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Biomedical subjects

K L Herrmann

Publications and source records attributed to K L Herrmann.

At least 37 records · Page 2Linked to original sources
PubMed1980

Gastroenteritis due to rotavirus in an isolated Pacific island group: an epidemic of 3,439 cases.

In the spring of 1964, 3,439 cases of acute gastroenteritis were reported from Truk District, an island group in the mid-Pacific. The causative agent was not identified in laboratory studies performed in that year. Retrospective serologic studies 15 years later with the complement fixation test and the enzyme-linked immunosorbent assay provided serologic evidence that this outbreak was caused by the human rotavirus that was first isolated in 1973.

Adolescent↗
PubMed1980

Testalgia associated with rubella infection.

Investigation of an outbreak of rubella on a college campus provided an opportunity to study the occurrence of orchitis, or testalgia, in male adolescents and young adults. Of 68 subjects with rubellla infection, five reported pain without swelling in one or both testicles lasting up to three days. Two of them had laboratory-confirmed rubella infection. Since the majority of all currently reported cases of rubella in the United States occur in persons 15 years of age and older, an increased awareness of rubella as a possible cause of testicular pain, and perhaps of orchitis, in postpubertal boys and men result in further characterization of this symptom.

Adult↗
PubMed1980

Infectious disease patterns in the Waorani, an isolated Amerindian population.

The Waorani Indians of eastern Ecuador provide a unique opportunity for studying exposure of an isolated human population to various infectious disease agents. Using serologic tests to determine antibody prevalence, skin test data, and stool examination for parasites, we have been able to construct a profile of infectious diseases which are endemic, and others which have been introduced into the Waorani population. These findings are compared with similar data reported from elsewhere in the Amazon. Serologic studies demonstrating the presence of antibody to measles and poliovirus type 3 after vaccination indicate that the Waorani respond normally to viral challenge with these agents. The question of genetic inability among aboriginal Amerindians to respond to viral agents is discussed. Finally, general recommendations are made regarding the future health care of the Waorani.

Adolescent↗
PubMed1978

False-positive rubella hemagglutination-inhibition (HAI) titers in neonates and children with conjugated hyperbilirubinemia.

Two neonates, one with extrahepatic biliary atresia and one with cystic fibrosis, and a 9-year-old child with atresia of the common bile duct had conjugated hyperbilirubinemia and elevated rubella HAI titers when kaolin pretreatment of serum was used. A beta-lipoprotein fraction of the serum that is frequently found in association with biliary obstruction was shown to be the probable source of the rubella HAI inhibitor. This beta-lipoprotein was not removed by standard kaolin treatment of serum, but was removed almost completely by dextran sulfate--calcium chloride treatment. In the presence of conjugated hyperbilirubinemia, routine kaolin pretreatment of serum is an inadequate measure for the removal of interfering substances, as false-positive rubella HAI results are obtained consistently.

Antibodies, Viral↗
PubMed1978

Diagnosis and etiology of nongonococcal urethritis.

The observation of more than four polymorphonuclear cells (PMN) per high-power field (hpf) in gram-stained smears of urethral secretions was found to differentiate patients with urethritis from patients without urethritis. A urethral discharge was present in 78% of patients with nongonococcal urethritis (NGU). Dysuria without demonstrable urethral discharge and with fewer than four PMN/hpf did not appear to fit into the NGU spectrum. NGU is now defined to include men who have negative urethral cultures for Neisseria gonorrhoeae with a urethral discharge and/or more than four PMN/hpf in their urethral smears. The findings of more than four PMN/hpf in the urethral smears of 22%of asymptomatic sexually active men with more than one sexual partner (polygamous controls) suggests that asymptomatic NGU is not uncommon. Chlamydia trachomatis was isolated significantly more frequently from the NGU study group than from the control group (P less than 0.001). This study adds Corynebacterium vaginale (Haemophilus vaginalis), group B streptococci, and yeasts to the list of sexually transmitted microorganisms that are not etiologic determinants of NGU.

Chlamydia trachomatis↗
PubMed1977

Epidemic measles in a highly vaccinated population.

During November, 1975, to May, 1976, measles occurred at a rate of 20.3 cases per 1000 in a purported immunized population, of whom historical and serologic survey revealed that 9 per cent had no history of either measles illness or vaccination and 18 per cent did not have detectable measles antibody. Antibody was detectable in 92 per cent of those vaccinated at greater than or equal to 13 months, 80 per cent at 12 months and 67 per cent of those vaccinated when less than one year old (P less than 0.001), but no significant differences existed with increasing years since vaccination (P greater than 0.1). A second vaccination increased detectable antibody prevalence only in those originally vaccinated when less than nine months old (42 to 80 per cent, P less than 0.02). During a measles outbreak, more cases occurred in those receiving vaccine when less than 12 months old than in those vaccinated at greater than or equal to 12 months (37 per cent vs. 9 per cent, P less than 0.001). A second vaccination protected those originally vaccinated at less than 12 months (35 per cent ill without a second vaccination vs. 2 per cent with, P less than 0.001). Thus, a single measles vaccination of children less than 12 months old does not protect; a second vaccination will protect this group.

Age Factors↗
PubMed1976

Rubella immunization. Persistence of antibody four years after a large-scale field trial.

A long-term comparative field trial of three live, attenuated rubella vaccines (HPV-77 DE-5, HPV-77 DK-12, and Cendehill) was initiated in 1969 on the islands of Kauai and Hawaii in the state of Hawaii. Rubella hemagglutination-inhibition (HI) tests on prevaccination serum specimens from 7,931 children in the two study areas indicated an overall susceptibility to rubella of nearly 70%. The rates of seroconversion of 5,153 seronegative subjects to HPV-77 DE-5, HPV-77 DK-12, and Cendehill vaccine were 97.5%, 99.9%, and 99.8%, respectively. Over the subsequent four-year follow-up period, during which time natural exposure to rubella was minimal, the percent decline of geometric mean titers did not vary substantially among the three vaccine groups and measured about twofold for all three. A total of only 28 vaccines (0.7%) who seroconverted to one of the vaccines in 1969 lost all measurable antibody by 1974. Measurable antibody persisted in more than 98% of all vaccinees over the four-year period. Reinfection, thought possibly to be an important factor in maintaining titers, did not occur frequently in the study population and could not be related to outbreaks of disease.

Age Factors↗
PubMed1976

Immunogenetic analysis and serum viral antibody titers in multiple sclerosis.

In order to investigate the possible relationships between multiple sclerosis (MS) and the factors of genetic predisposition and exposure to infectious agents, studies were undertaken in 59 male patients with MS to determine the histocompatibility antigen (HL-A) type and the serum antibody titer to rubeola hemagglutinin (HA), rubeola envelope antigen (V), rubeola nucleocapsid antigen (S), rubella, herpes simplex, cytomegalovirus, and parainfluenza 1. The incidence of HL-A7 was significantly higher, and HL-A12 incidence was significantly lower, in the MS group than in control groups. The geometric mean titers to rubeola HA and to the V and S antigens were lower in the HL-A7 positive control patients than in either the non-HL-A7 controls or the MS patients. There were no specific relationships of the rubeola titer to HL-A12. Antibody titers to the other viruses studied were not significantly different in MS patients as compared to controls, nor was there any relationship of HL-A7 or HL-A12 and serum titer to those viruses. This study provides further evidence of a genetic predisposition to MS, and of a relationship between rubeola and this disease. These findings suggests that the failure of MS to appear in individuals who might be genetically predisposed to this disorder may be related to their immune response to rubeola.

Adult↗
PubMed1976

Serologic response to revaccination with two rubella vaccines.

Three years after receiving rubella vaccine, 1,060 elementary school children living on the island of Maui, Hawaii, were revaccinated with either HPV-77 DE-5 or RA 27/3 rubella vaccine given subcutaneously or intranasally in order to compare the effectiveness of these two vaccines in raising antibody titers. RA 27/3 was the more effective booster vaccine, producing fourfold or greater titer rises in 20.1% of recipients, including 80% of children with hemagglutination-inhibiting antibody titers less than or equal to 1:40 at the time of revaccination, intranasal revaccination was not significantly more effective than subcutaneous revaccination, although it did elicit higher titers in children who responded. Responses differed according to the vaccine that children had received three years earlier. Because antibody titers have persisted in vaccinated children, routine administration of a second dose of rubella vaccine is not currently recommended.

Administration, Intranasal↗
PubMed1976

Evaluation of a mass measles immunization campaign in Yaoundé, Cameroun.

A mass measles immunization campaign carried out in Yaoundé, Cameroun, has been evaluated. Sixty per cent of the children were immune to measles at the time of the campaign. Only 51% of the susceptible children received vaccine. This was caused by a lack of attendance at the vaccination centres and errors in the selection of children given vaccine. The vaccine administered was relatively ineffective: 40% seroconversion. Difficulties which probably contributed to the low seroconversion rate included sub-optimal vaccine titre, inadequate doses of vaccine, and the relatively long time of vaccine utilization under tropical temperatures. Overall, 83% of the vaccine given to the vaccinating team was wasted. Future immunization campaigns can be improved through better screening of the children, improved handling of the vaccine, the use of marker vaccines, and improved health education.

Cameroon↗
PubMed1975

Nosocomial and maternally acquired herpesvirus hominis infections. A report of four fatal cases in neonates.

Four fatal cases of neonatal herpes simplex infection occurred during a two-month period in the perinatal intensive care unit of a hospital. Virus isolation or serologic studies, or both, implicated herpesvirus hominis type 2 in all four cases. Three of the infants developed symptoms in the first week of life and were probably infected in utero or at delivery. The fourth infant did not develop signs of illness until age 6 weeks, an interval much longer than that expected with disease acquired at birth. An epidemiologic investigation indicated that the most likely source of this fourth infant's herpes infection was by indirect contact with one of the other three infected neonates. Nosocomial spread of herpes simplex virus within a hospital nursery, although uncommon, may pose an added risk to the newborn infant if nursery techniques among infants are compromised.

Adolescent↗
PubMed1975

Rubella reinfection during pregnancy. A case of mistaken diagnosis of congenital rubella.

A case of subclinical rubella reinfection during pregnancy with serologic findings in the offspring initially led to an erroneous diagnosis of fetal infection. Laboratory diagnosis of congenital rubella infection, based on finding hemagglutination-inhibition (HI) activity in immunoglobulin M (IgM) fractions of newborn's serum after sucrose gradient fractionation, was questioned when apparent IgM-HI activity was to be probably due to nonspecific inhibitors, which resulted from bacterial action on the beta-lipoprotein in the serum. These findings emphasize some pitfalls encountered in arriving at a diagnosis based soley on serologic data. This case also illustrates the importance of keeping serum samples sterile when performing serologic tests.

Adult↗