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The activity of gamma-glutamyl transferase (GGT, EC 2.3.2.2) in sera of 68 healthy individuals, of 38 patients receiving anti-epileptic drugs, and of 27 patients having liver parenchymal lesions, was visualized after electrophoresis on cellulose-acetate gel using the substrate gamma-L-glutamyl-p-nitroanilide as a new colour reagent. The liberated p-nitroaniline was converted in situ into a lilac-coloured product using the Bratton-Marshall reaction. In most samples two bands were demonstrated, one located between albumin and alpha1-globulin, called GGT 1, the other located in the alpha2-globulin region, GGT 2. In a few samples a third band, GGT 3, with far less activity than the other bands, occurred in the beta-globulin region. When it occurred, an increase in total GGT activity was mainly due to an increase of GGT-1 activity. The possible role of the determination of GGT-1 activity as a monitor of microsomal enzyme induction is discussed.

An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of total anti-Campylobacter immunoglobulins in human sera. In this assay disintegrated Campylobacter bacteria were used as the antigen. Absorption tests including other possibly enteropathogenic bacterial species showed that the ELISA system displayed a high immunological specificity for Campylobacter. Using this ELISA it was found that in about 80% of Campylobacter patients these Campylobacter antibodies are produced to almost maximal levels within 8 days after onset of disease, and that they may persist for at least 4 months. Indeed, Campylobacter antibodies were demonstrated at low levels in a large number of control sera. However, accepting an antibody titre of 1:640 as indicative of Campylobacter infection, the statistical sensitivity of the ELISA system was 77% and the specificity 95%. In an epidemiological survey a high association was demonstrated between the severity of Campylobacter-related symptoms and antibody titre values. Assessment of Campylobacter antibody titres by means of this ELISA and by a complement fixation test in 92 sera from index patients and contacts with and without symptoms showed a high association of results.

A sero-epidemiological survey, using an indirect immunofluorescence test for IgG against Coxiella burnetii (phase II), was carried out in the Netherlands. Serum samples taken in 1968, 1975, 1979 and 1983 were tested. Occupational groups with a supposedly high risk of infection (veterinarians, residents of dairy farms and taxidermists) showed a significantly higher percentage of seropositives than defined controls. The percentage of seropositive amateur wool spinners was significantly higher than that of the controls from the same region. Since 1968 there has been no increase in the percentage of infected persons, indicating that, contrary to earlier assumptions, Q fever has been endemic in The Netherlands for a long time already. The increase in numbers of notified cases of overt Q fever is considered to be the result of the recent introduction of a sensitive indirect immunofluorescence test for IgM antibodies against C. burnetii. Antibody percentages in all age classes between 1 and 64 years were much alike, suggesting that most infections occur in early childhood. This is in accordance with the finding that 35% of our patients are younger than 3 years. The possibility of infection related to childbirth and lactation is discussed.

Fifty-four Rotterdam patients in which a primary infection with Campylobacter jejuni had been detected (index patients) were compared with 54 control subjects with regard to the consumption and preparation of foods 7 days before onset of illness and the keeping of pet animals. Significantly more index patients than controls had eaten chicken meat (47 v. 29; P = 0.0002), particularly at barbecues (14 v. 2; P = 0.0015). Marginally more index patients had eaten pork (47 v. 39; P = 0.048) or inadequately heated meat (13 v. 8), though in the last case numbers were too small to be statistically significant. The consumption of beef or mutton and outdoor eating (other than at barbecues) were essentially the same in both groups. There was no significant association with the keeping of pet animals, although a few more index patients had cage birds than controls (18 v. 12). Twenty-one (15%) of 136 household contacts of index patients also suffered from diarrhoea during the same period. Circumstantial evidence pointed to a common source of infection with the index patient in 13 instances (nine households) and probable intrafamilial spread of infection in six instances. Campylobacters were isolated from one of 110 swabs of kitchen work surfaces and eight of 107 swabs taken from lavatory bowls in index households.

Infection with Coxiella burnetti (Q fever) was diagnosed in 18 children younger than 3 years of age in The Netherlands during a 16-month period. The diagnosis was confirmed serologically by means of a complement-fixation test and immunofluorescence for IgM determination. A summary of the clinical, hematologic, serologic and epidemiologic features is given. Four children had relapsing episodes of fever during several months. The problem of childhood infection with C. burnetii, particularly in relation to the possibility of intrauterine infection or infection during birth and in the neonatal period, is discussed. In at least one child of this series, an infection by means of breast feeding was considered likely. Q fever is possibly underdiagnosed in children; it should be considered in children with fever of unknown origin.

Studies were conducted with four (50 to 70 kg) barrows to evaluate the mobile nylon bag technique (MNBT) for determining the apparent protein digestibility (AD) in a variety of feedstuffs. One-gram samples of each feedstuff, ground through a 1.0-mm mesh screen, were enclosed in nylon bags (25 X 40 mm; 48 microns mesh). Following predigestion (.01 N HCl; 4,000 Folin Intestinal Pepsin Units/liter), four bags of each sample were inserted into each pig via a duodenal T-cannula. The indigested contents were pooled within pig and feedstuff prior to crude protein analysis. The AD of each feedstuff was determined previously with four barrows according to the conventional method (CM), based on a 5-d total collection of feces following a 14-d adaptation period. The following results, AD (%), were obtained with the MNBT (n = 4) and CM (n = 4), respectively. Barley, 70.1 vs 81.2 (P less than .05); corn, 72.3 vs 82.1 (P less than .05); wheat, 79.6 vs 86.4 (P less than .05); corn gluten feed, 73.9 vs 70.9; rice bran, 57.3 vs 57.4; wheat middlings, 70.8 vs 79.4 (P less than .05); soybean meal, 89.9 vs 93.0; a mixture of soybean meal and hulls, 86.9 vs 88.8; coconut expeller, 65.0 vs 69.8; fababeans, 79.5 vs 78.5; peas, 87.6 vs 88.1; meat meal, 83.2 vs 84.0; complete diet (4.3% crude fiber), 76.3 vs 83.6 (P less than .05); and complete diet (13.6% crude fiber), 56.5 vs 55.0.(ABSTRACT TRUNCATED AT 250 WORDS)

Five patients with hand-, foot- and mouth disease, caused by infection with Coxsackievirus type A16, are described in an epidemic outbreak of this disease. Hand-, foot- and mouth disease, is characterized by a most distinctive enanthem-exanthemcomplex. In 65% of the cases a vesiculopapular exanthem is noted. Most cases are described in epidemic outbreaks. Although the vast majority of occurrences of the disease have been due to Coxsackie A16 viral infections, occasionally Coxsackie A5, A10 and enterovirus 71, seldom Coxsackievirus B1 or B3, have been etiologically incriminated. In this article attention is paid to the clinical characteristics, the epidemiology and the differential diagnostic aspects of hand-, foot- and mouth disease.

For several years the routine smallpox revaccination procedures at a central inoculation unit were arranged to assess the relation between vaccine titre (pock count) and success. Calf lymph batches were applied, diluted and undiluted, over a log titre range of 7.0-9.8. The dose-effect relationship did not appear to fit a linear equation on a log-probit scale, except in the lower part of the titre range. Plotted on this scale, the take rates of nearly all vaccine specimens of the required strength (> 10(8) PFU/ml) were lower than anticipated by linear extrapolation from low titres. Differences between batches were noted. These findings relate to pulp processing without purification. Fluorocarbon extraction of the calf skin harvest resulted in a 4-fold increase of vaccine volume with commensurate virus dilution; it also gave clearly higher take rates than parallel nonpurified vaccine specimens, whether at original strength or at 4-fold dilution.