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Query: UMLS:C0043167 (pertussis)
 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Severe hypothermia and an ascending impairment of shivering are previously undescribed clinical signs in hyperacute experimental allergic encephalomyelitis (EAE) in the Lewis rat. These occurred in hyperacute EAE induced by inoculation with guinea pig spinal cord homogenate and heat-killed Bordetella pertussis. Hypothermia was first detected on day 6-7 post-inoculation, within 12-24 h of the onset of neurological signs, and became more severe as the disease progressed. Rectal temperatures less than or equal to 30 degrees C were common at ambient temperatures of 19-22 degrees C. Shivering was assessed by palpation and by cold tremor electromyography. Shivering was absent in the tail by day 6-7 post-inoculation. The impairment then progressed to affect the hindlimbs, thorax and occasionally the forelimbs. Shivering was absent in hindlimbs with only mild or moderate weakness. Histological studies revealed perivascular inflammation with polymorphonuclear and mononuclear cells, oedema, fibrin deposition, haemorrhage, primary demyelination and axonal degeneration in the spinal cord, dorsal root ganglia and spinal roots. The brainstem was also involved but the cerebral hemispheres, including the hypothalamus, were spared. The close relationship between the severity of hypothermia and the extent of shivering impairment indicates that reduced shivering is an important cause of hypothermia in hyperacute EAE. It is concluded that this impairment of shivering is due not to hypothalamic damage but to lesions elsewhere in the central and peripheral nervous systems.
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PMID:Hypothermia due to an ascending impairment of shivering in hyperacute experimental allergic encephalomyelitis in the Lewis rat. 261 69

The toxicity of pertussis vaccines can probably be reduced and the immunogenicity increased by recent improvements in purity and selectivity. Inactivated poliovirus vaccines show promise of inducing immunity with 2 doses administered in infancy. The Expanded Program on Immunization (EPI) uses the diphtheria-tetanus-pertussis (DTP) vaccine, poliovirus vaccine, and measles virus vaccine. The incidence of serious toxicity (particularly screaming fits, attacks of pallor, or unusual behavior) and encephalitis is very low. A superior partially purified pertussis vaccine was developed by Sato that contained both the pertussis toxin and filamentous hemagglutinin. With the toxicity of purified-component vaccines reduced, the relevant pertussis antigens can be increased to the point where 2 doses will suffice. The present live oral polioviruses vaccine (OPV) and inactivated poliovirus vaccine (IPV) are prone to thermal instability and a cold chain may be a necessary component of immunization with live poliovirus vaccine in the near future. It was shown that 4th and 5th doses of OPV given at 4-week intervals after the 3rd dose elevated the proportion of infants who developed serum antibody to types 1, 2, and 3 antigen from 69%, 90%, and 76%, respectively, up to 83%, 96%, and 82%. DTP vaccine improved to 2 doses is adequate for initial coverage then full immunization for DPT, poliomyelitis, and measles at 3 and 9 months of age. Vero cells of a heteroploid karyotype and of an indefinite lifespan were used to develop a poliovirus vaccine, as they do not produce tumors in rodents. WHO and the US Food and Drug Administration accepted them as safe as cell substrates for certain purified viral vaccines. Measles virus vaccines also have thermal instability and immunogenicity. Thermal instability was greatly reduced with the introduction of buffered glycerol-sorbitol before lyophilization. Immunogenicity in the presence of maternally derived antibody while indicating successful immunization also indicates susceptibility to measles. In a trial of aerosolized vaccine in Mexican children of different ages using the Edmonston-Zagreb (E-Z) vaccine and the Edmonston-Swartz (E-S) vaccine, successful immunization was high even in 6-month-old infants with the E-Z strain but not with the E-S strain. Both OPV and IPV will continue in general use and improvements will come from more efficient delivery schemes, particularly pulse immunization.
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PMID:Feasible improvements in vaccines in the Expanded Programme on Immunization. 266 97

In 1976, despite a 20-year immunization program, vaccine-preventable diseases (other than smallpox) remained important causes of morbidity and mortality in Thailand. Three major problems were identified: a lack of proper target age groups, inadequate vaccination coverage, and a defective cold chain. The National Expanded Programme on Immunization (EPI), focusing on diphtheria, pertussis, tetanus, poliomyelitis, measles, and tuberculosis, was initiated on a nationwide basis in 1977. Data indicate that the program has reduced morbidity and mortality from most vaccine-preventable diseases in Thailand. The goal of the EPI is to have every eligible child fully immunized with efficacious vaccines by 1990. Strategies have been developed and are being used by the "accelerated EPI" to achieve this goal.
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PMID:Expanded Programme on Immunization in Thailand. 276 97

We reported previously that cold exposure increases by 2- to 3-times the maximal responsiveness of interscapular brown adipose tissue (IBAT) adenylate cyclase to stimulation by norepinephrine or fluoride and that the sensitizing effect of cold is the result of an increase in neural transmission to the tissue because it is abolished by prior surgical denervation of IBAT. The present report examined further the molecular basis of the sensitization of IBAT adenylate cyclase. Cold exposure increased the maximal responsiveness of adenylate cyclase to stimulation by guanylyl-5'-imidodiphosphate without altering the apparent affinity of the enzyme for the nucleotide. In addition, cold exposure increased the maximal extent of cholera toxin-mediated ADP-ribosylation of the alpha subunit of the stimulatory regulatory protein of adenylate cyclase (Gs alpha) in proportion to the increase in adenylate cyclase activity, but did not alter pertussis toxin-mediated labeling of the inhibitory regulatory protein. Direct measurement of Gs alpha by immunoblotting, however, revealed that sensitized membranes did not contain more Gs alpha protein. These results indicate that neural stimulation of IBAT produced by cold exposure alters the proportion of existing Gs molecules that are functional. The additional observation that sensitized adenylate cyclase activity did not reconstitute into cyc- S-49 lymphoma membranes suggests that the ability of neural stimulation to increase Gs function in IBAT might depend upon the interaction of Gs with factors that are unique to membranes of cold-exposed rats.
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PMID:Neural modulation of the stimulatory regulatory protein of adenylate cyclase in rat brown adipose tissue. 313 62

During the year 1983 the immunization programme according to the WHO-standard was finally started in the Melut region. The tables give details on the extension of tetanus immunization for neonatal tetanus, DPT (diphtheria, pertussis, tetanus) and also measles in the Melut hospital in 1983. For the first time, a functioning chain of cold storage units could be installed in this hospital. From March to November, 1983 details of mother-child care and ambulant patient care were also recorded.
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PMID:WHO immunization programme and hospital procedure in the Melut district, upper Nile region, south Sudan, in the year 1983 (report). 316 60

The Expanded Program on Immunization was initiated by the World Health Organization in 1974. In 1984, the World Bank, the UN Development Program, the UN Children's Fund, the World Health Organization, and the Rockefeller Foundation formed the Task Force for Child Survival, which, along with private and voluntary groups mobilizes support for the Immunization Program. With collaboration from the US Centers for Disease Control, the World Health Organization has produced training materials for use in various countries and worked with the UN Childrens Fund, which has contributed new cold chain methods for the immunization program. The immunization program provided a building block for a health infrastructure in many countries. It collaborated with the Diarrheal Diseases Control Program to develop integrated training programs, with the Division of Family Health to develop a training module on child spacing, and with the Nutrition Program in introducing vitamin A and iodine supplementation. In 1974, fewer than 5% of children in developing countries were immunized; today 50% are reached with a 3rd dose of polio or diphtheria-pertussis-tetanus vaccines. Immunization started slowly and then increased rapidly since the mid-1980s because the program's 1st objectives were to develop sound national plans and to train a core of competent managers in each country. Measles immunization coverage is low (37%) because the vaccination program is recent and the present vaccine cannot be given before the age of 9 months. Coverage of pregnant women for tetanus is even lower (19%). The number of immunizations could be increased if clinics would provide immunizations during acute care visits. Community mobilization and outside financial assistance are needed; full immunization of 1 child costs $10. The Expanded Program on Immunization hopes to achieve the eradication of polio by 2000 and the eradication of neonatal tetanus and 90% reduction in measles by 1995. Vaccines are being developed for yellow fever, hepatitis B, Japanese encephalitis B, rotavirus, typhoid, shigella, cholera, and leprosy, as well as a measles vaccine that can be given at 6 months. Primary care emphases will be on maternal and child nutrition, diarrheal disease control, birth spacing, and vitamin A and iodine supplementation. The Expanded Program on Immunization will focus on applied research, leaving basic research to be carried out by the Vaccine Development Program, the Basic Vaccinology Program, the Special Program of Research Development and Research Training in Human Reproduction, and the Diseases Control Program.
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PMID:Immunizing the children of the world: progress and prospects. 326 62

Although the prevention of infection through immunization is a central goal of maternal-child health programs in all developing countries, it is important to recognize that the role of vaccines varies greatly from country to country, from infection to infection, and from vaccine to vaccine. Immunization strategies must be as responsive to local disease patterns, needs, and opportunities as to technological advances in the creation, production, storage, and delivery of vaccines. This paper outlines the present state of the art for vaccines against measles, pertussis, poliomyelitis, tetanus, and tuberculosis. Other childhood infections in the tropics in need of a vaccine are the enteric infections, serious bacterial infections, vertically transmitted viral infections, and parasitic infections such as malaria. Immunization technologies related to the cold chain, delivery techniques, and adjuvants are constantly improving. Gains have also been made in outcome evaluation and disease surveillance. Ultimately, the success of the immunization effort depends on community participation and awareness.
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PMID:Recent advances in immunization. 331 42

Intranasal infection of mice with a sublethal dose of Bordetella pertussis produced hypoglycaemia and hyperinsulinaemia. Exposure to ether vapour did not modify serum insulin concentrations in control mice, but produced a marked transient hyperinsulinaemia in mice infected with B. pertussis. A similar hyperinsulinaemia in infected, but not control, mice was also seen after a brief (10-15 s) period of anoxia (produced by exposure to an atmosphere of 100% N2 or 100% CO2), or following the injection of histamine or 2-deoxyglucose. Exposure to cold (2-4 degrees C) or hypoxia (8% O2 in 92% N2), however, did not alter serum concentrations of insulin in control or infected mice. The hyperinsulinaemic response to ether stress observed in mice infected with B. pertussis was abolished by pretreatment with alloxan. The hyperglycaemic effects of histamine and 2-deoxyglucose were attenuated or abolished in mice infected with B. pertussis. However, none of the stimuli which produced hyperinsulinaemia in the infected mice resulted in any further lowering of the blood glucose concentration. Pretreatment of mice with pertussis toxin (150 ng/mouse, i.v.) produced hypoglycaemia similar in magnitude to that found in animals infected with B. pertussis. Moreover, exposure of mice treated with pertussis toxin to ether vapour produced marked hyperinsulinaemia. It is suggested that the metabolic alterations seen in animals infected with B. pertussis may be mediated by pertussis toxin.
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PMID:Hypoglycaemia and acute stress-induced hyperinsulinaemia in mice infected with Bordetella pertussis or treated with pertussis toxin. 354 69

Focusing on the worldwide state of immunization, attention is directed to the progress being made in control of the 6 diseases -- measles, pertussis, diphtheria, tetanus, poliomyelitis, and tuberculosis -- using the vaccines and equipment now available. Major problems in world-wide vaccine coverage to be resolved are: management to ensure that adequate amounts of potent vaccine are delivered on time to susceptible infants; and funds to pay for this system of delivery over the next few decades. In 1974, at the time Expanded Program on Immunization (EPI) was conceived, 5% of infants in the developing world received a 3rd dose of DPT or polio vaccine. At this time, more than 1/3 of infants in the developing countries receive a 3rd dose of DPT or polio vaccine, although only about 20% receive measles vaccine. Progress has been made, but it is not sufficient if the global target is to be realized. Except for measles, the target diseases have been brought under control in most of the European region, and eradication targets have been set for the end of the century. Additionally, there is wide use of vaccines against other diseases of importance to public health including rubella, mumps, hepatitis B, influenza, pneumonococcal and meningococcal infections. Africa has the highest mortality and morbidity rates for the target diseases, yet there has been some progress in EPI. In 1983, 19 countries achieved fully immunized rates of 45-87% of their target population. A priority for the African region is the upgrading of the management skills of the health workers involved in EPI. A major constraint in the region is the need for a good 'cold chain" to ensure that vaccines are stored and transported within the safe temperature range. 26 countries in the American region are considered to have achieved control of paralytic poliomyelitis. Innovative ideas have been used in this region, including the use of national immunization days and revolving funds for bulk purchase of vaccines. In the Southeast Asia region there has been a slow but steady increase in coverage for all antigens except BCG and measles. The major constraints in the Western Pacific region as the other regions are lack of management skills and financial resources. Some progress has been made in the Eastern Mediterranean region despite great variation in socioeconomic status between countries. Alternative strategies for the acceleration of EPI activities are outlined.
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PMID:A global view of immunisation. 382 Jan 51

Oral polio vaccine was introduced into India's national immunization program in 1979-80. Coverage with this vaccine has increased rapidly from 0.67 million in 1979-80 to 9.63 million in 1984-85. 3 doses of the vaccine are recommended at age 3-12 months, followed by a booster dose 12-18 months later. The vaccine is administered along with the DPT vaccine. The vaccines are provided as a package of services under the expanded program on immunization (EPI). India's government initiated the EPI in 1978 with the goal of reducing the morbidity and mortality due to diphtheria, pertussis, tetanus, poliomyelitis, tuberculosis, and typhoid fever by making vaccination services available to all eligible children and pregnant women by 1990. In 1985-86, measles vaccination was included in the program. Another objective was to achieve self-sufficiency in the production of vaccines required for the program. Immunization services are provided through the existing health care delivery system: hospitals, dispensaries, and maternal and child health (MCH) clinics in the urban areas primary health centers in rural areas. The aim of universal immunization for all India has been set for 1989-90; some areas may achieve this goal earlier. 30 districts and catchment areas of 50 medical colleges have been taken up in the universal immunization program for 1985-86. The objectives of the universal immunization program include: to provide universal immunization coverage to pregnant women and to infants; to document a reduction in the vaccine preventable diseases; to develop effective implementation and to streamline logistics; and to encourage the active participation of the medical faculty, interns, and students from the planning to the evaluation stages. The government of India provides the vaccines required under the national immunization program to the state health authorities. Over 50 million doses of oral polio vaccine are expected to be utilized during 1985-86. The annual requirements are likely to exceed 80 million doses by 1989-90. The planned targets of vaccination coverage are linked closely to the development of the cold chain system. Since 1984 field samples of oral polio vaccine have been collected for potency tests in order to monitor the quality of the cold chain for vaccines. The effectiveness of the control measures will be evaluated by determining the vaccination coverage of the eligible population and by recording the reduction in incidence of poliomyelitis in the area.
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PMID:National programme for the control of poliomyelitis. 383 34


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