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

Epidemic patterns of 12 infectious diseases based on the data derived from the surveillance system of infectious diseases in Japan are analyzed. Weekly numbers of patients per one monitor station (general clinics and hospitals) are calculated by prefecture. Based on these data, the patterns of epidemic are classified into five categories: Category 1, nationwide outbreak of short duration (rotavirus enteritis, hand-foot-mouth disease and herpangina); Category 2, nationwide outbreak of long duration (varicella); Category 3, concurrent outbreaks in several districts (rubella and erythema infectiosum); Category 4, epidemic of long duration in several prefectures at different times (measles, mumps, pertussis, streptococcal infection and atypical pneumonia); Category 5, unclear epidemic pattern (exanthema subitum).
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PMID:Epidemic patterns of infectious diseases from the results of the surveillance of infectious diseases in Japan. 336 59

Ethiopia is a country of 45 million people in northeast Africa. With a stagnant, agriculture-based economy and a per capita gross national product of $110 in 1984, it is one of the world's poorest nations. 70% of the children are mildly to severely malnourished, and 25.7% of children born alive die before the age of 5. Life expectancy is 41 years. The population is growing at the rate of 2.9%/year, but only 2% of the people use birth control. After the 1974 revolution, the socialist government nationalized land and created 20,000 peasant associations and kebeles (urban dwellers' associations), which are the units of local government. The government has set ambitious goals for development in all sectors, including health, but famine, near famine, forced resettlement programs, and civil war have prevented any real progress from being made. The government's approach to health care is based on an emphasis on primary health care and expansion of rural health services, but the Ministry of Health is allocated only 3.5% of the national budget. Ethiopia has 3 medical schools -- at Addis Ababa, Gondar, and the Jimma Institute of Health Sciences. Physicians are government employees but also engage in private practice. A major problem is that a large proportion of medical graduates emigrate. Ethiopia has 87 hospitals with 11,296 beds, which comes to 1 bed per 3734 people. There are 1949 health stations and 141 health centers, but many have no physician, and attrition among health workers is high due to lack of ministerial support. Health care is often dispensed legally or illegally by pharmacists. Overall, there is 1 physician for 57,876 people, but in the southwest and west central Ethiopia 1 physician serves between 200,000 and 300,000 people. In rural areas, where 90% of the population lives, 85% live at least 3 days by foot from a rural health unit. Immunization of 1-year olds against tuberculosis, diphtheria-pertussis-tetanus, poliomyelitis, and measles is 11, 6, 6, and 12% respectively. Infectious diseases dominate the medical scene in Ethiopia. In 1984, tuberculosis accounted for 11.2% of hospital admissions and 12.2% of deaths. The leading cause of childhood mortality in 1984 was diarrhea (45%). Malaria, trypanosomiasis, schistosomiasis, leishmaniasis, and meningococcal meningitis are endemic. Intestinal parasitism is rampant, and the nationwide prevalence of leprosy is 3/1000. Venereal diseases were the 9th most common cause of hospital outpatient visits in 1984, but AIDS is rare. The leading noninfectious diseases are rheumatic and syphilitic heart disease, hypertension, diabetes mellitus, hepatoma, and elephantiasis. Ethiopia has the highest number of cases of nonfilarial elephantiasis -- an estimated 350,000 cases -- in the world. Aside from a large influx of money, the most necessary changes to improve the health system are lowering the salaries of doctors and nurses, reorienting physician training toward primary health care, increasing the quality of existing health services, more efficient management, and better coordination between the Ministry of Health and the voluntary organizations.
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PMID:Health and medical care in Ethiopia. 271 Jan 85

805 clinical isolates were investigated for their in vitro sensitivity against Ro 15-8074 and Ro 19-5247 in comparison to cefaclor and cefalexin in a serial dilution test on solid medium. Ro 19-5247 had the strongest activity of all drugs tested against streptococci (except Streptococcus faecalis) and was as active as cefaclor and cefalexin against most strains of Staphylococcus aureus. Ro 19-5247 was the only oral cephalosporin active against Bordetella pertussis. It was on average 160 times more active than cefaclor against Haemophilus influenzae. In its activity against enterobacteria Ro 19-5247 was always superior to cefaclor and cefalexin. Only a few strains of Enterobacter aerogenes, Enterobacter cloacae, Klebsiella pneumoniae, Proteus vulgaris and Serratia marcescens were resistant to Ro 19-5247 as were all strains of Enterobacter agglomerans and Klebsiella ozaenae. Ro 15-8074 was inactive against staphylococci but ten times more active than cefaclor and cefalexin against Streptococcus pyogenes. There was no difference in the activity against Streptococcus pneumoniae and Streptococcus agalactiae. Against Haemophilus influenzae Ro 15-8074 acted 12 times stronger than cefaclor and 100 times stronger than cefalexin. The activity against enterobacteria corresponded to that of Ro 19-5247. Ro 15-8074 was also active against most strains of Enterobacter cloacae and Proteus vulgaris which were resistant to cefaclor and cefalexin.
Infection
PMID:In vitro activity of Ro 15-8074 and Ro 19-5247 in comparison to cefaclor and cefalexin. 359 8

Pertussis (whooping cough), a highly contagious disease of childhood, is increasingly recognized among reproductive-age adults and neonates. Described are three cases of maternal-infant pairs in which mother-to-newborn transmission probably occurred and was the cause of extensive morbidity and cost. Means of recognition, treatment, handling, and prevention of this potentially lethal childhood illness are discussed.
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PMID:Perinatal pertussis. 374 8

Pertussis and diphtheria, bacterial infections responsible for significant childhood morbidity and mortality in the developing world, are potentially controllable by mass immunization. The incidence of pertussis has been dramatically reduced in many areas of the world over the past 25 years by the use of pertussis vaccine. The massive increase in incidence of clinical pertussis in Great Britain and other European nations occurring after publicity about vaccine reactogenicity precipitated a marked decrease in vaccine acceptance has documented the efficacy of the vaccine and the necessity of continued immunization. The issue of potential toxicity is, nevertheless, being addressed with the development of a cell-free, component pertussis vaccine. The use of diphtheria toxoid, directed at protecting recipients against the systemic effects of diphtheria toxin, has resulted in excellent control of the disease in the United States and elsewhere. Certainly the use of these two vaccines on a mass scale is the preferred approach to worldwide control, if not eradication, of these infectious diseases.
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PMID:Selective primary health care: strategies for control of disease in the developing world. XVII. Pertussis and diphtheria. 389 57

The decline in infectious disease mortality in England and Wales beginning about 1880 has been attributed to improved nutrition, hygiene, and sanitation. Such an explanation does not adequately explain the lack of improvement in infant and diarrheal disease mortality before 1900 nor the abrupt subsequent decline. A hypothesis was proposed that the decline in fertility rate was a major cause of the decline in infant mortality by raising the median age at infection. The hypothesis could only be tested indirectly. A review of morbidity data demonstrates the importance of family characteristics on the median age at infection for measles, pertussis, and common respiratory illness. The association of parity with infectious disease mortality supports the hypothesis. A method was developed for estimating the change in birth order distribution resulting from declining fertility. Using 1949-1950 data, it was shown that declining fertility could account for at least a 24% decline in postneonatal mortality due to bronchitis and pneumonia. Age-specific measles mortality rates are consistent, with an increase in age at infection. Declining fertility appears to have played a major role in the decline in infectious disease mortality in England and Wales by increasing the median age at infection.
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PMID:Declining fertility in England and Wales as a major cause of the twentieth century decline in mortality. The role of changing family size and age structure in infectious disease mortality in infancy. 404 Mar 22

Pertussis (whooping cough), a two-stage process of disease (respiratory colonization and toxin-mediated disease) is caused by B. pertussis. The bacterium is unique. It is a pathogenic parasite with habitat only in human beings. Growth in the pathogenic form, both in in vitro and in vivo, requires conditions that permit the expression of pertussis toxin (PT) (also known as histamine-sensitizing factor, lymphocyte-leukocyte-promoting factor, islet-activating factor and pertussigen). The expression of growth and PT appear to be genetically interrelated. For multiplication in vitro the medium must be free of substances, such as fatty acids, that inhibit the enzymatic action required for elaboration of PT. In vivo the bacteria are uniquely localized to the cilia of the respiratory epithelium where they multiply. In situ the bacteria inhibit natural defenses of the respiratory tract (cilial, phagocytic and other activities); they tend not to spread and do not invade the underlying tissue. The extent of the areas of colonization, directly related to the number of bacteria in the infecting inoculum, influences the amount of toxin elaborated and consequently the intensity of the clinical symptoms. Other factors that influence the clinical disease are the inordinate susceptibility of the infant and genetically controlled susceptibility. A specific role for PT in the initial establishment of the infection is not clear, but it seems definite that PT-specific immunity influences the clearance of colonization in about 4 to 5 weeks. The clinical symptoms become manifest when the bacteria are waning. This clearance is influenced by the synthesis of IgA antibodies and pertussis toxin antibodies that may act by inhibiting the "enzyme" required for growth or by another mechanism. The pathology of the disease is the result of altered cellular functions of toxin-sensitized cells, not by histologic damage. PT is composed of two functional components like other exotoxins that cause infectious disease (e.g. diphtheria, cholera). Certain sites on one component enable PT to bind to specific receptors on tissue cells and enter the cell. The toxin ADP ribosylates a regulatory protein of the cytoplasmic membrane and thereby alters the function of the cell. Affected (sensitized) cells are insulin-secretory islets of the pancreas, lymphocytes and leukocytes, heart cells and others that have not been clearly identified, e.g. those that effect paroxysms and neurologic disturbances. The altered function of the cell in vitro is irreversible, and the restoration of the function of a particular tissue in vivo appears to be dependent on the renewal of the cells.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The concept of pertussis as a toxin-mediated disease. 609 69

All vaccines have--besides their specific effect on the immune response--more or less pronounced side effects on the organism and particularly on the immune system. The latter effects deserve special interest, whenever they increase the host defence against infectious diseases. Desirable paraspecific effects of vaccines are the induction of interferon, the enhancement of phagocytic function and the activation of lysosomal enzymes. Some vaccines exert different effects: attenuated live measles vaccine induces interferon, pertussis vaccine activates lysosomal enzymes of macrophages. Some clinical observations illustrate how paraspecific effects of vaccines can be utilized for therapeutic purposes.
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PMID:[Unspecific vaccination]. 616 50

Infection is a frequent complication and cause of death in renal failure, but the association between uremia, depressed immune status, and susceptibility to infection is far from proven. In the present studies, the effect of uremia on the inflammatory response and phagocytic ability was investigated in an animal model. The inflammatory response, as measured by the ability of leukocytes to mobilize into subcutaneous implanted sponges, was impaired at 6 hr but was normal 24 hr after implantation. The peripheral blood response of uremic animals to the leukocytosis promoting protein from Bordetella pertussis was similar to that of control animals. Reticuloendothelial clearance of labelled albumin was unimpaired but catabolism of this substance was reduced significantly in uremic animals. The ability of the uremic host to clear an intravenous challenge of virus was also depressed. Phagocytic and bactericidal capability of polymorphonuclear (PMN) leukocytes, measured in vitro by latex ingestion and phagocytosis and killing of Staphylococcus aureus, was normal. PMN phagocytic function in vivo was determined by the clearance of viable Escherichia coli from subcutaneously implanted sponges and no significant difference between control and uremic groups was found. These studies have further defined the effect of uremia on immune mechanisms and support our contention that uremia per se is not a major factor contributing to the compromised immune status in this host.
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PMID:Host immune status in uremia. IV. Phagocytosis and inflammatory response in vivo. 634 83

Advances in immunology, microbial genetics, molecular biology and biochemistry are opening prospects for new purified and synthetic antigens against infectious diseases, cancers of viral origin and some immunodeficiencies. Immunization programmes against major childhood diseases with commonly used vaccines gave excellent results and are leading to their virtual eradication in developed countries. However some vaccines like the one against pertussis proved to be of considerably lower effectiveness. Results achieved in developing countries are in general lagging behind due to lower immunization coverage. While in some countries immunization strategies for eradication of measles are discussed, in others it is questionable whether immunization should continue due to failures of immunization programmes. Evaluation of the effectiveness of national immunization programmes by surveillance and various other methods including the use of epidemiological models point ot the deficiencies of vaccine potency and/or stability and the inadequacy of vaccination schemes and coverages. There is a need to determine optimal immunization programmes for control and possible eradication with currently available antigens and new ones. For newly developed vaccines, ever increasing in number, but with the uncertainty of their appropriate public health use, it is essential to study their optimal and most cost-effective uses e.g., pertussis vaccination is an old unsolved problem and that against hepatitis B a new one. Better results can be obtained with current vaccines by appropriate modification of immunization programmes. Some of the proposed strategies for using recently developed vaccines are questionable and need critical examination.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Problems and progress in immunization. 638 85


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