Vaccination against virus disease.
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Biomedical subjects
Publications and source records attributed to S Krugman.
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A virus has been isolated from the serum and urine of patients with infectious hepatitis. This virus is a member of the parinfluenza group. It is serologically distinct from the known members of the group, but apparently is antigenically related to the simian type-2 parainfluenza viruses. A causal relationship between WB virus and infectious hepatitis has not been established.
WB virus has been shown to have a fine structure which is characteristic of members of the mumps-NDV-parainfluenza group of viruses. Viral internal component has been demonstrated within the cytoplasm of infected cells. The incorporation of internal component into virus filaments at the cell surface has also been demonstrated. The evidence presented suggests that virus filament formation occurs by a process of invagination of the cell membrane about the coiled strands of internal component lying beneath the membrane.
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Twenty patients with burn injuries were randomly assigned to a massage therapy or a standard treatment control group during the remodeling phase of wound healing. The massage therapy group received a 30-minute massage with cocoa butter to a closed, moderate-sized scar tissue area twice a week for 5 weeks. The massage therapy group reported reduced itching, pain, and anxiety and improved mood immediately after the first and last therapy sessions, and their ratings on these measures improved from the first day to the last day of the study.
Further-attenuated strains of measles virus may be distinguished from virulent strains by the following characteristics. Unlike virulent strains, attenuated strains of measles virus can be propagated in chick embryo fibroblast cultures, induce production of interferon in tissue culture cells, and produce plaques that can be distinguished from those produced by virulent strains. Unlike virulent measles virus, attenuated strains induce an inapparent infection in approximately 85% of vaccines. Symptoms such as fever, cough and rash, if present, are usually transient. Bacterial and central nervous system complications associated with natural measles infection are extremely rare after immunization. A 16-year, prospective study of immunologic response of 47 children who had natural measles and of 70 children immunized with live, further-attenuated measles vaccine revealed (1) that all 47 children with natural measles infection had high titers of hemagglutination-inhibiting (HAI) antibody (greater than or equal to 1:64) one month after vaccination and 15% had low titers (1:2-1:4) 16 years after vaccination; and (2) that all 70 children who received live, further-attenuated measles vaccine had high titers of HAI antibody (greater than or equal to 1:64) one month after vaccination, but in 36% of the group the titers declined to less than 1:8 16 years later. Neutralizing antibody was detectable in convalescent sera that had lost detectable HAI antibody. Reimmunization of children with undetectable HAI antibody induced a classic booster response. These prospective immunologic studies confirmed that immunity persists after immunization as well as after natural measles infection.
Studies of the natural history and prevention of viral hepatitis were initiated at Willowbrook State School in 1955. During the subsequent two decades there was considerable controversy regarding the ethical aspects of these studies. The background of these studies is described in detail in historical context. This report should provide the reader with information needed to make an independent objective judgement of the ethics of the Willowbrook hepatitis studies.
Studies with heat-activated serum containing hepatitis B virus (MS2 strain) revealed 1) it was not infectious, 2) it was antigenic and 3) it was protectie. Acitve immunization with this preparation was associated with the detection of antibody to the hepatitis B surface antigen (anti-HBs) and no detectable core antibody (anti-HBc). In addition, various investigators have prepared a synthetic hepatitis B peptide vaccine, These findings indicate that it should be feasible to develop an inactivated hepatitis B vaccine by the use of purified hepatitis B surface antigen or one of its polypeptides.
Seven population groups were tested by radioimmunoassay for the presence of hepatitis A antibody (anti-HAV), hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti-HBs). Detection of anti-HAV was indicative of past hepatitis A infection and presence of HBsAg or anti-HBs indicated past hepatitis B infection. The results of tests of 680 serum specimens from the seven groups were as follows: (1) of 100 newly admitted children to Willowbrook where hepatitis A and B were hyperendemic, 32% had anti-HAV and 4% had anti-HAV and 4% had HBsAg (1%) plus anti-HBs (3%); (2) of 100 Willowbrook residents who lived in the institution about three or more years, 97% had anti-HAV and 90% had HBsAg (32%) plus anti-HBs (58%); (3) of 100 new Willowbrook employees, 50% had anti-HAV and 13% had anti-HBs; (4) of 100 Willowbrook employees who worked in the institution more than three years, 75% had anti-HAV and 30% had HBsAg (3%) plus anti-HBs (27%); (5) of 80 house staff physicians, 27.5% had anti-HAV and 10% had anti-HBs; (6) of 100 student 34% had anti-HAV and 6% had anti-HBs; and (7) of 100 suburban teenagers 4% had anti-HAV and 5% had anti-HBs. This study confirmed the variability of the prevalence of hepatitis A and B markers among different population groups and the effect of socioeconomic status and environmental factors on the incidence of past infection caused by hepatitis A and B viruses.
The atypical measles syndrome is a relatively new disease that was first recognized 15 years ago. Initially, it occurred in children who were exposed to wild measles virus several years after they were immunized with killed measles vaccine. It was characterized by a two- to three-day prodrome of high fever, cough, headache, and myalgia followed by a rash that resembled Rocky Mountain spotted fever, scarlet fever, or varicella and associated with roentgenographic evidence of pneumonia with or without pleural effusion. This report highlights three unusual manifestations of this syndrome: 1) transient hepatitis, 2) persistence of pulmonary lesions for several years, and 3) occurrence of excessively high measles hemagglutination-inhibition antibody titers. Today, this syndrome occurs predominantly in adolescents and young adults.
Twenty-eight adult patients with burns were randomly assigned before debridement to either a massage therapy group or a standard treatment control group. State anxiety and cortisol levels decreased, and behavior ratings of state, activity, vocalizations, and anxiety improved after the massage therapy sessions on the first and last days of treatment. Longer-term effects were also significantly better for the massage therapy group including decreases in depression and anger, and decreased pain on the McGill Pain Questionnaire, Present Pain Intensity scale, and Visual Analogue Scale. Although the underlying mechanisms are not known, these data suggest that debridement sessions were less painful after the massage therapy sessions due to a reduction in anxiety, and that the clinical course was probably enhanced as the result of a reduction in pain, anger, and depression.