Examination of a selection of serum samples from adults from two regions of England showed that 50 % of men in the 16–24 years and over 55 years age groups had high titres of antibody to diphtheria toxin (DT). In contrast, only 11% of women aged 16 to over 55 years had high titres of antibody to DT. All human antisera with high anti-DT titres reacted with a synthetic peptide (SP) corresponding to the amino acids 141–157 of DT fragment A, with sera from men aged 35 to over 55 years showing the highest titres. High antibody titres to fragment A paralleled those to SP in both sexes. Titres of antibody to DT fragment B were highest in individuals with high titres to DT. In sera from both sexes immunoglobulin G1 was the predominant subclass reactive with all three antigens. However, both IgG1 and IgG4 and to a lesser extent IgG2 and IgG3 were present in immunoglobulin concentrates.

Piglets between 1 and 40 days of age were inoculated with varying numbers and with different isolates of Streptococcus suis type 2 by the intranasal, intravenous and subarachnoid routes. Less than 100 organisms of an isolate cultured from apparently normal pigs caused subclinical infection in 1-day-old piglets after intranasal inoculation. This infection was naturally transmitted between litter mates. Intravenous inoculation of a similar isolate in 7-week-old pigs resulted in a sub-clinical bacteraemia in 3 of 8 piglets. One other piglet developed a bacteraemia 7 days after inoculation and concurrently developed signs of lameness and nervous dysfunction. Ten piglets were inoculated by the subarachnoid route with a porcine isolate and two with an isolate from a person with clinical disease. Only the latter two pigs developed the classical signs of nervous disease associated with infection by S. suis type 2. It is concluded that strains of S. suis type 2, of varying pathogenicity for both pigs and man, are endemic in New Zealand. It is suggested that the occurrence of disease is associated with both exposure to a pathogenic strain and other, as yet undetermined, secondary factors.

Mice, rats, guinea-pigs and rabbits were inoculated with isolates of Streptococcus suis type 2. An isolate cultured from the tonsils of a healthy pig, produced disease in rabbits after intravenous inoculation but not in mice, rats or guinea-pigs. An isolate of S. suis type 2, that was pathogenic for pigs and had been cultured from a human patient with clinical disease, produced signs of neurological disease in mice, rats and rabbits following intravenous inoculation. There was an apparent dose response in mice with 31 % of mice receiving more than 106 organisms developing clinical disease, whilst mice receiving less than this did not develop disease. There were no detectable histopathological lesions in the brains or meninges of mice with nervous signs. It is proposed that the disease in mice may mimic that reported in humans and that mice may be a useful indicator species for determining the virulence of isolates cultured from pigs.

Between July 1976 and February 1989, 50 incidents of suspected red kidney bean poisoning were reported in the UK. Nine incidents in which nausea, vomiting and diarrhoea developed within 1–7 h of ingestion, were confirmed by the detection of haemagglutinin in the beans. The diagnosis was made on a further 23 incidents on the basis of symptoms, incubation time and the description of preparation of beans prior to consumption. The haemagglutinin (lectin), which occurs naturally in the red kidney bean, is inactivated by thorough cooking of well soaked beans. In many of the outbreaks reported the implicated beans were consumed raw or following an inadequate heat process.

When 168 fresh clinical isolates of Staphylococcus aureus were examined for their reactions on a medium containing 1 part in 100 000 crystal violet 50·6% of strains produced a purple appearance, 39·3% produced a white appearance and 10·1% produced a yellow appearance. Purple-reacting isolates were significantly associated with both invasive infections (P < 0·01) and hospital origin (P < 0·001). There were no significant associations between the crystal violet reactions and either animal contact or other properties previously reported to be characteristic of white and yellow-reacting strains (beta haemolysin and bovine coagulase production). The results of phage typing showed associations between susceptibility to group III phages and purple-reacting strains and between phage group II susceptibility and white and yellow-reacting strains. There was also a highly significant association between white reactions on crystal violet agar and susceptibility to lysis by a combination of all three groups (that is, I + II + III) and white-reacting strains were significantly more susceptible to lysis by phages 94 and/or 96, whether as a restricted pattern or as part of a broader pattern. The purple reaction on crystal violet medium may be a reliable marker of the ‘ hospital Staphylococcus’.

This study attempts to determine whether or not livestock are becoming more susceptible to epidemics of salmonella infections by the analysis of published data on the annual number of reported infections in various animals. The number of incidents reported each year may be subject to a variety of biases due to temporal and geographical differences in reporting practices. This study analysed these reports by the calculation of diversity indices which are not subject to some of these potential biases. The relationship between the ecological concept of niche width and the diversity of species or types occupying that niche is discussed. The diversity of salmonella types reported in fowl has shown a highly significant decline over the 13-year period 1976–88. It is suggested that this declining diversity may be related to the declining niche width of the biotope available to this pathogen. Although speculative, this reduction in niche width could be related to a declining genetic diversity in the host animals or to an increasing intensification of animal husbandry.

In Canada, the number of human isolates of verotoxigenic (VT +ve) Escherichia coli 0157:H7 from diarrhoeal cases and haemolytic uraemic syndrome and haemorrhagic colitis has increased from 25 in 1982 to 2384 in 1989. A total of 3273 VT + ve E. coli 0157:H7 strains (3255 strains isolated in Canada and 18 isolates from other countries) were phage typed. The phage typing scheme has been extended from 14 to 62 phage types. Of these, five types occurred exclusively in other countries (type 47 in Japan; and types 49, 50, 51 and 52 in the U.K.). Thirty-five different phage types were identified in Canada; only nine of these (1, 2, 4, 8, 14, 21, 23, 31 and 32), each accounted for more than 1 % of the cases from human sources. The same nine types were the only ones observed among the isolates from non-human sources (meat and slaughter houses) suggesting a food-borne transmission in most of the human cases. Phage types 1 (30·5%); 4 (21%); 8 (13·5%); 31 (8·9%) and 14 (8%) were encountered in varying frequencies in most of the provinces; infrequently occurring phage types also showed regional variation. Thirteen different phage types were identified among 151 outbreaks representing 556 isolates of E. coli 0157:H7. More than one phage type were encountered in 12 outbreaks whereas in 141 outbreaks, all strains in each, had the same phage type.

Reproducible and discriminating typing methods are required for epidemio-logical investigations. Numerical typing systems analyse patterns obtained in various ways by calculating similarity coefficients between isolates. In the present study, various measures of the efficiency of a numerical typing system are quantified. These include reproducibility, accuracy, and discrimination power.

Three different numerical typing methods for Escherichia coli were compared using these measures: (a) Biotyping with API 50 CH system, (b) Biochemical fingerprinting with the API 50 CH system and (c) Biochemical fingerprinting with the PhP-EC system. Biotyping qualitatively measures the results of a set of biochemical reactions as + or −. Biochemical fingerprinting also uses biochemical reactions, but the tests are scored quantitatively by measuring the kinetics and intensity of each reaction.

It was found that biotyping yielded poor reproducibility. When biochemical fingerprinting analysis was used with the API 50 CHE system the reproducibility and the discrimination was good. The PhP-EC system for biochemical fingerprinting showed equal reproducibility but was superior to the API 50 CH system with regard to discrimination power.

Biochemical reactions, using the PhP-EC system of biochemical fingerprinting, were evaluated in order to group strains into different clusters and to investigate whether a biochemical typing system may be used to distinguish between randomly selected Escherichia coli strains obtained from bacteraemic patients and healthy controls. Fifty epidemiologically unrelated strains isolated from blood of non-diabetic patients and 46 faecal control strains were studied. Separately, 70 E. coli strains from 64 diabetic patients with bacteraemia were investigated. Diversity index was 0·977, 0·969 and 0·941 respectively. The strains were clustered at a similarity level of 0·95. The bacteraemic and control strains were subdivided into 14 different clusters with 2–12 strains each and 40 ‘outliers’. The largest cluster was dominated by bacteraemic strains (9/12, 75%). Two other clusters were dominated by control strains. In the remaining groups blood and faecal isolates were evenly distributed. No biochemical test was able to distinguish between bacteraemic and faecal control strains. Strains from patients with diabetes mellitus were grouped in 11 clusters containing 2–14 strains and 22 ‘outliers’. The low diversity index of bacteraemic strains obtained from diabetic patients as compared to other strains indicated a greater homogenicity. However, no correlation was observed between the examined host factors and the clusters.

Variation amongst Achromobacter-like strains was examined by DNA restriction endonuclease digestion and rDNA gene patterns generated using a non-radioactive probe. Chromosomal DNA was extracted from 12 cultures representing Achromobacter groups B, E and F, all from human blood cultures. DNA fingerprinting using EcoRI, HaeIII or HindIII sub-divided the strains in a similar manner to that obtained by their protein patterns. The HaeIII patterns, with their small number of bands, were the easiest to interpret. The EcoRI patterns included a species-specific triplet of bands but minor band patterns allowed further differentiation. The Achromobacter group F strains comprised a separate taxon and were distinct from the group B and E strains by all techniques examined. The study demonstrates that, in addition to total DNA digest analysis, rDNA gene restriction patterns provide a simple but discriminatory electrophoretic method for distinguishing within Achromobacter groups B and E.

The blood culture records during the 6-year period 1984–9 were reviewed to compare the performance of the BACTEC aerobic (6B) and aerobic-hypertonic (8B) media for the recovery of Candida spp. and Torulopsis glabrata from blood. There were 137 positive blood culture sets that contained both a 6B and an 8B bottle. Sixty-eight different yeasts were recovered from 65 patients including 35 Candida albicans, 19 C. tropicalis, 6 C. parapsilosis, 4 C. krusei, 1 C. pseudotropicalis and 3 Torulopsis glabrata. The 8B medium detected 120 of the positive cultures (87·6%) and was the only positive medium in 35 (25·6%) sets, while the 6B medium detected 102 positive cultures (74·4%) and was the only positive medium in 17 (12·4%) sets (P < 0·04). For those sets in which both bottles were positive, radiometric detection occurred first in the 8B bottle in 39 sets and first in the 6B bottle in 11 sets (P < 0·001). The superior performance of the 8B bottle was not related to the administration of amphotericin B. Cultures of stock strains of C. albicans, C. tropicalis, and C. parapsilosis in 6B and 8B media with and without added blood confirmed the finding that 8B was substantially superior to 6B for the detection of candidaemia. It is concluded that an 8B bottle should be included in the blood culture set whenever candidaemia is suspected.

Neisseria cuniculi was isolated, between March 1987 and March 1989, from 38 cases of respiratory disease in small and large ruminants. In all but five cases N. cuniculi was cultured together with other potential respiratory pathogens. A survey was conducted to assess the prevalence of N. cuniculi in the pharyngeal region of Merino and Awassi purebred sheep, Awassi/East-Friesian and Merino/Romanov crossbred sheep and one exotic cross breed (goat/ibex).

N. cuniculi was isolated from 80–88% of the animals under 1 month of age. Among older animals, the microorganism was isolated from 20·5% of the pure bred animals and 79·3% of the crossbred ones. This difference was significant (P < 0·001) by the χ2 test. The prevalence of N. cuniculi in the second age group coincides with the susceptibility of the breeds to respiratory pathology.

This, we believe, is the first report of N. cuniculi involved in multiple cases of respiratory pathology and of a survey assessing the prevalence of this microorganism in small ruminants.

Evidence of past zoonotic infection was investigated serologically in randomly selected Northern Ireland farmers. The percentage of farmers with antibody was: Brucella abortus (0·7), Leptospira interrogans serovars (8·1), Borrelia burgdorferi (14·3), Toxoplasma gondii (73·5), Coxiella burnetii (28·0), Chlamydia psittaci (11·1) and Hantavirus (1·2).

The results show that Northern Ireland farmers have been exposed in the past to zoonotic infections. It is not known if these infections contributed to ill health in farmers but it is now time for the health of farm workers and their medical services to be reassessed.

In the search to find discriminative serological markers to differentiate between patients with acute brucellosis and those with chronic brucellosis, an enzyme-linked immunosorbent assay (ELISA) was used to determine and compare the brucella-specific IgE response in 80 sera from patients with acute brucellosis, 37 sera from patients with chronic brucellosis, 26 sera from patients with positive blood cultures for bacteria other than brucella and 51 sera from healthy controls. The IgE findings were compared to brucella-specific IgG, IgM, IgA and IgG1–4 demonstrated by ELISA, and to microagglutination test (MAT) results. Elevated (positive) antibrucella IgE titres were detected in 89 and 81 % of sera from patients with acute and chronic brucellosis respectively. The predominant antibodies found in patients with acute brucellosis were of the IgG, IgM, IgA, IgE, IgG1 and IgG3 types while in chronic brucellosis IgG, IgA, IgE and IgG4 were found. Although IgE can be detected in patients with brucellosis, it does not discriminate between the acute and chronic stages of the disease.

A high attack rate (17·3/100 000) of meningococcal disease in army recruits in Italy, with 95% of the cases due to serogroup C, constituted the motivating factors to make bivalent serogroup A + C meningococcal vaccination compulsory by law for army recruits starting January 1987. Because the vaccine was given only to the new recruits entering the army, full coverage was not achieved until January 1988. Nearly 900 000 subjects (300 000 yearly) were vaccinated between January 1987 and December 1989. There were no reports of any untoward reactions to the vaccine. Of the 300 000 recruits in service each year, 52, 21, 15, 5 and 4 cases of the disease occurred in 1985, 1986, 1987, 1988 and 1989, respectively (P < 0·001).

Of the 24 cases occurring since the start of the vaccination, only two (due to serogroup C) were attributable to vaccine failure. The remaining cases were in unvaccinated recruits (15 cases) or were due to serogroups other than A or C (7 cases). The cumulative incidence of meningococcal serogroup C in the 600 000 vaccinated recruits during the period 1988–89 was 0·2/100 000 (1 case amongst 600 000 recruits), while the corresponding figure in the 600 000 unvaccinatred recruits during the period 1985–6 was 11·3/100000 (68 cases amongst 600 000 recruits) (P < 0·001). The protective efficacy of the vaccine in 1987 was 91·2% (12 cases of meningococcal serogroup A and C disease from an average of 150 000 unvaccinated recruits observed for 1 year, and 1 case from the corresponding average of 150 000 vaccinated ones). In 1988 and in 1989 this figure could not be calculated because all recruits were vaccinated.

The incidence of meningitis caused by other serogroups of meningococci remained low, both before and after the mass vaccination campaign.

A total of 535 sera from eight species of wildlife were collected from different game areas in Tanzania between 1987 and 1989. These sera were tested for antibodies against foot-and-mouth disease, bovine herpes virus types 1 and 2, lumpy skin disease, bovine viral diarrhoea, Akabane, bovine ephemeral fever, bluetongue, enzootic bovine leucosis, African horse sickness and African swine fever viruses and Brucella abortus based on the expected species susceptibility. Sera from buffalo Syncerus caffer, wildebeest Connochaetes taurinus and topi Damaliscus korrigum contained antibodies against the majority of the pathogens tested. Antibodies to fewer pathogens were detected in sera from the other species. No antibodies to lumpy skin disease virus were detected in any of the sera examined. African horse sickness antibodies were detected in sera from Zebra and African swine fever antibodies were detected in wart hog. The occurrence of antibodies to these agents suggests that wild species act as reservoirs of infection for some of these pathogens. However, until the susceptibility of individual species is proven by isolation of the aetiological agents their role must remain speculative.

The objectives of this study were to determine the prevalence of scabies in an infested village; to educate the residents on self-treatment and prevention by the use of 5 % monosulfiram soap; to evaluate the short term effectiveness of this intervention by determining, 2 weeks later, the compliance to self-treatment and prevention; and to determine the prevalence rate on the second visit. In 59 households (96·7% of the village) containing 313 persons, an educational session was held and a leaflet distributed on the use and availability of the soap. Thirteen persons (4·2%) from eight households (13·6%) had scabies. After 2 weeks, 7 persons (2·2%) (2 persisting and 5 new cases) from 5 households (8·5%) were infested. Thus a cure rate of 85 % was obtained though the prevalence rate showed no statistically significant difference. Among the under 15 year olds, the numbers infected decreased from 10 to 3 while among the over 15 year olds, the numbers infected increased from 3 to 4, neither reading significance at the 5 % level.

Sera from 141 infants aged 0–12 months were examined for IgG antibodies to HHV-6, HSV, CMV, VZV and EBV and for HHV-6 specific IgM. Following the decline in maternal antibody, antibody to HHV-6 was found to rise by 5–6 months and approached the level found in adults by 11–12 months. In contrast the antibody rates for the other herpesviruses were much slower to rise, especially in the case of CMV and EBV. HHV-6 IgM antibodies were detected mainly in age groups showing a rapid rise in antibody to HHV-6. HHV-6-IgM was not detected in 235 cord blood samples. The data suggest that HHV-6 infection is acquired horizontally, at a very early age in Western Australia.

Occupants of 482 long-stay and 33 short-stay beds in 11 Leicester City Council homes for the elderly were studied during a 30-week period from September 1988 to March 1989 to determine the incidence, aetiology, morbidity, and mortality of acute upper respiratory tract viral infections and the use of influenza vaccine.

Influenza immunization rates by home ranged from 15·4 to 90% (mean 45%). There were no differences in the distribution of medical conditions by home. The highest immunization rates were seen in people with chest disease (77%), heart disease (60%), diabetes (56%), and those with three medical conditions (75%). There was an average of 0·7 upper respiratory episodes per bed per annum with a mortality of 3·4% (6/179). Half of all episodes were seen by a general medical practitioner and 81 of 90 (90%) referrals were prescribed antibiotics costing approximately £7.50 per patient. Lower respiratory tract complications developed during 45 (25%) of 179 episodes including 3 of 12 coronavirus infections, 3 of 9 respiratory syncytial virus infections, 2 of 4 adenovirus infections, 1 of 11 rhinovirus infections, but none of 5 influenza infections. Respiratory infections were caused mostly by pathogens other than influenza virus during the influenza period documented nationally. This highlights the role of coronaviruses, respiratory syncytial virus, and unidentified agents in the elderly, and questions the assumptions made in American estimates on the impact of influenza and the value of influenza vaccines.

The seasonal incidence of bluetongue virus (BTV) in Central Sudan is related primarily to fluctuations in the prevalence of the vector, Culicoides imicola. Population densities of this midge begin to rise with the onset of precipitation and peak during October, before falling sharply at the end of the rainy season in November. These are also the months of BTV transmission. Populations of C. schultzei, the commonest midge in Central Sudan, are also related to the rainy season but this species does not seem to be involved with BTV transmission.

BTV serotype 2 was isolated from C. imicola confirming the status of this midge as a known vector but a second isolate of the same serotype was made from a mixed pool of Culicoides not including C. imicola. This suggests that BTV transmission in the Sudan may involve more than one species of Culicoides. Epizootic haemorrhagic disease virus (EHDV) serotype 4 and a palyam virus were isolated from C. schultzei which indicates that this species may be involved in the transmission of BT-related viruses. Seven further virus isolates from sentinel calves at Shambat (Khartoum) confirmed the presence of BTV serotypes 1, 4 and 16, and an untyped EHDV (designated 318) in the Sudan. All of the viruses isolated and identified during the course of this work are recorded from the Sudan for the first time.