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

There has been a noticeable increase in the incidence of pertussis in West Germany over the last decade. Since the availability of adequate bacteriological diagnosis a much broader clinical spectrum can be attributed to infections with B. pertussis. Three patients with an unusual clinical presentation of pertussis are presented. A three month old infant presented with severe apneic spells without cough as the sole clinical symptoms of the infection. B. pertussis was isolated in the nasopharyngeal swab. A nine month old premature infant with bronchopulmonary dysplasia after long time intubation and artificial ventilation presented with apneic spells, pulmonary and cardiac decompensation and required ventilatory support. The diagnosis was suggested by a massive leucocytosis with lymphocytosis. The diagnosis on the patient was established by serologic methods. Adult contacts of this patient developed longstanding cough and clinical signs of pertussis. The diagnosis of pertussis in these persons was established by nasopharyngeal culture. The third patient with trisomy 21 and a corrected AV canal suffered from nonspecific cough and gradually developed signs of congestive heart failure with pneumonia. B. pertussis was isolated from the nasopharynx. This patient showed neither the typical paroxysmal coughing spells nor disclosed the typical lymphocytosis in his white blood count. Microbiological investigations of patients with symptoms of respiratory tract infections should include the isolation of B. pertussis. Thus, additional cases of pertussis not suspected on the basis of their initial clinical presentation will be detected.
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PMID:[Pertussis--an illness with typical clinical symptoms?]. 143 95

Whooping cough continues to be a major childhood disease in parts of West Germany. At age six, more than one third of the children in our area have had pertussis according to parental information, whereas only 12% received a specific vaccination. During a four-year period from 1984 to 1987, a total of 2,881 clinically diagnosed cases of whooping cough were investigated. The children had a mean age of 4.1 years, 11% of all patients were younger than one year and 6% of the patients were adults with a mean age of 35.8 years. No sex difference was observed in children (less than 20 years) with clinically overt whooping cough. The seasonal distribution showed that whooping cough was present throughout the year, peaking in early winter. In relation to clinical symptoms, the isolation rate of Bordetella pertussis or Bordetella parapertussis from nasopharyngeal swabs continuously decreased with the duration of paroxysms, starting with 56% positive swabs on day 1. Titers (greater than or equal to 1:100) of IgA-antibodies to B. pertussis antigens increased with the duration of paroxysmal coughing. B. pertussis, however, was also isolated from 152 of 964 patients without the clinical signs of whooping cough. IgA-antibodies were also found in 522 patients with non-typical respiratory symptoms, but not in healthy blood donors. Children with clinically diagnosed whooping cough were compared to a group of children showing the symptoms but without any clinical or laboratory signs of whooping cough. We can assume from our data that the incidence and duration of non-paroxysmal coughing, the nocturnal increase in coughing, fever, auscultatory findings and a contact anamnesis occurred with a similar frequency in the whooping cough group and the control group. Apart from the typical paroxysmal fits, whooping and vomiting were found significantly more often in the pertussis group. At least 19% of patients with a recent infection with B. pertussis, however, were not diagnosed by clinical symptoms. The leukocyte count differed only marginally between the three groups and was of no great diagnostic value. A relative lymphocytosis, however, was found significantly more often in whooping cough patients and in patients with laboratory-diagnosed infection with B. pertussis. Our study indicates that part of the symptomatology and some laboratory findings in whooping cough patients in endemic areas of West Germany may differ from the classical form of the disease. Furthermore, our data stress the importance of an accurate procedure in diagnosing B. pertussis infection, and this can be facilitated by a combination of bacteriological and serological tests.
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PMID:The epidemiological situation of pertussis in the Federal Republic of Germany. 177 29

In a clinical trial of stabilized yellow fever vaccine from Institute Pasteur in 77 children aged seven to eight months, fever was the most significant immediate and delayed side effect. Fever occurred in 12 (15.6%) children with in 48 hours of vaccination while it occurred in 10 (12.9%) children within ten days of vaccination. Other recorded side effects were pain at innoculation site in four (5.2%) children and vomiting in one (1.3%) child. Temperature recorded in 20 of the 22 febrile episodes ranged from 37.8 degrees C to 38.6 degrees C. One of the two patients who had temperatures of 39 degrees C and above had malaria parasites in her blood film. All episodes of fever except one responded to antipyretic. There was no episode of febrile convulsion and no feature suggestive of encephalitis. Of the 20 children who had neutralization test carried out against yellow fever virus six weeks after vaccination, the test was positive in post vaccination sera of 12 (60%) children whose pre-vaccination sera were negative. Two others showed evidence of partial protection. Although the seroconversion rate of 60% is less than reported in adults and older children, the result of this study shows that yellow fever vaccine is safe and fairly effective in infants. It is our suggestion that if a larger trial confirms our findings, the vaccine may be incorporated into the expanded programme on immunization (EPI) to be given at the age of seven months after completion of diptheria, tetanus, pertussis and poliomyelitis vaccinations and before measles vaccination is due.
West Afr J Med
PMID:Safety and efficacy of yellow fever vaccine in children less thanone-year-old. 227 33

Pertussis is a severe epidemic disease that causes significant morbidity and mortality in unimmunized children. It is now clear, however, that adults with atypical disease account for many of the cases and are often responsible for transmission to susceptible infants. Because of the extent of unrecognized pertussis in the adult population, mass pediatric immunization has been successful in controlling the disease in children but not in reducing the presence of the organism in the United States. Pertussis immunization of children is associated with a high rate of side reactions and is temporally related to severe neurologic disease and death in infants. These events are often considered to be reactions, but available scientific evidence indicates that few, if any, are actually caused by pertussis immunization. Pertussis vaccine reactogenicity in adults is anecdotally considered to be worse than in children, but direct studies do not support that. In the context of current programs emphasizing adult immunization, consideration should be given to booster doses of diphtheria-tetanus-pertussis in adults, using component pertussis vaccines when they become available.
West J Med 1989 Mar
PMID:The past, present, and future of pertussis. The role of adults in epidemiology and future control. 276 49

A sero-epidemiological survey of pertussis and a field trial with acellular pertussis vaccine was carried out in children in a rural village in Ghana, West Africa. ELISA antibody assays in 109 children aged three months to three years disclosed the rapid disappearance of transplacental maternal antibody in early infancy and the accumulation of seronegative children under three years of age. One hundred and ten children aged three months to three years were immunized with the newly developed acellular pertussis vaccine; 32 were immunized twice and 77 were immunized three times. Serological responses after immunization were measured in both groups. There were no severe adverse reactions attributable to vaccine injections among the children studied.
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PMID:Clinical and serological reactions after immunization of children in Ghana, West Africa, with the Japanese acellular pertussis vaccine. 287 30

A new combined DPT-Poliovirus vaccine (DPTP) has been developed in France. It contains the DPT components mixed with poliovirus antigens, prepared by culture on vero cells on microcarriers, inactivated by formalin and formulated at a level of 40-8-32 D-antigen units for the type 1, 2 and 3 respectively. A clinical evaluation of this vaccine was conducted in Mali (West Africa) among 320 infants 3 to 24 months of age. The infants were randomly assigned to 3 groups. One group received 2 doses of DPTP, a second group 2 doses of DPT and poliovirus vaccine (IPV) given in two separate sites, the third group 2 doses of DPT and oral poliovirus vaccine (OPV). In each group the 2 doses were given 3 months a part. No severe adverse reactions were observed and no statistical difference was noticed between the three groups for minor side effects. A seroconversion rate of 100% was observed to poliovirus antigens in the groups who received IPV simultaneously or combined with DPT, as compared to 49 to 77% in the group who received OPV. A seroconversion rate of 100%, 100% and 92% was shown in the DPTP group respectively to diphtheria, tetanus and pertussis antigens. No statistical difference was recorded between the 3 groups in the serological response to DPT antigens. A follow-up could be performed in 74 children one year after primary vaccination and a dramatic response to a booster dose of DPTP was measured.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of a new combined inactivated DPT-polio vaccine. 303 Aug 61

The existence of well established national reporting systems for monitoring pertussis incidence and vaccine uptake in the United Kingdom has allowed the epidemiology of whooping cough and the impact of vaccination to be studied in detail. The increase in pertussis morbidity that followed the decline in vaccine uptake in recent years confirms the continuing need for mass vaccination in a developed country. There is also evidence that pertussis may be responsible for many more deaths than official mortality statistics show. A national study of vaccine efficacy demonstrated over 80% protection against clinical disease during the first 5 years after vaccination. However, there is evidence that the current whole cell vaccine may protect less well against infection with agglutinogen serotype 3 than type 2 organisms which supports the view that both these antigens should be included in acellular vaccines to achieve good protection. In West Germany, unlike the UK, there are no national statistics on pertussis incidence, no national vaccination policy and no figures for vaccine uptake. Local studies have shown that vaccination rates are low and that pertussis is prevalent, particularly in the 2-4 year age-group, which is typical of a country with low uptake; similarly serotype 2 predominates.
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PMID:The current epidemiology of pertussis in the developed world: UK and West Germany. 327 23

Of 400 Washington State family practitioners surveyed in 1986, 46% of those who give routine immunizations reported that they require written parental consent before administering vaccine. In all, 57% of respondents said they discuss diphtheria-tetanus-pertussis, measles-mumps-rubella, and oral polio vaccine with their patients. Nearly half provide written information on these immunizations, except for inactivated polio vaccine, for which fewer than 20% of the physicians surveyed provide verbal or written information.
West J Med 1988 Apr
PMID:Family practitioners' immunization consent practice. Washington State, 1986. 338 60

Some of the factors influencing the isolation rate of Bordetella pertussis during a whooping cough epidemic in West Glamorgan, Wales, are reported. The organism was isolated from 39% of patients with clinical whooping cough, pernasal swabbing being much more successful than cough plates. Isolation rates were increased in the non-immunized, particularly in the first year of life. Erythromycin and co-trimoxazole significantly reduced the isolation rate of B. pertussis but this did not occur with penicillin. In this study 20% of patients were culture positive 6 weeks after the onset of their infection. It is suggested that the Department of Health and Social Security recommendation of a minimum period of three weeks exclusion of children from school is inadequate. During the epidemic, the proportion of strains of B. pertussis containing antigen 2 more than doubled.
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PMID:Bordetella pertussis isolation in general practice: 1977-79 whooping cough epidemic in West Glamorgan. 630 Feb 27

The 30 years between 1949-1979 cover the stages of post-war pertussis epidemics, required notification, required vaccination, regulation of the vaccine and public reaction against adverse reactions to pertussis vaccine. The disease, called "Hyakunichi-zeki" or cough lasting 100 days, rose and fell cyclically in Japan as it did in the West. Pertussis, a notifiable disease, was reported at about 150/100,000 in 1949-50. Probably the actual case rate is 10 times higher. The Preventive Vaccination Law was in effect nationwide in 1950, causing a decline in cases to a minimum of 0.2/100,000 in 1971. As effective antibiotics for secondary infection appeared, the minimum death rate was registered as 2 nationally in 1972. Most cases occur in July and August in unvaccinated children under 5 years old. The 1st 2 deaths from DPT vaccines, in 1974 and 1975, from encephalopathy and shock respectively, prompted temporary cessation of vaccination. Consequently, public acceptance of the vaccine decreased, and both case rate and antibody prevalence rose. 61 encephalopathy deaths and 18 shock deaths due to the vaccine were reported from 1952-1974, but this figure is probably low. Japan's standards for pertussis vaccine, controlled by the Japanese NIH, reflect those of WHO. Details of government regulation of vaccine standards, as well as research up to the late 1970s for finding a purer, safer and effective pertussis vaccine are reviewed briefly. It is unknown whether the protective antigen is identical or separate from toxic components of the organism. Although some improvements in vaccination schedules and vaccine purity have been made, a more potent and less toxic vaccine is needed.
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PMID:Japan's experience in pertussis epidemiology and vaccination in the past thirty years. 720 22


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