1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-7-42-b 10.15844/pedneurbriefs-7-6-3 Infectious Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Severe Reactions to DTP Vaccine http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 06 1993 01 07 2016 7 6 42 43 Copyright: © 1993 The Author(s) 1993 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Severe reactions associated with diphtheria-tetanus-pertussis vaccine: detailed study of children with seizures, hypotonic-hyporesponsive episodes, high fevers, and persistent crying

Severe reactions experienced by 60 children within 48 hours of DTP immunization were reported from the UCLA School of Medicine, Los Angeles, CA.

 Hamster Ovary Cell Neurologic Sequelae Pertussis Toxin

Severe reactions experienced by 60 children within 48 hours of DTP immunization were reported from the UCLA School of Medicine, Los Angeles, CA. These included seizures in 40 or 66% (6 with fever >40.5°C), collapse episodes in 14, and persistent crying in 6. Subjects with encephalopathy were not included in the study. Those with seizures had a high rate of personal and family histories of seizures, and 10% were afebrile. Chinese hamster ovary cell assays failed to reveal active pertussis toxin in acute sera. Long-term follow-up for possible neurologic sequelae was not performed. [1]

COMMENT. Seizures induced by pertussis immunization and fever are more severe than simple febrile seizures. Cherry JD and associates report that a first febrile convulsion within 3 or 7 days of pertussis immunization is more likely to last longer than 10 minutes, to be recurrent, and to have a focal pattern when compared to first seizures occurring more than 7 days after immunization [2]. They have estimated that one in a 1000 children immunized will have a seizure, and 6% of first febrile seizures are associated with pertussis immunization. The use of acellular DTP vaccines, recently approved by the FDA, may hopefully reduce the frequency and severity of neurological complications.

 Blumberg DA Lewis K Mink CM Christenson PD Chatfield P Cherry JD Severe reactions associated with diphtheria-tetanus-pertussis vaccine: detailed study of children with seizures, hypotonic-hyporesponsive episodes, high fevers, and persistent crying Pediatrics 1993 Jun 91 6 1158 65 8502521 Cherry JD Holtzman AE Shields WD Buch D Nielsen C Jacobsen V Pertussis immunization and characteristics related to first seizures in infants and children J Pediatr 1993 Jun 122 6 900 3 8501566 10.1016/S0022-3476(09)90014-2