PubMed Health⌕ Search

Biomedical subjects

V Romanus

Publications and source records attributed to V Romanus.

At least 37 records · Page 2Linked to original sources
PubMed1988

Mortality and morbidity from invasive bacterial infections during a clinical trial of acellular pertussis vaccines in Sweden.

A double blind placebo-controlled efficacy trial of two acellular pertussis vaccines was conducted in 3801 6- to 11-month-old children. Four vaccinated children died during 7 to 9 months follow-up as a result of Haemophilus influenzae type b meningitis, heroin intoxication with concomitant pneumonia, suspected septicemia, and Neisseria meningitidis Group B septicemia. From the actual death rate in children belonging to the same birth cohort in Sweden that could have been eligible for the trial, one death was expected among vaccinated children. Several investigations were carried out to examine the possibility that the deaths could be causally related to the vaccination. The relative risk for hospitalization due to systemic or respiratory infections was 1.07 (95% confidence interval, 0.95 to 1.20) and 0.83 (95% confidence interval, 0.64 to 1.08) in the vaccine groups as compared with the placebo group. Subsets of the population were studied for signs of immunosuppression. There was no indication of immunoglobulin deficiency or any sign of clinically significant leukopenia or lymphocytosis in vaccine recipients. The results of this analysis provide no evidence for a causal relation between vaccination with the studied acellular pertussis vaccines and altered resistance to invasive disease caused by encapsulated bacteria. The hypothesis that the two variables are related, however, cannot be refuted from these data.

Antibodies, Bacterial↗
PubMed1988

Invasive bacterial infections during an efficacy trial of acellular pertussis vaccines--implications for future surveillance in pertussis vaccine programmes.

During a placebo controlled trial of acellular pertussis vaccines a cluster of invasive bacterial infections with fatal outcome occurred among vaccinated children as compared with unvaccinated Swedish children of the same birth cohort (4). Clinical and immunological studies did not support the hypothesis of an immunosuppressive effect of the vaccines, which would explain the deaths, but the hypothesis could not be refuted by the data. To evaluate the safety of acellular pertussis vaccines regarding rare severe events--in particular invasive infectious diseases--prospective studies seem to be needed, comparing very large groups. A coordinated and controlled vaccine programme during 1-2 years in most of Sweden combined with national reports of invasive infections may serve as a basis for such a study. A possible study design is given below.

Bacterial Infections↗
PubMed1987

Swedish experience of two dose vaccination programme aiming at eliminating measles, mumps, and rubella.

In 1982 a two dose regimen was introduced in Sweden for the combined vaccination against measles, mumps, and rubella of children aged 18 months and 12 years. Since 1977 about half of the preschool children were vaccinated against measles annually, and since 1974 about 80% of 12 year old girls were vaccinated against rubella. During the period 1982 to 1985 90-93% of the eligible age cohorts of 18 month old children and 88-91% of the 12 year old children were immunised with the new combined vaccine. A study in 1982 of about 140 18 month old children who were nearly all seronegative before vaccination showed that 96%, 92%, and 99% seroconverted against measles, mumps, and rubella, respectively. A second study was carried out in 1983 of 247 12 year old children, of whom 11% lacked antibodies to measles, 27% to mumps, and 45% to rubella. This showed seroconversion in 82% and 80% against measles and mumps, respectively, and all children seroconverted against rubella. In the latest study in 1985 of 496 12 year olds 9% and 13% were seronegative against measles and mumps before vaccination, and 41% against rubella. Of these, 88% seroconverted to measles and 80% to mumps, and all converted to rubella when sera were tested by the haemolysis in gel method. After a neutralisation test against measles as well all children showed immunity to the disease. A low incidence of measles and declining figures for mumps and rubella were reported in 1984 to 1986. An outbreak of rubella during 1985 affected mainly boys in age cohorts in which only the girls had been vaccinated during the 1970s.

Child↗
PubMed1987

Tuberculosis in Bacillus Calmette-Guérin-immunized and unimmunized children in Sweden: a ten-year evaluation following the cessation of general Bacillus Calmette-Guérin immunization of the newborn in 1975.

An analysis was made of childhood tuberculosis in Sweden between 1969 and 1984 which included the 6.25 years before and the 9.75 years after the cessation of general Bacillus Calmette-Guérin (BCG) immunization of the new-born on April 1, 1975. The annual incidence of tuberculosis per 100,000 children ages 0 to 4 years increased from an average of 1.1 cases in the period 1970 to 1974 to 1.3 cases in the period 1975 to 1979 and to 2.1 cases in the period 1980 to 1984, including both children born in Sweden and those born abroad. Among children born in Sweden after April 1, 1975, tuberculosis occurred in 58 (57 unimmunized and one BCG-immunized), or 1.3 cases per 100,000 person years up to and including 1984. Eighteen of the 58 children were asymptomatic. Minor symptoms were reported in 13 and clinical illness in 27 children, 2 of whom developed meningitis and 1 of whom died of miliary infection. The relative increase of tuberculosis in the mainly unimmunized cohorts born in Sweden after April 1, 1975, compared with the mainly BCG-immunized cohorts born in Sweden in the period 1969 to 1974 was, by the end of 1984, estimated at 6.0 (95% confidence interval, 2.3, 16.1). Tuberculosis was about 10 times more common in non-BCG-immunized children born in Sweden of foreign parents than in those born of Swedish parents.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

Pertussis in Sweden after the cessation of general immunization in 1979.

Immunization against pertussis was introduced in Sweden in the 1950s and discontinued in 1979. This was followed by a low endemic level of pertussis for 3 years. Thereafter the incidence gradually increased and there were two outbreaks in 1983 and in 1985. In the period 1980 to 1985 pertussis was confirmed by culture or serology in 36,729 patients of which 11% were younger than 12 months of age and 69% were ages 1 to 6 years. An estimate of the total frequency of pertussis in preschool children was made from reports from a sample of the child health centers. The annual incidence rate per 100,000 population ages 0 to 6 years increased from the 700 cases in 1981 to 3200 in 1985. The ratio of total cases to those reported from the laboratories was 3:1 in 1981 and 2:1 in 1985. The cumulative incidence rate by the average age of 4 years was estimated at 16% of the unimmunized cohort born in 1980 compared with 5% of the immunized cohort born in 1978. The seriousness of pertussis was evaluated by studying the 2282 pertussis patients hospitalized from 1981 to the end of 1983. Forty-eight percent were infants younger than 12 months of age. Neurologic complications were noted in 4% and pneumonia in 14% of the hospitalized patients. Eleven children received assisted ventilation. Fatal outcomes were reported in 3 children (0.1%), 2 of whom had severe congenital disabilities.

Age Factors↗
PubMed1986

Vaccination with a combined vaccine against measles, mumps and rubella aiming at elimination of the three diseases.

General vaccination with a combined measles, mumps and rubella vaccine was introduced in Sweden in 1982. The vaccination is performed at the age of 18 months and 12 years. The coverage in the former age was about 90% and in the latter between 80 and 90%. Seroconversion against measles was 96% in 18 months old and 82% in the 12 year old. The corresponding figures concerning mumps were 93 and 80% and concerning rubella 99 and 100%. Before this vaccination was introduced preschool children were partly vaccinated against measles and teen-age girls against rubella. The measles morbidity is low since the beginning of the 1980's, the morbidity of mumps is unchanged while rubella was epidemic in 1985. Mainly unvaccinated age groups were affected.

Child↗
PubMed1983

Childhood tuberculosis in Sweden. An epidemiological study made six years after the cessation of general BCG vaccination of the newborn.

General BCG vaccination of the newborn was started in Sweden in the 1940s and was stopped on April 1, 1975. The effect of this change in policy has been analysed in a study of children born in Sweden in 1969 or later and whose names were entered in the Central Tuberculosis Register from 1969 to 1980. A comparison was made between two groups of children: 1. children born in Sweden between April 1, 1969 and December 31, 1974 and who contracted tuberculosis during that period; all the children in this group were BCG-vaccinated; 2. children born between April 1, 1975 and December 31, 1980 and who contracted tuberculosis during that period. Only one child in this group had been vaccinated. In the first group of vaccinated children 4 cases of pulmonary tuberculosis, one case of meningitis and one case of lymphadenitis were recorded. Among the unvaccinated children in the second group, 20 cases of pulmonary tuberculosis, one fatal case of miliary tuberculosis and two cases of meningitis were recorded. In addition 13 cases of mycobacterial lymph node disease and one case of skin granuloma were found, but these were considered likely to be caused by non-tuberculous mycobacterial infection. The incidence of pulmonary, miliary and meningeal tuberculosis was 8 times higher among children born to foreign parents (6.4 per 100 000 person-years) than among unvaccinated Swedish children (0.8 per 100 000). Despite the increase in incidence of tuberculosis which occurred after the cessation of vaccination of the newborn, the continued low incidence of tuberculosis in Swedish children up to and including 1980 does not justify the reintroduction of general BCG vaccination of the newborn in Sweden.

Adolescent↗
PubMed1982

Osteitis and other complications caused by generalized BCG-itis. Experiences in Sweden.

In 1973 an increase in the number of osteitis caused by BCG vaccination in the neonatal period was observed in Sweden. A high incidence of this complication, i.e. 1 case per 3000 vaccinated newborn children continued until this vaccination was interrupted in 1975. In the years 1972 to 1980 a total of 90 cases were reported to the Adverse Drug Reaction Committee. Earlier retrospective studies had disclosed 36 cases born between 1949-1968 and an active search for unreported cases in the 1970s revealed an additional 26 cases. Of the total of 152 known cases in Sweden, 82 were boys and 70 girls. The mean incubation period was 14 months for boys and 23 for girls. Extremely long incubation periods were seen, i.e. 6 years in two children and 12 years in one. Eleven children had multiple osteitis lesions. The epiphyses of the long bones of the extremities were the most frequent sites of the affection (109 lesions). Only in 6 patients the spine, which is the common site of osteitis caused by tuberculosis, was affected. Relapses occurred in two patients.

BCG Vaccine↗
PubMed1979

Epidemiological events surrounding a paralytic case of poliomyelitis in Sweden.

A case of clinical poliomyelitis occurred in Sweden in January 1977; it was the first indigenous case in Sweden since 1962. This incident was of particular interest as it provided an opportunity to study the spread of virus in a cluster of unvaccinated persons and in individuals more or less fully vaccinated with inactivated vaccine. The patient excreted wild type 2 virus and the same type was isolated from 25 other individuals, all of whom were close contacts of virus excretors. Among the close contacts, 14 of 20 unvaccinated preschool children were found to excrete virus, but excretion was not found in any of the 7 vaccinated children examined.

Child, Preschool↗