Joseph Stokes

The Persistence in the Human Circulation of Horse and Human Tetanus Antitoxins.

Summary Human subjects were passively immunized with either horse-globulin tetanus antitoxin or human gamma globulin tetanus antitoxin. The homologous antitoxin persisted at higher levels and for a much longer period of time than the heterologous. The horseglobulin antitoxin decreased very sharply after the first week, and, thereafter, followed a straight-line curve to its preimmunization level.

Studies on air-borne infection in a hospital ward

Summary Experiments have been reported on the prevention of air-borne infectionin white mice, conducted in a large hospital ward (14,000 cubic feet) subdivided into sixteen separate cubicles. Groups of animals were placed in some of the locations, while cultures of the hemolytic streptococcus of Lancefields Group C or of the virus of influenza A were atomized in one of the cubicles. Both organisms spread rapidly throughout the air of the ward. Ultraviolet irradiation and propylene glycol vapor were compared in their effectiveness as disinfectants of the air. With heavy concentrations of air-borne streptococci (more than 3,000 cells per cubic foot of air) most of the control mice died from streptococcal pneumonia and septicemia, while propylene glycol vapor protected them completely and ultraviolet irradiation failed to prevent death only in the cubicle containing the atomizer. With low concentrations of the streptococcus (200 to 500 organisms per cubic foot of air), all mice survived and cultures taken from the lungs on the eighth or tenth day failed to reveal the streptococcus. However, it could be shown in other experiments that a carrier state had been induced in the animals exposed under control conditions, and not in those protected by ultraviolet light barriers. This was demonstrated by inoculation of the virus of influenza A eight to ten days after exposure to the air-borne streptococcus. All mice died from influenza, but only those belonging to the control group now showed hemolytic streptococci in cultures taken from the lungs. Instillation of sterile broth only occasionally activated the streptococcus in the carrier. Ultraviolet irradiation and propylene glycol vapor were similarlyeffective in preventing the air-borne infection with the virus of influenza A. While all control mice succumbed to the disease, propylene glycol vapor protected the animals completely against death and only a few lesions were noted in animals from the cubicle containing the atomizer. More lesions and several deaths were observed in the same cubicle when the air was irradiated by ultraviolet lights, and pulmonary involvement was noted also in other locations close to the atomizer, under the same conditions. These results indicate that both ultraviolet light and propylene glycolvapor are effective disinfectants of the air. Their application will depend upon the individual problems and the location to be disinfected. It must be re-emphasized that only infection by droplet nuclei has been studied. Flugge droplet and possibly dust-borne infections may require different means of control.

Studies on air-borne infection in a hospital ward: II. Effects of ultraviolet irradiation and propylene glycolvaporization upon the prevention of experimental air-borne infection of mice by droplet nuclei

Summary Experiments have been reported on the prevention of air-borne infectionin white mice, conducted in a large hospital ward (14,000 cubic feet) subdivided into sixteen separate cubicles. Groups of animals were placed in some of the locations, while cultures of the hemolytic streptococcus of Lancefields Group C or of the virus of influenza A were atomized in one of the cubicles. Both organisms spread rapidly throughout the air of the ward. Ultraviolet irradiation and propylene glycol vapor were compared in their effectiveness as disinfectants of the air. With heavy concentrations of air-borne streptococci (more than 3,000 cells per cubic foot of air) most of the control mice died from streptococcal pneumonia and septicemia, while propylene glycol vapor protected them completely and ultraviolet irradiation failed to prevent death only in the cubicle containing the atomizer. With low concentrations of the streptococcus (200 to 500 organisms per cubic foot of air), all mice survived and cultures taken from the lungs on the eighth or tenth day failed to reveal the streptococcus. However, it could be shown in other experiments that a carrier state had been induced in the animals exposed under control conditions, and not in those protected by ultraviolet light barriers. This was demonstrated by inoculation of the virus of influenza A eight to ten days after exposure to the air-borne streptococcus. All mice died from influenza, but only those belonging to the control group now showed hemolytic streptococci in cultures taken from the lungs. Instillation of sterile broth only occasionally activated the streptococcus in the carrier. Ultraviolet irradiation and propylene glycol vapor were similarlyeffective in preventing the air-borne infection with the virus of influenza A. While all control mice succumbed to the disease, propylene glycol vapor protected the animals completely against death and only a few lesions were noted in animals from the cubicle containing the atomizer. More lesions and several deaths were observed in the same cubicle when the air was irradiated by ultraviolet lights, and pulmonary involvement was noted also in other locations close to the atomizer, under the same conditions. These results indicate that both ultraviolet light and propylene glycolvapor are effective disinfectants of the air. Their application will depend upon the individual problems and the location to be disinfected. It must be re-emphasized that only infection by droplet nuclei has been studied. Flugge droplet and possibly dust-borne infections may require different means of control.

Studies on measles

Summary 1.Twenty-two children who had been previously inoculated with egg-passage measles virus were exposed by chance at various intervals up to one year from the time of their inoculations to children with active cases of measles under field conditions. Three of these children developed typical measles, one developed mild measles, three developed an extremely mild disease distinguishable with difficulty as measles, and fifteen developed no disease. 2.Twenty-four children who had been previously inoculated withegg-passage measles virus were exposed by challenging injections of blood from active cases of measles at various intervals from the time of their original inoculations. Three of these children developed typical measles, two developed mild measles, five developed an extremely mild disease distinguishable with difficulty as measles, and thirteen developed no disease. One additional child showed a slight nasopharyngitis without fever, rash, or Koplik spots.Suitable control children and monkeys were injected with portions of the challenge material used and developed measles typical for the species injected. 3.The use of measles virus, attenuated by passage on the chorioallantoisof the developing chick embryo, for active immunization of children against measles gave results sufficiently encouraging to warrant further trial of such immunization in larger groups of susceptible children under field conditions inasmuch as forty of the forty-six children inoculated appeared to be completely or partially protected from measles.

Studies on Measles. V. the Results of Chance and Planned Exposure to Unmodified Measles Virus in Children previously Inoculated with Egg-Passage Measles Virus.

Summary 1. Twenty-two children who had been previously inoculated with egg-passage measles virus were exposed by chance at various intervals up to one year from the time of their inoculations to children with active cases of measles under field conditions. Three of these children developed typical measles, one developed mild measles, three developed an extremely mild disease distinguishable with difficulty as measles, and fifteen developed no disease. 2. Twenty-four children who had been previously inoculated withegg-passage measles virus were exposed by challenging injections of blood from active cases of measles at various intervals from the time of their original inoculations. Three of these children developed typical measles, two developed mild measles, five developed an extremely mild disease distinguishable with difficulty as measles, and thirteen developed no disease. One additional child showed a slight nasopharyngitis without fever, rash, or Koplik spots. Suitable control children and monkeys were injected with portions of the challenge material used and developed measles typical for the species injected. 3. The use of measles virus, attenuated by passage on the chorioallantoisof the developing chick embryo, for active immunization of children against measles gave results sufficiently encouraging to warrant further trial of such immunization in larger groups of susceptible children under field conditions inasmuch as forty of the forty-six children inoculated appeared to be completely or partially protected from measles.

Evidence for the propagation of the virus of serum hepatitis in the chick embryo

Evidence has been presented which indicates that the virus of serum hepatitis (SH) has been carried through 15 passages in the amniotic cavity of the chick embryo. 1. Intramuscular injection of amniotic fluid of the 9th and 15th passage into volunteers induced hepatitis without jaundice in 4 out of 6 and 2 out of 5 individuals, respectively, after incubation periods in excess of 60 days. 2. Serum taken from one of the patients in the first group during the acute stage of illness, when given to additional 4 volunteers resulted in 3 cases of hepatitis with, and one without jaundice. Challenge of the volunteers of the 1st group with natural virus (icterogenic serum) 8 months after the primary injection led to a second attack of hepatitis in 2 of the individuals. One of these was the donor of the serum referred to under 2. Possible reasons for the absence of solid immunity after the 1st exposure have been discussed.

Pediatric Immunization and the New Academy Schedule

The new American Academy of Pediatrics recommended immunization schedule should focus attention on the great gap that exists between availability of effective vaccines and the failure to immunize many children, particularly in urban poverty areas. Our public health inadequacies, the value of substituting multivalent for monovalent vaccines, and the immunologic basis for the efficacy of the former are discussed.