Measles morbidity among children inoculated against this infection

In the serological survey of 2009 children immunized against measles 285 children (14.2%) were found to be seronegative to this infection in the hemagglutination inhibition test with 4 hemagglutinating units of the antigen. Among 1724 immunized children showing positive response to vaccination and placed under dynamic observation for 11 years, 2 cases of measles were registered. At the same time, in the dynamic observation of 111 seronegative children 66 measles cases (59.5%) were registered during the above period, while among 169 children, also seronegative, but receiving booster immunization against measles, morbidity rate was only 1.2%. In some vaccinees the decrease of postvaccinal immunity to seronegative values was observed, but such decrease had no essential influence on the morbidity level among the vaccines. The increase of measles morbidity among schoolchildren immunized against this infection was due not to the decrease of their postvaccinal immunity, but to their concentration in schools and to their more intensive contacts with the sources of infection in comparison with children of preschool age.     

Influence of multiplicity of immunizations of children with inactivated influenza vaccine on immune response and the effectiveness of protection

The formation of immunity and epidemiological effectiveness of inactivated influenza vaccines in children, regularly immunized against influenza for three years, were evaluated. The study revealed that a year after each immunization the number of children having antibodies in liters regarded as protective decreased 2-2.5 times. At the periods of epidemics morbidity rate among the vaccines dynamically decreased in these years 1.3, 2.0 and 2.8 times. Considering that a year after the second immunization a high immune stratum (60-78%) was retained in the group under study, we propose that annual immunization of the same children be limited by a period of three years, followed by an interval of one year.     

Effectiveness of the seroprophylaxis of tick-borne encephalitis depending on the titer of homologous gamma-globulin antihemagglutinins

To give a rationale for using homologous gamma globulin with antihemagglutinin titers of 1 : 20 to 1 : 80 for the prophylaxis of tick-borne encephalitis, 5-year observations covering all persons attacked by ticks in one of the intensive natural foci of the disease in the Western Urals have been made. The threefold statistically significant difference in the morbidity rate of tick-borne encephalitis between groups of persons immunized and not immunized with gamma globulin has been shown.     

Total immunization of children against influenza decreases morbidity in a number of diseases among elderly persons during influenza epidemic

Immunization of children aged 3-6 years in kindergartens and school children aged 7-17 years against influenza with inactivated influenza vaccine was carried out in two districts of the Moscow region. The comparison of morbidity in influenza-like diseases among the immunized children with that among nonimmunized children in control districts revealed that the effectiveness of immunization was 60.9% in kindergartens and 68.8% in schools. The analysis of morbidity in a number of diseases among 158,451 elderly persons not immunized against influenza demonstrated that, in comparison with the control districts, in those districts where mass immunization of children was carried out morbidity in influenza-like diseases among elderly persons was 3.4 times lower and, out of other 10 diseases under study, morbidity in 8 diseases was 1.5-2.6 times lower. As indicated by the data obtained in this study, total anti-influenza immunization of children in organized groups not only essentially decreased influenza morbidity among children, but also greatly decreased morbidity in influenza and a number of diseases, appearing as complications of influenza infection, among nonimmunized elderly persons during influenza epidemic.     

Whooping cough morbidity and inoculation status

The analysis of pertussis morbidity and the state of immunity to pertussis has made it possible to evaluate the existing epidemiological situation as unfavorable. The restraining influence of specific prophylaxis on the epidemic process of pertussis becomes weaker due to the growing number of nonimmunized children; for this reason, the maximum morbidity rate in pertussis is observed among children under 5 years of age, as it was at the period before the introduction of mass immunization against pertussis. To prevent further possible increase in the intensity of the epidemic process of pertussis and in the severity of the clinical course of the disease, the number of children under 3 years of age, not immunized against pertussis, must be reduced by limiting the number of children exempted from immunization on medical grounds and by increasing the proportion of children immunized from the age of 3 months.     

Immunogenicity and the protective effectiveness of the subunit trivalent influenza vaccine Grippovac

In the process of the immunological approbation of several experimental batches of the triyalent subunit influenza vaccine Grippovac, the pronounced immunogenicity of the antigens of all strains contained in the vaccine was established; most of the vaccinees were found to retain sufficiently high antibody titers for a year, and the essential total increase of antibody titers was found to occur after a single booster immunization. The serological checking of the diagnosed cases of influenza among immunized and nonimmunized children, carried out in two boarding schools during the influenza epidemic in the winter of 1984-1985 provided the proofs of the high effectiveness of Grippovac in preventing viral influenza, types A and B: the decrease of influenza morbidity among the immunized children reached 79,5-67,2-66,5% and the total morbidity rate in influenza in these two boarding scholls dropped, on the average, 3,0-3,5 times.     

Assessment of the prophylactic effectiveness of an inactivated influenza vaccine by immunizing schoolchildren in the springtime

To evaluate the prophylactic effectiveness of influenza inactivated chromatographic vaccine, limited epidemiological observations were made on school children aged 11-14 years in Leningrad, in the autumn of 1981 and the spring of 1982. For immunization, made in a single administration, the vaccine composed of A (H3N2) + +A (H1N1) and containing 3.0-3.4 micrograms of hemagglutinin of each component per 0.2 ml of the preparation was used. Altogether 6928 schoolchildren were under observation; of these, 3686 children were immunized and 3242 children received placebo. The results of questioning and the analysis of morbidity rate among the schoolchildren, both immunized and receiving placebo, showed the safety and low reactogenicity of the vaccine irrespective of the time of the immunization campaign. The immunogenic potency of the preparation, as indicated by all observation results, proved to be higher in spring, than in autumn. The data thus obtained indicate that children immunized in spring were better protected and retained a higher level of protection within 12 months after immunization. The shift of the time of the immunization campaign from autumn to spring increased the immune layer in the groups of children by 16.5%. In 10 months after spring immunization the morbidity rate in influenza and acute respiratory diseases among the vaccinees was found to decrease 1.7 times.     

不同剂量丙种球蛋白联合地塞米松治疗儿童特发性血小板减少性紫癜的疗效观察

目的:探讨不同剂量丙种球蛋白联合地塞米松治疗儿童特发性血小板减少性紫癜(ITP)的临床疗效。方法:选择2010年7月至2015年7月间我院收治的特发性血小板减少性紫癜患儿78例,按照随机数字表法将其分为观察组38例及对照组40例。观察组采用200 mg/(kg·d)丙种球蛋白联合地塞米松进行治疗,对照组采用400 mg/(kg·d)丙种球蛋白联合地塞米松进行治疗。对两组患者的临床疗效、治疗前后血小板计数、血小板上升时间、血小板恢复正常时间、出血停止时间、住院时间、不良反应及医疗费用进行观察。结果:两组患儿血小板计数治疗前无显著差异(P0.05),治疗后两组血小板计数均呈逐渐升高趋势(P0.05),但组间比较无统计学差异(P0.05)。两组患儿血小板上升时间、血小板恢复正常时间、出血停止时间及住院时间均接近,无统计学差异(P0.05)。观察组治疗总有效率为94.74%,对照组为95.00%,两组无显著差异(P0.05)。观察组不良反应发生率为8.17%,对照组为12.50%,两者相比无统计学差异(P0.05)。观察组患儿平均医疗费用为(1.25±0.34)万元,对照组患儿平均医疗费用为(2.31±0.40)万元,观察组明显低于对照组,两者差异有统计学意义(P0.05)。结论:不同剂量丙种球蛋白联合地塞米松治疗ITP具有类似的临床疗效及安全性,但小剂量丙种球蛋白组治疗费用明显降低,因此值得临床推广应用。     

激素联合丙种球蛋白治疗小儿重症肌无力的疗效及对患儿免疫球蛋白和补体的影响

目的：探讨激素联合丙种球蛋白治疗小儿重症肌无力的临床疗效及对患儿免疫球蛋白和补体的影响。方法：回顾性分析在我院治疗的70例重症肌无力患儿的临床资料,采用随机序号的方式将其分为观察组和对照组各35例,观察组给予甲泼尼龙联合丙种球蛋白,对照组仅给予甲泼尼龙,观察两组的临床疗效及免疫球蛋白和补体变化情况。结果：观察组总有效率为94．3％明显优于对照组74．3％,两组比较有统计学意义（P〈0．05）;观察组症状明显缓解时间（6．55±1．35）d以及总住院天数（17．15±3．65）d较对照组明显缩短,两组比较差异均有统计学意义（P〈0．05）。结论：采用激素联合丙种球蛋白治疗小儿重症肌无力,可以明显改善患者肌无力症状,获得较为满意的临床疗效,值得进一步推广使用。     

Immunoprevention of staphylococcal infections at an industrial enterprise

The immunogenicity, immunological and epidemiological effectiveness of the subcutaneous, enteral and combined immunizations of the workers at a steel plant with staphylococcal toxoid has been studied. The subcutaneous injection of the adsorbed toxoid in a dose of 0.2 ml by means of the jet injector, model, was accompanied by moderate reactogenicity (the frequency of local reactions was 26.8%, and the frequency of systemic reaction 18%) and produced 4-fold increase in antitoxin titers and 12-fold decrease in the morbidity rate of staphyloccal infection. Enteral immunization in 3 administrations proved to be nonreactogenic and only slightly effective (antitoxin titers increased more than 2-fold, morbidity rate fell 2-fold). Combined immunization (subcutaneous and enteral) with the toxoid, preceded by the injection of gamma globulin, reduced the frequency of reaction 2- to 3-fold and stimulated antitoxin production (the titer increased 8-fold), thus decreasing the morbidity rate of staphylococcal infection 3.1-fold.     

INFECTIOUS HEPATITIS—Report of an Outbreak of 24 Cases

In an epidemic of 24 cases of infectious hepatitis in a small lumbering community, the majority of cases occurred in children. Sixteen of them were pupils in one school. The school apparently was the focus for the spread of infection, which is thought to have been through contact between persons. Five multiple case households with eight secondary cases were observed. With one exception, gamma globulin was not used for the prophylaxis of infectious hepatitis in families in which one member had the disease.     

Infectious hepatitis; report of an outbreak of 24 cases

In an epidemic of 24 cases of infectious hepatitis in a small lumbering community, the majority of cases occurred in children. Sixteen of them were pupils in one school. The school apparently was the focus for the spread of infection, which is thought to have been through contact between persons. Five multiple case households with eight secondary cases were observed. With one exception, gamma globulin was not used for the prophylaxis of infectious hepatitis in families in which one member had the disease.     

Prevention of infections hepatitis by gamma globulin

Infectious hepatitis, a viral disease, has become increasingly more important in recent years. It is believed that the great increase in reported cases is not due entirely to better reporting, but that there has been an actual increase in the incidence of this disease. The comparatively long incubation period in infectious hepatitis, the high incidence in persons in close contact with patients who have the disease, and the fact that in most instances contact between persons is the mode of spread, makes this disease particularly suitable for the use of an immunizing agent which would be administered after exposure. From the studies reviewed it is apparent that gamma globulin is of value in preventing hepatitis both when administered as mass prophylaxis in an epidemic, and when given to persons in close contact with a person who has the disease. Widespread use of gamma globulin prophylactically among persons who have been in close contact with the occasional patients with infectious hepatitis seen by practicing physicians might often obviate the need for mass immunization. It should be stated that there is little evidence for the effectiveness of gamma globulin in the therapy of infectious hepatitis. In a study in which very large amounts (average dose 45 cc.) of gamma globulin were given very early in the disease, no significant difference was observed between those injected and a control group.     

Immunological effectiveness of a booster inoculation against measles in children remaining seronegative after vaccination

Booster immunization against measles with a highly immunogenic vaccine leads to the development of prolonged postvaccinal immunity lasting at least 6-7 years (the term of observation) in the groups of children found to be seronegative after the titration of their blood sera with 1 hemagglutinating unit (HAU) of the antigen. The booster immunization of children in whose blood sera the minimal concentrations of antibodies can be determined in the presence of 1 HAU of the antigen (seronegative in the presence of 4 HAU) is less effective. The serological checks of immunized children entering preschool institutions and the primary grades at schools and the subsequent booster immunization of children found to be seronegative will lead to a further decrease in measles morbidity.     

PREVENTION OF INFECTIOUS HEPATITIS BY GAMMA GLOBULIN

Infectious hepatitis, a viral disease, has become increasingly more important in recent years. It is believed that the great increase in reported cases is not due entirely to better reporting, but that there has been an actual increase in the incidence of this disease. The comparatively long incubation period in infectious hepatitis, the high incidence in persons in close contact with patients who have the disease, and the fact that in most instances contact between persons is the mode of spread, makes this disease particularly suitable for the use of an immunizing agent which would be administered after exposure.From the studies reviewed it is apparent that gamma globulin is of value in preventing hepatitis both when administered as mass prophylaxis in an epidemic, and when given to persons in close contact with a person who has the disease. Widespread use of gamma globulin prophylactically among persons who have been in close contact with the occasional patients with infectious hepatitis seen by practicing physicians might often obviate the need for mass immunization. It should be stated that there is little evidence for the effectiveness of gamma globulin in the therapy of infectious hepatitis. In a study in which very large amounts (average dose 45 cc.) of gamma globulin were given very early in the disease, no significant difference was observed between those injected and a control group.     

Economic effectiveness of using a live measles vaccine in an agricultural area of the Ukrainian SSR

Economic effectiveness of vaccination against measles in an agricultural region of the Ukrainian SSR has been studied. At the period preceding vaccination expenses for each measles patient in the country were three times as low as those in towns. At the period of vaccination a considerable decrease in expenses covering the payment of sick-leave certificates given to mothers taking care of their sick children, in losses connected with absenteeism, in expenses for gamma globulin prophylaxis and the hospital treatment and outpatient servicing of measles patients was observed due to the sharp drop of the total morbidity rate and the increased number of school children among measles patients. In urban and rural areas the equalization of expenses for each patient occurred. In spite of increased expenses for each measles patient, the considerable economy of sums spent for controlling measles was achieved: about 70,000 rubles per annum.     

Comparison of immune response potentiation and in vivo inflammatory effects of Freund's and RIBI adjuvants in mice.

Freund's adjuvant and the RIBI adjuvant system were compared for their immune potentiating and toxic effects. Each adjuvant was administered with benzo(a)pyrene (BaP), a nonimmunogenic hapten, conjugated to a bovine gamma globulin (BGG) carrier protein to 10 mice intraperitoneally. Complete Freund's adjuvant was used at initial immunization, while incomplete Freund's was used for booster immunizations. Five mice were given the immunogen conjugate (BaP-BGG) in saline as a control. Antibody titers were determined by ELISA to both hapten and carrier after each of the two booster immunizations. Titers to BaP were 2- and 27-fold higher for RIBI than for Freund's after each of two booster immunizations. Titers to bGG were 119 and 12-fold higher for RIBI compared with Freund's. Titers to both immunogens were markedly less when administered in saline. Body weights were monitored in all three groups for the duration of the study. No differences were observed among the three groups. Mice from each group were euthanized at regular intervals to assess pathology. Splenic weight:body weight ratios were determined at the time of necropsy, and no differences were noted among the three groups. Granulomatous inflammatory lesions were most severe in the Freund's immunized mice, less severe in those immunized with RIBI, and least with saline. Results indicate that the RIBI system was more effective in potentiating an immune response and elicited less tissue reaction than did Freund's adjuvant with this particular immunogen.     

Immunostructure of school-age children inoculated against measles

The mass serological survey of school children immunized against measles was carried out by means of the hemagglutination inhibition test. As a result, 20.4% of these school children were found to be seronegative, and in 9.5% of them even the minimum concentration of measles antihemagglutinins (when titrated with 1 hemagglutinating unit of the antigen) was not detected. The accumulation of a considerable seronegative (measles-susceptible) stratum among children of school age occurred due to the low immunogenic potency of some batches of live measles vaccine, used for immunization in 1973, as well as due to the formerly practiced immunization of children under 1 year of age. A direct and close dependence of focal measles morbidity among immunized children having had contacts with the source of infection on the number of children among them, found to be seronegative after titration with 1 hemagglutination unit of measles antigen, was established.     

Live enteroviral vaccines for the emergency nonspecific prevention of mass respiratory diseases during fall-winter epidemics of influenza and acute respiratory diseases]

The results of the 3-year controlled trials of a new method of nonspecific urgent prophylaxis of influenza and acute respiratory diseases (ADR) by immunization of healthy adults with standard live enterovirus oral vaccines, introduced in 2-3 administrations at intervals of 7-10 days, at the initial stages of autumn and winter epidemics are presented. Observations, carried out in three republics, covered more than 150,000 persons immunized with enterovirus interferonogenic vaccines. A considerable decrease in morbidity rate among the vaccinees was achieved (on the average, by 3.2 times) in comparison to that among nonimmunized subjects. The method of nonspecific prophylaxis with live enterovirus interferonogenic vaccines is recommended during outbreaks of diseases induced simultaneously by several causative agents of influenza and ARD, as well as by pathogenic enterovirus strains.     

Evaluation of the prophylactic effect of gamma globulin in meningococcal infection.

Results of two controlled epidemiological tests evaluating the prophylactic effect of gamma globulin of Monogolian and Soviet production against meningococcal infection are presented. Observations were carried out on children aged 3 months to 4 years, not attending children's establishments. The results of the observation revealed the following prophylactic effect of gamma globulin of Mongolian production in the first two months after administration: index of efficiency--5.0, coefficient of efficiency--80%, P greater than 0.01. The efficiency of the prophylactic effect of Soviet gamma globulin was limited to one month: the index of efficiency amounted to 5.3, the coefficient of efficiency to 82.2%, P greater than 0.01. The course of meningococcal infection in the children who had received gamma globulin was less severe than in the children of the control group. Lethal outcome was recorded only in the group of children who had not received gamma globulin. The duration of the prophylactic effect of gamma globulin was found to depend on the height of the titres of specific antibodies in the preparation. The preparations are recommended as prophylactic means for children aged from 3 months to 4 years in doses of 1.5 ml (one dose) in the foci of meningococcal infection.