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U Heininger

Publications and source records attributed to U Heininger.

At least 19 recordsLinked to original sources
PubMed2006

Booster immunization with a hexavalent diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovirus vaccine and Haemophilus influenzae type b conjugate combination vaccine in the second year of life: safety, immunogenicity and persistence of antibody responses.

The immunogenicity and reactogenicity of booster vaccination with GSK Biologicals' hexavalent DTPa-HBV-IPV/Hib vaccine was assessed in toddlers aged 12-18 months previously primed with the same combination (N=341), or with DTPa-IPV/Hib and HBV administered separately (N=102; Trials 217744/059 and 217744/096). Antibody persistence at age 4-6 years was also assessed in children who had received a 4th consecutive dose of DTPa-HBV-IPV/Hib vaccine or separate DTPa-IPV/Hib and HBV vaccines in this study and in another study conducted under similar conditions in Germany. Prior to booster vaccination in the second year of life, antibody concentrations and seroprotection rates were similar irrespective of the primary vaccine used. One month after boosting with DTPa-HBV-IPV/Hib, substantial antibody increases were observed against all vaccine antigens indicative of previous immune priming. Seropositivity and booster response rates against all antigens were 97.4-100%. Reactogenicity following booster vaccination with DTPa-HBV-IPV/Hib was similar regardless of the primary regimen used. Three to four years after administration of the 4th DTPa-HBV-IPV/Hib dose, >90% vaccinees had persistent protective antibody concentrations against diphtheria, hepatitis B, Hib and the three poliovirus types. Anti-tetanus antibody concentrations were > or = 0.1 IU/ml in 76.4% subjects and seropositivity for pertussis antibodies ranged from 34.5% for PT to 98.9% for FHA. In conclusion, the combined hexavalent DTPa-HBV-IPV/Hib vaccine is immunogenic and safe when used for boosting in the second year of life, regardless of the primary vaccine used, and offers sustained protection during early childhood and beyond.

Child↗
PubMed2005

[Prevalence of perianal streptococcal dermatitis in children and adolescents].

Perianal streptococcal dermatitis (PSD), caused by group A beta-haemolytic streptococci (GABHS), is a frequently overlooked medical entity. We investigated the prevalence of PSD at the University Children's Hospital Basel, Switzerland, from October 2000 to May 2001. Two hundred fifty randomly selected patients were studied for signs of PSD by history, examination, and culture. In addition, a pharyngeal swab was taken for culture of GABHS. Perianal swabs were positive for GABHS in 12 patients (7 girls, 5 boys) resulting in a prevalence of 5%. A diagnosis of PSD was made in one further culture-negative patient with compatible history and clinical signs. Signs and symptoms of 13 patients with PSD were as follows: perianal redness (67%), obstipation (58%), painful defecation (50%), perianal itching (25%), and melaena (25%). Ten of 13 patients had one or more symptoms and were treated with an antibiotic: 7 with penicillin (50 000IE/kg/d) per os for 10 days, 3 patients received amoxicillin and clavulanic acid per os or intravenously for concomitant pneumonia (n=1) and urinary tract infections (n=2). Six of 10 patients responded to treatment and were also negative for perianal GABHS on followup. Four patients, however, required a second treatment cycle for persistence of symptoms: with oral penicillin for 14 days and oral clarithromycin for 10 days in 3 and 1 patients, respectively. One month later all 4 patients were free of symptoms and 3 were also negative for perianal GABHS. In 1 patient GABHS could still be cultured from the pharynx and the perianal region but was not retreated due to lack of symptoms. Three untreated patients remained asymptomatic on follow-up and were considered to be perianal carriers of GABHS. In conclusion, PSD was frequent in our study cohort; signs and symptoms of PSD should be searched for systematically in order to treat affected patients appropriately.

Adolescent↗
PubMed2005

Reporting of vaccine safety data in publications: systematic review.

PURPOSE: To assess current reporting practices of immunisation safety data in the scientific literature. METHODS: Systematic literature search for recent prospective clinical studies on vaccines in humans. The main outcome measures were methodological differences in the assessment, definition, analysis and presentation of 'adverse events following immunisation' (AEFI). RESULTS: In total, 182 published articles possibly satisfied defined inclusion criteria, of which 149 were included. Overall, the presentation of data on AEFI was inadequate: 45% of articles did not mention AEFI at all; if mentioned, case definitions of AEFI were not specified in the majority of articles; there was inconsistency of AEFI reporting between 'Methods' and 'Results' in up to 24% of articles; the observation period following immunisation and the method of follow-up with study subjects was not reported in 28% and 32% of studies respectively. CONCLUSIONS: We identified a lack of reporting of AEFI data as well as a heterogeneity of case definitions and methods for data collection, analysis and presentation of AEFI in recently published articles. Guidelines for standardised collection, analysis and publication of such data and standardised case definitions for AEFI are needed. Ideally, journal editors would agree on a minimum set of guidelines for structured presentation of vaccine safety data in publications.

Adverse Drug Reaction Reporting Systems↗
PubMed2005

The role of Bordetella infections in patients with acute exacerbation of chronic bronchitis.

BACKGROUND: Acute exacerbations of chronic bronchitis (AECB) are associated with a variety of viral and bacterial infectious agents, some of which are potentially preventable by immunization. Bordetella pertussis, which causes whooping cough, has not been studied in this context. We aimed to assess the role of Bordetella infections in patients with AECB. PATIENTS AND METHODS: Patients with AECB, who presented to participating private practices in Basel, Switzerland, between October 2000 and June 2002, were evaluated by a standardized questionnaire, nasopharyngeal swabs for culture (Bordetella spp.), and PCR (Bordetella spp. and selected other respiratory pathogens) and paired blood samples for serologic diagnosis of Bordetella infection. RESULTS: A total of 26 patients (34-86 years of age) were recruited. All culture and PCR samples were negative. Serology revealed Bordetella infection in eight (31%) patients. Duration of cough was shorter in patients with Bordetella infection compared to those without Bordetella infection (mean 15 days vs 41 days, p = 0.04). Cough > or = 21 days duration was present in three (43%) of seven patients with evidence of Bordetella infection compared to 17 (94%) of 18 controls (p = 0.012). Progression to convalescence from initial to follow-up visit after 4-6 weeks was comparable between both groups. CONCLUSION: Bordetella infections appear to play a significant role in AECB and preventive measurements such as immunization with acellular pertussis vaccines should be considered. Extended investigations are necessary to confirm our preliminary and provocative findings.

Adult↗
PubMed2004

Safety, reactogenicity and immunogenicity of a combined hexavalent tetanus, diphtheria, acellular pertussis, hepatitis B, inactivated poliovirus vaccine and Haemophilus influenzae type b conjugate vaccine, for primary immunization of infants.

Safety, reactogenicity and immunogenicity of GSK Biologicals' hexavalent DTPa-HBV-IPV/Hib vaccine (Infanrix)hexa) was assessed when used for primary vaccination at 3, 4 and 5 months of age (N = 2163), compared to the separate administration of DTPa-IPV/Hib and HBV vaccines (N = 720). A similar safety and reactogenicity profile was demonstrated for both vaccine regimens, as well as a good immune response for all antigen components. By offering protection against six diseases in a series of single injections, the hexavalent DTPa-HBV-IPV/Hib vaccine was shown to be a safe, well tolerated and immunogenic alternative to primary immunization with licensed separately administered vaccines.

Bacterial Capsules↗
PubMed2004

[Complications of infectious diseases and benefits of immunization].

Significant progress regarding hygiene, nutrition, and antimicrobial treatment as well as immunizations have lead to a significant decline of morbidity and mortality of infectious diseases in the recent past. Furthermore, immunizations are one of the most cost-effective tools for prevention. However, lack of perception of the substantial risks of complications associated with infectious diseases cause doubts about the necessity of immunizations today. This development is highly worrisome and needs to be adequately addressed by informing physicians and the public about the risks of vaccine-preventable diseases, efficiency, safety and benefits of available vaccines, as well as providing convincing arguments justifying current immunization recommendations. These activities are indispensable for successful implementation and continuation of current immunization programs.

Communicable Disease Control↗
PubMed2004

Influenza-associated myositis in children.

BACKGROUND: Influenza-associated myositis (IAM) is an infrequent and poorly known complication of influenza virus infection in children. The aim of this study was to describe five cases of IAM and to review the literature on IAM in children. PATIENTS AND METHODS: We conducted a retrospective analysis of cases of IAM diagnosed at two university children's hospitals in Switzerland during two consecutive influenza seasons. Findings were compared with 39 individual case reports and five publications summarizing an additional 272 cases identified by a medical online library (MEDLINE) search. RESULTS: Overall, 316 cases were analyzed. IAM typically occurred in school-aged children with a 2:1 male predominance. Influenza B and A viruses were identified in 76% and 24% of cases, respectively. The median interval between onset of influenza and onset of IAM was 3 days (range 0-18). The calf muscles were involved alone or together with other muscle groups in 69% and 31% of cases, respectively. Blood creatine phosphokinase (CPK) concentration was invariably elevated. Median duration to clinical recovery was 3 days (range 1-30). Rhabdomyolysis occurred in ten of 316 patients (3%), was more common in girls (80%), more often associated with influenza A (86%), and led to renal failure in eight patients (80%). CONCLUSION: Clinical and laboratory findings of IAM are highly characteristic and allow a rapid diagnosis during the influenza season.

Age of Onset↗
PubMed2003

Role of Chlamydia pneumoniae and Mycoplasma pneumoniae as causative agents of community-acquired pneumonia in hospitalised children and adolescents.

The aim of the study presented here was to determine the prevalence of Chlamydia pneumoniae versus Mycoplasma pneumoniae infections in paediatric patients with community-acquired pneumonia. A total of 50 patients (mean age, 5.5 years; median, 3.9 years) with community-acquired pneumonia were enrolled. Four patients were found to have Chlamydia pneumoniae infection (1 culture positive, 1 PCR positive and 2 serology positive) and 16 patients had Mycoplasma pneumoniae infection (2 PCR positive, 4 PCR and serology positive, 10 serology positive), including three patients with coinfection. The rates of Mycoplasma pneumoniae infection were 22%, 35% and 40% in children aged 1-3, >3-7 and >7 years, respectively. Acute Chlamydia pneumoniae infection was substantially less common than Mycoplasma pneumoniae infection in our study cohort.

Adolescent↗
PubMed2001

How to improve communication on vaccine issues at the national level? INFOVAC-PED: an example from Switzerland.

For physicians in private practice, rapid access to relevant and up-to-date objective information is required to better meet their clients' concerns on vaccine-related issues. To meet this need, INFOVAC-PED, an academic network of on call pediatric infectious diseases experts who can be reached free of charge at a central e-mail address, now answers Swiss physicians' questions within 24-48h. INFOVAC-PED also distributes monthly bulletins including news from the Federal Office of Public Health, vaccine producers, literature survey, and answers to most frequently asked questions. The rapid success of this novel initiative underlines the need to better support front line physicians.

Communication↗
PubMed2001

Diagnosis of acute haematogenous osteomyelitis and septic arthritis: 20 years experience at the University Children's Hospital Basel.

OBJECTIVE: To review the diagnostic experience with acute haematogenous osteomyelitis (AHOM) and/or septic arthritis at our institution. METHODS: Retrospective review of the medical records of those patients with a bacteriologically and/or radiologically confirmed diagnosis, hospitalised in the University Children's Hospital Basel, Switzerland between January 1980 and July 2000. RESULTS: 90 patients (61% males), 4 weeks to 14 years of age, met the inclusion criteria. Median duration of disease prior to hospitalisation was 3 days (range 0-14); 88% were admitted during the first week after onset of complaints. 81 patients received no antimicrobial therapy prior to hospitalisation and are the subject of this presentation. ESR (1st hour in mm; median 36; range 11-124), CRP (mg/l; median 64; range 0-221) and WBC (x 10(9)/l; median 13; range 5-34) were elevated in 100%, 82% and 58% of patients, respectively. Blood cultures (BC) and/or tissue cultures (TC) were performed in 79 (98%) patients. Overall, bacteria were isolated from 53 patients (65%) with Staph. aureus as the most frequent organism (n = 31; 50%). BC were performed in 67 patients and yielded 35 (52%) positive cultures; TC (n = 47) yielded 27 (57%) isolates. In 34 patients with both BC and TC performed, only 12 (35%) were positive in both tests. Diagnostic findings were observed in 23 (59%) of 39 plain radiographs, 31 (56%) of 55 sonograms, 39 (89%) of 44 99mTc-labeled bone scans and 4 (100%) of 4 MRI. 41 patients with diagnostic radiological findings had consecutive TC yielding 30 (73%) bacteriological isolates. Median duration of hospitalisation was 15 days (range 2-66). CONCLUSION: Our data indicate that the diagnostic procedures of choice should be 1) early bone scan or MRI, 2) BC and 3) TC. Of supportive laboratory parameters, ESR and CRP were most valuable in our hands.

Acute Disease↗
PubMed2001

Immunogenicity and reactogenicity of a single dose of a diphtheria--tetanus--acellular pertussis component vaccine (DTaP) compared to a diphtheria--tetanus toxoid (Td) and a diphtheria toxoid vaccine (d) in adults.

We compared immunogenicity and reactogenicity of a single dose of DTaP vaccine (containing tetanus and diphtheria toxoids and four acellular pertussis antigens) with conventional Td- or d-vaccines in 180 German adults. Antibody values against diphtheria and tetanus toxin and against the pertussis antigens fimbriae (FIM), filamentous hemagglutinin (FHA) and pertussis toxin (PT) were measured in pre- and post-immunization sera. Reactogenicity was determined by a patient diary card. Pre-immunization antibody values against diphtheria toxin were low in all three vaccine groups. After immunization, > or = 80% of the vaccinees in all three groups were fully protected (> or = 0.1 IU/ml), but geometric mean values were significantly higher in DTaP recipients compared to Td or d recipients (1.65 vs. 0.44 and 0.48, respectively; both P < 0.05). Pre-immunization antibody values against tetanus toxin were high in all three groups, and after immunization 100% of the vaccinees were protected (> or = 0.1 IU/ml). Furthermore, substantial antibody responses against pertussis antigens were elicited in DTaP recipients with geometric mean rises of 22.5, 4.1 and 7.5 for antibodies against FHA, fimbriae and PT, respectively. All three vaccines were well tolerated. Frequency and severity of local reactions were similar between DTaP and Td recipients and even less common in d recipients. Since DTaP did provide a significant boost of anti-pertussis antibodies and a significantly higher anti-diphtheria response than conventional Td vaccine without an increase of side effects, it might be an appropriate candidate for use in adults.

Adult↗