LIVE POLIO IRUS VACCINES

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Vaccination and Challenge-Poliomyelitis in Nicaragua 557 tory was confirmed. It may be noted in the table that eight of these patients were vaccinated during the mass vaccination program in Managua in 1958, and they received all three types of poliovirus as monovalent vaccines. The other seven patients had received liquid trivalent vaccine. These two groups will be considered separately. Cases among monovalent-vaccine-fed children. Cases Nos. 3 and 4, from whom fecal material was not collected, recovered completely within four months after the onset of paralysis. This could suggest that the transient paralysis observed was not due to poliovirus infection. From the stool sample of case No. 7, a nonpoliovirus agent was recovered in monkeykidney tissue culture (MKTC). The sample was collected 54 days after onset. In case No. 8, from whom a stool specimen was collected five days after onset, no agent was recovered by any of the laboratories. This fact may suggest an etiology unrelated to poliovirus. Unfortunately, stool specimens were not available from cases Nos. 1, 2, and 6. Serologic results on two of these cases do not make it possible to rule out poliovirus infection, and these cases, therefore, could be considered as vaccine failures. Cases among trivalent-vaccine-fed children. The onset of paralysis in cases Nos. 11 and 12 occurred within 48 hours after vaccine administration. The onset of paralysis in cases Nos. 10 and 13, occurred 49 and 44 days, respectively, after vaccine administration, and thus represent onsets well beyond the accepted incubation perriod.(3) They will be regarded as instances of vaccine failure if the stool and blood studies which are in progress confirm the clinical diagnosis of poliomyelitis. Cases Nos. 5 and 9 had onsets nine to 13 days after feeding, and in spite of the fact that they occurred within the period of the outbreak under consideration, they deserve comment since both might be suspected of vaccine strain etiology. Case No. 5. Although this 32-month-old child had had four injections of Salk vaccine, the last one being eight months previously, she was fed the trivalent vaccine on 11 December 1959. Her illness had onset 13 days later and after four days with a temperature of 38.5 ° C. she developed paralysis in both legs and then quadriplegia at which time she was hospitalized. One week later she was sufficiently improved to be taken home. Shortly thereafter her parents took her to Mexico City for rehabilitation treatment. After two and a half months she returned almost fully recovered. She was seen in mid-May at which time there was still some weakness in the right deltoid and right leg, but without any suggestion of muscular atrophy in either legs or arms. The prognosis of the pediatrician who treated her in Mexico City was for complete recovery in 30 to 60 days. A stool specimen from this patient, obtained 27 days after vaccination and 15 days after onset, yielded Type 3 poliovirus. Neutralizing antibodies to all three types of poliovirus were demonstrated in a serum specimen which was collected on the same date as the stool specimen. Available laboratory data do not rule out poliovirus infection, but the clinical evolution of this patient's disease is rather suggestive of a non-poliovirus etiology. Case No. 9. Poliovirus Type 1 has been isolated from a stool specimen taken 11 days after vaccination and two days after onset. Laboratory studies are not yet complete and the case is still under observation. The interval between vaccine administration and onset, as well as the fact that the virus isolated corresponds in type to the one responsible for the epidemic, requires that both natural infection and vaccine implication be carefully studied. Investigations designed to provide additional data for consideration are still in progress. In Table 7a the data are summarized for 12 paralytic cases for which the records for the dates and types of vaccine administered are incomplete or missing, or the patients failed to receive all three types of virus. Cases Nos. 16, 17, and 18 received only vaccines for Types 2 and 3 during the mass vaccination program in 1958. Stools from cases Nos. 16 and 18 were collected 25 and nine days, respectively, after onset, and, when examined in MKTC one yielded a non-poliovirus and the other no virus. Type 1 poliovirus was isolated from case No. 17. Because none of these three patients had received Type 1 vaccine they may be dismissed from further consideration. Cases Nos. 21, 23, 25, and 27 were apparently vaccinated as infants and are assumed to have received one dose of monovalent vaccine, presumably Type 2, since trivalent vaccine did not come into use in Managua until sometime in
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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 Discussion .......... .......
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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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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 373 -~~~~~~ics o 7 domin
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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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- Use of Sabin's Live Poliovirus Va
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TABLE 14. Use of Sabin's Live Polio
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Discussion 411 DR. ANDERSON: My que
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Course of Mass Immunization in USSR
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, _ _ Course of Mass Immunization i
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DISCUSSION CHAIRMAN LÉPINE: Thank
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Discussion 431 DR. STUART-HARRIS: I
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436 Efficacy-Field Evidence TABLE 1
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438 Efficacy-Field Evidence Adminis
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446 Efficacy-Field Evidence 446 Eff
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448 Efficacy-Field Evidence 448 lEf
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450 Efficacy-Field Evidence m Co 0
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452 Efficacy-Field Evidence ] ~~ ~
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454 Efficacy-Field Evidence It is n
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456 Efficacy-Field Evidence M.G. C
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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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Page 540 and 541: Poliomyelitis Vaccination in Poland
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Page 619 and 620: 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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