Effect of prior immunity on the shedding of virulent revertant virus in feces after oral immunization with live attenuated poliovirus vaccines

Article Abstract:

Poliomyelitis is the inflammation of the spinal cord due to infection with poliovirus, and is characterized by fever, sore throat, headache, vomiting, and neck and back stiffness. This condition has been virtually eliminated in the United States since 1972 due to the use of a poliovirus vaccine. This vaccine consists of the live poliovirus, which is attenuated or has diminished infective ability. The live attenuated poliovirus vaccine is given by mouth. However, despite widespread immunization with oral poliovirus vaccine (OPV), 5 to 10 cases of poliovirus occur each year in the United States. It is thought that the attenuated poliovirus may revert (change) to a virulent, or infective, form during passage through the gut. The incidence of reversion is not known, but most cases of poliomyelitis occur after the first dose of OPV. The enhanced-potency inactivated poliovirus vaccine (EIPV) is a more powerful or effective vaccine with a noninfective poliovirus and is given parenterally, or directly into the circulation. The initial use of EIPV with or without subsequent use of OPV may prevent the production of virulent revertant virus. The types of poliovirus detected in the feces of infants vaccinated with EIPV or OPV were assessed. Revertant virus was recovered from the feces of infants who were initially vaccinated with EIPV, and later with OPV. The transmission of virulent revertant virus requires further study. However, the combined use of EIPV and OPV enhances the production of antibody, or immune protein directed against poliovirus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Complications and side effects, Poliomyelitis, Feces, Poliovirus, Polioviruses, Poliomyelitis vaccine, Poliovirus vaccines

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Otitis media in children; I. The systemic immune response to nontypable Hemophilus influenzae

Article Abstract:

Otitis media (middle ear infection) is the most common reason for pediatric office visits among children up to two years old. One of the most frequent causes is the organism nontypable Hemophilus influenzae (NTHI). The persistent development of otitis due to NTHI may involve factors local and systemic immunity and the levels of these organisms in the noses and throats of children. The processes and mechanisms of respiratory colonization and disappearance of NTHI are unknown. Twenty-one infants persistently experiencing otitis media with effusion that was due to NTHI were observed for a two-year period. Antibody formation and the immune response to the NTHI were measured with a bactericidal assay. Bactericidal antibody was absent during the early phase of the infection, but developed in all infants during their convalescence. The bacterial count in fluids removed during tympanocentesis (perforation of the tympanic membrane in order to remove fluid behind it, and reduce the pressure in the middle ear) tended to be lower in those children with bactericidal antibody. Those children who lacked antibody, or developed it later, experienced otitis media more frequently. Reinfection with the same NTHI strains was rare in children if they possessed the specific bactericidal antibodies. Reinfection with other species of NTHI frequently occurred, however, indicating the absence of any cross-protection. The findings suggest that specific antibodies against strains of NTHI persist, and provide stable protection for extended periods. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Physiological aspects, Bacterial infections, Otitis media

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Cefuroxime treatment failure of nontypable Haemophilus influenzae meningitis associated with alteration of penicillin-binding proteins

Article Abstract:

In the United States, the treatment of purulent meningitis, due to Haemophilus influenzae has been ampicillin and chloramphenicol. More recently, the potential toxicity of chloramphenicol and increasing bacterial resistance to ampicillin have led clinicians to consider the use of some of the extended spectrum antibiotics of the cephalosporin group. Cefuroxime, one of the cephalosporins, was selected for use in the treatment of Haemophilus influenzae meningitis. The case of a 10-year-old boy describes a treatment failure, and additionally discusses the mechanism of resistance in the specific bacterial strain. The patient was diagnosed with a second episode of purulent meningitis due to Haemophilus influenzae. The first was successfully treated with intravenous chloramphenicol two years earlier. During this episode, initial treatment with cefuroxime for six days failed to resolve the symptoms or manifestations of the disease. Antibiotic therapy was changed to ampicillin and chloramphenicol. The patient's symptoms resolved and he was without fever for 24 hours. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Case studies, Evaluation, Drug therapy, Drug resistance in microorganisms, Microbial drug resistance, Identification and classification, Cefuroxime, Ampicillin, Hemophilus meningitis

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