[Frequency of antibodies against Trichinella spiralis and Echinococcus ssp. appearance in children with atopic diseases]. / Czestosc wystepowania przeciwcial przeciwko Trichinella spiralis i Echinococcus spp. wsród dzieci z chorobami atopowymi.

Parasitic infestation and atopic diseases have common features. The aim of our study was to evaluate the occurrence of Trichinella and Echinococcus seropositivity in children with atopic diseases. The study group involved 72 children aged from 2,5 to 18 years with asthma and allergic rhinitis. The control group comprised 30 children without allergic diseases. In 12 children with atopic diseases the serological tests were positive for Trichinella spiralis, in II for Echinococcus spp. and in 5 both for Trichinella and Echinococcus. In control group the serological tests were positive in 3, 6 and 3 children respectively. There were no differences in occurrence of positive results of serological tests in children with atopy and children without allergic diseases.

[Characteristics of children with diagnosed pertussis]. / Charakterystyka dzieci z rozpoznanym zakazeniem paleczka krztusca.

In 1997 a significant increase in the incidence of pertussis in the Lódz voivodship was noticed--the incidence increased from 3.32 in 1996 to 26.34. The aim of this work was the analysis of the course of pertussis in the Lódz voivodeship. Epidemiological history was analysed of 331 children with diagnosed pertussis from the end of 1996 to February 1998. The diagnosis was made on the basis of clinical picture and passive haemagglutination reaction (PHR). The highest incidence occurred between September and November 1997 (196/331--59.2%). Children aged 7-15 years and toddlers constituted the most numerous groups (respectively: 60.7% and 24.5%). The majority of children with pertussis (83%) received four doses of DTP vaccine, according to the current vaccination schedule. Only 8.2% of children did not receive DTP vaccination or received only 1 or 2 doses. In the majority of properly vaccinated children (73.5%--202/275) the disease appeared mainly after 6-15 years from the last 4th dose of DTP vaccine. From the group of children with pertussis, 18.7% required hospitalisation--these were mainly neonates and children aged 2 and 3 years. The number of children who developed pertussis was highest in school age children after 6-15 years from the last dose of vaccine. The severity of the disease, evaluated on the basis of the percentage of hospitalisations, was highest in the youngest age groups. The laboratory methods used (PHR) are not sufficient for proper diagnosis of pertussis, and cannot provide epidemiological data to assess the incidence of the disease. Increasing number of pertussis cases requires a revision in the schedule of prophylactic vaccination.

Hepatitis B vaccination in preterm infants.

UNLABELLED: Preterm infants, especially those with very low birth weight, are at risk of hepatitis B virus infection. They often require invasive diagnostic methods in their first weeks of life, intensive treatment and long-term hospitalisation. Therefore, hepatitis B vaccination is particularly justified in these patients. Our aim was to determine the reaction of preterm children to hepatitis B vaccination. The study comprised 64 preterm children whose birth weight ranged from 700 g to 2460 g (mean 1776.6 g +/- 480.4 g) and whose gestational age was between 25 and 36 weeks. A 10 microg dose of the recombinant vaccine Engerix-B (SmithKline Beecham) was given at intervals of 0, 1, 2 and 12 months. In 49.2% of the children vaccination was administered on the 1st day of life, and in the remaining cases between the 2nd and 119th days post delivery. One month after vaccination completion the levels of anti-hepatitis B surface antigen (HBs) antibodies were evaluated. In 98.4% of the vaccinated preterm infants the level of antibodies was > 10 mIU/ml. Mean level of anti-HBs antibodies in the group of children with birth weight < or = 2000 g was 2431.4 mIU/ml, while in those with birth weight >2000 g it was 4803.9 mIU/ml. In children with a birth weight < or = 1000 g, the mean level of anti-HBs antibodies was significantly lower than in those with birth weight >2000 g. The level of anti-HBs antibodies in children who started vaccination > 1 st day of life was significantly lower in preterm children with a birth weight < or = 2000 g than in those with a birth weight >2000 g. Although vaccination was started on the 1st day of his life, one child with birth weight of 2300 g developed a hepatitis B virus infection. One child did not respond to vaccination (anti-HBs < 10 mIU/ml) and in three cases the response was very poor (11 100 mIU/ml). These patients were given a supplementary booster double dose of Engerix B (20 microg). After 1 month the level of anti-HBs antibodies was evaluated again and high values of 657 mIU/ml to 14520 mIU/ml were observed. In the group of children with a birth weight < or = 1000 g the response to vaccination was weaker as compared to children with a birth weight >2000 g (P < 0.05). In systematic mass vaccination programmes, monitoring of antibody levels is not recommended unless the patient is at risk. However, in extremely preterm infants (< 1000 g at birth), especially after very serious infections, monitoring the level of anti-HBs antibodies after complete immunisation should be considered. In preterm infants who show very low postvaccination levels of anti-HBs antibodies, stimulation with an additional double booster dose of vaccine gives positive results. CONCLUSION: The majority of preterm infants (98.4%) responded well to hepatitis B vaccination given at intervals of 0, 1, 2 and 12 months and developed a protective level of antibodies. The level of anti-hepatitis B surface antigen antibodies in children with a birth weight >2000 g was higher than in those with a birth weight < or = 1000 g.

[Does vaccination protect a child of an HBs Ag carrier mother against HBV infection?]. / Czy szczepienie stanowi ochrone dziecka matki nosicielki HBs Ag przed zakazeniem HBV?

The aim of the study was to determine the degree of protection provided to the children born from HBs antigen carrying mothers, by vaccination administered according to the 0-1-2-12 scheme (Engerix B, SmithKline Beecham) as well as the level of HBs antibodies after a booster dose given 5 years later. The examination was conducted in 52 children. The level of HBs antibodies as well as the remaining serological markers of HBV infection were assessed at the age of 6. Four to six months after booster dose administration the level of HBs antibodies was assesed again. The markers of HBV infection were determined with the IMx-AUSAB test (Abbott Laboratories). After 5 years from the vaccination, 3 (5.8%) children were found infected with HBV; the performed assessment of their immune system did not reveal any significant compromise. Values of anti-HBs < 10 mlU/ml were found in 4 (8.2%) of 49 infection-free children and low levels (11-100 mlU/ml) in other 4 (8.2%) children, moderate (101-1000 mlU/ml) in 29 (55.8%), and very high (> 1000 mlU/ml) in 9 (17.3%). Four to six weeks after a booster dose, only one child did not respond to the vaccination. High levels of anti-HBs antibodies were obtained in the rest of the children. In our opinion there is a justified need to administer a booster dose 5 years after completing the vaccination in the risk group children.

Allergy to food in children with pollinosis.

The investigated group consisted of 56 children with hay fever. The method of evaluation included interview, skin prick tests and elimination-exposure diets. Our data showed that more than half of the examined children were potentially sensitive to basic corn allergens. Currently in about one third of them clinical food allergy symptoms appeared.