תוצאת חיפוש

Epidemiology of Invasive Hemophilus Influenzae B Infections in Bedouins and Jews; Conjugate Hib Vaccines

Limor Gortzak-Uzan*, Drora Fraser, Ron Dagan

Pediatric Infectious Disease Unit and Dept. of Epidemiology, Soroka Medical Center and Ben-Gurion University of the Negev, Beer Sheba

From 1989 to 1996, 139 cases of invasive Hemophilus influenzae B (Hib) infections were identified in children in the Negev, 110 of which occurred before introduction of the conjugate vaccine (1989-92). At that time there were 60.5 cases of Hib per 100,000 in the Negev among children under 5 years of age. During 1995-1996, when Hib conjugate vaccine was part of the regular immunization program, Hib decreased to 6.5 cases per 100,000 in that age group. The effectiveness of PRP-OMP vaccine was 96.5% among Jews and 89% among Bedouins, and the efficacy of the immunization program was 99.99%. This degree of success exceeded all expectations based on the literature. During the whole study period, Hib infections were more frequent among Bedouins than Jews. There was no significant difference in the occurrence of Hib among Jews in the Negev before and after the vaccine was introduced. Hib among Bedouins in the Negev was significantly more frequent than in the Israeli population as a whole before the vaccine was introduced. That gap narrowed after the vaccine was introduced because of the decrease in morbidity among the 2 groups.

* Medical student.

Diskitis in Brucellosis not Responsive to Anti-Brucella Treatment

D. Heldenberg, R. Sevi

Dept. of Pediatrics and Orthopedics A, Hillel Yaffe Medical Center, Hadera

A 14-year-old girl with fever and low back pain was diagnosed as having brucellosis and diskitis. Treatment with doxycycline and gentamicin had no effect nor was there any improvement when the treatment was changed to doxycycline and rifampicin. With cessation of this treatment and administration of cloxacillin fever was reduced and the back pain disappeared. After 12 days of IV cloxacillin, she was released from hospital with instructions to continue cloxacillin orally for another 4 weeks. We conclude that when a patient is suffering from brucellosis and diskitis and does not respond to the usual anti-brucellosis treatment, an anti-staphylococcal preparation should be added.

Six Cases of Acute Rheumatic Fever in One Year

George Habib, Ramiz Abu-Ahmad

Rheumatology Clinic and Dept. of Medicine, Nazareth Hospital; and Medical Dept. B, Carmel Medical Center, Haifa

During 1995, 6 cases of acute rheumatic fever were diagnosed here. Taking into account differences in total admissions, this appears to represent an increase over 1994. Most of the cases were males, with average age at diagnosis 19.5 years. All were of low socioeconomic status. 50% had cardiac involvement, and 1 needed treatment with corticosteroids. Most had pharyngeal symptoms prior to the acute attack, and 1 patient had 2 prior episodes of rheumatic fever. A thorough epidemiological study should be done in the Nazareth area to assess the real incidence of acute rheumatic fever, and to determine whether there is a true increase in incidence.