Follow-up study: protective immunization in the elderly.
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Aged↗
Biomedical subjects
F L Ruben
Publications and source records attributed to F L Ruben.
Loiasis in an American naturalist.
In March 1981, a 32-year-old male naturalist involved with collecting mammals for study was found to have an unexpected eosinophilia. Serum parasitic screening done at the Centers for Disease Control showed filarial titer by indirect hemagglutination of 1:1,024 and of 1:40 by bentonite flocculation. His travel history disclosed 3 months spent in Cameroon in 1978. He also gave a history of intermittent arm swelling for at least a year. Peripheral blood, collected repeatedly at mid-day and midnight and tested for microfilariae by the Knott technique, was negative. He was begun empirically on diethylcarbamazine, and on day 11 of treatment he removed a worm, identified as a male Loa loa, from his leg. He completed treatment without difficulty and has done well.
Adult↗
Responses of lymphocytes from human colostrum or milk to influenza antigens.
Paired samples of peripheral blood and colostrum or milk were obtained from women 1 to 6 days after delivery. After Ficoll-Hypaque centrifugation, peripheral blood lymphocytes (PBL) and colostrum or milk lymphocytes (COL) were examined for surface membrane characteristics and in vitro proliferative reactivity. As determined by sheep red blood cell rosetting and by immunoglobulin-coated beads, PBL showed an average of 54% T and 12% B lymphocytes, whereas COL showed 33% T and 22% B rosettes, respectively. Paired samples of PBL and COL were used for lymphocyte transformation with three distinct strains of influenza virus: A/USSR, A/Victoria, and B/Hong Kong. Of COL from nine subjects tested against all three strains of influenza virus, five samples (56%) gave positive responses to at least one. These studies indicate that COL contain cells responsive in vitro to several influenza antigens. Such sensitized cells may provide a mechanism for the transfer of antigen responsiveness and protection from the mother to the neonate.
Antigens, Viral↗
Serum theophylline levels after influenza vaccination.
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Adult↗
Prevention of influenza in the elderly.
A gradual evolution has occurred in the development of influenza vaccines to their present highly purified state. Although studies are limited and vaccines are far from perfect, influenza vaccines should be used in the geriatric age group. Chemoprophylaxis is currently available against influenza A; however, studies should be made of its safety and efficacy in the elderly. Because of the severe consequences of influenza in aged persons, there is need for continued evaluation of vaccines, improved delivery, improved education, and new strategies for the prevention of influenza in the elderly.
Aged↗
Cord blood lymphocyte in vitro responses to influenza A antigens after an epidemic of influenza A/Port Chalmers/73 (H3N2).
Samples of cord blood from 46 deliveries were collected between 2 and 8 mo after an epidemic of influenza caused by A/Port Chalmers/73 (H3H2) virus. Of 10 samples with HAI antibody titers against A/Port Chalmers of 1:16 or greater, one had 2-mercaptoethanol-sensitive IgM class antibodies against the virus. Lymphocyte proliferative responses with the use of A/Port Chalmers antigens were increased in six of 46 samples. These results provide immunologic evidence that certain neonates have IgM antibodies and lymphocytes sensitized for influenza A virus. Our results suggest, but do not prove definitively, that influenza A/Port Chalmers virus infected the fetus prior to delivery.
Antibodies, Viral↗
Parameters of humoral and cellular immunity of influenza A/USSR/90/77 (H1N1) virus in various age groups.
After a local epidemic of A/USSR influenza, immunologic parameters related to influenza A/USSR/90/77 (H1N1) virus were studied in four age groups: elderly persons (greater than or equal to 64 years), healthy adults (20-44 years), children (six to 13 years), and neonates (who served as controls). Sera from the first three groups had nearly equivalent titers of hemagglutination-inhibiting antibody (geometric mean titers, 1:8-1:11), which were greater than those in cord blood of neonates. Lymphocyte proliferation responses to influenza A/USSR viral antigens among study groups were similar, with mean stimulation ratios (to whole virus) of 4.2-5.4; neonatal cord blood samples were unresponsive (stimulation ratio, 1.1). In contrast, the magnitude of antibody-dependent cellular cytotoxicity against baby hamster kidney target cells infected with influenza A/USSR virus was significantly greater with lymphocytes from adults and elderly persons (P less than 0.05) than with those from children.
Adolescent↗
Respiratory failure secondary to Mycoplasma pneumoniae infection.
Three previously healthy patients presented with bilateral pulmonary infiltrates, hypoxemia, and respiratory failure associated with Mycoplasma pneumoniae infection. None had underlying pulmonary or immune deficiency diseases. One died with dense fibrotic reorganization of the lungs, and another survived after prolonged mechanical ventilatory assistance. Two developed pulmonary superinfections with Pseudomonas aeruginosa. All had extrapulmonary complications: one had Coombs'-positive hemolytic anemia, another myocarditis, and all three had abnormal results of liver function tests, consistent with hepatocellular dysfunction.
Adult↗
Human lymphocyte cytotoxicity against target cells infected with influenza A viruses of both recent and old strains.
In vitro measurement of lymphocyte cytotoxicity (LC) reflects one aspect of human cell-mediated immunity against influenza. We studied peripheral blood LC against target cells infected with 1 of 3 strains of influenza A virus; these represent both recent and old strains. Positive LC responses were obtained in 94 % of subjects. Responses were significantly greater against the older strains, A/New Jersey/76 (Hsw1N1) and A/PR/8/34 (H0N1), than against A/England/42/72 (H3N2). LC reactivity occurred even in the absence of detectable HAI antibody titers. These results showed that positive LC responses to a variety of influenza A strains are common in normal adults and suggested that LC may be a more sensitive indicator of previous influenza exposure than conventionally measured HAI antibodies.
Adult↗
Antitoxin responses in the elderly to tetanus-diphtheria (TD) immunization.
A high per centage of reported cases of tetanus and diphtheria in the United States occurs in persons over 60 years old. The sera of 69 elderly persons, mean age 80 years, were tested for prevalence of tetanus and diphtheria antibodies, and only 51% and 59%, respectively, had protective levels (greater than or equal to .01 AU/ml). In a prospective study 27 elderly volunteers were given 0.5 ml tetanus-diphtheria (Td) toxoid twice, seven months apart. Before toxoid 26% and 59% of persons had protective antitoxin levels against tetanus and diphtheria. After one dose the per cent protected rose to 42 and 88. After the second dose all persons immunized had protective levels. No subjects had significant side effects after either dose. These data demonstrate that many elderly persons lack protection against tetanus and diphtheria and document that two doses of Td toxoid would confer immunity to virtually all such persons.
Aged↗
Analysis of a community hospital employee tuberculosis screening program 31 months after its inception.
The employee tuberculosis screening program for this 450-bed, medical-surgical hospital was evaluated as of November 30, 1975. On that date, there were 1,488 employees, excluding physicians and medical and nursing students. Of the 626 employees tested at least twice with purified protein derivative, 28 converted their test from negative (zero induration) to positive (greater than or equal to 10 mm of induration), and 20 converted their tests from weakly reactive (3 to 9 mm of induration) to positive (greater than or equal to 10 mm of induration and showing a 6-mm or greater increase in induration over that resulting from the first test). The rate of conversion (tests with purified protein derivative going from negative to positive) was no different between the groups with high and with low degrees of exposure to tuberculous patients, suggesting the possibility of nonhospital-acquired infection in the latter group. A direct relationship existed between increasing age and increasing rate of conversion, suggesting that some of the convertors were not newly infected, but were persons with boosted reactivity. These data illustrate some of the practical problems of monitoring for tuberculous infections and subsequently offering preventive therapy to convertors.
Adult↗
Intradermal administration of bivalent and monovalent influenza vaccines.
Intradermal (ID) administration of 0.1 ml of a bivalent influenza vaccine containing 40 CCA units each of influenza A/New Jersey (Hswine 1N1) and A/Victoria (H3N2) virus antigens and of a monovalent vaccine containing 100 CCA units of influenza B/Hong Kong virus to 70 adult volunteers produced no serious reactions and only 7% bothersome side effects. Excluding persons with high (1:64 or greater) initial antibody titers, then 90% and 85% of persons had fourfold or greater rises in HAI antibodies to A/New Jersey and B/Hong Kong antigens, whereas 53% had rises to A/Victoria. The authors feel the ID route deserves further consideration for giving killed influenza vaccines to adults. However, an influenza virus type that was prevalent for many years may fail to give sufficient rise in HAI to consider the patient protected.
Adult↗
Absence of imune deficiencies in a case of progressive multifocal leukoencephalopathy.
Progressive multifocal leukoencephalopathy (PML) is a rare disease related to a slow virus infection of the central nervous system; it is usually seen in patients who have impaired immunologic function. The present patient with biopsy-proved PML was found to have no demonstrable defects in either cellular or humoral immunity as assessed by multiple parameters. Thus, it appears that PML may occur in the presence of intact immune responses.
Biopsy↗
Epidemiologic studies of Reye's syndrome: cases seen in Pittsburgh, October 1973-April 1975.
Twenty-seven cases of Reye's syndrome (RS) were admitted over a 19-month period to one urban hospital. All lived in a suburban or rural location and 23 cases occurred during two influenza outbreaks. Two to three months following the last cases of RS, 24 families of RS cases and 21 control families representing neighbors or friends were interviewed for factors which could predispose to RS. Children with RS had an illness immediately preceding the onset of RS more frequently than did controls (p less than .001). No other clinical, familial, or environmental factors distinguished RS children and families from controls. Water samples, collected during the interviews, from 34 homes showed no potential toxins. The geographic pattern of RS cases with localization exclusively to rural areas suggests that an as yet unidentified environmental factor may be related to the development of RS.
Adult↗
Reye syndrome with associated influenza A and B infection.
In early 1974, seventeen children were treated for Reye syndrome. Thirteen of these were studied for laboratory evidence of concomitant viral infection. Influenza B/Hong Kong was isolated from the pharynx in four of nine 1974 cases tested. One child had just recovered from varicella. Adenovirus type 2 and respiratory syncytial virus were isolated from two additional patients. Serologic tests for influenza suggested concomitant or recent influenza B infection in ten of 13 of 1971 cases. During February 1975, six children were treated for this syndrome. Influenza A/Port Chalmers was recovered from three in six 1975 cases, and all six showed significant antibody rises to influenza A. These studies suggest that influenza viruses provide a trigger mechanism for the development of Reye syndrome in susceptible children.
Adenoviridae↗
Humoral and secretory antibody responses to immunization with low and high dosage split influenza virus vaccine.
Tri (n-butyl) phosphate (TNBP)-split vaccine containing 6400 CCA units of influenza virus A/Aichi/68 (H3N2) was given intramuscularly to a group of volunteers. The changes in serum haemagglutination-inhibiting (HI) and nasal wash neutralizing antibody were measured, and the results compared with that of volunteers given a TNBP-split vaccine containing 400 CCA of the same virus. More volunteers given the high-dose vaccine developed a fourfold rise in serum HI antibody, and there was a greater increase in geometric mean titre in this group. In addition, more volunteers given the high-dose vaccine developed detectable nasal wash neutralizing and anti-neuraminidase antibodies. Following low-dose vaccine, the production of nasal wash antibody was not related to the serum antibody response. For both groups given vaccine, antibody was detected most frequently in nasal washings with relatively high levels of protein and IgA; the concentration of IgA was also directly related to the protein concentration.
Adult↗
Evaluation of two kinds of smallpox vaccine: CVI-78 and calf lymph vaccine. I. Clinical and serologic response to primary vaccination.
A comparative study of two smallpox vaccines, standard calf lymph vaccine, and an attenuated vaccine, CVI-78, was performed in 95 children. Primary vaccination with CVI-78 resulted in a more attenuated response than primary vaccination with standard vaccine. Sixty-one percent of those vaccinated with CVI-78 and 96 percent of those vaccinated with standard vaccine developed a major dermal reaction; 16 percent of those vaccinated with CVI-78 and 89 percent of those vaccinated with standard vaccine developed post-vaccination neutralizing antibodies. Twenty-seven percent of the children vaccinated with CVI-78 demonstrated neither a dermal nor serologic postvaccination response, whereas only 2 percent of those vaccinated with standard vaccination demonstrated no postvaccination response.
Allantois↗
In utero sensitization with influenza virus in man.
Following a community-wide epidemic of influenza A/England virus infection, 64 cord blood samples were evaluated for their fetal serum and lymphocyte responses to this virus. Cord sera were tested for HI antibody vs. A/England with and without 2-ME. A fourfold or greater reduction in titer was observed in four, indicating fetal IgM antibody responses. In addition, lymphocyte samples from three of 16 tested showed proliferative responses to influenza A suggesting fetal lymphocyte sensitization with influenza virus. These data suggest that, in some pregnancies, influenza virus is capable of transplacental sensitization of the fetus.
Female↗