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Related post: Career Awards 4 184,916 Fellowships 7 990,096 Totals 161 $28,169,347 Program Summary Activities of the Development and Applications Branch include comprehensive research programs on influenza and other viral respiratory diseases, viral hepatitis, viral vaccines, bacterial vaccines and antiviral substances. Because these programs for development of control measures are designated as high pri- ority by the Institute , funding is provided utilizing all mechanisms available to staff. The DAB carries out many of its objectives through directed research and is responsible for the major portion of the contract activities within the Microbiology and Infectious Diseases Program. It has been noted in past annual reports that staff has been concerned about reduction of contract funds and the DAB's ability to perform its mission satisfac- torily. Although DAB contract expenditures increased in FY83, much of the increase reflects the innovative funding techniques used by the Contract Manage- ment Branch and 3 new clinical trial awards with exceptionally large budgets. The drop from 44 contracts in FY82 to 30 in FY83 is more indicative of the further erosion of contract supported research. This situation will certainly reduce the ability to obtain "payoffs" from promising leads developed in basic research activities. The winter of 1982-1983 was not a particularly devesting influenza season, but H3N2, HlNl, and influenza B viruses all produced outbreaks of varying severity. In addition to the effectiveness of rimantadine in preventing Dramamine Online influenza infec- tions (shown in 1981-1982), another drug, ribavirin, was shown to be effective for the treatment of severe influenza infections when administered by aerosol. Although not directly sponsored by the NIAID, studies showed this drug to be effective in treating clinically severe respiratory syncytial virus infections in infants. These observations need to be amplified and confirmed in the next year. Attenuated influenza vaccines continue to show great promise, with data on the cold adapted recombinants suggesting safety and efficacy. Basic research is 9-2 providing many answers on the molecular nature of surface antigens of the virus and their interactions with host cells. The effectiveness of hepatitis B vaccines in preventing infections in most normal "at risk" adult populations has been established. Immuno-compromised groups may not receive the full benefits of the vaccine. The trial conducted in persons undergoing hemodialysis indicated that additional information is needed on vaccine dose, timing of vaccination, and nature of immune response before recommendations for usage can be made. Because of the expense of the licensed HBV vaccine, alternate vaccine antigen sources are required, an area of intense investigation. The DAB is prepared to undertake phase 1 and 2 testing of candidate preparations that may be developed. Animal models (woodchuck, ground squirrel, and Pekin duck) for hepatitis B infections are being vigorously explored by government scientists, contractors, and grantees. There is promise of an attenuated hepatitis A vaccine in the next 1-2 years, and small-scale volunteer testing Order Dramamine may be initiated Order Dramamine Online during FY84. As information from basic virologic research becomes available, antiviral drug development will be targeted at inhibition of specific viral functions. Several new drugs specific for herpes-induced thymidine-kinase are now undergoing pharma- cokinetic and toxicologic studies in animal models for assessment of potential usefulness in man. In addition to the various protocols for evaluation of adenine arabinoside, acyclovir and interferon for treatment of herpes virus infections in man, a new study has been undertaken for the evaluation of inter- feron for treatment of laryngeal papilloma in children. Also anticipated for this fiscal year is a controlled trial of Buy Dramamine treatment with interferon of Condyloma infections - an extremely common disease. The Purchase Dramamine program continues to serve as a WHO Collaborating Center on Interferon Reference and Research. Human gamma interferon and a cloned leukocyte Generic Dramamine preparation were added to the available reference agents. Collaborative efforts by the bacterial vaccines program have shown that various patient populations do respond to pneumococcal vaccine, but immunosuppressive treatment for their underlying illness can severely hamper that response. Pneumococcal vaccine may also protect against otitis media if the vaccine recip- ient develops type specific antibody after immunization. However, the lack of immunogenicity in infants under 2 years of age indicates that additional research is required to enhance the immunogenicity of the polysaccharide Purchase Dramamine Online vaccine. An approach to enhanced immunogenicity employing conjugation of polysaccharide to diphtheria toxoid appears successful for H^. influenzae antigen. Test preparations appear to be highly immunogenic in one-year olds, and plans are underway to initiate an efficacy trial of Buy Dramamine Online a PRP-toxoid conjugated vaccine this fiscal year. The development of a new non-reactogenic B^. pertussis vaccine has been of interest to the DAB for several years. A contract award for preparing an acel- lular vaccine will be awarded this year. In addition, it is hoped that clinical trials can be started Buy Cheap Dramamine that will use DTP that contains the "P" component developed by the Japanese. This vaccine is made by a U.S. manufacturer, utilizing bulk pertussis antigen purchased from the Japanese. The initial trials will be designed to measure reactogenicity and antigenicity of the "P" component. Efficacy trials of a new pertussis vaccine will most likely have to be performed outside of the U.S. 9-3 To date 188 children and 25 adults have been vaccinated with an attenuated varicella vaccine to determine its value in protecting the immunosuppressed against varicella infections. All vaccinees have responded immunologically, and though documented exposures in 17 vaccinees occurred, only 3 mild cases of chickenpox have occurred. During the past year the vaccine evaluation units have tested candidate vaccines in adults and children; they have also evaluated some antiviral compounds such as amantadine, rimantadine, and interferon for safety and effectiveness. Research Highlights Influenza Program Two antigenic types of influenza A viruses, HlNl and H3N2, continue to circulate and produce epidemics in the human population. The epidemic of influenza which occurred last winter was not particularly severe. Three viruses, A/Phil ippines-
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