This paper presents evidence for the involvement of herring gulls (Larus argentatus) as vectors in the recent outbreaks of Salmonella montevideo in sheep and cattle in Scotland and suggests that the transfer can take place over considerable distances. The breeding area in Scotland of herring gulls which overwinter in N.E. England is remarkably similar to the geographical distribution of the outbreaks. This pattern, together with the feeding behaviour of herring gulls on farmland, the presence of S. montevideo in herring gulls just before their departure from the wintering area and the timing of the return just before the peak of outbreaks are all circumstantial evidence implicating this gull in the outbreaks. The rapid return of these gulls to their breeding areas means that S. montevideo can be transported long distances in one day and raises the possibility that the original source of S. montevideo could have been in N. E. England rather than in Scotland.

Bats (Order: Chiroptera) have been widely studied as reservoir hosts for viruses of concern for human and animal health. However, whether bats are equally competent hosts of non-viral pathogens such as bacteria remains an important open question. Here, we surveyed blood and saliva samples of vampire bats from Peru and Belize for hemotropic Mycoplasma spp. (hemoplasmas), bacteria that can cause inapparent infection or anemia in hosts. 16S rRNA gene amplification of blood showed 67% (150/223) of common vampire bats (Desmodus rotundus) were infected by hemoplasmas. Sequencing of the 16S rRNA gene amplicons revealed three novel genotypes that were phylogenetically related but not identical to hemoplasmas described from other (non-vampire) bat species, rodents, humans, and non-human primates. Hemoplasma prevalence in vampire bats was highest in non-reproductive and young individuals, did not differ by country, and was relatively stable over time (i.e., endemic). Metagenomics from pooled D. rotundus saliva from Peru detected non-hemotropic Mycoplasma species and hemoplasma genotypes phylogenetically similar to those identified in blood, providing indirect evidence for potential direct transmission of hemoplasmas through biting or social contacts. This study demonstrates vampire bats host several novel hemoplasmas and sheds light on risk factors for infection and basic transmission routes. Given the high frequency of direct contacts that arise when vampire bats feed on humans, domestic animals, and wildlife, the potential of these bacteria to be transmitted between species should be investigated in future work.

Serological and virological features of dengue fever (DF) and dengue haemorrhagic fever (DHF) in Thailand were analysed in 2715 patients from 1999 to 2002. The illness was caused by DEN-1 in 45%, DEN-2 in 32%, DEN-3 in 18% and DEN-4 in 5% of patients. Almost all of the DHF cases caused by DEN-2 and DEN-4 were in secondary infection, while approximately 20% of the DHF cases caused by DEN-1 and DEN-3 were in primary infection. Male[ratio ]female ratio and age distribution were not different among four serotypes in primary and secondary infections. These results indicate that DEN-1 and DEN-3 induce DHF in both primary and secondary infections, and suggest that DEN-2 and DEN-4 in Thailand are less likely to cause DHF in primary infections.

In 1882 Robert Koch reported the isolation of tuberkelbazillen from human and bovine sources. Sixteen years later, Theobald Smith (1898) demonstrated that strains of Koch's tubercle bacilli from these two hosts differed in cell morphology, cultural characteristics and virulence in rabbits. He did not believe that these variants were limited to the hosts from which they were isolated nor that the differences resulted from adaptations to a given host. Indeed, he remarked that ‘It might be better to omit the host designation of such varieties in order to anticipate assumptions that they are necessarily limited to the host whose name they bear.’ Nevertheless, heedless of his own misgivings he termed them the ‘human’ and ‘bovine’ types.

A series of observational studies were evaluated concerning the risk of human papillomavirus (HPV) infection in pregnancy; however, the results were controversial. We systematically reviewed and collected data on studies regarding HPV prevalence published up to 30 April 2013, in which HPV was detected in pregnant women or both in pregnant and non-pregnant women. In total, 28 eligible studies were included that provided data on HPV infection concerning 13 640 pregnant women. The overall HPV prevalence in pregnant and age-matched non-pregnant women was 16·82% [95% confidence interval (CI) 16·21–17·47] and 12·25% (95% CI 11·50–13·01), respectively. The prevalence in the in three trimesters was 18·20%, 14·38%, and 19·32%, respectively. HPV-16 was the most frequently observed type, with a prevalence of 3·86% (95% CI 3·40–4·32). The overall HPV prevalence varied by study region, age, and HPV type. The meta-analysis showed a significantly increased risk of HPV infection in pregnant women, with a summary odds ratio (OR) of 1·42 (95% CI 1·25–1·61), especially for those aged <25 years (OR 1·79, 95% CI 1·22–2·63). The results suggest that pregnant women, especially those aged <25 years, are more susceptible to HPV infection.

Cytomegalovirus (CMV) infection remains the leading cause of congenital virus infection in developed countries. Measuring the national prevalence of this infection, especially among women of childbearing age, is of great value to estimate the risk of congenital CMV infection, as well as to identify risk groups that should be targeted for behavioural interventions and/or vaccination once a CMV vaccine finally becomes available. In order to fulfil these objectives, a seroprevalence survey was conducted in 2010, using a nationally representative, population-based sample of 2536 people aged between 15 and 49 years, living in metropolitan France and attending private microbiological laboratories for blood testing. All blood samples were analysed in the same laboratory and screened for CMV-specific IgG using an enzyme-linked immunoassay technique (Elisa PKS Medac Enzyme immunoassay). The overall point estimate of CMV infection seroprevalence for individuals aged 15–49 years was 41.9%. The estimates were higher in women than in men (respectively 45.6% and 39.3%), and people born in a non-Western country were more likely to be CMV seropositive than those born in France or in another Western country (93.7% vs. 37.7%). Our results showed that a substantial percentage of women of childbearing age in France are CMV seronegative and therefore at risk of primary CMV infection during pregnancy. Educational measures and future vaccine are key issues to prevent infection in pregnant women and congenital CMV disease.

No U.S. general population-based study has characterized the epidemiology and risk factors, including skin and soft tissue infection (SSTI), for healthcare-associated (HA) and community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA). We estimated the incidence of HA- and CA-MRSA and SSTI over a 9-year period using electronic health record data from the Geisinger Clinic in Pennsylvania. MRSA cases were frequency-matched to SSTI cases and controls in a nested case-control analysis. Logistic regression was used to assess risk factors, while accounting for antibiotic administration. We identified 1713 incident CA- and 1506 HA-MRSA cases and 78 216 SSTI cases. On average, from 2005 to 2009, the annual incidence of CA-MRSA increased by 34%, HA-MRSA by 7%, and SSTI by 4%. Age, season, community socioeconomic deprivation, obesity, smoking, previous SSTI, and antibiotic administration were identified as independent risk factors for CA-MRSA.

Respiratory viral infections are a leading cause of disease worldwide. A variety of respiratory viruses produce infections in humans with effects ranging from asymptomatic to life-treathening. Standard surveillance systems typically only target severe infections (ED outpatients, hospitalisations, deaths) and fail to track asymptomatic or mild infections. Here we performed a large-scale community study across multiple age groups to assess the pathogenicity of 18 respiratory viruses. We enrolled 214 individuals at multiple New York City locations and tested weekly for respiratory viral pathogens, irrespective of symptom status, from fall 2016 to spring 2018. We combined these test results with participant-provided daily records of cold and flu symptoms and used this information to characterise symptom severity by virus and age category. Asymptomatic infection rates exceeded 70% for most viruses, excepting influenza and human metapneumovirus, which produced significantly more severe outcomes. Symptoms were negatively associated with infection frequency, with children displaying the lowest score among age groups. Upper respiratory manifestations were most common for all viruses, whereas systemic effects were less typical. These findings indicate a high burden of asymptomatic respiratory virus infection exists in the general population.

In May 1992. a small, circumscribed community outbreak of infection due to verotoxin-producing Escherichia coli O157 phage type 49 occurred in a semi-rural area of south-east Scotland. On the basis of stool cultures, six cases were identified, one of whom was asymptomatic. One child developed the haemolytic uraemic syndrome. Although the source of infection of the index case was not established nor could the extent of person-to-person spread be fully determined, the clinical, microbiological and epidemiological evidence available indicated that a children's paddling pool served as the focal point in the transmission of infection causing the outbreak.

Public health surveillance requires the monitoring of waterborne disease, but sensitive and specific detection of relevant incidents is difficult.

The Communicable Disease Surveillance Centre receives information from various sources about clusters of cases of illness in England and Wales. The reporter may suspect that water consumption or recreational water exposure is the route of infection, or subsequent investigation may raise the hypothesis that water is associated with illness.

It is difficult to prove beyond reasonable doubt that such a hypothesis is correct. Water samples from the time of exposure are seldom available, some organisms are difficult to detect and almost everyone has some exposure to water. Therefore, we have developed a method of categorizing the degree of evidence used to implicate water. The categories take into account the epidemiology, microbiology and water quality information. Thus outbreaks are classified as being associated with water either ‘strongly’, ‘probably’ or ‘possibly’.

This system allows a broad database for monitoring possible effects of water and is not confined to the few outbreaks which have been intensively investigated or have positive environmental microbiology. Thus, for reported incidents, the sensitivity of classifying it as water associated should be high but this may be at the expense of specificity, especially with the ‘possible’ association.

IgM antibody response to Crimean-Congo haemorrhagic fever (CCHF) virus was monitored in experimentally infected sheep and cattle by an IgM capture enzyme-linked immunoassay (ELISA). Specific binding of antigen was detected by a rabbit anti-CCHF horseradish peroxidase conjugate or a sandwich technique with hyperimmune mouse anti-CCHF ascitic fluid and commercially available anti-mouse immunoglobulin peroxidase conjugate. The persistence of IgM antibody activity was found to be of shorter duration than in humans, and this may be a function of the relative lack of susceptibility of these animals to infection with CCHF virus. IgG antibody responses in the sheep could be monitoried by sandwich ELISA using commercially available anti-sheep immunoglobulin peroxidase conjugates. Total antibody activity in the sera of experimentally infected sheep, cattle and small mammals could be monitored in a competitive ELISA (CELISA) using rabbit anti-CCHF peroxidase conjugate. The CELISA was applied to the sera of 960 wild vertebrates from a nature reserve in South Africa, and the prevalence of antibody was found to be greatest in large mammals such as rhinoceros, giraffe and buffalo, which are known to be the preferred hosts of the adult tick (Hyalomma) vectors of the virus.

Using systematic review methodology, global research reporting the frequency of zoonotic bacterial pathogens, antimicrobial use (AMU) and antimicrobial resistance (AMR) in ornamental fish, and human illness due to exposure to ornamental fish, was examined. A survey was performed to elicit opinions of aquaculture-allied personnel on the frequency of AMU and AMR in ornamental fish. The most commonly reported sporadic human infections were associated with Mycobacterium marinum, while Salmonella Paratyphi B var. Java was implicated in all reported outbreaks. Aeromonas spp. were most frequently investigated (n=10 studies) in 25 studies surveying ornamental fish from various sources. High levels of resistance were reported to amoxicillin, penicillin, tetracycline and oxytetracycline, which was also in agreement with the survey respondents' views. Studies on AMU were not found in our review. Survey respondents reported frequent use of quinolones, followed by tetracyclines, nitrofurans, and aminoglycosides. Recommendations for future surveillance and public education efforts are presented.

The apparent family clustering of avian influenza A/H5N1 has led several groups to postulate the existence of a host genetic influence on susceptibility to A/H5N1, yet the role of host factors on the risk of A/H5N1 disease has received remarkably little attention compared to the efforts focused on viral factors. We examined the epidemiological patterns of human A/H5N1 cases, their possible explanations, and the plausibility of a host genetic effect on susceptibility to A/H5N1 infection. The preponderance of familial clustering of cases and the relative lack of non-familial clusters, the occurrence of related cases separated by time and place, and the paucity of cases in some highly exposed groups such as poultry cullers, are consistent with a host genetic effect. Animal models support the biological plausibility of genetic susceptibility to A/H5N1. Although the evidence is circumstantial, host genetic factors are a parsimonious explanation for the unusual epidemiology of human A/H5N1 cases and warrant further investigation.

Carbapenem-resistant Acinetobacter baumannii (CRAB) are an increasing infectious threat in hospitals. We investigated the clinical epidemiology of CRAB infections vs. colonization in patients, and examined the mechanisms of resistance associated with elevated minimum inhibitory concentrations (MICs) for carbapenems. From January to June 2009, 75 CRAB strains were collected. CRAB infection was significantly associated with malignancy and a high APACHE II score. The most dominant resistance mechanism was ISAba1 preceding OXA-51, producing strains with overexpression of efflux pump. Strains carrying blaOXA-23-like enzymes had higher carbapenem MICs than those carrying blaOXA-51-like enzymes; however, the presence of multiple mechanisms did not result in increased resistance to carbapenems. There was no difference in the resistance mechanisms in strains from infected and colonized patients. The majority of strains were genetically diverse by DNA macrorestriction although there was evidence of clonal spread of four clusters of strains in patients.

To evaluate whether or not human herpesvirus 8 (HHV8) can be transmitted through a non-sexual route a serological survey was carried out in a group of 51 catholic nuns. The seroprevalence rate and the geometrical mean antibody titre to anti-latent HHV8 antigen were similar in nuns and in a group of 60 women, matched by age, in the general population (27 vs. 24%; 1028 vs. 1575, respectively). Moreover, by using nested polymerase chain reaction (PCR), HHV8 DNA sequences were detected in 7 of 16 (43·8%) saliva and peripheral blood mononuclear cells (PBMC) from patients with classical Kaposi's sarcoma (KS) and in 3 out of 7 (42%) AIDS-KS patients. None of 5 HIV positive persons who did not have KS tested positive for HHV8 DNA. HHV8 DNA sequences were also detected in 2 of 12 (17%) saliva and 1 PBMC sample out of 12 healthy HHV8 positive individuals (age range: 30–80 years old). This paper suggests that non-sexual transmission of HHV8 is operating in our geographical setting and saliva may be a potential source of HHV8 spreading in the general population.

1. Ten pleuropneumonia-like strains isolated from various sources have been selected and studied with a view to discovering reliable criteria for differentiation. Three of them were isolated from the symbiotic association known in the literature as Streptobacillus moniliformis, six from lung lesions of rats and one from a swollen submaxillary gland of a rat. For comparison with these, six other strains, viz. three pleuropneumonia, one agalactia and two of Shoetensack's strains from lungs of dogs stated by him to be suffering from distemper and named by him Asterococcus canis type I and A. canis type II have been included in the inquiry.

2. Classification of the sixteen strains has been achieved by a comparative study of type of growth on liquid and solid media, morphology, pathogenicity and serological affinities. Table VII displays these differences.

3. The serological examination was of special importance for the whole problem of classification. For this purpose an agglutination test was devised which clearly revealed that the sixteen strains belonged to seven different serological types. As the strains of the same antigenic structure showed similar growth types in liquid and solid media and similar morphological appearances, seven species of pleuropneumonia-like organisms were set up:

(a) The L1 organism represents the first species. Three of the strains of this type were separated from Streptobacillus moniliformis cultures. The fourth culture of the same type was found in the lung of a rat, thus proving that this organism may occur independently as well as in symbiotic association.

New evidence of the symbiotic nature of the Str. moniliformis (an association of a streptobacillus with an L1) was given by the agglutination test, in so far as all sera prepared by immunization with Str. moniliformis cultures agglutinated to a fairly high titre the four different L1 strains.

(b) The L3 organism represents the second distinct type species. The five strains belonging to it originate from lung lesions of rats, viz. four from tame laboratory rats and one from a wild rat. This demonstrates that tame and wild rats contain the same variety of pleuropneumonia-like organism in the associated lung lesion. It is believed that 138 pleuropneumonia-like cultures isolated from lung lesions of rats by the writer belong to the same L3 species though only five of them have been studied here in detail.

(c) The L4 organism only once isolated from the enlarged submaxillary gland of a rat also suffering from lung lesions was proved to be definitely different from the L1 and L3 organisms by serological and other tests and represents therefore a third new type species.

(d) Furthermore the organisms of pleuropneumonia, agalactia, Asterococcus canis I and A. canis II would appear to be independent species of the same family.

4. Experiments on pathogenicity which are still in progress show so far that the L3 organism is pathogenic for mice. The L1 organism would appear to be devoid of pathogenicity when tested by similar methods.

5. The capacity of pleuropneumonia-like strains for forming associations with bacteria has been tested experimentally, and in a few cases success has been achieved. These associations with B. tetani and B. tetanomorphus, unlike that of L1 and the streptobacillus in the Str. moniliformis combination, though stable, are not such as to preclude the isolation in pure culture of the two anaerobic bacilli.

6. It is likely that the group of pleuropneumonia-like organisms is widely spread in nature. Search for such strains and thorough investigation of their properties would seem to be of prime importance in view of the minute size of the units which can give rise to growth and the light that might be shed by their study on the biological nature of the filterable viruses.

An automated early warning system has been developed and used for detecting clusters of human infection with enteric pathogens. The method used requires no specific disease modelling, and has the potential for extension to other epidemiological applications. A compound smoothing technique is used to determine baseline ‘normal’ incidence of disease from past data, and a warning threshold for current data is produced by combining a statistically determined increment from the baseline with a fixed minimum threshold. A retrospective study of salmonella infections over 3 years has been conducted. Over this period, the automated system achieved >90% sensitivity, with a positive predictive value consistently >50%, demonstrating the effectiveness of the combination of statistical and heuristic methods for cluster detection. We suggest that quantitative measurements are of considerable utility in evaluating the performance of such systems.

A survey was conducted to estimate the prevalence of Salmonella enteritidis and other salmonellas among Canadian commercial egg producing flocks. Environmental (faecal and eggbelt) samples from 152 of 295 (52·9%) randomly selected flocks were contaminated with salmonellas. Thirty-five different salmonella serovars were isolated. Eggbelt samples were more often contaminated with salmonellas than faecal samples (25·7 v. 10·1 %). The most prevalent serovars were S. heidelberg, S. infantis, S. hadar, and S. schwarzengrund; they were isolated from samples of 59/295 (20%), 18/295 (6·1%), 17/295 (5·8%), and 15/295 (5·1%) flocks, respectively. Feed samples of 21/295 (7·2%) flocks were contaminated with salmonellas. Salmonella enteritidis was isolated from the environmental samples of 8/295 (2·7%) flocks. Salmonella enteritidis phage type (PT) 8 was isolated from 5 flocks, PT 13a from 2 flocks, and PT 13 from 1 flock.

Listeriosis is a rare but severe foodborne disease with low morbidity and high case-fatality rates. Pregnant women, unborn and newborn babies are among the high-risk groups for listeriosis. We examined listeriosis cases reported to the enhanced surveillance system in England and Wales from 1990 to 2010 to identify risk factors influencing outcome. Cases were defined as pregnancy-associated if Listeria monocytogenes was isolated from a pregnant woman or newborn infants aged <28 days. Of the 3088 cases reported, pregnancy-associated listeriosis accounted for 462 (15%) cases and 315 cases resulted in a live birth. Several factors were identified as affecting the severity and outcome of listeriosis in pregnancy in both mother and child including: presence or absence of maternal symptoms, gestational age at onset of symptoms, and clinical presentation in the infant (meningitis or septicaemia). Deprivation, ethnicity and molecular serotype had no effect on outcome.

Active surveillance of Vibrio parahaemolyticus infection among hospitalized patients in Calcutta, India, showed the appearance of the O4[ratio ]K68 serovar for the first time in March 1998 alongside the continued predominant incidence of the O3[ratio ]K6 serovar. Strains belonging to both these serovars have been reported to possess pandemic potential. The genomes of O3[ratio ]K6 and O4[ratio ]K68 strains and for comparison, non-O3[ratio ]K6 and non-O4[ratio ]K68 strains isolated from two different countries, India and Thailand, were examined by different molecular techniques to determine their relatedness. The O3[ratio ]K6 and O4[ratio ]K68 strains from Calcutta and Bangkok carried the tdh gene but not the trh gene. Characterization of representative strains of these two serovars by ribotyping and by arbitrarily primed-polymerase chain reaction (AP-PCR) showed that the isolates had identical ribotype and DNA fingerprint. Pulsed-field gel electrophoresis (PFGE) performed with the same set of strains yielded nearly similar restriction fragment length polymorphism (RFLP) patterns for the O3[ratio ]K6 and O4[ratio ]K68 isolates from Calcutta and Thailand. Phylogenetic analysis of the NotI RFLP showed that the O3[ratio ]K6 and O4[ratio ]K68 strains formed a cluster with 78–91% similarity thus indicating close genetic relationship between the two different serovars isolated during the same time-frame but from widely separated geographical regions. The non-O3[ratio ]K6 and non-O4[ratio ]K68, in contrast, showed different ribotype, AP-PCR and PFGE patterns.