[The adsorbed-DTP-m vaccination of children with allergically altered reactivity]. / AKDS-m vaktsinatsiia detei s allergicheski izmennoi reaktivnost'iu.

Immunization and booster immunization with adsorbed DPT-m vaccine was carried out, respectively, in 45 and 15 children with different severity of the course of an allergic disease, each child receiving simultaneously individually prescribed complex drug therapy. The postvaccinal period took a relatively favorable course. General and allergic reactions and complications observed after the injection of the preparation did not hinder the continuation of the course of immunization, while the appearance of neurological reactions provoked doubts on the expediency of the repeated injection of this preparation. A decrease in the content of diphtheria and tetanus toxoids in one immunization dose did not lead to the decreased synthesis of specific antibodies. The present investigation showed the possibility of using adsorbed DPT-m vaccine with reduced antigen content in cases of both the remission of an allergic disease and the subacute course of such disease.

[Whooping cough morbidity and inoculation status]. / Zabolevaemost' kokliushem i sostoianie privitosti.

The analysis of pertussis morbidity and the state of immunity to pertussis has made it possible to evaluate the existing epidemiological situation as unfavorable. The restraining influence of specific prophylaxis on the epidemic process of pertussis becomes weaker due to the growing number of nonimmunized children; for this reason, the maximum morbidity rate in pertussis is observed among children under 5 years of age, as it was at the period before the introduction of mass immunization against pertussis. To prevent further possible increase in the intensity of the epidemic process of pertussis and in the severity of the clinical course of the disease, the number of children under 3 years of age, not immunized against pertussis, must be reduced by limiting the number of children exempted from immunization on medical grounds and by increasing the proportion of children immunized from the age of 3 months.

[Data from different Moscow polyclinics on the utilization of vaccination against diphtheria, pertussis, tetanus, and measles in children of first 3 years of life]. / Dannye ob okhvate privivkami protiv difterii, kokliusha, stolbniaka i kori detei pervykh trekhlet zhizni po materialam otdel'nykh poliklinik Moskvy.

The coverage of children by immunization against diphtheria, pertussis and tetanus during the first 3 years of life as indicated in forms No. 112 and No. 63 in 4 districts of Moscow was studied on the basis of the analysis of 1688 children's development histories. The coverage of children by immunization was found to be on the average 71.7%, fluctuating in individual districts from 58.6% to 85.9%. Immunization against measles covered 41.8% of children with fluctuations 24.2-51.2%. The most frequent reasons for the absence of prophylactic immunization in children during the first 3 years of life, or belated immunization in comparison with the specified terms, were contraindications due to neurological diseases (40.4%), exudative diathesis (15.9%) and recurrent viral infections (16.2%). Medical objections to immunization without sufficient grounds constituted 12.1% of all contraindications; among such objections those given by neuropathologists (9.8%) and pediatricians (2.3%) prevailed. To increase the coverage of children by immunization in the specified terms, the use of such measures as improving work with parents (explaining to them the importance of timely prophylactic immunization) and strict observance of instructions on medical contraindications may be considered most effective.

[Spread of whooping cough among adults today]. / Rasprostranenie kokliusha sredi vzroslykh liudei v sovremennykh usloviiakh.

Epidemiological surveys with the use of the clinical and bacteriological methods of examination were carried out in 107 foci of pertussis in families (283 adults), 25 foci in children's institutions (103 employees) and 1 focus in a surgical department for infants (29 adults). The infection was shown to be widely spread among adults at present: 23.7% in the surveyed families, 10% in children's institutions and 6.9% in the surgical department for infants. In the familiies, 26.2% of the adults were the first to fall ill with pertussis. no essential differences in the terms of the release of the infective agent, as well as in the course of the disease, in adults and in vaccinated children were found. Antiepidemic measures in respect to adult pertussis patients is proposed.

[Intensity of the epidemic process of whooping cough under conditions of mass immunization over a period of many years]. / Intensivnost' epidemicheskogo protsessa kokliucha v usloviiakh mnogoletnei massovoi immunizatsii.

On the basis of analysis of whooping cough incidence in 1959 to 1975 in Moscow the authors present characteristics of the epidemic process under conditions of planned many-year immunization of children against this infection. Whooping cough morbidity proved to undergo significant changes-from sharp falls the first 8 years of immunization to a relative stabilization with a gradual reduction the last 5 years. Marked seasonal and periodic elevations persist against the background of reduction of morbidity. Preschool- and schoolchildren are equally involved in the epidemic process; the most frequently involved are nonvaccinated children aged 1 year and 4 to 10 years, which lost postvaccinal immunity. Further reduction of the severity of whooping cough and increase in the number of unimanifested forms of the infection was noted. This was apparently connected not only with immunization, but also with the reduction of the virulence of H. pertusis detected in studying the cultures isolated in Moscow from 1967 to 1974. The intensity indices of the epidemic process in whooping cough pointed to the necessity of using a more effective vaccine for the protection of children from whooping cough, despite the noted reduction of morbidity, and diminished severity of the course of the disease, and of the causative agent virulence.

[Epidemiological evaluation of the effectiveness of the obligatory isolation of whooping cough patients in schools]. / Epidemiologicheskaia otsenka éffektivnosti obiazatel'noi izoliatsii bol'nykh kokliushem v shkolakh

Analysis of observations carried out under practical conditions (165 patients with pertussis from 48 foci) and the results of controlled epidemiological trial on the discontinuance of compulsory isolation of pertussis patients at schools (12 classes, 402 children) showed that isolation of the patients failed to stop the spread of infection in the focus. This was attributed to incomplete detection of the patients and their late isolation in conditions of wide incidence of mild forms and formes frustes of pertussis. When patients suffering from pertussis were left at school, there occurred no increase in the spread of the infection in the focus, in duration or severity of the disease and no increase of the period of discharge of the causative agent. However, the number of days of the patient's absence from school was greatly reduced. Taking into consideration the absence of an attack-like cough in patients with formes frustes, short duration and preponderance of the attacks at night in patients with a mild form of pertussis, no disturbances in the general condition of the child, and also no indications to the treatment, schoolchildren should be isolated by clinical indications only (pyrexia, marked catarrhal phenomena, frequent attack-like cough, complications, concomitant diseases); they can be admitted to school as soon as the mentioned signs subsided irrespective of the time lapse from the onset of the disease.