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Summary Two patients with rhinocerebral phycomycosis associated with diabetes are presented. The chronic nature of the illness in these two cases in emphasized in contrast to the more fulminant course of most previously reported patients. A high index of suspicion is needed to establish the diagnosis as rapidly as possible. Treatment of the underlying disease combined with amphotericin B therapy and radical surgical excision of all infected tissue is important to establish cure of these patients.

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The Alice strain of influenza A/England/42/72 (H3N2) live attenuated vaccine, when given by the intranasal route to 133 volunteers, was relatively nonreactogenic; only 12% of the vaccinees had upper respiratory tract symptoms after immunization. Seroconversion in 87.2% of subjects whose titers of humoral hemagglutination-inhibiting antibody before immunization were less than 1:8 demonstrated the immunogenicity of the vaccine. The overall seroconversion rate was 66.1% (geometric mean titer of hemagglutination-inhibiting antibody, 1:40.9). Antibody levels were unchanged at six months in 95.5% and at 12 months in 91.7% of the vaccinees. Because of the lack of natural influenza A infection during the season monitored, an experimental challenge study with homotypic virus (influenza A/Udorn/307/72 [H3N2]) was conducted eight months after immunization of a sample population of 22 subjects. Twelve of these subjects were vaccinees whose titers of hemagglutination-inhibiting antibody were greater than or equal to 1:64, and 10 were unimmunized controls whose titers of hemagglutination-inhibiting antibody were less than or equal to 1:8. The group with titers of greater than or equal to 1:64 represented 40.2% of the immunized population. The vaccine was highly effective in this selected group, with a 91% protection efficacy against illness and a 100% rate of protection against illness associated with influenza A infection.