A total of 3522 samples of serum, collected anonymously from women attending an antenatal clinic, was tested for hepatitis B surface antigen and antibody to hepatitis C. The prevalence of anti-HCV was low; only five confirmed positives were found (0·14%). The prevalence of hepatitis B overall was 0·56%, but was 1·04% in women from immigrant groups. Hepatitis B carriage is therefore four times more common than hepatitis C carriage in the antenatal population comprised of various ethnic origins. The patterns of infection in the two viruses are reversed, hepatitis B being more common in Asian, S.E. Asian and West Indian mothers and hepatitis C being more common in mothers of white Caucasian origin. Routine antenatal screening for anti-HCV is discussed.

Carrion is a major source of botulinal toxin for animals. A type D strain of Clostridium botulinum differed from type A and B strains in producing (1) much higher concentrations of toxin in putrefying mouse carcasses at several different temperatures over a period of 35 days, (2) toxicity that sometimes persisted in mouse carcasses for at least a year, and (3) mouse carcasses with exceptionally high oral toxicity. Fish carcasses were much less favourable than mouse carcasses for type D toxigenesis.

The study, together with earlier studies on types C and E, indicated that carrion contaminated with C. botulinum type C or D is likely to be particularly dangerous for animals that may ingest it. This accords with the observation that carrion-transmitted botulism in animals is usually caused by type C or D.

In November and December 1992, an outbreak of parvovirus B19 infection occurred among patients and staff on an adult mixed surgical ward at a large hospital in London. Three patients and 15 staff members were serologically confirmed as acute cases. The attack rate among susceptible members of staff was 47%. In those infected, arthralgia (80%) and rash (67%) were the most common symptoms. Of six susceptible in-patients on the ward, three became infected. One of the in-patients who had carcinoma of the mouth was viraemic for more than 10 days with marrow suppression resulting in the postponement of chemotherapy until intravenous immunoglobulin was given and he was no longer viraemic. Control measures taken included closure of the ward to new admissions, transfer of only immune staff to the ward, and restriction of the ward nursing staff to working only on that ward. Although no specific exposure was conclusively identified as a risk factor, there was a suggestion of an increased risk of acquiring parvovirus B19 infection among those staff who did not adopt strict hand washing procedures after each physical contact with a patient (RR = 2·33; P = 0·07). Knowledge of parvovirus B19 among interviewed health care workers was poor: only 42% reported knowing about parvovirus B19 and only 38% could name a patient category at risk of a severe outcome following infection. This is the first report of a nosocomial outbreak affecting an adult ward and of possible transmission of parvovirus B19 infection from staff to in-patients. Hospital control of infection teams should include parvovirus B19 in their outbreak containment plans.

This study demonstrates a very high prevalence of antibodies to hepatitis C virus among Icelandic intravenous (i.v.) drug users. Of 152 identified i.v. drug users 95 (63%) were shown to have antibodies to the hepatitis C virus. In contrast the seroprevalence in the general Icelandic population is low, (0·2%). Almost all cases of hepatitis C virus infection in Iceland are due to i.v. drug use or to use of infected blood or blood products. Sporadic cases with unexplained modes of transmission, a significant portion of hepatitis C infections elsewhere, are virtually non-existent in Iceland. The results of this study are consistent with the hypothesis that the sporadic community-acquired cases could be caused by blood transfer due to bites from insect vectors such as mosquitoes which are not found in Iceland.

A stratified and randomly-selected population sample was identified in 1990 in order to study the seroprevalence of nephropathia epidemica (haemorrhagic fever with renal syndrome) in Northern Sweden. Sera from 1538 subjects (750 men, 788 women), 25—64 years of age, were analysed for the presence of Puumala virus (PUV) specific-IgG by the indirect immunofluorescence antibody test. Specific IgG was detected in sera from 83 subjects (5·4%). Men and women had similar seroprevalence rates. The highest seroprevalences were found in subjects 55 years or older (8·0%) and among farmers and forestry workers (15·9%). The geographic distribution of seropositive individuals was uneven and there were significantly more seropositive persons in rural than in urban areas (P < 0·05).

A seroepidemiological survey was conducted in Singapore to assess the prevalence of antibody to human parvovirus B19. Sera were collected from 600 healthy individuals between 6 months and over 50 years of age and tested for IgG antibody against B19 virus by antigen capture indirect immunosorbent assay. The overall seropositivity rate was 16·2%. All the children under 5 years of age were seronegative. Antibody prevalence increased gradually from 3·5% in school children (5–14 years of age) to 7·7% in age group 15–19 years and then to 10·3% in young adults (20–24 years of age). In the age group 25–34 years the prevalence was 28% and in the age group over 35 years 65% had parvovirus B19 antibody. The results of the survey indicate that there has been very low incidence of B19 virus infection in Singapore during the last two decades.

The purpose of this research was to determine whether trappers in northern Alaska acquired immunity to rabies virus from non-bite exposures while trapping and skinning arctic foxes (Alopex lagopus). In coastal Alaska recurring epizootics presumably provide trappers ample opportunity for contact with rabid animals. Serum neutralization analyses of blood samples collected from 26 individuals were conducted. All but three had negative rabies neutralizing antibody levels (< 0·05 I.U./ml). Two of these had previously received rabies vaccine but one individual who had trapped for about 47 years with an estimated harvest of over 3000 foxes and who had never received pre- or post-exposure rabies vaccination had a rabies serum neutralizing antibody concentration of 2·30 I.U./ml. This represents the first report of an unvaccinated person acquiring rabies virus antibody with a titre above the 0·5 I.U./ml level considered acceptable by the World Health Organization.

An outbreak of measles occurred in a community school and the surrounding area in Crowborough, East Sussex, UK, from December 1992 to February 1993. There were 96 suspected cases reported: 66 cases among 1673 students at one school and 30 community cases. The majority of suspected cases were in those aged 11–17 (78%), 2 cases occurred in infants < 1 year old and 8 cases in adults aged 18 years or over. Data collected on 60 (91 %) of the 66 suspect school cases showed 56 (93%) had an illness which met a case definition of measles. Eighteen had confirmatory IgM measles antibody. Two cases were hospitalized. The local percentage uptake for measles immunization for the school age years affected varied between 64 % and 84 %. A survey of parents showed that approximately 74% of the students attending the school had a history of measles immunization. The immunization rates reported by parents for children who developed measles was 21 %. (29 % based on GP records) compared with 77 % for those who remained well. Vaccine efficacy was estimated to be 92%. This outbreak, along with others recently reported in older unimmunized children in the UK, reinforces the need for catch-up immunization programmes to reach this susceptible group of adolescents.

In an outbreak of measles in North Wales centred on a secondary school in 1991, 74 cases occurred over a period of 51 days. Before the outbreak started, 27 % pupils did not have a history of measles or immunization and were considered susceptible. Active case rinding and identification and vaccination of susceptible contacts commenced after the fourth generation of cases and further reduced the pool of susceptible schoolchildren from 17%, at the onset of the vaccination campaign, to 8%. A fifth generation of cases did not occur. Delays in diagnosis (mean 2·8 days) and notification (mean 6·1 days) hampered control. There was no evidence of primary vaccine failure (observed vaccine efficacy 97%). Sixty-nine (93%) cases were considered preventable. Reasons for the apparent success of the intervention are discussed.

An epidemiological study of hepatitis A and enteroviruses was conducted in a military diving training school, by evaluating the viral contamination of water using an ultrafiltration concentration technique, and assessing seroconversion and the presence of virus in stool specimens obtained from 109 divers and 48 controls. Three of 29 water specimens were positive for enterovirus by cell culture and 9 by molecular hybridization. There was little or no risk of virus infection during the training course (49 h exposure) because there was no significant difference between divers and controls for both viral isolation and seroconversion. However, a higher percentage of coxsackievirus B4 and B5 seropositive divers suggests that these were more exposed during previous water training. No hepatitis A virus (HAV) detection and no seroconversion to HAV was observed. The rate of HAV seropositive subjects was 17% in this 24·5-year-old population

An enzyme immunoassay employing recombinant Norwalk virus capsid protein was evaluated for the measurement of IgA responses. Tests on 23 volunteers and patients known to have been infected with Norwalk virus (NV) showed that 19 developed significant IgA responses, 2 had unchanging levels of IgA and 2 failed to respond. There was no evidence of IgA responses to NV following infection with Hawaii or Snow Mountain-like viruses.

Tests on sera from patients involved in outbreaks associated with eating contaminated shellfish suggest that some patients may have been infected with more than one strain of calicivirus. The use of the rNV EIA for measuring IgA and IgG responses in patients involved in a major outbreak of food poisoning affecting hospital staff indicated that the causative agent was probably NV.

Several methods for demonstrating antibody to Crimean-Congo haemorrhagic fever virus were compared on serum samples taken from 101 patients during the acute stage of illness and at intervals for up to 59 months thereafter, with emphasis on early detection of the immune response. The deaths of 23 patients on days 5–14 of illness were ascribed to the effects of the disease; two patients died later from other causes. Very few of the patients who died from the acute illness mounted an antibody response detectable by the methods tested. Four patients who died and 18 who recovered were treated with immune plasma collected from recovered patients. Treated patients acquired IgG antibody from the plasma, but it was possible to discern the onset of an endogenous IgM response in those individuals who survived the disease by all of the methods tested. Indirect immunofluorescence (IF) tests detected IgM and/or IgG antibodies at the earliest on day 4 of illness in about 10% of patients who survived the disease, and by day 9 all survivors had antibodies demonstrable by IF. A biotin-streptavidin IF technique offered no advantage over the standard IF test for the early detection of IgG antibody, but demonstrated higher antibody titles and detected IgM antibody earlier in about a quarter of the patients tested. An IgM-capture enzyme-linked immunoassay (ELISA) and an IgG sandwich ELISA demonstrated higher antibody titres than did IF tests, and detected antibody responses at an earlier stage of infection than did IF tests in about one-fifth of patients, but the reverse was true in a similar proportion of instances. A competition ELISA, which detected total antibody activity, produced lower titres than did the IgM and IgG ELISAs, but yielded results which were in close agreement with the findings in IF tests. It was concluded that the IF tests were most convenient for use in making a rapid serodiagnosis of the disease.

This paper reports the development and evaluation of serological tests for the differentiation of antibodies in animals infected with capripox and parapox viruses. Agar-gel immunodiffusion tests using sera from sheep with naturally-acquired infections and from sheep experimentally inoculated with orf or capripox viruses showed cross reactions. Virus-specific antibody responses to structural proteins of the viruses were analysed by Western-blot analysis. This analysis readily differentiated the infections as either capripox or contagious pustular dermatitis. The antibody responses to the 32 kDa and 26 kDa proteins of capripox virus provided a firm basis for differention.

An enzyme immunoassay (EIA) for astrovirus type 1 together with immune electronmicroscopy (IBM) was used to type a collection of 162 astroviruses obtained from 1981–93 from children with diarrhoea. The EIA was found to be specific for astrovirus type 1. Astrovirus types 2–4 were typed by IEM.

Astrovirus type 1 was the prevalent serotype 107/125 (86%), followed by type 3 (8%), type 4 (6%) and type 2 (1 %). Six samples containing astrovirus could not be typed or detected by EIA because they were coated with coproantibodies; 11 others were not identified. Virus particles could no longer be detected in 15/162 (9%) samples following storage for ≥ 2 years.

Selected samples containing astrovirus types 1–4 were passaged in CaCO2 cells and their identity confirmed by one or both assays. One sample was shown to have remained viable for 10 years when stored as an aqueous suspension at −20 °C.

Two patients with severe combined immune deficiency disease (SCID) were shown to be excreting astrovirus type 1 for 32 and 102 days respectively. One child was simultaneously shedding rotavirus and the other child was excreting adenovirus.

A rubella serological survey of 476 individuals selected by cluster sampling technique from Caieiras, a small town located in the outskirts of São Paulo city, southeastern Brazil, was carried out over the period November 1990–January 1991. The aim of the study was to characterize rubella epidemiology in a representative non-immunized community in south east Brazil. The survey comprised a seroprevalence study, stratified by age (0–40 years) and a seroconversion study of rubella vaccine in non-infected children below 2 years of age. Mathematical techniques were applied to resultant data sets to determine the age dependent rates of decay in the proportion of individuals with maternally derived antibodies, vaccine seroconversion, and infection of susceptibles, termed the force of infection, and to estimate the average age at first infection.

Sensitivity, specificity and predictive values of an enzyme-linked immunosorbent assay (ELISA) for detecting antibodies against bovine leukaemia virus (BLV) were evaluated using a representative sample of 145 serum pools, comprising from 3 to 48 individual sera. The sample was constituted according to the frequency distribution of the negative and positive pools analysed during a screening involving the whole cattle population of Belgium. Sensitivity and specificity were estimated to 88·9% and 100% and the predicted negative and positive values were 99·9% and 100%, respectively. These results indicate the use of serum pools is suitable for the detection of BLV infected herds in eradication campaigns.

Serological evidence was used to confirm an outbreak of Akabane disease in cattle in the Turkish Province of Aydin in 1980. Thereafter, serum collections from the Middle East were screened for the presence of neutralizing antibodies to Akabane virus. The results indicate that the virus was present in a number of provinces on the south Turkish coast in 1979 and 1980 but that it probably did not persist into 1981; the virus had also been present on Cyprus in 1980 and on at least one previous occasion. There was also evidence of limited virus transmission in the Orontes river valley in Syria in 1979 and less precise evidence to show that occasional infection occurred in the lower Jordan river valley. The failure of Akabane virus to persist in southern Turkey for more than two years indicates that this area is open to epidemic rather than endemic infection. The presence of neutralizing antibodies in the eastern Turkish Provinces of Gaziantep and Diyarbakir suggests that this might be the route whereby Akabane virus occasionally invades the Middle East region.