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Infectious episodes following diphtheria-pertussis-tetanus vaccination
Virginia Layng Millonig, PhD, RN, CPNP President, Health leadership Associates Potomac, Maryland
Infectious Episodes Following Diphtheria-Pertussis-Tetanus Vaccination
n
Jaber, L., Shohat, M., & Mimouni, Clinical Pediatrics, 27, 491-494.
M. (1988).
T
his prospective study was conducted in Israel on eighty-two infants, ages 2 to 12 months, to determine the incidence of infectious episodes after diphtheria-pertussis-tetanus (DPT) immunization. The occurrence of infectious episodes during the month following vaccination was compared to that during the month before its administration. The 3 days following vaccination were not included. In comparison to the month before immunization and the month following immunization, there were significantly more infants with fever (6.1% vs. 24.4%), with diarrhea (7.3% vs. 23.1%), and with cough (37.7% vs. 52.4%). After the first month of the study, there was an increasein morbidity in the region, so those casesthat had been seen during the latter 3 months were reevaluated. The same trend was found: in the month following immunization there were significantly more infants with fever, diarrhea, and cough. There was no correlation between the incidence of these episodes and the age at vaccination.
lmmunogenicity of the Haemophilus lnfluenzae Type b Capsular Pol saccharide Conjugate Vaccine in Chi i dren After Systemic Haemophilus lnfluenzae Type b Infections
n
Kaplan, S.L., Zahradnik, J.M., Mason, E.O., & Dukes, C. (1988). The journal of Pediatrics, 113,
272-277.
C
hi&-en less than 18 months of age generally do not develop protective levels of antibody to the capsular polysaccharide of Haemapbdusinfzuenzaetype b after a systemic infection causedby this organism. In this study 24 patients (mean age, 15.2 months) were immunized with polyribosylribitol phosphate170
diphtheria toxoid conjugate vaccine (PRP-D) 2 months after a systemicHatmopbihs infEuenzaetype b infection. Children ~24 months of age were immunized twice. Results of this study confirmed similar, previous studies and concluded that the antibody responseto vaccination for eatients <18 months of age did not differ from that of healthy control children of a similar age and that the majority of children lessthan 18 months of age do not develop protective levels of anti-PRP after a systemic infection.
Group A Streptococcal Rapid Test: Antigen Detection After 18-24 Hours of Penicillin Therapy
n
Beach, Clinical
P.A.,
Balfour,
L., & Lucia,
H.L. (1989).
Pediatrics, 28, 6-l 0.
T
his study was conducted on 29 children, ages 19 months to 16 years, before and after 18 to 24 hours of oral penicillin therapy to confirm the rapid disappearanceof detectable pharyngeal antigen and to determine whether the antigen detectable by commercially available kits was excreted into the urine. At 18 to 24 hour follow-up, subjectsreported having taken 2 to 4 doses of penicillin. At 24 hours, specimens from ten patients (34%) were positive. Nine of the ten patients who exhibited a positive result &er antibiotic therapy reported taking three doses of medication; one had taken four. One patient who reported taking just two doses of penicillin reverted to negative. In no casewas the group A streptococcal antigen detected in the urine of infected persons before or &er initiation of therapy. This study emphasizesthe difficulty in accuratelydiagnosing group A beta-hemolytic streptococcus (GABHS) if penicillin has been taken before presentation. Clinical and physical findings are altered by even a single day of therapy. In summary, three of the currently available tests for GABHS, discussed in this study, are not dependable in detecting group A streptococcal pharyngitis after penicillin has been administered, even for a short period of time. JOURNAL OF PEDIATRIC HEALTH CARE
Infectious Episodes Following Diphtheria-Pertussis-Tetanus Vaccination
n
Jaber, L., Shohat, M., & Mimouni, Clinical Pediatrics, 27, 491-494.
M. (1988).
T
his prospective study was conducted in Israel on eighty-two infants, ages 2 to 12 months, to determine the incidence of infectious episodes after diphtheria-pertussis-tetanus (DPT) immunization. The occurrence of infectious episodes during the month following vaccination was compared to that during the month before its administration. The 3 days following vaccination were not included. In comparison to the month before immunization and the month following immunization, there were significantly more infants with fever (6.1% vs. 24.4%), with diarrhea (7.3% vs. 23.1%), and with cough (37.7% vs. 52.4%). After the first month of the study, there was an increasein morbidity in the region, so those casesthat had been seen during the latter 3 months were reevaluated. The same trend was found: in the month following immunization there were significantly more infants with fever, diarrhea, and cough. There was no correlation between the incidence of these episodes and the age at vaccination.
lmmunogenicity of the Haemophilus lnfluenzae Type b Capsular Pol saccharide Conjugate Vaccine in Chi i dren After Systemic Haemophilus lnfluenzae Type b Infections
n
Kaplan, S.L., Zahradnik, J.M., Mason, E.O., & Dukes, C. (1988). The journal of Pediatrics, 113,
272-277.
C
hi&-en less than 18 months of age generally do not develop protective levels of antibody to the capsular polysaccharide of Haemapbdusinfzuenzaetype b after a systemic infection causedby this organism. In this study 24 patients (mean age, 15.2 months) were immunized with polyribosylribitol phosphate170
diphtheria toxoid conjugate vaccine (PRP-D) 2 months after a systemicHatmopbihs infEuenzaetype b infection. Children ~24 months of age were immunized twice. Results of this study confirmed similar, previous studies and concluded that the antibody responseto vaccination for eatients <18 months of age did not differ from that of healthy control children of a similar age and that the majority of children lessthan 18 months of age do not develop protective levels of anti-PRP after a systemic infection.
Group A Streptococcal Rapid Test: Antigen Detection After 18-24 Hours of Penicillin Therapy
n
Beach, Clinical
P.A.,
Balfour,
L., & Lucia,
H.L. (1989).
Pediatrics, 28, 6-l 0.
T
his study was conducted on 29 children, ages 19 months to 16 years, before and after 18 to 24 hours of oral penicillin therapy to confirm the rapid disappearanceof detectable pharyngeal antigen and to determine whether the antigen detectable by commercially available kits was excreted into the urine. At 18 to 24 hour follow-up, subjectsreported having taken 2 to 4 doses of penicillin. At 24 hours, specimens from ten patients (34%) were positive. Nine of the ten patients who exhibited a positive result &er antibiotic therapy reported taking three doses of medication; one had taken four. One patient who reported taking just two doses of penicillin reverted to negative. In no casewas the group A streptococcal antigen detected in the urine of infected persons before or &er initiation of therapy. This study emphasizesthe difficulty in accuratelydiagnosing group A beta-hemolytic streptococcus (GABHS) if penicillin has been taken before presentation. Clinical and physical findings are altered by even a single day of therapy. In summary, three of the currently available tests for GABHS, discussed in this study, are not dependable in detecting group A streptococcal pharyngitis after penicillin has been administered, even for a short period of time. JOURNAL OF PEDIATRIC HEALTH CARE