By the existing law for Great Britain it is enacted that “in every room in any factory or workshop sufficient means of ventilation shall be provided, and sufficient ventilation shall be maintained.” Not very much has been hitherto ascertained, however, as to the degree of purity actually existing in the air of factories and workshops generally, or as to what standard of purity may reasonably be expected considering the difficulties met with. A Departmental Committee was recently appointed by the Home Secretary to investigate and report upon the subject. The members of the Committee were Mr E. H. Osborn, Engineering Adviser to the Chief Inspector of Factories, and myself, with Mr C. R. Pendock, one of H. M. Inspectors of Factories, as Secretary. The Committee has just reported on the subject of general ventilation1, but reserving for a future Report the vitiation of air by dust, fumes, &c. from special manufacturing processes.

Denmark hosted four games during the 2020 UEFA European championships (EC2020). After declining positive SARS-CoV-2 test rates in Denmark, a rise occurred during and after the tournament, concomitant with the replacement of the dominant Alpha lineage (B.1.1.7) by the Delta lineage (B.1.617.2), increasing vaccination rates and cessation of several restrictions. A cohort study including 33 227 cases was conducted from 30 May to 25 July 2021, 14 days before and after the EC2020. Included was a nested cohort with event information from big-screen events and matches at the Danish national stadium, Parken (DNSP) in Copenhagen, held from 12 June to 28 June 2021. Information from whole-genome sequencing, contact tracing and Danish registries was collected. Case–case connections were used to establish transmission trees. Cases infected on match days were compared to cases not infected on match days as a reference. The crude incidence rate ratio (IRR) of transmissions was 1.55, corresponding to 584 (1.76%) cases attributable to EC2020 celebrations. The IRR adjusted for covariates was lower (IRR 1.41) but still significant, and also pointed to a reduced number of transmissions from fully vaccinated cases (IRR 0.59). These data support the hypothesis that the EC2020 celebrations contributed to the rise of cases in Denmark in the early summer of 2021.

Of all British colonies New Zealand is the one that most closely resembles Great Britain in size, in situation, and in climate. And the inhabitants of the two countries are of practically the same race. The vital statistics of New Zealand are therefore eminently suitable for comparison with those of Great Britain. In the present paper comparison has been restricted to the birth-rates and death-rates, and in this limited survey several points of interest present themselves.

The global outbreak of coronavirus disease 2019 (COVID-19) is greatly threatening the public health in the world. We reconstructed global transmissions and potential demographic expansions of severe acute respiratory syndrome coronavirus 2 based on genomic information. We found that intercontinental transmissions were rare in January and early February but drastically increased since late February. After world-wide implements of travel restrictions, the transmission frequencies decreased to a low level in April. We identified a total of 88 potential demographic expansions over the world based on the star-radiative networks and 75 of them were found in Europe and North America. The expansion numbers peaked in March and quickly dropped since April. These findings are highly concordant with epidemic reports and modelling results and highlight the significance of quarantine validity on the global spread of COVID-19. Our analyses indicate that the travel restrictions and social distancing measures are effective in containing the spread of COVID-19.

To understand the characteristics and influencing factors related to cluster infections in Jiangsu Province, China, we investigated case reports to explore transmission dynamics and influencing factors of scales of cluster infection. The effectiveness of interventions was assessed by changes in the time-dependent reproductive number (Rt). From 25th January to 29th February, Jiangsu Province reported a total of 134 clusters involving 617 cases. Household clusters accounted for 79.85% of the total. The time interval from onset to report of index cases was 8 days, which was longer than that of secondary cases (4 days) (χ2 = 22.763, P < 0.001) and had a relationship with the number of secondary cases (the correlation coefficient (r) = 0.193, P = 0.040). The average interval from onset to report was different between family cluster cases (4 days) and community cluster cases (7 days) (χ2 = 28.072, P < 0.001). The average time interval from onset to isolation of patients with secondary infection (5 days) was longer than that of patients without secondary infection (3 days) (F = 9.761, P = 0.002). Asymptomatic patients and non-familial clusters had impacts on the size of the clusters. The average reduction in the Rt value in family clusters (26.00%, 0.26 ± 0.22) was lower than that in other clusters (37.00%, 0.37 ± 0.26) (F = 4.400, P = 0.039). Early detection of asymptomatic patients and early reports of non-family clusters can effectively weaken cluster infections.

The want of success which has so persistently attended the efforts of most bacteriologists to isolate the B. typhosus from water supplies suspected to have caused enteric fever, suggested a study of the varieties of B. coli which are associated with the B. typhosus in the dejecta of patients suffering from enteric fever. It was hoped that the organisms in question might show cultural characteristics or reactions to specific sera, which would enable them to be distinguished from the varieties of B. coli present in the dejecta of healthy people; so that even if the B. typhosus were not detected, the presence of these special organisms might afford reasonable grounds for the belief that the water under examination had been fouled by the specific dejecta of cases of enteric fever. With this object in view 150 organisms have been examined; of these 80 were isolated from the stools of cases of enteric fever and 70 from the stools of healthy men. The enteric fever cases were five in number, one being a severe relapse, and the other four severe cases which terminated fatally. The stools were obtained during the third and fourth weeks of the disease and also, in the fatal cases, from the intestines after death had occurred.

1. Plasma heated to 56° C. for 4 min. is not clotted by staphylococcal coagulase or thrombin, but when heated in the presence of glycine remains sensitive to the action of these clotting agents.

2. With glycine, plasma no longer clots after heating at 62° C.

The aim of the study was to develop a procedure to remove spatial trends in irregularly spaced data, with trends partly due to regional differences. Median polish is often used on regularly spaced (lattice) data where column and row medians are removed. For irregularly spaced data a low-resolution map of the spatial locations is often used where data locations are assigned to the nearest lattice node followed by median polish. In this study regional polish was developed. The inverse distance weighted median was calculated based on observations from locations in the neighbourhood of the actual observation. The regional polish residual is obtained as the difference between the observed value and the weighted median. The regional polish procedure was applied to Salmonella Dublin data showing strong regional trends. Estimation of the range of influence between cattle herds with positive S. Dublin herd status was considerably improved with a stable parameter estimate and reduced standard error.

1. Meningococcal cerebrospinal meningitis in the Sudan does not materially differ in its progress and end result from the disease as found in Europe.

2. There is no racial peculiarity in response to infection or to chemotherapy.

3. There is no sex or age peculiarity in incidence. Both sexes and all ages respond to chemotherapy.

4. Sulphapyridine is superior to sulphanilamide in the shortening of invalidism and in the prevention of complications.

5. Oral administration of sulphapyridine is in the majority of cases as effective as intramuscular.

6. Dosage is related to the clinical stage of the disease, and to its duration before treatment. An initial dose of 2·5 g. sulphapyridine for adults, and 1·0—1·5 g. for children is prescribed for the serious case, with subsequent gradation of treatment to provide a maintenance dose.

7. Treatment, if it is going to give a good result, will produce a response within 24 hr. It need not be prolonged beyond 7 days. The third, fourth and seventh days of treatment are critical.

A survey of 13 linen chutes in eight hospitals was carried out to assess the amount of bacterial contamination on the inner walls of these chutes. It was shown that the average bacterial count in these chutes was low by general hospital standards (19·7 bacterial colonies per Rodac plate). This concentration was eight times less than the average concentration found on the floor surface at each linen disposal and collection point (153 bacterial colonies per Rodac plate).

Three chutes sampled during the survey were periodically cleaned but appeared to derive only very limited benefits from the cleaning method they used.

Tests carried out on three linen chutes showed that the bacterial surface contamination of a sterilized chute could normally reach a maximum concentration in a period of between 4 and 24 hr.

It is concluded that so long as good engineering practices are used in the construction of linen chutes the bacterial contamination on their inner surface should not contribute to the problem of hospital cross infection. For this reason, and because of the impracticability of sterilizing linen chutes at very short intervals of time, it is considered that cleaning of chutes would serve no practical purpose.

Thanks must be recorded to the authorities of all those hospitals who gave their permission for us to study their linen disposal chutes and afforded us every assistance.

We should also like to thank Mr W. Carson, Leader of the Building Services Research Unit, for his help and encouragement.

The work reported was a part of an investigation into the design of linen disposal chutes sponsored by the Western Regional Hospital Board, Scotland.

Gye and Kettle (1922), from a study of the effects of subcutaneous inoculation of silica alone, tubercle bacilli alone and tubercle bacilli with silica, arrived at the conclusion that there is, after the introduction of tubercle bacilli with silica, “a much greater local reaction than with an infection of tubercle bacilli alone and, further, that general dissemination is earlier and more active.” As a result, “a small dose of bacilli becomes a dose of considerable magnitude and, inasmuch as an important factor in determining an infectious process is the number of organisms introduced, a simple explanation is forthcoming of the effect of silica upon such tuberculous lesions as we have described.”

A foodborne outbreak related to milk cartons served in school lunches occurred in June 2021, which involved more than 1,800 cases from 25 schools. The major symptoms were abdominal pain, diarrhoea, vomiting, and fever. Although major foodborne toxins and pathogens were not detected, a specific Escherichia coli strain, serotype OUT (OgGp9):H18, was predominantly isolated from milk samples related to the outbreak and most patients tested. The strains from milk and patient stool samples were identified as the same clone by core genome multilocus sequence typing and single-nucleotide polymorphism analysis. The strain was detected in milk samples served for two days related to the foodborne outbreak at a rate of 69.6% and levels of less than ten most probable number/100 mL but not on days unrelated to the outbreak. The acid tolerance of the strain for survival in the stomach was similar to that of enterohaemorrhagic E. coli O157:H7, and the same inserts in the chu gene cluster in the acid fitness island were genetically revealed. The pathogenicity of the strain was not clear; however, it was indicated that the causative pathogen was atypical diarrhoeagenic E. coli OUT (OgGp9):H18.

The final choice of a suitable dilution of a given toxin will be made, partly from the difficult comparison with other known toxins, but mainly from the results of clinical observations in patients in the early stage of scarlet fever and in convalescents.

It is difficult to titrate scarlet fever toxin with accuracy. It will probably be found that by careful choice of subject and by several readings of the reactions at different intervals after the injection, one can differentiate between toxins of values x and 2x.

Seroprevalence estimation using cross-sectional serosurveys can be challenging due to inadequate or unknown biological cut-off limits of detection. In recent years, diagnostic assay cut-offs, fixed assay cut-offs and more flexible approaches as mixture modelling have been proposed to classify biological quantitative measurements into a positive or negative status. Our objective was to estimate the prevalence of anti-HCV antibodies among drug users (DU) in France in 2011 using a biological test performed on dried blood spots (DBS) collected during a cross-sectional serosurvey. However, in 2011, we did not have a cut-off value for DBS. We could not use the values for serum or plasma, knowing that the DBS value was not necessarily the same. Accordingly, we used a method which consisted of applying a two-component mixture model with age-dependent mixing proportions using penalised splines. The component densities were assumed to be log-normally distributed and were estimated in a Bayesian framework. Anti-HCV prevalence among DU was estimated at 43.3% in France and increased with age. Our method allowed us to provide estimates of age-dependent prevalence using DBS without having a specified biological cut-off value.

This study assessed accuracy of (a) recording Vibrio vulnificus infection on death certificates and (b) International Classification of Disease (ICD)-9 codes for V. vulnificus. Patients with microbiologically confirmed V. vulnificus infection were identified as part of co-ordinated surveillance in four USA Gulf Coast states between 1989 and 1993. Of 60 deaths, 51 death certificates were reviewed and V. vulnificus was recorded as the immediate cause of death on 11 (22%). There was no ICD-9 code for V. vulnificus infection, thus no patients had an ICD-9 code indicating V. vulnificus infection. Of 23 certificates where V. vulnificus was recorded on the death certificate, only 5 (22%) were coded for Gram-negative, septicaemia. This study highlights the importance of teaching physicians how to provide epidemiologically meaningful data on death certificates and the need for accurate ICD mortality codes.

COVID-19 serosurvey provides a better estimation of people who have developed antibody against the infection. But limited information on such serosurveys in rural areas poses many hurdles to understand the epidemiology of the virus and to implement proper control strategies. This study was carried out in the rural catchment area of Model Rural Health Research Unit in Odisha, India during March–April 2021, the initial phase of COVID vaccination. A total of 60 village clusters from four study blocks were identified using probability proportionate to size sampling. From each cluster, 60 households and one eligible participant from each household (60 per cluster) were selected for the collection of blood sample and socio-demographic data. The presence of SARS-CoV-2 antibody was tested using the Elecsys Anti-SARS-CoV-2 immunoassay. The overall seroprevalence after adjusting for test performance was 54.21% with an infection to case ratio of 96.89 along with 4.25% partial and 6.79% full immunisation coverage. Highest seroprevalence was observed in the age group of 19–44 years and females had both higher seroprevalence as well as vaccine coverage. People of other backward caste also had higher seropositivity than other caste categories. The study emphasises on continuing surveillance for COVID-19 cases and prioritizing COVID-19 vaccination for susceptible groups for better disease management.

In 1901 Miss Anderson (H.M. Principal Lady Inspector of Factories) and Dr Legge (H.M. Medical Inspector Factories) were instructed by H.M. Chief Inspector of Factories to investigate the conditions of labour in the Tinning of metals and metal articles with a view to the preparation of regulations for the conduct of this industry. Difficulties having arisen in assigning a cause for the plumbism undoubtedly existing among workers, and preparation of regulations appearing impossible without some knowledge of the source of illness, the writer was instructed to assist them experimentally in determining the causes.