Cellular and humoral immunodeficiency in children with vaccine-associated paralytic poliomyelitis

Markers of humoral and cellular immunity in 16 patients with vaccine-associated paralytic poliomyelitis (VAPP) were evaluated. Signs of immunodeficiency (decrease of T- and B-lymphocytes counts, impaired synthesis of immunoglobulins, defects of phagocytosis, decrease of NK number) were revealed in all of the patients. Majority of them (81.3%) had defects in humoral immunity. Decrease of CD31, CD4+ and CD8+ was detected in 86.7, 35.7 and 91.7% of the patients respectively. Study of serum immunoglobulins performed in 15 patients showed decrease of IgG, IgM and IgA levels in 6 (40%), 1 (6.7%) and 6 (40%) of the patients respectively. Agammaglobulinemia was diagnosed in one patient in which only trace quantities of IgA and IgG were detected and IgM level was well below the normal. Congenital deficiency of IgA was diagnosed in 3 children. Majority of the children (11 from 12) had comorbidities (frequent respiratory infections, dermatitis, changes of intestinal microflora). Thus, immunocompromised condition of a child is a risk factor for VAPP after administration of alive oral poliovaccine.     

Restless leg syndrome and associated factors in patients with paralytic poliomyelitis

Sleep and Biological Rhythms - The aim of this study was to assess the presence of Restless Leg Syndrome (RLS) in patients with poliomyelitis, and associated factors. Forty-six patients with...     

脑脊液乳酸和血清降钙素原及C反应蛋白对小儿细菌性脑膜炎的诊断价值

目的 探讨脑脊液乳酸、血清降钙素原及C反应蛋白对小儿细菌性脑膜炎的诊断价值。方法 选取我院2016年4月至2017年6月收治的50例细菌性脑膜炎患儿以及50例病毒性脑膜炎患儿进行作为研究对象,比较2类患儿脑脊液乳酸（LA）、血清降钙素原（PCT）及C反应蛋白（CRP）的水平,并分析其诊断价值。结果 细菌性脑膜炎组患儿脑脊液LA、血清PCT及CRP水平显著高于病毒性脑膜炎患儿（均P<0.05）。血清PCT诊断的灵敏度和特异度最高（96.4%、90.9%,P<0.05）。3项指标联合检测的灵敏度（100.0%）和特异度（95.5%）明显高于任一单项指标（均P<0.05）。经过Pearson相关性分析,脑脊液LA、血清PCT及CRP与小儿细菌性脑膜炎均呈显著正相关关系（均P<0.05）。结论 脑脊液乳酸、血清PCT及CRP对小儿细菌性脑膜炎的诊断和治疗效果监测有重要应用价值。     

Outbreaks of paralytic poliomyelitis and polio surveillance in Shandong province of China.

Widespread outbreaks of paralytic poliomyelitis occurred in Shandong province, China, starting from 1988. In 1989, 484 cases were recorded, which was the peak during the past 4 years. Although emergency immunization with trivalent oral poliovirus vaccine (OPV) was carried out in selected counties in 1989 and 1990, control of the outbreak was not satisfactory. OPV mass immunization campaigns were introduced to cover the whole province in early 1991, and the number of patients with paralytic poliomyelitis decreased to 95. In addition to this new immunization strategy, we began to construct new polio surveillance systems. These were a network for case-negative reporting and an immediate reporting system of acute flaccid paralysis (AFP). As for the case-negative reporting, presently more than 90% of counties have been reporting presence or absence of new AFP cases. Monitoring of AFP immediate reporting has also shown a gradual improvement in several aspects. These polio surveillance activities are crucial to polio eradication programme management.     

Patterns in the spread and serovirological diagnosis of serous meningitis

The epidemiological and clinico-etiological study of cases of acute serous meningitis with unknown etiology in children was carried out in a large industrial city at the period of a considerable morbidity rise caused by this infection. The maximum morbidity was registered among younger children under school age attending children's institutions. In 26 closed groups of children group morbidity was revealed (4 cases and more), in 5 such groups small local outbreaks were registered. The clinico-instrumental methods of study permitted one to differentiate the groups of children having serous meningitis of supposedly enteroviral etiology, and sero virological studies carried out with the use of a wide range of diagnostic reagents revealed the etiological role of group B Coxsackie virus, mainly type 4, in 20.6% of cases, ECHO virus, serotypes 3 and 11, in 20.7% of cases, and parotitis virus in 5.3% of cases.     

深圳市2005—2012年脊髓灰质炎疫苗相关病例流行病学分析

目的了解深圳市脊髓灰质炎疫苗相关病例(VAPP)发生情况及流行病学特征,为消灭脊髓灰质炎后期脊灰疫苗免疫策略的研究提供基础数据。方法采用流行病学方法对深圳市2005—2012年残留麻痹急性弛缓性麻痹AFP病例个案资料、病原学检测结果、VAPP病例进行分析。结果 2005—2012年共报告残留麻痹病例55例,其中VAPP病例8例,占15.54%;深圳市VAPP病例均为小年龄组小于6月龄的儿童,总发生率0.20/10万,无接触者VAPP病例,其中首次服苗的VAPP发生率为0.51/10万;无明显的地区和时间分布聚集性。结论 VAPP的发生是接种脊髓灰质炎减毒活疫苗难以克服的弱点,为减少VAPP病例及防止脊灰疫苗衍生病毒的发生,应在消灭脊髓灰质炎后期科学、合理地调整消灭脊髓灰质炎的免疫策略。     

Preparation and seric form of rabbit C reactive protein]

The preparation of rabbit C-reactive protein (CRP) involves a single step affinity chromatography. This preparation takes advantage of the calcium-dependent affinity of CRP for an agarose gel bearing 2-aminoethanol dihydrogen-phosphate as a ligand. A prior chromatography on agarose gel without the ligand allows the uptake of the serum amyloid P-component (SAP). The CRP prepared according to this method is able to form precipitating complexes in agarose with rabbit lipoproteins. The specificity of these interactions is studied. It is demonstrated that CRP-High Density Lipoproteins (HLD) association produces a second precipitation arc when the pure CRP is revealed by a specific antiserum in agarose. Moreover, CRP in the serum is shown to be in the bound form only, and the binding involves Low Density Lipoproteins (LDL) exclusively.     

Water-borne outbreak of serous meningitis caused by Echovirus-30 in Belarus

In recent years outbreak of enterovirus infections caused by Echovirus-30 were rather frequently registered in different European countries. A major outbreak caused by this virus took place during the summer-autumn period of 1997 in the city of Gomel, Belarus. Sanitary epidemiological and molecular epidemiological studies made it possible to determine that the outbreak was water-borne. The sequence analysis of Echovirus-30 strains isolated from water and the cerebrospinal fluid of patients revealed a minor divergence between them (0.2%) indicative of their practical identity. The comparison of the Belorussian isolates with the strains isolated in Europe in 1994-1998 also showed a small percentage of differences in their genomes, which showed that the outbreak of Echovirus-30 infection was probably brought to Belarus from the territories of European countries.     

C reactive protein concentrations during long distance running.

Long distance runners competing in events ranging from 15 to 88 km showed a distance related acute phase response as indicated by significantly raised serum C reactive protein concentrations. In trained athletes only a small rise in C reactive protein concentrations was seen after races of less than 21 km. After an 88 km ultramarathon concentrations comparable to those found in patients with small myocardial infarctions were detected. Indomethacin did not affect the increases in C reactive protein after the ultramarathon. This study has established serial C reactive protein concentrations for given race distances. These data may help in diagnosing myocardial infarction during long distance running. The acute phase response should be measured in untrained people running shorter distances to provide comparative data for the physically untrained population.     

Isolation of an intertypic poliovirus capsid recombinant from a child with vaccine-associated paralytic poliomyelitis

The isolation of a capsid intertypic poliovirus recombinant from a child with vaccine-associated paralytic poliomyelitis is described. Virus 31043 had a Sabin-derived type 3-type 2-type 1 recombinant genome with a 5'-end crossover point within the capsid coding region. The result was a poliovirus chimera containing the entire coding sequence for antigenic site 3a derived from the Sabin type 2 strain. The recombinant virus showed altered antigenic properties but did not acquire type 2 antigenic characteristics. The significance of the presence in nature of such poliovirus chimeras and the consequences for the current efforts to detect potentially dangerous vaccine-derived poliovirus strains are discussed in the context of the global polio eradication initiative.     

The acute-phase proteins serum amyloid A and C reactive protein in transudates and exudates

The distinction between exudates and transudates is very important in the patient management. Here we evaluate whether the acute-phase protein serum amyloid A (SAA), in comparison with C reactive protein (CRP) and total protein (TP), can be useful in this discrimination. CRP, SAA, and TP were determined in 36 exudate samples (27 pleural and 9 ascitic) and in 12 transudates (9 pleural and 3 ascitic). CRP, SAA, and TP were measured. SAA present in the exudate corresponded to 10% of the amount found in serum, that is, the exudate/serum ratio (E/S) was 0.10 +/- 0.13. For comparison, the exudate/serum ratio for CRP and TP was 0.39 +/- 0.37 and 0.68 +/- 0.15, respectively. There was a strong positive correlation between serum and exudate SAA concentration (r = 0.764; p < 0.0001). The concentration of SAA in transudates was low and did not overlap with that found in exudates (0.02-0.21 versus 0.8-360.5 g/mL). SAA in pleural and ascitic exudates results mainly from leakage of the serum protein via the inflamed membrane. A comparison of the E/S ratio of SAA and CRP points SAA as a very good marker in discriminating between exudates and transudates.