Tuberculosis (TB) remains a global leading cause of death, necessitating an investigation into its unequal distribution. Sun exposure, linked to vitamin D (VD) synthesis, has been proposed as a protective factor. This study aimed to analyse TB rates in Spain over time and space and explore their relationship with sunlight exposure. An ecological study examined the associations between rainfall, sunshine hours, and TB incidence in Spain. Data from the National Epidemiological Surveillance Network (RENAVE in Spanish) and the Spanish Meteorological Agency (AEMET in Spanish) from 2012 to 2020 were utilized. Correlation and spatial regression analyses were conducted. Between 2012 and 2020, 43,419 non-imported TB cases were reported. A geographic pattern (north–south) and distinct seasonality (spring peaks and autumn troughs) were observed. Sunshine hours and rainfall displayed a strong negative correlation. Spatial regression and seasonal models identified a negative correlation between TB incidence and sunshine hours, with a four-month lag. A clear spatiotemporal association between TB incidence and sunshine hours emerged in Spain from 2012 to 2020. VD levels likely mediate this relationship, being influenced by sunlight exposure and TB development. Further research is warranted to elucidate the causal pathway and inform public health strategies for improved TB control.

The association between time to positivity (TTP) of blood culture and the clinical prognosis of patients with Klebsiella pneumoniae bloodstream infection (BSI) remains unclear. A retrospective study of 148 inpatients with BSI caused by K. pneumoniae was performed at Shanghai Tongji Hospital, China, from October 2016–2020. The total in-hospital fatality rate was 32%. The median TTP was 11.0 (7.7–16.1) h and the optimal cutoff for prediction of in-hospital mortality was 9.4 h according to the ROC curve. Early TTP (<9.4 h) was a risk factor for in-hospital mortality by univariate analysis (OR = 2.5, 95% CI 1.2–5.0, P = 0.01), but not by multivariate analysis (OR = 2.7, 95% CI 1.0–7.4, P = 0.06). Old age, serum creatinine, white blood cells, and C-reactive protein values were risk factors for in-hospital mortality by multivariate analysis. Early TTP was not a risk factor for septic shock (OR = 1.8, 95% CI 0.6–5.1, P = 0.27) or ICU admission (OR = 1.0, 95% CI 1.0–1.0, P = 0.32). In conclusion, the in-hospital fatality rate of patients with K. pneumoniae BSI was relatively high and associated with an early TTP of blood cultures. However, no increased risk of mortality, septic shock or ICU admission was evident in early TTP patients.

1. The chain of evidence incriminating the house fly as a disseminator of typhoid fever is at present fairly complete, but many of the links are weak and not thoroughly strengthened by experimentation.

2. The bulk of experimental work has hitherto been done under highly unnatural and artificial circumstances and the results so obtained cannot be accepted unreservedly as giving a correct view of conditions in nature.

3. The experiments described in the present paper show that flies can ingest typhoid bacilli from natural matter, i.e. human faeces and urine, and carry them for a certain period of time.

4. There is no evidence to show that the typhoid bacilli multiply in the house fly. On the contrary the evidence goes to show that they are not adapted for prolonged life on or in the fly.

5. It thus follows that the house fly is a purely mechanical carrier of the typhoid bacillus and is not a natural “host” in the strict sense of the term.

6. Many bacilli closely resembling B. typhosus in cultural characteristics appear to be natural or, at least, common inhabitants of the intestine of the house fly. These are extremely likely to be mistaken for B. typhosus unless the most stringent tests are employed.

7. As might be expected there is evidence to show that a process of bacterial selection occurs in the fly's intestine. Some bacteria appear to flourish but others are rapidly eliminated. Among the latter must be numbered B. typhosus.

I have to thank my colleagues at the Lister Institute, particularly Dr Ledingham, Dr Henderson Smith and Dr Petrie, for much valuable help and advice during the course of these investigations. To Prof. Bainbridge, Dr Arkwright, Dr Penfold and Dr Macalister my thanks are also due, inasmuch as they helped to smooth over many difficulties both theoretical and practical.

The twenty-four young women and one man treated in an ultra-clean isolation ward should have had a low incidence of staphylococcal infection on grounds of age, sex and clean environment alone. However, they apparently acquired new strains of Staph. aureus at the rate of 4·7/100 patient weeks (3·9 multiple resistant strains/100 patient weeks) from the sixth week after admission onwards.

Environmental factors contributing to infection included introduction of resistant strains by the patients on admission, contact between patients in the unit, and failure to eliminate nasal carriage in staff and patients.

Host susceptibility was increased by malignancy, and by antibiotic and cytotoxic therapy. The nasal carriage rate of Staph. aureus was significantly greater for patients with repeated episodes of leucopenia induced by cytotoxic drugs.

A study is described of influenza A anti-neuraminidase antibodies in the sera of young people of three different age groups. Each serum was individually absorbed with viruses containing the N2 neuraminidases of 1957, 1968 and 1972. Rabbit antisera prepared against the viruses were similarly absorbed. Results obtained with the animal sera suggested that these neuraminidases were antigenically distinct, but the human sera had a broader range of anti-neuraminidase activity and gave indication of asymmetric antigenic relationships. Earlier workers who surveyed anti-haemagglutinin antibodies reported that the virus of primary infection absorbed all antibodies, and the virus of secondary infection only those directed against itself. We too found that the virus of secondary infection absorbed only homologous anti-neuraminidase antibody. However, although the primary infecting virus did absorb some secondary antibody, this absorption was incomplete and it lessened with the lengthening of the time interval between the primary and secondary infecting viruses. A similar pattern was seen with anti-haemagglutinin antibodies.

Absorption of anti-neuraminidase antibodies from human sera proved much more difficult than absorption of anti-haemagglutinin antibodies particularly after repeated influenza virus infections. The relative rarity of antigenic shift in the neuraminidase subunit also creates problems in the interpretation of results of serum neuraminidase antibody surveys.

Bile is often referred to as if its chemical composition was constant and that by treating samples of bile with extractives similar results would be obtained, whereas samples of human bile differ to such an extent that the term bile in itself signifies little. Two samples of human bile may differ to such an extent that while one sample has the qualities of true bile as regards its bile salt content the other may be entirely devoid of lytic action on red blood cells. Numerous experiments made with human bile obtained during life and from the post mortem room have shown this to be correct. The actual bile salt content of bile can be judged by boiling the bile to remove much of the protein, and also to destroy bacterial activity and then contrast the haemolytic activity of the treated sample with a 1 per cent, solution of bile salt in normal saline.

The SARS-CoV-2 pandemic persists with global repercussions. Initial COVID-19 symptoms encompass pneumonia, fever, myalgia, and fatigue. The human immune system produces IgM and IgG antibodies in response to SARS-CoV-2. Despite previous research, a comprehensive understanding of the interplay between clinical manifestations and humoral immune responses remains elusive. This study aims to scrutinize this association. 134 COVID-19 patients were enrolled, and stratified into mild, moderate, and severe symptom groups. Serum IgM and IgG levels were assessed thrice at one-month intervals using ELISA. The findings reveal significant elevation in serum IgG levels in moderate compared to mild cases (P < 0.001). Additionally, IgG production was significantly heightened in severe cases compared to both mild (P < 0.0001) and moderate (P < 0.05) groups. IgM and IgG levels peaked initially and diminished over time. While anti-SARS-CoV-2 antibodies are expected to confer protection, the direct correlation between IgG levels and symptom severity may arise from delayed immune activation, resulting in an intense antibody response in severe cases. Given evidence linking delayed immune function with a dysregulated innate immune response, comprehensive data collection should encompass not only serum IgG and IgM, but also early measurement of type I interferons at symptom onset. This could provide a more thorough understanding of COVID-19 progression.

While tetanus toxoid vaccination has reduced the incidence of tetanus in the developed world, this disease remains a substantial health problem in developing nations. Tetanus immune globulin (TIG) is used along with vaccination for prevention of infection after major or contaminated wounds if vaccination status cannot be verified or for active tetanus infection. These studies describe the characterisation of a TIG produced by a caprylate/chromatography process. The TIG potency and presence of plasma protein impurities were analysed at early/late steps in the manufacturing process by chromatography, immunoassay, coagulation and potency tests. The caprylate/chromatography process has been previously shown to effectively eliminate or inactivate potentially transmissible agents from plasma-derived products. In this study, the caprylate/chromatography process was shown to effectively concentrate TIG activity and efficiently remove pro-coagulation factors, naturally present in plasma. This TIG drug product builds on the long-term evidence of the safety and efficacy of TIG by providing a product with higher purity and low pro-coagulant protein impurities.

The occurrence of antibody to myxoma virus in wild rabbits following epizootics is highest in the semi-arid north-west of Victoria and lowest in temperate southern Victoria. Occurrence ranges up to about 90% in the north-west and to about 70% in the south except on the Western Plains where epizootics are rare and antibody occurrence seldom exceeds 30%.

The establishment of the European rabbit flea may be changing the pattern of occurrence of antibody in the north-west by causing spring outbreaks of myxomatosis. It is suggested that the effects of the replacement of a simple recurring system of epizootic and breeding season several months apart by the occurrence of myxomatosis twice in the same year, once coincident with the breeding season, will be complex. The occurrence of detectable antibody may be less dependent on the infection rate and may be dependent to some extent on the relative timing of spring myxomatosis and the breeding season.

Concentrations of the rodenticide ergocalciferol (vitamin D2) in samples of rodent baits laid in foodstores and in the laboratory were monitored over several months. Bait samples were solvent extracted and ergocalciferol concentration determined by high pressure liquid chromatography (HPLC). Ergocalciferol levels were constant for more than 21 days in dry samples and did not fall by more than 30% in 100 days. When water (10% w/w) was added to the baits in the laboratory the ergocalciferol concentration fell by approximately 30 % in 30 days. In these wet laboratory samples there was a rapid visible growth of fungus and in normal rodent control use baits should have been replaced when such deterioration became evident.

The effective reproduction number $ R $ was widely accepted as a key indicator during the early stages of the COVID-19 pandemic. In the UK, the $ R $ value published on the UK Government Dashboard has been generated as a combined value from an ensemble of epidemiological models via a collaborative initiative between academia and government. In this paper, we outline this collaborative modelling approach and illustrate how, by using an established combination method, a combined $ R $ estimate can be generated from an ensemble of epidemiological models. We analyse the $ R $ values calculated for the period between April 2021 and December 2021, to show that this $ R $ is robust to different model weighting methods and ensemble sizes and that using heterogeneous data sources for validation increases its robustness and reduces the biases and limitations associated with a single source of data. We discuss how $ R $ can be generated from different data sources and show that it is a good summary indicator of the current dynamics in an epidemic.

In works on Public Health and Water Analysis, it is a common observation that the amount of chlorine in inland surface waters near the seaboard is considerably higher than what obtains in samples from more inland parts.

H phase II → phase I conversion of Salmonella thompson was studied at different temperatures. All strains were isolated from one outbreak, and a convenient method of phase conversion was sought. In our hands this was best effected at 20° C.

Pooling of samples in detecting the presence of virus is an effective and efficient strategy in screening carriers in a large population with low infection rate, leading to reduction in cost and time. There are a number of pooling test methods, some being simple and others being complicated. In such pooling tests, the most important parameter to decide is the pool or group size, which can be optimised mathematically. Two pooling methods are relatively simple. The minimum numbers required in these two tests for a population with known infection rate are discussed and compared. Results are useful for identifying asymptomatic carriers in a short time and in implementing health codes systems.

Puumala virus (PUUV) causes many human infections in large parts of Europe and can lead to mild to moderate disease. The bank vole (Myodes glareolus) is the only reservoir of PUUV in Central Europe. A commercial PUUV rapid field test for rodents was validated for bank-vole blood samples collected in two PUUV-endemic regions in Germany (North Rhine-Westphalia and Baden-Württemberg). A comparison of the results of the rapid field test and standard ELISAs indicated a test efficacy of 93–95%, largely independent of the origin of the antigens used in the ELISA. In ELISAs, reactivity for the German PUUV strain was higher compared to the Swedish strain but not compared to the Finnish strain, which was used for the rapid field test. In conclusion, the use of the rapid field test can facilitate short-term estimation of PUUV seroprevalence in bank-vole populations in Germany and can aid in assessing human PUUV infection risk.

The importance of the accuracy of serological tests for syphilis has become more than ever emphasized by widespread testing and more efficient therapy. The problems are reviewed in the light of present knowledge of the specificity and sensitivity of standard serological tests for syphilis. Richardson's modification of the Wassermann reaction is described. The results of this test when applied to ninety-two cases giving doubtful or discrepant reactions by routine tests are presented and classified. The cases were followed up clinically. The results indicate that this simple test is a reliable and valuable adjunct to routine methods, and should be employed widely as a verification procedure.

1. It has been found possible to detect traces of the virus of foot-and-mouth disease in mixtures of this virus and that of vesicular stomatitis by cross-immunity tests in cattle. A quantity of the virus of foot-and-mouth disease as small as 1·3 I.D. 50 was revealed by the inoculation of such mixtures into cattle immune to vesicular stomatitis.

2. It is suggested that such a method would be useful in the analysis of possible mixed infections in field outbreaks.

3. The usefulness of complement-fixation tests to confirm the resolution of mixtures has been demonstrated.

The author wishes to thank the Director of this Institute, Dr I. A. Galloway, for his advice and encouragement. The technical assistance of Messrs E. Scoates and P. M. Mitchell is also gratefully acknowledged.