Acute diarrhoea in a community cohort of children who received an oral rotavirus vaccine in Northeast Brazil

Rotavirus is an important cause of childhood diarrhoea. A monovalent rotavirus vaccine (Rotarix?) was introduced into the Immunization Program of Brazil in 2006. In this study, we describe the incidence and burden of disease of rotavirus diarrhoea in two cohorts of children (vaccinated and unvaccinated). We followed two groups of 250 children under one year old, who were enrolled in December 2006 from a low-income residential area in Northeast Brazil. The children were monitored every two weeks for two years. Stool samples from children with diarrhoea were examined for the presence of rotavirus. Rotaviruses were genotyped using real time-polymerase chain reaction. The mean numbers of all-cause diarrhoea episodes/child (adjusted for age) in the first year were 0.87 and 0.84, in vaccinated and unvaccinated children, respectively. During the second year, the number of episodes/child decreased to 0.52 and 0.42. Only 16 (4.9%) of 330 stool samples were rotavirus-positive (10 vaccinated and 6 unvaccinated children) and only P[4]G2 rotaviruses were identified. All-cause diarrhoea episodes were more severe in unvaccinated children in the first year of age (p < 0.05), while vaccinated children had more severe episodes 18 months after vaccination. Rotavirus diarrhoea incidence was very low in both groups.     

The effect of vaccination and sea water entry on immunocompetence and susceptibility to Kudoa thyrsites in Atlantic salmon (Salmo salar L.)

The effect of intraperitoneal (IP) vaccination and sea water entry (SWE) on the immunocompetence of Cascade Atlantic salmon was investigated. Smolts were IP injected with Aqua Health's Forte trade mark vaccine (Listonella (Vibrio) anguillarum, Listonella ordalii, Vibrio salmonicida and Aeromonas salmonicida) at four times (42, 238, 433 and 630 degree days, DD) prior to SWE and were examined for immunocompetence. Immune response measurements included mitogen-driven proliferation of peripheral blood leukocytes (PBL), head kidney leukocyte respiratory burst activity and alternative complement hemolytic titres and were measured 24h prior to SWE, 72 h post-SWE and again 3.5 weeks post-SWE. A 50% reduction in the number of PBL was observed 3 days post-vaccination. At this time LPS-driven proliferation was low (stimulation index, SI, 1.5-2.9) in all groups prior to SWE compared with that of PBL from freshwater-reared Atlantic salmon parr (6.7). By 72 h and 3.5 weeks post-SWE, the LPS-driven SI from unvaccinated salmon and those vaccinated 630 and 433 DD prior to SWE increased 3-fold. In contrast, SI from salmon vaccinated 42 and 238 DD prior to SWE remained low. A similar pattern was observed for cultured PBL stimulated with PHA, although unlike LPS-stimulated PBL, the SI of cells from parr and unvaccinated control smolts remained low following SWE but increased in fish vaccinated 433 and 630 DD prior to SWE. The respiratory burst activity of head kidney leukocytes was not affected by SWE but showed a transient 50% depression 3 days post-vaccination. The alternative complement activity (ACH50) was similar for all treatment groups prior to and at 72h post-SWE. By 3.5 weeks post-SWE, ACH50 values in salmon vaccinated 42 and 238 DD prior to SWE doubled to 874 and 860 U/ml, respectively. The prevalence and severity of Kudoa thyrsites infections, detected in all treatment groups approximately 2400 DD following SWE, were not significantly different among groups. Atlantic salmon parr should be IP vaccinated no earlier than 433 DD before SWE to avoid an enhanced risk of acquiring pathogens because of transient depression in some immune mechanisms.     

湖南省健康人群血清总蛋白、白蛋白参考值调查

目的：本实验旨在建立湖南省健康人群血清总蛋白（TP）、血清白蛋白（ALB）及A/G比值的参考值区间。方法：收集4543例湖南省城乡健康参考个体,采用全自动生化分析仪测定其血清TP、ALB值,并计算A/G比值,按不同年龄、性别、城乡进行分组统计学分析,建立适合湖南省人群TP、ALB及A/G比值的参考值。结果：湖南省健康人群参考区间为TP：66.51～82.85 g/L,ALB：43.09～50.19g/L,A/G比值为1.05～2.19;TP随年龄增大而稍有升高,中年达到高峰,后随年龄增大而降低,在各年龄组,女性均高于男性（P〈0.05）,乡村地区TP值高于城市地区（P〈0.05）;ALB随年龄增大稍有升高,在青壮年到达高峰而后下降,在儿童青少年、青壮年组血清ALB男性高于女性（P〈0.05）,而在中年、老年组血清ALB无差别,乡村地区ALB值高于城市地区（P〈0.05）;A/G比值随年龄的变化存在一定的差异性,A/G比值随年龄增大稍有增高,在青壮年组达到高峰而后下降,且在各年龄组男性高于女性（P〈0.05）,城市地区A/G值高于乡村地区（P〈0.05）;湖南省健康人群的TP、ALB与全国其他省市的TP、ALB存在差异。结论：湖南省健康人群TP、ALB、A/G比值参考区间与全国其它省份稍有差异,血清TP、Alb、A/G比值存在年龄、性别和地区差异性。     

Seroresponse (IgG) after Vaccination and Natural Infection of Cattle with Babesia Divergens

The antibody response against Babesia divergens in vaccinated calves and in unvaccinated sentinels on farms where vaccination had been practiced routinely, was investigated using a live vaccine. Sera were obtained before and 3 weeks after vaccination in March and April, approximately 1 month before the animals were put out on pasture. Additional blood samples were collected at the end of the grazing season and again the next spring. At that time previously unvaccinated sentinel calves were vaccinated and their antibody response was tested 3 weeks later. All sera were analysed by an IF-technique. All of the vaccinated calves (100%) were seropositive 3 weeks after vaccination. The seroresponse did not differ signifacantly between animals vaccinated before their first or second grazing season although the age difference was about 12 months. No clinical symptoms of babesiosis were seen in vaccinated animals. The titres were, however, significantly higher 3 weeks after vaccination than 6 months later. After the grazing season about 42% of the unvaccinated sentinel calves were sero–positve. Two of these calves had clinical babesiosis on pasture in July and September respectively. The number of sentinel calves which became infected on pasture showed a large farm-to-farm variation although all cattle on the farms once had been infected-/vaccinated with B. divergens. Probably the different number of calves infected was a reflection of a variation in tick density on the different pastures. All calves, which were seropositive after the grazing season, were also seropositive after 6 months indoors. The titres declined during the winter period, but they were still within the range of 2 doubling dilution steps.     

Assessment of the variability in influenza A(H1N1) vaccine effectiveness estimates dependent on outcome and methodological approach

BACKGROUND: Estimation of Influenza vaccine effectiveness (VE) varies with study design, clinical outcome considered and statistical methodology used. By estimating VE using differing outcomes and statistical methods on the same cohort of individuals the variability in the estimates produced can be better understood. The Pandemic Influenza Primary Care Reporting (PIPeR) cohort of approximately 193,000 individuals was used to estimate pandemic VE in Scotland during season 2009-10. VE results for three outcomes; influenza related consultations, virological confirmed influenza and death were considered. Use of individualised records allowed all models to be adjusted for age, sex, deprivation, risk status relating to chronic illnesses, seasonal vaccination status and a marker of the individual's propensity to consult. For the consultation and death outcomes, VE was calculated by comparing consultation rates in the unvaccinated and vaccinated groups, adjusted for the listed factors, using both Cox and Poisson regression models. For the consultation outcome, the unvaccinated group was split into individuals before vaccination and those never vaccinated to allow for potential differences in the health seeking behaviour of these groups. For the virology outcome estimates were calculated using a generalised additive logistic regression model. All models were adjusted for time. Vaccine effect was demonstrated for the influenza-like illness consultation outcome using the Cox model (VE=49% 95% CI (19%, 67%)) with lower estimates from the model splitting the before and never vaccinated groups (VE=34.2% with 95% CI (-0.5%, 58.9%)). Vaccine effect was also illustrated for overall mortality (VE=40% (95% CI 18%, 56%)) and a virological confirmed subset of symptomatic individuals (VE=60% (95% CI -38%, 89%)). CONCLUSIONS: This study illustrates positive point estimates of Influenza VE across methodology and outcome for a single cohort of individuals during season 2009-10. Understanding of potential differences between approaches aids interpretation of VE results in future seasons.     

Prevalence of Helicobacter pylori Infection and Identification of Risk Factors in Rural and Urban Beijing, China

Background:  The prevalence of Helicobacter pylori is higher in developing countries such as China. The aim of this study was to investigate the prevalence of H. pylori in one rural and one urban region of Beijing, China.
Materials and Methods:  Healthy individuals in rural Pinggu and urban Haidian voluntarily participated in this study. The diagnosis of H. pylori infection was reached using the ¹³C-urea breath test. Associations between H. pylori and sex, age, living area (i.e. rural vs urban), education level, smoking, and alcohol consumption were evaluated.
Results:  Of the 1232 included subjects, 54.7% of tested individuals residing in Pinggu and 41.3% in Haidian were positive for H. pylori . In urban region, more individuals were negative for H. pylori (429 of 731), whereas in the rural region, more individuals were positive for H. pylori ( p <  .05). Univariate analysis identified geographic area and lower education and annual income as significant factors associated with H. pylori . Men in rural areas were more likely than women in rural areas to be infected, and both men and women in the rural area were more likely to be positive for H. pylori than men and women in the urban area (all p  < .05).
Conclusions:  H. pylori infection is common in both rural and urban regions of Beijing. Residing in a rural area, having a lower family income, and lower education level are significant risk factors associated with infection.     

Persistence of influenza serum antibodies in humans following immunization with a bivalent A/Victoria and A/New Jersey vaccine.

The persistence of serum antibodies 1 year after immunization with a bivalent vaccine containing recombinant viruses that were antigenically identical with A/Victoria/3/75 (H3N2) and A/New Jersey/8/76 (Hsw1N1) viruses was measured in 128 persons aged 18 to 65 years. Serum samples were tested with the hemagglutination inhibition assay against the two vaccine antigens and against A/Texas/1/77 (H3N2) and A/USSR/90/77 (H1N1) viruses. Prior to vaccination 56% and 79% of the participants had been found to be seronegative to A/Victoria and A/New Jersey antigens respectively; the geometric mean antibody titres were low (1:5 to 1:11) except in persons aged 51 to 65 years, whose mean titre of antibody to the A/New Jersey antigen was 1:23, and persons aged 26 to 35 years, whose mean titre of antibody to the A/USSR antigen was 1:25. By 3 weeks after vaccination 85% of the seronegative persons had a fourfold or greater rise in titres of antibodies to the viruses in the vaccine, and 70% had a fourfold increase in titre of antibody to the A/Texas antigen. Of the persons aged 26 to 35 years (seronegative and seropositive) 68% had a fourfold or greater increase in titre of antibody to the A/USSR antigen. There was no change in the mean titres of 19 unvaccinated control subjects during the observation period. At 6 and 12 months after vaccination the titres of antibodies to the A/Victoria and A/New Jersey antigens had declined moderately in all age groups from those observed 3 weeks after vaccination. The rate of decline was similar for the various antibodies except that to the A/USSR antigen in persons 26 to 35 years of age, in whom the decline was much slower.     

Creatinine versus specific gravity-adjusted urinary cadmium concentrations

The aim was to assess how urinary creatinine is affected by age, gender, body size and meat intake, and to determine to what extent such factors might affect the creatinine adjustment of urinary cadmium. The study was based on three Swedish studies: (1) 67 non-smoking women aged 20-50 years (24-h urine samples); (2) 289 men and 434 women aged 16-81 years (spot urine samples); and (3) 98 men and 105 women aged 19-72 years (spot urine samples). The effects of age, body surface area (as an indicator of muscle mass), and meat intake on urinary creatinine and cadmium were analysed using multiple regression analyses. Gender- and age-related variations in urinary creatinine and cadmium adjusted for creatinine or specific gravity were compared by ANOVA or ANCOVA. In the multiple regression analyses, body surface area, gender, age and meat intake were the major determinants of urinary creatinine. Urinary cadmium adjusted for creatinine and specific gravity were also dependent on body size, gender and age. Urinary cadmium adjusted for creatinine was 15-92% higher in women or older individuals than in men or younger individuals. Women or older individuals had -3 to 79% higher urinary cadmium adjusted for specific gravity than men or younger individuals had, and such a difference between gender or age group was less obvious in specific gravity adjustment than in creatinine adjustment. Thus, urinary cadmium adjusted for creatinine is more affected by age, gender, body size and meat intake than is specific gravity adjustment. When comparing individuals or populations with large differences in muscle mass or meat intake, such effects can be especially important. In such studies, specific gravity adjustment seems to be more appropriate.     

Creatinine versus specific gravity-adjusted urinary cadmium concentrations

The aim was to assess how urinary creatinine is affected by age, gender, body size and meat intake, and to determine to what extent such factors might affect the creatinine adjustment of urinary cadmium. The study was based on three Swedish studies: (1) 67 non-smoking women aged 20–50 years (24-h urine samples); (2) 289 men and 434 women aged 16–81 years (spot urine samples); and (3) 98 men and 105 women aged 19–72 years (spot urine samples). The effects of age, body surface area (as an indicator of muscle mass), and meat intake on urinary creatinine and cadmium were analysed using multiple regression analyses. Gender- and age-related variations in urinary creatinine and cadmium adjusted for creatinine or specific gravity were compared by ANOVA or ANCOVA. In the multiple regression analyses, body surface area, gender, age and meat intake were the major determinants of urinary creatinine. Urinary cadmium adjusted for creatinine and specific gravity were also dependent on body size, gender and age. Urinary cadmium adjusted for creatinine was 15–92% higher in women or older individuals than in men or younger individuals. Women or older individuals had –3 to 79% higher urinary cadmium adjusted for specific gravity than men or younger individuals had, and such a difference between gender or age group was less obvious in specific gravity adjustment than in creatinine adjustment. Thus, urinary cadmium adjusted for creatinine is more affected by age, gender, body size and meat intake than is specific gravity adjustment. When comparing individuals or populations with large differences in muscle mass or meat intake, such effects can be especially important. In such studies, specific gravity adjustment seems to be more appropriate.     

Creatinine versus specific gravity-adjusted urinary cadmium concentrations.

The aim was to assess how urinary creatinine is affected by age, gender, body size and meat intake, and to determine to what extent such factors might affect the creatinine adjustment of urinary cadmium. The study was based on three Swedish studies: (1) 67 non-smoking women aged 20-50 years (24-h urine samples); (2) 289 men and 434 women aged 16-81 years (spot urine samples); and (3) 98 men and 105 women aged 19-72 years (spot urine samples). The effects of age, body surface area (as an indicator of muscle mass), and meat intake on urinary creatinine and cadmium were analysed using multiple regression analyses. Gender- and age-related variations in urinary creatinine and cadmium adjusted for creatinine or specific gravity were compared by ANOVA or ANCOVA. In the multiple regression analyses, body surface area, gender, age and meat intake were the major determinants of urinary creatinine. Urinary cadmium adjusted for creatinine and specific gravity were also dependent on body size, gender and age. Urinary cadmium adjusted for creatinine was 15-92% higher in women or older individuals than in men or younger individuals. Women or older individuals had -3 to 79% higher urinary cadmium adjusted for specific gravity than men or younger individuals had, and such a difference between gender or age group was less obvious in specific gravity adjustment than in creatinine adjustment. Thus, urinary cadmium adjusted for creatinine is more affected by age, gender, body size and meat intake than is specific gravity adjustment. When comparing individuals or populations with large differences in muscle mass or meat intake, such effects can be especially important. In such studies, specific gravity adjustment seems to be more appropriate.     

The Impact of Influenza Vaccinations on the Adverse Effects and Hospitalization Rate in the Elderly: A National Based Study in an Asian Country

Objectives

To examine the risk of adverse effects of special interest in persons vaccinated against seasonal influenza compared with unvaccinated persons aged 65 and above.

Methods

We retrospectively observed 41,986 vaccinated elderly persons and 50,973 unvaccinated elderly persons in Taiwan from October 1, 2008, through September 30, 2009, using the National Health Insurance database. Neurological and autoimmune disorders and one-year hospitalization rates and in-hospital mortality rates were analyzed according to the vaccination status. Propensity score analysis was used to assess the relationship between adverse outcomes, hospitalization rates, and vaccination status.

Results

45% of the elderly received influenza vaccination. Multiple logistic regression showed that the probability of being vaccinated was related to more patients visiting for URI symptoms (odds ratio (OR), 1.03; 95% CI, 1.02–1.03), men (OR, 1.15; 95% CI, 1.12–1.17), increased age (OR, 1.02; 95% CI, 1.02–1.03), and more comorbidities (OR, 1.2; 95% CI, 1.17–1.23). There were no statistical differences in neurological and autoimmune diseases between the vaccinated and unvaccinated individuals using propensity score analysis, but vaccinated persons had a reduced hospitalization rate of 19% (odds ratio [OR], 0.81; 95% CI, 0.77–0.84) for the first six-months and 13% for one-year of follow-up (OR, 0.87; 95% CI, 0.85–0.9).

Conclusions

Based on data from the one-year follow-ups among 93,049 elderly persons in Taiwan, reassuring results for selected neurological and autoimmune diseases were found among the vaccinated individuals after adjusting other factors. Influenza vaccination decreased the risk for hospitalization. Public health strategies must continue to improve the influenza vaccination rate among the elderly with information based upon tangible evidence.     

Comparison of one- and two-dose regimens of influenza vaccine for elderly men.

In November and December 1984, 102 male residents of a long-term care facility (mean age 74.6 [extremes 59 and 97] years) received 0.5 ml of trivalent inactivated whole-virion influenza vaccine, containing 15 micrograms of the hemagglutinin of each of A/Philippines/2/82 (H3N2), A/Chile/83 (H1N1) and B/USSR/83. A second dose of the vaccine was administered to a subgroup of 55 randomly chosen subjects 8 weeks later. Serum samples were collected from all the subjects before and 4, 8, 12 and 16 weeks after administration of the first dose and were assayed for hemagglutinin-inhibiting (HAI) antibody to each of the three antigens. At 8 weeks there were significant increases (p less than 0.05) in the geometric mean titre of antibody and in the proportion of subjects with HAI antibody titres of 1:40 or more (except to the B/USSR antigen) in both groups. There were no differences between the groups at 8 weeks or at 16 weeks (8 weeks after administration of the second dose of vaccine) in the frequency of seroconversion, the geometric mean titre or the proportion of subjects with HAI antibody titres of 1:40 or more. Overall, 60%, 32% and 13% of the 102 subjects had titres of 1:40 or more to the A/Philippines, A/Chile and B/USSR antigens respectively at 16 weeks. The results suggest that a second dose of influenza vaccine given 8 weeks after the first does not enhance the immune response in elderly men and that a substantial proportion of this population remains unprotected against infection (having HAI antibody titres of less than 1:40) during the influenza season.     

Immunization interview survey in the Mongolian People's Republic.

An immunization interview survey was carried out in the urban and rural areas of Mongolia. The population sample interrogated comprised 1359 households with 6994 household members, 3634 of them younger than 15 years. The data collection unit was a private household, where information on administrative, demographic and socio-economic items was obtained in addition to detailed information on vaccination histories. A fair number of individuals with a positive history was found among children aged 1 to 5 years; the highest rates were determined among preschool and school-children aged 5 to 9. Significant differences in vaccination rates were found between urban and rural dwellers, urban areas displaying a higher proportion of vaccinated children in the younger age groups and rural areas among school-age children. A significantly higher proportion of vaccinated individuals was found among children living in somons than those living in aimac centres. No significant differences were found between children attending child collective institutions and those educated solely at home. The immunization interview survey was specially directed toward obtaining an estimate of the vaccinated population segment with reference to age in demarcated areas and thus detecting "weak spots" requiring remedial action.     

Implementation of a National Measles Elimination Program in Iran: Phylogenetic Analysis of Measles Virus Strains Isolated during 2010–2012 Outbreaks

Measles virus (MV) causes small and large outbreaks in Iran. Molecular assays allow identifying and the sources of measles imported from neighboring countries. We carried out a phylogenetic analysis of measles virus circulating in Iran over the period 2010–2012. Specimens from suspected cases of measles were collected from different regions of Iran. Virus isolation was performed on urine and throat swabs. Partial nucleoprotein gene segments of MV were amplified by RT-PCR. PCR products of 173 samples were sequenced and analyzed. The median age of confirmed cases was 2 years. Among all confirmed cases, 32% had unknown vaccination status, 20% had been vaccinated, and 48% had not been vaccinated. Genotypes B3 and D8 (for the first time), H1 and D4 were detected mainly in unvaccinated toddlers and young children. Genotype B3 became predominant in 2012 and was closely related to African strains. H1 strains were also found in small and large outbreaks during 2012 but were not identical to Iranian H1-2009 strains. A majority of the Iranian D4 strains during 2010–2012 outbreaks were linked to the D4 strain identified in the Pakistan in 2007. We identified a single case in 2010 belonging to D8 genotype with 99.7% identity to Indian isolates. Although the vaccination program is currently good enough to prevent nationwide epidemics and successfully decreased measles incidence in Iran, the fraction of protected individuals in the population was not high enough to prevent continuous introduction of cases from abroad. Due to increasing number of susceptible individuals in some areas, sustained transmission of the newly introduced viral genotype remains possible.     

Immunomodulatory effects of dietary β-1,3-glucan from Euglena gracilis in rainbow trout (Oncorhynchus mykiss) immersion vaccinated against Yersinia ruckeri

Potential immunostimulatory effects of orally administered β-glucan were investigated in combination with immersion vaccination against enteric redmouth disease caused by Yersinia ruckeri in rainbow trout (Oncorhynchus mykiss). A linear, unbranched and pure (purity ≥98%) β-1,3-glucan (syn. paramylon) from the alga Euglena gracilis was applied at an inclusion level of 1% β-glucan in feed administered at a rate of 1% biomass?day(-1) for 84 consecutive days. Fish were vaccinated after two weeks of experimental feeding and bath challenged with live Y.?ruckeri six weeks post-vaccination. Blood and head kidney were sampled at day 0, 13 (1 day pre-vaccination), 15, 55, 59 (day 3 post-challenge (p.c.)), 70 and 84. Vaccination induced significantly increased survival p.c., whereas the β-glucan had no effect on survival in either unvaccinated or vaccinated fish. Expression in head kidney of genes related to the acute phase response, i.e. interleukin-1β (IL-1β), serum amyloid A (SAA), precerebellin, and hepcidin, was significantly different in vaccinated fish receiving β-glucan compared to vaccinated controls at day 3 p.c., while no effect of β-glucan was observed among unvaccinated fish. Significant interaction between β-glucan and vaccination was found for the regulation of IL-1β, tumour necrosis factor-α, interferon-γ, SAA, precerebellin and hepcidin p.c. For SAA, the significant effect of β-glucan in vaccinated fish persisted at day 14 p.c. and 28 p.c. The difference in gene expression among vaccinated fish was mainly observed as down-regulations in vaccinated, β-glucan fed fish compared to up-regulations or no regulation in vaccinated controls. Slightly increased levels of plasma lysozyme activity were found in fish (both unvaccinated and vaccinated) receiving β-glucan at day 3 p.c. compared to control fed groups. This was associated with a faster clearance of Y.?ruckeri in unvaccinated fish receiving β-glucan. In contrast to the trend towards a beneficial effect of β-glucan on plasma lysozyme activity, a trend towards suppression of plasma antibodies was seen in both unvaccinated and vaccinated fish receiving β-glucan. However, the effects of β-glucan were not reflected in the survival curves, and the differences seen in plasma lysozyme activity and antibody levels may have counteracted and set off each other as well as counteracted any potential effect represented by the differences in gene expression found.     

Humoral response and protection from experimental challenge following vaccination of raccoon pups with a modified-live canine distemper virus vaccine.

Eight 8-wk-old raccoon pups (Procyon lotor) with maternal canine distemper virus (CDV) neutralizing antibodies (NAb) and 24 8-wk-old seronegative pups were administered a commercial modified-live CDV vaccine (Galaxy, D, Solvay Animal Health, Inc., Kitchener, Ontario, Canada). All 24 seronegative raccoons had detectable serum CDV NAb titers 14 days after the initial dose. Titers rose to maximum levels 4 wk post-vaccination. Mean titers for groups of vaccinated seronegative pups were maintained between 1:256 and 1:2,048 for the remainder of the 3 mo observation period. Geometric means of the serum CDV NAb titer of eight seronegative pups given a single vaccine dose at 8 wk of age did not differ significantly from those of eight pups that were given serial doses at 8, 12, and 16 wk of age, or from those of eight pups vaccinated once at 16 wk of age. Seven unvaccinated 8-wk-old raccoon pups used as controls remained seronegative throughout the trial. Seven out of eight 8-wk-old pups with maternal antibodies, vaccinated at 8, 12, and 16 wk of age, failed to develop a rise in their CDV NAb titers until at least 18 wk of age, 2 wk after the third vaccination. Titers in eight unvaccinated raccoons with maternal antibodies declined steadily to undetectable levels at 20 wk of age. A half-life of 10.55 days was calculated for maternally-derived CDV NAb in raccoon pups. Sixteen vaccinated raccoons were protected from clinical disease following experimental oronasal challenge with a virulent raccoon strain of CDV, 13 to 23 wk after vaccination. Serum CDV NAb titers at the time of challenge ranged from 1:12 to 1:384 and increased during the period of observation. Three of four unvaccinated seronegative raccoons used as controls failed to mount any detectable CDV NAb and were euthanatized after developing clinical signs of canine distemper 26, 29, and 30 days post-challenge (PC). Necropsies confirmed the diagnosis. The fourth control raccoon exhibited transient equivocal clinical signs, mounted a sluggish humoral response, but was clinically normal when euthanatized 42 days PC. In this raccoon, there was focal non-suppurative encephalitis with intranuclear inclusion bodies typical of CDV infection.     

Burden of Illness in UK Subjects with Reported Respiratory Infections Vaccinated or Unvaccinated against Influenza: A Retrospective Observational Study

Objective

Detailed data are lacking on influenza burden in the United Kingdom (UK). The objective of this study was to estimate the disease burden associated with influenza-like illness (ILI) in the United Kingdom stratified by age, risk and influenza vaccination status.

Methods

This retrospective, cross-sectional, exploratory, observational study used linked data from the General Practice Research Database and the Hospital Episode Statistics databases to estimate resource use and cost associated with ILI in the UK.

Results

Data were included from 156,193 patients with ≥1 general practitioner visit with ILI. There were 21,518 high-risk patients, of whom 12,514 (58.2%) were vaccinated and 9,004 (41.8%) were not vaccinated, and 134,675 low-risk patients, of whom 17,482 (13.0%) were vaccinated and 117,193 (87.0%) were not vaccinated. High-risk vaccinated patients were older (p<0.001) and had more risk conditions (p<0.001). High-risk (odds ratio [OR] 2.16) or vaccinated (OR 1.19) patients had a higher probability of >1 general practitioner visit compared with low-risk and unvaccinated patients. Patients who were high-risk and vaccinated had a reduced risk of >1 general practitioner visit (OR 0.82; p<0.001). High-risk individuals who were also vaccinated had a lower probability of ILI-related hospitalisation than individuals who were high-risk or vaccinated alone (OR 0.59). In people aged ≥65 years, the mortality rate was lower in vaccinated than unvaccinated individuals (OR 0.75). The cost of ILI-related GP visits and hospital admissions in the UK over the study period in low-risk vaccinated patients was £27,391,142 and £141,932,471, respectively. In low-risk unvaccinated patients the corresponding values were £168,318,709 and £112,534,130, respectively.

Conclusions

Although vaccination rates in target groups have increased, many people are still not receiving influenza vaccination, and the burden of ILI in the United Kingdom remains substantial. Improving influenza vaccination uptake may have the potential to reduce this burden.     

Anatomical patterning of visceral adipose tissue: race, sex, and age variation

Objective: We tested sex, race, and age differences in the patterning of visceral adipose tissue (VAT) and subcutaneous adipose tissue. Research Methods and Procedures: Contiguous 1‐cm‐thick magnetic resonance (MR) images of the abdomen were collected from 820 African‐American and white adults. Repeated‐measures ANOVA was used to examine the effects of image location, sex, race, and age (≥50 vs. <50 years) on adipose tissue areas. Maximum VAT area was identified for each subject from the raw data. Results: Compared to women, men had greater total VAT volume (p < 0.0001), and their maximum VAT area occurred higher in the abdomen (p < 0.0001). Among white men, maximim VAT area most frequently occurred 5 to 10 cm above L4‐L5, whereas in the other groups, maximim VAT area most frequently occurred 1 to 4 cm above L4‐L5 (p < 0.0001). African‐American men had greater total VAT volume than African‐American women (p < 0.01), but this sex difference was only significant using single images cranial to L4‐L5 + 2 cm. Age‐related increases in VAT tended to be greatest 5 to 10 cm above L4‐L5 in men and near L4‐L5 in women. Discussion: A single MR image 5 to 10 cm above L4‐L5 may allow more accurate conclusions than the L4‐L5 image regarding group differences in visceral adiposity.     

Mortality and age differences in marriage.

Data from the 1971 census population were used to evaluate the effects of age differences of married partners on mortality rates. Different age groups were isolated to highlight the association between mortality and age of spouse for specific ages of married men and women. Men married to much younger or to older women exhibited a higher mortality rate than men married to women who were only a few years younger than themselves. A similar trend was observed among women married to much younger or much older men compared with those whose spouses were a few years older or of similar ages as themselves. Trends for other age groups (women aged 60-69 years, men below 40, and women below 30) did not exhibit a clear pattern. Although statistical biases within age groups may in part account for the differences in the findings, the trend which emerged from the analysis suggests that lower morbidity is associated with the most common age combinations (husbands same age or slightly older than wives). Other factors could also account for the differences (e.g., selection of healthy partners in 1st marriages, differences in lifestyles between married and single).     

Intradermal vaccination of adults with three low doses (2 micrograms) of recombinant hepatitis B vaccine. I. Seroconversion rate and adverse effects

A total of 250 dentists (53.6% men and 46.4% women), with a mean age of 35.1 +/- 9.8 years, were submitted to serological tests for the diagnosis of hepatitis B (HB)--HBsAg, anti-HBs, anti-HBc, HBeAg, and anti-HBe--using a radioimmunoassay. One or more of these markers were detected in 78 individuals (31.2%) who were excluded from the group to be vaccinated. Of the 172 HB-susceptible individuals, 135 (78.5%) responded to the call and were intradermally injected with three 2 micrograms doses of the Belgian HB recombinant vaccine, applied at an interval of one month between the 1st and 2nd dose and of five months between the 2nd and 3rd dose. A new determination of HB markers carried out 50 days after the 3rd dose showed that 110 (81.5%) individuals had become anti-HBs positive (65.5% good responders and 34.5% poor responders). Mean serum anti-HBs titer of these 110 dentists was 42.4 U S/N, similar in both sexes. The adverse effects analyzed in 106 dentists were: (a) local: pain (12.3%), burning sensation (14.1%), pruritus (25.5%), erythema (28.3%), local heat (18.9%), and a hypochromic spot (32.1%); (b) systemic (4.7%): discomfort in two patients, and fever, anorexia, and asthenia in one patient each. Intradermal administration of a fourth 2 micrograms vaccine dose to 39 dentists (poor or non-responders) increased the total number of anti-HBs-positive individuals from 110 (81.5%) to 114 (84.4%), with the number of good responders increasing from 72 (65.5%) to 85 (74.6%). We conclude that the Belgian recombinant vaccine applied in the scheme used here induces a high rate of seroconversion and causes only mild and transitory adverse effects.