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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A recent analysis demonstrated a change in incidence approaching 100% for diseases against which we routinely immunize in the United States. At present, measles, mumps, rubella, invasive Haemophilus disease, poliomyelitis, diphtheria and tetanus are well-controlled but not eliminated. Diseases that now pose special problems include pertussis, hepatitis A and B and varicella. The incidence of pertussis surged in 1994, possibly in part because of waning immunity in the immunized population. Acellular pertussis vaccines are available for booster doses in children but are not now recommended for adults. Licensure of acellular pertussis vaccines for primary immunization of infants is eagerly awaited. Recombinant hepatitis B vaccine has been licensed for more than 10 years but there has been little change in disease incidence in the United States. Routine immunization of infants is now recommended but concerns exist about cost and persistence of immunity into adolescence. Inactivated hepatitis A vaccines appear to be highly effective in preventing clinical hepatitis and controlling epidemics. Potential target populations include military personnel, day-care attendees and travelers. Hepatitis A vaccine may be recommended for all children after approval by the United States Food and Drug Administration and if a combination vaccine becomes available. A live, attenuated varicella vaccine developed in 1974 and unlicensed in the United States is safe and highly effective in preventing varicella in healthy and immunocompromised populations. It also appears to reduce subsequent development of herpes zoster. Vaccines against pneumococci (conjugate vaccine), respiratory syncytial virus, rotavirus, tuberculosis and human immunodeficiency virus are needed. Research and technology to develop these vaccines must be developed, and efficient delivery mechanisms must be created and implemented.
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PMID:Present and future challenges of immunizations on the health of our patients. 763 35

Measles virus (MV) mRNA transcription and replication are thought to be controlled by cis-acting sequence elements contained within the terminal MV genomic noncoding nucleotides. To validate these promoter and regulatory signal assignments, cDNAs were constructed allowing synthesis of RNAs corresponding to a MV genome in which all coding and intercistronic regions were replaced by the chloramphenicol acetyl transferase (CAT) coding sequence. Transcript production by T7 polymerase starting and ending precisely with the MV genome terminal residues was achieved by fusing the T7 polymerase promoter and the hepatitis delta virus genome ribozyme followed by tandem T7 polymerase termination sequences to the MV genomic 5' and 3' ends, respectively. Transfection of these negative polarity transcripts, mimicking natural defective interfering RNAs of the internal deletion type, into MV-infected 293 cells gave rise to CAT activity which could be serially transferred and massively amplified together with progeny helper virus in fresh cells. Transfer was blocked only by antibodies able to neutralize MV infectivity, indicating that the chimeric RNA not only was encapsidated, transcribed, and replicated, but also packaged into virions. Sequence analyses confirmed that both the expected chimeric antigenome and mRNA products were transcribed and replicated with fidelity during serial passage. Minor changes introduced in the transcription promoter markedly compromised function. This system now can be exploited to examine MV genomic cis-acting regulatory elements and extended to the development of full-length MV cDNAs.
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PMID:Rescue of synthetic measles virus minireplicons: measles genomic termini direct efficient expression and propagation of a reporter gene. 774 54

Current US military recruit vaccination policy presumes that recruits have had a complete childhood immunization series. This assumption may not be appropriate for recruits from Micronesia, who may have had limited access to modern health care, including immunization programs. During 1988 and 1990, a cross-sectional serosurvey was conducted among 66 US military recruits, 56 from the Federated States of Micronesia and 10 from the Republic of the Marshall Islands, collectively referred to as Micronesia. Antibody seronegativity levels for 12 vaccine-preventable (or potentially so) diseases were: measles (52%), mumps (14%), rubella (21%), varicella (38%), diphtheria (39%) tetanus (0%), polio type 1 (4%), polio type 2 (0%), polio type 3 (14%), hepatitis A (9%), hepatitis B (17%), and hepatitis C (98%). Compared with Army recruits in general, Micronesian recruits were significantly more likely to be seronegative for measles and varicella and seropositive for hepatitis types A and B. Personal histories of disease were felt to be inadequate in predicting antibody status.
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PMID:Vaccine-preventable disease susceptibility in a young adult Micronesian population. 777 28

Between February and April 1991, six adults were admitted to the New York Hospital because of measles pneumonitis. The diagnosis was confirmed by serology and/or viral culture. Uncommon clinical features among patients with this diagnosis included thrombocytopenia, hepatitis, myositis, and hypocalcemia. All patients were markedly hypoxic (initial alveolar--arterial oxygen gradients while the patients were breathing room air, 40-61 mm Hg); four required support with mechanical ventilation. All patients received therapy with intravenous ribavirin (20-35 mg/[kg.d]) for 1 week. The respiratory status of five patients (one of whom was positive for human immunodeficiency virus [HIV]) who were treated early (days 2-5 of illness) promptly improved; all abnormal parameters eventually returned to baseline. Treatment of the sixth patient, who was presumed to be HIV-infected, was initiated on hospital day 22; this patient died of progressive oxygenation failure on day 38. We conclude that life-threatening measles pneumonitis in adults may be more common that previously appreciated, regardless of the patient's immune status. Therapy with intravenous ribavirin was well tolerated by our patients and was associated with reversal of respiratory compromise.
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PMID:Severe measles pneumonitis in adults: evaluation of clinical characteristics and therapy with intravenous ribavirin. 864 18

Fifteen cases of Gullian-Barre syndrome (GBS) following specific infection are reported. The infections include varicella, 7 infective hepatitis, 4 measles, 2 and mumps, 2. There are no specific clinical or electrophysiological features which serve to distinguish GBS seen in association of these infections from those seen in other clinical settings. There is epidemiological evidence to suggest the association between GBS and hepatitis A, and non A non B hepatitis is more of a chance occurrence. Detailed epidemiological studies are needed to established a clear relationship between other specific viral infections and GBS.
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PMID:Guillain-Barre syndrome following specific viral infections--an appraisal. 783 43

The clinical and laboratory characteristics of 201 cases of measles and its associations with complications were analyzed during an outbreak of this disease in Mexico City. The complications were hepatitis (45%), bacterial pneumonia (17%), oral candidiasis (13%), upper gastrointestinal tract hemorrhage (13%), epistaxis (8%), encephalitis (4%), subcutaneous emphysema (2%), and hypocalcemic tetany (1%). In a subgroup of 20 consecutive patients hypocalcemia was found in 14 cases (70%), associated with high levels of calcitonin in three cases. An increased lactate dehydrogenase (LDH) was observed in 83% of the patients, showing a significant association with the occurrence of complications (p = 0.04) especially in the patients with values of LDH above 750 IU/mL (odds ratio of 6.4). Two patients died (1% mortality). The young patients with measles can develop serious complications, and an increased level of LDH may be a prognostic indicative of these complications.
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PMID:[Measles in the young adult. Clinical features of 201 cases]. 805 46

In Ethiopia during 1960-1962, more than 100,000 people in the Omo and Didessa river valleys acquired yellow fever and 30,000 died. There have been no yellow fever cases since 1966. Some other aboviruses that arise sporadically are Jos virus, dengue fever, Crimean-Congo hemorrhagic fever, and group A arboviruses. By age 15, all people in surveyed regions were positive for hepatitis A virus. Prevalence of hepatitis B virus increases with age ( 75% of adults in urban areas and many rural areas). The frequency of carriers of hepatitis Bs antigen is greatest in areas where people practice ceremonial tattooing. During 1988-1989, 93% of jaundiced patients in a military camp in Ethiopia had antibodies to hepatitis E virus as a result of a waterborne outbreak. Other hepatitis viruses in Ethiopia are delta and C viruses. All 3 serotypes of poliovirus exist, especially type III. 93% of 1-year-olds have already acquired immunity to it. Peak frequency of onset among paralytic cases is 2 cases. Measles epidemics are common in children. An outbreak in southwestern Ethiopia had a mortality rate of 20%. Immunity to rubella is around 85% for 14-year-olds. It increases with age. Rotavirus causes diarrhea in many children, especially among 7-12 month old infants and in June and November. Most children have been exposed to Epstein-Barr virus, which is responsible for mononucleosis and maybe for Burkitt's lymphoma. Officials do not conduct ongoing surveillance of influenza in Ethiopia. Influenza epidemics have occurred in 1957 and 1963. Rabies is endemic, with dogs being responsible for most cases. In November 1992, there were 3978 AIDS cases. 75% are less than 40 years old, with males more likely to be HIV infected than females. The Falashas of northwest Ethiopia have the world's second highest endemic rate of human T cell leukemia virus-1. Officials do not know the extent of viral diseases because there is no well organized national laboratory. One is needed to conduct surveillance and to evaluate the effectiveness of vaccination activities.
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PMID:Viral diseases in Ethiopia: a review. 818 57

We evaluated clinical presentations and complications retrospectively in 48 pediatric patients hospitalized for suspected measles during a measles epidemic in Chicago. Fifty-one percent were < 15 months of age and 75% were < 4 years of age. Measles, diagnosed in 44 patients, was culture-proved in 18. Presentations were not always classic. Respiratory complications, otitis media, hepatitis, preterm labor, keratitis and central nervous system involvement were reported. The presence of stomatitis and hypotension in some patients raised the differential diagnoses of Kawasaki disease and toxic shock syndrome. Six patients with stomatitis, admitted with a measles-like illness, fulfilled the Centers for Disease Control and Prevention criteria for Kawasaki disease. Three were diagnosed with Kawasaki disease and 3 with measles. In addition to serology and echocardiographic changes, the platelet count and the erythrocyte sedimentation rate may be useful in distinguishing between measles and Kawasaki disease. Two of 10 patients with hypotension met the Centers for Disease Control and Prevention criteria for toxic shock syndrome. The diagnosis of measles, solely on clinical grounds, may therefore not be as straightforward as is generally accepted.
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PMID:Clinical presentations and complications of suspected measles in hospitalized children. 828 20

Polio, measles, rabies, tetanus, tuberculosis, and hepatitis cause much illness and death in Pakistan. Widespread and timely immunizations could, however, avert much of the associated morbidity and mortality. Pakistan therefore launched an Expanded Program on Immunization (EPI) in 1978 in an attempt to immunize the country's 15 million children under age 5 years. Special attention was given to children under 1 year of age and to married women who might bear children. Program results have been quite impressive. This paper focuses upon important milestones in the acquisition of technology and the initiation of the manufacture of crucial vaccines for the EPI. Sections describe the laboratories for producing vaccines against oral polio, measles, human diploid cell rabies, tetanus toxoid, and hepatitis B, as well as general issues and the future. In developing local capabilities to deliver the immunizations and promote their value, the immunization delivery system has grown to encompass an extensive national network, including refrigeration and deep freezer facilities, an efficient transportation system, the production of injection components, a fully trained immunization staff, and an accurate record-keeping system. Pakistan has also pursued a variety of approaches to health education and social marketing in order to motivate mothers to bring their children to immunization centers and to follow through with the full course of vaccines, including daily radio, television, and newspaper messages.
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PMID:Transferring manufacturing technology. Producing essential vaccines in Pakistan. 834 Feb 4

In this report the literature on all cases of documented measles with hepatobiliary disease was reviewed to describe the characteristics of measles associated hepatitis. We found 27 patients described. Their age ranged from 9 to 59 years. Male to female ratio excluding military facilities was 1:1. The clinical and laboratory presentation appeared to follow one of two patterns. The first was suggestive of hepatocellular dysfunction characterized by aminotransferase elevation. It was encountered in 24/27 cases, seven of them with atypical measles. This form of liver disease tended to be asymptomatic. It appeared early and resolved in a few days. The second pattern was characterized by cholestasis and jaundice. It was described in three cases. This type of hepatitis became apparent when measles began to recede and persisted for two weeks or longer. The variation in time of appearance of the two types of liver disease may imply distinct pathogenetic mechanisms.
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PMID:Measles associated hepatobiliary disease: an overview. 849 19


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