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

This paper is a partial cost-minimization analysis of preschool immunization delivery in Alberta and Ontario. Public health nurses deliver such immunization in Alberta while in Ontario it is usually provided by private physicians. In constant 1986 dollars, labour costs were 2.9 times higher in Ontario than in Alberta. Alberta and Ontario achieved equal success in preventing diphtheria, tetanus and poliomyelitis in the target population of zero to four years of age. Ontario's pertussis rates were higher than Alberta's from 1980 to 1986 inclusive (p less than 0.01). Rubella rates were higher in Alberta from 1980 to 1986 inclusive (p less than 0.05) but the congenital rubella rates for the same period were not. During 1980, Ontario's measles rate was higher (p less than 0.01) while for 1982 and 1986, Alberta's measles rates were higher. In 1986, Alberta's mumps rate was higher than Ontario's (p less than 0.01). The findings argue in favour of the less costly public health nurse approach to immunization delivery. A more definitive conclusion could have been reached had the provinces maintained more detailed age-specific disease incidence data.
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PMID:Infant and preschool immunization delivery in Alberta and Ontario: a partial cost-minimization analysis. 211 28

Vaccination has dramatically reduced the morbidity and mortality rates of a number of diseases. The crucial element of vaccination programs is commitment to widespread coverage and to containment of outbreaks. Vaccines have led to virtual elimination of poliomyelitis and promise to eliminate measles. The incidence of congenital rubella syndrome will probably only be diminished if vaccination is extended to all 1-year-olds and susceptible prepubertal girls. The employment of diphtheria toxoid is one of the great success stories in public health. The incidence of pertussis has declined because of the diphtheria-pertussis-tetanus (DPT) vaccine given to infants, although elimination of the disease will probably have to await development of a more potent pertussis antigen. A remarkable reduction in the incidence of tetanus and tuberculosis has also been achieved.
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PMID:Impact of vaccination on selected diseases in Canada. 397 83

The resolution creating the Expanded Programme on Immunization (EPI) was adopted by the World Health Assembly in 1974. Program policies were formalized in 1977, when the goal of providing immunization services for all children throughout the world by 1995 was set and WHO's priority attention to developing countries was specified. Immunization programs in Europe have had dramatic success in reducing morbidity and mortality from diphtheria, measles, neonatal tetanus, pertussis, and poliomyelitis. But there are still challenges to be met within the region. Targets adopted for the European region include 1) formal declaration of a commitment to the EPI goals and activities and definition of national targets for morbidity reduction for 1990 for each disease in the regional EPI; 2) development of a program to maintain immunization protection throughout life by 1986; 3) establishment of a system for monitoring suspected adverse effects of immunization by 1986; 4) completion of the basic immunization series by at least 90% of children no later than their 2nd birthday by 1990; 5) elimination of indigenous poliomyelitis, neonatal tetanus, and diphtheria by 1990; 6) elimination of indigenous measles by 1990 where effective immunization programs are already operating or 1995 in other areas; and 6) elimination of congenital rubella by the year 2000. In addition to optimizing their own national immunization rpograms, countries of the European region can also make valuable contributions to EPI programs elsewhere. In particular, monitoring of vaccine safety and efficacy can most readily be performed in developed regions, and quality control tests on vaccines will continue to be performed largely in laboratories in the industrial countries. Support will also be required in training staff from developing countries in appropriate testing techniques, and in giving the trainees both moral and financial support after their return to their own countries. Continued leadership from the countries of the European region will not only benefit the health of their own populations but will provide invaluable guidance to developing countries as their own immunization systems mature.
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PMID:Expanded Programme on Immunization: the continuing role of the European Region. 406 Jul 6

Immunisation has proved to be a generally safe and effective means of disease control, particularly where environmental approaches are impractical. Recent developments in vaccine production, aimed at selecting or synthesising in pure form the antigens needed to evoke a protective response, give hope of more effective and less toxic vaccines in future. Adequate trials of improved vaccines may, however, be difficult to carry out under modern conditions. Policies for the use of vaccines are sometimes controversial, particularly when there is concern about reactions, as with pertussis vaccine. Acceptance rates for measles and rubella vaccines in the UK have hitherto been disappointingly low and need to be increased if the aims of elimination of measles and congenital rubella are to be achieved. Cost-benefit analyses generally support the use of immunisation in disease control.
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PMID:Immunisation practice and policy. 651 78

The European region is passing through a period of rapid transition with the most dramatic changes in the countries of central and eastern Europe (CCEE) and the former USSR. These countries are now facing serious economic problems, a dramatic rise in unemployment and social unrest which has had an impact on the development of the regional immunization programme. The provision of an adequate vaccine supply has become a priority for many States in the region in their efforts to sustain immunization activities. New operational targets for the EPI in Europe in the 1990s were established by the European Advisory Group (Copenhagen, February 1993). These operational targets identify the steps to be followed by countries in order to achieve, by the year 2000, no indigenous cases of poliomyelitis, diphtheria, neonatal tetanus, measles, mumps and congenital rubella. They also include a sustained and continuing reduction in the incidence and adverse consequences of other communicable diseases, notably HIV infection (European target 5). Immunization coverage is generally high and stable in the Region. It was observed in 1990-1992 that pockets of non-immunized persons in any country can lead to outbreaks of disease. Most Member States, however, do not yet use immunization coverage for operational purposes despite being encouraged to monitor by geographical unit. Insufficient protection against pertussis has been observed in countries including Italy, the Russian Federation and Sweden (where pertussis immunization is not obligatory) and represents the build-up of a large susceptible population.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The regional vaccination program in Europe (1991-1993)]. 792 79

In 1993, the Childhood Immunization Initiative (CII) established disease elimination goals for six childhood vaccine-preventable diseases. Specific goals for 1996 include elimination of indigenous transmission of measles, rubella (and congenital rubella syndrome [CRS]), poliomyelitis (polio) caused by wild poliovirus, and diphtheria in all age groups; elimination of tetanus in children aged < 15 years; and elimination of invasive disease due to Haemophilus influenzae type b (Hib) in children aged < 5 years. This report summarizes progress toward reaching these goals during January-August 1994, compares these findings with those from the same period during 1993, and provides information about mumps and pertussis--diseases for which reduction goals will be established.
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PMID:Update: childhood vaccine-preventable diseases--United States, 1994. 809 Jan 60

In the United States, children are routinely vaccinated against nine diseases--diphtheria, Haemophilus influenzae type b (Hib), hepatitis B, measles, mumps, pertussis, poliomyelitis (paralytic), rubella, and tetanus. Based on public health surveillance and epidemiologic assessment of most of these diseases, the impact of childhood vaccination on reported occurrence has been substantial: provisional surveillance data for 1993 indicate that for five of these diseases and for congenital rubella syndrome (CRS), the number of reported cases is at or near the lowest levels ever, suggesting near interruption of transmission of these diseases. This report presents provisional data for December 1993 for these 10 diseases, compares provisional data for 1993 with final data for 1992, and describes the Childhood Immunization Initiative (CII).
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PMID:Reported vaccine-preventable diseases--United States, 1993, and the childhood immunization initiative. 829 25

Infections were considered to be etiological factors in 29 patients (10%) with infantile spasms; congenital CMV (n = 5), congenital or acquired CMV (n = 1), acquired CMV (n = 5), congenital rubella (n = 2), herpes simplex virus (n = 5), enterovirus (n = 1), adenovirus (n = 1), viral encephalitis of unknown agent (n = 3), meningococcus (n = 4), pneumococcus (n = 1) and pertussis (n = 1). The children with congenital infections had long-lasting tremor and convulsions from birth. Early EEG pattern was characteristic for children with herpes encephalitis but not for other patients. Infantile spasms appeared only some weeks after viral encephalitis. One patient with enterovirus and another with probable adenovirus infection had necrotic changes in their brain CT resembling those of herpes encephalitis. The response to ACTH was poor (38%) compared to the whole series (60%). The long-term outcome was also poor compared to the whole series; mental retardation in 90%, convulsions in 62%, abnormal EEG in 89%. Four children died during the follow-up of 7 years. Autopsy showed disseminated CMV infection in one patient and chronic CMV infection in another. The outcome of children with infectious etiology appears to be particularly poor. Thus, the prevention and specific diagnosis and treatment are important. Steroid therapy should be avoided in children with a history of herpes virus encephalitis (CMV, herpes simplex) in the past.
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PMID:Infantile spasms: infectious disorders. 830 17

Vaccination has dramatically reduced the number of annual cases of pertussis, diphtheria, measles and congenital rubella syndrome. Although side effects of immunizations can occur, serious adverse events are rare for all vaccines commonly used in the United States. Infantile spasms and sudden infant death syndrome are not associated with childhood vaccines. Compared with whole-cell pertussis vaccine, acellular pertussis vaccines are significantly less likely to produce moderate reactions such as fever, fussiness, pain, drowsiness, anorexia and local redness or swelling. Despite the documented safety and efficacy of childhood vaccines, concerns about vaccine safety increase when diseases such as measles, pertussis and rubella are no longer common. Parents need to be reminded that their child is susceptible to these diseases, that these diseases are preventable by reasonably safe and effective immunizations and that their child needs a series of vaccines at regular intervals by the age of two years. Since 1994, all physicians have been required by law to use the Vaccine information Statements for measles-mumps-rubella vaccine, diphtheria and tetanus toxoids and pertussis vaccine, poliovirus vaccines and tetanus and diphtheria toxoids for adults.
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PMID:An update on vaccine safety. 867 34

In contrast to the 1980s, immunization rates increased dramatically in the United States in the mid-1990s. Three-quarters of all 2-year-olds had received all recommended immunizations in 1997 as compared to just over one-half in 1992. Immunization rates for individual vaccines have reached 90 percent for three of the vaccines--measles, mumps, rubella; pollo; and Haemophilus influenzae type b (Hib). The vaccine for diphtheria, tetanus and pertussis, however, and the newer vaccine for hepatitis B have not yet reached 90 percent of 2-year-olds. The rising immunization levels in young children have resulted in declining incidence of almost all of the vaccine-preventable illnesses. Cases of measles and Hib have declined 95 percent and the incidence of rubella and congenital rubella, hepatitis B and mumps has also declined. Pertussis (whooping cough), however, continued its pattern of periodic increases and decreases. This lack of improvement is probably due to a combination of lower immunization levels for pertussis and waning immunity in previously immunized adolescents and young adults. Federal efforts such as the President's Childhood Immunization Initiative along with its Vaccines for Children program have been credited for a great deal of this improvement. These programs increased public awareness of the need for and access to immunizations, better tracking of immunizations and vaccine-preventable illnesses and have also removed cost barriers to receipt of such protection. At the same time, new vaccines (against chickenpox and rotavirus) and safer versions of older vaccines (pertussis) have been brought into widespread use. Children can now be vaccinated against increasing varieties of childhood diseases. While progress in immunization has been good, areas in need of improvement remain. Pertussis continues to be a problem both in terms of incidence and immunization levels. Also, immunization levels differ significantly by poverty level and race and ethnicity. Black, Hisparic, American Indian and Asian children are less likely to be fully immunized than non-Hispanic white children and poor children are less likely to be fully immunized than nonpoor children.
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PMID:Immunization and vaccine-preventable illness, United States, 1992 to 1997. 1032 22


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