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J F Seward

Publications and source records attributed to J F Seward.

9 recordsLinked to original sources
PubMed2004

Development and experience with an algorithm to evaluate suspected smallpox cases in the United States, 2002-2004.

Concerns that smallpox, an eradicated disease, might reappear because of a bioterror attack and limited experience with smallpox diagnosis in the United States prompted us to design a clinical algorithm. We used clinical features of classic smallpox to classify persons presenting with suspected smallpox rashes into 3 categories: those with high, those with moderate, and those with low risk of having smallpox. The classification guides subsequent diagnostic strategies, limiting smallpox laboratory testing to high-risk persons to minimize the number of false-positive test results. From January 2002 through June 2004, the Centers for Disease Control and Prevention (CDC) received 43 consultations regarding suspected smallpox cases. No patient was at high risk for having smallpox. One patient was tested for the presence of variola virus. Varicella was the diagnosis for 23 cases (53%). The algorithm worked well to guide clinical and public health responses to suspected smallpox cases. The poster is available from CDC, and an interactive version and laboratory protocol are available at http://www.bt.cdc.gov/agent/smallpox/diagnosis/riskalgorithm/index.asp. We recommend use of the algorithm in the United States and elsewhere.

Adolescent↗
PubMed2000

Postlicensure safety surveillance for varicella vaccine.

CONTEXT: Since its licensure in 1995, the extensive use of varicella vaccine and close surveillance of the associated anecdotal reports of suspected adverse effects provide the opportunity to detect potential risks not observed before licensure because of the relatively small sample size and other limitations of clinical trials. OBJECTIVES: To detect potential hazards, including rare events, associated with varicella vaccine, and to assess case reports for clinical and epidemiological implications. DESIGN AND SETTING: Postlicensure case-series study of suspected vaccine adverse events reported to the US Vaccine Adverse Event Reporting System (VAERS) from March 17, 1995, through July 25, 1998. MAIN OUTCOME MEASURES: Numbers of reported adverse events, proportions, and reporting rates (reports per 100,000 doses distributed). RESULTS: VAERS received 6574 case reports of adverse events in recipients of varicella vaccine, a rate of 67.5 reports per 100,000 doses sold. Approximately 4% of reports described serious adverse events, including 14 deaths. The most frequently reported adverse events were rashes, possible vaccine failures, and injection site reactions. Misinterpretation of varicella serology after vaccination appeared to account for 17% of reports of possible vaccine failures. Among 251 patients with herpes zoster, 14 had the vaccine strain of varicella zoster virus (VZV), while 12 had the wild-type virus. None of 30 anaphylaxis cases was fatal. An immunodeficient patient with pneumonia had the vaccine strain of VZV in a lung biopsy. Pregnant women occasionally received varicella vaccine through confusion with varicella zoster immunoglobulin. Although the role of varicella vaccine remained unproven in most serious adverse event reports, there were a few positive rechallenge reports and consistency of many cases with syndromes recognized as complications of natural varicella. CONCLUSION: Most of the reported adverse events associated with varicella vaccine are minor, and serious risks appear to be rare. We could not confirm a vaccine etiology for most of the reported serious events; several will require further study to clarify whether varicella vaccine plays a role. Education is needed to ensure appropriate use of varicella serologic assays and to eliminate confusion between varicella vaccine and varicella zoster immunoglobulin. JAMA. 2000;284:1271-1279

Adolescent↗
PubMed2000

Varicella mortality: trends before vaccine licensure in the United States, 1970-1994.

We examined varicella deaths in the United States during the 25 years before vaccine licensure and identified 2262 people who died with varicella as the underlying cause of death. From 1970 to 1994, varicella mortality declined, followed by an increase. Mortality rates were highest among children; however, adult varicella deaths more than doubled in number, proportion, and rate per million population. Despite declining fatality rates, in 1990-1994, adults had a risk 25 times greater and infants had a risk 4 times greater of dying from varicella than did children 1-4 years old, and most people who died of varicella were previously healthy. Varicella deaths are now preventable by vaccine. Investigation and reporting of all varicella deaths in the United States is needed to accurately document deaths due to varicella, to improve prevention efforts, and to evaluate the vaccine's impact on mortality.

Adult↗
PubMed1981

Comparison of births to Aboriginal and Caucasian mothers in Western Australia.

Live births and stillbirths to Aboriginal and Caucasian mothers in the period from 1975 to 1978 were studied, using the Western Australian Midwives Notification of Birth forms, Perinatal Death Certificates and Hospital Morbidity data. Aboriginal mothers were younger, shorter, had higher fertility, and were more likely to be grand multiparae than Caucasian mothers. Aboriginal infants were lighter and shorter than Caucasian infants. The adverse birthweight distribution of Aboriginal infants (13% weighed less than or equal to 2500 grams) accounted for the major part of the excess in the Aboriginal perinatal mortality rate, which was double that for Caucasians. The Aboriginal stillbirth rate appeared to be falling, while neonatal mortality remained high. Health services' preventive programmes, aimed at correction of the adverse birthweight distribution in the Aboriginal population, would be a major step towards the reduction of perinatal mortality in this group.

Adolescent↗