PubMed Health⌕ Search

Biomedical subjects

B Gellin

Publications and source records attributed to B Gellin.

5 recordsLinked to original sources
PubMed1993

Control of epidemic group A meningococcal disease in Auckland.

AIM: To study group A meningococcal vaccine delivery to infants less than 2 years of age in Auckland in 1987 to control epidemic disease. METHODS: Mechanisms of vaccine delivery and its facilitation are described. A detailed audit of delivery of vaccine to children less than two years using signed consent forms determined delivery source. This was the age group at highest risk, and poorly covered by routine childhood vaccines. Primary health care source of children presenting with disease was determined by telephone. RESULTS: The epidemic of group A meningococcal disease in the winters of 1985 and 1986 abated most likely due to the vaccination of high risk children (3 months-13 years) in 1987. 90% of the target population were vaccinated. In south Auckland the majority (92%) of vaccine doses for children less than two years of age was delivered by the Plunket Society with Department of Health backing aided by community health workers. By contrast delivery by, general practitioners was greater in north-west and central Auckland (approximately 25%, of dose 1), especially after the publicity over possible side effects (approximately 50% of dose 2). Coverage for dose 1 of children < 2 years was similar (89%) in south Auckland. Of children presenting with meningococcal disease 1 in 4 did not have an identifiable general practitioner. CONCLUSIONS: Vaccines to prevent serious paediatric illness are known to be highly cost effective. The best method of delivery of vaccinations may vary from area to area. Major community involvement including community health workers for the Maori and Pacific Island communities may have facilitated the dissemination of information in this campaign.

Adolescent↗
PubMed1992

Successful intervention in a group A meningococcal outbreak in Auckland, New Zealand.

During two consecutive winter seasons (1985 and 1986) Auckland, New Zealand, experienced epidemic rates of Group A meningococcal disease, a pattern not previously recognized in New Zealand. The overall rate was 8.3/100,000/year. The highest annual rate (64.7) occurred in children 0 to 23 months of age. A city-wide vaccine campaign commencing in May, 1987, was conducted over 6 weeks among children 3 months to 13 years of age with special emphasis on reaching populations at highest risk (Maori and Pacific Island Polynesian children in certain geographic regions of Auckland). Children from 2 to 13 years of age received a single dose of monovalent Group A meningococcal vaccine. Children ages 3 to 23 months received two doses at least 1 month apart. Overall approximately 130,000 doses were delivered; coverage was approximately 90% in the single dose target group. Among the younger children approximately 89% received the primary dose. Only approximately 26% received the recommended "booster" dose. After 2 1/2 years of active surveillance (1987 to 1989) there were no cases of invasive Group A meningococcal disease in children appropriately vaccinated for age. In contrast to this 100% efficacy the efficacy of a single dose of monovalent Group A meningococcal vaccine to prevent illness in the youngest children during the 1987 epidemic period was 52% (95% confidence interval (-330%, 95%)) falling to 16% (95% confidence interval, (-538%, 90%)) after 1 year. Four cases that occurred in infants 3 to 7 weeks before the scheduled "booster" campaign supports limited true efficacy. However, the prescribed 1 to 3-month interval between the two doses in infants may be too long.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Vaccines↗
PubMedDate not supplied

The contribution of reinfection to gonorrhea incidence in Alaska, 1983 to 1987.

Gonorrhea case reports to the Alaska Department of Health and Social Services were used to study the contribution of reinfection to rates of gonorrhea infection in Alaska. The case reports of 13,910 infections among 11,132 persons who had laboratory-proven gonorrhea between 1983 and 1987 were examined. Among 1,886 persons who had multiple infections, the average number of infections per person was 2.5 (range = 2-11). These persons accounted for 33.5% of all infections and 16.9% of all patients with gonorrhea from 1983 to 1987. Compared to persons with one infection, those having multiple infections were more likely to be Alaska Natives (relative risk = 1.8, 95% confidence interval = 1.6-1.9) and less than 21 years of age (relative risk = 1.3, 95% confidence interval = 1.2-1.4). There was no difference in risk between men and women. Two thirds of the reinfections occurred within 12 months of the initial infection. If gonorrhea incidence were calculated based on the number of people infected rather than as a "case rate," the mean annual rate (per 100,000) from 1983 to 1987 decreased from 1,644 to 1,228 (a 25.3% decrease) for Alaska Natives and from 316 to 267 (a 15.5% decrease) for non-Natives. Reporting gonorrhea incidence rates by number of persons infected rather than by total number of cases more accurately measures gonorrhea morbidity in a population and will allow prevention efforts to be directed to those persons who contribute the most to perpetuating the disease.

Adult↗