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

The effect of Bordetella pertussis vaccine on the cerebral vascular permeability in the mouse was studied by a radio-isotope method (131I-labelled HSA). Intravenous injection of 4 x 1010 heat-killed pertussis organisms caused a measurable increase in permeability in normal mice. Cryoinjury to the cerebral hemispheres resulted in a striking increase in vascular permeability at 24 h. This declined within 48 h and stabilized at a level fractionally higher than normal at 7 days ("healed lesion"). When pertussis organisms were injected into mice bearing ("healed lesion"). When pertussis organisms were injected into mice bearing "healed lesions" the increase in permeability was similar in magnitude to that in uninjured brain. The effect was increased by a second administration of pertussis 24 h after the first. The action of pertussis on a newly inflicted cryoinjury was protective. It is suggested that permeability changes in the cerebral vessels may be involved in the evolution of the encephalopathy attributed to the use of Bordetella pertussis vaccine in man.
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PMID:The effects of Bordetella pertussis vaccine on cerebral vascular permeability. 1 80

16 cases of neurological disease and/or death shortly after pertussis immunization are reported. Eight patients had convulsions, six with ensuing permanent defects. Severe polymyositis was observed in one case. Five infants died 12 h to 4 days after vaccination: two after acute encephalopathy and three in the form of a sudden unexpected death (SID). In two fatal cases the morphological changes in the brain corresponded to those of pertussis encephalopathy: neuronal degeneration in various parts of the cortex, especially in the region of the ammons horn, and in the cerebellum. There were no signs of inflammation. Three cases underwent forensic autopsy and death was attributed to bronchopulmonary infection. Complete neuropathological work-up was only done in one case, in which the brain was normal. The critique of episodical reports and the demand for prospective studies is appreciated. Knowledge of all possible forms of complications, however, is indispensable for future investigations. Polymyositis and SID have so far not been listed as abnormal reactions to immunization. The majority of our cases became known accidentally from hospital sheets or from discussions with collegues. For a detection of all possible cases a greater awareness of doctors for the problem of pertussis immunization appears necessary. Only another 23 cases have been reported to the health authorities of the state of Lower Saxony during the last 6 to 7 years. Of those, nine were either harmless reactions or diseases probably unrelated to vaccination. Two were cases of SID, 12 and 72 h after vaccination. It is concluded that only a minor proportion of possible complications is presently reported to the health authorities.
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PMID:[Complications of pertussis immunization (author transl)]. 1 70

During 1974, eight of 37 (22%) Bordetella organisms isolated from patients in Cincinnate were Bordetella parapertussis. This is in contrast to other experience in the United States where parapertussis has comprised less than5% of the Bordetella species isolated and suggest that B parapertussis infection may be more common in this country than generally recognized. The failure to appreciate the presence of this infection may result from the lack of cultures taken from children with mild disease and the failure todistinguish B parapertussis from B pertussis. Ccultures were obtained from family members of three of the children with B parapertussis, and B pertussis was isolated from members of two families, including the mother and sister of a child who died of pneumonia and encephalopathy. These cases suggest that patients with severe disease associated with B parapertussis should be carefully evaluated for the possibility of dual infection caused by b pertussis.
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PMID:Bordetella parapertussis. Recent experience and a review of the literature. 19 93

The benefit of pertussis vaccine in the control of pertussis is described in relation to the changes in incidence of pertussis during the past thirty years in the U. K. The current large epidemic of pertussis since November 1977 followed a decline in the acceptance of pertussis vaccine (DTP) from an average level of 70 to 80% of children in different areas in 1973 to less than 40% in 1976. The hazards of vaccine range from minor local to systemic (febrile) reactions. Convulsions, infantile spasms and more serious neurological illnesses have been described following inoculation. Serious neurological illnesses have been reported retrospectively and their causation in relation to pertussis vaccine inoculations is doubtful. They do not differ from similar illnesses in children of the same age which have developed without relationship to inoculations. Prospective studies of reactions in recently inoculated children are described. A national study of encephalopathy in babies and infants admitted to hospital in Great Britain is now taking place. Public acceptance of vaccine is hindered by publicity concerning the risks of vaccine and the need exists for improved health education concerning the merit of immunization.
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PMID:Benefits and risks of immunization against pertussis. 52 Jun 87

During 1970 to 1977 adverse reactions after pertussis vaccination were reported for 149 children, 56% male and 44% female. Their symptoms permitted to divide the vaccinees into 2 groups: one with more severe (S) and the second with other symptoms (0). No differences were observed in age and sex among the two groups. The interval between vaccination and appearance of first symptoms was longer for the 0 than for the S group. While less than one quarter of the reactions in the 0 group occurred after primovaccination, more than half of the S side effects were seen after the first vaccination. Further analysis of the S group revealed, that all but two of their symptoms (fever and encephalopathy) corresponded to the hypoglycaemic syndrome. The consequences hereof are discussed with regard to prevention and therapy.
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PMID:[Side effects of whooping cough inoculation]. 54 Aug 97

Data from the first year of the National Childhood Encephalopathy Study were reviewed to see whether any relation was apparent between pertussis vaccination and brain disease. Three hundred and eighty-seven cases of encephalitis and other specified neurological conditions in which the children were admitted to hospital were reported, of which 267 satisfied the study criteria. Control children were matched for age with the index cases, and medical and immunisation histories were reviewed. Few of the index cases had been vaccinated within 28 days before admission to hospital, so that no close association between vaccination and brain disease existed in most cases. The number of children who had recently been immunised was too small for any statistically useful conclusion to be reached about the risk associated with pertussis vaccine. The study is continuing.
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PMID:National Childhood Encephalopathy Study: an interim report. 70 4

Similar movement disorders developed in two 8-year-old retarded children while they were receiving phenytoin. Seizures subsequent to a diphtheria-pertussis-tetanus immunization had developed in each child at 1 to 2 months of age. A static encephalopathy ensued, characterized by mental retardation, ataxia, spasticity, and a mixed seizure disorder. Intermittent dystonia and choreoathetosis developed insidiously while serum phenytoin concentrations were in the therapeutic range. Sustained dystonia and choreoatheosis developed 2 hours after an oral provocation with phenytoin. The baseline abnormalities on the electroencephalogram remained unchanged during the choreoathetosis. Recognizable metabolic abnormalities known to be associated with similar movement disorders were excluded. It was concluded from these studies that the movement disorder is secondary to phenytoin and can occur at therapeutic serum concentrations. Phenytoin is a central anticholinergic agent and a central stimulant of serotonin, and may induce movement disorders as a result of altering these neurotransmitters in the brain. The variable expression of these movement disorders may relate to the nature of the preexisting striatal insult.
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PMID:Phenytoin-induced dystonia and choreoathetosis in two retarded epileptic children. 94 1

Pertussis as an infectious disease exhibits a number of unusual features, both with respect to its epidemiology and to the interaction of the bacteia with the infected host. Evidence that a virus may in some cases be the etiology of the syndrome has been reviewed and seems to be have been established in certain instances. Pertussis caused by a virus would not be difficult to accept insofar as the respiratory manifestations of the disease are concerned. It is difficult, however, to reconcile the hematologic changes of pertussis with what is presently known about the usual virus infection of humans. The clinical syndrome itself is suficiently unique as to be recognized in most cases. The use of antibiotics has considerably reduced the mortality of the disease by allowing treatment of complications. The other serious complication of disease, pertussis encephalopathy, remains a problem. The possible occurrence of hypoglycemia during pertussis has been noted and deserves further documentation especially in that it may contribute to the encephalopathy...
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PMID:Pertussis. 118 91

From 1950 to 1970 in Hamburg, 9240 patients under 15 years of age were treated as inpatients for pertussis. 1674 patients had pneumonia due to pertussis, 114 had pertussis encephalopathies, and 41 seizures. The fatality from pneumonia went from 2,26% (1950-1960) to 0,4% (1961-1970). Fatality from encephalopathy was less influenced (24% respectively, 17,9%). The mild clinical course of pertussis is also reflected in the reduced number of hospitalizations due to pertussis (1956, 3,7%; 1970, 0,8%). Permanent damage from complications due to pertussis was seen in 0,7% of survivors from pertussis pneumonia and in 3,4% after pertussis encephalopathy.
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PMID:[Pertussis and it complications-analysis of hospitalized patients in Hamburg 1950-1970 (author's transl)]. 120 1

Several social and medical attributes are associated with both avoidance or delay of vaccination and an increased risk of adverse events such as sudden infant death syndrome or childhood encephalopathy. Studies that fail to control adequately for such confounding factors are likely to underestimate the risks of adverse events attributable to vaccination. This paper reviews the literature on studies of severe adverse events after the administration of pertussis antigen-containing vaccines, with particular attention to the measures taken by different investigators to avoid this problem. Most published studies have reported a deficit of sudden infant death syndrome among vaccinees, which may reflect confounding in their study designs. An expression is derived to explore the extent of underestimation that may be introduced in such studies, under different sets of conditions. Confounding of this sort is a general problem for studies of adverse reactions to prophylactic interventions, as they may be withheld from some individuals precisely because they are already at high risk of the adverse event.
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PMID:Confounding in studies of adverse reactions to vaccines. 829 88


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