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J F Modlin

Publications and source records attributed to J F Modlin.

45 records · Page 3Linked to original sources
PubMed1977

Current status of rubella in the United States, 1969-1975.

Implementation of the rubella immunization policy in the United States has resulted in marked decreases in the number of reported cases of both rubella and CRS. Emphasis on immunization of one- to 12-year-old children has resulted in a dramatic reduction in reported rubella in this age group. Accordingly, the proportion of reported cases occurring in adolescents and young adults has increased. Therefore, it seems appropriate to place more emphasis on immunizing susceptible adolescent and adult females as an adjunct to routine immunization in early childhood. This joint strategy should result in a further decrease in the incidence of rubella and CRS.

Adolescent↗
PubMed1977

Epidemiologic studies of measles, measles vaccine, and subacute sclerosing panencephalitis.

Histories obtained in 350 of 375 clinically cofirmed cases of subacute sclerosing panencephalitis (SSPE) reported to a national registry showed that 292 patients had measles and 58 had no history of measles. Forty of the latter patients received live, attenuated measles virus vaccine. In patients with a history of measles, measles illness occurred before age 2 years in 46%, and a mean of 7.0 years before onset of SSPE. In contrast, there was no relationship of SSPE with age at vaccination in 35 of the 40 patients historically associated with measles vaccine, and SSPE occurred a mean of 3.3 years after vaccination. Based on estimated national measles morbidity data and national measles vaccine distribution data, the risk of SSPE following measles vaccination (0.5 to 1.1 cases/106) appears to be less than the risk following measles (5.2 to 9.7 cases/106). Because live measles vaccine is highly effective in preventing measles illness and a high proportion of children in the United States have received measles vaccine, these data are consistent with the observed downward trend in SSPE incidence since 1969.

Adolescent↗
PubMed1976

Risk of congenital abnormality after inadvertent rubella vaccination of pregnant women.

The risk to a fetus after rubella vaccination of its mother is unknown. The Center for Disease Control has compiled information from the pregnancies of 343 women inadvertently given rubella vaccine shortly before or after conception. The pregnancies of 145 women were terminated by therapeutic abortion, and rubella vaccine virus was recovered from the products of conception of nine women, including six of the 28 known to be seronegative to rubella at the time of vaccination. None of the 172 infants carried to term had either clinical or serologic evidence of rubella infection, including 38 infants of women known to be susceptible and 12 additional women estimated to be susceptible at the time of rubella vaccination. On the basis of the binomial distribution, the maximum risk of fetal infection after maternal rubella vaccination is between 5 and 10 per cent. The actual risk is probably less.

Abortion, Therapeutic↗
PubMed1976

Serologic response to revaccination with two rubella vaccines.

Three years after receiving rubella vaccine, 1,060 elementary school children living on the island of Maui, Hawaii, were revaccinated with either HPV-77 DE-5 or RA 27/3 rubella vaccine given subcutaneously or intranasally in order to compare the effectiveness of these two vaccines in raising antibody titers. RA 27/3 was the more effective booster vaccine, producing fourfold or greater titer rises in 20.1% of recipients, including 80% of children with hemagglutination-inhibiting antibody titers less than or equal to 1:40 at the time of revaccination, intranasal revaccination was not significantly more effective than subcutaneous revaccination, although it did elicit higher titers in children who responded. Responses differed according to the vaccine that children had received three years earlier. Because antibody titers have persisted in vaccinated children, routine administration of a second dose of rubella vaccine is not currently recommended.

Administration, Intranasal↗
PubMed1975

A review of five years' experience with rubella vaccine in the United States.

National morbidity figures show a decline in reported rubella and congenital rubella syndrome since 1969, concurrent with widespread use of rubella vaccine. In addition, no nationwide outbreak, such as the 1963-1964 epidemic, has occurred, though on the basis of long-term secular trends, one would be expected between 1970 and 1974. Recent rubella outbreaks have occurred in unimmunized students in high schools and universities, and there appears to have been a slight upward shift in the age-specific incidence of rubella in the United States since the beginning of widespread immunization. Currently available vaccines have provided durable protection to date, and, although reinfection is known to occur following vaccination, it has not proven a risk to the pregnant woman. There is a small but significant incidence of adverse reactions and a potential risk to the woman who is vaccinated during pregnancy. These data indicate that rubella vaccines are safe and effective. They also imply that rubella vaccines, as they are currently applied, have been successful in reducing the morbidity of congenital rubella syndrome, although continued surveillance will be necessary to confirm this trend.

Abortion, Spontaneous↗
PubMedDate not supplied

Mediastinitis after cardiovascular surgery.

Postoperative mediastinitis complicated 21 (3.4%) of 616 median sternotomy procedures at Beth Israel Hospital (Boston, Mass.) between 1975 and 1979. These cases were analyzed by means of a case control study to identify host and operative risk factors and to characterize the clinical features of mediastinitis. Eighteen patients with mediastinitis (86%) had serious underlying noncardiac diseases, as compared with 14 (33%) of 42 noninfected controls (P = .001). Reoperation was positively associated with infection (P = .03). All patients had abnormal sternal wounds and fever; sternal instability and mediastinal widening were unusual. Twelve patients (57%) were bacteremic. Twenty-four organisms were recovered from the 21 patients with mediastinitis; 13 of the isolates were gram-positive, and 11 were gram-negative. Infections due to gram-negative bacteria appeared earlier and were more likely to be bacteremic (70%). All gram-negative isolates and five of six isolates of Staphylococcus epidermidis were resistant to the antimicrobial agent used perioperatively. Patients were treated with extensive debridement and appropriate antibiotics. The mortality rate was 24% (five of 21). Long-term complications in survivors were not seen.

Cardiac Surgical Procedures↗
PubMedDate not supplied

Perinatal echovirus infection: insights from a literature review of 61 cases of serious infection and 16 outbreaks in nurseries.

A review of literature published before June 1985 revealed 61 reported cases of neonatal echovirus infection at a nonmucosal site, including 43 cases (70%) due to echovirus 11. Onset of disease occurred between the third and fifth days of life in 63% of cases, indicating that most infections are acquired in the immediate perinatal period rather than in utero. Mortality was higher in infants with severe hepatitis (83%) than in infants with infection of the central nervous system (19%). Acute illness occurred within one week before delivery in 68% of the mothers of nonnosocomially infected infants. There was a trend (P = .11) towards a higher mortality rate for infants born by cesarian section than for those delivered vaginally. In the 11 nosocomially acquired cases, the onset of infection was later and the mortality rate lower. In 16 outbreaks in nurseries, 206 infants developed illness attributed to echovirus infection. Attack rates of clinical disease were 22%-52% and illness was generally mild. In four outbreaks, six index cases were identified as infants who had acquired infection from their mothers; five of these infants had severe disease and three died. The 24 infants subsequently infected by nosocomial spread in these outbreaks had milder disease; three (12%) died. Thus, whereas acute illness in the mother before birth often precedes neonatal echovirus infection and infections transmitted vertically from mother to infant may be severe, postnatal transmission of the same serotype results in milder disease.

Cross Infection↗