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At least 19 recordsLinked to original sources
PubMed1979

Evidence of whooping-cough-vaccine efficacy from the 1978 whooping-cough epidemic in Hertfordshire.

The question of the efficacy of whooping-cough immunisation was central to the controversy that started in 1974. Definitive answers were not possible at the time because of the very low levels of whooping-cough in the preceding years and the absence of up-to-date information. The widespread abandonment of whooping-cough immunisation and the subsequent epidemic of whooping-cough have provided a natural epidemiological experiment. Figures from Hertfordshire in 1978 show that for children aged 4 years and under whooping-cough immunisation conferred 92% protection.

Child Health Services↗
PubMed1976

Epidemiological evaluation of immunisation and other factors in the control of whooping-cough.

The general incidence of whooping-cough is lower in fully immunised children, but present immunisation schedules do not adequately protect the infant below 1 year of age either from contracting infection or from its complications. In a recent outbreak in Glasgow, nearly one-third of notified cases were fully immunised. In Glasgow and probably in the U.K. as a whole, the persistance of whooping-cough in some areas is more strongly correlated with adverse socio-economic conditions that with lack of immunisation. The decline in recent years could be attributable to improvement in these conditions at least as much as to immunisation. There is no epidemiological justification for continuing mass immunisation, but there is a strong case for an intensified eradication policy which might include selective immunisation in high-risk groups and areas.

Adolescent↗
PubMedDate not supplied

[The controversy concerning whooping cough vaccination (author's transl)].

The importance of the neurological complications of whooping cough vaccination has been greatly exaggerated. Their frequency may vary tenfold, depending on the authors. Most of the latter are mainly linked to age and are thus coincidences. Other etiologies may be responsible, as also may a receptive constitutional background, the vaccine then simply reveals a preexisting condition. Present whooping cough vaccines are efficacious as shown by the fall in morbidity curves and the large number of cases in unvaccinated subjects during epidemics. Whooping cough in infants remains a problem which can only be solved by vaccination. Primary vaccination should be carried out as early as possible, while strictly observing the contraindications. The poor absorption of whooping cough vaccines is in favour of their injection by the intramuscular route which is better tolerated. Other vaccines with less reaction and more immunogenic are being sought.

Age Factors↗
PubMed1977

[Intensity of the epidemic process of whooping cough under conditions of mass immunization over a period of many years].

On the basis of analysis of whooping cough incidence in 1959 to 1975 in Moscow the authors present characteristics of the epidemic process under conditions of planned many-year immunization of children against this infection. Whooping cough morbidity proved to undergo significant changes-from sharp falls the first 8 years of immunization to a relative stabilization with a gradual reduction the last 5 years. Marked seasonal and periodic elevations persist against the background of reduction of morbidity. Preschool- and schoolchildren are equally involved in the epidemic process; the most frequently involved are nonvaccinated children aged 1 year and 4 to 10 years, which lost postvaccinal immunity. Further reduction of the severity of whooping cough and increase in the number of unimanifested forms of the infection was noted. This was apparently connected not only with immunization, but also with the reduction of the virulence of H. pertusis detected in studying the cultures isolated in Moscow from 1967 to 1974. The intensity indices of the epidemic process in whooping cough pointed to the necessity of using a more effective vaccine for the protection of children from whooping cough, despite the noted reduction of morbidity, and diminished severity of the course of the disease, and of the causative agent virulence.

Adolescent↗
PubMed1979

Whooping cough after stopping pertussis immunisation.

An epidemic of whooping cough occurred in a rural practice in Shetland, containing 144 children under 16. Before July 1974 all children were immunised against pertussis, but after that date immunisation was stopped. Of the 134 children studied, 93 had been immunised. Sixty-five of the children developed whooping cough. The incidence of infection was similar in those who had and had not been immunised. The incidence was also similar in those born before and after July 1974. There was no evidence to support the routine use of pertussis immunisation in rural Shetland.

Adolescent↗
PubMedDate not supplied

Pertussis toxin: the cause of the harmful effects and prolonged immunity of whooping cough. A hypothesis.

The nature of the pathogenesis and of the prolonged immunity of whooping cough has not been clearly defined. The literature of Bordetella pertussis indicated that only the antigen that induces histamine sensitization, lymphocytosis, and other biological reactions in mice is the cause of the harmful effects and prolonged immunity of whooping cough. This antigen has the general characteristics of bacterial protein exotoxins that cause the harmful effects of infectious diseases such as diphtheria and tetanus. It is proposed that this antigen, which is histamine-sensitizing, lymphocyte-leukocyte-promoting, and islets-activating (HSF-LPF-IAP), be designated pertussis toxin. Agglutinogen, hemagglutinin, and heat-labile (at 56 C) and heat-stable (at 100 C) toxins are no doubt interrelated with the immunologic and/or toxic reactions of whooping cough. It appears that the first defense against the disease is the antibody that prevents adhesion of the bacteria to the cilia of the respiratory epithelium and that the second defense is the antitoxin against pertussis toxin (HSF-LPF-IAP).

Agglutinins↗
PubMed1979

The serological diagnosis of whooping cough.

Indirect haemagglutination (IHA), agglutination and complement fixation tests (CFT) for Bordetella pertussis antibodies were compared on paired sera from 52 suspected cases of whooping cough and single sera from 83 children with no recent history of whooping cough. All three tests detected serotype antibodies 1, 2 and 3, but the IHA test was the most sensitive; in seven cases it was the only test to show a rise in titre. It is recommended, particularly with vaccinated children, that the serological diagnosis of whooping cough should be based upon a rise in titre. There should be a gap of at least 2-4 weeks between serum samples, depending on the age and vaccination state of the child. The CFT appears to detect a different antibody from that detected by the other two tests, and in three cases it was the only test to show a rise in titre.

Adolescent↗
PubMed1977

Vaccination against whooping-cough. Efficacy versus risks.

Calculations based on the mortality of whooping-cough before 1957 predict accurately the subsequent decline and the present low mortality. Notifications of incidence, though variable and incomplete, follow the same pattern of steady decline in the United Kingdom and are unaffected either by small-scale vaccination beginning about 1948 or by nationwide vaccination beginning in 1957. When valid comparisons can be made, attack-rates may be lower and complications fewer in vaccinated children, but allowance has to be made for overcrowding and socio-economic differences which may be more important as determinants of attack-rates. No protection by vaccination is demonstrable in infants. Adverse reactions and neurotoxicity following vaccinations were studied in 160 cases. In 79, the relationship to pertussis vaccine was strong. In 14 of these cases, reaction was transient but characteristic of a syndrome of shock and cerebral disturbance, which, in the other 65 cases, was followed by convulsions, hyperkinesis, and severe mental defect. It seems likely that most adverse reactions are unreported and that many are overlooked. Precise information about the efficacy and safety of this vaccine is lacking, because existing provisions, national and international, for epidemiological surveillance and evaluation are inadequate. The claim by official bodies that the risks of whooping-cough exceed those of vaccination is questionable, at least in the U.K.

Adolescent↗
PubMedDate not supplied

Nasal continuous positive airway pressure in the treatment of whooping cough.

A 3-week-old baby, suffering from whooping cough with severe attacks of apnoea and hypoxia, was treated by nasal CPAP with a positive airway pressure of about 5 cm H2O. The respiration improved rapidly and the transcutaneous oxygen tension increased to a normal level. The treatment was carried on for 7 days and discontinued gradually in the course of 3 days. The child was also treated with pertussis immunoglobulin and erythromycin. The CPAP system employed is easily and rapidly applied and allows normal nursing of the child during the treatment and manual lung physiotherapy in upright position. The treatment probably proved lifesaving.

Apnea↗
PubMed1979

[Preliminary findings with oral whooping cough vaccination in young infants (author's transl)].

A preliminary report is presented on oral vaccination against whooping cough. 23 babies younger than, and 2 older than nine weeks and 12 newborn infants were vaccinated orally. No side effects were observed. Serum antibody titres did not increase markedly, but no child was seronegative after vaccination. An evident antibody titre rise to a higher level than in serum was found in the saliva. These results point toward an adequate local immunity. At present a definite statement about the efficacy of this oral vaccination is difficult to make. Further investigations are necessary.

Administration, Oral↗
PubMed1976

[Azidocillin: activity in vitro, pharmacokinetics and therapeutic results in whooping cough].

In vitro activities of acidocillin and ampicillin were compared in 20 strains of Haemophilus influenzae, 50 strains of Enterococci and 4 strains of Bordetella pertussis by serial dilution test. There were no significant differences between both antibiotics. On Staphylococcus aureus (100 strains) and Streptococcus group A (25 strains) acidocillin was effective at the same degree as phenoxymethylpenicillin. After oral administration of 0.75 g acidocillin (1 h after a standard breakfast) serum peaks in 10 healthy adults were 6.1 +/- 0.51 mug/ml (after 1 1/2 h) which decreased to 0.5 +/- 0.10 mug/ml (after 4 h) and to 0.045 +/- 0.02 mug/ml (after 6 h). Urine-recovery in 9 h after oral administration of 0.75 g was found as of 58%, after i.v. administration of the same dose 78% (absorption rate nearly 74%). Therapy of whooping cough in 12 children with acidocillin (60 mg/kg/die) led to the disappearance of Bordetella pertussis from nasal swabs (only one failure caused by the child's frequent vomiting).

Administration, Oral↗