Search PubMed⌕ Search

Biomedical subjects

P E Slater

Publications and source records attributed to P E Slater.

At least 19 recordsLinked to original sources
PubMed1999

Clinical manifestations of Bordetella pertussis infection in immunized children and young adults.

STUDY OBJECTIVES: The incidence and prevalence of pertussis in adults have increased in recent years. It has been shown that previously immunized adults and adolescents are the main sources of transmission of Bordetella pertussis. The aim of this study was to describe the clinical presentation and the clinical course of pertussis in children and young adults who were immunized previously against B pertussis. DESIGN: Retrospective study. SUBJECTS: Children and young adults who were reported by local physicians to the Department of Epidemiology in the Israeli Ministry of Health with serologically confirmed pertussis and who were immunized previously were included. Information sought included personal data, epidemiologic data, signs and symptoms, laboratory results, initial diagnosis, and treatment. RESULTS: In the 95 previously immunized patients with serologically confirmed pertussis (mean age [+/- SD], 8.9 +/- 4.4 years old; range, 5 to 30 years old), the mean duration from onset of symptoms until the final diagnosis of pertussis was 23 +/- 15 days. The disease was usually atypical and generally mild. All the described patients had cough, usually prolonged, lasting 4 +/- 3.6 weeks. Only 6% had the classic whoop. The mean WBC count was 8.7 +/- 2.6 cells/mm6, and the lymphocyte count was 40 +/- 12%. Two patients were admitted to the hospital for severe pneumonia. Among the reported cases, the proportion of patients between the ages of 10 and 45 years increased from 6.5% during the period from 1971 to 1980, to 26% during the period from 1980 to 1990, and to 38% during a 1989 outbreak. CONCLUSIONS: Pertussis in previously immunized individuals is usually characterized by an atypical and relatively mild clinical course. Patients suffer mainly from a prolonged and persistent cough. Early diagnosis may lead to prompt administration of therapy. Prophylaxis of exposed persons might be effective in decreasing both severity and transmission of the disease.

Adolescent↗
PubMed1997

Screening for thyroid abnormalities among immigrants to Israel from the former USSR.

The exposure of some former Soviet citizens to radiation following the 1986 Chernobyl disaster has raised the question of the need to enroll these individuals in screening programs for thyroid abnormalities upon their immigration to Israel. Since screening programs have many drawbacks, and screening for thyroid disease has never been shown to decrease mortality or to improve survival, we are of the opinion that the establishment of thyroid screening programs will do more harm than good. The timely diagnosis of the very small excess in benign and malignant thyroid disease to be anticipated among the immigrants can be achieved in the community by the primary care physician armed with specific knowledge of the risks and the initial diagnostic approaches to suspected thyroid disease as well as information on the availability of specialist backup.

Emigration and Immigration↗
PubMed1996

International epidemiological and microbiological study of outbreak of Salmonella agona infection from a ready to eat savoury snack--II: Israel.

OBJECTIVES: To explain an increase in the incidence of salmonellosis caused by Salmonella agona in Israel between October 1994 and January 1995 in the light of an outbreak of S agona phage type 15 infection in England and Wales caused by consumption of a ready to eat savoury snack produced in Israel. DESIGN: Epidemiology of S agona in 1994-5 was analysed and two consecutive, case-control studies of 32 and 26 case-control pairs were performed. Phage typing and molecular methods were used to characterise strains of S agona isolated from cases and samples of the snack in Israel and England and Wales. RESULTS: The increase in the incidence of S agona between October 1994 and January 1995 was countrywide. Cases of infection with group B salmonella increased from 60% to 80% in children under 5 years old. In both case-control studies, cases consumed more of the snack than did controls (4.25 v 2.94 packets per week in the first study (P = 0.086) and 4.04 v 2.37 packets per week in the second study (P = 0.034)). When the two studies were combined there was a significant dose-response relation for the number of packets consumed weekly. Compared with consumption of less than two packets, the odds ratio was 1.43 for between two and six packets and 3.37 for seven or more packets (chi 2 for trend = 5.27, P = 0.02) S agona phage type 15 was isolated from a packet of the snack sold in Israel, and the strain was identical with those isolated from packets and cases in Israel and England and Wales. CONCLUSIONS: This outbreak of S agona was caused by the contamination of a snack produced in Israel. Even under modern operating conditions, large, widespread international outbreaks of foodborne disease can occur. The success of this investigation resulted from excellent international collaboration between public health authorities.

Case-Control Studies↗
PubMed1996

Control of rubella in Israel: progress and challenge.

Despite a high-compliance school girl rubella immunization program since 1973 and a program for the immunization of women of childbearing age since 1980, sporadic cases of the congenital rubella syndrome (CRS) continue to occur in Israel, particularly following rubella epidemics. At highest risk for a child with CRS are unimmunized Arab women and immigrants from Ethiopia, although CRS has also occurred in infants of immunized non-immigrant women. In order to make progress towards the elimination of congenital rubella, the Israel Ministry of Health has incorporated into its rubella immunization program the intermediate goal of interrupting endemic rubella transmission in the country. To this end, universal rubella vaccination at age one began in 1989, a second dose at age six years was introduced in 1994, inclusion of boys in the program aimed at 12-year-olds began in late 1995, and catch-up campaigns to immunize never-immunized children, boys and girls, are planned. Moreover, women of childbearing age will be encouraged to receive a second dose of rubella vaccine. While the WHO goal of no indigenous CRS by the year 2000 will not be met, it is expected that in the coming decade substantial additional progress towards the elimination of CRS will be made.

Adolescent↗
PubMed1995

Absence of an association between rubella vaccination and arthritis in underimmune postpartum women.

In a double-blind historical cohort study, 485 underimmune women who received rubella vaccine post-partum during 1985-1990 and 493 controls matched for age, place of residence and date of delivery were queried by phone concerning joint complaints following the pregnancy in question. Those reporting joint symptoms were invited for a personal interview at which joint symptoms and dates of their occurrence were explored in detail. Nineteen women in the vaccinated group (3.9%) and 16 from the control group (3.2%) were judged to have had joint symptoms compatible with the study definition of arthritis. The difference was not statistically significant. Thus, we were unable to find evidence for an association between rubella vaccination of underimmune adult women vaccinated post-partum and the subsequent development of arthritis. Rubella vaccine should continue to be used to immunize susceptible adult women against rubella in order to further the goal of elimination of the congenital rubella syndrome.

Adolescent↗
PubMed1995

Decay of maternally derived measles antibody in a highly vaccinated population in southern Israel.

The introduction of live attenuated measles vaccine in Israel during 1967 dramatically decreased the incidence of measles. However, cases still occur in periodic outbreaks and epidemics, with an increasing proportion of infants and children younger than 2 years of age. We examined the decay of maternally derived measles antibody during the first year of life in the Jewish population of Israel which represents a highly vaccinated population with immunization rates exceeding 90%. We used sera of healthy full term infants born in 1988 and 1989. Fifty specimens for each of the following age groups were used: 0 (cord blood), 2, 4, 6, 7 and 12 months. Three assays for each specimen were used: enzyme-linked immunosorbent assay (ELISA); hemagglutination-inhibition test (HI); and neutralization test (NT). Good correlation among all 3 tests was found. All cord blood specimens were positive by at least 2 assays. Seropositivity rates declined rapidly with age. Fifty percent of all 4-month-old infants and < 30% of all 6-month-old infants were positive by 1 test or more; at 12 months of age none of the tested specimens was positive by HI or NT and only 1 of 50 infants was positive by ELISA. In infants younger than 6 months of age, 5 (22%) of 23 specimens negative both by ELISA and by HI were positive by NT, but in 6-month-olds, only 2 (7%) of 28 negative by ELISA and HI were positive by NT, and in 12-month-olds none was positive. The results from southern Israel are similar to those obtained in North America and provide evidence that infants older than 6 months of age in a well-immunized population may be poorly protected against measles. On the basis of this information and epidemiologic data, the Israel Ministry of Health has recommended lowering the immunization age for measles, mumps and rubella from 15 months to 12 months.

Antibodies, Viral↗
PubMed1995

How many HIV infections are there in Israel? Reconstructing HIV incidence from AIDS case reporting.

BACKGROUND: The reporting of AIDS cases to Israel's Ministry of Health is believed to be accurate, but the completeness of HIV surveillance is unknown. We implement a model that reconstructs HIV incidence in Israel from AIDS case reports excluding Ethiopian immigrants. METHODS: We apply the well-known method of backcalculation to AIDS cases reported to the Ministry of Health. The data are adjusted statistically to account for reporting delays and the elimination of AIDS Related Complex reporting. The analysis also accounts for the impact of differential administration of antiretroviral therapy to HIV-infected persons over time. RESULTS: Excluding Ethiopian immigrants, we find that the cumulative number of HIV infections reported to the Ministry of Health through December 1993 (1,011) is not statistically different from the model's estimate of 922 (z = 1.04; p = 0.30), though the reported number of new infections in recent years exceeds the modeleted rate. CONCLUSIONS: The low HIV incidence estimated among non-Ethiopian Israelis is consistent with other studies of sexually transmitted diseases and HIV-related risky behavior in Israel. This result counters the hypothesis that an explosive HIV epidemic will occur. That the number of recently reported new infections exceeds the estimate from the model could indicate that the reporting system is catching up with the extant spread of disease, or that the model is missing some aspect of the dynamics of HIV in Israel. We suggest that comparing future annual HIV incidence rates to the model's upper bound of 80 infections per year will enable resolution of this issue over time.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Underutilization of influenza vaccine in Jerusalem.

BACKGROUND: Influenza is an annual winter disease which causes considerable morbidity in the general population and may be lethal in defined high-risk groups. A killed vaccine, recommended for the high-risk groups as well as for several occupational categories, is moderately protective against the disease, but vaccine sales suggest that use is low. METHODS AND RESULTS: In a hospital-based convenience survey of 295 persons belonging to groups for whom influenza vaccine is recommended, 78 (26.4%) reported having received the vaccine in 1989, and 74 (25.1%) in 1990. All vaccine recipients belonged to the 244 subjects eligible because of advanced age and/or chronic illness, giving vaccination rates in this group of 32.0% in 1989 and 30.3% in 1990. None of the 51 hospital doctors and nurses interviewed had received vaccine. Among the 244 eligible because of age or illness, vaccine receipt in 1990 was related to older age and number of risk factors, but even in subjects with three separate indications for receipt of vaccine, the vaccination rate was only 48%. Among persons advised by anyone to have influenza vaccine, 62.7% received vaccine in at least one of the two years, compared to a rate of 16.4% among subjects never advised to be vaccinated. Vaccine recommendation by a medical professional increased the vaccination rate to 69.3%. CONCLUSIONS: Influenza vaccine uptake in vaccine eligibles in Jerusalem is low, about 30% in the sick and elderly and considerably lower in medical personnel. Since influenza vaccination can save lives, it would be worthwhile to convince the medical profession to enthusiastically recommend this vaccine to high risk individuals and to explore novel ways of increasing uptake in the high-high risk groups such as persons in hospital or those residing in institutions.

Adolescent↗
PubMed1993

Forty years of meningococcal disease in Israel: 1951-1990.

Meningococcal disease accounts for approximately 20% of cases of bacterial meningitis in Israel. During the period 1951-1990, the annual incidence of meningococcal disease rarely exceeded two cases per 100,000 persons and was generally higher among non-Jews (largely the Arab population) than among Jews; there were some notable peaks of disease activity during 1963-1967, 1975, and 1987-1988. The highest incidence was among infants and young children, with a slight male predominance. The main period of disease activity was from January to April, but an unusual secondary peak in July coincided with the onset of peak summer temperatures. Monthly disease frequencies were significantly correlated with relative humidity. Incidence rates varied between regions and were lower in cities than in smaller settlements. Overall case-fatality rates decreased to approximately 11% for the period 1981-1990. Outbreaks were infrequent and tended to be small. Meningococci of serogroup B have dominated since the mid-1970s. Group A meningococci were isolated significantly more commonly from Arabs (26.26%) than from Jews (1.03%; P < .000001). The frequency with which group A organisms occurred among clinical isolates appeared to follow a more or less cyclical pattern.

Adolescent↗
PubMed1993

[Epidemiology of Hansen's disease in Israel].

There are currently 200 patients with Hansen's disease in Israel who are being followed by the Hansen's Disease Government Hospital and the Ministry of Health (prevalence 4.4/100,000). Most of them immigrated from countries where the disease is endemic. Dermatological findings dominated the initial clinical picture, although 5% of patients are asymptomatic contacts of known cases. Age at onset of disease was less than 20 years in 1/4 of the cases. The incidence in Israel is falling: 0.4/100,000 in 1985-89 compared to 3.6/100,000 in 1950-54. Neurologic and dermatologic findings in an immigrant of any age originating from countries where Hansen's disease is endemic, should prompt appropriate diagnostic evaluation, even years after immigration to Israel. Contacts of known cases of Hansen's disease should be aggressively screened, even if asymptomatic.

Age Factors↗
PubMed1993

The epidemiology of adult AIDS and HIV infection in Israel.

Between 1980 and 1992, 227 AIDS cases and 1,010 HIV seropositives were diagnosed in Israel, 222 AIDS cases and 965 seropositives occurring in persons aged 13 years and older. Among the AIDS cases, the predominant risk groups were male homo/bisexuals, intravenous drug abusers (IVDAs) and hemophiliacs. Among the seropositives, the predominant risk group comprised men and women originating in countries characterized by pattern II transmission; however, among nonimmigrants, male homo/bisexuals, IVDAs and hemophiliacs predominated. In recent years, there has been a gradual fall in the number of new seropositives among homosexuals and drug abusers, and the appearance of seropositive hemophiliacs has ceased. The spread of HIV infection in the indigenous heterosexual population has been negligible.

Acquired Immunodeficiency Syndrome↗