The presence of antibodies in the body fluids of the offspring of immunised parents has long been studied and variously explained. In 1912, Famulener2 published a clear summary of the work upon the subject up to that date. Renewed interest in the problem has been aroused by the work of the Department of Animal Pathology of the Rockefeller Institute for Medical Research, where the transmission of immunity to the Bacillus abortus is being studied. It has been shown by Little and Orcutt3 that agglutinins for this bacillus are transferred exclusively by the colostrum, since a calf from which colostrum is withheld does not show this agglutinin in its serum, although a high titre of agglutinin may be demonstrable in both serum and colostrum of the dam. Later Orcutt and Howe4, using a method of separating the protein fractions of serum devised by the latter5, 6, showed that the appearance of agglutinins in the serum of a calf fed with colostrum of high agglutinin titre was closely related to the appearance of euglobulin, which is absent from the blood of the newly born calf. Further, Smith and Little7 showed that this absorption of agglutinin from the digestive tract also occurred when the calf was fed with serum rich in that antibody. The association of agglutinin with the globulin fraction of serum, and in particular with the euglobulin fraction, has been demonstrated by Orcutt and Howe4, who found that “the agglutinins are associated with the protein fractions which are precipitated up to and including 16·4 per cent. of sodium sulphate,” and that “a large proportion of the agglutinins is associated with the fraction which is precipitated by 14·2 per cent. of sodium sulphate, euglobulin.” Again, although a milk might show a high titre of agglutinin, with no corresponding increase in the proportion of its globulin, yet the agglutinin was removed from the milk by a concentration of sodium sulphate which removed the globulin fraction of the protein.

Tuberculosis (TB) in children is a critical public health issue. In Bohol, Philippines, we found a high tuberculin skin test (TST)-positive prevalence (weighted prevalence = 6.4%) among 5476 children (<15 years) from 184 villages, with geographically isolated communities having prevalence as high as 29%. Therefore, we conducted a geospatial and hot spot analysis to examine the association between villages with high TST-positive prevalence (⩾6.5%) and access to medical care (distance (in kilometres and minutes of travel time) to the municipal Rural Health Units (RHU)), access to healthcare resources (distance to Provincial Health Office (PHO)) and socioeconomic determinants of health. Hot spot analysis revealed significant clusters of TST-positive prevalence in villages farthest from the PHO. Based on univariate analysis, the following variables associated with high prevalence were included in the multivariate model: minutes of travel time to the PHO, distance to the PHO, island villages and total deprivation based on socioeconomic indicators. In the final model, only distance to PHO in minutes was significant (P = 0.005). When evaluated further, greater than 1-hour drive significantly increased risk for TST-positivity (P = 0.003). Distance to healthcare resources likely increases the risk of TB transmission within the community. Expanding TB control efforts to geographically isolated areas is critical.

Family feasting during the Spring Festival is a Chinese tradition. However, close contact during this period is likely to promote the spread of coronavirus disease 2019 (COVID-19). This study developed a dynamic infectious disease model in which the feast gatherings of families were considered the sole mode of transmission. The model simulates COVID-19 transmission via family feast gatherings through a social contact network. First, a kinship-based, virtual social contact network was constructed, with nodes representing families and connections representing kinships. Families in kinship with each other comprised of the largest globally coupled network, also known as a clique, in which a feast gathering was generated by randomly selecting two or more families willing to gather. The social contact network in the model comprised of 215 cliques formed among 608 families with 1517 family members. The modelling results indicated that when there is only one patient on day 0, the number of new infections will reach a peak on day 29, and almost all families and their members in the social contact network will be infected by day 60. This study demonstrated that COVID-19 can spread rapidly through continuous feast gatherings through social contact networks and that the disease will run rampant throughout the network.

Hand, foot and mouth disease (HFMD) is a common infection in the world, and its epidemics result in heavy disease burdens. Over the past decade, HFMD has been widespread among children in China, with Shanxi Province being a severely affected northern province. Located in the temperate monsoon climate, Shanxi has a GDP of over 2.5 trillion yuan. It is important to have a comprehensive understanding of the basic features of HFMD in those areas that have similar meteorological and economic backgrounds to northern China. We aimed to investigate epidemiological characteristics, identify spatial clusters and predict monthly incidence of HFMD. All reported HFMD cases were obtained from the Shanxi Center for Disease Control and Prevention. Overall HFMD incidence showed a significant downward trend from 2017 to 2020, increasing again in 2021. Children aged < 5 years were primarily affected, with a high incidence of HFMD in male patients (relative risk: 1.316). The distribution showed a seasonal trend, with major peaks in June and July and secondary peaks in October and November with the exception of 2020. Other enteroviruses were the predominant causative agents of HFMD in most years. Areas with large numbers of HFMD cases were primarily in central Shanxi, and spatial clusters in 2017 and 2018 showed a positive global spatial correlation. Local spatial autocorrelation analysis showed that hot spots and secondary hot spots were concentrated in Jinzhong and Yangquan in 2018. Based on monthly incidence from September 2021 to August 2022, the mean absolute error (MAE), mean absolute percentage error (MAPE), and root mean square error (RMSE) of the long short-term memory (LSTM) and seasonal autoregressive integrated moving average (SARIMA) models were 386.58 vs. 838.25, 2.25 vs. 3.08, and 461.96 vs. 963.13, respectively, indicating that the predictive accuracy of LSTM was better than that of SARIMA. The LSTM model may be useful in predicting monthly incidences of HFMD, which may provide early warnings of HFMD epidemics.

Four outbreaks of food-poisoning are described in which over 100 cases in all of gastro-enteritis occurred, one being fatal. In each outbreak the infecting bacteria were indistinguishable culturally and in serological behaviour from the “G” strain of B. suipestifer.

The reasons are given for following Andrewes and Neave and classifying these as B. suipestifer. (sub-group II).

In twenty-five consecutive cases in which nasopharyngeal cultures have been made from patients suffering from bacteriologically proved cerebro-spinal meningitis, meningococci have been obtained.

A striking similarity between the organisms from the two sites has been shown to exist for not only are they of the same agglutinable type but in the majority of instances individual peculiarities of agglutination have corresponded. The closeness of relation has been further demonstrated by the carbohydrate reaction in one case in which the unusual property of bleaching glucose litmus broth to a yellow colour was possessed by both organisms. Nevertheless, in a certain number of instances, though organisms of a different agglutinable type have not been isolated, as by other workers, there have been found certain minor variations of agglutination. That most if not all of these variations are due to alteration of the agglutinable capacity of one of the organisms seems probable, as in the six cases where most marked difference existed (Nos. 1, 3 and 24 of Type I and Nos. 15, 16 and 18 of Type II) the chances of the other alternative, namely that a second infection had happened in each case to be of the same agglutinable type, are remote.

In the twenty-five cases the proportion of the types present has been shown to agree with that found by other workers during the same period. Seven of the infections (28 per cent.) have been due to Type I and eighteen (72 per cent.) to Type II.

Ten of the cases have occurred in children under the age of two years, and the proportion of the two types among them has been approximately the same as among older patients.

The writer is indebted to the members of the staff of St Bartholomew's Hospital for permission to publish their cases, and gratefully acknowledges the encouragement and assistance of Professor Andrewes at whose instigation these investigations were conducted.

The use of the hypergeometric distribution in calculations of sample volumes for safety testing is criticized. Alternative interpretations of the concept of ‘infective ml. doses’ lead to slightly different solutions, the simplest of which, involving the exponential function, is recommended for general use.

About 25 years ago Dr J. S. Haldane, Dr A. E. Boycott and Capt. Damant, R.N., in the course of investigations for the British Admiralty, worked out a system of decompression for divers and compressed air workers. This system was adopted by the Admiralty, and by its use compressed air sickness has been practically eliminated entirely amongst naval divers. The system has become known as stage decompression, although in fact stages are not an essential feature of it, though a convenience in practical working. The system has been frequently and fully described. The latest explanation will be found in the last edition, 1935, revised by Haldane and Priestly, of Respiration, by J. S. Haldane (Clarendon Press). Its most essential feature is that the pressure is lowered quickly to approximately half the absolute pressure during decompression, and one of the most important assumptions for working out the decompression tables is that different parts of the body saturate and desaturate at different rates. Enquiries sent out by me during 1934 to the United States, the principal countries of Europe and to Japan indicate, so far as definite information has been received in reply, that stage decompression has been universally adopted for divers, but in no case has it been adopted for caisson and tunnel workers in countries where State regulations already existed, except in a modified form, and I conclude that the reason for this failure to adopt stage decompression is the existence of statutory regulations, either still in force, or only partly modified in accordance with new ideas.

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.

This paper presents a summary of the work on Plague carried out in the Bacteriological Section of the Kenya Medical Research Laboratory, during the period August, 1926, to December, 1928, in connection with the preparation of prophylactic plague vaccine. It is divisible under the following sections:

A. Preparation of a vaccine of Haffkine type at Nairobi.

B. Tests on rats of the immunising potency of the vaccine.

C. Notes on the application of plague vaccine for human prophylaxis:

I. Experience in Kenya.

II. Discussion of the relative values of agar-grown and Haffkine's plague vaccines.

D. Notes on bacteriology and serology of Bacillus pestis:

I. Growth in fluid cultures under various conditions, etc.

II. Agglutinating sera and absorption tests.

Experiments I–VIII.

I shows that under the conditions shown the plates were covered with innumerable colonies 7 feet above ground level to ground level. The beds and trestles were used to keep the hut always uniform.

II shows that 8 feet above ground, i.e. on top of the crossbeams, the same conditions obtain.

III, IV, V, and VI show that the same condition exists in the area between the beds or trestles. The beds make no difference, better or worse.

VII shows practically the same condition high up on the beam between the beds. The inverted plates naturally show less colonies, as the organisms mostly fall on to the plates.

VIII confirms the above.

There is only one conclusion to draw from these experiments, and that is that practically speaking there is no difference in the number of organisms on the ground floor and 8 feet above it, in the ordinary men’s sleeping huts, Barrack Design 230/14.

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.

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.

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.

The stability of the biological reagents used in routine immunological procedures is a matter of practical interest to the public health worker, and an attempt has been made in the following research to estimate the period during which the diluted toxin used in the Schick test for the estimation of susceptibility to diphtheria remains potent. In the early days of Schick testing, although Leete (1920) reported that a diluted toxin retained its potency for as long as 5 weeks, it has hitherto been considered inadvisable to use a toxin at a longer interval than 48 hours after it had been diluted to its proper strength. Glenny, Waddington and Pope (1928) and O'Brien, Okell and Parish (1928) have introduced a new diluent consisting of a solution of a combination of crystal borax 57, boric acid 84 and sodium chloride 99 parts. A 1·5 per cent, solution of this mixture is now used as a diluent and has the effect of sustaining the potency of the diluted toxin over a greater period of time. In our work over 400 persons have been tested with toxins made up according to this formula, a comparison being made in each individual between the reactions elicited by an aged toxin, stored for varying periods at room temperature or in the cold room, with those produced by a fresh toxin. Enough toxin was made up at the beginning of the experiment to last over a considerable period of time, samples being sent to us by post periodically together with batches of freshly diluted toxin. The testing of reagents was carried out immediately on receipt, the lower age groups being selected in any series of individuals as being likely to give the largest number of reactors. The actual testing was performed practically throughout by one of us (J. C. J. McEntee) so as to maintain uniformity of technique. Each pair of toxins was controlled by a single injection of inactivated toxin and the results were scrutinised at the 4th and 10th days, a record of the comparative intensities of the positives being made at the same time. The results are recorded in Table I.

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.

The prominence recently given to the Rous sarcoma has increased the confusion of hypotheses about malignancy. With a view to clarification, one may say that there are three simple hypotheses of outstanding importance, viz.: (1) the living virus hypothesis, which regards living viruses as the actual and effective cause of both the avian and the mammalian disease; (2) the autogenous enzyme hypothesis, which ascribes both diseases to the development within living cells of an ens malignitatis resembling an enzyme rather than a virus; and (3) the “chronic irritation” hypothesis, which explains mammalian malignancy on this principle and considers fowl sarcoma to be of a different nature.

Animals protected from fleas by means of a sufficiently broad layer of “tangle-foot” and placed in plague-infected houses do not contract plague, but the control animals, not so protected, on several occasions (24 per cent.) developed the disease. Out of 247 fleas caught on the “tangle-foot,” 60 p.c. were human, 34 p.c. were rat and 6 p.c. were cat fleas. Plague-like bacilli were demonstrated in the stomach contents of one out of 85 human fleas dissected, and of 23 out of 77 rat fleas.

Water beds in use in this hospital were found to be contaminated with Pseudomonas aeruginosa. The addition of sodium hypochlorite, giving a final concentration of 200 parts/106 available chlorine, was found to be effective in preventing microbial contamination over a 6-month study period.