Biken journal最新文献

A total of 52 acute leukemic children have been safely and effectively vaccinated with live varicella (Oka strain) vaccine given under close clinical and immunological observation. The incidence of zoster in the vaccinated children group was slightly less than that in the group that had experienced natural varicella.

For prevention of nosocomial infection, 25 infants including high risk patients received an emergency injection of live varicella vaccine. Three patients developed a rash within 5 days after vaccination, but their symptoms were mild. The other 22 showed no clinical symptoms and gave an immune response. Twenty-two patients receiving immunosuppressive therapy were vaccinated and 20 of them showed a positive response in the varicella skin test. Of 14 vaccinated patients with malignancies, 2 giving a positive skin test, later showed clinical varicella, but their symptoms were not severe. One case with ALL was immunized safely under very poor conditions during the first induction therapy. No complications were observed in any patients.

One-hundred-ninety-one children with acute leukemia in remission for at least one year were immunized with 1 or more doses of live attenuated varicella vaccine. All were susceptible to varicella prior to vaccination. The only significant side effect was mild to moderate rash, seen especially in children with maintenance chemotherapy temporarily suspended for one week before and one week after vaccination. Children with rash were at some risk (10%) to transmit vaccine virus to varicella susceptibles with whom they had close contact.

Clinical and serological follow-up studies were made on 257 healthy children who had received live varicella vaccine (strain Oka) in Showa Hospital. Good antibody responses were shown with a seroconversion rate of 98.4% (253/257) by the immune adherence hemagglutination test. Mild adverse reactions were observed in 11 of the vaccinated children. During observation periods of 6 months to 4 years, 6 of the 253 children who were successfully vaccinated contracted mild varicella, while all 4 vaccinees who showed no primary immune response contracted mild to moderate clinical varicella. It is concluded that this vaccine is highly immunogenic and causes few clinical reactions in normal children.

The live attenuated varicella vaccine (Biken) derived from the Oka strain was used for immunization of childhood cancer patients in remission but on chemotherapy. Thirty nine patients were immunized without any severe adverse effects but 6 recipients had a small number of vesicles. Seroresponses were observed in 90% of recipients examined. During the follow-up period 6 leukemia recipients were suffered from natural varicella in family or community contacts. No vaccinee developed herpes-zoster during this study period.

Between 1974 and 1983, 60 persons have been immunized at Kyushu University Hospital with a live attenuated varicella-zoster virus vaccine, Oka strain. The recipients were classified into 3 groups: those with a malignancy, those with the nephrotic syndrome and those with diseases not related to immuno-hematologic dyscrasia. The only adverse clinical reactions to the vaccine were skin rash with 3-30 vesicles and a body temperature of 38 C, which were seen in 2/21 (9.5%), 4/16 (25%) and 3/23 (13%) patients in the respective groups within 5 weeks after vaccination. From 6 months to 9 years after the vaccination, exogenous varicella infection occurred in 5/21 (23.8%), 1/16 (6.25%), and 0/23 (0%) patients in the respective groups. It is concluded that for patients with malignancies, revaccination is desirable to ensure the protective effect of the vaccine.

A live varicella vaccine (Oka strain) was developed by serial passage of the Oka strain isolated in our laboratory, in human embryonic lung cells (11 times at 34 C) and guinea pig embryo cells (12 times at 37 C). It is slightly temperature sensitive at 39 C and shows a higher ratio of infectivity in guinea pig embryo cells to infectivity in human embryo cells than wild-type strains. The DNA digest with Hpa I enzyme of the Oka strain contained one unique fragment (K), although its mobility differed only slightly from that of the corresponding fragment of wild-type strains. Studies with clinical varicella zoster virus (VZV) isolates from vaccinees indicated that tests on the ratio of infectivity in guinea pig embryo fibroblasts (GPEF) to that in human embryo fibroblasts (HuEF) and the profile of the DNA digest with Hpa I are useful for differentiation of the vaccine strain from wild-type strains. The vaccine virus showed stable immunogenicity during at least 15 further repeated passages in human diploid cells, a character which seems helpful for production of a large quantity of vaccine virus for practical use.

Live attenuated varicella vaccine (Oka strain, 500 to 750 PFU) was inoculated into 234 children with various underlying diseases. Varicella-zoster virus (VZV) specific immune adherence hemagglutination antibody developed in 95% of initially seronegative subjects. VZV specific cellular immune responses were detected in 91% of subjects within 6 weeks after vaccination. A preliminary survey of 46 vaccinated normal-risk subjects during the first and the third year revealed excellent protection with the exception of one case who had not shown any antibody response at the fourth week.

Varicella vaccine was used safely and effectively for preventing ward infection with varicella. Ward infection was experienced 34 times in 5 years between 1977 and 1982. During these ward infections, varicella developed in 4 of 142 patients who received vaccine, 21 of 47 patients who did not receive vaccine and 1 of 9 who received transfusion with vaccine-boostered blood. Of the 142 vaccinated patients, the four in whom varicella developed showed symptoms 3 to 10 days after vaccination, indicating that vaccination had been too late. Details of a ward infection with varicella by airborne transmission and its prevention by vaccination are presented.