SummaryIn 1978 a severe epidemic of acute CNS diseases occurred in Hungary. Enterovirus type 71 (E71) proved to be the main aetiologieM agent. This could, however, be established only by special investigations, since the usual laboratory tests proved inefficient for diagnosis of E71 infections.Attempts to isolate virus in tissue cultures were made on 1952 samples from 686 patients. E 71 could only be isolated in cultures of a Vero cell line and even then only after 3 to 6 blind passages. Successful isolations were made from 47 stool samples, 5 throat swabs and 6 CNS samples originating from 44 patients. This represented only 13.6 per cent of the total number of E71 eases diagnosed in the course of studies, thus indicating the poor sensitivity of these tests. Suckling mice were unsuitable for the isolation of E71, although E71 tissue culture isolates proved pathogenic to these animals. Isolates could be identified by neutralization technique only after disaggregation of virions by ether treatment.Blood samples from t050 patients were tested :[or E71 antibodies by a radial plaque neutralization technique and those from 593 patients proved positive. A significant change in antibody level could only be detected in 52 out of 286 patients whose paired sera were available. The limited usefulness of this technique for the detection of current E71 infections was, however, indicated by the fact that 66 per cent of patients positive in virus isolation experiments already had antibodies in the early phase of their illness which remained at a constant level thereafter.Investigation of 684 blood samples from 511 patients for E 71-specific IgM antibodies showed this test to be the most reliable for the detection of current E7115 Arch. ViroL 71/3

Hungary has had a successful measles vaccination programme, achieving over 93% coverage in targeted groups. However, from September 1988 until December 1989, 17,938 measles cases were reported among the civilian population (attack rate [AR] = 169 per 100,000 population) with the majority of cases occurring in vaccinated people. National surveillance data were analysed to determine reasons for the outbreak and risk factors for vaccine failure. People born during 1971 and 1972 had been targeted for vaccination during campaigns in April and September of 1973 and had the highest AR (1332 and 1632 per 100,000, respectively). Epidemiological studies of vaccine efficacy conducted among secondary school students corroborated these findings. Among 754 secondary school students, those vaccinated during the April 1973 campaign were at highest risk compared with those vaccinated at routine health care after 1974 (relative risk = 10.9, 95% confidence interval [Cl]: 2.5-47.9). Among 341 primary school students, one-dose recipients were at higher risk compared with two-dose recipients controlling for age at and time elapsed since vaccination (P = 0.04).

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In Hungary three campaigns of oral immunization with Sabin's attenuated poliovirus strains were carried out in the period November, 1959, to June, 1960. (1) During November and December, 1959, the children aged 3 months to 14 years were twice fed with the trivalent vaccine in a single county (Gyor-Sopron county). (2) During December, 1959, to February, 1960, the children of the same ages were immunized in the whole country separately with types 1, 3, and 2 at monthly intervals. (3) The children who had escaped vaccination and the infants born between September 1, 1959, and February 29, 1960, were twice fed with the trivalent vaccine during May and June, 1960. The results of the serological and virological examinations carried out in several laboratories of specimens collected during the above campaigns were favourable (Weissfeiler, 1961). In this paper we present further data on the effectiveness of the mass oral vaccinations. The enterovirus excretion of the youngest healthy children was tested during the summer and early autumn of 1960-that is, during the season when the excretion rate of enteroviruses is usually the highest. We wished to see whether polioviruses were circulating in the population. In addition, the immune status of young children was examined six to eight months after vaccination. Materials and Methods Speciments.-Faecal samples were collected during August 24-31 and during October 26-31, 1960. The serum samples were collected during August 24-31. The samplings were organized by the local Public Health and Epidemiological Stations as ordered by the Ministry of Health according to a plan proposed by us. The specimens were sent in by ordinary mail. In August 300 healthy children aged 11 months to 4 years were tested. The children live in 10 counties (Baranya,

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