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Query: UMLS:C0009450 (infectious diseases)
 83,438 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effectiveness of oral erythromycin and amoxycillin in eradicating Bordetella pertussis from the nasopharynx was compared. Erythromycin in a dosage of 40--50 mg/kg/day was significantly more effective than amoxycillin in a dosage of 25--30 mg/kg/day. The organism did not disappear in three cases receiving a lower dosage of erythromycin. As antibiotic treatment does not affect the clinical course of fully-developed whooping cough, erythromycin is indicated primarily when particularly susceptible individuals are threatened by exposure. In such cases erythromycin should be given as soon as whooping cough is suspected.
Infection 1978
PMID:Effect of erythromycin and amoxycillin on Bordetella pertussis in the nasopharynx. 21 55

The nature of the pathogenesis and of the prolonged immunity of whooping cough has not been clearly defined. The literature of Bordetella pertussis indicated that only the antigen that induces histamine sensitization, lymphocytosis, and other biological reactions in mice is the cause of the harmful effects and prolonged immunity of whooping cough. This antigen has the general characteristics of bacterial protein exotoxins that cause the harmful effects of infectious diseases such as diphtheria and tetanus. It is proposed that this antigen, which is histamine-sensitizing, lymphocyte-leukocyte-promoting, and islets-activating (HSF-LPF-IAP), be designated pertussis toxin. Agglutinogen, hemagglutinin, and heat-labile (at 56 C) and heat-stable (at 100 C) toxins are no doubt interrelated with the immunologic and/or toxic reactions of whooping cough. It appears that the first defense against the disease is the antibody that prevents adhesion of the bacteria to the cilia of the respiratory epithelium and that the second defense is the antitoxin against pertussis toxin (HSF-LPF-IAP).
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PMID:Pertussis toxin: the cause of the harmful effects and prolonged immunity of whooping cough. A hypothesis. 23 66

In the case of infectious diseases with decreasing morbidity and mortality, the beneficial effects of vaccination should be reevaluated regularly with the help of special formulae. This procedure can be simplified by calculation of the epidemiologic trend and the so-called borderline risk Rlim, meaning the borderline number of complications when risks of the disease and risks of vaccination are equal. This method allows to estimate when the vaccination against a certain disease will lose its beneficial effect. A follow-up of the mortality of whooping cough in Austria leads to the conclusion that vaccination against whooping cough has lost its justification. In case of BCG vaccination the borderline mortality is not yet reached in Austria, although tuberculosis mortality and the number of prevented cases have decreased already to a very low level.
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PMID:Changes of risk and benefit in immunization against pertussis and tuberculosis. 52 Jun 88

The role of Bordetella bronchiseptica as a primary pathogen in nautrally occurring respiratory disease of dogs has been in question since its original isolation in 1911. A study to determine the incidence of B. bronchiseptica in a closed breeding kennel has revealed that the frequency of such isolations is closely associated with mild respiratory disease characterized by a moist, sometimes productive, cough. Infection with B. bronchiseptica usually occurred shortly after weaning and produced illness which lasted for one to two weeks. The organisms, however, continued to be shed for two to three months, and important factor in maintaining the infection in this kennel. Adult dogs sampled at frequent intervals did not harbor B. bronchiseptica in spite of their almost constant exposure to heavily infected pups; immunity to reinfection, therefore, appeared to develop. The involvement of several known canine respiratory viral agents was excluded by virus isolation and serological techniques. It therefore was concluded that B. bronchiseptica was the primary cause of respiratory disease in this large breeding kennel.
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PMID:Naturally occurring respiratory disease in a kennel caused by Bordetella bronchiseptica. 87 Feb 89

It remains clear that pertussis is a dangerous infectious disease that is well-controlled in industrialized countries by widespread immunization. In the developing world, it remains a source of high morbidity and mortality because of previously inadequate immunization programs. However, because of the intense efforts of the World Health Organization's Expanded Programme on Immunization, the effects of pertussis have already been ameliorated and show promise of being within a decade of approximating the situation in the developed world. Pertussis can be controlled only by immunization; other measures such as antimicrobial therapy offer negligible benefit. A problem that has been addressed in recent years is the excessive reactivity of whole-cell pertussis vaccine, which undoubtedly includes components of the organism that are irrelevant to the induction of immunity and are excessively reactive. Although epidemiologic studies appear to have largely, if not completely, absolved pertussis vaccine of responsibility for inducing death or permanent neurologic disability, a less reactive vaccine is highly desirable, not only to promote acceptance of a full course of immunization for the world's children but also for simple humanitarian reasons. Additionally, it has become evident that, because of waning immunity, pertussis increasingly occurs in adults. A less reactive vaccine would offer opportunity for reinforcement of immunity beyond childhood. The development of better, though as yet incomplete, understanding of the biology of Bordetella pertussis and its relation to humanity offers the opportunity for the production of less reactive vaccines free of irrelevant components. Acellular pertussis vaccines have been used exclusively in Japan for more than 10 years, and one such preparation, combined with diphtheria and tetanus toxoids, was licensed in the United States in late 1991 for use as the fourth and fifth doses of DTP, given at 15 months and prior to school entry. Field trials of this and other acellular DTP preparations are currently under way to determine their clinical efficacy in infants. It is probable that, within a very few years, whole-cell pertussis vaccine will be replaced by these newer preparations and that, in addition, the acellular product will be combined with other antigens, such as Haemophilus influenzae type b vaccine.
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PMID:Epidemiology of pertussis and reactions to pertussis vaccine. 128 14

Vaccination is the most effective way to prevent infectious diseases. Recombinant DNA technologies have provided powerful new tools to develop vaccines that were previously impossible or difficult to make, and to improve the vaccines that were already available but had been developed using old technology. In the case of whooping cough, an effective vaccine (composed of killed bacterial cells) is available, but its use is controversial because of the many side effects that have been associated with it. An improved vaccine against this disease should contain pertussis toxin, a molecule that needs to be detoxified in order to be included in the vaccine. Classical methods of detoxification, such as formaldehyde treatment have been used to inactivate this toxin. We have used recombinant DNA technologies to clone the pertussis toxin gene, express it in bacteria, map the B and T cell epitopes of the molecule, and to identify the amino acids that are important for enzymatic activity and toxicity. Finally, we have used this information to mutate the gene in the chromosome of Bordetella pertussis in order to obtain a strain that produces a molecule that is already non-toxic. This genetically inactivated pertussis toxin was tested extensively in animal models and clinical trials and was found to induce an immune response that is superior in quality and quantity to that induced by the vaccines produced by conventional technologies.
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PMID:Recombinant acellular pertussis vaccine--from the laboratory to the clinic: improving the quality of the immune response. 138 2

Development of the Japanese acellular pertussis vaccines (APVs) of the 1980s involved six procedural or conceptual features that were discontinuous with the then-accepted views of how pertussis vaccines should be made and tested. These discontinuities were: modification of the standard intracerebral mouse test for protective potency; use of culture supernates, rather than cells, of Bordetella pertussis as the feedstock for antigen purification; use of haemagglutination as a measure of protective antigen(s); identification of pertussis toxin (PT) as the main protective antigen; complete inactivation of the biological activities of PT by formalin; and the use of a single strain of B. pertussis. Several of these discontinuities had long precedence in the pertussis literature, but the original observations had not been incorporated into the mainstream of pertussis vaccinology and were therefore 'premature'. The APVs, purified from culture-supernates, emerged after a long period of unsuccessful research on the split-cell pertussis vaccines, i.e. those derived from the bacterial cells themselves. There is a brief discussion of why APVs have taken so long to obtain acceptance outside Japan, and of how the listed discontinuities may be explicable in terms of antigen processing by the immune system. General lessions, applicable to vaccines for other infectious diseases, may be learned from this account of how APVs have evolved from whole-cell pertussis vaccines.
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PMID:Multiple discontinuity as a remarkable feature of the development of acellular pertussis vaccines. 152 73

University students with persistent cough of greater than or equal to 6 days' duration were evaluated for evidence of infection with Bordetella pertussis. Of 130 students studied during a 30-month period, 34 (26%) were found to have evidence of recent infections with B. pertussis. Infection was identified by direct fluorescent antibody assay of a nasopharyngeal specimen in one student and serologically in 33 additional subjects. B. pertussis was not recovered on culture of nasopharyngeal specimens from any subjects. Students with B. pertussis infection were identified in seven of the eight 3-month periods in which students were enrolled during the 30-month investigation, suggesting an endemic rather than epidemic pattern of infection in this university population. Illnesses of students with pertussis were similar to the illnesses of students without pertussis. The findings in this study suggest that adult populations in which endemic illness occurs at a relatively constant rate may be the reservoirs for pertussis outbreaks in susceptible children. Immunization programs in the future will need to employ booster doses for adults if complete control of B. pertussis infection is our goal.
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PMID:A search for Bordetella pertussis infection in university students. 155 32

The therapeutic perspectives of flomoxef, SCE 2787, cefpirome, cefepime, latamoxef, cefotaxime and of piperacillin plus tazobactam were comparatively evaluated by their in vitro activity against 1119 clinical isolates of 83 bacterial species. Escherichia coli, Klebsiella spp. Enterobacter sakazakii, Proteus spp. and Shigella spp. were about equally susceptible to the cephalosporins (MIC90: 0.06 to 0.5 mg/l), while the MIC90 for piperacillin plus tazobactam was between 2 and 16 mg/l. Enterobacter cloacae, Enterobacter aerogenes and Serratia spp. were most susceptible to SCE 2787, cefpirome and cefepime (MIC90: 0.06 to 2 mg/l) followed by latamoxef, cefotaxime, flomoxef and piperacillin plus tazobactam. For Citrobacter spp., Providencia spp. and Yersinia enterocolitica MIC90 were between 0.06 and 0.5 mg/l. Flomoxef was between 2 to 4 log2 less active against these species but more active than piperacillin plus tazobactam (MIC90: 2 and 8 mg/l). Morganella morganii and Hafnia alvei were most susceptible to cefepime, cefpirome and latamoxef (MIC90: 0.13 to 0.5 mg/l) while cefotaxime (MIC90: 8 mg/l) and piperacillin plus tazobactam (MIC90: 8 and greater than 64 mg/l) were the least active compounds. SCE 2787, cefepime and cefpirome were the most potent beta-lactams against the majority of the 13 species of non-fermentative bacilli (NFB) investigated (MIC90: 0.5 to 16 mg/l). The oxacephems were the least active compounds against NFB. Cefepime was the most active of the compounds included against Pseudomonas aeruginosa (MIC90: 16 mg/l). Haemophilus spp., Neisseria gonorrhoeae and Bordetella pertussis were most susceptible to cefotaxime (MIC90: 0.03 to 0.06 mg/l). Latamoxef had the lowest activity of all compounds against gram-positive cocci. Flomoxef was the most active compound against penicillinase producing Staphylococcus aureus and about equally active as the other betalactams against methicillin susceptible staphylococci of other staphylococcal species.(ABSTRACT TRUNCATED AT 250 WORDS)
Infection 1991
PMID:In vitro activity and stability against novel beta-lactamases of investigational beta-lactams (cefepime, cefpirome, flomoxef, SCE2787 and piperacillin plus tazobactam) in comparison with established compounds (cefotaxime, latamoxef and piperacillin). 166 18

Bordetella pertussis and the disease whooping cough have mysterious unique features among bacterial infectious diseases. Numerous studies gradually provided information that permitted the development of a pertussis vaccine and the assessment of its potency relative to human efficacy. The advances in the understanding of B. pertussis, its pathogenicity and immunity that led to the development of a pertussis vaccine are presented.
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PMID:History of the development of pertussis vaccine. 177 6


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