Hepatitis A immunity and travel history.

Travel histories were taken from 1111 British travellers. Serological testing showed that increasing age and a past history of jaundice were associated with a greater likelihood of travellers being immune to hepatitis A. Neither travel to nor the duration of stay in areas of increased hepatitis A endemicity influenced the level of hepatitis A immunity. It is concluded that travel histories from British citizens normally resident in the U.K. cannot be used to identify those travellers in whom serological prescreening would be of value prior to immunoglobulin prophylaxis.

An outbreak of Salmonella saint-paul infection associated with beansprouts.

In March 1988, there was an outbreak of infection by a strain of Salmonella saint-paul with a distinctive antigenic marker. A total of 143 reports were received between 1 March and 7 June. Preliminary investigations suggested that raw beansprouts were a possible source of infection and a case-control study confirmed the association. S. saint-paul of the epidemic type was isolated from samples of beansprouts on retail sale in different cities in the United Kingdom and from mung bean seeds on the premises of the producer who was most strongly associated with cases. In addition, Salmonella virchow PT34 was isolated from samples of raw beansprouts and was subsequently associated with seven cases of infection. Four other serotypes of salmonella were also isolated from beansprouts. On 8 April the public were advised to boil beansprouts for 15 seconds before consumption, and the premises of the one producer associated with many cases were closed. As a result of these actions there was a significant decrease in the number of infections with S. saint-paul.

Hepatitis A immunity in British adults--an assessment of the need for pre-immunisation screening.

A total of 858 British adults were screened for immunity to hepatitis A. Immune rates ranged from 13% in the 16-20 years age group to 61% in the 51-55 years age group. Factors affecting these rates are discussed and the implications for pre-immunisation screening are considered.

Immunity to diphtheria in young British adults.

Of 906 recruits aged between 16 and 20 years who were Schick-tested upon entry to the Royal Air Force, 775 were tested for circulating Corynebacterium diphtheriae antitioxin by means of an indirect haemagglutination (IHA) method. Of the total population, 95.7% were Schick-test negative, 3.5% were Schick-test positive and 0.8% gave pseudo-reactions. Of those tested by the IHA test, 37.7% were regarded as immune, 47.0% as 'immune-susceptible' and 15.3% as non-immune. Discrepancies between the two tests were discovered. Of those persons found to be Schick-test positive, 34.6% possessed circulating antitoxin; of those Schick-test negative, 13.5% were regarded as non-immune. A history of diphtheria immunisation in childhood was found to be a poor predictor of immunity. A protocol for selective diphtheria immunisation of adults is proposed.

Significance of dipstick haematuria. 1. Correlation with microscopy of the urine.

The reliability of a chemical test for haematuria has been evaluated in patients referred for investigation of suspected renal or urological disease. Red blood cells in concentrations of 10/microliter or greater were found in 24% of urines giving a negative dipstick result, 82% of urines giving a trace positive result and nearly 100% of urines giving dipstick results greater than this. The accuracy of the reagent strip in predicting the presence or absence of significant haematuria was improved by testing several urines from each patient. On the basis of this study, if significant haematuria is present, reagent strip urine testing is an efficient method for its detection.

The serological diagnosis of Mycoplasma pneumoniae infection: a comparison of complement fixation, haemagglutination and immunofluorescence.

A total of 193 sera were examined for antibody to Mycoplasma pneumoniae by three techniques - complement fixation (CF), haemagglutination (HA) and immunofluorescence (IF), the last method being used to assess IgM, IgG and IgA antibodies. The most reliable single test for diagnosis was HA, and the most useful combination of tests was HA with IF (IgM and IgG). The IgA IF was not found to be diagnostically helpful.

Salmonella urinary tract infection in pregnancy.

Two cases of urinary tract infection in pregnancy are presented in which non-typhoid salmonellas were isolated in significant numbers from the urine. The implications of urinary tract excretion of salmonellas on laboratory identification protocols and hospital control of infection in maternity units is discussed.

An evaluation of gentamicin EMIT--its performance on the Kem-O-Mat and its role in the small laboratory.

An investigation was made into the use of gentamicin EMIT on the Coulter Kem-O-Mat in a small microbiology laboratory. EMIT was found to correlate well with plate assay and to be a more rapid, more precise and technically less time-consuming method. EMIT was more expensive in clinical use. This single disadvantage was considered to be outweighed by a saving in capital equipment expenditure and by the benefits to the laboratory and clinician.