The protective effect of maternal antibody against many viral diseases has been recognized. The use of maternal immunization has been considered as a means to augment this protection in the young infant against disease. Advantages of maternal immunization include the fact that young infants are most susceptible to infections but least responsive to vaccines, that pregnant women are accessible to medical care and respond well to vaccines, that IgG antibodies cross the placenta well during the third trimester, and that immunization of the pregnant woman has the potential to benefit both the mother and the infant. Disadvantages include the potential inhibition of an infant's response to active immunization or natural infection and liability issues with pharmaceutical companies and physicians. Immunization of pregnant women with viral vaccines for poliovirus, influenza viruses, and rubella has been described and maternal vaccination with these vaccines has been found to be safe for both the mother and the fetus. An open-label study of post-partum women immunized with the purified fusion protein of RSV (PFP-2, Wyeth-Lederle Pediatrics and Vaccines, Inc., Pearl River, NY) demonstrated that the vaccine was non-reactogenic and immunogenic; RSV-specific antibody was detected in breast milk. Immunization of pregnant women with purified protein or subunit vaccines could be considered against neonatal viral pathogens, such as respiratory syncytial virus, parainfluenza viruses, herpes group viruses, and human immunodeficiency virus. Further studies are needed to define the safety and efficacy of maternal immunization.

Female↗

PubMedDate not supplied

Relation of serum antibody to glycoproteins of respiratory syncytial virus with immunity to infection in children.

Immunity in relation to passively transferred maternal and naturally-induced serum antibody to the viral proteins was determined in 34 children who were followed from birth through three years of age for respiratory syncytial virus infection (RSV). Sera were tested by immunoglobulin class-specific enzyme-linked immunosorbent assay using the attachment and fusion proteins of the Long strain. The basis for immunity for maternal antibody in primary infection was assessed by a comparison of the distribution of antibody titers in a) 7 children who had an upper respiratory illness to 12 whose illness was accompanied by lower respiratory disease and of b) 13 children with an RSV-associated illness in the first 6 months of life who were age-matched as to month and approximate day of birth with 11 not infected in the same period. Infection induced immunity was evaluated by a comparison of antibody titers in 19 children who were reinfected with RSV in the year following their primary infection to 15 in whom reinfection was not documented. A statistical analysis of titers revealed that antibody to the fusion protein is an important correlate of immunity. In all three comparisons, the children with less RSV disease had significantly higher IgG anti-F titers prior to infection. No differences were observed between IgA anti-F or IgG and IgA anti-G titers.

Antibody Formation↗

PubMedDate not supplied

Considerations of the risk of influenza in children and indications for prophylaxis.

The development of effective prophylaxis against influenza virus infections presents a special challenge. Stimulation of a protective response apparently requires more than one exposure to the virus. The virus may then change its surface antigens to render ineffective previously acquired immunity. Ideally, artificial prophylaxis should stimulate better protection than does natural infection and should anticipate antigenic change. Children experience the highest morbidity, accompanied by considerable risk, during influenza epidemics. At the same time, children in school and day care are the most important disseminators of virus in the community. Consideration should be given to providing protection for all children against influenza when effective methods and strategies have been found. Such prophylaxis would decrease not only morbidity and serious disease in children but also the risk of exposure of high-risk adult patients.

Adolescent↗

PubMedDate not supplied

Antigenicity and reactogenicity of influenza A/USSR/77 virus vaccine in children--a multicentered evaluation of dosage and safety.

Clinical trials of monovalent A/USSR/77 (H1N1) and trivalent A/USSR/77 (H1N1), A/Texas/77 (H3N2), and B/Hong Kong/72 inactivated influenza virus vaccines were carried out in 358 children and adolescents. Only split-virus vaccines were administered to children younger than 13 years of age. No serious local or systemic reactions were observed among the study participants. Two doses of vaccine containing 7-20 micrograms of the A/USSR/77 (H1N1) viral antigen were required to achieve serum titers of hemagglutinin-inhibiting (HA1) antibody greater than 1:40. However, single doses containing 7-20 micrograms of the A/Texas/77 (H3N2) or B/Hong Kong/72 antigens stimulated serum HAI antibody levels of 1:40.

Adolescent↗

PubMedDate not supplied

The pediatrician's role in influenza control.

Influenza is the most important of acute respiratory illnesses that cause persons to seek medical care. For infants some other viruses such as respiratory syncytial and parainfluenza viruses share in the assault but influenza is the only respiratory virus for which we have tools for prevention. We need to use these tools effectively to build a wall of protection around vulnerable patients. The fact that influenza vaccine does not have the same efficacy as other pediatric vaccines should not discourage its use but should challenge us to implement fully the current recommendations. Not only is influenza a slippery, changeable virus but also the pathogenesis of the infection and the host response are different. Influenza virus invades and destroys the respiratory epithelium and a viremic phase is not essential to this destruction. Therefore the virus is sheltered from many of the host immune and protective mechanisms that can be stimulated by natural infection or vaccines. Furthermore immunity to influenza tends to wane even after natural infection. Thus the challenge is to extend the utilization of the available vaccine and the antiviral to decrease the unrelenting serious morbidity associated with influenza. The hope is that better vaccines and antivirals will soon be available to aid in the battle. The cold recombinant vaccine, a live attenuated virus developed by Massaab, has potential for use in children. Rimantadine, an analogue of amantadine, has fewer side reactions and has been shown to be effective in children. Ribavirin, recently licensed for treatment of respiratory syncytial virus disease, is also effective for treatment of both influenza A and B viruses.

Amantadine↗

PubMedDate not supplied

Potentiation of the immune response to influenza virus subunit vaccines.

Influenza subunit vaccines are poorly immunogenic in unprimed lower animals and man and a method was sought to potentiate the humoral response. Intact heterologous influenza A virus vaccine (A/Victoria/3/75 [H3N2]) potentiated the antibody response of hamsters to A/NJ/76 [Hsw1 N1] subunit vaccines but large doses of intact virus were required. Studies in seronegative young human adults showed that much lower doses of homologous A/NJ/76 [Hsw1 N1] virus potentiated the antibody response to both the hemagglutinin and neuraminidase subunits of A/NJ/76 influenza vaccines. This suggests that future influenza subunit vaccines for use in seronegative people should contain a small amount of whole virus vaccine, sufficient to potentiate the immune response to the subunits but insufficient to be reactogenic.

Adolescent↗

PubMedDate not supplied

[Influence of influenza epidemics on the urban population].

The results of studies carried out in 1974-1979 according to the programme of epidemiological survey of influenza among the population of Houston (USA) developed by the Research Center for Influenza at the Baylor Medical College are reviewed. The data of selective virological and epidemiological surveys of the population were used for comparative analysis of several epidemic outbreaks caused by different antigenic variants of influenza virus. The analysis has been aimed at the detection of "high risk" groups of the population, investigation of the effect of influenza on the health of the population, determination of the factors conducive to virus spread, development of methods for the evaluation of the efficacy of influenza control measures, as well as determination of the earliest signs of activity of influenza viruses among the population and search for the best method of prediction of an epidemic virus for the following season.

Absenteeism↗