LIVE POLIO IRUS VACCINES

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Minnesota Studies With Oral Poliomyelitis Vaccine 173 3. Gard, S., Bottiger, M., and Lagercrantz, R.: Vaccination with attenuated poliovirus Type 1, the CHAT strain. In: Live Poliovirus Vaccines, First International Conference. Scient. Pub. no. 44 of the Pan American Health Organization, pp. 350-354, 1959. 4. Gelfand, H. M., Potash, L., LeBlanc, D. R., and Fox, J. P.: Intrafamilial and interfamilial spread of living vaccine strains of polioviruses. J. Am. M. Assn. 170: 2039-2048 (Aug. 22) 1959. 5. Horstmann, D. N., Niederman, J. C., and Paul J. R.: Attenuated Type 1 poliovirus vaccine. Its capacity to infect and to spread from "vaccinees" within an institutional population. J. Am. M. Assn. 170: 1-8 (May 2) 1959. 6. U. S. Department of Commerce, Weather Bureau: Local climatological data with comparative data, 1958, Minneapolis-St. Paul, Minnesota. 7. Gelfand, H. M., LeBlanc, D. R., Potash, L., Clemmer, D. J., and Fox, J. P.: The spread of living attenuated strains of polioviruses in two communities in Southern Louisiana. Presented before the Epidemiology Section, American Public Health Association, Atlantic City, Oct. 19, 1959.
14. THE CAPACITY OF LIVE ATTENUATED POLIOVIRUSES TO CAUSE HUMAN INFECTION AND TO SPREAD WITHIN FAMILIES* JOHN R. PAUL, DOROTHY M. HORSTMANN, JOHN T. RIORDAN, E. M. OPTON, AND R. H. GREEN Section of Epidemiology and Preventive Medicine, Yale University School of Medicine, and the WHO Regional Poliomyelitis Laboratory for the Americas DR. PAUL (presenting the paper): The purpose of this report is to document the capacity of three attenuated polioviruses to take and to spread within families when given as a trivalent vaccine, according to the outline of the field trial described earlier today in the paper by Dr. Horstmann and her colleagues.l This work is essentially a study by the Yale Poliomyelitis Study Unit, in which I am only a spokesman. Others who did most of the work are listed on the title page. Mention has already been made of the degree to which alimentary infection by these strains was induced in this particular field trial, involving as it did approximately 50 families, about the size of Dr. Verlinde's study, although the environment was different. The setting was in a village in Costa Rica. For the privilege of carrying out this study there, we are much indebted to the Minister of Health, Dr. Quirce, and to the Director General of Health, Dr. Vargas-Méndez. The strains of the attenuated poliovirus used were kindly supplied by Dr. Cox, and are known as the Lederle attenuated poliovirus strains. I want to mention again that the design of the trial called for the feeding of an index child under the age of two years in each of 48 separate families in which the siblings, who were all under the age of five, were left unfed, so they could be included in the study as susceptibles. In other words, an object of the trial was to see how far these polioviruses got in this particular setting, why they got where they did, or why * Representing studies planned and carried out by the Yale Poliomyelitis Study Unit under the auspices of the Pan American Sanitary Bureau and in close cooperation with the Ministry of Health of Costa Rica. 174 not. And again may I emphasize that the objective of this study was not to compare the capacities of individual attenuated poliovirus strains, but rather to consider the problem as one of experimental epidemiology. A special framework has been established here, and it should be recognized from the start that the findings reflect the effectiveness of this vaccine when administered within this particular environment. This is a point which Professor Stuart-Harris made yesterday, and Professor Zhdanov has emphasized it in his use of the term "ecology." In other words, our study is more academic than practical, and could be said to recall Topley and Webster's observations of a generation ago on experimental epidemiology in mice. Their results were wholly dependent upon the age and immune status of their mice, the size of the box in which their mice were placed, its environment, and the presence of extraneous infections.' Our results are dependent upon similar factors. RESULTS A theoretical schema for depicting the in/fectability of an attenuated poliovirus strain when given as a vaccine is presented first in a series of diagrams. Figure 1 is a schematic diagram to illustrate hypothetically the results in a group of 48 potential vaccinees (designated by 48 horizontal lines) who have been given two doses of triple, live poliovirus vaccine one month apart, on 30 July and 30 August. The blank background would indicate that the vaccine did not give rise to antibodies in any of this group. Figure 2 is a continuation of the diagram in Fig. 1 to illustrate hypothetically, complete suc-
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LIVE POLIO IRUS VACCINES Papers Pre
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SECOND INTERNATIONAL CONFERENCE ON
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Preface The accumulation of informa
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Dr. Ghislain COURTOIS Director, Pri
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Dr. Edith PETTE Institute for the R
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50 Discussion sages of neurovirulen
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Application of Genetic Markers to D
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Discussion 67 TABLE 1. INCIDENCE OF
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Experimental Studies on Animals wit
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6. DETECTION OF A "NON-DETECTABLE"
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Detection of a "Non-Detectable" Sim
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Discussion 87 Dr. Koprowski's state
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Discussion 89 recognize its effects
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Laboratory Investigations of Attenu
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Discussion 99 In the case of Table
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8. BEHAVIOR OF COLD MUTANTS OF POLI
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Behavior of Cold Mutants of Poliovi
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DISCUSSION CHAIRMAN BURNET: Thank y
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114 Safety-Field Evidence of Safety
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118 S afety-Field Evidence of S af
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Vaccination of Pregnant Women and Y
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Development and Persistence of Poli
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Virologic, Serologic Investigations
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_ _ _ _ _ _ _ _ Virologic, Serologi
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cARE NUC:4I Discussion 267 CUAw # J
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Discussion 269 in the investigation
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Virological Findings, Antibody Resp
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4. ROUTINE IMMUNIZATION WITH ATTENU
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Routine Immunization With Attenuate
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Experimental Infectionwith CHATAtte
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Experimental Infection with CHATAtt
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Experimental Infection with CHATAtt
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Vaccination of Full-Term Infants wi
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Response of Newborn Infants to Vacc
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Susceptibility of Newborn Infants t
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9. IMMUNIZATION OF NEWBORN INFANTS
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Immunization of Newborn Infants wit
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Discussion 323 vaccinated siblings
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Discussion 325 Discussion 325 ance
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transplacental antibodies, or antib
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Recent Experience with Lederle Triv
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11. FURTHER EXPERIENCES WITH ORAL P
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Further Experiences with Oral Polio
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Minnesota Studies with Oral Poliomy
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13. USE OF ATTENUATED LIVE POLIOVIR
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Use of Attenuated Live Poliovirus V
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Use of Attenuated Live Poliovirus V
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DISCUSSION CHAIRMAN LÉPINE: The tw
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Discussion 375 -~ ~~~~isuso 7 DR. C
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i 14. EFFECTS OF RAPID MASS IMMUNIZ
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Live Poliovirus Immunization-Condit
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Use of Sabin's Live Poliovirus Vacc
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TABLE 14. Use of Sabin's Live Polio
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436 Efficacy-Field Evidence TABLE 1
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452 Efficacy-Field Evidence ] ~~ ~
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458 Discussion 458 Discussion~~~~~~
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Vaccination with CHAT Strain Type 1
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25. VACCINATION AND CHALLENGE-POLIO
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Discussion 575 ence last year. The
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602 Summary of the Conference 602 S
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608 Index Antibodies-continued half
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610 Index Bulychev, N. P., paper, 4
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612 Index Coxsackie--continued B-3
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614 Index Epidemics-continued intro
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616 Index Genetic stability-continu
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618 Index Infants-continued source
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620 Index Laboratory surveillance d
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622 Index Monkey neurovirulence, 95
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624 Index pH neutralization test, 6
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626 Index Poliomyelitis virus-conti
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628 Index Serological response-cont
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630 Index T marker-continued T- str
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632 Index Vaccine, Attenuated-conti
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634 Index Virus isolations and anti
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