PubMed Health⌕ Search

Biomedical subjects

R Slepon

Publications and source records attributed to R Slepon.

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

Sex differences in the humoral antibody response to live measles vaccine in young adults.

BACKGROUND: Following vaccination of children using high-titre live measles vaccine, excess non-specific mortality was reported, particularly among females. Since vaccination with live measles virus results in a temporary depression of the immune response to other antigens, the female predominance in subsequent non-measles mortality may be due to sex differences in response to live measles vaccines. METHODS: In this study, the immunogenicity of standard titre live Schwarz strain measles vaccine was examined 2 and 4 weeks post-vaccination in 223 males and 66 female aged 18-20 years in Israel in 1991. RESULTS: Females had higher post-vaccination geometric mean titre (GMT) at all levels of pre-vaccination titres at both 2 and 4 weeks. Furthermore, after controlling for differences in pre-vaccination titres, overall the post-vaccination GMT for females was about 50% higher than for males (P < 0.001). CONCLUSIONS: These findings indicate that females exhibit a stronger humoral immune response to measles vaccine. Possible sex differences in immunosuppression following measles vaccination should be explored.

Adolescent↗
PubMed1994

Epidemiology of acute diarrheal diseases in children in a high standard of living rural settlement in Israel.

Epidemiologic patterns of acute diarrheal diseases in a high standard of living communal settlement, situated in a region endemic for enteric diseases, were evaluated by a historical prospective study of 284 children (12,064 child months) from August, 1988, through July, 1992. Three hundred eighty-three episodes of acute diarrhea were identified, yielding a rate of 0.38 episode per 12 child months. One hundred and children (35.6%) were reported to have 1 to 4 diarrheal episodes and 29 (10.2%) children had 5 or more diarrheal episodes during the follow-up period. The mean number of episodes of acute diarrhea per 12 child months in children ages 0 to 2 years was 2.28, in 2- to 6-year-olds 0.44, in 6- to 13-year-olds 0.12 and in 13- to 18-year-olds 0.03 (P < 0.001). Children less than 12 months of age had a lower incidence of acute diarrheal diseases during the months they were being breast-fed than children that were fed with formula during the same period (1.22 vs. 3.06 episodes per 12 child months, respectively; P < 0.001). Enteropathogens were isolated in 40% of diarrheal episodes in which stool cultures were obtained. The identification rates of the various enteropathogens were: diarrheagenic Escherichia coli, 11%; Shigella spp., 10%; Giardia lamblia, 10%; Salmonella spp., 4%; Staphylococcus aureus, 3%; Campylobacter jejuni, 1%. Potential interventions against acute diarrhea in this set up of a high standard of living rural community are education of caretakers and parents on hygienic practices that can prevent transmission of pathogens among the young children and encouraging mothers to breast-feed their children.

Acute Disease↗
PubMed1994

Incidence of diabetes mellitus in various population groups in Israel (1989 and 1990).

A prospective survey of all newly diagnosed insulin-dependent diabetes mellitus (IDDM) children and adolescents aged 0-17 years in Israel was conducted for the years 1989 and 1990. All diabetic clinics in Israel treating young diabetics were contacted and they returned written reports to us. Each clinic was also visited regularly by a member of the team who reviewed the individual charts to obtain data on population origin as well as medical and demographic data. A total of 187 patients were identified (164 Jews and 23 Arabs), giving a total incidence rate of 5.46/10(5). Analysis of the incidence rates by population groups showed that Arabs and Jews originating in Asia had the lowest incidence (2.77 and 4.58/10(5) respectively), followed by Jews whose fathers were born in Israel (5.61/10(5)). The highest incidence was registered for Jews originating from Europe and North America (9.34/10(5)). The female-to-male preponderance ratio was higher in the Jews originating in Asia (2.1) than in Jews originating in Europe and North America (1.2). Comparing the present data with a survey performed for the years 1975-80 we found a statistically significant increase in incidence in all population groups. Our findings strongly suggest an influence of genetic factors on the incidence of childhood IDDM.

Adolescent↗
PubMed1994

Clinical, serological and molecular characteristics of 471 hepatitis B virus carriers.

A total of 471 Israel Defense Forces (IDF) blood donors identified as hepatitis B virus (HBV) carriers were examined a few months after blood donation. When compared to the general population of IDF blood donors the HBV carriers were older, belonged to certain ethnic groups and were predominantly males. Physical examination revealed minimal findings: 1 (0.3%) had splenomegaly and 5 (1.6%) had hepatomegaly. Fifty-two individuals (11.1%) had elevated liver enzymes. E antigen was present in 3.2% of HBV carriers, 94% had anti-e antibodies and 1.9% had anti-delta antibodies. Of 258 carriers tested for HBV DNA, 29 (11.2%) were positive. Abnormal liver enzymes were significantly associated with the presence of e antigen as well as with the presence of HBV DNA.

Adult↗
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

Drug use among Israeli army personnel: an epidemiological study.

A survey of drug use among Israeli army personnel was conducted as part of a national survey of drug use initiated by the Anti Drug Authority of Israel during 1990. One thousand one hundred and twenty-five male and female soldiers from various units and ranks were selected by the use of randomized cluster sampling. Seventy to eighty-five per cent of the soldiers presented negative attitudes towards the use of illicit drugs and its users. Only 67 (6.1%) soldiers reported the use of some illicit drugs in the last 30 days; half of them started to use drugs before the age of 18. The main reported use was of hashish, marijuana and tranquillizers. The use of opium, heroin, cocaine was rarely reported. The use of cigarettes and alcohol within the last 30 days was much higher and was reported by 44.6% and 69.0% of the soldiers, respectively. Using multiple logistic regression analysis it was shown that illicit drug use in the last 30 days was significantly associated with higher number of individuals per household, less satisfaction with military service, and positive attitudes towards the use of drugs. The results of the present study, along with a comparison with different populations that were surveyed parallel to our research indicate that military service in the Israel Defence Force (IDF) is not associated with significant use of illicit drugs. Our results indicate the need for more attention to alcohol and cigarette use among army personnel.

Journal Article↗
PubMed1993

Ethnic and gender differences in the prevalence of anti-cytomegalovirus antibodies among young adults in Israel.

The population of Israel comprises offspring of immigrants from countries of high and low incidence of cytomegalovirus infection. To evaluate possible ethnic differences in the prevalence of antibodies against cytomegalovirus in young adults, blood samples were taken from a random sample of 422 Israel military recruits aged 18-19 years, during 1987. Antibodies against cytomegalovirus were determined by means of ELISA. Subjects originating from North Africa or Asia had higher prevalences than those originating from Western countries (84.0% and 74.0% versus 60.0%, P < 0.001) and the differences persisted after adjustment for gender, education and socioeconomic status. The prevalence of antibodies was significantly lower in men than in women (63.1% versus 76.5%). These findings identify subpopulations who are at increased risk of primary cytomegalovirus infection during adulthood and may be candidates for future anti-cytomegalovirus vaccines.

Adolescent↗
PubMed1993

Depression of the immune response to an inactivated hepatitis A vaccine administered concomitantly with immune globulin.

Inactivated hepatitis A virus (HAV) vaccine is given in a three-dose schedule. When rapid protection is needed, injection of immune globulin (IG) concomitantly with the first dose could provide passive protection until adequate active antibody response has developed. A possible effect of IG on the immune response to the vaccine was studied in healthy volunteers; 28 received vaccine alone, and 34 received the first dose simultaneously with 5 mL of IG. A control group received hepatitis B vaccine, and a fourth group received IG alone. Four weeks after the first vaccine dose, all subjects had detectable ELISA anti-HAV antibodies. Several weeks after each vaccine dose, the geometric mean titer of antibodies was significantly lower in those who received vaccine with IG but higher than in those who received IG alone. Results for neutralizing antibodies yielded a similar trend. If IG is given with HAV vaccine, a further booster vaccine dose may be required to ensure long-lasting immunity.

Adult↗
PubMed1992

Sociodemographic factors and the declining prevalence of anti-hepatitis A antibodies in young adults in Israel: implications for the new hepatitis A vaccines.

In order to examine changes in the epidemiology of hepatitis A virus (HAV) infection in Israel during the past decade, a sero-epidemiological study was carried out in 1989 in a random sample of 1153 members of the permanent army, aged 21-30 years. Of the males 59.2%, and 54.3% of the females were anti-HAV antibody positive (p = 0.22). At all ages, the highest prevalence was in those of North African origin, followed by those of Asian, native Israeli and Western origin. There was a marked decline in the prevalence of antibodies in later birth cohorts, (from 74.4% in those born in 1959-1960, to 47.8% in those born in 1967-1968). Age, ethnic origin, number of siblings, more than two younger siblings and smoking were independently significantly associated with anti-HAV antibodies. Despite an overall decline in family size in later birth cohorts, ethnic differences remain prominent. These findings suggest that when the new active hepatitis A vaccines become available, their use in small children should dramatically reduce the incidence of diseases in highly endemic areas by limiting intrafamilial spread of the disease.

Adult↗
PubMed1991

Reduction of transmission of shigellosis by control of houseflies (Musca domestica)

The effect of control of houseflies on the incidence of diarrhoea and shigellosis was evaluated in a prospective crossover intervention study at two military field bases several kilometers apart. In early summer, 1988, intensive fly control measures (mainly bait and trap strategy) were introduced on one base, while the other served as a control. After 11 weeks, as new cohorts arrived, the intervention was abruptly discontinued in the first base and instituted in the second for the next 11 weeks. The study was repeated the next summer. Overall, fly counts were 64% lower on the bases exposed to fly control measures (p = 0.024). Concomitantly, clinic visits dropped by 42% (p = 0.146) for diarrhoeal diseases and by 85% for shigellosis (p = 0.015), as did rates of seroconversion, by 76% (p = 0.024) for antibodies to Shigella and by 57% (p = 0.006) for antibodies to enterotoxigenic Escherichia coli. The findings indicate that houseflies, acting as mechanical vectors, transmit Shigella (and possibly enterotoxigenic E coli) diarrhoeal infections.

Adolescent↗
PubMed1991

Prevalence and correlates of diphtheria toxin antibodies among young adults in Israel.

The paucity of information about immunity against diphtheria of young adults in Israel prompted us to analyse sera from a random sample of 480 recruits (263 males and 217 females) aged 18-19 years. Antitoxin antibody levels were determined by means of ELISA. Of the recruits 58.1% had antibody values greater than 0.1 IU/ml; 38.5% had amounts between 0.01 and 0.1 IU/ml, which is considered low when using the ELISA method, and 3.3% had less than 0.01 IU/ml. The results of this study suggest that a booster dose of antidiphtheria vaccine should be given to adults in Israel in order to ensure adequate antibody levels.

Adolescent↗
PubMed1991

Ethnic differences in the prevalence of hepatitis B surface antigen among Israeli blood donors: changes between 1972 and 1988.

The prevalence of hepatitis B surface antigen (HBsAg) carriers among blood donors in Israel during 1988 was compared with that in a similar survey carried out on donors during 1972. The overall age- and sex-standardized prevalence of HBsAg declined from 1.22% to 1.01%. The ethnic differences previously observed were much diminished in native Israelis. The age of highest prevalence shifted from 18-21 to 31-40 years of age, probably due to a cohort effect. The higher prevalence among males has persisted. These findings indicate that the strong ethnic differences in the prevalence of HBsAg previously observed in Israel probably reflect the high rate of infections in the country of birth, and although intra-family spread may have persisted, the overall infection rate in Israel is much lower.

Adolescent↗
PubMed1991

Sociodemographic factors associated with serum anti-Shigella lipopolysaccharide antibodies and shigellosis.

The association between various sociodemographic variables and the presence of anti-Shigella sonnei lipopolysaccharide (LPS) antibodies was examined in a random sample (N = 383) of male Israeli conscripts. Of the male conscripts, 190 (49.6%) had pre-existing antibodies against S. sonnei LPS (defined as HA titres of greater than or equal to 1:10 after treatment of sera with 2-mercaptoethanol). Univariate analysis revealed a significant positive association between the presence of humoral anti-S. sonnei LPS antibodies and sociodemographic variables including Eastern origin (p = 0.007), low socioeconomic status (p = 0.0016), and the number of siblings (p = 0.023). When multiple logistic regression was used to control simultaneously for the effects of the other variables, ethnic origin emerged as the strongest correlate of anti-S. sonnei LPS antibodies. On the other hand, the association of the sociodemographic variables in subjects suffering from S. sonnei infection during their military service, was in the opposite direction (p less than 0.001 for both socioeconomic status and ethnicity). These findings suggest differences between subpopulations in acquired immunity to S. sonnei due to differences in exposure to the homologous organism prior to military service.

Adult↗
PubMed1991

Prospective study of the association between serum antibodies to lipopolysaccharide O antigen and the attack rate of shigellosis.

A means for determining immune status against shigellosis would significantly improve the design and evaluation of interventional and other epidemiologic studies. Previous case-control studies have indicated the potential role of humoral antilipopolysaccharide antibodies. To test this proposition, 190 soldiers serving in a field unit were monitored prospectively for 2.5 months for shigellosis. Blood samples were taken at the beginning of the follow-up period and tested for serological evidence of prior exposure to Shigella sonnei and Shigella flexneri. The risk for acquiring S. sonnei shigellosis was 3.7 times higher for individuals lacking homologous antibodies (P less than 0.02). The risk for acquiring S. flexneri shigellosis was 2.4 times higher for individuals lacking antibodies, although a low attack rate for S. flexneri resulted in numbers too small to achieve statistical significance. While the importance of the serum antilipopolysaccharide antibodies in protection against the disease remains unclear, these findings demonstrate that they are strong markers of acquired immunity. Serological markers should be incorporated in epidemiologic studies of shigellosis and in the design and evaluation of future trials of potential anti-Shigella vaccines.

Antibodies, Bacterial↗
PubMed1991

Mumps vaccination of young adults is unwarranted.

A clinical and epidemiological study of mumps was carried out over a 18-month period and included 104 soldiers (61% of the reported cases in the Israel Defence Forces). The average number of days off work was 12.9 +/- 9.2 days. The most common complication was orchitis (19/72 men; 26%), followed by 3 cases of pancreatitis (3%) and 2 cases of meningitis (2%). 13 men with orchitis were tested, and all had normal spermograms. No long term important sequelae were described. The transmission rate was low with no respondent reporting more than one secondary case among soldiers serving in the same unit. The socio-economic level of mumps patients was comparable to that of the general army population at the time of the study. Our data do not support a mass immunization program of the adult population.

Adolescent↗
PubMed1990

Response to trivalent oral poliovirus vaccine with and without immune serum globulin in young adults in Israel in 1988.

Fifteen cases of type 1 paralytic poliomyelitis occurred in August 1988, mainly among young adults in the Jewish population of Israel, where vaccine coverage exceeds 90%. The military forces, as a precaution against further spread of the virus, vaccinated all recruits in late September. They received oral poliovirus vaccine (OPV) simultaneously with prophylactic immune serum globulin (ISG) to protect against hepatitis A virus infection. Since it is generally not recommended to administer live vaccines simultaneously with ISG, the serologic response to OPV given at the same time as ISG was compared with the response when OPV was given alone; specimens were also available from a control group receiving ISG alone. No effect of ISG on the antibody response to OPV was found, and thus there appears to be no contraindication to giving OPV at the same time as injecting pooled ISG--particularly relevant for travelers to areas endemic for both diseases, who have to leave at short notice. Of recruits 18-19 years of age, 21% lacked antibodies to type 1 poliovirus, suggesting either a decline in antibody titers with age or a lack of vaccine potency during earlier years. After the booster, only 2% lacked type 1 antibody, and the geometric mean titer increased from 1:16 to 1:698.

Adult↗