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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The epidemiology of whooping cough in a vaccinated population was studied during an outbreak of paroxysmal cough in an elementary school with 258 pupils in Turku, Finland. Nasopharyngeal specimens for isolation of Bordetella pertussis and/or sera for ELISA detection of antipertussis immunoglobulin M, A and G antibodies were taken from 94% of children who were prospectively followed for two months. Bordetella pertussis was isolated in six patients, and 17 culture-positive cases with Bordetella parapertussis were identified. Patients with Bordetella pertussis or Bordetella parapertussis were found simultaneously in the same classrooms. Comparison of immunoglobulin M responses to Bordetella pertussis and Bordetella parapertussis was used for differential diagnosis of these two infections. Twenty-six cases with pertussis and 27 cases with parapertussis were diagnosed. The results of this prospective study suggest that Bordetella parapertussis is a more common etiologic agent of mild respiratory tract infection among vaccinated school-aged children than is generally recognised. The possibility that Bordetella pertussis was converted to Bordetella parapertussis during this outbreak is discussed.
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PMID:Mixed outbreak of Bordetella pertussis and Bordetella parapertussis infection in Finland. 286 Oct 90

3801 children aged 5-11 months were entered into a blind placebo-controlled trial of pertussis vaccine. 954 were randomised to receive placebo (vaccine solvent), 1419 to receive a two-component vaccine containing formaldehyde detoxified lymphocytosis promoting factor (LPF) and filamentous haemagglutinin, and 1428 to receive an LPF-toxoid vaccine. After 7-13 weeks 3724 infants received a second dose. Immediate side-effects were mild. Small local reactions occurred more often in the vaccinated infants than in those who received placebo, especially after the second dose of the two-component vaccine. During 15 months of follow-up from 30 days after the second dose, culture-confirmed whooping cough (cough and a positive culture of Bordetella pertussis) occurred in 40 placebo, 27 LPF-toxoid vaccine, and 18 two-component vaccine recipients. The point estimate of protective efficacy was 54% (95% confidence intervals 26-72%) for the LPF-toxoid vaccine and 69% (47-82) for the two-component vaccine; protection against culture-confirmed whooping cough of over 30 days duration was 80% (59-91%) and 79% (57-90%), respectively.
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PMID:Placebo-controlled trial of two acellular pertussis vaccines in Sweden--protective efficacy and adverse events. Ad Hoc Group for the Study of Pertussis Vaccines. 289 26

Specific immunoglobulin A (IgA) to Bordetella pertussis filamentous hemagglutinin (FHA) and pertussis toxin (PT) was determined in mucosal secretions by an enzyme-linked immunosorbent assay (ELISA). It took 3 to 4 h to complete the ELISA. The upper limits of normal values for age were determined in nasopharyngeal (NPH) secretions from 23 patients with viral infections and in 10 healthy adults working with pertussis patients or cultures. A significant IgA response to FHA was found in 38 of 54 (70%) and to PT in 28 of 54 (52%) NPH secretions from patients with pertussis confirmed by culture, serology, or both. The rate of positive responses to either antigen (44 of 54 [81%]) was significantly higher than that by culture alone (29 of 54 [54%]; P less than 0.01). The rate of positive responses increased from 65% in patients with symptoms for 1 week or less to 87 to 92% in patients with symptoms for 2 or more weeks. The specific IgA response to PT was found in 100% of NPH samples from 17 unimmunized children less than 3 years of age and in only 30% of adults and immunized children greater than 3 years of age. A response to FHA was found in 65 to 73% of the NPH secretions in all age groups. Saliva samples were found to contain specific IgA to FHA and PT in all age groups, but these were of diagnostic value in 50% (11 of 22) of the adult patients. The specificity of the ELISA was 100% (10 of 10 negatives) in NPH secretions from patients with pertussis-like cough who had negative cultures and serology. The results indicate that determination of specific IgA to PT and FHA in NPH aspirates represents a sensitive and rapid diagnostic method for the detection of pertussis.
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PMID:Specific immunoglobulin A to Bordetella pertussis antigens in mucosal secretion for rapid diagnosis of whooping cough. 289 84

To help develop better diagnostic tests for pertussis, we examined the serologic response to whole-cell proteins of Bordetella pertussis after natural infection or vaccination with diphtheria-tetanus-pertussis vaccine. Serum specimens collected during a pertussis outbreak investigation and from uninfected persons were used in Western blot (immunoblot) analyses to determine the presence of immunoglobulin G (IgG) and IgA antibodies to specific B. pertussis proteins. IgG antibodies to proteins of molecular masses 220 and 210 kilodaltons (kDa) were detected in 14 of 18 serum samples obtained from patients with culture-confirmed pertussis greater than or equal to 40 days after the onset of coughing. IgA antibodies were detected in 15 of the 18 samples. Of 19 serum samples obtained from patients who had not been ill with pertussis, 6 contained IgG antibodies to these proteins and 1 contained IgA antibodies. The two proteins bound antiserum specific for filamentous hemagglutinin and comigrated with purified filamentous hemagglutinin. IgG antibodies to two additional protein bands of molecular masses 84 and 75 kDa were associated with previous vaccination. Antibody to the 84-kDa protein was detected in 15 of 17 vaccinated, never-infected persons, and antibody to the 75-kDa protein was detected in 16 of the 17. None of 11 nonvaccinated, never-infected persons tested had antibodies to either protein. All seven fully vaccinated persons with culture-documented infection had antibodies to both proteins. Antibodies to the 84-kDa protein were detected in 6 of 22 nonvaccinated and infected persons, and antibodies to the 75-kDa protein were detected in 8 of the 22. Use of Western blot analysis in this study allowed us to distinguish antibody responses to infection and immunization.
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PMID:Immunoblot analysis of humoral immune responses following infection with Bordetella pertussis or immunization with diphtheria-tetanus-pertussis vaccine. 290 Aug 46

The Gram-negative bacterium Bordetella pertussis is the agent responsible for whooping-cough, and much interest has focused on the functions, structures and immunological properties of the molecules exposed at its outer surface. We have found by electron microscopy that cells of two strains of B. pertussis are covered with a crystalline surface lattice. This lattice is not an extrinsic layer of high molecular weight glycoproteins, such as occur on many other bacteria, but is a natural crystal of an intrinsic membrane protein of 40,000 Mr. This molecule has been shown to be an anion-selective member of an extensive family of proteins ("porins") that render Gram-negative outer membranes permeable to solutes of up to approximately 650 Mr. Computer image processing reveals a trimeric channel-like structure that closely resembles other porins visualized in artificial arrays after treatment with detergents, but in a novel (p2) crystal form. This correlation provides a "missing link" between earlier structural studies based on artificial arrays of porins (of undefined physiological status), and membrane-permeabilization experiments with solubilized porins (in undefined structural states). For the strains characterized so far, crystallinity of the porin surface lattice shows an intriguing correlation with nonpathogenicity.
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PMID:Naturally crystalline porin in the outer membrane of Bordetella pertussis. 290 51

A survey of 256 private practice paediatric patients with chronic cough revealed that 50% were asthmatic, 28% had upper respiratory infections including bronchiolitis and bronchopneumonia, while 22% had whooping cough despite being fully immunised. Diagnosis and management were discussed. The only cough mixture of real value appears to be a bronchodilator.
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PMID:Chronic cough and cough mixtures in a private paediatric practice. 357 5

The transmission of whooping cough in a general practice community was followed after the identification of the first case for nearly three years. Intensive case-finding was undertaken to detect contacts of known cases of whooping cough and to take pernasal swabs from those with any cough; 102 swabs were taken. In three months 39 cases of whooping cough were clinically diagnosed, 17 (44%) of which were confirmed bacteriologically. All had a prolonged paroxysmal cough, one-third reported a catarrhal phase, 18 (46%) vomited with paroxysms and nine (23%) whooped. No isolations of Bordetella pertussis were obtained from the 84 contacts with non-paroxysmal coughs. There was no evidence that subclinical bordetella infection (showing none of the signs of whooping cough) is a common occurrence.It is probable that many recognizable cases of whooping cough are missed because it can be a milder illness than is often realized and commonly exhibits neither whooping, vomiting nor a catarrhal phase. Paroxysms may be infrequent. The diagnosis of whooping cough should be suspected from a prolonged paroxysmal cough alone.
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PMID:A search for subclinical infection during a small outbreak of whooping cough: implications for clinical diagnosis. 366 3

An acute upper respiratory disease was observed in two broad-breasted white (BBW) turkey primary breeder flocks. Associated clinical signs included sneezing, depression, and a deep dry cough originating from large conducting airways. Morbidity reached approximately 15-20% of the hens in an affected house. None of the turkeys died, and total feed consumption was not affected. A minimal effect upon egg production was noticed. Sera from an acutely affected flock exhibited a marked rise in titer to Bordetella avium compared with preinfection sera samples. In Case 1, B. avium was isolated in pure culture from affected birds. In Case 2, B. avium was diagnosed by serological results and clinical signs; bacteriological examination was not attempted. The findings presented here are consistent with an acute clinical outbreak of B. avium-induced turkey rhinotracheitis (turkey coryza) in BBW turkey breeder hens.
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PMID:Clinical outbreak of Bordetella avium infection in two turkey breeder flocks. 372 68

Four hundred and sixty admissions for whooping cough to three hospitals between 1974-9 were reviewed. Many children had a long illness. More than half of them had severe or moderately severe coughing spasms and a quarter had pronounced feeding difficulties. The incidence of clinical pneumonia and convulsions was low and there were no deaths. The disease continues to be much more severe in infancy. There was some evidence that the disease declined in severity over the period studied. A number of factors including increased use of erythromycin may have contributed to this change.
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PMID:The severity of whooping cough in hospitalised children--is it declining? 398 82

A review was conducted of all patients seen at Upstate Medical Center, Syracuse, NY, from June 1975, to June 1983, whose nasopharyngeal specimens were positive by specific Bordetella pertussis-fluorescent antibody stain. Sixty-one patients were identified; 46 were hospitalized and 15 were outpatients. The age and immunization status of the two groups were compared. Admission diagnosis, indices of illness severity, and clinical course were assessed for the hospitalized patients. Review of the house officers' initial differential diagnoses disclosed that pertussis was considered in the diagnosis in only 45% of the cases. Bronchiolitis was the next most commonly listed diagnosis. Frequent vomiting and severe coughing were the most helpful clinical findings leading to an accurate diagnosis. Abnormal chest roentgenograms and elevated white blood cell counts were present in a minority of our patients, whether the initial diagnosis was correct or not. Younger and less-immunized patients had more severe and prolonged clinical courses. This study demonstrates that the diagnosis of pertussis is often missed or delayed because clinical findings are similar to those of other respiratory infections in infancy. Suspicion of the diagnosis in children with nonspecific respiratory illness is required for early diagnosis, treatment, and prevention of spread to susceptible individuals.
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PMID:Inaccurate diagnosis in infants with pertussis. An eight-year experience. 401 97


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