Community-based immunization is the primary method available today by which to reduce the scale of morbidity, and, in certain countries, mortality, associated with the most common childhood viral and bacterial infections. The decline in the incidences of a number of important vaccine preventable infections, such as polio, diphtheria and measles, in many countries, and the worldwide eradication of the smallpox virus, is testimony to the effectiveness of this method of control.

A prevalence study of personnel on a Royal Naval Air Station revealed that 23·0% of 2479 personnel were carrying a meningococcus. Selected groups of personnel were subsequently swabbed monthly for a year. We have shown that it is only by repeated swabbing and the use of optimal methods including enrichment media that one can have a hope of identifying the ‘true’ carriage rate. A presumed virulent strain of Neisseria meningitidis B 15 P1·16 was repeatedly isolated from three personnel who remained well, as did their colleagues both at their work place and socially. The study served to emphasize our lack of knowledge of the virulence factors associated with N. meningitidis.

An outbreak of infection due to Streptococcus zooepidemicus (Lancefield Group C) is described. At least 11 patients were affected and the infection was responsible for, or contributed to, the deaths of seven of these. Clinical features included septicaemia, meningitis and endocarditis. The source of infection was unpasteurized milk from a dairy herd with mild intermittent mastitis.

Recovery of Yersinia enterocolitica and related strains from faecal samples enriched in 1% buffered peptone water (pH 7·2) and incubated at 4 °C for 17–21 days was compared with recovery from 1% peptone water buffered to pH 8·0 and incubation over the temperature range 4–26°C. Best recovery was obtained by use of the alkaline medium incubated at 9°C. Greatest recovery was obtained after incubation for 10–14 days, but most strains (> 75%) were recovered after 1 week.

Rabbit polyclonal hyperimmune antibodies to Yersinia pestis, and a mouse monoclonal antibody against the capsular antigen fraction 1 (F1) were compared in immunofluorescence (IF) tests. Fluorescent antibody conjugates were prepared from polyclonal antisera to four F1 positive Y. pestis strains; the conjugated antibody to strain A1122 gave the strongest IF staining of F1 positive and F1 negative Y. pestis strains. Indirect assays were rejected in favour of direct assays utilizing polyclonal and monoclonal reagents because the increased background staining reduced the effective contrast of bacterial visualisation. Polyclonal conjugates gave fairly homogeneous staining of Y. pestis bacterial populations, but in monoclonal assays a skew distribution of fluorescence intensity was observed, the majority of bacteria being poorly stained. The proportion of cells stained well by the monoclonal sufficed for easy identification of Y. pestis of the F1 positive phenotype however, and staining was not affected by washing the bacteria or treating them with formaldehyde. Y. pestis strains of the F1 positive genotype reacted with the monoclonal if bacteria were grown at 37 °C but not if the growth temperature was reduced to 25°C thus preventing capsule production. The polyclonal conjugate reacted with bacteria of these strains that had been grown at either temperature. Strains of F1 negative genotype grown at either temperature. Strains of F1 negative genotype grown at either temperature reacted with the polyclonal conjugate but not with the monoclonal. Cross reactions between the polyclonal reagents and Y. enterocolitica biovar 2, serovar O 8 could not be removed by selective absorption; however, the monoclonal antibody gave no cross reaction.

The F1 phenotypic status of bacterial preparations was verified by ELISA measurement of the fraction 1 antigen concentration. Antigen levels for F1 positive and F1 negative phenotypes differed by about three logs for suspensions of Y. pestis harvested from solid media.

The polyclonal and monoclonal direct IF tests applied to spleen and blood smears of laboratory mice infected with Y. pestis were able to differentiate between lethal infection with an F1 positive strain carrying all four classical virulence determinants, an F1 positive vaccine strain, and an F1 negative strain.

Food poisoning due to Salmonella typhimurium phage type 141 was unusual inthe Sheffield area before 1984. The sudden increase in incidence of this phage type during 1984 and 1985, and its causative role in several small outbreaks in this period have been investigated. Epidemiological and laboratory investigations suggested that hens' eggs were the most likely source of S. typhimurium phage type 141.

The first recognized outbreak of haemorrhagic colitis due to Escherichia coli O 157. H7 in the United Kingdom affected at least 24 persons living in East Anglia over a 2-week period. Theillnesses were characterized by severe abdominal pain and bloody diarrhoea of short duration. Eleven patients were admitted to hospital and there was one death. Patients were mainly adult women who had not eaten out of the home in the 2 weeks before onset. Unlike previously reported outbreaks hamburgers were not the vehicle of infection, and a case-control study suggested that handling vegetables, and particularly potatoes, was the important risk factor.

The stool samples of 75 patients with gastroenteritis and/or loose and watery faeces at three hospitals and one clinic in Zaria were examined for Cryptosporidium. The stool samples were concentrated by the formol–ether method and stained with safranin–methylene blue. Sixteen (21%) samples were positive. The rate of detection was higher among females (27%) than males (17%) and among adults (29%) than children (8%). The study confirmed the presence and possible significance of Cryptosporidium, which is a known zoonotic protozoan, in the aetiology of human gastroenteritis in Zaria, Nigeria.

Two hundred and seventy-five consecutive clinical isolates of coagulase-negative staphylococci, including strains associated with disease, contaminants and skin colonizers, were speciated, tested for slime production and for their sensitivity to a range of antibiotics. Staphylococcus epidermidis was the most commonly identified species, comprising 63% of all isolates. Slime production was detected in half the strains of Staph. epidermidis, Staph. haemolyticus and Staph. Saprophyticus but was rare in other species. Most Staph. haemolyticus strains and approximately half of the Staph. epidermidis strains were resistant to five or more antibiotics. A significant association was found between slime production and multiple antibiotic resistance. For catheter-associated strains, clinical relevance was predictable by species i.e. Staph. epidermidis. Multi-resistant slime-positive Staph. haemolyticus strains, although infrequently associated with disease, were common skin colonizers, presumably acquired from the hospital environment. We describe a practical and inexpensive scheme for thespeciation of human coagulase-negative staphylococcal isolates.

Between 1980–5, 224 outbreaks of salmonellosis associated with poultry-meat were reported in Scotland. In total 2245 persons were affected, 12 of whom died. Twenty-one salmonella serotypes were identified from those affected, while 33 serotypes were isolated from poultry during routine monitoring and disease investigation. Existing measures to prevent the spread of salmonellae within poultry flocks and processing plants are failing. It is suggested that irradiation of poultry-meat may be the only effective method of reducing the public health problem of poultry-borne salmonellosis.

Colonization of the intestine by putative pathogens was followed longitudinally in a cohort of 56 infants born during one calendar year in a rural Mexican village with faecal cultures taken every fortnight and every time a child had diarrhoea. The frequency of isolation of pathogens during episodes of diarrhoea was compared with that of matched controls from the same cohort. Incidence of diarrhoea during the first year of life was 98%, diminishing to 93% during the second year. The incidence curves for each year were not significantly different (P > 0·1). Isolation of enteropathogenic Escherichia coli, enterotoxigenic Escherichia coli producing heat-stable (ST) and/or heat-labile (LT) enterotoxins and rotaviruses was significantly higher in infants with diarrhoea during the first 2 years of life. In the case of shigella, although no significant differences were found by semester of life, 13 of 16 children in which these strains were found had diarrhoea. Isolation of Salmonella spp., Campylobacter spp. and protozoa were not significantly different in the two groups during the period studied. Strains showing localized adherence to HEp-2 cells or the presence of colonization factor antigens I or E8775 were found with significantly higher frequency in children with diarrhoea. Eighty-two percent of ST+ or LT+ ETEC strains isolated produced one of the three known colonization factors.

Recent reports of the isolation of microorganisms from used soap bars have raised the concern that bacteria may be transferred from contaminated soap bars during handwashing. Since only one study addressing this question has been published, we developed an additional procedure to test this concern. In our new method prewashed and softened commercial deodorant soap bars (0·8% triclocarban) not active against Gram-negative bacteria were inoculated with Escherichia coli and Pseudomonas aeruginosa to give mean total survival levels of 4·4 × 105 c.f.u. per bar which was 70-fold higher than those reported on used soap bars. Sixteen panelists were instructed to wash with the inoculated bars using their normal handwashing procedure. After washing, none of the 16 panelists had detectable levels of either test bacterium on their hands. Thus, the results obtained using our new method were in complete agreement with those obtained with the previously published method even though the two methods differ in a number of procedural aspects. These findings, along with other published reports, show that little hazard exists in routine handwashing with previously used soap bars and support the frequent use of soap and water for handwashing to prevent the spread of disease.

Serratia marcescens was isolated in pure culture from cases of septic abortion in 4 cows on one farm and 10 buffaloes on two other farms. A reddish vaginal discharge was observed after abortion in all animals and in the internal organs of the aborted fetuses. All but two of the isolates produced prodigiosin, and two of the isolates from buffaloes were atypical in that they fermented raffinose. O-serological, bacteriophage and bacteriocin typing revealed four different strains. All cows were infected by the same strain, and this strain was also isolated from the semen of a breeding bull on the same farm. In another farm a strain of serotype O 14 was isolated from 6 of 10 buffaloes, and two other distinct strains were isolated from the remainder. The strain from the cattle was sensitive to gentamicin and so were two of the buffalo isolates. The infected cows were treated with intra-uterine gentamicin and the organism disappeared from cervical mucus after 3 days. Each animal after abortion showed a raised titre of agglutinating antibody to their respective isolate. A survey of 1172 healthy buffaloes and cattle gave an incidence of 1·8% with raised titres towards S. marcescens.

Twenty-one strains of Haemophilus ducreyi were analysed by Western blotting using two antisera produced in mice. Common antigens of molecular weights 58, 46, 41, 28, 22 and 16 kDa were detected in all the strains. The antigens were protein in nature, since they could not be detected in whole-cell lysates which had been treated with proteinase K. The H. ducreyi strains showed antigenic cross-reactivity with strains of H. influenzae and H. parainfluenzae, but showed minimal or no cross-reactivity with seven other species of bacteria.

This paper examines the sensitivity and specificity of two ELISA assays for IgM antibodies to Mycobacterium leprae, one employing natural phenolic glycolipid and the other employing a synthetic disaccharide glycoconjugate as antigen. Estimates of sensitivity and specificity are derived, based on a panel of sera from leprosy cases in Malawi and various non-leprosy controls from the UK. Though both assays were able to identify a high proportion of multibacillary patients, neither was able to detect a high proportion of paucibacillary patients without considerable loss of specificity. The implications of the inverse relationship between sensitivity and specificity are discussed with reference to the predictive value of such tests in such areas as Malawi, where the large majority of cases are paucibacillary.

Ticks of the Ornithodoros moubata complex were collectedfrom domestic pig sties and dwelling houses, and from a warthog habitat, and tested for the presence of African swine fever (ASF) virus. Collections were made in 9 of the 24 districts of Malawi, these being primarily the districts in which O. moubata is most numerous. ASF virus was isolated from ticks collected in both domestic pig sties and houses in certain villages in Mchinji district where ASF outbreaks had recently occurred. Mchinji district is in the centre of a large ASF enzootic area which stretches into other districts of Malawi and also into Zambia and Mozambique. The high titre of virus in some of the ticks demonstrates that O. moubata can act as a virus reservoir and potential vector of disease in the field situation in Malawi.

A simple and sensitive M antibody-capture radioimmunoassay (MACRIA) is described which utilizes crude commercial VZV antigen and a single monoclonal anti-VZV antibody. This was compared to the immunofluorescence (IF) test for IgM antibody and was used to study IgM responses in sera from 261 patients with varicella and 220 patients with herpes zoster.

With MACRIA, IgM antibodies were detected in all patients with varicella. The IgM antibodies appeared shortly after onset of rash, reached peak levels between 1 and 4 weeks after onset and then declined to low or undetectable levels in most, though not all, patients after 3 months. IgM antibodies were also detected in 98·2% of patients with herpes zoster, but the levels of IgM were significantly lower than after varicella and there was wider individual variation both in magnitude and duration of the IgM responses, in some cases only lasting 2–3 weeks.

Comparison between MACRIA and IF showed good agreement in the detection of IgM antibodies following varicella. Discordant results were obtained with 13% of sera. of which 81% were taken either early or late after onset of rash and contained very low IgM levels. In contrast, 62 (28%) of the 220 sera from patients with zoster gave discordant results in the two tests, all except five being MACRIA positive but IF-negative. The largest proportion of discordant results were obtained with sera taken more than 3 months after onset of rash, but 18 (29%) contained high IgM levels and were taken during the period of peak IgM responses. The diagnostic applications of the VZV MACRIA are discussed.