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IMMUNISATIONS

IMMUNISATIONS. Janet Anderson courtesy of Pamela Lewis. MEASLES. Viral, droplet spread, incubation 10 days Coryza, conjunctivitis, fever, rash Complications, pneumonia,encephalitis,death Notifiable

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IMMUNISATIONS

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  1. IMMUNISATIONS Janet Anderson courtesy of Pamela Lewis

  2. MEASLES • Viral, droplet spread, incubation 10 days • Coryza, conjunctivitis, fever, rash • Complications, pneumonia,encephalitis,death • Notifiable • Catch up programme offered to those with incomplete immunization because of increasing notifications

  3. MUMPS • Viral,droplet spread, incubation 14-21 days • Parotid swelling • Complications oophritis,orchitis,pancreatitis,and meningitis • Notifiable

  4. RUBELLA • Viral, droplet spread incubation 14-21 days • Mild illness with rash and lymphadenopathy • Maternal rubella, 1st trimester 90% foetal damage ( microcephaly, deafness, cataracts, PDA etc) • History needs confirmation with saliva or serology

  5. DIPHTHERIA • Corynebacteria diphtheriae • Incubation 2-5 days Infectious for four weeks • Inflammatory exudate causing grey membrane in resp tract. Potential obstruction • Toxin mediated damage to myocardium, nervous system and adrenals

  6. TETANUS • Toxin mediated from tetanus bacillus • Incubation 4-21 days • Spore spread • Muscular rigidity with spasms ---(lock jaw)

  7. POLIO • Polio virus • Faecal/oral spread, Incubation 3-21 days • Virus may be shed for 6 weeks • Range of severity asymptomatic to paralysis

  8. PERTUSSIS • Bordetella pertussis • Incubation 7-10 days • Infectious until 3 weeks after onset of paroxysms • Paroxysmal cough can be associated with apnoea and /or vomiting • Complications--- SIDS, bronchopneumonia and cerebral hypoxia

  9. HAEMOPHILUS INFLUENZAEType B • Hib • Meningitis with high incidence of complications +/- bacteraemia • Epiglottitis • Osteomyelitis

  10. MENINGOCOCCAL DISEASE • Neisseria meningitidis • Type C vaccine, Type B no vaccine---(also available Type A for travelers) • Incubation 2-3 days • Onset can be fulminant • Meningitis / septicaemia • Fever, vomiting, purpuric rash

  11. Routine Immunisations • 2 months Diphtheria Pertussis Tetanus Hib Polio Pneumococcal (PCV) • 3 months Diphtheria Pertussis Tetanus Hib Polio Men C • 4 months Diphtheria Pertussis Tetanus Hib Polio Pneumococcal MenC

  12. Immunisations • 12 months Men C and Hib • 13 months MMR and Pneumococcal • 3 to 5 yrs Diptheria Pertussis Tetanus Polio MMR • 15 yrs Diptheria Tetanus Polio

  13. Active Immunity • Live Attenuated Vaccines eg BCG, MMR, yellow fever, oral polio • Inactivated Vaccines eg influenza • Extracts of or Detoxified Endotoxins eg tetanus

  14. Passive Immunity • Normal Immunoglobulin eg for replacement therapy of agammaglobulinaemia • Specific Immunoglobulin eg tetanus, VZV rabies, HepB and palivizumab for RSV protection

  15. Contraindications To Vaccination • General – Febrile illness • Anaphylaxis to previous dose or to components of vaccine • Severe local reaction • Inconsolable unexplained crying >3 hrs within 72hrs • Encephalopathic illness (hypotonic-hyporesponsive episode (HHE)) within 72 hours • Live Vaccines – Immunosuppressed, eg prednisolone therapy, chemotherapy, HIV (note MMR), BMT within 6 month. Pregnancy

  16. DTaP/IPV/Hib and MenC • Diptheria, Tetanus, acellular pertussis, Inactivated polio , Haemophilus influenzae and Meningitis C • New changes are inactivated polio (im) and acellular pertussis • Well tolerated, minimal side effects

  17. MMR • Measles, Mumps and Rubella • Serious illnesses associated with significant mortality • Fever common 6 to 10 days post vaccination • 1:1000 febrile convulsion • Can be given to egg allergic children • NOT associated with Autism and IBD

  18. BCG • Administered to at risk babies in neonatal period • Since 2006 risk-based programme for other children as well • Local Side effects common • Do not give to HIV + or immunocompromised Mantoux induration > 6mm Previous BCG or past/ present TB.

  19. PNEUMOCOCCAL VACCINES • Pneumovax > 2years 23- valent polysac • Prevenar < 2yrs 7- valent • Indications for those not previously immunised ---asplenia, SS, Chronic lung or heart disease

  20. OTHERS • RSV - passive immunisation—Synargis –given during RSV season to high risk groups • HBV – at risk groups (at present) • HPV – Human Papilloma Virus vaccine Given to 12-13 year old –due to increase coverage to 17-18 year olds in September 2008 Protects against 70% of cervical cancers

  21. ANAPHYLAXIS • ABC • Adrenaline 10 mcg/Kg (0.01ml/Kg 1:1000) • Hydrocortisone 4mg/Kg • Chlorphenamine

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