The prevalence of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is increasing day by day in the region, including Turkey. The study aimed to examine AIDS-related deaths in Turkey between 2009 and 2018 according to the national death registration system records. In this descriptive study, data on AIDS-related deaths were obtained from the Turkish Statistical Institute. The data consist of the cause of death codes, year of death, age and gender. Findings were presented using numbers and percentages. Seven hundred twenty-one AIDS-related deaths were reported in Turkey between 2009 and 2018. AIDS-related deaths in Turkey increased more than twice at the end of 10 years. The male/female death ratio is 4.5. Deaths under the age of 15 were 4.2% in total; however, they were increased to 10.2% in 2018. AIDS-related deaths are decreasing in the world but increasing in Turkey. The data from the Ministry of Health do not match the data of the national death registration system. Establishing a strong and accurate HIV/AIDS reporting system and identifying the causes and risk groups of this increase in AIDS-related deaths are critical.

A new type of Salmonella (S. rubislaw), exhibiting alpha-beta phase variation and found to have caused enteritis in man, has been described. Its antigenic formula is XI, r ↔ e, n, x.

A study of stool Escherichia coli in 60 children with gastroenteritis and 18 control children was carried out in Auckland, New Zealand in 1977. Toxigenic strains, heat labile and heat stable, predominated in the stools of only three children, all of whom had concomitant rotavirus. Classical enteropathogenic E. coli (EPEC) were found in patients and controls. Only one patient had many EPEC in the stool (086. H2), they were variably toxigenic and rotavirus was also present. No toxigenic serotype was isolated. Two potential pathogens were sometimes found. Overall there was no evidence for a substantial causative role for disease producing E. coli in these children.

1. An attempt has been made to ascertain by physiological observations on school children whether the radiant heat from a heating installation comprising electric panels suspended from the ceilings and walls of the classrooms, in a semi open-air school, was sufficient to impart adequate warmth to children while performing the ordinary curriculum of an elementary school.

2. During identical cold weather conditions, observations were made on children in two schools in the same area, the one heated by electric ceiling and wall panels and the other, the control school, heated by hot-water radiators and pipes.

3. The children in classrooms heated by radiant heat from electric ceiling and wall panels were found to be attempting to perform ordinary elementary school work under conditions of chilling incompatible with comfort and efficiency, and without such compensating factors as frequent exercise and controlled nutrition, neither of which are possible in such a school.

4. The observations made on the children in the semi open-air electric-panel heated school, the air temperatures and cooling powers encountered in the classrooms, and the control observations made in the hot-water heated school under similar weather conditions prove that the radiant heat emitted from the electric ceiling and wall panels was insufficient to impart adequate warmth to the children, and that the heating system as at present installed and controlled, is unable adequately to cope with such cold conditions as are commonly met with during the winter months of the year.

The residential home was investigated to study the endemic virus population. During this study, oral poliovirus vaccine was given to the children and the effect of vaccination on endemic enteroviruses and adenoviruses was investigated. In the light of these findings, the problem of virus interference is discussed. The health of the children is related to their virus infections.

We are indebted to Prof. S. D. M. Court and Prof. C. A. Green for the active interest they have taken in this investigation; to Miss J. McQuillin, B.Sc., F.I.M.L.T., for her technical assistance; also to the matron of the home and her staff for their co-operation in supplying the specimens, and to Mr L. J. Whitlock of the Royal Victoria Infirmary and his staff for arranging their transport to the laboratory.

In toxoplasma-antibody titrations with the dye-test the tolerances of the parasite Toxoplasma gondii are approximately normally distributed on the logarithm of the serum dilution. Log LD 50 (the logarithm of the titre), the variance of the tolerance distribution and the variances of the sample distributions were estimated by probit analysis of data obtained with titrations of a serum which contained the antibody. An empirical expression was derived relating the fraction of parasites attacked by the antibody to the time of incubation with the antibody. Approximately the same values for the titre and the variance of the distribution were obtained for every incubation period between 20 min. and 4 hr.

The author is indebted to Mr J. C. A. Zaat and to Dr E. F. Drion of the Statistical Division of the Central Organization TNO for helpful discussions and assistance with the statistical calculations. The technical assistance of Miss A. K. Fast is gratefully acknowledged.

Two single-tube media, lactose-tryptone-lauryl sulphate broth (LTLSB) and lauryl-tryptose-mannitol broth were tested in parallel in a series of 1111 tests on water samples from a variety of sources.

LTLSB was found to be superior both in gas and indole production from Escherichia coli when incubated at 44 °C and is recommended as the most suitable single-tube confirmatory test for this organism.

Antigenic substances have recently been extracted in soluble form from many bacteria, and the work of Boivin & Mesrobeanu (1934), Raistrick & Topley (1934) and Topley et al. (1937) has shown that polysaccharides in combination with other non-protein substances extracted from certain Gram-negative bacilli stimulate an effective immunity in mice and specific antibody formation in rabbits. The antigenicity of similar extracts of pneumococci has not been so readily demonstrated. Berkefeld filtrates of pneumococci lysed by bile or by alternate freezing and thawing were found to be non-antigenic in rabbits (Avery & Morgan, 1925; Avery & Neill, 1925), although it was possible to immunize mice effectively with bacteria-free solutions obtained from cultures of pneumococci (Perlzweig & Steffen, 1923; Perlzweig & Keefer, 1925; Meyer, 1927). The essential antigen for the production of immunity in mice has been shown to be the type-specific polysaccharide which is effective only in small doses, usually between 0.01 and 0.00001 mg. (Schiemann & Caspar, 1927; Schiemann, 1929; Enders, 1930; Wadsworth & Brown, 1931; Avery & Goebel, 1933). The type-specific polysaccharide has, however, been found to be without antigenic activity in rabbits (Avery & Goebel, 1933; Downie, 1937).

Myxomatosis on the Western Plains is an enzootic disease in contrast with the epizootic pattern which is general in eastern Australia. The most unusual aspects are the presence of significant numbers of diseased rabbits throughout the winter and the continuously low percentage of rabbits with antibodies to myxoma virus.

Climatic and topographic conditions are unsuited to the production of the high densities of mosquitoes necessary for widespread epizootics. Under these conditions the effects of less efficient methods of myxomatosis transmission are apparent. The unusual epidemiology of myxomatosis has resulted in selection for virulence of the virus similar to that which has occurred under summer epizootic conditions. All field strains are now in the mid range of virulence.

A modification of Sharpe's microdroplet counting technique is presented which permits viable counting of Bacteroides fragilis. Lysed horse blood was added to 0·1 ml soy digest agar droplets and 2% was found to be the optimal concentration which combined adequate intradroplet colony size with acceptable visibility on the counting screen of the Colworth Droplette machine.

The investigation of plasmid similarity is an important component in the surveillance of antimicrobial resistance and in the detection of epidemic plasmids. The use of restriction endonucleases in the classification of transferable, multiply-resistant plasmids from faecal Enterobacteriaceae isolated at the Children's Emergency Hospital, Khartoum was investigated. Twenty-four transconjugant plasmids, coding for 11 different resistance patterns, each of molecular weight 62 MDa. were studied using four restriction enzymes; Pst I, Eco R I, Hind III and Ara II. Fifteen different digest profiles were obtained. Restriction profiles discriminated between plasmids with differing resistance patterns and demonstrated homology of plasmids with common resistance patterns. Restriction endonuclease digest patterns provide a potentially rapid and reproducible method of plasmid classification, that could contribute towards surveillance systems in tropical countries with a high prevalence of antimicrobial resistance.

The report investigates the variation in results noticed when testing iodophor disinfectants in the presence of a 5% (w/v) yeast suspension.

It was found that these variations were not related to individual iodophor formulations but bore a direct relationship with the storage time of the prepared yeast suspension.

A testing rate for measles above 80% is required by the WHO European Region Measles Elimination strategy to verify elimination. To comply with this rate, we explored factors associated with the return of oral fluid kits (OFK) by suspected measles cases. We described the cases and conducted a mixed-effects analysis to assess the relationship between socio-demographic and public health management characteristics and the likelihood of returning an OFK to the reference laboratory. Of 3,929 cases who were sent a postal OFK, 2,513 (67%) returned the kit. Adjusting for confounding, registration with a general practitioner (GP) (aOR:1.48, 95%CI:1.23–1.76) and living in a less deprived area (aOR:1.35, 95%CI:1.04–1.74) were associated with an increased likelihood of returning the OFK. The odds of returning the OFK also increased if the HPT contacted the parents/guardians of all cases prior to sending the kit and confirmed their address (aOR:2.01, 95%CI:1.17–3.42). Cases notified by a hospital (aOR:1.94, 95%CI:1.31–2.87) or GP (aOR:1.52; 95%CI:1.06–2.16) also had higher odds of returning the OFK. HPTs may want to consider these factors when managing suspected cases of measles since this may help in increasing the testing rates to the WHO-recommended level.

A method for the estimation of chloramphenicol in faeces and bile is described. It has been shown that the bile contains high concentrations of the antibiotic, but the faeces small amounts. It is considered that the faecal concentration is dependent on the biliary supply.

The action of chloramphenicol on the gut flora is described and the dominance of yeasts on complete suppression of the conforms is reported, drawing attention to the possibility of intestinal moniliasis following unrestricted use of the antibiotic.

An explanation of ‘relapses’ in the chloramphenicol treatment of typhoid fever is given, and the possible effect of chloramphenicol on immunity response is discussed.

The Department of Veterans Affairs operates a large, centrally administered health care system consisting of 173 hospitals and 4 free standing outpatient clinics nationwide with approximately 945115 hospital discharges, 24·2 million outpatient visits, and 2·86 million persons served annually over the time frame of the review. The purpose of the study was to define whether such a system could effect timely change in the incidence of tuberculosis (TB) using centralized programme planning and flexible field implementation. A retrospective review of the number of newly diagnosed cases of active TB treated at veterans health care facilities between 1 October 1990 and 30 September 1997 was determined by using a standardized annual case census.

Intervention included implementation of the most current guidelines for the prevention of transmission of TB in the community and hospital setting, including administrative and engineering controls and a change in personal protective equipment. Centrally directed programme guidance, education, and funding were provided for field use in health care facilities of widely varying size and complexity.

The numbers of total reported cases of TB decreased significantly (P < 0·001) throughout the veterans health care system (nationally and regionally), with the case rate decreasing at a rate significantly greater than that seen in the USA as a whole (P < 0·0001). TB associated with multi-drug resistance (isoniazid and rifampin) and HIV coinfection also significantly decreased over the study period. Therefore, a large, centrally administered health care system can effectively combat a re-emerging infectious disease and may also demonstrate a successful outcome greater than seen in other, perhaps less organized health care settings.

A survey of both the prevailing and the desirable conditions for housing small laboratory animals, with particular reference to rats and mice, is described. The data surveyed are confined to laboratories in Great Britain and include requirements of space, heating, ventilation and building construction, with such accessories as cages, feeding devices and other equipment.

An analysis of the medical condition of 223 entrants to the nursing profession is attempted, with particular reference to 161 such nurses examined in accord with the recommendations of the King Edward's Hospital Fund for London (1943). This is followed by a short-term medical follow-up on these nurses by clinical examination, weight records, and ancillary tests. Of the total number of entrants eight (3·6 %) were rejected on medical grounds, and four (2·5 %) of the 161 were rejected on the findings of the initial examination.

An analysis of the sixty-five (29 %) nurses lost to the profession in their first year of service shows that 70 % had attempted an uncongenial vocation. It is suggested that vocation selection tests should be tried in attempting to lessen this costly drain of recruits. This figure of 29 % is no higher than the peacetime figure found by the Lancet Commission (Athlone Report, 1938).

An analysis of the illnesses of the nursing staff at Westminster Hospital during 3 years from 1 July 1943 to 30 June 1946 is presented, nearly 60 % of the illnesses being accounted for by respiratory tract infection and cutaneous sepsis. It has been shown that illness of more than 50 days in duration accounts for only 5 % of attacks of illness, but practically 30 % of the time lost through illness. It is suggested that such illness should be differentiated in analyses, from illnesses of shorter duration. A comparison of illnesses in staff nurses and student nurses follows; the figures suggest a lower morbidity rate in staff nurses, but the number of staff nurses is so small that the author cannot state that this has been demonstrated.

A comparison table between previous illness surveys and the present figures is presented which demonstrates a decreasing number of attacks of illness per nurse over the last 20 years in this country, probably due to better basic conditions of life.

A similar but international comparison applied to respiratory tract infection and cutaneous sepsis demonstrates that the former accounts for about 40 % of all the attacks of illness in this country and internationally. The previous figures for Great Britain, however, are exceptional in showing a much higher incidence of sepsis than elsewhere; this has not been substantiated by the present survey.

Figures for the amount of time lost per year through sepsis, tonsillitis and catarrhal disease are compared with those of Branson (1933) of 20 years ago, and perhaps illustrate the beneficial effect of surgery in cutaneous sepsis, and of sulphonamides in tonsillitis, as against the negligible therapeutic advances in catarrhal disease. The amount of tonsillitis sustained by nurses in the children's ward is shown as being out of proportion to the number of nurses employed.

Finally suggestions are made for promoting the health of nurses, which include: (i) the provision of a ‘welfare officer’ in the nurses' home; (ii) illness allowance proposals; (iii) remarks on the technique of ‘reporting sick’; (iv) staffing children's ward with senior nurses only.

The outbreak of food infection which we are about to describe is of interest from more than one point of view. Not only was it possible to determine the organism which caused the outbreak and to trace its source to a paratyphoid carrier, but the bacteriological results yielded an important contribution to the difficult question of the differentiation of Bacillus paratyphosus B. and B. enteritidis, which for some years has been much discussed among bacteriologists.

Beginning in January 1997, American immunization policy allowed parents and physicians to elect one of three approved infant vaccination strategies for preventing poliomyelitis. Although the three strategies likely have different outcomes with respect to prevention of paralytic poliomyelitis, the extreme rarity of the disease in the USA prevents any controlled comparison. In this paper, a formal inferential logic, originally described by Donald Rubin, is applied to the vaccination problem. Assumptions and indirect evidence are used to overcome the inability to observe the same subjects under varying conditions to allow the inference of causality from non-randomized observations. Using available epidemiologic information and explicit assumptions, it is possible to project the risk of paralytic polio for infants immunized with oral polio vaccine (1·3 cases per million vaccinees), inactivated polio vaccine (0·54 cases per million vaccinees), or a sequential schedule (0·54–0·92 cases per million vaccinees).