Guillain Barré syndrome (GBS), which is triggered by autoantibodies produced in response to antigenic stimuli such as certain infections and vaccinations, is the most common cause of acute flaccid paralysis worldwide. Campylobacter, the most common bacterial enteric infection in the USA, is reported to be the most commonly diagnosed antecedent of GBS, yet little information is available about the risk of post-Campylobacter GBS. Data collected through active, population-based surveillance in the Emerging Infections Program during the 2009–2010 novel Influenza A (H1N1) vaccination campaign allowed us to compare confirmed and probable GBS cases to non-cases to determine whether antecedent Campylobacter infection (or a diarrhoeal illness consistent with campylobacteriosis) was more common among cases and to assess the risk of GBS following Campylobacter infection. We estimate that 8–12% of GBS cases in the USA are attributable to Campylobacter infection (or a diarrhoeal illness consistent with campylobacteriosis), with 434–650 cases of post-diarrhoeal GBS annually and about 49 cases of GBS per 100 000 Campylobacter infections. These results provide updated estimates for post-Campylobacter GBS incidence in the USA and highlight an important benefit of effective measures to prevent Campylobacter infections.

Salmonella enterica causes an estimated 1 million domestically acquired foodborne illnesses annually. Salmonella enterica serovar Enteritidis (SE) is among the top three serovars of reported cases of Salmonella. We examined trends in SE foodborne outbreaks from 1973 to 2009 using Joinpoint and Poisson regression. The annual number of SE outbreaks increased sharply in the 1970s and 1980s but declined significantly after 1990. Over the study period, SE outbreaks were most frequently attributed to foods containing eggs. The average rate of SE outbreaks attributed to egg-containing foods reported by states began to decline significantly after 1990, and the proportion of SE outbreaks attributed to egg-containing foods began declining after 1997. Our results suggest that interventions initiated in the 1990s to decrease SE contamination of shell eggs may have been integral to preventing SE outbreaks.

Both maternal 25-hydroxyvitamin D (25(OH)D) concentrations during pregnancy andplacental amino acid transporter gene expression have been associated withdevelopment of the offspring in terms of body composition and bone structure.Several amino acid transporter genes have vitamin D response elements in theirpromoters suggesting the possible linkage of these two mechanisms. We aimed toestablish whether maternal 25(OH)D and vitamin D-binding protein (VDBP) levelsrelate to expression of placental amino acid transporters. RNA was extractedfrom 102 placental samples collected in the Southampton Women's Survey,and gene expression was analysed using quantitative real-time PCR. Geneexpression data were normalised to the geometric mean of three housekeepinggenes, and related to maternal factors and childhood body composition. Maternalserum 25(OH)D and VDBP levels were measured by radioimmunoassay. Maternal25(OH)D and VDBP levels were positively associated with placental expression ofspecific genes involved in amino acid transport. Maternal 25(OH)D and VDBPconcentrations were correlated with the expression of specific placental aminoacid transporters, and thus may be involved in the regulation of amino acidtransfer to the fetus. The positive correlation of VDBP levels and placentaltransporter expression suggests that delivery of vitamin D to the placenta maybe important. This exploratory study identifies placental amino acidtransporters which may be altered in response to modifiable maternal factors andprovides a basis for further studies.

Although rare, typhoid fever cases acquired in the United States continue to be reported. Detection and investigation of outbreaks in these domestically acquired cases offer opportunities to identify chronic carriers. We searched surveillance and laboratory databases for domestically acquired typhoid fever cases, used a space–time scan statistic to identify clusters, and classified clusters as outbreaks or non-outbreaks. From 1999 to 2010, domestically acquired cases accounted for 18% of 3373 reported typhoid fever cases; their isolates were less often multidrug-resistant (2% vs. 15%) compared to isolates from travel-associated cases. We identified 28 outbreaks and two possible outbreaks within 45 space–time clusters of ⩾2 domestically acquired cases, including three outbreaks involving ⩾2 molecular subtypes. The approach detected seven of the ten outbreaks published in the literature or reported to CDC. Although this approach did not definitively identify any previously unrecognized outbreaks, it showed the potential to detect outbreaks of typhoid fever that may escape detection by routine analysis of surveillance data. Sixteen outbreaks had been linked to a carrier. Every case of typhoid fever acquired in a non-endemic country warrants thorough investigation. Space–time scan statistics, together with shoe-leather epidemiology and molecular subtyping, may improve outbreak detection.

Infections with Vibrio spp. have frequently been associated with consumption of bivalve molluscs, especially oysters, but illness associated with clams has also been well documented. We describe the 2312 domestically acquired foodborne Vibrio infections reported to the Cholera and Other Vibrio Illness Surveillance system from 1988 to 2010. Clams were associated with at least 4% (93 persons, ‘only clams’) and possibly as many as 24% (556 persons, ‘any clams’) of foodborne cases. Of those who consumed ‘only clams’, 77% of infections were caused by V. parahaemolyticus. Clam-associated illnesses were generally similar to those associated with other seafood consumption. Clams associated with these illnesses were most frequently harvested from the Atlantic coastal states and eaten raw. Our study describes the contribution of clams to the overall burden of foodborne vibriosis and indicates that a comprehensive programme to prevent foodborne vibriosis need to address the risks associated with clams.

In June 2011, a cluster of suspected cases of Guillain–Barré syndrome (GBS), which can follow Campylobacter jejuni infection, was identified in San Luis Río Colorado (SLRC), Sonora, Mexico and Yuma County, Arizona, USA. An outbreak investigation identified 26 patients (18 from Sonora, eight from Arizona) with onset of GBS 4 May–21 July 2011, exceeding the expected number of cases (n = 1–2). Twenty-one (81%) patients reported antecedent diarrhoea, and 61% of 18 patients tested were seropositive for C. jejuni IgM antibodies. In a case-control study matched on age group, sex, ethnicity, and neighbourhood of residence, all Arizona GBS patients travelled to SLRC during the exposure period vs. 45% of matched controls (matched odds ratio 8·1, 95% confidence interval 1·5–∞). Exposure information and an environmental assessment suggested that GBS cases resulted from a large outbreak of C. jejuni infection from inadequately disinfected tap water in SLRC. Binational collaboration was essential in investigating this cross-border GBS outbreak, the first in mainland North America since 1976.

Campylobacter is a common but decreasing cause of foodborne infections in the USA. Outbreaks are uncommon and have historically differed from sporadic cases in seasonality and contamination source. We reviewed reported outbreaks of campylobacteriosis. From 1997 to 2008, 262 outbreaks were reported, with 9135 illnesses, 159 hospitalizations, and three deaths. The annual mean was 16 outbreaks for 1997–2002, and 28 outbreaks for 2003–2008. Almost half occurred in warmer months. Foodborne transmission was reported in 225 (86%) outbreaks, water in 24 (9%), and animal contact in seven (3%). Dairy products were implicated in 65 (29%) foodborne outbreaks, poultry in 25 (11%), and produce in 12 (5%). Reported outbreaks increased during a period of declining overall incidence, and seasonality of outbreaks resembled that of sporadic infections. Unlike sporadic illnesses, which are primarily attributed to poultry, dairy products are the most common vehicle identified for outbreaks.

Data from dung-baited pitfall traps show that dung beetles (Coleoptera: Scarabaeidae) do not discriminate against dung from sheep or cattle treated with avermectin. On the contrary, for a period post-treatment, dung from animals treated with avermectin attracted more beetles than dung from untreated animals. This effect was more marked with cattle dung than with sheep dung. The period of enhanced attractiveness of sheep dung was restricted to dung produced during the first day after treatment, whereas with cattle dung, the effect was still evident in faeces produced 25 days after treatment. Cattle dung produced from 3–25 days post-treatment caused 100% mortality in newly hatched larvae of the bushfly, Musca vetustissima Walker (Diptera:Muscidae). In dung of day 35, mortality was 93.6%. Dung collected from sheep from 1–6 days after treatment also caused 100% mortality of fly larvae, but by day 28, no toxic effects were detectable. Field observations on the colonization of cattle pats confirmed the enhanced attractiveness of dung from treated animals and suggested that departure rates from treated dung were lower than those from untreated dung. Treated pats supported higher beetle populations than untreated pats and burial was more rapid. The potentially serious implications of the enhanced attractiveness of avermectincontaminated dung are discussed in relation to the survival of dung beetle communities.

Natural populations of four species of the Anopheles gambiae complex occurring in southern Africa were sampled and individuals identified using ovarian polytene chromosomes (19 species A, 190 species B, 140 species C and 54 A. merus Dön.). The genotypes of these same insects were scored for three loci coding for non-specific esterases, and one locus coding for tetrazolium oxidase, after electrophoresis. There is no intra-specific variation at the tetrazolium oxidase locus; species A, B and C share a common allozyme and A. merus is unique. The relative gene frequencies for the 16 allozymes of the three esterase loci for each species give a minimum probability of correct identification of 0·9533 under the worst conditions of sampling, i.e., where samples consist of equal mixtures of species. In practice, resort to such probabilities is necessary only in the discrimination between species A and C. This system of identification is superior to the chromosome method because all adults, whether male or female, and at whatever stage of the gono-tropic cycle, are identifiable.

The brooded embryos and/or juveniles of the sea stars Neosmilaster georgianus (Studer, 1885) and Lysasterias perrieri (Studer, 1885) and the isopod Glyptonotus antarcticus (Eights, 1853) were examined for their acceptability using the sympatric sea star Odontaster validus (Koehler, 1906) as a predator. Organic extracts were prepared from embryos of both sea stars and juveniles of Lyasterias perrieri and Glyptonotus antarcticus and tested in alginate food pellets to confirm whether lack of acceptability was chemically based. We found both intact whole embryos and juveniles of the sea star Neosmilaster georgianus were not acceptable to Odontaster validus. A methanol extract of the embryos was palatable. This could be the result of either the sequestration of deterrent chemicals within embryos or the presence of noxious compounds that were not extractable in methanol. Embryos and juveniles of the sea star Lysasterias perrieri were not acceptable to sea stars. Food pellets containing methanol extracts of unacceptable embryos were deterrent against sea stars, suggesting a chemical defence. Juvenile brooded isopods (Glyptonotus antarcticus) were also found to be unacceptable in sea star feeding bioassays. Significant rejection of alginate pellets containing a lipophilic dichloromethane methanol extract of juveniles indicated that this lack of acceptability was chemically based. Our study provides further support for chemical defences in the offspring of brooding lecithotrophic Antarctic marine invertebrates.

Lack of reliable data about street vendors, who are difficult to survey, has hampered efforts to improve the safety of street-vended food. A two-phase method for sampling vendors, surveying first in areas of concentrated vending activity identified by local authorities and second in randomly selected areas, was developed and implemented in two Guatemalan cities where street-vended food had been implicated in cholera transmission. In a 4-day survey in Escuintla, 59 vendors (42 from phase 1, 17 from phase 2) were interviewed. They demonstrated good knowledge of food safety and cholera but unsafe practices, implying that more effective, practical training was needed. In a 6-day survey in Guatemala City, 78 vendors (77 from phase 1, 1 from phase 2) were interviewed. Sixty-eight (87%) vendors stored water, usually in wide-mouthed vessels prone to contamination; this led to a field test of a new system for safe water storage. Useful information for public health planning and intervention can be gathered rapidly with this new method for surveying street vendors.