LIVE POLIO IRUS VACCINES

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Use of Sabin's Live Poliovirus Vaccine in Mexico 409 o o o o o o Cz a o C-11 o wD 0 a r O rd C mCI rD 0 _ a Ii 0., zU EO o IO O O Od G rd O m O OtO c, o D rdO b[ G -i ~~0 0bC be- 0: 0 o C1 ,01 C Io cO [0 o 00 c / ~ ~ oo ~ Ir I oo n | ioo _ | C Cb Oo CDc aei ~~:s~~ O, O ~? Oí ru NNm~~~~- GO GiO lc ~ o ,t o o GOiM GO GO~3 1 . Vo m.' =
DISCUSSION CHAIRMAN LÉPINE: The papers by Dr. Sabin and Dr. Ramos Alvarez are now open for discussion. DR. MELNICK: Dr. Sabin showed that after the mass feeding in Toluca polio isolations dropped from 11 to 1 per cent, but not to zero. I should like to hear whether he might predict how long it will remain at this low level. Even if it dropped to zero, how long might it be before live viruses came into the community and caused reinfection? If wild viruses do come in, 1 believe Dr. Sabin's data showed that reinfections will occur. His paper indicated that immunity reached close to 100 per cent of the population by the age of four. Yet, even in this community, the immune mothers carried poliovirus to the extent of about 5 per cent. The viruses which they carried, as I recall, belonged to all three polio types and not just to one. I should also like to raise the question of how we might prevent the reintroduction of polioviruses into mass vaccinated communities if we already know that immune persons can carry virus again, and perhaps again and again. DR. SABIN: The first marked reduction occurred after a single feeding of trivalent vaccine. The second feeding was given to only a small number of children, and was not a mass feeding. Whether or not the second trivalent feeding would have reduced the dissemination of polioviruses to a still lower level is something which may be expected but has not been demonstrated. But, as an indication of what nature itself does, we can look at the reported cases of poliomyelitis in the city of Toluca, which I think throws some light on the question. The pattern in Toluca, which is a city on trade routes with many people passing through it, is almost comparable to the pattern of measles. That is, you have one year with a high incidence and the next year with a very low incidence, followed by another year with a very high incidence. That has been the pattern of recent years. This indicates that even after a period of high 410 natural dissemination, which is associated with a high incidence of paralytic cases, there develop enough resistant intestinal tracts to stop the dissemination of the Type 1 poliovirus responsible for most of the clinical cases to such an extent that the following year there are very few cases -when I say very few, two to three has been the pattern-until additional children who are not immune come into the community. The point about the mothers: I myself remarked that it seemed to me somewhat peculiar that, in a population in which presumably they would be exposed repeatedly, 5 per cent of the mothers should still be found to be carriers of poliovirus. But to be a carrier of polio is not an all-or-nothing affair as regards capacity to transmit virus. A person may become infected and yet may not be able to transmit. It is quite possible, on the basis of many previous studies, that the young children who are primarily infected and excrete large amounts of virus are chiefly responsible for continuing dissemination. They can disseminate it to a number of others, including mothers, who may then have only low levels of multiplication. This is also comparable to experiences which many bacteriologists and epidemiologists have recorded for dysentery. It is not enough to be a carrier of dysentery. A person who has a few dysentery bacilli is not a disseminator, a person who has a million per gram is a disseminator. The very fact that such marked reduction in dissemination could be achieved by a single feeding of trivalent vaccine indicates that we have to repeat it, as I said, in order to produce not only more immunization but also more intestinal resistance. Whether or not, and to what extent, such massive immunization will achieve, by continuing programs, the blockade to natural dissemination of polioviruses is something the virus laboratories will have to continue working on for the next few years and give us the answer. That available evidence warrants the attempt to eliminate naturally occurring polioviruses by this technique is to me beyond doubt,
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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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Page 6. Vaccination of Full-Term In
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Page 23. Vaccination against Poliom
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Dr. Ghislain COURTOIS Director, Pri
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Dr. Edith PETTE Institute for the R
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4 Introductory Remarks 4 Introducto
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6 General Considerations immunity a
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8 General Considerations from accep
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10 General Considerations 10 Genera
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14 Safety-Laboratory Evidence of At
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- 26 Safety-Laboratory Evidence of
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DISCUSSION CHAIRMAN ANDERSON: There
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30 Discussion CHAIRMAN ANDERSON: Th
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32 TABLE 1. Safety-Laboratory Evide
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40 Discussion Of the 22 monkeys inf
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DISCUSSION CHAIRMAN ANDERSON: Thank
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46 Discussion a paralytic case. Thi
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48 Discussion + - + + I + - I + + 1
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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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122 Discussion 122 Discussion~~~~~~
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10. LABORATORY INVESTIGATIONS OF TH
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126 VIRUS 1 MAhONEY Safety-Field Ev
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128 Safety-Field Evidence óf Safet
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DISCUSSION CHAIRMAN ZHDANOV: This p
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11. EPIDEMIOLOGICAL AND VIROLOGICAL
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12. SPREAD OF A VACCINE STRAIN OF P
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148 Saf ety-Field Evidence of Saf e
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152 Saf ety-Field Evidence of Safet
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DISCUSSION CHAIRMAN ZHDANOV: The pa
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158 Discussion 158 Díscussion~~~~~
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160 Discussion specimens. We were u
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. . . 168 Safety-Field Evidence of
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14. THE CAPACITY OF LIVE ATTENUATED
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176 Saf ety-Field Evidence of Saf e
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Field, Laboratory Experiences With
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16. STUDIES ON LIVE POLIOVIRUS VACC
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Studies on Live Poliovirus Vaccine
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Da. HORSTMANN: If I may answer for
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Discussion 205 Discussion 205 tried
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NOTE: The Spanish translation of th
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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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Discussion 329 Discussion 329 born
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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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Page 446 and 447: DISCUSSION CHAIRMAN LÉPINE: Thank
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Page 453 and 454: 436 Efficacy-Field Evidence TABLE 1
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460 460 Discussion Discussion~~~~~~
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462 Discussion one was sponsored by
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Vaccination with CHAT Strain Type 1
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Live Virus Vaccine Studies in South
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Discussion 481 the ages of the five
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Immunological and Epidemiological E
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DISCUSSION CHAIRMAN STUART-HARRIS:
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Further Observations on First Field
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Further Observations Qn First Field
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Further Observations on First FielJ
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Poliomyelitis Vaccination in Poland
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24. A SMALL-SCALE TRIAL WITH LIVE P
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Live Poliomyelitis Vaccine-Small-Sc
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25. VACCINATION AND CHALLENGE-POLIO
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Vaccination and Challenge-Poliomyel
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26. VACCINATION WITH ATTENUATED POL
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Vaccination with Attenuated Poliovi
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Discussion 575 ence last year. The
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Large-Scale Practical Trials, Use o
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594 Discussion 594 Disenísion ~ ~
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596 Discussion 596 Díscussion~~~~~
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598 Discussion 598 Discussion high
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602 Summary of the Conference 602 S
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Appendix The following letter was r
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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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LIVE POLIO IRUS VACCINES

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