PEDIATRICS Vol. 37 No. 4 April 1966, pp. 630-636
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PARALYTIC POLIOMYELITIS IN A CHILD WITH HYPOGAMMAGLOBULINEMIA: PROBABLE IMPLICATION OF TYPE I VACCINE STRAIN

Te-Wen Chang M.D.1, Louis Weinstein M.D.1, and H. Edward MacMahon M.D.1

1 Infectious Disease Service and the Pathology Department of the New England Medical Center Hospitals and the Department of Medicine, Pathology, and Pediatrics of the Tufts University, School of Medicine, Boston, Massachusetts

1. An instance of paralytic poliomyelitis developing 7 weeks after administration of live type I poliomyelitis virus vaccine in a child with hypogammaglobulinemia is described.

2. The strain of virus isolated from pharyngeal washings and stool possessed the characteristics of "vaccine-like" strain. No other enteroviruses were detected.

3. Antibodies of diphtheria, the 3 serological types of poliomyelitis virus, and a number of other viruses could not be demonstrated despite apparent adequate "immunization" to some of these agents.

4. Histological studies revealed a marked activity in the reparative process in the spinal cord and a conspicuous absence of secondary lymph follicles throughout the body.

5. It is suggested that live vaccines be administered to patients with a significant degree of gamma-globulin deficiency with great caution. The possibility of the simultaneous administration of a properly selected dose of specific antibody or gamma-globulin deserves consideration in such instances.

Submitted on June 11, 1965
Accepted on August 10, 1965