[Comment on the contribution by R. Pietsch and H. Riegel: "Implementation of poliomyelitis revaccination"].
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Biomedical subjects
Publications and source records attributed to K J Volkmer.
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An immature female Dirofilaria was found in the subcutaneous tissue of a patient under diethylcarbamazine-provocation. The worm demonstrates a characteristic cuticular pattern on the head and longitudinal ridges in the midbody region; it could therefore be characterized as a Dirofilaria of the subgenus Nochtiella.
Six patients with acute trichinellosis were studied. Three patients were treated with mebendazole and the other three with thiabendazole. Both drugs were given at a daily dose of 50 mg per kg body weight for seven consecutive days. No substantial differences were evident in the efficacy of the two drugs when symptoms, clinical findings, and laboratory data were followed for three months. However, mebendazole was better tolerated than thiabendazole. The diagnosis was based on epidemiological data and positive antibody tests. In two cases, diagnosis was confirmed by isolation of trichinella larvae from 10 ml blood samples filtered through polycarbonate membranes.
The effect of high dosage therapy with Mebendazole was studied in 5 patients with cystic echinococcosis and 2 patients with alveolar echinococcosis involving several organs. Follow-up studies at regular intervals from 7 to 20 months indicated an improvement of the pathological findings initially observed. This could clearly be demonstrated by the radiographic findings in cases with pulmonary involvement. The desintegration or dissolution of pulmonary cysts was observed within a few months after treatment with Mebendazole had begun. However, consolidation of previously emptied cysts occurred during the follow-up later. Allergic reactions were observed after commencement of drug therapy in two cases. These were probably due to spillage of antigenic material. The following treatment periods were tolerated well. No serious toxic side effects were observed in the other cases described here.
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Menichlopholan, biphenyl compound, in a single dose of 2 mg/kg body weight, gave a 73%-90% cure rate in the treatment of pulmonary infections due to Paragonimus uterobilateralis at two centers in Nigeria. Ninety-five patients were followed up for 4 months, and 58 for 1 year. Side effects of the drug included sweating and body pains, but there was no significnat biochemical or hematological evidence of damage to the internal organs. The advantages of single dose therapy are likely to make menichlopholan the treatment of choice for paragonimiasis in Africa, and probably elsewhere.
The radiographic pattern in the course of experimentally infected Rhesus monkeys with the two African fluke species Paragonimus africanus and P. uterobilateralis consist of hilar dilatation, streaky, patchy or diffuse shadows, cavities, atelectases and pleural reactions. All animals develop changes in both lungs, those infected with P. africanus preferentially in the lower parts. There is an obvious correlation with the autopsy findings in the same animals as well as radiological features in human infections in the endemic area.
96% of the P. uterobilateralis patients and 86.5% of the P. africanus patients showed a positive reaction with the homologous antigen in the passive haemagglutination test (PA). Common antigens of the two species were demonstrated by cross reactions. About 75% of the Paragonimus sera reacted also with the heterologous antigen with titres greater than or equal to 1:160. The PA test can be useful in the evaluation of the efficacy of treatment and is well suited for seroepidemiologic purposes. The complement fixation (CF) test was not suitable for serodiagnostic or seroepidemiologic studies nor for the assessment of the cure of African Paragonimiasis since antibodies persisted for at least one year after treatment. Comparative studies on levels of IgA, IgE, IgG and IgM seems to be of no diagnostic value in African paragonimiasis because no significant correlation between immunoglobulin concentration and paragonimiasis could be recognized. Very high IgE levels--up to 100 times higher than in Europeans--were found in nearly all sera. Shipment of filter papers blood specimens collected from P. africanus patient resulted in a significant decrease of antibody reactivity in all sera, the loss being about 30% in the parasitologically proven patients.
A research programme on African paragonimiasis was carried out in eastern Nigeria, which included the epidemiology, parasitology and clinical and radiological studies. The radiological pulmonary changes are described in detail and differentiated from tuberculosis.
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Nearly 40 million journeys abroad were recorded from the Federal Republic of Germany last year. 60-70% of travellers going to southern countries seek medical advice for preventive measures, particularly in Public Health centres. Inquiries for vaccinations are prevalent. Current aspects of immunization against yellow fever, cholera, tetanus, polio, typhoid fever, hepatitis A, hepatitis B, rabies meningococcal meningitis, European tick-borne encephalitis, measles and tuberculosis are discussed. Finally, some remarks on malaria prevention, hygiene, health insurance and information services are given in brief.