LIVE POLIO IRUS VACCINES

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Vaccination with Attenuated Polioviruses in Costa Rica 571 screened by the conference panels, 59 were accepted as paralytic poliomyelitis. Forty-five of these occurred in non-vaccinated persons. Results of virological studies on the 27 of the 45 from whom specimens were obtained are summarized in Table 2. Poliovirus was isolated from 15 of these stool samples. Type 2 poliovirus was isolated from 12 patients, Type 3 from two, and Type 1 from one. Non-polio enteroviruses were isolated from four, no virus was obtained from five stools, and the results in three instances are pending. Of the 59 polio cases, 26 were in the metropolitan area and 13 of these were in non-vaccinated individuals. The remaining 33 cases were scattered among all of the seven provinces and 32 of them were in nonvaccinated persons. It should be noted that two of the cases in non-vaccinates, which were clinically accepted as paralytic poliomyelitis, were seronegative for all three types of poliovirus and in one of these patients the serologic finding was confirmed by a second blood specimen obtained one month after the first. The remaining 14 of the 59 confirmed paralytic poliomyelitis cases occurred in individuals who had received oral poliovirus vaccine. Thirteen of the 14 cases were reported from the metropolitan area and the other came from the province of San José. The virological findings in these cases are summarized in Table 2, where it may be seen that six poliovirus isolates were recovered. Types 2 and 3 were both recovered from one patient, and four of the other five isolates in cases were Type 2 poliovirus. Type 1 was not recovered. Non-polio enteroviruses were isolated from two specimens and one failed to yield any virus. Stool examinations are incomplete in two instances. Table 3 presents a summary of accumulated data pertaining to the 14 paralytic cases which had a history of oral poliovirus vaccination. Stool and blood specimens were collected from 13 of them, and from one case serum only was obtained. Up to this time, complete laboratory results are available for seven of the 14 patients. For three others, serologic findings are available, and in two of these stool examinations are incomplete. Of the remaining four recently reported cases, neither stool nor blood specimens have yet been examined. With the exception of case No. 286 which will be discussed separately, all of the patients received oral poliovaccine more than seven weeks before the onset of illness. Case No. 53. Isolation of ECHO virus from the fecal material obtained more than one month after onset is not very significant for the implication of this agent as the cause of the illness; however, the isolation of ECHO virus from four of its six household contacts gives reason to entertain this possibility. The absence of Type 2 antibodies more than a month after the illness started shows clearly that the symptoms were not caused by Type 2 virus, either wild or of vaccine origin, although it does indicate a lack of response to the Type 2 vaccine. Type 1 vaccine was not fed to this patient and the high titer of Type 1 antibodies suggests the possibility that a Type 1 infection may have been the cause of the disease. Cases Nos. 269, 270, 277, and 283. Two of the patients received the full course of oral vaccination with monovalent strains, and one received trivalent vaccine. The last one (283) received only Type 2 vaccine. The lapse of time between vaccination and onset exculpates the vaccine as the cause of symptoms in all four of these cases. The isolation of Type 2 poliovirus from the fecal specimens of these cases plus the presence of Type 2 specific antibodies in their sera indicate a lack of response to the Type 2 vaccine. Also the serologic results of Cases Nos. 270 and 277 indicate a lack of response to Type 1 vaccine. Case No. 228. No stools were collected. Serology establishes Type 1 infection and lack of response to Type 2 vaccine administered at six months of age. Case No. 282. The last monovalent vaccine dose was administered five months before illness occurred. No enteric viruses were found in the stool collected nine days after onset. The serology indicates the possibility of Type 1 infection and consequently a Type 1 vaccine failure. Case No. 286. This patient received trivalent vaccine ten days before the onset of illness. Preliminary examination of the stool collected nine days after onset, indicated the presence of Types 2 and 3 poliovirus. Also, the presence of a Coxsackie virus is suggested by mouse inoculation results. A serum taken on the same day as the stool sample showed an antibody titer of 1:128 against Types 1 and 2, and a titer of 1:4 against Type 3. The stool examination is not
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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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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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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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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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456 Efficacy-Field Evidence M.G. C
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Vaccination with CHAT Strain Type 1
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Live Virus Vaccine Studies in South
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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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