Are healthcare workers in England and Wales at increased risk of tuberculosis?

OBJECTIVE: To determine whether healthcare workers in England and Wales are at increased risk of tuberculosis and to examine the frequency of drug resistance in this population. DESIGN: Comparison of notification rates by occupation obtained from national tuberculosis notification surveys in 1988 and 1993, with denominators from the 1991 census. SUBJECTS: People with notified tuberculosis in professional and associate professional occupations from the two surveys. MAIN OUTCOME MEASURES: Rates of notified tuberculosis in health professionals (mainly doctors) and health associate professionals (mainly nurses) compared with rates in other professional and associate professional occupations, adjusted for ethnic group, sex, and age. RESULTS: 119 cases of tuberculosis were identified in healthcare workers, including 61 nurses and 42 doctors. The crude notification rate in healthcare workers was 11.8 per 100,000 per year (95% confidence interval 9.8 to 14.1) compared with 3.3 per 100,000 per year (2.9 to 3.6) in other professional and associate professional occupations; rate ratios were higher (range 1.7 to 3.2) in all ethnic groups. The relative risk adjusted for ethnic group, sex, and age was 2.4 (95% confidence interval 2.0 to 3.0), slightly higher for health professionals (2.7 (1.9 to 3.8)) than for associate professionals (2.0 (1.5 to 2.6)). No multiple drug resistant strains of tuberculosis were identified in healthcare workers. CONCLUSIONS: Better detection and notification of cases of tuberculosis in healthcare workers may account for some of the apparent increased risk, but these findings imply that tuberculosis remains a hazard for healthcare workers and highlight the importance of ensuring that occupational health monitoring and protection workers are not neglected.     

Ixodes scapularis Say on white-tailed deer (Odocoileus virginianus) from Long Point, Ontario.

Ixodes scapularis Say was the only species of tick found on white-tailed deer, Odocoileus virginianus, collected at Long Point, Ontario from October 1972 to August 1973. Adults were most abundant from September 1972 to April 1973. Larvae were found throughout the study period except during February. Nymphs were scarce during winter months but fairly common during spring and summer. Most adults were found on the neck and shoulders. Larvae occurred mainly on lower regions of the body and nymphs mainly on the head, shoulders, forelegs and brisket.     

THE SUSCEPTIBILITY OF THE PLANT CELL TO VIRUS DISEASE

A number of spraying experiments showed that the virus cannot enter a plant unless some of the cells are injured. It is not essential that such injury should be brought about in the presence of the virus. The chances of infection fall off rapidly in the first few minutes after injury, but infection occurs occasionally as long as half an hour after the cell is damaged.
Inoculations by micropipette into single cells of the host plant yielded only about one-tenth of the expected number of infections. This suggests differences in the susceptibility of the cells to virus attack.