Polio antibody outfit of newborns and infants born after 20 years of mass vaccination with live poliovaccine

Antibodies against type 1 and 2 poliovirus were tested in 250 infants and against type 3 poliovirus in 341 infants aged 0-13 months to compare the polio antibody outfit of newborns and infants born to three groups of mothers: (a) nonvaccinated, above 35 years of age; (b) vaccinated with attenuated poliovirus but having had chance of contact with wild poliovirus during childhood, age 22-35 years, and (c) vaccinated but not having had contact with wild poliovirus, below 22 years of age. Over 90% of newborns had specific neutralizing antibodies against all three poliovirus types. With increasing infant age the percentage of antibody-positive infants decreased: by age 9-11 months only 46%, 27% and 14% of infants displayed antibodies to polio-virus types 1, 2 and 3, respectively. Geometric mean titres decreased accordingly. Differences between infants born to mothers of the above three groups were nonsignificant: the results obtained suggest that future newborns will also possess satisfactory levels of antibodies acquired from mothers who have only had contact with attenuated vaccine poliovirus.     

Viral attributes and host factors in carcinogenesis: herpesviruses.

This paper describes two different experiments of nature: 1) the persistence of unusual virus strains of Epstein-Barr virus (EBV) (which proved oncogenic in vitro) and cytomegalovirus (CMV) in lymphoid cells following congenital or early acquired infection; 2) the occurence of multiple cases of Burkitt's lymphoma and nasopharyngeal carcinoma in one family. All the members of this family were EBV viral capsid antigen (VCA) and nuclear antigen (EBNA) antibody positive. The two patients with nasopharyngeal carcinoma had high titers of EBV-VCA, EA, and EBNA antibodies. The only member of this family having EBV early antigen (EA antibodies in addition to the patients with tumors was the mother. Borderline IgA deficiency was documented in 3 members of this family. These findings illustrate the importance of host factors (intracellular resistance to transformation and secondarily, immunological surveillance) in the outcome of the host-virus challenge whether cancer or infectious disease is the outcome. Extensive studies of these cases may provide the best insight into the mysteries of viral oncogenesis.     

Cytomegalovirus in the mononucleosis syndrome in children

In 7 children aged 18 months to 7 years isolated from a group of 128 children with infectious mononucleosis the cytomegalovirus infection was found. Infection was diagnosed by determination of antibodies against immediate early and late CMV antigen by means of the ELISA test. Besides that, antibodies were determined against the capsid antigen and early antigen of EB virus by the method of indirect immunofluorescence. In four children only cytomegalovirus infection was found and three had a mixed infection with both viruses and the diagnosis in these cases was: infectious mononucleosis (due to EBV) with coexistent or following CMV infection. In the sera of two children with cytomegalovirus mononucleosis changes were observed in the antibodies against EBV which is explained as a result of interactions between CMV and EBV in the organism of the host.     

Post-transfusion cytomegalovirus infection in newborn infants

Post-transfusional cytomegalovirus infection (P.T.C.M.V.) represents a minor part (perhaps about 0.2%) when compared with C.M.V. infections or maternal origin (congenital 0.2-0.5% - post-natal first year 20%). However P.T.C.M.V. infections are associated with higher morbidity and mortality because: These infections develop in infants born from uninfected mothers (C.M.V. sero-negative mothers). These newborns have no passively acquired antibodies from maternal origin which probably prevent or limit the spreading of P.T.C.M.V. infection in infants born from C.M.V. seropositive mothers. Transfused newborns are essentially recruited among great premature infants. The transfusional needs of these newborns are great: many of them receive more than ten micro-transfusions of red blood cells during their hospitalisation period. So the risk for developing C.M.V. infection is high (10-20%). The limited immune competence of these newborns and the fact that many already suffer from other developmental defects explain the severity of these P.T.C.M.V. infections. This contrasts with the well-supported C.M.V. infections post-natally acquired in term newborns. Prevention of P.T.C.M.V. infections is possible (A. Yeager, 1981) when using blood from C.M.V. sero-negative donors. Frozen blood appears also effective. It is highly desirable that blood Transfusion Centers permit such a prevention for red blood cells transfusion or exchange-transfusion in newborns less than 1 500 g B.W. and for intra-uterine transfusions.     

Concentration and avidity of anti-tetanus antibodies in mother-infant pairs: Relation to immunization time

Abstract The concentration and avidity of anti-tetanus antibodies in two groups of mother-infant pairs were compared. Mothers immunized during pregnancy and their newbons (group A) had significantly higher antibody concentrations than mothers immunized at least a year before their last pregnancy and their newborns (group B) as measured by an indirect enzyme immunoassay (EIA) procedure. Antibody avidity of samples was measured by an inhibition EIA technique and urea denaturation test. Although antibody avidity was higher in group B, the differences were not significant. These findings may represent a secondary antibody response to a protein antigen, when considering that all mothers in both groups had received a primary tetanus vaccination during childhood. In mothers with a history of primary tetanus immunization, a single booster dose of tetanus toxoid during pregnancy is enough to induce protective levels of antibodies with reasonably high avidity in both mother and newborn.     

Transplacental measles immunity in infants in the 1st year of life]

A total of 187 parturients (66 with a history of measles and 121 immunized with live measles vaccine, or LMV, in childhood) and their 187 newborn infants, as well as 195 children aged up to 1 year, were examined. Antimeasles antibodies in blood sera were detected in the hemagglutination inhibition test. In all mothers with a history of measles and in their newborn infants antimeasles antibodies in different titers were detected. In mothers, formerly immunized with LMV, antimeasles antibodies were absent in 5.8% and in their newborn infants, in 6.6% of the examinees. Among children aged up to 1 year, born of formerly immunized mothers, more rapid disappearance of passive antimeasles immunity was observed. In cases of contact with measles, the serological examinations of all children born of mothers immunized with LMV should be carried out in order to protect seronegative children by passive or active immunization.     

The main characteristics of outbreaks of hospital infections in the USSR in 1986-1988

The analysis of 69 outbreaks of hospital infections in different regions of the USSR in 1986-1989 (the number of patients affected by these infections was 1,517) showed that most of these outbreaks (41) occurred at hospital wards for newborn infants. Acute enteric infections prevailed in the total structure of the outbreaks (73.7%). Purulent septic infections among newborns constituted a quarter of all outbreaks. Opportunistic microbes, and mainly Klebsiella, were the dominating element in the etiology of outbreaks in hospital wards for newborn infants. In pediatric wards in among adult hospital patients the etiology of outbreaks was completely, or almost completely, determined by pathogenic microorganisms, mainly salmonellae and shigellae. Outbreaks among hospital patients of three above-mentioned groups were characterized by differences in sources, routes and factors of the transmission of infection.     

Maternal antibodies against tetanus toxoid do not inhibit potency of antibody responses to autologous antigen in newborn rhesus monkeys

Background

Our previous study suggested newborns have competent immune systems with the potential to respond to foreign antigens and vaccines. In this study, we examined infant immune responses to tetanus toxoid (TT) vaccination in the presence of maternal antibody to TT.

Methods

We examined changes in plasma levels of tetanus toxoid‐specific IgG1 (anti‐TT IgG1) in a total of eight infant rhesus macaques from birth through 6 months of age using a commercial Monkey Anti‐TT IgG1 ELISA kit.

Results

A significant correlation between anti‐TT IgG1 levels in vaccinated dams and their paired newborn infants was detected in control (non‐vaccinated) infants as previously reported. Maternal anti‐TT IgG1 levels declined rapidly within 1 month of birth in non‐vaccinated infants (n=4). In four infants vaccinated with TT at birth, we found two had rapid and robust antibody responses to vaccination. Interestingly, the other two first showed declining TT antibody levels for 2 weeks followed by increasing levels without additional vaccine boosts, indicating all four had good antibody responses to primary TT vaccination at birth, despite the presence of high levels of maternal antibodies to TT in all four infants.

Conclusions

Our data indicate that newborn macaques have competent immune systems that are capable of generating their own primary antibody responses to vaccination, at least to tetanus antigens. Maternal antibodies thus do not significantly impair antibody response to the vaccination, even when received on the day of birth in infant rhesus macaques.     

Human newborn natural killer cell responses to activation by monoclonal antibodies. Effect of culture with herpes simplex virus

Deficient responses by NK cells may contribute to the susceptibility of human newborns to severe HSV infections. Furthermore, HSV disseminates widely during neonatal infection and may also infect and interfere with the function of blood mononuclear cells (MNC). To determine whether the function of newborn NK cells would be affected by contact with HSV, and whether newborn NK cells might be permissive for HSV replication, newborn MNC were cultured with HSV in vitro for 3 days. Before culture, the intracellular calcium mobilization in newborn NK cells induced by mAb to CD2 and CD16 did not differ from that of adult NK cells. This result argues against immaturity of an early NK cell activation event in human newborns. After culture with HSV the Ca2+ flux response was unaffected by lysis of K562 targets by newborn NK cells and NK-dependent suppression of HSV replication in fibroblasts were preserved or increased. Incorporation of thymidine by NKH-1 cells following stimulation with PHA and IL-2 was not suppressed. NK cells recovered from these cultures did not contain infectious HSV and synthesis of HSV-specific proteins was not detected by immunoprecipitation although HSV genome was detected by DNA hybridization. Our results extend the in vitro model stimulation systems in which newborn NK cells respond positively to include triggering through the CD2 Ag, cross-linking of cell surface CD 16 Ag and response to a pathogen, HSV.     

双管同步换血治疗新生儿高胆红素血症的临床分析

目的:探讨外周动静脉双管同步换血术治疗新生儿高胆红素血症临床疗效。方法:回顾性分析了采用外周动静脉双管同步换血术治疗的32例高胆红素血症患儿,比较换血前后血清胆红素的变化。结果:32例患者换血前后总胆红素有明显变化,显著下降(P<0.01)。不过在治疗后出现术后感染2例,经对症处理后痊愈。结论:新生儿外周动静脉双管同步换血术治疗新生儿高胆红素血症简单、实用、安全,值得进一步推广应用。     

Alpha 1-antitrypsin deficiency in childhood

Alpha-1-antitrypsin is a blood glycoprotein synthesized in the liver. It is a protease inhibitor of the serpine group and has a specific action for elastase. Alpha-1-antitrypsin electrophoresis shows about 20 phenotypes, the normal one being PiM. The allele PiZ is usually responsible for liver or lung disease in children or adults, respectively. Eleven per cent of PiZZ infants present with prolonged neonatal cholestasis. Twenty-five of 45 PiZZ infants with prolonged neonatal cholestasis presented with later cirrhosis. Persistence of jaundice beyond the sixth month of age, early development of splenomegaly, persistence of hard hepatomegaly and liver function abnormalities, and early portal fibrosis have a poor prognostic significance. The most severe course occurs in infants with an early histologic pattern of paucity of interlobular bile ducts. Portal hypertension was present in 19 of 25 children presenting with cirrhosis; 8 of 25 PiZZ children with cirrhosis died during childhood.     

不同胎龄早产儿早期凝血指标的变化及其临床意义

目的:研究不同胎龄早产儿早期凝血指标的变化及其临床意义。方法:选取2012年1月至2017年7月期间我院出生的新生儿392例为研究对象。根据新生儿胎龄的不同分为早期早产儿组(胎龄27~31周)78例、中期早产儿组(胎龄32~33周)102例、晚期早产儿组(胎龄34~36周)116例以及足月新生儿组(胎龄37~42周)96例。四组新生儿出生后2h内抽取静脉血检测凝血指标,包括凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB),并应用Pearson相关性分析分析新生儿胎龄与上述各项凝血指标水平的相关性。结果:早期早产儿组、中期早产儿组、晚期早产儿组、足月新生儿组的出生体重以及胎龄呈逐渐上升趋势,不同组别新生儿的出生体重以及胎龄差异均有统计学意义(P0.05)。早期早产儿组、中期早产儿组、晚期早产儿组、足月新生儿组PT、APTT均呈逐渐下降趋势,FIB呈逐渐上升趋势,不同组别新生儿PT、APTT、FIB差异均有统计学意义(P0.05)。Pearson相关性分析显示,新生儿胎龄与PT、APTT呈负相关(r=-0.567、-0.691,P=0.000、0.000),而新生儿胎龄与FIB水平呈正相关(r=0.623,P=0.000)。结论:不同胎龄早产儿早期凝血功能存在异常变化,新生儿胎龄与PT、APTT均呈负相关关系,与FIB呈正相关关系,临床应予以重视,及时检测其凝血指标,必要时应予以干预治疗。     

Neonatal pneumopericardium.

Summary: Pneumopericardium developed in three newborn infants, including a set of twins, with respiratory distress syndrome. The rarity of this condition and its occurrence in two newborns suggest an anatomic predisposition, especially in premature infants requiring assisted ventilation. Two of the infants died; one had undergone pericardiocentesis. From a review of the literature and from our cases we conclude that conservative therapy appears warranted in cases of isolated pneumopericardium although the number of cases reported is too small to provide a definite answer.     

新生儿抚触的研究进展

新生儿抚触作为儿科护理的新理念,是一种对新生儿健康十分有益的自然健康医疗技术。开展新生儿抚触对新生儿有特别重要的意义。抚触可以促进婴儿体格和智能的发育、增进睡眠、稳定情绪;抚触可以增强免疫力、促进食物的消化和吸收;抚触可以促进早产儿生长发育、新生儿缺氧缺血性脑病患儿的康复;抚触可以降低新生儿黄疸、避免发生胆红素脑病;抚触可促进母婴之间情感交流;抚触可利于产后妈妈的恢复。总之,无论是对家庭、社会、医院、还是对新生儿自身来讲,抚触都是非常有意义、重要且必要的,作为家长及医院工作人员都应该了解并掌握新生儿抚触的方法以及注意事项,因此,在临床工作和家庭中都应该积极主动的广泛开展新生儿抚触,目前各国都在研究并开展新生儿抚触这种护理技术,未来新生儿抚触将会被越来越多的家庭所认识并在医院中和家庭中广泛开展。     

Fumarylacetoacetase measurement as a mass-screening procedure for hereditary tyrosinemia type I.

Fluorometric quantitative tyrosine determination on dried-blood spots is the primary neonatal screening test used for tyrosinemia type I (HT) in the province of Quebec. Succinylacetone determination on these same spots is used as the complementary test when the tyrosine level is higher than a given threshold. This procedure has proved to be less discriminant over the past few years because of changes in newborn feeding and because of early discharge of newborns from the nursery. We have developed an enzyme-linked immunosorbent assay (ELISA) to measure the deficient enzyme in HT in dried-blood spots. Fumarylacetoacetase (FAH) (E.C.3.7.1.2) was measured retrospectively by an ELISA on 25 dried-blood samples from proven patients with HT and prospectively in 72,000 specimens received in the neonatal screening program. In this pilot project, FAH was measured first, and, if necessary, succinylacetone was determined as the complementary test. All 25 samples from proven patients and specimens from four other patients detected in the pilot study have shown almost complete absence of FAH in dried-blood samples. At a cutoff level of 12.5% of normal adult blood spotted on the same type of paper, only 30 other cases disclosed FAH levels low enough to warrant succinylacetone measurement but had no detectable succinylacetone. The false-positive rate is thus 1:2,400 with this primary ELISA. However, blood transfusion in newborns prior to blood collection on filter paper may yield false-negative tests, since FAH is present in erythrocytes of normal donors.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cord blood and breast-milk antibodies in neonatal rotavirus infection.

Studies were carried out during an outbreak of rotavirus type 2 infection in a neonatal nursery to determine the protective role of antibodies in cord blood and breast milk. The range, distribution, and geometric mean titres of rotavirus-specific antibody in the cord blood were similar among rotavirus-positive and rotavirus-negative neonates, and the amount of virus excreted did not correlate with antibody levels. Despite the protective effect of breast feeding, the pattern of rotavirus-specific IgA and IgG antibodies in the expressed breast milk of mothers of babies who were rotavirus excreters and non-excreters was similar. Nevertheless, a higher proportion of expressed breast milk samples contained rotavirus-specific IgA group 2 (92%) and type 2 (97%) specific antibodies than type I (67%) antibodies, and the geometric mean titres of group 2 and type 2 specific antibodies were tenfold higher than type I antibodies. Among breast-fed babies who excreted rotavirus there was no correlation between type 2 rotavirus-specific IgA antibodies in expressed breast milk and the amount of neonatal virus excretion. These studies suggest that factors other than the rotavirus antibodies in expressed breast milk are of importance in preventing rotavirus infection in newborn infants.     

Streptococcus group B in meningitis and infection of newborn infants

Streptococci were isolated from the liquor or blood of 102 newborn infants and 16 infants in the first month of their life, suspected of having purulent meningitis, in 22 cases (18,5%). 5 isolated streptococcal strains were classified with group B on the basis of their cultural, biochemical and serological features. All of these strains were isolated from newborn infants during the first 3-4 days of their life. The occurrence of group B streptococci among all examined newborn infants was 4.8%; among the newborns with the positive results of bacteriological examination (73 infants) this figure was as high as 6.8%. The authors emphasize the necessity of producing, on an industrial scale, diagnostic preparations for the identification of group B streptococci playing a significant role in septic diseases and meningitides in newborns.     

Epidemiological aspects of cytomegalovirus infection in babies aged under one

Sreening data obtained on babies aged under one and selected by random (1,910 children) or target (2,658 children) choice for cytomegalovirus (CMV) infection during the period of 10 years (1992-2001) were compared with mortality rate. The methods used were enzyme immunoassay, immunofluorescence and polymerase chain reaction. The babies were divided as follows: newborn infants (group I), babies aged 1-3 months (group II), 4-6 months (group III) and 7-12 months (group IV). Specific clinical features of CMV infection in newborn infants were studied on 69 cases (37--with CMV monoinfection and 32--with mixed infection). The serological screening revealed a 2.1-fold growth of the infection rate among randomly selected newborn infants during the 10 year period. Positive correlation between the infection rate among children of this age group and the neonatal mortality rate was established. High risk factors of CMV infection were revealed as well as increased infection rate and frequency of clinical cases with the prevailing neurological pathology in group III. Early diagnosis, the exclusion of mixed infections and early adequate therapy were shown to play a decisive role in the outcome of the disease. The algorithm of epidemiological surveillance and the regional program of prophylaxis were worked out.     

Chromosome studies in a neonatal population

The results of chromosome studies on 6809 consecutive newborn infants are presented. One hundred and one (1.48%) were heterozygous for a marker chromosome, the significance of which is not at present clear. Twenty-two infants (0.32%) had a major chromosome abnormality. Only six of these infants (0.09%) had a clinically recognizable abnormal phenotype (Down''s syndrome). The occult chromosome abnormalities included five sex chromosome abnormalities (one 47,XYY; two 47,XXY; two 47,XXX) and 11 balanced translocations. Seven of these were t(DqDq) and four were reciprocal translocations. The results of the present survey are combined with four other similar neonatal surveys in which a total of 23,328 newborns have been screened. Of these, 117 (0.5%; range 0.65-0.32%) had major chromosome abnormalities. The majority of these (72.7%) would not have been detected at birth without chromosome studies, an important fact in the context of prenatal diagnosis of chromosome disease and the early ascertainment of high-risk families.     

Perinatal care in British Columbia: Diagnosis and management of hemolytic disease of the newborn

We undertook to measure standards of perinatal care in British Columbia by studying the management of hemolytic disease of the newborn as the sample situation.Our data show that many isoimmunized pregnant women are delivered in hospitals that have infrequent experience with this problem, and by physicians who have little experience with this disease.The physician referral pattern, in regard to maternal isoimmunization, indicated that the more severely affected patients were managed by specialists, particularly those attached to teaching hospitals. However, 25% of the infants treated by exchange transfusion were managed by nonspecialists in nonteaching hospitals.Hospital record search, used as a method of medical audit and as a source of data for comparison with physician reports, did not result in dependable or complete information. Rates of disagreement between items from two data sources, physician report and hospital record, were frequently very high. Our experience suggests that comparison of these two data sources is not an ideal method of assessment of quality of care.A smaller caseload of isoimmunized pregnant women will result from the present prevention program. Nevertheless, cases will continue to occur. Our work supports the conclusion that a program of continuing education covering the diagnosis and management of hemolytic disease of the newborn is still necessary.