Vaccinations against bacterial infections.

1. As with any therapeutic measure, prophylactic vaccination is to be jugded by the correlation between benefit and harm or expenditure. By benefit is meant a not to short-lived substantial decrease in the morbidity and/or mortality. Harm refers to the number and severity of side effects in the individual child vaccinated and expenditure means the economic burden placed upon society. 2. The evaluation of many vaccinations at present varies between two extremes: On the one hand vaccination procedures are considered to provide an opportunity to eradicate most of the infectious diseases, on the other hand there is a tendency to assess side effects more drastically the more likely the danger of the particular disease seems eliminated once and for all. 3. An attempt is made to discuss the achieved or achievable standard of vaccination measures against bacterial infections in the light of 3 classes of vaccines. The first class involves well established and commonly used vaccines such as BCG and DPT vaccines although differences in opinion exist on their future employment. 4. The second class involves newer vaccines or vaccines that are under development as for instance vaccines against meningococci, pneumococci, H. influenzae and enteropathogenic E. coli. 5. The third class includes vaccines whose realisation at present appears to be yet difficult or hardly feasible, for instance vaccines against enterotoxins of enteropathogenic organisms, against lues, gonorrhea or for example against organisms of the infectious hospitalism.

[Trends in infectious diseases]. / Trends in der Infektologie.

Infectious diseases can be comprehensively divided in 4 groups by means of the parameters morbidity and lethality. This enables us to describe the continuously changing epidemiologic situation till the present state in this country in a simple way. New essential trends in etiology and pathogenesis are outlined, followed by a few selected therapeutical and prophylactic aspects. Finally problems of intrauterine acquired and neonatal infections are discussed.

Vaccinations against bacterial infections.

The achieved or achievable standard of vaccination measures against bacterial infections is discussed with reference to 3 groups of vaccines. The first group involves well established and commonly used vaccines such as BCG and DPT vaccines. The second group includes newer vaccines or vaccines that are under development, for instance vaccines against meningococci, pneumococci, H. influenzae and enteropathogenic E. coli. The third group covers vaccines whose realisation at present appears to be difficult or hardly feasible, for instance vaccines against enterotoxins of enteropathogenic organisms, against lues, gonorrhea or, example, against organisms of hospital infections.

[The clinico-diagnostic value of C-reactive protein, determined by simple radial immunodiffusion and compared with latex agglutination]. / Der klinisch-diagnostische Wert des C-reaktiven Proteins (CRP), bestimmt in der einfachen radialen Immundiffusion (RID) und verglichen mit der Latexagglutination.

Importance of CRP-determination in rapid diagnosis of septic diseases in children is being examined. Specificity and sensitivity of white blood cell count, thrombocyte count, blood sedimentation rate, differential blood count and CRP were evaluated statistically. Rapid diagnosis was performed with sera of 95 patients shortly after being admitted on ward. The values of children with serious bacterial diseases were compared with those of children with serious abacterial ones. Significant superiority of CRP was established. To be successful a rapid and simple method must be available. In our study combined measurement of CRP by latex agglutination and RID has turned out to be advantageous for early detection of bacterial infection.

Meningococcal infections in the German Democratic Republic 1971-1984.

Since May 1979 all meningococcal strains isolated in the GDR have been investigated microbiologically. Despite a generally low incidence, a marked increase in meningococcal infections has been observed. From a total of 650 strains sent to our institute up to 1984, 515 could be serogrouped. 54 strains belonged to serogroup A, 292 to B, 125 to C, two to X, eight to Y, one to Z, 30 to W-135 and three to 29E. There were no substantial changes in the distribution of the groups. In our study we tried to find out whether there are any correlations between the epidemiological and microbiological data. A record was made of the age distribution, clinical picture and regional distribution of the meningococcal strains isolated. Rifampicin chemoprophylaxis of contacts was introduced in 1981.

The measles eradication programme in the German Democratic Republic.

After 3 years of intensive preparations the Ministry of Health of the German Democratic Republic started a national measles eradication programme in 1967. Vaccination was at first voluntary, but became compulsory in 1970. Through a vaccination campaign using Leningrad-16/SSW attenuated live vaccine, the disease was virtually eliminated throughout the country by 1972. In 1973 and 1974 only sporadic cases of measles were observed. The number of vaccination failures was negligible. Combined immunization against measles and poliomyelitis provoked no unusual reactions, and the difference between the seroconversion rates following combined or separate immunization was not statistically significant.

[Laboratory experiments with a polyvalent extract vaccine for oral immunization against E. coli enteritis]. / Laboratoriumsversuche mit einem polyvalenten Extraktimpfstoff zur Oralimmunisierung gegen Enteritiscoli-Infektionen.

Bacteria of E. coli causing enteritis can be extracted by EDTA-sodium. These extracts having lower dry weights result in better protective effects in contrast to sodium-deoxycholate extracts. The EDTA-sodium extracts can be concentrated, purified and sterile filtrated. Thus the production of polyvalent vaccines is possible. A direct relation exists between the effectiveness of the extracts and the virulence of the strains used for extraction. The more virulent the original strain the better is the protective effect of the vaccine produced by extraction of the original strain. The single components of the polyvalent vaccine show a certain improvement of their protective effects. For estimating the immunizing dose, it is necessary to consider the limiting dose. When exceeding this dose the protective effect or the vaccine does not further increase but remains constant of even decreases. The immunizing dose wanted must be greater than the ED50 but smaller than the limiting dose. Extremely high oral doses of vaccine result in symptoms of incompatibility in mice.

[Rotavirus diarrhea in childhood]. / Rotavirus-Diarrhoe im Kindesalter.

Electron microscopy of 350 diarrhoeal faeces revealed Rotavirus-particles in 145 cases. All patients with Rotavirus-infections showed symptoms of acute gastroenteritis lasting 1 to 8 days. Additionally to diarrhoea most cases presented fever and vomiting. None of the patients showed toxicosis.

[The protective effect of an EDTA-sodium-extract-vaccine obtained from swine-pathogenic E. coli in a field trial. 1. Communication: Direct and indirect immunization of suckling piglets (author's transl)]. / Die Schutzwirkung von EDTA-Na-Extraktimpfstoffen aus schweinepathogenen E. coli-Bakterien in Feldversuchen. 1. Mitteilung: Direkte und indirekte Immunisierung von Saugferkeln.

Pentavalent EDTA-Sodium-extract-vaccines and monovalent EDTA-Sodium-extract-vaccines obtained from swine-pathogenic E. coli and produced in Berlin-Buch were used in field trials to test their antiepizootic effect in industrial pig-farms in the district of Wroclaw. The pentavalent vaccine contained extracts from E. coli O138, O139, O141, O147, and O149, whereas extracts from O8, O115 and O149 were used as monovalent vaccines. The field trials were conducted as blind trials is closed stocks of pigs. We employed direct oral immunization of suckling piglets and indirect immunization via sow vaccination. Direct oral immunization was tested in 382 suckling piglets. 190 animals were vaccinated, 192 animals received placebo. Neither the pentavalent vaccine nor a monovalent vaccine obtained from an epizootie strain of this stock gave protection in terms of a decrease in the duration of disease or a reduction of morbidity and mortality. Direct oral-immunization of suckling piglets thus was ineffective. Indirect immunization of the suckling piglets via vaccination of sow was performed in 189 pregnant sows 18--15 days before farrowing. 84 sows received vaccines i.m., 105 were given placebo i.m. These sows farrowed 1717 pigs, 777 of which were immunized indirectly and 940 treated with placebos. With the pentavalent vaccine and with the monovalent vaccine obtained from an epizootic strain we achieved significant protection of the indirect vaccinated suckling piglets.

[The protective effect of an EDTA-sodium-extract-vaccine obtained from swine-pathogenic E. coli in a field trial. 2. Communication: Immunization of weanling piglets (author's transl)]. / Die Schutzwirkung von EDTA-Na-Extraktimpfstoffen aus schweinepathogenen E. coli-Bakterien im Feldversuch. 2. Mitteilung: Immunisierung von Absatzferkeln.

Pentavalent EDTA-Sodium-extract vaccines and monovalent EDTA-Sodium-extract vaccines obtained from swine-pathogenic E. coli were used to test their antiepizootic effect in industrial pig farms, 2929 piglets after weaning were included in this field trial, 1309 were immunized partly orally, partly i.m., 1620 piglets received placebos accordingly. By means of oral immunization the pentavalent vaccine was capable of reducing the morbidity of the vaccinated animals significantly. Intramuscular immunization with the pentavalent vaccines produced significant differences in morbidity too. A monovalent vaccine obtained from E. coli O149 and E. coli O8 was shown to be equally effective, whereas a monovalent vaccine obtained from E. coli O115 was ineffective. But in this stock there were infections with O149 but none with O115 or O8.

[Preliminary results of an atiepizootic field test using EDTA-Na extract vaccine from Escherichia coli strains pathogenic to swine in swine production industrial units]. / Erste Ergebnisse eines antiepizootischen Feldversuches mit einem EDTA-Na-Extraktimpfstoff aus schweinepathogenen Escherichia-coli-Stämmen in Anlagen der industriemässigen Schweineproduktion.

An anti-epizootic field test was applied to industrialised pig farms in the region of Wroclaw, Poland, to test the effectiveness of a pentavalent EDTA (calcium disodium edetate)--sodium vaccine extracted from Escherichia coli strains with pathogenicity to swine. The vaccine had been received from a centre in Berlin-Buch, GDR. The vaccine failed to provide any protection, when orally applied to nursed piglets. However, both morbidity and mortality were reduced and, thus, an anti-epizootic effect on nursed piglets produced, when the vaccine had been injected intramuscularly to the pregnant mother animals, prior to farrowing. In weaned piglets morbidity was sucessfully reduced by both oral as well as intramuscular administration.