Nosocomial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks among health care workers have been scarcely reported so far. This report presents the results of an epidemiologic and molecular investigation of a SARS-CoV-2 outbreak among laundromat facility workers in a large tertiary centre in Israel. Following the first three reported cases of SARS-CoV-2 among laundromat workers, all 49 laundromat personnel were screened by qRT-PCR tests using naso- and oropharingeal swabs. Epidemiologic investigations included questionnaires, interviews and observations of the laundromat facility. Eleven viral RNA samples were then sequenced, and a phylogenetic analysis was performed using MEGAX.

The integrated investigation defined three genetic clusters and helped identify the index cases and the assumed routes of transmission. It was then deduced that shared commute and public showers played a role in SARS-CoV-2 transmission in this outbreak, in addition to improper PPE use and social gatherings (such as social eating and drinking). In this study, we present an integrated epidemiologic and molecular investigation may help detect the routes of SARS-CoV-2 transmission, emphasising such routes that are less frequently discussed. Our work reinforces the notion that person-to-person transmission is more likely to cause infections than environmental contamination (e.g. from handling dirty laundry).

Estimation of farm prevalence is common in veterinary research. Typically, not all animals within the farm are sampled, and imperfect tests are used. Often, assumptions about herd sizes and sampling proportions are made, which may be invalid in smallholder settings. We propose an alternative method for estimating farm prevalence in the context of Brucella seroprevalence estimation in an endemic region of Kazakhstan. We collected 210 milk samples from Otar district, with a population of about 1000 cattle and 16 000 small ruminants, and tested them using an indirect ELISA. Individual-level prevalence and 95% confidence intervals were estimated using Taylor series linearization. A model was developed to estimate the smallholding prevalence, taking into account variable sampling proportions and uncertainty in the test accuracy. We estimate that 73% of households that we sampled had at least one Brucella-seropositive animal (95% credible interval 68–82). We estimate that 58% (95% confidence interval 40–76) of lactating small ruminants and 14% (95% confidence interval 1–28) of lactating cows were seropositive. Our results suggest that brucellosis is highly endemic in the area and conflict with those of the official brucellosis-testing programme, which found that in 2013 0% of cows and 1·7% of small ruminants were seropositive.

During the outbreak of influenza due to A (H3N3) viruses in Finland in 1985/6 virus pairs were isolated from the same clinical specimens in embryonated hens' eggs (CE) and in canine kidney cell cultures (MDCK). Some of these isolates, the E and M pairs, were distinguished by their reactions in haemagglutination inhibition (HI) tests carried out using polyclonal antisera, and by receptorbinding properties, as evidenced by differences in their elution activity from erythrocytes. Passage of the E- and M-virus isolates in the foreign host affected their serological characteristics, but the E virus did not convert to an M-like virus and the M virus did not convert to an E-like virus. Returning the viruses to grow in the host used for their isolation changed the serological reactions so that they were once more close to the reactions of the original isolates. This contrasts with the changes in receptor-binding properties. Rapid elution from hen erythrocytes, which has been described as a property of viruses binding to the SAα2,3Gal sequence in preference to SAα2,6Gal, characterized the virus passages grown solely in MDCK cell cultures. Cultivation of the M virus in CE, at any stage of its passage history, made the virus irreversibly incapable of elution. The M virus was more sensitive than the E virus to HI antibodies against heterologous viruses of the H3N2 subtype, and, when used as an antigen in HI serology, it more frequently (90% vs. 69%; P < 0·01) detected diagnostic antibody responses in patients infected with viruses of this subtype in 1985/6. Use of antigens with a different passage history in HI serology provided evidence that this superiority, which may be due to the ability of the virus to pick out anamnestic antibody responses, is unrelated to the receptor-binding peculiarity of the M virus under consideration. The results support the concept that the host cell can select a diversity of virus variant subpopulations from a single clinical specimen during isolation and subsequent cultivation procedures. Moreover, the MDCK-grown influenza viruses may correspond better than the egg-grown isolates to the natural epidemic viruses.

Sustaining the impact of hepatitis B virus (HBV) vaccination on incidence and prevalence of HBV infection requires increasing and maintaining the uptake of vaccine among those at risk. In recent years, the level of vaccine uptake among people who inject drugs (PWID) in the UK has levelled-off. Data (2015–2016) from the national unlinked-anonymous monitoring survey of PWID, an annual survey that collects data from PWID across England, Wales and Northern Ireland, were used to examine HBV vaccine uptake. Data from participants who had injected drugs during the previous year were used to investigate sources of hepatitis B vaccine doses as well as factors associated with vaccine uptake. Among the 3175 anti-HBc-negative participants, 3138 (99%) reported their vaccination status; 23% (714) reported no vaccine uptake. Among those not vaccinated, 447 (63%) reported being sexually active and 116 (16%) reported sharing needles and syringes. Majority of those not vaccinated reported accessing services in the previous year that could have provided hepatitis B vaccine doses. These missed opportunities for vaccinating of PWID indicate a need for additional targeted interventions.

The Isle of Ely is the northern half of the geographical County of Cambridge-shire and forms in itself a separate administrative county. It is the heart of the fen country, and its population is one which long retained a degree of isolation and independence tending to preserve in its members certain mental, and perhaps physical characters peculiar to themselves. It is interesting to recall that from this neighbourhood came Boadicea, Queen of the Iceni, and Hereward the Wake, who proved such stubborn enemies to the conquerors of their country.

Sera were collected from female cattle in 118 commercial herds being subjected to a programme to eradicate brucellosis by test and slaughter, in an area in which vaccination of heifer calves with Brucella abortus strain 19 was compulsory. Of 4583 sera positive by the Rose Bengal plate test, the brucellosis radioimmunoassay was positive for 1524, the complement fixation test for 1363 and the indirect haemolysis test for 1141. These figures, and supporting evidence from the eradication programme, suggest that the radioimmunoassay may be a useful supplementary test in problem herds.

Medico-legal death investigation systems have the potential to play an important role in disease surveillance. While these systems are in place to serve a public function, the degree to which they are independent of central government can vary depending on jurisdiction. How these systems use this independence may present problems for public health initiatives, as it allows death investigators to decline to participate in government-led surveillance regardless of how critical the studies may be to public health and safety. A recent illustration of this problem in the UK is examined, as well as general lessons for removing impediments to death investigation systems participating in public health research.

Two collections of trimethoprim R plasmids, isolated from strains of Escherichia coliduring 1978–83 and 1987–8 respectively, were retrospectively screened with specific biotinylated DNA probesfor the presence of genes encoding particular DHFR enzymes. The results confirmed that the type I DHFR gene was the predominant plasmid-encoded gene conferring trimethoprim resistance in strains of E. coli from the Nottingham area of the UK, but indicated that genes encoding the more recently recognized types of DHFR enzymes haappeared in the bacterial gene pool and could be recognized with increased frequency in the latter plasmid collection. Thiswasparticularly true of the type IIIa and type VII enzymes which together accounted for 27 % of the trimethoprim R plasmid examined in 1987–8.

Values for the ascorbic acid content of a number of foods sold in diverse markets were determined by titration against 2: 6 dichlorophenolindophenol in acid solution. The results showed that the least expensive material was not necessarily the poorest source of vitamin C and might be more valuable than expensive foods. Samples of cabbage from the cheap market contained 329% as much vitamin C as samples from expensive sources. These results on comparison with figures recorded for fresh garden produce showed that market foods have lost some of their vitamin C content on exposure for sale, but still contain satisfactory amounts of ascorbic acid when purchased.

Results from different samples of fruits and vegetables showed wide variation. No data relating to storage before purchase were available, so limiting figures were used for each food. Mean values were calculated for purposes of comparative tabulation.

The effect of household storage after purchase was noted for foods from inexpensive and fashionable markets. The values obtained showed that the loss of ascorbic acid in foods stored in the home after a period of exposure for sale, though marked, was not as serious as has previously been indicated.

An irregular fall in the ascorbic acid content of some of the material examined was noted and investigated. Wide variations in the amount of ascorbic acid present in different parts of individual fruits and vegetables were observed. In view of experimental results it is recommended that foods be purchased and prepared for consumption immediately before use.

Canned foods from diverse markets were examined to determine their ascorbic acid content, and it was shown that the vitamin is distributed throughout solid and liquid. Although a percentage of vitamin is destroyed on heating, those fruits and vegetables initially high in ascorbic acid retained sufficient vitamin to afford a better, and frequently cheaper, source of vitamin than unheated samples with a low ascorbic acid content. Considerable quantities of vitamin C are lost when the liquid from canned vegetables is discarded. When the syrup from cans is used as well as the fruit the vitamin available to the consumer is frequently greater than the amount yielded by the same weight of raw fruit from market sources.

Raw and canned plant tissues from cheap and expensive sources were compared for their antiscorbutic value in the human diet, and for the cost of the daily requirement at ruling market prices. It was found that a day's ration of ascorbic acid could be purchased at a cost as low as a farthing to as high as a pound.

A complex disease picture prevalent in this country has been traced (Spira, 1928) to the protracted ingestion of drinking water derived from the tap, and of food prepared in aluminium cooking utensils. No indication could at that time be given of the exact irritant, beyond stating that a mineral or metal seemed to be involved. Further observation revealed a frequent association with paraesthesiae affecting the hands and fingers, especially those supplied by the dorsal cutaneous branch of the ulnar nerve. The feet were affected to a lesser extent. Since there is, in the present state of our knowledge, only one poison which affects the ulnar nerve, namely, fluorine, Spira (1933) concluded that it may be this halogen which was one of the aetiological factors concerned. It was the wide-spread occurrence of mottled teeth in this country (Spira, 1942a, b), known to be produced by a drinking water with a content of not less than 1 part of fluorine per million parts of water (1 p.p.m.), equivalent to gr. 1/120 of fluorine to a pint of water, ingested during the period of calcification of the teeth, which helped to establish the fact that it is indeed fluorine which is the causative agent producing signs and symptoms of a hitherto obscure origin.

Preliminary record of attempts to produce the typhoid-carrier state in the rabbit and to obtain evidence of the presence of this condition by bacteriological examination of the faeces.

Conditions in institutions for children or defectives may become peculiarly favourable to the propagation of hookworm disease. The subject of the present study is a long-standing infection with Ancylostoma duodenale in the Hospital for the Insane at Goodna, Queensland, the largest of the three hospitals for the insane maintained by the State Government. The investigation was of special interest because the institution is in a region in which the general population is free from hookworm disease, owing to low rainfall, and because the infection was with A. duodenale, while the predominating hookworm infection of Queensland is with Necator americanus.

1. 52·6% of marmots placed in contact with marmots infected with plague by inhalation developed pulmonary plague and died within 4–6 days.

2. Marmots suffering from pneumonic plague are infective at an early stage of the disease and the animals which such marmots infect acquire plague after a short incubative period.

3. Pulmonary plague can be readily transmitted to the small marmot (Spermophilus citellus Linn.), and these animals, when suffering from pulmonary plague, are in turn capable of transmitting the same type of plague through the respiratory passages.

4. Septicaemic plague can be developed in marmots very easily as a result of respiratory infection and also by direct subcutaneous inoculation with small amounts of culture.

5. The marmot can acquire plague by way of the alimentary tract and spread the disease by feeding on plague-infected carcases. The histological appearances observed in the lesions of these cases are characteristic.

Although Malta is historically linked with the zoonosis brucellosis, there had not been a case of the disease in either the human or livestock population for several years. However, in July 2013 a case of human brucellosis was identified on the island. To determine whether this recent case originated in Malta, four isolates from this case were subjected to molecular analysis. Molecular profiles generated using multilocus sequence analysis and multilocus variable number tandem repeat for the recent human case isolates and 11 Brucella melitensis strains of known Maltese origin were compared with others held on in-house and global databases. While the 11 isolates of Maltese origin formed a distinct cluster, the recent human isolation was not associated with these strains but instead clustered with isolates originating from the Horn of Africa. These data was congruent with epidemiological trace-back showed that the individual had travelled to Malta from Eritrea. This work highlights the potential of using molecular typing data to aid in epidemiological trace-back of Brucella isolations and assist in monitoring of the effectiveness of brucellosis control schemes.

More cells of Shigella sonnei were recovered on a chemically defined medium than on complex media after the cells were irradiated with ultraviolet light. The temperature of incubation affected the numbers of colony-forming cells that could be recovered. A temperature of 37° C. yielded the largest number of colonies compared with temperature of 15, 27 and 44° C. Recovery of irradiated cells was favoured when the cells were held in buffer at 25° C. for 2½ hr. before plating on solid media.

Laboratory and field trials were conducted to determine the efficacy of the candidate rodenticide flupropadine against the house mouse (Mus musculus L.). In laboratory feeding tests, family groups of wild mice maintained in pens and conditioned to feeding on plain foods were offered flupropadine at either 0·10%, 0·15%, 0·18% or 0·20% in pinhead oatmeal bait. Overall mortalities in replicated 21-day treatments were 66/71 (93·0%), 71/79 (89·9%), 72/70 (94·7%) and 69/75 (92·0%) respectively.

In 17 field trials carried out against mice infesting farm buildings, flupropadine was used at 0·10%, 0·15% and 0·18% in oatmeal bait. Mean treatment success, estimated from live-capture and mortality data, was 88·6%, 96·2% and 96·6% respectively.

Flupropadine was found to be as near effective against mice as calciferol/warfarin and the second-generation anticoagulant rodenticides difenacoum, bromadiolone and brodifacoum. In further comparison with the anticoagulants, treatment with flupropadine bait achieved markedly quicker control.

1. No entamoebae, cysts, or other parasites were found.

2. Streptococci were present in the stools of all babies more than three weeks old, but only three haemolytic strains were isolated, which appears to be a lower proportion than occurs in adult stools.

3. Colon bacilli were present in the stools of all babies more than two weeks old, and haemolytic strains occurred in 12 per cent, of the specimens examined, that is in the same proportion as in adult stools.

4. Staphylococcus albus was much more commonly found than in adult stools and in greater abundance.

5. There was no bacteriological difference between the stools of the 78 breast-fed babies and those of the 13 artificially-fed infants, except that the haemolytic strains of B. coli occurred relatively more frequently in the case of the artificially-fed infants but owing to the small number of haemolytic strains isolated it would be unwise to lay too much stress on these figures.

In conclusion I wish to offer my sincere thanks to Dr Jewesbury, Physician to the Children's Department of St Thomas's Hospital, for supplying me with the necessary material and for information as to methods of feeding, and I am also greatly indebted to Professor Dudgeon and Dr Wordley for their constant help and advice.

The epidemiological target of lockdowns is to drive down the effective reproduction number (Rt) to less than 1. A key unknown is the duration that lockdowns need to be in place to achieve this and which lockdown measures are effective. Daily number of laboratory confirmed community coronavirus 2019 cases were extracted from regular reports from the Ministry of Health Singapore from 20 March 2020 to 4 May 2020. We generated daily Rt to estimate the time needed for these public health lockdown measures to control the spread of severe acute respiratory syndrome coronavirus 2 as demonstrated by Rt < 1. It took about 14 days of nationwide lockdown for the Rt trend to change and start falling. The upper limit of the 95% confidence interval for time to Rt < 1 was day 15 of lockdown. We have shown that it is possible to start ‘bending the Rt curve’ about 2 weeks after implementation of specific lockdown measures with strict compliance.

On visiting a farm near Grahamstown for the purpose of examining some cattle, our attention was drawn to a young dog which was sick. The owner stated that he had been unable to keep a dog on the place, that they all died.

In the last memoir of this series (Greenwood, Topley and Wilson, 1931) we discussed at some length the modifications of the course of herd sickness effected by immunisation of entrants to the herds. Briefly, these were our conclusions: efficient artificial immunisation (the criteria of efficiency being the usual standardising methods of a laboratory) confers a considerable temporary advantage upon mice entering an infected herd. The risk of death during the period of herd life when the rate of mortality is especially high is greatly reduced, so that when one has the case of a herd or group temporarily exposed to special risks, the value of the expedient is very great. But no method of artificial immunisation we have tried will render the immunised animals impervious to the risks which their membership of the herd entails.