[Efficiency of seasonal influenza vaccine in persons older than 65 in Romania. Pilot case-control study I-MOVE, 2008-2009]. / Eficacitatea vaccinului gripal sezonier la persoanele cu vârsta peste 65 de ani din România. Studiul pilot caz-martor I-MOVE, 2008-2009.

Cantacuzino Institute conducted between September 2008 and June 2009, a pilot case-control study to monitor the influenza vaccine effectiveness on people over 65 years of age from Romania. This study is part of the I-MOVE project "Monitoring the vaccine effectiveness during seasonal and pandemic influenza in EU/EEA member states, 2008-2009", coordinated by EpiConcept, France and financed by European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden. Forty seven family doctors and epidemiologists from Bucharest and seven influenza sentinel districts were selected to participate in this project, based on epidemiological and geographical criteria. Family doctors swabbed all people over 65-years-old consulting for influenza like illness (ILI). Influenza confirmed cases (classified as cases) were compared to influenza negative controls. Influenza vaccine effectiveness (IVE) was obtained using the formula: 1 - odds ratio, with 95% confidence interval (CI). One hundred and three ILI patients were enrolled in the study. Ninety nine from them (96.1%) were swabbed in the first 7 days after the onset, met the inclusion criteria and case definition and were included in analysis. Thirty (30.3%) were ILI flu positive and were classified as cases, sixty nine (69.7%) were ILI flu negative and classified as controls. Influenza vaccine effectiveness adjusted for the predefined set of confounders (age, sex, chronic diseases, smoking, previous influenza vaccination, functional status) was 86.8% (95% CI, 38.0, 97.2); influenza vaccine coverage in people older than 65 years was 49.4%. The result of the study showed a high influenza vaccine effectiveness in the elderly. In order to achieve a greater precision, the national and also the European samples should be extended for the next season.

Isolation and characterization of egg yolk antibodies IgY from hens immunized with different influenza virus strains.

A comparison of two precipitation methods of IgY from normal hen eggs was made. For method I the precipitation agent is represented by PEG 6000, and for method II by organic solvents. The comparative study of some parameters (protein concentration, ovalbumin content, presence of non-specific inhibitors, PAA-gel electrophoresis) shows that method I is more efficient and more convenient than method II. Using this method, we isolated and characterized IgY preparations from hens immunized with circulating influenza virus strains: A/Singapore/6/86 (H1N1), A/Shanghai/11/87 (H3N2) B/Beijing/1/87 and B/Yamagata/16/88 These viral IgY antibody preparations are homogeneous, lacking anti-host cell antibodies and non-specific inhibitors. Their NI titres and HI titres are higher than those found in the sera of immunized birds.

Seroepidemiological study of the circulation of influenza C virus in man.

The seroepidemiological study of the circulation of influenza C virus was achieved by testing HI antibodies in human sera collected from healthy subjects in Bucharest belonging to various age groups. The investigations were carried out over a two years period (October 1988--September 1990), using 3 influenza C virus strains: C/Taylor/1233/47, C/USSR/0303/77 and C/Moscow/1/84, the last two being antigenically similar. The analysis of the distribution of HI antibody values against the three influenza C virus strains showed that over October 1988--June 1989 the reported circulating viruses belonged to two distinct antigenic groups, one similar to the prototype C/Taylor/47 strains and the other to C/USSR/and/C/Moscow strains, whilst during the July 1989--September 1990 time interval viruses belonging solely to the C/USSR and C/Moscow antigenic group circulated. Similarly, one should note that circulation of influenza C viruses is not seasonal, it can appear anytime and even several times per year; this accounts for the relatively high and permanent antibody level in the population belonging to all age groups.

The immune response induced by a split influenza vaccine. Studies on cellular immunity.

The aim of this study is to evaluate the effects exerted in vivo upon the general reactivity of the immune system by a commercial split influenza vaccine produced by the Cantacuzino Institute, Bucharest-Romania. The vaccine was intramuscularly administered to 14 volunteers with no precedent of influenza vaccination and no major immune disorders. We have investigated in vitro the polyclonal proliferation of peripheral lymphocytes and the phagocytosis developed by peripheral granulocytes, before and three weeks after vaccination. Our experimental results indicate that the vaccine might have a modulatory action on peripheral leukocyte concentration induces the activation of polyclonal lymphocyte proliferation and of the phagocytosis potential of granulocytes. These effects are not dependent on the age of the vaccinees.

The response in hemagglutinoinhibiting antibodies following influenza vaccination of HIV-infected children.

The study investigated the response in hemagglutinoinhibiting antibodies (HI) induced by the purified inactivated trivalent influenza vaccine prepared for the epidemic season 1996-1997, administered to a group of 24 human immunodeficiency virus (HIV)-infected children as compared to a group of HIV seronegative controls. The titres of serum HI antibodies were determined before and 30 days after vaccination. The evolution of the immune response in HIV seropositive children showed significant increases against all the antigenic components of influenza vaccine both as concerning the geometrical mean titres of HI antibodies and the protection rate (titres > or = 1:40). However, the amplitude of the immune response reported in the HIV seropositive group was lower, but insignificantly as compared to the HIV seronegative control group. No association between the individual response in HI antibodies and the determined amount of CD4' T lymphocytes was noticed.

Viral etiology of acute respiratory infections in infants and young children.

114 children with acute respiratory infections were investigated to detect the viral etiological agents. The following methods were used: the direct immunofluorescence technique for the rapid diagnosis from tracheobronchial aspirates and the serological reactions--hemaglutinoinhibition and complement fixation reaction--to determine the increase of antibodies titres. Of 55.2% respiratory infections with a viral etiology, 60.3% represent acute infections of the lower respiratory tract. Due to the influenza epidemic reported between October 1996 and February 1997 (with a higher number of cases than in the last 5 years), most viral respiratory infections were caused by influenza viruses (57.14%). The direct immunofluorescence technique proved to be sensitive and specific in detecting the viral etiological agents which caused respiratory infections. Thus, using this technique, a positive diagnosis was made in 68.2% of cases, of which 49.2% were positive by the hemagglutination and complement fixation reactions, too. The test specificity could have been higher if the pathological products had been prelevated within the first three days after the onset of the disease.

[Oculo-orbital manifestations of paranasal sinus diseases]. / Manifestari oculo-orbitare în afectiuni sinusale.

PURPOSE: The paper is a study of the oculo-orbital affections established by the sinusal lesions. METHODS: The study is retrospective for five years and it is affected by the patients with ocular and orbital affections hospitalized in Ophthalmological Clinic. Were used the sheets of the patients and a collaboration with ORL Clinica, where the sinusal affections were surgical cured. RESULTS: The ocular lesions caused by the sinusal inflammations were: acute uveitis, orbital cellulitis, unilateral exophthalmia without obvious inflammatory signs. The oculo-orbital signs were missing with oculo/sinusal treatment. CONCLUSIONS: Without treatment, the inflammatory or tumoral affections of the paranasal sinus, established oculo-orbital complications and the patients request the first time the oculist. It is necessary a collaboration between the ORL--ist and the oculist physician for of these cases.

[False-positive ELISA reactions for the hepatitis C virus and the human immunodeficiency virus after anti-influenzal vaccination]. / Reactii ELISA fals pozitive fata de virusul hepatitei C si virusul imunodeficientei umane dupa vaccinarea antigripala.

Possible appearance of ELISA false-positive results for hepatitis C virus (HCV) and human immunodeficiency virus (HIV) after vaccination against influenza was studied on 402 volunteers before, and 30 and 90 days after that. Our results prove that influenza vaccine can sometimes induce false-positive ELISA for HCV, but not for HIV. Their frequency is relatively small--0.96% in 10-20-years-old group and 3.1% in over 60 years age, while in 3-6 years age there were not registered this kind of reactions. The surveillance of individual ELISA-positive cases over time proves that cross-reacting antibodies HCV raised after vaccination against influenza are present only in second sera, that means 30 days after vaccination, but these antibodies disappeared 90 days later.

[ELISA in the rapid diagnosis of influenza using as the detecting antibodies polyclonal antinucleoprotein sera]. / ELISA in diagnosticul rapid al gripei utilizând ca anticorpi detectori seruri policlonale antinucleoproteina.

Hyperimmune polyclonal sera were obtained in order to use them as capture and detecting antibodies in rapid diagnostic of influenza A and B viruses by ELISA. The test shown 100% specificity. The sensitivity in directly detection of influenza viruses in human samples compared of influenza isolations was 49,25% for type A and 53,33% for type B. The sensitivity was increased after 48 hours from inoculation of human samples in cell culture-86,75% for type A detection and 80,0% for type B detection from supernatant mammalian tissue culture (MDCK).

Comparative study of the immunogenicity of aqueous versus aluminium phosphate adsorbed split influenza vaccine C.I.

The antibody responses induced by the split influenza vaccine adsorbed on aluminium phosphate and the corresponding, nonadsorbed vaccine, both prepared in the Cantacuzino Institute, were studied in subjects belonging to three different age groups: 3-6, 10-15 and over 60 years of age, respectively. In all age groups the immunogenicity of the two vaccine preparations was similar, being uninfluenced by the level of preexisting antibodies. The immunogenicity of both vaccines was similar even in children considered to be non-primed. There were no differences in the persistence and specificity of antibodies induced by the two vaccines. No significant enhancement of the immunogenicity by aluminium phosphate was observed.