116 IMMUNOLOGY 



antibodies when freed from protein, yet all will react with anti- 

 bodies to form precipitates, fix complement, etc. It is always diffi- 

 cult to exclude traces of protein in the polysaccharide preparation 

 a.s important factors in antibody stimulation. 



WhoopinCx Cough Immunization. — While whooping cough im- 

 munization has been practiced for many years, it is only since 

 Sauer (1933) pul)lished his results using vaccine composed of 

 several freshly isolated smooth hemolytic strains of H. pertussis 

 grown on human l)lood, that its value seems to be established by 

 clinical experience. 



Since Bradford and Slavin (1937) have reported the isolation 

 of ten atypical strains of //. pertussis like organisms from cases 

 presenting clinical evidence of wliooping cough, it would suggest 

 the existence of more than one serological type or strain of //. 

 pertussis. These atypical strains have been called '^ parapertussis" 

 since they darken the cough plate medium, show early pleo- 

 morphism and to a slight degree are said to resemble B. hronchi- 

 septicus. Sauer (1939) does not approve of combining them with 

 H. pertussis in a vaccine as he thinks this would "weaken the 

 vaccine. ' ' 



Sauer 's vaccine contains from 15 to 20 billion organisms per 

 cubic centimeter. He recommends giving from 70 to 80 billion 

 bacteria in divided weekly doses over a period of approximately 3 

 or 4 weeks. In his protocols he mentions giving young nonim- 

 mune children simultaneous injections of 10 to 15 billion in each 

 arm for 3 successive weeks. In Sauer 's hands, the results re- 

 ported are very encouraging since he records failure of the vaccine 

 to protect in only 1.3 per cent of 4,200 cases whereas the incidence 

 in a control group was 13 times as great. 



Immunization With Detoxified Toxins. — According to Sim- 

 mons (1941) immunization with tetanus toxoid (detoxified toxin) 

 is now employed by practically all armies. The United States 

 Army attempts to establish an initial immunity to tetanus by ad- 

 ministering three 1 c.c. doses of toxoid given three weeks apart. 

 In order to maintain this immunity, an injection of 1 c.c. of toxoid 

 is given at the end of one year, also at the time of departure for 

 active duty in a theater of war if six months has elapsed since the 

 last dose or whenever the soldier is wounded or exposed to tetanus 

 infection. 



