Outbreak of paralytic poliomyelitis in Finland: widespread circulation of antigenically altered poliovirus type 3 in a vaccinated population.

An outbreak of 9 cases of paralytic poliomyelitis and 1 non-paralytic case occurred in Finland between August, 1984, and January, 1985, after two decades of freedom from the disease attributable to a successful immunisation programme. During the outbreak poliovirus type 3 was isolated from the patients, from about 15% of healthy persons tested, and from sewage water. At least 100 000 persons were estimated to have been infected.

Elimination of poliomyelitis in Finland.

In Finland paralytic poliomyelitis has disappeared after immunization programs carried out exclusively with inactivated poliovirus vaccine (IPV). A sharp decrease in the number of patients with poliomyelitis occurred after mass vaccination in 1960-1961, when 51% of the population had received the complete primary vaccination. Immunity is maintained by continuous vaccination of infants, whose vaccination rate is close to 98%.

Etiology of mild acute infectious myocarditis. Relation to clinical features.

The etiology of mild myocarditis, diagnosed on the basis of serial ECG changes during an acute infection, was studied in 126 consecutive conscripts. A fourfold rise in the antibody titers in the paired serum samples was required for a positive etiologic diagnosis. An etiologic diagnosis was made probable in 47% of the patients.

Coxsackie B virus antibodies in myocardial infarction.

Evidence for the association between Coxsackie B virus infections and myocardial infarction was studied in a prospective follow-up examination. Using the micro neutralization test, 9 (15%) of 59 patients with acute myocardial infarction and 1 (2.6%) of 38 control patients showed a fourfold, or higher, antibody increase in paired serum samples against Coxsackie B1-5 viruses.

Antigen content of inactivated poliovirus vaccine for use in a one- or two-dose regimen.

The immunologic response to inactivated poliovirus vaccine following one and two doses has been studied in infants in developing and developed countries using vaccine prepared at the Rijks Instituut voor de Volksgezondheit, The Netherlands. Virus was grown in microcarrier cultures of monkey kidney cells, purified, concentrated, and inactivated with formalin. The vaccines used contained different quantities of D-antigen units for each of the three types.

Theoretical and practical considerations in the application of killed poliovirus vaccine for the control of paralytic poliomyelitis.

This paper contains a summary of the principles upon which the preparation and use of killed poliovirus vaccine (KPV) are based, as well as a summary of earlier and more recent work suggesting the feasibility of formulating a KPV preparation that would be fully and durably effective in a one- or two-dose regimen. The essential factor in the preparation of such a vaccine is the inclusion of a sufficient mass of the immunizing antigen, for each of the three antigenic types of poliovirus, to induce the formation of humoral antibody and/or immunologic memory after the first dose. The results of a series of studies carried out in West African and Scandinavian countries are summarized, which suggest that such a vaccine should contain 40, 8, and 32 D-antigen units for types I, II and III, respectively.

Potency test of inactivated polio vaccines in guinea pigs.

A trial with five different inactivated polio vaccines offered an opportunity to compare children's antibody titres with the antibody responses in guinea-pigs elicited by the same batches of vaccines. The potency test in guinea-pigs was carried out according to the European Pharmacopoeia. Polio antibodies were determined by the neutralization test in Vero cell tubes.

Experiences with polio vaccination and herd immunity in Finland.

Since the mass vaccination in 1960, infants have been vaccinated systematically with inactivated polio vaccine. By school entry 97% of children have received complete primary vaccination. Since 1964 no case of poliomyelitis has been found in Finland.

Inactivated poliovaccine: adverse reactions and antibody responses.

Adverse reactions and antbody responses after inactivated poliovaccine were studied in 380 children. Fever reaction (greater than or equal to 37.5 degree C rectally) was recorded in 14% of children after the first poliovirus vaccination and in 19% after the second.

Infections and other maternal factors as risk indicators for congenital malformations: a case-control study with paired serum samples.

An obstetric population of 48,000 individuals was prospectively followed up for evidence of possible teratogenic factors that might be associated with congenital malformations. Serum samples from 274 mothers of defective children and from paired controls were collected during early pregnancy and approximately one month after delivery and tested for antibodies against ten different viruses, Mycoplasma pneumoniae, and Toxoplasma. These data were supplemented with clinical information on infections, other diseases, drug intake, and other potentially teratogenic factors during pregnancy.

The efficacy of polio vaccination in Finland.

The inactivated polio vaccine has eliminated not only the disease but also polioviruses from Finland. The last endemic cases of poliomyelitis were seen in 1961, and two were imported in 1964. To check whether polioviruses were still circulating in Finland, an intensified search for polioviruses was carried out in 1972-1974 in sewage, among patients with polio-like diseases and among healthy preschool children.

Polio antibodies and HLA antigens in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a fatal, progressive disease of the central nervous system. Its possible association with poliomyelitis was studied by measuring neutralizing antibodies against polio virus types 1, 2 and 3 in the sera and cerebrospinal fluids of 11 ALS-patients, but antibody titers did not markedly differ from those of the controls. The HLA antigens of 12 ALS patients were also determined, in order to reveal any possible genetically-determined susceptibility to the disease.

Herpes simplex virus infection in the newborn.

Fourteen cases of neonatal herpes simplex virus infection in 10 boys and 4 girls are described. The disease was disseminated in 9 cases. In 5 cases skin symptoms predominated, and 1 had only central nervous system symptoms.

Cardiac manifestations during a Coxsackie B5 epidemic.

During a widespread Coxsackie B5 epidemic which occurred in Finland in the autumn of 1965 18 patients with acute myopericarditis were admitted to Kuopio Central Hospital (530 beds, representing a hospital district with 270,000 inhabitants) within a period of three months.The mean age of these patients was 28 years. Twelve were males and six were females.

Timing of different virus neutralizing 19S and 7S antibodies in natural coxsackie infections of newborn babies and adults.

Neutralizing Coxsackie antibodies arising from natural infections with Coxsackie virus type B3 or B5 were studied in adults and newborn babies. No differences could be found between the antibody response of the newborn babies and that of the adults. The antibody titres rose approximately as rapidly in the babies as in the adult patients, and the means of the peak titres did not differ significantly in the two groups.