Management of women at term with pregnancy complicated by rubella.
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Female↗
Biomedical subjects
M Grandien
Publications and source records attributed to M Grandien.
Management of pregnant women with diarrhoea at term and of healthy carriers of infectious agents in stools at delivery.
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Campylobacter Infections↗
Comparison of three techniques for detection of respiratory viruses in nasopharyngeal aspirates from children with lower acute respiratory infections.
A comparison of immunofluorescence (IF), enzyme-linked immunosorbent assay (ELISA), and isolation in tissue culture (TC) for detection of respiratory viruses was performed on 496 nasopharyngeal aspirates from children under 5 years of age with lower acute respiratory infections who were receiving attention at three hospitals in Buenos Aires, Argentina. All samples were tested by the three methods for respiratory syncytial virus (RSV), influenza A and B, adenovirus, and parainfluenza 1 and 3. Viral diagnosis was made in 167 samples (33.7%); of these, 124 (74.3%) were isolated in TC, whereas 120 (71.8%) were detected by ELISA and 127 (76%) by IF. RSV was detected in 121 samples, mainly by ELISA and IF. The sensitivity and specificity of each rapid technique as compared with isolation in TC were similar, reaching 98% and 92%, respectively. When ELISA was compared with IF, the sensitivity was 95%, and the specificity was 98%. Adenovirus was detected in 18 patients by TC. For this virus, rapid techniques sensitivity as compared with TC was low (almost 22%). Parainfluenza 3 was readily detected by IF and TC; influenza A, B and parainfluenza 1 were detected in few samples; and tissue culture proved more efficient than rapid techniques. The results indicate that both rapid techniques are good tools for the detection of most respiratory viruses except for adenovirus, for which TC cannot be omitted.
Adenoviridae Infections↗
Rotavirus serology and breast-feeding in young children in rural Guinea-Bissau.
One hundred and forty-four children aged 9-20 months living in 14 villages in a rural area of Guinea-Bissau were examined for circulating rotavirus antibodies twice in a 15-month period. An immunofluorescence technique was used. About 3/4 of the children seroconverted, independent of age on entering the study. The age-specific proportion of seropositivity increased from 4/40 (10%) at 9-11 months to 26/29 (90%) at 33-35 months of age. All the initially seropositive children retained detectable antibodies to rotavirus. The relative risk of seroconversion was 1.4 times (95% confidence interval 1.0-2.0) more common among children living in villages by the mainroad as compared to those living off the road. Contact rate is probably dependent on population density and mobility but not on age. Breast-feeding, decreasing sharply through the age interval covered by the follow-up (9-35 months), had no apparent influence on seroconversion at the ages concerned.
Antibodies, Viral↗
Diagnosis of influenza A virus infections by detection of specific immunoglobulins M, A, and G in serum.
The value of immunoglobulin M (IgM) detection in the early diagnosis of influenza A was examined in a prospective study during an outbreak of influenza A/Philippines/2/82 (H3N2) virus infection in February and March 1986. The IgM response was investigated in sera from 64 adults with influenzalike symptoms; we found a fourfold rise in titer or high titers (greater than or equal to 80) of influenza A virus antibodies by the complement fixation test. The IgM response, analyzed by the hemadsorption immunosorbent technique, was compared with the IgG and IgA responses analyzed by an indirect enzyme-linked immunosorbent assay and the hemadsorption immunosorbent technique, respectively. Antigen detection in nasopharyngeal secretions by immunofluorescence was performed for all patients on admission to hospital. Specific IgM was detected in 86% (55 of 64) of the patients with influenza A. In sera from 36% (18 of 64) of the patients it was detected already on admission. Influenza A virus antigen was detected in nasopharyngeal cells by immunofluorescence on admission in 53% (34 of 64) of the patients. A combination of immunofluorescence and IgM results gave a significantly higher diagnostic rate, 69% (P less than 0.01), on admission than did each of the two tests separately. An IgA serum antibody response was seen in 76% (48 of 64) of the cases but did not contribute to any increase in the diagnostic rate. IgM detection by the hemadsorption immunosorbent technique was found to be a valuable supplement for the diagnosis of influenza A in an early phase of the disease.
Aged↗
Antigenic characterization of respiratory syncytial virus associated with acute respiratory infections in Uruguayan children from 1985 to 1987.
The occurrence of subgroup A and B strains of respiratory syncytial virus (RSV) was studied during three epidemic years, 1985 to 1987, in Uruguay. A set of monoclonal antibodies was selected according to their reactivity with local RSV isolates and used for the typing of RSV directly in nasopharyngeal cells by indirect immunofluorescence. Of 77 specimens, 69 could be typed as belonging to subgroup A or B, 5 could not be typed with the restricted set of monoclonal antibodies employed, and 3 reacted with both subgroup-specific antibodies. In 1985 and 1986 subgroup A predominated, accounting for 65.7% of all typed specimens, but in 1987 subgroup B surpassed subgroup A, accounting for 82.4% of the samples.
Antibodies, Monoclonal↗
Use of nasal and pharyngeal swabs for rapid detection of respiratory syncytial virus and adenovirus antigens by enzyme-linked immunosorbent assay.
Nasal and pharyngeal swabs from 134 children with acute respiratory diseases were examined for the presence of respiratory syncytial (RS) virus and adenovirus antigens by enzyme-linked immunosorbent assay (ELISA). The results were compared with those obtained by virus isolation and serology. Altogether, 56 RS virus-positive (prospective study), 51 adenovirus-positive (retrospective study), and 27 negative (prospective study) samples were examined. The sensitivities of ELISA were 96 and 98% for RS virus and adenovirus antigen detection, respectively. No false-positive results were observed. It is concluded that the joint eluate from a nasal and a pharyngeal swab, properly taken and handled, serves well for the detection of RS virus and adenovirus acute respiratory infections by ELISA.
Adenovirus Infections, Human↗
[Insufficient protection against new influenza strains. An early start of the influenza season means widespread epidemics].
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Antibodies, Viral↗
Detection of an immunoglobulin M response in the elderly for early diagnosis of respiratory syncytial virus infection.
The indirect fluorescent-antibody technique was compared with indirect and mu-capture enzyme-linked immunosorbent assays for the detection of respiratory syncytial virus (RSV) immunoglobulin M (IgM) in the elderly. Sera from 47 patients (mean age, 70 years) with acute lower respiratory tract infections caused by RSV were investigated. Specific IgM was detected in 81% (38 of 47) of the patients. The fluorescent-antibody technique, which gave 70% positive results, proved to be the most sensitive of the three methods. An IgM response was seldom seen in sera from the elderly within the first week of disease, but was present in 85% of sera (33 of 39) collected between days 11 and 30 of disease. In some patients it persisted for more than 6 weeks. Detection of IgM was found to be a useful tool for the diagnosis of RSV infections in elderly patients.
Aged↗
Detection of human rotaviruses which do not react with subgroup I- and II-specific monoclonal antibodies.
Of 126 rotavirus-positive specimens, 7 could not be subgrouped (I or II). These strains showed a distinct reaction with a monoclonal antibody recognizing a common region on VP6, but they did not react with VP6 subgroup-specific monoclonal antibodies although they contained as much viral antigen as the subgrouped strains.
Antibodies, Monoclonal↗
Management of pregnant women with contagious infections at delivery.
Since 1970 pregnant women with contagious infections in the country of Stockholm have been delivered at the Danderyd Hospital, the only hospital in the area which has departments of obstetrics and pediatrics as well as infectious diseases. This paper presents data from a prospective study carried out during a period of 10 years (1975-1984). The study includes 303 women and their newborns who for various reasons were transferred to the Department of Infectious Diseases (DID) before or after delivery. A comprehensive microbiological investigation was made in order to establish an etiological diagnosis in all women included in the study. A possible transmission of the infection from the mother to her fetus/child before or after delivery was also investigated. Only 0.17% of the pregnant women in the area needed care at the DID at delivery or in the puerperal period. 9% of the deliveries occurred at another hospital, 32% at the DID and the remaining at the obstetrical department, Danderyd Hospital. The rate of complications, including cesarean sections, was 12%. Of the 165 women suffering from an infectious disease at the time of delivery, 40% had a verified viral disease--in most cases varicella or mumps, 28% had a bacterial infection and for 32% no etiology of the disease could be established. The study population also includes women suspected either to be incubated with a contagious disease or to be carriers of infectious agents, as well as healthy mothers whose newborns were expected to be carriers of infectious agents such as rubella and varicella. None of the women died during the study period but 5 were seriously ill and 3 needed intensive care. The rate of stillbirths was the same as reported among all births in the country of Stockholm but the perinatal mortality rate was significantly higher (see also a following article, ref. 27). Our routines prove the necessity to take special care of pregnant women carrying a contagious infectious agent at term.
Communicable Disease Control↗
A longterm follow-up study of children born to women with contagious diseases at delivery.
Data are presented from a long-term follow-up study of 308 live born children to women admitted post partum to the Department of Infectious Diseases (DID), Danderyd Hospital, Sweden, during a 10-year period (1975-1984) for avoiding nosocomial transmission of infections in the obstetrical wards. The rate of stillbirths (1/309 deliveries) was not higher than reported for all births in Stockholm. 20% of the live born children were transferred within 24 h after birth to the pediatric department for observation, but half of them could return to their mothers at the DID within 6 days (generally 3 days). Four newborns were treated at an intensive care unit. Only 3 fatalities occurred, all of them among newborns to mothers with an overt infection at delivery. The fatality rate (1.8%) was significantly higher among the newborns of these mothers than normally (0.3%) noted among all children born in Stockholm county during the period studied. Two of the 3 newborns, who all died within 3 days of life, had a low birth weight (600 and 1,000 g). The total number of newborns with low birth weights (less than 2,500 g) was, however, not higher in the above-mentioned group of newborns than for all children born in Stockholm county 1980. None of the 3 fatalities was caused by infection transmitted from the mother. No further deaths occurred. Infections in pregnancy at term, at birth or post partum were transmitted from the women to 41 (13%) of their newborns.(ABSTRACT TRUNCATED AT 250 WORDS)
Bacterial Infections↗
Detection of specific IgM antibodies for the diagnosis of Mycoplasma pneumoniae infections: a clinical evaluation.
The diagnostic value of detection of specific IgM antibodies was analysed in Mycoplasma pneumoniae infections. In a retrospective clinical and serological study, M. pneumoniae IgM antibodies were determined by a mu-capture ELISA using enzyme-labelled antigen. The study group consisted of 91 patients with significantly raised titers in paired sera or a single high titer of complement fixation antibodies. About 40% of the patients had been treated with antibiotics ineffective against M. pneumoniae infections prior to admission to hospital. Treatment with erythromycin or tetracycline was shown to give a shorter period of fever compared to if no or ineffective therapy was given. Specific IgM antibodies were detected in about 80% of sera sampled 9 days or more after onset of symptoms. In sera sampled at 7-8 days after onset IgM antibodies were found in about 40% of the sera but only occasionally in sera sampled earlier. In the age group 0-20 years 88% of the patients developed an IgM response. In the higher ages (greater than 60 years) a significantly lower rate of IgM responders was observed.
Adolescent↗
Latex agglutination test for adenovirus diagnosis in diarrheal disease.
A commercial latex agglutination test for diagnosis of adenovirus in diarrheal disease (Adenolex, Orion Diagnostica, Finland) was evaluated by comparison with the results obtained by ELISA, electron microscopy (EM), and virus isolation. Fifty specimens originated from the diagnostic routine, and 50 were selected from a previous epidemiological study on the etiology of diarrheal disease in children. Thirteen of the 100 specimens reacted with the latex control, impairing interpretation of the results. Although the ELISA detected adenovirus antigen in 10(2) higher dilutions than the latex agglutination test, a total agreement was obtained between results by the two tests for 87 specimens including 42 positives. The two additional positives found by EM and virus isolation could not be diagnosed by the latex agglutination test. Of 37 specimens containing enteric adenoviruses (types 40 and 41), the agglutination test diagnosed all but 4 specimens containing type 41 virus. These four specimens were negative also by ELISA and adenovirus had been detected by virus isolation on the 293 cell line. The latex agglutination test gave positive results with nine specimens containing adenovirus types other than the enteric types 40 and 41. The latex agglutination test was found to be a rapid and simple method for the detection of adenovirus in diarrheal disease. Compared to ELISA and EM, the sensitivity was 100% and 95% respectively, and the specificity 100%.
Adenoviridae Infections↗
Serum antibody responses to individual viral polypeptides in human rotavirus infections.
A radioimmunoprecipitation assay (RIPA) was used to study the serum antibody responses to individual polypeptides that developed after infection with viruses from human rotavirus subgroups I and II. Paired sera from eight children (1 to 8.5 years of age) were used in the study. Although all of the eight acute sera were negative by the complement fixation test, four of them were positive by RIPA, indicating a previous infection by rotavirus. A significant difference in the number of polypeptides immunoprecipitated was seen among the convalescent sera. The number of polypeptides immunoprecipitated was found to be related to previous infection experience. At most, ten different polypeptides were immunoprecipitated: seven structural polypeptides VP1 to VP7 and three non-structural polypeptides, NS1, NS2 and NS3. No sera immunoprecipitated VP8 or VP9. Acute sera positive by RIPA immunoprecipitated up to five polypeptides, VP1, VP2, VP3, VP4 and VP6. One of the non-structural proteins (NS2) was found to be particularly immunogenic, since antibodies to this polypeptide were detected in several convalescent sera. Among the structural proteins VP2 and VP6 were found to be the two immunodominant polypeptides which were recognized by all convalescent sera. Only three convalescent sera immunoprecipitated VP7, the major type-specific antigen responsible for inducing neutralizing antibodies. Three of four originally seronegative children with no reactivity in the convalescent sera to VP7 developed neutralizing antibodies to a single serotype. One child developed antibodies to two serotypes.
Antibodies, Viral↗
Respiratory syncytial virus infections in adults.
In a retrospective 10-year study of 57 adult patients admitted to Orebro Medical Center Hospital, Sweden, with RS virus infections, pneumonia was diagnosed in 36. A primary episode of obstructive airway symptoms was observed in 20% of the patients with pneumonia. Several patients had a long period of fever and a protracted stay in the hospital. No fatal cases or serious complications were registered. Compromised hosts did not appear to be overrepresented in the material, nor did patients with impaired immune responses seem to be more seriously ill. Laboratory findings indicated that the RS virus pneumonia in adults was in some cases due to a mixed bacterial and RS virus infection, but in a few cases it was caused by the RS virus alone. Positive epidemiologic findings were found only in a few cases. The length of the period between the seasonal peak incidences of RS virus infection varied. A tendency to recurrent long and short intervals between the peak incidences was observed. An IgM antibody response to RS virus was common, and IgM detection was found to be a useful complement in the diagnosis of RS virus disease.
Adult↗
Amantadine for prophylaxis against influenza A.
Amantadine, 200 mg daily, for 5 days was used in an attempt to restrict the spread of influenza A in a hospital ward. After index cases of influenza A amantadine was given to 2 patients with clinical symptoms and to 8/10 patients who were not yet ill. No further case of clinical influenza was seen among the patients, but 3 of those receiving amantadine developed subclinical infection. No side effects of amantadine were noted. Amantadine was not given to any of the 23 hospital staff on duty. In this group 8 cases of influenza A appeared, 3 of them during the week after the introduction of amantadine to patients.
Amantadine↗