[Findings on the occurrence of complications caused by DEV and HDVC (delta) vaccines]. / Rilievo della incidenza delle complicanze da vaccini DEV e HDCV (delta).

The complications arising from two different anti-rabies vaccines were compared: DEV (duck embryo vaccine; the schedule included 14 daily doses plus 3 boosters) and HDCV (human diploid cells vaccine; the schedule included 5 doses plus 1 booster). 2646 patients were immunised, following a post-exposure prophylaxis, at the Antirabies Unit of the Institute of Hygiene of Rome. Among the 1434 patients immunised with DEV, 364 (25.38%) developed side-effects, whilst among the 1212 subjects immunised with HDCV only 47 (3.88%) developed side-effects. Using DEV the more frequent complications were as follows: fever (48.62%), regional adenopathy (49.45%), erythema (89.29%), local induration (41.48%). Using HDCV the main complication was fever (65.96%). The principal association of complication in DEV were: erythema + induration + edema + adenopathy + fever; general malaise + asthenia + adenopathy; dizziness + headache. Hyperthermia resulted often associated with regional adenopathy and the general malaise with the headache in the vaccinated with HDCV. All complications were widely distributed during the period of immunisation. However most side-effects arose following the 5th DEV dose or the 2nd HDCV dose. Regional adenopathy, was the more persistent and less tolerated symptom, also local erythema showed a long persistence, whilst the other symptoms regressed within 48-72 hours with proper therapy and rest. Sex and age did not influence the incidence nor the type of complications. Neither neuroparalysis was detected nor serious impairment of health. In our study the coincidence of unwanted effects, following an antirabies immunisation, seems lower than that described in the literature. This was probably due to the high level of purification of the vaccine and possibly to the different recording of the minor symptoms.

[Effect of previous anti-rabies treatment with Fermi type vaccine on the antibody response to one dose of HDCV]. / Influenza di pregressi trattamenti antirabbici con vaccino tipo Fermi sulla risposta anticorpale ad una dose di HDCV.

We report the effect of previous anti-rabies treatments following a single HDCV challenge. The aim is to obtain guidelines for the re-vaccination of patients previously already immunised. 37 adults at risk for rabies, vaccinated 5-10 years before using a Fermi vaccine, were challenged with a single HDCV dose. 29 adults, previously not immunised were used as a control. Neutralizing antibodies' titres (indirect fluorescent antibody microtest) were monitored on day 0 (HDCV challenge) and 15. The best group produced an optimal response to the antigenic challenge: all subjects reached responses higher than the serum-conversion limit (0.5 U.I./ml), and 43.2% of patients had titres higher than 8 I.U./ml. Neither the number of previous injections of antirabies vaccine (5, 15, 20), nor the years between the first and the second vaccination were related to the antibody response. In the control group the serum-conversion limit was obtained in 31% of patients, and only 13.8% of them produced titres higher than 0.5 U.I./ml. Our data support a short vaccination schedule for patients at risk, who had an history of vaccination. In agreement with nerve-tissue vaccines, specific World Health Organisation Committee (1984), and in our researches of Fermi type, we suggest that in patients having an history of vaccination (documented by antibody titres), a single HDCV dose, monitoring the antibody response, is sufficient to control a new, not dangerous infection (site and type of the wound, animal, local epidemiology). Patients without a laboratory documentation of the previous antibody titres, or patients with a dangerous infection, should be challenged with three HDCV doses on day 0, 3, 7.

Screening of thalassaemia carriers in intermediate school of Latium: results of four years' work.

From 1975 to 1979 the Rome Microcythaemia Centre carried out four health education campaigns and thalassaemia screenings among students of the intermediate schools throughout Latium, under the auspices and with the financial support of the Health Authorities of the Latium region. This project is aimed at avoiding reproduction by pairs of thalassaemia carriers and the birth of homozygous children. During the four campaigns 138 501 students were examined, that is, 70 to 76% of those enrolled. Of these 3343 were found to be thalassaemic. Thus the overall prevalence of thalassaemia in Latium is 2.41%, with minor fluctuations from one province to another and, above all, a slight, though definite, trend towards higher values in the southern part of Latium bordering on Campania. The screening was welcomed by the population and the thalassaemic families, there were no detectable negative side-effects, and it resulted in an increased awareness of the problem of the thalassaemias.

First premarital screening of thalassaemia carriers in intermediate schools in Latium.

In the 1975 to 1976 school year, under the auspices of the Health Authorities of the Latium Region, the Rome Microcythaemia Centre carried out for the first time a partial screening survey of thalassaemia carriers among the students of the compulsory intermediate school in Latium. This work was the beginning of a new preventive school health service aimed at the prophylaxis of Cooley's disease. In 23 places investigated in Latium, 17724 students were examined, 13354 of whom were in Rome and 4370 elsewhere. The mean percentage of co-operation was 70% and the mean percentage of thalassaemia 2.42%. Thalassaemic students were invited to attend the centre for a check-up along with their families: about half had already come in by the end of June 1976. All students examined, whether normal or thalassaemic, have received written results of the tests. The screening survey aroused notable interest and obtained wide approval both at school and at home. The news of being thalassaemia carriers, even if not welcome, was never the cause of family tragedy.

Prevalence in the Rome healthy population of antibodies to a human Polyoma - virus (BK - strain).

A serological study of determine the prevalence of infections caused by human Polyoma-virus (BK strain) among the healthy population of Rome has been performed. Such virus was originally isolated from a patient undergoing a kidney transplantation, and later found in patients undergoing immunosuppressive therapy. Previous serological studies showed high incidences of infections, caused by this virus, in human populations. Other viruses, antigenically related, were found in patients suffering from progressive multifocal leukoencephalopathy. Serum samples coming from 482 healthy subjects classified by age and 100 cord blood serum samples were analyzed for antibody titers using haemoagglutination-inhibition and complement fixation tests. High incidence of infection caused by BK virus in the Roman population was found: specifically the haeomagglutination-inhibition test resulted positive in 65.2% of the samples. A remarkable similar trend between the results obtained with both the techniques was observed, although differences in antibody serum levels were present. The infections, which are not transmitted during the intrauterine life, are first noted at about two years of age. The Authors finally briefly discuss the possible epidemiological meaning of the spreading of this infection.

[Presence of cytomegalovirus in maternal milk]. / Sulla presenza del cytomegalovirus nel latte materno

The AA. make in evidence the role of the milk as carrier of Cytomegalovirus. The virus was isolated in the 23.5% of the 17 specimens of milk examinated within the first 48 hours from the delivery. The contemporary observation of the urins of the womans was negative.