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Query: UMLS:C0043167 (pertussis)
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Two children are described with frequent relapsing haemolytic uraemic syndrome. In the first child, the disease reoccurred twice and in the second three times. In both, relapses could be related to a viral infection, as well as to a preceding inoculation for diphtheria--pertussis--tetanus--poliomyelitis in the second patient. Recurrent haemolytic-uraemic syndrome (H.U.S.) may constitute a discrete clinical form of H.U.S.
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PMID:Recurrent haemolytic uraemic syndrome. 5 34

The expanded programme on immunization feasibility studies is currently running into its second year of operations. The objectives of the study are to test the possibility of increased coverage using both fixed centre and mobile field teams for the vaccination of children under the age of 2 years against measles, poliomyelitis, diphtheria, pertussis, tuberculosis and smallpox and also to test the immunological response to two doses of pertussis and two doses of oral polio. Reports so far indicate some success in the areas of training and manpower development as well as the development of the cold chain system which is considered to be the most important requirement for an efficient, expanded immunization programme. It goes without saying that the progress of the study has been marked by some technical, social and administrative constraints.
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PMID:The expanded program in immunization. Ghana's experience. 11 81

A major purpose of a state-wide survey to document the vaccination status of 1,003 2-year-old children was to identify factors associated with failure to receive the recommended vaccinations. With a basic series of immunization defined as three doses of diphtheria-tetanus-pertussis (DTP), three oral polio vaccine (OPV), one measles, and one rubella, 72.5% of the children had completed the series. When the completed series was redefined to include a fourth DTP and mumps vaccine the rate of completion dropped to 40.8%. However, 59.1% of the children who had not completed this optimal series could be brought up-to-date with a single visit to their provider of medical care. Demographic variables independently associated with completion of the basic series were increased paternal education (P less than .001), increased maternal education (P less than .02), smaller family size (P less than .01) and higher socioeconomic status, as determined by census tract or rural town of residence (P less than .02). Race was not found to be a factor associated with vaccination rates when socioeconomic status was controlled. Patients who received their vaccinations from private physicians had a better vaccination rate than those who attended health department clinics. This difference persisted even when socioeconomic status was controlled by residence (P less than .02). The simultaneous comparison of parental education and family size demonstrated that a child having one parent with less than 12 years education or having at least three siblings has a fourfold greater risk of failure to complete his immunization than children whose parents are both college graduates. By using paternal and maternal education level and family size as screening variables, children at high risk for failure to complete their immunizations could be identified prospectively and made the target of intervention programs to improve compliance.
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PMID:Risk factors associated with failure to receive vaccinations. 48 72

Herd infections, especially in children, are strongly influenced epidemiologically by social and demographic factors which have contributed favorably to a general decline in incidence and mortality during the past 50 years or more. Intervention procedures such as immunization cannot be evaluated or planned realistically except against these background factors. Assessed in this way, immunization against diphtheria and poliomyelitis was unequivocally effective in reducing incidence and morbidity of these diseases. By comparison, pertussis vaccine has a very limited protective effect, the value of which, as morbidity decreases, may be offset by the intrinsic toxicity of the vaccine and by the possibility of infrequent but severe brain damage in some children.
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PMID:Infection and immunization. 49 31

Quadruple vaccines (DTP-P), prepared by mixing crude adsorbed Salk poliomyelitis vaccines, heat-killed pertussis vaccines and adsorbed purified diphtheria and tetanus toxoids were found to be toxic for mice. However, by using purified poliomyelitis and heat-killed formalinized pertussis components, vaccines were prepared that were non-toxic. The pertussis component of these vaccines retained potency over extended periods of storage. Stable, potent DTP-P vaccines offer an excellent alternative to DTP and live poliomyelitis vaccine in the basic immunization of infants and children.
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PMID:Quadruple vaccines containing pertussis and poliomyelitis vaccines. 56 23

Serum antibodies (AB) have been measured before and after vaccination in haemodialysed children. The main finding was a normal increase in AB titres following adsorbed vaccines (diphtheria, tetanus, pertussis and poliomyelitis) demonstrating a normal humoral immune ability. By contrast, a poor response to live attenuated viruses (poliomyelitis and measles) was observed. Two additional findings were an inhibitor effect of tetanus toxoid in mice by uraemic serum, and a constant negative Schick test indicative of suppressed non-specific skin reactivity.
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PMID:Serum antibodies before and after immunisation in haemodialysed children. 60 Sep 57

Investigation of measles outbreaks during the fall of 1976 led to the discovery that Alkaska's school immunization law was not being enforced. In an effort to control a large outbreak of measles in Fairbanks, children were required to show proof of measles vaccination or be excluded from school. Of the Fairbanks schoolchildren, 25% were vaccinated against measles; 1,251 (11%) of 11,727 unvaccinated schoolchildren were excluded in January, and no further cases of measles occurred. Subsequently, the school law was enforced statewide, and on March 1, 1977, all children not immunized against diphtheria, tetanus, pertussis, polio, measles, and rubella were excluded from school (7,418 [8.3%] of 89,108). One month later, fewer than 51 children still did not meet immunization requirements. More than 35,000 children were vaccinated in the immunization campaign; no adverse side effects to any vaccine were reported.
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PMID:Enforcement of school immunization law in Alaska. 64 53

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 controlled field-trial in infants in the Philippines, a two-dose schedule with an interval of 6 months between injections using a concentrated adsorbed DPT-vaccine was evaluated. The serologic response against the three components in the vaccine was satisfactory, whereas the side-effects in the concentrated vaccine group did not differ from those observed in a control DPT group. After two injections, the coverage percentage with DPT-vaccine was shown to be higher than 70%. Two implications of the introduction of the two-dose DPT-immunization schedule are discussed, i.e. (a) the possibility of using it as the nucleus of a complete schedule including immunization against poliomyelitis, BCG, smallpox and measles, and (b) the consequences which the interval of 6 months might have on the epidemiological spread of B. pertussis infections.
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PMID:A two-dose schedule for immunization of infants using a more concentrated DPT-vaccine. 75 47

Various workers, including T. D. Stewart, claim that the aboriginal Americas were relatively disease-free because of the bering Strait cold-screen, eliminating many pathogens, and the paucity of zoonotic infections because of few domestic animals. Evidence of varying validity suggests that precontact Americns had their own strains of treponemic infections, bacillary and amoebic dysenteries, influenza and viral penumonia and other respiratory diseases, salmonellosis and perhaps other food poisoning, various arthritides, some endoparasites such as the ascarids, and several geographically circumscribed diseases such as the rickettsial verruca (Carrion's disease) and New World leishmaniasis and trypanosomiasis. Questionably aboriginal are tuberculosis and typhus. Accordingly, virtually all the "crowd-type" ecopathogenic diseases such as smallpox, yellow fever, typhoid, malaria, measles, pertussis, polio, etc., appear to have been absent from the New World, and were only brought in by White conquerors and their Black slaves. My hypothesis is that native American medical care systems--especially in the more culturally advanced areas--were sufficiently sophisticated to deal with native disease entities with reasonable competence. But native medical systems could not cope with the "crowd-type" disease imports that struck Indian and Eskimos as "virgin-field" populations. Reanalysis of native population losses through a genocidal combination of diease, war, slavery and attendant cultural disruption by Dobyns, Cook and others strongly suggest that traditiona estimates underplayed the death toll by a factor of the general order of ten. This would make for an immediately pre-contact Indian population of some 90-111 million instead of the tradition 8-11 million. Evidence is growing that Indians may have been no more susceptible to new pathogens that are other "virgin soil" populations, and thus their immune systems need not be considered less effective than those in other people. Present-day high mortality rates in Indians of both continents from infectious disease imports may be more socioeconomic than anything else.
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PMID:Aboriginal new world epidemiolgy and medical care, and the impact of Old World disease imports. 79 20


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