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R Handsher

Publications and source records attributed to R Handsher.

43 records · Page 3Linked to original sources

Modified staphylococcal absorption method used for detecting rubella-specific immunoglobin M antibodies during a rubella epidemic.

A recently described method for detecting rubella-specific immunoglobulin M (IgM) antibody based on absorption of IgG by Staphylococcus aureus strain Cowan I has been applied to 198 sera collected during a recent rubella epidemic in Israel. Modification of the original method introduced for the present study includes treatment with 2-mercaptoethanol of antibody remaining after absorption by staphylococci. This treatment confirms that the residual antibody is IgM (sensitive to 2-mercaptoethanol) rather than IgG (2-mercaptoethanol resistant). None of the 67 control patients (seropositive for rubella but without history of recent illness or contact) had specific IgM when tested by this method, though 15 showed some residual antibody after staphylococcal absorption. A total of 125 of 131 rubella convalescents (95%) were positive 4 to 49 days after onset of the clinical symptoms. Six patients had no IgM antibodies when tested by the method described, and all were convalescents tested late in relation to onset of clinical symptoms (beyond 3 weeks). When density gradient centrifugation was applied to clarify some results, 2 of 3 convalescents classified as IgM negative by the staphylococcal absorption method did in fact possess IgM antibody. None of 10 controls tested by density gradient centrifugation was IgM positive. This combination of staphylococcal absorption and 2-mercaptoethanol treatment is recommended as a screening test for selection of IgM positives, in addition to the use of a more sensitive method (such as density gradient centrifugation) on at least some samples classified as IgM negative.

Absorption↗

Serologic studies in 11,460 pregnant women during the 1972 rubella epidemic in Israel.

A total of 11,460 women in the first 4 months of pregnancy, either exposed to or with suspected clinical rubella were tested for rubella antibody during an extensive epidemic of this disease in 1972. The proportion of women who were seronegative decreased from 25% at the beginning of the epidemic to 16% toward the end. In 542 (79%) of 682 cases with suspected clinical rubella, the laboratory findings were consistent with recent rubella infection, while in the remaining 140 cases of suspected clinical rubella recent infection could be excluded by serologic tests. CF tests were more useful than HI for confirmation of clinical rubella, and especially for retrospective diagnosis, since elevated titers (larger than or equal to 1:16) were suggestive of recent infection. Paired sera were tested from 4203 patients exposed to rubella: 1126 of the subjects were seronegative and the remaining 3077 seropositive (HI larger than or equal to 1:16) on first testing. In the seronegative group, 278 seroconversions were detected (24.6%): 247 cases of clinical rubella (21.9%) and 31 seroconversions without clinical symptoms (2.7%). Among the seropositive subjects in 2306 instances (74.9%) recent subclinical rubella could be excluded by low and stable HI or CF antibody titers in paired sera. In 32 (1.1%) an antibody rise (HI or CF) without clinical symptoms was detected, and in the remaining 739 (24%) high CF titers were found in paired sera, and these were classified as suspected subclinical rubella.

Antibodies, Viral↗

Placental transfer of maternal poliovirus antibodies in full-term and pre-term infants.

This study was designed to investigate the placental transfer of maternal poliovirus antibodies in full-term and pre-term infants. Two hundred healthy, Israeli born mothers and their infants, were enrolled immediately after birth. The study population comprised two groups: a full-term group of 150 mothers and their infants, and a pre-term group of 50 mothers and their infants (gestational age < 35 weeks). Maternal and umbilical cord blood samples were taken in all cases. Antibody titers against the three poliovirus serotypes and a polio virus type 1 strain that caused an outbreak in 1988 (epidemic strain 1) were measured by a microneutralization system. The proportion of individuals with protective titers against each of the poliovirus types tested was slightly lower in the infants compared with their mothers. When protection to all strains combined was tested, the difference between mothers and infants was significant (P < 0.05). Transplacental transfer to epidemic strain 1 was less effective--12% of the premature infants were not protected against it at birth. The geometric mean titers against poliovirus types 1, 3 and epidemic type 1 strain were significantly lower in the pre-term group than in the full-term group. In both the full-term and pre-term groups there were significant linear correlations between the maternal and neonatal antibody titers for each of the polio viruses tested. For all poliovirus types, the transfer of maternal antibodies to the full-term infant was significantly higher than the transfer of maternal antibodies to the pre-term infant (P < 0.001). Owing to diminished transfer of maternal antibodies, pre-term infants are at greater risk of poliovirus infection.

Adult↗

Neonatal coxsackievirus group B infections: experience of a single department of neonatology.

Coxsackie infections in 14 infants born in a single neonatal unit were studied. The clinical presentation was mild nonspecific disease in eight infants and an overwhelming multiorgan disease in six. Three infants with systemic disease died. Vertical transmission of the virus from a colonized mother was documented in five mothers who infected seven infants. The remaining seven infants were infected horizontally, presumably from infected personnel. Coxsackie B1 was isolated in four of the cases and type B3 in two cases of systemic disease. Intravenous gammaglobulin combined with human leukocyte interferon was utilized in three cases of overwhelming disease and two infants of these infants survived.

Acyclovir↗

Successful control of poliomyelitis by a combined OPV/IPV polio vaccine program in the West Bank and Gaza, 1978-93.

In the 1970s the incidence of poliomyelitis in Gaza and the West Bank was high, even among children immunized with as many as four doses of oral polio vaccine (OPV). This was thought to be due to interference in uptake from other enteroviruses in the environment. A combined program of OPV and inactivated polio vaccine (IPV) was instituted in these areas in 1978, and the incidence of polio declined dramatically. Wild poliovirus findings in sewage in 1990-91 coupled with two outbreaks of polio, one in Israel in 1988 and another in Jordan in 1992, were reminders that the area should still be considered endemic. The potential of fresh entry of wild poliovirus may occur via persons who may have personal protection but may still shed the virus due to inadequate enteric immunity. In addition, the combined program protects against vaccine-associated poliomyelitis. A similar modified combined OPV/IPV program has been adopted in Israel. The combination of OPV and IPV provides an important alternative strategy in the worldwide effort to eradicate poliomyelitis.

Adolescent↗

Israel in the elimination phase of poliomyelitis--achievements and remaining problems.

Following the introduction of a combined EIPV and OPV schedule in 1990, no more cases of paralytic poliomyelitis were diagnosed and no wild poliovirus strain was isolated in the sewage. 100% seropositivity and high geometric mean titers (GMTs) to the three types of poliovirus vaccine strains and to the type 1 poliovirus 1988 epidemic strain were observed at the completion of the immunization schedule and one year later. The study of the immune profile of various age groups vaccinated with either EIPV or OPV had shown that the immunity to the epidemic poliovirus strain was less satisfactory, in terms of percent of seropositivity and GMTs, than to the poliovirus vaccine strains. In individuals previously immunized with either EIPV or OPV a high and quick immune response to both the 1988 epidemic and vaccine strains was observed after a booster dose of OPV. Follow-up to four years after the booster pointed to some decrease in the extent and intensity of the seropositivity to the 1988 epidemic strain as compared to the immune profile to the poliovirus vaccine strains. Maintaining Israel in the phase of polio elimination requires: > 95% national coverage, homogenously distributed; maintaining high immune profile to the three poliovirus types, including a satisfactory immune level to the 1988 epidemic strain in all the age groups at risk of polio; early detection of the introduction of wild poliovirus into the environment and of the occurrence of foci of indigenous activity; reducing the risk of exposure to massive infectious doses.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗