ABSTRACT
The safety and immunogenicity of acellular pertussis (AP) vaccine in outbreak control was determined in a randomized, double-blind, controlled trial. Participants received AP vaccine (n=102), which contained 25 microg of pertussis toxoid (PT) and 3 microg of filamentous hemagglutinin (FHA), or licensed meningococcal vaccine (MN; n=97). Local reactions (pain or tenderness, redness, swelling, and induration) and systemic reactions (fever, sleepiness or lethargy, and irritability) were similar among AP and MN vaccinees. One month after AP vaccination, the geometric mean level of IgG anti-PT was 33.1 microg/mL, with 2-fold increases in 85% of patients and 4-fold increases in 73% of patients; for IgG anti-FHA, the respective values were 34.7 microg/mL, 92%, and 63%. After 6 months of follow-up, no serological evidence of pertussis was seen among symptomatic or asymptomatic subjects. However, recent evidence of Bordetella pertussis infection before immunization was shown. Thus, AP vaccine was safe and immunogenic in adults.
Subject(s)
Disease Outbreaks , Personnel, Hospital , Pertussis Vaccine , Whooping Cough/epidemiology , Whooping Cough/prevention & control , Adult , Antibodies, Bacterial/blood , Bordetella pertussis/immunology , Double-Blind Method , Hemagglutinins/immunology , Humans , Middle Aged , Ohio/epidemiology , Pertussis Vaccine/adverse effects , Pertussis Vaccine/immunology , Toxoids/immunology , VaccinationABSTRACT
From 1989 to 1998, the incidence of pertussis increased in Massachusetts adolescents and adults, reaching 71 and 5 per 100,000, respectively, by 1998, whereas the incidence in children remained stable. By 1998, 92% of cases occurred in adolescents and adults. Nationally, in contrast, adolescents and adults had incidences of only 5 and 0.8 per 100,000, respectively, and accounted for 47% of cases. The availability of a specific serologic test and active surveillance by public health personnel in Massachusetts are at least partial explanations. The rise in incidence may be real, however, because, as diagnostic efforts increased, the percentage of patients with a positive serologic test result also increased. Cases identified in adolescents and adults were quite severe: 83% and 87%, respectively, experienced paroxysmal cough, 45% and 41% experienced vomiting, and 41% and 52% experienced a cough lasting >4 weeks. Administration of acellular pertussis vaccine in these age groups could prevent this substantial morbidity.
Subject(s)
Whooping Cough/epidemiology , Adolescent , Adult , Age Distribution , Bordetella pertussis/isolation & purification , Child , Child, Preschool , Female , Humans , Immunization , Incidence , Infant , Infant, Newborn , Male , Massachusetts/epidemiology , Seasons , Sex Factors , Time FactorsABSTRACT
Data are presented for 139 children assessed for abuse by burning, and findings are contrasted with previous reports in the literature. The results support assertions that burn abuse is most prevalent among children under 3 years of age, and is usually perpetrated by a caretaker who is young, single and poorly educated. The data do not support findings from other studies that boys outnumber girls as victims. Previous reports that immersion burns constitute the major burn type are also contradicted by the present study and results are examined in terms of sampling techniques. A disproportionate number of alleged abusers in this study are female, a finding which is discussed relative to the average age of the victim and the events reported as precipitating abuse. This study indicates that burn abuse is most common in families of two or more children, and that the youngest child is at highest risk.
Subject(s)
Burns/etiology , Child Abuse , Adolescent , Adult , Birth Order , Child , Child, Preschool , Educational Status , Family Characteristics , Female , Humans , Infant , Male , Middle Aged , Patient Admission , Single PersonABSTRACT
The effectiveness of a primary prevention program for children of divorce is evaluated. Subjects included 82 mother-child pairs. Mothers had been separated for 33 months or less and did not have prior histories of using mental health services. Subjects were assigned to one of four conditions: (a) the Children's Support Group alone (CSG), (b) the CSG and the Single Parents' Support Group (SPSG), (c) the SPSG alone, or (d) a no-treatment control group. Data collected before, after, and 5 months following intervention, were analyzed using analyses of covariance with preintervention scores as covariates and pre-post and post-follow-up difference scores as dependent measures. Children in the CSG-alone condition improved most in self-concept and parents in the SPSG-alone condition improved the most in adjustment. Improvements were either maintained or did not change differentially across groups at follow up. Adaptive social skills of CSG-alone children compared to children in the CSG/SPSG groups showed significant post-to-follow-up improvements.
