Immunizations/Communicable diseases

a bacteriostatic agent that was previously used in vaccines to prevent contamination. because of possible association with brain and nerve damage, it is no longer used except in the influenza vaccine

organism genetically alltered to produce an antigen

organism altered and joined with another substance to heighten immune response

toxin treated by heat or chemicals to weaken the toxin effects but retain ability to produce an antigen

direct contact, airborn and skin lesions

14-21 days

all lesions are crusted over

fever, melaise, anorexia, irritability

macular rash-> pruretic vesicular lesions

lesion fluid for PCR

Symptomatic 

Immunocompromised kids use IV or oral acyclovir and immune globulin with 96 hr of exposure

Vaccine 72 hrs after exposed will reduce symptoms

Parvo virus B-19

5-14 years

resp secretions and blood

4-21 days

• Mild illness followed by rash
• Slapped face appearance
• Lace-like erthematous, maculopapular rash, spares hands and feet

Testing possitive for IgM for Parvo virus B-19

supportive treatment

Keep children out of direct sunlight or cover skin with light, loose clothing (sunlight will make rush worse)

• Abrupt onset of fever, chils, runny nose, sore throat, malaise, aches, headache, anorexia
• May develop nausea and diarrhea
• Improves after 3-5 days
• Complications, OM, secondary infections, febrile seizures, encephalitis, pneumonia, croup

Viral cultural or rapid antigen testing from nose/throat; FA; indirect immunofluorescent antibody staining

• Supportive treatment
• Antivirals

asthma

• Most common in spring and summer
• Direct contact with resp secretions or droplets
• Begins with URI, then invades bloodstream
• Can cause severe illness (meningitis, epiglottitis, pneumonia, septic arthritis and cellulitis) 
• Sever sequalae and death if untreated

• Blood, CSF, middle ear aspirate culture
• For invasive disease, IV antibiotics for 10 days
• Dexamethasone may be used to reduce neurologic damage with meningitis
• Rifampin given to protect others in household
• Exposed children should recieve vaccine

• Droplet percautions until 24 hrs after initiation of antibiotics
• Identify potential contacts and check immunization status
• Inform family and friends that rifampin turns urin and other body fluids oragne and will cause stains

Morobillivrus

• Infection uncommon in US
• Epidemic in other countries
• Direct contact with resp droplets, airborne spread
• Incubation 8-12 days
• Prodrom phase (3-5 days) fever, conjunctivitis, coryza, cough, anorexia, koplik spots

• Testing: IgM measles antibody
• Supportive treatment
• Antibiotics for secondary infections
• Immune globulin may decide severity in infants, immunocompromised children and pregnant women 
• Death from neuroloic or resp complications occur in 1-3 of 1000 cases
• Reportable disease

• Airborne precautions while child is in hospital
• Cool mist humidifier
• Suction gently as needed
• Nonaspirin pyretics, antitussives for coughing, antiprurtics for itching
• Dim lights, cover windows if child is sensitive to light
• Bedrest with diversional activities
• Elevate HOB
• Avoid use of soaps, keep skin clean & dry
• Small, cool liquids, may need blended, or pureed and mashed foods

Niessa meningitdis (gram-neg diplococcus)


Winter or early spring

Children living in poverty at higher risk

Most common in children under 2 and 15-18

Drop tansmission

Incubation 2-10 days

Abrupt onset of fever, chills, malaise, aches, vomiting and prostration (extreme exhaustion)

Maculopapular ras: petechial and may progress to purpura and sepsis

septic shock may occur

necrosis with gangrene and loss of tissue/limb, DIC, hearing loss, neuro disablities, scaring

• Cultures of blood, CSF; gram stain of lesion
• IV penicillin 5-7 days
• Aggressive ICU care to maintain airway, treat shock
• 10% of children will die
• Close contacts are given rifampin, ceftriaxone, cipro or Z-pack
• Vaccine may be given to prevent secondary cases
• Reportable disease

• Standard & droplet precautions until antibiotic therapy for 24 hrs
• Observe for shock & resp failure
• Identify close contacts & provide prophylaxis
• Educate them about any med side effects
• Teach close contacts signs of illness and when to call doctor
• Coordinate rehab for child

under 6 months

pertussis

• infection or immunity is long lasting
• Disease may occur as immunity wanes
• Nasal congestion, runny nose, cough
• With coughing: gagging, apnea, gasping, cyanosis, vomiting and profuse mucous production 
• Direct contact with droplets
• INcubation 7-10 days
• COmplications: pneumonia, atelectasis, encephalopathy, death

• NP culture or PCR
• Supportive care
• Macrolide antibiotics

• Droplet precautions until 5 days after antibiotics
• Continuous assessment of resp status
• Monitor with pulse oximeter
• Remain with chil during coughing spells to monitor for cyanosis
• Give oxygen if ordered
• Have emergency equipment prepared
• Provide humidification
• Ecourage rest periods
• Small frequent feedings of desired foods

• Birth
• 1-2 months
• 6-18 months

• Min of 4 wk between doses 1 and 2
• Min of 8 wk between doses 2-3
• Final dose no earlier than 24 wk and at least 16 wk after first dose

• 2 months
• 4months

• Max age for first dose is 14 wk, 6 days
• Max age for last dose is8 months
• Cant start after 15 weeks

• 2 months
• 4 months
• 6 months
• 15-18 months
• 4-6 yr
• 11-12 yr
• ten year booster shots 

• Min of 6 months between dose 3-4 
• Boster can be either Tdap or Td

• 2 months
• 4 months
• 12-15 months

• 2 months
• 4 months
• 6 months
• 12-15 months

• 2 months
• 4 months
• 6-18 months
• 4-6 years 

Final dose should be after 4 years and at least 6 months from previous dose

must be 2 years or older to recieve live vaccine

• 12-15 months
• 4-6 years

given 6-11 months if traveling internationally

• 12-15 months
• 4-6 years

• 12 months to 2 years
• 6-18 months following

11-12 years

• Can be given earlier to high risk groops
• If given before 16 years, booster recommended

11-12 years

second dose 1-2 months after first

third 6 months after first dose