The sensitivity of the haemagglutination, complement-fixation and indirect fluorescent antibody tests in the diagnosis of primary and recurrent hydatid disease is presented. In the first, diagnostic titres were obtained in 90%, 80% and 96% of 50 patients with hepatic and 64%, 60% and 68% of 25 patients with pulmonary cysts, respectively. In the postoperative study of 62 patients, elevated titres of HA, CF and IFA antibodies in 30 led to the presumptive diagnosis of recurrent disease, confirmed later by radiological and surgical follow-ups. In the 32 others the proportion of positive reactors was 29%, 6% and 28% in HA, CF and IFA tests. These patients had no detectable cysts. This indicates that in post-operative patients a negative CF test may be of a better prognostic value in indicating absence of cysts than the HA and IFA tests.

A surveillance programme is described which is intended to assess the effects of influenza virus infections on communities at large by collating influenza virus isolations and consultations for respiratory infections from general practices with new claims for sickness benefit and deaths from all causes. Particular importance is attached to relating virus isolations to symptomatic respiratory disease seen in practices of known age and sex structure.

Between 1969 and 1974, 1467 packets (3309 samples) of pork sausages and sausage meat produced by two large and two medium sized manufacturers and several local butchers were examined for the presence of salmonellas. Of these, 435 packets (786 samples) were found to contain salmonellas, but there was a wide variation in the isolation rates according to the producer. The salmonella incidence in samples from several small and two medium sized producers was low (0–11%) while the results from the two large producers investigated showed a striking difference, the rate of salmonella contamination in the product of one was low (about 2%) and in that of the other consistently high (40–60%).

A comparison of liquid enrichment media, incubation temperatures and selective agar media was also carried out to determine the most efficient combination for the isolation of salmonellas from minced meat products. The results showed that (a) incubation of enrichment cultures at 43° C. yielded a consistently greater number of salmonella isolations than at 37° C., regardless of plating medium, (b) tetrathionate broth A (Rolfe) was superior to selenite broth as an enrichment medium at both 37 and 43° C. and (c) brilliant green agar gave better results than deoxycholate citrate sucrose agar and bismuth sulphite agar as a selective medium.

The distribution in the environment of Naegleria fowleri, the causal agent of primary amoebic meningoencephalitis has been investigated in this study. N. fowleri was isolated only from a thermally polluted canal. These amoeboflagellates were not isolated from another thermally polluted canal in the neighbourhood indicating that, apart from high temperature, other factors are involved in the selective proliferation of N. fowleri. This species was absent in all other samples originating from two canals, a stream, two lakes, several reservoirs and slow sandfilters of a water supply service and also a water distribution network. Many other amoebae able to grow at 42° C. were found in different places. Most of the N. fowleri strains isolated were not virulent for mice, although they showed all the characteristics of the pathogenic strains.

The ability of a new, surface-antigen-adsorbed influenza virus vaccine to induce serum antibody in hamsters, and to protect these hamsters against subsequent homologous virus challenge, is reported. In addition, similar studies in hamsters have also been carried out using the surface antigen material prior to adsorption to the aluminium hydroxide carrier. The new, adsorbed vaccine is at least as effective as inactivated saline influenza virus vaccine in inducing serum antibody and protection in hamsters; the unadsorbed surface antigen material, however, did not confer protection to hamsters challenged subsequently with homologous virus.

Endemic infection in male surgical wards has been studied during three periods. There was some infection due to gram-negative bacilli, though Staphylococcus aureus remained as the single most important pathogen even in the absence of epidemic spread. Beta haemolytic streptococci were isolated in large numbers from the lesions of four patients with deep wound infection. Changes introduced in the pattern of post-operative care reduced sepsis due to Staph. aureus, reduced the severity of wound infection and apparently decreased the need for antibiotic therapy. Patients who became infected were retained in hospital longer than those who escaped clinically apparent infection.

One hundred and fifty-six infections or episodes of infection associated with Pseudomonas aeruginosa in six hospitals over 14 months were investigated. Pyocine typing and serotyping suggested that 145 distinct episodes had occurred, caused by 78 different strains. During this period 15 distinct strains were isolated from the environment at one of the hospitals; 12 of these were apparently un-associated with infection in the same ward during the period, and 4 were of types not encountered in infective processes at any hospital. There appeared to be a rather higher proportion of unclassifiable pyocine inhibition patterns among the environmental strains; in general these strains also produced smaller amounts of haemolysin. If failure to produce haemolysin in vitro is correlated with lack of virulence in vivo, this may partially explain the sporadic nature of hospital infection with Ps. aeruginosa, despite the prevalence of strains of this species in the environment.

Measurements have been made of the extent of air exchange between patient rooms in a fully air-conditioned hospital using a tracer-gas method.

When the rooms were ventilated at about six air changes per hour, had an excess airflow through the doorway of about 0.1 m.3/sec. and the temperature difference between rooms and corridor was less than 0.5° C., concentrations of the tracer in rooms close to that in which it was being liberated were 1000-fold less than that in the source room. This ratio fell to about 200-fold in the absence of any excess airflow through the doorways. Considerable dilution took place along the corridors so that the concentration fell by around 10-fold for every 10 m. of corridor.

A group of 23 volunteers were each inoculated with 600 CCA of a new form of influenza virus A/England/42/72 vaccine; this vaccine consisted of purified haemagglutinin and neuraminidase antigens adsorbed to alhydrogel. No significant reactions to the vaccine were reported. Twenty-two volunteers produced increased titres of serum HI antibody, and all showed increased titres of NI antibody after immunization. Thus, for volunteers with no pre-immunization serum HI antibody, the geometric mean titre of serum antibody increased from 1/5 to 1/196 after immunization. Ten volunteers developed local neutralizing antibody after immunization; this antibody response was detected most frequently in volunteers who showed the greater serum antibody response to immunization, and in nasal washings with the higher concentrations of protein and IgA. Ten weeks after immunization, the vaccinees and a group of matched controls were inoculated intranasally with attenuated A/England/42/72 virus. Evidence of infection with the challenge virus was found in 14 of the control subjects and in one of the vaccinees. The results indicate that the surface-antigen-adsorbed vaccine induced high titres of serum antibody, and gave significant protection against challenge infection.

Experiments were conducted simultaneously with gas and particle tracers to determine the relative loss of particles between source and recipient sites in the hospital ward units. The magnitude of this loss could be accounted for by the assumption of sedimentation from well-mixed air masses during the time required for movement between source and recipient sites. As a consequence of this loss the degree of isolation between patient rooms for airborne particles was between 4 and 25 times greater than that for gaseous contamination, which reflects the actual transport of air between the rooms.

The design and construction of portable spinning-disk particle generators suitable for field studies is discussed.

Substantial transfer of R factors occurred in vivo, under certain conditions, in the rumen of adult sheep in the absence of any antibiotic treatment. A starvation period of 24–48 hr. was required to produce the conditions necessary, when even quite low inocula (ca. 103 cells) of donor and recipient E. coli could grow within the rumen and reach a population density sufficient for transfer to take place. The results indicate that under the same conditions R factors may be transferred between organisms in the lower intestinal tract also. Without the starvation period, the inoculation of even massive numbers (1010 cells) of the same organisms resulted in almost no detectable transfer.

Some of the experimental animals on which a starvation period was imposed became carriers of either the inoculated recipient E. coli, or of R factor bearing coliforms, and these formed 1–10% of the total coliform population of the faeces for at least 6 weeks.

The recovery of virulence by means of reversion of a live streptomycin-dependent (Sm D) Salmonella typhimurium vaccine was studied in CD–I Swiss mice. Initially, a one–step Sm D mutant was obtained from a virulent streptomycin-sensitive (Sm S) S. typhimurium strain. Afterwards, two pools of streptomycin-independent (Sm I) revertants were prepared from the Sm D strain. The virulence of the Sm D strain and of the Sm I revertants was tested intraperitoneally. In the virulence testing the original suspension of the Sm I revertants, as well as their 1st and 10th passages on plain medium, medium + 50 μg. streptomycin/ml, and medium + 1000 μg. streptomycin/ml, were used. The results show that the Sm D mutant was avirulent, its avirulence being due to an intrinsic, genetic quality. The Sm I revertants, compared to the original Sm S strain, also displayed a lack of virulence. However, afterwards, the Sm I revertants behaved quite differently, according to their subsequent passages. Indeed, there was an increase in virulence after passages on plain medium, whereas after similar passages on medium containing the drug, the virulence not only failed to increase, but disappeared almost completely. Moreover, the passages on medium containing 1000 μg. streptomycin/ml, induced a return to the status of drug–dependence. The danger of recovery of virulence by means of revertants is evaluated.

Mud samples collected during 1974 from a large proportion of the lakes and waterways of London were examined for Clostridium botulinum. Of 69 such sites, 50 (72·5%) contained at least one type of the organism. Of the 50 positive sites, 31, 12, 1 and 10 contained, respectively, types B, C, D and E. Most of the demonstrations of type B required trypsinization of culture filtrates. An examination of 7 lakes in Edinburgh, made for the purpose of comparison, showed that 4 contained type B and one type C.

An analysis of the results gave quantitative information on the value of (1) resampling apparently negative lakes, (2) the use of both heated and unheated culture inocula, and (3) trypsinization of culture filtrates.

A mathematical model is described for the transport of gaseous or airborne particulate material between rooms along ventilated passageways.

Experimental observations in three hospitals lead to a value of about 0.06m.2/sec. for the effective diffusion constant in air without any systematic directional flow. The ‘constant’ appears to increase if there is any directional flow along the passage, reaching about 0.12 m.2/sec. at a flow velocity of 0.04 m./sec.

Together with previously published methods the present formulae make it possible to calculate the expected average amounts of gaseous or particulate material that will be transported from room to room in ventilated buildings in which the ventilation and exchange airflows can be calculated.

The actual amounts transported in occupied buildings, however, vary greatly from time to time.

The present experimental model offered the opportunity to study particular aspects concerning the avirulence stability of live streptomycin-dependent (Sm D) Salmonella vaccines, under conditions resembling human enteric fever. The results seem to indicate that, in practice, the risk of reversion to a virulent form during oral antityphoid vaccination with Sm D strains remains slight even after the interruption of concomitant streptomycin administration.

The epizootic range of Rift Valley fever in Kenya is defined from the results of virus isolations during epizootics, and from an extensive serological survey of cattle which were exposed during an epizootic. A study of the sera from a wide range of wild bovidae sampled immediately after the epizootic, showed that they did not act as reservoir or amplifying hosts for RVF.

Virus isolation attempts from a variety of rodents proved negative. Rift Valley fever did not persist between epizootics by producing symptomless abortions in cattle in areas within its epizootic range. A sentinel herd sampled annually after an epizootic in 1968 revealed not one single seroconversion from 1969 to 1974. Certain forest and forest edge situations were postulated as enzootic for Rift Valley fever, and a small percentage of seroconversions were detected in cattle in these areas, born four years after the last epizootic. This has been the only evidence for the persistence of the virus in Kenya since 1968, and may be a part of the interepizootic maintenance cycle for Rift Valley fever in Kenya, which otherwise remains unknown.

Groups of patients with lepromatous and tuberculoid leprosy and hospital staff from six leprosaria in East Africa and ‘non-contact’ groups of villagers or staff from general hospitals have been skin tested with 10 reagents. These were prepared by ultrasonic disintegration from M. tuberculosis, M. duvalii, M. chelonei and 7 other species identified in the Ugandan environment. Comparisons were made of the percentages of positive reactors in each study group for each reagent. The ‘specific’ defect of lepromatous patients was found to apply to a variable extent to six of the species tested, but not to M. tuberculosis, M. avium or M. ‘A*’. The defect applied most noticeably to M. nonchromogenicum and M. vaccae, suggesting that they are more closely related to M. leprae than are the other species tested. The reagent Chelonin produced unexpected and anomalous results in the lepromatous group. It is suggested that this was due to an unusually slow clearing of Arthus' reaction.

A virus was isolated from pock-like vesicular eruptioiis of camels in Northern Kenya. This virus was shown to be a pox virus with many characteristics of members of the Orthopox group. It appears to be identical with camelpox strains from Iran and has similar properties to certain East African variola strains.

Twenty-eight pigs died in an outbreak of streptococcal meningitis in an East Anglian herd. Most were 10–14 weeks old. The outbreak lasted from January to April and was finally controlled by antibiotic therapy. A similar number of losses had occurred in the previous year though no diagnosis had then been made.

The causal agent appeared to be a haemolytic streptococcus belonging to group D and provisionally designated Streptococcus suis type 2. It is probably identical with de Moor's group R streptococcus which causes a similar disease in the Netherlands. It is serologically distinct from Streptococcus suis type 1 which causes meningitis in piglets. Type 2 infection in pigs appears to be widespread in England and Wales and to occur in animals up to the age of at least 14 weeks.

A comparison is drawn between Str. suis meningitis in pigs and group B streptococcal meningitis in human infants.

Ephemeral fever antibody was found in domestic cattle in Kenya across a wide range of ecological zones, from highland forests and grasslands to desert and semidesert thorn scrub. Antibody was found in several species of game animals, notably waterbuck and buffalo, where over 50% of the samples showed antibody to EF. Evidence was obtained to show that the virus had been cycling in these wild ruminant populations between epizootics in domestic cattle.