Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0348321 (Haemophilus)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In developing countries, where economic development is lacking and literacy rates are low, priority must be given to primary health care and to the establishmend of sustainable health care delivery systems. The World Health Organization's Expanded Program of Immunization was designed with the goal of immunizing all children against measles, pertussis, tetanus, poliomyelitis, tuberculosis, and diphtheria by 1990. A second function of the immunization program is to establish a health care delivery system. Today 50% of infants receive 3 doses of diptheria/pertussis/tetanus and polio vaccines, and 70% receive at least 1 dose. Measles kills 2 million children every year. The standard strain of attenuated vaccine is given at 9 months, and 1 dose protects 95% of children for life. Tetanus kills 800,000 infants every year. The vaccine must be refrigerated, and 2 doses are essential. Tuberculosis kills 2 million children under 5 every year. The attenuated BCG vaccine should be given at birth, and a single dose confers some protection. Diphtheria is most common among poor, urban children in termperate climates, and 3 doses of toxoid at monthly intervals are recommended. Poliomyelitis paralyzes 250,000 children a year. 4 doses of live attenuated Sabin vaccine are recommended. The vaccine is very sensitive to heat. Other vaccines in use or being developed include yellow fever, meningococcus, Japanese B encephalitis, rubella, hepatitis B, cholera, rotavirus, pneumonococcus, and Haemophilus influezae. 2 problems that confront the delivery of health services, including immunization, are lack of funds and lack of access to susceptible populations. Approaches to the lack of funds problem include fee for service, taxation, beter management of existing resources, reallocation of health resources, and increased funding from donor nations. Approaches to the problem of access include vaccination whenever children come into contact with a health facility for any reason, channeling by members of the community, involvement of traditional healers and birth attendants, outreach services, mass campaigns, pulse technics, and financial incentives.
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PMID:Vaccination strategies in developing countries. 305 59

Enzyme immunoassays are attaining increased usage for the direct detection of microbial antigens in body fluids. Advantages of enzyme immunoassays include a high degree of sensitivity resulting from the inherent magnification of the enzyme-substrate reaction and the use of objective end points without the need for radioactivity. Enzyme immunoassays have been developed for the reliable detection of several important microbial antigens in body fluids, including antigens of rotavirus, hepatitis B virus, and Haemophilus influenzae type b. However, standard enzyme immunoassay techniques are not sufficiently sensitive for the measurement of some antigens from other viruses, bacteria, and parasites in concentrations that commonly occur in body fluids during the course of infectious diseases. This review examines some of the limitations of currently available enzyme immunoassay technology and discusses approaches to increasing the sensitivity and specificity of enzyme immunoassay systems. Methods for improving these assay systems include the use of monoclonal antibodies, improved methods of enzyme-immunoreactant conjugation, more sensitive substrate systems, improved methods of antigen-antibody access, and the direct measurement of microbial enzymes. The use of such techniques should lead to the development of efficient enzyme immunoassay systems for the direct detection of a wide range of bacterial, viral, and parasitic infections.
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PMID:Enzyme immunoassays for the detection of infectious antigens in body fluids: current limitations and future prospects. 680 27

Immunization of infants and children is the most effective strategy for decreasing the incidence of some infectious diseases. Most invasive disease due to Haemophilus influenzae type b occurs before age 5 years, and routine vaccination of infants for hepatitis B is currently recommended because selective immunization of high-risk persons has not been feasible. Decades of use of poliovirus vaccine has effectively eliminated cases of wild-virus infection, although some vaccine-related cases still occur. The newly approved varicella vaccine appears to be a cost-effective way to decrease infection rates in children. Improved immunization rates for influenza and pneumococcal and meningococcal diseases could help decrease excess mortality in elderly persons and those with chronic illness.
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PMID:Vaccination update. Hib, hepatitis, polio, varicella, influenza, pneumococcal and meningococcal disease. 747 50

Inactivated and trivalent oral poliovirus vaccines contain either formalin-inactivated or live, attenuated poliovirus, respectively, of the three serotypes. Interference among the three attenuated poliovirus serotypes was minimized with a "balanced-formulation" vaccine, and serologic responses after IPV were optimized by adjusting the antigenic content of each inactivated poliovirus serotype. Seroconversion is dependent on both the relative content as well as the absolute quantity of virus in the vaccine. The "gold standard" method to assess humoral antibody responses following vaccination is the neutralization assay. Any detectable titer of neutralizing antibody against poliovirus is considered protective against clinical paralytic diseases. Recently, standard procedures were adopted for conducting neutralization assays. Efforts are being undertaken now to develop a combined diphtheria and tetanus toxoids and pertussis vaccine and IPV vaccine in the United States using a dual-chambered syringe that mixes the content of both vaccines at the time of injection; this approach is necessary to overcome the potential detrimental effect of thimerosal on IPV (the preservative in DTP). Other vaccines that combine DTP and/or Haemophilus influenzae type b and/or hepatitis B with IPV appear feasible but require further investigation. New combination vaccines should induce similar or superior levels of neutralizing antibody in serum for individual protection against paralytic disease and mucosal immunity that effectively decreases viral replication in the intestine and pharynx for population protection against transmission of poliovirus.
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PMID:Defining surrogate serologic tests with respect to predicting protective vaccine efficacy: poliovirus vaccination. 762 65

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

New vaccines, anti-Haemophilus b and anti-hepatitis B, are now available in clinical practice. Specific recommendations have led to modifying the calendar. Practitioner has to explain these new vaccines to the families because they are not compulsory. Combined vaccines (like five valence) is useful to improve compliance. In the near future, new vaccines like the well tolerated acellular pertussis, and new combined vaccines will be available.
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PMID:[Vaccination in children]. 766 4

Allogeneic bone marrow transplant patients are severely immunocompromised during the immediate posttransplant period, and the risk for common and opportunistic infections may persist for many months. The role of reimmunization for these patients, however, remains unsettled. We briefly review current concepts regarding the recapitulation of immunity from the totipotential hematopoietic stem cells in the donor marrow. The fact that various components of the new immune system mature at different rates can have clinical consequences with regard to specific infections. Most previously immunized patients become antibody seronegative within a few months after allogeneic marrow transplantation. Adoptive transfer of specific antibody-producing cells from the donor to the recipient has been demonstrated in small clinical trials, and is augmented when both donor and recipient are vaccinated. Passive transfer of immunity is more easily achieved to recall antigens than to neoantigens. Primary immunization requires prolonged antigenic stimulation and mature T-cell function or help from natural killer cells. Most healthy patients generate adequate antibody titers to vaccinations that are given 12 months after transplantation, but the presence of chronic graft-versus-host disease can diminish the response. Currently available vaccines have been evaluated in marrow transplant patients. Protein antigens such as tetanus and diphtheria toxoids are more immunogenic than polysaccharide antigens such as pneumococcal vaccine. The new polysaccharide-protein conjugate vaccines, such as the Hemophilus influenzae type b vaccine, also appear more immunogenic. Inactivated poliovirus vaccine has been used successfully. Relatively few data are available about hepatitis B or influenza vaccines. The literature supports the use of standard vaccines in allogeneic bone marrow transplant patients. However, more data on the optimal methods and timing of immunization are needed. We present guidelines for a reimmunization schedule.
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PMID:Reimmunization after allogeneic bone marrow transplantation. 770 53

Vaccines comprising combinations of diphtheria, tetanus and pertussis (DTP) components with Haemophilus influenzae b polysaccharide--protein conjugates (DTP-Hib) are now available. Combinations of DTP-Hib with additional components such as inactivated poliomyelitis vaccine, hepatitis B vaccine, meningococcal and pneumococcal polysaccharide-protein conjugates are under development. Other combinations, such as Hib vaccine with meningococcal A, B and C components and possibly pneumococcal conjugates, or non-capsulated Haemophilus components combined with pneumococcal conjugates, developed against bacterial meningitis and otitis media respectively, are of potential interest. Combination vaccines against enteric infections and including potentially cholera, typhoid, ETEC, Shigella, rotavirus and possibly Campylobacter and Helicobacter components, may become available in the longer term. The control of these combinations is likely to be based on pharmacopoeial requirements for the individual components. However, the evaluation of combinations may not be straightforward and the interaction of the components with each other may influence reactogenicity, immunogenicity and stability and will complicate laboratory control tests. Indications of this have already arisen with some DTP-Hib combinations but are likely to increase as additional components are added. For example, the use of diphtheria and tetanus proteins as carriers for multiple polysaccharide conjugates may lead to excessive antitoxin production and epitope suppression of anti-polysaccharide responses. Other problems may result from competition for binding sites on adjuvant molecules. The requirements for new vaccine combinations need to be considered carefully and should not be made solely on assumptions based on the properties of individual components.
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PMID:Control testing of combined vaccines: a consideration of potential problems and approaches. 777 62

Early intervention for persons infected with human immunodeficiency virus (HIV) involves characterization of the stage of HIV disease, institution of therapy to prevent associated infections and postpone deterioration of immune function, and assistance in preventing transmission of the virus. This review examines the available data on the efficacy of current recommendations regarding the evaluation and management of persons with early HIV infection. Existing evidence supports the efficacy of physical examination, monitoring of the CD4+ cell count, tuberculin testing (with chemotherapy for persons who test positive), anergy testing, Papanicolaou testing and screening for gonorrhea and chlamydial infection (for high-risk women), screening for syphilis, antiretroviral therapy (for symptomatic patients), and guidance in reducing the transmission of HIV. Recommended measures for which evidence of clinical efficacy is less certain include immunization against infections due to influenza virus, Streptococcus pneumoniae, Haemophilus influenzae, and hepatitis B virus as well as antiretroviral therapy for asymptomatic persons. Quantitative measurement of viral titers appears promising for the monitoring of HIV disease and antiretroviral therapy; the correlations of these titers with clinical end points need to be confirmed.
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PMID:Early intervention for persons infected with human immunodeficiency virus. 779 7

Recent additions to the immunization schedule include acellular pertussis vaccine, and hepatitis B vaccine for all infants and selected adolescents. The third dose of OPV is recommended at 6 months of age and the first dose of MMR vaccine at 12 to 15 months. A new vaccine against Haemophilus influenzae type b has been licensed. Children aged 6 months and older with asthma, diabetes, or heart disease should receive influenza vaccine. Children aged 2 years and older with asplenia, immunosuppression, and nephrotic syndrome may be candidates for pneumococcal immunization.
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PMID:Childhood immunization guidelines: current and future. 785 58


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