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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence and prognosis of childhood asthma and wheezing illness (AW) was studied using data obtained at ages 7, 11, and 16 from a national cohort of 8806 children born in 1958. By the age of 16, 24.7% were reported to have experienced at least one episode of AW. In 18.3% AW had started before the age of 8, but only 4.2% continued to have symptoms in later childhood. A further 3.6% began to have AW between the ages of 8 and 11, and 2.8% began between the ages of 12 and 16. Of those with AW at age 7, 28.3% had symptoms at 11 and 16.5% at 16; these proportions were about doubled if AW at 7 had been severe. The associations between natural history and a large number of perinatal, social, environmental, and medical factors were examined. Those which predicted the onset of AW after the age of 7 were: male sex of child; mother aged 15-19 at child's birth; history of pneumonia, whooping cough, throat or ear infections or tonsillectomy; eczema, allergic rhinitis; and periodic vomiting or abdominal pain.
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PMID:The natural history of asthma in childhood. 374 73

The benefits and risks of both the vaccine for pertussis and the disease itself are reviewed in this article. Unlike with the smallpox vaccine, it seems unlikely that a vaccine will be developed to eradicate pertussis completely, since most confer only a short-term immunity. A longitudinal study was undertaken to compare the mortality and morbidity rates of pertussis with the adverse reaction rate of the vaccination program. Risks of the vaccination, such as erythema, drowsiness, and vomiting are well known. However, the issue of neurologic difficulties has surfaced and disagreement exists. Some association does seem to exist between the vaccine and neurologic problems; however, the morbidity and mortality of whooping cough is of a greater health consequence than these rare neurologic reactions.
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PMID:Routine pertussis immunization. 384 7

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

ALTHOUGH WE HAVE FAILED TO PRODUCE EITHER PAROXYSMAL COUGH OR VOMITING IN RHESUS MONKEYS, CYNOMOLGUS MONKEYS AND MARMOSETS, WE HAVE FOUND IN MARMOSETS SEVERAL FEATURES OF PERTUSSIS INFECTION SIMILAR TO THOSE SEEN IN CHILDREN WITH WHOOPING COUGH: catarrh, persistence of colonization of the naso-pharynx with Bordetella pertussis for 4-11 weeks, change of serotype during colonization and inability of type 1 organisms to establish themselves as the predominant serotype.As in children, we have found that intramuscular vaccine of type 1,2,3 was more effective than type 1,2 in preventing persistent infection with the currently prevalent serotypes 1,2,3 and 1,3. A mixed vaccine (1,2,3 and 1,3) seemed to produce agglutinin 3 in the serum more consistently than a pure type 1,2,3 vaccine. The duration of colonization, after naso-pharyngeal challenge, was greatly reduced in animals with agglutinin 3.Local immunity, resulting from previous infection, was even more effective than a good vaccine in preventing subsequent persistent colonization. Marmosets may be useful in studying the possible development of aerosol pertussis vaccine for human use.
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PMID:Experimental pertussis infection in the marmoset: type specificity of active immunity. 436 10

During the 1970s whooping cough returned in Sweden after an absence of more than 10 years and is now seen in all age groups, During a three-year period 174 adults with culture-verified whooping cough were identified in Gothenburg. Most of the patients had typical symptoms with whooping attacks and often vomiting. The disease was long lasting but complications were rare. Physicians should be aware that whooping cough may occur in adults, since adults may be an important source of infection for infants and erythromycin given in the catarrhal phase may modify the clinical course.
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PMID:Whooping cough in adults. 679 29

This paper presents preliminary findings about morbidity observed in a prospective epidemiological study in a village community near Khartoum during 1977-1979. A total of 293 under-five children in 310 households were followed up for two years. Each household was visited twice monthly and information of the disease pattern was collected. Cough, fever and diarrhoea were found to be the commonest cause of morbidity. The average incidence being 296, 292 and 217 episodes respectively per 100 children per year. Vomiting, skin disease and conjunctivitis occurred at a much lower rate. Measles was observed in 14% of children under one year of age. The incidence of whooping cough was low an no outbreak occurred during the two years of observation. The seasonality of various diseases, their severity and age distribution is discussed and compared over the two year period.
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PMID:Morbidity patterns among under-five children in a rural community in Sudan. 724 43

The effect of consanguinity on fertility, reproductive loss, and development disorders were studied in South India. The population investigated included 377 unselected mothers who, along with their children, were followed up longitudinally. Each mother was interviewed regarding consanguinity, details of reproductive performance, and death of any offspring. Marriages were classified as unrelated or between uncle and niece, between first cousins, between first cousins once removed, between second cousins, between second cousins once removed, and between third cousins. Among the 377 marriages, 156 (41.4%) were consanguineous and 221 (58.6%) were nonconsanguineous. Consanguinity was more prevalent among Hindus than among Muslims or Christians. The mean and standard deviation in the age of women were similar in all age categories at the time of the study, but the numbers of pregnancies and live births were higher in consanguineous than in nonconsanguineous unions. The mean number of living children were not significantly different in the 2 groups. Although the intrauterine wastage showed no significant difference between the 2 groups, extrauterine loss of life, especially the death rate of children, was higher in the consanguineous marriages. The causes of death in the nonconsanguineous group were diptheria, tuberculosis meningitis, acute nephritis, convulsive disorder, and brain abscess. The causes of death in the consanguineous group were measles with complications, gastroenteritis, pyogenic meningitis, whooping cough, convulsive disorder, undiagnosed fever, burns, and undiagnosed illness with persistent vomiting. In regard to developmental anomalies, in only 1 instance was the condition unequivocally due to autosomal recessive inheritance. In the majority of the remaining cases the disorders were polygenic or multifactorial in origin. The frequency of developmental anomalies was significantly more frequent among the children of consanguineous parents.
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PMID:Reproductive wastage and developmental disorders in relation to consanguinity in south India. 731 41

Concurrent outbreaks of illnesses that were manifested by cough and that were suspected to be due to Bordetella pertussis and Mycoplasma pneumoniae infection were investigated in a midwestern town in Illinois. Three studies were conducted: questionnaires on the clinical and epidemiological characteristics of illness were administered to patients; serological tests were performed to confirm the presence of each pathogen and to develop case definitions for each illness; and case definitions were applied to responses to a mail-in questionnaire for estimating the magnitude of both outbreaks. In 135 cases of suspected pertussis and 42 cases of suspected mycoplasmal infection, subjects had a cough for > or = 14 days (the pertussis outbreak case definition). Among 20 laboratory-confirmed cases, a cough for > or = 14 days had a specificity of 20% for pertussis, and a cough for > or = 28 days plus whoop and/or vomiting had a specificity of 90% for pertussis. Six hundred-seventeen pertussis cases per 100,000 population and 1,179 cases of M. pneumoniae infection per 100,000 population occurred. In this setting, the standard outbreak case definition for pertussis lacked adequate specificity to distinguish pertussis from mycoplasmal infection. The magnitude of each outbreak was greater than the number of reported cases suggested.
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PMID:Concurrent outbreaks of pertussis and Mycoplasma pneumoniae infection: clinical and epidemiological characteristics of illnesses manifested by cough. 775 86

The polymerase chain reaction (PCR) was recently added to conventional culture and serology for the diagnoses of Bordetella pertussis infection in a large vaccine efficacy trial in Germany. In vaccinees or family members who had illnesses with cough, two nasopharyngeal swabs (calcium alginate for culture and Dacron for PCR) were taken and initial and follow-up clinical data were obtained. PCR was done using oligonucleotide primers PTp1 and PTp2 which amplify a 191-base pair DNA fragment of pertussis toxin operon. From December, 1993, to May, 1994, 555 pairs of swabs were processed; 28 grew B. pertussis and 9 grew B. parapertussis. Twenty-six of the 28 subjects with B. pertussis-positive cultures also had positive PCR results as did one of the 9 B. parapertussis cases and 82 additional samples were positive by PCR. PCR increased the identification of subjects with B. pertussis infections by almost 4-fold. Clinical characteristics were analyzed by laboratory category (Group 1, 28 culture-positive; Group 2, 82 culture-negative, PCR-positive; and Group 3, 436 culture- and PCR-negative). Group 1 subjects were more likely to have a diagnosis of definite or probable pertussis and to have paroxysmal cough, posttussive vomiting, whooping and a cough duration of > or = 4 weeks than Group 2 or 3 subjects. In contrast Group 2 subjects were more likely than Group 1 subjects to have had previous pertussis immunization or prior antibiotics. PCR identified many mild illnesses caused by B. pertussis that were not identified by culture.
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PMID:Polymerase chain reaction identification of Bordetella pertussis infections in vaccinees and family members in a pertussis vaccine efficacy trial in Germany. 776 Nov 86

Whooping cough can be caused by either Bordetella pertussis or Bordetella parapertussis. Although the two species share an almost complete DNA identity, Bordetella parapertussis does not produce pertussis toxin, which is thought to be the main virulence factor of Bordetella pertussis. In order to elucidate the role of pertussis toxin in causing the typical symptoms of whooping cough, clinical information from 33 patients with culture-positive Bordetella parapertussis infection was collected and compared to that from 331 patients with infection caused by Bordetella pertussis. Isolated strains of Bordetella parapertussis lacked pertussis toxin expression, as was demonstrated by negative tests for histamine sensitization. This was further substantiated in vivo by a significantly lower leukocyte count in the parapertussis group as compared to the pertussis group. Frequencies of typical symptoms of whooping cough, such as paroxysmal coughing, whooping and vomiting, were almost identical in the two groups. Nocturnal coughing and contact anamnesis were noted more often in the Bordetella pertussis group. Children in the parapertussis group were significantly more often vaccinated with whole-cell pertussis vaccine than children infected with Bordetella pertussis. The results indicate that pertussis toxin may not play a decisive role in causing the typical symptoms of whooping cough, such as paroxysmal coughing, whooping and vomiting.
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PMID:Role of pertussis toxin in causing symptoms of Bordetella parapertussis infection. 795 64


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