In a previous paper (Twort, Baker, Finn & Powell, 1940) we were able to show that the bactericidal properties of phenolic -aerosols were correlated with their physical characters, though our experiments were not sufficiently numerous or varied to enable us to estimate separately the effect of the different factors operative. Here we propose to describe similar tests which we have carried out on the germicidal smokes used by Twort & Baker (1940, 1941), namely, those produced by smouldering cardboard impregnated with potassium nitrate, and by dropping incense and Peru balsam on to hot metal surfaces. There were also used mixtures obtained by distilling Peru balsam under reduced pressure: fraction I, b. p. 109–110° C; fraction II, b. p. 120–138° C; fraction III, bp 148–155° C, at 3 mm. Hg, and the residue from this operation.

(1) A number of Dysentery bacilli of the mannite-fermenting type have been isolated from an English asylum.

(2) These bacilli may be divided into two sub-groups, (a) those that do, and (b) those that do not (1) ferment sorbite and (2) form indol in peptone beef broth in six days.

(3) Several attempts to infect a monkey with sorbite-fermenting strains were not successful.

(4) No Dysentery bacilli were found in an examination of a considerable number of flies infesting the surroundings of chronic and acute cases of bacillary dysentery.

My thanks are due to Dr H. de R. Morgan for kindly co-operation in part of this work, to Dr J. C. G. Ledingham for his valuable advice and assistance at all times, and to Dr W. F. Menzies for supplying the material for examination.

Hepatitis E virus infection is a major cause of acute hepatitis, typically self-limiting but occasionally leading to liver failure. Understanding disease progression factors could inform prevention strategies. This study aimed to analyse the characteristics of a large cohort of hospitalised hepatitis E patients in Tianjin, China, and explore factors influencing their progression to liver failure. A total of 1279 hospitalised patients with hepatitis E were included in this cross-sectional study in Tianjin, China. Student's t-test and the Mann–Whitney U-test were used for comparisons. Multiple logistic regression analysis was used to explore the association. Among these 1279 patients, 107 (8.4%) developed liver failure. Patients with diabetes mellitus (DM) (95% confidence interval [CI] 1.150–2.887, p = 0.011), liver cirrhosis (95% [CI] 2.229–7.224, p < 0.001), and hepatitis B (95% [CI] 1.159–4.512, p = 0.017) were more likely to progress to liver failure. Hepatitis E patients with comorbid DM, liver cirrhosis, or hepatitis B virus co-infection have higher risks of developing liver failure. Hepatitis E vaccination may be recommended for these vulnerable patients to curb disease severity.

The incidence of reported infections of non-typhoid Salmonella is affected by biases inherent to passive laboratory surveillance, whereas analysis of blood sera may provide a less biased alternative to estimate the force of Salmonella transmission in humans. We developed a mathematical model that enabled a back-calculation of the annual seroincidence of Salmonella based on measurements of specific antibodies. The aim of the present study was to determine the seroincidence in two convenience samples from 2012 (Danish blood donors, n = 500, and pregnant women, n = 637) and a community-based sample of healthy individuals from 2006 to 2007 (n = 1780). The lowest antibody levels were measured in the samples from the community cohort and the highest in pregnant women. The annual Salmonella seroincidences were 319 infections/1000 pregnant women [90% credibility interval (CrI) 210–441], 182/1000 in blood donors (90% CrI 85–298) and 77/1000 in the community cohort (90% CrI 45–114). Although the differences between study populations decreased when accounting for different age distributions the estimates depend on the study population. It is important to be aware of this issue and define a certain population under surveillance in order to obtain consistent results in an application of serological measures for public health purposes.

The impact of hepatitis B virus (HBV) infection on clinical outcomes of coronavirus disease 2019 (COVID-19) remains unclear. The aim of this study is to explore this impact. For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Cochrane library, China National Knowledge Infrastructure (CKNI), China Science and Technology Journal Database (VIP), and Wan Fang database for articles between 1 January 2020 and 1 February 2023. We used the Newcastle–Ottawa Quality Assessment to evaluate the study’s quality. A random-effects meta-analysis was performed utilising the rates of severe/critical illness and death in COVID-19 patients with and without HBV infection. Eighteen studies with a total of 40,502 participants met the inclusion criteria. The meta-analysis showed that compared to those without HBV infection, COVID-19 patients with HBV were at increased risk of mortality (OR = 1.65, I2 = 58%, and 95% CI 1.08–2.53) and severity (OR = 1.90, I2 = 44%, and 95% CI 1.62–2.24). The region and gender may influence the outcomes of COVID-19 patients with HBV infection, but it requires more global data to confirm. In conclusion, HBV infection is significantly linked to an increased risk of severity and mortality in COVID-19.

The evaporation rates of small particles in aerosols of the following substances have been measured: 4−n−hexyl-1:3-resorcinol, 1, 1, 1-trichloro-2, 2−di (p−chlorphenyl)ethane (‘DDT’), 1, 1, 1−trichloro-2-p−chlorphenyl-2-o−chlorphenyl-ethane (‘op′-DDT’), γ-hexachloro-cyclo-hexane (‘BHC’, ‘Lindane’, ‘Gammexane’), ‘Dieldrin’ and azobenzene.

The slit ultra-microscope method was used; a consideration of the experimental conditions leads to the conclusion that the results are of reliable quantitative significance.

In a cohort of 272 treatment-naive individuals with chronic hepatitis C infection acquired on a known date who were enrolled in the UK HCV National Register, a progressive improvement in response to treatment was found with the evolution of antiviral therapies from 20% (25/122) for interferon monotherapy to 63% (55/88) for pegylated interferon+ribavirin therapy. Multivariable analysis results showed increasing age to be associated with poorer response to therapy [odds ratio (OR) 0·84, 95% confidence interval (CI) 0·72–0·99, P=0·03] whereas time since infection was not associated with response (OR 0·93, 95% CI 0·44–1·98, P=0·85). Other factors significantly associated with a positive response were non-type 1 genotype (P<0·0001) and combination therapies (P<0·0001). During the first two decades of chronic HCV infection, treatment at a younger age was found to be more influential in achieving a sustained viral response than treating earlier in the course of infection.

The following investigation was undertaken during November and December 1911 with the object of determining the source of infection in a series of cases of anthrax which occurred in the same yarn mill. The investigation resulted in proving that anthrax spores were present in a variety of East India wool and in the yarn manufactured therefrom.

Nine isolates from pigs persistently infected with a recent Italian isolate of swine vesicular disease (SVD) virus, ITL/9/93, were collected sequentially over 121 days and were characterized antigenically and biochemically. There was an accumulation of amino acid (aa) substitutions in the capsid proteins throughout the carrier state that could be correlated with alterations in antigenicity in virus isolates collected late stage in infection. The aa substitutions detected mainly occurred in VP1 and antigenic changes were detected in late isolates both at antigenic site 1, resulting in loss of binding of Mab 4GO7, and at a closely located site which has not yet been named, recognized by Mab C29. In further experiments groups of pigs were exposed to a range of SVD viruses, but no virus was isolated beyond 16 days post infection (dpi) nor viral RNA detected beyond 42 dpi. Attempts to transfer infection to sentinel pigs introduced some time after initial infection of the original pigs were largely unsuccessful. The carrier state was established in only one out of five experimental infections of pigs with SVD virus and can therefore be considered a rare sequel to infection with SVD virus and is of limited significance in the epidemiology of the disease.

In 1956–58 septic lesions in men of the R.A.F. accounted for about 3% of all admissions to sick-quarters or hospital and about 5% of admissions excluding respiratory disease; 1% of all men in the service were admitted with sepsis each year. Incidence fell with age, particularly up to the age of 25 years. The rates for women were about 50% higher.

Recruits experienced more than twice as much sepsis as trained men and boy apprentices. Officers had only half the admission rate of other ranks. These contrasts could have been explained by differences in age. There was no evidence of seasonal variation in the incidence of sepsis, but in recruits and boy apprentices epidemics of sepsis unrelated to season occurred.

I am indebted to Dr J. C. McDonald and Professor R. E. O. Williams for helpful criticism, to Professor P. Armitage for statistical advice and to the Director-General, Royal Air Force Medical Services, for permission to publish the results.

An outbreak of streptococcal throat infection which took place in a preparatory school for boys (some of whom were choristers) over three terms from November 1983 to June 1984 is described. Typing of the organism revealed that four successive outbreaks, each due to a different type, had occurred. Thirty-nine per cent of the boys were affected, the incidence of infection being higher among boarders than day boys. Infection seemed to spread via the forms, dormitories and choir. Recurrent attacks occurred in 32% of infected boys. The complication rate was 8%. Treatment with penicillin was always effective but did not prevent reinfection. Suggestions for the management of an outbreak of sore throat in a school are given.

Two phenotypes of human influenza A(H1N1) virus are currently circulating in Japan. One (group 1) agglutinates both chicken and goose red blood cells (CRBC and GRBC), the other (group 2) agglutinates GRBC but not CRBC. In the 1995/6 season, group 2 viruses accounted for 70% of the H1N1 viruses isolated in MDCK cells. The 1995/6 viruses were located on two branches of the genetic tree. One branch contained both group 1 and group 2 viruses and the other branch contained only group 2 viruses. Group 2 viruses had aspartic acid at residue 225 in the haemagglutinin (HA) protein, the key amino acid residue for group 2 phenotype. The HA protein of group 1 viruses had a change from aspartic acid to asparagine at residue 225 and the expressed HA protein of these viruses adsorbed CRBC. Serial passage of group 2 viruses in MDCK cells or embryonated chicken eggs caused these viruses to gain the ability to agglutinate CRBC. MDCK-adapted viruses had the same amino acid sequences of HA polypeptide as the original ones, but egg-adapted viruses had changed amino acid sequences. The expressed HA protein from one egg-adapted virus that originally belonged to group 2 adsorbed CRBC.

This paper gives an abbreviated account of part of a research programme which followed the Aberdeen typhoid outbreak of 1964. Chloramphenicol, the main antibiotic used in treatment, was shown to have a minimum inhibitory concentration (MIC) of between 5 and 2.5 μg./ml. for the S. typhi phage type 34 of the outbreak. The MIC for methacycline was between 2.5 and 2 μg./ml. Whereas the deep and shallow broth techniques used gave similar results with these antibiotics, the MIC for ampicillin, and also cephaloridine, was less in the deep than in the shallow broths.

Serum assays in patients given ampicillin or cephaloridine yielded abnormally high concentrations of both antibiotics when S. typhi phage type 34 was the test organism whereas, with other test organisms, the concentrations were within expectation. These abnormally high values fell within expected values when the sera under investigation had first been heated to 56° C. for 30 min. before assay against the S. typhi of the outbreak.

The findings with ampicillin suggested that dosages given were satisfactory. With cephaloridine the concentrations found in patients' sera seemed to show that twice daily doses of 0.5 g. fell short of adequacy.

The clinical and molecular epidemiology of glycopeptide-resistant Enterococcus faecium was investigated during an outbreak on a renal unit. Forty-nine patients were colonized or infected during a 15-month period. Sites of colonization included faeces, urine, intravenous (IV) catheter tips and wound swabs. Ten patients had infections, which included five bacteraemias and three episodes of peritonitis. Pulsed-field gel electrophoresis of 43 patient isolates of glycopeptide-resistant E. faecium identified seven strains during the first 7 months of the outbreak. Three of these strains affected five or more patients. One strain accounted for 17/43 isolates. Isolates that were possibly related to another renal unit strain were cultured from patients at two other Manchester hospitals. These isolates were epidemiologically-related, and may represent a single Manchester epidemic strain. Of five patients who had multiple isolates of glycopeptide-resistant E. faecium, three had isolates representing a single strain and two were colonized or infected by more than one strain.

Mice given an intraperitoneal injection of 0.5 mg. Corynebacterium parvum (dry weight) before vaccination with heat-killed (HK) or acetone-killed (AK) Salmonella typhimurium vaccine and later challenged intraperitoneally with S. typhimurium strain 1566, showed a statistically significant increase in mortality when compared with mice that had received only C. parvum but no vaccine. They also showed a higher mortality rate than mice receiving only HK or AK vaccine or mice that had received no vaccine before challenge. Prior administration of C. parvum to mice that are vaccinated with HK or AK vaccine appears to make them more susceptible to an intraperitoneal challenge with S. typhimurium. This was more apparent with HK vaccine than with AK vaccine.

1. Opinions upon the relationship between anti-rabies immunity and the rabicidal power of rabies-immune serum have been stated.

2. The rabicidal antibody content of the sera of rabbits immunised with etherised virus, living fixed virus and carbolised virus has been determined while at its maximum and compared with the degree of immunity acquired after each method of treatment.

Ankylostomiasis was first discovered in men working in Cornish mines in October, 1902 (this Journal, Vol. III. p. 95), though there had been many cases of illness clearly referable to this cause for some eight years previously. The number of men who were too ill to do their ordinary work was greater about two years before the cause of “Dolcoath anaemia” was identified. These men had either stopped at home or had been employed on the surface instead of underground: in this way they had avoided further infections, and in many cases had progressed towards a spontaneous cure. At the time therefore of our first enquiry the number of sick men was less than it had been. Anaemic miners were, however, still very numerous and, without anything like an exhaustive search among the 750 underground hands at Dolcoath mine, we found 14 men with less than 50 p.c. haemoglobin and 19 more with less than 75 p.c. The general pallor prevalent among the men on looking at a shift as a whole was very striking, and complaints of shortness of breath on climbing the ladders were frequent. The disease, in short, was at that time a meterial hindrance in carrying on the work of the mine.

1. The appearance and disappearance of typhoid bacilli in the faeces in these four cases bore no relation to changes in the diet nor to the physical state of the stools, but the later they appeared the shorter was the duration of their appearance.

On the disappearance of typhoid bacilli from the stools the intestinal flora tended to become more simple.

2. B. coli was the only organism invariably present at every examination.

3. Streptococci were very much more abundant in the earlier stages of the disease, when milk formed the greater part of the diet, than in the later stages.

4. In two cases where boils occurred on the body the causative organism had previously been isolated in large numbers from the faeces.

5. With stools slightly alkaline to litmus the flora in these cases was relatively simple and fermentative in type. There is no apparent advantage, therefore, in giving a high carbohydrate diet except in cases of marked alkalinity and putrefaction.