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

Convulsions or status epilepticus in 11 infants after pertussis vaccination are reported. In 3 cases grand mal epilepsy persisted and 2 children developed infantile epileptic encephalopathy (Lennox syndrome). On the basis of our own experience, the incidence of seizures approximates 1:4800 infants vaccinated or 1:12 800 vaccinations. According to a recent prospective study from the USA, the incidence of seizures may be closer to 1:600 infants. Since there is a significant difference between the incidence of spontaneous fits in children of the same age group and the incidence after vaccination, a causal relationship between the seizures and vaccination appears to be confirmed. The following conclusions are drawn from these observations: 1. In view of the usually benign course of whooping cough today, current vaccination against pertussis is hardly satisfactory. Improvement of the available vaccines is an urgent necessity. The protection should include the population most at risk, i.e. infants during the first few months of life. 2. Parents should be better informed about the risks involved in pertussis vaccination. 3. Booster inoculations should be abandoned. 4. Health authorities should decide whether the current pertussis vaccination program should be continued. 5. Complications following vaccination should be registered at a national centre.
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PMID:[Convulsions after whooping-cough vaccination]. 679 99

Levine produced encephalitis in Lewis rats after injection of pertussis vaccine together with spinal cord tissue of guinea-pigs. This animal model was used as an assay for the possible side-effects of pertussis vaccines prepared from whole bacteria or with extracted antigens. Wistar and Lewis rats were injected with a mixture of guinea-pig spinal cord and cFA together with vaccines into the pad of each hind food. During a period of 25 days, the rats were observed for paralysis, ataxia, and death. Wistar rats were not found to be sensitive enough. Lewis rats were high susceptible in this model; they developed a high rate of allergic encephalopathy. DPT-vaccines prepared with soluble antigens showed a reduced neurotoxic activity. The results were compared with the histamine-sensitizing assay and the mouse weight-gain test. In these assays similar results were found. The proposed animal assay is recommended in the preclinical testing of pertussis vaccines.
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PMID:Allergic encephalomyelitis in rats - toxicity assay for pertussis vaccines. 693

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

Pertussis, one of the most communicable respiratory diseases, has a wide spectrum of severity, which generally decreases with age. Adults with waning immunity, who have subclinical pertussis, frequently infect nonimmunized or underimmunized children within the same household. High levels of pertussis activity persist, even in highly immunized populations. Infants less than 2 months of age have the highest attack rate and greatest morbidity and mortality. Serious complications include apnea, pneumonia, encephalopathy, and recurrence of coughing spasms with cyanosis. These complications further contribute to a protracted disease course in young infants. Although a decrease in the incidence of pertussis has occurred since the advent of active immunization in the United States, recent data show a striking resurgence in cases. Widespread transmission of disease, even in immunized individuals, and subclinical adult infection, which serves as a reservoir for disease in young infants, underscore the need for a more effective vaccine immunization strategy.
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PMID:Pertussis in the young infant. 776 15

In August 1991, the Institute of Medicine released a report entitled Adverse Effects of Pertussis and Rubella Vaccines, which examined, among others, the relation between immunization with whole-cell diphtheria-tetanus-pertussis (DTP) vaccine and both acute encephalopathy and chronic neurological damage. The committee reviewed information from a wide range of both professional and lay sources and found that the evidence is consistent with a possible causal relation between DTP vaccine and acute encephalopathy, although it is insufficient to establish causality. The range of excess risk of acute encephalopathy following DTP immunization is consistent with that estimated from the National Childhood Encephalopathy Study: 0.0 to 10.5 cases per million immunizations. The committee concluded that the evidence is insufficient to indicate either the presence or absence of a causal relationship between DTP vaccine and permanent neurological damage. The evaluative methods used by the committee are briefly described and the evidence underlying its conclusions presented.
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PMID:Acute encephalopathy and chronic neurological damage after pertussis vaccine. 790 66

Absolute contraindications to pertussis immunization should be limited to anaphylaxis or unexplained encephalopathy following a previous dose. Other contraindications including marked febrile reactions (> 40.5 degrees C), hypotonic-hyporesponsive episodes, prolonged screaming (> 3 h) and severe local reactions (more than half the limb involved) are relative, as no long-term adverse consequences have been noted, and must be weighed up in the context of the risk of pertussis to the individual child. Each of these contraindications will affect less than 1% of children. Paediatricians should strongly discourage the inappropriate deferral of pertussis immunization due to mild illness and the omission of pertussis vaccine because of inappropriate contraindications, such as many of those mentioned in the product information. This is especially important in children who have underlying conditions which may place them at greater risk of acquisition of and complications from natural pertussis infection.
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PMID:The Australian College of Paediatrics Policy Statement. Contraindications to immunization against pertussis. 794 40

Reassessment of the role of whole-cell pertussis vaccine as a cause of permanent neurologic damage is necessitated by the 10-year follow-up of the National Childhood Encephalopathy Study (NCES) in Great Britain. The findings of this study demonstrate that infants and young children with serious acute neurologic disorders are at an increased risk of later neurologic impairment or death, irrespective of the initial precipitating event. The results, however, do not establish a casual relationship between pertussis vaccination and chronic neurologic abnormalities. The Academy reaffirms its earlier conclusion that whole-cell pertussis vaccine has not been proven to be a cause of brain damage and continues to recommend pertussis vaccination in accordance with the guidelines in the 1994 Red Book.
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PMID:The relationship between pertussis vaccine and central nervous system sequelae: continuing assessment. American Academy of Pediatrics Committee on Infectious Diseases. 858 96

This report provides updated information concerning the potential adverse events associated with vaccination for hepatitis B, poliomyelitis, measles, mumps, diphtheria, tetanus, and pertussis. This information incorporates findings from a series of recent literature reviews, conducted by an expert committee at the Institute of Medicine (IOM), of all evidence regarding the possible adverse consequences of vaccines administered to children. This report contains modifications to the previously published recommendations of the Advisory committee on Immunization Practices (ACIP) and is based on an ACIP review of the IOM findings and new research on vaccine safety. In addition, this report incorporates information contained in the "Recommendations of the Advisory Committee on Immunization Practices: Use of Vaccines and Immune Globulins in Persons with Altered Immunocompetence" (MMWR 1993;42[No. 44-4]) and the "General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)" (MMWR 1994;43[No. RR-1]). Major changes to the previous recommendations are highlighted within the text, and specific information concerning the following vaccines and the possible adverse events associated with their administration are included: hepatitis B vaccine and anaphylaxis, measles vaccine and a) thrombocytopenia and b) possible risk for death resulting from anaphylaxis or disseminated disease in immunocompromised persons; diphtheria and tetanus toxoids and pertussis vaccine (DTP) and chronic encephalopathy; and tetanus-toxoid-containing vaccines and a) Guillain-Barre syndrome, b) brachial neuritis, and c) possible risk for death resulting from anaphylaxis. These modifications will be incorporated into more comprehensive ACIP recommendations for each vaccine when such statements are revised. Also included in this report are interim recommendations concerning the use of measles and mumps vaccines in a) persons who are infected with human immunodeficiency virus and b) persons who are allergic to eggs; ACIP is still evaluating these recommendations.
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PMID:Update: vaccine side effects, adverse reactions, contraindications, and precautions. Recommendations of the Advisory Committee on Immunization Practices (ACIP) 880 42

Three hundred forty patients were diagnosed with pertussis infection at the Pediatric Clinic of the University of Catania, Sicily during the period 1979-1994. None of these patients had been previously vaccinated. Fourteen developed neurological complications at some point in their course, which took the form of seizures (both febrile and afebrile) and, in some cases, encephalopathy. Serious permanent neurological sequelae were not observed in this series of patients though they had pertussis severe enough to require hospitalization.
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PMID:Neurological complications in hospitalized patients with pertussis: a 15-year Sicilian experience. 881 98

The tolerance and side effects of vaccinations were determined in patients with congenital adrenal hyperplasia (CAH) who receive physiological corticosteroid substitution. In a retrospective approach, questionnaires about the frequencies of vaccinations and observed side effects were sent to CAH patients, and medical records were reviewed. We received 82 questionnaires from 63 patients with CAH and salt-losing and 19 patients without salt-losing. Patients age ranged from 2-40 years. No statistical differences were found for vaccination frequencies between patients with or without salt-losing. CAH patients had received complete vaccinations against diphtheria, tetanus and poliomyelitis in 79%, 85% and 78%, respectively, whereas pertussis vaccination was complete in only 23%. Live vaccination against measles, mumps and rubella was performed in 63%, 50% and 38%. Side effects of vaccination were indicated in 5 out of 82 questionnaires who all belonged to CAH patients with salt-losing. Transient side effects were an anaphylactic reaction, probably to tetanus immunoglobulin, in 1 case, and fever and convulsions after diphtheria, pertussis and tetanus (DPT) vaccine in 2 cases. In 2 further patients putative complications were noted. Encephalitis with permanent disabilities was observed after the third DPT vaccination, but a causative relation could not be established. In another boy, encephalopathy noticed after measles vaccination was induced by previous toxicosis. Although encephalopathy was described in 2 patients after vaccinations, no vaccination damage could be proven in our retrospective study. As expected, an increased vaccination risk in CAH patients was not demonstrated.
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PMID:Vaccine tolerance in steroid substituted patients with congenital adrenal hyperplasia. 923 2


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