A study was made in liquid medium over 7 days at 37° C. of the inhibitory action of nineteen antibacterial, antifungal and antiprotozoal drugs on twenty strains of M. gallisepticum, eight other avian mycoplasmata, six mammalian mycoplasmata, two saprophytic mycoplasmata and the L-form of Streptobacillus moniliformis (L–1).

The twenty strains of M. gallisepticum from Britain and other countries showed a similar range of drug sensitivity except where resistant strains were included. Tylosin and demethylchlortetracycline appeared to have the highest inhibitory action, followed by erythromycin, spiramycin, tetracycline, chlortetracycline, oxytetracycline and ethidium bromide. A ‘Zone Phenomenon’ frequently occurred with sodium aurothiomalate, inhibition often being observed between 0·1 and 2·0 μg./ml. Polymixin and nystatin had no inhibitory effect on the growth of any mycoplasmata tested. With the exception of erythromycin and streptomycin in some cases, the pattern of sensitivity observed with the mycoplasmata of diverse origin was similar to that of M. gallisepticum, most strains, however, being somewhat more resistant than M. gallisepticum to many of the drugs.

The incidence of purulent staphylococcal infections at a large Swedish university hospital was followed during 3 years and has been described as an expression of the incidence of hospital infections.

A marked decrease in the relative number of infections was found. The decrease was most evident among infections with ‘80/81’ strains and other antibiotic resistant hospital strains and was parallel in all the departments investigated. This is taken as an evidence for the assumption that the lowering of the amount of staphylococcal infections was brought about by a factor that was active throughout the hospital, probably some hygienic preventive measure.

A hygienic programme, which has been developed and maintained during several years at a large Swedish university hospital, is presented in detail. The composition and working methods of the Infection Control Committee are described and some economic calculations given. The possible connexion between the hygienic measures and a marked decrease of the incidence of infections is discussed. This decrease did not occur until a satisfactory method for the routine hand disinfection had been introduced, using a commercial antibacterial cleaner containing 3% hexachlorophene.

A variola minor outbreak in a 36-bed hospital-ward comprised seven cases of overt variola after the first case. Clinical and epidemiological findings were typical, seven of the eight cases of overt variola being confirmed by virus isolation or antibody titrations. In addition, thirteen definite and seven possible instances of subclinical variola were deduced from complement-fixation or haemagglutination-inhibition tests. A discussion is made of the validity of serological criteria of variolous and vaccinial infections.

Over a 2-year period a dermatology department was shown to be a valid model for the long-term study of hospital cross-infection. In the absence of specific anti-bacterial measures, consistently high levels of Staph. aureus and Gram-negative bacilli were found throughout the environment. ‘Broadcasts’ of Staph. aureus were particularly evident in the bathrooms, and notable sites of heavy, cumulative contamination were the communal baths, bedding, settled dust, and the hands of the staff.

Cross-infection of lesions occurred in ninety-four of the 233 ‘uncontrolled’ patients—15 cases being due to Gram-negative bacilli. Autogenous infection occurred in another fifteen cases. Nasal carriage of Staph. aureus developed in fifty-one patients after admission.

In one of the two main wards nasal disinfection (with ‘Soframycin’ nebulizers) was used for 4 months, and was effective in the treatment and prevention of nasal carriage; but it produced no change in the level of environmental contamination or in the incidence of cross-infection—even though efficient cleansing of the baths was also instituted. In contrast, during two separate periods of the work disinfection of skin lesions (with ‘Rikospray Antibiotic’) markedly reduced the counts of pathogens in the environment, and virtually abolished both cross-infection and the development of nasal carriage.

1. Long-established infection of a mouse colony with Eperthyrozoon coccoides was eliminated by regular insecticidal treatments designed to reduce infestation with lice and fleas.

2. Undesirable consequences of E. coccoides infection upon mice used as experimental animals are noted and an easy routine for exclusion of this parasite from mouse colonies is suggested.

A serological study of cytomegalovirus infection in London shows it to be prevalent. Under 5 years of age only 4% of children have antibodies, but this increases to 15% by 10 years of age and 21% by 15 years. The maximum incidence of 54% is reached by 25–35 years, and this is maintained in the older age groups of the population. In two mixed day schools the incidence of infection was significantly lower than in a boarding school, suggesting that close prolonged contact is required for spread of infection.

Different strains of cytomegalovirus possess common group-specific complement-fixing antigens.

It is suggested that clinical disease caused by cytomegaloviruses is more frequent and more varied than previously believed, although diagnosis may be difficult without virological help.

Of 918 severely subnormal patients in mental deficiency hospitals in Lincolnshire 917 were tested by the toxoplasmin skin tests, forty-nine out of 265 patients were dye tested because of a positive skin test or other indication. All patients in another group of 655 subnormals were dye tested, and comparison of these results with those of groups from the normal population showed that in children there was an excess of about 20% of dye-test positivity among the subnormals—a figure identical with that found by Thalhammer in Vienna.

The excess of positives became progressively less with increasing age and by middle age the incidence was the same in subnormals as among blood donors in the county. It is suggested that this indicates that patients in hospital are exposed to a lower risk of acquiring infection and that the higher incidence among adult males than among adult female defectives is due to the fact that more of them go out to work, many of them on farms. This factor could also explain the lower incidence of positivity in adult mongols and epileptics who are less commonly employable.

Possible explanations of the higher incidence among subnormal than among control children are discussed. Although it is tempting to assume that it indicates that some may be cases of congenital toxoplasmosis, the lack of gradient between child mongols, child epileptics and other subnormal children does not support this hypothesis. The numbers of mongol and epileptic children were too small to give statistically significant results. It is possible that the home environments of severely subnormal children exposed them to a higher risk of infection than did the homes of the control children and that the observed excess of dye and skin-test positivity may be due to increased incidence of acquired infection before their admission to hospital.

It was found that there was reasonable concordance between the dye test at a titre of 1/8 and skin sensitivity reactions exceeding 7 mm. in diameter, but poor agreement if 10 mm. was taken as the criterion of positivity.

Despite the lesser sensitivity of the skin test, the pattern of the results was the same as that observed in the dye-test survey, and the value of the skin-test for epidemiological surveys was confirmed.

By means of the fluorescent antibody method and of acridine orange staining experimental infection with adenovirus type 14 has been investigated in KB and MK cell cultures. Intracellular changes could be shown to precede the appearance of the cytopathic effect.

Thus, progressive stages in the development of adenovirus at this level could be separated both by the demonstration of the specific antigen and by the appearance of an altered DNA.

Both methods have proved to be equally useful for the detection of virus multiplication and of the histochemical changes induced in the cells.

No significant differences have been found to exist with respect to the cell line used.

The Antarctic provides unusually simplified conditions for the study of the persistence and exchange of micro-organisms of the upper respiratory tract. The work reported here was done while the author was in the Falkland Islands Dependencies Survey and the United States Antarctic Research Program.

Staph, aureus and Staph, albus persisted in the noses, and a-haemolytic streptococci in the throats of men throughout long periods of isolation and semi-isolation in Antarctica.

On the whole, men kept their own strains (phage types) of Staph, aureus despite living in very close contact with each other.

Persistent carriers of Staph, aureus (90% or more positive swabs per individual) continued to carry this organism for as long as 2 years in Antarctica. Data from men at Wilkes and Hallett IGY Stations indicated that there was a decrease in the intermittent and occasional carrier rates, resulting in a much lower total carrier rate after 12 months Antarctic isolation.

Evidence is presented to suggest that β-haemolytic streptococci had disappeared from throats after 12 months of isolation. It is thought that the absence of upper respiratory infections in these communities is due to absence of the bacterial or viral agents.

There is an urgent need for further work on the carriage of micro-organisms in the present unique epidemiological conditions of the Antarctic, and for better laboratory facilities there.

1. Antisera prepared in rabbits or calves against live Salmonella dublin gave mice some degree of protection against oral infection with this organism. Both antiserum prepared against heat-killed S. dublin and dead vaccines prepared in a variety of ways produced little or no immunity.

2. A rough variant of S. dublin of low virulence for mice, no. 17 A, produced a reasonably good immunity against oral infection with S. dublin in mice but not in calves. Mice that survived injection with another rough variant that possessed a considerable degree of virulence for these animals, no. 51, were immune to oral infection with S. dublin. Experimentally and naturally, this variant and, to a lesser extent, 9S, a smooth variant of S. gallinarum of reduced virulence, produced an appreciable degree of immunity in calves against S. dublin infection; none of the calves injected with these variants showed any signs of ill-health as a result.

3. Two rough variants of S. cholerae-suis, nos. 3 and 6, possessed a considerable degree of virulence for mice; those that survived were resistant to oral infection with S. cholerae-suis. Experimentally and naturally, both variants produced an appreciable degree of immunity in pigs.

4. Mice that survived vaccination with the rough S. cholerae-suis variant no. 6 were resistant to oral infection with S. dublin. Those that survived vaccination with the rough S. dublin variant no. 51 were resistant to oral infection with S. cholerae-suis and S. typhi-murium; they were fully susceptible to parenteral administration of Escherichia coli and Erysipelothrix rhusiopathiae.

5. Vaccination with S. cholerae-suis variants 3 and 6 and S. dublin variant 51 provoked the formation of H but not O antibodies. These variants were never found to mutate from rough to smooth in vitro or in vivo.

1. In many parts of the Caribbean there is a high mortality between 6 months and 2 years due to malnutrition and gastro-enteritis. These two conditions are so closely inter-connected that they can conveniently be regarded as a single syndrome, for which the term ‘weanling diarrhoea’ has recently been suggested. The clinical picture revealed by visits to children's wards was in line with the vital statistics.

2. The prevalence of malnutrition and gastro-enteritis in infants and young children is the result of child-feeding practices characteristic of the area. The duration of breast-feeding is shorter than in Africa and Asia. After 3 months or so breast-feeding, if it does not cease altogether, becomes partial, and in general there is a steady change in the direction of less breast milk. In some territories weaning at an even earlier stage in infancy seems to result in the common occurrence of malnutrition in infants under 6 months of age.

3. The foods given to supplement or replace breast milk include processed cow's milk, starch roots and fruits and cereals. Imported processed milk supplies good quality protein otherwise lacking in the child's diet, but the use of expensive proprietory infant milk foods, out of line with family purchasing power and given in over-diluted form, is among the causes of malnutrition. The use in infant and child feeding of dried skim milk-much the cheapest kind of milk in terms of nutritive value-is increasing and this trend should be encouraged.

4. Most of the malnutrition is of the ‘marasmic’ type. Classical kwashiorkor, now comparatively rare, was seen more often 5–10 years ago.

5. It is suggested that the conventional practice of grouping deaths in the periods 0 to 1 and 1 to 4 has, in the Caribbean and other developing areas, retarded recognition of the importance of malnutrition and gastro-enteritis as the principal cause of death during and after the weaning period. The analysis of mortality statistics according to shorter age intervals is desirable.

6. Further studies and action are recommended concerned with the following: the continuing analysis of mortality and morbidity statistics to elicit relationships with malnutrition; child feeding practices in the different territories; the social and economic background of individual victims of malnutrition and of the feeding errors responsible for their condition; improvement in the treatment of malnourished children; the scope and efficiency of maternal and child health services; the distribution of dried skim milk and its extension.

7. The establishment of a Caribbean Nutrition Centre will contribute to the prevention of malnutrition and help in solving long-term problems of food supply and nutrition in the area.

The aetiology of acute respiratory infections between September 1962 and August 1963 was studied in two general practices in Cambridge. These practices were reasonably representative of the permanent community of Cambridge.

There were 592 spells of acute respiratory infection in the combined practices, representing an incidence of 11·4 spells per 100 persons. Children aged 0–4 had the highest rates (51·6 spells per 100 persons).

It was possible to establish a diagnosis in 62·5% of cases investigated. Influenza and parainfluenza infections featured prominently, being responsible between them for 46·6% of all respiratory infections investigated. From September 1962 to January 1963, parainfluenza viruses were prevalent, causing acute laryngo-tracheo-bronchitis in children (croup), and an influenza-like illness in adults. From February to April 1963, influenza A (Asian) was epidemic, a clinical diagnosis of influenza being frequently confirmed by laboratory studies at this time. There were nine cases of Eaton agent infection, seven of which had PAP, the other two being family contacts who later developed influenza-like illnesses.

Adenovirus (four cases), and RS virus (three cases) were not prevalent to any large extent in Cambridge during the survey.