Pneumococcus, Pneumococcal Disease, and Prevention

The Vaccine Book

Volumn , Issue , 2003, Pages 257-277

  Hackell, Jill G ^a  

^a WYETH RESEARCH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 17644374628     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1016/B978-012107258-2/50021-4     Document Type: Chapter

References (94)

1. Advisory Committee on Immunization Practices Prevention of Pneumococcal Disease: Recommendations of the ACIP. Mortality Morbidity Weekly Report 1997, 46(RR-08):1-24.
2. Levine O., Farley M., Harrison L.H., et al. Risk Factors for Invasive Pneumococcal Disease in Children: A Population-Based Case-Control Study in North America. Pediatrics 1999, 103:1-5.
3. Kaplan S.L., Mason E.O., Barson W.J., et al. Three-Year Multicenter Surveillance of Systemic Pneumococcal Infections in Children. Pediatrics 1998, 102:538-544.
4. Eskola J., Anttila M. Pneumococcal Conjugate Vaccines. Pediatr. Infect. Dis. 1999, 18:543-551.
5. Schuchat A., Robinson K., Wenger J.D., et al. Bacterial Meningitis in the United States in 1995. New England J. Medicine 1997, 337:970-976.
6. Austrian R. Pneumococcal Infections. Bacterial Vaccines 1984, 257-285. Chapter 9, Academic Press, Orlando. R. Germanier (Ed.).
7. Hausdorff W.P., Bryant J., Paradiso P., Siber G.R. Which Pneumococcal Serogroups Cause the Most Invasive Disease: implications for Conjugate Vaccine Formulation and Use, Part 1. Clin. Infect. Dis. 2000, 30:100-121.
8. Hausdorff W.P., Bryant J., Kloek C., Paradiso P., Siber G.R. The Contribution of Specific Pneumococcal Serogroups to Different Disease Manifestations: Implications for Conjugate Vaccine Formulation and Use, Part II. Clin. Infect. Dis. 2000, 30:122-140.
9. Hausdorff W.P., Siber G., Paradiso P.R. Geographical Differences in Invasive Pneumococcal Disease Rates and Serotype Frequency in Young Children. Lancet 2001, 357:950-952.
10. Dagan R., Givon-Lavi N., Shkolnik L., Yagupsky P., Fraser D. Acute Otitis Media Caused by Antibiotic-Resistant Streptococcus pneumoniae in Southern Israel: Implication for Immunizing with Conjugate Vaccines. J. Infect. Dis. 2000, 181:1322-1329.
11. Friedland I.R., Klugman K.P. Antibiotic-Resistant Pneumococcal Disease in South African Children. Am. J. Dis. Child. 1992, 146:920-923.
12. Nava J.M., Bella F., Garau J., et al. Predictive Factors for Invasive Disease Due to Penicillin-Resistant Streptococcus pneumoniae: A Population-Based Study. Clin. Infect. Dis. 1994, 19:884-890.
13. Inostroza J., Trucco O., Prado V., et al. Capsular Serotype and Antibiotic Resistance of Streptococcus pneumoniae Isolated in Two Chilean Cities. Clin. Diagn. Lab. Immunol. 1998, 5:176-180.
14. Koh T.H., Lin R.V.T.P. Increasing Antimicrobial Resistance in Clinical isolates of Streptococcus pneumoniae. Ann. Acad. Med. Singapore 1997, 26:604-608.
15. Gray B.M., Converse G.M., Dillion H.C. Epidemiologic Studies of Streptococcus pneumoniae in Infants: Acquisition, Carriage, and Infection during the First 24 Months of Life. J. Infect. Dis. 1980, 142:923-933.
16. Ghaffar F., Friedland I.R., McCracken G.H. Dynamics of Nasopharyngeal Colonization by Streptococcus pneumoniae. Pediatr. Infect. Dis. J. 1999, 18:638-645.
17. Vives M., Garcia M.E., Saenz P., et al. Nasopharyngeal Colonization in Costa Rican Children during the First Year of Life. Pediatr. Infect. Dis. J. 1997, 16:852-858.
18. Sung R.Y.T., Ling J.M., Fung S.M. Carriage of Haemophilus influenzae and Streptococcus pneumoniae in Healthy Chinese and Vietnamese Children in Hong Kong. Acta Paediatr. 1995, 84:1262-1267.
19. Schrag S.J., Beall B., Dowell S.F. Limiting the Spread of Resistant Pneumococci: Biological and Epidemiologic Evidence for the Effectiveness of Alternative Interventions. Clin. Microbiol. Rev. 2000, 13:588-601.
20. Dagan R., Melamed R., Muallem M., Piglansky L., Yagupsky P. Nasopharyngeal Colonization in Southern Israel with Antibiotic-Resistant Pneumococci during the First Two Years of Life: Relation to Serotypes Likely To Be Included in Pneumococcal Conjugate Vaccines. J. Infect. Dis. 1996, 174:1352-1355.
21. Dagan R., Fraser D. Conjugate Pneumococcal Vaccine and Antibiotic-Resistant Streptococcus pneumoniae: Herd Immunity and Reduction of Otitis Morbidity. Pediatr. Infect. Dis. 2000, 19:S79-S88.
22. Gillespie S.H., Balakrishnan I. Pathogenesis of Pneumococcal Infection. J. Med. Microbiol. 2000, 49:1057-1067.
23. Avery O.T., Dubos R. The Protective Action of a Specific Enzyme against Type III Pneumococcus Infection in Mice. J. Exp. Med. 1931, 54:73-89.
24. Alonso deVelasco E., Verheul A.F.M., Verhoef J., Snippe H. Streptococcus pneumoniae: Virulence Factors, Pathogenesis, and Vaccines. Microbiol. Rev. 1995, 59:591-603.
25. Cundell D.R., Weiser J.N., Shen J., Young A., Tuomanen E.I. Relationship between Colonial Morphology and Adherence of Streptococcus pneumoniae. Infect. Immun. 1995, 63:757-761.
26. Bruyn G.A.W., Zegers B.J.M., van Fruth R. Mechanisms of Host Defense against Infection with Streptococcus pneumoniae. Clin. Infect. Dis. 1992, 14:251-262.
27. Goldblatt D. Conjugate Vaccines. Clin. Exp. Immunol. 2000, 119:1-3.
28. Baxendale H.E., Davis Z., White H.N., Spellerberg M.B., Stevenson F.K., Goldblatt D. Immunogenetic Analysis of the Immune Response to Pneumococcal Polysaccharide. Eur. J. Immunol. 2000, 30:1214-1223.
29. Douglas R.M., Paton J.C., Duncan S.J., Hansman D.J. Antibody Response to Pneumococcal Vaccination in Children Younger Than Five Years of Age. J. Infect. Dis. 1983, 148:131-137.
30. Foote J., Eisen H.N. Kinetic and Affinity Limits on Antibodies Produced during Immune Responses. Proc. Natl. Acad. Sci. U.S.A. 1995, 92:1254-1256.
31. 197 in United States Infants. Pediatrics 1998, 101:604-611.
32. Steinhoff M.C., Edwards K., Keyserling H., Thoms M.L., Johnson D.C., Madore D., Hogerman D. A Randomized Comparison of Three Bivalent Streptococcus pneumoniae Glycoprotein Conjugate Vaccines in Young Children: Effect of Polysaccharide Size and Linkage Characteristics. Pediatr. Infect. Dis. J. 1994, 13:368-372.
33. 197 Conjugate Vaccine in Infants and Toddlers. Pediatr. Infect. Dis. 1999, 18:757-763.
34. Black S., Shinefield H., Fireman B., Lewis E., Ray P., Hansen J.R., Elvin L., Ensor K.M., Hackell J., Siber G., Malinoski F., Madore D., Chang I., Kohberger R., Watson W., Austrian R., Edwards K. Efficacy, Safety and Immunogenicity of Heptavalent Pneumococcal Conjugate Vaccine in Children. Pediatr. Infect. Dis. J. 2000, 19:187-195. The Northern California Kaiser Permanente Vaccine Study Center Group.
35. Choo S., Seymour L., Rhonwen M., Quataert S., Lockhart S., Cartwright K., Finn A. Immunogenicity and Reactogenicity of a Pneumococcal Conjugate Vaccine Administered Combined with a Haemophilus influenzae Type B Conjugate Vaccine in United Kingdom Infants. Pediatr. Infect. Dis. J. 2000, 19:854-862.
36. 197 among Infants with Sickle Cell Disease. Pediatrics 2000, 106:965-972.
37. Eskola J., Kilpi T., Palmu A., Jokinen J., Haapakoski J., Herva E., Takala A., Kayhty H., Karma P., Kohberger R., Siber G., Makela H. Efficacy of Pneumococcal Conjugate Vaccine against Acute Otitis Media. New Engl. J. Medicine 2001, 344:403-409.
38. Dagan R., Melamed R., Zamir O., Leroy O. Safety and Immunogenicity of Tetravalent Pneumococcal Vaccines Containing 6B, 14, 19F and 23F Polysaccharides Conjugated to Either Tetanus Toxoid or Diphtheria Toxoid in Young Infants and Their Boosterability by Native Polysaccharide Antigens. Pediatr. Infect. Dis. J. 1997, 16:1053-1059.
39. Wuorimaa T., Kayhty H., Leroy O., Eskola J. Tolerability and Immunogenicity of an 11-Valent Pneumococcal Conjugate Vaccine in Adults. Vaccine 2001, 19:1863-1869.
40. Anderson E.L., Kennedy D.J., Geldmacher K.M., Donnelly J., Mendelman P.M. Immunogenicity of Heptavalent Pneumococcal Conjugate Vaccine in Infants. J. Pediatr. 1996, 128:649-653.
41. Anttila M., Voutilainen M., Jantti V., Eskola J., Kayhty H. Contribution of Serotype-Specific IgG Concentration, IgG Subclasses and Relative Antibody Avidity to Opsonophagocytic Activity against Streptococcus pneumoniae. Clin. Exp. Immunol. 1999, 118:402-407.
42. O'Brien K.L., Steinhoff M.C., Edwards K., Keyserling H., Thoms M.L., Madore D. Immunologic Priming of Young Children by Pneumococcal Glycoprotein Conjugate, but Not Polysaccharide Vaccines. Pediatr. Infect. Dis. 1996, 15:425-430.
43. Vella P.P., Marburg S., Staub J.M., et al. Immunogenicity of Conjugate Vaccines Consisting of Pneumococcal Capsular Polysaccharide Types 6B, 14, 19F, and 23F and a Meningococcal Outer Membrane Protein Complex. Infect. Immunol. 1992, 60:4977-4983.
44. Soininen A., Seppala I., Nieminen T., Eskola J., Kayhty H. IgG Subclass Distribution of Antibodies after Vaccination of Adults with Pneumococcal Conjugate Vaccines. Vaccine 1999, 17:1889-1897.
45. Obaro S.K., Huo Z., Banya W.A.S., Henderson D.C., Monteil M.A., Leach A., Greenwood B.M. A Glycoprotein Pneumococcal Conjugate Vaccine Primes for Antibody Responses to a Pneumococcal Polysaccharide Vaccine in Gambian Children. Pediatr. Infect. Dis. J. 1997, 16:1135-1140.
46. Goldblatt D., Pinto Vaz A.R.J.P.M., Miller E. Antibody Avidity as a Surrogate Marker of Successful Priming by Haemophilus influenzae Type b Conjugate Vaccines following Infant Immunization. J. Infect. Dis. 1998, 177:1112-1115.
47. Eskola J. Immunogenicity of Pneumococcal Conjugate Vaccines. Pediatr. Infect. Dis. J. 2000, 19:388-393.
48. Anttila M., Eskola J., Ahman H., Kayhty H. Differences in the Avidity of Antibodies Evoked by Four Different Pneumococcal Conjugate Vaccines in Early Childhood. Vaccine 2000, 17:1970-1977.
49. Goldblatt D., Akoto O.Y., Ashton L., Asafo-Adjei E., Brainsby K., Twumai P., Baffoe-Bonnie B. Does One Dose of Pneumococcal Conjugate Vaccine Induce Immunological Memory in Toddlers?. 40th Interscience Conference on Antimicrobial Agents and Chemotherapy, Presentation 42 2000.
50. Usinger W.R., Lucas A.H. Avidity as a Determinant of the Protective Efficacy of Human Antibodies to Pneumococcal Capsular Polysaccharides. Infect. Immun. 1999, 67:2366-2370.
51. 197 Vaccines: Effect of Saccharide Size on Immunogenicity and Interactions with Simultaneously Administered Vaccines. J. Infect. Dis. 1997, 176:445-455.
52. Dagan R., Eskola J., Leclerc C., Leroy O. Reduced Response to Multiple Vaccines Sharing Common Protein Epitopes That Are Administered Simultaneously to Infants. Infect. Immun. 1998, 66:2093-2098.
53. Ahman H., Kayhty H., Vuorela A., Leroy O., Eskola J. Dose Dependency of Antibody Response in Infants and Children to Pneumococcal Polysaccharides Conjugated to Tetanus Toxoid. Vaccine 1999, 17:2726-2732.
54. Insel R.A. Potential Alterations in Immunogenicity by Combining or Simultaneously Administering Vaccine Components. Combined Vaccines and Simultaneous Administration: Current Issues and Perspectives 1995, Vol. 754:35-47. New York Academy of Sciences, New York.
55. O'Brien K.L., Moulton L., Reid R., Weatherholtz R., Hackell J., Kohberger R, Chang I., Siber G., Santosham M. Invasive Disease Efficacy of a 7-Valent Pneumococcal Conjugate Vaccine among Navajo and White Mountain Apache (N/WMA) Children. Presented at 19th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID) 2001.
56. Obaro S., Adegbola R.A., Banya W., Greenwood B Carriage of Pneumococci after Pneumococcal Vaccination. Lancet 1996, 348:271-272.
57. Mbelle N., Huebner R.E., Wasas A.D., Kimura A., Chang I., Klugman K.P. Immunogenicity and Impact on Nasopharyngeal Carriage of a Nonavalent Pneumococcal Conjugate Vaccine. J. Infect. Dis. 1999, 180:1171-1176.
58. Dagan R., Melamed R., Muallem M., Piglansky L., Greenberg D., Abramson O., Mendelman P.M., Bohidar N., Yagupsky P. Reduction of Nasopharyngeal Carriage of Pneumococci during the Second Year of Life by a Heptavalent Conjugate Pneumococal Vaccine. J. Infect. Dis. 1996, 174:1271-1278.
59. Dagan R., Muallem M., Melamed R., Leroy O., Yagupsky P. Reduction of Pneumococcal Nasopharyngeal Carriage in Early Infancy after Immunization with Tetravalent Pneumococcal Vaccines Conjugated to Either Tetanus Toxoid or Diphtheria Toxoid. Pediatr. Infect. Dis. J. 1997, 16:1060-1064.
60. O'Brien K.L., Bronsdon M.A., Carlone G.M., Facklam R.R., Schwartz B., Reid R.R., Santosham M. Effect of a 7-Valent pneumococcal Conjugate Vaccine (7vPnC) on Nasopharyngeal Carriage (NP) among Navajo and White Mountain Apache (N/WMA) Children. Presented at 19th Annal Meeting of the European Society for Paediatric Infectious Diseases (ESPID) 2001.
61. 197 Conjugate Pneumococcal Vaccine (PncCRM9)-Protection against Individual Serotypes. Presented at 40th Interscience Conference on Antimicrobial Agents and Chemotherapy, Abstract 2000, 686.
62. Dagan R., Givon-Lavi N., Porat N., Sikuler-Cohen L., Fraser D. Immunization of Toddlers Attending Day Care Centers (DCCs) with a 9-Valent Conjugate Pneumococcal Vaccine (PncCRM9) Reduced Transmission of Streptococcus pneumoniae (Pnc) and Antibiotic Resistant S. Pneumoniae (R-Pnc) to Their Young Siblings (YS). Presented at 40th Interscience Conference on Antimicrobial Agents and chemotherapy, Abstract 2000, 687.
63. Nieminen T., Kayhty H., Leroy O., Eskola J. Pneumococal Conjugate Vaccination in toddlers: Mucosal Antibody Response Measured as Circulation Antibody-Secreting Cells and as Salivary Antibodies. Pediatr. Infect. Dis. J. 1999, 18:764-772.
64. Korkeila M., Lehtonen H., Ahman H., Leroy O., Eskola J., Kayhty H. Salivary Anti-Capsular Antibodies in Infants and Children Immunised with Streptococcus pneumoniae Capsular Polysaccharides Conjugated to Diphtheria of Tetanus Toxoid. Vaccine 2000, 18:1218-1226.
65. Choo S., Zhang Q., Seymour L., Akhtar S., Finn A. Primary and Booster Salivary Antibody Responses to a 7-Valent Pneumococcal Conjugate Vaccine in Infants. J. Infect. Dis. 2000, 182:1260-1263.
66. Johnson S.E., Rubin L., Romero-Steiner S., Dykes J.K., Pais L.B., Rizvi A., Ades E., Carlone G.M. Correlation of Opsonophagocytosis and Passive protection Assays Using Human Anticapsular Antibodies in an Infant Mouse Model of Bacteremia for Streptococcus pneumoniae. J. Infect. Dis. 1999, 180:133-140.
67. Stack A.M., Malley R., Thompson C.M., Kobzik L., Siber G.R., Saladino R.A. Minimum protective Serum Concentrations of Pneumococcal Anti-Capsular Antibodies in Infant Rats. J. Infect. Dis. 1998, 177:968-990.
68. Siber G.R. Methods for Estimating Serological Correlates of Protection. Pertussis Vaccine Trials 1997, 283-296. Karger, Basel, Switzerland. F. Brown, D. Greco, P. Mastrantonio, S. Salmaso, S. Wassilak (Eds.).
69. Klugman K.P., Koornhof H.J., Robbins J.B., Le Cam N.N. Immunogenicity, Efficacy and Serological Correlate of Protection of Salmonella typhi Vi Capsular Polysaccharide Vaccine Three Years after Immunization. Vaccine 1996, 14:435-438.
70. Adams W.G., Deaver K.A., Cochi S.L., Pikaytis B.D., Zell E.R., Broome C.V., Wenger J.D. Decline of Childhood Haemophilus influenzae type b (Hib) Disease in the Hib Vaccine Era. J. Am. Med. Assoc. 1993, 269:221-226.
71. Black S., Shinefield H., Hansen J., Elvin L., Laufer D., Malinoski F. Post Licensure Evaluation of the Effectiveness of Seven Valent Pneumococcal Conjugate Vaccine. Pediatr. Infect. Dis. J. 2001, 20(12):1105-1107.
72. Zielen S., Buhring I., Strnad N., Reicheback J., Hoffman D. Immunogenicity and Tolerance of a 7-Valent Pneumococcal Conjugate Vaccine in Nonresponders to the 23-Valent Pneumococcal Vaccine. Infect. Immun. 2000, 68(3):1435-1440.
73. Sorensen R.U., Leiva L.E., Giangrosso P.A., Butler B., Javier F.C., Sacerdote D.M., Bradford N., Moore C. Response to a Heptavalent Conjugate Streptococcus Pneumoniae Vaccine in Children with Recurrent Infections Who Are Unresponsive to the Polysaccharide Vaccine. Pediatr. Infect. Dis. J. 1998, 17:685-691.
74. Vernacchio L., Neufeld E.J., Macdonald K., et al. Combined Schedule of 7-Valent Pneumococcal Conjugate Vaccine followed by 23-Valent Pneumococcal Vaccine in Children and Young Adults with Sickle Cell Disease. J. Pediatr. 1998, 103:275-278.
75. King J.C., Vink P.E., Farley J.J., Parks M., Smilie M., Madore D., Lichenstein R., Malinoski F. Comparison of the Safety and Immunogenicity of a Pneumococcal Conjugate with a Licensed Polysaccharide Vaccine in Human Immunodeficiency Virus and Non-Human Immunodeficiency Virus-Infected Children. Pediatr. Infect. Dis. J. 1996, 15:192-196.
76. Molrine D., Antin J., Guinan E., Soiffer R., Ambrosino D., Maldonado J., Wilson M. Pneumococcal Conjugate Vaccine (PCV) Elicits Protective Responses in Allogeneic Bone Marrow Transplant (BMT) Recipients. 41st Interscience Conference on Antimicrobial Agents and Chemotherapy, Abstract 2001, 2035.
77. Glezen W.P., Alpers M. Maternal Immunization. Clin. Infect. Dis. 1999, 28:219-224.
78. Fedson D.S. Pneumococcal Conjugate Vaccination for Adults: Why It's Important for Children. Pediatr. Infect. Dis. J. 2000, 19:183-186.
79. Sankilampi U., Honkanen P.O., Bloigu A., Leinonen M. Persistence of Antibodies to Pneumococcal Capsular Polysaccharide Vaccine in the Elderly. J. Infect. Dis. 1997, 176:1100-1104.
80. Mufson M.A., Krause H.E., Schiffman G. Long-Term Persistence of Antibody following Immunization with Pneumococcal Polysaccharide Vaccine. Proc. Soc. Exp. Biol. Med. 1983, 173:270-275.
81. Mufson M.A., Krause H.E., Schiffman G., Hughley D.F. Pneumococcal Antibody Levels One Decade after Immunization of Healthy Adults. Am. J. Med. Sci. 1987, 293:279-289.
82. Hilleman M.R., Carlson A.J., McLean A.A., Vella P.P., Weibel R.E., Woodhour A.F. Streptococcus Pneumoniae Polysaccharide Vaccine: Age and Dose Responses, Safety, Persistence of Antibody, Revaccination, and Simultaneous Administration of Pneumococcal and Influenza Vaccines. Rev. Infect. Dis. 1981, 3(Suppl.):S31-S42.
83. Kraus C., Fischer S., Ansorg R., Hottemann U. Pneumococcal Antibodies (IgG, IgM) in Patients with Chronic Obstructive Lung Disease 3 Years after Pneumococcal Vaccination. Med. Microbiol. Immunol. 1985, 174:51-58.
84. 197 Conjugated Pneumococcal Oligosaccharide Vaccines in Young and Elderly Adults. Infect. Immun. 1997, 65:242-247.
85. Powers D.C., Anderson E.L., Lottenbach K., Mink C.M. Reactogenicity and Immunogenicity of a Protein-conjugated Pneumococcal Oligosaccharide Vaccine in Older Adults. J. of Infect. Dis. 1996, 173:1014-1018.
86. Musher D.M., Groover J.E., Watson D.A., Rodriguez-Barradas M.C., Baughn R.E. IgG Responses to Protein-Conjugated Pneumococcal Capsular Polysaccharides in Persons Who Are Genetically Incapable of Responding to Unconjugated Polysaccharides. Clin. Infect. Dis. 1998, 27:1487-1490.
87. Romeoro-Steiner S., Musher D.M., Cetron M., Pais L.B., Groover J.E., Fiore A.E., Plikaytis B.D., Carlone G.M. Reduction in Functional Antibody Activity against Streptococcus pneumoniae in Vaccinated Elderly Individuals Highly Correlates with Deceased IgG Antibody Avidity. Clin. Infect. Dis. 1999, 29:281-288.
88. Musher D.M., Hoang M.P., Baughn R.E. Protection against Bacteremic Pneumococcal Infection by Antibody to Pneumolysin. J. Infect. Dis. 2001, 183:827-830.
89. Alexander J.E., Lock R., Peeters C.C., et al. Immunization of Mice with Pneumolysin Toxoid Confers a Significant Degree of Protection against at Least Nine Serotypes of Streptococcus Pneumoniae. Infect. Immun. 1994, 62:5683-5688.
90. Virolainen A., Russell W., Crain M.J., Rapola S., Kayhty H., Briles D.E. Human Antibodies to Pneumococcal Surface Protein A in Health and disease. Pediatr. Infect. Dis. J. 2000, 19:134-138.
91. Nabors G.S., Braum P.A., Herrmann D.J., Heise M.L., Pyle D.J., Gravenstein S., Schilling M., Ferguson L.M., Hollingshead S.K., Briles D.E., Becker R.S. Immunization of Healthy Adults with a Single Recombinant Pneumococcal Surface Protein A (PspA) Variant Stimulates Broadly Cross-Reactive Antibodies to Heterologous PspA Molecules. Vaccine 2000, 18:1743-1754.
92. Briles D.E., Hollingshead S.K., King J., Swift A., Braun P.A., Park M.K., Ferguson L.M., Nahm M.H., Nabors G.S. Immunization of Humans with Recombinant Pneumococcal Surface Protein A (rPspA) Elicits Antibodies That Passively Protect Mice from Fatal Infection with Streptococcus pneumoniae Bearing Heterologous PspA. J. Infect. Dis. 2000, 182:1694-1701.
93. Hvalbye B.K.R., Aaberge I.S., Lovik M., Haneberg B. Intranasal Immunization with Heat-Inactivated Streptococcus Pneumoniae Protects Mice against Systemic Pneumococcal Infection. Infect. Immun. 1999, 67:4320-4325.
94. Uhari M., Kontiokari T., Niemela M. A Novel Use of Xylitol Sugar in Preventing Acute Otitis Media. Pediatrics 1998, 102:879-884.