PubMed Health⌕ Search

Biomedical subjects

R Handsher

Publications and source records attributed to R Handsher.

At least 37 records · Page 2Linked to original sources
PubMed1994

Four-year follow-up of the immune status of young adults given a single booster dose of trivalent oral poliovaccine.

In 1988 an outbreak of type 1 paralytic poliomyelitis occurred in Israel. Almost the entire population in the age group 0-40 years received a single dose of trivalent oral polio vaccine. We examined the serological responses to the vaccine at 2 weeks and 4 years later, in a group of 17 vaccines. Geometric mean antibody titres (GMTs) against both the type 1 epidemic and Mahoney strains had declined by about 50% from the levels found at 2 weeks after vaccination. However, they were still more than five times higher than the prevaccination levels. All vaccines had neutralizing antibody titres against both the type 1 strains of at least 1:64, well above the 1:8 titre regarded as protective. The GMTs against the type 2 and 3 strains declined to about one-third of the 2-week postvaccination levels but were also well above protective levels. These findings indicate that antibody titres against both the Mahoney and epidemic type 1 strains remained at very adequate levels over a period of at least 4 years. Thus the immunity resulting from a single booster dose of oral poliovaccine in young adults is likely to be long-lasting, a finding of particular importance for travellers on extended visits to endemic areas.

Adolescent↗
PubMed1994

Effect of maternal immunization with oral poliovirus vaccine on neonatal immunity.

During the summer of 1988, an outbreak of poliomyelitis caused by poliovirus 1 occurred in Israel, during which a national mass immunization campaign with oral poliovirus was undertaken. This prospective study was undertaken to assess the effect of maternal oral poliovirus immunization during the third trimester of pregnancy on neonatal immunity against poliovirus. Cord blood specimens of 88 neonates, born 2 to 7 weeks after maternal immunization, were examined for antipoliovirus antibodies and compared with 100 samples obtained from neonates 7 months before the outbreak. Blood samples were also obtained from the 62 mothers of neonates who had been immunized 2 to 5 weeks before delivery. Sera were tested for neutralizing antibodies to the 3 poliovirus types using a microneutralization technique. The geometric mean titer to poliovirus type 1 was significantly higher in neonates whose mothers were immunized during pregnancy (87.1) than in the offspring of the nonvaccinated group (53.0), P < 0.05. Two to 3 weeks after immunization, geometric mean titers against all 3 poliovirus types were higher in maternal blood than in cord blood whereas 4 to 5 weeks after vaccination a significant difference was found for type 3 only. Although oral poliovirus immunization during pregnancy resulted in higher neonatal antibody titers to poliovirus type 1, the proportion of newborns with titers of < 1:8 to the 3 poliovirus types did not change significantly.

Antibodies, Viral↗
PubMed1993

Response of hemophilic patients to poliovirus vaccination: correlation with HIV serology and with immunological parameters.

Hemophilic patients may present immunological dysfunctions resulting from either human immunodeficiency virus (HIV) infection, or other factors like impure factor VIII concentrate and other viral infections. We evaluated prospectively the serologic response to polio vaccination of Israeli hemophilic patients who were vaccinated during an outbreak of poliomyelitis. Eighty-two hemophilic patients, 43 seronegative and 39 seropositive for human immunodeficiency virus (HIV), were vaccinated with enhanced inactivated poliovirus (eIPV). Titers of antibodies for poliovirus types 1-3 were determined before and 4 weeks after immunization. T helper and suppressor lymphocytes (T4 and T8), B and T lymphocyte mitogenic response, and natural killer cells were tested and correlated with the response to vaccination. Both groups responded to vaccination with increased titers of antibodies to the three viral types, 4 weeks after immunization. HIV-seronegative patients, however, exhibited higher titers than the HIV-seropositive group. The same pattern was found when 21 patients were tested 1 year after the exposure to eIPV. HIV seropositive patients were grouped according to their T4 count (between 16/microliter and 500/microliter). There was no statistically significant difference in the response of these different groups to vaccination. No correlation was found between the response to vaccination and other immune parameters. These results suggest that asymptomatic HIV-seropositive hemophilic patients respond well to eIPV, irrespective of their T4 count.

Adolescent↗
PubMed1993

Age differences in immunity against wild and vaccine strains of poliovirus prior to the 1988 outbreak in Israel and response to booster immunization.

During the 1988 type 1 polio outbreak in Israel, most cases occurred in previously vaccinated subjects aged 11-30 years, suggesting a possible age-related immunity deficit against the wild virus responsible for the outbreak. We examined type 1 poliovirus neutralizing antibody titres against the Sabin strain, the standard wild strain (Mahoney), the wild strain responsible for the 1988 outbreak and a previous wild strain from the region, on frozen sera drawn prior to the mass vaccination campaign from subjects aged 6 to 40 years. Response to vaccination with oral poliovaccine (OPV) was examined in a subgroup aged 18-40 years. At all ages, the highest antibody titres prior to the outbreak were against the Sabin strain. Geometric mean titres (GMTs) against both the Sabin strain and the wild Mahoney strain were significantly higher in the age groups 6-7, 12-13 and 30-40 years compared with the 18-29-year-olds. For the other wild strains, the GMT for those aged 30-40 years was significantly and substantially higher than in the other age groups, followed by the 12-13- and 6-7-year-olds and lowest in those aged 18-29 years. Following vaccination with OPV in subgroups aged 18-29 and 30-40 years, GMTs against Sabin and all wild strains were similar to each other and in both age groups. These findings suggest that there was a relative immunity gap against the wild type 1 strains in the age group that lacked prior exposure to wild virus and had received the last OPV dose more than 17 years previously.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Molecular epidemiology of type 1 polioviruses isolated in Israel and defined by restriction fragment length polymorphism assay.

The genomic variability of 27 type 1 polioviruses (PV-1) isolated in Israel during 1980-1991 was examined by restriction fragment length polymorphism (RFLP) analysis of a reverse-transcribed genomic fragment amplified by polymerase chain reaction. By using the restriction enzymes HaeIII, DdeI, and HpaII, strain-specific restriction profiles were generated for the PV-1/Mahoney and PV-1/Sabin strains and 27 wild-type isolates. The profile observed for PV-1 isolated during an outbreak in 1988 was also observed for PV-1 isolated from different places in Israel in 1982 and 1983, 1987, and 1991. This profile, characterized by the lack of the DdeI site, was different from the DdeI profile of PV-1 isolated in 1984 or in 1986 from sporadic cases of poliomyelitis. The diversity of circulating PV-1 in Israel was also confirmed by nucleotide sequence analysis. The epidemiologic information provided by the RFLP and sequence data establishes a clear epidemiologic link between epidemic and sporadic virus strains and demonstrates the power of this molecular approach to epidemiology.

Base Sequence↗
PubMed1991

Immune response to polio vaccination in bone marrow transplant recipients.

Following a small outbreak of poliomyelitis which occurred in the summer of 1988 in Israel, two sequential doses of inactivated polio vaccine (IPV) were administered to 42 bone marrow transplant (BMT) recipients (aged 2-50 years) who were 6-96 months (median 16 months) after transplantation. Prior to vaccination, only 68-80% patients (n = 42) had protective (greater than or equal to 4) antibody levels against the three serotypes of poliovirus, compared with 92-96% (n = 25) before BMT (p = 0.02 for types 1 and 3). After the second dose of IPV, 89-98% (n = 27) of the recipients had protective antibody levels. The pre-vaccination antibody titers were lower than before BMT (p = 0.006, 0.0007 and 0.0008 for types 1,2 and 3, respectively). After the first dose of IPV, antibody titers rose in the 42 patients (p = 0.002, 0.043 and 0.002 for types 1, 2 and 3, respectively) and following the second dose, a further increase in antibody levels was noted. Regression analysis revealed that graft-versus-host disease, pre-BMT polio antibody titers, age and type of transplantation (allogeneic versus autologous) were significant explanatory variables for the specific antibody levels, while the time lapse between BMT and vaccination, and primary disease proved of no significance. Vaccination against poliovirus after BMT is advocated, as it reinstates and raises the lost specific humoral immunity.

Adolescent↗
PubMed1990

Poliomyelitis outbreak in Israel in 1988: a report with two commentaries.

An outbreak of 15 cases of paralytic poliomyelitis caused by type 1 poliovirus between July and October, 1988, prompted mass vaccination of the whole Israeli population under the age of 40 years. The focus of the outbreak (12 cases) was the Hadera subdistrict, one of two subdistricts where enhanced inactivated poliovaccine (eIPV) had been the only poliovaccine used for infants since 1982. 9 of the 15 victims were 15 years or older, and 9 had previously been immunised with at least three doses of oral poliovaccine (OPV). The authors are divided in their interpretation of the findings. One group considered that the likely causative factors were the greater susceptibility of young adults previously vaccinated with OPV as well as transmission of wild poliovirus to susceptible people by children with low gut immunity against poliovirus after vaccination with eIPV; they concluded that a vaccination programme combining eIPV with OPV is the best option for Israel in future. The other group believed the causative factors were exposure to contaminated sewage or close social contact within the epidemic foci, the presence of an epidemic strain differing from the wild Mahoney and Sabin type 1 vaccine strains, and the lower seropositivity rates and geometric mean titres of neutralising antibodies to the epidemic than to vaccine strains; they believe that eIPV is the means to achieve effective control of poliomyelitis in Israel.

Adolescent↗
PubMed1990

Poliovirus vaccination responses in HIV-infected patients: correlation with T4 cell counts.

HIV infection is known to impair both cellular and humoral immunity. The antibody levels to poliovirus were measured in 17 HIV-infected and 3 HIV-seronegative homosexual men before and after vaccination with enhanced inactivated poliovirus vaccine (eIPV). The subjects were tested for neutralizing antibodies to poliovirus types 1, 2, and 3; the number of peripheral blood T4 cells and lymphocyte responses after stimulation with phytohemagglutinin, concanavalin A, and pokeweed mitogen were measured. Before vaccination, all subjects demonstrated neutralizing antibodies to the three types of poliovirus. After eIPV administration, a rise in anti-poliovirus antibody titer was noted in subjects whose T4 cell count was greater than 200/ml, whereas the group with low T4 cell counts failed to respond. The response to eIPV immunization correlated with the number of circulating T4 cells and the mitogen-induced lymphocyte stimulation index.

Adult↗
PubMed1990

Sociodemographic correlates of neutralizing poliovirus and hepatitis A virus antibodies as markers of different modes of acquiring immunity.

The prevalence and sociodemographic correlates of antibodies against poliovirus and hepatitis A virus (HAV) were compared in a random sample of 457 military recruits in Israel inducted during 1987. Lower socioeconomic status (SES) was associated with a higher prevalence of anti-HAV antibodies (67.3 vs 32.5 percent), whereas the reverse was true for type 1 poliovirus (78.4 vs 89.5 percent). While the high prevalence of anti-HAV antibodies observed in the lower SES groups reflects considerable natural exposure to enteroviruses, immunity against poliovirus appears to be determined primarily by compliance with vaccination.

Antibodies, Viral↗
PubMed1989

Polio in Israel.

Explore the source record for details and available documents.

Israel↗
PubMed1989

Immunologic memory induced at birth by immunization with inactivated polio vaccine in a reduced schedule.

One hundred forty-one healthy newborns were immunized 24 hours after birth with one dose of inactivated polio vaccine (IPV) of enhanced potency. Following the administration of a second vaccine dose six months later, a considerable proportion of babies responded with neutralizing antibody (NA) to the three poliovirus types. The very rapid occurrence and high antibody titer were indicative of an anamnestic response. Twenty-one infants who still had NA less than 1:4 to one-more poliovirus types after the second vaccine dose responded with very high NA values 7-10 days after a supplementary dose of IPV. It appears that IPV of enhanced potency administered at birth is apt to induce immunologic memory, which should provide the basis for protection against paralytic poliomyelitis in case of exposure to wild poliovirus later in life.

Humans↗
PubMed1989

A ten-year experience in control of poliomyelitis through a combination of live and killed vaccines in two developing areas.

We describe a successful program of poliomyelitis control using a combination of killed and live polio vaccines over a 10-year period in two developing areas, the West Bank and Gaza, adjacent to a relatively developed country, Israel. During the 1970s, immunization using live trivalent oral polio vaccine (OPV) in these areas covered more than 90 percent of the infant population. Nevertheless, the incidence of paralytic polio continued to be high, with many cases occurring in fully or partially immunized persons. It was thought that this could be due to interference with OPV take by other enteroviruses present in the environment due to poor sanitary conditions in these areas. A new policy combining five doses of OPV with two doses of inactivated polio vaccine (IPV) was adopted and implemented in 1978. In the 10 years since then, immunization coverage of infants increased to an estimated 95 percent and paralytic poliomyelitis has been controlled, despite exposure to wild poliovirus from neighboring countries including an outbreak in Israel in 1988. This experience suggests that wide coverage using the combination of IPV and OPV is an effective vaccination policy that may make eradication of polio possible even in developing areas.

Disease Outbreaks↗
PubMed1987

Vaccine-associated contact paralytic poliomyelitis with atypical neurological presentation.

Paralytic poliomyelitis presenting with quadriparesis, transient encephalitis and bulbar symptoms in 2 patients in close contact with recently vaccinated children with trivalent live oral polio vaccine is described. Symmetrical lower motor neuron involvement of deltoid muscles with electromyographic confirmation was found. Upper motor neuron signs, with symmetrical hyperactive deep tendon reflexes developed in the lower extremities. Poliovirus Type-2 vaccine-like strain was cultured from one patient and both patients showed significant antibody titers rises to poliovirus. Attention is drawn to the possible clinical differences between vaccine associated poliomelitis and the usual features found in wild strain poliomyelitis. It is suggested that in selected cases, non-immunized contacts be given inactivated polio-vaccine when the vaccinees are immunized with the live oral-vaccine.

Adult↗
PubMed1985

Subclinical rubella in pregnancy--occurrence and outcome.

Between the years 1972 and 1979, 40,589 pregnant women were tested for rubella antibodies following suspected illness or exposure, using hemagglutination-inhibition (HI), complement fixation and staphylococcal absorption for determination of specific immunoglobulin M (IgM). Recent primary infection was confirmed by antibody rise in paired sera and/or the presence of specific IgM. Reinfection was differentiated from primary asymptomatic rubella by absence of specific IgM. Determination of neutralizing antibodies was also useful in confirming reinfections. Clinical rubella was confirmed in 1,448 patients (3.6%). In 154 cases asymptomatic rubella infection was detected; 98 had primary infection and 56 experienced reinfection. In a selected group of 2,200 women exposed to confirmed rubella, 6.8% had clinical rubella, 3.8% asymptomatic infection, and in 7.1% the results were doubtful. Reinfection was detected in 12.4% of 265 women with initially low HI titers. The prospective follow-up on pregnancy outcome was available in 87 women with asymptomatic infection. Seven cases of congenital rubella were detected in the group of primary infections, while all 25 children born following reinfection were healthy.

Antibodies, Viral↗
PubMed1978

Response to experimental challenge in persons immunized with different rubella vaccines.

The response to experimental challenge with rubella virus was studied in 113 volunteers, ages 13 to 17 years, immunized with three rubella vaccines: HPV-77-DE-5 and Cendehill (inoculated subcutaneously) and RA-27/3 (administered subcutaneously to one group and intranasally to a second group). The occurrence of side effects ranged from 16% in the Cendehill vaccines to 32% in the RA-27/3-intranasal vaccinees. Antibody response to primary vaccination as measured by CF was significantly lower in the Cendehill vaccines. Challenge by intranasal instillation of RA-27/3 a year later produced no adverse effects. Serologic response was measured by testing for CF, HI, and neutralizing and sensitizing antibodies. Booster response, a fourfold increase in antibody fiter after challenge as evidenced by at least one of the tests, occurred in 67% of the Cendehill vaccinees, in 47% of HPV-77 vaccines, and in only 7 to 11% of RA-27/3 vaccinees. Of 37 subjects exhibiting booster response, 27 had an increase in antibody titer demonstrated by two or more serologic tests; 16 of these 27 were Cendehill vaccinees. These results confirm our previous observations and that of others that the RA-27/3 rubella vaccine has the highest immunogenic potential.

Adolescent↗