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Active immunization against tetanus and diphtheria in infants and children
208
THE
Amino M.
JOURNAL
Acids as a Source of .Nitrogen A. 116:
2135,
OF
ALLERGY
for Allergic
Infants.
Hill,
L.
W.:
J. A.
1941.
A synthetic protein-free food, prepared by casein hydrolysis and intended for use as a milk substitute, was fed to thirty-six infants for from two weeks to three months. It appeared to be as satisfactory a milk substitute clinically as certain other preparations commonly used. It was thought to be especially suited to very young infants. Its chief disadvantage was its taste, which resembled strong beef tea, and caused some infants to refuse it either from the start, or after a short period of time. Specifically, satisfactory results were obtained with this milk substitute in half the cases, while in a quarter they were unsatisfactory, and the remainder inconclusive. The adequacy of the preparation as regards nitrogen metabolism for short periods at least, had already been demonstrated, It and
is pointed out that, no milk-free that it is desirable to have several
Active
Immunization
Bigler,
5. A.,
and
Against Werner,
Tetanus M.:
diet for infants t.ypes available.
and Diphtheria
J. A. M.
A. 116:
2356,
is without
disadvantages
in Infants
and Children.
1941.
The unsatisfactory status of tetanus prevention by means of antitoxin induces interest in a possible alternate solution by active immunization wTith toxoid. Since 50 per cent of tetanus deaths are in children, their protection is particularly important. Two hundred and forty infants and children from 8 months of age to 6 years of age were included in this study, the body of which concerns itself wit.h alum-precipitated combined diphtheria and tetanus toxoids. In most instances two injections were given three months apart, and a third was given one to twelve months later. A shorter interval between the initial injections is considered less desirable. Either 0.5 or 1.0 e.c. of toxoid was given. The response, as measured weeks and months later in tetanus and diphtheria antitoxin units, was good. Granting we do not know exactly what level of tetanus antitoxin is protective, it was apparent that higher levels are found one week after the third and even after the second injection than are obtained with the usual prophylactic antitoxin injections. These levels were also maintained for weeks rather than for a few days. In one child there was a failure of both diphtheria and tetanus Reactions were few. No abscesses occurred. Vrticaria was enresponse. countered twice; in one case, a few hours after injection; in the other case, irn The general febrile reactions were fewer and milder mediately after injection. than occur with pertussis vaccine. Approximately one-half of the group were allergic persons. It is concluded that it would seem safe a stimulating dose of tetanus toxoid after with tetanus spores.
Sensitivity and
Garner,
to Horse Serum Due to Previous W. P.
Am.
J. Dis.
Child.
62:
to give an injury
Injections
previously involving
immunized probable
of Antigen.
Toomey,
persons infection
J. A.,
765, 1941.
Fourteen hundred patients of whom 207 had diphtheria, seventy-five had meningitis, sixty-one had erysipelas, and 1,057 had scarlet fever are included in this These patients were admitted to the City Hospital of Clevestatistical survey. land between 1934 and 1938. All were given intradermal tests of 0.1 C.C. of 1:lO dilution of horse serum and also conjunctival tests with the same material. Irrespective of the outcome all but two then received specific therapeutic serum. The two in whom it was omitted had a general reaction following the tests.
THE
Amino M.
JOURNAL
Acids as a Source of .Nitrogen A. 116:
2135,
OF
ALLERGY
for Allergic
Infants.
Hill,
L.
W.:
J. A.
1941.
A synthetic protein-free food, prepared by casein hydrolysis and intended for use as a milk substitute, was fed to thirty-six infants for from two weeks to three months. It appeared to be as satisfactory a milk substitute clinically as certain other preparations commonly used. It was thought to be especially suited to very young infants. Its chief disadvantage was its taste, which resembled strong beef tea, and caused some infants to refuse it either from the start, or after a short period of time. Specifically, satisfactory results were obtained with this milk substitute in half the cases, while in a quarter they were unsatisfactory, and the remainder inconclusive. The adequacy of the preparation as regards nitrogen metabolism for short periods at least, had already been demonstrated, It and
is pointed out that, no milk-free that it is desirable to have several
Active
Immunization
Bigler,
5. A.,
and
Against Werner,
Tetanus M.:
diet for infants t.ypes available.
and Diphtheria
J. A. M.
A. 116:
2356,
is without
disadvantages
in Infants
and Children.
1941.
The unsatisfactory status of tetanus prevention by means of antitoxin induces interest in a possible alternate solution by active immunization wTith toxoid. Since 50 per cent of tetanus deaths are in children, their protection is particularly important. Two hundred and forty infants and children from 8 months of age to 6 years of age were included in this study, the body of which concerns itself wit.h alum-precipitated combined diphtheria and tetanus toxoids. In most instances two injections were given three months apart, and a third was given one to twelve months later. A shorter interval between the initial injections is considered less desirable. Either 0.5 or 1.0 e.c. of toxoid was given. The response, as measured weeks and months later in tetanus and diphtheria antitoxin units, was good. Granting we do not know exactly what level of tetanus antitoxin is protective, it was apparent that higher levels are found one week after the third and even after the second injection than are obtained with the usual prophylactic antitoxin injections. These levels were also maintained for weeks rather than for a few days. In one child there was a failure of both diphtheria and tetanus Reactions were few. No abscesses occurred. Vrticaria was enresponse. countered twice; in one case, a few hours after injection; in the other case, irn The general febrile reactions were fewer and milder mediately after injection. than occur with pertussis vaccine. Approximately one-half of the group were allergic persons. It is concluded that it would seem safe a stimulating dose of tetanus toxoid after with tetanus spores.
Sensitivity and
Garner,
to Horse Serum Due to Previous W. P.
Am.
J. Dis.
Child.
62:
to give an injury
Injections
previously involving
immunized probable
of Antigen.
Toomey,
persons infection
J. A.,
765, 1941.
Fourteen hundred patients of whom 207 had diphtheria, seventy-five had meningitis, sixty-one had erysipelas, and 1,057 had scarlet fever are included in this These patients were admitted to the City Hospital of Clevestatistical survey. land between 1934 and 1938. All were given intradermal tests of 0.1 C.C. of 1:lO dilution of horse serum and also conjunctival tests with the same material. Irrespective of the outcome all but two then received specific therapeutic serum. The two in whom it was omitted had a general reaction following the tests.