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Biomedical subjects

R H Bernier

Publications and source records attributed to R H Bernier.

31 records · Page 2Linked to original sources
PubMed1982

Poliomyelitis vaccination for the international traveler.

Adults who travel to areas where poliovirus is endemic or epidemic have a statistically small yet potentially important risk of exposure to wild poliovirus. Vaccination is recommended for persons at risk of acquiring poliovirus infection. The vaccination schedule depends on the time remaining before departure and the patient's immunization status.

Adult↗
PubMed1981

Abscesses complicating DTP vaccination.

Reports of abscesses after the use of diphtheria and tetanus toxoids and pertussis vaccine (DTP vaccine) from two different lots (No. 1 and 2) of a single manufacturer (manufacturer A) prompted an investigation into the rates of abscess formation following the use of DTP vaccine from several different manufacturers. A total of 74 abscesses for lot 1, 16 for lot 2, and three for other DTP products was uncovered. The overall rate after lots 1 and 2 was 1.1 per 1,000 doses administered compared with 0.01 per 1,000 doses for DTP vaccine from other manufacturers (P less than .0001). Faulty technique, site and route of inoculation, microbiologic contamination, and hypersensitivity were ruled out as likely explanations for the increase in abscesses among recipients of DTP vaccine from manufacturer A. Use of a single needle to withdraw vaccine from the vial and to inoculate the vaccinees, combined with high aluminum adjuvant content in the implicated vaccine, may have led to an increased rate of abscess formation.

Abscess↗
PubMedDate not supplied

Elimination of indigenous measles from the United States.

In October 1978, a nationwide initiative to eliminate indigenous measles from the United States by October 1, 1982, was announced. The measles elimination program has three major elements: attaining and maintaining high immunization levels, aggressive and effective surveillance, and vigorous response to cases. In 1980, immunization levels in children entering school for the first time were 96%, indicating that the necessary levels have been attained in the age group. Mechanisms are in place to assure maintenance of these levels; these rely heavily on the use of immunization requirements for school attendance in each state. Aggressive surveillance systems have been developed for each state to detect suspected measles cases as soon as possible after they occur and to investigate them within 24 hr of notification. The clinical definition of measles used is fever of greater than or equal to 101 F (38.3 C); rash of three or more days duration; and cough, coryza, or conjunctivitis. The response to outbreaks involves identifying persons in the area who are at risk of contracting measles, determining those who are possibly susceptible, and ensuring that these persons are vaccinated. In school outbreaks, susceptible students are vaccinated or excluded from school until the outbreak is over. During 1981, measles morbidity reached a record low level of only 3,032 reported cases (provisional total). Epidemic measles occurred in only a few outbreaks of limited size and duration, and endemic cases were restricted to a small number. Imported cases averaged slightly more than two per week, occasionally producing limited outbreaks, but more often resulting in no secondary spread. Transmission of measles has been interrupted in most of the United States. With continued vigorous implementation of the current strategy and with additional measures to lessen the risk of importations, it appears likely that the goal to eliminate indigenous measles transmission will be attained by October 1982.

Adolescent↗
PubMedDate not supplied

Some observations on poliomyelitis lameness surveys.

Since 1974, greater than 100 different surveys have been carried out throughout the developing world to estimate the prevalence of lameness due to poliomyelitis. Reported prevalence rates have ranged from less than 1 to a high of 25 per 1,000 children surveyed and have prompted many countries to undertake polio vaccination programs. A review of surveys conducted to date reveals considerable variation in both the choice and use of survey methods and in the assumptions made in the analysis and interpretation of findings. More precise and comparable data about the risk of poliomyelitis could be obtained in future surveys by incorporating a standard case definition, by using house-to-house case-finding methods in representative community-based samples, by analyzing and presenting rates in more clearly defined ways, and by selecting stable populations for study.

Adolescent↗
PubMedDate not supplied

Measles seroconfirmation using dried capillary blood specimens in filter paper.

Because the incidence of measles has declined in recent years, the potential for confusion of measles with other morbilliform rashes has increased. Routine serologic testing of suspected cases of measles is recommended but it has been hampered, particularly in young infants and children, by the requirement of performing venipuncture. We have compared measles hemagglutination inhibition antibody testing performed on dried capillary whole blood collected on filter paper strips with testing of serum specimens obtained simultaneously by venipuncture. We assessed overall comparability, diagnostic sensitivity and specificity and acceptability and practicality for field use. Of the 125 capillary-venous sets compared, there was a 4-fold difference in hemagglutination inhibition titer between the two types of specimens in only one set (0.8%). Diagnostic sensitivity using capillary blood was 100% and specificity was 96%. Immunoglobulin M assessments on six capillary-venous sets were in complete agreement (three positive in both, three negative in both). In a pilot program of field use, filter paper blood collection was associated with a 97% (36 of 37) success rate in obtaining specimens from individuals with suspected cases of measles. This method of blood collection and testing is an accurate, feasible and acceptable means for seroconfirmation of measles.

Antibodies, Viral↗