A Quest for a Universal Plasma-Derived Antivenom Against All Elapid Neurotoxic Snake Venoms

This review describes the research aimed at the development of universal antivenom against elapid neurotoxic snake venoms. The antivenoms produced in Thailand in the 1980s were of low potency, especially against the elapid venoms. This was thought to be due to the low immunogenicity of the α-neurotoxins, which are the most lethal toxins in these venoms. Comparisons of various α-neurotoxin conjugates and polymers, and also different immunological adjuvants, showed that the adjuvant used is the major determinant in the antibody response in horses. The potent Freund’s adjuvant was not used due to its severe local side-effect in horses. Therefore, a novel immunization protocol termed ‘low dose, low volume multi-site’ was developed for use in horses. This immunization protocol has led to the production of highly potent monospecific antivenoms against several elapid and viperid venoms, and two potent polyspecific antivenoms, one against 4 neurotoxic and another against 3 hematotoxic venoms. The immunization protocol has also led to other improvements in antivenom production including: several fold increases in antiserum potency, a reduction in the time required to reach therapeutically useful antibody titers, a 90% reduction in the amount of venom used, and 100% of the horses responding to the immunization program. This development is partly responsible for significant decrease in the Thailand’s annual snakebite death toll from a few dozens to mostly nil in recent years. Finally, a simple and novel immunization strategy, using a ‘diverse toxin repertoire’ composed of numerous elapid toxin fractions as immunogen, was proposed and tested. This immunization procedure has resulted in the successful production of a widely paraspecific antiserum against at least 36 neurotoxic venoms of 28 species encompassing 10 genera and from 20 countries on four continents, and possibly against all elapid venoms with α-neurotoxins as the lethal toxins. These results indicate that, with optimizations of the composition of the ‘diverse toxin repertoire’, the immunization scheme and antibody fractionation to increase the antivenom neutralizing potency, an effective universal antivenom against the neurotoxic elapid snakes of the world can be produced.

The management and economics of east coast fever.

This book chapter tackles the management and economics of east coast fever. At about the time of ILRAD's establishment in 1973, a vaccination procedure was being developed at the East African Veterinary Research Organization (EAVRO) at Muguga, Kenya. The infection-and-treatment method (ITM) is an immunization procedure against ECF. It involves inoculation of live sporozoites of T. parva, usually in the form of a semi-purified homogenate of T. parva-infected ticks, combined with simultaneous treatment with a dose of a long-acting formulation of the antibiotic oxytetracycline. Whilst safe and very effective when administered correctly, production and delivery of this live ECF vaccine is complicated, expensive and time consuming, and at the time of ILRAD's founding, there were doubts as to whether such a procedure was commercially viable. The future for ILRI in the pathology and immunoparasitology of theileriosis will be guided by the vaccine, balanced against the evolving prospects for a subunit vaccine. The future in the epidemiology and economics of ECF management will be developing and evaluating current or novel control methods.

Live Music Therapy as an Active Focus of Attention for Pain and Behavioral Symptoms of Distress During Pediatric Immunization

A total of 100 children coming for routine immunization to pediatric outpatient department were included and were divided into experiment (n = 50) and control (n = 50) groups. Experiment group received live music therapy during immunization procedure. Control group received no intervention. The Modified Behavior Pain Scale (MBPS), 10-point pain levels, and 10-point distress levels were documented by parents. Duration of crying was recorded by investigators. Pre- and postimmunization blood pressures and heart rates of parents holding the children were also measured and recorded by investigators. Independent and paired t tests were used for analysis. All 3 domains of the Modified Behavior Pain Scale and duration of crying showed significant improvement ( P < .05) in the experiment group. Pain and distress levels also showed statistically nonsignificant improvement in experiment group. Blood pressure and heart rate of parents showed no difference. Music therapy could be helpful to children, parents, and health care providers by reducing discomfort of the child during pediatric immunization.

IMMUNIZATION FOR COMPLEX NETWORK BASED ON THE EFFECTIVE DEGREE OF VERTEX

The basic idea of many effective immunization strategies is to first rank the importance of vertices according to the degrees of vertices and then remove the vertices from highest importance to lowest until the network becomes disconnected. Here we define the effective degrees of vertex, i.e., the number of its connections linking to un-immunized nodes in current network during the immunization procedure, to rank the importance of vertex, and modify these strategies by using the effective degrees of vertices. Simulations on both the scale-free network models with various degree correlations and two real networks have revealed that the immunization strategies based on the effective degrees are often more effective than those based on the degrees in the initial network.