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2.
BMC Infect Dis ; 19(1): 75, 2019 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-30665366

RESUMO

BACKGROUND: Acute respiratory infections (ARIs) represent an important cause of morbidity and mortality in children, remaining a major public health concern, especially affecting children under 5 years old from low-income countries. Unfortunately, information regarding their epidemiology is still limited in Peru. METHODS: A secondary data analysis was performed from a previous cross-sectional study conducted in children with a probable diagnosis of Pertussis from January 2010 to July 2012. All samples were analyzed via Polymerase Chain Reaction (PCR) for the following etiologies: Influenza-A, Influenza-B, RSV-A, RSV-B, Adenovirus, Parainfluenza 1 virus, Parainfluenza 2 virus, Parainfluenza 3 virus, Mycoplasma pneumoniae and Chlamydia pneumoniae. RESULTS: A total of 288 patients were included. The most common pathogen isolated was Adenovirus (49%), followed by Bordetella pertussis (41%) from our previous investigation, the most prevelant microorganisms were Mycoplasma pneumonia (26%) and Influenza-B (19.8%). Coinfections were reported in 58% of samples and the most common association was found between B. pertussis and Adenovirus (12.2%). CONCLUSIONS: There was a high prevalence of Adenovirus, Mycoplasma pneumoniae and other etiologies in patients with a probable diagnosis of pertussis. Despite the presence of persistent cough lasting at least two weeks and other clinical characteristics highly suspicious of pertussis, secondary etiologies should be considered in children under 5 years-old in order to give a proper treatment.


Assuntos
Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Coqueluche/etiologia , Infecções por Adenoviridae/epidemiologia , Infecções por Adenoviridae/etiologia , Bordetella pertussis/genética , Bordetella pertussis/isolamento & purificação , Pré-Escolar , Infecções por Chlamydophila/epidemiologia , Infecções por Chlamydophila/etiologia , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/isolamento & purificação , Tosse/microbiologia , Estudos Transversais , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Influenza Humana/epidemiologia , Influenza Humana/etiologia , Masculino , Mycoplasma pneumoniae/isolamento & purificação , Vírus da Parainfluenza 3 Humana/genética , Vírus da Parainfluenza 3 Humana/isolamento & purificação , Peru/epidemiologia , Pneumonia por Mycoplasma/epidemiologia , Pneumonia por Mycoplasma/microbiologia , Infecções Respiratórias/epidemiologia , Infecções por Respirovirus/epidemiologia , Infecções por Respirovirus/etiologia , Coqueluche/diagnóstico , Coqueluche/epidemiologia
3.
Pediatr Infect Dis J ; 37(2): 126-131, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28777209

RESUMO

OBJECTIVES: Hispanic infants are at greater risk of pertussis compared with other racial/ethnic groups. Studies have shown that the source of Bordetella pertussis infection for most infants is household members. Using a case-control study, we examined risk markers for pertussis among Hispanic and non-Hispanic infants and evaluated whether maternal parity, a proxy for household size, contributes to the ethnic disparity. METHODS: We evaluated infants born in California during 2013-2014; cases were infants reported to California Department of Public Health with pertussis occurring before 4 months of age, and controls were infants who survived to at least 4 months of age without pertussis. Bivariate comparisons and multivariate logistic regression models were used to identify risk markers for pertussis in Hispanic and non-Hispanic infants. RESULTS: Increased maternal parity was associated with greater risk of pertussis, with a clear dose response observed with increasing risk for additional prior births. Teenage mothers were more likely to have infants with pertussis. These were both independent risk factors across all racial/ethnic groups, even when adjusting for important covariates. Preterm birth and Medicaid insurance were also identified as independent risk markers among Hispanic infants only. CONCLUSIONS: Infants of all races/ethnicities with older siblings or born to younger mothers are at increased risk of pertussis. Among Hispanic infants, prematurity and Medicaid insurance were independent risk markers for pertussis. These factors highlight the need to ensure prompt immunization of pregnant women with Tdap at the earliest opportunity starting at 27 weeks gestation.


Assuntos
Hispano-Americanos/estatística & dados numéricos , Coqueluche/etnologia , Adolescente , Adulto , California/epidemiologia , Estudos de Casos e Controles , Feminino , Disparidades nos Níveis de Saúde , Humanos , Lactente , Masculino , Fatores de Risco , Coqueluche/etiologia , Adulto Jovem
4.
Clin Infect Dis ; 65(12): 2099-2104, 2017 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-29099909

RESUMO

Background: Natural infection with Bordetella pertussis is thought to result in 4-20 years of immunity against subsequent symptomatic pertussis infection. However, these estimates are based on studies in unvaccinated or whole-cell pertussis-vaccinated children. We conducted a population-based study of pertussis infection and reinfection during a 5-year period in California in an cohort vaccinated exclusively with acellular pertussis (aP) vaccine. Methods: California surveillance data were reviewed to identify all children with 2 reported incidents of pertussis with symptom onset between 1 January 2010 and 31 December 2015. Case investigation reports were reviewed, and children with ≥2 episodes of symptomatic pertussis infection that met the case definition were included. Results: Of 26259 pertussis cases reported in children (aged <18 years), 27 children met the inclusion criteria. Recurrent cases occurred among children of all ages; 5 (19%) were <6 months of age at the time of their first illness. The time from initial infection to reinfection was <1 year in 11 (41%) cases. Twenty-one children (78%) had received ≥3 doses of diphtheria and tetanus toxoids and aP vaccine at the time of their first pertussis infection, 1 (4%) had received 1 dose, and 5 (19%) were unvaccinated. Conclusions: Recurrent cases of pertussis infection are extremely rare. Based on this surveillance data, approximately 0.1% of children who were infected with pertussis experienced a clinically significant second episode of pertussis within 4 years. More research is needed to understand the immune response to B. pertussis infection in children vaccinated with aP vaccines.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Vacinas contra Difteria, Tétano e Coqueluche Acelular/efeitos adversos , Vigilância da População , Coqueluche/epidemiologia , Adolescente , Bordetella pertussis/imunologia , Bordetella pertussis/isolamento & purificação , California/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Vacinas contra Difteria, Tétano e Coqueluche Acelular/imunologia , Feminino , Humanos , Lactente , Masculino , Recidiva , Coqueluche/etiologia , Coqueluche/microbiologia , Coqueluche/prevenção & controle
5.
J Travel Med ; 24(3)2017 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-28355615

RESUMO

Background: Pertussis is a highly contagious, vaccine-preventable respiratory infection that is endemic worldwide. There are limited data regarding the occurrence of pertussis in travelers. The objective of this study is to identify travel-related pertussis cases reported to the GeoSentinel Surveillance Network. Methods: This is a descriptive, retrospective analysis of GeoSentinel records from 25 travel/tropical medicine clinics in 16 countries. Frequencies of demographic and travel-related characteristics and symptoms of 74 cases of pertussis in travelers and new immigrants from 1999 to 2015 were analysed. Results: There were 74 probable and confirmed cases of pertussis in the GeoSentinel database; median age was 44 years, and 38 (51%) patients were female. Tourism was the most common reason for travel (41; 55%). Country of exposure was determined in 66 cases with travelers returning from India and China constituting the highest number of cases (10 cases each; 15% each). Seventy of 74 (95%) patients had respiratory symptoms, while fatigue and fever were reported by 21 (28%) and 20 (27%), respectively. Immunization status against pertussis was unknown. Most cases were reported after 2005 (69; 93%). Conclusions: Our study describes 74 cases of pertussis acquired during travel and reported to the GeoSentinel Network. Pertussis should be considered in returned travelers who present with respiratory symptoms. Surveillance and detection of imported cases are important to prevent onward transmission in the community. The pre-travel consultation provides an opportunity to verify immunization status and provide routine vaccinations such as pertussis.


Assuntos
Bordetella pertussis/isolamento & purificação , Vigilância de Evento Sentinela , Medicina de Viagem , Coqueluche/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Saúde Global , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Coqueluche/etiologia , Coqueluche/prevenção & controle , Adulto Jovem
6.
Pediatr Crit Care Med ; 18(1): e42-e47, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27811532

RESUMO

OBJECTIVE: To identify factors associated with malignant pertussis. DESIGN: A retrospective case notes review from January 2003 to August 2013. Area under the receiver-operator characteristic curve was used to determine how well vital sign and white cell characteristics within 48 hours of hospital presentation identified children with malignant pertussis. SETTING: The national children's hospital in Auckland, New Zealand. PATIENTS: One hundred fifty-two children with pertussis. MEASUREMENTS AND MAIN RESULTS: There were 152 children with confirmed pertussis identified, including 11 children with malignant pertussis. The area under the receiver-operator characteristic curve was 0.88 (95% CI, 0.78-0.97) for maximum heart rate. The optimal cut-point was 180 beats/min, which predicted malignant pertussis with a sensitivity of 73% and a specificity of 91%. The area under the receiver-operator characteristic curve was 0.92 (95% CI, 0.81-1.0) for absolute neutrophil count, 0.85 (95% CI, 0.71-0.99) for total WBC count, 0.80 (95% CI, 0.63-0.96) for neutrophil-to-lymphocyte ratio, and 0.77 (95% CI, 0.58-0.92) for absolute lymphocyte count. All children with malignant pertussis had one or more of heart rate greater than 180 beats/min, total WBC count greater than 25 × 10/L, and neutrophil-to-lymphocyte ratio greater than 1.0 with an area under the receiver-operator characteristic curve of 0.96 (95% CI, 0.91-1.0) for a multivariate model that included these three variables. CONCLUSIONS: Clinical predictors of malignant pertussis are identifiable within 48 hours of hospital presentation. Early recognition of children at risk of malignant pertussis may facilitate early referral to a PICU for advanced life support and selection for trials of investigational therapies.


Assuntos
Índice de Gravidade de Doença , Coqueluche/diagnóstico , Coqueluche/etiologia , Criança , Pré-Escolar , Cuidados Críticos , Progressão da Doença , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Contagem de Leucócitos , Masculino , Prognóstico , Curva ROC , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Sensibilidade e Especificidade , Sinais Vitais , Coqueluche/terapia
7.
Commun Dis Intell Q Rep ; 41(3): E264-E278, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-29720076

RESUMO

Introduction: The Paediatric Active Enhanced Disease Surveillance (PAEDS) network is a hospital-based active surveillance system employing prospective case ascertainment for selected serious childhood conditions, particularly vaccine preventable diseases and potential adverse events following immunisation (AEFI). PAEDS data is used to better understand these conditions, inform policy and practice under the National Immunisation Program, and enable rapid public health responses for certain conditions of public health importance. PAEDS enhances data available from other Australian surveillance systems by providing prospective, detailed clinical and laboratory information on children with selected conditions. This is the second of the planned annual PAEDS reporting series, and presents surveillance data for 2015. Methods: Specialist surveillance nurses screened hospital admissions, emergency department records, laboratory and other data, on a daily basis in 5 paediatric tertiary referral hospitals in New South Wales, Victoria, South Australia, Western Australia and Queensland to identify children with the selected conditions. Standardised protocols and case definitions were used across all sites. Conditions under surveillance in 2015 included acute flaccid paralysis (a syndrome associated with poliovirus infection), acute childhood encephalitis (ACE), influenza, intussusception (IS; a potential AEFI with rotavirus vaccines), pertussis and varicella-zoster virus infection (varicella and herpes zoster). Most protocols restrict eligibility to hospitalisations, ED only presentations are also included for some conditions. Methods: : In 2015, there were 674 cases identified across all conditions under surveillance. Key outcomes of PAEDS included: contribution to national AFP surveillance to reach WHO reporting targets; identification of signals for Mycoplasma pneumoniae and parechovirus-related outbreaks (ACE surveillance); and demonstration of high influenza activity with vaccine effectiveness (VE) analysis supportive of vaccination. Surveillance for IS remains ongoing with any identified AEFIs reported to the relevant State Health Department; varicella and herpes zoster case numbers decreased slightly from previous years in older children not eligible for catch-up. Pertussis case numbers increased in early 2015 and analysis of cases in children aged <1 year demonstrated the importance of timely childhood and maternal immunisation. Conclusions: PAEDS continues to provide unique policy-relevant data on serious paediatric conditions using hospital-based sentinel surveillance.


Assuntos
Encefalopatia Aguda Febril/epidemiologia , Vacinas Bacterianas/efeitos adversos , Influenza Humana/epidemiologia , Intussuscepção/epidemiologia , Paraplegia/epidemiologia , Infecção pelo Vírus da Varicela-Zoster/epidemiologia , Vacinas Virais/efeitos adversos , Coqueluche/epidemiologia , Doença Aguda , Encefalopatia Aguda Febril/etiologia , Adolescente , Austrália/epidemiologia , Criança , Pré-Escolar , Notificação de Doenças/estatística & dados numéricos , Feminino , Hospitais , Humanos , Lactente , Influenza Humana/etiologia , Intussuscepção/etiologia , Masculino , Paraplegia/etiologia , Vigilância em Saúde Pública , Vacinação/efeitos adversos , Infecção pelo Vírus da Varicela-Zoster/etiologia , Coqueluche/etiologia
8.
Dig Dis Sci ; 61(10): 2972-2976, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27557706

RESUMO

BACKGROUND: Current guidelines emphasize vaccination for influenza and pneumococcus for IBD patients and the avoidance of live virus vaccines for those who are on immunosuppressive (ISS) therapy. Given the recent resurgence of measles and pertussis infections, we assessed the immune status of our IBD population in order to advise about these risks. METHODS: We prospectively collected measles and pertussis titers in our IBD patients from February 1-May 1, 2015. Immune status based on standard threshold values was determined: measles antibodies ≤0.8 antibody index (AI) = negative immunity, 0.9-1.1 AI = equivocal immunity and titers ≥1.2 AI = positive immunity. For pertussis immunity, anti-pertussis antibodies ≤5 IU/mL were considered negative immunity. Univariate analysis was performed to examine predictive factors including age, disease duration, and current medical therapies. RESULTS: A total of 122 patients' titers were assessed (77 Crohn's disease, 1 indeterminate colitis, and 45 ulcerative colitis). Sixteen (13.1 %) patients lacked detectable immunity to measles, and four (3 %) had equivocal immunity. Twelve (75 %) of the measles non-immune patients were on ISS therapy versus 65 (64 %) of 102 immune patients (OR 1.7, 95 % CI 0.5-5.9, p = 0.34). Out of 96 patients, 58 (60 %) were not immune to pertussis. Disease duration ≥10 years and age ≥50 were associated with significant lower measles titers. CONCLUSIONS: A significant number of our IBD patients lack immunity to measles, and a majority of our IBD patients do not have detectable immunity to pertussis. Importantly, the majority of the measles non-immune patients are on ISS therapy and therefore unable to receive a booster.


Assuntos
Anticorpos Antibacterianos/imunologia , Anticorpos Antivirais/imunologia , Bordetella pertussis/imunologia , Imunossupressores/efeitos adversos , Doenças Inflamatórias Intestinais/tratamento farmacológico , Sarampo/imunologia , Morbillivirus/imunologia , Coqueluche/imunologia , Adulto , Idoso , Colite Ulcerativa/tratamento farmacológico , Colite Ulcerativa/imunologia , Doença de Crohn/tratamento farmacológico , Doença de Crohn/imunologia , Feminino , Humanos , Imunização Secundária , Doenças Inflamatórias Intestinais/imunologia , Masculino , Sarampo/etiologia , Vacina contra Sarampo/uso terapêutico , Pessoa de Meia-Idade , Vacina contra Coqueluche/uso terapêutico , Estudos Prospectivos , Estados Unidos , Coqueluche/etiologia , Coqueluche/prevenção & controle , Adulto Jovem
9.
Transpl Infect Dis ; 18(2): 280-3, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26808962

RESUMO

Whooping cough is a respiratory infection with a severity that varies with age, immune status, and probably with other factors such as the degree of exposure and the virulence of the organism. The most frequent microorganism responsible for whooping cough is Bordetella pertussis. We present the case of a 62-year-old renal transplant recipient presenting with typical and severe manifestations of whooping cough caused by B. pertussis.


Assuntos
Transplante de Rim/efeitos adversos , Coqueluche/etiologia , Antibacterianos/uso terapêutico , Feminino , Humanos , Hospedeiro Imunocomprometido , Pessoa de Meia-Idade , Coqueluche/tratamento farmacológico
11.
Perm J ; 19(3): 59-63, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26176570

RESUMO

The authors conducted a matched case-control study of laboratory-confirmed pertussis cases, occurring from 1/1/1996 to 12/31/2005, in children up to 12 years of age who were members of a large managed care organization. Sixty-five laboratoryconfirmed cases of pertussis were identified. Using multivariable conditional logistic regression analysis, the authors did not detect a statistically significant association between pertussis and household passive exposure to cigarette smoking.


Assuntos
Poluição por Fumaça de Tabaco/efeitos adversos , Coqueluche/etiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Vacina contra Coqueluche/uso terapêutico , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Vacinação/estatística & dados numéricos
12.
Med. prev ; 21(1): 32-38, 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-152633

RESUMO

La tos ferina es una enfermedad infecciosa, desconocida durante siglos, a la que no se hace referencia en la Grecia clásica y en Roma, habiéndose realizado su primera descripción en el s. XVI. En los últimos años, se ha observado un incremento en el número de casos, incluso en países que han logrado buenas en lactantes, especialmente en aquellos que no han iniciado o completado la primovacunación, ocupando de acuerdo con la OMS, el quinto lugar entre las causas de muerte prevenibles por vacuna. Aunque se dispone de una profilaxis eficaz desde hace más de medio siglo, no se ha logrado aún el control de la enfermedad, por lo que se han propuesto algunas estrategias, como la vacunación de adolescentes y adultos, de la embarazada y de los contactos del lactante, con el fin contribuir a mejorar el control de la misma (AU)


The whooping cough is an infectious disease. Unknown for centuries, there are no references of this disease in classic Greece nor in Rome, and its first description appears only in the WVI century. There has been an increase in the number of cases in the latter years, even in countries with good vaccine - coverage. This disease presents a high mortality rate in infants, especially in those that have not started or completed primal vaccination. According to WHO, this disease is fifth among the different causes of death that could be prevented by the use of the vaccine. In spite of having and efficient prophylaxis for oven fifty years, control of the disease has not been yet achieved. For this reason, some strategies have been proposed such as vaccination of adolescents and adults, pregnant women, and those in contact with infants so that these may contribute to the control of the disease (AU)


Assuntos
Humanos , Masculino , Feminino , Coqueluche/diagnóstico , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Coqueluche/etiologia , Coqueluche/história , Coqueluche/mortalidade , Coqueluche/terapia
13.
In. Álvarez Sintes, Roberto. Medicina General Integral. Tomo. V. La Habana, ECIMED, 3ra.ed; 2014. .
Monografia em Espanhol | CUMED | ID: cum-58949
14.
APMIS ; 121(4): 311-5, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23030784

RESUMO

Mannose-binding lectin (MBL) is an important molecule of the innate immunity. The low level of MBL in the serum is associated with increased susceptibility to respiratory infections. In this study, MBL concentrations were determined from the sera of 125 Finnish pertussis patients and from 430 control subjects. Severe MBL deficiency (<50 ng/mL) was found more often in the patients than in the controls (11.2% vs 5.8%, p = 0.038). Moreover, the deficiency was detected more frequently in the adult patients than in the controls [20.4% vs 8.6%, p = 0.021; odds ratio 2.7 (95% confidence interval 1.1-6.5)]. Our findings suggest, for the first time, that MBL deficiency predisposes to pertussis infection, at least in adults.


Assuntos
Lectina de Ligação a Manose/deficiência , Coqueluche/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Lectina de Ligação a Manose/fisiologia , Pessoa de Meia-Idade , Risco
15.
FEBS Lett ; 586(4): 459-65, 2012 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-22289177

RESUMO

Bordetella pertussis adenylate cyclase toxin (ACT) intoxicates cells by producing intracellular cAMP. B. pertussis outer membrane vesicles (OMV) contain ACT on their surface (OMV-ACT), but the properties of OMV-ACT were previously unknown. We found that B. pertussis in the lung from a fatal pertussis case contains OMV, suggesting an involvement in pathogenesis. OMV-ACT and ACT intoxicate cells with and without the toxin's receptor CD11b/CD18. Intoxication by ACT is blocked by antitoxin and anti-CD11b antibodies, but not by cytochalasin-D; in contrast, OMV-ACT is unaffected by either antibody and blocked by cytochalasin-D. Thus OMV-ACT can deliver ACT by processes distinct from those of ACT alone.


Assuntos
Toxina Adenilato Ciclase/farmacocinética , Toxina Adenilato Ciclase/toxicidade , Bordetella pertussis/patogenicidade , Animais , Anticorpos Antibacterianos/administração & dosagem , Bordetella pertussis/ultraestrutura , Células CHO , Linhagem Celular , Membrana Celular/metabolismo , Membrana Celular/ultraestrutura , Cricetinae , Cricetulus , Citocalasina D/farmacologia , Humanos , Camundongos , Microscopia Eletrônica de Transmissão , Tripsina/farmacologia , Coqueluche/etiologia , Coqueluche/microbiologia , Coqueluche/patologia
16.
Int J Environ Res Public Health ; 9(12): 4626-38, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23330226

RESUMO

Pertussis continues to be a relevant public-health issue. The high coverage rates achieved have decreased the spread of the pathogen, but the waning of immunity implies a relevant role of adolescents and adults in the infective dynamics as they may represent a significant source of infection for unvaccinated or incompletely immunized newborns. The passive surveillance system is affected by many limitations. The underestimation of pertussis in adolescents, young adults and adults is mainly related to the atypical clinical characteristics of cases and the lack of lab confirmation. The real epidemiological impact of pertussis is not always perceived, anyway, the unavailability of comprehensive data should not hamper the adoption of active prophylactic interventions aimed at preventing the impact of waning immunity on pertussis. To avoid an increase of the mean age of acquisition of the infection, a booster dose of low-antigen content combined vaccine should be adopted in adolescents and adults. A decreased risk of infection in newborns can be achieved with the cocoon strategy, although the debate on this aspect is still open and enhanced surveillance and further studies are needed to fine-tune the pertussis prevention strategy.


Assuntos
Vacinação , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Fatores Etários , Humanos , Incidência , Itália/epidemiologia , Coqueluche/etiologia
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