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Transcript
م عدي فارس الفرطوسي.م PhD Pediatric Nsg St. Immunization Immunity natural acquired Active immunity: Resistance developed in response to stimulus by an antigen (infecting agent or vaccine) and is characterized by the production of antibodies by the host. Passive immunity: Immunity conferred by an antibody produced in another host. It may be acquired naturally or artificially (through an antibody-containing preparation). Immunizing agents Immunoglobulin There are 5 major classes: IgM, IgA, IgG, IgE, IgD. Two types of immunoglobulin preparations are available for passive immunization: Normal human immunoglobulin Specific (hyper-immune) human immunoglobulin Antisera or antitoxins These are materials prepared in animals or non human sources such as horses. 1 Immunoglobulin and antiserum Human normal immunoglobulin Human specific immunoglobulin Hepatitis A Measles Rabies Tetanus Mumps Hepatitis B Varicella Diphtheria Non human ig (antisera) Diphtheria Tetanus Gas gangrene Botulism التسمم الوشيقي Rabies Vaccination Vaccination: is a method of giving antigen to stimulate the immune response through active immunization. A vaccine is an immuno-biological substance designed to produce specific protection against a given disease. A vaccine is “antigenic” but not “pathogenic”. Types of vaccines a) Live vaccines لقاحات حية b) Attenuated live vaccines لقاحات حية موهنة c) Inactivated (killed vaccines) معطلة d) Toxoids ذفان e) Polysaccharide and polypeptide (cellular fraction) vaccines )السكاريد وببتيد (جزء خلوي f) Surface antigen (recombinant) vaccines. المستضد السطحي (المؤتلف) اللقاحات. Live vaccines Live vaccines are made from live infectious agents without any amendment. The only live vaccine is “Variola” small pox vaccine, made of live vaccine cow-pox virus (not variola virus) which is not pathogenic but antigenic, giving cross immunity for variola. Live attenuated (avirulent) vaccines Virulent pathogenic organisms are treated to become attenuated and a virulent but antigenic. They have lost their capacity to induce full-blown disease but retain their immunogenicity. Live attenuated vaccines should not be administered to persons with suppressed immune response due to: 1. Leukemia and lymphoma 2 2. Other malignancies 3. Receiving corticosteroids and anti-metabolic agents 4. Radiation 5. pregnancy Types of vaccines Live vaccines Small pox variola vaccine Live Attenuated vaccines BCG Typhoid oral Plague Oral polio Yellow fever Measles Mumps Rubella Intranasal Influenza Typhus Killed Inactivated vaccines Cellular fraction vaccines Toxoids Typhoid Diphtheria Cholera Tetanus Pertussis Plague Rabies Salk polio Intra-muscular influenza Japanise encephalitis Meningococcal polysaccharide vaccine Pneumococcal polysaccharide vaccine Hepatitis B polypeptide vaccine Recombinant vaccines Hepatitis B vaccine Routes of administration a) Deep subcutaneous or intramuscular route (most vaccines) b) Oral route (sabine vaccine, oral BCG vaccine) c) Intradermal route (BCG vaccine) d) Scarification (small pox vaccine) e) Intranasal route (live attenuated influenza vaccine) Scheme of immunization 1) Primary vaccination One dose vaccines (BCG, variola, measles, mumps, rubella, yellow fever) Multiple dose vaccines (polio, DPT, hepatitis B) 2) Booster vaccination To maintain immunity level after it declines after some time has elapsed (DT, MMR). Periods of maintained immunity due to vaccines a) Short period (months): cholera vaccine b) Two years: TAB vaccine c) Three to five years: DPT vaccine d) Five or more years: BCG vaccine e) Ten years: yellow fever vaccine f) Solid immunity: measles, mumps, and rubella vaccines. The Cold Chain The "cold chain" is a system of storage and transport of vaccines at low temperature from the manufacturer to the actual vaccination site. 3 The cold chain system is necessary because vaccine failure may occur due to failure to store and transport under strict temperature controls. Vaccine carriers: Vaccine carriers are used to carry small quantities of vaccines (16-20 vials) for the out of reach sessions. 4 fully frozen ice packs are used for lining the sides, and vials of DPT, DT, TT and diluents should not be placed in direct contact with frozen ice packs. The carriers should be closed tightly. Ice packs: The ice packs contain water and no salt should be added to it. Among the vaccines, polio is the most sensitive to heat, requiring storage at minus 20 degree C. Vaccines which must be stored in the freezer compartment are : polio and measles. Vaccines which must be stored in the COLD PART but never allowed to freeze are : typhoid, DPT, tetanus toxoid, DT, BCG and diluents 4 جدول اللقاحات الروتينية في العراق 1027 اللقاح موعد اعطاء اللقاح خالل 12ساعة بعد الوالدة التهاب الكبد الفايروسي نمط ب االحادي -جرعة اولى خالل 71ساعة بعد الوالدة BCGبي سي جي OPV0شلل االطفال الفموي -جرعة الصفر عمر شهرين OPV1شلل االطفال الفموي -جرعة اولى Rota Virus Vaccineاللقاح الفايروسي الدوار -جرعة اولى اللقاح الخماسي -جرعة اولى عمر اربعة أشهر OPV2شلل االطفال الفموي -جرعة ثانية Quad vaccineاللقاح الرباعي -جرعة اولى Rota Virus Vaccineاللقاح الفايروسي الدوار -جرعة ثانية عمر ستة اشهر OPV3شلل االطفال الفموية -جرعة ثالثة Rota Virus Vaccineاللقاح الفايروسي الدوار -جرعة ثالثة Penta vaccineاللقاح الخماسي -جرعة ثانية عمر تسعة أشهر Measlesالحصبة المنفردة - -فيتامين Aم 100الف وحدة عالمية عمر خمسة عشر شهرا German Measlesجرعة اولى MMRالمختلطة عمر ثمانية عشر شهرا من 6 - 2سنوات .1 .2 .3 .4 .5 .6 OPV1شلل االطفال الفموي -جرعة منشطة اولى Quad vaccineاللقاح الرباعي -جرعة منشطة ثانية م 200الف وحدة عالمية فيتامين A OPV2شلل االطفال الفموي -جرعة منشطة ثانية اللقاح الثالثي -جرعة منشطة ثانية DPT جرعة ثانية MMRالمختلطة . اللقاح الفايروسي الدوار) . ( Rota Virus Vaccine ال نبدأ بتلقيح الطفل بلقاح الفايروسي الدوار اذا تجاوز عمر -ثالث اشهر . اليتم اعطاء اي جرعة من لقاح الفايروسي الدوار اذا اكمل الطفل عمر ثمانية اشهر. اللقاح الخماسي = )لقاح الثالثي +كبد نمط ب +لقاح المستدمية النزلية( HIB اللقاح الرباعي = ( لقاح الثالثي +لقاح المستدمية النزلية HIBنوع ب ) في حال عدم ظهور الندبة بعد مضي شهرين على التلقيح بلقاح ال ( بي سي جي ) يعاد التلقيح مرة ثانية 5