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E Isolauri

Publications and source records attributed to E Isolauri.

152 records · Page 9Linked to original sources

Protection of infants against rotavirus diarrhoea by RIT 4237 attenuated bovine rotavirus strain vaccine.

A randomised, double-blind, placebo-controlled trial was conducted to evaluate the ability of RIT 4237 live attenuated bovine rotavirus (subgroup 1) vaccine strain to protect against natural rotavirus infection in children. 178 infants aged 8 to 11 months received a single oral dose of RIT 4237 vaccine or placebo and were followed up serologically and clinically during a subgroup 2 rotavirus epidemic. No side-effects attributable to the vaccine were observed. During the 5 months' observation after vaccination 2 of the 86 vaccine recipients and 18 of 92 placebo recipients had rotavirus diarrhoea lasting more than 24 h (p less than 0.001). The vaccine-protection rate was thus 88%. The 2 children in the vaccine group with rotavirus diarrhoea were regarded as primary vaccine failures since they had no detectable serum antibody responses after vaccination. Vaccine prepared from RIT 4237 strain of attenuated bovine rotavirus thus seems to protect children against heterologous subgroup 2 rotavirus diarrhoea.

Animals↗

Clostridium difficile in young children. Association with antibiotic usage.

Clostridium difficile was isolated from the stools of 11/52 (21%) of children aged 0 to 2 years hospitalized with diarrhoea, and from 17/52 (33%) of a control group of hospitalized children with no diarrhoea; this difference was not significant. Direct demonstration of C. difficile toxin from the stools was positive in 1 case with diarrhoea and in 5 control cases. The children with positive stool culture for C. difficile had had significantly more treatments with antibiotics or chemotherapeutics than those with negative C. difficile culture (3.3 +/- 2.7 vs. 1.6 +/- 1.8, p less than 0.001), but there was no significant difference in the incidence of diarrhoea in the past. During a 4-6-month follow-up, C. difficile disappeared from the stools of 24 out of 28 initially culture-positive children; 3 of the 4 children with persistent C. difficile had received antibiotics during the follow-up period. We conclude that the presence of C. difficile is common in the stools of young children up to the age of 2 years, and that C. difficile is more frequently found in children who have received antimicrobial therapy. Most cases of C. difficile carriage state are symptomless at this age.

Anti-Bacterial Agents↗

Immunogenicity and safety of live oral attenuated bovine rotavirus vaccine strain RIT 4237 in adults and young children.

A candidate oral live rotavirus vaccine, strain RIT 4237, of bovine origin, was tested for immunogenicity and safety in man. In adults the vaccine did not cause clinical symptoms, and a booster response in rotavirus serum antibodies was seen in 2/20 subjects. In seronegative young children one oral dose induced seroconversion to homologous virus in 15/17 (88%) children seronegative by enzyme immunoassay and in 13/19 (68%) children seronegative by a neutralisation assay. The vaccine did not produce gastrointestinal or constitutional symptoms in the children, nor did it cause rotavirus excretion in the stools. The results suggest that the RIT 4237 strain is a promising candidate for a vaccine against human rotavirus, and the vaccine-induced immunity against natural human rotavirus infection should be evaluated in future trials.

Administration, Oral↗

Epidemiologic background for the need of rotavirus vaccine in Finland. Preliminary experience of RIT 4237 strain of live attenuated rotavirus vaccine in adults.

Epidemiologic evidence from Finland indicates a dramatic change in the seasonal pattern of acute diarrhoea over the past 30 years. While in the 1950's the majority of cases occurred in late summer the seasonal peak in the 1970's was in winter and spring, coinciding with the prevalence of rotavirus infections. It is not possible to determine retrospectively the aetiologic agents involved in the summer diarrhoea, but EPEC may have been one of them, as EPEC are quite rare in Finland today compared to the 1950's. Another change over the time period is a shift in the age distribution of acute diarrhoea from neonates towards older infants. Rotavirus is today associated with approximately 50% of the cases of acute diarrhoea in children in Finland. Based on experience in one Central Hospital it was estimated that the treatment of rotavirus infections may require some 7300 hospital days in Finland annually, which figure is comparable to that of mumps. As a recent cost-benefit analysis in Finland indicated that a mumps vaccination programme would be economically quite efficacious, the same could be assumed to be true for rotavirus vaccination, provided that an effective and safe vaccine was available. In a preliminary trial of RIT 4237 strain of live attenuated rotavirus vaccine in 20 healthy adult volunteers no clinical symptoms and no excretion of vaccine virus were observed. Rotavirus ELISA antibody booster response was found in 1/20 vaccinees.

Adult↗

Clinical and laboratory features of Yersinia, Campylobacter and Salmonella infections in children.

Clinical and laboratory findings of 78 paediatric patients with infections due to enteroinvasive bacteria were analysed. The material included 33 cases of Yersinia enterocolitica, 21 of Campylobacter jejuni, 21 of Salmonella and 2 of Shigella infection, reflecting the current order of frequency ot these enteropathogens in Finnish paediatric population. Diarrhoea was the presenting symptom in 73% of the cases with Yersinia, 90% with Campylobacter and 100% with Salmonella. Conversely, abdominal pain on admission occurred more frequently (p less than 0.01) in patients with Yersinia (68%) than with Campylobacter (38%) or Salmonella (24%). Diarrhoea caused by each of the three enteric bacteria was clinically indistinguishable, with gross blood and mucoid stools occurring in most of the cases. However, faecal leucocytes were more frequently present in diarrhoea due to Y. enterocolitica (87%) and C. jejuni (83%) than Salmonella (36%); p less than 0.025). Diarrhoea due to Y. enterocolitica was typically associated with signs of systemic response, including fever greater than or equal to 39 degrees C, WBC count over 11 X 10(9)/l, and C-reactive protein greater than or equal to 10 mg/l. These criteria may thus be helpful in differentiating Yersinia infections from other cases of exudative diarrhoea in children. The clinical picture of Y. enterocolitica infection probably reflects the more invasive nature of this enteropathogen as compared with C. jejuni or Salmonella.

Adolescent↗

Milk versus no milk in rapid refeeding after acute gastroenteritis.

Sixty-five infants (mean age 14.7 months, range 6-34 months), hospitalized for acute gastroenteritis, were treated with oral rehydration and rapid reintroduction of full feedings appropriate for age. Cow's milk and milk products were eliminated from the diet of 27 infants, whereas the remaining 38 children continued to receive their usual milk and milk products as parts of the mixed diet. There was no difference between the groups in the clinical recovery from diarrhea. No child had prolonged diarrhea. No new cases of clinical atopy were observed at 1-month follow-up, and there were no significant increases in the total or milk-specific IgE levels. Serum IgG and IgA antibodies to beta-lactoglobulin and alpha-casein were initially present in the majority of the children, but there were no appreciable changes in these cow's milk antibodies after gastroenteritis, regardless of the type of diet. It is concluded that cow's milk and milk products can be safely given in acute gastroenteritis as parts of the mixed diet for children over 6 months of age. Rapid reintroduction of feedings is beneficial for recovery from diarrhea, and there appears to be little need for dietary restrictions in this age group.

Acute Disease↗