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

Whooping cough is endemic throughout the world. It becomes epidemic every 4-5 years (Yugoslavia 3-4 yrs). In Europe its incidence ranges from 0.4 (Hungary) to even 59/100.000 inhabitants (Rumania; Yugoslavia 28), with a general letality of 0.1% (infants: 1%; 75% children who die are younger than one yr). Only 5-10% cases are supposed to be registered. A low socioeconomic status is more and more emphasized as the principal risk factor. Its transmission rate is high (home contacts: 80-100%); infectivity lasts five weeks, disease from the beginning of incubation to the sanation lasts 50-60 days. Female children are more frequently affected. The term "Pertussis syndrome" is more end more used because a similar disease can be caused by various agents (B. pertussis; B. parapertussis: 5%-20%-30% cases; B. bronchiseptica rarely; adenoviruses, RS virus, parainfluenza virus, influenza A and B virus, HSV, CMV, EBV, entero-, adeno-, corona-, rota-viruses; chlamydiae and mycoplasmae). Prior to introducing vaccination, 95% of population have had a typical or atypical form of pertussis. Its differential diagnosis includes pneumonias of various etiology, bronchitis, bronchiolitis during an acute respiratory infection, bronchial asthma, cystic fibrosis, tuberculosis and lymphadenopathy. Morbidity in USA was reduced by vaccination from 157 to 0,5-1,5/100,000 inhabitants; in SR Croatia it was six times reduced in period 1959-1970. According to the official sources 81% of children in Croatia and Yugoslavia get primovaccinated; the 80% level is generally accepted as a rational goal. Immunization schedules differ from country to country. Local and general reactions after combined vaccines are mostly caused by pertussis component.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Review of the present status of prevention, prophylaxis and therapy of pertussis and parapertussis]. 229 2

The Expanded Programme on Immunization (EPI) was initiated in India in 1978 with the objective to reduce morbidity and mortality from diphtheria, pertussis, tetanus, poliomyelitis and childhood tuberculosis by providing immunization services to all eligible children and pregnant women by 1990. Measles vaccine was included when the EPI was accelerated by launching the Universal Immunization Programme (UIP) in 1985-6. Approximately half of all infants now receive complete primary immunization with diphtheria, polio and tetanus (DPT), oral polio vaccine (OPV) and BCG vaccine. Forty-six per cent of pregnant women currently receive a second or booster dose of tetanus toxoid (TT). Surveillance reports from selected areas have documented impact through reduction of disease incidence. Although vaccination coverage levels are increasing, continued acceleration is needed to achieve the universal levels targeted for 1990.
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PMID:The expanded programme on immunization: a decade of progress in India. 247 39

To focus attention on the problem of infant mortality in Lebanon, data were compiled on infant mortality from 1978 to 1986 at the American University of Beirut Medical Center. Causes of death are analyzed for 602 males and 398 females. 54.9% deaths occurred at 1 month of age and 77.4% died within the 1st year. Autopsies were performed on .7%. 37.7% of all neonatal deaths were due to neonatal diseases such as hyaline membrane disease, asphyxia neonatorum, immaturity, necrotizing enterocolitis, hemorrhage, hemolysis, meconium aspiration, and kernicterus. Better prenatal care would reduce this group, or the administration of corticosteroids to the mother 24-48 hours prior to delivery, as well as rapid resuscitation at birth and prevention of the 5 curses: hypoxemia, hypoglycemia, hypothermia, hypotension, and acidosis. Although unavailable in Lebanon, administration of surfactants through an endotracheal tube would also help. Infections constitute 25.1% of deaths; many are preventable through adequate public health measures and strict personal hygiene, i.e., diseases such as sepsis, pneumonia, meningitis, gastroenteritis, hepatitis, encephalitis, and 1-2 cases of the following: diphtheria, measles, peritonitis, tetanus, tuberculosis, cytomegalis inclusion, herpes, parathyphoid, pertussis, poliomyelitis, and shigellosis. Congenital diseases were 21.6%. In utero diagnosis could prevent some diseases and in utero treatment is possible for hydrocephalus and hydronephrosis. Screening programs postnatally could lead to treatment. 5.9% were malignancies such as leukemia, lymphoma, brain tumors, histocytosis, Wilm's tumor, Ewing sarcoma, and Hodgkin's disease. Early diagnosis is critical if mortality is to be reduced in this group, but medical advances are still needed. 2.9% are miscellaneous diseases such as poisoning, rheumatic diseases, marasmus, Reye's syndrome, nephrosis, rickets, and epilepsy. Most of these diseases are preventable, except for rheumatic inflammation of the heart. Recommended necessary steps to reduce infant mortality are: prenatal care, diagnosis and screening, intrauterine surgery; resuscitation and intensive care centers with modern equipment and trained personnel; national vaccination and screening programs; adequate public health measures and hygiene; parental education; and well-equipped hospitals to serve all regardless of income level.
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PMID:Pediatric mortality: an avoidable tragedy. 251 28

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 developing countries, where economic development is lacking and literacy rates are low, priority must be given to primary health care and to the establishmend of sustainable health care delivery systems. The World Health Organization's Expanded Program of Immunization was designed with the goal of immunizing all children against measles, pertussis, tetanus, poliomyelitis, tuberculosis, and diphtheria by 1990. A second function of the immunization program is to establish a health care delivery system. Today 50% of infants receive 3 doses of diptheria/pertussis/tetanus and polio vaccines, and 70% receive at least 1 dose. Measles kills 2 million children every year. The standard strain of attenuated vaccine is given at 9 months, and 1 dose protects 95% of children for life. Tetanus kills 800,000 infants every year. The vaccine must be refrigerated, and 2 doses are essential. Tuberculosis kills 2 million children under 5 every year. The attenuated BCG vaccine should be given at birth, and a single dose confers some protection. Diphtheria is most common among poor, urban children in termperate climates, and 3 doses of toxoid at monthly intervals are recommended. Poliomyelitis paralyzes 250,000 children a year. 4 doses of live attenuated Sabin vaccine are recommended. The vaccine is very sensitive to heat. Other vaccines in use or being developed include yellow fever, meningococcus, Japanese B encephalitis, rubella, hepatitis B, cholera, rotavirus, pneumonococcus, and Haemophilus influezae. 2 problems that confront the delivery of health services, including immunization, are lack of funds and lack of access to susceptible populations. Approaches to the lack of funds problem include fee for service, taxation, beter management of existing resources, reallocation of health resources, and increased funding from donor nations. Approaches to the problem of access include vaccination whenever children come into contact with a health facility for any reason, channeling by members of the community, involvement of traditional healers and birth attendants, outreach services, mass campaigns, pulse technics, and financial incentives.
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PMID:Vaccination strategies in developing countries. 305 59

The Expanded Programme on Immunization (EPI) was established in 1974 to develop and expand immunization programs throughout the world. In 1977, the goal was set to make immunization against diphtheria, pertussis, tetanus, poliomyelitis, measles and tuberculosis available to every child in the world by 1990. Problems encountered by the Program have included: lack of public and governmental awareness of the scope and seriousness of the target diseases; ineffective program management; inadequate equipment and skills for vaccine storage and handling; and insufficient means for monitoring program impact as reflected by increasing immunization coverage levels and decreasing incidence of the target diseases. When the EPI was initiated in 1974, fewer than 5% of children in developing countries were receiving a 3rd dose of DPT and poliomyelitis vaccines in their 1st year of life. These coverage levels have now surpassed 50% in developing countries, and millions of cases of the target disease have been prevented. Over 700,000 measles deaths were prevented by immunization in developing countries in 1987, and an increasing number of neonatal tetanus deaths is now being prevented by maternal immunization and improved childbirth conditions. Poliomyelitis immunization efforts have been so successful that the Pan American Health Organization is leading a drive to eradicate poliomyelitis from the Americas by 1990. The successes of the Program represent a major public health achievement, but much remains to be done. Measles still kills nearly 2 million children each year, neonatal tetanus kills some 800,000 newborns, and pertussis nearly 600,000 children. 250,000 cases of paralytic poliomyelitis still occur annually. The major challenges now facing the EPI are accelerating and sustaining national immunization efforts.
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PMID:Expanded programme on immunization. 317 15

Although the prevention of infection through immunization is a central goal of maternal-child health programs in all developing countries, it is important to recognize that the role of vaccines varies greatly from country to country, from infection to infection, and from vaccine to vaccine. Immunization strategies must be as responsive to local disease patterns, needs, and opportunities as to technological advances in the creation, production, storage, and delivery of vaccines. This paper outlines the present state of the art for vaccines against measles, pertussis, poliomyelitis, tetanus, and tuberculosis. Other childhood infections in the tropics in need of a vaccine are the enteric infections, serious bacterial infections, vertically transmitted viral infections, and parasitic infections such as malaria. Immunization technologies related to the cold chain, delivery techniques, and adjuvants are constantly improving. Gains have also been made in outcome evaluation and disease surveillance. Ultimately, the success of the immunization effort depends on community participation and awareness.
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PMID:Recent advances in immunization. 331 42

By immunizations many infectious diseases and their associated severe complications can be prevented. The high importance of vaccinations must be emphasized by the paediatricians. But it is also very important to know the contraindications and especially the rare complications and also adverse reactions following some immunizations e.g. against pertussis, tuberculosis, measles, rubella, diphtheria, tetanus and polio, which must be carefully investigated. The contraindications to immunizations must be paid attention, but they should not be dramatized. Slight adverse reactions following some immunizations some hours or days later may not be considered as complications (e.g. some children develop fever, become restless or have a broken sleep in the following night; reddening at the place of injection, a transitory exanthem and others). Incomplete knowledges and informations in side of some physicians must be removed by permanent graduate medical education.
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PMID:[Contraindications and complications in vaccinations]. 332 94

The formation of an air pouch in the subcutaneous tissues of a rat previously inoculated intradermally with Freund's mycobacterial adjuvant for the induction of arthritis, provokes a marked but transient inflammatory reaction in the cavity lining of the pouch. The dependence of this reaction on arthritis development was investigated. It was found that rats inoculated with mycobacterial adjuvant by subcutaneous or intraperitoneal injection failed to produce either a pouch reaction or develop arthritis. Intradermal injections of carrageenan, mycobacteria (M. tuberculosis in saline), Freund's incomplete adjuvant alone or containing Salmonella typhimurium lipopolysaccharide and Bordetella pertussis organisms or mycobacterial adjuvant containing egg albumin were also ineffective. Intradermal injections of type II collagen in Freund's incomplete adjuvant did induce arthritis but no pouch reaction; however, this could be elicited after direct challenge with antigen. Pretreatment of rats intraperitoneally with saline suspensions of mycobacteria or a moderate dose of cyclophosphamide prevented both the pouch reaction and arthritis developing to intradermal mycobacterial adjuvant. Pretreatment of rats with mycobacteria was without effect on type II collagen-induced arthritis. From the results of this study it would appear that the air pouch reaction and arthritis induced by adjuvant are directly associated. The inability of collagen to induce a similar reaction demonstrates a fundamental dissimilarity with mycobacterial adjuvant in its mechanism of production of arthritis.
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PMID:Polyarthritis and the air pouch reaction: dissimilarity of adjuvant and collagen models. 337 28

Ethiopia is a country of 45 million people in northeast Africa. With a stagnant, agriculture-based economy and a per capita gross national product of $110 in 1984, it is one of the world's poorest nations. 70% of the children are mildly to severely malnourished, and 25.7% of children born alive die before the age of 5. Life expectancy is 41 years. The population is growing at the rate of 2.9%/year, but only 2% of the people use birth control. After the 1974 revolution, the socialist government nationalized land and created 20,000 peasant associations and kebeles (urban dwellers' associations), which are the units of local government. The government has set ambitious goals for development in all sectors, including health, but famine, near famine, forced resettlement programs, and civil war have prevented any real progress from being made. The government's approach to health care is based on an emphasis on primary health care and expansion of rural health services, but the Ministry of Health is allocated only 3.5% of the national budget. Ethiopia has 3 medical schools -- at Addis Ababa, Gondar, and the Jimma Institute of Health Sciences. Physicians are government employees but also engage in private practice. A major problem is that a large proportion of medical graduates emigrate. Ethiopia has 87 hospitals with 11,296 beds, which comes to 1 bed per 3734 people. There are 1949 health stations and 141 health centers, but many have no physician, and attrition among health workers is high due to lack of ministerial support. Health care is often dispensed legally or illegally by pharmacists. Overall, there is 1 physician for 57,876 people, but in the southwest and west central Ethiopia 1 physician serves between 200,000 and 300,000 people. In rural areas, where 90% of the population lives, 85% live at least 3 days by foot from a rural health unit. Immunization of 1-year olds against tuberculosis, diphtheria-pertussis-tetanus, poliomyelitis, and measles is 11, 6, 6, and 12% respectively. Infectious diseases dominate the medical scene in Ethiopia. In 1984, tuberculosis accounted for 11.2% of hospital admissions and 12.2% of deaths. The leading cause of childhood mortality in 1984 was diarrhea (45%). Malaria, trypanosomiasis, schistosomiasis, leishmaniasis, and meningococcal meningitis are endemic. Intestinal parasitism is rampant, and the nationwide prevalence of leprosy is 3/1000. Venereal diseases were the 9th most common cause of hospital outpatient visits in 1984, but AIDS is rare. The leading noninfectious diseases are rheumatic and syphilitic heart disease, hypertension, diabetes mellitus, hepatoma, and elephantiasis. Ethiopia has the highest number of cases of nonfilarial elephantiasis -- an estimated 350,000 cases -- in the world. Aside from a large influx of money, the most necessary changes to improve the health system are lowering the salaries of doctors and nurses, reorienting physician training toward primary health care, increasing the quality of existing health services, more efficient management, and better coordination between the Ministry of Health and the voluntary organizations.
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PMID:Health and medical care in Ethiopia. 271 Jan 85


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