Observations on the use of tetrazolium salts in the vital staining of bacteria.
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Biomedical subjects
Publications and source records attributed to L GREENBERG.
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After a brief historical review of the events leading to the development of diphtheria prophylactics, the author discusses the effect of immunization on diphtheria epidemiology and the principles governing the choice of prophylactics. For immunization campaigns to be really effective a high proportion of the population must be immunized, and the pre-school age-groups must be included. Indeed, there is evidence that primary immunization should not be delayed beyond the third or fourth month of life. The prophylactic used should be antigenically highly potent and should confer long-lasting immunity with three injections at the most.The author then considers the use of combined immunization, which is approached with caution in some countries but is generally accepted in North America, and goes on to discuss the immunization of adults. The fact that adults may have severe reactions to parenterally administered diphtheria toxoid has led to attempts to develop reaction-free prophylactics. Toxoid administered orally appears not to cause reactions but is not yet so effective as parenteral toxoid.
The results of a survey of diphtheria toxoids from a number of countries in different parts of the world show that wide differences exist in the potency values of the preparations in use today. Samples received from 20 laboratories in 11 countries were found to have variations ranging from 0.24 to 45.4 times the potency of the Canadian reference standard-a 189-fold spread. Specific reference is made in the article to the different types of toxoid, such as purified toxoid, aluminium-phosphate precipitated (PTAP), alum-precipitated toxoid (APT), formal toxoid (FT), etc., and their relative potency values are discussed. The results of these assays underline the inadequacies of minimum requirement tests used in most countries and the need for more precise methods of control.
The results of comparative assays have revealed considerable variation in the potencies of tetanus toxoids produced in different laboratories. Some manufacturers are able consistently to produce toxoids high in potency; others are not able to do so. While further work is required in order to correlate the animal assay with results in man, these results once more stress the inadequacies of minimum requirement tests used in most countries for controlling products of this type and the need for more precise methods of control.
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