Kari Penttinen

RAPID EFFECT ON ENDEMIC MEASLES, MUMPS, AND RUBELLA OF NATIONWIDE VACCINATION PROGRAMME IN FINLAND

An immunisation programme to eliminate measles, mumps, and rubella from Finland within 10 years was started in November, 1982. A combined live vaccine is being given twice, at the ages of 14-18 months and 6 years, but at the beginning of the project children between these age limits are also being immunised. Because vaccinations are traditionally done by the public health nurses, special attention was paid to their motivation. 2.5 years after the launch of the project, 80.9% of the target children had been vaccinated. The incidence of measles has fallen by 93% and that of mumps by 87% compared with a normal prevaccination year (1982). A similar fall in incidence was seen for rubella, but only in the vaccinated age groups. Although elimination of measles, mumps, and rubella is not likely to be achieved with the present vaccination coverage, a drastic fall in the incidence of all three target diseases has occurred already. Every effort is being made to improve the coverage and thus to achieve the ultimate goal of the project.

VIRUS ANTIBODIES IN SERUM SPECIMENS FROM PATIENTS WITH MULTIPLE SCLEROSIS, FROM SIBLINGS, AND MATCHED CONTROLS. A FINAL REPORT*

Interviews were conducted with 229 patients with multiple sclerosis, 172 of their siblings and 219 matched controls from the general population. Serum specimens were taken and tested with 15 different antigens. An increased antibody response was observed in the patients and to a lesser extent in the siblings, but this seems to be directed almost selectively against measles virus antigens. The antibody levels to measles were highest in all study groups in that area in Finland for which the population has the highest relative risk to contract multiple sclerosis. No correlation could be found between the antibody levels and different clinical variables. Reports on increased antibody titers against different viruses in various chronic diseases, as well as the validity of serological results indicating an immunopathological process in the central nervous system, are discussed.

Determination of mumps and influenza antibodies by haemolysis-in-gel.

SummaryA stabilized modification of the single radial haemolysis-in-gel (HIG) technique was developed. Crude mumps or influenza virus preparations were coupled to erythrocytes with CrCl3 and mounted in agarose gel containing diluted guinea pig serum.Serial serum samples taken from 204 conscripts before and after vaccination with a killed mumps vaccine were analysed with the HIG technique. The results showed that the sensitivity of the HIG test in detecting seroconversion was higher than that of the conventional haemagglutination inhibition test (HI). The correlation between the diametre of the rings of haemolysis and antibody titres measured by the standard complement fixation (CF) technique was fairly good.62 pairs of sera from patients with suspected influenza were tested by both the HIG-method and the conventional CF and HI techniques. The HIG test appeared to be as sensitive as the common methods in detecting increases in antibody levels.The HIG test was found to be insensitive to the nonspecific inhibitors of haemagglutination and aggregated IgG while it was slightly affected by the rheumatoid factor.These features together with the technical ease of performing the test, make the HIG test superior to the conventional HI and CF techniques in mumps and influenza diagnostics.

Wart-virus antibodies and the prognosis of wart disease.

Abstract Wart-virus antibodies from 182 patients Summary with warts were studied by the micro-immunodiffusion method. 57% of the patients had measurable antibodies, the titres varying from 1 to 512. The longer the duration of the disease or the larger the number of tumours, the lower the serum antibody levels were. Complement-fixation antibodies were of the IgG type only, and were demonstrable in only 12% of the cases (titres 4-512). If the antibodies were IgG type, there was a good chance of healing.

Measles Virus Antibody in Cerebrospinal Fluids from Patients with Multiple Sclerosis

A strong measles-specific gel precipitation reaction was found in the cerebrospinal fluid (C.S.F.) of two patients with multiple sclerosis (M.S.) (total of 15 tested). The serum and C.S.F. specimens from these two patients were tested for measles antibody by six assay methods. The results were compared with those obtained from serum and C.S.F. specimens of a patient with subacute sclerosing panencephalitis (S.S.P.E.). The gel precipitation line produced by the C.S.F. from the M.S. patients was identical with one of the three lines produced by the C.S.F. from the S.S.P.E. patient. The main antigenic component responsible for measles antibody appearing in the C.S.F. of the S.S.P.E. patient and the M.S. patients was also electrophoretically similar, and the corresponding antibody was associated with IgG. The serum/C.S.F. antibody titre ratios with the various assay methods used suggest that the C.S.F. antibodies are mainly to other than envelope components of measles virus. No complement-fixing antibody against 27 other viruses or Mycoplasma pneumoniae was found in the C.S.F. of the two M.S. patients.

Association between Influenza during Pregnancy and Childhood Leukaemia

This report based on the data available from the Finnish Cancer Registry and from virus isolations gives further support to the association (P=0·04) between maternal influenza of the 1957 “Asian” type and subsequent later leukaemia in the infants. No such association was found from other influenza epidemics.

Q fever in Finland: clinical, immunological and epidemiological findings.

Clinical, immunological and epidemiological features of 14 human cases of Q fever diagnosed at Aurora Hospital are presented. All patients had an acute febrile disease and 9 (64%) had respiratory symptoms, 4 (29%) verified pneumonia, and 9 (64%) hepatitis, which in 4 biopsied cases proved to be granulomatous. Presence of circulating immune complexes was shown in 10/11 patients investigated by the platelet aggregation test (PAT) and the platelet iodinated protein A (PIPA) test. Q fever is not known to be endemic in the Nordic Countries. However, the causative agent, Coxiella burnetii, should tolerate our climate and there is a rich potential animal reservoir. All patients had visited some endemic area shortly before they were taken ill. In 3 cases the interval between arrival in Finland and the onset of symptoms was more than double the reported maximal incubation period, namely 69, 75 and 88 days. We suggest that these patients acquired the infection after their return to Finland from their clothing or from souvenirs. If so, Q fever could be acquired by this mechanism by persons who have never visited an area where the disease is endemic.

The effects of anionic polymers on cell attachment and growth behaviour, with a note on a similarity in the effect of fresh human serum

Abstract Anionic polymers in small concentrations inhibit cell attachment to a glass surface and cause cells to clump. The mechanism of these two effects seems to be similar; when the attachment is inhibited HeLa cells will stick together. Neither in protein-free medium nor in albumin-containing medium, the anionic polymers have any effect. The effect of anionic polymers is indistinguishable from the effect of fresh clumping serum. Both effects can be inhibited by thrombin. The clumping effect of fresh human serum is inhibited by anti-β-lipoprotein sera. The effect of the anionic polymers seems to be due to their electrochemical properties. The possible mechanism for the action of anionic polymers is briefly discussed. It is suggested that the anionic polymers act mainly on the cell surface increasing its negative charge, decreasing the deformability of the cell or changing the micro environment around the cell. The effect of the anionic polymers may also be attributable to their interaction with β-lipoproteins.

MEASLES ANTIBODIES DETECTED WITH VARIOUS TECHNIQUES IN SERA OF PATIENTS WITH MULTIPLE SCLEROIS

Hemagglutination inhibition (HI) antibody titers to measles, rubella, mumps, and La Crosse virus in 137 patients with multiple sclerosis and 137 controls matched by date of birth and place of residence were measured and are reported according to age. The measles HI titers were significantly higher in serum specimens of patients with multiple sclerosis (geometric mean 1/82) than in the controls (geometric mean 1/43). In addition, the measles HI titers decreased significantly in the older age groups of the controls, whereas a similar decrease was not observed in the MS patients. No significant differences in the HI titers of rubella, mumps, and La Crosse virus were found between the MS group and the control group. Measles antibodies were further analyzed in a representative smaller series of sera from 49 MS patients and 49 controls by inhibition of salt‐dependent hemagglutinin, gel precipitation, and platelet aggregation. With each of the techniques used, higher levels of measles antibody titers or stronger reactions were observed in the MS group. However, when measles antibodies detected with various techniques were compared in individual serum specimens of MS patients, no clear correlation between the high titers or strong reactions was discernible. The nature of the antibody response to measles virus in MS patients and the light thrown by the results obtained on the etiopathogenesis of multiple sclerosis is discussed.

Porcine C1q and the solid-phase immunoassay of human immune complexes.

Experiments were undertaken to determine if porcine C1q could replace human C1q in the solid-phase immunoassay of human immune complexes (ICs). Porcine C1q was obtained by a two-cycle precipitation method involving dialysis against chelating agents in low ionic strength buffer. C1q was adsorbed to polystyrene beads and in vivo- or in vitro-formed ICs binding to the solid-phase C1q were detected with 125I-labeled or horseradish peroxidase-conjugated anti-human gamma antibodies. Unfractionated, heat-aggregated human gamma globulin (delta IgG) could be detected at 20 ng/ml when diluted in buffer only. The detection threshold changed to 40-80 ng delta IgG/ml when the assay was run with buffer containing normal human serum diluted 1: 1000 (the serum dilution used for detecting natural ICs). Analysis of systemic lupus erythematosus sera revealed that 60% contained highly significant levels of ICs (binding greater than or equal to 3 S.D. above the mean of controls). Comparison with platelet aggregation test results revealed a highly significant correlation between the two methods (P less than 0.0001), even though each assay detected ICs in several serum specimens negative in the other test. These results demonstrate that porcine C1q can functionally replace human C1q in the solid-phase immunoassay of human ICs. Since porcine blood is normally a waste product of the meat-processing industry, it is an obvious source of easily isolated C1q for use in such an assay.