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Query: UMLS:C0043167 (pertussis)
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Following the outbreak of poliomyelitis in Gazankulu in 1982, the immunisation services in Gazankulu were thoroughly examined. As a result of this, a comprehensive immunisation policy for Gazankulu was accepted in November 1986. The broad aim of the policy is to provide effective immunisation to all Gazankulu residents against tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis and measles. A specific objective is that by the end of 1987, 85% of under-5s should have been vaccinated against these six diseases and by the end of 1990 this percentage should be 97%. The detailed strategies to reach these objectives are highlighted. Within the framework of the objectives, the policy allows different areas to formulate individual strategies. Programme monitoring and community involvement are two crucial aspects of the policy and these are discussed in detail. The early successes and difficulities in implementing this policy are discussed.
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PMID:Provision of immunisation--the Gazankulu experience. 361 43

The Expanded Programme on Immunization (EPI) whose goal is to reduce morbidity and mortality by providing children with immunizations against diphtheria, pertussis, tetanus, poliomyelitis, measles, and tuberculosis continually faces the problem of documenting immunization coverage rates. Therefore the EPI seeks simple, effective, and inexpensive methods of evaluation which could be implemented in different countries. An example of such a method is a simplified cluster sampling technique of estimation of immunization coverage through the examination of 210 children, selected randomly as 30 groups of 7 children each. In 1978-1984 more than 1000 immunization coverage surveys were performed all over the world, mainly in developing countries. In a modified way this method is also used to collect data on morbidity and mortality of certain EPI target diseases as well as diarrhoeal diseases.
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PMID:[The cluster method in conducting epidemiological research]. 379 17

Focusing on the worldwide state of immunization, attention is directed to the progress being made in control of the 6 diseases -- measles, pertussis, diphtheria, tetanus, poliomyelitis, and tuberculosis -- using the vaccines and equipment now available. Major problems in world-wide vaccine coverage to be resolved are: management to ensure that adequate amounts of potent vaccine are delivered on time to susceptible infants; and funds to pay for this system of delivery over the next few decades. In 1974, at the time Expanded Program on Immunization (EPI) was conceived, 5% of infants in the developing world received a 3rd dose of DPT or polio vaccine. At this time, more than 1/3 of infants in the developing countries receive a 3rd dose of DPT or polio vaccine, although only about 20% receive measles vaccine. Progress has been made, but it is not sufficient if the global target is to be realized. Except for measles, the target diseases have been brought under control in most of the European region, and eradication targets have been set for the end of the century. Additionally, there is wide use of vaccines against other diseases of importance to public health including rubella, mumps, hepatitis B, influenza, pneumonococcal and meningococcal infections. Africa has the highest mortality and morbidity rates for the target diseases, yet there has been some progress in EPI. In 1983, 19 countries achieved fully immunized rates of 45-87% of their target population. A priority for the African region is the upgrading of the management skills of the health workers involved in EPI. A major constraint in the region is the need for a good 'cold chain" to ensure that vaccines are stored and transported within the safe temperature range. 26 countries in the American region are considered to have achieved control of paralytic poliomyelitis. Innovative ideas have been used in this region, including the use of national immunization days and revolving funds for bulk purchase of vaccines. In the Southeast Asia region there has been a slow but steady increase in coverage for all antigens except BCG and measles. The major constraints in the Western Pacific region as the other regions are lack of management skills and financial resources. Some progress has been made in the Eastern Mediterranean region despite great variation in socioeconomic status between countries. Alternative strategies for the acceleration of EPI activities are outlined.
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PMID:A global view of immunisation. 382 Jan 51

Oral polio vaccine was introduced into India's national immunization program in 1979-80. Coverage with this vaccine has increased rapidly from 0.67 million in 1979-80 to 9.63 million in 1984-85. 3 doses of the vaccine are recommended at age 3-12 months, followed by a booster dose 12-18 months later. The vaccine is administered along with the DPT vaccine. The vaccines are provided as a package of services under the expanded program on immunization (EPI). India's government initiated the EPI in 1978 with the goal of reducing the morbidity and mortality due to diphtheria, pertussis, tetanus, poliomyelitis, tuberculosis, and typhoid fever by making vaccination services available to all eligible children and pregnant women by 1990. In 1985-86, measles vaccination was included in the program. Another objective was to achieve self-sufficiency in the production of vaccines required for the program. Immunization services are provided through the existing health care delivery system: hospitals, dispensaries, and maternal and child health (MCH) clinics in the urban areas primary health centers in rural areas. The aim of universal immunization for all India has been set for 1989-90; some areas may achieve this goal earlier. 30 districts and catchment areas of 50 medical colleges have been taken up in the universal immunization program for 1985-86. The objectives of the universal immunization program include: to provide universal immunization coverage to pregnant women and to infants; to document a reduction in the vaccine preventable diseases; to develop effective implementation and to streamline logistics; and to encourage the active participation of the medical faculty, interns, and students from the planning to the evaluation stages. The government of India provides the vaccines required under the national immunization program to the state health authorities. Over 50 million doses of oral polio vaccine are expected to be utilized during 1985-86. The annual requirements are likely to exceed 80 million doses by 1989-90. The planned targets of vaccination coverage are linked closely to the development of the cold chain system. Since 1984 field samples of oral polio vaccine have been collected for potency tests in order to monitor the quality of the cold chain for vaccines. The effectiveness of the control measures will be evaluated by determining the vaccination coverage of the eligible population and by recording the reduction in incidence of poliomyelitis in the area.
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PMID:National programme for the control of poliomyelitis. 383 34

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

SJL/J, PL/J, and (SJL/J x PL/J)F1 mice were immunized with bovine, guinea pig, mouse, or rat myelin basic proteins (MBP) in adjuvant containing Mycobacterium tuberculosis H37Ra. Twenty-four and 72 hr later, Bordetella pertussis vaccine was given i.v. All MBP tested induced experimental allergic encephalomyelitis (EAE) in SJL/J and F1 mice; however, bovine MBP was inactive in PL/J mice. Each strain was immunized in a similar manner with peptic peptides, residues 1-37, 43-88, and 89-169 of guinea pig MBP. In contrast to the SJL/J strain, which has been shown to recognize a major encephalitogenic determinant in peptide 89-169, PL/J and F1 mice responded primarily to an encephalitogenic determinant within peptide 1-37. Analysis of antibody levels showed that SJL/J mice made no antibody to peptide 1-37, although anti-peptide 89-169 antibodies were consistently found. Conversely, PL/J mice responded well to peptide 1-37, but only an occasional animal made a significant response to peptide 89-169. (SJL/J x PL/J)F1 mice were more susceptible to EAE than either parental strain, as shown by the percentage of animals showing neurologic signs and by clinical severity.
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PMID:Induction of experimental allergic encephalomyelitis in PL/J and (SJL/J x PL/J)F1 mice by myelin basic protein and its peptides: localization of a second encephalitogenic determinant. 618 47

Any medical intervention is expected to prevent sickness and complications of a disease rather than to induce them. This is true for therapy as well as prophylaxis. Special formulas have been developed to calculate the risks and benefits of vaccinations simply but with sufficient accuracy. The risk ratio (Q) tells how many times the risk of contracting certain complications or even death from a disease is greater in unvaccinated than in vaccinated individuals. The risk difference (D) directly expresses the number of complications or deaths that may be prevented by a certain vaccination. It is even possible to evaluate the epidemiologic trend of a disease and to calculate or estimate the point of time when the risks of disease and vaccination are just balanced, ie, when a vaccination has lost its beneficial effect. Vaccinations against measles, poliomyelitis and tick borne encephalitis in Austria are highly beneficial. BCG vaccination is still beneficial on a low level in Austria as far as protection against tuberculosis is concerned. This effect will persist for the rest of this century. The benefit of pertussis vaccination depends on the local epidemiologic situation. It has expired for non-risk groups in Austria since 1976 but continues to persist in the US.
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PMID:Risks and benefits of vaccinations. 656 19

In 1978 the Ministry of Health and Social Welfare (MHSW) of Liberia launched the Expanded Program on Immunization (EPI) with the 5-year objective of establishing an 80% reduction in child mortality and morbidity from measles, polio, diphtheria, neonatal tetanus, pertussis, and tuberculosis. The program at first adopted a strategy of using 15 mobile units in 11 operational zones to deliver vaccinations throughout the country. However, by 1980, despite support from the Baptist World Alliance, the UN International Children's Emergency Fund (UNICEF), and the World Health Organization (WHO), it became evident that the mobile strategy was neither economically feasible nor practical. Therefore, with support from the US Agency for International Development (USAID), the EPI shifted to a strategy of integrating immunization activities into the existing network of state health facilities. After 5 years, in 1982, the Program was evaluated by a team from the MHSW, WHO, USAID, and the Centers for Disease Control. The evaluating team felt that the EPI's strategy was good, but its goals were not being achieved due to deficiencies in funding, clinic supervision, and rural community outreach, as well as shortages of kerosene and spare parts needs to keep the essential refrigerators in operating condition. Measles remains endemic; in the capital, Monrovia, only 9% of the children have been vaccinated against it. Immunization coverage is particularly low in the capital the countries. Other reasons for low vaccination coverage in Liberia are lack of community awareness of existing facilities and the importance of vaccination and lack of coordination at the community level to use the existing facilities efficiently. International assistance is still needed, especially to develop heat-stable vaccines, so that maintenance of refrigerators will not be necessary.
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PMID:A perspective on controlling vaccine-preventable diseases among children in Liberia. 656 18

A survey was conducted in the Northern Province of Papua New Guinea to assess immunization coverage against tuberculosis, diphtheria, pertussis, tetanus, and poliomyelitis among a random sample of 211 childred, aged 6-23 months. The national government's Expanded Programme on Immunization calls for immunizing at least 80% of the country's childred, and specifically calls for administering Bacille Calmette Guerine (BCG) vaccine to infants as soon as possible following birth; a 1st dose of Sabin for poliomyelitis and a 1st dose triple antigen (TA) against diphtheria, pertussis, and tetanus 2 months following birth; and a 2nd dose of Sabin and of TA at 4 months of age. 3rd doses of Sabin and TA were recommended by the government, but 3rd doses were not specific targets of the program. The current study assessed the degree to which coverage was achieved in the Northern Province. The sample of 7 childred from 30 population clusters was selected according to a method recommended by the World Health Organization. 30 population clusters were randomly drawn from census field counts of the inhabitants of the Northern Province. Random technics were used to pick a starting household in each cluster, and succeeding households were identified by selecting the household located nearest to the previously contacted household. Households in each cluster were contacted until 7 children, aged 3-23 months were identified. These 7 children in each of the 30 clusters constituted the sample. A responsible member of the houshold was asked for information on the child in regard to name, sex, birth date, and type and date of vaccination. Verbal reports were then verified by checking records at the rural health centers. This survey methodology proved to be an efficient and practical means for collecting immunization data. The survey revealed that 39% of the 211 children, aged 6-23 months were completely vaccinated, i.e., they had received the BCG vaccine and 2 doses of Sabin and TA. Of those completely vaccinated 77% had been completely vaccinated before they were 12 months old. When the immunization data obtained in the survey were compared to immunization data obtained from routine immunization records maintained by the health centers, the routine recordings were found to be acceptably accurate. Therefore, the recommendation was made that an examination of these routine records every 6 months at the district, provincial, and national level would provide an accurate technique for periodically assessing progress toward the country's immunization goals. Surveys should also be undertaken, but less frequently. Findings indicated that coverage in the Northern Province was less than the overall national coverage. Nationwide 64% of the children under the age of 1 year have received BCG, 49% 2 doses of Sabin and 50% 2 doses of TA. Respective fiquers for the Northern Province were 56%, 41%, and 46%. There is a need a greatly increase immunization efforts throughout the nation but there is even a greater need to do so in the Northern Province.
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PMID:Vaccination coverage in Northern Province, Papua New Guinea. 659 68

Pertussigen, one of the biologically active proteins from Bordetella pertussis, was found highly active as an adjuvant to promote the induction of experimental allergic encephalomyelitis (EAE) in (SJL X BALB/c)F1 mice that had received at the same time an injection of mouse spinal cord (MSC) homogenized in complete Freund's adjuvant containing 4 mg of Mycobacterium tuberculosis H37RA per milliliter (CFA-H37). In this system 2 mg of MSC induced EAE, but a dose of 4 mg was more effective. As little as 250 ng of pertussigen facilitated induction of EAE, and 400 ng uniformly did so. Pertussigen was most effective when given iv from 1 day before to 5 days after administration of MSC homogenized in CFA-H37, when a uniform and severe disease was induced 11-13 days after immunization. Pertussigen given as late as 20 days after MSC-CFA-H37 still precipitated a mild form of EAE which appeared 8-12 days after the injection of pertussigen. When pertussigen was given 5 days after immunization, a chronic, nonfatal type of EAE was induced, and this persisted for the entire 74 days of observation. Histologic findings in the brain and spinal cord 15 days after sensitization in mice which received pertussigen and developed EAE showed perivascular infiltrates consisting mainly of mononuclear cells.
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PMID:Elicitation of experimental allergic encephalomyelitis (EAE) in mice with the aid of pertussigen. 660 26


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