The problem of the comparative nutritive value of bread made from the various high grade white or “patents” flours and the so-called “standard” meal is of some interest. The inclusion of a considerable portion of the bran in standard bread is claimed to increase largely the nutritive value of the bread. It has been known for many years that wholemeal bread containing the bran particles was especially useful as an article of diet for persons suffering from constipation, the laxative effect being due partly to the mechanical presence of indigestible fibre, partly to the irritation of the intestinal wall by the sharp bran particles causing increased peristalsis. This effect is to some extent lost after prolonged feeding.

Green & Mellanby (1928, 1930) were the first to direct attention to a specific relationship between vitamin A deficiency and infection. They studied the occurrence of spontaneous infections in vitamin A-deficient rats and concluded that animals fed on a diet deficient in vitamin A, but complete in all other respects, develop multiple infective lesions and die. Since then vitamin A has become known as the ‘anti-infective’ vitamin.

The incidence of purulent staphylococcal infections at a large Swedish university hospital was followed during 3 years and has been described as an expression of the incidence of hospital infections.

A marked decrease in the relative number of infections was found. The decrease was most evident among infections with ‘80/81’ strains and other antibiotic resistant hospital strains and was parallel in all the departments investigated. This is taken as an evidence for the assumption that the lowering of the amount of staphylococcal infections was brought about by a factor that was active throughout the hospital, probably some hygienic preventive measure.

A cluster of Salmonella Paratyphi B variant L(+) tartrate(+) infections with indistinguishable pulsed-field gel electrophoresis patterns was detected in October 2015. Interviews initially identified nut butters, kale, kombucha, chia seeds and nutrition bars as common exposures. Epidemiologic, environmental and traceback investigations were conducted. Thirteen ill people infected with the outbreak strain were identified in 10 states with illness onset during 18 July–22 November 2015. Eight of 10 (80%) ill people reported eating Brand A raw sprouted nut butters. Brand A conducted a voluntary recall. Raw sprouted nut butters are a novel outbreak vehicle, though contaminated raw nuts, nut butters and sprouted seeds have all caused outbreaks previously. Firms producing raw sprouted products, including nut butters, should consider a kill step to reduce the risk of contamination. People at greater risk for foodborne illness may wish to consider avoiding raw products containing raw sprouted ingredients.

On 14 November 1967 an investigation was begun at the University of South Florida to determine the cause of an increased number of gastrointestinal illnesses on campus. An estimated 300 students suddenly became ill with nausea, vomiting, abdominal pain, and diarrhoea. While at first food poisoning was suspected, no common food, water, or toxic exposure could be found. The data collected were most consistent with Winter Vomiting Disease. This entity is characterized by acute gastrointestinal illnesses which may occur in epidemic form in residential schools between September and March. Most investigators suspect that a viral agent is responsible for the illnesses, though attempts to isolate a virus have been unsuccessful. The incubation period in the University outbreak was estimated at 28 hr., and contact was the most likely mode of transmission. The outbreak illustrated that Winter Vomiting Disease in residential institutions may be an accentuation of the gastrointestinal illnesses occurring simultaneously in the community at large.

As part of an interventional study to determine glycopeptide-resistant enterococci (GRE) acquisition on a three-ward haematology unit, rectal swabs were taken weekly from 293 patients recruited to the study between June 1995 and December 1996. The GRE isolates obtained from the first positive rectal swab from 120 colonized patients, the isolates from 7 patients with clinical infection and 43 isolates obtained from the ward environment were compared by pulsed-field gel electrophoresis (PFGE). Sixty-three of 120 patients were colonized by one of strains A-H, while 49 were colonized by unique strains. The first 18 weeks were associated with the highest prevalence of GRE by rectal swab, with a single strain A responsible for 52% of acquisitions on ward 2, 22% on ward 3 and 36% on ward 4. Other smaller ward associated clusters were evident. Environmental sampling of ward 2 during this time showed that all but 2 of 30 isolates were indistinguishable from strain A. As the GRE prevalence fell, rectal swab and environmental isolates became more heterogeneous, and strain A disappeared after week 55. GRE prevalence rose again in the final 15 weeks of the study, and a new predominant strain B emerged on ward 2 responsible for 50% of new acquisitions. In the seven patients with clinical infection with GRE, the clinical isolates were compared with the contemporaneous rectal swab isolate, and were found to be the same in only two cases. An analysis of five long-term carriers colonized for a median of 19 weeks (range 11–34) showed colonization with at least two and in one case six distinct strains, raising the question of how many strains may be colonizing a patient at any one time, and suggesting that multiple colonies should be analysed. These data suggest that cross-infection was an important factor in the spread of GRE when the colonization rate was high.

A significant proportion of a consignment of branded Parma Ham was found to have ‘blown’ tins; the associated bacterial flora was therefore investigated. No Salmonella or Shigella were found. Clostridium welchii type A and Clostridium bifermentans were isolated in moderate numbers only from enrichment cultures of the ham. Staphylococcus spp. and coryneform bacteria were obtained from all tins and Group D streptococci were present in a few. No food-poisoning cases were associated with this ham.

1. The influence of the thyroid gland on the production of antitoxins to two alum-precipitated bacterial exotoxins has been investigated in different animal species.

2. Rats, rabbits and mice produce more circulating antitoxin when thyroidectomized, and less when made hyperthyroid by thyroxine administration, than control animals.

3. Guinea-pigs produce slightly less antitoxin when thyroidectomized, and markedly more when thyroxine treated, than control animals.

We are grateful to Dr J. S. F. Niven for histological examination of tissues, and to Miss M. V. Mussett, B.Sc., for statistical analyses. The alum-precipitated tetanus toxoid XW 2044, and tetanus toxin XW 1322, were kindly supplied by Miss Mollie Barr, M.Sc., of the Wellcome Research Laboratories, Beckenham, Kent, and we are also grateful to Mr P. Rodican of the Lister Institute, Elstree, for a supply of tetanus toxin 829.

The presence of pneumococcal capsular antigen (PCA) in the oropharynx was sought in subjects without respiratory tract infection. Saliva specimens from 239 subjects were analysed by counter-current immunoelectrophoresis using ‘Omni-serum’. 15.5% gave positive reactions but only 24% of positive samples were typable and therefore due to pneumococcal or pneumococcal-like antigens. Given that oropharyngeal production of antigens occurs we investigated whether PCA in expectorated sputum arose from oropharyngeal contamination. Sixteen patients with pneumococcal pneumonia, and with sputum positive for PCA, were investigated in detail. On the basis of serotyping and concentration the PCA in sputum was thought to arise from the lower respiratory tract in all cases. This was confirmed by a simple, novel approach involving the comparison of concentrations in concomitant samples of saliva and sputum. Thus while oropharyngeal production of antigens poses a potential diagnostic problem the latter approach can be used to exclude contamination.

Futher experience with the method of measuring the precipitum obtained when experimenting with precipitating antisera has shown that finer degrees of reaction cannot be satisfactorily determined by means of the apparatus described by Nuttall. In the latter apparatus capillary tubes were used in which to measure the precipitum therein deposited. It is true that capillaries as far as possible of the same calibre were used, nevertheless we have found that different readings were obtained when experimenting with tubes of varying calibre, variations evidently due to physical causes which prevent an equal degree of “packing” of the deposit in tubes of unequal width. We have modified the method after finding that calibrated tubes of uniform bore gave more constant results, and have devised a simple apparatus which greatly facilitates the making of measurements.

The possible risks of infection associated with the practice of licking envelopes, stamps and labels were investigated. Although pathogenic bacteria and viruses were not isolated from sample envelopes obtained from various sources, the gums used in manufacture were found to exert a protective effect against death from desiccation on the bacteria and viruses which had been introduced into them. Staph. aureus and Salm. paratyphi B remained viable for several months in dried films of two out of four gums tested. An echovirus could be recovered from similar films for up to 30 days, and an adenovirus for up to 10 days.

Bacterial multiplication occurred in the gum used for the manufacture of postage stamps. The comparison is drawn between the possible consequences of minimal contamination of this gum and of cans of corned beef in the light of recent studies.

1. Clinical examination of 374 industrial women workers and 289 housewives of comparable type was made in Oxfordshire in August 1942 and repeated four times subsequently on the same groups up to March 1944.

2. It was concluded that the diet of these women was adequate to prevent obvious signs of vitamin deficiency but that there was a general tendency for the general nutritional state, assessed clinically, to deteriorate during the 19 months of this study. This deterioration was associated with complaint of fatigue.

3. The women workers residing in areas where the water was low in iodine content tended to show enlargement of the thyroid gland. The enlargement increased in those already affected, and the incidence also increased.

The author is much indebted to Dr J. O. Irwin for his assistance in statistical presentation of the data and to Dr Harriette Chick for helpful criticism.

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’.

Dengue infection in China has increased dramatically in recent years. Guangdong province (main city Guangzhou) accounted for more than 94% of all dengue cases in the 2014 outbreak. Currently, there is no existing effective vaccine and most efforts of control are focused on the vector itself. This study aimed to evaluate different dengue management strategies in a region where this disease is emerging. This work was done by establishing a dengue simulation model for Guangzhou to enable the testing of control strategies aimed at vector control and vaccination. For that purpose, the computer-based dengue simulation model (DENSiM) together with the Container-Inhabiting Mosquito Simulation Model (CIMSiM) has been used to create a working dengue simulation model for the city of Guangzhou. In order to achieve the best model fit against historical surveillance data, virus introduction scenarios were run and then matched against the actual dengue surveillance data. The simulation model was able to predict retrospective outbreaks with a sensitivity of 0.18 and a specificity of 0.98. This new parameterisation can now be used to evaluate the potential impact of different control strategies on dengue transmission in Guangzhou. The knowledge generated from this research would provide useful information for authorities regarding the historic patterns of dengue outbreaks, as well as the effectiveness of different disease management strategies.

In the Medical Research Council's Special Reports, Nos. 91 and 92, and in the Journal of Hygiene, vol. XIV. No. 1, July, 1925, W. G. Savage and P. Bruce White stress the desirability of restricting the term “B. paratyphosus B” to the organism of paratyphoid fever and nothing else, and of designating the organism that most commonly causes food-poisoning outbreaks as B. aertrycke, and not as B. paratyphosus B (type aertrycke). In view of the fact that the features of a paratyphoid fever outbreak due to infected ice-cream, and of an aertrycke enteritis due to infected pork as occurring in Aberdeen in 1925 emphasise the distinction between paratyphoid fever and aertrycke enteritis, it has seemed well to record these two outbreaks in some detail for the purpose of contrasting them the one with the other and with the milkborne Gaertner enteritis which is recorded in the preceding paper.

Swine Vesicular Disease virus (SVDV) did not survive drying at high relative humidities (r.h.) but there was little virus loss at low r.h.

Purified virus dried in films was inactivated by formaldehyde fumigation only at high r.h. Inactivation was also influenced by the suspending medium from which the virus was dried. Purified virus resuspended in distilled water and then dried, was rapidly killed, but that in tissue culture fluid survived.

A Technique for drying serum proteins from the frozen state has been described by Greaves & Adair (1939). For war requirements the procedure has been to dry in 12 oz. medical flats into each of which is put 200 c.c. of serum. The bottles are then placed in a −20° C. cold room on shelves slightly inclined to the horizontal. The inclination is to allow the maximum quantity of serum to be dried consistent with the exposure of a reasonable surface area from which to dry. This method of freezing produces a wedge-shaped block of serum in the bottle (Fig. 1) and is very efficient. Large amounts of serum for the use of the Army have been dried in this manner by Greaves and his colleagues.

Data from the 1997–2004 Surveys of Prevalent HIV Infections Diagnosed were analysed by three geographical areas of residence and treatment to describe the heterogeneous growth of the HIV epidemic in England and provide projections to 2007. Between 1997 and 2004, the number of diagnosed HIV-infected adults resident in England increased by 163% (14223 to 37459). Within the ‘London environs’ the increase was 360% (742 to 3411), within the rest of England 219% (4417 to 14088) and within London 120% (9064 to 19960). By 2004, the London environs had the largest proportion of infections acquired through heterosexual sex (and in particular women) and the most recently diagnosed population. Projections indicate over half of diagnosed HIV-infected adults will live outside London by 2007. The epidemiology of diagnosed HIV infection within the London environs is likely to be a predictor of future trends in England overall.