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

During a pertussis epidemic, the majority of children admitted with respiratory disease were under one year old and had pneumonia, with or without pertussis syndrome; heart failure was common. A greater proportion of those with 'pneumonia alone' were slightly older, were malnourished, were admitted earlier and recovered slightly faster than those who had 'pertussis with pneumonia'. Differential white cell count was of little help in diagnosis and chest X-ray findings seldom altered management. Eight percent of the pertussis and 3 percent of the pneumonia groups died: all had pneumonia and additional complications, and 71 percent of those who died were under one year of age. Results suggest that two or more infections of triple antigen may protect some children from an attack of pertussis so severe that hospital care would be needed.
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PMID:Childhood pertussis and pneumonia admissions in the highlands of Papua New Guinea. 27 31

Although guinea pigs have been frequently used as a model of asthma, antibodies produced in this species are generally gamma1 and gamma2 and belong to IgG. The antibody responsible for asthmatic attacks in humans is IgE, and such is quite different from gamma1 and gamma2, immunologically. Guinea pigs are not therefore an adequate model for investigating anti-asthmatic drugs which inhibit IgE-mediated mediator release, such as disodium cromoglycate. On the other hand, rats do produce an antibody similar to human IgE, the so-called homocytotropic antibody (HTA), by sensitization with dinitrophenylated ascaris extract (DNP-As) together with killed Bordetella pertussis as an adjuvant. To rats actively sensitized with DNP-As or passively sensitized with HTA serum against DNP-As, intravenous administration of antigen did not produce a transient increase in respiration (unlike that of guinea pigs) immediately after the antigen treatment, but a respiratory disorder similar to that seen during asthmatic attacks in humans did occur. The response to antigen was reproducible in passively sensitized rats compared with that of actively sensitized ones, though the symptom was moderate. The effect of N(3', 4'-dimethoxycinnamoyl) anthranilic acid (N-5'), a new anti-allergic drug, was determined in cases of experimental asthma in passively sensitized rats. Respiratory disorders as a result of antigen were clearly inhibited with oral administration of this agent.
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PMID:[Experimental asthma in rats, and the effect of N (3', 4'-dimethoxycinnamoyl) anthranilic acid (N-5') (author's transl)]. 71 Oct 29

Young dogs of two age groups, six weeks and 12 weeks respectively, were infected by aerosol with a strain of Bordetella bronchiseptica which had been isolated from a dog with pneumonia. Clinical respiratory disease characterised by coughing and in some cases purulent nasal discharge was induced in both groups of infected dogs and also in dogs kept in contact. B bronchiseptica was recovered from the nasal cavity, trachea, bronchi and lung parenchyma of infected and contact animals. At necropsy, masses of Gram-negative bacteria were found trapped in the cilia of the respiratory epithelia and there was an exudate containing neutrophils in the mucosae of the respiratory tract at all levels. A close similarity was noted between the lesions produced in the dog and those described in pertussis infection in man. Experimental respiratory disease in the dog due to B bronchiseptica may offer a model system for the study of the human disease.
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PMID:Experimental respiratory disease in dogs due to Bordetella bronchiseptica. 125 23

An analysis of the risk factors for pertussis and the possible respiratory sequels was carried out in a sample of 499 children and adolescents aged 10-16 years from the general population in north-eastern France. 44 subjects (8.8%) had pertussis during childhood; and the sex ratio was 1 in these cases. Pertussis was significantly associated with a maternal history of respiratory disease, residence in a rural area and coal heating. In a multiple logistic regression model, a maternal history of respiratory disease was the only significant factor (p = 0.01), the number of siblings being of borderline significance (p = 0.06). No increase in respiratory symptoms or asthma prevalence was found in our subjects who had pertussis during childhood.
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PMID:Pertussis in French adolescents: risk factors and respiratory sequels. 185 76

During a 3-year survey of 805 children with acute lower respiratory tract infection (ALRI) who were admitted to three hospitals in Buenos Aires, 31 fatal cases were recorded--a fatality rate of 3.8%. Of the 31 children who died, 77% were less than 1 year of age, 48% were boys, 58% were malnourished, 29% had previous respiratory disease, and 22% had previous congenital disease. All children who died had clinical diagnoses of pneumonia (71%) or bronchiolitis (29%). Autopsies were performed in 14 of the cases. Viral etiology was determined by both cell culture and indirect immunofluorescence (IIF) assay of either nasopharyngeal aspirates (NPA) or lung tissue and bacterial etiology was determined by isolation of organisms from blood, lung tissue, and/or pleural fluid. NPA was examined for Bordetella pertussis by IIF. Pathogens were identified in 65% of fatal cases. Seven cases were bacterial; seven cases were viral; and six cases resulted from mixed infections. Lung tissue yielded positive etiologic results in 10 of 13 cases. Histopathologic examination performed on specimens from the 14 autopsied children revealed necrotizing bronchiolitis with intranuclear inclusions (n = 5) and multifocal pneumonia (n = 9).
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PMID:Etiologic, clinical, and pathologic analysis of 31 fatal cases of acute respiratory tract infection in Argentinian children under 5 years of age. 227 Apr 6

Pertussis (whooping cough) is an acute respiratory disease caused by Bordetella pertussis. It occurs worldwide and is an important cause of morbidity and mortality in areas where immunization rates are low, particularly among children less than 1 year of age. The characteristic presentation of pertussis is paroxysmal coughing followed by a long inspiratory effort that produces the classic whoop. Lymphocytosis is frequently present. Complications include pneumonia and seizures secondary to hypoxia. The paroxysmal and convalescent stages of the illness can each last several weeks. Transmission occurs readily by respiratory droplets, and atypical or mild cases in older children and adults can be important in spread of the infection. Isolation, early erythromycin therapy, and erythromycin prophylaxis can reduce transmission, but vaccination is the primary means of control. An inactivated whole cell suspension of the bacterium has been an effective vaccine for protecting against pertussis since the 1950s, but whole cell vaccine may allow mild infections to occur and has been associated with local and systemic reactions that have eroded public acceptance. Component or acellular pertussis vaccines that are less reactogenic have been in use in Japan since 1981 and appear to be effective there. Development of an acellular preparation that is equally or more efficacious than whole cell vaccine may be possible, but clinical trials for measurement of protection against pertussis are difficult and trials with new pertussis vaccines will have to be carefully performed to avoid the controversies generated by earlier trials.
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PMID:Prevention of pertussis. 256 May 81

Despite the increasing prevalence of pertussis in young adults and infants, reports of maternal-neonatal pertussis are rare. Our study involves three neonates who apparently acquired pertussis from their adolescent mothers. The diagnosis of pertussis was initially missed in all of the patients. The mothers had mild respiratory disease. All three newborns presented with life-threatening coughing and choking spells without a characteristic inspiratory whoop. Two neonates had apnea, bradycardia, cyanosis, and unresponsiveness, but were without the initial lymphocytosis that is distinctive of pertussis. These two neonates had a clinical course that was consistent with the historic "100-day-cough." They required prolonged ventilatory support and hospitalization at a high cost. The other neonate had a terminal pulmonary hemorrhage. Strategies for the early diagnosis, treatment, and prevention of this potentially lethal disease in neonates are discussed.
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PMID:Pertussis in neonates. 280 62

Pertussis is a serious respiratory disease in infants. Immunization prevents infection in some; in others it permits infection but prevents disease. Epidemics occur when immunization rates fall. Whole-cell vaccine has proved to be a safe and effective method of disease control. Whole-cell vaccines have been used because the bacterial components responsible for immunity have not been identified. New component vaccines have not been licensed in the United States because they do not meet standards for efficacy. Whole-cell pertussis vaccine has been associated with febrile and afebrile seizures which are generalized and occur within 72 hours of immunization. Permanent brain damage caused by pertussis vaccine is rare. One study suggested a risk of 1:310,000 immunizations which is not precise and probably excessive; however, even using this figure, the risk-benefit ratio for 3 immunizations is favorable when compared to the risks of the natural disease. Child neurologists should recommended immunization for brain damaged infants with static or chronic brain syndromes. Pertussis immunization should be delayed or omitted when the neurologic status is unclear.
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PMID:Pertussis: the disease and the vaccine. 307 5

Pertussis is a common, highly infectious, respiratory disease that predominantly affects children. As many as 60 million cases with more than a 1/2 million deaths occur annually. The highest incidence rates are observed in developing countries where immunization coverage is low. Accurate diagnosis under field conditions is hampered by current laboratory methods. The control of pertussis is accomplished largely through immunization and improvement of socioeconomic conditions. Although the adsorbed DPT vaccine is associated with some side effects, its benefits outweigh the risks when the vaccine sequelae are compared with the morbidity and mortality caused by the natural disease. Surveillance of pertussis and outbreak investigations provide valuable information about the disease and its effectiveness of ongoing immunization programs. (author's)
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PMID:Pertussis: epidemiology and control. 348 48

Incidental to a phase II study of acellular and whole-cell pertussis vaccines involving 342 infants who were clinically observed from birth until the age of 9 months, subclinical pertussis was retrospectively diagnosed in 10 infants on the basis of serological evidence. IgG and IgA to filamentous haemagglutinin (FHA), pertussis toxin (PT) and agglutinogens 2 and 3 (AGG2, 3) were assayed by enzyme-linked immunosorbent assay (ELISA) in serum obtained at birth and at 2, 4, 6 and 9 months of age. All 10 infants had > or = 4-fold rises in at least two different pertussis IgG antibodies. Nine of the 10 infants had > or = 4-fold increases in all three IgG antibodies measured. One infant had > or = 4-fold increases in IgG-FHA and IgG-AGG2,3 but not IgG-PT. Seven infants had raised IgA antibodies to PT and FHA and 4 infants had raised IgA antibodies to AGG2,3. Subclinical infection provoked differing degrees of antibody production in response to multiple antigens. Subclinical infection was detected in both unvaccinated infants (4) and in infants who had been vaccinated from 2 months of age with either acellular (4) or whole-cell vaccines (2). Subjects were 8 months of age or younger and only 1 had completed primary vaccination. Other infections of infancy were commonly detected; 4 infants had upper respiratory disease about the time of subclinical pertussis. None had a household member with symptomatic pertussis. Likelihood of subclinical infection was related to significantly lower levels of maternally acquired pertussis IgG-AGG2,3 antibodies but not associated with infants' nutritional status.
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PMID:Subclinical pertussis in incompletely vaccinated and unvaccinated infants. 748 85


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