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Biomedical subjects

H Cody Meissner

Publications and source records attributed to H Cody Meissner.

At least 19 recordsLinked to original sources
PubMed2007

Influenza vaccines: a pediatric perspective.

PURPOSE OF REVIEW: To understand the burden of disease attributable to influenza among children and to understand the basis for changing recommendations for immunization of young children. I will review the current recommendations regarding use of trivalent, inactivated influenza vaccine and live, attenuated influenza vaccine. RECENT FINDINGS: Annual immunization of all children between 6 and 59 months of age and their household contacts is recommended starting with the 2006-2007 season, including a two-dose strategy for children under 9 years of age. SUMMARY: Expanded recommendations are expected to reduce the number of outpatient visits, hospitalization rates and mortality rates due to influenza for both children and adults.

Forecasting↗
PubMed2005

Reducing the impact of viral respiratory infections in children.

This article reviews the epidemiology and clinical aspects of the major viral causes of upper and lower respiratory tract disease in children. Particular emphasis is placed on prevention and control of viral disease through the use of vaccines and antiviral agents. Evolution of new viral pathogens, such as avian influenza virus and the SARS-CoV, are discussed.

Age Distribution↗
PubMed2005

Dose-response study of a quadrivalent measles, mumps, rubella and varicella vaccine in healthy children.

BACKGROUND: A combined measles, mumps, rubella and varicella (MMRV) vaccine would facilitate universal immunization against 4 diseases by decreasing the number of injections and thus enhancing compliance and coverage rates. If a second dose of varicella vaccine were to be recommended, MMRV could be used to administer a routine second dose of M-M-RII with the added advantage of boosting varicella-zoster virus (VZV) antibody titers. METHODS: Subjects 12-23 months of age received a single injection of 1 of 3 lots of an MMRV vaccine (ProQuad) containing high, middle or low VZV potency, or VARIVAX given concomitantly with M-M-RII. Recipients of MMRV received a second injection of MMRV approximately 90 days later. RESULTS: We enrolled 1559 subjects in the study. Antibody response rates to VZV 6 weeks after 1 injection of high potency MMRV (88.6%) or 2 injections of MMRV of any varicella potency (99.7-100%) were similar to the response rates after concomitant administration of M-M-RII and VARIVAX (93.1%). The second injection of MMRV boosted VZV antibody titers. Antibody responses to measles, mumps and rubella were >or=98%, similar to the control, after 1 or 2 injections of MMRV. MMRV was generally well-tolerated during the 42 days after vaccination. CONCLUSIONS: One injection of high potency MMRV resulted in antibody responses to the 4 vaccine components equivalent to those found after concomitant administration of M-M-RII and VARIVAX. A second injection of MMRV resulted in a significant boost in VZV antibody. This boost may translate into enhanced immunogenicity against varicella, which is known to correlate with increased protection.

Antibodies, Viral↗
PubMed2004

Evaluation of combined live, attenuated respiratory syncytial virus and parainfluenza 3 virus vaccines in infants and young children.

We evaluated a combination respiratory syncytial virus (RSV) and parainfluenza 3 virus (PIV3) live, attenuated intranasal vaccine for safety, viral replication, and immunogenicity in doubly seronegative children 6-18 months old. RSV cpts-248/404 and PIV3-cp45 vaccines were combined in a dose of 10(5) plaque-forming units of each per 0.5-mL dose and compared with monovalent vaccines or placebo. The virus shedding pattern of RSV was not different between monovalent RSV cpts-248/404 vaccine and combination vaccine. Modest reductions in the shedding of PIV3-cp45 vaccine virus were found after the administration of RSV cpts-248/404 and PIV3-cp45 vaccine, relative to monovalent PIV3 vaccine; 16 (76%) of 21 children given combination vaccine shed PIV3-cp45 versus 11 (92%) of 12 of those given monovalent PIV3 vaccine. Both vaccines were immunogenic, and antibody responses were similar between the monovalent groups and the combination group. Combined RSV/PV3 vaccine is feasible for simultaneous administration, and further studies are warranted.

Administration, Intranasal↗
PubMed2004

Measles vaccines and the potential for worldwide eradication of measles.

The annual number of reported measles cases in the United States has declined from between 3 million and 4 million in the prevaccine era to <100 cases in association with the highest recorded immunization rates in history. Because of continued importation of measles into the United States, young children who are not vaccinated appropriately may experience more than a 60-fold increase in risk of disease. Unsubstantiated claims suggesting an association between measles vaccine and neurologic disorders have led to reduced vaccine use and a resurgence of measles in countries where immunization rates have declined below the level needed to maintain herd immunity. To address the possibility of worldwide control of measles, efforts to ensure high immunization rates among people in both developed and developing countries must be sustained.

Autistic Disorder↗
PubMed2003

Palivizumab prophylaxis reduces hospitalization due to respiratory syncytial virus in young children with hemodynamically significant congenital heart disease.

OBJECTIVES: To evaluate the safety, tolerance, and efficacy of palivizumab in children with hemodynamically significant congenital heart disease (CHD). STUDY DESIGN: A randomized, double-blind, placebo-controlled trial included 1287 children with CHD randomly assigned 1:1 to receive 5 monthly intramuscular injections of 15 mg/kg palivizumab or placebo. Children were followed for 150 days. The primary efficacy end point was antigen-confirmed respiratory syncytial virus (RSV) hospitalization. RESULTS: Palivizumab recipients had a 45% relative reduction in RSV hospitalizations (P=.003), a 56% reduction in total days of RSV hospitalization per 100 children (P=.003), and a 73% reduction in total RSV hospital days with increased supplemental oxygen per 100 children (P=.014). Adverse events were similar in the treatment groups; no child had drug discontinued for a related adverse event. Serious adverse events occurred in 55.4% of palivizumab recipients and 63.1% of placebo recipients (P<.005); none were related to palivizumab. Twenty-one children (3.3%) in the palivizumab group and 27 (4.2%) in the placebo group died; no deaths were attributed to palivizumab. The rates of cardiac surgeries performed earlier than planned were similar in the treatment groups. CONCLUSIONS: Monthly palivizumab (15 mg/kg IM) was safe, well-tolerated, and effective for prophylaxis of serious RSV disease in young children with hemodynamically significant CHD.

Antibodies, Monoclonal↗
PubMed2003

Selected populations at increased risk from respiratory syncytial virus infection.

Respiratory syncytial virus (RSV) is the principal cause of bronchiolitis and pneumonia in infants and young children worldwide. Deficits in cellular immunity appear to promote severe RSV disease in children with malignancies, those undergoing chemotherapy and bone marrow transplant recipients. Respiratory syncytial virus infection appears to exacerbate pulmonary symptoms of cystic fibrosis. In such patients RSV disease may result in a prolonged hospital course, which is often complicated by the need for mechanical ventilation. Retrospective analyses of hospital admissions for RSV bronchiolitis among Native American and Alaskan Native children younger than 1 year of age have demonstrated rates of 62 per 1000 or higher, compared with the national average of 34 per 1000. Among these ethnic groups, specific host factors as well as environmental factors appear to contribute to these comparatively high rates of hospitalization for RSV infection. Respiratory syncytial virus has the potential to cause disease in all age groups. A 3-year observational study found that individuals who lived in a community setting, or who cared for young children on a consistent basis, experienced acute respiratory infections more commonly than those living independently or whose interaction with children was limited.

Adolescent↗
PubMed2003

Hematologic effects of linezolid in young children.

BACKGROUND: Linezolid is an effective and well-tolerated antibiotic for the treatment of Gram-positive infections, including hospital and community-acquired pneumonia and complicated and uncomplicated skin and skin structure infections. In adults linezolid treatment for >/=2 weeks has been associated with reversible hematopoietic suppression, primarily thrombocytopenia. OBJECTIVE: To evaluate the occurrence of hematologic effects in children with Gram-positive infections in an open label study of linezolid vs. vancomycin. METHODS: Detailed analyses of hematologic data, including reported hematologic adverse events, complete blood counts, reticulocyte index (RI) and iron studies (serum iron and transferrin saturation), were conducted in both groups at baseline and during and after treatment with the use of an intent-to-treat analysis. RESULTS: Three hundred sixteen patients (median age, 1.65 yr) randomized 2:1 to linezolid (n = 215) or vancomycin (n = 101) were treated. Total treatment durations were similar in the vancomycin group (12.2 +/- 6.4 days; median, 11.0 days) and the linezolid group (11.3 +/- 5.0 days; median, 11.0 days) (P = 0.20). No significant differences were noted in drug-related hematologic events, such as thrombocytopenia (linezolid, 1.9% vs. vancomycin, 0%; P = 0.170), anemia (linezolid, 1.4% vs. vancomycin, 1.0%; P = 0.771) or neutropenia (linezolid, 0% vs. vancomycin, 0%). Hemoglobin values also were similar between treatment groups when assessed by shifts from baseline to lowest recorded value. Frequency of occurrence of any substantially abnormal value for hemoglobin (15.7% vs. 12.4%), platelets (12.9% vs. 13.4%) and neutrophils (5.9% vs. 4.3%) were similar in the linezolid and vancomycin groups. No clinically relevant changes in RI or iron studies were noted between treatment groups, and parallel increases in RI occurred with both linezolid and vancomycin. CONCLUSIONS: No significant differences in hematologic profiles between linezolid and vancomycin occurred in this pediatric population.

Acetamides↗
PubMed2003

Revised indications for the use of palivizumab and respiratory syncytial virus immune globulin intravenous for the prevention of respiratory syncytial virus infections.

Palivizumab and Respiratory Syncytial Virus Immune Globulin Intravenous (RSV-IGIV) are licensed by the Food and Drug Administration for use in preventing severe respiratory syncytial virus (RSV) infections in high-risk infants, children younger than 24 months with chronic lung disease (formerly called bronchopulmonary dysplasia), and certain preterm infants. This report summarizes the clinical trial information on which the guidance in the accompanying policy statement for administering RSV prophylaxis to certain children with a history of preterm birth, chronic lung disease, or congenital heart disease is based. On the basis of results of a recently completed clinical trial, palivizumab is appropriate for infants and young children with hemodynamically significant congenital heart disease. RSV-IGIV should not be used in children with hemodynamically significant heart disease. Palivizumab is preferred for most high-risk infants and children because of ease of intramuscular administration. Monthly administration of palivizumab during the RSV season results in a 45% to 55% decrease in the rate of hospitalization attributable to RSV. Because of the large number of infants born after 32 to 35 weeks' gestation and because of the high cost, immunoprophylaxis should be considered for this category of preterm infants only if 2 or more risk factors are present.

Antibodies, Monoclonal↗
PubMed2002

Prevalence of superantigen-secreting bacteria in patients with Kawasaki disease.

OBJECTIVES: To assess the prevalence of superantigen secreting bacteria in children with acute Kawasaki disease (KD) relative to control patients. STUDY DESIGN: Bacterial cultures were obtained in a blinded fashion from the throat, rectum, and groin of 45 patients with untreated acute KD and 37 febrile control patients from 6 centers in the United States. Cultures were processed for the presence of superantigen-producing bacteria at a central laboratory. RESULTS: Staphylococci or streptococci that produced superantigens (TSST-1, SEB, SEC, SPEB, SPEC) were isolated from 25 of 45 patients with KD (56%) as compared with 13 of 37 (35%) control patients (P =.078). Because SEB- and SEC-producing Staphylococcus aureus have not been associated with KD and because they do not induce a Vbeta2+ T-lymphocyte response, we analyzed the difference between groups relative to superantigens TSST-1 or SPEB/SPEC production. TSST-1 secreting S aureus or SPEB/SPEC producing group A streptococci were isolated from 20 of 45 (44%) patients with KD compared with 7 of 37 (19%) control patients (P =.019). CONCLUSIONS: The overall isolation rates of superantigen (TSST-1, SPEB, SPEC, SEB, SEC) producing bacteria between patients with KD and febrile control patients were not statistically significant. However, future studies should further examine the potential role of Vbeta2-stimulatory superantigens (TSST-1 and SPEB/SPEC) in KD.

Antigens, Bacterial↗