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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
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
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
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.
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.
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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