Quiz 2 Part 1 Immunization

HPV Statistics

No test for HPV Know your partner before you have unprotected sexual activity with this person. 360,000 persons in the U>S. get genital warts every year. + 11,000 women get cervical cancer in the U.S. every year.

Tdap Vaccine Risks

Risks: Pain where the shot was given. Redness or swelling at the injection site. Mild fever 100 degrees F. Headache, Fatigue, Nausea, Vomiting, diarrhea, stomach ache, Chills, sore joints, body aches. Rash, swollen glands, fainting seizures.

Influenza1918 Pandemic (H1N1virus)

1918 Pandemic (H1N1) Most severe pandemic in recent history. Cause: H1N1 virus with genes of avian origin. First identified in the U.S. in military personnel in the spring of 1918. 500 million people (1/3 of the world population) were infected with the virus Number of deaths were estimated at 50 million world wide, U.S. deaths were about 675,000. 1930's Influenza virus isolated from people proving that influenza is caused by a virus not a bacterium. 1968 New H3N2 influenza virus causes a pandemic, 100,00 deaths in the U.S. a million deaths worldwide, in people over 65yrs. still in circulation today.

Influenza 1970's - 1999

1970's H1N1(Swine Flu) outbreak at Ft. Dix, N.J. The CDC vaccinates 25% of the U.S. population (48 million) people. Vaccination program stopped because of cases of Guillium Barre`syndrome. 1996 Avian flu (H5N1) isolated in a farmed goose in China. 1997 First human (H5N1) infection identified in Hong Kong. 1997 FluNet developed to track Flu viruses globally. 1999 Avian and Swine flu identified in pigs dominate flu virus in pigs in 1999 1999 neuroaminidase inhibitors oseltamivir (Tamilflu) and zanamivir (Relenza) are licensed to treat flu.

Influenza 2007 - 2012

2007 Food and Drug Administration approves fist U.S. vaccine for people against the avian flu A(H5N1). 2009 New H1N1 virus is detected in the U.S. June 11, World Health Organization declares 2009 H1N1 outbreak a pandemic. Rapid immunoassays can detect flu in 15 minutes in the health care providers' office. October 2009 Monavalvalent H1N1 pandemic vaccine is administered. August 2010 WHO declares end to 2009 flu pandemic, recommends that children 6 mons and older be vaccinated. 2012 WHO recommends a quadrivalent vaccine. FDA approves permvir (Rapivab) to treat flu in adults (Intravenous medication)

Influenza 2017+

2017 CDC update Guidelines recommends use of non pharmaceutical measures to help prevent a Pandemic of Flu based of scientific evidence. Stay home when sick Cover a cough or sneeze. (use your elbow to catch you cough or sneeze) Wash your hands frequently. Influenza: Adults - 1dose annually preferably before the beginning of the Flu season every Fall. Children: Regular Flu vaccine at 6 mons. Flu researchers study the strains of flu virus around the world and prepare a vaccine for the population in the United States based on this research. Haemophilus influenza, type b (Hib) Strep B: 1st dose 2 mons, 2nd dose 4 mons, 3rd or 4th dose 12-15 mons.

Smallpox

As late as the 18th Century (1700's) Smallpox killed 400,00 people annually. One third of the survivors went blind. Case fatality rate was 20-60% in adults for infants was 80-98%. Survivors were left with disfiguring scars. The "Good News" was that if you survived you were immune. Inoculation / Variolation was practiced in China, India, and the Continent of Africa long before it was in Europe in the 18th century used smallpox to inoculate older children and adults.

Chickenpox

Chickenpox is a very contagious disease caused by the varicella virus (VZV). Symptoms: a blister -rash , itching, fatigue, loss of appetite and fever. The rash appears on the abdomen and can spread over the entire body including inside the mouth, eyelids, or genital area. Individuals with comprised immune systems due to HIV/AIDES, cancer, transplants, Chemotherapy, or immunosuppressive medications or long term steroid therapy may develop life threatening complications: Complications: bacterial infections- Group A Strep infections, pneumonia, infection /inflammation of the brain, bleeding/sepsis, dehydration. These may prove fatal. Vaccine: 1st dose 12-16 mos. 2nd dose 4-6 years. Adults 1-2 doses 19-55 years.

MMR

Congenital Rubella Syndrome: growth retardation, cataracts, deafness, congenital heart defects, cognitive disability. Children born with CRS require a lot of support to achive developmental goals and may require life long support. It is important for women to know if they are protected form Rubella before getting pregnant. Once pregnancy is confirmed the healthcare provider will order a rubella titer to confirm that the women is protected form Rubella.

Smallpox 2

Edward Jenner observed that milk maids in England had beautiful complexions and no scars from Smallpox. The milk maids, however had cowpox on their hands as a result of milking cows. 1796 Jenner inoculated James Phipps , a young boy. Phipps was ill for 10 days and recovered. When Jenner inoculated him with Smallpox no disease developed. Today we do not vaccinate for Smallpox because the disease has been eradicated and so children no longer receive a vaccine for Smallpox.

Hepatitis B Disease & Vaccine

Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. Virus is transmitted through blood and other body fluid contact with an infected person. The virus can survive outside the body for at least 7 days. Hep B causes a potentially life-threatening liver infection, putting people at high risk for cancer and cirrhosis. Symptoms: yellowing of the skin and eyes, dark urine and extreme fatigue. Nausea and vomiting, abdominal pain, acute liver failure = fatal. . The Vaccine: given Hepatitis B: Birth -1st dose, 1month -2nd dose, 6-18 months - 3rddose, 95% effective.

Meningitis 4

Initial diagnosis of meningococcal meningitis can be made by clinical examination followed by a lumbar puncture showing a purulent spinal fluid. The bacteria can sometimes be seen in microscopic examinations of the spinal fluid. The diagnosis is supported or confirmed by growing the bacteria from specimens of spinal fluid or blood, by agglutination tests or by polymerase chain reaction (PCR). The identification of the serogroups and susceptibility testing to antibiotics are important to define control measures. Viewed as a medical emergency. Admission to a hospital or health center is necessary. Isolation of the patient is not necessary. Appropriate antibiotic treatment must be started as soon as possible, ideally after the lumbar puncture has been carried out if such a puncture can be performed immediately. If treatment is started prior to the lumbar puncture it may be difficult to grow the bacteria from the spinal fluid and confirm the diagnosis. However confirmation of the diagnosis should not delay treatment. A range of antibiotics can treat the infection, including penicillin, ampicillin and ceftriaxone. Under epidemic conditions in Africa in areas with limited health infrastructure and resources, ceftriaxone (Ceftin) is the drug of choice.

MMR-Measles (Rubeola)

Measles: infection of the respiratory system. Symptoms include: fever, cough, red eyes, and a generalized macular papular, erythematous rash. Virus is highly contagious, spread through coughing and sneezing via close personal contact, or direct contact with secretions. Children who have measles must stay home from school, until the rash fades away. If you have had the disease you have some immunity to the strain of the virus that you had, but not other strains of the virus. Vaccine: 1st dose given at 12 mons, 2nd dose give at 4-6 years of age. Adults 19-55 years of age -2 doses. Adults: 1-2 doses age 19-55 years.

Meningitis

Meningococcal meningitis is a rare but serious bacterial infection. It causes the membranes that cover the brain and spinal cord to become inflamed. Each year, approximately 1,000 people in the U.S. get meningococcal disease, which includes meningitis and septicemia (blood infection).Usually has a more sudden onset and is a more severe illness than viral meningitis. Meningococcal infection may cause: meningitis- inflammation of the brain and spinal cord and the coverings that surround them. sepsis - an infection of the blood. Meningococcal vaccine: Adults 1 or more doses life time. Additional information can be found on the Centers for Disease Control Website. www.CDC.gov

Genital Human Papillomavirus (HPV)

Most commonly sexually transmitted infection in the U.S. Most sexually active men and women get it at some point in their lives. There are many different types of HPV. Some types cause genital warts and cancer. Some types can be prevented by a vaccine. HPV is spread through oral, vaginal, or anal sex with someone who has the virus. The infected person may have no symptoms. HPV can cause cervical, vaginal, vulular, penial, or anal cancers. Also cancer of the throat, tongue, and tonsils, (oropharyngeal cancer). HPV vaccines safe and effective. Males & Females 1st dose age 13-15 years, 2nd dose 19-21 years, 3rd dose 22-26 years. HPV-2 Females only, HVP-4 Females and Males.

MMR-Mumps (Parotitis)

Mumps: a contagious disease that passes from one person to another via through saliva, nasal secretions and close personal contact. If you have mumps the cardinal symptom is swelling of the salivary glands in the face, fever, headache, muscle aches, fatigue, and loss of appetite. Symptoms appear 12-25 days after exposure. (Chipmunk appearance) Adult males not exposed to the disease as children, who contact the disease as adults can develop Orchitis and become sterile as a result of the disease. Adult females who are pregnant may miscarry as a result of having the disease. A common childhood disease. 30-40 % of infected individuals will not develop symptoms. Permanent hearing loss in 5/10,000 persons. Vaccine has been available since the early 1960's , 1st dose 12-16mons, 2nd dose 4-6 years. Adults: 1-2 doses 19-55 years.

Tdap (Tetanus, Diphtheria, Pertussis) VIS

Pertussis (Whooping Cough): spread from person to person through secretions from and sneezing and coughing. Symptoms: severe coughing spells, difficulty breathing, vomiting, disturbed sleep. Can lead to weight loss incontinence, and rib fractures, can be fatal to infants, can lead to pneumonia, and death in adolescents and adults. Vaccine: given as per pervious with Tetanus, and Diphtheria. Additional Tdap at 11-12 years. There were as many as 200,000 cases of pertussis, and hundreds cases of tetanus were reported in the United States each year. Tetanus-Diphtheria booster should be given every ten years. It is recommended that Healthcare workers and Grandparents get a Tdap if they are around newborns and very young children.

Poliovirus aka (Poliomyelitis)

Poliovirus is an enterovirus. Infection enters the body via the fecal-oral meaning that the person ingests the virus an viral replication occurs in the digestive tract. The virus is shed in the feces of infected individuals. Symptoms: fever, headache, sore throat. Most people recover from this with no permanent problems within a few days. Paralytic Poliomyelitis occurs in less than 1% of poliovirus infections. Paralytic disease occurs when the virus enters the Central Nervous System. And replicates in motor neurons within the spinal cord, brain stem, or motor cortex, leading to temporary or permanent paralysis. Can cause respiratory arrest and death in some cases. Vaccine: 1st dose 2 mons, 2nd dose 4 mons, 3rd dose 6-18 mons, 4thdose 4-6 years.

Why Immunize?

Protect children from preventable diseases. Protect children from serious illness and complications vaccine-preventable diseases. Prevent outbreaks of preventable diseases. Vaccination is safe and effective. Vaccination has lead to a decline in the number of U.S. cases of infectious diseases. The Academy of Pediatrics, the American Academy of Family Physicians and the Centers for Disease control recommend vaccination as a way to protect children. Vaccinations can save you time and money as a parent.

MMR-German Measles (Rubella)

Rubella: aka German measles, 3 day measles is a contagious viral infection known by it's red rash. Symptoms include mild fever, headache, stuffy nose or runny nose, inflamed red eyes, enlarged, tender lymph nodes at base of skull, back of neck, and behind the ears. Cardinal symptom is the fine pink rash which develops on the face and spreads quickly to the rest of the body and disappears in the same sequence. Rubella is a mild infection and once you are over the disease you have permanent immunity. If you are pregnant and you develop German measles, conquences to the unborn child may be severe. Up to 90% of infants born to mothers who contacted Rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. The highest risk to the fetus is in the first trimester.

Tdap(Tetanus, Diphtheria, Pertussis) VIS

T-dap given to pregnant women can protect newborn babies against pertussis. Tetanus (lockjaw) enters the body through cuts in the skin or puncture wounds such as stepping on a rusty nail. Symptoms: painful muscle tightening and stiffness usually all over the body. Tightening of muscles in the head and neck causes the individual to be unable to open their mouth, swallow, and may cause respiratory arrest. Tetanus kills about 1-10 infected individuals even with good medical care. Diphtheria: caused by bacteria. Spread from person to person through coughing and sneezing. Symptoms: a thick coating to form in the back of the throat, can lead to breathing problems, heart failure , paralysis, and death.

Meningitis 3

The bacteria are transmitted from person-to-person through droplets of respiratory or throat secretions from carriers. Smoking, close and prolonged contact - such as kissing, sneezing or coughing on someone, or living in close quarters with a carrier - facilitates the spread of the disease. Average incubation period is four days, but can range between two and 10 days. The most common symptoms are a stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting. In addition in infants bulging fontanelle and ragdoll appearance are commonly found. A less common but even more severe (often fatal) form of meningococcal disease is meningococcal septicemia, which is characterized by a haemorrhagic rash and rapid circulatory collapse. Even when the disease is diagnosed early and adequate treatment is started, 8% to 15% of patients die, often within 24 to 48 hours after the onset of symptoms. If untreated, meningococcal meningitis is fatal in 50% of cases and may result in brain damage, hearing loss or disability in 10% to 20% of survivors.

Meningitis 2

The bacteriumNeisseria meningitidis, also called meningococcus, causes meningococcal meningitis It has the potential to cause large epidemics. Twelve types of N. meningitides, called serogroups, have been identified, six of which (A, B, C, W, X and Y) can cause epidemics. In children and teens, meningococcus is the most common cause of bacterial meningitis. The disease can affect anyone of any age, but mainly affects babies, preschool children and young people. In adults, it is the second most common cause. About 1 in 10 people have these bacteria in the back of their nose and throat.

Meningitis 5

Three types of vaccines available: Polysaccharide vaccines are used during a response to outbreaks, mainly in Africa: ***They are either bivalent (serogroups A and C), trivalent (A, C and W), or tetravalent (A, C, Y and W). ***They are not effective before 2 years of age. ***They offer a 3-year protection but do not induce herd immunity. Conjugate vaccines are used in prevention (into routine immunization schedules and preventive campaigns) and outbreak response: ***They confer longer-lasting immunity (5 years and more), prevent carriage and induce herd immunity. ***They can be used as soon as of one year of age. ***Available vaccines include: ******Monovalent C ******Monovalent A ******Tetravalent (serogroups A, C, Y, W). Protein based vaccine, against N. meningitidis B. It has been introduc See the CDC website: www.cdc.gov