Experience of using bacterial lysate IRS 19 for the prophylaxis of the diseases of respiratory organs in organized groups

To solve the problem of unfavorable sanitary and epidemiological situation in diseases of respiratory organs in one of the organized groups in the Moscow region, a preparation prepared from a group of curative vaccines, IRS 19, was used. For controlling the effectiveness of its prophylactic action two groups of 250 persons were formed. As a result, morbidity rate in respiratory diseases decreased 2.5-3 times. In 1.5 months after the use of the preparation was started the coefficient of protection against the whole group of diseases of respiratory organs was 70%.     

Immune response following administration of multicomponent vaccine VP-4 in elderly patients

The dynamics of immunological characteristics after the administration of polycomponent vaccine B[symbol: see text]-4 to elderly persons, constituting a risk group with respect to acute respiratory diseases and exacerbations of chronic inflammatory diseases of respiratory organs, was studied. The nasal-oral administration of the vaccine induced immunological shifts in the systems of local and systemic immunity. The content of the populations of lymphocytes with markers CD3, CD4, CD16, CD20 was found to have positive dynamics. Considerable shifts in the system of local immunity were registered: the content of sIgA and IgA in the saliva greatly increased; in addition, an increase in the titers of antibodies to Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli was observed in persons with initially low titers.     

Nonspecific inherited risk factors for acute respiratory diseases in children living in the western part of the Baikal-Amur railway

Variation of 9 polymorphic loci was compared in 2 groups of children from Russian native and migrant population of Western area of Baikal-Amur Railway--those who suffered from acute respiratory diseases during first year of life and their parents, and normal children and their parents. Frequencies of genotypes 1-1 (HP locus). 00 (ABO locus), and pp (F locus) were significantly higher in normal children than in the affected ones. Heterozygosity observed in native parents of the diseased children was lower as compared with other groups. It was possible to distinguish two groups, according to the degree of genic similarity: the first one included healthy children and their parents from migrant and native population, the second one included all affected children and their parents. Significance of association between phenotypes at 3 loci (HP, ABO, P) and predisposition of the children to acute respiratory diseases were evaluated. A conclusion was made that in children of both migrant and native Russian parents similar combinations of anthropological traits and gene markers are the factors of their nonspecific resistance to acute respiratory diseases.     

Pneumococcal and chlamydial infections in a closed community

An epidemic outbreak of acute respiratory infection (295 patients) in an organized group of young people was observed in December-May 1997-1998. Pneumococcal etiology was established by means of indirect immunofluorescence reaction in cases of outpatient pneumonia (81.9%), acute bronchitis (80%) and acute respiratory diseases (92.5%). Respiratory chlamydiosis caused by Chlamydia pneumoniae was detected in enzyme immunoassay with the use of immunoComb Chlamydia Bivalent IgG in patients with pneumonia (66.7%), acute bronchitis (60%) and acute respiratory diseases (50%). Synergic relationship between pneumococcal and chlamydial infections was noted.     

HLA system antigens in persons with differing susceptibility to the causative agents of acute respiratory diseases

The relationship between the susceptibility of the body to infections caused by influenza A and B viruses, parainfluenza viruses, adenoviruses, Mycoplasma pneumoniae and antigens of the HLA system was studied on a group of 400 adolescents placed under clinico-epidemiological surveillance for two years. The relationship between histocompatibility antigens and acute respiratory diseases was manifested in a decrease or increase in the occurrence of recurrent diseases and infections or in the probability of the development of the diseases in infected persons. HLA B40 was associated with resistance to influenza A, B18 and B21 were associated with resistance to parainfluenza, B15 and B35 were associated with resistance to M. pneumoniae infection; susceptibility to influenza B was registered in persons with HLA B12 and to M. pneumoniae infection, in persons with HLA B16 and B18. With respect to different infective agents, the relative risk of infection varied within 1.7 and 5.0.     

The use of influenza vaccines and remantadine for protection against influenza in industrial enterprises

The effectiveness of inactivated and live influenza vaccines and remantidin was studied in persons with different annual morbidity rate in influenza and acute respiratory diseases (ARD). After three and more years of immunization with the inactivated vaccine the number of seroconversions to viruses A (H1N1) and A (H3N2) in vaccinees decreased, respectively, from 75.0 to 26.0% and from 79.3 to 38.8%, and after an interval of two years or the alternation of inactivated and live vaccines the number of seroconversions increased to 57.9-64.0%. The significant decrease of morbidity rate in influenza and ARD were observed only in persons, having had frequent ARD in their medical history and immunized with live and inactivated vaccines simultaneously or separately with the alternation of these vaccines every year (the effectiveness index being equal to 1.7-1.8). At the period of epidemic the controlled administration of remantadin to persons with contraindications to immunization ensured the decrease of morbidity rate in influenza 1.5-1.8 times; in vaccinees, highly susceptible to ARD, the administration of remantadin decreased morbidity rate 2.3 times.     

Data on the study of the epidemiology of rotavirus infection in Leningrad

The results obtained in the study of rotavirus infection in Leningrad in 1984-1987 are presented. Enzyme immunoassay techniques were used for the examination of 4,715 children aged 0-14 years and 1,162 adults with diagnosed acute enteral infection of unknown etiology, as well as the control group of 556 of healthy children aged 0-6 years and 77 healthy adults. The rotavirus antigen was detected in 1.210 sick children (25.7%) and 133 sick adults (11.4%), as well as in 6 healthy children (1.1%), but not detected in healthy adults. The following epidemiological regularities of rotavirus infection were established: the highest sick rate among children aged 0-2 years and a low level of rotavirus carriership among healthy persons; the seasonal character of rotavirus infection, its outbreaks occurring in winter and the epidemic periods varying in their character and duration in different years; the prevailing role of rotaviruses in the development of winter rises of acute enteral infection of unknown etiology in the city among children aged 0-2 years. The problem of the respiratory syndrome in rotavirus diarrhea is discussed. The rotavirus antigen was detected in 39 out of 144 children (27%) with diagnosed acute respiratory virus diseases and in 4 out of 99 nasopharyngeal washings (4%) from diarrhea patients. Adenoviruses were shown to play an insignificant role in the etiology of diarrhea (10% of cases).     

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.     

Prevalence and structure of acute respiratory virus infections

Information on epidemiology of acute respiratory virus infections (ARVI) is reviewed and analyzed. In addition to influenza viruses, the role of respiratory syncytial viruses (RSV), rhino- and adenoviruses, as well as other viruses, in the development of respiratory diseases, especially in newborns, young children and elderly persons, is emphasized. A high proportion of RSV in the etiology the severe forms of ARVI and in the development of intrauterine infection is pointed out. The conclusion has been made that the identification of the causative agents of ARVI with the use of modern methods makes it possible to determine the real role of each of the pathogens in the formation of the severe forms of diseases, as well as the expediency of vaccinal prophylaxis.     

Mutation at the T-cell receptor locus in people a long time after acute and prolonged irradiation

The frequency of lymphocytes with mutations at genes of T-cell receptor (TCR) is determined in 165 persons exposed to ionizing radiation 16-40 years after the influence. Depending on a type of irradiation and time, elapsed from the moment of exposure, all inspected persons were divided into 3 groups: 1) the analysis performed 16-40 years after acute irradiation; 2) the analysis--9-13 years after acute irradiation; 3) the analysis--9-13 years after prolonged irradiation. The persons with elevated frequencies of TCR-mutant cells were detected in all three groups. In the first group they have compounded 36% of persons inspected, in the second--25%, in the third--15%. The percentage of persons with elevated frequencies of mutant cells in all groups was significantly higher than in control groups. Taking into account fast enough elimination of radiation-induced TCR-mutant cells it is possible to suspect, that the cause of elevated frequency of mutant cells in the part of the persons can be genome instability.     

Epidemiological trial of the prophylactic effectiveness of the interferon inducer dipyridamole with respect to influenza and acute respiratory diseases

The epidemiological effectiveness of dipyridamol, an interferon-inducing agent used for the prevention of influenza and viral acute respiratory diseases, was tested in 4 epidemiological trials, 3 of them carried out as double blind trials. Observations were made in groups of adults (a research institute, a factory) and children (a kindergarten, a school), comprising 1040 subjects in the test groups and 771 subjects in the control groups. The drug was used during the whole epidemic period (January--March 1983) according to the following schedule: 1 oral administration in 8 days, in doses of 8 mg for adults, 50 mg for schoolchildren and 24 mg for children in the kindergarten. The epidemiological effectiveness of the drug was evaluated by comparing the total morbidity rates in influenza and acute respiratory diseases in the test and control groups. The results of 4 trials showed a pronounced epidemiological effectiveness of dipyridamol. The values of the epidemiological effectiveness index of the drug were 2.38 in the kindergarten, 1.55 at the school, 7.42 at the factory and 2.16 at the research institute. The results of the study of dipyridamol suggest that further investigations should be made with a view to use it for the mass prevention of influenza and acute respiratory diseases.     

Results of introducing a comprehensive system of influenza control in the population of Severodvinsk

A complex differentiated system of influenza control, based on scientific principles, was introduced into practice during 1976-1980 in Severodvinsk. The main component of this system was the mass prophylactic immunization of the population of the city, including children and elderly persons, with live and inactivated vaccines manufactured in the USSR. At the period of influenza epidemics remantadin was used for the urgent prophylaxis and treatment of influenza. As a result, influenza morbidity in Severodvinsk was reduced 1.5-2 times in comparison with that in the neighboring control cities. The cases of pneumonia and bronchitis, the most severe postinfluenza complications, decreased in number 1.8 and 1.4 times, respectively. The proportion of influenza A in the structure of acute respiratory diseases decreased by one-half. These results demonstrate the effectiveness of the prophylactic and therapeutic measures carried out in the city.     

Significance of Legionella pneumophila in human respiratory pathology

The etiological structure of acute pneumonia and acute respiratory diseases was studied with a view to establishing the proportion of L. pneumophila among other causative agents of such diseases. A total of 299 patients were examined over time. The etiological diagnosis based on the data of serological examination was made in 70.6% of the patients with acute pneumonia and in 65% of the patients with acute respiratory viral infections and influenza. In the etiology of pneumonia, the leading role was found to belong to influenza A (H3N2) and B viruses, as well as to adenovirus, while in the etiology of acute respiratory viral infections and influenza, to influenza B virus, adenovirus and Mycoplasma pneumoniae. The importance of L. pneumophila in the etiology of acute pneumonia and acute respiratory diseases was shown. The proportion of L. pneumophila proved to be, on the average, 9.9% in acute pneumonia and 9.8% in acute respiratory diseases. L. pneumophila occurred most frequently in mixed infections in combination with adenovirus and influenza B virus. Diseases of Legionella etiology were found to have a seasonal character, occurring mostly in winter and spring.     

Genetic blood markers in arthritic diseases]

In the course of studying patients affected with arthritic diseases (bronchial asthma, sugar diabetes) a relationship between those diseases and the blood groups of the Hp and MN systems was established. Patients with bronchial asthma more frequently than in the controls belonged to the Hp 2-2 type and to blood groups MN and O (I), whereas the patients affected with sugar diabetes are usually of the Hp 2-1 type and belong to the belong to the blood groups MN and A(II). The investigation of patients affected with other diseases having a pathogenesis similar to that of bronchial asthma or of diabetes and the observation of healthy persons after prophylactic inoculations as well as the study of sugar metabolism in healthy persons all confirm the relationship of Hp, MN and ABO antigens with arthritic diseases.     

Antigenic anachronism of the influenza A(H2N2) viruses in Leningrad in 1980. I. The epidemiological and serological characteristics of the influenzal infection caused by A/Leningrad/80 (H2N2) viruses

In April-May 1980 a number of unrelated outbreaks of influenza-like diseases were registered in Leningrad in an infant home (50 out of 68 children under observation, aged 3 months to 2 years, were affected) and among the pupils of a boarding school (13 out of 50 adolescents under observation, aged 15-17 years, were affected). 5 strains of influenza A virus were isolated from 3 sick children and 1 clinically healthy child. A similar virus was isolated from a sick adolescent in a boarding school, as well as from a female patient aged 24 years at a domiciliary focus of infection (a sporadic case). In the subsequent laboratory investigation all these 7 strains were identified as viruses A/H2N2. Isolated cases of seroconversion to hemagglutinin H2 were definitely registered in 6 patients during February--May 1980. In 3 cases, including the 24-year old female patient with an acute respiratory disease, seroconversion to hemagglutinin H2 was observed in combination with the release of influenza viruses A/H2N2 from these patients. 2 influenza virus strains with this antigenic characteristic were isolated from a young female patient at an interval of 3 days. Among the patients admitted to the clinics of the Research Institute of Influenza in Leningrad on account of acute respiratory diseases isolated cases of diagnostically significant seroconversion to hemagglutinin H2 constituted 3.5% among children and 4.5% among adults. The study of the level of antihemagglutinins in the population revealed that in 1980 persons aged 18-50 years showed a high level of antihemagglutinins.(ABSTRACT TRUNCATED AT 250 WORDS)     

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.     

An epidemiologic projection of foci of Q fever within herds

In one of the rural regions of the nonchernozem zone retrospective epidemiological diagnosis was carried out in connection with high morbidity rates in acute respiratory diseases and influenza. This diagnosis was shown to cover cases of Q fever. Altogether 172 cases of this infection were retrospectively diagnosed. This infection affected persons working at one of sheep-breeding complexes, as well as at enterprises, technologically linked with this complex. Sheep proved to be the source of this infection, that was confirmed both serologically and by the registered cases of the isolation of Coxiella strain from sheep.     

Metabolic changes in blood in pulmonary tuberculosis patients from various blood groups

285 Patients suffering from the respiratory tract organs primary tuberculosis were subjected to the tests on definition of blood groups according to AB0 system, as well as its total proteolytic activity, alpha 1-antitrypsin, ceruloplasmin, general haptoglobin, lysozyme, malonic dialdehyde and diene conjugates levels were estimated. The sick persons as compared with the healthy ones were defined to reveal a tendency to increase of the persons with 0(I)- and B(III)-blood groups and decrease of those ones with A(II)-groups. Independently on the pulmonary tuberculosis patients phenotypic index their tested blood biochemical indices levels increase. As an exception is the proteolytic activity of the persons with B(III)- blood group, and also alpha 1-antitrypsin and lysozyme--with 0(I) and AB(IV) groups, in this case their rates failed to exceed the norm confidential interval. The blood metabolic parameters were defined as independent on its group.     

Dynamics of autoantibodies in elderly persons in the process of vaccination with Grippol and multicomponent vaccine VP-4

The dynamics of antibodies to organ specific and organ nonspecific antigens in the process of combined immunization with Grippol, an influenza polymer subunit vaccine and polycomponent vaccine VP-4 used for prophylaxis of acute respiratory infections, was under study. Persons aged 65 years and older were vaccinated. Grippol alone was introduced in a single subcutaneous injection into 92 persons and Grippol in combination with vaccine VP-4--to 103 persons. B[symbol: see text]-4 Vaccine was introduced intranasally and orally (6-8 doses). The administration of vaccine VP-4 was started simultaneously with vaccination with Grippol. Prior to immunization and 1 and 5 months later autoantibodies to the following antigens were detected: DNA (native and denaturated), collagen, elastin, myelin basic protein, microsomal fractions of kidneys, lungs, heart, liver, intestine, pituitary body, thyroid gland, pancreas, adrenal glands, ovaries, mucous and muscular layers of stomach. The number of persons with the level of antibodies at least to one of the antigens under study exceeding the normal values prior to vaccination varied from 19.4 +/- 8.6% to 41.5 +/- 7.7%, the average values of positive sera being 0.26 +/- 0.05 to 0.32 +/- 0.08 delta OD. One and 5 months after vaccination both values varied within the same limits in both groups. Immunization with Grippol as well as with its combination with vaccine VP-4 was found to increased spectrum of antibodies to tissue antigens and their increased content. The data give evidence that Grippol and vaccine Vp-4, introduced according to the immunization schedule used in these experiments, do not induce development of autoimmune processes.     

Frequency of detecting bacteria of the genera Citrobacter and Hafnia in different contingents of examined adults]

A study of the incidence of bacteria of the Citrobacter and Hafnia genus in adults permitted to establish a greater occurrence of the mentioned microbes in the patients with various acute intestinal diseases in comparison with the healthy ones. Bacteria of the Citrobacter and Hafnia genus were revealed in the patients with acute intestinal diseases of obscure etiology, which often were diagnosed as gastroenteritis, enteritis, etc. Bacteria of the Citrobacter and Hafnia genus were revealed in the dysentery patients. Results of studies carried out among various healthy groups of the population indicated no significant differences in respect to the carrier state of the Citrobacter and Hafnia bacteria both within each of the groups of the persons examined and between them. Further studies directed to the investigation of the etiological role of bacteria of the Citrobacter and Hafnia genus in the pathology of enteric disturbances are necessary.