[An evaluation of the epidemiological and immunological efficacy of the vaccinal prophylaxis of diphtheria and tetanus]. / Otsenka épidemiologicheskoi i immunologicheskoi éffektivnosti vaktsinoprofilaktiki difterii i stolbniaka.

The extensive use of adsorbed diphtheria-tetanus toxoid with reduced antigen content was found to be ineffective in the prophylaxis of diphtheria: 86.3% of diphtheria patients among those who had been immunized with this preparation fell only a year after the first booster immunization, and the proportion of those who proved to be unprotected against diphtheria on years 3, 4 and 5 after immunization reached, respectively, 21.0%, 35.5% and 49.4%. The number of children immunized with this preparation at common preschool institutions may reach 50% and more, and with an increase in the coverage of children with immunization from 10% to 50% the proportion of unprotected children may rise from 7.4% to 17.8%. The proportion of preschool institutions, insufficiently protected from diphtheria and, as a consequence, running a considerable risk of becoming (in case of the penetration of this infection) the foci of diphtheria, was found to reach 32.9%.

[The specific prophylaxis of diphtheria in adults with adsorbed DT-m anatoxin]. / Spetsificheskaia profilaktika difterii u vzroslykh ADS-M anatoksinom.

The dependence of immune response on commonly observed immunity characteristics prior to immunization has been established on the basis of the study of the kinetics of immune response in adults receiving injections of adsorbed diphtheria-tetanus (DT) toxoid with reduced antigen content, both for routine immunization and on epidemiological indications. The necessity of the practical use of immunological screening for the differentiated approach to the choice of a suitable preparation (adsorbed diphtheria toxoid, adsorbed DT toxoid or adsorbed DT toxoid with reduced antigen content) and immunization schedule for adults, especially in epidemic foci, has been substantiated.

[Indices of diphtheria (antitoxic) immunity in the dynamics of the disease and its treatment in adults]. / Pokazateli difteriinogo (antitoksicheskogo) immuniteta v dinamike zabolevaniia i lecheniia u vzroslykh.

A total of 1,034 serum samples from 618 persons, including patients with different forms of diphtheria, carriers of the toxigenic forms of Corynebacterium diphtheriae, and angina patients, were studied. Analysis of the incidence of antibodies to C. diphtheriae toxin and their titers revealed that in more than half of all diphtheria patients no antibodies to C. diphtheriae toxin were detected upon admission to hospital. At the same time in 26% of the patients no antibodies were detected during the whole period of the disease; in such patients the toxic and subtoxic forms of diphtheria were registered twice as often as in seropositive patients. In 31% of the patients seronegative by the moment of hospitalization a rapid increase in the titers of antibodies C. diphtheriae toxin was observed in the course of the disease, which was indicative of the secondary character of immune response in patients who had been immunized earlier.

[Immunological effectiveness of secondary revaccination against tetanus performed at prolonged intervals]. / Immunologicheskaia éffektivnost' vtoroi revaktsinatsii protiv stolbniaka, provedennoi s udlinennymi intervalami.

After primary immunization with adsorbed DPT vaccine antitetanus immunity was retained for 9-10 years in 90.6-98.4% of children covered by this study. The second booster immunization of children against tetanus with adsorbed DT toxoid with reduced antigen content, made at an interval prolonged to 7-10 years under the conditions of lower antitoxic immunity, ensured a high level of intense antitetanus immunity. These data point to the possibility of prolonging the interval between booster immunizations to 9-10 years and reducing the number of injections and antigenic load.

[Epidemiologic surveillance of diphtheria and measles]. / Epidemiologicheskii nadzor za difteriei i kor'iu.

The epidemiological surveillance of diphtheria and measles makes it possible to evaluate the actual coverage of different groups of population with immunization and the state of this protection, to determine the tendencies of the epidemic processes of the afore-mentioned infections, to assess the efficacy of prophylactic and antiepidemic measures, and to develop well-grounded recommendations aimed at preventing the formation of foci of group infections and the lethal outcomes of diphtheria and measles.

[Immunological structure of the population in a system of epidemiological surveillance of diphtheria]. / Immunologicheskaia struktura naseleniia v sisteme épidemiologicheskogo nadzora za difteriei.

The characteristics of antitetanus and antidiphtheria immunity in children, adolescents and adults in Perm have been determined by means of the passive hemagglutination test, and the tendency towards the decrease of their immunity to diphtheria with the increase of their age has been established. The registered and actual coverage of children and adolescents by immunization is characterized on the basis of the presence of antibodies to the tetanus component of combined vaccines. A considerable proportion of persons at boarding schools and vocational technical schools has been found to be seronegative with respect to diphtheria. The seasonal dynamics of antitoxic immunity is presented.

[Evaluation of the immunological effectiveness of the planned vaccinal prophylaxis of diphtheria and tetanus in Sverdlovsk and Sverdlovsk Province]. / K otsenke immunologicheskoi éffektivnosti planovoi vaktsinoprofilaktiki difterii i stolbniaka v Sverdlovske i Sverlovskoi oblasti.

The level and intensity of antitoxic immunity to diphtheria and tetanus in children and adolescents were determined. The presence of tetanus antitoxin in titers exceeding the protective level in 96.3-98.5% of the examined children and adolescents is indicative of a high actual coverage by immunization. Protective titers against diphtheria were lower. There was no essential difference in the levels of protection in children immunized according to the vaccination schedule and in those immunized with some deviations from this schedule. A considerable part of newborns and children aged 3 months had antibodies to diphtheria and tetanus antitoxins. After the third booster immunization changes in antidiphtheria immunity characteristics occurred only in 2.5% of the vaccines and no changes in antitetanus immunity characteristics were observed.

[Immunity to diphtheria and tetanus in some of the administrative territories of the RSFSR]. / Sostoianie immuniteta k fidterii i stolbniaku na nekotorykh administrativnykh territoriiakh RSFSR.

The article deals with the state of immunity to diphtheria and tetanus among the adult population in some administrative regions of the RSFSR. Of the children and adults covered by the survey, 91.3-96.7% were found to have protective antibody titers against diphtheria and 98.7-100%, against tetanus. An essential drop in the level of immunity to diphtheria in persons over 18 years of age was revealed: 71.7% of them were nonimmune, which correlated with the high morbidity rate among these persons. At the same time the percentage of adults nonimmune to tetanus was considerably lower than that of adults nonimmune to diphtheria, reaching only 27.1%. The state of immunity to tetanus in adults was found to depend on the seasons.

[Monthly dynamics of the antitoxic immunity against diphtheria and tetanus and of normal antibodies to fraction I of the plague microbe in adults]. / Pomesiachnaia dinamika antitoksicheskogo immuniteta protiv difterii i stolbniaka i normal'nykh antitel k fraktsii I chumnogo mikroba u vzrosylkh.

Monthly characteristics of antitoxic immunity to diphtheria and tetanus toxoids in 3,334 adults in Ryazan were determined. As a result, the following differences were established: the characteristics of antidiphtheria immunity were somewhat higher in the autumn-winter period and dropped to the minimal level in the winter-spring period; the maximal characteristics of antitetanus immunity clearly coincided with the hot season, its minimal characteristics with the cold season. For the first time the frequency and titers of normal antibodies to fraction I of Pasteurella pestis in humans were determined. Their monthly dynamics proved to be parallel to the curve indicating the characteristics of antitetanus immunity, but on a lower level: 1-10%. The presence of normal antibodies was accompanied by higher titers to tetanus toxoid, but not to diphtheria toxoid. According to the results of earlier studies, normal antibodies were shown to be the sign of homologous reactivity in inbred animals. Our data indicate that these antibodies can serve as the indirect sign of heterologous reactivity in humans.

[Further improvements in schedules for immunizing children against diphtheria and tetanus]. / Dal'neishee sovershenstvovanie skhemy immunizatsii detei protiv difterii i stolbniaka.

The study of the rational schedule of revaccinations made at different ages for the prevention of diphtheria and tetanus was carried out on 800 children belonging to the age groups of 6-9 years and 11-14 years. The content of diphtheria antitoxin was determined by Jensen's method, and the content of tetanus antitoxin in the passive hemagglutination test. In the first age group immunity to the above-mentioned infections was determined after the primary immunization, and in the second age group after the first revaccination made at an age indicated in the schedule. The high level of immunity to both diphtheria and tetanus was shown to preserve for 6-7 years. For this reason intervals between revaccinations scheduled for children achieving a definite age in accordance with the existing scheme of immunization against diphtheria and tetanus may be increased. the most rational time for such revaccinations is the age of 9 (instead of 6) years and 16 (instead of 11) years.

The use of a passive hemagglutination test (PHA) in the diagnosis of viral eye diseases. Investigation of lacrimal fluid for the presence of antibody to herpes simplex virus (HSV).

The use of a passive haemagglutination test (PHA) with a stable erythrocyte diagnostic preparation sensitized with herpes simplex virus for the detection of antibody to herpes simplex virus (HSV) in the lacrimal fluid of the patients is described. Specific antibody to HSV antigen was found in 68% of the lacrimal fluids taken from patients suffering from herpetic eye disease. In patients with superficial keratitis the antibodies were found more frequently and in higher titers than in deep involvements of the cornea. In patients with keratitis and keratouveitis of unknown etiology, antibody in tears was found in 23%, and in those with inflammatory diseases of nonherpetic etiology, in 14.2%. In clinically normal subjects and patients with non-inflammatory eye affections no HSV antibody could be found in tears. Geometric mean antibody titers in tears of patients with herpes simplex keratitis and keratouveitis were statistically significantly higher than in patients with other diagnoses. The diagnostic importance of HSV antibody found in tears is discussed.

[Antidiphtheria and antitetanus antitoxic immunity indices in the population of the Estonian SSR (an assessment of the effectiveness of a planned vaccine prophylaxis)]. / Pokazateli protivodifteriinogo i protivostolbniachnogo antitoksicheskogo immuniteta u naseleniia Estonskoi SSR (k otsenke éffektivnosti planovoi vaktsino-profilaktiki).

In 1972-1974 and 1977 in the Estonian SSR children and adults were surveyed for the presence of antibodies against tetanus and diphtheria toxins (toxoids) by means of the passive hemagglutination test. The level of protection against tetanus was revealed to correspond to the proportion of child population covered by vaccination: in 1977, with 98.8% covered by vaccination, the level of protection among children aged 7 to 14 years and adolescents of 15-19 years exceeded 98%; with the increase of age (every 10-15 years) the level of protection against tetanus regularly decreased. This dynamics correlated with the existing terms of postvaccinal immunity and the epidemiological independence of tetanus as infectiion. The level of protection in child population against diphtheria in 1972-1974 and 1977 lagged behind the level of protection against tetanus and the coverage by vaccination. The diphtheria component of adsorbed DPT vaccine seemed to be unable to ensure the sufficient level and intensity of immunity under conditions of a sharply decreased risk of encounter with the infective agent. In persons aged 40 years and over the indices of immunity against diphtheria were higher than against tetanus. These indices resulted from diphtheria infection at the prevaccination period and could serve as an objective sign in following up the decrease of the process of diphtheria epidemics.