A long-term study comparing membrane filtration with Colilert defined substrates in detecting fecal coliforms and Escherichia coli in natural waters.

Assessment methods for determining the presence and number of fecal bacteria and Escherichia coli (E. coli) in waters, foodstuffs, sewage effluent, and soils have evolved from multiple tube fermentations (MTF's) to membrane filtrations (MF's) to, most recently, defined substrate technologies (DST's). Mounting evidence indicates Colilert DST (IDEXX, Westbrook, ME) to be a versatile assessment technique for detecting and enumerating E. coli over a range of applications. This study compared the performance of Colilert DST with a confirmed standard MF technique using m-FC broth (Millipore, Bedford, MA) in assessing E. coli in ten different environmental water samples obtained monthly over a 3-year period from the upper Appomattox River, VA. For the duration of the study, E. coli counts measured by Colilert DST were positively correlated (Pearson's correlation coefficient=0.956; slope=0.979; p<0.0001) with E. coli counts measured by confirmed MF procedures. The results of a two-factor ANOVA revealed that Colilert DST counts compared equally to confirmed MF counts by year (p=0.974), by stream sampled (p=1.0), and by season (p=0.696). E. coli counts were significantly lower during cold season months (Dec/Jan/Feb) than during warm season months (Jun/Jul/Aug) for each year contributing to marked variation in sample quality. Counts obtained by Colilert DST compared equally to those obtained by MF across all samples and dates for the three years. Colilert DST presents a laboratory protocol that is simpler to manage, quicker to process, and easier to quantify results than MF. These factors, plus the enhanced precision and versatility of Colilert DST over the span of this three-year study attests to its suitability for testing ambient surface waters.

Funnel-web spider (Atrax robustus) antivenom in the treatment of human envenomation.

Envenomation by the Sydney funnel-web spider may lead to serious illness or death. After an antivenom which had been raised in rabbits was proven to reverse the signs of envenomation in animals, a trial was conducted in patients. Nine patients (aged 3-82 years) with severe envenomation by funnel-web spiders received treatment with an antivenom to the venom of Atrax robustus. Concomitant diseases in the victims included rheumatoid arthritis, diabetes mellitus, complete heart block, pyrexia of unknown origin, and carcinoma of the ovary, which were being treated with appropriate drugs. Because of the introduction of the antivenom, the syndrome which previously caused either death or a hazardous illness which required two to three weeks of hospital care now became an illness lasting one to three days. So far there have been no definite adverse reactions to the antivenom. There have been no deaths since the antivenom has been used, and it is hoped that human fatalities as a result of funnel-web spider envenomation will become a thing of the past.

Influenza immunization in adults with diabetes mellitus.

The antibody responses to influenza vaccination of a group of adult diabetic patients were compared with responses in a healthy group of regular volunteer vaccinees. The initial and final geometric mean hemagglutination-inhibiting antibody titers were lower in the patient group, but the relative increase in titers was greater for each of the vaccine components. The percentage of fourfold rises in individual titers was greater in the diabetic group than in the control group. It was concluded that patients with diabetes mellitus responded normally to influenza vaccination. This was confirmed in an additional study. There was no significant difference in the antibody responses of patients treated with insulin or oral antidiabetic agents. There was no impairment of diabetic control as a result of influenza vaccination when this was evaluated by measuring the concentration of glycosylated hemoglobin, or by random blood glucose estimations. There was no significant change in the serum insulin level after immunization in patients on oral diabetic agents. It was concluded that influenza vaccination was safe and effective in adult diabetic patients.

Changing to U100 insulins.

The change of insulin strength to 100 units/mL is underway, and patients should be changed now. Make sure the syringe is changed at the same time. Only in those patients having a dose greater than 100 units will the syringe (ordinary medical 2.0 mL syringe) be the same, but the volume is different. Further information and help may be obtained from the insulin manufacturers, hospital diabetic clinics, State offices of the Diabetes Federation of Australia, or the Hot Line Service.

U100 insulin and the general practitioner.

On August 1 1980, U100 insulins (100 units/mL) will be introduced and other strengths will be phased out over four months. During that period all insulin-dependent diabetics will need to be seen and helped to adjust to their new dosage volume. The new system is decimal, and provided the new appropriate syringes are used, much more simple. Experience has shown that mistakes in dosage are much fewer with U100 insulins. General practitioners will be in the forefront of the campaign to educate patients.

Penicillin update.

The penicillins are the safest and most commonly prescribed antibiotics in Australia, accounting for 7.8 per cent (8 million prescriptions) of all 'Pharmaceutical Benefit' prescriptions for the year 1977/78. The range of penicillins available covers a very wide spectrum of susceptible bacteria, and includes the majority of all bacterial infections seen by the general practitioner.

Bioavailability study of diphtheria immunoglobulin (human).

A diptheria immunoglobulin has been prepared from selected blood donations to the Australian Red Cross Transfusion Services. A dose of 250 I.U. has been demonstrated to raise the titre of diptheria antitoxin in non-immune subjects to protective levels within 24 h, and these levels remain protective for at least 5 wk. Supplies are available from the various branches of the Australian Red Cross Transfusion Services.