An influenza A epidemic caused by H1N1 virus.
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Biomedical subjects
Publications and source records attributed to G Meiklejohn.
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During the winter of 1977-1978 three influenza A virus serotypes (A/Vic/3/75, A/Texas/1/77 [both H3N2], and A/USSR/90/77 [H1N1]) circulated in Denver, offering us the opportunity to apply fluorescent antibody techniques to the specific identification of these viruses. Surface antigens of infected, unfixed primary monkey kidney cells were stained in suspension by an indirect immunofluorescence technique with anti-H3N2 and anti-H1N1 antisera. In tests of cells infected with known viruses, the members of the H3N2 family could not be distinguished from one another, but were easily distinguished from H1N1 strains. A total of 101 hemadsorption-positive clinical specimens were evaluated over a 6-month period. Forty-five of 48 influenza A H3N2 and 24 of 29 H1N1 specimens confirmed by hemagglutination inhibition were correctly identified by membrane fluorescence of cultured cells, with no misidentifications among influenza strains and with 1 false positive among 24 non-influenza isolates. The average time to identification by this technique was 4 days compared to 7 days by hemagglutination inhibition. Live cell membrane fluorescence is a simple, rapid, and accurate method for identifying and grouping influenza A viruses.
A unique opportunity occurred in February 1977 to assess the efficacy of an influenza virus vaccine given to military personnel in doses of 400 chick cell-agglutinating (CCA) units of A/Victoria/3/75, 400 CCA units of A/New Jersey/76, and 500 CCA units of B/Hong Kong/72 viruses. After cessation of all influenza virus vaccine administration in mid-December 1976, approximately 200 unvaccinated U.S. Air Force personnel arrived per week beginning February 1, 1977, at Lowry Air Force Base, Denver, Colorado. Arriving unvaccinated personnel were assigned to one of 12 units with previously vaccinated personnel. A sharp outbreak of influenza A occurred on the base during February that was due to an A/Texas/1/77-like virus, a variant of the A/Victoria/3/75 prototpye. Fifty-four cases of influenza A were documented in the student population on the base. During the two-week peak of the outbreak, attack rates were 10-fold higher in unvaccinated than in vaccinated students, and the overall estimate of vaccine efficacy was 80%. Thus, despite animal tests suggesting considerable antigenic drift, a vaccine containing influenza A/Victoria/3/75 virus provided good protection against the variant strain.
In military personnel aged 17-25 years, only one of four experimental influenza A/New Jersey/76 virus vaccines produced a satisfactory hemagglutination-inhibiting (HAI) antibody response when a dose of 200 chick cell-agglutinating (CCA) units was used. A second injection of 400 CCA units of vaccine caused seroconversion in all persons. Although an early comparison of experimental split-product and whole-virus vaccines suggested that the former were relatively ineffective, a later comparison with different lots of the vaccines showed no difference between vaccines of these two types. The influenza A/NJ/76 virus vaccine evoked a high HAI antibody response to influenza A/PR/8/34 (H0N1) virus but not to H1N1 or H3N2 strains.
Advantages and disadvantages of academic tenure for clinical faculties, including an appraisal of its financial burdens, the utility of modified or alternative systems, and the issue of abolition of tenure, were examined through a questionnaire to which deans and faculty representatives of 106 American medical schools responded during 1975-76. Tenure is valued by most deans and faculty members. A flexible tenure policy permitting appointment of some faculty members to senior academic posts without tenure was endorsed by the deans of 10 selected medical schools who were interviewed. Growth of medical faculties is decelerating; a steady state has not been attained but is imminent. Financial pressures and demands for change will increasingly challenge the tenure system.
Before and after vaccination with a commercial inactivated influenza vaccine containing A/Aichi/2/68 (H3N2) and B/Massachusetts/1/71 antigens, the serum hemagglutination inhibition antibody titers to homologous and heterologous strains of A and B influenza viruses were measured in 45 renal transplant patients and 66 healthy controls (62 for the B strains). At least a fourfold titer rise to the homologous A strain occurred in 14 of 45 transplant patients (31%) versus 37 of 66 controls (56%). Fourfold or greater heterologous A rises occurred in only 8 of 45 transplant patients (18%) compared with 40 of 60 controls (61%). In both the homologous and heterologous B responses, at least fourfold hemagglutination inhibition titer rises were seen in significantly fewer transplant patients than control subjects. In the transplant group, no correlation was observed between degree of antibody response and age, previous influenza vaccination, percentage of patients initially seronegative, time since transplantation, dose of immunosuppressive drugs, level of renal function, or nature of original renal disease.
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Configurations of both the protein and lipid components of human red blood cell ghosts are examined by laser Raman spectroscopy. Protein configuration is estimated from bands observed in the Amide III region at 1240-1267 cm-1 in water and the Amide I' region at 1630-1670 cm-1 observed in 2H2O. The protein fraction appears to contain 40-55 percent alpha-helix with little beta-configuration. The hydrophobic side chains of the phospholipid component, as interpreted from the 1060-1130 cm-1 C-C stretching region, are estimated to contain 55-65 percent all-trans rigid configuration. These estimated are within the limits set by other physical techniques.
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The results of routine determination of the blood group of smallpox patients admitted to a Madras hospital over a six-month period suggest that the distribution of blood groups among such patients and the severity of illness among patients of various blood groups do not support the hypothesis that susceptibility or resistance to this disease is associated in any direct way with the possession of A or B blood group substances or antibodies to them. The results reported and other considerations discussed make it improbable that the distribution of blood groups among the population of South India has been influenced by the endemic prevalence of smallpox in that part of the world.