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)

A measles outbreak in an inner-city area primarily involved preschool-aged children younger than 5 years of age. The reasons why 31 unvaccinated preschool children with measles disease had not been vaccinated were investigated. For some patients, health care providers missed opportunities to vaccinate eligible patients against measles. Of the 26 patients whose full immunization status was known, ten (38%) were vaccinated with diphtheria and tetanus toxoids and pertussis vaccine and/or oral poliovirus vaccine at a time when they could have received measles vaccine simultaneously, according to recommendations of the Immunization Practices Advisory Committee and the American Academy of Pediatrics. In addition, five of ten health care providers interviewed missed at least one opportunity to administer measles vaccine because of a minor illness that was not a contraindication to vaccination. Unvaccinated patients were more likely to receive health care in the public sector, have single mothers, and have parents who had no knowledge of existing vaccines; they were less likely to be age-appropriately immunized with other antigens. If measles immunization levels among preschool children in the United States are to be increased, education of both health care providers and parents, coupled with innovative strategies targeted to preschool children, particularly of low socioeconomic groups in inner cities, are needed.
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PMID:Measles outbreak among unvaccinated preschool-aged children: opportunities missed by health care providers to administer measles vaccine. 278

The COVER scheme, a method for the rapid evaluation of vaccine coverage in England and Wales, is described. The primary aim of the scheme is to improve cover by providing health district vaccination programme coordinators with relevant timely information. Quarterly data were obtained from, analysed and promptly fed back to, 126 health districts on cohorts of children who had recently attained the target ages for receiving the selected sentinel vaccines; 18 months for third diphtheria and third pertussis and 2 years for measles. Although the data suggested that vaccination cover is improving, national performance still falls well short of 90%, the 1990 target set by the World Health Organisation for countries in Europe.
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PMID:COVER (cover of vaccination evaluated rapidly): description of the England and Wales scheme. 278 29

A simplified schedule, applicable in developing countries, has been tested for diphtheria, tetanus and pertussis (DTP) and polio immunization. It comprised two injections, six months apart starting at the age of 3 to 8 months. DTP and inactivated polio (IPV) vaccines of special composition and live measles vaccine given at the age of 9 to 14 months induced a good antibody response. Special attention is being given to pertussis immunity. Although low agglutination titers may sometimes be found, DTP vaccination was shown to interrupt the normal periodicity of pertussis epidemics. From the relatively high proportion of vaccines which attained pertussis specific serum IgA antibodies in the course of four years following vaccination, it could be deduced that vaccination does not prevent infection although it protects against disease. Based on these results, successful immunization against seven diseases will be possible in two sessions; DTP, IPV, and BCG vaccinations at the age of 3 to 8 months; and DTP, IPV, measles and yellow fever vaccination at the age of 9 to 14 months.
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PMID:Vaccines and immunization schedules. 286 13

A survey of Washington state pediatricians and allied health professionals showed that two thirds provide written information to parents on diphtheria-tetanus-pertussis; measles-mumps-rubella; and oral polio vaccines. Twenty-two percent of pediatricians provide written information on inactivated polio vaccine. Sixty-two percent of pediatricians who give immunizations require a parent's signature as evidence of having provided information or obtained consent.
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PMID:Pediatricians' immunization consent practices in Washington state. 288 65

Infectious diseases are a primary cause of hearing impairment and produce about 25% of profound losses. Of these, one fifth are congenital. The major infections include rubella, cytomegalovirus, measles, pertussis, meningitis, and acute otitis media. Hearing loss from ototoxicity is also observed with a number of drugs, notably the aminoglycosides, loop diuretics, and cisplatin. Preventive measures are defined according to primary, secondary, and tertiary principles. Three principles of prevention are considered: direct action, defined objectives, and the variability of effective prevention according to cause.
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PMID:Prevention of hearing impairment from infection and ototoxic drugs. 298 88

Oral and inactivated poliomyelitis vaccines (OPV and IPV), were given to 160 children two months old, in a low income population at Rio de Janeiro. The vaccination was repeated 2 and 4 months later, always in association with diphtheria, tetanus and pertussis (DPT) vaccine. Blood specimens were collected before vaccination at the time of the third dose of vaccine and later at the time of measles vaccination, when the children were nine months old. The serological response to two doses of IPV showed high titres of antibody in all but one child and 100% conversion after three doses. Although poliomyelitis has been controlled in Brazil by the use of OPV in large mass campaigns, the results obtained with IPV support the possibility of its use in the basic immunization schedule, providing lower costs could be achieved for the inactivated vaccine.
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PMID:Serological evaluation of poliomyelitis oral and inactivated vaccines in an urban low-income population at Rio de Janeiro, Brazil. 301 70

In developing countries, where economic development is lacking and literacy rates are low, priority must be given to primary health care and to the establishmend of sustainable health care delivery systems. The World Health Organization's Expanded Program of Immunization was designed with the goal of immunizing all children against measles, pertussis, tetanus, poliomyelitis, tuberculosis, and diphtheria by 1990. A second function of the immunization program is to establish a health care delivery system. Today 50% of infants receive 3 doses of diptheria/pertussis/tetanus and polio vaccines, and 70% receive at least 1 dose. Measles kills 2 million children every year. The standard strain of attenuated vaccine is given at 9 months, and 1 dose protects 95% of children for life. Tetanus kills 800,000 infants every year. The vaccine must be refrigerated, and 2 doses are essential. Tuberculosis kills 2 million children under 5 every year. The attenuated BCG vaccine should be given at birth, and a single dose confers some protection. Diphtheria is most common among poor, urban children in termperate climates, and 3 doses of toxoid at monthly intervals are recommended. Poliomyelitis paralyzes 250,000 children a year. 4 doses of live attenuated Sabin vaccine are recommended. The vaccine is very sensitive to heat. Other vaccines in use or being developed include yellow fever, meningococcus, Japanese B encephalitis, rubella, hepatitis B, cholera, rotavirus, pneumonococcus, and Haemophilus influezae. 2 problems that confront the delivery of health services, including immunization, are lack of funds and lack of access to susceptible populations. Approaches to the lack of funds problem include fee for service, taxation, beter management of existing resources, reallocation of health resources, and increased funding from donor nations. Approaches to the problem of access include vaccination whenever children come into contact with a health facility for any reason, channeling by members of the community, involvement of traditional healers and birth attendants, outreach services, mass campaigns, pulse technics, and financial incentives.
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PMID:Vaccination strategies in developing countries. 305 59

Estimates of a recent yearly incidence of 400 000 cases of paralytic poliomyelitis, 2.5 million deaths from measles and its complications, over 1 million deaths from neonatal tetanus, and 735 000 deaths from pertussis in Asia, Africa, and Latin America now pose a greater challenge for new action than did the worldwide eradication of smallpox several years ago. By virtue of the conditions obtaining in the developing countries mere expansion or acceleration of what is being done now--even with modifications that may achieve a temporary increase in vaccine coverage--cannot achieve the desired rapid elimination and continuing control of these diseases. A new strategy--namely, bringing the vaccine to the people during annual national days of vaccination--has already been used successfully in some small and large developing countries of Latin America for the rapid elimination and continuing control of polio. This strategy could be adapted to include vaccination against measles, pertussis, and neonatal tetanus by additional training of community volunteers in the large auxiliary health armies that work with the existing health services each year.
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PMID:Strategy for rapid elimination and continuing control of poliomyelitis and other vaccine preventable diseases of children in developing countries. 308 Nov 60

A 1960-62 study of southwestern Alaskan Eskimos documented an infant mortality rate--102.6 deaths per 1,000 live births--that was four times greater than that of U.S. whites. In 1980-81, 20 years after the original study, a similar cohort was identified in this population so that changes in infant mortality and other birth characteristics could be examined. Average birth weight and the amount of prenatal care received by the mothers increased from 1960 to 1980. Birth weight and prenatal visits were positively correlated. Results of the followup also revealed a 1980-81 infant mortality rate--17.1 deaths per 1,000 live births--that was less than a fifth of the 1960-62 rate and no longer significantly different from the national rate. Major changes associated with the decrease in mortality during the first 28 days of life (neonatal mortality) were a significant increase in the proportion of infants born in hospitals and an associated decrease in the number of deaths of infants weighing less than 2,500 grams at birth. The reduction in mortality during the rest of the first year of life was related to a decrease in deaths due to infectious diseases, particularly measles and pertussis. Changes in infant mortality reflect the increased availability of health care in this region, improved immunization programs, and the establishment of the Bethel Prematernal Home in Bethel, AK.
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PMID:Decline in infant mortality of Alaskan Yupik Eskimos from 1960 to 1980. 308 25

A large, randomized, double-blind trial has made available sufficient data to recommend the simultaneous administration of combined measles-mumps-rubella (MMR), diphtheria and tetanus toxoids and pertussis (DTP), and oral poliovirus (OPV) vaccines to all children 15 months old or older who are eligible to receive these vaccines. In this trial, serologic response and clinical reaction rates following primary immunization with MMR were compared in a test group of 405 children given MMR simultaneously with DTP and OPV and a control group of 410 children given MMR followed by doses of DTP and OPV vaccine 2 months later. Seroconversion rates to each MMR component exceeded 96% in both groups, and the geometric mean titers achieved against the other 6 antigens also were similar in both groups. Rates of most of the common vaccine-associated clinical reactions to DTP and MMR were not augmented by simultaneous administration of these 2 vaccines. Some minor side effects were reported more frequently in the simultaneous-administration group, but these difference were judged to be related to artifacts of the study design rather than to differences in the safety of the 2 vaccine schedules. Data from the Center for Disease Control's Monitoring System for Adverse Events Following Immunization have been reviewed, particularly the information from Idaho, Louisiana, and Tennessee, where policies to administer MMR, DTP, and OPV simultaneously have been in effect for periods ranging from several months to years. The evidence suggests no increased risk of reactions associated with the simulaneous administration of these antigens. The overall implications of simultaneous administartion have not been fully defined, but it is anticipated that implementation of this new schedule will result in at least 3 benefits: a decrease in the number of health care provider visits required for immunization during the 2nd year of life, and accompanying decrease in costs, and an increase in the percentage of children who will be fully or partially immunized by 24 months of age. Some health care providers may continue to prefer administering MMR at 15 months followed by DTP and OPV at 18 months, especially for patients who are known to be compliant.
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PMID:New recommended schedule for active immunization of normal infants and children. 309 14


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