The epidemiology of measles in Poland: prevalence of measles virus antibodies in the population.

WHO has adopted a goal of eliminating indigenous measles from the European Region by the year 2007. The strategy focuses on reducing the proportion of susceptible individuals in the population to low levels and maintaining these low levels of susceptibility. Routine vaccination against measles for children aged 13-15 months was introduced in Poland in 1975, and a second dose added in 1991. High coverage (> 95%) is achieved with both doses. In order to assess progress towards measles elimination in Poland, a serological survey was performed to evaluate the impact of vaccination on the susceptibility profile of population. Three thousand residual serum samples from individuals aged 1-30 years were collected from hospitals in six selected voivodeships (administration units) in Poland. These were tested for measles-specific IgG using a commercial ELISA. Overall 4% (120/3000) were negative for measles virus antibody. The highest proportion of negatives (8.2%) occurred among cohorts born 1977-81--the only cohorts in which susceptibility exceeded the WHO targets. 'Catch-up' vaccination strategies should target these cohorts.

[Subacute sclerosing panencephalitis (SSPE) in Poland in 1996-1999. Phase VII of epidemiologic studies]. / Podostre stwardniajace zapalenie mózgu (SSPE) w Polsce w latach 1996-1999. VII etap badan epidemiologicznych.

In the seventh phase of epidemiological studies of SSPE data were gathered on patients who developed the disease in 1996-1999. In this time period the diagnosis was confirmed in only 10 cases (4 in 1996, 4 in 1997, 0 in 1998 and 2 in 1999). This is a significant reduction of incidence in relation to the preceding stages, in particular to the years 1993-1995 in which 49 new cases were still reported. This is not ruling out the possibility that at the beginning of the years 2,000 cases would be diagnosed in which the first symptoms developed several or more months earlier.

[Serological survey of measles antibody prevalence in chosen regions in Poland]. / Poziom przeciwcial odrowych u ludzi w wybranych województwach w Polsce.

Serological survey of measles antibody prevalence in the Polish population was carried out in 1998. The study group consisted of population in 6 regions: Warsaw, Wroclaw, Poznan, Lublin, Tarnobrzeg and Zielona Gora. A total of 3,000 serum samples were collected from individuals aged from 12 months to 30 years. Sera were assayed for measles specific IgG by ELISA test. All samples with titres < or = 0.5 IU were considered as negative. Serological survey has revealed a total of 4% negative samples. The highest percentage of susceptibles was noted among persons aged 15-19 years (8.2%), and among children who have just finished their first year of life (8%). The need for revaccination of teenagers aged 15-19 years is suggested.

[Use of RT-PCR and nested PCR for diagnosing enterovirus infections]. / Zastosowanie metody RT-PCR i nested-PCR do wykrywania zakazen enterowirusami.

An application of reverse transcription (RT-PCR) and nested-PCR for the detection of human enteroviruses isolated in Poland is described. A specific 297-bp fragment was amplified by the method from all studied enteroviruses strains. Amplification system and the nested primers allowed to detect RNA isolated from 10(1) TCID50/ml which corresponded to one molecule of viral RNA in tested volume. However, applicability of the method for routine diagnosis of enterovirus neuro-infection should be reassessed in extensive clinical studies.

[Evaluation of the usefulness of the ELISA method for determining the level of enterovirus antibodies in serum and cerebrospinal fluid]. / Ocena przydatnosci metody ELISA do oznaczania poziomu przeciwcial dla enterowirusów w surowicy i plynie mózgowo-rdzeniowym.

The usefulness of the methods was compared: complement fixation test (CFT), neutralization test (NT) and ELISA IgG and IgM against enteroviruses for the evaluation of specific immune reaction in sera and cerebrospinal fluid (CSF) samples of patients with confirmed enterovirus infections. The criteria were established for the assessment of ELISA results in rapid diagnosis of enterovirus neuroinfections. The criteria accepted by the producer lowered the sensitivity of the method and the possibility of recognition of local synthesis of antibodies in the CNS. The use of serum negative in CFT and negative CSF as reference for the determination made possible using of that kit for rapid diagnosis of neuroinfections. The modified ELISA IgG test makes possible determination of antibodies in CSF and serum, and accepting the generally recognized criteria for local production of antibodies in the CNS the ELISA test makes possible rapid diagnosis of neuroinfections which is not possible by other methods.

[Use of the western blot method for detecting antibodies against proteins of various rotavirus strains]. / Zastosowanie metody western blot do wykrywania przeciwcial dla bialek róznych szczepów rotawirusów.

The aim of this work was to adapt the Western blot method to analyse the humoral response to proteins of rotavirus strains having various antigens. 10 serum samples from animals immunized with SA11, 18 serum samples from hospitalized children with rotavirus infections and 17 serum samples from healthy adults were examined for rotavirus antibodies using Western blot. Antibodies against all structural rotavirus proteins were detected. The examined sera reacted differently with rotavirus proteins depending on the strain used. The highest IgG reactivity was observed for Wa and SA11, while the lowest was noted for DS-1. At the same time a different level of cross-reactivity of human sera with specific proteins of antigenically varying rotaviruses was observed. The sera taken from adults showed a lower reactivity with proteins of antigens used compared with sera from children. The exception was VP6 of the Ito strain for which the reactivity of adult sera was statistically higher. Essential differences in the reactivity of children's and adult sera were found mainly in the case of VP2 and VP4 belonging to the SA11 strain and VP4 and VP7 of the Ito strain. From these investigations we can conclude that the Western blot method may be useful in assessing immune response caused by rotaviruses. The results of reactivity of some human sera with proteins of strains used indicates that the persons had previously been infected by antigenically varied rotaviruses.

[Subacute sclerosing panencephalitis (SSPE) in Poland in the years 1993-1995. The sixth stage of epidemiological research]. / Podostre stwardniajace zapalenie mózgu (SSPE) w Polsce w latach 1993-1995. VI etap badan epidemiologicznych.

Data was collected about 49 newly diagnosed cases of SSPE in the years 1993-1995 in Poland. In the analyzed period of time a falling of tendency the incidence of SSPE was maintained. Overall incidence--0.42 per million population, was lower than the incidence in years 1990-1992, when it was 0.72. The tendency of a shift towards older age group was maintained--the peak incidence was observed among 19 year olds, as opposed to 15 year olds in the previous analyzed time period. The authors explain the dropping SSPE incidence in Poland with a drop in measales incidence, which is a consequence of growing measles vaccine coverage rates. The influence of a big measles epidemic which occurred in 1989-1990 on a potential rise in number of SSPE cases has not been noted, but further observations are needed.

[The outbreak of an epidemic of tick-borne encephalitis in Kielec province induced by milk ingestion]. / Ognisko epidemii mlecznej kleszczowego zapalenia mózgu w województwie kieleckim.

Outbreak of tick-borne encephalitis (TBE) was reported between May 14 and June 20 1995 in Busko Zdrój in Kielce Province. Drinking fresh (unboiled) goat's milk from private breeding was probable reason of the outbreak. 63 person drank goat's milk from the same source; 15 were hospitalized with neurological symptoms, 33 persons had an influenza-like symptoms and were treated in out-patient department (27) or healed spontaneously (6), and 15 persons were healthy. TBE virus antibodies were found in CSF of all 15 persons with neuroinfection syndromes. IgM and IgG against TBE virus were present in sera of 15 hospitalized patients and 20 patients with influenza like-syndromes. Antibodies to TBE virus were detected in serum of one of 19 goats from the breeding farm confirming the source of TBE virus infection.

Comparative analysis of HSV-1 temperature mutants proteins and their reactivity.

Protein's characteristic of temperature sensitive (ts 28 degrees C) and temperature resistant (tr 39 degrees C) mutants and native HSV-1 strain was performed. Electrophoretic and Western-blott analysis of virus proteins and their reactivity tested by immunoenzymatic staining was the main subject of the presented paper. There were found no significant differences in the protein structure between native strain and its temperature clones in electrophoresis. It is important that slight differences observed in protein's antigenic reactivity of ts 28 degrees C (54 kDa) and tr 39 degrees C (99-100; 160 kDa), do not influence on the possible application of the mutants for immunization and challenging.

Characterization of rotaviral RNA isolated from children with gastroenteritis in Poland.

Rotaviruses were detected in 37% (331/895) of stool specimens collected from children with gastroenteritis attending three hospitals in Warsaw between January 1981 and March 1994. An analysis of rotavirus electrophoretypes circulating in Warsaw and Cracow, Poland, over 6 years showed that all 176 electrophoretypes encountered were characteristic of group A rotaviruses. Based on variations in the migration pattern of RNA genome segments when passed through polyacrylamide gels, 10 different electrophoretypes were identified: 86% were long patterns and 14% were short patterns. Mixed infections were observed in two cases.

[Subacute sclerosing panencephalitis in Poland in the years 1990-1993. Stage V of epidemiologic studies]. / Podostre stwardniajace zapalenie mózgu (SSPE) w Polsce w latach 1990-1993. V etap badan epidemiologicznych.

The authors summarize the results of the fifth stage of epidemiological investigation on SSPE. The first stage covered the years 1971-1976, the next stages covered the periods: 1977-1983; 1984-1986; 1987-1989. In the period 1990-1993 data on 95 patients with SSPE were obtained. Morbidity rates continued to show a decreasing tendency (from 0.8 to 0.6 per 1,000,000 population) in the years 1990-1993, being lower the median morbidity (amounting to 0.98) in 1985-1989. Morbidity rates continued to shift towards older age groups: while the peak morbidity (25.7%) in the years 1990-1992 was noted in the 14-15 age range, in 1993 the peak (28.6%) was found in the age group of 16 to 19 years.

[Use of western-blotting technique and computer analysis for comparing cellular antigens of coagulase-negative staphylococci]. / Zastosowanie techniki western-blotting i analizy komputerowej do porównania antygenów komórkowych szczepów gronkowców koagulazo-ujemnych.

Western-Blotting technique and computer programme have been used to analyse cellular antigenic patterns of coagulase-negative staphylococci mainly of S. epidermidis and S. saprophyticus species. It was shown that antigenic pattern among strains of one species was similar. Intra strains differences are mainly quantitative. The qualitative differences concern not quantitatively dominant antigens. The main antigens of S. epidermidis and S. saprophyticus strains were of 28 and 44 kD molecular weight respectively. The antigens of molecular weight around 44, 48, 89 and 105 kD were detected in antigenic extract of strains from different species. Only one of the quantitatively dominant antigen of m. w. 48 kD, was localised in all analysed materials. The method presented here was used for the first time to analyse staphylococcal antigens. Such analysis could be performed not only for bacterial antigens.

[Evaluation of changes in the epidemiological situation of SSPE in Poland in the years 1977-1991 (in the course of 15 years after the introduction of mandatory antimeasles vaccination)]. / Ocena zmian w sytuacji epidemiologicznej SSPE w Polsce w latach 1977-1991 (tj. w okresie 15 lat po wprowadzeniu obowiazkowych szczepien przeciwodrowych).

The authors present the results of an epidemiological study of SSPE in Poland conducted since 15 years. Since the years covered by the study (1977-1991) included the first period after the introduction of obligatory vaccinations against measles in our country, the most important aim of this analysis was to find out the possible influence of the effect of these vaccinations on SSPE incidence. A comparison of the data obtained in successive stages of the study shows that a slow gradual decrease of the annual incidence of SSPE has been taking place in our country (from at least 1.6 per million before 1983 to 0.69 in 1991). The effect of the vaccinations is visible also in a significant increase of the mean age of SSPE onset which is a result of ever more widespread vaccination of the youngest children. These observations indicate unequivocally that the aetiological factor in SSPE is a wild strain of measles virus and not that used for vaccinations.

[Influence of patient age and year of developing the disease on immunologic response to measles virus in subacute sclerosing panencephalitis (SSPE)]. / Wplyw wieku chorych i roku zachorowania na odpowiedz immunologiczna dla wirusa odry u osób z podostrym stwardniejacym zapaleniem mózgu (SSPE).

Analyses were concerning 338 SSPE patients investigated in the years 1984-1989 from a group in which 305 persons were known regarding year of illness development and their age at the time of sample taking. The analysis has shown statistically significant decrease of antibodies against measles virus with increase of age of tested patients. At the same time, it was found that in persons who developed disease in 1983-1985 and in 1988, increase of mean value of antibodies against measles virus was evident during first 2-3 years from beginning of the SSPE. Comparison of mean values of antibodies against measles virus in age groups of SSPE patients and normal population, revealed existence of relation between these groups where source of antibodies constituted of a wild measles virus. Our analyses indicate influence of measles wild virus circulating in the population on immunological response to this virus in sera of patients with SSPE.

[Analysis of the correlation between measles and subacute sclerosis panencephalitis (SSPE) before and after introduction of vaccination in Poland]. / Analiza wspólzaleznosci pomiedzy odra a podostrym stwardniajacym zapaleniem mózgu (SSPE) przed i po wprowadzeniu szczepien ochronnych w polsce.

Number of SSPE cases were analysed depending on epidemiologic situation of measles in Poland. Statistic analysis exhibit significant correlation between measles incidence in first year of live and total number of SSPE cases born in the same years. Problems antimeasles vaccination for eradication measles and SSPE were discussed based on the correlation.

[Changes in the level of humoral response for measles virus in patients with subacute sclerotic panencephalitis during 1984-1989]. / Zmiany w poziomie odpowiedzi humoralnej dla wirusa odry u chorych na podostre stwardniejace zapalenie mózgu w latach 1984-1989.

Immunological response to measles virus in serum and cerebro-spinal fluid of 338 patients with subacute sclerotic panencephalitis (SSPE) during the years 1984-1989, was investigated. It was found that mean titer and distribution of results of antibody determination by the hemagglutination inhibition (OZHA) method in patients sera are visibly differing during consecutive years of investigation. Analysis of these parameters in determination by the immunoenzymatic methods (ELISA) has shown their higher stability. Also results of determinations of IgG concentration in sera of patients with SSPE did not demonstrate significant differences between consecutive years of investigation. Systematic decrease of mutual relation between antibodies to measles virus detected by ELISA and OZHA was found. Analysis of local synthesis of antibodies to measles virus in the central nervous system has revealed that it most strongly expressed by hemagglutinin.

[Use of western blotting methods in diagnosis of viral infection causing tick-borne encephalitis]. / Zastosowanie metody western blott w diagnostyce zakazen wirusem kleszczowego zapalenia mózgu.

A Western blot method for investigation of antigens and of immunological response to tick-borne encephalitis was prepared. An analysis was performed testing cross reactions of proteins of prepared antigen with sera for four Polish strains of tick-borne encephalitis and four other flaviviruses. Usefulness for diagnosis of infections in humans was determined by comparison of Western blot method with ELISA immunoenzymatic test. It was found that elaborated method permits equally as ELISA for evaluation of immune response in immunoglobulin classes. By evaluation of response for individual virus components, Western blot method enables at the same time verifications of nonspecific determinations which result from reaction of antibodies present in tested diagnostic materials with nonviral antigens.

[Seroconversion after vaccine with trivalent influenza vaccine during the epidemic season 1990/1 in Poland]. / Serokonwersja poszczepienna po podaniu trójskladnikowej, podjednostkowej szczepionki przeciw grypie w sezonie epidemicznym 1990/91 w Polsce.

Vaccination was performed by influenza virus vaccine, trivalent type A and B. We vaccinated about 50,000 persons in Poland in different groups of age. HI and NI tests were used for testing antibody level for A/Taiwan/1/86 (H1N1), A/Shanghai/16/89 (H3N2) and B/Yamagata/16/89. The rise of antibody level was statistically significant.