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

It is estimated that 4 million children die each year of vaccine-preventable diseases and that another 4 million are permanently disabled. Although vaccination is the most cost-effective health technology, there is a gap between what we know and what we apply. We seem to be succeeding more in attaining new knowledge than in applying what we know. It takes more than a string of discoveries to provide the benefits of science to the people. Appropriate application of the vaccines presently available against diseases such as measles, poliomyelitis, neonatal tetanus, and pertussis could result in a significant reduction in mortality and morbidity among infants and children attributable to these diseases; continued development and deployment of newer vaccines against some dominant components of the diarrhea-dysentery-pneumonia complex of illnesses could result in further reduction. Improved management practices; more heat-stable, less-expensive, and safer vaccines; and vaccines that require fewer doses are critical for success in future immunization programs.
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PMID:Importance of vaccines in child survival. 266 93

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

The main causes of infant mortality in 71% of the cases are diarrhea, measles, acute respiratory infection, and neonatal tetanus. A UN child survival strategy includes growth monitoring, oral rehydration, breast feeding, immunization, fertility, food and female literacy (GOBI-FFF). Previous research has shown a correlation between low levels of infant mortality and high levels of female literacy. Educated women are more likely to delay marriage, and childbearing. Child mortality is much higher for those born to women under 20 years old and also much higher for those born within 1 or 2 after the previous birth. Maternal mortality is also higher for mothers under 20 and with closely spaced births of 3 or more children. The majority of adults in developing countries have knowledge of family planning but teen pregnancy is a concern. Better nutrition during pregnancy would decrease infant deaths. Growth monitoring is another way to reduce infant mortality and morbidity. The difficulties are in the reluctance to adapt programs to local traditional methods of growth monitoring and going to direct recording scales. Immunization is estimated to have prevented over 3 million deaths from measles, tetanus, whooping cough and polio in 1984 alone. In spite of progress, only 50% of children in developing countries are immunized against diphtheria, pertussis, polio, and tetanus by the age of 1 year. these activities must be integrated into primary health care and community development projects to make better contact with people needing this service. oral rehydration therapy not only reduces mortality from diarrhea but can reduce morbidity by reducing the duration of the illness and by increasing the weight gain. Breast feeding has been shown in many studies to reduce the risk of deaths of infants. The promotion of breast feeding includes the issues of maternity leave, job security, and child care at the work place.
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PMID:Targeted interventions and infant mortality. 269 Apr 13

Adverse reactions after diphtheria, pertussis, tetanus, polio vaccination at 18 months of age were investigated in three groups: 74 children injected in the deltoid muscle with a 16-mm (5/8-in) needle, 64 in the anterolateral thigh with a 16-mm needle, and 67 in the anterolateral thigh with a 25-mm (1-in) needle. No significant differences in systemic reactions were observed. Severe pain occurred in 30.5% of the groups injected in the thigh compared with only 8.1% of the group injected in the arm (P less than .001). Children vaccinated in the thigh had decreased movement of the extremity significantly more often than those injected in the arm (49.9% v 25.6%, P less than .0005), and two thirds of the former limped for 24 to 48 hours. Redness and swelling were observed more often after injection in the arm than in the thigh (58.1% v 26.7%, P less than .0005). The only effect of changing needle length in the groups injected in the thigh was the occurrence of more redness and swelling in children vaccinated with the 16-mm needle compared with the 25-mm needle. Overall, parents rated more reactions as moderate to severe among children injected in the thigh than among children injected in the arm (64.2% v 37.9%, P less than .001). The deltoid muscle appears to be the preferred site for administration of diphtheria, pertussis, tetanus, polio vaccine at 18 months of age.
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PMID:Adverse reactions to diphtheria, tetanus, pertussis-polio vaccination at 18 months of age: effect of injection site and needle length. 229 83

In March 1986 five sudden infant deaths were reported, following the diphtheria-tetanus toxoids-pertussis and inactivated poliomyelitis virus (DTP-IPV) immunization of the infants concerned. An epidemiological study was carried out in order to investigate the possibility of a relationship between this immunization and sudden infant death syndrome (SIDS). A detailed examination of the five cases had been carried out by a doctor. An exhaustive survey of all postneonatal deaths occurring between January and March 1986 was conducted and also a matched case-control survey. No significant differences were found in the immunization rates between SIDS and other causes of death, nor between SIDS and living controls. These results are compared with the results from previously published studies on the topic.
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PMID:Sudden infant death and immunization: an extensive epidemiological approach to the problem in France--winter 1986. 272 54

In 1976, despite a 20-year immunization program, vaccine-preventable diseases (other than smallpox) remained important causes of morbidity and mortality in Thailand. Three major problems were identified: a lack of proper target age groups, inadequate vaccination coverage, and a defective cold chain. The National Expanded Programme on Immunization (EPI), focusing on diphtheria, pertussis, tetanus, poliomyelitis, measles, and tuberculosis, was initiated on a nationwide basis in 1977. Data indicate that the program has reduced morbidity and mortality from most vaccine-preventable diseases in Thailand. The goal of the EPI is to have every eligible child fully immunized with efficacious vaccines by 1990. Strategies have been developed and are being used by the "accelerated EPI" to achieve this goal.
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PMID:Expanded Programme on Immunization in Thailand. 276 97

In the developing world, excluding China, less than 40% of infants receive a third dose of diphtheria-tetanus-pertussis or poliovirus vaccines. More than 3 million children still die annually from measles, neonatal tetanus, and pertussis, while more than a quarter of a million children are crippled by poliomyelitis. Acceleration of existing efforts, with the use of approaches that must differ according to the requirements of individual countries, constitutes the overriding priority for the Expanded Programme on Immunization (EPI). In evaluating immunization programs, priority should be placed on monitoring immunization coverage and disease incidence. Routine reports are essential for this purpose, although they may usefully be supplemented by surveys. The problems revealed by an evaluation of immunization programs can be taken as being generic to the health services as a whole, until proven otherwise. Therefore, in remedying these problems, approaches that improve the health services as a whole should be sought.
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PMID:Global control of vaccine-preventable diseases: how progress can be evaluated. 276 5

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

As part of a study with a quadruple inactivated vaccine (diphtheria-pertussis-tetanus-polio), the serologic response to the pertussis antigen was investigated in infants at the age of routine immunization, inoculated with one of the following two regimens: either 0.5 ml vaccine at 2 and 3 1/2 months and a booster six months later, or an identical dose of vaccine given at 2, 4 and 6 months and a booster at the age of 12 months. A pertussis agglutination titer of greater than or equal to 1:10 was considered an immune response to the administration of the antigen. Two basic doses of pertussis antigen induced an immune response in about 92% of children, which was very close to that following three basic doses. A 100% seroconversion was observed in both groups one month after the booster dose, and geometric mean values were high in both regimens. At one and two years after the booster, the pertussis agglutinins were present in 100% of children of both groups, with higher geometric mean values in the group given the three basic doses regimen.
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PMID:A modified schedule for routine pertussis immunization. 287 16

As part of the evaluation of a new combined Diphtheria-Tetanus-Pertussis-Poliomyelitis (DTP-Polio) inactivated vaccine, the pertussis agglutinin response was studied in 62 infants, two to three months old. Each dose of vaccine combined these antigens in a 0.5 ml volume, and contained at least four International Protective Units of pertussis antigen adsorbed on aluminium hydroxide. Infants were vaccinated with three doses of DTP-Polio vaccine at two month intervals. Pertussis agglutinin determinations showed a satisfactory response after two DTP-Polio vaccine doses. Although higher agglutinin titres were apparent after three doses than after two, no significant difference was observed in the seroconversion rate after two or three doses (88.8% and 96.3% respectively). The DTP-Polio vaccine would thus seem suitable for use in a two-dose primary immunization schedule against pertussis.
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PMID:Pertussis immunization of infants using a new combined DTP-polio vaccine. 287 19


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