An outbreak of E. coli O157 infection with evidence of spread from animals to man through contamination of a private water supply.

An outbreak of E. coli O157 infection occurred in the Highland Region of Scotland in the summer of 1999. The source of the outbreak was traced to an untreated private water supply. All six cases identified arose in visitors to the area, and most had very limited exposure to the contaminated water. Permanent residents on the same supply were unaffected. The E. coli O157 isolates from the water, sheep faeces collected from around the source and the human stool samples were indistinguishable using pulsed field gel electrophoresis. Previously reported outbreaks of E. coli O157 linked to potable water supplies have resulted from structural or treatment failures, which allowed faecal contamination of source water. Here, contamination of the water supply and subsequent human infection was due to the use of an untreated, unprotected private water source in a rural area where animals grazed freely.

A survey of malignant disease in Zaire.

Over a period of 13 years 794 patients were seen with confirmed malignant disease at the Centre Medical Evangelique hospital at Nyankunde in north-eastern Zaire, which services a population of approximately 500 000. Malignant disease of the skin accounts for 24% of the total number of malignancies. The commonest tumour in women, as in the West, is breast cancer. Among males, however, Kaposi's sarcoma makes up 15% of all male malignancy and malignant melanoma another 7%, giving a contrasting picture to developed nations. In both types of malignancy the majority of cases presented with foot primaries. Patients with Kaposi's sarcoma tended to be younger than those with malignant melanoma. There appears to be no marked change in frequency of either Kaposi's sarcoma or malignant melanoma, in contrast with the sharply rising incidence in Western populations.