An electron microscopical investigation of small round viruses in non-bacterial gastroenteritis.

Small round viruses implied in non-bacterial gastroenteritis were observed by electron microscope in stool specimens collected from 1993 to 1996. The specimens relative to 1981 were re-examined. The identified viruses are astroviruses (n = 6), caliciviruses (n = 7), Norwalk-like viruses (n = 34) and Parvoviruses (n = 6). Immunoelectron microscopy (IEM) and solid-phase immunoelectron microscopy (SPIEM) were used in order to verify serological differences existing among Norwalk-like viruses from different outbreaks. The results obtained suggest a possible circulation, in Liguria, of two serotypes of antigenically different viruses in the period considered.

Increasing prevalence of HTLV-III infection in intravenous drug users in Liguria, Italy.

Anti-HTLV III prevalence has been investigated in serum samples of 638 intravenous drug users collected over May 1981 - March 1985 and stored at -20 degrees C. Separately, in a prospective way, we have studied 68 IV drug abusers (53 Genoese and 15 of Sanremo area) of whom we have collected, at least, one serum specimen for each year, starting with 1981. We have also tested for anti-HTLV III presence serum samples of: 91 subjects of Hospital staff (Infectious Diseases Department and Laboratory workers); 32 workers in Therapeutic Communities for drug users and 24 family contacts of anti-HTLV III positive drug users. And then serum samples of two groups of general population collected for other seroepidemiological investigations in 1982 (256 subjects) and 1984 (538 subjects) were tested. No IV drug user was positive in 1981 whilst from 1982 up to 1984 there was a strong rising of the prevalence of anti-HTLV III positive subjects: 2, 22, and 39 per cent, respectively. The prevalence remained about 40% in the first months of 1985. The investigations carried out also show that HTLV III spread in Sanremo area slightly before than in Genoa and neighbourhood. No subject positive for anti-HTLV III has been detected among the Hospital staff and in workers of Therapeutic communities who have more probability to get in contact with infected subjects or their blood, as well as in the general population. A positive case has been discovered in a family contact (the wife of a positive for anti-HTLV III IV drug user). Some epidemiological and public health questions linked to the situation observed, at present, in Liguria, are discussed.

Kaposi's sarcoma and HTLV-III infection. Virus-like particles in skin lesions: experimental observations.

Skin biopsies from a subject affected by KS and AIDS were examined by means of EM. Samples were obtained both in correspondence of a typical nodule, and from an apparently normal area. The disease process had started at least 8 mo. before, and the patient showed a reduced number of OKT4 cells, with an inversion of the normal T4/T8 ratio. Besides that, high titre antibodies versus HTLV-III were present, whereas antibodies versus CMV and EBV were not demonstrable. Light and electron microscopy demonstrated the typical picture of KS, with marked proliferation of undifferentiated endothelial and spindle-like cells within a network of collagen fibers. Neoformed capillaries very rarely showed an organization comparable to small vessel of normal dermis. Retro-virus-like particles recalling the ones described in lymph-nodes of subjects affected by AIDS by Armstrong et al. (1984) were observed in the skin tissue obtained in correspondence of the Kaposi lesion; the same were either isolated or gathered in small groups within cytoplasmic vescicles. Similar particles were not evidenced in the tissue obtained from normal skin. The interpretation of morphological aspects requests of course a great caution. However the observation seems to be noteworthy, specially if one considers the demonstrated association between retro-virus of HTLV-III group and AIDS, and that its unusual frequency as well as the malignancy in an immunodepressed host are as yet poorly understood.

Prevalence of infections caused by AIDS and hepatitis B viruses in jailed people.

Prevalence of positive subjects to anti-HTLV III and HBV markers (HBsAg; anti-HBc; anti-HBs) has been studied both among jailed people and wardens of Sanremo Jail. Out of 92 subjects in custody, 11 were anti-HTLV III positive and 44 had acquired HBV infection markers (antigen and/or antibodies). One of the wardens resulted anti-HTLV III positive whilst 14 appeared to have been infected by HBV. All anti-HTLV III positive subjects, but the warden, were intravenous drug users. The study of prevalence was the first step of a perspective monitoring program in Ligurian Jails.

Interplay of cell and serum immunologic markers in chronic persistent or active hepatitis B.

Immunologic markers associated with hepatitis B virus (HBV) infection (HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc, anti-delta) were tested by radioimmunoassay of serum from chronic hepatitis patients. The corresponding liver biopsy samples were examined for the presence of HBsAg, HBcAg, and delta antigen in the cells by direct immunofluorescence and by electron microscopy. Seventy patients were selected for the presence of both circulating HBsAg and anti-HBc. Comparison of chronic persistent (CPH) and chronic active (CAH) hepatitis showed a significantly greater frequency of intracytoplasmic HBsAg in CPH, especially in the absence of intranuclear HBsAg, and a greater frequency of intranuclear delta antigen and/or circulating anti-delta in CAH. The delta/anti-delta system was almost systematically associated with serum anti-HBe. At variance with HBeAg/anti-HBe, delta/anti-delta found significantly more frequently in patients originating from Southern rather than from Northern or Central Italy. The prevalence of both these immunologic systems was related to the age of the patients.

[Efficacy of influenza vaccination: results in a community controlled for 2 years]. / Ricerche sulla efficacia della vaccinazione influenzale: risultati in una comunita' controllata per un biennio.

The effectiveness of influenza vaccination has been studied in an old age colony during the winters 1977-78 and 1978-79. The subjects, vaccinated and non-vaccinated, were submitted to continuous clinical and virological controls for about 6 months during the cold season. Three blood samples were obtained from the vaccinated subjects: 2 in November (before and after vaccination) and 1 in May of the following year. From the non-vaccinated 2 blood samples were obtained in November and May, respectively. The hemagglutino-inhibition test (HAI) permitted studying the serological response after vaccination, and verifying changes of the antibody titer to be related to influenza virus infections, contracted during the winter, which had escaped the clinico-virological detection. The serological response to the bivalent vaccine employed in November 1977 (A/Victoria/3/75 - 600 I.U.; B/Hong Kong/8/73 - 300 I.U.) was good for type A virus, and fair for B type. The low circulation of influenza virus, both among the 61 non-vaccinated and the 126 vaccinated subjects, during the following winter 1977-78 did not allow to arrive at any information on the vaccine protective efficacy. In autumn 1978 a trivalent vaccine had been employed, containing 300 I.U. of A/Texas/1/77, A/USSR/90/77, B/Hong Kong/8/73 viruses, respectively. During the following winter 1978-79, cases of infection, caused by type B/Hong Kong/5/72 - like influenza viruses were detected. The morbidity turned out significantly lower (P less than 0.05) in the vaccinated subjects (4 out of 140 cases) versus the non-vaccinated (7 out of 56 cases). The protection index supplied by the vaccine on such occasion was 77%.

Chenodeoxycholic acid (CDCA) versus ursodeoxycholic acid (UDCA): a comparison of their effects in pregnant rats.

Treatment of pregnant rats with ursodeoxycholic acid or chenodeoxycholic acid at 3 dose levels resulted in no dismorphogenic effects although embryotoxicity and fatty infiltration in maternal liver were more frequent after CDCA. Light microscopic examination showed no evidence of derangement in fetal liver. Electron microscopic study, carried out in maternal liver, showed that changes were present only in dams treated with the highest doses of both bile acids.

Further researches on live influenza virus vaccines.

A/Port Chalmers 1/73 and A/Victoria 3/75 live vaccines were well tolerated after oral administration and showed good immunogenic properties in subjects devoid of immune-defence or having low antibody titer. A/Victoria 3/75 vaccine was prepared before the epidemiological appearance of the corresponding virus which demonstrates that the preparation of a vaccine with new strains can be made in a comparatively short time. Our experiments and controls allow us to establish that the oral administration of influenza virus, grown on chicken kidney embryo, elicits the appearance of HI antibodies in a high number of susceptible subjects. A 60% seroconversion rate obtained after administration of two doses represents a favourable result, the more so as the vaccine can be considered absolutely safe in very young subjects.

Preliminary results of oral influenza vaccination with live attenuated viruses.

151 subjects, vaccinated by oral route with live influenza viruses attenuated in the USSR (bivalent A/England/42/72-B/Hong Kong/5/72 vaccine) and 66 non-vaccinated cohabitants have been studied. The vaccination did not cause any important side effect. The vaccine showed good immunizing activity: HI antibodies appeared in 91% of the subjects initially devoid of antibodies against A type and in 70% against B type. No viral diffusion occurred from the vaccinated to the cohabitants. During an A/Port Chalmers/1/73 epidemic the morbidity (3.3%) among the orally vaccinated patients turned out significantly lower than that among the non-vaccinated cohabitants (12.1%). The protection index was 72.6%.

Virus-like antigen associated with hepatitis A: investigations in children's acute hepatitis.

Stool specimens, collected from 8 children with viral hepatitis [5 of type A, presumably, and 3 of type B (HBsAg-positive)] during the acute phase, were examined in the electron microscope. The presence of 27-nm virus-like particles, aggregated by the convalescent serum of a chimpanzee infected with MS-1 and not by the serum of the same animal drawn before infection, was detected by immune electron microscopy (IEM) in the stools of 3 out of the 5 children with suspected hepatitis A. The virus-like particles (HA-Ag) present in the stools were aggregated by the serum drawn from the corresponding subject during convalescence and not by that obtained in the acute phase of the disease. Employing as antigen a stool particle preparation purified by isopycnic banding in cesium cloride, it was pointed out that, in all 5 children with suspected hepatitis A, antibodies capable to cause the aggregation of HA-Ag particles, appeared. Anti-HA antibodies turned out to be present also in three lots of commercial immunoglobulins. In the three subjects with type B hepatitis (HBsAg-positive) neither virus-like particles with a 27-nm diameter were observed, nor anti-HA antibodies appeared in the convalescent serum.

Sero-epidemiological survey on human and swine influenza A. Situation at the onset of summer 1976.

A serological survey was performed to detect the presence of HI antibodies against the swine-like A/New Jersey/76 (Hsw1 N1) and the human A/Victoria 3/75 (H3N2) virus strains in the sera of 700 subjects of different age, and of 244 swine. HI antibodies against A/New Jersey/76 strain were not detected in 308 subjects younger than 31 years. They turned out to be present in 8% of the subjects from 31 to 43 years, always at low titre, and at a different titre, in 50% of the subjects from 44 to 58 years and in 90% of the subjects older than 58 years. None of the 244 swine tested from breeding farms of Liguria, Piedmont and Lombardy turned out to be endowed with antibodies against A/New Jersey/76 virus. This shows that the swine-like virus, which caused infections in the human population up to about 1930, did not circulate any more subsequently and that the swine also are now free from this infection. As far as the A/Victoria 3/75 strain is concerned, HI antibodies were detected in the different age groups with a frequency ranging between 41 and 69%. The fact that in many subjects antibodies were present at low titre suggests that their presence should be only partially brought back to infections caused by A/Victoria 3/75 but that in many cases it is the expression of a heterologous response to previous infections caused by other A H3N2 strains. HI antibodies against A/Victoria 3/75 were found also in 13% of the swine examined. A group of older people, who had been regularly immunized for years with the inactivated (A H3N2-B vaccine) showed an HI antibody titre significantly higher in comparison with subjects of equivalent age not vaccinated both against A/Victoria 3/75 and A/New Jersey/76.

Immunization against human and swine-like influenza A: serological response to two inactivated vaccines of different formulation.

The immunizing capacity and the tolerability of two purified vaccines containing the inactivated A/New Jersey/76 ( x 53 recombinant) swine-like strain were studied. A trivalent vaccine (A/New Jersey/76-300 I.U.; A/Victoria 3/75-300 I.U.; B/Hong Kong 5/75-300 I.U.) was administered to 31 subjects over 50 years of age. No side-effects were observed and it caused a good HI antibody response to A/New Jersey/76, fairly good for B strain and modest for A/Victoria 3/75. A monovalent vaccine (A/New Jersey/76-400 I.U.) was administered to 32 subjects in the age range from 16 to 43 years. HI antibodies occurred in 84% of the subjects, devoid of antibodies before vaccination. Younger subjects (between 16-20 years) generally developed fairly low antibody titres; one among them (16-year-old) had a temperature rise within 48 h after vaccination. The Authors expect that the X 53 recombinant with the surface antigens of the A/New Jersey/76 strain may be employed for the preparation of the inactivated vaccine to be used in an emergency situation and discuss the composition of the vaccine more adapt for the present epidemiological situation.

Oral influenza vaccination with live attenuated viruses. 2. Protective efficacy during a type A(H3N2) epidemic.

151 subjects, orally immunized with live attenuated influenza virus of the Institute for Viral Preparations of Moscow (bivalent A(H3N2) England 72 and B vaccine) and 66 non vaccinated cohabitants were studied during an epidemic caused by strains similar to A/Port Chalmers/73. 5 cases of disease were virologically or serologically ascertained among the vaccinated (morbidity 3.3%) and 8 among the non-immunized cohabitants (12.1%). The difference turned out statistically significant. By comparing the incidence of the disease in the two groups the protection resulting from vaccination was 72.6%.

Oral influenza vaccination with live attenuated viruses. 1. Acceptability, immunogenicity and transmissibility.

151 subjects were vaccinated by oral route with live attenuated influenza virus vaccine, bivalent A and B, prepared in the U.S.S.R. Each subject received two vaccine doses with a 10-day interval. Vaccination did not bring about any important clinical manifestation and the incidende of the symptoms after vaccination was not significantly different in comparison with what observed in the non vaccinated cohabitants. The vaccine showed good immunizing activity: among the subjects who before vaccination, had a HI antibody titer lower than 1/16, 91% responded for A type, and 70% for B type. Several subjects with starting low antibody titers also responded to vaccination. Among the cohabitants of the vaccinated no influenza virus infections were serologically ascertained, thus showing that no transmission of the virus from the vaccinated to the cohabitants occurred.