ICMR BULLETIN VOL.6-No.-4-APRIL-1976
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- ICMR BULLETIN VOL.6-No.-4-APRIL-1976
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COMMUNITY HEALTH CELL
VoL 6 No. 4
April, 1976
326, V Main, I Block
Koramangala
Bangalore-560034
CONTROLLED FIELD TRIAfedWITH ALUMINIUM PHOSPHATE ADJUVANT
CHOLERA VACCINE IN CALCUTTA, 1975-1976
The rationale for large-scale use of any
vaccine in the prevention of an infectious
disease lies in the demonstration of its
effectiveness in man by properly designed
controlled field trials.
It is essential for
such a field study to include vaccinated and
controlled groups1.
Cholera vaccine has been greatly over
rated as a preventive measure against the
disease. This impression of effectiveness was
built up on several earlier observations and
field studies without adequate controls.
duration of protection could not be determined
as there were only a few cases of cholera that
year.
During the second phase an agar grown
classical cholera vaccine
and an EZ Tor
(haemolytic) vaccine were used to determine
whether EZ Tor and classical cholera vaccine
give cross protection.
There was little
difference in the incidence of cholera in all
three groups-including the control, in the
first three months, thus leaving the question
unanswered:
Does EZ Tor'
vaccine
protect
against classical cholera infection?
EARLIER CONTROLLED FIELD TRIALS (1963-1973):
FOUR
Several controlled
field
trials with
varieties of conventional cholera vaccine were
conducted in three countries namely India,
Philippines and Bangladesh.
The first field trial in Calcutta was
initiated
in the year 1964,
where five
different cholera vaccines and a control TAB
vaccine were used.
"The trial could not give
any unequivocal answer to the question of
efficacy of cholera vaccine, although the
three agar
grown vaccines
showed 30-40%
effectiveness11^.
The second trial was conducted in 196s
in two phases3. During the first phase of the
trial an agar grown vaccine from the Central
Research Institute, Kasauli was compared with
a casein hydrolysate vaccine from the Haffkine
Institute, Bombay.
The agar grown vaccine
showed an effectiveness of 40%.
However, the'
CONTROLLED
FIELD
TRIALS
IN
THE
PHILIPPINES:
The first trial was carried out on about
584,000 people in Negros Occidental Province
in 1964.
The aim of the trial was to deter
mine the effectiveness of a classical cholera,
a cholera El Tor and an oil-adjuvant vaccine".
The trial showed that both classical cholera
and EZ Tor vaccines afforded protection of
about 50% but showed a varying duration of
effectiveness.
The immunity conferred by
V. cholerae vaccine declined rapidly after
three months whereas that of EZ Tor continued
up to six months.
An oil-adjuvant vaccine,
prepared by the Chiba Serum Institute, Japan,
conferred the highest degree of protection for
a longer period of time, but owing to the
severe reactions caused by the vaccine, its
use could not be recommended.
The second
trial5 was initiated
in 1966
in an attempt
to
improve the
over-all
effectiveness by administering cholera EZ Tor
vaccine in three different doses: one injec
tion
with 8 x 1()9 organisms per ml,
two
injections of the same vaccine and a single
injection of a double dose (16 x 10^ organisms
per ml.). No improvement in protection, which
was statistically
significant, was observed
with one or two doses of the single strength
or with the one injection of double strength
vaccine.
The third trial in the Philippines6 was
conducted with monovalent Ogawa and Inaba
vaccines prepared from classical and EZ Tor
strains of V. cholerae. The results indicated
that all four vaccines tested offered a signi
ficant degree of protection which varied from
58-71%.
The fourth field trial7 was conducted
between July 1971 and Februaryj 1972 to assess
the relative effectiveness of the intradermal
and subcutaneous routes of administration of
the same cholera vaccine.
The trial showed
that both these routes were effective and. gave
significant protection against cholera.
In
the 1-5 years age group, the vaccine afforded
a more lasting protection when given sub
cutaneously (6 months) than when given intra
dermally (4 months).
Four controlled field trials were under
taken in East Pakistan (now Bangladesh) bet
ween 1963 and 1969.
The first trial was
initiated in November, 1963.
An agar grown
phenol killed commercial classical cholera
vaccine (CRL vaccine) with high mouse potency
was used along with a control TAB vaccine.
During the first year of study8 the incidence
of cholera in the vaccinated group was 1.7
per 1000, whereas in. control group it was 6.1
per 1000.
In a follow-up
study9 it was
observed that the effectiveness was 76% during
the first cholera season (December, 1963 June, 1964) and 62% during the second cholera
season
(July 1964 - June 1965)
following
vaccination.
However, many of the children
under five years lost protection during the
second
cholera season.
The high
mouse
potency (CRL)
vaccine
produced
untoward
reactions among adults.
During the second trial a whole cell
vaccine (CRL) and an Ogaua fraction purified
antigen were used.
The results of these two
trials showed that: a high potency vaccine can
give significant protection upto 18 months;
more than 70% protection could be obtained
2
during the first 7 months but beyond that
period protection fell in the age group below
5 years; and the vaccine had no effect on
asymptomatic carriers in family contacts of
cholera patients. The purified Ogawa antigen
afforded significant
protection to adults
against Inaba serotype.
The third trial10 was conducted during
1966-67 and children aged 3 months to 14 years
were inoculated with a commercially
made
classical cholera vaccine with one and two
dose schedules.
During the 8 months cholera
season follovzing immunization, a single
dose
produced 46% and 2 doses provided 64% protec
tion. The single dose was virtually ineffec
tive in children. The enhanced effect of 2 dose schedule
was
presumably due to the
booster effect in children under 5 years.
Duration of significant protection even with 2
doses did not extend beyond the
first 3
months.
The fourth field trial11 in rural East
Pakistan (now Bangladesh) was conducted in
1968-69
with
a
monovalent whole
cell
V. eholerae Inaba vaccine, a monovalent whole
cell V. choleras Ogawa vaccine and a purified
Inaba antigen. A total of 45,711 children in
the age
group 0-14 years were inoculated.
Inoculations were given annually for 2 years
just before the start of the cholera season
and follow up was continued for one additional
year. All the cholera cases that occured were
due to Inaba serotype, so that protection
could be studied only against that serotype.
Two annual injections of the whole cell Inaba
vaccine gave the highest level of protection,
averaging 84% over the 3 years of follow-up;
a single injection of the puri fied 工nda
vaccine gave less protection
(51%).
Two
annual injections of the whole cell Ogawa
vaccine failed to protect children
under
5
years
but
gave
48%
protection
to
children in the age group 5-14 years against
Inaba cholera.
Hence, monovalent vaccine
cannot be recommended for
general public
health use as it gives relatively low protec
tion to infection with a heterologous strain.
The following facts have been brought
out by the results of the above field trials:
The degree of protection afforded by the
vaccines now available does not exceed
50 to 60 per cent and for a period of
3-6 months only.
Longer protection was observed with an
oil-adjuvant vaccine in the Philippines
and with a high mouse potency vaccine in
Dacca.
These two vaccines could not be
recommended for
mass immunization as
they produced severe reactions.
Cholera
vaccines did not modify the
severity of the symptoms in vaccinated
cholera patients.
Vaccination did not reduce
of inapparent infection.
the frequency
The rate of protection was
0-4 years old children.
lowest among
Duration of significant protection, even
with 2 doses did not extend beyond 3
months
in the cholera season.
The
degree of protection of the groups immu
nized with 2 doses of 8 x 10^
and
16 x 10^ vibrios did not differ signi
ficantly.
Vaccine-induced
protection
against
cholera depends upon the development of
type-specific immunity.
RECENT DEVELOPMENTS:
A great deal of research is now in pro
gress in many laboratories throughout the
world to develop more effective immunizing
agents against cholera and a few of them are
being tried in large-scale controlled field
trials. A brief outline
of these trials is
as follows:
nization and the Government of Indonesia.
final results of the trial are not
available.
The
yet
PRESENT TRIAL BY ICMR CHOLERA RESEARCH CENTRE:
Aluminium compounds are generally recog
nised as the safest adjuvants and their use is
based
on
wide
experience
with
other
vaccines12.
A cholera vaccine (containing
4000
million
organisms
of
classical
V. choleras of both Ogawa and Inaba sero
types per 0.5 ml)
adsorbed with aluminium
phosphate as adjuvant has been used in a
controlled field trial in Calcutta during
1975-76 by the ICMR Cholera Research Centre.
Tetanus toxoid was used as placebo. Volunteers
above 5 years received 0.5 ml (8000 million
vibrios) and those below 5 were administered
0.25 ml of the vaccines given intramuscularly
as a single dose. Children below 1 year were
not included in the trial.
STUDY AREA & CHOLERA INCIDENCE:
The study area comprised 17 Municipal
Wards of Calcutta and two adjoining Wards of
South Dum Duni Municipality with a total popu
lation of above 500,000.
The above area was
selected on the basis of a high incidence of
cholera during the past 10 years. The average
annual incidence was 0.5 per 1000, and it was
estimated that a minimum of 100,000 volunteers
should be inoculated with each vaccine to
ensure a statistically significant result.
PREPARATORY PHASE:
It is now fully established that the
severe fluid and electrolyte loss in cholera
is caused by an enterotoxin elaborated by
V. coolerae during its multiplication in the
gut.
This toxin
has been purified and
converted to toxoid.
One such product, the
glutaraldehyde toxoid is being used for a
controlled, field trial in Bangladesh.
The
objective of the study is to determine the
role of antitoxic
immunity in protecting
against cholera. The follow-up of the trials
is not yet completed.
During the preparatory phase 150 health
assistants were recruited and were trained for
the programme. Each volunteer was inoculated
with a separate sterile needle following a
strict random allocation. The vaccine bottles
were identical and were coded as "A” and "B”.
The identity of the vaccines during the vacci
nation phase was not ;disclosed.
The vacci-*
nation team consisted of one recorder and one
vaccinator.
Four such teams were closely
supervised by one health inspector who had
previous experience of similar
controlled
trials conducted in Calcutta. . Two physicians
were constantly supervising and assessing the
vaccination programme.
Aluminium hydroxide adsorbed cholera vaccine:
STUDY POPULATION & VACCINATION PHASE:
A controlled
field trial
with
the
aluminium hydroxide adsorbed cholera vaccine
was undertaken in Surabaya, Indonesia with the
joint collaboration of the World Health Orga
The vaccination phase was completed in 45
working days.
A total of 203,170 volunteers
were vaccinated on a random basis during the
inoculation phase, of which 101,096 received
Cholera Toxoid:
3
the adjuvant cholera vaccine and 101,030 were
given placebo (tetanus toxoid).
Out of a
total enumerated population of 529,580 about
69.6 * could be contacted.
Of the 69.6%
contacted, only 38・4* could be vaccinated by
repeated home visits: 24.7% refused to accept
vaccination while 6.5% were found to be ill.
During the cholera field trials in Calcutta in
1964 and 1965 about 36% and 35% of the study
population respectively could be vaccinated.
The refusal rate was high which is to be
expected in an urban population.
Out of the
total of 14,291 vaccinated in 1-4 year agegroup, 7,159 received the vaccines and 7,132
the placebo.
Similarly of 46,956 volunteers
in the 5-9 years age-group 23,481 were given
cholera vaccine and 23,475 placebo.
Overall
figures show that 101,096 were given the
vaccine
and 101,030
the
placebo.
The
male:female ratio was 1000:766 among
the
vaccinated volunteers and reflects the overall
sex ratio
of the study area
which was
1000:726 according to the 1971 census.
REACTIONS TO VACCINE:
Assessment of reactions following vacci
nation shows that there was little significant
difference between those in cholera vaccine
and placebo groups.
The reactions looked for
were erythema, pain, local tenderness and
swelling, headache, fever and vomiting.
It
was, however,
observed that the adjuvant
vaccine produced a rise of temperature in
21.7 % of volunteers as compared to 11.3% in
placebo group. The fever was mild.
patients.
Round-the-clock
vigilence was
employed at the hospital so that every cholera
case coming from the study area for admission
was sampled before any antibiotic is adminis
tered. In case of any doubt the houses of the
cholera cases are visited to determine their
vaccination status.
The results of the first 90 days period
of follow-up showed that of 27 cholera cases
detected during this period 5 belonged to
vaccine group and 22 to placebo group.
The
overall protection offered by the adjuvant
vaccine was 77.3% which was statistically
highly significant (P<0.01).
When the period
of follow-up was extended upto 180 days the
overall efficacy of the vaccine appeared to be
60.6%, a figure which is statistically signi
ficant (P<0.01).
It is interesting to note that children
between 1 and 4 years of age were protected by
the adjuvant vaccine at the rate of 100% for
180 days, which was statistically significant.
Trials
conducted
earlier in
Bangladesh,
Philippines and Calcutta with conventional
cholera vaccines had shown a poor degree of
protection in this
particular age group.
Considering the fact that it is this young age
group which is mostly affected by cholera in
endemic areas, the high degree of protection
offered by the aluminium phosphate adjuvant
vaccine may be regarded as an important find
ing. It may be noted that,in a similar trial
with aluminium
hydroxide adjuvant vaccine
conducted in Indonesia, better protection was
found amongst children below 4 years of age.
FOLLOW-UP PHASE & RESULTS:
The follow-up of the vaccinated volun
teers was started 7 days after the start of
the vaccination phase.
It was decided to
continue the follow-up phase for a period of
2 years.
Since the incidence of cholera in the
study area was calculated on the basis of
hospitalised cases, it was decided to restrict
the follow-up to the hospitals.
A hospital
follow-up is less cumbersome, economic. and
more acceptable since only genuine cholera
cases, acute enough to be hospitalised, are
encountered. The follow-up at the home level
stands the occasional risk of including subclinical infection,
on whom the
cholera
vaccine has no effect.
All acute cholera
cases in Calcutta and its suburbs are admitted
mainly to the Infectious Diseases Hospital
which is situated within the study area.
No
other hospitals in Calcutta admit cholera
4
Considering the results obtained so far
in the present trial, it may be concluded that
the aluminium
phosphate adjuvant
cholera
vaccine, if administered prior to an epidemic
season, may be able to modify the course of
the epidemic by
effectively reducing the
number of cholera cases, particularly among*
children below 4 years.
REFERENCES:
1.
Cvjetanovic, B. 1965. Proceedings of the
Cholera Research Symp., Honolulu, U.S.
Govt. Printing Office, Washington, D.C.
p. 355.
2.
Taneja, B.L.
1965.
Proceedings of the
Cholera Research Symp., Honolulu, U.S.
Govt. Printing Office, Washington, D.C.
p. 373.
L
d
d
.
e
o
g
A ■>
s• p
d
a
an
37
3
冬
4.
D 3
加
3.
R.,
Shnvastava,
A H a, B.L., Rao, M.S.
1967.
Controlled
e effectiveness
of
of the
Tor. Bull VZd Hlth
T
e •J
Azunn, J.C.,
Cruz, A.,
Pesigan, T.P.,
Alvero, M., Camena, T・， Suplido, R. and
Ledesma, L.> Gomez, C.Z.
1967.
A Con
trol] ed field trial of the * effectiveness
of cholera and cholera EZ Tor.
Bull Wld
Hlth
37, 703..
5.
Philippine Cholera Committee.
1968. A
controlled field trial of the effective
ness of various doses of cholera EZ Tor
for vaccine in the Philippines.
BuZZ “Zd
Hlth Org. 3& 917.
6.
Philippine Cholera Committee. 1973.
A
controlled field trial of effectiveness of
monovalent classical and EZ Tor cholera
vaccines in the Philippines.
Bull VZd
Hlth Org. 49, 13.
7.
Philippine Cholera Committee.
1973. A
controlled field trial of the effective
ness of the intradermal and subcutaneous
administration.
“Zd Hlth Org.
49^
389.
8.
Beneson, A.S.
and
Oseasohn, R.0.,
Fahimuddin, M.D.
1965.
Field trial of
in
rural
East Pakistan.
cholera vaccine
Lancet Z, 450.
9.
Beneson, A.S., Mosley, M., Fahimuddin, M.
and Oseasohn, R.O. 1968. Cholera vaccine
field trials in East Pakistan: Effective
ness in the field.
8〃ZZ Wld Hlth Org.
38, 359.
10. Mosley, W.H., Me Cormack,W.H•, Fahimuddin,
M.,
Aziz, K.M.A.,
Rahman, A.S.M.M.,
Chowdhury, A.K.M.A., Martin, A.R., Feeley,
J.C. and Phillips, R.A. 1969. Report of
1966-1967 Cholera vaccine field trial of
rural East Pakistan.
B〃ZZ Wld Hlth Org.
409 177.
11. Mosley, W.H.,
Aziz, K.M.A.,
Rahman,
A.S.M.M., ChowdhuryVA.K.M.A. and Ahmed, A.
1973.
Field trials of monovalent Ogaua
and Inaba
cholera vaccines
in rural
Bangladesh - 3 years of observation.
12. Joo, 1.
1974.
* Cholera1 edited by
Barua, D.
and
Burrows, W.
Saunders
Company, PhiladeIphia, U.S.A., p. 333.
ABSTRACTS
Some Research Projects completed in 1975
BIOCHEMISTRY
Biosynthesis and metabolism
in chicken
of phospho lipids
Studies
on
32P
incorporation , into
chicken liver under in vivo conditions showed
that its incorporation reached a maximum at
6 hrs
after injection and that
estrogen
injected simultaneously accentuated the rate
of incorporation by 80%. The incorporation of
32P into liver phospholipids of estrogentreated birds (treated for 10 days) was also
greatly enhanced.
There was a simultaneous
increase in the synthesis of neutral lipids.
The
hormone-treated birds secreted
these
lipids into serum at a much faster rate than
the controls.
The results also suggested an
increased rate of conversion of phosphatidyl
ethanolamine into phosphatidyl choline.
Cyclic AMP was found to inhibit
the
synthesis of fatty acids from acetate at
higher
concentrations while
at very low
concentrations this synthesis was activated.
The cyclic nucleotide specifically inhibited
the acetate incorporation into triglycerides
as compared to other lipids.
Tliere was no
indication of an enhanced lipolysis.
Cyclic AMP also inhibited the incorpo
ration 32P into phospholipids under £九 vitro
conditions and this effect was found to be not
due to a decreased 32P incorporation into the
precursors of phospholipids.
Dr. S. Krishna Murthy,
Lecturer
Deptt. of Biochemistry
Indian Institute of Science
Bangalore.
5
Studies m the kidney glutiminase
Earlier studies1 on albino rats
showed
that adrenalectomy caused diuresis, negative
nitrogen balance, acidosis and excess excre
tion of both sodium and potassium.
Amongst
the nitrogenous products, there was a marked
increase (about three to four fold) in ammonia
excretion.
Chemical analysis of the adrenalectomized rat kidneys showed there was hyper
trophy, increased RNA and protein.
The enzy
matic analysis, in particular the enzymes in
volved in the formation of ammonia like amino
acid deaminases, glutami c-dehydrogenas e and
glutaminases, showed that there was a pheno
menal
change in the activity of
kidney
glutaminases but almost no change in other
ammonia forming enzymes.
The enzymatic analysis of the ammonia
forming enzymes of adrenalectomi zed rat kidney
showed that there was increase in the activity
of
kidney glutaminases.
Kidney glutami
nase exists in three forms (i) phosphate
dependent (pH optima 7.4), (ii) phosphate
independent (pH optima 7.4) and (iii) glutami
nase II (-ketoacid dependent, pH optima 8.5).
The activity of the above three
increased
under adrenalectomized condition
and
the
additional observation was that a new peak
appeared at pH 6.0. This peak was due to the
combined activities of the three forms of
glutaminases. When adrenalectomized rats were
injected with adrenal extract or a mixture of
corticosteroids, the pH 6.0 peak did not
appear and there was no increase in urinary
ammonia.
A
phosphate
dependent
pH 6.0
glutaminase studies was ' isolated. Kinetic
studies
and
optimum
temperature
showed
that the enzyme was different as compared to
the normal phosphate dependent glutaminase.'
The above experiments showed that as a res
ponse to acidosis, due to the adrenalectomy,
these glutaminases are formed to help to main
tain homeostasis2. When adrenalectomized rats
were fed with added pyridoxine (3 mg per rat
per day) diet, the pH 6.0 glutaminases did not
appear and there was no diuresis, acidosis and
the ammonia excretion was normal.
Dr. G.D. Kalyankar
Prof. & Chairman
Deptt. of Biochemistry
St. John*s Medical College
Bangalore.
REFERENCES:
1.
6
Swam ananda, A.K.K.
and Kalyankar, G.D.
1971. (Abst) Indian J Physiol Pharmacol.
15,49.
2.
Nikumb, S.K., Zachariah, E.,and Kalyankar,
G.D. 1973. Proc Symp Control
Mechanisms
i in
Cellular Processes,
BARC, Bombay
p. 223.
PUBLICATIONS:
1.
Swamananda, A.K.K.
and Kalyankar G.D.
1973. Indian J Physiol Pharmacol (Abst)
", 145.
2.
Swamananda, A.K.K.
and Kalyankar, G.D.
1973. Effect of corticosteroids of kidney
glutaminases.
Proc
Abst Soc Biol Chem
India. 32, 16.
3.
Kalyankar, G.D.
and Swamananda, A.K.K.
1974.
Corti cos teroi ds - related kidney
glutaminases and urinary ammonia changes.
Proc International Union Physiol Sciences
11, 121.
Functional role of urea cycle intermediates in
brain
The distribution of
argininosuccinate
synthetase and argininosuccinase, arginase and
synthetic capability of urea in the cere
bellum, cerebral cortex and brain stem were
studied.
The cerebral cortex showed high
argininosuccinate synthetase, argininosuccinase and synthetic capability of urea from
aspartic acid and citrulline.
Of the three
regions the cerebellum had a high arginase
activity.
The activities of the enzymes
transamidinase and ornithine aminotransferase
involved in the metabolism of arginine
and
ornithine in pathways, other than urea forma
tion, were studied in the three regions of the
rat brain. The activity of creatine phospho
kinase in the three regions was the same. The
carbamyiphosphatase activity was highest in
cerebellum.
Cerebral cortex had a high acti
vity of aspartic acid trans carb amylas e. The
brain stem amongst the three regions had the
lowest activities of glutamine synthetase and
glutaminase.
The activities of the above
enzymes in the different regions are discussed
in relation to urea production and the uti
lisation of the urea cycle intermediates.
Intraperitoneal
injection
of
large
amounts of citrulline brought about a rise in
glutamine synthetase activity of the cere
bellum and brain stem and a rise in ornithine
aminotransferase in the cerebral cortex and
liver. The results, are discussed in relation
to the mechanism of action of citrulline in
alleviation
states.
of
toxicity
in
hyperammonemic
Dr. B. Sadasivudu
Prof, of Biochemistry
Kurnool Medical College
Kumool.
PUBLICATIONS:
1.
Sadasivudu, R.,
and
Indira, H.R,
Distribution of the
involved in
the disposal of arginine and ornithine on
different regions of rat brain.
Brain
Res.
7% -326«.
2.
Sadasivudu, R.
and Indira, H.R.
1974.
Studies on the distribution of urea cycle
enzymes in different regions of rat brain.
J of Neurochem. 23, 267.
1974.
ICMR NEWS
ICMR/DGHS SEMINAR ON CHOLERA CONTROL
A Seminar on Cholera Control is being held
from May 20-28, 1976 at the Cholera Research
Centre, Mohammad Ishaq Street, Calcutta.
The
objective of the seminar is to review the
recent trends in epidemiology, diagnosis and
methodology of treatment.
The seminar will
consist of lectures
discussions,
demons
trations and field visits.
Twenty to thirty
participants chosen
from cholera
endemic
States and Union Territories are expected to
attend the seminar.
ICMR/WHO NATIONAL COURSE ON TREPARAHON AND STANDARDISATION OF
SALMONELLA DIAGNOSTIC SERA' HELD AT THE DEPARTMENT OF MICROBIOLOGY,
LADY HARDINGE MEDICAL COLLEGE, NEW DELHI FROM APRIL, 12-17, 1976
The course was a sequel to the ICMR/LHMC
workshop-cum-seminar
on
Microbiological
Investigations in the Epidemiology of Enteric
Infection* held at' Lady Hardinge Medical
College,
from 9th to 14th December,
1974.
In a survey carried out on the availabi
lity of salmonella diagnostic sera,
it was
found that some centres had stopped producing
these sera and among those, which were produc
ing antisera, many did not absorb the
anti
sera. This meant great hardship to the peri
pheral laboratories.
The faculty consisted of 5 members and
included Dr. Benard Rowe, WHO consultant.
Dr.
Rowe is the
Director of the
Salmonella
Shigella Reference Centre,
Central Public
Health Laboratories, Colindale, London.
The
12 participants selected,
came from existing
salmonella sera production centres.
The recommendations of the workshop
given below:-
I.
Central Research
Institute,
Indian Veterinary Research Institute,
Izatnagar
3.
Haffkine Institute, Bombay
4.
King Institute, Guindy
5.
Institute of
Hyderabad.
6.
Vaccine Institute, Baroda.
7.
Laboratory of the Serologist
Govt, of India, Calcutta
8.
Pasteur Institute, Shillong
9.
Public Health Laboratory, Poona
Preventive
10. National Institute of
Diseases, New Delhi.
Medicine,
to the
Communicable
are
As a first priority the following centres
will produce a basic set of adsorbed
salmonella sera comprising of 0=2, 0=9,
H-a, H-d and Vi antisera:
1.
2.
Kasauli
These laboratories must submit their sera
for quality control to the Salmonella
Reference Centre, Central Research Insti
tute, Kasauli, before supplying the anti
sera.
Information regarding the availability of
these sera must be published in the NICD
7
bulletin. These sera should be available
within one year.
II.
After this basic
set
of
sera
is
available,
the
Salmonella
Reference
Centre, C.R.I., Kasauli should prepare
polyvalent 0 and H sera, absorbed 0 and H
factor sera and rapid diagnostic sera for
H antigens.
III. The manufacturing
laboratories should
motivate the laboratories to whom they
supply sera, to take part in the National
Salmonella Surveillance Programme.
The aim of the reconanendations was to
establish a network of salmonella surveillance
in the country and to step up the production
of diagnostic sera.
The Manual of Procedures for Salmonella
Serology & Production of Diagnostic Sera pre
pared for this course is compact, compre
hensive and very useful for anyone taking up
production
of
diagnostic
reagents
for
salmonella work.
THE CENTRAL JALMA INSTITUTE FOR LEPROSY (ICMR), AGRA
This leprosy centre was established in
Agra in 1967 by the Japanese l-eprosy Founda
tion, Tokyo, in collaboration -with the Central
and the U.P. Government.
The centre consists of a complex, which
includes an
administrative set up and a
supporting laboratory for a 50 bedded hospital
alongwith an out patient department.
For the
last 10 years this Institute has done consi
derable work in establishing an active centre
for the care of leprosy patients.
The JALMA
team commenced its clinical activities in
1966, on a comparatively small scale.
These
activities gradually expanded and in 1968
there was an out patient department in the
centre and clinics at Ghatampur, Etawah &
Mathura.
By 1969 the centre was running a
40-bedded hospital.
The laboratory is very
well equipped.
With the help of the Colombo
Plan staff a small beginning was made in
research on immunology of leprosy in 1972.
JAWA centre has been extremely well
maintained and caters for leprosy patients
free of cost.
The total laboratory space
comprises .about 12 big laboratories, apart
from the self contained Out Patient Department
Laboratory.
The centre was taken over by the Ministry
of Health & Family Planning on April the 1st,
1976 and placed under the ICMR.
8
On April 18, 1976, an inaugural function
was arranged at JALMA, Agra.
The Chief
Minister of U.P., the Minister of Health &
Family Planning, the Japanese Ambassador, the
Chief of the JALMA, the State Minister of
Health,
The Director-General
of
Health
Services
and the Director-General , Indian
Council of Medical Research were present.
®
Dr. Karan Singh,
Union Minister for
Health & Family Planning was presented a giant
symbolic key by Mr. Ueda, Chief of JALMA.
The
key
was
in
turn
presented
to
Dr. C. Gopalan, Director-General, ICMR.
The
function was very well attended.
A Scientific Advisory Committee, consist
ing of experts in various fields of leprosy,
has been constituted by the ICMR.
Detailed
plans for future work at this centre will be
drawn up by the Scientific Advisory Committee,
in consultation with the Director and the
Technical Committee of the ICMR.
The Council
plans to develop JALMA into a laboratory
centre for certain special type of work in
leprosy i.e. immimology,
microbiology and
chemotherapy etc., making use of the clinical
facilities already established at the centre.
The Director has been selected and is expected
to take up his post shortly.
Other staff is
being recruited.
The centre will be known as
the Central
JALMA
Institute for Leprosy
(ICMR):
丹
COUNCIL'S TRAINING PROGRAMMES FOR 1976-77
(A) EXISTING ANNUAL TRAINING COURSES:
Animal Technicians Training:
Nutrition & Endocrinology:
Nutrition,
At the Laboratory Animals Information
Service, National Institute of Nutrition,
Hyderabad.
(1)
Annual Certificate Course in Nutrition;
(December 1, 1976 to February 28, 1977)
Ninth Annual Animal Technicians Training
Course:(For a period of three months from
September 1, 1976)
(2)
M.Sc.
(Applied
Nutrition)
Course:
(June 1, 1976 to February 28, 1977)
(3)
Annual Certificate Course in Human Nutri
tion for Teachers in Agricultural Uni
versities: (August - October, 1976)
At the National Institute of
Hyderabad.
(4)
Annual Training Course in Endocrinologi
cal Techniques and their Application:
Biostatistics:
At the National Institute of
Hyderabad.
Nutrition,
*Third Training Course in
for Statisticians and Medical
Workers.
Research
(B) NEW TRAINING COURSES DURING 1976-77:
Reproductive Biology and Fertility Control:
At the Institute for Research in
duction, Bombay.
(1)
Repro
Annual Certificate Course in Reproductive
Biology and Fertility Control:
(November1, 1976 to April 30, 1977)
(2)
Annual Training Course on Hormone Assays:
(February 1, 1977 to March 31, 1977)
(3)
Annual Training Course in Endocrinology
and Fertility Control: (October, 1976)
(4)
Annual Training Course in Cytology
Cytogenetics: (September, 1976)
and
*At the Virus Research Centre,
Diploma course in Virology.
Blood
Group
Reference
Centre,
Comprehensive programoe in Blood Banking
Technology and Basic Haematology:
(For a
period of 3 months from February 15,1976)
Inmunology:
Amobiasis:
At the
cutta.
School of Tropical Medical,
Cal
Technician's Training Course in the field
of Amoebiasis:
(For a period of three
months from April 1, 1976)
Occupational Health:
At the National Institute of Occupational
Health, Ahmedabad.
This course» meant for the medical practitioners to be organised in co-operation
with Directorate of Mines Safety, Dhanbad.
(2) "Diploma in Occupational Health
the
year 1976-77 un加r Gujarat University.
Pharmacology and Drug Trials:
At ICMR/WHO Research and Training Centre
in Immunology,Department of Biochemistry,
New Delhi.
At Dr. U.K. Sheth1 a Unit、 Seth C.S・ Medi
cal College, Bonibay.
(1) *
A
*Annual
Poona.
(1) *
Pneumoconiosis :
Haematology:
At the
Bombay.
Virology:
Training
Course
in
Immunology
short-term
training.
course
for
four
weeks
*
9
(2) *A long-term
training.
course
for
weeks *
twelve
(C) COURSES FOR TALENT SEARCH SCHEME FELLOWS:
Cell-Biology and Cyto-Genetics:
At the
Indian Institute of
Bangalore. April 12-21, 1976.
Science,
Principles & Methods' in Medical Statistics:
Haematological Techniques:
*
*
At the Tuberculosis Chemotherapy Centre,
At the Department of Haematology, Post
Madras.
graduate Institute of Medical Education
and Research, Chandigarh.
Courses in limiunological Techniques:
*
At the Department of Biochemistry, AI IMS,
New Delhi.
Biochemistry & Instrumentation:
At the National Institute of
Hyderabad. March 1-10, 1976.
Nutrition,
*Dates to be announced later
INDIAN COUNCIL OF MEDICAL RESEARCH
TECHNICAL REPORT SERIES
1.
Research in Medical Education 1970
13. Techniques in Blood
2.
Research in Health Practices 1970
14. Laboratory Methods in
Thyroid Diseases 1972
3.
Acute .Encephalopathy Syndrome in
1970.
4.
Technical Review
India 1970
on
Exfoliative Cytology 1971
6.
Symposium on Nutrition
1971
and
Serology 1972
Investigation
of
Children
17. Proceedings of the First Annual Meetings
of the Indian Academy of Cytologists 1972
Pneumoc oniosis
5.
Group
in
Heart Disease
18. Growth and Physical Development of
Infants and Children 1972
Indian
19. Review of Work Done in Rural Water
in India 1972
Supply
20. Genetics and our Health 1972
7.
8.
9.
Developments in
India 1971
Industrial Psychology
in
21. All India Conference on Research in Repro
duction and Fertility 1973
Study Group in Urolithiasis 1971
Proceedings of Seminar on Innnunity and
Immunoprophylaxis in Cholera 1971
22. A study of Morbidity Patterns and Standard
of Medical
Care
in the Rural Health
Centres of West Bengal 1973
Work
10. Assessment of the National Filaria Control
Programme (India 1961-70)
1971
23. Proceedings of the First All-India
shop Conference on Stroke, 1971
11. Diagnosis and Treatment of Pesticide Pois
oning 1971
24. Proceedings of Seminar on Infectious Hepa
*
titis and.Study Group on Australia Anti
gen, 1971
12. Symposium on
Drugs 1972
10
Clinical
Evaluation
of new
25. Atlas of
Histopathology
of
Hepatitis and Cirrhosist 1974
Liver:
26. Studies on Pre-school Children 1974.
(Price Rs.4/- each except No.25 = Rs.10/-)
27. Studies on Weaning and Supplementary Foods
1974.
(Available from Division of Publication & In
formation, Indian Council of Medical Research,
Ansari Nagar, New Delhi-110016)
11
EDITORIAL BOARD
Chairman
Dr. C. Gopalan
Director-General
Editor
Dr. S.V. Apte
Members
Prof. Usha K. Luthra
Dr. Sabita Tejuja
Dr. A.D. Taskar
Dr. G.V. Satyavati
Printed and Published by Shri Prem Chand for the Indian Council of Medical
Research, New Delhi at the ICMR Offset Press, New Delhi.
R.N. 21813/71
Position: 1894 (15 views)