Prevalence of intestinal parasitic infestation,salmonellosis, brucellosis,tuberculosis, and hepatitis B among immigrant children in Glasgow.

Two hundred Asian and 100 each of African, Chinese, and Scottish children were screened for intestinal parasitic infestations, salmonellosis, brucellosis, hepatitis B antigen (HBsAg), and tuberculosis. There was a fairly high incidence of Giardia lamblia among Asian and Scottish children and of Trichuris trichiura among the Chinese. Hookworm ova were seen only in Africa children. There were no chronic carriers of Salmonella or Brucella, and no one was suffering from salmonellosis or brucellosis. Tuberculin sensitivity was found in only 4% of immigrant and 1% of Scottish children: the difference was small and neither figure suggests a continuing high incidence of tuberculosis in Glasgow. Only seven immigrant children were found to be HBsAg carriers. Among the families of these carriers there was a high incidence (84%) of HBsAg or antibody (HBsAb). The survey shows that immigrant children in Glasgow do not constitute a health hazard to the indigenous population. Moreover, severe overcrowding is not a prominent feature among the immigrant families in Glasgow but is greatest among the local Scots.     

The trend of acquired immunity with live poliovirus vaccine and the effect of revaccination: follow-up of vaccinees for ten years

The persistence of neutralizing antibody (NA) against three types of poliovirus acquired after two doses of trivalent live attenuated poliovirus vaccine (LPV) has been followed up for ten years in individual vaccinees. Sixty-seven children were bled once a year over a five year period following the primary vaccination. More than 80% of them retained NA against all three types of poliovirus. Thirty-two individuals whose NA titres were 1:16 or over for types 1 and 2 and 1:4 or over for type 3 at the fifth year were further followed up for a further five years and it was shown that during this period some of them had a naturally-acquired antibody rise, mostly against type 3 virus. At the sixth to eighth year after the primary vaccination, one further dose of the trivalent vaccine was administered to the children whose NA titres were down to 1:8 or less and the effect of booster vaccination on NA was followed. Other subjects were revaccinated with LPV and their fecal excretion of the vaccine virus was investigated. The results showed that a decrease in serum antibody level could be a good indicator of the local resistance of the alimentary tract and that reinfection could occur if serum NA had decreased to 1:8 or less, which allowed a virus excretion in the stools.     

Evaluation of an enzyme-linked immunosorbent assay based on binding inhibition for type-specific quantification of poliovirus neutralization-relevant antibodies

To detect neutralization-relevant antibodies against 3 types of poliovirus (PV) without using tissue cultures and live viruses, an enzyme-linked immunosorbent assay (ELISA) based on monoclonal antibody-binding inhibition was evaluated using sera from 80 vaccinated Japanese children and 60 Pakistani poliomyelitis patients. Compared with the neutralization test, the sensitivity of the inhibition ELISA was 100% (111/111) for detection of anti-PV1 antibody, 98.3% (118/120) for anti-PV2, and 96.5% (82/85) for anti-PV3, and the specificity was 93.1% (27/29), 100% (20/20), and 92.7% (51/55), respectively. Thus, the inhibition ELISA showed excellent potential as a seroepidemiologic tool in both vaccinated and naturally-infected populations.     

Prevalence of antibodies to poliovirus in 1978 among subjects aged 0-88 years.

The antibody state of a population aged 6 months to 88 years to poliovirus types 1, 2, and 3 was determined by examining 919 sera collected in Lancashire, London, and southern and south-east England. In subjects aged over 2 years the immune state was surprisingly uniform, although the older patients had probably acquired practically all their antibodies as a result of natural infection and those under 16 through vaccination. at least 95% had detectable antibodies to at least one poliovirus type and about 60% to all three types, with the exception of a cohort of children born between 1963 and 1968, in whom the proportions were about 80% and 40% respectively. These children were born around the time of the changeover from inactivated to oral vaccine, when immunisation rates were low and there was confusion over the number of doses required. These results indicate that a complete course of vaccine or a booster dose at or around school-leaving age is necessary.     

Indicators of immunity in children vaccinated with live poliomyelitis vaccine]

Serological examination of 1057 children, residents of Leningrad, vaccinated with poliomyelitis vaccine at the appropriate calendar dates according to the scheme, showed the presence of antibodies to the polioviruses in 81.5-99.1% of the cases. There were more serologically negative children against the virus type III, and much less--against the virus type II. The value of the mean geometrical titres somewhat decreased with the advance of the children's age and the time lapse after the vaccination and revaccination. The greatest antibody titres determined were against the poliovirus type II, and the least--against type III. No antibodies against the viruses of types I and III were revealed in case of deficiency against the poliovirus type II. The number of children with the absence of antibodies against the poliovirus of all the types was insignificant.     

Polio antibody outfit of newborns and infants born after 20 years of mass vaccination with live poliovaccine

Antibodies against type 1 and 2 poliovirus were tested in 250 infants and against type 3 poliovirus in 341 infants aged 0-13 months to compare the polio antibody outfit of newborns and infants born to three groups of mothers: (a) nonvaccinated, above 35 years of age; (b) vaccinated with attenuated poliovirus but having had chance of contact with wild poliovirus during childhood, age 22-35 years, and (c) vaccinated but not having had contact with wild poliovirus, below 22 years of age. Over 90% of newborns had specific neutralizing antibodies against all three poliovirus types. With increasing infant age the percentage of antibody-positive infants decreased: by age 9-11 months only 46%, 27% and 14% of infants displayed antibodies to polio-virus types 1, 2 and 3, respectively. Geometric mean titres decreased accordingly. Differences between infants born to mothers of the above three groups were nonsignificant: the results obtained suggest that future newborns will also possess satisfactory levels of antibodies acquired from mothers who have only had contact with attenuated vaccine poliovirus.     

Evaluation of poliovirus antibody titers in orally vaccinated semi‐captive chimpanzees in Uganda

Background To understand immunological responses in chimpanzees vaccinated with live‐attenuated vaccine (oral polio vaccine; OPV), serum neutralizing antibodies against poliovirus types 1, 2, and 3 were investigated over time. Methods The neutralizing antibody titers against poliovirus types 1, 2, and 3 were determined by microneutralization test using 100 ID₅₀ of poliovirus types 1, 2, and 3 (Sabin strains). Results Neutralizing antibodies against poliovirus types 1, 2, and 3 were detected in 85.7%, 71.4%, and 65% of the serum from 42 chimpanzees tested 9 years post‐vaccination. The neutralizing antibody titers in chimpanzees were similar to the documented levels in human studies as an indicator of vaccine efficacy. Conclusions This study reveals persistence of neutralizing antibodies in chimpanzees for at least 9 years after vaccination with OPV. This first study in chimpanzees provides useful information for the evaluation of the success of vaccination with OPV in other captive apes.     

Antibody status to poliomyelitis,measles, rubella,diphtheria and tetanus,Ontario, 1969-70: deficiencies discovered and remedies required.

A serologic survey was made in 15 health unit areas, testing some 5000 individuals in the age groups 4 to 6, 11 to 13, 15 to 17 and 23 to 45 years. Two types of serious deficiency were found. Only 65% of children 4 to 6 years old had antibodies to all three types of poliovirus, the antibodies being due almost entirely to immunization with Salk vaccine. Even in children who had had six or more doses only 74% had antibodies to the three types. The high percentage of students 11 to 13 and 15 to 17 years old with poliovirus antibodies can be attributed largely to natural infection and to Sabin vaccine in the mass campaign of 1962, as well as to Salk vaccine. In children who had received Sabin vaccine as well as Salk vaccine a very high level of immunity was found. The immunity of the school-age population will decline to an insufficient level unless Sabin vaccine is used after immunization with Salk vaccine. Of children 4 to 6 years old 18% had no diphtheria antitoxin and 6% had no tetanus antitoxin. Even in those who had had six or more doses of the antigens 5% had no diphtheria antitoxin and 1 to 2% had no tetanus antitoxin. This apparently refractory state is probably due to the use of unadsorbed toxoids, and it is clear that adsorbed toxoids should be used. In the adults, diphtheria antitoxin was found in only 55% and tetanus antitoxin in only 38%.     

Human Circulating Antibody-Producing B Cell as a Predictive Measure of Mucosal Immunity to Poliovirus

Background

The “gold standard” for assessing mucosal immunity after vaccination with poliovirus vaccines consists in measuring virus excretion in stool after challenge with oral poliovirus vaccine (OPV). This testing is time and resource intensive, and development of alternative methods is a priority for accelerating polio eradication. We therefore evaluated circulating antibody-secreting cells (ASCs) as a potential means to evaluate mucosal immunity to poliovirus vaccine.

Methods

199 subjects, aged 10 years, and previously immunized repeatedly with OPV, were selected. Subjects were assigned to receive either a booster dose of inactivated poliovirus vaccine (IPV), bivalent OPV (bOPV), or no vaccine. Using a micro-modified whole blood-based ELISPOT assay designed for field setting, circulating poliovirus type-specific IgA- and IgG-ASCs, including gut homing α4β7+ ASCs, were enumerated on days 0 and 7 after booster immunization. In addition, serum samples collected on days 0, 28 and 56 were tested for neutralizing antibody titers against poliovirus types 1, 2, and 3. Stool specimens were collected on day 28 (day of bOPV challenge), and on days 31, 35 and 42 and processed for poliovirus isolation.

Results

An IPV dose elicited blood IgA- and IgG-ASC responses in 84.8 to 94.9% of subjects, respectively. In comparison, a bOPV dose evoked corresponding blood ASC responses in 20.0 to 48.6% of subjects. A significant association was found between IgA- and IgG-ASC responses and serum neutralizing antibody titers for poliovirus type 1, 2, 3 (p<0.001). In the IPV group, α4β7⁺ ASCs accounted for a substantial proportion of IgA-ASCs and the proportion of subjects with a positive α4β7⁺ IgA-ASC response to poliovirus types 1, 2 and 3 was 62.7%, 89.8% and 45.8%, respectively. A significant association was observed between virus excretion and α4β7⁺ IgA^- and/or IgG-ASC responses to poliovirus type 3 among immunized children; however, only a weak association was found for type 1 poliovirus.

Discussion

Our results suggest that virus-specific blood ASCs, especially for type 3 poliovirus, can serve as surrogate of mucosal immunity after vaccination. Further studies are needed to evaluate the duration of such memory responses and to assess the programmatic utility of this whole blood-based mucosal ASC testing for the polio eradication program.     

捕捉法ELISA检测脊髓灰质炎IgA抗体方法的建立与应用

建立了一种检测脊髓灰质炎(简称脊灰)IgA抗体的捕捉法ELISA(Aac-ELISA)。方法敏感,快速,特异,用于检测144份脊灰可疑病人的血清,IgA抗体检出率为77.8％(112/144).而这些血清的IgM抗体检出率为65.2％(94/144)。如同时检测IgM和IgA抗体,则阳性率可达91.7％(132/144)。麻痹后1～3天内IgA的检出率为76.5％(13/17),4～7天内为95％(19/20)。最长检出IgA的一例可疑病人,其血清收集于病后第59天。本方法在一部分16天后可疑病人IgM阴性血清中查出IgA阳性,故可以作为查IgM抗体诊断方法的补充,尤其适用于诊断感染后未能及时收到血清标本,IgM已经转阴而IgA抗体仍为阳性的病人。     

Inactivation of poliovirus with β-propiolactone

The recovery of poliovirus D-antigen after virus inactivation was studied for two inactivating agents (β-propiolactone and formalin) using the three poliovirus types (Sabin types 1, 2 and 3). With β-propiolactone (BPL), D-antigen recoveries were high (88, 88 and 60%, respectively) but were significantly less when formalin was used (22, 15 and 25%). β-Propiolactone inactivated virus was purified, combined with Freund's adjuvant and used to hyperimmunize rabbits. High titres (50 000–200 000) of specific neutralizing antibody were obtained.     

Antibodies to poliomyelitis virus in cord blood of neonates born to from mothers in contact or not in contact with the wild virus

Neutralizing antibodies to polioviruses in cord blood of neonates born from 64 mothers under age 20 and in 53 mothers aged 30 years and over were investigated in order to know and compare the transfer to newborns of antibodies to polioviruses produced by live oral vaccine mainly and those antibodies induced by natural contact with wild poliovirus strains. Total immunity for the two groups was higher than 80% for the three types of polioviruses, with only virus 3 showing an immunity below 80% (77.4%) in mothers aged 30 years and over. Average geometric titers though relatively low may be considered satisfactory. However, there is a statistically significant difference in titers to poliovirus type 2 (24.9) in mothers over age 30 years as compared to those found in mothers below age 20 years (10.8), for which we have found no explanation. It is not deemed necessary for the time being to take special prophylactic measures with these children given the occurrent epidemiologic status quo.     

Immunization with Live Measles Virus Vaccine

One hundred and fifty children who had no measurable serum measles antibody were vaccinated with live measles virus. All showed post-vaccinal serum antibody levels generally considered sufficient to prevent measles.One hundred and thirty-nine (93%) of the infants and children demonstrated one or more symptoms following vaccination. In view of their generally mild and limited nature, and of the protection subsequently afforded, this procedure would seem to be a real advance in preventive medicine.     

Transplacental antibodies. Part III: Maternal antibodies against polioviruses, M. parotitidis and M. parainfluenzae

In 1981 we examined 247 sera for the presence of antibodies against all three types of poliovirus and 253 sera for antibodies against M. parotitidis and three types of M. parainfluenzae viruses. The sera were obtained from the cord blood of mothers between 15 and 34 years of age. All mothers were divided into four age groups, each with primipara and multipara subgroups. The rate of seropositivity for type 1 and type 2 poliovirus-specific antibody was in all age groups higher than 90%, the overall seropositivity rate for type 3 poliovirus antibody was 83.6%, with 73.1% as the lowest rate for age group of youngest mothers. Significant seropositivity variations between the primipara and multipara subgroups were recorded only for type 3 antibody in the two age groups of oldest mothers (25-29 and 30-34 years). This is consistent with the assumed booster effect of Sabin vaccine strains on mothers of families with more than one child. Antibodies specific to mumps virus were present in the cord blood of 78.6% of all mothers and the rates of seropositivity were found to rise with the increasing age. Seropositivity for M. parainfluenzae type 1-specific antibody was demonstrated in 95.8%, for type 2-specific antibody in 98.9% and for type 3-specific antibody in 100% of mothers, which is suggestive of high herd immunity levels in the population.     

Poliovirus excretion in Guatemalan adults and children with HIV infection and children with cancer.

More than 20 patients with persistent poliovirus infections have been identified and reported to WHO. To date, almost all of these patients have had B-cell immune deficiency disorders. Since there are limited data on patients with HIV infection who have received oral poliovirus vaccine (OPV), we studied adults and children to determine if persons with acquired immunodeficiency due to HIV infection or cancer chemotherapy in a developing country setting had prolonged excretion of polioviruses. Stool samples from 94 HIV-infected children and 101 adults and 50 children surviving cancer in Guatemala City were cultured for polioviruses. No polioviruses were detected in any of the 195 persons with HIV infection or the 50 with cancer. The evidence from this and other studies indicates that the persistent poliovirus excretion in HIV-infected individuals is an unlikely event.     

Life expectancy in children with cerebral palsy.

OBJECTIVE--To determine life expectancy of children with cerebral palsy. DESIGN--Cohort analysis, by means of register compiled from multiple sources of ascertainment, of all children with cerebral palsy born during 1966-84 to mothers resident in Mersey region. Status of children was determined by flagging through NHS central register. SUBJECTS--1258 subjects with idiopathic cerebral palsy, of whom 1251 were traced and included in analysis. MAIN OUTCOME MEASURES--Effect of functional ability (ambulation, manual dexterity, and mental ability), sex, birth weight, and gestational age on survival. RESULTS--20 year survival for whole cohort was 89.3% for females and 86.9% for males. For subjects with no severe functional disabilities 20 year survival was 99% (95% confidence interval 98% to 100%), while subjects severely disabled in all three functional groups had 20 year survival of 50% (42% to 58%). Subjects with birth weight < or = 2500 g had 20 year survival of 92% (89% to 95%), while those with birth weight > 2500 g had survival of 87% (84% to 89%). Subjects with gestational age of > 37 weeks had 20 year survival of 93% (91% to 96%), while those with gestational age > or = 37 weeks had survival of 85% (83% to 88%). Birth weight and gestational age were less predictive of survival than functional disability. Best statistical model used gestational age and number of severe functional disabilities as predictors. CONCLUSIONS--Life expectancy of this cohort of children with cerebral palsy was greater than has been suggested in some previous studies. This has important implications for social, educational, and health services.     

Infant-feeding practices among immigrants in Glasgow.

Two hundred and six Asian, 99 African, 99 Chinese, and 102 Scottish children from 172 families were studied to ascertain infant-feeding practices. After arriving in the United Kingdom most of the immigrant mothers had not wished to breast-feed their babies because of wrong information or misconceptions about British infant-feeding practices. The Asians had largely adopted British habits of introducing solid foods to their babies'' diets, but the habits of the African and Chinese mothers in this respect had changed little. Furthermore, many of the African and Chinese children had received no vitamin preparation. The survey showed that all mothers resident in Britain urgently need advice on some aspects of infant feeding.     

Antibody state to poliovirus in first year university students, 1984.

Circulating antibodies to poliovirus were estimated in a group of 300 British and 84 foreign first year students who registered at the health centre of Nottingham University in 1984. Detectable antibodies to all three poliovirus serotypes were found in 212 (71%) of the British students but in only 47 (56%) of those from abroad. Most of the British students (280; 93%) had been born in 1965 or 1966, when uptake of poliomyelitis vaccine was declining. Immunisation histories showed that 10 British and 29 foreign students (3% and 35%) had no record of any immunisation; only five British and two foreign students, however, were negative for all three poliovirus serotypes. These findings provide evidence that a high proportion of British born people aged 18-29 have adequate circulating poliovirus antibodies despite incomplete immunisation schedules. Though this is reassuring, the absence of antibodies in some students and the lack of previous immunisation against poliomyelitis in 39 suggest that reinforcing doses of vaccine at the time of leaving school or beginning further education are still warranted, particularly for students from other countries. The findings also emphasise the need for accurate immunisation records.     

Excretion of attenuated polioviruses in children vaccinated with live oral poliovirus vaccine

The excretion of attenuated polioviruses was studied in a group of nursery children vaccinated with 105TCD50 of each type of virus. The primovaccinated children were found to excrete type 1 poliovirus for 8 weeks, type 2 for 11 weeks after the vaccination with the type 1 + 2 bivaccine. Poliovirus type 1 as eliminated by 78% and type 2 by 98% of the vaccinees. The separately administered type 3 was detectable for 6 weeks and was isolated from 100% of the vaccinees. The highest per cent of children with type 1 excretion positivity was recorded at week 5, with type 2 positivity at week 1 and with type 3 positivity at week 2. The poliovirus excretion peaked early after the vaccination, the titres of the poliovirus type 2 were the highest. The children revaccinated next year with the type 1 + 2 bivaccine eliminated the respective types of virus 1 - 2 weeks; type 3 poliovirus was detectable for 6 weeks after revaccination and was excreted by the highest per cent of vaccines. The contact infections caused by the attenuated polioviruses developed in 9 from 22 children vaccinated previously. The excretion of polioviruses did not last longer than 1 week. The contact infections were most frequently caused by the poliovirus type 2. The examined children, particularly those vaccinated previously, turned out to excrete also other enteroviruses identified as Coxsakieviruses B 4 and B 5 and Echovirus 21. In the primovaccinated these viruses were isolated only from those with the negative excretion of polioviruses.     

Excretion of live attenuated polioviruses in the faeces of orally vaccinated children. Comparison of two immunization schedules

The excretion of live, attenuated poliovirus vaccine strains was determined in the feces of Prague Infants home children given 10(5) PFU of type 1 and 2 and 2.10(5) PFU of type 3 vaccine in a routine annual mass campaign. The first two faeces specimens examined in each vaccinee prior to immunization were negative for the virus. A total of 476 stool specimens were collected from 37 children at weekly intervals for a period of 18 weeks. The presence of type 1 poliovirus in the faeces of children given monovalent type 1 vaccine was detectable for 9 weeks, with a maximum in first week, and the virus was isolated in 74.2% of vaccinees. The timing of bivalent type 2 and type 3 vaccine was 9 weeks after monovalent type 1 immunization. The excretion of these two types of poliovirus was found to persist for at least 6 weeks. Type 2 poliovirus was isolated in all vaccinees, type 3 in 70.4% of children. The highest percentage of children excreting type 2 poliovirus was recorded in the first week, the excretion of type 3 peaked three weeks after bivaccine administration. The excretion peaks were reached relatively early postvaccination, with type poliovirus reaching the highest titre per 1 g of faeces. After revaccination (one year later) with monovalent type 1 vaccine, the vaccine strain of type 1 poliovirus could be detected for 6 weeks and was present in the highest percentage of positive stool samples.(ABSTRACT TRUNCATED AT 250 WORDS)