Fatal Anaphylactic Shock

Werne, J

doi:10.1001/jama.1946.02870260014003

Cited by 26 publications

(4 citation statements)

References 28 publications

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“…Three further doses of pertussis vaccine were given, each followed by progressively more severe exacerbations of the encephalitis, but an encephalitic episode also occurred unrelated to vaccination. It is also noteworthy that twins feature in several reports of neurological reactions after pertussis vaccination.10 11 [91][92][93][94] No significant progress seems to have been made in unravelling the problem since an annotation on encephalopathy and pertussis vaccination was published in1950.95 It stated that 4 to 7 0 of apparently normal children have a convulsion, mostly associated with pyrexial illnesses, before they are 5 years old, that 5 to 10'U of these convulsions are followed by epilepsy in later life, and that violent and local convulsions often leave cerebral sequelae, especially if the child is aged under 12 months. The annotation stated that the most puzzling are those encephalopathies encountered after prophylactic inoculations, which sometimes occur by chance, since there is at least one case of a child having a severe convulsion a quarter of an hour before a dose of vaccine was to have been given.…”

Section: Difficulties In Obtaining Adverse Reaction Reportsmentioning

confidence: 93%

Reactions after pertussis vaccine: a manufacturer's experiences and difficulties since 1964

Griffith¹

1978

BMJ

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Summary and conclusionsPertussis vaccines vary in quality, safety, and efficacy according to the production strains of Bordetella pertussis, the method of manufacture, and quality control procedures. It is therefore not justifiable to combine information on the incidence, nature, and severity of reactions after all manufacturers' pertussis vaccines as if they were a single product. Attempts were made to collect information on all suspected cases of severe reactions that occurred after administration of about 15 million doses of Wellcome pertussis vaccines in the United Kingdom and Northern Ireland from 1964 to mid-1977. Altogether six deaths, six neurological reactions with sequelae, and 17 convulsions without sequelae were reported, but some were clearly not attributable to the vaccine, while, in other cases, the available information was inadequate for assessing the role of vaccination. Neurological disorders, similar to those reported in a few children after pertussis vaccination, occur unexpectedly in apparently healthy infants at the recommended age for immunisation, so chance association between vaccination and these events can be expected in some children. The Joint Committee on Vaccination and Immunisation has made several recommendations aimed at reducing severe reactions after pertussis vaccination. These include replacing plain vaccine with aluminium-adsorbed vaccine, but there is no clear evidence that the aluminium-adsorbed vaccine produces fewer reactions than the plain.There are difficulties enough in deciding the cause of events that occur after vaccination, since these reactions often occur naturally in children of vaccination age. The task is made even harder by the assumption that various manufacturers' vaccines are the same and the lack of information available to manufacturers about cases in which their vaccine has been implicated. Information on vaccines administered is entered on immunisation records cards; it should be used and referred to if reactions occur.

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Section: Difficulties In Obtaining Adverse Reaction Reportsmentioning

confidence: 93%

Reactions after pertussis vaccine: a manufacturer's experiences and difficulties since 1964

Griffith¹

1978

BMJ

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“…In the protracted delayed reactions, the oral use of steroids is called for. 8. In severe delayed reactions to penicillin, the use of penicillinase, one intramuscular injection of 800,000 units, has proved very useful.…”

Section: Treatmentmentioning

confidence: 99%

Anaphylactic Drug Reactions

Kern¹

1962

JAMA

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“…An antigen-antibody response to previous specific sensitization has been suggested as a possible cause, but this is difficult to reconcile with the relatively large number of children who developed neurological sequelae following a first inoculation. It could well account, however, for some of the other cases-for instance, those of Werne and Garrow (1946), where necropsies "disclosed lesions consistent with death in anaphylactic shock." .2.…”

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confidence: 99%

“…(1954) considered that " most neurological illnesses which follow prophylactic inoculation are manifestations of hypersensitivity," and Brody (1947) favoured a sensitization phenomenon as an explanation in the two cases reported by him, pointing out that both had a family history of allergic disturbances. However, allergy was recorded in only two other instances in the reviewed cases: the father of twins reported by Werne and Garrow (1946) as having died within 20 hours of a second diphtheria-pertussis inoculation had had two episodes of angioneurotic oedema of the lip; and one of Kong's (1953) cases had a personal and family history of asthma and eczema. An antigen-antibody response to previous specific sensitization has been suggested as a possible cause, but this is difficult to reconcile with the relatively large number of children who developed neurological sequelae following a first inoculation.…”

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confidence: 99%

Neurological Complications of Pertussis Immunization

Berg¹

1958

BMJ

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Since Madsen (1933) first drew attention to the possibility of serious consequences following active immunization against whooping-cough, reports of neurological sequelae of such immunization have come from various parts of the world. These sequelae (post-inoculation poliQmyelitis is not being considered here) have ranged from transient convulsions with complete recovery to gross crippling, mental retardation, and death.A survey of the literature, greatly facilitated by Kong's (1953) At 15 months grand-mal episodes became associated with the original convulsive pattern, and it was found necessary to increase the dose of phenobarbitone to 1 gr. (65 mg.) daily, and introduce phenytoin sodium, 3 gr. (50 mg.) thrice daily.Electroencephalography on May 16, 1956 (aged 19+ months), was considered diagnostic of epilepsy with the epileptic activity generalized and no focus. The main activity was in the delta range and of high frequency.At 2 years of age no significant progress had been made mentally; fits were controlled with phenobarbitone, 1 gr. (65 mg.) twice daily, and primidone, 250 mg. twice daily; and there were no focal neurological signs.At 3 years the child remained grossly retarded mentally, with no speech or understanding of speech, inability to do anything for himself, and an I.Q. of 23 on the Griffiths mental development scale. Fits were less severe and were controlled with primidone, 250 mg. twice daily, alone. Localizing neurological signs were absent, as were signs of disease elsewhere.In the accompanying review of the literature, the 107 case reports from 25 sources mentioned in Table I were examined.

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Fatal Anaphylactic Shock

Cited by 26 publications

References 28 publications

Reactions after pertussis vaccine: a manufacturer's experiences and difficulties since 1964

Reactions after pertussis vaccine: a manufacturer's experiences and difficulties since 1964

Anaphylactic Drug Reactions

Neurological Complications of Pertussis Immunization

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