Effectiveness of live or killed plague vaccines in man.

While the safety of the available live plague vaccine EV 76 (Paris) continues to be the subject of further study, the USP formol-killed, virulent Pasteurella pestis (Yersinia pestis) suspension capable of protecting 60% of non-human primates, particularly Hanuman langurs (Presbytis entellus), warrants further clinical tests and field trials. Inoculated in a dosage of 2x10(9) killed plague bacilli (1 ml), followed by a booster of 400 million organisms (0.2 ml) in 1-3 months, this vaccine stimulates the appearance of passive mouse-protection antibodies (below an index of 10) and passive haemagglutinins in 60%-65% of human subjects. Recent experiences in Viet-Nam demonstrate that personnel vaccinated with the USP vaccine, although frequently exposed, enjoy almost complete freedom from the disease. One of the 4 known and confirmed cases of bubonic plague in North Americans occurred in an unvaccinated individual. Among individuals inoculated with the USP vaccine, 2 confirmed cases of pneumonic plague and 1 case of asymptomatic pharyngeal plague have been recorded. The incidence of plague in the Republic of Viet-Nam during the past 3 years is estimated at 13 263 cases in a population in part vaccinated with a live plague which exhibited inadequate immunogenic efficacy in experimental tests.