1. The primary aim of the experiment was to find out if certain combinations of container and gas tube give a greater proportion of positive results than others (with the same strength of inoculation) and if possible to elucidate the causes of any differences between combinations.

The earlier results indicated that the best combination was a 7 × 1 ½ in. test-tube with a 4 × ¾ in. gas tube. Later experiments failed to maintain this preference but did show a definite disadvantage in using a very small gas tube. Whether this is due to the absolute sinallness of the gas tube or the smallness of its volume relative to the total amount of liquid used cannot be decided, for the latter was the same in all combinations. This was the only shape or sizefactor that was definitely influential on the evidence of these experiments. Yet if size of gas tube is intrinsically important the absence of reactions with acid but no gas is puzzling.

Attempts to break down the points involved in changes in shape and size of gas tube and container into a number of simple factors showed that several considerations might be involved, too many to cover in one experimental lay-out; but by including extreme combinations it was hoped that some indication might be obtained of the more important factors. With the new and successful combination of 7 × 1½ in. test-tube with 4 × ¾ in. gas tube, the gas tube holds 22% of the total volume of medium plus inoculum, the same proportion as the standard 6 × ⅝ in. test-tifbe and in. gas tube. This seems to be in support of standard practice if it is relative volumes that are important.

2. The analysis of plate counts shows that the opacity method, with the strain employed, gives complete control of the population and the three methods of assessing the plate count were in good agreement with one another.

The χ2 values were as a rule subnormal. This result excludes the possibility of any lack of control of the population in any one set of plates, but the reason for the subnormality is of some interest. It may plausibly be attributed to the factor of competition among developing colonies for the nutrient medium available so that the chance of development of a colony is smaller when a large number of others are present than when there are only a few. A toxic emanation from a colony which excluded the formation of another colony within a certain distance of it would have the same effect.

3. In the main experiment the percentage of positive tubes was about half (20% as against 45%) that to be expected from the plate counts on the usual Poisson hypothesis; or looking at the matter the other way the mean number of organisms per tube (0·22) deduced from the percentage of positives was about half the 0·5 expected from the plate counts. We have found no reason for this and in two subsequent experiments the agreement was satisfactory.

4. No difference was found between 2 × ⅜ and If in. gas tubes with a 6 × ⅝ in. test-tube or between rimmed and rimless gas tubes.

Crimean–Congo haemorrhagic fever virus (CCHFV) is an emerging viral pathogen with pandemic potential that is often misdiagnosed. Case fatality in low-resource settings could be up to 40% due to close contact between animals and humans. A two-year cross-sectional study was conducted in Fagge abattoir, Kano State, Nigeria, to estimate the seropositivity of CCHFV in camels using a commercial multi-species competitive enzyme-linked immunosorbent assay (ELISA). A closed-ended questionnaire was administered to the abattoir workers to assess their awareness, mitigation, and behavioural practices associated with CCHF. Of the 184 camels tested, 179 (97%) were seropositive for CCHFV (95% confidence interval (CI): 93.77, 99.11). The median (interquartile range (IQR)) age of respondents was 41 (35–52), with 62% having no education. Respondents had little knowledge about CCHFV and the concept of zoonotic disease. In this study, the high estimated prevalence of antibodies to CCHFV in camels highlights the heightened risk of transmission of CCHFV in Nigeria. Similarly, a concerning lack of knowledge and inadequate preventive practices, alongside a prevalence of high-risk behaviours associated with CCHF among abattoir workers, were noted in this study. Thus, there is an urgent need for comprehensive public health education and collaborative One Health strategies to avert the threats of spillover events.

As Bulgaria transitions away from Global Fund grant, robust estimates of the comparative impact of the various response strategies under consideration are needed to ensure sustained effectiveness of the tuberculosis (TB) programme. We tailored an established mathematical model for TB control to the epidemic in Bulgaria to project the likely outcomes of seven intervention scenarios. Under existing programmatic conditions projected forward, the country's targets for achieving TB elimination in the coming decades will not be achieved. No interventions under consideration were predicted to accelerate the baseline projected reduction in epidemiological indicators significantly. Discontinuation of the ‘Open Doors’ program and activities of non-governmental organisations would result in a marked exacerbation of the epidemic (increasing incidence in 2035 by 6–8% relative to baseline conditions projected forward). Changing to a short course regimen for multidrug-resistant TB (MDR-TB) would substantially decrease MDR-TB mortality (by 21.6% in 2035 relative to baseline conditions projected forward). Changing to ambulatory care for eligible patients would not affect TB burden but would be markedly cost-saving. In conclusion, Bulgaria faces important challenges in transitioning to a primarily domestically-financed TB programme. The country should consider maintaining currently effective programs and shifting towards ambulatory care to ensure program sustainability.

The last 30 years have been changes in emphasis in the study of streptococci and streptococcal diseases. Earlier work concentrated mainly on the sources and methods of cross-infection and descriptive epidemiology of Streptococcus pyogenes in its major manifestations of respiratory, cutaneous and invasive infection and in the complications of rheumatic fever (RF), scarlet fever (SF) and post-streptococcal glomerulonephritis (PSGN).

The numbers and types of bacteria in thirty-nine samples of dried whale meat of the 1946–7 and 1947–8 Antarctic whaling seasons have been investigated.

The total number of bacteria was low for this type of product and there were about equal numbers of clostridia and aerobic bacteria.

A detailed examination of the clostridia present showed that they were of types commonly found in material from mammalian sources.

No Clostridium pathogenic to the mouse was found, although some cultures on prolonged incubation killed mice by ammonia poisoning. Ammonia poisoning was produced by injection of cultures and never by oral administration.

The direct complement fixation test was performed to follow the antibody response in chickens infected with avian infectious bronchitis virus. Concentrated allantoic fluid (4 units) was used as an antigen and allowed to react with serially diluted antiserum in the presence of two complete units of guinea-pig complement for 3 hr. at 4°C. and ½ hr. at 37°C. before the addition of sensitized cells. Serum was unheated and used either fresh or within one month of storage at −30°C. Individual birds showed a rise and fall of complement-fixing antibody both after primary and secondary inoculations. The complement-fixing antibody was detected as early as the seventh day after primary inoculation. The highest complement fixation titre (1/32 to 1/64) was recorded from 14 to 21 days after inoculation with a subsequent gradual decline.

The results of the direct complement fixation tests have been correlated with the serum neutralization test. The neutralizing antibodies usually appeared by the 14th day but were not detected at a significant titre until the 21st day after primary inoculation. Serum neutralizing antibodies were still present at high titres even after 7 weeks of infection but the complement-fixing antibodies had disappeared by that time.

Shigella flexneri 4a caused sustained outbreaks in a large long-stay psychiatric centre, Taiwan, 2001–2006. Trimethoprim-sulphamethoxazole (SXT) prophylaxis was administered in 2004. We recovered 108 S. flexneri 4a isolates from 83 symptomatic (including one caregiver) and 12 asymptomatic subjects (11 contacts, one caregiver). The isolates were classified into eight antibiogram types and 15 genotypes (six clusters) by using antimicrobial susceptibility testing and pulsed-field gel electrophoresis of NotI-digested DNA, respectively. These characteristics altered significantly after SXT prophylaxis (P < 0·05), with concomitant emergence of SXT-resistant isolates in two antibiogram types. P01 (n = 71), the predominant epidemic genotype, caused infection in two caregivers and five patients under their care; two P01 isolates were recovered from the same patient 6 months apart. These results indicate the importance of sustained person-to-person transmission of S. flexneri 4a by long-term convalescent, asymptomatic or caregiver carriers, and support the emergence of SXT-resistant strains following selective pressure by SXT prophylaxis.

Common childhood infectious diseases have been associated with a reduced risk of following haematopoietic malignancies, but investigations on multiple myeloma (MM) are scarce. Information about 213 MM cases and 1128 healthy controls were obtained from a multicentre population-based Italian case-control study. The association between chickenpox, measles, mumps, pertussis and rubella and the MM risk was estimated by unconditional logistic regression, adjusting for age, gender and residence area. No association was found between MM risk and any considered infectious disease. The number of infections was slightly inversely associated with the risk of MM, but statistical significance was not reached (OR 0.87, 95% CI 0.55–1.4 for 1-2 diseases vs. none and OR 0.68, 95% CI 0.41–1.1 for 3-5 diseases, respectively, P = 0.131). We did not find a clear evidence that common infections during childhood are associated with the subsequent risk of developing MM.

The chief object of the research here recorded was to try and bring this Colony into line with other plague centres from which valuable figures on this subject have already been recorded.

This study evaluated the impact of maternal vaccination against rubella on the levels of specific rubella IgG (rIgG) in 198 newborn cord sera samples. Detailed maternal vaccination data were available. Specific rIgG was measured using a commercial enzyme immunoassay. Most mothers (78.8%) had been vaccinated against rubella at least once in their lives. In 15 (7.6%) cord sera samples, the concentration of specific rIgG was below 11 IU/ml, which was classified as seronegative. Statistical analysis using multiple logistic regression (n = 198) showed that newborns of mothers born between 1986 and 1995, and those born to unvaccinated mothers, were more likely to be seronegative (odds ratio (ORs) 5.2 and 4.9, respectively, adjusted for sex and gestational age). For vaccinated mothers (n = 156), those born between 1986 and 1995 were more likely to have seronegative newborns (OR 11.5 adjusting for sex, gestational age and time since last vaccination). Mothers of the 15 (7.6%) seronegative newborns might have been susceptible to rubella during pregnancy. Checking the vaccination status therefore recommended.

A new fast-growing mycobacterium, designated strain QGD101T, was isolated from the sputum of an 84-year-old man suspected of tuberculosis in Wuhan Medical Treatment Center, Hubei, China. This strain was a gram-staining-negative, aerobic, non-spore-forming and catalase-positive bacterium, which was further identified as the NTM by PNB and TCH tests. The moxifloxacin and levofloxacin exhibited strong suppressing function against QGD101T with MIC values of 0.06 and 0.125 µg/ml after drug susceptibility testing of six main antimicrobial agents on mycobacteria. Based on the sequence analysis of 16S rRNA, rpoB, hsp65 and 16S-23S rRNA internal transcribed spacer, the strain QGD101T could not be identified to a species level. Mycobacterium moriokaense ATCC43059T that shared the highest 16S rRNA gene sequence similarity (98%) with strain QGD101T was actually different in genomes average nucleotide identity (78.74%). In addition, the major cellular fatty acids of QGD101T were determined as C18:1ω9c, C16:0 and C18:2ω6c. The DNA G + C content was 64.9% measured by high performance liquid chromatography. Therefore, the phenotypic and genotypic characterisation of this strain led us to the conclusion that it represents a novel species of mycobacteria, for which the name Mycobacterium hubeiense sp. nov. (type strain QGD101T = CCTCCAA 2017003T = KCTC39927T) was proposed. Thus, the results of this study are very significant for the clinical diagnosis of tuberculosis and future personalised medicine.

Norovirus (NoV) is the greatest cause of infectious intestinal disease in the UK. The burden associated with foodborne outbreaks is underestimated in part because data are dispersed across different organisations. Each looks at outbreaks through a different lens. To estimate the burden of NoV from seafood including shellfish we used a capture-recapture technique using datasets from three different organisations currently involved in collecting information on outbreaks. The number of outbreaks of NoV related to seafood including shellfish in England was estimated for the period of 2004–2011. The combined estimates were more than three times as high (N = 360 using Chao's sample coverage approach) as the individual count from organisation three (N = 115), which captured more outbreaks than the other two organisations. The estimates were calculated for both independence and dependence between the datasets. There was evidence of under-reporting of NoV outbreaks and inconsistency of reporting between organisations, which means that, currently, more than one data source needs to be used to estimate as accurately as possible the total number of NoV outbreaks and associated cases. Furthermore, either the integration of reporting mechanisms or simplifying the process of reporting outbreaks to organisations is essential for understanding and, hence, controlling disease burden.

Cryptosporidium is a zoonotic protozoan parasite with public health importance worldwide. The objectives of this study were to (1) conduct a meta-analysis of published literature for oocyst shedding and diarrhoea outcomes, and (2) develop recommendations for standardization of experimental dose–response studies. Results showed that for the outcome of oocyst shedding in faeces, the covariates ‘experimental species’, ‘immunosuppression’, ‘oocyst dose’ and ‘oocyst dose’ × ‘age’ were all significant (P ⩽ 0·05). This study suggests that exposing mice, piglets, or ruminants, and using immunosuppressed experimental hosts, is more likely to result in oocyst shedding. For the outcome of diarrhoea in experimentally infected animal species, the key covariates ‘experimental species’, ‘age’ and ‘immunosuppression’ were significant (P ⩽ 0·2). Therefore, based on the results of this meta-analysis, these variables should be carefully reported and considered when designing experimental dose–response studies. Additionally, detection of possible publication bias highlights the need to publish additional studies that convey statistically non-significant as well as significant results in the future.

During 2003, a cluster of initially unexplained pneumonia cases (two fatal) occurred in patients aged <50 years in a British city. Routine culture tests were inconclusive, however, pneumococcal infection was suspected and the putative outbreak was investigated using non-culture methods. Clinical samples from ten patients were tested by pneumococcal polymerase chain reaction (PCR) and multi-locus sequence typing (MLST), or Binax NOW® pneumococcal urine antigen test and serotype-specific enzyme-linked immunosorbent assay (ELISA). Lung samples from the deceased patients were PCR positive and yielded different MLST types. Two patients in one family group were serotype 1 pneumococcal antigen positive. Two further patients were serotype 1 antigen positive, and one serotype 4 positive. Two antigen-positive cases were also serum PCR positive. Non-culture methods confirmed the disease aetiology in six cases. Serotype and MLST results showed no single outbreak, but a family cluster of cases in a high background of pneumococcal pneumonia, providing important epidemiological data that would not otherwise have been available.

Dufton And Bedford (1933) have denied the claim made by me (1932) that bright sources antagonise the “nose-closing” rays given off by dull red and dark sources of heat. They are supported by Winslow, Greenburg and Herring-ton (1934). These five authors have used the same method, viz. the insertion of a well-fitting tube in one nostril of the subject, the connection of this tube with a recording instrument, and the leaving open the other nostril for breathing, the mouth being kept shut.

Diarrhea is a common cause of morbidity and mortality and the incidence of diarrhea in the world has changed little over the past four decades. To assess the prevalence of and healthcare practices for diarrhea, a cross-sectional study was conducted in Pudong, Shanghai, China. In October 2014, a total of 5324 community residents were interviewed. Respondents were asked if they had experienced diarrhea (defined as ⩾3 passages of watery, loose, bloody, or mucoid stools within a 24-h period) in the previous month prior to the interview. The monthly prevalence of diarrhea was 4·1% (95% CI: 3·3–4·8), corresponding to an incidence rate of 0·54 episodes per person-year. The proportion of individuals with diarrhea who sought healthcare was 21·2% (95% CI: 13·4–29·0). Diarrhea continues to impose a considerable burden on the community and healthcare system in Pudong. Young age and travel were identified as predictors of increased diarrhea occurrence.

In June 2015, an outbreak of cryptosporidiosis with 35 cases (23 probable and 12 laboratory-confirmed) occurred among 191 attendees of a residential rehabilitation holiday for paediatric organ transplant patients (n = 49) and their families at a hotel in Somogy county, Hungary. The overall attack rate was 18%. Most of the cases were transplanted children who experienced severe acute disease and required adjustment to their tacrolimus immunosuppression. A retrospective case-control study suggested an association between recreational water exposures and illness: cases were seven times more likely than controls to have swum in the children's pool (odds ratio 7.17; 95% confidence interval 2.9–17.2; P < 0.0001) and five times more likely to have used the jetted whirlpool (odds ratio 5.25; 95% confidence interval 2.1–13.1; P < 0.0001). This was the first outbreak of cryptosporidiosis in Hungary and it is especially unfortunate that it affected vulnerable children who experienced severe symptoms. Cryptosporidium presents specific infection control difficulties in treated recreational water venues; the link to a whirlpool is unusual and highlights the importance of the age-appropriate use of these facilities and reminding users not to immerse their heads or swallow the water. Cryptosporidiosis is more commonly linked to children’ pools where improved bather hygiene and promoting exclusion of diarrhoea cases could help to avoid similar outbreaks.

It has been shown that S. schaudinnii will easily pass through Berkefeld V filters under a negative pressure of considerably less than one atmosphere, but B. pyocyaneus was always found in the filtrates in association with the spiro-chaetes. Attempts to pass S. schaudinnii through Berkefeld N filters were uniformly negative.

Inoculation experiments on native volunteers made with (a) filtrates containing S. schaudinnii and B. pyocyaneus, (b) a mixture of these organisms combined with B.fusiformis, and (c) an emulsion of B.fusiformis in broth, did not give rise to ulceration.

In former reports by us, considerable attention was devoted to a study of the number and nature of the cellular elements in milk.We found that cells, sometimes in enormous numbers, are present in all milk (cow, goat, ass, man), that considerable variations in number occur without apparent cause, and that the presence of the slighter forms of non-suppurative mastitis does not seem to influence definitely the number of these cells.