Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0043167 (pertussis)
 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Factors to be considered in designing immunization programs in developing countries are summarized. The limiting factors will usually be costs of vaccines, administration equipment and supplies, transport and maintenance of the cold chain. Choices have to be made about the sources of vaccines, whether produced locally or imported, size of vaccine lots and type of package, and quality control of vaccines. Selection of vaccines is treated in a separate appendix, but generally 3 groups are recognized: 1) recommended for general use: smallpox, diphtheria, tetanus, pertussis, BCG, typhoid and measles; 2) recommended for special cases: polio and yellow fever; 3) not recommended for developing countries: rubella, mumps, influenza, cholera; and 4) vaccines in development stage only: arbovirus, rickettsia, trachoma, meningococci, plague and shigella. Schedules for vaccine administration are suggested, such as plans for vaccination every 2 years, plans for 4 courses of vaccinations including 1 at school entry, and special programs such as smallpox campaigns and immunization of adolescent girls and fertile women with tetanus. Finally the importance of recording of vaccinees and assessment of programs is discussed.
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PMID:Design of immunization programmes for developing countries. 467 78

The subunit structure of islet-activating protein (IAP), pertussis toxin, has been analyzed to study a possibility that this protein is one of the A-B toxins [Gill, D. M. (1978) in Bacterial Toxins and Cell Membranes (Jeljaszewicz, J., & Wadstrom, T., Eds.) pp 291-332, Academic Press, New York]. Heating IAP with 1% sodium dodecyl sulfate caused its dissociation into five dissimilar subunits named S-1 (with a molecular weight of 28 000), S-2 (23 000), S-3 (22 000), S-4 (11 700), and S-5 (9300), as revealed by polyacrylamide gel electrophoresis; their molar ratio in the native IAP was 1:1:1:2:1. The molecular weight of IAP estimated by equilibrium ultracentrifugation was 117 000 which was not at variance with the value obtained by summing up molecular weights of the constituent subunits. The preparative separation of these IAP subunits was next undertaken; exposure of IAP to 5 M ice-cold urea for 4 days followed by column chromatography with carboxymethyl-Sepharose caused sharp separation of S-1 and S-5, leaving the other subunits as two dimers. These dimers were then dissociated into their constituent subunits, i.e., S-2 and S-4 for one dimer and S-3 and S-4 for the other, after 16-h exposure to 8 M urea; these subunits were obtained individually upon further chromatography on a diethylaminoethyl-Sepharose column. Subunits other than S-1 were adsorbed as a pentamer by a column using haptoglobin as an affinity adsorbent. The same pentamer was obtained by adding S-5 to the mixture of two dimers. Neither this pentamer nor other oligomers (or protomers) exhibited biological activity in vivo. Recombination of S-1 with the pentamer at the 1:1 molar ratio yielded a hexamer which was identical with the native IAP in electrophoretic mobility and biological activity to enhance glucose-induced insulin secretion when injected into rats. In the broken-cell preparation, S-1 was biologically as effective as the native IAP; both catalyzed ADP-ribosylation of a protein in membrane preparations from rat C6 glioma cells. In conclusion, IAP is an oligomeric protein consisting of an A (active) protomer (the biggest subunit) and a B (binding) oligomer which is produced by connecting two dimers by the smallest subunit in a noncovalent manner. Rationale for this terminology is discussed based on the A-B model.
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PMID:Subunit structure of islet-activating protein, pertussis toxin, in conformity with the A-B model. 629 44

Our experiments have delineated the flow of information in the cyclic nucleotide cascade of vision of ROS. A single, photoexcited rhodopsin molecule activates several hundred phosphodiesterase molecules in two stages. First, photoexcited rhodopsin (R*) interacts with transducin (T), a peripheral membrane protein consisting of alpha- (39 kD), beta- (36 kD), and gamma- (approximately 10 kD) subunits. R* catalyzes the exchange of GTP for GDP bound to the subunit of transducin. About 500 T alpha- GTPs are produced per photoexcited rhodopsin at low light levels. T alpha-GTP, released from the beta- and gamma-subunits of transducin, then interacts with the phosphodiesterase to relieve the inhibitory constraint imposed by its gamma-subunit. Hydrolysis of GTP bound to T alpha serves to restore the system to the dark state. Transducin is the amplified signal carrier in this light-triggered cascade. The formation of hundreds of T alpha- GTPs is likely to be the first stage of amplification in visual excitation. The photoactivation of the phosphodiesterase in ROS closely resembles the activation of adenylate cyclase in hormone-sensitive cells. Our cholera toxin labeling studies have shown that transducin is akin to the signal-coupling G protein of the adenylate cyclase system. Cholera toxin specifically ADP- ribosylates and inactivates the GTPase activity of T alpha, just as it does with Gs. The action of pertussis toxin on ROS further underscores the homology of the photoreceptor and hormone-responsive systems. It seems likely that transducin, the stimulatory G protein, and the inhibitory G protein are members of the same family of signal-amplifying proteins. The study of the cyclic nucleotide cascade of vision is proving to be rewarding in affording a view of a recurring motif of signal amplification in nature in addition to providing insight into the mechanism of vision.
Cold Spring Harb Symp Quant Biol 1983
PMID:Transducin and the cyclic GMP phosphodiesterase: amplifier proteins in vision. 632 79

The B. pertussis model of atopy as proposed by Szentivanyi in 1968 has been a starting point for much research involving the pathogenesis of COLD. Moreover, it supplied more insight into the pharmaco-therapeutic approach toward this group of diseases. In this review, it is shown that products of bacteria considered to be a constituent of the normal flora of the human upper respiratory tract, such as H. influenzae, elicit changes in adrenoceptor responsiveness which are compatible with an enhanced tendency toward bronchoconstriction. One of the features of human atopy is enhanced mediator release after appropriate stimuli resulting in bronchoconstriction. This phenomenon can be mimicked in an animal model, the H. influenzae-vaccinated rat or guinea pig; enhanced histamine synthesis and release are found in vivo as well as in vitro. The effects point in the direction of a beta-adrenergic defect which is not only demonstrable in biochemical but also in physiologically oriented parameters. Pulmonary smooth muscle tissue appears to be less responsive to beta-adrenergic agonists and has an enhanced tendency to contract. The view that these changes are indeed the reflection of changes in adrenoceptor systems has been investigated in guinea pigs and rats. In both species impairment of beta-adrenergic systems together with a reduction in the number of beta 2-adrenoceptors was found after vaccination. Also the involvement of other factors, e.g., catecholamines, has been demonstrated. Comparable changes occur within the pulmonary adrenoceptor populations of COLD patients, suggesting disturbed homeostasis in the autonomic nervous system, possibly leading to bronchoconstriction. The question whether a bacterial factor is important in these changes and might induce, sustain or enhance the effects of other factors or even have a role in the pathogenesis of COLD is discussed in this review.
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PMID:Changes in beta-adrenergic responses as a consequence of infection with micro-organisms. 632 8

Following the severe 1974 W. H. O. warning, many countries want to develop an expanded programme of immunization during the period extending till 1990, to control 6 major diseases: diphtheria, tetanus, poliomyelitis, pertussis, measles and TB. No single programme can be proposed as the economic, epidemiological and structural problems differ according to countries and regions. C. Fillastre suggests a methodology to be used in the assessment of the initial situation with regard to existing epidemiological data, immunizations against the afore mentioned diseases, vaccines health structures (cold chain) and staff. The implementation of the supervision of material and staff and of an assessment system, allowing programme changes at any time on the basis of improvements achieved is mandatory.
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PMID:[Development of an operational immunization programme (author's transl)]. 734 42

During mid-1988 in Zambia, a baseline survey of 388 households in Choma District in the Southern Province was conducted to collect data on immunization coverage among children 12-23 years old, diarrhea morbidity among children younger than 5, use of oral rehydration among these children, and nutritional status among children 24-59 months old. 75% of children were completely immunized against BCG, polio, diphtheria-pertussis-tetanus, and measles and had an immunization card compared to 36% for rural Zambia in 1986. Immunization coverage ranged from 79% for measles to 95% for BCG. The rural health centers (RHCs) reported 38 patients with measles, suggesting either that some children did not fully benefit from the immunization program or problems existed with the cold chain. Fluctuation in the DPT and polio vaccine supply resulted in a dropout rate of 12% between 1st and 3rd dose and 9% between 1st and 2nd dose, respectively, compared to 38% and 31%, respectively, for rural Zambia (1986). 22% of children had had a recent episode of diarrhea. The 2-week diarrhea incidence rate was 0.16 (assuming the diarrhea episode lasted 6 days). The annual diarrhea incidence rate stood at 4.8 episodes/child. 52% of children who had had a diarrheal episode used oral rehydration solution obtained from an RHC or a community health worker. 15% ingested home-made sugar/salt solution. 81% of mothers would first take their child with diarrhea to an RHC. Only 10% of households had access to potable water from a borehole. Leading water sources were shallow water holes (32%), dug wells (25%), and rivers (16%). The water supply evaporated during the dry season for 50% of households. Dumping feces in the bush (67%) and use of a pit latrine (30%) were the main methods of feces disposal. After the harvest, 38% of children 12-23 months old and 74% of those 24-59 months old were well-nourished. A health education program on safe water supplies and better sanitation and an intersectoral agriculture and health program are needed to control diarrhea and to fight malnutrition, respectively.
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PMID:A primary health care baseline survey in a rural district in Zambia. 762 3

This paper opens by briefly tracing the development of vaccines from Edward Jenner's work in 1796 to the present. The proportion of deaths from communicable diseases in developed and developing countries is discussed, and it is noted that, in 1990, communicable diseases killed 575,000 people in industrialized countries and 16 million people in developing countries. In developed countries, there were no deaths from measles, malaria, tetanus, or pertussis, and only seven from diarrheal disease as compared to 1,006,000, 926,000, 505,000, 321,000, and 2,866,000, respectively, in developing countries. By the end of the century, AIDS will overshadow the communicable disease profile. Annual mortality figures from bites by rabid animals, snakes, insects, etc. are also grossly underreported. A look at the common biologicals used in developing countries shows that at least eight bacterial and eight viral vaccines are in common use globally. The origin and indications for each vaccine are tabulated. Data on anti-serum vaccines, plasma-derived preparations, and biological response modifiers (available in industrialized countries) are similarly tabulated. Consideration of the industrial production of immunogens in developing countries reveals that most production relies on outdated technology. Vaccines exhibit suboptimal performance in these settings either due to factors relating to individual vaccines or to community circumstances. Individual vaccines which exhibit inadequate potency in adverse circumstances include liquid vaccines and lyophilized vaccines and prophylactics. This situation is exacerbated by unsatisfactory vaccine administration practices, malnutrition, and cases of immunosuppression. Suboptimal performance at the community level is due to procurement procedure, the cost of vaccines, poverty, population growth, failures in the cold chain, lack of trained personnel, religion and gender bias, and political factors, such as war. A suitable remedial action plan requires integrated action at the international, national, and community levels. Such an effort would be aided by improved mortality data collection techniques and by multidisciplinary research to update indigenous manufacturing technology.
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PMID:Human immunization in developing countries: practical and theoretical problems and prospects. 788 21

A cost-effective strategy aimed at the immunization of all children and pregnant women residing in the plantation sector of Malaysia is outlined. It is based on a partnership between government, nongovernmental organizations and the private sector, and is supported by UNICEF. Over a million people reside on the Malaysian plantation estates: only 17% of the estates have their own hospitals; immunization services exist on only 1.5%; 40% of the estates are at least 5 kilometers from the nearest government health facility; and 64% lack transport for workers and their dependents to seek care away from the plantations. Two nongovernmental organizations, the Malaysian Paediatric Association and the Malaysian Society of Health, initiated discussions with the United Planting Association of Malaysia. A pilot study was undertaken by the groups on 6 estates in Selangor State, which included all the children at their first birthday. Tuberculosis, diphtheria/pertussis/tetanus, poliomyelitis, and measles immunization coverages were 88%, 44%, 59%, and 66%, respectively. The association of plantations accepted the organizations' proposals for all estates to: register all births; provide free transportation to government health clinics for the immunization of all eligible children and pregnant women; and enforce immunization schedules and record-keeping. The Ministry of Health agreed to provide free immunization of children and pregnant women; send mobile teams to estates that could assemble 20 or more eligible people for immunization; provide the estates with educational materials dealing with immunization; arrange that the maintenance of the cold chain be supervised by local medical officers of health; consider the training of estate hospital assistants with the help of the nongovernmental organizations. The total immunization plan was launched in September 1990. A manual was distributed to the estate managers, hospital assistants on the estates, and the medical officers who would implement and monitor the program. It is expected that total child immunization will be achieved in the foreseeable future in the estate sector.
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PMID:Strategy for child immunization in Malaysian plantations. 794 48

In Bangladesh an evaluation of the Expanded Programme on Immunization (EPI) was conducted in February 1993. Data, including immunization coverage based on random surveys, were collected from all 4 divisions, 8 rural districts, 25 sub-districts (thanas) and from the cities of Dhaka and Chittagong. The Review Team assessed and made several recommendations concerning immunization coverage, surveillance for the EPI target diseases, immunization in urban areas, the cold chain and logistics, training, communication and social mobilization, other primary health care (PHC) interventions, vaccine supply, and the sustainability of EPI achievements. The population of Bangladesh is 110 million, with an estimated 3.6 million newborns during 1993. More than 90% of the 108,000 routine monthly immunization services are being conducted as scheduled. Nationally, among children 0-11 months of age, BCG coverage is 89%, as measured by evaluation surveys, coverage with 3 doses of diphtheria/pertussis/tetanus (DPT3) and oral polio vaccine (OPV3) is 63%, and measles coverage is 59%. Coverage with a second dose of tetanus toxoid (TT2) for pregnant women is 80%. In urban areas, BCG coverage for infants is 92%, DPT3/OPV3 76%, measles 68%, and TT2 for pregnant women 82%. In 2/3 of the sites visited, immunization was combined with vitamin A supplementation, oral rehydration treatment, or family planning. The coverage for both BCG and DPT3/OPV3 increased from only 2% in 1985 to almost 90% of infants having BCG immunization services in 1992. Yet only 50% of children are reached before their first birthday, and at least 20% of newborns are not protected against neonatal tetanus at birth. DPT1 and DPT3 drop-out is 29% nationally and 17% in urban areas. In 1992, an estimated 117,000 cases of neonatal tetanus and 6700 cases of poliomyelitis were prevented by immunization. Surveys of neonatal tetanus in selected districts have confirmed a reduction in incidence from 40/1000 live births in 1986 to 10/1000 in 1991.
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PMID:Expanded programme on immunization. Programme review. 800 3

Although Papua New Guinea agreed to reach 90% immunization of children under one year of age, this country and 5 others were unable to reach the coverage target. A survey of facilities was conducted, and analysis revealed serious systems failures and operational problems. Consequently, large numbers of children were receiving ineffective vaccines. When immunization coverage is low, disease is transmitted to those without coverage. For example, a failure of a single dose of the diphtheria-pertussis-tetanus (DPT) or oral polio vaccine results in only partial protection and the ability to transmit the diseases purportedly covered. There is great waste of effort and work, money, health worker time, facilities use, and equipment and vaccines, when inadequate coverage is achieved. Improvements are needed in assuring vaccine potency, adequate distribution, maintenance of the cold chain, and transportation of vaccine supplies. The causes of vaccine damage include the distribution chain of international supplies, vaccine temperatures by type of vaccine, vaccine conditions, vaccine storage conditions, storage risk factors, kerosene refrigerator conditions, sanitary immunization practices, and quality assurance points in the distribution chain. There were situations where boxes were supposed to be lined with frozen ice packs, but there were inadequate numbers of ice packs; road transport time with packs should be 1 day or less, when in fact it took 1-2 days, and air shipments could take a week. Placement in refrigerators may mean warming on one shelf and freezing on another shelf. When mobile teams transported vaccines to rural areas, the carrying boxes were insufficiently packed for transport longer than 1 day. Recommended measures were procurement of appropriate vaccines and equipment, development of guidelines, instructions and supervision, and provision of training. Area medical stores need to perform quality assurance when vaccines arrive, are being unpacked, or are in storage before shipment to another location.
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PMID:Vaccines in the national immunization programme. 815 96


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