Despite consistent public health efforts, the burden of viral disease in India remains high. The present study was undertaken to understand the aetiology, frequency and distribution of viral disease outbreaks in the state of Odisha between 2010 and 2019. This was a prospective study conducted at the Virology Research and Diagnostic Laboratory located at ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, wherein all the outbreaks of viral aetiologies were investigated and analysed to provide a comprehensive picture of the state of viral disease outbreaks in the region. A total of 191 suspected viral outbreaks were investigated by the team from VRDL during September 2010 and September 2019 reported from all the 30 districts of Odisha. Annual number of suspected cases ranged from 185 to 1002. The most commonly suspected outbreaks were of viral hepatitis (55 outbreaks; 1223 cases) followed by dengue (45 outbreaks; 1185 cases), chickenpox (30 outbreaks; 421 cases), viral encephalitis (27 outbreaks; 930 cases), measles (23 outbreaks; 464 cases), chikungunya (10 outbreaks; 593 cases) and rubella (1 outbreak; 60). The outbreaks peaked in frequency and intensity during the months of July and September. The epidemiology of viral disease outbreaks in the region is presented in the study. Health system preparedness based on evidence is essential for early detection and adequate response to such viral outbreaks.

(1) 855 primary cases of typhoid fever in households in Birmingham were investigated.

(2) In 124 or 14·5% of these cases a history of mussel eating within four weeks of the onset of the disease was obtained.

(3) In 17 instances the histories were conclusive of mussel infection.

(4) The curve of mussel-typhoid cases arranged in their weeks of commencement tallies closely with the importation of mussels into Birmingham.

(5) Mussel infection is one of the causes contributing to the autumnal rise of enteric fever.

(6) Some of the sources from which mussels are sent to the Birmingham market are known to be exposed to dangerous sewage contamination.

(7) 65 samples of mussels obtained on entering the Birmingham market from 22 different known sources were analysed bacteriologically.

(8) The results in terms of (a) the total number of organisms, (b) the number of glucose-fermenters, (c) the number of spores of Bacillus enteritidis sporogenes, and (d) the number of Streptococci shew that pollution to a dangerous degree of a large proportion of mussels placed on the market for human consumption exists.

(9) 14 experiments were carried out in relation to mussels subjected to mussels subjected to moist heat at 100°C.

(10) These shew that the ordinary method of cooking to mussels does not remove the risk of typhiod infection and that mussels may be heated in a steam steriliser at 100° C. continuously for as long as four and a half hours without sterilisation.

(11) Legisaltion is necessary to prohibit the gathering of mussels for human consumption from mussel beds exposed to sewage contamination.

In view of the observations made of late years on the action of red light in variola, it was thought that it might be of interest to ascertain, if possible, whether the red, or other rays of daylight, exerted any influence in cases of vaccinia; that is to say, with a disease the specific virus of which differs from that of variola probably only in that its pathogenic capabilities are modified, while vaccinia presents clinically many points of resemblance to variola.

1. That the epidemic was due to infection of the water supply is borne out by the following points:

(a) The explosive character of the outbreak as shown in Graph II which is characterised by a rapid rise to peak at the end of third week followed by a sharp fall and a gradual tailing off to the end of the epidemic.

(b) The widespread distribution of cases (see Map), no area supplied by water from the city having escaped.

(c) The rapid decline which followed the adoption of appropriate measures to deal with the water supply.

2. 255 persons in the city area (including the 12 military cases) were definitely affected (equivalent to a rate of 3·1 per 1000 of the population). As shown by the rise in the death-rate for the rural area it is apparent that a far greater number of persons were actually attacked.

3. The outbreak had its origin in a defective manhole in the Mental Hospital grounds whereby the sewage overflowed into a rubble drain and infected the water supply. This defect had existed for twenty-five years, and an epidemic in the hospital fifteen years previously established the reservoir from which infection was disseminated through the city.

4. The spread of typhoid was favoured by unsatisfactory arrangements for the filtration of the water supply. This is borne out by the endemic character of the disease prior to the installation of an effective filtration plant.

5. The institution of this plant was followed by an immediate reduction in the incidence of the disease until, as at the present time, water-borne typhoid has been practically eliminated.

6. The value of such a plant combined with chlorination and bacteriological examination has been shown.

1. Recovery of a strain of Brucella abortus Bang from a foetus aborted by a cow in Mauritius is reported.

2. Agglutination tests performed on samples of blood from cows of the Government Dairy indicate that contagious abortion of cattle is present in this country; approximately 24% of the animals from the Government Dairy belonged to the latent or past infection group; 18 % to the active infection group and 15% were presumptive bacilli excreters.

3. As aresult of agglutination tests with the blood serum from man Undulant fever due to Br. abortus is suspected to occur in Mauritius.

The Virus Reference Laboratory, Colindale, first embarked on laboratory investigations for smallpox early in 1947. From then, in conjunction with the Department of Bacteriology, University of Liverpool, it provided a complete diagnostic service throughout England and Wales until 1962, after which the service became available regionally until eradication was effected. Up to 1970 it had investigated 2696 specimens from suspected cases of smallpox and had recovered 108 strains of variola and 248 of vaccinia virus. These last were from persons suffering the complications of vaccination. Some outbreaks following smallpox importation are discussed but infection among laboratory staff during this period was not demonstrated.

Coronavirus disease-2019 (COVID-19) elicits a range of different responses in patients and can manifest into mild to very severe cases in different individuals, depending on many factors. We aimed to establish a prediction model of severe risk in COVID-19 patients, to help clinicians achieve early prevention, intervention and aid them in choosing effective therapeutic strategy. We selected confirmed COVID-19 patients who were admitted to First Hospital of Changsha city between 29 January and 15 February 2020 and collected their clinical data. Multivariate logical regression was used to identify the factors associated with severe risk. These factors were incorporated into the nomogram to establish the model. The ROC curve, calibration plot and decision curve were used to assess the performance of the model. A total of 228 patients were enrolled and 33 (14.47%) patients developed severe pneumonia. Univariate and multivariate analysis showed that shortness of breath, fatigue, creatine kinase, lymphocytes and h CRP were independent factors for severe risk in COVID-19 patients. Incorporating age, chronic obstructive pulmonary disease (COPD) and these factors, the nomogram achieved good concordance indexes of 0.89 [95% confidence interval (CI) 0.832–0.949] and well-fitted calibration plot curves (Hosmer–Lemeshow test: P = 0.97). The model provided superior net benefit when clinical decision thresholds were between 15% and 85% predicted risk. Using the model, clinicians can intervene early, improve therapeutic effects and reduce the severity of COVID-19, thus ensuring more targeted and efficient use of medical resources.

Hand, foot and mouth disease (HFMD) is a common infection in the world, and its epidemics result in heavy disease burdens. Over the past decade, HFMD has been widespread among children in China, with Shanxi Province being a severely affected northern province. Located in the temperate monsoon climate, Shanxi has a GDP of over 2.5 trillion yuan. It is important to have a comprehensive understanding of the basic features of HFMD in those areas that have similar meteorological and economic backgrounds to northern China. We aimed to investigate epidemiological characteristics, identify spatial clusters and predict monthly incidence of HFMD. All reported HFMD cases were obtained from the Shanxi Center for Disease Control and Prevention. Overall HFMD incidence showed a significant downward trend from 2017 to 2020, increasing again in 2021. Children aged < 5 years were primarily affected, with a high incidence of HFMD in male patients (relative risk: 1.316). The distribution showed a seasonal trend, with major peaks in June and July and secondary peaks in October and November with the exception of 2020. Other enteroviruses were the predominant causative agents of HFMD in most years. Areas with large numbers of HFMD cases were primarily in central Shanxi, and spatial clusters in 2017 and 2018 showed a positive global spatial correlation. Local spatial autocorrelation analysis showed that hot spots and secondary hot spots were concentrated in Jinzhong and Yangquan in 2018. Based on monthly incidence from September 2021 to August 2022, the mean absolute error (MAE), mean absolute percentage error (MAPE), and root mean square error (RMSE) of the long short-term memory (LSTM) and seasonal autoregressive integrated moving average (SARIMA) models were 386.58 vs. 838.25, 2.25 vs. 3.08, and 461.96 vs. 963.13, respectively, indicating that the predictive accuracy of LSTM was better than that of SARIMA. The LSTM model may be useful in predicting monthly incidences of HFMD, which may provide early warnings of HFMD epidemics.

Under the title of “The inference of local degeneracy from a comparison of the vital tatistics of the people,” the late Dr C. S. Morrison, Medical Superin tendent of the County and City Asylum, Hereford, published a somewhat alarming account of the local conditions (Journal of Mental Science, vol. LIII, 1907, p. 795). After showing that the mean quinquennial rate of admissions to the Asylum had risen from 4·8 per 10,000 inhabitants in 1871–1875 to 7·0 in 1891–1895 and after a slight drop in the succeeding period to 7·2 in 1901–1905. (not including boarded-out patients in the latter case), he proceeds to remark upon the prevalence of thyroid insufficiency.

Current World Health Organization (WHO) reports claim a decline in COVID-19 testing and reporting of new infections. To discuss the consequences of ignoring severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, the endemic characteristics of the disease in 2023 with the ones estimated before using 2022 data sets are compared. The accumulated numbers of cases and deaths reported to the WHO by the 10 most infected countries and global figures were used to calculate the average daily numbers of cases DCC and deaths DDC per capita and case fatality rates (CFRs = DDC/DCC) for two periods in 2023. In some countries, the DDC values can be higher than the upper 2022 limit and exceed the seasonal influenza mortality. The increase in CFR in 2023 shows that SARS-CoV-2 infection is still dangerous. The numbers of COVID-19 cases and deaths per capita in 2022 and 2023 do not demonstrate downward trends with the increase in the percentages of fully vaccinated people and boosters. The reasons may be both rapid mutations of the coronavirus, which reduced the effectiveness of vaccines and led to a large number of re-infections, and inappropriate management.

Escherichia albertii is an emerging foodborne enteropathogen associated with infectious diarrhoea in humans. In February 2023, an outbreak of acute gastroenteric cases was reported in a junior high school located in Hangzhou, Zhejiang province, China. Twenty-two investigated patients presented diarrhoea (22/22, 100%), abdominal pain (21/22, 95.5%), nausea (6/22, 27.3%), and vomiting (3/22, 13.6%). E. albertii strains were successfully isolated from anal swabs collected from six patients. Each isolate was classified as sequence type ST2686, harboured eae-β gene, and carried both cdtB-I and cdtB-II subtypes, being serotyped as EAOg32:EAHg4 serotype. A comprehensive whole-genome phylogenetic analysis revealed that the six isolates formed a distinct cluster, separate from other strains. These isolates exhibited minimal genetic variation, differing from one another by 0 to 1 single nucleotide polymorphism, suggesting a common origin from a single clone. To the best of our knowledge, this represented the first reported outbreak of gastroenteritis attributed to E. albertii outside of Japan on a global scale.

In September 2002, facsimiles were sent to 360 primary-care physicians alerting them to a local outbreak of Q fever. The physicians subsequently submitted serology samples on significantly more patients than in a previously comparable period in 2001. Facsimile cascade assists effective communication with primary-care physicians in an outbreak investigation.

f2 bacteriophage in the presence of fetal calf serum (at a final concentration of 10%) was exposed to six commonly used disinfectants for times of 10, 20 and 30 sec. At the end of exposure times skim milk neutralized the disinfectant activity and residual virus was assayed using the plaque technique. The 6 disinfectants considered were Javex, sodium hydroxide, ethanol, Wescodyne, One Stroke Ves-Phene and Sonacide. A 0.25% (w/v) solution of sodium hydroxide and 1/50 Javex (1200 parts/106 chlorine) were the most effective of the six disinfectants considered since 105 f2 bacteriophage were inactivated in 30 seconds in each instance. Since a 0.25% (w/v) solution of sodium hydroxide had a pH of 12.5 this made it too caustic to use as a disinfectant in many practical situations. It was concluded therefore that Javex at some dilution less than 1/50 (greater than 1200 parts/106 chlorine) was the most practical of the six disinfectants to use. Ethanol (95%, v/v) inactivated 103 f2 bacteriophage in 30 seconds while 1/20 Wescodyne and undiluted Sonacide inactivated 101 virus particles. Ves-Phene at a dilution of 1/50 was a completely ineffective virucide during the 30 sec exposure. The resistance of f2 bacteriophage to inactivation by these six disinfectants was compared with that of echovirus 11 and coxsackievirus B5. In all instances except exposure to undiluted Sonacide, f2 was comparable in resistance to inactivation and in many cases had greater resistance.

Gaseous insecticides, such as methyl bromide and methallyl chloride, are being used on an increasing scale against insects attacking stored products such as grain, tobacco, etc. Their use involves two possible dangers. In the first place, the worker may be poisoned either during the actual gassing operation or during the preparatory period. Secondly, there is the possible danger to consumers through the absorption of these furnigants into the stored product.

In a recent report (Greenwood et al. 1936) we included a short discussion of the few scattered observations that we had made on the effects of the dispersal of an infected herd (pp. 189–92). Briefly, we had found that the division of a herd, in which an epidemic due to Bact. typhi-murium was under way, into small isolated groups was followed by a greatly decreased rate of mortality in those groups when the dispersal was carried out at the beginning of the beginning of the epidemic period. Reaggregation of the groups resulted in a fresh spread of the disease, but the final mortality was lower than in a similar herd which had not been dispersed during the earlier stages of cage life (Topley, 1922). In a subsequent experiment (Topley & Wilson, 1925) dispersal was carried out at a later stage of epidemic spread, and very different results were obtained. For the first three weeks or so after division into small groups there was no material difference between the mortality experienced by the dispersed and not-dispersed mice. But at about the 25th day the death-rate in each of the dispersed herds showed a definite decline, while that in the undispersed herds continued unabated for some further length of time.

We examined the association between contact with children and the clinical course of COVID-19 among COVID-19-positive adult patients. Participants completed a survey to assess demographics, medical information related to their COVID-19 diagnosis, contact with children at home and at the workplace. Patients were aged 45.68 ± 14.38 years, mostly female (72.1%), 842 were not hospitalized and 167 were hospitalized. At home, there were no differences between groups for the number of child contact hours or total child hours (hours × number of children) per week (Ps > 0.05). The number of children at home was greater among patients not hospitalized (P < 0.05), however this was no longer significant after controlling for covariates (P > 0.05). At the workplace, there were no differences between groups (all Ps > 0.05). Sub-group analysis found the proportion of patients that were treated in the intensive care unit (ICU) was greater among patients with no child contact (P < 0.05). A secondary analysis found that patients with no child contact had an increased likelihood of thromboembolism (P < 0.05) and a trend towards more overall COVID-19-related complications (P = 0.076). Overall, an association between contact with children and hospitalization was not found when adjusting for covariates. Sub-group analysis indicated a possible protective effect for more severe disease; however, these findings need further study.

Many studies have investigated the positivity rate of hepatitis B surface antibody (HBsAb) after hepatitis B vaccine (HepB) immunization. However, the antibody level, assessed monthly or at more frequent intervals after each of the three doses, particularly within the first year after birth, has not been previously reported. To elucidate the level of antibody formation at various times after vaccination, the current study used the available detection data of HBsAb in hospitalized children to analyze the HBsAb level after immunization combined with their vaccination history. Both the positivity rate and geometric mean concentration (GMC) increased sequentially with immunization doses, reaching their peaks earlier after the third dose than after the first two doses, and the rate of HBsAb positivity was able to reach 100% between 11 and 90 days after completing the three doses of HepB. Within one year after receiving the three doses, the antibody positivity rate and GMC were maintained above 90% and 100 mIU/mL, respectively, and subsequently steadily declined, reaching the lowest value in the 9th and 10th years. The current findings reveal, in more detail, the level of antibody formation at different times following each dose of HepB in hospitalized children, particularly in the age group up to one year after vaccination. For the subjects of this study, we prefer to believe that the proportion of HBsAb non-response should be less than 5% after full immunization with HepB, provided that the appropriate time for blood collection is chosen.

This study aimed to evaluate the contrast-enhanced ultrasound (CEUS) features of ureteral tuberculosis (UTB) and ureteral malignant tumour and to explore its application value in the differentiation of UTB from ureteral tumour. The ultrasound (US) and CEUS imaging features of 33 and 12 cases of pathologically confirmed UTB and ureteral malignant tumour, respectively, were retrospectively evaluated, and echo of the ureteral wall, abnormal echo of the lumen, degree of ureteral dilation and CEUS patterns of the two diseases were statistically analysed. The results revealed that the lumen echo of UTB was hyperechoic or anechoic, whereas that of ureteral tumour lesions was hypoechoic (χ2 = 28.22, P < 0.001). The wall echo of the obstruction site differed between the two diseases; in UTB, the ureteral wall was thickened but the outer wall remained intact, whereas in ureteral tumour, both the malignant tumour wall and outer wall were irregular (χ2 = 30.25, P < 0.001). CEUS of UTB revealed nonenhancement or heterogeneous enhancement in the lumen, whereas that of ureteral tumours revealed significant homogeneous enhancement (χ2 = 30.25, P < 0.001). Thus, CEUS can reveal lesion microcirculation and be used to evaluate blood supply characteristics in the lesion, indicating that it has high potential for differentiating the two diseases.