Adverse Effects of Pertussis and Rubella Vaccines (1991) / Chapter Skim
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2 Histories of Pertussis and Rubella Vaccines
2 Histories of Pertussis and Rubella Vaccines
Pages 9-31
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From page 9... ...
~ The terms pertussis and whooping cough are used interchangeably throughout this report. 2 The terms immunization and vaccination are used interchangeably throughout this report.
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Kloos and colleagues (1981) suggest that the absence of a clinical description of pertussis prior to the sixteenth century may reflect adaptation of a close genetic variant of B
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Other severe respiratory complications include bronchopneumonia, a frequent complication in elderly people, atelectasis, bronchiectasis, interstitial and subcutaneous emphysema, and pneumothorax. CNS complications following pertussis include acute encephalitis that can progress to convulsions, stupor, and coma.
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Pertussis is highly infectious; attack rates in nonimmunized populations have been reported to range from 25 to 50 percent in schools and from 70 to 100 percent in susceptible household contacts (Centers for Disease Control, 1985; Gordon and Hood, 1951; Kendrick, 1940; Linnemann, 19791. Epidemiologic and laboratory studies suggest that natural Pertussis infection confers vigorous, long-lasting immunity (Gordon and Hood, 1951; Huang et al., 1962; Stallybrass, 1931~.
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It should be reiterated in reviewing these figures that the SPSS captures only an estimated 5 to 10 percent of pertussis cases in the United States (Centers for Disease Control, 1990~. In light of the vagaries of pertussis detection and diagnosis, pertussis mortality and incidence rates worldwide substantially underestimate the true magnitude of the disease.
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Time Trends Mortality rates from pertussis in the industrialized world have declined significantly in the twentieth century. In Great Britain, at the turn of the century, approximately 1 in 1,000 children under age 15 years died of pertussis, with mortality rates being significantly higher among infants less than age 1 year.
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pertussis to resp~ratory epithelium is required for the pathogenesis of whooping cough (Pittman, 1970~. Adherence appears to involve a bacterial outer membrane
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Acellular Vaccines Acellular pertussis vaccines were developed in Japan, prompted by ad 4 Throughout this report, the acronym DPT has been adopted for the triple vaccine because of its historic usage. It is synonymous with DIP.
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Brief History of the Controversy Pertaining to Adverse Events Following Pertussis Vaccination Madsen, of the State Serum Institute in Copenhagen, Denmark, was the first to describe the use of whole-cell pertussis vaccine on a large scale (Madsen, 1925, 19331. His vaccine successfully controlled two outbreaks in the Farce Islands.
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From page 19... ...
Brody and Sorley reported only one case, but their report led to the first warnings that pertussis vaccine should not be administered to those with a known necrologic disorder. In Britain in 1974, questions about the safety of pertussis vaccines were widely publicized in the popular press after newspaper accounts of a study suggesting adverse reactions (Kulenkampff et al., 1974)
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Rubella subsequently evoked little interest in the medical community until 1941, when a report appeared associating congenital cataracts with maternal exposure to the disease during pregnancy (Gregg, 1941~. A flurry of subsequent reports confirmed this association and further noted increased risks of congenital heart disease and deafness following maternal exposure to the disease, thus establishing the classical congenital rubella triad (Greenberg et al., 1957; Lundstrom, 1962; Manson et al., 1960; Pitt and Keir, 1965~.
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From page 21... ...
Descriptive Epidemiology Ecology of the Rubella Virus Rubella virus is spread by airborne droplet nuclei or by close contact. Rubella does not appear to be as contagious as certain other common viral childhood diseases are, as indicated by seroepidemiologic studies showing that even after explosive outbreaks, 10 to 20 percent of young adults may remain susceptible (Plotkin, 1988~.
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From page 22... ...
With the advent of mass immunization, rubella incidence rates declined by more than 95 percent compared with those in the prevaccination era, although isolated epidemics in susceptible groups have continued to occur (Cherry et al., 1988~. Nature of the Rubella Virus The initial realization of the teratogenic potential of maternal rubella in the early 1940s spurred attempts to isolate and characterize the responsible agent.
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Pertussis and Rubella Vaccines: A Brief Chronology. Brief History of the Controversy Pertaining to Adverse Events Following Rubella \7accination Two types of adverse events after rubella immunization have primarily been reported.
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Acute arthralgia and arthritis following vaccination were also reported in the earliest studies of rubella vaccines (American Journal of Diseases of Children, 1969; Barnes et al., 1972; Horstmann et al., 1970; Lerman et al., 1971; Spruance and Smith, 19711. All rubella vaccine strains have been associated, to some extent, with reactions in the joints.
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Presented at NIAID/FDA/CDC/USAID Status of Acellular Pertussis Vaccines Swedish Trial Update, Bethesda, MD, February 8-9, 1988. Bordet J
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1986. Diphtheria, tetanus, and pertussis vaccine: a comparison of the immune response and adverse reactions to conventional and acellular pertussis components.
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Presented at the NIAID/ FDA/CDC/USAID Workshop on the Status of Acellular Pertussis Vaccines Swedish Trial Update, Bethesda, MD, February 8-9, 1988. Halstead SB, Diwan AR, Oda AI.
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1966. Thrombocytopenic purpura following rubella infection in children and adults.
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1988. Status of Acellular Pertussis Vaccines & Swedish Trial Update: Transcript of a Workshop.
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1990. Evidence linking rubella vaccines to chronic arthritis.
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1984. Pertussis toxin and extracytoplasmic adenylate cyclase as virulence factors in Bordetella pertussis.
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