This systematic review and meta-analysis aims to estimate the prevalence of coronavirus disease 2019 (COVID-19) vaccine hesitancy in Turkey, which can aid future health policies and strategies. A comprehensive search was conducted on various databases using keywords related to COVID-19 vaccine hesitancy in Turkey. Quality assessment was performed using Joanna Briggs Institute (JBI) checklist for prevalence studies. Data extraction was conducted. The random effect model (DerSimonian and Laird method) was used in pooled prevalence data analysis (95% confidence interval [CI]). A total of 1,072 articles were identified. After removing duplicates and excluding articles, 61 articles remained for bias assessment. Among these, 19 articles with low risk of bias were included in the review and meta-analysis. Total population included in the analysis was 15,164, vaccine hesitancy was 30.5% (95% Cl: 24.3–36.8%). Prevalence of the vaccine hesitancy was found to be 39.8% (95% Cl: 31.4–48.2%) in studies conducted before the initiation of vaccination, while in studies conducted after the commencement of vaccination, hesitancy was 20.4% (95% Cl: 12.9–28%). We suggest conducting high-quality studies in different populations to understand the level of vaccine hesitancy, as many of the previous studies have mainly focused on healthcare workers and students, and rest were community-based studies, which have generally shown high bias. Also, we suggest that early vaccination can reduce vaccine hesitancy.

Experiments in the quality control of water samples are being conducted in the Public Health Laboratory Service and the water industry in the United Kingdom. The number of distributions which have been made is 7 and 92 laboratories are now participating. The methods used for preparing and distributing samples are described. Some participating laboratories use the multiple tube method and some use membrane filtration to assess the presence of coliforms and Escherichia coli. The results are, therefore, a mixture of estimated numbers and direct colony counts.

A collection of Salmonella Typhimurium isolates obtained from sporadic salmonellosis cases in humans from Lower Saxony, Germany between June 2008 and May 2010 was used to perform an exploratory risk-factor analysis on antimicrobial resistance (AMR) using comprehensive host information on sociodemographic attributes, medical history, food habits and animal contact. Multivariate resistance profiles of minimum inhibitory concentrations for 13 antimicrobial agents were analysed using a non-parametric approach with multifactorial models adjusted for phage types. Statistically significant associations were observed for consumption of antimicrobial agents, region type and three factors on egg-purchasing behaviour, indicating that besides antimicrobial use the proximity to other community members, health consciousness and other lifestyle-related attributes may play a role in the dissemination of resistances. Furthermore, a statistically significant increase in AMR from the first study year to the second year was observed.

Prototype strains of the influenza A (H3N2) virus can be arranged on a gradient showing the degree of the antigenic drift which the haemagglutinins of the strains have undergone. The demonstration of fine antigenic differences is based on an antiserum absorption test which allows a detailed antigenic analysis of strains. The gradient provides information on variation in strains occurring in different geographical areas and its use may be helpful in differentiating between introduced strains and locally developing variants.

In continuation of previous work involving accentuated effects of perspiration on chrome upper leather, the present paper records observations of such effects in more complicated conditions.

Thus, effects were studied at varying temperatures and pH of tans, buffered tans, buffered perspiration, buffered perspiration coupled with tans, buffering material itself and soap solutions.

Particular reference is made to the influence of basicity on the stability of the chrome complex against perspiration in such buffered chemical systems. Brown grain leathers are considered as well as box and willow calf.

A method is evolved for minimizing spueing risks or the formation of Glauber's salts in the vamps of worn footwear, by appropriate treatment of the skins before cutting up into shoe upper components.

Finally, some foot-bath experiments and the dark, cracky grain of worn insoles are discussed from the general point of view of perspiratory action on footwear.

The writer acknowledges with thanks the assistance of Messrs L. P. Huggett, B.Sc., A.I.C., and W. H. F. Jackman, B.Sc., A.I.C., in the routine analytical work. His best thanks are also due to the Director and Council of the Research Association for permission to publish.

In 2013, the national surveillance case definition for West Nile virus (WNV) disease was revised to remove fever as a criterion for neuroinvasive disease and require at most subjective fever for non-neuroinvasive disease. The aims of this project were to determine how often afebrile WNV disease occurs and assess differences among patients with and without fever. We included cases with laboratory evidence of WNV disease reported from four states in 2014. We compared demographics, clinical symptoms and laboratory evidence for patients with and without fever and stratified the analysis by neuroinvasive and non-neuroinvasive presentations. Among 956 included patients, 39 (4%) had no fever; this proportion was similar among patients with and without neuroinvasive disease symptoms. For neuroinvasive and non-neuroinvasive patients, there were no differences in age, sex, or laboratory evidence between febrile and afebrile patients, but hospitalisations were more common among patients with fever (P < 0.01). The only significant difference in symptoms was for ataxia, which was more common in neuroinvasive patients without fever (P = 0.04). Only 5% of non-neuroinvasive patients did not meet the WNV case definition due to lack of fever. The evidence presented here supports the changes made to the national case definition in 2013.

The objective of this study was to assess the impact of a possible unmeasured confounding variable in a previously published association between the effects of household water supply and positive results for hepatitis A serology. This was estimated using a path of integration between two methods of sensitivity analysis, called Rosenbaum's method and Greenland's external adjustment. The association between household water supply and positive results for hepatitis A (outcome) serology was insensitive to confounding unless the odds ratio for the association between the confounder and the outcome was ⩾4. The integration of the two sensitivity analysis methods presented proved useful when assessing the effects of a potential unmeasured confounder.

Matching individuals reported to a sentinel surveillance scheme for hepatitis C between 2000 and 2005 to individuals with a hospital episode for hepatitis C-related liver disease in the same hospitals, we estimated that the number of cases of hepatitis C-related end-stage liver disease in these English hospitals was 42% (597/419) higher than Hospital Episode Statistics (HES) would indicate. Further, matching records of hepatitis C-related deaths in HES to death certificates, we estimated that, between 2000 and 2005, the true number of deaths from hepatitis C-related end-stage liver disease was between 185% (353/124) and 257% (378/106) higher than the number recorded in routine mortality statistics. We provide estimates of under-recording that can be used to modify existing models of disease burden due to hepatitis C and provide a simple approach to improve the monitoring of trends in severe hepatitis C-related morbidity over time.

We studied the spread of influenza in the community between 1993 and 2009 using primary-care surveillance data to investigate if the onset of influenza was age-related. Virus detections [A(H3N2), B, A(H1N1)] and clinical incidence of influenza-like illness (ILI) in 12·3 million person-years in the long-running Royal College of General Practitioners-linked clinical-virological surveillance programme in England & Wales were examined. The number of days between symptom onset and the all-age peak ILI incidence were compared by age group for each influenza type/subtype. We found that virus detection and ILI incidence increase, peak and decrease were in unison. The mean interval between symptom onset to peak ILI incidence in virus detections (all ages) was: A(H3N2) 20·5 [95% confidence interval (CI) 19·7–21·6] days; B, 18·8 (95% CI 15·8·0–21·7) days; and A(H1N1) 17·0 (95% CI 15·6–18·4) days. Differences by age group were examined using the Kruskal–Wallis test. For A(H3N2) and A(H1N1) viruses the interval was similar in each age group. For influenza B there were highly significant differences by age group (P = 0·0001). Clinical incidence rates of ILI reported in the 8 weeks preceding the period of influenza virus activity were used to estimate a baseline incidence and threshold value (upper 95% CI of estimate) which was used as a marker of epidemic progress. Differences between the age groups in the week in which the threshold was reached were small and not localized to any age group. In conclusion we found no evidence to suggest that influenza A(H3N2) and A(H1N1) occurs in the community in one age group before another. For influenza B, virus detection was earlier in children aged 5–14 years than in persons aged ⩾25 years.

Influenza activity was studied in the Rome population from 1956 to 1976 by analysis of mortality from respiratory causes and from all causes. During cold weather months, type A influenza virus was associated, as a rule, with epidemic excess deaths at two year intervals while type B virus was prevalent twice during epidemic excess mortality periods. Excess absenteeism from work and virus isolation data were also compared with epidemic excess mortality during four consecutive years. The evidence obtained indicated that influenza virus isolation alone does not represent a reliable index of epidemic influenza activity in this population. The proportion of deaths attributed to respiratory causes consistently increased in every epidemic, the most pronounced increases occurring during large epidemics. The break-down by age of deaths from respiratory causes in the course of two epidemic periods showed that the percentage distribution of deaths was essentially the same as in non-epidemic periods. This evidence indicates that the same factors influencing the age-related distribution of mortality from respiratory causes during non-epidemic periods, probably affect the fatal outcome of influenza during epidemics.

A cluster of 18 scarlet fever cases and large illness absenteeism (32%, 58/184) in a school prompted concern and further investigation. We conducted telephone interviews with parents to ascertain cases and better comprehend parents' views. We identified 19 cases, of which 13 reported scarlet fever diagnosis by a physician and only seven fulfilled the probable case definition. We concluded that the outbreak was far smaller than suspected and found that communication and reporting could be improved. Accurate information and communication is essential in an outbreak; the school's concern could have been alleviated sooner and response measures better targeted.

We attempted to predict epidemics of influenza B, focusing on B/Victoria/2/87-like (V) and B/Yamagata/16/88-like (Y) lineages, in Yamagata, Japan. We collected 9624 nasopharyngeal swabs for virus isolation from patients with respiratory infections between 1996 and 2003 and 237 sera for seroepidemiological analysis by haemagglutination–inhibition test in 2001. We isolated 424 V-lineage and 246 Y-lineage viruses during the study period. Three herald viruses in the 2000–2001 season enabled us to predict a V-lineage epidemic in the following season. However, another V-lineage epidemic occurred in the 2002–2003 season, although we caught four herald Y-lineage viruses, whose antigenic drift was suggested by seroepidemiological study, at the end of the previous season. Since the epidemiology of the two influenza B lineages remains unclear, a careful watch should be kept on these lineages in order to provide effective public-health strategies against future epidemics.

Experiments were performed which show that virulent strains of Salmonella paratyphi A contain an additional antigen which has all the properties of a Vi antigen.

The anti-Vi immune serum combined in suitable proportions with an anti-0 immune serum exerted maximal bactericidal effect on virulent strains.

Laboratory tests in adult outpatients with longer lasting coughs to identify a potential causal pathogen are rarely performed, and there is no gold standard for these diagnostic tests. While the diagnostic validity of serological tests for pertussis is well established their potential contribution for diagnosing adenovirus and influenza virus A and B infections is unclear. A sentinel study into the population-based incidence of longer lasting coughs in adults was done in Rostock (former East Germany) and Krefeld (former West Germany). A total of 971 outpatients who consulted general practitioners or internists were included. Inclusion criteria were coughing for ⩾1 week and no chronic respiratory diseases. We evaluated the performance of polymerase chain reaction (PCR) as well as IgG and IgA serology, applying a latent class model for diagnosing infections with adenovirus, B. pertussis, and influenza virus A and B. The adult outpatients first sought medical attention when they had been coughing for a median of 3 weeks. In this situation, direct detection of infectious agents by PCR had a low sensitivity. Modelling showed that additional serological tests equally improved sensitivity and specificity for diagnosis for adenovirus, B. pertussis and influenza virus A and B infections. The combination of serology and PCR may improve the overall performance of diagnostic tests for B. pertussis and also for adenovirus, and influenza virus A and B infections.

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.

The occupational risk of acquiring minor respiratory infections for paediatric student nurses was estimated by performing serological examinations with influenza A, B, C, parainfluenza, mumps, respiratory syncytial virus, adenovirus and Mycoplasma pneumoniae at 6-month intervals over a period of 4 years in paediatric student nurses at two schools of nursing and students at one school of medical technology, litre increases against all tested agents occurred 1·86 times more often in the student nurses than in the medical technology students, the most frequent agents in both groups being influenza A and B. No difference in the relative distribution of the agents could be verified in the two occupational groups. Data on the protective value of pre-infectious antibody levels for influenza A, B, and coronavirus OC43 and on the importance of the spread of single agents among classmates are presented.

The virulence of strains of the three types of poliovirus have been examined by the subcutaneous injection of monkeys. The strains used were the Sabin attenuated Types 1, 2 and 3, Cox attenuated Types 1, 2 and 3, the Brunenders Type 1 partially attenuated strain, MEF-1, Type 2 and Saukett, Type 3.

The results obtained indicated that the subcutaneous route of injection offers a promising method for comparing and characterizing strains of poliovirus.

Some deep wells in the chalk are liable to contamination. The pollution may gain access to the wells by means of fissures or “swallow-holes” in the water-bearing stratum, and, through these defects, micro-organisms and organic matter may find their way into the water supply of a town from points many miles distant. The risk of chalk waters becoming contaminated is daily growing more probable: quick and cheap transit is responsible for an exodus from the town to the country which serves as a gathering ground for water supplies; and the chalk uplands and countryside, which formerly were sparsely populated, are in many places becoming covered with collections of houses and small villages, whose only method of sewage disposal is by means of cesspools into the chalk on which the houses are built. If the chalk is sound and unfissured, this method of sewage disposal is not harmful to distant water supplies; but, given a fissure or swallow-hole, the intestinal micro-organisms and organic matter from some outlying village, may make the water from a deep well some miles away unfit to drink. I know at present of five important wells in the chalk in different parts of England, which are, in this manner, liable to intermittent and undoubted faecal contamination; but, in only two of these places are means taken to purify the water before it is distributed to the consumers. A typhoid carrier or a case of enteric fever might distribute bacilli to a distant town through some imperfection in the stratum, and the consequences, without doubt, would be very disastrous; yet probably there are many towns in the country which take the risk of such an epidemic.

Two published methods for the maximum likelihood estimation of a common relative potency from a series of parallel-line assays are shown to be equivalent.