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PubMedDate not supplied

[Possibility of occurrence of mild spinal forms of poliomyelitis in subjects immunized repeatedly with live poliomyelitis vaccine].

The results of clinical, epidemiological, serological and virological examinations of patients with mild spinal forms of poliomyelitis occurring under conditions of mass immunization with oral live poliomyelitis vaccine are presented. The etiological role of poliomyelitis virus types I and III in these diseases has been established. It has been shown that multiple vaccination does not always prevent diseases but in these cases they are milder. Serological examination of patients and normal subjects suggests inadequacy of seroconversion to poliomyelitis viruses under conditions of mass vaccination of the population against poliomyelitis.

Child, Preschool↗
PubMed1978

Poliomyelitis: Epidemiology and prophylaxis. 6. Geographic synchronism in poliomyelitis epidemics in Kenya.

In the 1950s, van Loghem drew attention to what he called "synchronism" in the epidemics of poliomyelitis in western Europe. The 1952 epidemic in the Netherlands affected Belgium and neighbouring parts of the Federal Republic of Germany at the same time. A comparable phenomenon is described from Kenya. Notwithstanding the fact that in the three population concentrations of the country the three poliovirus types may well be endemic, epidemics of poliomyelitis repeatedly occurred synchronously in these areas. However, there seems to be no synchronism between poliomyelitis epidemics in Kenya and those in neighbouring East African countries. Tentative explanations are put forward for the similarities and differences between Europe and East Africa. The importance of the phenomenon as observed in Kenya for control by mass immunization campaigns is stressed.

Humans↗
PubMedDate not supplied

[Development of immunity to the poliomyelitis virus in infants with various methods of administering a live poliomyelitis vaccine].

The data have been obtained which indicate that the effectiveness of vaccination with live trivalent poliomyelitis vaccine may be increased and 90--100% of the vaccinated infants under 1 year of age may develop marked resistance of the alimentary tract and high antibody titers in the blood serum to the threee types of poliomyelitis virus in the course of 3 vaccinations. Some regularities of the formation of immunity to individual poliomyelitis virus types in the course of 4 vaccinations with trivalent vaccine were revealed and specified. The results indicate that the contact of vaccine virus with the oropharyngeal tissues during immunization has a favourable effect on the development of immunity. Vaccination of infants under 1 at 6-week intervals between vaccine feedings creates solid immunity in 90--100% vaccines. Administration of the next vaccine dose 6 weeks after the previous one stops multiplication of the dominating type of vaccine virus and prevents its long-term passage in the intestinal tract decreasing the probability of emergence of vaccine virus variants with increased pathogenicity.

Antibodies, Viral↗
PubMed1977

Poliomyelitis: epidemiology and prophylaxis. 4. Serological and virological surveys conducted after a mass vaccination campaign for the control of a threatening poliomyelitis epidemic.

In 1973, a type 1 poliomyelitis epidemic in Kenya was curtailed at an early stage by two mass distributions of trivalent oral vaccine. It was considered useful to know the immunity status of the child population that had resulted from the vaccine distributions and that had presumably contributed to its control. We also wished to know to what extent wild and vaccine virus strains were in circulation after the mass vaccination campaign. Anal swabs and blood were collected from a sample of the children in four areas where the efficiency of vaccine distribution had varied, and the results of virus isolation attempts and antibody tests are reported. Three poliovirus strains were isolated. It was surprising that, in general, the herd immunity after two vaccination rounds did not substantially differ from that found in Kenya on other occasions. Possible reasons for these results are discussed.

Age Factors↗
PubMed1978

Poliomyelitis surveillance in England and Wales, 1969-1975.

Poliomyelitis continued to be a rare disease in England and Wales in the period 1969-75. Only 31 paralytic and 44 cases of possible non-paralytic poliomyelitis were recorded during the 7 years. Of the 31 paralytic cases approximately one third were vaccine-associated; 3 were patients who had recently received oral poliovaccine and 7 had been in contact with a vaccinated person. Five of these 7 patients were parents of recently vaccinated children. The rate of vaccine-associated poliomyelitis was estimated in recipients to be 0.2 and in contacts 0.4 per million doses of vaccine given. Marker test results were reported on 555 strains of poliomyelitis virus isolated during 1969-75, using the reproductive capacity temperature test. Forty-eight (8.6%) resembled wild virus in this property, 15 strains being type 1, 8 type 2 and 25 type 3. Most of these isolations of apparently wild virus were from excreters with no symptoms of poliomyelitis, although 3 of the 15 type 1 strains were from patients with paralytic poliomyelitis and 3 from possible cases of non-paralytic poliomyelitis. None of the 8 apparently wild type 2 viruses was from a case of paralytic illness and only 1 of the 39 type 3 strains. Eleven of the 31 paralytic cases were in patients in whom the infection was likely to have been acquired abroad.

Adolescent↗
PubMed1978

Advantages and disadvantages of killed and live poliomyelitis vaccines.

Decision-making on the use of poliomyelitis vaccines in the WHO Expanded Immunization Programme, and particularly in the developing nations, needs to be based on an understanding of the epidemiology of poliomyelitis in different parts of the globe. Even with two safe and effective kinds of poliomyelitis vaccine available, poliomyelitis has by no means been eradicated from the world. In developed countries that are considered well-vaccinated, certain sectors of the population may be inadequately protected against risk of infection by indigenous or imported wild polioviruses. In developing nations that are in transition toward an epidemic phase of poliomyelitis, wild polioviruses will continue to be a threat until thorough immunization is established and maintained. Killed-virus poliomyelitis vaccines have proved to be effective in certain countries that have used them exclusively; these are small countries with excellent public health systems, where coverage by the killed vaccine has been wide and frequent. Live vaccines, administered to hundreds of millions of persons during the past decade, have also been remarkably safe and effective. However, in certain warm-climate countries induction of antibodies in a satisfactorily high proportion of vaccinees has been difficult to accomplish. The advantages and disadvantages of each kind of poliomyelitis vaccine need to be weighed with respect to the particular setting in which a vaccine has been or will be used.

Child↗
PubMed1977

Outside Europe. Is poliomyelitis a serious problem in developing countries?--the Danfa experience.

Children were examined for lameness in the Danfa Project district of rural Ghana to assess the impact of endemic poliomyelitis and to test a widely held hypothesis that paralytic poliomyelitis is relatively rare in such districts (less than 1 per 1000 children affected). The observed prevalence of lameness attributable to poliomyelitis was 7 per 1000 school-aged children, and the annual incidence is estimated to be at least 28 per 100 000 population. Although no evidence for an epidemic was found, these rates are comparable with those in the USA and Europe during the years of severe epidemics and indicate that a high price is being paid in the Danfa district for the natural acquisition of immunity. As a result, immunisation against poliomyelitis has been given high priority. A teacher questionnaire was also tested for use in postal surveys as a rapid means of estimating the prevalence of lamenes attributable to poliomyelitis in countries with a reasonable network of primary schools.

Adolescent↗
PubMed1979

Poliomyelitis in the fetus and the newborn. A comment on the new understanding of the pathogenesis.

A survey of the literature shows that although poliovirus may be recovered from fetuses whose mothers have paralytic poliomyelitis, there is no evidence that the fetuses themselves are affected. It is suggested that if postnatal poliomyelitis results from an autoallergic response not developed in the fetus, then poliovirus cannot enter the CNS of the fetus. When a mother has paralytic poliomyelitis at delivery the neonate has a 40 per cent chance of poliomyelitis, with a case fatality rate of about 50 per cent. It is suggested that most of these neonates become infected by virus entry into the exposed olfactory and nasal nerve endings after the membranes have burst. This would explain the very short incubation period and the high case and case fatality rates.

Female↗
PubMed1976

[Ultrastructural changes in the central nervous system of monkeys in poliomyelitis].

The ultrastructure of cells of the central nervous system of Rhesus monkeys in experimental poliomyelitis caused by virus of poliomyelitis Type 3 was studied. It was found out that the virus of poliomyelitis was localized in nerve cells, astocytes, oligodendrocytes, the endothelium of capillaries and macrophages. This justifies the conclusion that pathological changes in the cells referred to the above result from reproduction of the virus therein. Ultrastructural changes in infected cells are divided into three stages: the first stage corresponded to eclipse-phase of infection; the second -- to the period of reproduction of the virus and composition of viral particles; and the third -- to the period following the escape of the virus from the cell. A definite combination of nonspecific changes in organoids of various cells with specific viral inclusions makes the ultrastructural picture of cells in poliomyelitis sufficiently characteristic for differential diagnosis. Pathogenesis of the developing lesions is discussed.

Animals↗
PubMed1977

Poliomyelitis: epidemiology and prophylaxis. 5. Results of a two- and three-dose vaccination experiment.

In tropical countries, seroconversion rates following oral poliomyelitis vaccination are frequently unsatisfactory. In an area of the Machakos district in Kenya, 4000 children under 5 years of age have been registered and are visited fortnightly by trained field staff as part of a comprehensive, population-based, longitudinal surveillance project. It was considered possible that poliomyelitis vaccine, given orally to children twice or three times at home, would produce satisfactory conversion rates. After collection of blood from a random sample of the children, vaccine was given twice to all children under 5 years of age. Blood was then collected a second time from a different sample of children. After a third dose of vaccine, a third blood collection followed. The percentages of the children that received vaccine each round were calculated and the sera tested for antibodies. It appeared that the mean titre was more strongly related to age than to the number of doses of poliomyelitis vaccine received. Improvement of herd immunity after two vaccine distributions was significant for a few age groups and for two types of vaccine only. In none of the groups was a significant improvement obtained by the third vaccine distribution. The problems associated with vaccination by live poliomyelitis vaccine in tropical countries are discussed in relation to the results.

Age Factors↗
PubMed1979

Comparison of methods for estimating the frequency of paralytic poliomyelitis in developing countries.

Standard reporting systems have proved to be unreliable in estimating the frequency of paralytic poliomyelitis in many developing countries. The effectiveness of three survey methods for estimating the prevalence of lameness attributable to poliomyelitis were compared in the Danfa Health Project district of rural Ghana. Lameness was studied because it is easily identified by inexpensive survey techniques. A postal survey of school headteachers was the least costly and most accurate method, giving a prevalence of lameness attributable to poliomyelitis of 7.2 per 1000 schoolchildren. This method is recommended for countries with an extensive network of primary schools. Medical examinations in a village health survey yielded a prevalence of 4.6 per 1000 children aged 6-15 years. This method was relatively expensive but could be justified if the survey was multipurpose. A question added to the annual district census showed a prevalence of 2.2 per 1000 children, a rate still many times higher than estimates from national statistics. The inclusion of such a question in a census or other national survey entails little additional cost and with more careful questioning results should improve. Repeated surveys can be used to assess the success of poliomyelitis vaccination programmes.

Adolescent↗
PubMedDate not supplied

[Dynamics of secretory and serum immunoglobulins in children in the course of vaccinations with live poliomyelitis monovaccines].

The influence of vaccination with live poliomyelitis monovaccines on the formation of immunoglobulins in the blood serum and the buccal secrets was studied in infants under 1 year. There was a correlation between rises in the levels of serum immunoglobulins (Ig) of the A, G, and M classes and titers of neutralizing antibody to the three poliomyelitis virus types. The highest level of secretory IgA was observed after immunization with type I monovaccine. The level of secretory IgA correlated with the virus-neutralizing activity of the buccal cavity secretes for poliomyelitis virus types I, II, and III. After immunization with type II and III monovaccines there was an insignificant increase of the IgA content in the buccal cavity secretes. In contrast to poliovirus type I which was isolated from throat samples in 40% of the vaccinees, the other two types of poliomyelitis virus were not found in throat swabs. It is suggested that in the course of immunization with live poliovirus vaccine there are differences in the immunogenesis to poliovirus of different types.

Antibodies, Viral↗
PubMed1979

Epidemiological, clinical, and pathomorphological characteristics of epidemic poliomyelitis-like disease caused by enterovirus 71.

In May-September, 1975, an outbreak of epidemic disease clinically and pathomorphologically simulating nearly all known forms of poliomyelitis occurred predominantly among young infants in Bulgaria. Most cases presented benign aseptic meningitis, sometimes with a short period of general cerebra- symptoms. Paralytic forms, such as bulbar polioencephalitis, anterior poliomyelitis, isolated pareses of the facial nerve, occasional cases of encephalomyocarditis, etc., were observed in about 21% of all cases. Over one-fourth of the paralytic cases with bulbar symptoms ended fatally. In March, 1976 another sporadic fatal case of this disease was examined. No new cases occurred in 1977. Histopathological examinations in all fatal cases regularly revealed lesions in the grey matter of the medulla and spinal cord typical of acute anterior poliomyelitis and bulbar polioencephalitis, with some peculiar features of localization and depth of the involvement of the brain stem. The similarity to poliomyelitis and precariously rapid increase in the incidence led to the decision to urgently vaccinate the entire human population with Sabin's live poliovirus vaccine simultaneously in the whole country in order to produce interference with the circulating agent. This aim appeared to have been achieved partially because soon the number of new cases of the disease began to decrease; however, no sharp and complete break in the curve of the incidence occurred. By the time of mass vaccination, the results of virological examinations started before were not yet available. Later, comprehensive complete evidence was obtained that over 25 fatal and many other typical cases of the disease were associated with an enterovirus proved to be antigenically related to enterovirus 71. The diseases in Bulgaria, 1975, differ considerably in the frequency of paralytic forms and in severity from the epidemics caused by enterovirus 71 in Sweden, 1973, Australia, 1972--1973, USA, 1969--1972, and Japan, 1972--1973.

Adolescent↗
PubMed1979

Enterovirus 71 isolated from cases of epidemic poliomyelitis-like disease in Bulgaria.

Virological and serological studies of an epidemic disease in Bulgaria, 1975, were carried out. Epidemiologically, clinically and pathomorphologically, the disease simulated almost all known forms of poliomyelitis, acute stem encephalitis, encephalomyocarditis and aseptic meningitis. The studies completely rules out the participation of polioviruses and provided comprehensive evidence for the etiological role of a peculiar enterovirus subsequently identified as enterovirus (EV) type 71 known in the literature since 1974. Altogether, in 1975 and 1976 from 65 cases of poliomyelitis-like disease (PLD) 92 strains of EV71 were isolated, including 37 strains from the brain and medulla, 1 from the cerebrospinal fluid, 10 from mesenterial lymph nodes and tonsils and 44 from faeces. In addition, in 282 convalescent cases of the disease, diagnostic seroconversion or high titers of antibody to this virus were demonstrated. The most successful virus isolation was achieved by inoculation of green monkey kidney cell cultures and newborn white mice. Bulgarian strains of enterovirus 71 regularly caused paralysis in monkeys and morphological poliomyelitis-like lesions in their CNS, and paralysis and myositis with Zenker necrosis in newborn white mice, cotton rats, Syrian hamsters, and 3-week-old cotton rats. The diseased rodents had much more virus in their mucles than in brains.

Adult↗
PubMedDate not supplied

Is poliomyelitis an auto-allergic disease triggered by virus?

The neuropathology of poliomyelitis is reviewed and the reasons for the inflammatory response are examined. It is concluded that the response is due to the release of a previously sequestered self-antigen from virus infected or damaged cells. The inflammation is consistent with an auto-allergic response by lymphocytes senitised before the viral infection. A model for the mechanism of genetic susceptibility is proposed. Simultaneous infection with other enterovirus, the incubation period of paralytic poliomyelitis and the case and fatality rates with the Kolmer and Cutter vaccines are examined with this auto-allergic model. Second attacks of poliomyelitis are reviewed and the reduced severity of the second attack is attributed to the action of blocking antibody. The model is examined with reference to ECHO, Coxsackie and other viral infections of the CNS. The use of blocking antibody as a therapeutic agent is considered.

Animals↗