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

116 immunizations were given to 61 children with febrile convulsion or epilepsy who had not had a seizure for 1 year since the last attack. In 92 of the 116 immunizations the electroencephalogram (EEG) was examined before and after immunization. No adverse effects on the EEG were observed in 19 immunizations with Japanese encephalitis, measles, mumps or rubella vaccines. Epileptic spikes reappeared after 10 immunizations and epileptic spikes increased after 10 immunizations among 73 given for diphtheria, acellular pertussis and tetanus (DPT), diphtheria and tetanus (DT), or Bacillus Calmette-Guerin (BCG). A convulsion was observed once in one child 7 days after immunization with BCG. A follow-up EEG examination is necessary after children with convulsive disorders are immunized.
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PMID:Adverse effects on EEG and clinical condition after immunizing children with convulsive disorders. 228 15

A prospective study of immunogenicity and adverse effects of 1553 doses of diphtheria and tetanus toxoids and whole cell pertussis vaccine (DTP) was performed in 538 children observed longitudinally from 2 months to 20 months of age. Subjects were randomized to the standard four-dose immunization schedule or to a three-dose schedule (with a saline injection substituted for DTP at 6 months of age). The three-dose schedule could not be recommended on the basis of serologic data. Compliance for completing a clinical observation form in the 48 hours following injections was greater than 99%. Fever, local reactions, or adverse behavioral effects were described in association with 96% of DTP doses and 36% of placebo injections. Contraindications to DTP immunization developed in 3% of study children. No convulsion, hypotonic hyporesponsive episode, encephalopathy, or temperature greater than 40.5 degrees C occurred. Behavioral and local inflammatory effects occurred maximally in the first 6 hours following vaccine but fever peaked later. There was no interrelationship between occurrence of local reaction and fever. Data suggest that age has more effect on the type and rate of adverse clinical events than does vaccine dose number. Existing antibody levels to vaccine components, lot of vaccine, breast-feeding, or gestational age did not affect rate or type of clinical reactions. Neither occurrence of reactions nor the use of acetaminophen affected antibody response to vaccine.
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PMID:Longitudinal study of adverse reactions following diphtheria-tetanus-pertussis vaccine in infancy. 230 82

Before the whole-cell pertussis vaccine was available, Bordetella pertussis infections were an important cause of morbidity and mortality in infants. To determine the extent of continuing morbidity in an era of vaccination, a retrospective review was conducted of the records of neonates and infants hospitalized with pertussis infection at Parkland Memorial Hospital and Children's Medical Center, Dallas, Tex. During the 20 years from 1967 through 1986, 182 patients were younger than 24 months. Among 176 patients whose immunization history was recorded, 89% had received fewer than two doses of pertussis vaccine. The mean hospital stay was 7.4 days (range, 1 to 69 days). A convulsion occurred in 11 patients (6%). Apnea was reported in 45 patients (25%) and observed in the hospital in 26 (14%). Nine patients (5%) received mechanical ventilatory therapy. Intensive care monitoring was required in 18 patients (10%). Three (1.6%) died, all with secondary bacterial pneumonia. This hospital-based population indicates that pertussis continues to be a cause of serious morbidity and mortality in infants.
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PMID:Pertussis in hospitalized children. 240 94

To evaluate the risk of neurologic events after vaccination with diphtheria-tetanus-pertussis (DTP) vaccine, we used data from the Centers for Disease Control Monitoring System for Adverse Events Following Immunization to compare the family history of convulsions in persons reporting neurologic events with that in persons reporting nonneurologic events; these events have an onset within 3 days of immunization with DTP vaccine, given either alone or with oral poliovirus vaccine. Persons reporting neurologic events were 6.4 times more likely to report a prior personal history of convulsions than those reporting nonneurologic events (95% confidence interval 4.7 to 8.8), and were 2.4 times more likely to report a history of convulsions in first-degree family members, that is, siblings or parents (95% confidence interval 1.7 to 3.4). Similar risks were noted for subgroup analyses controlling for type of event (febrile vs nonfebrile convulsion), age at immunization, source of report, number of previous doses of DTP vaccine, and day of onset. Because the Centers for Disease Control monitoring system receives reports on a nonrandom sample of all adverse events after immunization, selection bias could not be ruled out. On the basis of these data, we conclude that children with a family history of seizures are at increased risk of neurologic events, primarily febrile convulsions, after DTP vaccination. However, this increase in risk may reflect a nonspecific familial tendency for convulsions rather than a specific vaccine effect. Considering the rare occurrence of neurologic events after DTP vaccination, the generally benign outcome of febrile convulsions (which make up the majority of these neurologic events), and the possible increased risk of pertussis in the general population if the estimated 5% to 7% of persons with a first-degree family history of convulsions were exempted from pertussis vaccination, we further conclude that a history of convulsions in siblings or parents should not be a contraindication to pertussis vaccination. Special care in the prevention of postvaccination fever may be warranted in children with a family history of seizures.
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PMID:Family history of convulsions and use of pertussis vaccine. 255 66

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

Neuronal firing during experimental convulsions triggered a large increase in brain eicosanoid synthesis. Mature astrocytes are an important source of cerebral prostanoids. Endogenously formed prostaglandins possess anticonvulsive properties of biological relevance. These conclusions suggest new ideas that might explain the formation and functions of prostanoids in the brain. First, as augmented neuronal discharge is a prerequisite for enhanced prostanoid synthesis during seizures, a functional coupling between firing neurons and prostanoid-forming astrocytes may be expected. Second, the anticonvulsive effects of endogenous prostanoids suggest that astroglia-derived substances might regulate neuronal activity. The phenomenon of convulsion-induced prostanoid synthesis may, therefore, represent a new example of neuron-glia interaction. Neither K+-induced membrane depolarization nor receptor activation by drugs with affinity to alpha or beta adrenoceptors, dopamine, serotonin, muscarine, histamine, GABA, glutamate, aspartate, adenosine, and opioid receptors evoked eicosanoid synthesis in astrocytes. The only physiologically relevant ligand that induced prostanoid synthesis concentration dependently in astrocytes was ATP and related nucleotide triphosphates, as well as nucleotide disphosphates. In peripheral nerves ATP serves as a cotransmitter. The effect of the P2 agonists was reduced by pertussis toxin. The mechanism by which eicosanoids regulate neuronal activity remains to be elucidated.
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PMID:Formation and function of eicosanoids in the central nervous system. 267 46

We investigated the rates of local and systemic reactions following 9920 diphtheria-tetanus toxoids-pertussis immunizations from 25 lots of commercially available, United States-licensed diphtheria-tetanus toxoids-pertussis adsorbed vaccines from four manufacturers as a function of vaccine lot, endotoxin content, pertussis vaccine potency and percent of mouse weight gain. There were significant differences between the rates of reactions by lot for all local and systemic reactions except convulsions and hypotonic hyporesponsive episodes. For these latter reactions there were insufficient cases for analyses. P was less than 0.0001 for local reactions, fever, drowsiness, fretfulness, anorexia and screaming and 0.017 for vomiting. No single lot was associated with the highest or lowest rate of reactions for more than 3 of the 11 reactions. There was a significant positive association of endotoxin unit (EU) content and the percent of vaccine recipients who developed fever (P = 0.004). Fever increased in frequency from 20.6% of children immunized with vaccine lots that contained 2500 EU to 55.1% of children immunized with vaccine lots containing 40,000 EU. There were significant positive associations of all local reactions and pertussis vaccine potency (P = 0.0004), and percent of mouse weight gain (P less than 0.0001). There was also a positive association of percent mouse weight gain and persistent screaming (P = 0.001). However, for the majority of reactions there was no clinically meaningful associations between reaction rates and the biological properties of the vaccine studied.
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PMID:Analyses of adverse reactions to diphtheria and tetanus toxoids and pertussis vaccine by vaccine lot, endotoxin content, pertussis vaccine potency and percentage of mouse weight gain. 277 30

This revision of the Immunization Practices Advisory Committee (ACIP) statement on diphtheria, tetanus, and pertussis updates the statement issued in 1981 and incorporates the 1984 supplementary statement on the risks of pertussis disease and pertussis vaccine for infants and children with personal histories of convulsions. It includes a review of the epidemiology of the three diseases, a description of the available immunobiologic preparations, and the appropriate immunization schedules. Also included are revisions in the schedule for combined diphtheria and tetanus toxoids, when pertussis vaccine is contraindicated, and revisions in the recommendations on precautions and contraindications to vaccine use, on immunization for infants and children who have underlying neurologic disorders, and on tetanus prophylaxis in wound management.
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PMID:Diphtheria, tetanus, and pertussis: guidelines for vaccine prophylaxis and other preventive measures. Recommendation of the Immunization Practices Advisory Committee. Centers for Disease Control, Department of Health and Human Services. 299 52

In a prior prospective study, we evaluated the nature and rates of adverse reactions occurring within 48 hours following 15,752 diphtheria-tetanus-pertussis (DTP) immunizations. Nine children had convulsions, and nine had hypotonic-hyporesponsive episodes. After an interval of 6 to 7 years, we were successful in contacting the families of 16 of these children to determine whether any had evidence of neurologic impairment too subtle to have been detected at the time of initial evaluation. All 16 were considered normal by their parents and were doing well in school. A complete neurologic and psychometric evaluation was performed on 13 of these children. No child had significant neurologic deficit, although four had minor neurologic abnormalities. Psychometric testing revealed normal performance IQ scores (104.3 +/- 15.8) but low verbal IQ scores (91.8 +/- 18.4); however, these lower verbal IQ scores can be explained by the proportion of Hispanic and bilingual children in this sample. Therefore, there is no evidence that any of these 16 children have any serious neurologic damage as a result of a convulsion or a hypotonic-hyporesponsive episode temporally associated with a prior diphtheria-tetanus-pertussis immunization.
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PMID:Infants and children with convulsions and hypotonic-hyporesponsive episodes following diphtheria-tetanus-pertussis immunization: follow-up evaluation. 325 5

Data on 2062 reports from the Monitoring System for Adverse Events Following Immunization, Centers for Disease Control (CDC), were analyzed to compare the risk of a personal or family history of convulsions in children who had a neurologic adverse event after receipt of diphtheria-tetanus-pertussis (DTP) vaccine with those who had a nonneurologic adverse event. Children with a neurologic event after DTP vaccine had a 7.2 times higher risk for personal history of convulsions (95% confidence limits 4.5 to 11.5) and a 4.5 times higher risk for family history of convulsions (95% confidence limits 3.1 to 6.7) than did children with an adverse event that did not affect the nervous system. Children with either a febrile or nonfebrile convulsion after receipt of DTP were significantly more likely to have a personal history of convulsions than children with a nonneurologic adverse event (P less than 0.0001). Children with a febrile convulsion after receipt of DTP but not children with nonfebrile convulsions were significantly more likely to have a family history of convulsions than those with a nonneurologic adverse event. It is recommended that pertussis vaccination be deferred in children with a personal history of a convulsion until it can be determined that an evolving neurologic disorder is not present. If such disorders are found, these children should be given the combined pediatric diphtheria and tetanus toxoids (DT) vaccine to complete the series.
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PMID:History of convulsions and use of pertussis vaccine. 387 40


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