No abstract

Ruutu, I? Loss of protective immunity to polio, diphtheria and Huemophilus infhnzue type b after allogeneic bone marrow transplantation. APMIS 104: 383-388, 1996. Immunity to poliovirus, diphtheria and Huemophilus injluenzue type b (Hib) was studied in 16 adult recipients of a bone marrow transplant from an HLA-identical sibling donor in order to evaluate the need for revaccinations. T-cell depletion was not done in any case. The donors and patients were studied before bone marrow transplantation (BMT) and the patients I. 3, 6, and 12 months later. Prior to the BMT 10 of 11 patients were immune (titre 24) to all vaccine poliovirus types by a standard microneutralization assay. At 12 months after BMT only two of seven patients were immune to all vaccine types, and none had immunity against an antigenically altered poliovirus type 3 strain Finland. The geometric means of antibody titres against poliovirus types I , 2, and 3 strain Saukett and strain Finland declined gradually after 1 month postgrafting, being 4.4, 5.4, 3.3, and 1.3 respectively at 12 months after BMT. At 1 year 6 of 11 patients had immunity against diphtheria by a toxin neutralization method, but the antitoxin geometric mean level had decreased to a barely protective level, 0.01 IU/ml. The geometric mean Hib antibody concentration decreased during the first 6 months after BMT and thereafter increased slightly. A significant proportion of BMT recipients lose their protection against polio, diphtheria and Hib, and revaccinations are necessary.

No abstract

IgM, IgA, and IgG antibodies to Bordetella pertussis were measured in paired sera from 34 patients who were culture-positive for pertussis by enzyme-linked immunosorbent assay (ELISA) with disrupted B. pertussis bacteria, purified pertussis toxin, or outer membrane proteins (OMP) as antigens. Paired sera from 50 patients with other respiratory infections were used as controls. The sensitivities of the assays from paired sera were 61%, 90%, and 90% and specificities were 98%, 92%, and 72%, respectively. Of the patients culture-positive for pertussis, 68% had positive levels of antibody to pertussis toxin antigen in their first serum samples, obtained at the same time as samples for culture. Infants had antibody responses to pertussis toxin antigen, in contrast to weak antibody responses measured by B. pertussis antigen. The results from this study indicate that ELISA, especially measuring pertussis toxin IgA, is a valuable additional tool for diagnosing pertussis and can be used as a complementary test with cultures.

An enzyme-linked immunosorbent assay (ELISA) and bacterial agglutination (BA) method for determining the presence of antibodies to Bordetella pertussis were compared on serum samples from 21 patients with whooping cough and their 76 family members. The overall diagnostic agreement between the two methods was 77%. The data for BA-detected antibodies correlated best with IgG and IgA antibodies to B. pertussis. All of the culture-positive patients showed serologic positivity in both assays during the follow-up. Pertussis was diagnosed by ELISA in most cases from the first serum sample. Both methods proved to be good diagnostic aids in culture-negative patients, although the value of BA is more retrospective because of the need for paired sera. The kinetics of IgM, IgA, IgG, and agglutinating antibodies to B. pertussis is presented.