[The problem of rubella diagnosis].
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Biomedical subjects
Publications and source records attributed to W Ehrengut.
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Among 48 adults without a history of tetanus immunization, we found with the aid of indirect hemagglutination test 20 individuals with protective tetanus antibody titers, 23 with low levels of antitoxin (under 0,1 I.U./ml) and 5 devoid of tetanus antitoxin. In two blood samples of 99 unvaccinated children under 3 years of age (taken at 7 months intervall) 12,1% showed tetanus antitoxin in the first serum sample and 16,2% in the second sample. Protective antibody titers could be found only in 4 children in each of the first and second serum sample. The data suggest a silent oral immunization by tetanus bacilli thus boosting under unhygienic conditions the tetanus immunity with advancing age.
The polio neutralisation test was performed in 199 paired sera from mothers and their newborn infants from the Hamburg area and in 69 paired sera from Bamako (Mali). Antibodies against all 3 poliovirus types were demonstrated in 52.3% of Hamburg and in 78.0% of bamako mothers. The significantly inferior protection of Hamburg mothers was caused by a lower rate of polio 3 antibodies. Only 65.3% of the Hamburg mothers had polio 3 antibodies in contrast to 88.0% of Malian mothers. Newborn infants from Hamburg had significantly higher polio 2 antibody titres than their mothers, newborn infants from Bamako in contrast had significantly lower polio 2 and 3 antibody titres than their mothers. Both groups share an insufficient transferral of polio 3 antibodies. When only titres outside the range of error of the neutralisation test (1 titre step) are considered as different, all 3 polio types in both groups show agreement of titres in mother and child in more than 90%.
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A study was carried out to determine the titres of haemagglutination inhibiting and neuraminidase antibodies after vaccination of 90 subjects, aged 19 to 35 years, with three aluminium oxide adsorbate and three fluid monovalent influenza A/New Jersey/8/76 vaccines with 54, 108 and 216 IU/dose. Blood samples were taken 1, 3 and 6 months after vaccination. The serological findings showed that adsorbate vaccines induced higher antibody titres than did fluid vaccines with double the antigen content. 'Unprimed persons' reacted to the adsorbate vaccine vaccination with a much higher antibody formation response.
The Diphtheria antitoxin level (indirect haemagglutination) was measured in blood samples respectively cord blood of 185 mothers and their newborns. Protective titers (greater than or equal to 0.1 I.U. Diphtheria antitoxin/ml) were found in 29.2% of the confined women and in 27% of their newborn babies. A review of similar investigations from the literature is given, and diphtheria toxoid boosters are recommended for youngsters and adults to improve the relatively poor immunity status against diphtheria in the population.
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Following vaccination against rubella, persons are sometimes detected who, despite repeated rubella vaccinations (Cendehill strain), show absence of seroconversion in the HAI or HIG test. Eighteen female probands, showing no serological antibody response on two occasions, by the above test methods after vaccination, demonstrated seroimmunity before vaccination documented by neutralising antibodies against rubella virus in serum samples, or a booster effect induced by the vaccination. The reason for these apparent vaccination failures could be a residual immunity following either rubella infection in utero or in earliest childhood.
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The incidence of Chlamydia psittaci infections in Hamburg has been studied using the complement fixation test on 655 human sera collected from patients with respiratory tract diseases. Of the 653 sera investigated, 78 (11.9%) showed antibody titers between 1:8 and 1:128. Of the positive sera, 21 (16.9%) presented values of greater than or equal to 1:32. This infection is encountered more often in individuals over 21 years of age (15.9% to 23.4%) than in persons under 20 (0.8% to 6.0%). General practitioners' attention must be drawn to Chlamydia psittaci infections, since they seem to be of greater importance in human pathology than is generally assumed.
A serological survey of young nurses, mainly aged 17 to 22 years, showed that only 1.5% of nurses from pediatric departments (n = 335) were without rubella antibodies compared with 4.3% seronegative nurses from general wards (n = 278). Very rarely some nurses still considered a history of rubella as a basis of their rubella immunity. Nurses born in different parts of West Germany demonstrated various percentages of serological immunity towards rubella before the onset of their work. In Hamburg rubella vaccination has been offered already since 1972 to 15 years old schoolgirls. Therefore it was understandable, that nurses born in Hamburg (308) were seronegative, only in 2.6% whilst nurses born in other parts of Germany with later onset of the vaccination programme lacked rubella antibodies up to 8.1%.
An analysis of diphtheria antibodies (indirect haemagglutination technique) in 85 paired sera of Malian mothers and their newborns (cord blood) showed that all mothers had protective antibody levels (greater than 0.1 I.U./ml). 81 per cent of the neonates demonstrated protective immunity towards diphtheria. Since in Mali respiratory diphtheria is rare, is may be assumed that a silent immunization by skin sores, contaminated with diphtheria germs takes place. This assumption is supported by an analysis of 30 unimmunized 6 to 24 months old babies from whom 10 had protective and 16 low levels of diphtheria antibodies in their sera. By inclusion of 13 further children of the same age group (possibly previously immunized, since they had demonstrable antibodies against tetanus) we found a geometric mean diphtheria antibody titer for all 43 children of 0,08 I.U./ml.
A comparison is made between the admissions of children with whooping-cough in Hamburg (with a low pertussis immunization rate) and München (with a higher rate of vaccinated children).
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