No demonstrable association between the Leningrad-Zagreb mumps vaccine strain and aseptic meningitis in a large clinical trial in Egypt.

To address the claim that the Leningrad-Zagreb (L-Z) mumps vaccine strain is causally associated with aseptic meningitis, a prospective, post-marketing safety study was conducted with a measles-mumps-rubella vaccine (MMR) (TRESIVAC(R); Serum Institute of India Ltd., Pune, India), which uses the L-Z strain as its mumps component in Egypt. In all, 453 119 children (65 423 children aged 16-24 months and 329 211 children aged 5-7 years) received MMR. The control groups which, as a result of local health regulations, were slightly younger than vaccinees, comprised 12 253 and 46 232 children, respectively. Using questionnaires, the parents recorded solicited local, systemic and neurological adverse events for up to 42 days post-vaccination. All data were analysed externally on an intention-to-treat basis by individuals not participating in the study. Local and/or systemic reactions were reported in a small percentage of participants, with pain, fever and parotitis being the most common signs among vaccinees in both age groups. No case of aseptic meningitis, encephalitis, anaphylaxis or convulsions was observed in any participant. Thus, in this series of more than 450 000 Egyptian children, the L-Z mumps vaccine strain in this vaccine did not cause aseptic meningitis. The vaccine is considerably cheaper than Western competitors and a valid alternative to other MMR vaccines.

Cluster survey evaluation of coverage and risk factors for failure to be immunized during the 1995 National Immunization Days in Egypt.

BACKGROUND: In 1995, Egypt continued to experience endemic wild poliovirus transmission despite achieving high routine immunization coverage with at least three doses of oral poliovirus vaccine (OPV3) and implementing National Immunization Days (NIDs) annually for several years. METHODS: Parents of 4188 children in 3216 households throughout Egypt were surveyed after the second round of the 1995 NIDs. RESULTS: Nationwide, 74% of children are estimated to have received both NID doses, 17% one NID dose, and 9% neither NID dose. Previously unimmunized (47%) or partially immunized (64%) children were less likely to receive two NID doses of OPV than were fully immunized children (76%) (P < 0.001). Other risk factors nationwide for failure to receive NID OPV included distance from residence to nearest NID site >10 minute walk (P < 0.001), not being informed about the NID at least one day in advance (P < 0.001), and residing in a household which does not watch television (P < 0.001). Based on these findings, subsequent NIDs in Egypt were modified to improve coverage, which has resulted in a marked decrease in the incidence of paralytic poliomyelitis in Egypt. CONCLUSIONS: In selected situations, surveys can provide important information that is useful for planning future NIDs.

PIP: In 1995, Egypt was experiencing endemic wild poliovirus transmission despite achieving high routine immunization coverage with at least 3 doses of oral poliovirus vaccine (OPV3) and implementing National Immunization Days (NIDs) annually for several years. The parents of 4188 children aged 0-47 months in 3216 households throughout Egypt were surveyed after the second round of the 1995 NID in an attempt to gain some insight into the extent of NID OPV coverage nationwide, why children were not immunized during the NIDs, and the effectiveness of the NID media campaign. Countrywide, an estimated 74% of children have received both NID doses, 17% 1 NID dose, and 9% neither NID dose. Previously unimmunized (47%) or partially immunized (64%) children were less likely to receive 2 NID doses of OPV than were fully immunized children (76%). Other risk factors nationwide for failing to receive NID OPV included living farther than 10 minutes by foot from the nearest NID site, not being informed about the NID at least 1 day in advance, and living in a household which does not watch television. Based upon these findings, subsequent NIDs in Egypt were changed to improve coverage, which has resulted in a marked decrease in the incidence of paralytic poliomyelitis in the country.

Recurrence of Rift Valley fever in Egypt.

Rift Valley fever (RVF) has been recorded in man and in domestic animals in Egypt after a 12-year absence. Human infections were first noted in the Aswan Governorate in late May, 1993. Only cases of ocular disease, an infrequent and late manifestation, were reported. Of 41 cases, 35 were tested serologically and 27 (77%) had RVF virus-specific IgM antibodies. An estimated 600-1500 infections occurred in the region. Abortions in cattle and buffalo were seen concurrently and antibodies to RVFV were present in 39% of domestic livestock, presumably unvaccinated. RVFV was isolated from an aborted water buffalo fetus.

[Behavior of fluorescein dye in the vascularized cornea of the animal eye after local application of certain drugs (author's transl)]. / Verhalten des Fluoresceinfarbstoffs an der vaskularisierten Cornea des Tierauges nach lokaler Medikamenteneinwirkung.

In pigmented rabbits we investigated the much-used drugs pilocarpine, atropine, and tropicamide (Mydriaticum, Roche) with regard to their possible influence on the permeability of newly formed corneal vessels. Sodium fluorescein was chosen as test substance. Corneal vessels were produced by introcorneal injection of 0.1 N NaOH. Their development required 2--3 weeks and their growth about 4--6 weeks. A 2-week period of stability followed and was used for the local application of the above drugs. An evident influence on the diffusion of fluorescein could not be ascertained. Tropicamide induced a narrowing of the dye column in the corneal vessels. This phenomenon may be due to a narrowing of supplying vessels. In all cases, dye diffusion took place especially at the peripheral loops of the corneal vessels.