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PREPARATION OF DRIED ACETONE-INACTIVATED AND HEAT-PHENOL-INACTIVATED TYPHOID VACCINES.

Controlled field trials of two dried inactivated typhoid vaccines have been carried out in British Guiana and Yugoslavia under the sponsorship of the World Health Organization. This paper gives details of the methods of preparation of these vaccines in such a manner as to permit of replication by others.Both vaccines were derived from the Ty 2 strain of Salmonella typhosa. For production of the acetone-inactivated vaccine, a portion of the surface agar growth of the Ty 2 strain was treated with acetone by the Landy method modified so that inactivation and handling were done in liquid suspensions rather than on a filter, and the vaccine was dried in the final containers. For the heat-phenol product, another portion of the same growth was processed by heating, the addition of 0.5% phenol and holding at room temperature for 72 hours followed by freeze-drying in the final containers. These vaccines are designed for use within a few hours of the addition of the reconstituting fluid.

Acetone↗

PHYSICAL AND CHEMICAL STUDIES OF TWO DRIED INACTIVATED TYPHOID VACCINES (VACCINES K AND L).

This paper reports on studies of the physical and chemical properties of dried acetone-inactivated and heat-phenol-inactivated typhoid vaccines (vaccines K and L respectively) which have been tested in controlled field trials in British Guiana and Yugoslavia. Determinations of nitrogen, dry weight, moisture and salt contents were made in Washington and Copenhagen. Eight laboratories collaborated in opacity determinations on the reconstituted vaccines.

Acetone↗

STUDIES ON THE INFLUENCE OF THE ROUTE OF IMMUNIZATION IN THE ACTIVE MOUSE PROTECTION TEST WITH INTRAPERITONEAL CHALLENGE FOR POTENCY ASSAY OF TYPHOID VACCINES.

In order to determine the reasons for the differences found in the potencies of typhoid vaccines in the course of active mouse protection tests when immunization was done subcutaneously or intraperitoneally and followed by intraperitoneal challenge, a series of experiments were conducted which have suggested that intraperitoneal immunization and challenge may be adversely or favourably influenced by the presence of undetermined substances in certain types of vaccine.Vaccines that prove least effective when administered intraperitoneally may affect the experimental animals in such a way that they do not respond optimally to the antigenic components of the vaccine, or some components of those vaccines may damage the peritoneum so that the animals are rendered more susceptible to the subsequent intraperitoneal challenge. On the other hand, it is possible that, where other vaccines show their greatest efficacy when administered intraperitoneally, this may be due to the presence of substances that enhance the vaccine's activity by inducing a non-specific local resistance in the peritoneum.The author suggests lines along which these questions may be investigated.

Animals↗

RESULTS OF THE STUDY OF TYPHOID VACCINES IN FOUR CONTROLLED FIELD TRIALS IN THE USSR.

In field trials of typhoid vaccine in the USSR, a comparison was made of the effectiveness of chemical, heat-killed, and alcoholized vaccines. All of them conferred protection if administered in sufficient dosage, and variations in effectiveness could usually be traced to size of dosage. The heat-killed vaccine, however, appeared to be significantly more effective than the others. The immunological history of a vaccinated person apparently had no essential influence on the effectiveness of a vaccine, and the data indicated that two doses of the vaccine conferred no greater protection than one.

Adolescent↗

A contribution to the laboratory assay of typhoid vaccines.

In the laboratory assay of typhoid vaccines many questions still remain open. The results of experiments are at times ambiguous, and there is no satisfactory agreement between them and the results of the various field trials. The authors of the present paper have attempted to clear up some of the causes of discrepancy. They have concluded that in evaluating the efficacy of various types of vaccine much depends on the vaccine and challenge doses used. By employing low or high doses of vaccine, it is possible to obtain different results in respect of the qualities of the vaccines compared. The time interval between vaccination and challenge also has a certain influence.Experimentally infected mice were examined for the presence of Salmonella typhosa in the peritoneum and in the blood. The authors' experiments show that bacteraemia, observable 30 minutes after intraperitoneal challenge, represents an important indicator of vaccine efficacy. This approach enabled them to obtain clearer and more detailed information regarding the protective power of the vaccine employed than would have been revealed by the more death or survival of the test animals.

Animals↗

Specific immune responses in typhoid fever & after TAB vaccination.

The specific immune responses to Salmonella typhi were investigated in 131 patients suffering from typhoid fever and 34 healthy individuals after TAB vaccination. A proportion of individuals failed to develop either specific humoral or cell mediated immune responses. About 5 per cent of the patients with natural infection and nearly 9 per cent of the vaccine recipients failed to develop both the responses. Frequent reinfection and carrier state, and lack of absolute protection following TAB vaccination could be due to the inability of a proportion of naturally infected and TAB vaccinated individuals to mount sufficient specific immune responses, due to the same mechanism.

Adolescent↗

[Monoclonal antibodies against the lipopolysaccharide of Salmonella typhi 9,12,VI:d. Analysis of passive protection in a mouse model of typhoid fever].

The current work was undertaken in order to assess the role of the monoclonal antibodies (Mabs) to lipopolysaccharide (LPS) of Salmonella typhi in the induction of passive protection against the challenge with the bacteria in a mice model. BALB/c mice were immunized with the whole bacteria, mice with high anti-LPS antibody titers were killed, the spleens were removed and splenocytes were fused with the mouse plasmocytoma SP2/0. Two IgM monoclonal antibodies against porins were developed. Each one of these Mabs recognized the polysaccharide region of LPS. Passive immunization with supernatant fluid of mice with one of these monoclonal antibodies did not protect against challenged with 20 LD50 and 100 LD50 of Salmonella typhi. The results suggest that LPS is not valuable immunogen for the induction of a protective status against typhoid fever.

Animals↗

[Characteristics of preparations of typhoid antigens obtained by ultrafiltration].

The properties of the preparations of the total typhoid antigens isolated by various methods, purified and concentrated by ultrafiltrations, were studied, and the technique of the preservation of their high solubility on drying (the neutralization and removal of disperse components prior to drying) was developed. Preparations obtained by ultracentrifugation were characterized by lower ash content and, when compared with alcohol tryptic preparations, had better antigenic properties, inducing the synthesis of not only O- and Vi-, but also H-antibodies in high titers.

Animals↗

[Trial of the new chemical sorbed typhoid monovaccine P in a strictly controlled experiment].

A comparative study of the reactogenicity and immunologial activity of a new chemical sorbed typhoid monovaccine II, reference-vaccine (chemical sorbed monovaccine from tryptic antigens) and placebo-sorbent (hydroxy aluminium gel) was made under conditions of strictly gested monovaccine II, an equal capacity to induce formation of O- and Vi-antibodies, and also an accumulation of H-antibodies not induced by refrence-vaccine.

Adolescent↗

Field trials with killed oral typhoid vaccines.

The article gives the results of the use of two types of killed oral typhus vaccine administered to students 10 to 19 years of age in two urban areas of the Province of Santiago. Vaccine from the German Democratic Republic (GDR) was administered to 37,517 students and placebo to an equivalent control group. The period of observation was 18 months (November 1973-April 1975). The other product, from the German Federal Republic (GFR) was administered to 37,566 students, with placebo given to an equivalent control group. In this case the observation period was 7 months (October 1974-April 1975). The antigenic composition of the two vaccines is qualitatively and quantitatively different as are the characteristics of their preparation. In the field trial with the product from the GDR, the morbidity for typhoid fever in the vaccinated and control groups showed statistically significant differences, even though on the border line level. Satisfactory and highly significant results had been obtained with the product in earlier field trials. The difference observed between morbidity in the two groups in the field trial with GFR vaccine was not significant. It is emphasized in this regard that the observation period was shorter in this case, which precludes definitive conclusions. A high proportion of reliable confirmation of diagnosis of cases is evident for both field trials. The findings show the need for subjecting this type of vaccine to further and better field trials.

Administration, Oral↗

The sad and tragic life of Typhoid Mary.

As society grapples with contemporary moral questions raised by the barring of HIV-infected people from jobs and even crossing some national borders, it is probably useful to re-examine the case of Typhoid Mary. The case of Mary Mallon shows how an earlier age resolved the conflict that arises when society's right to protect itself from unnecessary exposure to disease impinges on the liberty of individual citizens.

Carrier State↗

[Strengthening the immune response to typhoid vaccine by subcutaneous RNA administration].

The authors demonstrated the adjuvant activity of the RNA preparations injected subcutaneously. In the treatment of mice with the vaccine with a stimulant there was increase of antibody production and of their resistance to infection with typhoid causative agent in comparison with the animals which were only immunized. When the adjuvant was used the vaccine dose could be devreased 2- to 8-fold without any reduction of the immunity formed. RNA injection to the immunized animals on the 25th day after the onset of the experiment produced a revaccinating effect.

Adjuvants, Immunologic↗

Cholera and typhoid vaccine. The current state of play.

The field of travel medicine is undergoing rapid change. Vaccination recommendations change with disease outbreaks, emerging infections and the availability of new vaccines. The following information on typhoid and cholera vaccination should be used in conjunction with up to date information and individualised for each traveller. It is emphasised that vaccination forms just part of the pretravel health consultation and does not replace the need for appropriate preventive advice and information.

Adolescent↗

[Vaccination against typhoid fever: results and perspectives].

The review deals with the world history and the current status of typhoid fever vaccination. It analyzes parenteral and oral killed cellular, oral live attenuated, molecular vaccines are analyzed. The results of field trials of parenteral and oral vaccines in the areas showing different epidemiology and incidence are analyzed. The problems in the designing of molecular typhi vaccines are considered. The results of designing the new generation vaccines S. typhi strains attenuated by means of site-specific mutagenesis and Vi-polysaccharide-protein conjugates are presented.

Humans↗

Toxic megacolon in typhoid fever.

A 40-year-old man with bacteriologically documented typhoid fever who was receiving correct antibiotic treatment developed toxic megacolon. Because of progressive clinical deterioration, the patient underwent surgical treatment, with quick postoperative improvement while receiving antibiotics and total parenteral nutrition.

Adult↗