Early immunization of neonates with trivalent oral poliovirus vaccine.

Described is the evaluation in Brazil of the immune response of early immunization with trivalent oral poliovirus vaccine (TOPV). A total of 85 normal neonates from São Paulo were assigned one of the following immunization schedules: group A--one dose of TOPV at birth and subsequent doses at 2, 4, and 9 months of age; or group B--one dose of TOPV at 2, 4 and 6 months of age. Blood samples were collected sequentially from the mother at delivery, from the umbilical cord, and from the child at 2, 4, 6, 9 and 12 months of age for assay of poliovirus neutralizing antibodies. Administration of TOPV at birth, in addition to establishing immunity against poliomyelitis at an earlier stage, produced a superior immune response to poliovirus type 3. At the end of the first year, the proportion of susceptible individuals was 3.7% in group A and 25.9% in group B. When immunization against poliomyelitis is started at birth, excellent seroconversion rates are obtained from the third dose onward.     

Immunogenicity of oral poliovirus vaccine administered in mass campaigns versus routine immunization programmes.

Reported are the results of a study to investigate the immunogenicity of oral poliovirus vaccine (OPV) when administered in mass campaigns compared with that following routine immunization programmes. For this purpose, paired sera were collected from a cohort of children before and after a mass vaccination with OPV in Morocco in 1987. Serum samples and information on vaccination status and other confounding factors that could influence antibody responses to OPV were collected. Neutralizing antibody titres to poliovirus types 1, 2 and 3 were determined using a standardized assay. OPV doses administered exclusively during the mass campaign were consistently associated with higher type-specific seroprevalence rates than the same number of doses administered in the routine programme. These findings could not be attributed to differences in confounding factors. Enhanced secondary spread of vaccine virus may have occurred but could not be demonstrated because of limitations in the study design. Mass campaigns appear to be highly effective in raising the dose-related poliovirus type-specific immunity of the population above that achieved by the routine immunization programme. Our findings support the continued use of mass campaigns as an adjunct to routine programmes in order to both enhance and catalyse current efforts to achieve the global eradication of poliomyelitis by the year 2000.     

Evaluation of house-to-house versus fixed-site oral poliovirus vaccine delivery strategies in a mass immunization campaign in Egypt.

Among poliomyelitis eradication activities recommended by WHO are national immunization days. Most campaigns have delivered oral poliovirus vaccine (OPV) from fixed sites, reaching 80-90% of target populations. Although house-to-house vaccination provides nearly universal coverage, countries have been reluctant to use this approach because it is considered more costly and logistically difficult. To quantify the cost-effectiveness of both these strategies, we compared the vaccine coverage and vaccination costs per child for house-to-house and fixed-site delivery (38% and 13% higher, respectively), the costs per child vaccinated were similar. This was due primarily to the high coverage levels achieved in house-to-house delivery (100% versus 86%) and the reduced vaccine wastage. Vaccinating children at highest risk of infection was only 25-50% as expensive on a per child basis using house-to-house delivery, since such children were less likely to visit fixed sites. These findings may not be generalizable to other countries where labour costs are higher and the population density lower; however, house-to-house delivery may prove to be the most cost-effective eradication strategy by ensuring universal access to immunization.     

Some results of the work on mass immunization in the Soviet Union with live poliovirus vaccine prepared from Sabin strains

In the course of campaigns for the mass immunization of large segments of the population of the Soviet Union with live poliovirus vaccine prepared in the USSR from attenuated Sabin strains, some 15 200 000 persons received oral vaccine in 1959 and over 77 478 800 persons (mainly between 2 months and 20 years old) in 1960. Approximately 95% of these were given the vaccine incorporated in dragées.     

Immunogenicity and reactogenicity of rhesus rotavirus vaccine given in combination with oral or inactivated poliovirus vaccines and diphtheria-tetanus-pertussis vaccine.

Immunogenicity and reactogenicity of the oral rhesus rotavirus vaccine (RRV) were assessed among 72 infants (6 weeks old) in Lahore, Pakistan, from August to December 1985. Special emphasis was placed on the possible interaction or interference caused by giving RRV at the time infants received their first polio immunization. RRV was given to the infants at the same time as diphtheria-tetanus-pertussis (DTP), oral poliovirus vaccine (OPV), or inactivated poliovirus vaccine (IPV). The immune response to RRV was assessed by plaque-reduction neutralization 3 weeks after immunization and serum immunoglobulin (Ig) G and IgA antibody levels to poliovirus type 1 were tested by enzyme-linked immunosorbent assay (ELISA) after polio immunizations. Of the infants in the group given RRV with OPV, 50% had a two- to four-fold rise in neutralization titre against rotavirus, compared with 22% in the group given RRV with DTP and 20% in the group given RRV and IPV (P less than 0.05). Interference by live oral polio vaccination in the response to RRV seems unlikely. We observed no significant difference in rates of seroconversion of IgG antibodies to poliovirus type 1 among infants aged 18 and 21 weeks who received RRV and OPV (81%), RRV with delayed OPV (67%), or RRV and IPV (59%). Administration of RRV was safe and was not associated with adverse reactions in the 6 weeks old infants. The low rate of seroconversion to rotavirus suggests that a more antigen-rich vaccine or multiple doses of the same vaccine might produce a better immune response.     

诸暨麻疹疫苗免疫持久性研究

目的　了解麻疹疫苗免疫成功 2 5年后的免疫水平。方法　流行病学调查与实验室检测相结合。结果　麻疹疫苗初免成功 2 5年后尚有 5 3 66%～ 70 97%的人检出麻疹HI抗体 ;HI抗体阴性者中 92 3 1%检出SN抗体 ;未见再免成功与不成功者免疫水平有明显差异 ,不同抗体水平免疫成功者与自然麻疹患者 10年间感染麻疹情况不尽相同 ,免疫成功者主要表现为隐性感染 ,未见自然麻疹患者发生感染的。结论　在基本无自然麻疹的环境 ,麻疹疫苗一旦免疫成功 ,大多数人免疫力至少可维持 2 5年以上 ,甚至更长。再免仅能使HI抗体阴性和低水平者抗体暂时性迅速升高 ,对远期免疫持久性无明显增强作用。SN抗体更能反映机体免疫力。从免疫学观点看野病毒感染要强于疫苗免疫。     

Inactivation of human rotavirus, SA11 and other enteric viruses in effluent by disinfectants.

A preparation of infectious human rotavirus, isolated from faeces and resuspended in wastewater effluent, was shown to be inactivated by chlorine, chlorine dioxide, ozone and peracetic acid. Infectivity was assayed in MA 104 cells by the detection of cell-associated viral antigen by immunofluorescence. The inactivation curves were similar to those reported for other enteric viruses. Human rotavirus was at least as resistant as poliovirus, coxsackievirus, echovirus and f2 coliphage and was strikingly less sensitive to inactivation than the simian rotavirus, SA11. The latter was generally the most sensitive of the six tested viruses yet is often taken as being representative of the human rotaviruses.     

The control of hepatitis B virus infection with vaccine in Yupik Eskimos. Demonstration of safety, immunogenicity, and efficacy under field conditions

In 1981, a hepatitis B vaccine demonstration project was initiated among Yupik Eskimos of southwest Alaska to demonstrate that, under field conditions, the vaccine was safe, immunogenic, and efficacious. Laboratory tests for serologic markers of hepatitis B virus infection (HBsAg, anti-HBs, and anti-HBc) performed on sera collected in May 1981 from 3,988 residents of 17 remote Eskimo villages revealed that 2,645 (66.3%) had no evidence of hepatitis B virus infection. Because of a limited supply of vaccine, specific criteria for selection were used so that those at highest risk of infection would be immunized first. In November 1981, the first dose of vaccine was administered to 1,693 carefully selected individuals. The second dose was administered to 1,678 (99.1%) of those who received the first dose, and the final dose was administered to 1,630 persons (96.3%). Serologic follow-up showed the vaccine to be safe (0.4% experienced minor adverse reactions) and immunogenic (97.4% developed antibody). Vaccine-induced antibody levels were significantly higher for persons less than 30 years of age (p less than 0.001) and for females (p less than 0.001). Vaccine recipients were also protected from hepatitis B virus infection (p = 0.002). This public health measure proved to be feasible and effective in this remote arctic population despite difficult conditions for delivery and administration of this temperature-sensitive vaccine. This strategy for immunization is now being applied on a larger scale in Alaska as part of a program for the primary prevention of this infection and its sequelae.     

阜阳市2009-2011年麻疹疫苗强化免疫效果分析

目的 对阜阳市2009 -2011年麻疹减毒活疫苗(measles attenuated live vaccine,MV)强化免疫及查漏补种效果进行分析,为2012年如期实现消除麻疹的目标提供依据.方法 分析2009-2011年MV强化免疫及查漏补种免疫状况,并根据麻疹监测结果进行描述性分析.结果 2009-2011年MV强化免疫平均报告接种率达98.45％;麻疹发病率由强化免疫前5年(2005-2009年)的8.96/10万迅速下降到2010-2011年的0.27/10万,下降了96.99％;麻疹发病高峰依然是4～5月;强化免疫及查漏补种实施前后发病年龄均集中在8月龄～4岁和5～14岁两个年龄段.结论 MV强化免疫及查漏补种可以在短期内迅速大幅度降低麻疹的发病率,使麻疹疫情得到有效控制,应继续大力加强常规接种工作,将麻疹发病控制在低水平状态.     

Integration of vitamin A supplementation with the expanded program on immunization does not affect seroconversion to oral poliovirus vaccine in infants

Childhood immunization programs may provide infrastructure for delivering vitamin A supplements to infants in developing countries. The effect of giving vitamin A, an immune enhancer, on antibody responses to trivalent oral poliovirus vaccine (TOPV) is unknown. A randomized, double-blind, placebo-controlled clinical trial was conducted to determine the effect of giving vitamin A simultaneously with TOPV on antibody responses to poliovirus. Infants (n = 467) received oral vitamin A, 15 mg retinol equivalent (RE), 7.5 mg RE or placebo with TOPV at 6, 10 and 14 wk of age. Antibody responses to poliovirus types 1, 2 and 3 were measured by a microvirus neutralization assay at enrollment and at 9 mo of age. Seroconversion rates to poliovirus types 1, 2 and 3 ranged from 98 to 100% in the three treatment groups, and there were no differences in mean antibody titers to poliovirus types 1, 2 and 3 among treatment groups. This study demonstrates that oral vitamin A does not affect antibody responses to poliovirus vaccine when integrated with the Expanded Program on Immunization.     

临沂市部分人群麻疹抗体水平及麻疹疫苗强化免疫血清学效果监测

目的了解临沂市麻疹疫苗强化免疫的效果和人群麻疹抗体水平.方法随机抽取2个县区1 534名0～39岁健康人,应用酶联免疫吸附试验检测麻疹IgG抗体.结果1 534人中抗体阳性1190人,阳性率77.57%,几何平均滴度(GMT)1:783.1～12岁儿童抗体阳性率最高(85.71%～98.44%),GMT则从6岁开始下降至中低等水平,抗体阳性率有随年龄增长而下降的趋势.观察麻疹疫苗初种8～12月龄儿童188人,免疫成功率为96.81%;麻疹疫苗复种5～7岁儿童186人,免疫成功率61.29%;免疫后抗体GMT初、复种疫苗分别比免疫前提高28.4倍和3.1倍.结论大年龄儿童及成人的麻疹抗体水平仅达到中低水平;不论是初种或复种,免疫前抗体处于中低等水平者其免疫成功率显著高于免疫苗高抗体水平者.     

2009-2014年寿光市新生儿乙型肝炎疫苗免疫后5年效果分析

目的 观察新生儿乙型肝炎疫苗免疫后5年预防效果。方法 对完成3剂次5μg酿酒酵母乙肝疫苗接种及免后抗体检测者5年后进行随访调查,定量检测乙肝表面抗原抗体(抗-HBs)、乙肝核心抗体(抗-HBc)。结果 对初免应答抗-HBs≥100mIU/ml且无乙肝疫苗再接种史的577名儿童检测结果分析,抗-HBs阳性377例、阳性率65.34%,几何平均滴度(GMT)37.75 mIU/ml±88.37 mIU/ml,无乙肝表面抗原(HBsAg)阳性者。与5年前的初免后检测结果比较,抗-HBs阳性率下降34.66%,年均递减8.16%;GMT下降91.58%,年均递减40.08%。出生体重重、初免应答水平高5年后抗-HBs阳性率高于出生体重轻、初免应答水平低者。结论 基因重组乙肝疫苗免疫后5年,免疫效果良好,存在较好的免疫持久性和保护效果。出生体重与初免应答水平可能影响免疫持久性。     

Booster immunization with a hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovirus vaccine and Haemophilus influenzae type b conjugate combination vaccine in the second year of life: safety, immunogenicity and persistence of antibody responses

The immunogenicity and reactogenicity of booster vaccination with GSK Biologicals' hexavalent DTPa-HBV-IPV/Hib vaccine was assessed in toddlers aged 12-18 months previously primed with the same combination (N=341), or with DTPa-IPV/Hib and HBV administered separately (N=102; Trials 217744/059 and 217744/096). Antibody persistence at age 4-6 years was also assessed in children who had received a 4th consecutive dose of DTPa-HBV-IPV/Hib vaccine or separate DTPa-IPV/Hib and HBV vaccines in this study and in another study conducted under similar conditions in Germany. Prior to booster vaccination in the second year of life, antibody concentrations and seroprotection rates were similar irrespective of the primary vaccine used. One month after boosting with DTPa-HBV-IPV/Hib, substantial antibody increases were observed against all vaccine antigens indicative of previous immune priming. Seropositivity and booster response rates against all antigens were 97.4-100%. Reactogenicity following booster vaccination with DTPa-HBV-IPV/Hib was similar regardless of the primary regimen used. Three to four years after administration of the 4th DTPa-HBV-IPV/Hib dose, >90% vaccinees had persistent protective antibody concentrations against diphtheria, hepatitis B, Hib and the three poliovirus types. Anti-tetanus antibody concentrations were > or = 0.1 IU/ml in 76.4% subjects and seropositivity for pertussis antibodies ranged from 34.5% for PT to 98.9% for FHA. In conclusion, the combined hexavalent DTPa-HBV-IPV/Hib vaccine is immunogenic and safe when used for boosting in the second year of life, regardless of the primary vaccine used, and offers sustained protection during early childhood and beyond.     

Effects of listening to music with headphones on hearing--especially under noisy conditions

The purpose of this experiment was to clarify the effects of exposure to music using headphones under noisy conditions on hearing. The most comfortable loudness (MCL) for three kinds of music (Rock, Popular, Japanese songs) decided by two normal hearing subjects was measured under 6 noisy conditions (Train, Subway, Tram, Bus, Underground, Street) in a soundproof room. In the same manner, the MCL of favorite tunes of five subjects were measured. Temporary threshold shift 2 min after exposure (TTS2) to music for 30 min at the highest MCL was obtained. Furthermore, the characteristics such as spectral structures in one-third octave band or level fluctuations (coefficient of variation) were obtained for noise and music and compared. Statistical analysis revealed that MCL in Street was significantly higher than under other conditions and there was no significant differences in MCL among the various types of music. However, the highest MCL was found for Rock. About 20 dB of TTS was observed in one ear and the hazardous of headphones use in noisy conditions was suggested.     

Control of a type 1 poliomyelitis epidemic in British Guiana, 1962-63, with trivalent oral poliovirus vaccine. 1. Epidemiological aspects

An epidemic of poliomyelitis took place in British Guiana during the winter of 1962-63. A total of 485 paralytic cases occurred over a 10-week period, 90% in children under 5 years of age.