LIVE POLIO IRUS VACCINES

Routine Immunization With Attenuated Poliovirus of Children in Philadelphia 279
The miscellaneous illnesses were: earaches
(eight), mumps (four), insomnia (two), wheezing,
teething, pharyngitis, fretfulness, thrush, and
undescribed (one each). Seven children were
hospitalized: four for pneumonitis, two for bacterial
meningitis proved by cerebrospinal fluid
culture, and one for herniorrhaphy. There was
one death: a three-month-old boy was found dead
five weeks after receiving Type 1 and ten days
after Type 3 vaccine; during this time the child
had seemed well.*
dren indicated a random distribution. In addition,
no excess of any one type of illness was observed
in both study districts at a particular
interval after administration of a strain of
vaccine.
Community Surveillance. There were approximately
3800 persons, including 991 children five
years old or younger, in the 830 households of
vaccinated children.
Between the end of January and the end of
July 1959, 97 cases of aseptic meningitis,
Vaccine
TABLE 3. CONDITION OF CHILDREN AND DISTRIBUTION OF ILLNESSES BY INTERVALS AFTER
VACCINATION
Interval 1Kind and number of Illnesses Delin- Not
After
Vaccine Air Cold Cold & Zxan- Fever Cough Gastro- Mlsc. Total 'll quent or Vaccin- Total
Vaccination Feaer thema intest. Illnssesa raopped ated Childran
(day) (No. ) (No.) ( ) (No.)
1-7 21 6 6 8 4 5 2 52
1 8-14 24 6 5 3 4 46
i 1521 40o 2 2 1 1 3 4 53 5i7 16 850
I 22-28 39 16* i 8 4i 1 2 6 79
Other* 25 10 7 3 6 3 3 57
1-7 16 3 4 8 6 37
8-14 18 8 3 4 1 34
Type 3 15-21 24 10 2 1 4 3 4i 550 39 45 850
22-28 -
27 8 5 2 4 7 2 55
Other* 25 9 6 1 1 2 2 46
01-7 1 3 1 2 2 9
8-14 8 3 1 1 1 '14
Type 2 15-21 8 4 3 1 16 251 16 515 850
22-28 8 3 1 1 1 14
[Other* 4 2 6 1 2 15
· Illnesses occurring after 28 days and after an unknown interval.
t Two from one district, 14 from the other.
§ Three from one district, eight from the other.
The incidence of illnesses was similar during
each of the four intervals after administration of
each type of vaccine except for a slight predominance
during the 22-28-day interval, possibly because
the mothers tended to recall the illnesses
that had occurred during the period just before
the clinic visit.
Sajety of Vaccine. This was not a safety test.
However, no case of poliomyelitis, paralytic or
nonparalytic, occurred in a vaccinated child.
Analysis of the minor illnesses in vaccinated chil-
* Complete postmortem study, including histologic
examination of the brain, the medulla, and the spinal
cord, and virologic study by The Pennsylvania State
Virologic Laboratory of frozen specimens of these
tissues in chick embyro, mice, and tissue culture failed
to reveal the cause of death or a diagnosis. No lesions
of poliomyelitis were found.
encephalitis, and miscellaneous paralytic disease
that occurred in the entire City of Philadelphia
were screened as possible cases of poliomyelitis.
Laboratory studies,t performed in each case,
gave no evidence of poliomyelitis. On the basis
of these studies and the clinical findings, none of
the 97 cases was considered to be poliomyelitis
by the Department of Public Health.
The first isolations of poliovirus (Type 3) were
made in July 1959 from two children in whom
the onset of paralytic disease was June 11 and
June 19. The third case occurred July 19. The
three children, the only persons known to have
contracted poliomyelitis during the study, lived in
t Courtesy of Dr. Klaus Hummeler, Chief, Commonwealth
of Pennsylvania Virus Diagnostic Laboratory,
Children's Hospital of Philadelphia.