As Scotland is the only home country for which information is published on the regional distribution of the mortality from cancer according to site, it seemed of interest to examine whether a particular site, or group of sites, had any special geographical location. With this object in view the present investigation was undertaken for the period 1923–8.

Space-time interaction analysis was applied to data from 101 elementary school children who contracted variola minor during an epidemic in Bragança Paulista County, Brazil. One school had two and the other three shifts of students occupying the same classrooms each day. There was no evidence found for excessive numbers of cases to occur among unvaccinated students occupying the same desks or seated near the desks occupied by cases occurring during another shift. Only three cases occurred among the 31 unvaccinated students occupying desks of students with variola from other shifts. Only one of these three subsequent cases occurred at a time interval suggestive of transmission. For the three models tested there was no evidence of space-time interaction between time of onset of the disease and location of desk for pairs of students from different shifts.

1. The protection afforded by glycine and other amino-acids to guinea-pig complement against heat-inactivation is increased in the presence of sugars, although the latter are not themselves protective.

2. No significant increase in protective activity occurs in the presence of the alcohols derived from some of the sugars tested.

3. A marked exception amongst the alcohols is inositol, which reinforces the protective power of glycine at least as much as do the sugars.

4. The fourth component of complement is destroyed by heating at 63° C. for 30 min. It is, however, protected against heat-inactivation by glycine, and this protective effect is intensified in the presence of glucose and inositol.

5. The protection afforded to serum by the presence of glycine or glycine dissolved in glucose is removed when the system is dialysed, indicating that if a complex is formed it is readily dissociable.

This paper deals with the result obtained after testing, by the “Dick” method, the susceptibility of a series of adults to scarlet fever toxin. The toxin used was produced by the Wellcome Physiological Research Laboratory. While various strengths of solutions were tried to begin with from 1:2500 to 1:250, no advantage was found to result from the use of a solution stronger or weaker than 1:1000. The tests were, therefore, carried out with the standard “Dick” toxin as supplied by this firm.

1. The A.S.O. titre of cord blood is about 1½ times that in the mother's blood taken 4 weeks before delivery.

2. The distribution of A.S.O. levels in cord bloods from multiparae with children at school is not significantly different from that in multiparae whose children are under school age, or in primiparae.

3. Among these groups, only primiparae show a significantly increased A.S.O. level in winter.

4. The distribution of A.S.O. levels among the five social classes defined by the Registrar-General's occupation code showed a significant trend towards higher levels in the lower social grades.

We wish to thank Mr D. M. W. Maxwell, F.R.C.S., F.R.C.O.G. and Miss D. Slade, S.R.N., S.C.M. at Taplow, and Professor J. C. McC. Browne, F.R.C.S., F.R.C.O.G., Dr W. Hayes, D.Sc., F.R.C.P.I. and Miss M. Tweedle, S.R.N., S.C.M. at Hammersmith Hospital for their kind help.

Understanding historical environmental determinants associated with the risk of elevated marine water contamination could enhance monitoring marine beaches in a Canadian setting, which can also inform predictive marine water quality models and ongoing climate change preparedness efforts. This study aimed to assess the combination of environmental factors that best predicts Escherichia coli (E. coli) concentration at public beaches in Metro Vancouver, British Columbia, by combining the region’s microbial water quality data and publicly available environmental data from 2013 to 2021. We developed a Bayesian log-normal mixed-effects regression model to evaluate predictors of geometric E. coli concentrations at 15 beaches in the Metro Vancouver Region. We identified that higher levels of geometric mean E. coli levels were predicted by higher previous sample day E. coli concentrations, higher rainfall in the preceding 48 h, and higher 24-h average air temperature at the median or higher levels of the 24-h mean ultraviolet (UV) index. In contrast, higher levels of mean salinity were predicted to result in lower levels of E. coli. Finally, we determined that the average effects of the predictors varied highly by beach. Our findings could form the basis for building real-time predictive marine water quality models to enable more timely beach management decision-making.

We carried out a retrospective study of acute gastroenteritis (AGE) outbreaks reported between 1 January 2015 and 31 December 2021 in Catalonia (Spain) to compare the incidence from 2015 to 2019 with that observed from 2020 to 2021. We observed a higher incidence rate of outbreaks during the prepandemic period (16.89 outbreaks/1,000,000 person-years) than during the pandemic period (6.96 outbreaks/1,000,000 person-years) (rate ratio (RR) 0.41; 95% confidence interval (CI) 0.34 to 0.51). According to the aetiology of the outbreak, those of viral aetiology decreased from 7.82 to 3.38 outbreaks/1,000,000 person-years (RR 2.31; 95% CI 1.72 to 3.12), and those of bacterial aetiology decreased from 5.01 to 2.78 outbreaks/1,000,000 person-years (RR 1.80; 95% CI 1.29 to 2.52). There was a great reduction in AGE outbreaks in Catalonia. This reduction may have been due to the effect of the nonpharmaceutical measures applied to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the collapse of the healthcare system and epidemiological surveillance services may also have had a strong influence.

Pus from a lumbar abscess in a boy, aged 10 years, produced severe general tuberculosis in a guinea-pig. A culture from this guinea-pig resembled a bovine strain in primary culture on egg and a eugonic human strain in subculture on glycerine egg and glycerinated potato. The virulence of the strain was high for the guinea-pig and irregular for the rabbit. For some rabbits the pathogenic effects of the strain were much more severe than those of typical human bacilli and approached, but did not equal, those of bovine bacilli. The results in other rabbits were similar to those of eugonic human bacilli. Cultures recovered from the rabbits resembled in characters the original strain, which was therefore not a mixture of the human and bovine types of tubercle bacilli. The strain cannot be described as ‘human’ or ‘bovine’ according to the usually accepted distinction between these types in the rabbit, but according to the results in the vole could be classified as belonging to the human type.

Bovine tuberculosis (bTB) is a chronic, zoonotic infection of domestic and wild animals caused mainly by Mycobacterium bovis. The Test and Vaccinate or Remove (TVR) project was a 5-year intervention (2014–2018) applied to Eurasian badgers (Meles meles) in a 100 km2 area of County Down, Northern Ireland. This observational study used routine bTB surveillance data of cattle to determine if the TVR intervention had any effect in reducing the infection at a herd level. The study design included the TVR treatment area (Banbridge) compared to the three adjacent 100 km2 areas (Dromore, Ballynahinch, and Castlewellan) which did not receive any badger intervention. Results showed that there were statistically lower bTB herd incidence rate ratios in the Banbridge TVR area compared to two of the other three comparison areas, but with bTB herd history and number of bTB infected cattle being the main explanatory variables along with Year. This finding is consistent with other study results conducted as part of the TVR project that suggested that the main transmission route for bTB in the area was cattle-to-cattle spread. This potentially makes any wildlife intervention in the TVR area of less relevance to bTB levels in cattle. It must also be noted that the scientific power of the TVR study (76%) was below the recommended 80%, meaning that results must be interpreted with caution. Even though statistical significance was achieved in two cattle-related risk factors, other potential risk factors may have also demonstrated significance in a larger study.

This experimental study aimed to determine the activity of a near-UVA (405 nm) LED ceiling system against the SARS-CoV-2 virus. The ceiling system comprised 17 near-UVA LED lights with a radiant power of 1.1 W/each centred at 405 nm wavelength. A 96-multiwell plate, fixed to a wooden base, was inoculated with suspensions of VERO E6 cell cultures infected with SARS-CoV-2 virus and irradiated at a distance of 40 cm with a dose of 20.2 J/cm2 for 120 min. The collected suspensions were transferred to VERO cell culture plates and incubated for 3 days. The maximum measurable log reduction obtained, starting from a concentration of 107.2 TCID50/mL, was 3.0 log10 and indicated inhibition of SARS-CoV-2 replication by the near-UVA LED ceiling system. Near-UVA light at a 405-nm wavelength is emerging as a potential alternative treatment for localised infections and environmental decontamination because it is far less harmful to living organisms’ cells than UV-C irradiation.

We investigated whether household to clinic distance was a risk factor for death on tuberculosis (TB) treatment in Malawi. Using enhanced TB surveillance data, we recorded all TB treatment initiations and outcomes between 2015 and 2018. Household locations were geolocated, and distances were measured by a straight line or shortest road network. We constructed Bayesian multi-level logistic regression models to investigate associations between distance and case fatality. A total of 479/4397 (10.9%) TB patients died. Greater distance was associated with higher (odds ratio (OR) 1.07 per kilometre (km) increase, 95% credible interval (CI) 0.99–1.16) odds of death in TB patients registered at the referral hospital, but not among TB patients registered at primary clinics (OR 0.98 per km increase, 95% CI 0.92–1.03). Age (OR 1.02 per year increase, 95% CI 1.01–1.02) and HIV-positive status (OR 2.21, 95% CI 1.73–2.85) were also associated with higher odds of death. Model estimates were similar for both distance measures. Distance was a risk factor for death among patients at the main referral hospital, likely due to delayed diagnosis and suboptimal healthcare access. To reduce mortality, targeted community TB screening interventions for TB disease and HIV, and expansion of novel sensitive diagnostic tests are required.

The results are presented of testing untreated producer–retailer herd milk samples for the presence of Brucella abortus during the period 1965–1972 in the North Lancashire region.

There was a steady decline in the incidence of infected herds from 22 % in 1965 to 12% in 1971. A sharp fall to 5% in 1972 suggests that the introduction of the Brucellosis Incentives Scheme and the eradication programme has helped to reduce the practice of selling brucella-infected cattle in the open market which was prevalent in the period 1965 to 1970.

This practice of selling brucella-infected cattle may also be a prime factor in the changing pattern of distribution of the biotypes of B. abortus which was observed during the period 1965 to 1970.

A comparison of the two areas in the region show that the incidence of herd infection was always greater in the area containing flying herds than in the area in which self-contained herds predominated.

An account is given of outbreaks of anthrax among mink, which occurred in Great Britain during 1936–8, and the possible danger to human beings from this source is discussed. Attention is called to the peculiar features of one of the outbreaks and to the probable mode of infection.

Acknowledgements. My best thanks are due to Dr D. Jordan Lloyd for supplying information and references concerning the dressing of pelts, to the Veterinary Department of the Ministry of Agriculture for details of outbreaks of anthrax during 1936–8, and to Dr F. C. Minett for his assistance in compiling this paper.

This study aims to locate the knots of cumulative coronavirus disease 2019 (COVID-19) case number during the first-level response to public health emergency in the provinces of China except Hubei. The provinces were grouped into three regions, namely eastern, central and western provinces, and the trends between adjacent knots were compared among the three regions. COVID-19 case number, migration scale index, Baidu index, demographic, economic and public health resource data were collected from 22 Chinese provinces from 19 January 2020 to 12 March 2020. Spline regression was applied to the data of all included, eastern, central and western provinces. The research period was divided into three stages by two knots. The first stage (from 19 January to around 25 January) was similar among three regions. However, in the second stage, growth of COVID-19 case number was flatter and lasted longer in western provinces (from 25 January to 18 February) than in eastern and central provinces (from 26 February to around 11 February). In the third stage, the growth of COVID-19 case number slowed down in all the three regions. Included covariates were different among the three regions. Overall, spline regression with covariates showed the different change patterns in eastern, central and western provinces, which provided a better insight into regional characteristics of COVID-19 pandemic.

During the period 1971–4, Torulopsis glabrata formed 42% of yeasts isolated from 5677 clinical specimens from patients with cancers, diabetes mellitus, chronic renal failure, pregnancy or major surgical operations complicated by mycotic infections. The significance of T. glabrata in these patients is discussed.

The study aimed to explore the relationship between eosinophils and the prognosis of varicella in adults. We retrospectively reviewed the medical records of patients who were hospitalised in The Fifth People's Hospital of Suzhou with a diagnosis of adult varicella during the period between 1 January 2012 and 31 December 2020. Of the 359 patients, 228 (63.51%) had eosinopenia. The proportion of patients with mild type disease was significantly lower in the eosinopenia group than that in the non-eosinopenia group (50.44% vs. 65.65%, P = 0.006). The proportion of the patients with common type disease was significantly higher in the eosinopenia group than that in the non-eosinopenia group (39.47% vs. 28.24%, P = 0.039). The proportion of the patients with severe type disease was higher in the eosinopenia group, although the difference did not reach statistical significance (10.09% vs. 6.11%, P = 0.243). The rates of high fever (47.81% vs. 32.82%, P = 0.008; relative risk (RR) 1.296, 95% confidence interval (CI) 1.091–1.540), headache (43.42% vs. 22.14%, P < 0.001; RR 1.415, 95% CI 1.233–1.623), anorexia (53.51% vs. 35.88%, P = 0.001; RR 1.367, 95% CI 1.129–1.655) and complications (82.89% vs. 64.12%, P < 0.001; RR 2.106, 95% CI 1.460–3.038) were also significantly higher in the eosinopenia group. Among the complications, the liver injury and skin infection were more serious in the eosinopenia group. The disease course was significantly longer in the eosinopenia group than that in the non-eosinopenia group (9.43 ± 1.89 days vs. 8.73 ± 1.25 days, P < 0.001). The improvement rate of liver injury in the recovery period was lower in the eosinopenia group than that in the non-eosinopenia group (35.38% vs. 50%, P = 0.012). The study found that adult varicella patients with eosinopenia had a more serious condition, a higher morbidity of complications and a slower recovery. Blood eosinophils can be used as a new predictor of the severity of adult varicella.

1. Nairobi township and other areas about the Mount Kenya endemic centre have frequently been penetrated by persons suffering from plague, but, at least during the last few years, plague has failed to become established in this way.

2. A survey of rats and fleas, conducted at Mombasa upon 66 truckloads of maize in transit, resulted in no rats being seen or captured, whilst only seven fleas (2 ♂ and 2 ♀ X. cheopis, 1 ♂ and 1 ♀ D. lypusus and 1 ♀ Ct. cabirus) were collected from clean white rats after they had been allowed to run about in the maize.

3. Although maize continues to be repeatedly unloaded and handled at Mombasa, this town has remained free from plague.

4. We have failed to obtain any evidence that the transport of maize from endemic centres by railway is a factor in the dissemination, of plague.

The Guillain-Barré syndrome (GBS) has been previously associated with Zika virus infection. We analysed the data from all the patients with GBS diagnosis that were admitted to a referral hospital, in Tapachula City during the period from January 2013 to August 2016, comparing the incidence of GBS according to the temporality of the Zika outbreak in Southern Mexico. Additionally, we described the clinical and epidemiological characteristics of the GBS patients admitted before or after the Zika outbreak. We observed a sharp increase in the number of patients hospitalised due to GBS from the time the first confirmed Zika cases appeared in Mexico. Clinically we observed GBS cases before zika outbreak had more frequently history of respiratory/gastrointestinal symptoms and GBS during zika outbreak had significantly more frequently recent history of rash/conjunctivitis. Although we cannot affirm that the increased cases of GBS have a specific aetiologic association with Zika, our results suggest that this observed outbreak of in Tapachula, might have been associated to the emerging Zika epidemic, locally and suggests that rare complications associated with acute infections (such as GBS) might be useful in the surveillance systems for emerging infections.

Serology data are an increasingly important tool in malaria surveillance, especially in low transmission settings where the estimation of parasite-based indicators is often problematic. Existing methods rely on the use of thresholds to identify seropositive individuals and estimate transmission intensity, while making assumptions about the temporal dynamics of malaria transmission that are rarely questioned. Here, we present a novel threshold-free approach for the analysis of malaria serology data which avoids dichotomization of continuous antibody measurements and allows us to model changes in the antibody distribution across age in a more flexible way. The proposed unified mechanistic model combines the properties of reversible catalytic and antibody acquisition models, and allows for temporally varying boosting and seroconversion rates. Additionally, as an alternative to the unified mechanistic model, we also propose an empirical approach to analysis where modelling of the age-dependency is informed by the data rather than biological assumptions. Using serology data from Western Kenya, we demonstrate both the usefulness and limitations of the novel modelling framework.