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Objective: The objective of this study was to perform a pooled analysis of the immunogenicity and reactivity results obtained in 2 trials carried out in Spain with a combined DTP-HB vaccine., Patients and Methods: Vaccine was administered according to one of two existing vaccination schedules: 2-4-6 and 3-5-7 months of age. Blood samples for antibody determination were obtained 3-6 weeks after the third dose. Anti-diphtheria, anti-tetanus and anti- B. pertussis antibodies were measured by ELISA and anti-HB by radioimmunoassay. Local and general signs and symptoms were recorded by the parents on diary cards for a 4-day follow-up period after each vaccination., Results: A total of 231 infants received three doses of DTP-HB vaccine. All of these doses were accompanied by the corresponding diary card (693 data points for the evaluation of reactogenicity). Two-hundred and nineteen subjects ere included in the analysis of immunogenicity. After the full vaccination course, all subjects had sero-protective titers against diphtheria, tetanus and hepatitis B and were sero-positive of B. pertussis. Geometric mean titers of anti-HB antibodies was 1986 mIU/ml. Pain at the injection site (64%) and unusual crying (71.5%) were the most frequently reported local and general symptoms, respectively. Fever (rectal temperature > or = 38 degrees C) was reported after 46% of the doses, but was considered as severe (> 39.5 degrees C) only in 5 cases., Conclusions: These results show that this combined DTP-HB vaccine induced a strong immune response to all vaccine components. The safety profile of this DTP-HB is similar to that of classical DTP vaccines.

The immunogenicity of oral diphtheria, pertussis, tetanus, (DPT) and polio vaccines was examined. Six hundred seventy-seven children (Group I) were given hepatitis B vaccine at 0, 2, and 6 months of age and the oral DPT-polio vaccines were administered at 2, 4 and 6 months of age. A control group of 731 children (Group II) received only oral DPT-polio vaccines. In both groups the vaccine efficacy against poliomyelitis was 96% for serotype I and 100% for serotype II. For serotype III, the vaccine efficacy was 98% and 97% for groups I and II, respectively. In both groups 97% of the children had antibodies against B. pertussis and all children were positive for tetanus and diphtheria. No immune interference between the oral DPT and polio vaccines and the hepatitis B vaccine when they were given simultaneously could be demonstrated as the immune response to the DPT and polio vaccines were identical in both groups. It can be concluded that the simultaneous administration of the hepatitis B vaccine with the DPT and polio vaccines did not interfere with the immune response to the other antigens.

The cases of tuberculosis in the Pediatric Units of the Basque Autonomous Community during the period of 1980-89 were studied. The annual incidence rate in the 0-4 year old age group was 5.8 per 100.00 in Biscay (95% confidence interval: 4.0-7.6), 5.9 (2.3-9.5) in Alava and 16.7 (12.7-20.7) in Guipúzcoa. Out of the 263 registered cases, 55 (21%) corresponded to meningitis and/or miliaria, 194 (74%) to respiratory tuberculosis and 14 (5%) to other clinical forms. Of these cases, the diagnosis in 83 (32%) was based on results from microbiological cultures, in 8 (3%) on histological examinations and in the remaining 172 (65%) on other diagnostic criteria. In 226 cases (86%) no scars were found nor were there any antecedents of BCG vaccination. In 32 patients (12%), there were scars or antecedents of BCG vaccinations and in 5 cases no information was available. The estimated protective effect of the BCG vaccination in the 0-4 year old group was 88% and in the 5-14 year old group 63%. We recommend that the efficiency of the BCG vaccination program be studied in order to assess the need of this program.

Usefulness of N.B.T.-test (absolute values and percentages) has been tested in the diagnosis of "acute meningitis" in pediatric age. A total of 210 children of different ages have been divided in 3 groups: group A, consisting of 105 children with bacterial meningitis. Group B, 36 children with viral meningitis and group C formed by 69 health children. Differences between groups A and B were statistically significant (p less than 0.001) on both percentage and absolute values, while they were non-significant (p less than 0.001) on both percentage and absolute values, while they were non-significant between B and C groups. On serial controls of N.B.T. test percentage value during follow-up of the disease, a progressive normalization was observed which authors think had value for evaluation of the efficacy of the treatment as well as for prognostic significance. Results were tabulated on the normogram of Feign et al., with significant areas for each group.

We tried to evaluate the utility of the Limulus Test in the diagnosis of acute meningitis. The study was made in 60 patients divided in three groups: Group A, formed by 37 children affected by purulent meningitis of known etiology; Group B, formed by 10 children affected by purulent meningitis of unknown etiology; Group C, formed by 13 children with viral meningitis. The results were compared with a control group (Group D), of 10 healthy children. The results correlated with the etiology, the cuantitative count of germs/ml. in C.S.F. and the clinical evolution. The results indicated that the Test is a rapid, simple and useful tool for the detection of endotoxin in the C.S.F. of purulent meningitis caused by Gram negative germs.

Authors report results of the study on a series of 100 pediatrics patients with Campylobacter gastroenteritis whose ages were between 1 month and 14 years. Incidence of Campylobacter jejuni isolation among 2,733 samples of diarrheal stools, examined during a period of 3 years, was 146 cases (5.03%). Several epidemiological, clinical and therapeutic aspects of the infection are analysed. Campylobacter jejuni is an important enteric pathogen in infancy, and clinical symptoms due to infection are diarrhea, fever, vomits and abdominal pain. Illness is frequently self-limited and resolution is favourable in most cases with symptomatic treatment.

Three infants with the acquired immunodeficiency syndrome (AIDS) are reported. Two cases belong to infants died with AIDS; one of them have as infection source multiple transfusions of blood during the neonatal period and the other case was an haemophilic children transfused several times with commercial factor VIII. The third case belong to an infant, four months old, with AIDS-related complex, born of mother intravenous drug abuser. The authors comments some characteristics about pediatric AIDS and the present problems.

We report a four-year-old girl, previously splenectomized because of thalassemia major, who was admitted with gastroenteritis, abdominal pain and high grade fever. At laparotomy she was found to have appendicitis and mesenteric adenitis. Blood and stool cultures grew yersinia enterocolitica. Clinical course was favourable under Ampicillin-Gentamycin treatment. The importance of iron metabolism in the pathogenesis of yersinia sepsis is stressed, being this topic reviewed.

Five cases of perinatal HBV infections of vertical transmission (mother-child) are reported. The authors comments the most important clinical and epidemiological characteristics of this way of transmission in paediatrics patients and emphasized the interest that has the screening in pregnant women. Finally, the guide-lines of neonatal prophylaxis recommended is described.