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

Using decision analysis, we estimated the benefits, risks and costs of routine childhood immunization against pertussis. Without an immunization program, we predict that there would be a 71-fold increase in cases and an almost fourfold increase in deaths (2.0 to 7.6) per cohort of one million children. With a vaccination program, we predict 0.1 case of encephalitis associated with pertussis and five cases of post-vaccination encephalitis; without a program, there would be only 2.3 cases of encephalitis associated with pertussis. Community vaccination would reduce by 61 per cent the costs related to pertussis. Our analysis supports continuation of vaccination in routine childhood immunization programs, but suggests the need for more reliable data on complications from the vaccine, further study of the epidemiology of pertussis and development of a less toxic vaccine.
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PMID:Pertussis vaccine--an analysis of benefits, risks and costs. 3 53

Parents from four practices were surveyed to ascertain reactions of children to diphtheria-pertussis-tetanus (DPT) vaccine in the 48 hours after immunization. Vaccines were administered according to current recommendations. Responses were scored in three categories: temperature, behavioral changes, and local reactions. Questionnaires were returned by 1,232 (84.9%) patients. Only 7.0% reported no reaction, while 336 (27.3%) reported mild, 722 (58.6%) moderate, and 88 (7.1%) severe reactions. Over 50% experienced temperatures of at least 100 F, and 80% noted behavioral changes; 72.2% had local reactions. No encephalitis, seizures, or hospitalizations were reported. Reactogenicity was similar for the five immunizations of the recommended series and the two manufacturers evaluated. Reported reactions in the control group were significantly lower than in the study group. These reaction rates underline the need to reevaluate present DPT vaccines.
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PMID:Diphtheria-pertussis-tetanus vaccine: reactogenicity of commercial products. 44 Aug 17

IgE levels of 31 infants who had severe complications after whooping cough vaccination, were determined by RIST. The patients had convulsions, encephalitis or anaphylactic shock symptoms. All but two had elevated IgE levels for their age. It is suggested that, in certain genetically predisposed human beings, pertussis antigen can also induce IgE synthesis, as has already been established in rodents.
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PMID:IgE levels of infants with complications after pertussis vaccination. 46 14

Data from the first year of the National Childhood Encephalopathy Study were reviewed to see whether any relation was apparent between pertussis vaccination and brain disease. Three hundred and eighty-seven cases of encephalitis and other specified neurological conditions in which the children were admitted to hospital were reported, of which 267 satisfied the study criteria. Control children were matched for age with the index cases, and medical and immunisation histories were reviewed. Few of the index cases had been vaccinated within 28 days before admission to hospital, so that no close association between vaccination and brain disease existed in most cases. The number of children who had recently been immunised was too small for any statistically useful conclusion to be reached about the risk associated with pertussis vaccine. The study is continuing.
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PMID:National Childhood Encephalopathy Study: an interim report. 70 4

The vaccination status was investigated in 1482 patients between the ages of 1 and 14 years admitted to hospital with scarlet fever. Most of the patients were vaccinated against tuberculosis (97.7%), diphtheria, tetanus and whooping-cough (95.3%) and poliomyelitis (94.1%), relatively few against measles (21.1%) and very few indeed against mumps (0.7%) and tick-borne encephalitis (1.9%). The booster vaccination against tetanus and diphtheria had been omitted in more than 40%. Although the beneficial results of vaccination against tuberculosis, diphtheria-pertussis-tetanus and poliomyelitis remained more or less the same, the tendency towards vaccination did not spread as might have been anticipated. On the contrary, the extent of vaccination decreased, especially during the past years. In the same way the tendency towards vaccination against measles showed a sudden slowing down after a period of rapid increase. This implies that vaccination of children does not tend towards perfection. The vaccination rates differ widely between foreign children living in Vienna and natives. Although the foreigners show a similar vaccination distribution pattern as the natives, the numbers of unvaccinated children are much higher.
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PMID:[Vaccination status of children in the Vienna area (author's transl)]. 74 51

In a murine model of T cell-mediated autoimmune disease, experimental autoimmune encephalitis (EAE), 80% of all encephalitogenic T cell clones in H-2u mice use the V beta 8.2 TCR element. To induce EAE in susceptible strains of mice either heat-killed Bordetella pertussis organisms or Bordetella pertussis toxin (PT) must be injected in addition to Ag in CFA. We investigated the mechanisms by which PT facilitates the induction of EAE. Our data show, that PT interferes with the induction of Ag-induced peripheral T cell anergy. Furthermore it has a specific adjuvanticity for the autoantigen pAc1-11 in vivo and acts as a selective mitogen in vitro. We also tested the hypothesis that PT is a bacterial superantigen that specifically expands the V beta 8.2+ subset of T cells, thereby expanding the encephalitogenic T cell clones that are contained in this subset, so that the number of autoreactive T cells is brought over a critical threshold, necessary to induce autoimmune disease. Our data show that PT is not a superantigen. Staphylococcal enterotoxin B, a V beta 8.2-specific superantigen, does not enhance the immune response to the encephalitogenic peptide.
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PMID:Pertussis toxin prevents the induction of peripheral T cell anergy and enhances the T cell response to an encephalitogenic peptide of myelin basic protein. 171 74

5-15% of all 3-15 year old children in the world are mentally impaired. In fact, 0.4-1.5% (10-30 million) are severely mentally retarded and an additional 60-80 million children are mildly or moderately mentally retarded. Birth asphyxia and birth trauma account for most cases of mental retardation in developing countries. 1.2 million newborns survive with severe brain damage and an equal number die from moderate or severe birth asphyxia. Other causes of mental retardation can also be prevented or treated such as meningitis or encephalitis associated with measles and pertussis; grave malnutrition during the 1st months of life, especially for infants of low birth weight; hyperbilirubinemia in neonates which occurs frequently in Africa and countries in the Pacific; and iodine deficiency. In addition, iron deficiency may even slow development in infants and young children. Current socioeconomic and demographic changes and a rise in the number of employed mothers may withhold the necessary stimulation for normal development from infants and young children. Primary health care (PHC) interventions can prevent many mental handicaps. For example, PHC involves families and communities who take control of their own care. Besides traditional birth attendants, community health workers, nurse midwives, physicians, and other parents must also participate in prevention efforts. For example, they should be trained in appropriate technologies including the risk approach, home risk card, partograph, mouth to mask or bag and mask resuscitation of the newborn, kick count, and ictometer. WHO has field tested all these techniques. These techniques not only prevent mental handicaps but can also be applied at home, health centers, and day-care centers.
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PMID:Prevention of mental handicaps in children in primary health care. 178 28

Bias in the evaluation of CNS complications following pertussis immunization are the following: 1) Notifications of postimmunization adverse events, 2) Publications by vaccine producers on the frequency of adverse reactions, 3) Comparison of permanent brain damage after DPT and DT immunization, 4) Pro-immunization, 5) Immunization associated viral encephalitis, 6) Accuracy of statistics, 7) Personal. A review of these points indicates an underestimation of CNS complications after pertussis immunization.
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PMID:Bias in evaluating CNS complications following pertussis immunization. 179 99

Contrary to the regular immunization schedule for children, the majority of immunization are done in adulthood in case of special risks only, such as old age, chronic illness or exposure. The protection against a variety of communicable diseases has to be monitored and if necessary to be boosted regularly. Based on the routine vaccination scheme 1991 of the Federal Department of Public Health, the following vaccinations which are commercially available in Switzerland are discussed in this review: diphtheria, Haemophilus influenzae, hepatitis B, influenza, measles + mumps + rubella, meningococci, pertussis, pneumococci, poliomyelitis, tetanus, rabies, tuberculosis, varicella and tick encephalitis. Furthermore, the current recommendations are given for the prophylactic and therapeutic use of immunoglobuline preparations.
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PMID:[Active and passive immunization: 1991 status]. 185 65

Communicable diseases represent a considerable burden in terms of suffering and costs. The decision to develop a new vaccine varies with perspectives. The public health perspective is influenced largely by cost-benefit ratios; the community perspective by a strong desire to alleviate suffering and disability from disease and from vaccine side-effects; and that of vaccine producers by demand, technological feasibility of development, and anticipated return on investment. Each of these perspectives is important. However, they often are mutually exclusive. From a humanitarian and epidemiological perspective, the most urgent needs related to communicable diseases are those of the poorest countries; in the industrialised world, with the exception of the vaccine for the acquired immunodeficiency syndrome (AIDS), public health priorities, evaluated in terms of the cost-benefit ratio, often differ from those of the market, which usually selects its priorities according to return on investment. The six vaccines used in the Expanded Programme of Immunisation (EPI) are offered cheaply through a highly efficient bidding system. It would have to be extended, under the same form or differently, to other vaccines, such as those for rabies, hepatitis B, or japanese encephalitis. For vaccines that are being developed, such as conjugated polysaccharide or acellular pertussis vaccines, it is difficult to foresee how these expensive vaccines can be distributed. The situation is even worse for vaccines to be developed specifically for the third world. To make these vaccines available to everyone there must be technology that enables producers to sharply reduce production costs, and a subsidy for research and development and production.
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PMID:Lag between discovery and production of new vaccines for the developing world. 197 2


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