1. It has been shown that certain nitrite-destroying organisms when grown along with V. Cholerae prevent the appearance of the cholera-red reaction. This is not due to the non-formation of nitrite, but to its rapid destruction by the enitrite-destroying organisms.

2. Certain nitrite-destroying organisms fail to prevent the cholera-red reaction.

3.It has been shown in the case of the B. dysenteriae (Flexner) that the failur to prevent the cholera-red reaction is due to an inhibition of the growth of both organisms when grown together.

Mycoplasma pneumoniae is a main pathogen causing community-acquired pneumonia in children and young adults. Since the emergence of macrolide-resistant M. pneumoniae in the early 2000s in Japan, it has been increasingly reported worldwide as a growing problem in treatment for children. With increasing macrolide-resistant M. pneumoniae and limited data regarding its characterization and molecular analysis, we investigated the dominant M. pneumoniae strains during the recent outbreak in South Korea, and evaluated if there was an association between a specific type and macrolide resistance. Between October 2014 and December 2016 in South Korea, 249 respiratory specimens obtained from patients with confirmed M. pneumoniae pneumonia were genotyped the P1 adhesin gene, and the mutations associated with resistance (A2063G and A2064G) were tested by sequencing the targeted domain V regions of the 23S ribosomal RNA gene. Results revealed that M. pneumoniae type 1 were predominant, which was strongly associated with macrolide-resistance during the whole study period. This is the first study assessing whether M. pneumoniae subtype is related to macrolide resistance during the outbreak of M. pneumoniae.

1. Plasma heated to 56° C. for 4 min. is not clotted by staphylococcal coagulase or thrombin, but when heated in the presence of glycine remains sensitive to the action of these clotting agents.

2. With glycine, plasma no longer clots after heating at 62° C.

An isolation policy in a hospital for skin diseases is reported. Patients carrying penicillin- and tetracycline-resistant organisms were to be isolated in single rooms, though barrier nursing was not practised. The policy failed because the single beds rapidly became blocked with long-stay patients and because even in a single-bed unit patients acquired staphylococci within 3–7 days of admission. Patients with skin diseases often do not feel ‘ill’ and resent isolation.

When a number of persons is exposed to a particular pneumoconiosis-producing dust for the same period under apparently similar conditions, some of them develop the disease while others escape. It is possible that the less easily affected group comprises merely those who by chance or through some inborn or acquired local physical difference, e.g. nose-breathing, receive smaller doses of the noxious dust into the lungs. It is also possible that they are a selected group of peculiar constitutional type. The latter view has been accepted by some authorities and used in practice in selecting entrants to the mining industry, on the ground that by excluding certain anthropometric types the incidence of pneumoconiosis, or of pneumoconiosis complicated by tuberculosis, would thereby be reduced, though no adequate statistical data have so far been published to support this hypothesis.

This study aimed at comparing the factors associated with the natural progression between typical progressors (TPs) and rapid progressors (RPs) in HIV-infected individuals. A retrospective study was conducted on 2095 eligible HIV-infected individuals from 1995 to 2016 in a high-risk area of Henan Province, China. Propensity score matching was used to balance covariates, and the conditional logistic regression analyses were performed to explore the factors of natural disease progression among HIV infectors. A total of 379 pairs of RPs and TPs were matched. The standardised difference values of all covariates were less than 10%. HIV-infected individuals transmitted through sexual transmission (odds ratio (OR) 0.56, 95% confidence interval (CI) 0.36–0.85) were more likely to progress to AIDS compared with those infected through contaminated blood. Older age at diagnosis of HIV-infected individuals (OR 0.72, 95% CI 0.58–0.89) exhibited a faster progression to AIDS. HIV-infected individuals identified through a unique survey (OR 7.01, 95% CI 2.99–16.44) were less likely to progress to AIDS compared with those identified through medical institutions. HIV-infected individuals who had higher baseline CD4+T cell counts (OR 3.37, 95% CI 2.59–4.38) had a slower progression to AIDS. These findings provide evidence for natural disease progression from HIV to AIDS between TPs and RPs.

The aim of the study was to develop a procedure to remove spatial trends in irregularly spaced data, with trends partly due to regional differences. Median polish is often used on regularly spaced (lattice) data where column and row medians are removed. For irregularly spaced data a low-resolution map of the spatial locations is often used where data locations are assigned to the nearest lattice node followed by median polish. In this study regional polish was developed. The inverse distance weighted median was calculated based on observations from locations in the neighbourhood of the actual observation. The regional polish residual is obtained as the difference between the observed value and the weighted median. The regional polish procedure was applied to Salmonella Dublin data showing strong regional trends. Estimation of the range of influence between cattle herds with positive S. Dublin herd status was considerably improved with a stable parameter estimate and reduced standard error.

To understand the characteristics and influencing factors related to cluster infections in Jiangsu Province, China, we investigated case reports to explore transmission dynamics and influencing factors of scales of cluster infection. The effectiveness of interventions was assessed by changes in the time-dependent reproductive number (Rt). From 25th January to 29th February, Jiangsu Province reported a total of 134 clusters involving 617 cases. Household clusters accounted for 79.85% of the total. The time interval from onset to report of index cases was 8 days, which was longer than that of secondary cases (4 days) (χ2 = 22.763, P < 0.001) and had a relationship with the number of secondary cases (the correlation coefficient (r) = 0.193, P = 0.040). The average interval from onset to report was different between family cluster cases (4 days) and community cluster cases (7 days) (χ2 = 28.072, P < 0.001). The average time interval from onset to isolation of patients with secondary infection (5 days) was longer than that of patients without secondary infection (3 days) (F = 9.761, P = 0.002). Asymptomatic patients and non-familial clusters had impacts on the size of the clusters. The average reduction in the Rt value in family clusters (26.00%, 0.26 ± 0.22) was lower than that in other clusters (37.00%, 0.37 ± 0.26) (F = 4.400, P = 0.039). Early detection of asymptomatic patients and early reports of non-family clusters can effectively weaken cluster infections.

1. Meningococcal cerebrospinal meningitis in the Sudan does not materially differ in its progress and end result from the disease as found in Europe.

2. There is no racial peculiarity in response to infection or to chemotherapy.

3. There is no sex or age peculiarity in incidence. Both sexes and all ages respond to chemotherapy.

4. Sulphapyridine is superior to sulphanilamide in the shortening of invalidism and in the prevention of complications.

5. Oral administration of sulphapyridine is in the majority of cases as effective as intramuscular.

6. Dosage is related to the clinical stage of the disease, and to its duration before treatment. An initial dose of 2·5 g. sulphapyridine for adults, and 1·0—1·5 g. for children is prescribed for the serious case, with subsequent gradation of treatment to provide a maintenance dose.

7. Treatment, if it is going to give a good result, will produce a response within 24 hr. It need not be prolonged beyond 7 days. The third, fourth and seventh days of treatment are critical.

Denmark hosted four games during the 2020 UEFA European championships (EC2020). After declining positive SARS-CoV-2 test rates in Denmark, a rise occurred during and after the tournament, concomitant with the replacement of the dominant Alpha lineage (B.1.1.7) by the Delta lineage (B.1.617.2), increasing vaccination rates and cessation of several restrictions. A cohort study including 33 227 cases was conducted from 30 May to 25 July 2021, 14 days before and after the EC2020. Included was a nested cohort with event information from big-screen events and matches at the Danish national stadium, Parken (DNSP) in Copenhagen, held from 12 June to 28 June 2021. Information from whole-genome sequencing, contact tracing and Danish registries was collected. Case–case connections were used to establish transmission trees. Cases infected on match days were compared to cases not infected on match days as a reference. The crude incidence rate ratio (IRR) of transmissions was 1.55, corresponding to 584 (1.76%) cases attributable to EC2020 celebrations. The IRR adjusted for covariates was lower (IRR 1.41) but still significant, and also pointed to a reduced number of transmissions from fully vaccinated cases (IRR 0.59). These data support the hypothesis that the EC2020 celebrations contributed to the rise of cases in Denmark in the early summer of 2021.

This study determined long-term health outcomes (≥10 years) of Q-fever fatigue syndrome (QFS). Long-term complaints, health-related quality of life (HRQL), health status, energy level, fatigue, post-exertional malaise, anxiety, and depression were assessed. Outcomes and determinants were studied for the total sample and compared among age subgroups: young (<40years), middle-aged (≥40–<65years), and older (≥65years) patients. 368 QFS patients were included. Participants reported a median number of 12.0 long-term complaints. Their HRQL (median EQ-5D-5L index: 0.63) and health status (median EQ-VAS: 50.0) were low, their level of fatigue was high, and many experienced post-exertional malaise complaints (98.9%). Young and middle-aged patients reported worse health outcomes compared with older patients, with both groups reporting a significantly worse health status, higher fatigue levels and anxiety, and more post-exertional malaise complaints and middle-aged patients having a lower HRQL and a higher depression risk. Multivariate regression analyses confirmed that older age is associated with better outcomes, except for the number of health complaints. QFS has thus a considerable impact on patients’ health more than 10 years after infection. Young and middle-aged patients experience more long-term health consequences compared with older patients. Tailored health care is recommended to provide optimalcare for each QFS patient.

The global outbreak of coronavirus disease 2019 (COVID-19) is greatly threatening the public health in the world. We reconstructed global transmissions and potential demographic expansions of severe acute respiratory syndrome coronavirus 2 based on genomic information. We found that intercontinental transmissions were rare in January and early February but drastically increased since late February. After world-wide implements of travel restrictions, the transmission frequencies decreased to a low level in April. We identified a total of 88 potential demographic expansions over the world based on the star-radiative networks and 75 of them were found in Europe and North America. The expansion numbers peaked in March and quickly dropped since April. These findings are highly concordant with epidemic reports and modelling results and highlight the significance of quarantine validity on the global spread of COVID-19. Our analyses indicate that the travel restrictions and social distancing measures are effective in containing the spread of COVID-19.

This study aimed to investigate the diverse clinical manifestations and simple early biomarkers predicting mortality of COVID-19 patients admitted to the emergency department (ED). A total of 710 patients with COVID-19 were enrolled from 6,896 patients presenting to the ED between January 2022 and March 2022. During the study period, a total of 478 patients tested positive for COVID-19, among whom 222 (46.4%) presented with extrapulmonary manifestations of COVID-19; 49 (10.3%) patients displayed gastrointestinal manifestations, followed by neurological (n = 41; 8.6%) and cardiac manifestations (n = 31; 6.5%). In total, 54 (11.3%) patients died. A Cox proportional hazards model revealed that old age, acute kidney injury at presentation, increased total leukocyte counts, low platelet counts, decreased albumin levels, and increased LDH levels were the independent predictors of mortality. The albumin levels exhibited the highest area under the curve in receiver operating characteristic analysis, with a value of 0.860 (95% confidence interval, 0.796–0.875). The study showed the diverse clinical presentations and simple-to-measure prognostic markers in COVID-19 patients presenting to the ED. Serum albumin levels can serve as a novel and simple early biomarker to identify COVID-19 patients at high risk of death.

The practice of flour bleaching originated in this country about ten years ago; bleaching, however, is said to have been attempted in France two or three years prior to this. The practice was rapidly adopted by millers in the United Kingdom, in America, and elsewhere. Such bleaching is applied only to roller-milled flour. Numerous patents have been granted for bleaching appliances and for the application of various chemicals to the bleaching of flour. Ozone, chlorine, oxides of chlorine, bromine, nitrogen peroxide and other oxidising substances have been suggested and tried as bleaching agents. Of these substances nitrogen peroxide is the only one which has given satisfactory results, and all commercial bleaching of flour at the present time depends on the use of this substance. It can be produced in various ways and from a variety of materials. Two methods of production, which may convniently be termed the chemical and electrical methods, are in use commercially at the present time. In the first of these nitrogen peroxide is produced by the action of nitric acid on ferrous sulphate, the amount of gas formed being controlled by regulating the supply of acid and ferrous sulphate. A current of air charged with the gas is led through a revolving reel or “agitator” as it is called, through which a stream of flour is continually flowing. The flour in its passage is throughly exposed to the action of the nitrogen peroxide, and is bleached when it emerges from the agitator. In actual practice this process possesses certain commercial disadvantages. The apparatus requires constant attention if the degree of bleaching is to be properly controlled; overbleaching and condensation of acid resulting in local staining of the flour are liable to occur, while in the hands of ordinary workmen the use of strong acids is not entirely free from risk. As regards expense, it compares unfavourably with other methods, some of which are said to be worked at one-tenth of the cost of the acid process.

Tuberculosis (TB) remains a threat to public health and is the second cause of death due to a single infectious agent after HIV/AIDS. The worldwide distribution of TB is heterogeneous. The incidence is decreasing in most high-income regions, but the situation remains worrying in many parts of the world. The emergence of Mycobacterium tuberculosis strains resistant to key agents used in treatment (rifampin and isoniazid) contributes to TB transmission around the world. To achieve TB elimination, both high and low endemic countries must upscale their efforts to decrease disease transmission and improve cure rates. Management of drug-resistant TB is of particular importance. In this paper, we discuss the different models of care of multidrug-resistant TB (MDR-TB), the ethical considerations and the specific constraints present in high income countries. The management model chosen by the Belgian TB specialists in accordance with public health authorities as well as building of a specific MDR/XDR-TB isolation unit are also discussed.

Hand-foot-mouth disease (HFMD) is an acute infectious disease caused by serotypes of the enterovirus (EV) family. HFMD reinfection occurs commonly in lack of cross-protection between different EV serotypes. In this study, we investigated the hazards of HFMD reinfection using Cox-proportional hazard model. Retrospective data of 95 209 HFMD cases in Wuhan during 2008–2015 was used. Kaplan–Meier survival methods and Cox-proportional hazard model were used to estimate the hazard probabilities. Of the all HFMD cases, about 2% experienced reinfection (1842/95 209). Kaplan–Meier curves revealed the reinfection risk sharply increased before 40 months from first infection. Higher hazards of reinfection were detected among those who were males, aged 3 years and below, scattered children, belonging to urban areas and first infected with coxsackievirus (CV)-A16 compared with their respective counterparts. Cox-proportional hazard model suggested that gender, age, group, living area and serotypes of first infection had significant effect on reinfection even after adjusting for potential confounding effects of other selected factors considered in the study. These results indicate that boys aged 3 years and below, especially those living in urban areas and first infected with CV-A16 are more prone to reinfection. Interventions should be imposed on these high-risk populations.

Immunization of men with various amounts of salmonella antigens gave a linear relationship between the logarithm of the dose and the logarithm of the titres of the antibodies produced. No secondary response was observed for any of the doses used. These doses of salmonella vaccine did not interfere with or stimulate simultaneous primary or secondary vaccination with tetanus and diphtheria vaccine.

When a 1:5 mixture of trimethoprim (TMP) and sulphadiazine was fed to pigs intra-nasally infected with Bordetella bronchiseptica, 10 mg/kg/day was shown to be highly effective in suppressing the organism. This dose level had little effect on numbers of TMP-resistant coliforms in faeces, but oral doses of 30 mg/kg/day eventually selected a resistant population. It is suggested that the proliferation of resistant coliforms would be minimized by administration of the lowest oral dose rates of antibacterial drugs compatible with efficacy.

Two elementary schools were served lunches that were cooked in the same kitchen. An outbreak of Escherichia coli O157:H7 occurred at one school where the dishes that were prepared for the school were lukewarm and kept for 33 min at an average temperature of 45 °C before serving. However, no outbreak occurred at the other school where dishes were hot and were kept for 60 min at an average temperature of 50 °C before serving. In a series of experiments on the survival of E. coli O157:H7 in the liquid portion of similarly prepared food, the population of E. coli O157:H7 was reduced by 10−3 by heating at 50 °C for 60 min and by only 10−1 by heating at 45 °C for 40 min. Further, E. coli O157:H7 survived at 45 °C for 40 min but not at 50 °C for 60 min at pH 4·0 with a 4·0% salt concentration that was similar to that of the liquid part of the food. These results indicate that pH and salt concentration of cooked food markedly affect the survival of E. coli O157:H7 and help to explain the occurrence of the disease outbreak at only one of the schools.