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.

We propose that postal Change-of-Address (CoA) data can be used to monitor/predict likely second wave caseloads in viral infections around urban epicentres. To illustrate the idea, we focus on the tri-state area consisting of New York City (NYC) and surrounding counties in New York, New Jersey and Connecticut States. NYC was an early epicentre of the coronavirus disease 2019 (Covid-19) pandemic, with a first peak in daily cases in early April 2020, followed by the second peak in May/June 2020. Using CoA data from the US Postal Service (USPS), we show that, despite a quarantine mandate, there was a large net movement of households from NYC to surrounding counties in the period April–June 2020. This net outward migration of households was strongly correlated with both the timing and the number of cases in the second peaks in Covid-19 cases in the surrounding counties. The timing of the second peak was also correlated with the distance of the county from NYC, suggesting that this was a directed flow and not random diffusion. Our analysis shows that CoA data is a useful method in tracking the spread of an infectious pandemic agent from urban epicentres.

Circulating 25-hydroxy vitamin D (25(OH)D) is related to decreased rates of gastrointestinal and ear infections in school-age children. Vitamin D-binding protein (DBP) transports 25(OH)D and exerts immunological functions; however, it is unknown whether DBP is associated with infectious morbidity in children. We quantified plasma DBP concentrations in 540 school-age children at the time of recruitment into a cohort study in Bogotá, Colombia and obtained daily information on infectious morbidity symptoms and doctor visits during the school year. We compared the incidence rates of gastrointestinal and respiratory symptoms across quartiles of DBP concentration by estimating adjusted incidence rate ratios (IRRs) with 95% confidence interval (CI). We also estimated the per cent of the associations between DBP and morbidity that were mediated through 25(OH)D using a counterfactual frame. Mean ± s.d. DBP concentration was 2650 ± 1145 nmol/l. DBP was inversely associated with the rates of diarrhoea with vomiting (IRR for quartiles 2–4 vs. 1 = 0.48; 95% CI 0.25–0.92; P = 0.03) and earache/ear discharge with fever (IRR for quartiles 2–4 vs. 1 = 0.29; 95% CI 0.12–0.71; P = 0.006). The DBP–morbidity associations were not mediated through 25(OH)D. We conclude that plasma DBP predicts lower incidence of gastrointestinal and ear infections in school-age children independent of 25(OH)D.

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 chemical changes which occur in the dissolved solids of sewage on discharge into sea-water have been investigated by several workers (see references 1–11). Some observation on the difference of these changes to those occurring in polluted fresh water have been made by Letts and Richards (6,11). In regard to waters whose saline composition is not such as to preclude their admissibility for potable purposes on this account, Liversidge(12) has made a brief communication on the variation in the free and albuminoid ammonia.

The purpose of the study was to describe the results of follow up of human contacts of bovine tuberculosis. The bovine tuberculosis cases occurred on farms in North Staffordshire between 1993 and 1997. A total of 162 people were identified as having close contact with cattle diagnosed as having bovine tuberculosis, or who had drunk unpasteurized milk from a herd with bovine tuberculosis. A retrospective review of chest clinic notes was performed. One hundred and thirty-eight people attended for follow up, and Heaf test results, necessity for chest X-ray and further clinical follow-up are described. No case of human Mycobacterium bovis infection was identified. It is suggested that follow-up of human contacts is limited to those with close contact with herds who have bovine tuberculosis and cattle with visible pulmonary lesions or evidence of udder infection. Children on the farms with affected cattle should also be offered BCG in advance of the routine school's programme.

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.

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.

This study describes epidemiological trends for acute rotavirus gastroenteritis (RVGE) in Belgium in children aged ⩽5 years during the period June 2007 to May 2014 after the introduction of routine rotavirus (RV) vaccination. This period encompassed the switch from lyophilized to the liquid formulation of Rotarix™ (GlaxoSmithKline, Belgium) in August 2011. Uptake of RV vaccine remained consistently high throughout the study period with Rotarix the brand most often used. RV was present in 9% (1139/12 511) of hospitalized cases with acute gastroenteritis included in the study. Epidemiological trends for hospital admissions for RVGE remained consistent throughout the study period, with no evidence of any change associated with the switch from lyophilized to liquid formulation of Rotarix. This suggests both formulations perform similarly, with the liquid formulation not inferior regarding ability to reduce hospital admissions for acute RVGE in children aged ⩽5 years. A strong seasonal effect was observed with most RVGE occurring in the winter months but with some variability in intensity, with highest incidence found in those aged 6–24 months. The main observation was the decreased number of hospital admissions for RVGE in Belgium that occurred during winter 2013/2014.

A sensitive antigen suspension is described for use with a simple slide agglutination method which makes possible a serological diagnosis or exclusion of typhoid fever without recourse to a laboratory. The method has been tested on 414 sera sent to our laboratory; it detected all cases with a titre of 1: 80 or more, and most of those with a titre of 1: 40. The method was further tested on 130 clinically observed cases, in which it gave satisfactory results. The S. A. method gave a positive result with 98 out of 100 sera from patients with typhoid fever, whereas the classical Widal reaction gave a positive result with 68 of them only.

The intensity and rapidity of the slide agglutination reaction provide a rough measure of the titre of a serum. A quick and distinct agglutination indicates a titre of 1: 80 or more and is diagnostic of typhoid fever. A slow and indistinct result is obtained when the titre of the serum is about 1: 40. A negative test indicates with great probablity that a diagnosis of typhoid fever may be excluded.

We think the method succeeds because the nature of the suspension employed and the peculiar behaviour of slide agglutinations permit the detection of O agglutinins as well as H agglutinins.

The result of bacteriological research indicates that the material infected is probably not large compared to the total amount used, and that in suspected samples of both hair and bristles anthrax bacilli can be isolated either by inoculation of animals or by plate cultivation.

Difficulties are met with in the inoculation of animals owing to the presence of the bacillus of malignant oedema, which, unless special methods are used as shown by Duncan, will often mask the presence of the anthrax bacillus altogether.

In separation by means of agar plates the presence of bacilli very closely resembling anthrax again leads to error. Three types of these bacilli have been met with in hair and bristles; viz.: Bac. A2 or Bac. anthracoides of Bainbridge, possibly the same as Bac. subtilis, the Bac. A1, and Bac. A. The last two do not exactly correspond with any known bacilli, and so far as we know at present are of little importance, but in view of the experiments of Gilruth showing that guinea-pigs, rabbits, and sheep can resist the inoculation of large doses of virulent anthrax bacilli completely, provided these organisms are mixed with a larger quantity of some other organisms which are non-pathogenic to these animals, and that a small amount of immunity to pure anthrax is conferred, it is certain that the presence of these anthrax-like bacilli, evidently closely related to the anthrax bacillus, cannot but be of benefit; and it is possible that further experiments may show that injections of them mixed with cultures of anthrax bacilli of varied virulence may confer a higher degree of immunity than do mixtures of anthrax with other non-pathogenic bacilli, as shown by Gilruth (1904).

Residential locations of cases are often used as proxy measures for the likely place of exposure and this assumption may result in biases affecting both surveillance and epidemiological studies. This study aimed to describe the importance of domestic travel in cases of human campylobacteriosis reported during routine surveillance in Iceland from 2001 to 2005. Various measures of disease frequency were calculated based upon the cases' region of residence, adjusting location of domestic travel cases to their travel region, as well as separate estimations for travellers and non-travellers. Of the 376 cases included in the analysis, 37% had travelled domestically during their incubation period. Five of the eight regions were identified as high-risk when considering domestic travel whereas there were no high-risk regions when considering only region of residence. The change in regional representation of disease occurrence indicates the importance of collecting domestic travel information in ongoing surveillance activities.

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.

A variety of factors that affect lecithinase activity and lecithinase production by Cl. welchii were studied. The lecithinase activity was time and temperature dependent. The optimum temperature varied from 30° to 46° C. according to the strain of Cl. welchii employed. Maximum lecithinase activity was produced after 12–60 hr. There was considerable strain variation. This could easily account for the differences in the published data.

Commercial purified lecithinase was more readily destroyed by heat than the lecithinase produced by Cl. welchii in culture media. The enzyme inactivation pattern at 60° C. was similar to that at 90° C. This is not in agreement with the reports of others who found that less enzyme was inactivated at the higher temperatures.

Acid pH values completely inactivated the enzyme. However, alkaline pH values did not significantly destroy the enzyme. The lecithovitellin reaction was completely inhibited at pH values of 1–5. The optimum pH for the reaction was around pH 7–8.

The production of lecithinase was dependent upon the pH of the culture medium. One strain produced measurable lecithinase at pH values of 5·5–8·5, whereas another strain produced lecithinase only at pH values 6–5–7–5.

Lecithin stimulated the production of lecithinase in a chemically defined medium.

SARS-CoV-2 superspreading occurs when transmission is highly efficient and/or an individual infects many others, contributing to rapid spread. To better quantify heterogeneity in SARS-CoV-2 transmission, particularly superspreading, we performed a systematic review of transmission events with data on secondary attack rates or contact tracing of individual index cases published before September 2021 prior to the emergence of variants of concern and widespread vaccination. We reviewed 592 distinct events and 9,883 index cases from 491 papers. A meta-analysis of secondary attack rates identified substantial heterogeneity across 12 chosen event types/settings, with the highest transmission (25–35%) in co-living situations including households, nursing homes, and other congregate housing. Among index cases, 67% reported zero secondary cases and only 3% (287) infected >5 secondary cases (“superspreaders”). Index case demographic data were limited, with only 55% of individuals reporting age, sex, symptoms, real-time polymerase chain reaction (PCR) cycle threshold values, or total contacts. With the data available, we identified a higher percentage of superspreaders among symptomatic individuals, individuals aged 49–64 years, and individuals with over 100 total contacts. Addressing gaps in the literature regarding transmission events and contact tracing is needed to properly explain the heterogeneity in transmission and facilitate control efforts for SARS-CoV-2 and other infections.

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.

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.

Bovine tuberculosis (bTB) is prevalent among livestock and wildlife in many countries including New Zealand (NZ), a country which aims to eradicate bTB by 2055. This study evaluates predictions related to the numbers of livestock herds with bTB in NZ from 2012 to 2021 inclusive using both statistical and mechanistic (causal) modelling. Additionally, this study made predictions for the numbers of infected herds between 2022 and 2059. This study introduces a new graphical method representing the causal criteria of strength of association, such as R2, and the consistency of predictions, such as mean squared error. Mechanistic modelling predictions were, on average, more frequently (3 of 4) unbiased than statistical modelling predictions (1 of 4). Additionally, power model predictions were, on average, more frequently (3 of 4) unbiased than exponential model predictions (1 of 4). The mechanistic power model, along with annual updating, had the highest R2 and the lowest mean squared error of predictions. It also exhibited the closest approximation to unbiased predictions. Notably, significantly biased predictions were all underestimates. Based on the mechanistic power model, the biological eradication of bTB from New Zealand is predicted to occur after 2055. Disease eradication planning will benefit from annual updating of future predictions.

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.