin and Zhenxiong counties. Among the 516 pol sequences, 187 (36.2%) were clustered. Zhaotong natives, individuals aged ≥60 years, and illiterate individuals were more likely to be found in the network. Assortativity analysis showed that individuals were more likely to be genetically associated when stratified by age, education level, occupation, and reporting area. The genetic diversity of HIV-1 reflects the complexity of local HIV epidemics. Molecular network analyses revealed the subpopulations to focus on and the characteristics of the risk networks. The results will help optimise local prevention and control strategies.

A survey of serum samples from all age groups in the population has shown a rapid acquisition of antibody between the ages of 1 and 6 years which reaches a plateau in concentration and does not disappear later.

The concentration of antibody in cord serum may be four or more times greater than that in the mother's serum.

Presence or absence of a record of past infection by measles is not necessarily reflected by the titre of antibody in the serum.

Low antibody titres in very young infants may be due to an imperfectly developed antibody producing mechanism.

The author gratefully acknowledges the assistance of all those who made this survey possible. In particular, she is indebted to Dr G. I. Watson of the College of General Practitioners and his colleagues (see list) for their help in the collection of so many of the serum samples, and to Mr D. A. Bamgboye for his excellent technical assistance.

Ultra-centrifugation of emulsions from suckling mouse brains infected with the MEF1 strain of poliomyelitis virus separates a non-infective antigen, or soluble antigen, from infective virus. This antigen is responsible for most of the complement fixation and explains the high titres obtained. On the other hand, the same virus, and also Mahoney, Type 1 poliomyelitis virus, grown in monkey kidney tissue culture, fail to produce this soluble antigen, and this is probably a factor in the low complement-fixing titres obtained in tests with these fluids.

The author would like to express her appreciation of Miss M. Butchart's valuable technical assistance.

During the period 1961–91 a total of 567 635 strains of Staphylococcus aureus from hospitalized patients in Denmark have been characterized according to their antibiotic resistance, site of isolation and phage type. Strains of phage group II (typed by the phages 3A, 3C, 55 and 71) have been analysed further. The occurrence of group II strains was relatively constant (approximately 16%) from 1961 until 1983. Since then the frequency of group II strains increased; in 1991 they accounted for 22.7% of all S. aureus strains isolated. Strains of group II can, on the basis of their phage types, be divided in four subgroups: 3A, 71, 71 + and the ‘rest of group II’. Furthermore, within these groups strains may differ from one another in respect to their sensitivity to phages.

The increased isolation of group II strains during recent years was because of an increase in strains of subgroups 71 + and the ‘rest of group II strains’. In 1991 these two subgroups accounted for 89.7% of all group II strains. Furthermore, an increasing number of group II strains, 71.4% in 1991, was typable only at RTD × 100. The increase in the number of group II strains was even throughout Denmark. All four subgroups of group II have, during the observation period, become more frequently resistant to penicillin and/or tetracycline. Strains typed at 100 × RTD of subgroup 71 + and the ‘rest of group II’ are more frequently antibiotic resistant than the rest of the group II strains.

Strains of the increasing subgroups occurred most often in abscesses.

We evaluated laboratory reports as early indicators of West Nile virus (WNV) disease cases in Texas. We compared WNV laboratory results in the National Electronic Disease Surveillance System Base System (NBS) to WNV disease cases reported to the state health department from 2008 to 2012. We calculated sensitivity and positive predictive value (PPV) of NBS reports, estimated the number of disease cases expected per laboratory report, and determined lead and lag times. The sensitivity and PPV of NBS laboratory reports were 86% and 77%, respectively. For every 10 positive laboratory reports, we expect 9·0 (95% confidence interval 8·9–9·2) reported disease cases. Laboratory reports preceded case reports with a lead time of 7 days. Electronic laboratory reports provided longer lead times than manually entered reports (P < 0·01). NBS laboratory reports are useful estimates of future reported WNV disease cases and may provide timely information for planning public health interventions.

Invasive meningococcal disease (IMD) reported to the Massachusetts Department of Public Health from 1988 to 2011 was reviewed. The average annual incidence of IMD/100 000 decreased from 1·57 [95% confidence interval (CI) 1·42–1·73] for 1988–1991 to 0·22 (95% CI 0·17–0·29) for 2008–2011. The pattern of decreasing incidence over time differed by age group. There was a decrease in IMD/100 000 in the 0–4 years age group after 1991 from 10·92 (95% CI 8·08–14·70) in 1991 to 5·76 (95% CI 3·78–8·72) in 1992. Incidence in the 0–4 years age group remained below 5/100 000 per year on average thereafter. A substantial reduction in incidence in all age groups was observed between 2000 and 2009, which began before the introduction of conjugate meningococcal vaccine in 2005. Marked reductions in incidence of IMD in Massachusetts, and elsewhere, deserve further investigation with respect to potential factors that go beyond the introduction and deployment of improved meningococcal vaccines.

In a previous paper (This Journal, vol. VI. p. 524) we have given an account of the quantitative estimation of plague bacilli in the blood of 16 septicaemic cases. It remains now to supplement this number with a further series and to add some observations on the infectivity of the urine and faeces.

Due to differences in the circulation of influenza viruses, distribution and antigenic drift of A subtypes and B lineages, and susceptibility to infection in the population, the incidence of symptomatic influenza infection can vary widely between seasons and age-groups. Our goal was to estimate the symptomatic infection incidence in the Netherlands for the six seasons 2011/2012 through 2016/2017, using Bayesian evidence synthesis methodology to combine season-specific sentinel surveillance data on influenza-like illness (ILI), virus detections in sampled ILI cases and data on healthcare-seeking behaviour. Estimated age-aggregated incidence was 6.5 per 1000 persons (95% uncertainty interval (UI): 4.7–9.0) for season 2011/2012, 36.7 (95% UI: 31.2–42.8) for 2012/2013, 9.1 (95% UI: 6.3–12.9) for 2013/2014, 41.1 (95% UI: 35.0–47.7) for 2014/2015, 39.4 (95% UI: 33.4–46.1) for 2015/2016 and 27.8 (95% UI: 22.7–33.7) for season 2016/2017. Incidence varied substantially between age-groups (highest for the age-group <5 years: 23 to 47/1000, but relatively low for 65+ years: 2 to 34/1000 over the six seasons). Integration of all relevant data sources within an evidence synthesis framework has allowed the estimation – with appropriately quantified uncertainty – of the incidence of symptomatic influenza virus infection. These estimates provide valuable insight into the variation in influenza epidemics across seasons, by virus subtype and lineage, and between age-groups.

Anthrax is still a severe public health problem and threat to human health. A cutaneous anthrax outbreak occurred in Jiangsu Province, a non-endemic anthrax region of eastern China, from July to August 2012. Epidemiological and laboratory investigation were initiated to trace the source of infection and identify the risk factors of the outbreak. On 25 July 2012, 17 persons were exposed to a sick cow, which had been imported from northeast China a few days previously. Of the 17 exposed, eight developed symptoms between 1 and 8 days and were diagnosed as cutaneous anthrax cases. Three main genes of Bacillus anthracis were detected from both human and cow meat samples, indicating that the outbreak was associated with this infected cow. A retrospective cohort study showed that contact with blood and presence of skin damage contributed to the case infection with B. anthracis. The outbreak highlights the need to enhance quarantine for imported livestock, which should have been vaccinated prior to importation, the significance of education for high-risk individuals, and training for primary healthcare workers even in anthrax-free areas.

A blastogenic test to detect peripheral blood leukocytes specifically sensitized to foot-and-mouth disease virus antigen is described. The test is carried out in microtitre plates and optimum conditions were found by titration. These employed 7.5 × 105 cells/well and 20 complement fixing units of antigen. Peak [3H]thymidine incorporation was found to take place at 2–3 days.

In this study the drug resistance pattern of 3559 Mycobacterium tuberculosis strains isolated in Austria between 1995 and 98 was evaluated. Of these strains, 165 (4·6%) were resistant to one or more drugs, 113 (3·2%) to one of the tested drugs and 53 (1·5%) to two or more drugs. Monodrug resistance was observed most often to isoniazid (56 strains), followed by streptomycin (44 strains). Resistance to rifampicin or ethambutol alone was rarely seen (12 strains and 1 strain, respectively). Of the 53 strains resistant to 2 or more drugs, 25 were resistant to isoniazid and streptomycin, while 17 were multidrug resistant. Molecular typing revealed a large diversity among the multidrug-resistant strains.

The parasite referred to in the preceding paper was found by Dr Gerrard in the polymorphonuclear leucocytes of a dog. As is stated by Dr Gerrard, the parasite is evidently similar to that discovered by Bentley and described by him, and afterwards by James, as the Leucocytozoon canis. Dr Gerrard sent some films, stained by him by Leishman's method, to Sir Patrick Manson, and they were handed on to me for description and identification. These films had faded in transit, they were therefore decolorised and restained by various methods. All the staining reactions mentioned in this description refer to these old films.

Melioidosis is an infectious disease caused by Burkholderia pseudomallei, a bacterium endemic in Southeast Asia and northern Australia. In New Caledonia, sporadic cases were first described in 2005; since then, more cases have been identified. To improve our understanding of melioidosis epidemiology in New Caledonia, we compared the local cases and B. pseudomallei isolates with those from endemic areas. Nineteen melioidosis cases have been diagnosed in New Caledonia since 1999, mostly severe and with frequent bacteraemia, leading to three (16%) fatalities. All but one occurred in the North Province. Besides sporadic cases caused by non-clonal strains, we also identified a hotspot of transmission related to a clonal group of B. pseudomallei that is phylogenetically related to Australian strains.

Jerusalem is the resort of so many tourists and pilgrims who chiefly visit the country in the healthy spring season and see little of the conditions in which the poor of the land live, that it may be difficult for them to realize that it is a city where malaria is exceedingly rife and where the most elementary sanitary regulations are utterly neglected.There is no proper public water supply, no sewers worth the name, vaccination is not enforced even when small-pox is epidemic and there is no attempt to isolate those suffering from infectious diseases. This state of things is undoubtedly largely due to remissness and ignorance on the part of the Turkish Government, but the situation is made very complicated and difficult on account of the “ Capitulations ” by which all foreign subjects are practically independent of the Local Authority "and accept no orders except through their own Consuls.

No investigations seem to have been made in recent years as to the prevalence of intestinal worms among the general population in this country. The present results are derived from the microscopical examination of the stools of 500 in-patients of Guy's Hospital. The cases were taken consecutively by beds all through the hospital, without any selection, over a period of ten months, and comprise surgical and medical as well as gynaecological and other special patients. Nearly all were inhabitants of London.

Antimicrobial resistance (AMR) is a complex problem that is a threat to global public health. Consumption of turkey meat may be an important source of foodborne exposure to resistant bacteria; recent outbreaks of multi-drug-resistant Salmonella Reading in Canada and the USA have implicated raw turkey products. To better understand the epidemiology of AMR in farmed turkey production, a scoping review was conducted. The objectives were to identify (1) modifiable factors potentially associated with antimicrobial-resistant Campylobacter, Enterococcus, Escherichia coli and Salmonella enterica along the farm-to-fork pathway in turkeys, and (2) data gaps with respect to factors potentially associated with AMR and Canadian commercial turkey production. A comprehensive search of the peer-reviewed literature was conducted in 2019 and updated in 2021. Thirteen references were included, reporting 36 factors. Antimicrobial use factors and their potential associations with AMR were most frequently reported (n = 15 factors; 42%), followed by biosecurity (n = 11; 31%) and management practices (n = 10; 28%). This review revealed important data gaps; no factors pertaining to S. enterica or to stages other than the farm (e.g. abattoir, retail) were identified, and only one Canadian reference was identified. These findings will inform priorities for future research and surveillance regarding turkeys and AMR.