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Biomedical subjects

J Mertsola

Publications and source records attributed to J Mertsola.

108 records · Page 6Linked to original sources
PubMed1989

Acute otitis media and respiratory virus infections.

We studied the association of acute otitis media with different respiratory virus infections in a pediatric department on the basis of epidemics between 1980 and 1985. Altogether 4524 cases of acute otitis media were diagnosed. The diagnosis was confirmed by tympanocentesis in 3332 ears. Respiratory virus infection was diagnosed during the same period in 989 patients by detecting viral antigen in nasopharyngeal mucus. There was a significant correlation between acute otitis media and respiratory virus epidemics, especially respiratory syncytial virus epidemics. There was no significant correlation between outbreaks of other respiratory viruses and acute otitis media. Acute otitis media was diagnosed in 57% of respiratory syncytial virus, 35% of influenza A virus, 33% of parainfluenza type 3 virus, 30% of adenovirus, 28% of parainfluenza type 1 virus, 18% of influenza B virus and 10% of parainfluenza type 2 virus infections. These observations show a clear association of respiratory virus infections with acute otitis media. In this study on hospitalized children Haemophilus influenzae strains were the most common bacteriologic pathogens in middle ear fluid, occurring in 19% of cases. Streptococcus pneumoniae was present in 16% and Branhamella catarrhalis in 7% of cases. There was no association between specific viruses and bacteria observed in this study.

Female↗
PubMed1988

Adenovirus infection in families.

Eighteen families were followed up for four to six weeks after one member of each family was diagnosed as having an adenovirus infection. In 17 of 18 index cases the diagnosis was based on the rapid detection of adenovirus hexon antigen in the nasopharyngeal mucus specimens and in one case (the only adult index case) on isolation of the virus. All index cases had high temperatures associated most commonly with tonsillitis, acute otitis media, gastroenteritis, or febrile convulsions. In 14 of the 16 families with symptomatic contacts the index case was the first symptomatic case, or one of the first symptomatic cases, in that family. Fifteen (94%) of the siblings and 20 (56%) of the parents had signs and symptoms of acute infection during the follow up period. In 10 (63%) and eight (20%) of these cases, respectively, adenovirus was confirmed. The mean (SD) incubation period of confirmed adenovirus infections was 10 (3) days. The observations show that adenovirus infection spreads actively to other siblings in the family. Rapid diagnosis permits parents to be informed prospectively about the expected spread and clinical picture of the illness in the family.

Adenoviridae Infections↗
PubMed1986

C reactive protein in the evaluation of febrile illness.

We studied prospectively 154 febrile children to determine the diagnostic value of the quantitative serum C reactive protein concentrations (CRP). Children with acute otitis media, acute tonsillitis, or treated with antibiotics during the two previous weeks and infants less than 2 months of age were excluded. Ninety seven children were from private paediatric practice and 57 were patients who had been admitted to hospital. The comparison group consisted of 75 children with confirmed bacterial infections whose CRP values were recorded retrospectively. In the study group 35 (23%) children had a confirmed viral infection, 92 (59%) had a probable viral infection as judged from the clinical picture and outcome of the illness, and 27 (18%) had a bacterial or probable bacterial infection. When the duration of the disease was more than 12 hours and the CRP value less than 20 mg/l, all children had a confirmed or probable viral infection. Nine children (one from the study group and eight from the comparison group) were found to have a septic infection and a CRP value of 20 mg/l or less. In all these cases, however, the duration of the symptoms was less than 12 hours. In addition CRP less than or equal to 20 mg/l was found in five (14%) children with urinary tract infection in the comparison group. CRP values of 20-40 mg/l were recorded in children with both viral and bacterial infections. A CRP value greater than or equal to 40 mg/l detected 79% of bacterial infections with 90% specificity. Our data show that determination of serum CRP concentrations is a valuable tool in evaluating children who have been ill for more than 12 hours.

Adolescent↗
PubMed1986

Salbutamol in the treatment of whooping cough.

A double blind placebo-controlled study was performed to evaluate the efficacy of salbutamol in the treatment of 25 pertussis patients. The diminishing of paroxysmal cough in the treatment group did not differ significantly from that of the control group.

Adult↗
PubMed1985

Mixed outbreak of Bordetella pertussis and Bordetella parapertussis infection in Finland.

The epidemiology of whooping cough in a vaccinated population was studied during an outbreak of paroxysmal cough in an elementary school with 258 pupils in Turku, Finland. Nasopharyngeal specimens for isolation of Bordetella pertussis and/or sera for ELISA detection of antipertussis immunoglobulin M, A and G antibodies were taken from 94% of children who were prospectively followed for two months. Bordetella pertussis was isolated in six patients, and 17 culture-positive cases with Bordetella parapertussis were identified. Patients with Bordetella pertussis or Bordetella parapertussis were found simultaneously in the same classrooms. Comparison of immunoglobulin M responses to Bordetella pertussis and Bordetella parapertussis was used for differential diagnosis of these two infections. Twenty-six cases with pertussis and 27 cases with parapertussis were diagnosed. The results of this prospective study suggest that Bordetella parapertussis is a more common etiologic agent of mild respiratory tract infection among vaccinated school-aged children than is generally recognised. The possibility that Bordetella pertussis was converted to Bordetella parapertussis during this outbreak is discussed.

Antibodies, Bacterial↗
PubMed1985

Class-specific antibody response to lymphocytosis promoting factor (LPF) and fimbriae (F) in pertussis.

IgM, IgA and IgG antibodies to lymphocytosis promoting factor and fimbriae were measured by enzyme-linked immunoassay in seropositive and/or culture-positive patients without symptoms of pertussis, culture-negative patients with typical whooping cough symptoms, and culture-positive patients with typical symptoms. The culture-negative patients with typical symptoms had higher antibody levels in the first specimens and stronger responses to these antigens than the other patients. Antibody levels in the first specimens and antibody responses did not correlate with patients' age and duration of symptoms before taking of the first specimens. Thus, no correlation occurred between the symptoms of pertussis and antibody levels or antibody responses to fimbriae or lymphocytosis promoting factor. Bacteria were less likely to be isolated from those with strong antibody responses and this stresses the need of using both isolation and serology in the diagnosis of pertussis.

Adolescent↗
PubMed1985

A rapid and simple method for evaluation of serum opsonic capacity against Bordetella pertussis by chemiluminescence.

Serum opsonic capacity against Bordetella pertussis was studied by using quantitative chemiluminescence (CL) which is known to have several advantages over conventional methods in the evaluation of opsonization and phagocytosis. For opsonization, sera from whooping cough patients or from controls were incubated with killed B. pertussis cells at 37 degrees C for 30 min. Polymorphonuclear leukocytes, mononuclear cells or unfractionated leukocytes, all from healthy blood donors, were added to the opsonization mixture and CL emission was measured. Bacteria opsonized in diluted sera of whooping cough patients caused the activation of leukocytes manifested as a CL emission and no CL emission was observed when unopsonized B. pertussis was incubated with leukocytes. The opsonins could be detected by using any type of leukocyte preparation. Sera from adults vaccinated with DTP in the childhood gave rise to a large CL emission. Sera from whooping cough patients produced CL responses in more dilute solutions than those from vaccinated controls and sera from unvaccinated infants did not contain opsonins against B. pertussis. In unvaccinated infants suffering from whooping cough no opsonins were detectable in sera collected one week after the onset of the disease. However, the development of the opsonic capability against B. pertussis was observed in follow-up sera of all patients. The CL assay is simple, rapid, and reproducible offering new possibilities to evaluate humoral immune mechanisms and phagocytosis in whooping cough.

Adult↗
PubMed1984

Diagnosis of pertussis.

During a local outbreak of pertussis mainly involving school-children and adults, 71 patients with suspected whooping cough and 25 of their household contacts were studied in the course of 1 day so as to compare enzyme-linked immunosorbent assay (ELISA) with bacterial isolation in the diagnosis of pertussis. Serum samples and two nasopharyngeal swabs were collected from all persons. Five different culture media were used. Twenty-eight cases were diagnosed within 2 days by measuring IgM- and IgA-class antibodies to Bordetella pertussis in the first serum samples of patients. Fifty cases were identified when paired serum samples were used. Cultures were positive in only nine patients. The results show that ELISA is a valuable aid in the diagnosis of pertussis in patients with negative cultures.

Adolescent↗
PubMed1984

An outbreak of Yersinia pseudotuberculosis infection.

Nineteen patients were involved in an outbreak of infection caused by Yersinia pseudotuberculosis serotype 3. No epidemics attributable to this microorganism have been previously reported; the most extensive known cluster of cases involved four children in one family and their pet dog. The key finding in the outbreak described in the present study was the bacteriologic identification of serotype 3 in stool specimens from patients with clinically typical yersiniosis. Twelve cases were identified by isolation of Y pseudotuberculosis from stool specimens. An ELISA permitted serological diagnosis of the remaining seven cases. The antibody response was unusually slow in some patients. A noteworthy feature of the outbreak was the high incidence of postinfection complications, which developed in 10 of 19 patients. In spite of active screening of the respective families and environments of the patients, no transmitting factor was found, and the precise source of the infection remains unknown.

Adolescent↗
PubMed1983

Intrafamilial spread of pertussis.

Intrafamilial spread of pertussis was evaluated in 21 families (97 individuals) of patients with whooping cough diagnosed by culture or by ELISA serology. During follow-up (average six months), an infectivity rate of 83% was established by an ELISA within these families. However, 46% of the secondary cases were asymptomatic. Most of the asymptomatic cases were in adults or vaccinated children. Unvaccinated infants had classic whooping cough and were exposed to pertussis by their vaccinated siblings or parents. The incidence of classic symptoms of pertussis decreased with age, and atypical pertussis was usually culture negative but rapidly diagnosed by measurement of the IgM- and IgA-class antibodies by ELISA.

Adolescent↗
PubMed1983

Serologic diagnosis of pertussis: comparison of enzyme-linked immunosorbent assay and bacterial agglutination.

An enzyme-linked immunosorbent assay (ELISA) and bacterial agglutination (BA) method for determining the presence of antibodies to Bordetella pertussis were compared on serum samples from 21 patients with whooping cough and their 76 family members. The overall diagnostic agreement between the two methods was 77%. The data for BA-detected antibodies correlated best with IgG and IgA antibodies to B. pertussis. All of the culture-positive patients showed serologic positivity in both assays during the follow-up. Pertussis was diagnosed by ELISA in most cases from the first serum sample. Both methods proved to be good diagnostic aids in culture-negative patients, although the value of BA is more retrospective because of the need for paired sera. The kinetics of IgM, IgA, IgG, and agglutinating antibodies to B. pertussis is presented.

Adolescent↗
PubMed1982

Current status of pertussis and pertussis vaccination in Finland.

The pertussis vaccination programme was started in Finland in 1952. Since then the incidence of the disease has decreased. No major epidemics have occurred during the last two decades. The majority of the patients with pertussis are children of school age. Their disease is characterized by prolonged cough without whooping and it is difficult to diagnose. The patients with atypical pertussis are, however, the major reservoir for transmission of the disease to young infants, in whom it can be serious. Recently developed ELISA for measuring antipertussis IgM and IgA antibodies is a valuable aid in the diagnosis of these cases. Pertussis vaccination has been a subject of considerable controversy in recent years. The vaccine used in Finland has proved to be safe and effective. This observation emphasizes the need for careful comparison of the vaccines used in different countries.

Adolescent↗
PubMedDate not supplied

Rapid identification of Bordetella pertussis pertactin gene variants using LightCycler real-time polymerase chain reaction combined with melting curve analysis and gel electrophoresis.

Recently, eight allelic variants of the pertactin gene (prn1-8) have been characterized in Bordetella pertussis strains isolated in Europe and the United States. It has been suggested that the divergence of the pertactin types of clinical isolates from those of the B. pertussis vaccine strains is a result of vaccine-driven evolution. Sequencing of the prn, which is relatively time-consuming, has so far been the only method for the differentiation of prn types. We have developed a rapid real-time polymerase chain reaction assay suitable for large-scale screening of the prn type of the circulating strains. This method correctly identified the prn type of all tested 41 clinical isolates and two Finnish vaccine strains. The method is simple and reliable and provides an alternative for sequencing in pertussis research.

Amino Acid Sequence↗