The standard six-dose intramuscular (i.m.) rabies post-exposure vaccine regimen using a new purified chick embryo cell (PCEC) vaccine was compared with two economical multisite intradermal (i.d.) PCEC regimens, a multisite i.m. PCEC schedule and a subcutaneous regimen using a suckling mouse brain (SMB) rabies vaccine manufactured in Thailand. The neutralizing antibody results for the four-site and eight-site i.d. and the standard i.m. PCEC regimens were similar over 3 months. A three-site i.m. PCEC regimen had no advantage. The SMB vaccine gave the lowest antibody levels. Human rabies immune globulin therapy significantly increased the GMT of all groups on day 7, unlike equine antirabies serum (EARS). Both antisera suppressed antibody responses to PCEC on days 14 and 28. Three generalized reactions probably related to EARS were the only serious side effects. An eight-site i.d. PCEC vaccine regimen proved as immunogenic as the routine i.m. schedule and, if implemented as post-exposure prophylaxis, would be the cheapest widely available tissue culture vaccine regimen. The protective efficiency should now be tested in patients bitten by rabid animals.

This paper describes a simple and rapid microcapsule agglutination (MCA) test. The results obtained by this new test have been compared with those obtained by the microtitre MCA and the microscopic agglutination (MA) test. The procedures required for the new test are easier and can be performed more rapidly than those necessary for the microtitre MCA test. Furthermore, the new test is more sensitive than the MA test in the early stages of leptospirosis.

This new test appears satisfactory as a screening test for the early diagnosis of leptospirosis.

The fungal skin flora of a sample of 205 elderly persons in Alexandria, drawn by cluster sampling probability technique, was investigated. Pathogenic yeasts were isolated from 18·6% and 10·3% of skin and nails respectively. Candida albicans (16·1% and 7·3%) was prominent. A low prevalence of dermatophytes grown on agar (2·4% from skin and 2·9% from nails) was observed. In contrast, saprophytic filamentous fungi comprised 45·4 and 50·7% of skin and nails samples respectively. This study showed no statistically significant effect of sociodemographic variables (sex, marital status, crowding index, and income per capita) on the skin flora. There was no statistical significant difference between elderly diabetics and non-diabetics as regards fungal skin flora.

A retrospective epidemiological study of 22 observations of invasive pulmonary aspergillosis, of which 18 were fatal, occurring over a period of 30 months, implicated certain building sites within the hospital. The building works were responsible for the diffusion into the atmosphere of fungal spores from normally closed reservoirs, notably false ceilings, fibrous thermal and/or acoustic insulation materials and roller-blind casings. The results of our study permit us to suggest that protective measures should be set up or that immunodepressed patients are evacuated when such works are to be carried out in an in-patient establishment.

Eighty prostitutes wore tested by solid-phase radioimmunoassay for serum markers of hepatitis B virus (HBV). Of 8 (10%) with hepatitis B surface antigen (HBsAg), 6 (75%) also had hepatitis Be antigen (HBeAg). Antibodies to HBsAg (anti-HBs) and to hepatitis B core antigen (anti-HBc) were found in 52 (65%). Antibodies to HBeAg (anti-HBe) were positive in 32 (40%). Anti-HBc alone was found in 5 (6%) and anti-HBs alone in 2 (2%). Sixty-seven (84%) were positive for at least one HBV marker and 13 (16%) were still susceptible to infection. Hepatitis B markers were more prevalent in prostitutes than in the normal Spanish population. Age, a history of sexually transmitted diseases (STD), drug abuse and promiscuity are factors which were highly related to hepatitis B markers. We concluded that screening prostitutes for the presence of markers and vaccinating those who are negative would be worth while.

Between 1976 and 1986, 258 incidents of suspected scombrotoxic fish poisoning were reported in Britain. Histamine analysis was carried out on 240 fish samples from these incidents, and 101 were found to contain > 5 mg histamine/100 g fish. The symptoms most consistently reported were rash, diarrhoea, flushing and headache. In recent years there has been a decrease in the number of confirmed scombrotoxic outbreaks and a trend towards more sporadic incidents. Of fish samples with > 20 mg histamine/100 g, 94% were from incidents in which scombrotoxic symptoms were characteristic, but where fish had 5–20 mg/100g only 38% of incidents were clinically distinctive. Guidelines are presented based on the interpretation of quantitative histamine analysis of fish samples from scombrotoxic poisoning incidents.

In one locality in Italy where the incidence of psittacosis has increased rapidly since 1980, a hospital-based study and a seroepidemiological survey were carried out in order to define the clinical and epidemiological features of psittacosis in that area.

Registers of the Virology Unit of the University of Ancona, Italy, were reviewed and all hospitalized patients with a serological diagnosis of psittacosis were identified. A total of 76 cases were found and studied. A presumptive bird source was identified in 80% of 62 patients, on whom a detailed investigation had been possible. Poultry represented the most frequent probable source of infection. Clinically, the predominant pattern of illness was a moderately severe lower respiratory tract infection, with chest X-rays showing pulmonary shadowings in 68 patients (89%).

In the seroepidemiological study, 51 out of 143 subjects were exposed to birds (35·7%), but only 7 out of 90 urban adult blood donors (7·3%) were positive for chlamydial antibodies using the microimmunofluorescence test.

Strains of Candida albicans can be differentiated by the morphological features of streak colonies developed on malt agar. A morphotyping system is proposed, where numerical codes are assigned primarily on the basis of the nature and extent of marginal fringing and the surface topography of the streak colony. The system allows ready differentiation to be made of morphotypcs, requires no specialized equipment or expertise and provides a simple and reproducible means for epidemiological studies of candida and candidosis.

Monthly bacteriological water testing of traditional water sources (ponds, rivers, unprotected springs and traditional wells) used by five villages in northeastern Imo State, Nigeria, was conducted during the period January 1983 to August 1985. The membrane-filtration technique was used to detect faecal coliforms (FC) and faecal streptococci (FS). Evidence of faecal pollution was seen throughout the year for all water sources. During the study period, the monthly geometric mean counts per 100 ml of water (all sources combined) ranged from 760 to 17877 for FC and from 678 to 17394 for FS. The peak period of faecal pollution occurred during the transition between the dry and wet seasons and in the early wet season. During this peak pollution season (February–May), the geometric mean counts were 2·5–7·2 times higher than in the remaining part of the year for all source types except rivers, with ponds being the most heavily polluted. Preliminary findings on the sensitivity and specificity, in this tropical environment, of the standard membrane-filtration technique for enumerating FC are presented. The implications of the findings of this study for the environmental control of waterborne and hygiene-related diseases are discussed.

Fifty-eight bottles of natural mineral water, taken from the point of sale, were bacteriologically examined. No coliforms or Aeromonas sp. were isolated from any sample. High total bacterial counts were found particularly in the still waters. Most of the organisms isolated in the total counts were Gram-negative rods, but Gram-positive organisms were also isolated. Gram-positive cocci were further identified, some of which were known human commensals suggesting contamination of the waters prior to bottling.

During a 3-year period Branhamella catarrhalis was isolated in significant numbers from 239 (1·3%) of 19488 specimens of sputum sent for routine microbiological examination at a 700-bed general hospital. The majority of patients (83%) were over 60 years of age and 65% were male. There was a distinet seasonal variation in isolations with a peak incidence during the winter and early spring, a pattern not found with other pathogens. Susceptibility to amoxycillin decreased by approximately 50% over the 3 years, corresponding to an increased incidence of beta-lactamase-producing strains. There were minimal changes in susceptibility to other antimicrobial agents. Underlying pulmonary disease was the major factor predisposing to B. catarrhalis infection, and 71% of patients were smokers or ex-smokers.

Between April 1983 and December 1985, 576 strains of Neisseria gonorrhoeae were isolated in our laboratory from patients attending Sexually Transmitted Diseases (STD) clinics. Of these, 61 (10·6%) were penicillinase-producing. Studies on these strains by plasmid analysis, auxotyping and serogrouping showed that the predominant type strains harboured the Asian resistance plasmid, were prototrophic, and were of serogroup WII/WIII. About half of the strains, both of the African and Asian type, harboured the transfer plasmid. Strains of serogroup WII/WIII were less sensitive to tetracycline and cefoxitin than serogroup WI strains.

We report the isolation and characterization of ten strains showing an increase in the minimal inhibitory concentrations to penicillin (MICs > 0·1 μg/ml), and describe the epidemiological, clinical and microbiological features.

The susceptibility of 3432 meningococcal strains isolated from patients in the recent epidemic wave (1978–86) in Spain, to several antimicrobial agents used in the treatment and chemoprophylaxis of meningococcal infection has been tested. Most were resistant to sulphadiazine but sensitive to other antibiotics.

The possible existence of a new pattern of behaviour of meningococcal to penicillin is discussed.