Safety and Immunogenicity of Two Doses of a Quadrivalent Meningococcal Polysaccharide Diphtheria Toxoid Conjugate Vaccine in Indian and Russian Children Aged 9 to 17 Months

Objective: Evaluation of tolerability, safety and immunogenicity ofa two-dose series of a quadrivalent meningococcalpolysaccharide diptheria toxoid conjugate (ACYW-D) vaccine inIndian and Russian infants/toddlers.Design: Open-label, single-arm, phase III multi-national trial.Study participants: 300 children aged 9-17 months, previouslyunvaccinated against meningococcal disease from four siteseach in India (n=200) and the Russian Federation (n=100).Intervention: Two 0.5 mL doses of ACYW-D by intramuscularinjection, 3-6 months apart.Main outcome measures: Meningococcal antibody titers toserogroups A, C, W-135 and Y, determined using a serumbactericidal assay in the presence of human complement beforevaccination and 28 days after the second vaccination. Titers ?1:8against either/all of the A, C, W-135 or Y were considered sero-protective.Results: After dose 2, 95.7–99.5% and 92.9–99.0% of infants/toddlers achieved seroprotection across the four serogroups inIndia and the Russian Federation, respectively. No immediateadverse events were reported after any dose of ACYW-D.Solicited reactions were reported in 49.2% of participants, andwere mainly of Grade 1 severity, and resolved within three days.Unsolicited adverse events were reported in 19.1% of infants:one event (Grade 3 diarrhea, resolving within one day) wasconsidered related to study vaccine. No non-serious adverseevents led to premature withdrawal from the study. Four seriousadverse events were reported; none were considered related tostudy vaccine. No deaths occurred during the study.Conclusions: A two-dose series of ACYW-D vaccine in Indianand Russian children (9-17 month) was well-tolerated with nosafety concerns, and induced robust bactericidal antibodyresponses against the meningococcal serogroups contained inthe vaccine

An interesting case of visceral larva migrans (VLM).

Human toxocariasis is primarily a soil transmitted zoonosis.We report a case of two and half year old male child who presented with fever, anorexia and hepatosplenomegaly. Hemogram showed anaemia (Hb 5.8), leukocytosis (TLC 26,500) and marked eosinophilia (AEC 14,100). Further investigations revealed hypergammaglobulinemia, CT scan of Abdomen showed low density lesions in liver and liver biopsy showed noncaeseating epitheloid cell granulomas and infiltrates of lymphocytes and eosinophils. We decided to get a confirmatory serological diagnostic test for Toxocara and the result was positive .Child was treated for it with Oral Albendazole and responded dramatically.