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PubMed1980

Lack of correlation between complications after smallpox vaccination and the ABO blood-group system.

Blood group [ABO system] distribution was analysed in 245 children with complications after smallpox vaccination. One hundred and thirty-two children had neurological and 113 and skin or mucosal complications. 41.6% of the children were blood-group A or AB. 58.4% were blood group O or B, which was not a significant difference from the normal population [44.7%---48.7% and 51.0%---55.9%, respectively]. The analysis did not show in persons possessing blood groups A or AB an enhanced susceptibility to complications following antismallpox immunization or to particularly severe clinical forms of these complications. Immunological advantages in persons with blood group O or B were not found either.

ABO Blood-Group System↗
PubMed1954

Local complications of BCG vaccination in pre-school children and new-born babies.

The local complications resulting from BCG vaccination in new-born babies and pre-school children in Taiwan are discussed. The author points out that severe local reactions at the site of vaccination are rare, but that the frequency of regional glandular enlargement and abscess formation is alarmingly high-particularly among new-born babies-and there is a danger of the prestige of BCG vaccination being lowered in consequence.

BCG Vaccine↗
PubMed1970

Experience with electron microscopy in the differential diagnosis of smallpox.

The usefulness of negative-contrast electron microscopy in the rapid differential diagnosis of poxvirus and herpesvirus exanthems is described in this study of 301 specimens from patients with vesicular exanthematous diseases. Specimens from patients with smallpox, various forms of vaccination complications, varicella, zoster (shingles), and herpes simplex are included in this evaluation. Electron microscopy, when applied to the study of lesion material, was found to be more sensitive than the classical techniques of virus isolation in the diagnosis of both poxvirus and herpes/varicella virus infections. However, since specific identification of a virus within a group cannot be made morphologically by electron microscopy, it is recommended that both electron microscopy and virus isolation methods be employed for the routine differential diagnosis of vesicular exanthematous diseases in the reference diagnostic laboratory.

Animals↗
PubMed1971

Complications of smallpox vaccination, 1968. Results of a statewide survey in Alaska.

A survey was made to determine the incidence in Alaska of complications of smallpox vaccination during 1968. Of the 206 medical personnel responding to the questionnaire, 20 (or 9.7 percent) observed a complication. Twenty-six complications were reported, 20 of which occurred in primary vaccinees. Accidental implantation was the most common complication, but two cases of eczema vaccinatum and two of generalized vaccinia were observed. There were no deaths or cases of postvaccinial encephalitis or vaccinia necrosum. Of the 26 complications, 19 were theoretically preventable.

Adolescent↗
PubMed1997

Familial liability to complications after BCG vaccination.

Adverse reactions induced by vaccination with bacille Calmette-Guerin (BCG) were observed in three infants from two blood-related families. A boy and a girl showed disseminated BCG infection with a fatal course in the former case. The third infant had regional suppurative lymphadenitis. Cases of two other children from the same families are also described: a boy who received BCG vaccine after 5 y of age without complications, and a girl who has not yet been vaccinated. The clinical course and immunological evaluation of the reported cases suggest a congenital immunodeficiency of an unusual transient nature. The role of genetic factors in familial susceptibility to mycobacterial infection also needs to be taken into consideration.

BCG Vaccine↗
PubMedDate not supplied

Impact of vaccine cost and information about complications of varicella on parental decision regarding varicella vaccine.

BACKGROUND: The influence of providing information about complications of disease and vaccine cost on parental decision to vaccinate against varicella was assessed. METHOD: During telephone interviews of 330 parents of infants aged 9 months, parents were asked if they would agree to have their child vaccinated and were presented information first about varicella complications and then about cost of the vaccine. RESULTS: When complications were explained but information about cost was not, 94% of parents were favourable toward having their child vaccinated. When complications were not explained but cost was presented, this percentage was only 34%. When both cost and complications were presented, 60% of parents were favourable toward the vaccine. INTERPRETATION: In improving receptivity towards varicella vaccine, parents should always be presented data regarding varicella complications by their health care provider.

Chickenpox↗
PubMed1989

Immunogenicity of the intradermal route of hepatitis B vaccination with the use of recombinant hepatitis B vaccine.

In March 1987, 32 hospital employees were enrolled in a prospective trial of intradermal recombinant hepatitis B vaccination. Enrollees were given 0.1 ml of vaccine on days 1, 30, and 180. Two weeks after the third intradermal vaccination, 81%, or 26, of the enrollees showed seropositivity (greater than or equal to 10 mIU antibody/ml) for hepatitis B surface antibody. Five of six nonresponders were given a fourth intradermal vaccination. Two additional seroconversions occurred, resulting in an overall conversion rate of 90% for recipients of up to four intradermal vaccine doses. Complications of vaccination were limited primarily to the occasional persistence (less than 6 months) of hyperpigmentation at the injection site. Administration of recombinant hepatitis B vaccine by the intradermal route proved to be a safe and effective method of vaccination. Cost savings of preexposure immunization with the intradermal versus the intramuscular route of vaccination were approximately $90 per enrollee. Efficacy and safety can be maximized by employing a fourth vaccine dose and routinely documenting seroconversion after vaccination.

Antibody Formation↗
PubMed2006

Comparison of naturally acquired antibody responses against the C-terminal processing products of Plasmodium vivax Merozoite Surface Protein-1 under low transmission and unstable malaria conditions in Sri Lanka.

We report here, for the first time, a comparison of naturally acquired antibody responses to the 42 and 19 kDa C-terminal processing products of Plasmodium vivax Merozoite Surface Protein-1 assayed by ELISA using p42 and p19 baculovirus-derived recombinant proteins, respectively. Test populations comprised patients with microscopy confirmed acute P. vivax infections from two regions endemic for vivax malaria where low transmission and unstable malaria conditions prevail, and a non-endemic urban area, in Sri Lanka. The antibody prevalence to the two proteins, both at the individual and population levels, tend to respond more to p42 than to p19 in all test areas, where >14% of individuals preferentially recognized p42, compared with <2% for p19. In patients with no previous exposure to malaria, 21% preferentially recognized p42, whereas none exclusively recognized p19. A significantly lower prevalence of anti-p19 IgM, but not anti-p42 IgM, was observed among residents from endemic areas compared with their non-endemic counterparts. Individuals from both endemic areas produced significantly less anti-p19 IgM compared with anti-p42 IgM. IgG1 was the predominant IgG isotype for both antigens in all individuals. With increasing exposure to malaria in both endemic areas, anti-p19 antibody responses were dominated by the functionally important IgG1 and IgG3 isotypes, with a concurrent reduction in IgM that was lacking in the non-endemic residents. This antibody switch was also reflected for PvAMA-1 as we previously reported with the identical battery of sera. In contrast, the antibody switch for p42 was restricted to endemic residents with more extensive exposure. These results suggest that an IgM-dominated antibody response against the p42 polymorphic region in endemic residents may interfere with the development of an IgG-dominated "protective" isotype shift to p19, that may complicate vaccine development.

Adolescent↗
PubMed2002

Hepatitis B and hepatitis C.

Hepatitis B and C are worldwide infectious hepatitides which are distinct in terms of epidemiology and molecular biology, but which may be quite similar in terms of clinical manifestations and histopathology, in both the acute and chronic stages. Hepatitis B virus (HBV), the human prototype of the Hepadnaviridae family of viruses is not directly cytopathic and viral hepatitis is caused by the cellular immune response to HBV. Patients infected with HBV may also have hepatitis D (delta) virus (HDV) infection, either as co-infection or a superinfection. Hepatitis D virus does not infect independently. Better control of HBV has also led to a decline in the incidence of HDV. Hepatitis C virus (HCV) is on of the Flaviviridae family of viruses, and is quite heterogeneous, with six major genotypes and more than 100 subtypes. Hepatitis C virus circulates as quasispecies that result from mutations accumulated over time, which probably enable HCV to replicate efficiently or resist immune mechanisms. Quasispecies have complicated vaccine development. Both HBV and HCV will recur in the transplanted liver. The risk of developing hepatocellular carcinoma is significantly greater in both HBV- and HCV-infected individuals.

Biopsy↗
PubMed2003

Q fever: a biological weapon in your backyard.

Coxiella burnetii, which causes Q fever, is a highly infectious agent that is widespread among livestock around the world. Although the culture process for coxiella is laborious, large amounts of infectious material can be produced. If used as an aerosolised biological weapon, coxiella may not cause high mortality, but could provoke acute disabling disease. In its late course, Q fever can be complicated by fatal (eg, endocarditis) or debilitating (eg, chronic fatigue syndrome) disorders. The diagnosis of Q fever might be delayed because of non-specific and protean presentations. Effective antibiotic treatment is available for the acute form of disease but not for the chronic complications. Vaccination and chemoprophylaxis in selected individuals may be used in the event of bioterrorism.

Animals↗
PubMed2002

Infectious diseases in systemic lupus erythematosus: risk factors, management and prophylaxis.

Infections are one of the leading causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Therapeutic, disease-related and genetic factors all contribute to a lupus patient's increased susceptibility to infections. Although bacterial pathogens are the most common cause of infections, a wide variety of pathogens have been reported. In high-risk populations, identification and treatment of chronic infections such as tuberculosis, hepatitis B or human immunodeficiency virus, are important prior to the institution of immunosuppression to prevent reactivation or exacerbation of the infection. Judicious use of corticosteroids and cytotoxic drugs is critical in limiting infectious complications. Vaccines against influenza and pneumococcus appear to be safe and immunogenic in SLE patients and their routine administration should be encouraged.

Bacterial Infections↗
PubMed1993

CD8+ cytotoxic T lymphocytes against antigenic variants of caprine arthritis-encephalitis virus.

Cytotoxic T lymphocytes (CTL) specific for caprine arthritis-encephalitis virus (CAEV) were characterized using a colorimetric immunocytochemistry assay to measure surviving target cells. Peripheral blood lymphocytes from a CAEV-infected goat were cytotoxic to autologous, CAEV-infected dermal fibroblast target cells following in vitro stimulation of the lymphocytes with CAEV antigen. The lymphocytes were not cytotoxic to infected allogeneic target cells or to mock-infected autologous or allogeneic target cells. This CAEV antigen-specific, major histocompatibility complex-restricted cytotoxicity was mediated by CD8+ lymphocytes as demonstrated by selective depletion with anti-CD8 antibody and complement. CTL primed with one isolate of CAEV (CAEV-Co) had no detectable activity against target cells infected with either of two neutralization variants and diminished activity against target cells infected with three other neutralization variants. This apparent variability of CTL-sensitive epitopes among CAEV isolates may contribute to CAEV escaping immune control and may complicate vaccine design.

Animals↗
PubMed1988

Aldolase activity of a Plasmodium falciparum protein with protective properties.

Immunization with a 41-kilodalton blood stage antigen (p41) of Plasmodium falciparum induces immunity to malaria in monkeys. However, antigenic polymorphism and repetitive amino acids commonly found in protective antigens complicate vaccine development. The gene encoding p41 has now been cloned and analyzed. Sequencing and hybridization studies revealed that the gene structure is highly conserved in 14 parasite isolates from three continents. This finding and the lack of repetitive amino acids in the translated DNA sequence may indicate that p41 has an essential function. In this study the protein was found to be 60 percent homologous to the key glycolytic enzyme aldolase from vertebrates, and the affinity-purified p41 protein from parasites showed aldolase activity.

Animals↗
PubMedDate not supplied

Addisonian crisis and tuberculous epididymo-orchitis.

OBJECTIVE: To describe a case of acute primary adrenal insufficiency in which tuberculosis was subsequently detected as the etiologic factor when the patient presented with tuberculous epididymo-orchitis. METHODS: A case of acute primary adrenal insufficiency associated with bilaterally enlarged adrenal glands is reported, along with the subsequent finding of a scrotal mass diagnosed as tuberculous epididymo-orchitis. Diagnosis, adrenal function, and results of imaging studies after institution of antituberculous treatment are discussed. RESULTS: A 41-year-old Egyptian man, who had immigrated to the United States 5 years previously, had acute psychosis and addisonian crisis. A substantially increased early morning level of plasma adrenocorticotropic hormone and a low level of serum cortisol confirmed the diagnosis of primary adrenal insufficiency. Both adrenal glands were enlarged but without calcification on computed tomography. A previous bacille Calmette-Guérin vaccination complicated the interpretation of a positive tuberculin skin test result. Both lungs were clear on chest radiography and computed tomography. Seven months later, the patient had a left scrotal mass and underwent radical orchiectomy. Examination of the pathology specimen showed caseous granulomatous inflammation and necrosis, and acid-fast bacilli were identified. Culture was positive for Mycobacterium tuberculosis. CONCLUSION: In a patient from a country where tuberculosis is endemic, tuberculosis should be considered in the differential diagnosis when primary adrenal insufficiency is detected, especially in association with enlarged or calcified adrenal glands. Extra-adrenal tuberculous involvement should be actively sought because it may provide indirect microbiologic or histologic clues. Other than the lungs, special attention should be paid to the genitourinary system.

Addison Disease↗
PubMed1975

[Possibility of the occurrence of the Shwartzman phenomenon during administration of a reacting dose of typhoid antigen through the respiratory tracts].

This work is devoted to the study of possible vaccinal complications of Schwartzmann's phenomenon type following subcutaneous injection to rabbits, sensitized by typhoid antigen, of a reacting dose of the same antigen through the respiratory tracts. The reacting dose of the antigen of 0.5; 1.0, 1.5 ml was injected to the rabbits in the form of a dry and liquid aerosol intratracheally intrapulmonary and subcutaneously. Animals to which the reacting dose of the same antigen (0.1; 0.25; 0.5; 1.0 mg) was injected intravenously served as control. Local Schwartzmann's phenomenon was reproduced after administration of all the reacting doses of typhoid antigen tested by intravenous method only. Administration of the reacting dose of the same antigen through the respiratory tracts failed to produce local Schwartzmann's phenomenon, this pointing to the difference in the reaction of rabbit organism sensitized with typhoid antigen to the administration of a reacting dose of the same antigen through the respiratory tracts, in comparison with the intravenous method.

Aerosols↗
PubMed2003

Contacts of tuberculosis patients in high-incidence countries.

The risk of acquiring infection with Mycobacterium tuberculosis correlates with duration of exposure to an infectious source of tuberculosis. Contact identification is therefore a comparatively high-yield activity. However, in resource-poor settings tuberculin is rarely available, and even where it is available, non-specific cross-reactions to tuberculin resulting from BCG vaccination complicate the interpretation of tuberculin test results. The identification of a putative infection with M. tuberculosis in a contact must result in intervention. Excluding active tuberculosis is mandatory before preventive therapy is provided. This might prove difficult in areas where the most and often only affordable diagnostic means is microscopy. The International Union Against Tuberculosis and Lung Disease (IUATLD) has thus proposed to target preventive therapy to healthy children below the age of 5 years living in the same household as a sputum smear-positive tuberculosis case, with the sole recourse to clinical contact examination. While this approach will lead to treatment of a considerable proportion of uninfected children, the advantages are several-fold: first, these are the easiest identifiable contacts; second, they are particularly prone to progression to disease if infected; third, emerging drug resistance is of little concern at that age; fourth, administration of preventive treatment can be delegated to the source case. This approach is safe, simple, and affordable.

Carrier State↗