Skin lesions with histopathology similar to that seen in lesions in man have been produced in calves by the experimental inoculation of cultures of Myco. ulcerans. Sensitization of infected calves to mammalian tuberculin as well as to ulceranin has been demonstrated.

It is considered unlikely that cattle are a reservoir of infection for man.

The expenses of this investigation were met by a research grant from the Board of Management, Alfred Hospital.

We are indebted to Dr A. V. Jackson, Director of Pathology, Alfred Hospital, for the reports on histopathology.

Epidemic surveillance is an effective means to determine the characteristics of acute diarrhoea and the benefits of disease control and prevention. The epidemiological, clinical, and aetiological data of adult (aged ⩾15 years) acute diarrhoea in a general hospital in Shanghai were collected and analysed. Out of 2430 acute diarrhoea patients, 162 subjects were sampled (sample ratio 15:1). The sampled subjects had an average age (±s.d.) of 44 ± 18 years; 142 (87·7%) had a history that indicated ingestion of contaminated food; and 40 (24·7%), 54 (33·3%), and 73 (45·1%) patients had diarrhoea that was attributed to viral, bacterial, and unknown aetiological origins respectively. Viral diarrhoea is mainly prevalent during the winter and spring months, while bacterial and diarrhoea of unknown aetiology occur mainly in the summer months. The average age of the unknown aetiology group (48 ± 19 years) was significantly older than that of the viral diarrhoea group (39 ± 16 years). The number of patients with vomiting in the viral group (30·6%) was significantly higher than that in the bacterial (17·1%) and unknown aetiology (8·2%) groups. Viral and bacterial infections are the main cause of acute diarrhoea in Shanghai. However, further effective technological means are needed to improve the surveillance, control, and prevention of acute diarrhoea.

Ultra-centrifugation of emulsions from suckling mouse brains infected with the MEF1 strain of poliomyelitis virus separates a non-infective antigen, or soluble antigen, from infective virus. This antigen is responsible for most of the complement fixation and explains the high titres obtained. On the other hand, the same virus, and also Mahoney, Type 1 poliomyelitis virus, grown in monkey kidney tissue culture, fail to produce this soluble antigen, and this is probably a factor in the low complement-fixing titres obtained in tests with these fluids.

The author would like to express her appreciation of Miss M. Butchart's valuable technical assistance.

We evaluated laboratory reports as early indicators of West Nile virus (WNV) disease cases in Texas. We compared WNV laboratory results in the National Electronic Disease Surveillance System Base System (NBS) to WNV disease cases reported to the state health department from 2008 to 2012. We calculated sensitivity and positive predictive value (PPV) of NBS reports, estimated the number of disease cases expected per laboratory report, and determined lead and lag times. The sensitivity and PPV of NBS laboratory reports were 86% and 77%, respectively. For every 10 positive laboratory reports, we expect 9·0 (95% confidence interval 8·9–9·2) reported disease cases. Laboratory reports preceded case reports with a lead time of 7 days. Electronic laboratory reports provided longer lead times than manually entered reports (P < 0·01). NBS laboratory reports are useful estimates of future reported WNV disease cases and may provide timely information for planning public health interventions.

1. An electrophoretically homogeneous antigen preparation extracted from a strain (LII) of Pseudomonas aeruginosa by trichloracetic acid inhibits four phages active against this strain, and two phages (5 and 14) to which it is resistant but which attack a mutant strain LIII–3 bi.

2. An extract prepared in the same way from strain LIII–3 bi has no antigenic or inhibitory properties. Lysis of LIII–3 bi organisms by chloroform, however, yields a potent inhibitor active against several phages.

3. TCA extracts from immunologically distinct Ps. strains AII, BII and GII also inhibit phages 5 and 14 to which these strains are resistant.

4. The effect of a third phage (13) on Ps. LIII–3 bi is activated by the extract from strain LII which normally inhibits phages 5 and 14. Prolonged contact with very dilute solutions of the extract also causes activation of phage 5. Activation of phage 14 has not been observed.

5. The above findings are discussed in relation to current theories of phage action and phage inhibition.

From pneumococci a species antigen can be obtained which on injection gives protection against pneumococci of different types.

Species antigen is a somatic constituent of pneumococci and can be obtained in solution free of protein. It may be of carbohydrate nature, but is not derived from the type-specific material.

The bodies of pneumococci contain another substance which on injection opposes species immunization. This opposition factor is closely associated with the protein content.

Inconstant results from injection of preparations containing species antigen are due to the presence of opposition factor in varying amount.

A high degree of species immunity can be secured by the use of species antigen freed from opposition factor.

The remarkable paper by Fred. Griffith on the significance of pneumococcal types, reproduced in the preceding pages of this Journal, in which it was first published 38 years ago (Griffith, 1928), describes a series of careful and painstaking experiments which show beyond doubt that the ability to produce a polysaccharide capsule can regularly be restored to ‘rough’ (R) strains of pneumococci which have lost it, by the subcutaneous inoculation of mice with a mixture of a small number of the living R bacteria and an excess of heat-killed, capsulated (S) virulent bacteria. The inoculated mice frequently died from septicaemia and virulent, capsulated S organisms could be isolated from the blood. On the other hand, in control experiments, the injection of suspensions of heat-killed S bacteria alone never yielded living organisms, while recovery of virulent S organisms by (mutational) reversion, following inoculation of living R bacteria alone, was a rare event. Griffith called this phenomenon ‘transformation’ and, at least in the field of bacterial genetics, this name is still specifically used to describe it.

This prospective, multicentre study was conducted between September and October 2003 in 38 French departments of internal medicine, infectious disease and hepatogastroenterology and included 406 consecutive HBV-infected patients (positive HBsAg), half of whom were HIV-infected (53%). The aim was to outline the main characteristics of hepatitis B virus (HBV)-human immunodeficiency virus (HIV) co-infected patients in French hospitals. HBV-HIV co-infected patients (85% were receiving HAART; mean CD4 count 447±245/μl, HIV RNA load <400 copies/ml, 67% of patients), compared to HIV-negative patients, were more often male, injecting drug users, HBeAg-positive and HCV-HIV co-infected (P<10−4). They underwent liver biopsy less often (31% vs. 51%, P<10−4), particularly those with severe immunodeficiency. They received anti-HBV treatment more often (75% vs. 45·7%, P<10−4), mainly lamivudine and tenofovir. Significant improvements in the management of such patients are awaited mainly in the appraisal of liver disease by either liver biopsy or non-invasive alternatives to liver biopsy.

1. A fluid enrichment medium containing sulphite and bismuth based on Read's modification of one of Wilson & Blair's media has been devised and the claims of Read (1939) and Seal (1939) as to the value of such a medium has been confirmed.

2. A saccharose mannitol sulphite bismuth alcohol phenol red agar medium is described and has been found to allow rich growth of the true cholera vibrio and to inhibit the growth not only of B. coli and B. lactis aërogenes but of many vibrios liable to be mistaken for the true vibrio cholerae.

3. Thirty-one strains of true cholera vibrios, obtained from the National Collection, grew rapidly and profusely in the media.

4. Of twenty-five cholera-like and para-cholera strains six grew well, whilst the growth of nineteen was scanty or nil.

5. Of eleven El Tor vibrios five grew in both fluid and solid bismuth media, five grew only on the solid medium and in one no growth occurred in either medium. The El Tor colonies were much smaller than those of the epidemic cholera strains.

The parasite referred to in the preceding paper was found by Dr Gerrard in the polymorphonuclear leucocytes of a dog. As is stated by Dr Gerrard, the parasite is evidently similar to that discovered by Bentley and described by him, and afterwards by James, as the Leucocytozoon canis. Dr Gerrard sent some films, stained by him by Leishman's method, to Sir Patrick Manson, and they were handed on to me for description and identification. These films had faded in transit, they were therefore decolorised and restained by various methods. All the staining reactions mentioned in this description refer to these old films.

The three experiments with which this report deals were undertaken with the object of re-examining the conversion factor 1600 which had been provisionally allotted by the Second International Conference on Vitamin Standardization (1934) for converting the results of spectrophotometric tests for vitamin A into international units.

1. In the introduction, the characteristics of the people are given from the observations of administrative and medical officers well acquainted with the area, fertility of the land and ample rainfall being the main theme of each observation.

2. The topography, climate and local conditions are given, including notes on crop production, habitations, clothing, domestic animals, origin of the people and food.

3. The population figures and rat and human plague figures are discussed. The rat and flea population figures over a twelve month trapping period are given and notes made on interesting biological problems arising out of these figures.

4. The male and female ratios in a Rattus population in plague endemic areas offer an interesting problem for further investigation. It would be instructive to find out what are the factors responsible for high female ratios and the significance of such female dominance being peculiar to endemic areas.

5. The field rodent and flea survey figures are discussed. Although an interchange of fleas takes place between them and house rats, plague remains absent from such communities.

6. There is no evidence to show that there is carriage of infection from endemic centres, either by rats, fleas, merchandise or man.

7. A comparison is drawn between a Kenya endemic centre and an Indian one, similarities and differences being noted. The similarities are that both areas are extremely fertile, large crops of cereals being grown, and the diets of both man and rats are confined to this inadequate source of nourishment. The great differences between Indian and Kenyan endemic centres are the flea species present and that India suffers a much heavier mortality rate in man than does Kenya.

8. It is suggested that the low incidence of plague in man in Kenya is partly explained by the habits of Rattus, which in the typical dwellings of native areas nests in the thatch. Its ectoparasites are then unlikely to come into contact with man. In buildings where rats nest underground contact between its flea (then Xenopsylla cheopis) and man is likely to be very close and constant, and areas containing such buildings are usually distinguished by the epidemic nature of the disease.

Anthrax is still a severe public health problem and threat to human health. A cutaneous anthrax outbreak occurred in Jiangsu Province, a non-endemic anthrax region of eastern China, from July to August 2012. Epidemiological and laboratory investigation were initiated to trace the source of infection and identify the risk factors of the outbreak. On 25 July 2012, 17 persons were exposed to a sick cow, which had been imported from northeast China a few days previously. Of the 17 exposed, eight developed symptoms between 1 and 8 days and were diagnosed as cutaneous anthrax cases. Three main genes of Bacillus anthracis were detected from both human and cow meat samples, indicating that the outbreak was associated with this infected cow. A retrospective cohort study showed that contact with blood and presence of skin damage contributed to the case infection with B. anthracis. The outbreak highlights the need to enhance quarantine for imported livestock, which should have been vaccinated prior to importation, the significance of education for high-risk individuals, and training for primary healthcare workers even in anthrax-free areas.

(1) The young of parents both of which have been injected with an immunising mixture of diphtheria toxin and antitoxin, show immunity of the same order as that of young from similarly treated mothers and normal fathers.

(2) The injection of certain foreign substances into a female guinea-pig appears to have a direct effect on the offspring in diminishing their resistance to diphtheria toxin, shown equally well by the young of mothers injected, (a) before the attainment of sexual maturity, (b) during pregnancy, and (c) after birth during the period of lactation.

(3) A single injection of diphtheria toxin may give rise to a condition of active immunity (as tested by the resistance of the young) in guinea-pigs possessing hereditarily transmitted passive immunity. Should this injection of toxin give rise to great constitutional disturbance, the young may show lowered resistance, whereas, if it give rise to but slight constitutional disturbance, the young show a high degree of immunity. These effects appear to be accentuated if similar injections are repeated in the next generation.

In a previous paper (This Journal, vol. VI. p. 524) we have given an account of the quantitative estimation of plague bacilli in the blood of 16 septicaemic cases. It remains now to supplement this number with a further series and to add some observations on the infectivity of the urine and faeces.

Using isolates from reported cases of Escherichia coli O157 from Alberta, Canada in 2002, we applied randomization tests to determine if cases associated with an outbreak or statistical space–time cluster had more similar pulsed-field gel electrophoresis patterns, based on Dice coefficients, than expected by chance alone. Within each outbreak and space–time cluster, we assessed the mean, median, 25th percentile, 75th percentile, standard deviation, coefficient of variation, and interquartile range of the Dice coefficients of each pairwise comparison among the isolates. To assess the statistical significance of measures of location (e.g. mean) and variation (e.g. standard deviation) we created randomization distributions using all isolates or only isolates from sporadic cases. We determined that randomization tests are an appropriate tool for evaluating the similarity among isolates from cases that have been linked epidemiologically or statistically. We found little difference between using all cases or only sporadic cases when creating our randomization distributions.

Nasal swabs were taken from 369 four-year-old children in two South Wales towns and cultured for Streptococcus pneumoniae. The organism was isolated in 34% of the specimens, similar rates being found in boys and girls in the two towns. The children were swabbed again a year later, when the prevalence of nasal pneumococci had fallen to 25%. There was no association between the presence of the organism on the two occasions. Types 6 and 23 were most often isolated. After excluding children who had received an antibiotic, the proportion carrying a pneumococcus was higher in those who had recently had a respiratory infection than in the rest, although the difference was not quite statistically significant. There was a significant negative association between the presence of Staphylococcus aureus and Strep. pneumoniae.

We aimed to assess vaccination coverage (VC) in 17-year-old French young adults (YAs) participating in one mandatory Day of Defence and Citizenship (DDC). Between June 2010 and May 2011, YAs participating in 43 randomly selected mandatory sessions of the DDC programme in Poitou-Charentes (France) were asked to provide their personal vaccination record. Tetanus, diphtheria, polio, hepatitis B, Haemophilus influenzae b, pertussis, measles, mumps and rubella vaccination status were assessed at ages 2, 6, 13 and 17 years. Of 2610 participants, 2111 (81%) supplied documents for evaluation. Of these, 1838 (87%, M:F sex ratio 0·96) were aged 17 years (9% of the global population of this age in the area). The assessment of the 17-year-olds demonstrated the following rates of complete vaccination: diphtheria-tetanus-polio 83%; measles, mumps and rubella 83%; pertussis 69%; H. influenzae b 61%; human papillomavirus 47%; and hepatitis B 40%. At age 6 years, only 46% had received two doses of the vaccine against measles. The YAs were not aware of their status but were in favour of vaccination. VC in YAs is insufficient, particularly for hepatitis B, pertussis and measles. Combined vaccines and the simplification of vaccination schedules should improve VC. Preventive messages should focus on YAs.

1. Considerable differences in antigenic efficiency are encountered among batches of (1) diphtheria toxoid, and (2) Cl. welchii (perfringens) toxins prepared under standardized conditions. These differences were revealed in the results of hyperimmunization of horses.

2. Such differences in antigenic efficiency in batches of diphtheria toxoid were also detected by means of injections into guinea-pigs. Two injections, each of 2 Lf doses, were given at an interval of 28 days, and the response measured by means of antitoxin titrations on bleedings taken 10 days later.

3. A general correlation was found between antigenic efficiency as measured by these two methods.

4. A method is described for comparing the affinity for antitoxin, of batches of diphtheria toxoid, by determining the test dose of mixtures containing 9 Lf doses of toxoid and 1 Lr dose of a fixed toxin. The greater the avidity of the antitoxin, the more toxoid entered into combination with it.

5. A correlation was found to exist between affinity for antitoxin and antigenic efficiency of toxoid, as measured both by the response of horses to hyperimmunization and the response of guinea-pigs to two spaced injections.

6. It is tentatively suggested that crude toxoids may contain molecules possessing varying degrees of affinity for antitoxin, due to slight steric structural differences.

The primary source from which all vaccines are derived is a culture of the organism against infection by which it is desired to protect the animal. The culture may be used as a vaccine either alive or dead.- We are concerned here only with the latter. Such a killed culture comprises the organism itself and the products of its metabolism, together with part or the whole of the culture medium in which it has grown. This mixture may be called a whole vaccine. By appropriate treatment a “whole vaccine,” may be deprived of some or all of such constituents as are not concerned in bringing about, when inoculated into animals, those changes which constitute protection. Such a vaccine may be called a derived vaccine in the case when all the immaterial constituents are not removed, the term antigen being reserved to designate that substance which alone is concerned in conferring protection. The main object of this investigation is the preparation of a derived vaccine with the hope that the antigen may ultimately be isolated.