Pertussis in hospitalized children

Article Abstract:

For many years pertussis, also known as whooping cough, was a significant cause of serious illness and death among children. A vaccine against Bordetella pertussis, the bacteria that causes this infection, has reduced these statistics in the past few decades. However, there have been highly publicized reports about adverse reactions to the vaccine. These adverse effects occur very rarely, but an decrease in the rate of vaccination has resulted; a 33 percent increase in pertussis cases was reported from 1982 and 1983 to 1984 and 1985. To further investigate the incidence of pertussis among children, a retrospective study which examined the records of hospitalized children at one major medical center from 1967 to 1986 was performed. During the first 10-year period, there were 45 cases of suspected pertussis; during the following 10-year period, there were 137. Cultures were performed on 80 children, and 43 percent of these (34 children) tested positive for the B. pertussis bacteria. Fluorescent antibody tests indicated a positive diagnosis for 132 children. Immunization records were available for 176 children, and 89 percent of these had received less than the recommended doses of the pertussis vaccine. Complications among these children included convulsion in 6 percent and difficulty breathing, which was reported in 25 percent and observed in the hospital in 14 percent. Five percent of the patients required artificial respiration, and three children died. These findings indicate that pertussis is still a significant cause of death and illness among children in this country. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Statistics

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Total serum IgE levels in children with pertussis

Article Abstract:

Previous research has reported that Bordetella pertussis, the bacteria that causes pertussis (whooping cough), causes a rise in immunoglobulin E (IgE) levels. An increased immune response of antibody production has also been observed in children infected with Bordetella pertussis. To further investigate this relationship, concentrations of IgE were measured in 20 children diagnosed with whooping cough. An age-dependent difference in reaction was observed; levels of serum IgE increased with the age of the child. Normal levels of IgE were measured in children from birth to 24 months old and in children from 13 to 24 months old. However, children between the ages of 3 and 12 years had elevated IgE levels in their blood during infection with B pertussis. Pertussis toxin, a by-product of B pertussis, is presumed to stimulate the production of IgE antibodies. Possible explanations for this strong interaction are discussed. The increased levels of IgE in the older children may indicate a variation in pertussis infection. The lack of response noted in the younger children may be associated with both a physiologic depression of the immune system and infection-induced depression of the immune response. The interaction between IgE and pertussis toxin is still not fully understood, nor are the variations in the immune response as exhibited by the different age groups. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Immunoglobulin E

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Comparison of the safety and immunogenicity of acellular (BIKEN) and whole-cell pertussis vaccines in 15- to 20-month-old children

Article Abstract:

The acellular diphtheria and tetanus toxoids and pertussis vaccine (DT-aP) combination may be more effective and safer than the whole-cell diphtheria and tetanus toxoids and pertussis vaccine (WC-DTP). Both of these vaccines are given to children to protect against diphtheria, tetanus and pertussis, or whooping cough. Among 246 children between 15 and 20 months old who had received a three-dose series of the WC-DTP vaccine during infancy, 82 were vaccinated with DT-aP and 146 received WC-DTP. More local reactions (at the site of the vaccination) occurred between six and 48 hours after vaccination among children who received the WC-DTP vaccine than among those who received the DT-aP vaccine. Children who received the WC-DTP vaccine also suffered more systemic reactions during the first 24 hours, with half of those who received DT-aP showing no negative reactions. Blood levels of antibodies against pertussis were higher among children in the DT-aP group than among those in the WC-DTP group.

Evaluation, Children, Vaccination of children, Vaccination, DPT vaccine, Diphtheria-tetanus-pertussis vaccines

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