Influenza immunisation in HIV-Infected person

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Recommendations pertaining to the use of viral vaccines: Influenza 2013

Here we provide recommendations for the use of viral vaccines in anticipation of the 2013 Southern Hemisphere influenza season. For a review of the 2012 influenza season, please refer to the website of the National Institute for Communicable Diseases of the National Health Laboratory Service (http://www.nicd.ac.za)

Surveillance of respiratory viruses

Respiratory virus isolates made at the National Institute for Virology from 1982 to 1991 were studied. An active virus surveillance programme, 'viral watch', which recruits throat swab specimens from a network of monitoring centres - mainly in the Witwatersrand and Vereeniging area with one centre in Middelburg - that represent a cross-section of the population, provided 68% of the specimens and 74% of the isolates, with an isolation rate of 25,5%. This was significantly higher than that of routine specimens (17,7%). Of the 966 isolates, influenza viruses accounted for 527 (54,7%), para-influenza for 122 (12,6%), respiratory syncytial virus for 34 (3,4%) and adenovirus for 106 (11,0%). Influenza viruses showed a definite seasonal peak between June and August whereas the other viruses, although they showed a winter predominance, were isolated throughout the year. An active virus surveillance programme is particularly valuable in monitoring respiratory virus epidemiology in the population

Viral hepatitis B - an overview

Worldwide the hepatitis B virus (HBV) is responsible for a large proportion of all forms of liver disease and is probably the most frequent cause of chronic viral disease in man. The economic and human cost of HBV is further exacerbated by its association with hepatocellular carcinoma (HCC), one of the ten most common malignant human tumours

Rubella in South Africa: An impending Greek tragedy?

Background. The incidence of congenital rubella syndrome (CRS) is unknown in South Africa. There is evidence that it may be significant and largely undetected, particularly in the upper socio-economic group. This may be due to incomplete routine administration of MMR vaccine in infancy and a build-up of susceptible females reaching the childbearing age group who could be exposed to the extensive reservoir of virus in the unimmunised public sector of the population.Objective. To assess the extent of the immunity gap to rubella by testing for protective IgG antibodies and the incidence of rubella infection by testing for IgM antibodies in sera. The data obtained would also be used to model the extent of CRS.Design. Residual laboratory serum specimens from public and private laboratories were serologically tested for rubella IgG antibodies to investigate the immunity gap in the population and IgM antibodies in sera collected from the measles rashlike illness surveillance programme. Modelling exercises calculated the force of infection and the predicted incidence of CRS in South Africa.Results. The serological immunity gap was significantly greater in the private sector specimens compared with the public sector – 10.7% versus 5.4%, respectively. In most years rubella caused much more rash-like illness than measles, with a significant number (5.1 - 9.6%) of rubella-positive IgM specimens occurring in women of childbearing age.Conclusion. Modelling of the data suggests that the extent of CRS may be grossly underestimated in South Africa. Approximately 654 cases are calculated to occur every year. It is suggested that selective immunisation of girls before puberty should be instituted together with a routine rubella immunisation programme of infants to forestall a possible future outbreak of CRS, as occurred in Greece in 1993

Should pregnant urban South African women be screened for hepatitis B?

The prevalence of hepatitis B virus (HBV) infection in the South African urban obstetric population, which consists of white, black, coloured and Asian patients from different socio-economic, cultural and geographical backgrounds, is unknown. Routine screening performed in 3 469 urban pregnant women revealed that 42 patients were HBV surface antigen-positive (a prevalence of 1,21%). Only 2 patients (4,6%) were hepatitis B e antigen (HBeAg)-positive (0,06% of the entire cohort), whereas the remaining 40 were identified as hepatitis B e antibody-positive. Despite a significant increase in the numbers of black patients, there has not been an accompanying increase in the number of HBV carriers. Replicative infection was equally distributed among white and black pregnant women

Primary and secondary infection with human parvovirus B19 in pregnant women in South Africa

A study of human parvovirus B19 infection in 1 967 pregnant women of all races in Johannesburg revealed an overall prevalence of 24,9% for IgG antibodies and 3,3% for IgM antibodies. Of the 64 IgM-positive sera indicating active infection, 62 were resistant to urea denaturation. No differences in the prevalence of IgG antibodies between population groups were observed, but active infections, as demonstrated by IgM antibodies, were significantly more prevalent in black than in white, coloured or Asian mothers

Hepatitis B virus prevalence in two institutions for the mentally handicapped

A comparative study of the prevalence of hepatitis B virus infection in two institutions for the mentally handicapped was carried out between April and November 1989 and April and August 1991. The institutions were situated within 10 km of each other in north-eastern Johannesburg. One institution had a significantly higher prevalence of virus markers, 68% (139 of 203) compared with 23% (40 of 176), was in poorer condition and had more severely handicapped residents with more aggressive behaviour. However, the most important difference between the two institutions was that residents at the higher-prevalence institution were admitted at a considerably younger age. Younger individuals appear to be more susceptible to infection and are more likely to develop persistent infection, thus contributing to a greater pool of infection in the institution