Isotypes of human vaccinal antibodies to the Vi capsular polysaccharide ofSalmonella typhi

Summary The immunoglobulin class and IgG subclass distribution of anti-Vi antibodies elicited by vaccination with a single injection of the purified polysaccharide or three injections of the inactivated whole cell typhoid vaccine was examined using an immunoenzymatic assay. The two vaccines induced antibody responses of similar magnitude and the predominant subclass of IgG antibodies was IgG1.     

血常规结果在常见传染病鉴别诊断中的应用

目的探讨血常规结果对伤寒、肾综合征出血热(HFRS)、疟疾、传染性单核细胞增多症(IM)等4种传染病的鉴别诊断意义。方法收集2000年5月~2004年5月期间血常规资料;伤寒患者58例、HFRS患者47例、疟疾患者23例、IM患儿54例、呼吸道感染患者38例。对血常规结果进行分析。收集健康成人及儿童静脉血共70份进行血常规检查作为正常对照组。结果伤寒患者血常规显示白细胞计数正常或偏低,嗜酸性粒细胞(EOS)消失;HFRS患者血常规显示血小板计数<100×109/L,多数病例白细胞分类可见异型淋巴细胞(简称异淋),但是异淋比例多在15%以下;疟疾患者血常规显示血红蛋白轻度减低,血小板计数<100×109/L,多数病例血涂片可直接找到疟原虫;IM患儿血常规显示淋巴细胞比值升高,异淋易见,多数病例异淋比例>10%。结论血常规检查结果可以作为伤寒等4种传染病的辅助诊断及鉴别诊断指标。     

Preparation and testing of a Vi conjugate vaccine using pneumococcal surface protein A (PspA) from Streptococcus pneumoniae as the carrier protein

In the current study pneumococcal surface protein A (PspA) was conjugated to Vi capsular polysaccharide from Salmonella Typhi to make available a vaccine against typhoid fever that has the potential to also provide broad protection from Streptococcus pneumoniae. High yielding production processes were developed for the purification of PspAs from families 1 and 2. The purified PspAs were conjugated to Vi with high recovery of both Vi and PspA. The processes developed especially for PspA family 2 could readily be adapted for large scale production under cGMP conditions. Previously we have shown that conjugation of diphtheria toxoid (DT) to Vi polysaccharide improves the immune response to Vi but can also enhance the response to DT. In this study it was shown that conjugation of PspA to Vi enhanced the anti-PspA response and that PspA was a suitable carrier protein as demonstrated by the characteristics of a T-cell dependent response to the Vi. We propose that a bivalent vaccine consisting of PspA from families 1 and 2 bound to Vi polysaccharide would protect against typhoid fever and has the potential to also protect against pneumococcal disease and should be considered for use in developing countries.     

Working Group on quality,safety and efficacy of typhoid Vi capsular polysaccharide conjugate,vaccines, Jeju,Republic of Korea, 5–7 September 2012

Typhoid fever is a gastrointestinal disease transmitted through the ingestion of contaminated water or food. The bacterium, Salmonella enterica subspecies enterica serovar Typhi is an important cause of illness and death in many poor countries where access to safe water and basic sanitation is limited. Humans are the only natural host and reservoir of S. Typhi. Typhoid fever causes around 21 million cases and at least 200,000 deaths per year. Currently, several groups are developing typhoid conjugate vaccines that are expected to be safe and effective in infancy or early childhood. The World Health Organization convened a meeting, in collaboration with the Korea Food and Drug Administration, with experts group in September 2012 to develop guidelines for regulatory evaluation of the quality, safety and efficacy of typhoid conjugate vaccines. This report summarizes collective views on scientific and technical issues that need to be considered in the guidelines.     

河南省2004-2011年伤寒流行病学特征分析

目的了解2004-2011年河南省伤寒的流行病学特征。方法收集《疾病监测信息报告管理系统》中的监测数据,描述2004-2011年河南省伤寒的流行特征,通过SPSS 15.0软件进行统计分析。结果 2004-2011年河南省共报告伤寒病例1 163例,发病率为0.154/10万;2004-2010年发病率呈下降趋势,而2011年呈上升趋势（Z=-15.221 7,P〈0.01）。伤寒发病率的时间高峰在8月份（Z=6.125 9,P〈0.01）。省辖市之间伤寒发病率的差异有统计学意义（χ2=489.996 9,P〈0.01）,较高的地区在三门峡、平顶山、信阳和焦作。男性发病682例,女性481例,男性发病率（0.176/10万）高于女性（0.131/10万）（χ2=25.213 7,P〈0.01）。5岁以下儿童发病率较高,病例主要分布在农民、学生和散居儿童中。结论应加强伤寒的疫情监测,关注高发季节、高发地区和高发人群,采取综合性的防治措施。     

江苏省伤寒/副伤寒流行现况、菌株耐药及其分子分型

目的 掌握江苏省伤寒/副伤寒流行现况、病原菌耐药性以及分子分型特征,以确定监测重点.方法 对2007-2011年江苏省伤寒/副伤寒疫情采用描述流行病学回顾性分析;210株伤寒/副伤寒沙门菌耐药性测定采用K-B纸片扩散法;81株伤寒沙门菌分子分型运用脉冲场凝胶电泳(PFGE).结果 近5年江苏省伤寒/副伤寒年均报告发病率为0.47/10万,呈总体下降趋势.人群年龄别发病以0岁组(1.70/10万)高发.病原谱以伤寒沙门菌为主(66.19%),其次为甲型副伤寒沙门菌(23.81%).伤寒/副伤寒沙门菌对萘啶酸耐药率最高(66.19%),对环丙沙星等6种抗生素耐药率低于10.00%,多重耐药率为30.00%.近3年伤寒沙门菌分属4个克隆群37个PFGE型,优势带型为JPPX01.JS0027(11.11%),JPPX0 1.JS0001为地区独特性菌型,JPPX01.JS0014、JPPX01.JS0018和JPPX01.JS0024为扩散性菌型.特征菌型成簇分析发现3起病例具有聚集性特征.结论 江苏省伤寒/副伤寒发病率维持在较低水平,婴儿高发.菌株对多数抗生素较敏感,但部分药物耐药性在增加.由于近年伤寒呈现高度散发状态,未出现占绝对优势的菌型,推测近期发生大规范流行的可能性较小.     

张锡纯伤寒学术思想初探

近代名医张锡纯认为,通过对脉诊的辨证,可以分析病情、确定病位、掌握病候、执简驭繁地对伤寒进行辨证论治。同时指出:临证时,须根据病机病情的变化,灵活化裁运用经方。张氏运用经方时的"知常达变"思想对我们今天研究经方、运用经方裨益匪浅。     

铜仁市茶店镇一起伤寒暴发疫情的调查报告

目的查明铜仁市茶店镇发生伤寒暴发疫情规模及原因,控制疫情蔓延结果 2011年10月,铜仁市茶店镇发生伤寒暴发疫情,发病28例,罹患率仅为1.41‰。采集现症病人全血28份,分离到伤寒菌株19株。结论该起疫情为水源污染引起的暴发。     

1990～2000年桂林市伤寒调查报告

目的为探讨广西伤寒流行特点、流行因素、研究防治对策 ,选择伤寒监测点。方法1999年底至2000年初对桂林市及辖区县进行了详细的流行病学专题调查。结果桂林市伤寒副伤寒发病率从1990年的15.84/10万上升到2000年91.88/10万 ,上升了480.06 %,83.11 %的乡 (镇 )有病例报告,学生发病比例从1995年的21.27 %上升到1999年的32.34%。甲型副伤寒杆菌所占比例逐年增高 ,2000年上升到98.41 %,变为主要流行菌型 ,药敏试验对氟哌酸、氯霉素、庆大霉素等常用抗生素敏感 ,但有82.40 %对磺胺甲基异f唑耐药。22所学校饮用水源监测合格率仅为22.72 %。结论加强重点地区的伤寒监测 ,及时发现、治疗病人以及政府部门加大投入 ,完善、建设基础卫生设施刻不容缓