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

A recent analysis demonstrated a change in incidence approaching 100% for diseases against which we routinely immunize in the United States. At present, measles, mumps, rubella, invasive Haemophilus disease, poliomyelitis, diphtheria and tetanus are well-controlled but not eliminated. Diseases that now pose special problems include pertussis, hepatitis A and B and varicella. The incidence of pertussis surged in 1994, possibly in part because of waning immunity in the immunized population. Acellular pertussis vaccines are available for booster doses in children but are not now recommended for adults. Licensure of acellular pertussis vaccines for primary immunization of infants is eagerly awaited. Recombinant hepatitis B vaccine has been licensed for more than 10 years but there has been little change in disease incidence in the United States. Routine immunization of infants is now recommended but concerns exist about cost and persistence of immunity into adolescence. Inactivated hepatitis A vaccines appear to be highly effective in preventing clinical hepatitis and controlling epidemics. Potential target populations include military personnel, day-care attendees and travelers. Hepatitis A vaccine may be recommended for all children after approval by the United States Food and Drug Administration and if a combination vaccine becomes available. A live, attenuated varicella vaccine developed in 1974 and unlicensed in the United States is safe and highly effective in preventing varicella in healthy and immunocompromised populations. It also appears to reduce subsequent development of herpes zoster. Vaccines against pneumococci (conjugate vaccine), respiratory syncytial virus, rotavirus, tuberculosis and human immunodeficiency virus are needed. Research and technology to develop these vaccines must be developed, and efficient delivery mechanisms must be created and implemented.
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PMID:Present and future challenges of immunizations on the health of our patients. 763 35

The Expanded Program on Immunization (EPI) is a component of the Child Survival Project (CSP). Its objective is to reduce the incidence rates of measles, diphtheria, pertussis, tetanus, tuberculosis, and poliomyelitis by increasing effective vaccination coverage. In 1991, CSP/EPI developed a national plan to introduce national immunization of infants against hepatitis B, which is an endemic disease in Egypt. Hepatitis B virus (HBV) causes acute hepatitis and chronic liver disease. Studies have shown that by maturity most of the population has been infected with hepatitis A and greater than 50% with hepatitis B. The recommended series of 3 intramuscular doses of hepatitis B vaccine induces a protective antibody response (anti HBs) in 90% of healthy adults and 95% of infants, children, and adolescents. Several studies have shown that the currently licensed vaccines produce high rates of seroconversion ( 95%) and induce adequate levels of anti HBs when administered to infants at 2 months, 4 months, and 6 months of age. Scheduling was adjusted to coincide with the currently adopted 2, 4, and 6 month vaccination schedule for oral poliomyelitis virus (OPV) and diphtheria-pertussis-tetanus (DPT) to allow a delay of vaccination from 2 to 3 months following birth. Long term studies of healthy adults and children indicate the immunologic memory remains intact for at least 9 years and confers protection against HBV infection even though anti HBs levels may decline below detectable levels. Safety of hepatitis B vaccines has been verified through experience with millions of doses administered worldwide after licensure. Pain at the injection site (3-29%) and a temperature greater than 37.7 degrees Celsius have been the most frequently reported side effects among adults and children. Nearly 90% of children and 96% of newborns had no reactions to the vaccine. Any presumed risk of adverse events must be balanced against the expected risk of acute and chronic liver disease associated with hepatitis B virus infection.
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PMID:Integration of hepatitis B immunization in the Expanded Program on Immunization of the Child Survival Project. 777 76

The development of insulin-dependent diabetes mellitus is thought to be related to environmental trigger factors acting upon a background of genetic predisposition to the disease. Viral infections, toxins, and dietary factors are being considered as trigger factors. The authors studied the relationship of the development of diabetes from birth up to 15 years of age to the type of feeding in infancy, childhood infections, and vaccination among 55 patients attending Endocrinology Clinics of the Ethio-Swedish Children's and Tikur Anbessa Hospitals over the period January 1990 to December 1991. 74 unaffected siblings and 107 unrelated individuals were included as controls. No significant difference was found in relation to type of feeding up to the ages of three, six, and twelve months or older between patients and unaffected siblings. Histories of measles, chicken pox, and whooping cough were equally distributed between the two groups. The introduction of bottle-feeding, however, was significantly more frequent among unrelated controls at three months and six months of age. The use of cow's milk and other formulas in bottle-feeding showed a significant negative association with the development of diabetes. An history of vaccination against tuberculosis, measles, diphtheria, pertussis, tetanus, and polio was significantly more common among unrelated controls than diabetics. There was no significant difference in family history of diabetes in first degree relatives, parental education, and level of income between diabetics and unrelated controls. The authors suggest that more extensive studies are warranted.
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PMID:The relation of early nutrition, infections and socio-economic factors to the development of childhood diabetes. 783 52

Emerging infectious diseases such as prolonged diarrheal illness due to water-borne Cryptosporidium, hemorrhagic colitis and renal failure from food-borne E. coli O157:H7, and rodent-borne hantavirus pulmonary syndrome as well as reemerging infections such as tuberculosis, pertussis, and cholera vividly illustrate that we remain highly vulnerable to the microorganisms with which we share our environment. Prompt detection of new and resurgent infectious disease threats depends on careful monitoring by modern surveillance systems. This article focuses on five important elements of improved surveillance for emerging infections: 1) strengthening the national notifiable disease system, 2) establishing sentinel surveillance networks, 3) establishing population-based emerging infections programs, 4) developing a system for enhanced global surveillance, and 5) applying new tools and novel approaches to surveillance.
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PMID:Emerging infectious diseases in the United States, Improved surveillance, a requisite for prevention. 784 Apr 68

The acceptance of vaccinations depends on the quality of information on effects and side effects. This publication deals with the results of three questionnaire studies: Questionnaire 1 was directed to the general population and contained questions on vaccination history and acceptance of vaccinations, questionnaire two and three were addressed to practitioners (general medicine/paediatrics/internal medicine) with additional questions on the number of vaccinations performed per year. An average of 50% of the persons taking part in the questionnaire study had been vaccinated within the last 10 years against diphtheria, tetanus, polio and/or influenza. The acceptance of these vaccinations was quite satisfactory whereas opinions on mumps and measles vaccinations were quite negative. In the course of the questionnaire study with practitioners it could be demonstrated that vaccinations against diphtheria, tetanus, polio and influenza were regarded as useful while immunisation against mumps, measles, tuberculosis, pertussis and chicken-pox were not regarded as useful. Information programes on vaccinations and the need for further investigations are discussed as well as the problem of mandatory vaccinations.
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PMID:[Acceptance of preventive vaccinations by physicians and the general population]. 791 98

A cost-effective strategy aimed at the immunization of all children and pregnant women residing in the plantation sector of Malaysia is outlined. It is based on a partnership between government, nongovernmental organizations and the private sector, and is supported by UNICEF. Over a million people reside on the Malaysian plantation estates: only 17% of the estates have their own hospitals; immunization services exist on only 1.5%; 40% of the estates are at least 5 kilometers from the nearest government health facility; and 64% lack transport for workers and their dependents to seek care away from the plantations. Two nongovernmental organizations, the Malaysian Paediatric Association and the Malaysian Society of Health, initiated discussions with the United Planting Association of Malaysia. A pilot study was undertaken by the groups on 6 estates in Selangor State, which included all the children at their first birthday. Tuberculosis, diphtheria/pertussis/tetanus, poliomyelitis, and measles immunization coverages were 88%, 44%, 59%, and 66%, respectively. The association of plantations accepted the organizations' proposals for all estates to: register all births; provide free transportation to government health clinics for the immunization of all eligible children and pregnant women; and enforce immunization schedules and record-keeping. The Ministry of Health agreed to provide free immunization of children and pregnant women; send mobile teams to estates that could assemble 20 or more eligible people for immunization; provide the estates with educational materials dealing with immunization; arrange that the maintenance of the cold chain be supervised by local medical officers of health; consider the training of estate hospital assistants with the help of the nongovernmental organizations. The total immunization plan was launched in September 1990. A manual was distributed to the estate managers, hospital assistants on the estates, and the medical officers who would implement and monitor the program. It is expected that total child immunization will be achieved in the foreseeable future in the estate sector.
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PMID:Strategy for child immunization in Malaysian plantations. 794 48

In the past decade, many infectious diseases in children that were perceived to have been almost eliminated have returned with a vengeance in Texas. Across the state, vaccination rates are exceptionally low, and outbreaks of measles, mumps, and pertussis have been identified. Tuberculosis cases in children increased 77%, and cases of congenital syphilis increased 578% between 1987 and 1991. The new epidemic of HIV infection has placed additional strain on an already overburdened, inadequate public health system in Texas. This article identifies some of the major infections of public health significance among the children of Texas. A common theme for most of these problems is that they are preventable diseases that are not being prevented. Many children in Texas will suffer now and in the future if these public health problems remain ignored.
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PMID:Infectious disease of public health significance among children and adolescents in Texas. 807 74

The author describes her participation in an immunization project in Togo, one of many such projects supported by Canada's International Immunization Program. The Togo project was run by CUSO in partnership with the Canadian Public Health Association. In Togo, the infant mortality rate is significant. Thus the institution of an immunization program against major childhood illness (diphtheria, polio, tetanus, pertussis, measles and tuberculosis) was of paramount importance. Based in the maritime region of Togo, the project the author worked on helped 60,000 children and 200,000 women of childbearing age. The health team didn't attempt to change the behavior of the people of Togo since their cultural health care beliefs have existed for centuries and differ significantly from those of North Americans. Rather, efforts centered on health teaching, which increased the immunization rate from 16 to 63 per cent and decreased the incidence of disease.
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PMID:[Vaccination in Togo]. 807 24

Bordetella pertussis and Mycobacterium tuberculosis, routinely used to promote the development of autoimmune disease, were recently reported to also be effective in inducing protection against an autoimmune disease. Thus, we previously demonstrated that SJL/J and (SJL/J x BALB/c)F1 mice that are genetically susceptible to experimental autoimmune encephalomyelitis (EAE) become highly refractory to the induction of the disease following their exposure to B. pertussis and M. tuberculosis. In the present study, the pertussis toxin (PT) from B. pertussis and the purified protein derivative (PPD) of M. tuberculosis, were found to be sufficient to fully protect against EAE and thus may be the major bacterial components responsible for conferring protection. The 65-kDa heat-shock protein played only a marginal role in the protection against EAE induced by these bacteria. Both PT and PPD were protective when given before, but not after, the encephalitogenic challenge, and minute amounts (5-50 ng) emulsified in oil were sufficient to confer long-lasting resistance to EAE. The effect of PT or PPD on EAE differed from that of mitogens or bacterial superantigens, suggesting that their protection ability was not attributable merely to mitogenic or superantigenic properties. The mechanism of protection is not yet clear. Preliminary studies revealed a complex mechanism of protection whereby PPD and PT may operate differently. Thus, only PPD-induced, but not PT-induced, protection was transferrable by CD4+ T lymphocytes bearing an alpha beta T cell antigen receptor. Neither PT nor PPD had a protective effect on EAE mediated by preformed pathogenic T lymphocytes and it is most likely that they exert their protection by affecting the development of such T lymphocytes. How bacteria such as B. pertussis and M. tuberculosis can either enhance the development of an autoimmune disease or protect against the disease is not yet clear. However, identifying PT and PPD as the bacterial components active in protection may allow a better understanding of the modulatory effects of bacteria and point to the potential use of such bacterial products in immunomodulation of autoimmune diseases.
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PMID:Protection against autoimmune disease by bacterial agents. II. PPD and pertussis toxin as proteins active in protecting mice against experimental autoimmune encephalomyelitis. 809 58

Despite improvements in infant mortality, 500,000 infants die every year in the Americas. In Costa Rica, child mortality dropped from 68/1000 live births in 1970 to 20/1000 in 1980 as a result of improved hygiene and nutrition, immunization, and treatment. In most other countries of the Americas, infant mortality rates have declined substantially mainly because of public health programs. Educational levels of mothers and per capita national product also exert a notable influence on infant mortality. Poverty inflicts health problems: 177 million children are malnourished, and 40% of children in developing countries are undernourished, a state of affairs responsible for almost 60% of infant deaths. Breast-feeding plays a vital role in the first year of life by providing high quality nutrition and immunological protection, and emotional bonding between the mother and the child. Unfortunately, breast-feeding prevalence and duration is on the decline in developing countries. Safe drinking water and good sanitation are crucial in preventing and reducing child mortality. Women who become pregnant at either extreme of the reproductive age are exposed to higher maternal and pediatric risks; so are multiparous women, and women with short birth intervals. Most child deaths between the ages of 1-4 are preventable by health intervention: the main causes are diarrheal and respiratory diseases, malnutrition, and vaccine-preventable infectious diseases. Intestinal infections cause almost 5 million child deaths a year, and oral rehydration therapy is the most effective preventive measure. Vaccination is the most effective means of preventing measles, polio, tetanus, diphtheria, tuberculosis, and pertussis. In many countries, malaria has resurfaced with some 250-300 million new cases every year. Children and pregnant women are especially vulnerable to suffer serious complications. There were a quarter million cases of cholera in the Americas between early 1991 and August, 1992. AIDS is also a threat to child health because of the rising numbers of infected mothers and pregnant women.
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PMID:Children's health in the developing world: much remains to be done. 814 86


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