Assessment of the diagnostic effectiveness of antigenic preparations from Sonne shigellae]

The authors studied the diagnostic possibilities of 4 diagnistic agents from Sh. sonnei. A total of 1500 from 1122 persons were investigated. Specificity and sensitivity of the diagnostic agents from Sh. sonnei were determined. Methodical priciples of the objective assessment of the diagnostic efficacy of the antigenic preparations in the controlled epidemiological trial were elaborated. A possibility of establishment of the etiological diagnosis of Sonne dysentery in the passive hemagglutination or blast agglutination tests by the results of testing with the diagnostic agents of the serum obtained from the patient once or by determining the dynamics of the antibody titre rise in coupled serum portions was not great.     

Study of the immunological effectiveness of the enteral vaccination of volunteers with detergent Sonne dysentery monovaccine]

The authors evaluated the immunological results of enteral and subcutaneous injection of detergent Sonne dysentery vaccine to volunteers (changes in homo- and heterologous antibodies in the blood and saliva recorded by means of common indirect hemagglutination test and that modified according to Coombs' test, and IgG, IgM, and IgA concentration recording. Both immunization methods induced specific antibody formation: enteral vaccination caused chiefly the accumulation of secretory antibodies of IgA class, and subcutaneous -- of serum antibodies belonging to IgG class. The supposed mechanisms determining the capacity of enteral administration of the antigen to provoke an immune response different from that caused by its subcutaneous injection are discussed.     

Changes in the etiologic structure of Sonne shigellosis in its multiyear dynamics

The dynamics of Sonne dysentery morbidity in connection with changes in the structure of S. sonnei circulating among the population of Leningrad for the period of 1959-1984 was studied. Considering such sign as the leading fermentovar, three smaller periods were established in this stretch of time. Changes in the structure of circulating shigellae were accompanied by changes in the intensity and direction of tendencies or decrease in the manifest and asymptomatic forms of infection, as well as in annual morbidity levels and seasonal rises. A slow decrease in morbidity, which started in 1974, occurs in the presence of the predominant circulation of S. sonnei, fermentovar II, among the population; this fermentovar showed greater virulence and immunogenicity than other biovars. One of the decisive moments characterizing the dynamics of the epidemic process of Sonne dysentery is the intensity of the circulation of shigellae in the S-form, and the intensity of the population immunity of the host, linked with this fact, is subject to phasic fluctuations during each annual epidemic cycle.     

The possibility of using the demonstration of Shigella antigens in the study of the epidemic process in dysentery

The detection of Shigella antigens in feces in accordance with the results of the passive hemagglutination test is more effective than the bacteriological method for finding out persons infected with Shigella, especially in the absence of pronounced clinical manifestations of dysentery, and can be used in the study of the mechanism of the epidemic process. The examination of two groups, each consisting of permanent and temporary members, has revealed that the use of this method for detection of the antigen makes it possible to perform the epidemiological analysis of morbidity and, in particular, to determine the source(s) of infection.     

Conditions and factors determining the etiological structure of dysentery and its changes. Report 1. Epidemiological theory of etiological selectivity of the main (primary) pathways of infection and their differences in various nosological forms of dysentery]

The authors present the elaborated and formed epidemiological theory ("conformity theory") according to which the etiological structure of dysentery is determined by the etiological selectivity of the main (primary) waves of transmission of the infection differing in various nosological forms of dysentery. In Grigoriev-Shiga dysentery the domestic way of the spread of infection plays the main role, in Flexner and Newcastle dysentery--the water way, and in Sonne dysentery--the food way (particularly through the milk). Evolution of the etiological structure of dysentery serves as the reflection of evolution of the principal ways of transmission. The complex of prophylactic and antiepidemic measures in individual noslogical forms of dysentery should be differentiated and be directed in epidemiological sense to the neutralization of the corresponding main (primary) way of transmission of the infection.     

Population migrations and the epidemic process of Flexner and Sonne dysentery

Analysis of the materials from the Khabarovsk Territory for the representative period of 25 years (1956-1980) revealed the influence of the migration of the population on the level and dynamics of morbidity in different kinds of dysentery, Flexner's dysentery shown to occur more frequently than Sonne dysentery. Intensive migrations increase the proportion of susceptible persons among the population, thus facilitating the formation and circulation of Shigella strains with pronounced virulence.     

Isolation and characteristics of Shigella antigens during the course of dysentery

In 2,436 fecal samples and 1,272 urinary samples taken from 633 patients with dysentery caused by S. flexneri, S. newcastle and S. sonnei, Shigella antigens were detected by means of the passive hemagglutination test with antibody diagnostic agents and the antibody neutralization test. The antigen-binding activity of shigellae in urine dynamically increased in the course of dysentery. The comparison of the parallel results of both serological tests made it possible to evaluate the dispersion of the released antigen: it dynamically increased in the course of the disease, this increase being particularly high in feces. The dispersion of Shigella antigens in urine was greater than in feces over the entire course of the disease. These regularities in the release of the antigens and especially the specific features of the serological tests determined the scheme of the serological diagnosis of dysentery by the indication of Shigella antigens.     

Experience with the diagnosis of dysentery in adults by determining antibodies to Shigella in the saliva]

Concentration of immunoglobulins and titres of antibodies to Sh. sonnei, Sh. flexneri and enteropathogenic E. coli 0111 was determined in mixed saliva and the blood serum of patients suffering from Sonne dysentery, acute intestinal diseases of unknown etiology, and healthy individuals. The sum total immunoglobulin concentration in mixed saliva proved to be 53--81 times less than in the blood serum, but in the first substrate there was 53--75, and in the second--15% of immunoglobulin A. There proved to be distinct changes in the specific IgA-antibodies in the saliva of patients with Sonne dysentery. A preponderant accumulation of IgG-antibodies was noted in the blood serum. Elevation of both types of antibodies was maximal during the second week of the disease. Sonne dysentery was diagnosed in 80% of the patients by recording the intensity of shifts in the specific antibodies in the saliva, and in 63%--in the blood. The expediency of immunological testing of saliva for the diagnosis of dysentery is substantiated.     

Immunoglobulin and antibody content in the blood serum, coprofiltrate and saliva of patients with Sonne dysentery]

The authors studied the immunoglobulin and specific antibodies content of various classes in the serum, coprofiltrates and the saliva of 68 patients suffering from Sonne dysentery and in 48 healthy adult persons. Mancini's test demonstrated a significant elevation of IgG and IgM content in the blood of dysentery patients in comparison with that in healthy persons, and the absence of any changes in the IgA content. The titres of specific IgG-, IgA- and IgM-antibodies in determination in the modified Coombs' test increased consideerably during dysentery infection and were found in high titres during the first week of the disease; they reached the maximum during the second week and persisted at this level for 3 weeks. The greatest antibody elevation was in the IgA-class. Antibodies revealed in the coprofiltrates and the saliva of dysentery patients belonged to IgA- and IgG-class. There proved to be a correlation of the antibody changes in these two secretions.     

Method for the short-term prognosis of annual morbidity indices in Sonne-type dysentery

A method for making the short-term prognosis of the annual morbidity rate in Sonne dysentery, both total and among individual groups of population, is presented. The preliminary prognosis is based on the expected data on meteorological factors, supplied by the weather forecast service, and the final prognosis, on the actual prognostic factors for June-July of the current (prognosed) year.     

Specificity of the serological diagnosis of dysentery using erythrocytic reagents

The serological specificity of the diagnosis of dysentery, made by different methods with the use of antigenic and antibody erythrocyte diagnostic agents under the conditions of the circulation of different Shigella species and subspecies in a given locality, has been compared. The method for the determination of the diagnostic titer of the total serum antibody activity has proved to be the least specific. The methods for the detection of Shigella antigens, especially over time, in patients' excretions and for the determination of serum antibody activity show complete specificity. The combination of specificity and sensitivity makes the detection of Shigella antigens in feces by means of the passive hemagglutination test and the antibody neutralization test the method of choice for the diagnosis of dysentery.     

Serological method of detecting the antigens of the causative agent of Sonne dysentery in lysates of the fecal inoculates from patients]

Serological method of detection of Sh. sonnei antigens in the lysates of the patients, fecal cultures is suggested and approved. In the majority of cases of the results of bacteriological and serological methods of study of the feces coincided. Data confirming the specificity of the antibody neutralization test (ANT) in Sonne dysentery are presented. In connection with detection of the screening action of the Vi-antigen of typhoid bacilli there were elaborated additional methods for verifying the specificity of the ANT results. It is recommended to keep agar plates after selection of suspicious colonies during the bacteriological test; the lysate of the microbial crop should be additionally subjected to the ANT, this considerably increasing the percentage of laboratory confirmations of dysentery caused by Sh. sonnei.     

A trial application of the latex test for evaluation of antibody level in rabbit immune sera]

A latex test was elaborated which served for evaluation of quality of rabbit immune sera for antigen 0 of selected Gram-negative bacteria. Sensitivity and specificity of this test in comparison with passive hemagglutination and immunoenzymatic DOT-ELISA reactions was evaluated. These studies were performed on immune sera for antigen O of Salmonella groups B, C1, C2, D and E, Yersinia pseudotuberculosis and in antigen preparations for above listed microorganisms both in homologous and heterologous systems. It was found that sensitivity of the latex test is 9 to 160 times lower than that of passive hemagglutination and 7 to 307 lower than for DOT-ELISA. Sensitivity of the latex test and passive hemagglutination reaction was evaluated on the basis of results of cross reaction between studied antigens and unabsorbed rabbit sera, establishing so called sensitivity indexes, which were informing how many times heterologous titer is lower than homologous titer. So evaluated sensitivity of the latex test was close to sensitivity of the passive hemagglutination reaction. It was found that slide latex test is characterized by satisfactory sensitivity and good sensitiveness and may be used for evaluation of antibody level 0 antigens of Salmonella and Yersinia. The value of this test is characterized by high repeatability of results, as well as low work and time-consuming.     

Etiologic structure of bacterial dysentery in the USSR in 1983-1985

The etiological structure of dysentery in the USSR in 1983-1985 is characterized. Sonne dysentery was found to prevail in the territories with adequate water supply, while dysentery caused by Shigella flexneri prevailed at the territories with unsatisfactory water supply. S. dysenteriae and S. boydii were found to play a limited role in the etiology of dysentery. In the presence of global pandemic, an increase in the isolation rate of S. dysenteriae I in the USSR is observed. The data on the biochemical structure of S. sonnei are presented.     

The mechanism of the development of the epidemic process in Sonne dysentery

An epidemic outbreak of Sonne dysentery has been studied. The data of epidemiological monitoring before and after the epidemic have been analyzed. The real prognostication value of controlling the biological properties of Shigella sonnei and the increase of their intrapopulation heterogeneity at the period of the activation of the epidemic process of Sonne dysentery has been established.     

Use of immunoenzyme analysis in the rapid diagnosis and study of the characteristics of circulating O-antigen in biological fluids of patients with acute dysentery Sonne

The data on the clinical approval of the original enzyme immunoassay system for the determination of somatic O-antigen in the blood serum and urine of patients with acute Sonne dysentery are presented. The level of the antigen determined in the biological fluids of patients has been shown to depend on the severity of the disease. Different types of dynamic curves, reflecting the level of O-antigen in the biological fluids of patients with acute Sonne dysentery and characteristic of different clinical forms of the disease, have been established.     

Comparative characteristics of the epidemiology of intestinal coli infection caused by 2d-category Escherichia and of Sonne dysentery]

The authors present the results of a comparative study of Sonne dysentery and of the intestinal coli infection 0124 and 0151; significant differences in their epidemiology shown were chiefly caused by a different degree of pathogenicity of the causative agents of these diseases. A low degree of escherichia pathogenicity, and, in this connection, dependence of the character of the infection manifestation on the dose of the causative agent indicated food factor of the infection spread to be necessary for the origination of the clinically expressed disease. Epidemiological observations and bacteriological data showed that in diseases of escherichia etiology only those persons who had clinical manifestations of the disease could serve as epidemiologically significant sources of infection. In this connection prophylaxis of the mentioned affection should be primarily based on the intensification of the general sanitary measures.     

Indicators of spontaneous and stimulated nitroblue tetrazole test of polymorphous-nuclear leucocytes in acute dysentery patients

140 healthy individuals and 93 sick with acute dysentery were subjected to an examination by spontaneous and by bacterial preparations stimulated reaction with nitroblue tetrazole (NBT test). Indicators in healthy persons were normal in the spontaneous, and increased in the NBT test, stimulated by bacterial preparations. Indicators of the spontaneous NBT test in patients with acute dysentery were raised with a maximum in the period of early convalescence. Stimulation by a live shigella culture--the dysentery vaccine--revealed by means of Sonne diagnostic high, and when endotoxin from Serratia marcescens and dysenterin was used as an inductor, mild indicators of NBT test activity. When a polyvalent agglutinating dysentery serum was used as a stimulator, the activity increased considerably, and a simultaneous use of serum and vaccine had an inhibiting effect on the indicators of the stimulated NBT test. The obtained results testify the sufficient high reserve possibilities of leucocytes towards complete phagocytosis and the efficiency of the NBT test, stimulated by bacterial preparations for the study of functional and metabolic activity of leucocytes in the process of acute bacterial dysentery.     

Detection of hepatitis B surface antigen using passive hemagglutination

The passive hemagglutination test (Sero-Test CCB) for the detection of hepatitis B surface antigen (HBsAg) has been developed. The comparative study of the sensitivity of Sero-Test CCB, the passive hemagglutination test Hepanostikon (developed by Organon, the Netherlands) and the radioimmunoassay (with the use of an experimental assay kit provided by the Institute of Vaccines in Dessau, GDR) has been carried out by the determination of HBsAg in 100 coded sera from viral hepatitis patients and hepatitis virus carriers. Both passive hemagglutination tests (Sero-Test CCB and Hepanostikon) have yielded coinciding results (r = 0.90). The sensitivity of Sero-Test CCB has been found to exceed that achieved with the use of electrophoretic techniques 30-150 times, though it is 8 times lower than the sensitivity of the radioimmunoassay. The test kits Sero-Test CCB HBsAg are used for the examination of donor blood and for the survey of groups of persons subjected to a high risk of contacting hepatitis B infection in hemodialysis and transplantation centers, surgical wards, etc.     

Trial of the toxins of the Sonne microbe and cholera vibrio in an isolated loop of mouse small intestine]

Enterotoxic properties of neuro-and endotoxins of Sonne dysentery bacillus, of cholerogen, and Bowen's cholera vibrio endotoxin were determined on a model of an isolated loop of the mouse small intestine. In definite doses all the mentioned preparations could induce dilatation of the isolated loop of the mouse small intestine. In case of Sonne bacillus neurotoxin this property correlated with the toxicity of the preparation for the animals and failed to depend on the virulence and biochemical reference of the strain from which it was obtained. Marked variations in the sensitivity of mongrel and linear mice to the mentioned preparations were noted.