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Summary: Meningococcal polysaccharide (Men‐Ps) vaccine immunogenicity following either primary immunization or revaccination in adults was evaluated. The study population consisted of subjects who have received tetravalent Men‐Ps vaccine once (group 1) or at least twice, with a 2–6 dose range (group 2). Human leucocyte antigen (HLA)‐typing was performed by polymerase chain reaction and specific immunoglobulin (Ig)G was measured by enzyme‐linked immunosorbent assay. Nine months post‐immunization, the percentages of individuals with levels of anti‐Men‐Ps IgG ≥ 2 µg/ml were comparable in both groups, with the exception of anti‐Men‐PsW135 IgG, which were significantly higher in group 2. The percentage of subjects doubling IgG levels at 9 months was significantly higher in group 1. The high baseline anti‐Men‐Ps antibody levels negatively influenced the response to revaccination, suggesting a feedback control of specific IgG. The calculated durability of anti‐Men‐Ps IgG was 2·5–4·5 years, depending on the Men‐Ps, following a single vaccine dose. No interference by other vaccinations nor HLA alleles association with immune response were observed. This study confirms that Men‐Ps vaccine in adults is immunogenic, even when administered repeatedly, and underlines the vaccine suitability for large‐scale adult immunization programmes that the higher costs of conjugate vaccines may limit in developing countries. Meningococcal polysaccharide (Men‐Ps) vaccine immunogenicity following either primary immunization or revaccination was evaluated in adult subjects who have received tetravalent Men‐Ps vaccine once (group 1) or at least twice, with a 2–6 dose range (group 2). Nine months post‐immunization, the percentages of individuals with levels of anti‐Men‐Ps immunoglobulin (Ig)G ≥ 2 µg/ml were comparable in both groups, with the exception of anti‐Men‐PsW135 IgG, which were significantly higher in individuals receiving booster doses. This study confirms that Men‐Ps vaccine in adults is immunogenic, even when repeatedly administered, and underlines the vaccine suitability for large‐scale adult immunization programmes that the higher costs of conjugate vaccines may limit in developing countries. [ABSTRACT FROM AUTHOR]

Clin Microbiol Infect 2010; 16: 1282–1284 Effective control of tuberculosis (TB) includes discrimination of subjects with active TB from individuals with latent TB infection (LTBI). As distinct interferon (IFN)-γ and interleukin (IL)-2 profiles of antigen-specific T-cells have been associated with different clinical stages and antigen loads in several viral and bacterial diseases, we analysed these cytokines in TB using a modified QuantiFERON-TB Gold In Tube test. Detection of IL-2 in addition to IFN-γ distinguishes not only Mycobacterium tuberculosis-infected subjects from healthy controls, but also individuals with LTBI from active TB patients. This may help to improve diagnostic tests for TB. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate immunological safety and immunogenicity of influenza vaccine administration in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Patients and methods: Twenty-four patients with low and/or stable disease activity 14 with SLE (mean age 43.42±12.18 years; 13 women) and 10 with RA (mean age 51±14.57 years; 9 women), diagnosed on the basis of the American College of Rheumatology criteria, have been immunized with trivalent split influenza vaccine without adjuvant. Further 24 non-vaccinated patients, 14 with SLE and 10 with RA, and 10 vaccinated healthy subjects, all age- and sex-matched, were used as controls. The patients underwent clinical and laboratory (specific anti-influenzavirus antibodies, auto-antibodies, peripheral blood lymphocyte subpopulations) evaluation before and 30 days after vaccination; auto-antibodies were also assessed at 90 days and disease activity at 90 and 180 days. Results: The specific antibody response towards the three used antigens (A/New Caledonia/20/99, A/Moscow/10/99, and B/Shangdong/7/97) significantly increased in both patients and healthy controls, without any significant difference between them. No significant difference could instead be observed on the clinical activity, auto-antibodies, and peripheral blood lymphocyte subpopulations before and after vaccination, and between patients and controls. Conclusions: Trivalent split influenza vaccine without adjuvant seems to be safe and immunogenic in patients with SLE and RA, provided that only patients with low and/or stable disease activity are selected. [Copyright &y& Elsevier]

Rheumatoid arthritis ( RA) patients under immunosuppressive therapy are particularly susceptible to infections, mainly of the respiratory tract, thus vaccination may represent a strategy to reduce their incidence in this vulnerable population. In the 2009-10 influenza season, the safety and immunogenicity of co-administered non-adjuvanted seasonal and MF59-adjuvanted pandemic influenza vaccines were evaluated in this study in 30 RA patients under therapy with anti-tumour necrosis factor ( TNF)-α agents or Abatacept and in 13 healthy controls ( HC). Patients and HC underwent clinical and laboratory evaluation before ( T0), 1 ( T1) and 6 months ( T2) after vaccinations. No severe adverse reactions, but a significant increase in total mild side effects in patients versus HC were observed. Both influenza vaccines fulfilled the three criteria of the Committee for Proprietary Medicinal Products ( CPMP). Seroconversion rate for any viral strain in patients and HC was, respectively, 68 versus 45 for H1- A/ Brisbane/59/07, 72 versus 81 for H3- A/ Brisbane/10/07, 68 versus 54 for B/ Brisbane/60/08 and 81 versus 54 for A/ California/7/2009. A slight increase in activated interferon ( IFN)-γ-, TNF-α- or interleukin ( IL)-17 A-secreting T cells at T1 compared to T0, followed by a reduction at T2 in both patients and HC, was registered. In conclusion, simultaneous administration of adjuvanted pandemic and non-adjuvanted seasonal influenza vaccines is safe and highly immunogenic. The largely overlapping results between patients and HC, in terms of antibody response and cytokine-producing T cells, may represent further evidence for vaccine safety and immunogenicity in RA patients on biologicals. [ABSTRACT FROM AUTHOR]

Abstract: Twenty-eight patients with low-moderate, stable rheumatoid arthritis (RA), under treatment with tumor necrosis factor (TNF) α blockers, were immunized at least once with non-adjuvanted trivalent influenza vaccine during three consecutive influenza seasons. Antibodies toward A influenza antigens significantly increased and reached protective levels, still detectable 6 months after vaccination, both in RA patients and healthy controls. Response to B antigen instead was only observed from the second year for healthy controls and in the third year for patients. No significant difference in disease activity and anti-nuclear antibodies was observed as a consequence of vaccine administration, whereas T regulatory cells showed a significant increase 30 days after immunization in RA patients. This study confirms safety of influenza vaccine administration in RA patients treated with TNFα blockers. The cohort follow-up revealed the overcoming of poor B vaccine antigen immunogenicity via repeated vaccinations. Finally, protective antibody response was still observed 6 months after vaccination. [Copyright &y& Elsevier]

Highly infectious diseases involve clinical syndromes ranging from single to multiorgan infections and pose a constant threat to the public. In the absence of a definite treatment for most causative agents, patients benefit from maximum supportive care as clinical conditions may deteriorate in the short term. Hence, following initial case identification and isolation, rapid transportation to a specialized treatment unit must be considered in order to minimize the risk of secondary infections, but this is limited by available infrastructure, accessible care en route and the patient’s clinical condition. Despite the development of consensus curricula for the clinical management of highly infectious patients, medical transportation lacks a common European approach. This article describes, as examples, three current European concepts for the domestic relocation of highly infectious patients by ground vehicles and aircraft with respect to national legislation and geography. [ABSTRACT FROM AUTHOR]