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Evaluation of red cross gamma globulin as a prophylactic agent for poliomyelitis 5 Reanalvsis of results based on laboratory-confirmed cases



Evaluation of red cross gamma globulin as a prophylactic agent for poliomyelitis 5 Reanalvsis of results based on laboratory-confirmed cases



Journal American Medicine Assoc: 21-27



Appropriate specimens from patients with clinically diagnosed cases of poliomyelitis from the controlled field tests of gamma globulin made in Utah, Texas, and Iowa and Nebraska in 1951 and 1952 were tested to determine which cases were or were not caused by one of the recognized types of poliomyelitis virus. A new analysis of the data on such confirmed cases was done to determine the effectiveness of gamma globulin in prevention of poliomyelitis. Infections with all 3 types of poliomyelitis virus occurred in the area under study. Clinically diagnosed cases developing in those who received gamma globulin were due either to type 1 poliomyelitis or to agents other than poliomyelitis virus. During the time when gamma globulin appears to have shown some effect in preventing paralytic disease, an approx. equal number of cases in groups receiving gamma globulin and gelatin could not be confirmed as poliomyelitis by laboratory tests. These unconfirmed cases represented 41% of the gamma globulin group and 17% of the gelatin control group. Viral agents isolated from these excluded cases were unaffected by type-specific poliomyelitis anti-serums, a mixture of these serums, or gamma globulin. Of 16 such agents isolated, 15 came from patients whose disease could not be shown to be due to poliomyelitis virus or from the sibling contacts of those patients. The exclusion of disease not attributable to poliomyelitis virus from the study shows gamma globulin to be slightly more effective against poliomyelitis than it appeared formerly. Protection and/or modification to the point of eliminating detectable paralytic involvement by the time of the 60 day muscle examination probably occurred even in those receiving gamma globulin during the week before onset; protection was most conspicuous during the next 4 weeks after injn. and appears to have lasted well into the period of 6 through 8 wks. after injn. Protection appears to have been a combination of prevention and modification of disease. These data offer very suggestive, although not conclusive, evidence in support of the use of gamma globulin after exposure. Laboratory tests on contacts of patients with confirmed cases of poliomyelitis indicate that the amount of antibody given the patients in this study did not interfere with infection or development of active immunity to an important degree.

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Accession: 024640335

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PMID: 13183798


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