Inadequate Immunization Research Articles

DICER1: A Key Player in Rheumatoid Arthritis, at the Crossroads of Cellular Stress, Innate Immunity, and Chronic Inflammation in Aging.

Loss-of-function or knockout mouse models have established a fundamental role for the RNAse III enzyme DICER1 in development and tissue morphogenesis and/or homeostasis. These functions are currently assumed to result mainly from the DICER1-dependent biogenesis of microRNAs which exhibit important gene expression regulatory properties. However, non-canonical DICER1 functions have recently emerged. These include interaction with the DNA damage response (DDR) pathway and the processing of cytotoxic non-coding RNAs, suggesting that DICER1 might also participate in the regulation of major cellular processes through miRNA-independent mechanisms. Recent findings indicated that reduced Dicer1 expression, which correlates with worsened symptoms in mouse models of joint inflammation, is also noted in fibroblast-like synoviocytes (FLS) harvested from rheumatoid arthritis (RA) patients, as opposed to FLS cultured from biopsies of osteoarthritic patients. In addition, low DICER1 levels are associated with the establishment of cellular stress and its associated responses, such as cellular senescence. Senescent and/or stressed cells are associated with an inflammatory secretome (cytokines and chemokines), as well as with “find-me” and “eat-me” signals which will attract and activate the innate immune compartment (NK cells, macrophages, and neutrophils) to be eliminated. Failure of this immunosurveillance mechanism and improper restauration of homeostasis could lead to the establishment of a systemic and chronic inflammatory state. In this review, we suggest that reduced DICER1 expression contributes to a vicious cycle during which accumulating inflammation and premature senescence, combined to inadequate innate immunity responses, creates the appropriate conditions for the initiation and/or progression of autoimmune-autoinflammatory diseases, such as RA.

Incomplete immunization coverage among children aged 12–23 months and associated factors in Togo in 2017

Introduction Inadequate immunization coverage remains a public health problem in Africa. In Togo, only 62% of children under one year of age were fully immunized as assessed by the third Demographic and Health Survey conducted in 2013, hence not achieving the 90% or more immunization target for national coverage as set by the World Health Organization (WHO). In view of this, it appears necessary to carry out operational research to identify obstacles to complete immunization coverage in Togo. Methods A cross-sectional survey was conducted from February 27th to March 5th 2017 in the six health regions of Togo. A modified WHO Epi Cluster sampling method was used for sample selection. Children aged 12 to 23 months who were living with one of the parents or guardians from selected households were recruited for the study. Data was collected using a pre-tested questionnaire through door-to-door visits and face-to-face interviews. Interviewers assessed immunization status of selected children based on immunization cards or parent's recall. Multilevel logistic regression analysis was performed to assess factors associated with incomplete immunization coverage. Results A total of 1261 households were included. Respondents were predominantly women (91.9%) and 22.8% had secondary or higher education level. Immunization cards were available for 85.3% of children. Complete immunization coverage was 72.3% (95% confidence interval, 95% CI: [69.7–74.8%]) and 90.7% of the children were vaccinated against tuberculosis. Main barriers to children's full immunization reported by parents or guardians were: long distance to the health center (32.2%), poor road conditions (13.3%), lack of means of transport (10.5%) and lack of time (9.0%). After controlling for both individual and contextual level variables, children whose mothers attended secondary school or above were 33%, adjusted odds ratio (aOR) = 0.67, CI [0.47–0.94] less likely to have an incomplete immunization coverage compared to those with no education level. The likehood of incomplete immunization in children decreased with the increase household's income (aOR = 0.73, 95% CI [0.58–0.93]). In addition, children who did not have an immunization card (aOR = 13.41, 95% CI [9.19–19.57]) and those whose parents did not know that children immunization was free of charge (aOR = 1.82, 95% CI [1.00–3.30]) were more likely to have an incomplete immunization. Finally, children whose parents had to walk a half hour and one hour to the health center were 57% more likely to have an incomplete immunization coverage (aOR = 1.57, 95% CI [1.15–2.13]) than those whose parents had to walk less than half an hour. Conclusion This study confirms that the goal of 90% coverage at the national level has not been achieved in 2017 and the factors associated with incomplete coverage of immunization were identified. Innovative strategies such as using electronic cards and the strengthening of sensitization must be initiated for a complete immunization coverage in Togo.

Pertussis Resurgence: School Nurses as a Safety Net for Children.

After a decade of decreases in the incidence of vaccine-preventable diseases, in the late 1980s the incidence began to increase. Four vaccine preventable diseases, including pertussis, caused major epidemics, and children were the most vulnerable during these outbreaks. Due to waning immunity, genomic changes, and inadequate herd immunity in adults, infants and children are at risk for contracting pertussis. Pertussis is a vaccine-preventable disease. Pertussis is difficult to diagnose early because the presentation is similar to common problems such as bronchitis or upper respiratory infections. School nurses should be able to identify signs and symptoms in the earliest stage possible to prevent transmission and refer for treatment early. The purpose of this article is to provide school nurses with information to understand the disease and identify individuals infected with pertussis.

Outbreaks of Varicella Zoster in a Military Nursing Institute: Infection Control in Hospital and Institutional Environments

Background: Varicella zoster (VZ) is a highly contagious exanthematous disease. The Indian VZ clade 5 has a high outbreak potential with attack rates of 90%, which thwarts all the infection control endeavors in hospital and institutional environments. Four VZ outbreaks occurring over four different years were investigated with military nursing students in a tertiary-care hospital in order to delineate infection control protocols. Methods: VZ outbreaks were investigated by hospital infection control committee utilizing standard definitions and protocols after establishing epidemiological linkage. A total of 114 nursing students were evaluated through a questionnaire developed to assess clinicodemographic, exposure, confinement and vaccination parameters. Outbreak control measures included isolation of patients; quarantined close-contacts and suspects; acyclovir treatment; immunization of susceptible candidates against VZ. Results: There were four different outbreaks comprising a total of 23 patients including five breakthrough patients with cumulative attack rate of 39%. Most patients had mild VZ. Most common sources were friends. Also, 25 students had no exposure to VZ or VZ vaccine, and were identified to be susceptible candidates and accordingly, were vaccinated. Conclusions: Outbreaks of VZ are emerging in the developing countries due to inadequate immunization coverage, primary failure to seroconvert, or failure to mount immune response despite seroconversion, or secondary failure due to waning immunity. Outbreaks of VZ may have variable epidemiological dynamics and may not be controlled with standard infection-control programs. There is a need to augment existing capabilities for optimizing outbreak management in institutional settings.

Prevalence of Inadequate Immunity to Measles, Mumps, Rubella, and Varicella in MLB and NBA Athletes.

Background:Multiple outbreaks of vaccine-preventable viral diseases have occurred in professional sports in recent years. Currently, there is no established protocol for vaccination or immunity screening for professional athletes.Hypothesis:There are significant differences in the prevalence of inadequate immunity dependent on age, sport, country of birth, and participation in collegiate sports.Study Design:Cross-sectional cohort study.Level of Evidence:Level 4.Methods:A sample of Major League Baseball (MLB) and National Basketball Association (NBA) players were screened for serologic evidence of immunity to measles, mumps, rubella, and varicella prior to the 2015 and 2016 seasons. The results were designated as adequate (immune) or inadequate (equivocal or nonimmune) based on laboratory criteria. Comparison with an age-matched control group was performed using data from the National Health and Nutrition Examination Survey (NHANES).Results:A total of 98 athletes (62 MLB, 36 NBA) were screened. The prevalence of inadequate immunity for any virus was 35.5% in MLB players and 33.3% in NBA players. There was a significantly greater risk of inadequate immunity to rubella (risk ratio, 6.38; P < 0.01) and varicella (risk ratio, 4.21; P < 0.01) in athletes compared with the age-matched NHANES population. Our analysis did not reveal differences in rates of immunity based on sport, country of birth (US born vs international), or participation in college athletics. There was a lower rate of inadequate immunity to varicella with increasing age (odds ratio, 0.72; P = 0.05).Conclusion:One-third of athletes studied had inadequate immunity to 1 of the 4 viruses tested. Younger players had a significantly greater risk of inadequate immunity to varicella. Birth outside the US and lack of participation in college athletics were not found to influence immunity rates.Clinical Relevance:These results can inform the development of future screening programs to prevent outbreaks of viral infections in professional athletes.

Characteristics of wild polio virus outbreak investigation and response in Ethiopia in 2013\u20132014: implications for prevention of outbreaks due to importations

BackgroundEthiopia joined the Global Polio Eradication Initiative (GPEI) in 1996, and by the end of December 2001 circulation of indigenous Wild Polio Virus (WPV) had been interrupted. Nonetheless, the country experienced multiple importations during 2004–2008, and in 2013. We characterize the 2013 outbreak investigations and response activities, and document lessons learned.MethodThe data were pulled from different field investigation reports and from the national surveillance database for Acute Flaccid Paralysis (AFP).ResultsIn 2013, a WPV1 outbreak was confirmed following importation in Dollo zone of the Somali region, which affected three Woredas (Warder, Geladi and Bokh). Between July 10, 2013, and January 5, 2014, there were 10 children paralyzed due to WPV1 infection. The majorities (7 of 10) were male and below 5 years of age, and 7 of 10 cases was not vaccinated, and 72% (92/129) of < 5 years of old children living in close proximity with WPV cases had zero doses of oral polio vaccine (OPV). The travel history of the cases showed that seven of the 10 cases had contact with someone who had traveled or had a travel history prior to the onset of paralysis. Underserved and inaccessibility of routine immunization service, suboptimal surveillance sensitivity, poor quality and inadequate supplemental immunization were the most crucial gaps identified during the outbreak investigations.ConclusionPrior to the 2013 outbreak, Ethiopia experienced multiple imported polio outbreaks following the interruption of indigenous WPV in December 2001. The 2013 outbreak erupted due to massive population movement and was fueled by low population immunity as a result of low routine immunization and supplemental Immunization coverage and quality. In order to avert future outbreaks, it is critical that surveillance sensitivity be improved by establishing community-based surveillance systems and by assigning surveillance focal points at all level particularly in border areas. In addition, it is vital to set up in hard to reach areas a functional immunization service delivery system using the “Reaching Every Child” approach, including periodic routine immunization intensification and supplemental immunization activities.

Unintended pregnancy and its impact on childhood rotavirus immunization in Peru.

ABSTRACTObjectiveTo examine the association between unintended pregnancy and inadequate rotavirus immunization in Peruvian children.MethodsUtilizing cross-sectional observational data from the 2012 Demographic and Health Survey (DHS), logistic regression analysis was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between unintended pregnancy and inadequate rotavirus immunization among children.ResultsOf 9 620 pregnancies in the five years preceding the survey, 5 396 of them (56.1%) were reported as unintended, of which 2 981 were mistimed (30.9%) and 2 415 (25.1%) were unwanted. A total of 5 187 children (54.9%; 95% CI = 53.8%–56.1%) were recorded to have inadequate rotavirus immunization. Maternal literacy status was found to be a significant effect modifier of the association between pregnancy intention and rotavirus immunization (P value = 0.006). Among children born to illiterate mothers, unintended pregnancy was significantly associated with increased odds of inadequate rotavirus immunization (aOR = 2.6; 95% CI = 1.2–4.4), as compared to children from intended pregnancies. Deficient rotavirus immunization was significantly predicted by inadequate polio, pneumococcal, and influenza vaccinations; having a television in the household; and less maternal education. In contrast, having received breast-feeding education was protective against inadequate rotavirus immunization. Among literate mothers, there was no association between pregnancy intention and rotavirus immunization.ConclusionOur study provides evidence that improving literacy among mothers could increase rotavirus vaccination uptake among children from unintended pregnancies.

Post-Neonatal tetanus from broomstick injuries: a word of caution for caregivers

Tetanus is a vaccine-preventable disease that is acquired through exposure to the spores of the bacterium Clostridium tetani which are ubiquitous in the soil. Post-neonatal tetanus is an increasing problem in developing countries, including Nigeria. This is mainly as a result of inadequate immunization coverage, unsustainable immunization programmes, and non-administration of booster doses of tetanus toxoid at appropriate periods to eligible children. The spores of the bacterium can get into the body through broken skin, commonly through injuries from contaminated objects. There have also been reports of broomstick injury as the portal of entry. Indeed, it has been reported to be the commonest portal of entry in a center in Nigeria. This is important because flogging (of children) with brooms is common in parts of Nigeria, despite it being forbidden in several cultures in the country. Two cases of post-neonatal tetanus arising from broomstick injuries in Uyo, Nigeria, are herein reported, to illustrate the inherent dangers and implications of broomstick injuries in children. It is hoped that advocacy campaigns will be conducted at different public health fora to raise awareness of the general population concerning post-neonatal tetanus from broomstick injuries. Furthermore, there is urgent need to institutionalize the administration of booster doses of tetanus toxoid at primary and secondary school entry.

Screening of Corynebacterium diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis in throat swab specimens of children with upper respiratory tract infections

Although a significant decrease has been reported in the incidence of diphteria in many regions of the world following the routine diphtheria immunization programs, the emergence of new cases indicated that toxigenic strains are still circulating in the community. Diphtheria vaccine does not provide protection against asymptomatic carriage and colonization of non-toxigenic Corynebacterium diphtheriae. It is a known fact that invasive infections may arise from non-toxigenic C.diphtheriae strains that the non-toxigenic strains can become toxigenic strains leading to diphteria. It is also known that there is a risk of diphteria outbreaks due to decreased antitoxin level and inadequate adult immunization programs. In our country, there is no routine surveillance of toxigenic and non-toxigenic C.diphtheriae. In the present study we aimed to investigate the presence of C.diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis in children presenting with the symptoms of upper respiratory tract infections that might be confused with those moderate diphteria, in order to highlight the requirement of microbiological surveillance and to create awareness about these microorganisms among public health experts, microbiologists and clinicians. Throat swab specimens were obtained from children who were admitted to the pediatric outpatient clinics, in Dr. Sami Ulus Obstectrics, Children Health and Diseases Educational and Research Hospital, with upper respiratory tract infections between 1 February 2016-22 March 2016. The specimens were inoculated in 5% sheep blood agar plates. The plates that were incubated in appropriate conditions, were evaluated for Group A beta hemolytic streptococcocci. Subsequently, culture plates were sent to the Public Health Institution of Turkey, National Respiratory Pathologens Reference Laboratories for the investigation of the presence of C.diphtheriae, C.ulcerans and C.pseudotuberculosis. The growth in each plate were collected with a sterile swab and inoculated in tryptic soy broth. Following 2 hours of incubation at 37oC, subcultures were inoculated in cystine-tellurite-blood agar (CTBA) and 5% sheep-blood agar plates; after an overnight incubation tellurite-reducing colonies were inoculated in Tinsdale agar plates. The suspected colonies with positive cystinase activity were identified by conventional methods and also with Coryne API (Biomerieux, France) systems. Toxicity tests (ELEK, PCR) were performed to investigate whether the C.diphtheriae strains were producing toxins. A total of 500 patients were involved in the study. Of these 260 (52%) were girls and 240 (48%) were boys with a mean age of 76 (range, 21-213) months. All patients except one were fully vaccinated with boosters. Most common presenting symptoms of the patients were fever (19.8%), sore throat (52.6%), cough (49.2%), tonsillar hyperemia (97.6%), presence of crypt (24.6%), and membrane over tonsils (1%). Group A beta-hemolytic streptococcocci were detected in the throat swab cultures of 66 (%13.2) patients. Genotypically toxin negative C.diphtheriae biovar gravis was identified in the throat swab cultures of 3 patients (2 girls and 1 boy). The tonsils were hyperemic and hypertrophic in all the patients with C.diphtheriae biovar gravis. C.ulcerans and C.pseudotuberculosis were detected in none of the patients. It is considered that similar regular cross-sectional studies or routine screening programs are expected to raise awareness about this forgotten microorganism both epidemiologically and microbiologically.

Maternal immunization: An opportunity to protect the vulnerable from infectious disease

Abstract Vaccination is one of the most cost effective techniques to prevent disease. Access to healthcare during antenatal visits provides an important opportunity to vaccinate the pregnant women with inadequate immunization and extending the benefit to the fetus also till it develops its own immunity after birth. There are many tropical infections like influenza, diphtheria, pertusis where the antenatal immunization can be of extreme benefit by providing protection and thus decreasing the maternal and neonatal maternal mortality and morbidity.

Knowledge, Attitudes and Practices of Agricultural Workers towards Tetanus Vaccine: a Field Report.

Agricultural Workers are both more exposed to tetanus and at higher risk to be inadequately immunized than other usual recipients of the same vaccine. Our cross-sectional questionnaire-based study aimed to evaluate tetanus vaccination status, knowledge, attitudes and practices in Agricultural Workers in North-Eastern Italy. Bivariate and multivariate logistic regression analyses were used to identify, from individual and work-related characteristics, factors significantly associated with appropriate vaccination status. Among 707 participants, 58.4% had an up-to-date immunization status. In 33.1%, last booster was performed by an Emergency Department. The main reason for inadequate immunization was having forgotten the recommended periodic booster (146/707; 20.7%). Attitude towards tetanus vaccination was somehow favourable in 79.5% of participants, and 72.7% correctly identified tetanus vaccination as mandatory for Agricultural Workers. A lower degree of false beliefs and better knowledge of official recommendations were significant predictors of vaccine propensity. The main predictor for an appropriate vaccination status was interaction with a healthcare provider, in general (adjusted Odds Ratio, adjOR 2.516 95%CI 1.707-3.710), and specifically regarding vaccine counseling, (adjOR 6.275 3.184-12.367 and adjOR 9.739 95%CI 3.933-24.111 for general practitioners and occupational physicians, respectively). Our study enlightens the key role of healthcare providers in recalling and promoting vaccination policies, as well in increasing the general awareness of Agricultural Workers regarding vaccines and official recommendations.

Sporadic cases of adult measles: a research article

BackgroundMeasles caused by a paramyxovirus, characterized by fever, malaise, cough, coryza conjunctivitis, a maculopapular rash is known to result in pneumonia, encephalitis and death. Fatal cases of measles in Sri Lanka are rare after implementation of the National Immunization Programme in 1984. Thereafter 0.1% case fatality rate was observed during October 1999–June 2000 which is a very low figure compared to other regional countries. Immunization guidelines were further revised in 2001, 2011 and in 2012 when additional immunization was recommended to age group 4–21 years; who are likely to have inadequate immunization, in order to achieve elimination of Measles by 2020. However, in 2013–2014, 4690 cases were reported and the majority were children less than 1 year of age. The occurrence in adults is hard to retrieve in published epidemiological reports, however had been 38% (out of 1008 patients) in the 3rd quarter of 2013. During this outbreak 73/101 (72%) reported from the North Central Province of Sri Lanka had been more than 12 years of age with 50% being more than 29 years. 14 Sri lankan adult patients [median age 32 years (range 25–48)] who presented sporadically from June 2014 to March 2016, with confirmed measles infection were enrolled retrospectively after informed consent. Details with regards to their clinical presentation, immunization and other relevant areas were collected using an interviewer administered questionnaire or using patient management records.ResultsThe patients presented with high fever, headache, severe body aches, sore throat, dry cough, intense tearing, red eyes and posterior cervical lymphadenopathy over 3–5 days duration. Later they developed discrete maculopapular rash helping the diagnosis. They had a variable degree of leucopenia, lymphocytosis, thrombocytopenia and derangements in the liver functions mimicking any other acute febrile illnesses such as dengue, chikungunya, leptospirosis or Zika virus infection.ConclusionAt least a 3–5 day delay in the diagnosis was observed (even after the appearance of the rash in some patients), due to non-awareness of its occurrence, unfamiliarity of measles in adults, non-specific nature of the illness and non-availability of rapid diagnostics, risking transmission to the immune-compromised or non-immune staff or patients. Identification of the source of infection in these sporadic adult cases and their virologic surveillance and molecular epidemiology will be important to interrupt the transmission and to achieve the targeted elimination of measles from Sri Lanka by 2020.

The Effect of Chronic Hepatitis B Virus Infection on BDCA3+ Dendritic Cell Frequency and Function.

Chronic hepatitis B virus (HBV) infection results from inadequate HBV-specific immunity. BDCA3+ dendritic cells (DCs) are professional antigen presenting cells considered to be important for antiviral responses because of specific characteristics, including high interferon-λ production. BDCA3+ DCs may thus also have a role in the immune response against HBV, and immunotherapeutic strategies aiming to activate DCs, including BDCA3+ DCs, in patient livers may represent an interesting treatment option for chronic HBV. However, neither the effect of chronic hepatitis B (CHB) infection on the frequency and function of BDCA3+ DCs in liver and blood, nor the effect of the viral surface protein (HBsAg) that is abundantly present in blood of infected individuals are known. Here, we provide an overview of BDCA3+ DC frequency and functional capacity in CHB patients. We find that intrahepatic BDCA3+ DC numbers are increased in CHB patients. BDCA3+ DCs from patient blood are not more mature at steady state, but display an impaired capacity to mature and to produce interferon-λ upon polyI:C stimulation. Furthermore, in vitro experiments exposing blood and intrahepatic BDCA3+ DCs to the viral envelope protein HBsAg demonstrate that HBsAg does not directly induce phenotypical maturation of BDCA3+ DCs, but may reduce IFN-λ production via an indirect unknown mechanism. These results suggest that BDCA3+ DCs are available in the blood and on site in HBV infected livers, but measures may need to be taken to revive their function for DC-targeted therapy.

Mo1871 Insufficient Vaccination and Inadequate Immunization Rates Among Korean Patients With Inflammatory Bowel Diseases

Mo1871 Insufficient Vaccination and Inadequate Immunization Rates Among Korean Patients With Inflammatory Bowel Diseases

P453. Insufficient vaccination and inadequate immunisation rates amongst Korean patients with inflammatory bowel diseases

P453. Insufficient vaccination and inadequate immunisation rates amongst Korean patients with inflammatory bowel diseases

A scoping review of female disadvantage in health care use among very young children of immigrant families

Preference for sons culminates in higher mortality and inadequate immunizations and health care visits for girls compared to boys in several countries. It is unknown if the negative consequences of son-preference persist among those who immigrate to Western, high-income countries. To review the literature regarding gender inequities in health care use among children of parents who migrate to Western, high-income countries, we completed a scoping literature review using Medline, Embase, PsycINFO and Scopus databases. We identified studies reporting gender-specific health care use by children aged 5 years and younger whose parents had migrated to a Western country. Two independent reviewers conducted data extraction and a quality assessment tool was applied to each included study. We retrieved 1547 titles, of which 103 were reviewed in detail and 12 met our inclusion criteria. Studies originated from the United States and Europe, using cross-sectional or registry-based designs. Five studies examined gender differences in health care use within immigrant groups, and only one study explored the female health disadvantage hypothesis. No consistent gender differences were observed for routine primary care visits however immunizations and prescriptions were elevated for boys. Greater use of acute health services, namely emergency department visits and hospitalizations, was observed for boys over girls in several studies. Studies did not formally complete gender-based analyses or assess for acculturation factors. Health care use among children in immigrant families may differ between boys and girls, but the reasons for why this is so are largely unexplored. Further gender-based research with attention paid to the diversity of immigrant populations may help health care providers identify children with unmet health care needs.

Evaluation of measles–rubella vaccination for mothers in early puerperal phase

BackgroundThe postpartum period is an ideal opportunity to vaccinate mothers with inadequate immunity to vaccine-preventable diseases including measles and rubella. MethodsA prospective study of measles–rubella (MR) vaccination in the early puerperal phase was conducted in 171 mothers, who had insufficient antibody titers when screened for immunity to measles (≤1:4 on the neutralization test [NT]) or rubella (≤1:16 on the hemagglutination inhibition [HI] test) during pregnancy. To evaluate the efficacy of MR vaccination in the postpartum period, we determined their post-vaccination antibody titers and immune responses to vaccination, and investigated the association between these and their prolactin (PRL) levels and Th1/Th2 ratios at the time of vaccination. We also examined the passage of viral RNA and antigen into breast milk. ResultsOf the 169 participants who completed the study schedule, 117 and 101 had low antibody titers against measles and rubella, respectively. In the measles-seronegative group, the antibody-positive rate was 87% on the NT assay, and the NT geometric mean antibody titer was 11.4 (95% confidence interval [CI], 10.0–13.0). In the rubella-seronegative group, the antibody-positive rate was 88% on the HI test assay, and the HI geometric mean antibody titer was 64.0 (95% CI, 53.9–76.0). There was no association between the post-vaccination antibody titers and the PRL levels or Th1/Th2 ratios at the time of vaccination. In the rubella-seronegative group, subjects with higher Th1/Th2 ratios showed higher rates of responsiveness than those with lower ratios (P=0.045). Although measles virus RNA was isolated from the breast milk of two vaccinated mothers, breastfeeding was not associated with clinical disease in any infants. ConclusionMR vaccination in the early puerperal phase is considered an effective way to prevent the diseases, regardless of the mother's immunological status and hormonal milieu.

Knowledge, attitudes, beliefs and practices of construction workers towards tetanus vaccine in Northern Italy.

Construction workers (CWs) are both more exposed to tetanus and at higher risk to be inadequately immunized. Our aim was to evaluate tetanus immunization status and knowledge/attitudes towards tetanus vaccination in CWs in Italy. In this field report, the immunization status of 554 unskilled CWs (i.e. labourers). Immunization status was assessed recalling immunization booklets/certificates. Attitudes and knowledge were collected through a standardized questionnaire. In 240/554 CWs, immunization status was inadequate/not documented: in 184 subjects (33.2%), the last vaccination shot was older than 10 years, whereas basal immunization was incomplete in 20 cases, more frequently in foreign-born people (FBP) than in Italian born (IBP) (OR=7.116). In 198 cases (35.7%), an Occupational Physician (OPh) performed last booster, usually with monovalent (T, n=173) vaccine. The main reason for inadequate immunization was having forgotten the periodic booster (148/554; 26.7%), whereas 42 subjects (7.6%) deliberately avoided tetanus vaccine because of personal/religious beliefs, more frequently in FBP than in IBP (OR=3.182). In summary, the prevalence of inadequate immunization status was relatively high (43.4%): the high prevalence of “forgotten boosters” enlightens the key role of OPh in recalling and promoting vaccination policies. Moreover, the inappropriate use of Td vaccine points out the opportunity for educational campaigns in OPh.

Health benefits of Il-10 egg yolk antibodies administered to milk-fed dairy calves

Cryptosporidium parvum infection in calves causes villous atrophy, resulting in reduced surface area and absorptive capacity of the small intestine. Prevention and treatment of C. parvum infections are hindered by a lack of approved, efficacious products and inadequate colostral immunity. An integral component of infection is the dampening of the cell-mediated response by inducing anti-inflammatory cytokines. In calves, ileal intraepithelial lymphocytes express interleukin-10 (Il-10) when infected with C. parvum. Interleukin-10 decreases production of interferon-gamma, which is a vital Thl-associated cytokine. Studies have shown that Il-10 knockout mice are resistant to C. parvum infection. Oral administration of chicken egg yolk antibodies as a means of controlling enteric disease in calves is of interest to the dairy industry. Egg yolk Il-10 antibodies have been shown to survive gastrointestinal transit, are accessible in the intestinal lumen, and remain locally active, without persistence of systemic residues. Therefore, the objective of this trial was to investigate the effect of feeding Il-10 antibodies on calf health and performance after natural C. parvum infection in pre-weaned Holstein dairy calves.

Association of feeding practices and immunization with nutritional status of infants in jasra block of Allahabad district

Objective: The objective was to find the association of feeding practices and immunization with nutritional status of infants in Jasra Block of Allahabad district. Materials and Methods: A cohort study was conducted in a rural community among infants born during the period of November 2011 to April 2012. Information, Education and Counselling was given to their mothers starting from last 3 months of pregnancy and continued till the newborns completed 1-year of age. Then feeding practices, immunization, and nutritional status (in terms of weight for age) was assessed. Results: About 56.25% infants were exclusively breastfed and 53.75% infants were timely started on complementary feeding. 87.5% infants were fully immunized and the rest 12.5% were partially immunized. Growth of more than half of the infants, i.e., 47 (60%) followed a normal growth curve and weight of 33 (40%) infants was below 2 standard deviation. There was no significant difference between the mean weight at birth (i.e., 2.56 kg for infants with adequate feeding and immunization practices and 2.51 kg for infants with inadequate immunization and feeding practices). On the other hand, difference in the mean weight among two groups at 3, 6, and 9 months was statistically significant. Conclusion: Feeding practices and immunization have an association with nutritional status of infants in terms of better weight for age.