Speaker: Paul Reading, PhD, Clinical Neurologist, Department of Neurology, Newcastle General Hospital, Newcastle-Upon-Tyne, United Kingdom.

Results from an open-exploratory study point out that the cholinesterase inhibitor rivastigmine (Exelon, Novartis) has a positive effect on the neuropsychiatric complications of Parkinson’s disease (PD), particularly hallucinations and sleep disturbances, and significantly enhances cognitive performance without worsening motor control.

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Speaker: Jose Ferreira, MD, Pediatric Epilepsy Neurologist, Pediatric Epilepsy and Neurology Specialists, Tampa, Florida.

Topiramate (Topamax medication, Ortho-McNeil), a broad-spectrum antiepileptic, appears to be efficacious and generally well­tolerated in pediatric and adolescent migraine prophylaxis, substantially reducing migraine headache frequency and severity and improving the disability associated with migraine.

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Combination Therapy for Relapsing-Remitting MS Speaker: Silva Markovic-Plese, MD, Clinical Fellow, Neuroimmunology Branch, the National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, Maryland.

Interferon beta-1b (INF-beta-1b) (Betaseron, Berlex) and azathioprine (Imuran drug, Prometheus) combination therapy appears to offer an effective treatment approach in patients with relapsing-remitting multiple sclerosis (RRMS) who are refractory to treatment with INF beta-lb alone.

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Currently, the only varicella vaccine product available in the U.S. is the live virus sold as Varivax® (Merck). The vaccine is administered as a single injection to children between 12 months and 13 years of age and as a two- injection series to at-risk adults (see Figure 1).

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The two different formulations of pneumococcal vaccines currently available in the U.S. are pneumococcal conjugate vaccine 7-valent, also called PCV7 and sold as Prevnar® (Wyeth-Lederle), and pneumococcal 23-valent vaccine (Pneumovax 23® [Merck] and Pnu-Immune-23® [Wyeth-Lederle]). The pneumococcal conjugate vaccine 7-valent is a conjugated vaccine, rendering it more immunogenic in infants and children younger than 2 years of age and in patients with immunodeficiencies. The 23-valent vaccine is indicated for use in adults aged 65 or older, immunocompromised adults, and in children older than 2 years of age with chronic illnesses associated with increased risk of pneumococcal disease. PCV7 is administered as a four- injection series, typically starting in the second month of life (see Figure 1). The 23-valent vaccine is administered as a single injection, with booster injections considered every five years. In October 2000, the ACIP recommended that all infants aged 2 to 24 months receive PCV7 as part of their routine vaccination schedule.

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In this section, we discuss specific agents that are currently affected by problems of supply.

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Introduction

Vaccines are a cost-effective means of preventing many infectious diseases. Successful vaccination campaigns are credited with eradicating life-threatening diseases such as polio and smallpox from the Western Hemisphere. Unfortunately, recent vaccine shortages may threaten the success of current immunization programs.

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