Experiments I–VIII.

I shows that under the conditions shown the plates were covered with innumerable colonies 7 feet above ground level to ground level. The beds and trestles were used to keep the hut always uniform.

II shows that 8 feet above ground, i.e. on top of the crossbeams, the same conditions obtain.

III, IV, V, and VI show that the same condition exists in the area between the beds or trestles. The beds make no difference, better or worse.

VII shows practically the same condition high up on the beam between the beds. The inverted plates naturally show less colonies, as the organisms mostly fall on to the plates.

VIII confirms the above.

There is only one conclusion to draw from these experiments, and that is that practically speaking there is no difference in the number of organisms on the ground floor and 8 feet above it, in the ordinary men’s sleeping huts, Barrack Design 230/14.

The prominence recently given to the Rous sarcoma has increased the confusion of hypotheses about malignancy. With a view to clarification, one may say that there are three simple hypotheses of outstanding importance, viz.: (1) the living virus hypothesis, which regards living viruses as the actual and effective cause of both the avian and the mammalian disease; (2) the autogenous enzyme hypothesis, which ascribes both diseases to the development within living cells of an ens malignitatis resembling an enzyme rather than a virus; and (3) the “chronic irritation” hypothesis, which explains mammalian malignancy on this principle and considers fowl sarcoma to be of a different nature.

Mice given an intraperitoneal injection of 0.5 mg. Corynebacterium parvum (dry weight) before vaccination with heat-killed (HK) or acetone-killed (AK) Salmonella typhimurium vaccine and later challenged intraperitoneally with S. typhimurium strain 1566, showed a statistically significant increase in mortality when compared with mice that had received only C. parvum but no vaccine. They also showed a higher mortality rate than mice receiving only HK or AK vaccine or mice that had received no vaccine before challenge. Prior administration of C. parvum to mice that are vaccinated with HK or AK vaccine appears to make them more susceptible to an intraperitoneal challenge with S. typhimurium. This was more apparent with HK vaccine than with AK vaccine.

In twenty-five consecutive cases in which nasopharyngeal cultures have been made from patients suffering from bacteriologically proved cerebro-spinal meningitis, meningococci have been obtained.

A striking similarity between the organisms from the two sites has been shown to exist for not only are they of the same agglutinable type but in the majority of instances individual peculiarities of agglutination have corresponded. The closeness of relation has been further demonstrated by the carbohydrate reaction in one case in which the unusual property of bleaching glucose litmus broth to a yellow colour was possessed by both organisms. Nevertheless, in a certain number of instances, though organisms of a different agglutinable type have not been isolated, as by other workers, there have been found certain minor variations of agglutination. That most if not all of these variations are due to alteration of the agglutinable capacity of one of the organisms seems probable, as in the six cases where most marked difference existed (Nos. 1, 3 and 24 of Type I and Nos. 15, 16 and 18 of Type II) the chances of the other alternative, namely that a second infection had happened in each case to be of the same agglutinable type, are remote.

In the twenty-five cases the proportion of the types present has been shown to agree with that found by other workers during the same period. Seven of the infections (28 per cent.) have been due to Type I and eighteen (72 per cent.) to Type II.

Ten of the cases have occurred in children under the age of two years, and the proportion of the two types among them has been approximately the same as among older patients.

The writer is indebted to the members of the staff of St Bartholomew's Hospital for permission to publish their cases, and gratefully acknowledges the encouragement and assistance of Professor Andrewes at whose instigation these investigations were conducted.

About 25 years ago Dr J. S. Haldane, Dr A. E. Boycott and Capt. Damant, R.N., in the course of investigations for the British Admiralty, worked out a system of decompression for divers and compressed air workers. This system was adopted by the Admiralty, and by its use compressed air sickness has been practically eliminated entirely amongst naval divers. The system has become known as stage decompression, although in fact stages are not an essential feature of it, though a convenience in practical working. The system has been frequently and fully described. The latest explanation will be found in the last edition, 1935, revised by Haldane and Priestly, of Respiration, by J. S. Haldane (Clarendon Press). Its most essential feature is that the pressure is lowered quickly to approximately half the absolute pressure during decompression, and one of the most important assumptions for working out the decompression tables is that different parts of the body saturate and desaturate at different rates. Enquiries sent out by me during 1934 to the United States, the principal countries of Europe and to Japan indicate, so far as definite information has been received in reply, that stage decompression has been universally adopted for divers, but in no case has it been adopted for caisson and tunnel workers in countries where State regulations already existed, except in a modified form, and I conclude that the reason for this failure to adopt stage decompression is the existence of statutory regulations, either still in force, or only partly modified in accordance with new ideas.

This report summarizes closed, family, and open studies conducted sequentially over a 10 month period with the Cendehill rubella virus vaccine in more than 16,000 children and adolescents. This strain of rubella was attenuated by serial propagation on primary rabbit kidney cell cultures. Inoculation of the Cendehill vaccine produced seroconversion in 97% of the 3589 susceptible (seronegative) vaccinated persons. There was no spread of the virus to susceptible controls living in close contact with those vaccinated. The vaccine was well tolerated. No arthritis or arthralgia occurred in 860 female subjects 13–18 years of age who were included in the study. The Cendehill vaccine would appear to meet the requirements of an acceptable vaccine.

With regard to the influence of malarial infection on the Wassermann test some controversy prevails:

Wassermann and Lange (1913) refer to Meyer and Bonfiglio who, working in Italy, obtained a positive reaction in 80 per cent. of the cases where the blood contained parasites; in some of their cases positive reactions were obtainable for several months after the disappearance of fever and parasites. For this reason Wassermann and Lange advise to put every case, coming from a malaria-infected country and showing a positive reaction, under quinine treatment and to repeat the test after a lapse of six weeks.

Nasal colonization with Staphylococcus aureus occurred in 18% of babies leaving a maternity unit and had risen to 40% by 6 weeks after birth. S. aureus was first acquired by 34·5% of babies after discharge. Female infants were more likely to be colonized than males. Colonization was not significantly different between babies receiving standard postnatal care and those nursed on the Special Care Baby Unit.

Crystal violet (CV) tests showed that purple-reacting isolates accounted for approximately 60% of strains, whether first detected at hospital discharge or subsequently acquired. Purple-reacting strains, once acquired, were significantly better able to persist than non purple-reacting strains and formed a cumulatively higher proportion of the strains isolated at 6 weeks after birth than at hospital discharge. CV purple-reactions were significantly associated with lysis by phages of groups III and I and non-purple-reactions were significantly associated with lysis by phages of group II and/or 94/96.

Maternity units remain a significant route whereby strains of S. aureus with some characteristics associated with a hospital origin gain access to the community.

The most important of the proteid constituents of milk is casein. From 70 to 90% of the total proteids of milk consists of this substance1. In milk, casein exists as a soluble calcium compound, which is not precipitated by boiling, but from which casein is deposited by the addition of acid or by the action of rennet2. This phenomenon is known as the curdling of milk and is a preliminary to its gastric digestion, both the acid in the stomach and the rennet being capable of producing it. By artificially influencing the nature of its curd we can influence the digestibility of the milk. In human gastric digestion and in the experiments detailed below both acid and rennet are present. The curdling of milk is a necessary preliminary to its digestion in an acid medium, and by influencing this process we can also influence the digestibility of the milk.

In order to assess the HIV prevalence in healthcare workers (HCWs) in Burkina Faso, we conducted a national survey in 97 health facilities from urban and rural areas. Of 1570 HCWs who agreed to participate, 1013 (64·5%) provided a urine sample for HIV testing. The crude prevalence of HIV in HCWs was 3·5% (95% CI 2·3–4·6). HIV prevalence was 0·7% in students and trainees, 3·8% in nurses and midwives, 4·5% in administrative workers, and 4·6% in laboratory workers. After age and area standardization, men from the Demographic Health Survey (DHS) had a similar HIV prevalence (2·3%, 95% CI 1·4–2·9) as male HCWs (2·5%, 95% CI 1·1–4·0), while female HCWs were more infected (4·5%, 95% CI 2·5–6·0) than women from the DHS (2·1%, 95% CI 1·3–2·4). A voluntary counselling and testing (VCT) programme should be specifically implemented and adapted for female HCWs.

The following contribution to the aetiology of cerebrospinal meningitis is published with a view to calling attention to the possible part played by dust in the causation of this disease. The strong connection between dusty occupations and cases of cerebrospinal fever, as here detailed afford, it is believed, a prima facie presumption that dust may be one of the vehicles of the specific germ.

Our study population consisted of all children and adolescents, with laboratory-confirmed SARS-Co-V-2 infection, hospitalised from February 2020 through February 2022, among residents of the Tel Aviv (TA) District, Israel. There were 491 children and adolescents hospitalised with Sars-CoV-2 infection. Among them, 281 (57%) admitted with coronavirus disease 2019 (COVID-19) as the primary cause of admission (rate of 39 per 100 000). Among all children and adolescents in the TA District, the highest hospitalisation rates were observed among infants and children below the age of 4 years (rate of 311 per 100 000 population). Severe disease was observed mostly among children with multiple underlying medical conditions. Admission rates were also elevated among residents of the ultra-orthodox community (rate ratio (RR) compared to the rest of the district; 95% confidence interval (CI) 2.38–3.82). Admission rates with COVID-19 as primary cause of admission were higher during Omicron compared to Delta predominance period (RR 1.7; 95% CI 1.22–2.32). Targeted social and public health policies should be put in place when rates of disease start to increase, such as encouraging vaccine uptake for eligible children and social distancing when necessary, taking into account already existing social and learning gaps, in order to reduce the burden of disease.

The epidemic of tuberculosis has posed a serious burden in Qinghai province, it is necessary to clarify the epidemiological characteristics and spatial-temporal distribution of TB for future prevention and control measures. We used descriptive epidemiological methods and spatial statistical analysis including spatial correlation and spatial-temporal analysis in this study. Furthermore, we applied an exponential smoothing model for TB epidemiological trend forecasting. Of 43 859 TB cases, the sex ratio was 1.27:1 (M:F), and the average annual TB registered incidence was 70.00/100 000 of 2009–2019. More cases were reported in March and April, and the worst TB stricken regions were the prefectures of Golog and Yushu. High TB registered incidences were seen in males, farmers and herdsmen, Tibetans, or elderly people. 7132 cases were intractable, which were recurrent, drug resistant, or co-infected with other infections. Three likely cases clusters with significant high risk were found by spatial-temporal scan on data of 2009–2019. The exponential smoothing winters' additive model was selected as the best-fitting model to forecast monthly TB cases in the future. This research indicated that TB in Qinghai is still a serious threaten to the local residents' health. Multi-departmental collaboration and funds special for TB treatments and control are still needed, and the exponential smoothing model is promising which could be applied for forecasting of TB epidemic trend in this high-altitude province.

Phylogenetic analysis was performed on the haemagglutinin and neuraminidase subtype N2 genes of low-pathogenic avian influenza viruses (LPAIVs) detected in Ireland between 2003 and 2007. Nucleotide sequences were compared to previously published sequences from the National Centre for Biotechnology Information. Sequences from viruses of the same subtype isolated in different years were compared to examine the possibility that LPAIVs may have been maintained in Ireland from year to year. All viruses had closest identity with published sequences of European lineage, supporting the conclusion that LPAIVs had been introduced to Ireland by dabbling ducks that had migrated from Europe. The data suggested that different subtypes of virus had been introduced each year. However, there was evidence that some LPAIVs may have been maintained in the sedentary waterfowl population for consecutive seasons. Furthermore, almost identical H6 and H10 sequences with different N types were found in isolates from the same season, suggesting that reassortment had occurred.

1. The incidence of haemolytic streptococci in the patients of a Hospital School for rheumatic children was determined over a period of 1 year.

2. In the total of 1644 throat and 1644 nasal swabs, group A strains were isolated from 20 throat and two nasal swabs. Eighty-seven strains of Lancefield's groups C and G and 54 strains of groups other than A, C, or G were isolated

3. There was no evidence of cross-infection.

4. Factors contributing to the low incidence of group A strains and the absence of cross-infection are discussed.

5. The carriage of groups C and G strains did not appreciably affect the erythrocyte sedimentation rate.

6. Although no direct evidence is available, the experience of the present study suggests that the incidence of streptococci in an institution for rheumatic children may be reduced by: (a) bacteriological screening before admission; (b) regular swabbing and Lancefield's grouping of streptococci isolated for the early detection of group A strains; and (c) administration of penicillin or sulphadiazine prophylactically to even a limited number of children.

We thank Prof. R. S. Illingworth for his advice in the writing of this paper, Dr J. L. Emery for laboratory facilities, Dr R. E. O. Williams for his advice in the planning of the investigation, and the matron and sisters of Ash House Hospital School, Sheffield, for their assistance.

The expenses of the investigation were defrayed by a grant from the Medical Research Council.

A split-product influenza A vaccine which contained an influenza B strain (B/Hong Kong/8/73) and two influenza A strains, antigenically identical with A/Fort Dix/741/76 (HswlNl) and A/Victoria/3/75 (H3N2), was offered to personnel of the CPHL. Changes in the antibody status were followed with serum samples collected from 153 participants on the day of vaccination and 1, 13 and 18 months thereafter. During the two epidemic seasons in the trial period there were only four serological influenza A infections (2·6%) among the vaccinees. This is one eighth of the corresponding infection rate (22%) in the general population estimated on the basis of other indices.

The vaccinees' antibody response was strongly influenced by the age of the individual subjects. During the trial period the decrease in the antibody titres slowed down. The geometric mean titres of homologous HI antibodies were still substantially higher at the end of the period than at the beginning. This also applied to heterologous antibodies against H1N1 viruses in persons born between 1926 and 1952. In participants born after 1952, the vaccine was not able to evoke these antibodies, and in participants born in or before 1925 the boosting effect was poor.

Water beds in use in this hospital were found to be contaminated with Pseudomonas aeruginosa. The addition of sodium hypochlorite, giving a final concentration of 200 parts/106 available chlorine, was found to be effective in preventing microbial contamination over a 6-month study period.