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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A large outbreak of haemorrhagic fever (subsequently named Ebola haemorrhagic fever) occurred in southern Sudan between June and November 1976. There was a total of 284 cases; 67 in the source town of Nzara, 213 in Maridi, 3 in Tembura, and 1 in Juba. The outbreak in Nzara appears to have originated in the workers of a cotton factory. The disease in Maridi was amplified by transmission in a large, active hospital. Transmission of the disease required close contact with an acute case and was usually associated with the act of nursing a patient. The incubation period was between 7 and 14 days. Although the link was not well established, it appears that Nzara could have been the source of infection for a similar outbreak in the Bumba Zone of Zaire.In this outbreak Ebola haemorrhagic fever was a unique clinical disease with a high mortality rate (53% overall) and a prolonged recovery period in those who survived. Beginning with an influenza-like syndrome, including fever, headache, and joint and muscle pains, the disease soon caused diarrhoea (81%), vomiting (59%), chest pain (83%), pain and dryness of the throat (63%), and rash (52%). Haemorrhagic manifestations were common (71%), being present in half of the recovered cases and in almost all the fatal cases.Two post mortems were carried out on patients in November 1976. The histopathological findings resembled those of an acute viral infection and although the features were characteristic they were not exclusively diagnostic. They closely resembled the features described in Marburg virus infection, with focal eosinophilic necrosis in the liver and destruction of lymphocytes and their replacement by plasma cells. One case had evidence of renal tubular necrosis.Two strains of Ebola virus were isolated from acute phase sera collected from acutely ill patients in Maridi hospital during the investigation in November 1976. Antibodies to Ebola virus were detected by immunofluorescence in 42 of 48 patients in Maridi who had been diagnosed clinically, but in only 6 of 31 patients in Nzara. The possibility of the indirect immunofluorescent test not being sufficiently sensitive is discussed.Of Maridi case contacts, in hospital and in the local community, 19% had antibodies. Very few of them gave any history of illness, indicating that Ebola virus can cause mild or even subclinical infections. Of the cloth room workers in the Nzara cotton factory, 37% appeared to have been infected, suggesting that the factory may have been the prime source of infection.
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PMID:Ebola haemorrhagic fever in Sudan, 1976. Report of a WHO/International Study Team. 30 55

Standard whole virus influenza vaccine (1974-1976) containing 700 chicken cell agglutinating (CCA) units of type A (Port Chalmers/1/75) or Port Chalmers plus Scotland/840/74) and 500 units of type B (HK/8/73) antigens was found to produce excessive systemic toxicity in adult volunteers. Using experimental monovalent A and B vaccines, most of the observed toxicity was shown to be associated with the B antigen. Injection of 500 CCA units or more of B vaccine was followed within 10-16 hours by malaise and chills in approximately one-third of vaccines. Chills, malaise, and local pain were more common in volunteers lacking prevaccination serum HI antibody than in those in whom this antibody was present. Toxicity was not related to the presence of endotoxin or bacterial contamination of vaccine; it appeared to be "intrinsic" to the viral antigen. The mechanism for the toxicity in man may be the same as the direct pyrogenic effect of influenza antigen for rabbits previously observed by others. Detoxification of the B antigen by prolonged exposure to formalin reduced the side effects of a 500 CCA unit dose to acceptable levels without impairing its antigenicity.
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PMID:Systemic reactions to influenza B vaccine. 32 77

Graded doses of inactivated whole influenza A/New Jersey/8/76 virus vaccine were injected into healthy volunteers. Presence of hemagglutination-inhibiting (HAI) antibody was uncommon before vaccination in persons younger than 45 years and most common in those older than 65 years. All vaccine doses (4-61 microgram of hemagglutinin) induced HAI antibody in at least 50% of recipients, although a booster dose was required to induce high titers in those younger than 24 years of age. A tendency for HAI titers to increase with increasing age and dose was noted. A trivalent vaccine (composed of A/New Jersey/76, A/Victoria/75, and B/Hong Kong/73) given to persons 21-44 years old produced HAI antibody titers to A/New Jersey/76 similar to those produced by the same dose of A/New Jersey/76 as a monovalent vaccine and produced higher titers in subjects 65 years of age or older. Increases in neuraminidase-inhibiting antibody were small and infrequent. Local and system symptoms were commonly reported after vaccination but were mostly mild (11% had moderate pain and 19% had muscular aches). Reactions were less common among those with HAI antibody at the time of vaccination and were unacceptably severe (in 20% of recipients) only in seronegative recipients given the 61-microgram dose of hemagglutinin.
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PMID:Antibody responses and reactogenicity of graded doses of inactivated influenza A/New Jersey/76 whole-virus vaccine in humans. 34 21

Six patients developed persistent muscular cramps, aching pain, and fatigability after an influenza-like illness. Electromyography showed myopathic changes, although results of routine laboratory investigations were normal in all but one patient, whose serum creatine kinase concentration was slightly increased. All but one of the patients improved: three were asymptomatic within one to two years. The syndrome was probably a benign form of polymyositis.
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PMID:Benign postinfection polymyositis. 70 4

An outbreak of acute crural myalgia in children is reported. The severe calf pain followed an influenza-like episode, with subsequent complete recovery. Laboratory studies in most cases showed elevated creatine phosphokinase and SGOT values, with a low peripheral white blood cell count. Electromyographic studies were normal. Results of one muscle biopsy were normal. This postviral myalgia is a distinctive syndrome only recently being recognized in the United States.
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PMID:Acute postinfectious crural myalgia in children. 85 Aug 7

Possible side effects to two commercial influenza vaccines (Alorbat and Begrivac S) were investigated in 893 adults (18-60 years). Both vaccines, administered by jet injections, were similarly tolerated. About 90% of vaccinated subjects had neither subjective nor objective reactions. Swelling or pain at the site of injection was reported by 11.5% of those vaccinated by Alorbat, 4.5% complained of not feeling well but only 1.1% had verifiable disorders. Local reactions occurred in 12.4% of those receiving Begrivac S, with 7.7% systemic reactions of which 1.1% were verifiable. Those re-vaccinated had a similar incidence of side reactions to those with primary vaccinations. Reactions which did occur were obviously due to the vaccination method. One person had urticaria and oedema, possibly due to reaction to foreign protein; this would suggest that the degree of purity of the vaccine should be checked by the manufacturers.
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PMID:[Reactions to inactivated influenza vaccines (alorbat and begrivac s) (author's transl)]. 91 56

In a field trial a new influenza subunit vaccine was tested in parallel with a vaccine prepared from the whole virus. The subunit vaccine essentially contained only the proteins of the viral envelope, haemagglutinin and neuraminidase, which had been selectively solubilized by treatment with cetyl trimethylammonium bromide. Both vaccines contained 700 IU of strain A/Port Chalmers/73 in 0.5 ml. They were given to volunteers by the subcutaneous route with and without the addition of Al (OH)3 as adjuvant. Blood samples were taken on days 0, 28 and 90. Development of antibodies was assayed in the haemagglutination-inhibition (HI) and neuraminidase-inhibition (NI) test. All vaccines exhibited a very good immunogenic effect as judged from the number of volunteers with at least a four-fold rise in antibodies in the HI-test and those reaching titres that are considered to be sufficiently high for protection against disease. The best results were obtained with the aqueous subunit vaccine. All four vaccines also stimulated the formation of neuraminidase-inhibiting antibodies. The vaccines were well tolerated by the volunteers. The incidence of minor local reactions such as redness, swelling and pain varied according to the vaccine used, as shown on statistical evaluation. The aqueous subunit vaccine clearly proved to be superior in this respect.
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PMID:[Field trial with a new type of influenza subunit vaccine (author's transl)]. 99 32

A comparison was made of the antibody response and subjective reactions to zonally-purified influenza vaccine in aqueous suspension and in peanut oil adjuvant 65-4. Both preparations contained 700 CCA units of A/Aichi/2/68, and 300 CCA units of B/Mass/1/71. Subjective reactions were recorded by asking the volunteers to complete a record daily for 5 days. Pain at the injection site was recorded by 64 per cent of the recipients of the oil adjuvant vaccine compared with 35 per cent of the aqueous recipients, but local redness was more frequent after aqueous vaccine. Systemic symptoms was recorded a little more frequently after aqueous than oil adjuvant vaccine. When measured 71/2 weeks after a single dose of vaccine, the HAI geometric mean antibody titre (G.M.T) to the A/Hong Kong/1/68 antigen (antigenically similar to the A/Aichi/2/68 antigen in the vaccine) increased 2-7 fold after aqueous and 16-4 fold after adjuvant vaccine. Sixty-two weeks after vaccination the antibody titres remained higher in those given adjuvant vaccine. The G.M.T. to B/Mass/1/71 increased 1-9 fold 71/2 weeks after aqueous vaccine and 3-7 fold after adjuvant vaccine. The antibody response to both influenza A and B antigens was broader in the recipients of adjuvant vaccine. The G.M.T. to A/England/42/72 increased 2-8-fold after aqueous and 13-fold after adjuvant vaccine; and to B/England/847/73 it increased 1-3-fold after aqueous and 1-9-fold after adjuvant vaccine.
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PMID:Response to influenza vaccine in adjuvant 65-4. 105 29

Almost 6,000 healthy adults inoculated with influenza vaccine were asked to record daily for 5 days the presence or absence of defined local and general symptoms; 70 percent completed and returned the record. The overall incidence of subjective reactions derived in this way was high; approximately 50 percent complained of local pain and 40 percent of general symptoms. Only about one-third of vaccinees recorded no symptoms. The incidence of subjective local reactions was about 8 percent higher in women than men. Among 5,600 vaccinees a total of 63 days sickness absence was attributed to reaction in the week of immunization (1.1 days per 100 employees). Almost all the absences were of less than 3 days duration, unsupported by a doctor's certificate. In the week of vaccination sickness absence among vaccinees was not higher than that of non-vaccinees. Although the incidence of subjective reaction was found to be high and vaccination might itself cause some sickness absence, most of the reactions appear to be trivial. Among 700 employees who were interviewed 1 or 2 days after vaccination in 1973, the incidence of what was judged to be significant local pain and erythema was about 5 percent. Nevertheless,the reactions appear to have an important effect on acceptance of influenza vaccination. From the answers given to a questionnaire 30 percent of employees who refused vaccination did so either because they previously had symptoms after vaccination, or because others had told them of their occurrence. In approximately 16,500 injections, only 2 patients had an acute reaction resembling anaphylaxis.
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PMID:Reactions to injected influenza vaccine. 112 81

The clinical and antibody responses to Alice strain (AS) live attenuated influenza A (H3N2) vaccine and killed parenteral (KP) bivalent influenza vaccine were compared in a randomly allocated group of 150 elderly volunteers. AS recipients experienced more symptoms but these were mild and short in duration. Rhinitis occurred in 45% and pain at injection site in 25% of the AS and KP groups, respectively. Influenza A (H3N2) serum hemmaglutination inhibition titer responses were significantly higher in KP vaccinees; 95% of KP AND 60% OF AS recipients with initial titers smaller than or equal to 1:16 had fourfold or greater titer rises. KP induced significantly higher nasal neutralization titers but the proportion with fourfold or greater responses was not significantly different. Previous studies have shown poor correlations between antibody levels induced by live influenza vaccines and protection. Natural and/or challenge studies are needed before efficacy of influenza vaccines can be established.
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PMID:Alice strain live attenuated influenza (H3N2) vaccin in an elderly population. 116 13


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