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Biomedical subjects

M Stenvik

Publications and source records attributed to M Stenvik.

At least 37 records · Page 2Linked to original sources

Inadequacy of mucosal IgM antibodies in selective IgA deficiency: excretion of attenuated polio viruses is prolonged.

A nationwide vaccination campaign with oral poliovirus vaccine was organized in Finland in 1985 in order to cease an outbreak of poliomyelitis. We followed eight IgA-deficient individuals and nine controls for poliovirus excretion in feces and for antibody responses in serum and saliva. Five weeks after oral poliovirus vaccination all eight IgA-deficient individuals were still excreting polioviruses, in contrast to one of nine controls. The concentration of polioviruses, as estimated by a semi-quantitative immunofluorescent assay, was generally higher and the test was significantly more often positive in the samples from the IgA-deficient individuals. Although serum levels of antibodies to poliovirus type 3 were lower in IgA-deficient individuals before vaccination, both measurements showed that the two groups had similar antibody levels 4 weeks after vaccination. IgA-deficient individuals lacked salivary IgA antibodies to poliovirus types 1 and 3 but had increased levels of IgM antipolio antibodies, which were shown to carry secretory component. We conclude that the mucosal IgM antibodies of IgA-deficient individuals eliminate polioviruses less efficiently than do the IgA antibodies of normal individuals.

Adolescent↗

Simultaneous administration of Haemophilus influenzae type b capsular polysaccharide-diphtheria toxoid conjugate vaccine with routine diphtheria-tetanus-pertussis and inactivated poliovirus vaccinations of childhood.

A Haemophilus influenzae type b capsular polysaccharide-diphtheria toxoid conjugate vaccine (PRP-D) is capable of protecting infants against invasive H. influenzae diseases. Therefore it is very likely that it will be incorporated in routine vaccination schedules during the next few years. In order to test the suitability of simultaneous administration of PRP-D and other vaccines we administered it to 25 infants mixed with diphtheria-tetanus-pertussis vaccine at 3, 4 and 6 months and simultaneously, but in a separate syringe, with inactivated polio vaccine at 12 months. A comparison group of equal size received only diphtheria-tetanus-pertussis and inactivated poliovirus vaccines. The concentration of postvaccination antibodies to diphtheria toxoid was 0.411 IU/ml in the group that received PRP-D vs. 0.352 IU/ml in the comparison group, to tetanus toxoid 3.666 vs. 3.668 IU/ml and the neutralization titer to poliovirus type 1 was 370 vs. 320 units in the comparison group, to type 2 titer values were 230 vs. 270 units and to type 3, respectively, 210 vs. 290 units. Thus the seroresponse to antigens in routine vaccines was not affected by the presence of PRP-D in the vaccination schedule, and PRP-D can safely and effectively be included in the vaccination schedule of infancy.

Bacterial Vaccines↗

Viruses in sewage waters during and after a poliomyelitis outbreak and subsequent nationwide oral poliovirus vaccination campaign in Finland.

During an outbreak of paralytic poliomyelitis in Finland in 1984 and 1985 the widespread circulation of the causative wild-type serotype 3 poliovirus in the population was documented by demonstrating the virus in sewage water specimens in 13 different locations in the greater Helsinki district and in 13 other cities or towns all over the country. After the nationwide campaign with oral poliovirus vaccine in 1985, poliovirus serotypes 2 and 3 were readily isolated from sewage waters for up to 2 months, whereas type 1 poliovirus seemed to disappear from the sewage more rapidly. All of these isolates were temperature sensitive and therefore most likely vaccine related. The efficacy of the vaccination campaign in regard to elimination of the epidemic type 3 strain was evaluated by a follow-up study on viruses in sewage waters continued for 12 months through the subsequent expected season of poliomyelitis. Several types of enteroviruses, including five vaccine-related poliovirus strains, were identified in the 72 virus-positive specimens out of 93 studied. No wild-type polioviruses were found, indicating the success of the campaign.

Disease Outbreaks↗

Virus excretion and strain specific antibody responses after oral poliovaccine in previously immunised children.

A nation-wide campaign with trivalent oral poliovirus vaccine was organized in Finland in February-March 1985 in order to stop the unexpected outbreak of poliomyelitis. Excretion time of the vaccine viruses and antibody responses due to vaccination were studied in a group of healthy 6-year-old children who were classmates to one of the patients during the outbreak and who also had been screened for excretion of the epidemic poliovirus type 3 strain. While faecal excretion of at least one of the three vaccine virus serotypes was documented in all 19 children, only one throat specimen out of 106 studied was positive in the virus isolation test. The mean excretion times for types 1, 2, and 3 were 13, 21, and 21 days, respectively, and five children were still excreting a vaccine virus strain at 5 wk. Faecal excretion of the type 3 vaccine virus was not seen in children who had been excreting the epidemic type 3 strain 4 mo earlier. Excretion of a respective vaccine virus strain was usually well correlated to a booster response in serum neutralising antibodies to types 2 and 3 but not to type 1 poliovirus. A relatively high prevaccination antibody level did not always prevent the take of the corresponding vaccine virus strain. An increase in the level of neutralising serum antibodies towards at least one poliovirus serotype was observed in all but one of the 17 children studied. Antibody responses to the live vaccine strains were similar to those towards the corresponding nonattenuated strains while the absolute antibody titres against the epidemic P3/Finland/23127/84 strain remained relatively low in most sera studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Proportions of immunoglobulin isotypes in paralytic poliomyelitis and after vaccination.

Immunoglobulin isotype composition of poliovirus antibodies was studied by isotype-specific solid-phase radio-immunoassay (RIA) in four patients with paralytic poliomyelitis, five adults receiving live poliovirus vaccine as a booster immunization, and seven children receiving first doses of inactivated poliovirus vaccine. In paralytic poliomyelitis serum and cerebrospinal fluid (CSF) poliovirus antibodies were mainly of IgG1, IgG3, and IgA isotypes. IgM antibodies were found in sera but not in CSF. Either IgG2 and IgG4 antibodies were undetectable or the titers were low. In adults who had received live trivalent poliovirus vaccine, antibodies against poliovirus type 3 were detected in IgG1 (53% of total antibodies), IgG3 (25%), IgM (9%), IgA (8%), IgG2 (3%), and IgG4 (2%) isotypes. In prevaccination and late postvaccination sera the share of IgG3 antibodies was exceptionally high (35%). In children who received inactivated poliovirus vaccine, antibodies developed in IgG1 (53-61% of total antibodies for poliovirus types 1, 2, and 3), IgG3 (12-21%), and IgM (23-33%) isotypes. Antibody levels in IgG2, IgG4, and IgA isotypes were low and observed only in a few cases. Like other viral antibodies IgG1 and IgG3 isotypes were the major IgG subclasses in poliovirus antibodies.

Adult↗

Nucleic acid sequence relationships between enterovirus serotypes.

Forty-eight different enterovirus serotypes were analysed by a nucleic-acid hybridization test using probes derived from the 3' end of coxsackievirus A21 (CA21) and B3 (CB3), poliovirus 3 (P3) and enterovirus 70 (E70). More than 90% of the serotypes could be detected with this collection of reagents. The CB3 probe reacted with all the coxsackie B viruses, with all three poliovirus serotypes, and with almost all of the 30 ECHO virus types tested. In addition some of the coxsackie A viruses and the BrDr 73 strain of enterovirus 71 gave a positive signal with this probe. The P3 probe detected all the poliovirus strains and also some coxsackievirus A isolates but no coxsackie B or ECHO viruses. A similar hybridization pattern as with the P3 probe was obtained when the CA 21 probe was used. The E70 probe appeared to be strain-specific. The results indicate that nucleic-acid hybridization is a useful method for rapid detection and subgrouping of enteroviruses during virus isolation, and that the test could be further developed for typing of the strains.

Animals↗

Localized outbreak of enteroviral meningitis in adults.

During a thorough surveillance of viral infections of the central nervous system an outbreak of aseptic meningitis was discovered in the western part of Finland in late 1985. The 21 diseased young adults were carefully studied by different virological methods. A presumed viral etiology, in all cases of enteroviral origin, was found in 16 of 20 (80%) with adequate specimens. Four different enteroviruses were associated with this episode; in 9 cases the presumed etiological agent was echovirus 5, while coxsackie B5, echo 25 and echo 17 viruses appeared to be responsible for 4, 2 and 1 case, respectively. Sensitivity of different diagnostic methods as regards detection of the echovirus 5 infections was in order: increase of type-specific neutralizing serum antibodies, isolation of virus from faeces, isolation from throat and group diagnosis by demonstrating an increase in complement-fixing antibodies to coxsackie B5 virus antigen.

Adult↗

Antipolio prophylaxis of immunocompromised children during a nationwide oral poliovaccine campaign.

A nationwide vaccination campaign with oral poliovirus vaccine was organized in Finland in 1985 to halt an outbreak of poliomyelitis. Immunocompromised persons and their household contacts were excluded from the oral poliovirus vaccine target group and given instead a dose of inactivated poliovirus vaccine. This gave us an opportunity to determine whether immunocompromised persons are protected from poliomyelitis during an outbreak and oral poliovirus campaign. Fourteen children, ages 3 to 17 years, with leukemia were given a booster dose of a novel high antigen content, trivalent inactivated poliovirus vaccine. All but two responded by an at least 4-fold increase in serum-neutralizing antibodies to at least one poliovirus serotype. These results indicate that children with acute lymphocytic leukemia in remission respond well to a booster dose of inactivated poliovirus vaccine. Antibody concentrations to the uncommon local epidemic strain of type 3 poliovirus remained, however, relatively low in most patients (median, 1:6) suggesting relatively impaired heterologous response to vaccination. Possible spread of live vaccine viruses to the inactivated poliovirus-vaccinated children and their close contacts was evaluated by examining weekly fecal specimens from 20 children and their 19 regular adult contacts for cytopathic viruses. No polioviruses were isolated from 224 specimens examined, indicating that this high risk population was well-protected from unintended exposure to live polioviruses.

Adolescent↗

Outbreak of paralytic poliomyelitis in Finland: widespread circulation of antigenically altered poliovirus type 3 in a vaccinated population.

An outbreak of 9 cases of paralytic poliomyelitis and 1 non-paralytic case occurred in Finland between August, 1984, and January, 1985, after two decades of freedom from the disease attributable to a successful immunisation programme. During the outbreak poliovirus type 3 was isolated from the patients, from about 15% of healthy persons tested, and from sewage water. At least 100 000 persons were estimated to have been infected. With 1.5 million extra doses of inactivated poliovirus vaccine to children under 18 years of age and an oral poliovirus vaccine campaign covering about 95% of the entire population in February-March, 1985, the outbreak was halted in February, 1985. Impaired herd immunity to the epidemic strain of poliovirus type 3, which differed from the type 3 vaccine strains in both immunological and molecular properties, was important in the emergence of this outbreak. The inactivated poliovaccine that had been used in the vaccination programme was relatively weakly immunogenic, especially as regards the type 3 component. Whether continuous antigenic variation of poliovirus type 3 has wider epidemiological implications is not known.

Adolescent↗

Antigenic and molecular properties of type 3 poliovirus responsible for an outbreak of poliomyelitis in a vaccinated population.

Virus isolated from an outbreak of poliomyelitis in Finland has been examined serologically and at the molecular level. The causative agent was an antigenically unusual strain of type 3 poliovirus, which was unrelated to the strains used to manufacture either live or killed poliovaccines. It is likely that the antigenic properties of the virus played a part in establishing a limited outbreak of poliomyelitis in a vaccinated population.

Amino Acid Sequence↗

Outbreak of poliomyelitis in Finland in 1984. Description of nine cases with persisting paralysis.

Finland has been free of poliomyelitis since 1964 following a high coverage regular immunization programme using the Salk-type trivalent inactivated poliovirus vaccine. In late 1984 an outbreak of poliomyelitis with widespread circulation of poliovirus type 3 throughout the country was found. A thorough surveillance revealed 9 sporadic cases with acute persisting paralysis, all shown to be caused by poliovirus type 3. The preceding 20-year period free from poliomyelitis contributed to some diagnostic problems.

Adolescent↗

Coxsackie B virus antibodies in myocardial infarction.

Evidence for the association between Coxsackie B virus infections and myocardial infarction was studied in a prospective follow-up examination. Using the micro neutralization test, 9 (15%) of 59 patients with acute myocardial infarction and 1 (2.6%) of 38 control patients showed a fourfold, or higher, antibody increase in paired serum samples against Coxsackie B1-5 viruses. This difference is significant (p less than or equal to 0.05). None of the patients or controls revealed symptoms of a viral infection during the blood sampling. Virus isolation from throat and feces was negative in all patients and controls. This finding agrees with some previous studies suggesting that the Coxsackie B group may in some cases have a causal role in myocardial infarction, or may act as a triggering factor.

Adult↗

Experiences with polio vaccination and herd immunity in Finland.

Since the mass vaccination in 1960, infants have been vaccinated systematically with inactivated polio vaccine. By school entry 97% of children have received complete primary vaccination. Since 1964 no case of poliomyelitis has been found in Finland. An intensified search for polioviruses among patients with polio-like diseases, among preschool children and in sewage did not reveal any polioviruses, giving evidence of their disappearance. Studies on immunity showed unexpectedly large numbers of preschool children without detectable antibodies to type 1 and especially to type 3. Their response to a booster dose revealed a secondary type reaction, indicating immunity. Thus, antibodies in low or even undetectable titres protect individuals from polio infection and furthermore may eliminate polio viruses from the country.

Child↗

Viral and mycoplasmal antibodies in patients with myocardial infarction.

The suggestion that infection might provoke myocardial infarction prompted a controlled study among 49 patients with myocardial infarction for antibody titres to 22 viruses, and to Mycoplasma pneumoniae and Chlamydia psittaci. The frequency of significant rises in antibody titres was similar in patients with myocardial infarction, 7 (14%) out of 49, and in control patients, 8 (22%) out of 37. Thus, in our limited series we could not confirm the hypothesis that viral or mycoplasmal infection are significantly associated with myocardial infarction. Seven of 15 infections, evenly distributed within the two groups, were due to influenza A virus, which was epidemic in Finland at the time of survey January--March 1980. No acute Coxsackie B virus infections were observed.

Adult↗

Potency test of inactivated polio vaccines in guinea pigs.

A trial with five different inactivated polio vaccines offered an opportunity to compare children's antibody titres with the antibody responses in guinea-pigs elicited by the same batches of vaccines. The potency test in guinea-pigs was carried out according to the European Pharmacopoeia. Polio antibodies were determined by the neutralization test in Vero cell tubes. In our experience the potency test according to the European Pharmacopoeia is suitable for comparing different batches of vaccines manufactured in the same laboratory, but not for comparing vaccines prepared by different manufacturers.

Animals↗

Inactivated poliovaccine: adverse reactions and antibody responses.

Adverse reactions and antbody responses after inactivated poliovaccine were studied in 380 children. Fever reaction (greater than or equal to 37.5 degree C rectally) was recorded in 14% of children after the first poliovirus vaccination and in 19% after the second. Restlessness was reported in 15% and 14% of the chidren. Fever reaction exceeding 38.5 degree C was seen in 5% of the vaccines. Before the first vaccination at the age of six month 29% of the 48 children had antibodies against poliovirus type 1 and 2 and 43% against type 3. The first vaccination induced no significant changes in antibody titers. After the second vaccination antibody responses were low and 35%, 9%, and 35% remained seronegative to types 1, 2 and 3, respectively. After the third vaccination at the age of two years the respective geometric mean titers were 1:67, 1:335 and 1:48. No measurable antibodies were found to type 1 in 23%, to type 2 in 2%, and to type 3 in 10%. Only one child was triplenegative. All seronegative children were revaccinated and in all vaccinees a seroconversion ocurred two weeks after the booster dose. The combination of inactivated poliovaccine to DPT (Diphtheria, Tetanus, Pertussis) vaccine induced no significant change in poliovirus antibodies or in adverse reactions.

Antibodies, Viral↗