Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0043167 (pertussis)
 19,595 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The immunization status of active duty pediatric dependents served by the National Naval Medical Center was surveyed to estimate the degree to which this group was in compliance with immunization requirements. Four hundred sixteen patients who presented consecutively to a pediatric acute care clinic had their medical and immunization records screened. Ten percent of patients did not have complete records of immunization. Of the 375 patients remaining, 52 (13.9%) were deficient in one or more required immunizations based on their current age. The highest rates of delay were seen for the Haemophilus influenza vaccine followed by measles, mumps, rubella, and diphtheria, tetanus, and pertussis. The most common reason for missing immunizations was parental unfamiliarity with the recommended schedule. This study suggests that a significant number of dependents in our catchment area were delayed in immunization and that accurate record keeping and patient education about immunizations needs to be improved.
Mil Med 1993 Jun
PMID:Immunization status of a military dependent population. 836 91

Concern about emerging and reemerging respiratory pathogens prompted the development of a respiratory disease reference laboratory at the Naval Health Research Center. Professionals working in this laboratory have instituted population-based surveillance for pathogens that affect military trainees and responded to threats of increased respiratory disease among high-risk military groups. Capabilities of this laboratory that are unique within the Department of Defense include adenovirus testing by viral shell culture and microneutralization serotyping, influenza culture and hemagglutination inhibition serotyping, and other special testing for Streptococcus pneumoniae, Streptococcus pyogenes, Mycoplasma pneumonia, and Chlamydia pneumoniae. Projected capabilities of this laboratory include more advanced testing for these pathogens and testing for other emerging pathogens, including Bordetella pertussis, Legionella pneumoniae, and Haemophilus influenzae type B. Such capabilities make the laboratory a valuable resource for military public health.
Mil Med 2000 Jul
PMID:The Naval Health Research Center Respiratory Disease Laboratory. 1092 Jun 35

Three cases of pertussis (whooping cough) identified in a military emergency department are reported. Two of these cases involved infants with typical presentations. One of these infants was too young to have received immunizations, and the other child was only partially immunized. The third case involved an active duty soldier with a chronic cough. Pertussis has become increasingly important as a cause of chronic cough in adults. As a result of the infectivity of this organism, close-quarter situations, such as day care centers and military barracks, create the opportunity for substantial person-to-person transmission. Typical and atypical clinical presentations of pertussis are discussed, with an emphasis on currently available diagnostic modalities. The epidemiology and pathophysiology of this disease are also reviewed. The medical management of active duty soldiers and their dependents (both pediatric and adult) with this largely underappreciated infection and their close contacts is presented.
Mil Med 2002 Mar
PMID:Pertussis in a military and military beneficiary population: case series and review of the literature. 1190 69

Pertussis, once a serious respiratory disease in children, has recently been identified as a common cause of chronic cough in adults. Military personnel are known to be vulnerable to this disease. After a training barracks exposure to pertussis, routine arrangements for contact prophylaxis with erythromycin failed. This experience is reported here as well as that of our subsequent aggressive attempts using directly observed prophylaxis (DOP) with standard erythromycin regimens. No secondary cases occurred. However, many contacts (35%) could not finish a 14-day course despite DOP, mostly because of nausea (85%) or diarrhea (72%). Seventeen (18%) soldiers missed classes because of erythromycin side effects; five required emergency department visits or hospital admission for the same. Sixteen (17%) soldiers were switched to azithromycin because of side effects; all were able to complete a 14-day course without symptoms. High adherence rates with erythromycin administration using DOP are attainable but may trigger unacceptable toxicities; alternative prophylactic regimens should be considered for active duty personnel.
Mil Med 2004 Jun
PMID:Experience with directly observed prophylaxis using erythromycin in military trainees exposed to pertussis. 1528 68

History reveals a tremendous impact of respiratory pathogens on the U.S. military, dating back to the time of the Revolutionary and Civil Wars, during which 90% of casualties were for nonbattle injury, including several respiratory illnesses such as measles, whooping cough, and complicated pneumonia. The devastating impact of the influenza pandemic at the end of World War I led to a more proactive approach to research into the etiologies and potential preventive measures for such diseases. The development of the Armed Forces Epidemiological Board, with its subordinate commissions, coincided with the massive mobilization for World War II. Efforts of the board during and after the war led to significant progress against many common pathogens, such as the landmark studies of group A Streptococcus among young trainees at Warren Air Force Base, which led to the development of highly effective prophylactic and therapeutic strategies to prevent rheumatic fever. Military pediatricians contributed greatly to this work, as well as subsequent investigations into both the pathogenesis of and prophylactic therapy for a variety respiratory pathogens, including pertussis and respiratory syncytial virus. The momentum of this work continues to this day, among researchers from all three military branches.
Mil Med 2005 Apr
PMID:History of U.S. military contributions to the study of respiratory infections. 1591 85

Pertussis has had a resurgence in recent years. Women of child-bearing age and adults with infant contact are important reservoirs of infection because of waning immunity. Recent infant deaths and outbreaks led to new tetanus, diphtheria, and acellular pertussis (Tdap) vaccine recommendations, but vaccination rates remain low. A performance improvement project was started at Walter Reed Army Medical Center to target women of child-bearing age. Women treated in Gynecology had their electronic medical record screened for Tdap during their vital signs assessment. Those eligible for vaccination were directed to the Immunization Clinic. The intervention was considered successful if the patient received the vaccine within 30 days of the visit. Data were compiled on vaccination rates 1 month before and 1 and 3 months after the start of the performance improvement project. Only 13.9% of all patients had a documented Tdap at any time. During the first month following the intervention, vaccination rates within 30 days of the appointment increased from 0.38% to 6.5% (p < 0.005). The effect waned at 3 months following intervention, with only 1.1% of patients vaccinated within 30 days of the appointment. Overall vaccination rates remain low, and future studies should focus on barriers to vaccination to prevent morbidity and mortality.
Mil Med 2013 Oct
PMID:Tdap coverage in a military beneficiary population: room for improvement. 2408 28

Pertussis is a highly contagious, vaccine preventable upper respiratory disease. The incidence of the disease has been rising in the past few decades. During the winter of 2015, an upper respiratory outbreak occurred in one of Israel Defense Forces basic training bases in northern Israel. Following the detection of the first primary cases, a suspected outbreak investigation was initiated in conjunction with more rigorous clinical and laboratory testing efforts to include specific antibody enzyme-linked immunosorbent assay assays and polymerase chain reaction to diagnose pertussis. Initially, 1,596 soldiers were surveyed clinically using a questionnaire and physicians' interviews for upper respiratory disease symptoms. A total of 158 soldiers were further evaluated and 38.6% (61) of those were diagnosed as having pertussis (with laboratory evidence). Based on the protocol that we developed during the course of this outbreak, a postexposure prophylaxis was given to every soldier for whom there was a high level of suspicion for infection and met the inclusion criteria for the postexposure prophylaxis protocol. The effects of the postvaccination waning immunity among a vaccinated population were demonstrated, thus the need of maintaining a high index of suspicion of Brodetella pertussis as a causative agent during respiratory diseases outbreaks in young soldiers.
Mil Med 2017 03
PMID:Pertussis Outbreak Among Soldiers During Basic Training: The Need for Updated Protocols. 2829 99