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From the Walter Reed Army Institute of Research, Washington 12, D. C. and The Pasteur Institute of Tananarive, Tananarive, Madagascar
Abstract
The current work adds information on the character of the serologic response in persons recovered from pneumonic or bubonic plague and establishes that this response is modified by vaccination. Unvaccinated persons recovered from either form of the disease usually possess appreciable levels of antibody against capsular protein for months or years but rarely maintain significant amounts of antitoxin. In contrast, those who had been vaccinated prior to infection usually have appreciable amounts of both types of antibodies for months or years after recovery.
It was concluded on the basis of the limited experience of others and ourselves that a single inoculation of living attenuated P. pestis, strain EV, elicits demonstrable antibody and antitoxin in relatively few persons. The present study clearly demonstrates that after basic immunization with strain EV, subsequent injections of the vaccine over a period of years progressively enhance the production and maintenance of the antibodies by the individual and by the group.
The detection of antibodies against the capsular protein and toxin of P. pestis in sera of a few Malgache with no known history of plague or vaccination once again raises the possibility that unrecognized and possibly clinically inapparent infections with P. pestis do occur in persons residing in an area endemic for plague.
Purified murine toxin of P. pestis produces erythema and edema in the skin of normal persons but intradermally injected capsular protein is relatively non-toxic. In general, fewer vaccinated and unvaccinated Malgache reacted positively to toxin than did normal American volunteers. As little as 11 µg of intradermally injected capsular protein, unlike a similar amount of toxin, elicited an appreciable specific antibody response in the majority of previously vaccinated, but not unvaccinated, persons. Comparison was made between dermal reactivity to these 2 antigens and the concurrent level of circulating specific antibody; however, no clear-cut relationship between skin reactivity and circulating antibody was forthcoming.
Footnotes
1 The work reported here is part of a collaborative study undertaken on the advice of the Committee on Plague of the Commission on Immunization of the Armed Forces Epidemiological Board. Certain funds were made available by the Office of the Surgeon General, Contract No. DA-49-007-MD-77. The authors are grateful to Doctors K. Goodner, K. F. Meyer and T. E. Woodward of the Committee on Plague for their advice and to Doctors J. A. Hightower and B. H. Hoyer for their assistance in the field work.
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