Potential Effects of Immunization on the Host Defense Systems in Human Milk

  • Larry K. Pickering
  • Guillermo Ruiz-Palacios


Diarrheal disease mortality data from the Pan American Health Organization (1,2) indicate that in 1976 in North America, diarrhea accounted for 1.4% and 0.9% of infant deaths in children less than 1 year of age and children 1 to 4 years of age, respectively. In tropical areas of America, diarrhea accounted for 15 to 23% of all infant deaths and 15 to 26% of deaths in children 1 to 4 years of age (table 1). In many areas of the world diarrhea remains the leading cause of death in infants and young children (2).


Human Milk Diarrheal Disease Acute Diarrhea Infectious Diarrhea Cholera Vaccine 
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  1. 1.
    Pan American Health Organization. 1980. Diarrheal diseases in the Americas. Epidemiol. Bull. (PAHO), 1:1.Google Scholar
  2. 2.
    Mata, L. 1982. Epidemiology of acute diarrhea in childhood. In Acute diarrhea: Its nutritional consequences in children. J.A. Bellanti ed. Raven Press, New York.Google Scholar
  3. 3.
    Cleary, T.G., Pickering, L.K.: 1986. Update on infectious diarrhea. In Advances in Pediatric Infectious Diseases. S. Aronoff, ed. Year Book Medical Publishers, Chicago, IL. 1:117.Google Scholar
  4. 4.
    Gurwith, M.J., Williams, T.W. 1977. Gastroenteritis in children: A two year review in Manitoba. I. Etiology. J. Infect. Dis. 136:239.CrossRefGoogle Scholar
  5. 5.
    Pickering, L.K., Evans, D.J., Munoz, O., et al. 1978. Prospective study of enteropathogens in children with diarrhea in Houston and Mexico. J. Pediatr. 93:383.CrossRefGoogle Scholar
  6. 6.
    Black, R.E., Merson, M.H., Huq, I., et al. 1981. Incidence and severity of rotavirus and Escherichia coli diarrhea in rural Bangladesh. Implications for vaccine development. Lancet 1:141.CrossRefGoogle Scholar
  7. 7.
    Guerrant, R.L., Kirchoff, L.V., Shields, D.S., et al. 1983. Prospective study of diarrheal illness in North-eastern Brazil: Patterns of disease, nutritional impact, etiologies, and risk factors. J. Infect. Dis. 148:986.CrossRefGoogle Scholar
  8. 8.
    Pickering, L.K., Cleary, T.C. Approach to patients with gastrointestinal infection and food poisoning. In Textbook of Pediatric Infectiou Disease. Ed. R.D. Feigin and J.D. Cherry. W.B. Saunders, Philadelphia, PA (in press).Google Scholar
  9. 9.
    Levine, M.M., Kaper, J.B., Black, R.E., et al. 1983. New knowledge on pathogenesis of bacterial enteric infections as applied to vaccine development. Microbiol. Rev. 47:510.Google Scholar
  10. 10.
    Guerrant, R.L., Moore, R.A., Kirschenfeld, P.M., et al. 1975. Role of toxigenic and invasive bacteria in acute diarrhea of childhood. N. Engl. J. Med. 293:567.CrossRefGoogle Scholar
  11. 11.
    Levine, M.M., Bergquist, E.J., Nalin, D.R., et al. 1978. Escherichia coli strains that cause diarrhoea but do not produce heat-labile or heat-stabile enterotoxins and are non-invasive. Lancet 1:1119.CrossRefGoogle Scholar
  12. 12.
    Edelman, R., Levine, M.M. 1983. Summary of a workshop on enteropathogenic Escherichia coli. J. Infect. Dis. 147:1108.CrossRefGoogle Scholar
  13. 13.
    Toledo, M.R.F., Alvariza, M.C.B., Murahovschi, J., et al. 1983. Enteropathogenic Escherichia coli serotypes and endemic diarrhea in infants. Infect. Immun. 39:586.Google Scholar
  14. 14.
    Sakazaki, R., Tamura, K., Saito, M. 1967. Enteropathogenic Escherichia coli associated with diarrhea in children and adults. Jpn. J. Med. Sci. Biol. 20:387.Google Scholar
  15. 15.
    Gurwith, M., Hinde, D., Gross, R., et al. 1978. A prospective study of enteropathogenic Escherichia coli in endemic diarrheal disease. J. Infect. Dis. 137:292.CrossRefGoogle Scholar
  16. 16.
    Levine, M.M., Edelman, R. 1984. EPEC of classic serotypes associated with infant diarrhea: Epidemiology and pathogenesis. Epidem. Rev. 6:31.Google Scholar
  17. 17.
    Clausen, CR., Christie, D.L. 1982. Chronic diarrhea in infants caused by adherent enteropathogenic Escherichia coli. J. Pediatr. 100:358.CrossRefGoogle Scholar
  18. 18.
    Rothbaum, R.J., Partin, J.C, Saalfield, K., et al. 1983. An ultrastructural study of enteropathogenic Escherichia coli infection in human infants. Ultrastruct. Pathol. 4:291.CrossRefGoogle Scholar
  19. 19.
    Scotland, S.M., Day, N.P., Rowe, B. 1980. Production of a cytotoxin affecting Vero cells by strains of Escherichia coli belonging to traditional enteropathogenic serogroups. FEMS Micro. Let. 7:15.CrossRefGoogle Scholar
  20. 20.
    Cleary, T.G., Mathewson, J.J., Faris, E., et al. 1985. Shiga-like cytotoxin production by enteropathogenic Escherichia coli serogroups. Infect. Immun. 47:335.Google Scholar
  21. 21.
    Mathewson, J.J., Johnson, P.C., DuPont, H.L., et al. 1985. A newly recognized cause of travelers’ diarrhea: Enteroadherent Escherichia coli. J. Infect. Dis. 151:471.CrossRefGoogle Scholar
  22. 22.
    Remis, R.S., MacDonald, K.L., Riley, L.W., et al. 1984. Sporadic cases of hemorrhagic colitis associated with Escherichia coli 0157:H7. Ann. Intern. Med. 101:624.Google Scholar
  23. 23.
    Reis, M.H.L., Guth, B.E.C., Gomes, T.A.T., et al. 1982. Frequency of IS. coli strains producing LT, ST or both in children with and without diarrhea in Sao Paulo. J. Clin. Micro. 15:1062.Google Scholar
  24. 24.
    Yamamoto, T., Honda, T., Miwatani, T., et al. 1984. A virulence plasmid in Escherichia coli enterotoxogenic for humans. Intergenetic transfer and expression. J. Infect. Dis. 150:688.CrossRefGoogle Scholar
  25. 25.
    Formal, S.B., Hale, T.L., Sansonetti, P.J. 1983. Invasive enteric pathogens. Rev. Infect. Dis. 5:S702.CrossRefGoogle Scholar
  26. 26.
    Giannella, R.A., Formal, S.B., Dammin, G.J., et al. 1973. Pathogenesis of salmonellosis: Studies of fluid secretion, mucosal invasion, and morphologic reaction in the rabbit ileum. J. Clin. Invest. 52:441.CrossRefGoogle Scholar
  27. 27.
    Jiwa, S.F. 1981. Probing for enterotoxigenicity among the salmonellae: An evaluation of biological assays. J. Clin. Micro. 14:463.Google Scholar
  28. 28.
    Finkelstein, R.A., Marchlewicz, B.A., McDonald, R.J., et al. 1983. Isolation and characterization of a cholera-related enterotoxin from Salmonella typhimurium. FEMS Microbio. Lett. 17:239.CrossRefGoogle Scholar
  29. 29.
    Blaser, M.J., Wells, J.G., Feldman, R.A., et al. 1983. Campylobacter enteritis in the United States. Ann. Intern. Med. 98:360.Google Scholar
  30. 30.
    Ruiz-Palacios, G.M., Torres, J., Torres, N.I., et al. 1983. Cholera-like enterotoxin produced by Campylobacter jejuni. Characterization and significance. Lancet 2:250.CrossRefGoogle Scholar
  31. 31.
    Kaper, J.B., Bradford, H.B., Roberts, N.C. et al. 1982. Molecular epidemiology of Vibrio cholerae in the U.S. Gulf Coast. J. Clin. Microbiol. 16:129.Google Scholar
  32. 32.
    Bartlett, J.G. 1979. Antibiotic-associated pseudomembranous colitis. Rev. Infect. Dis. 1:530.CrossRefGoogle Scholar
  33. 33.
    Thompson, CM., Gilligan, P.H., Fisher, M.C., et al. 1983. C. difficile cytotoxin in a pediatric population. Amer. J. Dis. Child. 137:271.Google Scholar
  34. 34.
    Cooperstock, M., Riegle, L., Woodruff, C.W., et al. 1983. Influence of age, sex and diet on asymptomatic colonization of infants with Clostridium difficile. J. Clin. Micro. 17:830.Google Scholar
  35. 35.
    Wada, N., Nishida, N., Iwaki, S., et al. 1980. Neutralizing activity against C. difficile toxin in the supernatants of cultured colostral cells. Infect. Immun. 29:545.Google Scholar
  36. 36.
    Kim, K., Pickering, L.K., DuPont, H.L., et al. 1984. In vitro and in vivo neutralizing activity of human colostrum and milk against purified toxins A and B of Clostridium difficile. J. Infect. Dis. 150:57.CrossRefGoogle Scholar
  37. 37.
    Pickering, L.K., Keswick, B.H. Rotavirus and Norwalk virus. In Clinical Virology Manual. Edited by S. Spector, G. Lancz, and I. Lee. Elsevier Science Publishing Company, Inc., New York, New York (in press).Google Scholar
  38. 38.
    Champsaur, H., Questianx, E., Prevot, J., et al. 1984. Rotavirus carriage, asymptomatic infection, and disease in the first two years of life. I. Virus shedding. J. Infect. Dis. 149:667.Google Scholar
  39. 39.
    Yolken, R.H., Wyatt, R.G., Zissis, G., et al. 1978. Epidemiology of human rotavirus types 1 and 2 as studied by ELISA. N. Engl. J. Med. 299:1156.CrossRefGoogle Scholar
  40. 40.
    Mietens, C, Kleinhorst, H., Hilpert, H., et al. 1976. Treatment of infantile JE. coli gastroenteritis with specific bovine and E. coli milk immunoglobulins. Eur. J. Pediatr. 132:239.CrossRefGoogle Scholar
  41. 41.
    Levine, M.M., Black, R.E., Clements, M.L., et al. 1981. Duration of infection derived immunity to cholera. J. Infect. Dis. 143:818.CrossRefGoogle Scholar
  42. 42.
    Joo, I. 1974. Cholera vaccines. In Cholera. Ed. D. Barma and W. Burrows. W.B. Saunders, Philadelphia, PA.Google Scholar
  43. 43.
    Pierce, N.F. 1980. Suppression of the intestinal immune response to cholera toxin by specific serum antibody. Infect. Immun. 30:62.Google Scholar
  44. 44.
    Svennerholm, A.M., Holgren, J., Hanson, L.A., et al. 1977. Boosting of secretory IgA antibody response in man by parenteral cholera vaccination. Scand. J. Immunol. 6:1345.CrossRefGoogle Scholar
  45. 45.
    Svennerholm, A.M, Hanson, L.A., Holgren, J., et al. 1980. Different secretory immunoglobulin A antibody response to cholera vaccination in Swedish and Pakistani women. Infect. Immun. 30:427.Google Scholar
  46. 46.
    Levine, M.M., Nalin, D.R., Craig, J.P., et al. 1979. Immunity to cholera in ma.n: Relative role of antibacterial versus antitoxic immunity. Trans. R. Soc. Trop. Med Hyg. 73:3.CrossRefGoogle Scholar
  47. 47.
    Edelman, R. 1985. Prevention and treatment of infectious diarrhea. Speculations on the next ten years. Am. J. Med. 785:99.CrossRefGoogle Scholar
  48. 48.
    Levine, M.M., Nalin, D.R., Hooever, D.L., et al. 1979. Immunity to enterotoxigenic Escherichia coli. Infect. Immun. 23:729.Google Scholar
  49. 49.
    Baldini, M.M., Raper, J.B., Levine, M.M., et al. 1983. Plasmid-mediated adhesion in enteropathogenic Escherichia coli. J. Pediatr. Gastroenterol. Nutr. 2:534.CrossRefGoogle Scholar
  50. 50.
    Woodward, W.E. 1980. Volunteer studies of typhoid fever and vaccines. Trans. R. Soc. Trop. Med. Hyg. 74:553.CrossRefGoogle Scholar
  51. 51.
    Pierce, N.F., Sacci, J.B., Jr. 1984. Enhanced mucosal priming by cholera toxin and procholeragenoid with a lipoidal amine adjuvant (Avridine) delivered in liposomes. Infect. Immun. 44:469.Google Scholar
  52. 52.
    Wahdan, M.H., Serie, C., Cerisier, Y., et al. 1982. A controlled field trial of live Salmonella typhi strain Ty21a oral vaccine against typhoid: Three year results. J. Infect. Dis. 145:292.CrossRefGoogle Scholar
  53. 53.
    Formal, S.B., Maenza, R.M., Austin, S., et al. 1967. Failure of parenteral vaccines to protect monkeys against experimental shigellosis. Proc. Soc. Exp. Biol. Med. 125:347.Google Scholar
  54. 54.
    Tramont, E.C., Chung, R., Berman, S., et al. 1984. Safety and antigenicity of Typhoid-Shigella sonnei vaccine (strain 5076–1C). J. Infect. Dis. 149:133.CrossRefGoogle Scholar
  55. 55.
    Wyatt, R.G., James, W.D., Bohl, E.H., et al. 1980. Human rotavirus type 2, cultivation in vitro. Science 207:189.CrossRefGoogle Scholar
  56. 56.
    Bishop, R.F., Barnes, G.L., Cipriani, E., et al. 1983. Clinical immunity after neonatal rotavirus infection: A prospective longitudinal study in young children. N. Engl. J. Med. 309:72.CrossRefGoogle Scholar
  57. 57.
    Vesikari, T., Isolauri, E., Delem, A., et al. 1983. Immunuogenicity and safety of live oral attenuated bovine rotavirus vaccine strain RIT 4237 in adults and young children. Lancet 11:807.CrossRefGoogle Scholar
  58. 58.
    Vesikari, T., Isolauri, E., D’Hondt, E., et al. 1984. Protection of infants against rotavirus diarrhoea by RIT 4237 attenuated bovine rotavirus strain vaccine. Lancet 1:977.CrossRefGoogle Scholar
  59. 59.
    Tao, H., Changan, W., Zhaoying, F., et al. 1984. Waterborne outbreak of rotavirus diarrhoea in adults in China caused by a novel rotavirus. Lancet 1:1139.CrossRefGoogle Scholar
  60. 60.
    Dimitrov, D.H., Estes, M.K., Rangelova, S.M., et al. 1983. Detection of antigenically distinct rotaviruses from infants. Infect. Immun. 41:523.Google Scholar
  61. 61.
    Kovar, M.G., Serdula, M.K., Karks, J.S., et al. 1984. Review of the epidemiologic evidence for an association between infant feeding and infant health. Pediatrics 74(Suppl):615.Google Scholar
  62. 62.
    Feachem, R.G., Koblinsky, M.A. 1984. Interventions for the control of diarrhoeal diseases among young children: Promotion of breast feeding. Bull. W.H.O. 62:271.Google Scholar
  63. 63.
    Goldman, A.S., Goldblum, R.M. 1985. Protective properties of human milk in nutrition in pediatrics. In Walker W.A., ed., Basic Science and Clinical Application. Little Brown and Company.Google Scholar
  64. 64.
    Pickering, L.K., Kohl, S. Human milk humoral immunity and infant defense mechanisms. In Human Milk in Infant Nutrition and Health. Ed. R.R. Howell, F.H. Morriss, L.K. Pickering. Charles C. Thomas, Springfield, IL (in press).Google Scholar

Copyright information

© Plenum Press, New York 1986

Authors and Affiliations

  • Larry K. Pickering
    • 1
    • 2
  • Guillermo Ruiz-Palacios
    • 1
    • 2
  1. 1.Program in Infectious Diseases and Clinical Microbiology and Department of PediatricsUniversity of Texas Medical School at HoustonUSA
  2. 2.Department of Infectious Diseases Institute of NutritionMexico CityMexico

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