LIVE POLIO IRUS VACCINES

368 Efflcacy-Laboratory Evídence
36 EfcayLaoroy vdec
Intestinal Parasitism. A parasite survey was
conducted in one of the recreation camps and the
findings of this study have been correlated with
the poliovirus antibody studies. Among 22 children
who carried Giardia lanmblia and were
undergoing atabrine treatment there were
three type-specific seronegatives for Type 1, of
whom two became positive, and one seronegative
for Type 3, who also converted. Of the remaining
18 Giardia-infested children, all of whom
were triple-positives, 17 experienced four-fold
or greater booster responses for one or more types
of poliovirus.
Sixty-seven of the children were infested with
Trichuris trichiura, Ascaris lumbricoides, or
Endamoeba coli, and various combinations of
these parasites. In this group of children there
was a total of 16 type-specific seronegatives including
all three virus types, and 13 of thle 16
converted: six for Type 1, six for Type 3, and one
for Type 2; one seronegative for each virus type
failed to convert. Among the remaining triplepositive
children who were parasitized, all but
12 manifested four-fold or greater booster responses
to one or more types of poliovirus.
Mumps. Seventeen children were given oral
poliovirus vaccine while undergoing an attack of
infectious parotitis. Among them were one child
who was negative for Type 1 and another who
was negative for Type 3 polioviruses; both converted.
Of the remaining 15 triple-positive children,
eight manifested booster responses to one
or more poliovirus types.
Influenza. There was a single type-specific
seronegative among six children who suffered attacks
of influenza during the oral vaccination
program. This single Type 3 seronegative converted
and three of the other five children showed
booster responses for one or more types of virus.
Herpangina. During the winter of 1959-1960,
a number of clinically typical cases of herpangina
were admitted to the Sanatorio Covadonga, of
Havana. When afebrile but while ulcers were
still present on the anterior pillars, five of these
children, whose ages varied from 14 months to
five years, were fed a dose of trivalent oral poliovirus
vaccine after the collection of stool and
blood specimens. Laboratory examination of
stools is not yet completed. To date, three nonpolio
enteric viruses, as yet unidentified, have
been isolated either in day-old mice or in tissue
culture from the pre-vaccination stools and Type
3 poliovirus has been recovered from several of
the post-vaccination stools.
The serologic evidence obtained from the preand
post-vaccination sera of four of the five children,
of whom one was a triple negative, shows
that six of the seven type-specific seronegatives
converted and a booster response from 1:64 to
1:1024 was shown in one of the children. The
triple-negative child converted for all three virus
types.
When the blood and stool investigations associated
with these children are completed and the
non-polio enteric viruses identified, this study
will be the subject of a separate report.
DISCUSSION
During the past two years, we have administered
the Lederle attenuated poliovirus strains to
approximately 10,000 children in various parts
of Cuba. The bulk of these children were between
six and 12 years of age. Our studies have
included the administration of the vaccine in
capsular and fluid form. Monovalent vaccine
has been given at intervals of seven, 15, and 21
days, and simultaneously. Trivalent liquid vaccine
has been given in a single dose. There have
bheen no instances of nervous-system disease
among any of these vaccinated children and we
have observed no unfavorable side effects attributable
to vaccination. On the other hand, in spite
of nutritional problems, heavy parasitic infestations,
and concurrent virus infections including
rubeola, rubella, varicella, influenza, mumps, and
herpangina, the responses in these children have
been good and none of these various complicating
conditions has either been augmented by vaccination
or been shown to contraindicate vaccination.
The speed, simplicity, and effectiveness of the
trivalent vaccination under Cuban conditions obviously
makes it the method of choice. By reducing
the residual collective poliomyelitis susceptibility
of children to a level comparable to that
of the adult population, as indicated by the seronegative
index, we believe that poliomyelitis as a
public health problem in Cuba will disappear.