Public health implications of an outbreak of rabies in arctic foxes and reindeer in the Svalbard archipelago, Norway, September 2011.

Between 16 September and 5 October 2011 rabies was diagnosed in two arctic foxes and eight reindeer in the Svalbard archipelago, in Norway. This outbreak occurs at the end of the reindeer hunting season and poses an increased risk to many people that were involved in the hunt. As of 28 September 2011, 280 people had received post-exposure prophylaxis. No human cases of rabies have occurred.

Safety and immunogenicity of a combined DTPa-IPV vaccine administered as a booster from 4 years of age: a review.

A combined DTPa-IPV booster vaccine was administered as a 4th or 5th dose after DTPa or DTPw priming. Over 99% vaccines developed antibody levels considered to be protective to diphtheria, tetanus and poliovirus, and >95% mounted a response to acellular pertussis antigens. Rectal temperature >39.5 degrees C was observed in at most 3.2% of vaccinees. Swelling >50 mm occurred in 24% of DTPa-primed compared to 5.5% of DTPw-primed children. Large swelling involving the entire upper arm (extending to involve the elbow joint) was reported for up to 1.2% of DTPa-primed subjects, which is consistent with literature reports for other DTPa vaccines.

[Should school children receive pertussis vaccine?]. / Bør skolebarn få kikhostevaksine?

BACKGROUND: A study comparing diphtheria immunity in Norwegian and Russian schoolchildren indicated low immunity against diphtheria in Norwegian children before the booster dose given at age 11 years. The pertussis epidemic in Norway 1997-98 demonstrated decreasing vaccine immunity from age 5-6 years. The possibility of improving immunity against both diseases by a booster dose during early school age is therefore under consideration. MATERIAL AND METHODS: Immune response and adverse events were studied after a combined vaccine against diphtheria, tetanus, pertussis (acellular) and poliomyelitis (DTPa-IPV) given at seven years of age, and a combined vaccine against diphtheria, tetanus and pertussis (acellular) (DTPa) at 11 years of age, in two parallel trials including 124 and 83 participants respectively. RESULTS: The trials confirmed that the diphtheria immunity is lower than it ideally should be in more than 40% of children before the booster dose at age 11. Pertussis immunity is difficult to assess because there is no clear relationship between antibody levels and protection. All study participants responded well to all vaccine components. The 11-year-old children reported higher occurrence of adverse events than the 7-year-olds. All adverse events were brief and none were serious. INTERPRETATION: The results indicate that a booster dose of DTPa-IPV in early school age would give better protection against diphtheria and pertussis in Norwegian schoolchildren, without unacceptable side effects.

[Vaccine against Haemophilus influenzae type b--antibody response and adverse effects]. / Vaksine mot Haemophilus influenzae type b--antistoffrespons og bivirkninger.

In 1992 it was decided to implement vaccination against Haemophilus influenzae type b (Hib) in the Norwegian vaccination programme. The chosen vaccine consists of Hib-polysaccharide conjugated to tetanus toxoid. To suit the Norwegian vaccination schedule, Hib-vaccine was given together with vaccine against diphtheria, tetanus and pertussis (DTP) at three, five and ten months of age. Since all earlier studies with the Hib-vaccine have used other time schedules, a pilot study was conducted to test antibody response and side effects when using the Norwegian schedule. 44 infants were vaccinated with Hib-vaccine and DTP at three, five and ten months of age. Blood samples showed that 95% had protective antibody titer against Hib after two doses, 100% after three. The response to the other antigens was adequate. There were only minor side effects. After introduction of the Hib-vaccine the incidence of invasive Hib-infection in children below three years of age has decreased considerably.

[Dystrophy caused by upper airway obstruction]. / Dystrofi forårsaket av øvre luftveisobstruksjon.

We describe three infants whose main symptoms were poor weight gain, delayed motor development and recurrent respiratory infections. Obstructive sleep apnea was diagnosed, and all three improved after adenotomy or adenotonsillectomy. Obstructive sleep apnea is an important differential diagnosis in infants showing retarded development and failure to thrive.