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Biomedical subjects

Jann Storsaeter

Publications and source records attributed to Jann Storsaeter.

9 recordsLinked to original sources
PubMed2006

Changes in seroprevalence to four herpesviruses over 30 years in Swedish children aged 9-12 years.

BACKGROUND: Changing social conditions and life-styles in Sweden may have affected the spread of varicella-zoster virus (VZV), herpes simplex virus (HSV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV). OBJECTIVES: To study possible changes over 30 years in prevalence of antibodies against VZV, HSV, CMV, and EBV in Swedish children, using modern serological methods. STUDY DESIGN: Serum samples from 819 Swedish children who were 9-12 years old in 1967-1968, in 1977-1978 (two cohorts), and in 1997, respectively, were examined. IgG antibodies against VZV, HSV, and CMV were measured by well validated enzyme-linked immunosorbent assays and against EBV by indirect immunoflourescense. RESULTS: The seropositivity for VZV for 9-12 years old children was 50% in 1967-1968, 74-82% in 1977-1978, and 98% in 1997. The corresponding figures were 31%, 53%, 50%, and 58% for CMV, 35%, 35%, 32%, and 38% for HSV, and 64% in 1967-1968 and in 1977-1978 (both cohorts), and 62% in 1997 for EBV. CONCLUSIONS: The seroprevalence for VZV increased significantly from 1967-1968 to 1997, and there was also a significant but smaller increase in the CMV seroprevalence, while seroprevalence to HSV and EBV remained relatively stable.

Antibodies, Viral↗
PubMed2006

Is there a need for a new generation of vaccines against pertussis?

Current vaccines against pertussis have proved their safety and efficacy in large-scale clinical trials. Despite high vaccination coverage, pertussis is still prevalent and increasing, probably as a result of waning immunity. Addition of new antigens, such as adenylate cyclase, to current vaccines might improve some aspects of the immune response to vaccination, but are unlikely to significantly increase the duration of protection. Intranasal, oral and DNA pertussis vaccines are some way from clinical development, although one live attenuated, intranasal pertussis vaccine may soon enter Phase I trials. In the meantime, the potential of currently available safe and efficacious pertussis vaccines should be maximised. Rationalisation of pertussis boosters in childhood and introduction of widespread repeat booster vaccination in adolescents and adults would already lessen disease prevalence and morbidity among susceptible infants.

Administration, Intranasal↗
PubMed2006

Long-term follow-up of Swedish children vaccinated with acellular pertussis vaccines at 3, 5, and 12 months of age indicates the need for a booster dose at 5 to 7 years of age.

OBJECTIVES: The purpose of this work was to evaluate the long-term effectiveness of vaccination with acellular pertussis vaccines at 3, 5, and 12 months of age. METHODS: Clinical follow-up of reported culture- and polymerase chain reaction-confirmed cases of pertussis was initiated during October 1997 in most of Sweden (except Gothenburg and environs). The study population included 90% of Swedish children born during 1996 or later (ie, who received diphtheria-tetanus-acellular pertussis vaccines at 3, 5, and 12 months of age) and children who had participated in a large pertussis vaccine trial in 1993-1996. Age-specific incidences were estimated using reported culture- or polymerase chain reaction-confirmed pertussis from October 1997 to September 2004 in areas covered by enhanced surveillance. In addition, annual overall and age-specific incidences of pertussis throughout Sweden before and after introduction of acellular pertussis vaccines were estimated. RESULTS: The overall incidence of notified culture- and polymerase chain reaction-confirmed pertussis dropped from 113 to 150 per 100,000 during 1992-1995 to 11 to 16 per 100,000 during 2001-2004. In areas of enhanced surveillance, the incidence of pertussis was 31 per 100,000 person-years after 2 doses and 19 per 100,000 person-years after the third dose at 12 months of age. The age-specific incidence remained low for approximately 5 years after the third dose but increased in children aged 6 to 8 years, becoming 32 and 48 per 100,000 person-years, respectively. The highest incidence occurred among infants who were unvaccinated or had received only 1 dose of diphtheria-tetanus-acellular pertussis vaccine. CONCLUSIONS: The increased incidence among 7- to 8-year-olds (ie, mainly acellular pertussis vaccine-vaccinated children) suggests waning of vaccine-induced protection from pertussis. Along with a concomitant increase in incidence among infants, most likely infected by older siblings, these data suggest a booster dose of acellular pertussis vaccine is warranted from 5 to 7 years of age.

Child↗
PubMed2005

Pertussis antitoxin decay after vaccination with DTPa. Response to a first booster dose 3 1/2-6 1/2 years after the third vaccine dose.

Longitudinal serum samples were collected from 542 children that had participated in a Swedish pertussis vaccine trial 1992-1995 [Gustafsson L, Hallander HO, Olin P, Reizenstein E, Storsaeter J. A controlled trial of a two-component acellular, a five-component acellular, and a whole-cell pertussis vaccine. N Engl J Med 1996;334(6):349-355] and who did not contract pertussis. The sera were analyzed for post vaccination antibody decay and for booster response of anti-PT (IgG antibodies against pertussis toxin), as measured by ELISA. Generally, an initial rapid decay of antitoxin antibody concentration was followed by a slower decay; the change occurring when the geometric mean level of antitoxin concentration reached 8-9 ELISA Units/mL (EU/mL). The time needed to reach this level was 8-9 months after the third dose in a 2, 4, and 6 months schedule. A "best-fit" combined regression model was used to predict when 50% of the children have less than the minimum level of detection of anti-PT (1EU/mL). This occurred about 65 months after dose 3 at an age of 6 years. The anti-PT response to a booster dose was evident but the post-booster geometric mean values decreased with number of years after the third dose and the response appeared later. The results indicate that a pre-school booster might be considered at 6 years of age or earlier.

Antibodies, Bacterial↗
PubMed2004

Mycoplasma pneumoniae and Legionella pneumophila in community-acquired lower respiratory tract infections among hospitalized children: diagnosis by real time PCR.

Mycoplasma pneumoniae and Legionella pneumophila are increasingly recognized as important agents of community-acquired lower respiratory tract infections (LRTI). Mycoplasma pneumoniae has been also recognized as a cause of nosocomial infections. The aim of this study was to investigate the role of real time polymerase chain reaction (PCR) for the rapid diagnosis of these infections among hospitalized children with community-acquired LRTI. During 2001, 65 children were prospectively studied. Microbiological investigation consisted of capillary PCR with a LightCycler for M. pneumoniae and L. pneumophila in induced sputum or throat swab specimens, IgM enzyme immunoassay for M. pneumoniae and immunofluorescence for L. pneumophila in paired sera. Serology testing showed acute M. pneumoniae infection in 18 (27.5%) patients and L. pneumophila in 1 (1.5%). M. pneumoniae was also detected in sputum specimen by capillary PCR in 9 (50%) serologically diagnosed cases, including 4 (22%) with non-diagnostic IgM levels in the acute phase. Capillary PCR and IgM enzyme immunoassay diagnosed together 15 (83%) M. pneumoniae cases in the acute phase. It is concluded that M. pneumoniae is an important cause of LRTI necessitating hospitalization among children in Greece. Capillary PCR in sputum may diagnose M. pneumoniae LRTI in the acute setting and direct therapy and isolation of patients.

Adolescent↗
PubMed2003

Low levels of antipertussis antibodies plus lack of history of pertussis correlate with susceptibility after household exposure to Bordetella pertussis.

Prospectively collected data in a Swedish vaccine efficacy trial were used to investigate transmission of pertussis from small study infants to other household members. Forty one percent (258/627) of the exposed persons with paired serology had laboratory confirmed pertussis. The majority of those with laboratory confirmed pertussis had less than 14 days of cough and many were asymptomatic. High susceptibility to symptomatic pertussis was found among persons with low initial IgG antibody concentrations against pertussis toxin, especially those without previous history of pertussis vaccination or disease.

Adolescent↗
PubMed2003

Declining pertussis incidence in Sweden following the introduction of acellular pertussis vaccine.

Acellular pertussis vaccines were introduced nation-wide in Sweden in 1996, 17 years after the withdrawal of whole-cell pertussis vaccine from the childhood immunisation schedule. We report national data on age specific incidence of culture-confirmed Bordetella pertussis for 1986-2000, and clinical follow-up for 3 years (October 1997-September 2000) in children born in 1996-2000 and from children born in 1993-1994 who had participated in a trial of pertussis vaccines. The annual incidence of culture-confirmed B. pertussis was 89-150 per 100,000 before introduction of acellular pertussis vaccines and has dropped to 17-26 per 100,000. The data suggest that unimmunised infants and children who have received only one dose of pertussis vaccine were provided some protection. The decline is most obvious from the second dose onwards and remained stable for 4-5 years after the third dose in the absence of any booster dose. The first signs of waning immunity were observed at 6-7 years of age in the trial cohort. The short-term benefits reflect high vaccination coverage and high initial efficacy. The full impact of the acellular pertussis vaccination programme in infants remains to be established.

Adolescent↗
PubMed2003

Immunogenicity and reactogenicity of a single dose of live attenuated varicella vaccine and a booster dose of measles-mumps-rubella vaccine given concomitantly at 12 years of age.

Universal varicella-zoster virus (VZV) childhood vaccination is still debated, but adult chickenpox may be severe. It could be prevented by vaccination of seronegative adolescents. This study aimed to determine the feasibility of coadministration of a VZV vaccine and the measles-mumps-rubella (MMR) booster at 12 y of age. Guardians of 1231 12-y-old pupils where asked about the history of chickenpox in their children. 190 had no chickenpox history and 12 of 62 of them lacked VZV antibodies. Additional history-negative children were also recruited. 199 history-positive children received only MMR and 98 history-negative children received an MMR vaccine and a VZV vaccine. Serum samples were drawn before vaccination and after 8 weeks. Viral antibodies were measured by immunofluorescence (VZV) and enzyme-linked immunosorbent assays (VZV, MMR). All 184 history-positive children tested had VZV antibodies. 17/89 VZV-vaccinated and tested children (19%) lacked VZV antibodies before vaccination. 12 (71%) seroconverted after 1 dose. Cell-mediated immunity (CMI) against varicella was tested in 3/5 children who did not seroconvert after 1 dose of VZV vaccine. They seroconverted after a second dose and had measurable CMI. VZV vaccination did not affect the MMR response and there were no severe side-effects. A history of varicella infection, as reported by the guardian, is reliable, but a negative history was incorrect in 81% of the cases. This population of 12-y-old children may require 2 doses of VZV vaccine, at least when given simultaneously with the MMR vaccine.

Antibodies, Viral↗