An outbreak of staphylococcal food poisoning in Europe caused by contaminated lasagne was detected and monitored by both national and international surveillance systems. The common source was a pasta-producing factory in Italy and high levels of Staphylococcus aureus were detected in packets of dried lasagne distributed in Luxembourg, the UK, France and Italy. Forty-seven cases were reported in the UK. Outbreaks of staphylococcal food poisoning attributed to mishandling during the food processing stage are uncommon and pasta as the food vehicle is rare. Prompt recognition of the outbreak and rapid identification of the food vehicle enabled most of the consignment to be withdrawn from the market.
AKU ELZEIN, E. M. E. Recovery of bluetongue virus serogroup from sera collected for a serological survey from apparently healthy cattle, from the Sudan, 529 ADESIYUN, A. A. see ALABI, D. A. ALAHI, D. A. and ADESIYUN, A. A. Studies on microbial quality of filtered water in households of a university community in Nigeria, 239 ANDERSON, M. J. see NOKES, D. J. ANDERSON, R. M. and GRENFELL, B. T. Quantitative investigations of different vaccination policies for the control of congenital rubella syndrome (CRS) in the United Kingdom, 305 ANDERSON, R. M. see NOKES, D. J. ARITA, I., WICKETT, J. and FENNER, F. Impact of population density on immunization programmes, 459 ASHWORTH, L. A. E. see CONLAN, J. W. AURELI, P. see WOOLAWAY, M. C. AVILLEZ, MARIA FRANCISCA and PAIXAO, MARIA TERESA. Excretion of faecal viruses during the first year of life including attendance at a day nursery in Lisbon, Portugal, 545 AYLIFFE, G. A. J. see ROTTER, M. L.
An enzyme-linked immunosorbent assay (ELISA) for the rapid diagnosis of antibiotic-associated colitis (AAC) is presented. Commercially available antisera to Clostridium difficile toxins contain antibodies to other antigens found in non-toxigenic C. difficile and other bacteria. Removal of these unwanted antibodies by absorption increased the specificity of ELISA for detection of C. difficile toxins. Specimens tested included 40 faecal extracts positive for cytotoxicity from cases of AAC, 30 diarrhoeic and 30 well-formed stools negative for cytotoxicity and 50 culture filtrates of toxigenic and non-toxigenic C. difficile and other clostridial species. Use of absorbed sera reduced false-positive reactions observed with faecal specimens from 23 to 8%. About 90% of specimens that were positive by the tissue culture cytotoxicity test were positive by ELISA using the absorbed sera. The relative merits of ELISA and other methods for the rapid diagnosis of AAC are discussed.
Summary Influenza surveillance in the UK between the years 1982 and 1985 has demonstrated the regular winter appearance of influenza A virus of both H1N1 and H3N2 subtypes and influenza B. Their antigenic diversity is described and correlated with the national statistics for morbidity and mortality for influenza. One unexpected finding has been that despite the wide circulation of influenza viruses there has been a continuation of winters without significant increases in influenza deaths or morbidity. A previous report of influenza surveillance (Pereira & Chakraverty, 1982) noted an already unusual series of three consecutive winters with this pattern. This report records a further 4 years bringing a total of seven successive winters without evidence of epidemics of severe disease associated with influenza viruses, as indicated by the national UK statistics.
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In developing countries tuberculous meningitis is a difficult infection to differentiate from other central nervous system (CNS) infections. This paper presents the history, physical findings, laboratory data, and clinical course of 100 patients who were admitted to a special ward and had CSF cultures positive for Mycobacterium tuberculosis. Fifty-four patients were comatose when admitted and 76 had meningeal signs. Mean admission CSF values were WBC 531, glucose 23 mg/dl, and protein 166 mg/dl. Only two CSF AFB smears were positive. Sixty-one percent of the chest X-rays taken were consistent with pulmonary tuberculous and 39% were normal. Twenty-four patients died within the first week after admission, before the clinical diagnosis was made and anti-tuberculous therapy could be started. Fifty-three of 76 patients given antituberculous therapy died. Neurologic sequelae developed in 48% of the survivors. The high mortality and morbidity rates in this patient-group were due to the severity of illness on admission and the predominance of children (54%).
Application of a skin lotion to the body after showering greatly reduced the number of bacteria and skin scales dispersed from 10 men and 10 women. This effect lasted for at least 4 h when surgical clothing was worn. The use of a skin lotion to reduce bacterial dispersal could provide a simple and inexpensive alternative to an ultraclean air system or uncomfortable operating clothing during surgery requiring these procedures.
Young adult mice were inoculated intravenously with strains JB or Peter C of Mycoplasma pulmonis. A few were inoculated intranasally with strain JB. This strain but not Peter C was isolated for 50 days or more from the urines of more than half of the mice. Those of strains TO, C3H and CBA, but not CFLP, were susceptible. Recovery of mycoplasmas was intermittent and sometimes the numbers isolated varied within individual mice and between mice of a particular strain, ranging from 5 X 10(1) to greater than or equal to 5 X 10(7) colour-changing units/ml. Fifty serial passes of M. pulmonis, strain JB, in mycoplasmal medium resulted in attenuation, the organisms after inoculation of TO mice not being recovered from the urine and excretion not being stimulated by treating the mice with progesterone. At autopsy, the organisms of early passage were usually but not invariably isolated from the kidneys of mice that had been urinary excretors. About half of the latter had no renal histopathological changes. The others had usually minimal renal perivascular lymphocytic infiltrates but occasionally more widespread inflammatory changes. The findings may have relevance to the spread of mycoplasmal infection within mouse colonies and suggest that an association between such infection and nephritis in other species, including man, should be sought more closely.
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SummaryIn the Netherlands, case histories of 160 patients aged more than 1 month, with meningitis due to bacteria other thanNeisseria meningitidis, Haemophilus influenzaeandStreptococcus pneumoniaewere reviewed in order to look for associations between the bacteriological data and the course of disease.The incidence of such cases was about 0·8/100000/year.Escherichia coliandListeria monocytogeneseach accounted for about 15% of the cases. The case-fatality rate was 18·8% (Gram-negative bacteria, 25%; Gram-positives, 15%) and sequelae occurred in 13·3% of the surviving patients (14 and 13% Gram-negative and Gram-positive, respectively). Hearing loss was the most prevalent sequela (50%). Predisposing factors were present in 70% of patients (69 and 71% respectively), especially in meningitis due to enteric Gram-negative bacteria (except for salmonella) and due to staphylococci.Surveillance is important because the incidence of meningitis due to these micro-organisms is likely to increase and because the problems in antibiotic treatment have not yet been solved.
SUMMARY A total of 571 swine sera collected at an abattoir in the city of Obihiro, Hokkaido during the period February–November 1984 were tested for antibody against human (H1N1) influenza virus strains. A high prevalence of antibody was observed for only 3 months from April to June in that year, in 81/180 sera (45·0%) to A/USSR/92/77 strain and in 50/180 sera (27·8%) to a current epidemic strain (A/Hokkaido/1/84). Some cross-reactions were observed between the A/USSR/92/77 and A/Hokkaido/1/84 antibodies ( r = 0·75). Only minor relationships were noted between the A/New Jersey/8/76 (swine type H1N1) and A/USSR/92/77 ( r = 0·35) or A/Hokkaido/1/84 ( r = 0·51) antibodies. Absorption of sera positive for antibody to the A/Hokkaido/1/84 strain with the homologous virus strain removed all detectable antibodies, while the absorption of the sera with the A/New Jersey/8/76 strain produced incomplete absorption in one half of the sera tested. These resultsstrongly suggest that the swine became infected with a human H1N1 virus as piglets during an epidemic of influenza which occurred in the human population during January and February 1984.
SUMMARY The carriage of Staphylococcus aureus was studied in a group of 28 men living in a totally isolated environment for a year. Initially, nasal, axillary and perineal swabs were taken at weekly intervals, but from week 24 throat swabs were taken from known nasal carriers. Several attempts were made during the study to eradicate S. aureus . Eight subjects consistently carried their own phage type throughout the study, despite the application of antibacterial agents. In three subjects strains were isolated late in the study of a phage type which had either not been isolated before in this study, or had not been found for a prolonged period. Nine of the 12 nasal carriers also yielded S. aureus from the throat. It is apparent that following attempted eradication, S. aureus may seem to disappear, only to reappear some time later; ‘eradication’ in this case would be an erroneous appellation.
SUMMARY The brucellin skin test and the lymphocyte transformation test were compared in heifers infected with virulent Brucella abortus strain 544, heifers vaccinated against brucellosis and unexposed cattle. Results of the in vitro lymphocyte transformation test were consistently positive for all 9 Brucella-infected heifers while the skin test was consistently positive for 6 of the 9 heifers. In 7 heifers repeatedly vaccinated with B. abortus strain-19 vaccine the in vitro test classified 3 animals as positive whereas the skin test identified all the animals as infected during most of the experimental period. Four heifers injected with a single dose of B. abortus strain 19 were consistently negative to the lymphocyte transformation test while the skin test classified all the animals as infected during most of the experimental period. The skin test gave strong reactions indicative of Brucella infection in heifers vaccinated with ‘Duphavac’ and ‘Abortox’ vaccines whereas the lymphocyte transformation test was consistently negative with these vaccines. The two tests were negative in unexposed cattle. It was concluded that the in vitro test correlated better with Brucella isolation than the in vivo test did and that the lack of agreement between the results of the two tests is likely to be due to the different antigens used in the assays.
SUMMARYIn a prospective survey carried out over 9 months in 1984 in the Department of Bacteriology, Belfast City Hospital, Campylobacter jejuni was isolated from 24 out of 1200 faecal specimens (2%) from patients with acute diarrhoea. This isolation rate is much lower than that from other parts of mainland Britain which report an isolation rate of between 8 and 15%. It is difficult to explain this large discrepancy but the limited availability of unpasteurized milk and the generally worse summer here (fewer barbecues, picnics) may be some reasons to explain this low incidence in N. Ireland.
A 1-year prospective study of nosocomial bacteraemia was performed at Hvidovre Hospital with special reference to frequency, focus of infection and prognosis. All patients were examined clinically in order to confirm the bacteraemia. In total, 98 hospital-acquired bacteraemias were observed, giving an incidence rate of 0.28%. Bacteraemia due to Escherichia coli, Staphylococcus aureus and Staphylococcus epidermidis predominated. The overall mortality was 38%; 65% of the patients with S. aureus bacteraemia died, 25% due to the bacteraemia. The most common types of infection were urinary tract infections and intravenous catheter infections. Fifty-five of the bacteraemias were caused by foreign bodies, mostly urinary catheters and intravenous catheters, and in 14 cases the focus was unknown. The patient population was severely ill patients. We conclude that nosocomial bacteraemia occurs specially in severely ill patients often preceded by indwelling urinary or intravenous catheters. The patients seldom die due to the bacteraemia, but they die with concomitant bacteraemia.
SUMMARY A total of 6593 serum samples from birds, received for diagnostic testing or surveys between 1974 and 1983, were titrated by direct complement fixation (CF) test against Chlamydia psittaci antigen. The percentage of positive reactions found was variable for domestic poultry, ranging from 1·5 in chickens to 22·2 in geese, and was highest in pigeons Columba livia (47·3) and collared doves Streptopelia decaocto (51·4). A moderate incidence was found for game birds (29·0), wild ducks (23·3) and imported birds of the order Psittaciformes (15·9). The highest titres were found in pigeons, collared doves and psittacines, confirming that infection is both frequent and active in these birds in Britain. Results of isolation of chlamydia from similar sources will be reported subsequently.
SUMMARYVirus of the bluetongue (BT) serogroup was recovered from 11% of cattle sera collected from apparently healthy animals in Khartoum Province for the sole purpose of screening for BT antibodies. Since these sera did not contain BT antibodies, the donor cattle could have been scored as BT free in the serological survey.Virus was initially isolated in chicken embryos inoculated intravascularly, and was further adapted to Vero cell cultures. Isolates were identified as belonging to the BT serogroup using the agar gel immunodiffusion (AGID) and complement fixation (CF) tests.The results indicated that cattle in the Sudan could harbour BT virus without showing symptoms of the disease. Such an observation necessitates further work to clarify the role of cattle in the epidemiology of BT in the Sudan.
SUMMARYThe eradication of smallpox was achieved by surveillance and containment vaccination after the failure of mass immunization campaigns. The reasons for this failure are considered in this paper. Comparison of population densities in the Indian subcontinent and Africa show that in highly populated areas even an 80% vaccine coverage will still leave a density of susceptibles high enough to maintain the disease, a finding with important implications for other vaccine campaigns.
Three outbreaks of influenza caused by influenza A H1N1 occurred in a boys' boarding school in 1978, 1979 and 1983. The serological response to infection with variants of the H1N1 virus was studied by radial haemolysis and haemagglutination inhibition after primary infection and reinfection. The persistence of this antibody was also studied. Infection in 1978 resulted in the production of persistent antibody to both the haemagglutinin and neuraminidase of the homotypic strain. Antibody which cross-reacted with later variants of the virus was less frequently produced, the peak response was delayed and such antibody persisted less well. Infection in 1979 resulted in a similar response to that observed in 1978 after primary infection. Reinfection resulted in a broad response in all cases. In 1983 all infected boys produced antibody which reacted with the homotypic strain but only approximately one-third of primary infections produced antibody which reacted with the A/USSR/92/77 strain. The neuraminidase of the A/USSR strain failed to detect one third of the primary infections. Reinfection again resulted in a broad response.
