Infectious disease surveillance in China.

A national system of infectious disease surveillance was established in 1959 in China. Now it consists of three subunits, namely, national disease reporting system (NDRS), nationwide disease surveillance points (DSPs), and surveillance network for specific infectious diseases. There are 35 notifiable infectious diseases, which are divided into Classes A, B, and C. The functions of the surveillance include explaining the natural history of infectious diseases, describing the distribution of case occurrence, triggering disease-control effort, monitoring epidemic of infectious diseases during natural disasters, predicting and controlling epidemics and providing the base of policy adjustment.

A natural vaccine candidate strain against cholera.

E1 Tor Vibrio cholerae (EVC) strains may be classified into two kinds-epidemigenic (EEVC) strains and non-epidemigenic (NEEVC) strains-based on a phage-biotyping system. A large number of EEVC strains have been screened for toxigenic and putative colonization attributes. One such naturally occurring strains (designated IEM101) has been found which is devoid of genes encoding cholera toxin (CT), accessory cholera enterotoxin (ACE), zonula occludens toxin (ZOT), but possesses RS1 sequences and toxin-coregulated pilus A gene (icpA) although icpA is poorly expressed. It expresses type B pili but does not possess type C pili. It is an E1 Tor Ogawa strain and does not cause fluid accumulation in rabbit ilcal loop tests. Active immunization of rabbits with strain IEM101 elicited good protection against challenge with virulent strains of V. cholerae O1. Oral administration caused no side effects in 15 human volunteers, colonized the gut for four to ten days and elicited good immune responses.

[Study on the characteristics of molecular epidemiology for Salmonella typhi isolated in China. II. Analysis of 16S rRNA gene restriction patterns (16S rRNA GRP) of S. typhi isolated in China].

16S rRNA gene, a highly conservative gene in molecular evolution, was labeled with digoxigenin-11-dUTP by PCR. Using it as a probe, we investigated the 16S rRNA gene restriction patterns (16S rRNA GRP) of S. typhi after their chromosomes were digested with Pst I. Results show that the Pst I 16S rRNA GRP appears obvious polymorphism in strains of distinctive sources. The fragments containing 16S rRNA gene are sized 7.0-26.5kb in 16S rRNA GRP of Pst I. 119 strains can be divided into 38 ribotypes. Most of the strains causing outbreaks from Dalian in 1990 and strains isolated during the pandemic from Yili, Xinjiang in 1991 have the same ribotype; some ribotypes contain epidemic strains which are from different geographic areas; some strains from sporadic cases have their unique ribotypes. We also find the 16S rRNA GRP with Pst I of S. typhimurium rather different from that of S. typhi. Data from further analysis of Pst I ribotypes by mean-linkage clustering method show that pandemic strains, outbreak strains and epidemic strains cluster at 0.55 in genetic distance; nonepidemic strains and strains from sporadic cases gather to form another cluster at 0.70 in genetic distance. Ribotype of strain 251, which was isolated forman asymptomatic carrier is different from the two clusters. The ribotype of S. typhimurium is apparently far distant, comparing with that of S. typhi.

The role of leucocytes in the induction of fluid secretion by Salmonella typhimurium.

Nitrogen mustard (N2M) treatment of rabbits induced neutropenia, and, in ligated ileal loops, it inhibited fluid secretion induced by salmonella or by cholera toxin (CT). Pretreatment of rabbits with indomethacin almost abolished salmonella-induced fluid secretion and significantly reduced that induced by CT. Similar effects of N2M and indomethacin on fluid secretion induced by salmonella, but not by CT, have been reported by other workers and used to implicate prostaglandins, from the salmonella-induced inflammation, as mediators of fluid secretion. In contrast, we show that N2M treatment, in addition to reducing CT-induced secretion, caused severe morphological alterations to ileal mucosa. Irradiation techniques were developed for inducing neutropenia, but they did not totally inhibit salmonella-induced leucocyte influx into ileal mucosa. We propose an alternative mechanism for the inhibitory effect of N2M on salmonella- and CT-induced secretion, based on the known anti-mitotic activity of N2M. Also, the anti-secretory effect of indomethacin cannot be attributed uniquely to its anti-inflammatory activity because it depressed CT-induced secretion as well as salmonella-induced secretion. These results support the concept of pathophysiological secretion in infectious diarrhoea, developed previously for rotavirus and extended to bacterial infections.

The influence of cultural conditions on the expression in Salmonella typhimurium of an antigen related to cholera toxin.

The choice of strain, culture conditions, composition of medium and size of inoculum all affected the expression of a cholera-toxin-related antigen (CTRA) in Salmonella typhimurium. A previous study had shown that the number of organisms expressing CTRA in Casamino acid Yeast Extract (CYE) medium decreased between 4 h and 6 h in uninterrupted culture. In the present experiments, organisms harvested at 4-5 h were subcultured into fresh CYE medium and incubated for a further 2 h; the total number of organisms increased, and the decrease in the proportion of organisms expressing CTRA was reduced. Use of Hartley Digest Broth in place of CYE medium increased the proportion of organisms expressing CTRA in all strains tested, in both the uninterrupted and the subculture procedures. The higher the initial inoculum, the lower was the proportion of organisms expressing CTRA. The presence of the antigen in cells remained constant for about 18 h after transfer from 37 degrees C to 4 degrees C. These data have important implications for the production and purification of CTRA: they show that it was expressed during log-phase of growth, and they suggest that expression was regulated by a non-growth-limiting factor. Moreover, some avirulent strains were better producers of the antigen than virulent ones. The significance of the data is discussed in relation to the in-vivo situation.

Quantification of the leucocyte influx into rabbit ileal loops induced by strains of Salmonella typhimurium of different virulence.

Leucocyte influx into rabbit ileal loops, induced by strains of Salmonella typhimurium of different virulence, was assessed with 111Indium-labelled leucocytes. Strains fell into two groups on the basis of their leucotactic potential: "virulent" strains (which induced fluid secretion) caused a dose-dependent leucocyte influx; strains which did not induce fluid secretion failed to induce a significant leucocyte influx. Fluid secretion was never observed in the absence of leucocyte influx, but leucocyte influx per se did not induce fluid secretion. The phenotype of the challenge inoculum influenced fluid secretion; young log-phase organisms induced fluid secretion with a higher frequency than overnight cultures. These findings support earlier evidence implicating leucocytes in an interactive but not exclusive role in the genesis of salmonella-induced fluid secretion. They suggest, though do not prove, that interaction of leucocytes with the appropriate phenotype of organisms results in the release of a host-derived or bacterial secretagogue, or both. The bacterial factor may or may not be the antigen related to cholera toxin, described previously.

Expression of an antigen in strains of Salmonella typhimurium which reacts with antibodies to cholera toxin.

Six strains of Salmonella typhimurium (W118, TML, SL1027, LT7, M206 and Thax 1) of different virulence were examined for the presence of antigens which react with antibodies to cholera toxin (anti-CT). A fluorescent-antibody-labelling technique employing anti-CT was used to analyse antigen expression. A rapid increase in the proportion of cells producing a CT-related antigen was demonstrated in cells in early log phase (1-4 h growth) followed by a rapid decline during mid-late log phase in each of the six strains. The nature of the CT-related antigen was analysed by immunoblotting using anti-CT. An antigen of mol. wt equivalent to a high-mol. wt species of CT B subunit was detected in polymyxin-B extracts of all strains but greater amounts were observed in the strains that we consider avirulent. Nothing equivalent to a CT A-related subunit was observed in any of the strains. The relatedness of the salmonella antigen to CT was limited. The high-mol. wt antigen was not disrupted in the denaturing conditions of SDS-PAGE; nothing was detected by enzyme-linked immunosorbent assays with either ganglioside or anti-CT as anchor.