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Vaccine Preventable Diseases
Ana H. Corona, MSN, FNP-C
Nursing Instructor
May 2008
More presentations @: www.nurseana.com
Vaccine Preventable Diseases
• Bacteria and Viruses that
cause vaccine
preventable disease and
death still exist and can
be passed on to people
who are not protected by
vaccines.
• Convincing parents to
adhere to childhood
immunizations is not quite
difficult as before.
Vaccines
• A vaccine is a medical • Prior to the invention
preparation given to
of vaccines infectious
provide immunity from
diseases swept
a disease.
through towns,
villages, and cities
• The development of
with a horrifying
vaccines against
vengeance.
diseases is
considered among
• Vaccines have limited
one of the greatest
many of the lifeaccomplishments of
threatening infectious
medical science.
diseases.
Smallpox
• Smallpox is an acute, contagious, and
sometimes fatal disease caused by the variola
virus (an orthopoxvirus).
• The symptoms of smallpox begin with high fever,
head and body aches, and sometimes vomiting.
• A rash follows that spreads and progresses to
raised bumps and pus-filled blisters that crust,
scab, and fall off after about three weeks,
leaving a pitted scar.
Smallpox
• Early results from
laboratory studies
suggest that the drug
cidofovir may fight
against the smallpox
virus;
• Treatment: supportive
therapy (e.g., intravenous
fluids, medicine to control
fever or pain) and
antibiotics for any
secondary bacterial
infections that may occur.
• The density of the rash is
greater on the face than
on the body.
•
Man with smallpox. Public Health Images Library (PHIL) id# 131. Source:
CDC/Barbra Rice
Smallpox lesions on skin of trunk. Picture taken in Bangladesh, 1973. Public
Health Images Library (PHIL) ID # 284. Source: CDC/James Hicks
Face lesions on boy with smallpox. Public Health Images
Library (PHIL) ID # 3. Source: CDC/Cheryl Tyron
The distribution of the smallpox rash is usually similar to that
shown here. It is most dense on the face, arms and hands, legs
and feet. The trunk has fewer pocks than the extremities.
• After exposure, it takes
between 7 and 17 days
for symptoms of smallpox
to appear (average
incubation time is 12 to
14 days).
• The majority of patients
with smallpox recover, but
death may occur in up to
30% of cases. Many
smallpox survivors have
permanent scars over
large areas of their body,
especially their face.
Some are left blind.
Pocks are usually present on the palms of the hands
and on the soles of the feet.
• Smallpox normally
spreads from contact with
infected persons.
• Smallpox also can be
spread through direct
contact with infected
bodily fluids or
contaminated objects.
• Rarely, smallpox has
been spread by virus
carried in the air in
enclosed settings such as
buildings, buses, and
trains.
The smallpox virus dies within 24 hours. If an aerosol release of smallpox
occurs, 90% of virus matter will be inactivated or dissipated in about 24
hours. Smallpox can be prevented through use of the smallpox vaccine.
There is no proven treatment for smallpox, but research to evaluate new
antiviral agents is ongoing.
A Woman with Smallpox
Early results from laboratory studies suggest that the drug
cidofovir may fight against the smallpox virus; Treatment:
supportive therapy (e.g., intravenous fluids, medicine to
control fever or pain) and antibiotics for any secondary
bacterial infections that may occur.
Smallpox vs Chickenpox
Smallpox
Chickenpox
More pocks
on arms and
legs
More pocks
on body
Rash
Distribution
On palms and Usually
soles
present
Usually
absent
Differentiating Smallpox and Chickenpox
Smallpox
chickenpox
Fever
2 – 4 days before
rash
At time of rash
Rash
Appearance
Pocks in same stage
Pocks in several
stages
Development
Slow
Rapid
Distribution
More pocks on arms
and legs
More pocks on body
On palms and soles
Usually present
Usually absent
Death
1 in 10 die
Very uncommon
Smallpox Vs Chickenpox: the relative density of rash on
different parts of the body should be carefully observed. This
diagram illustrates the differences that are usually seen.
Chickenpox
Chickenpox
• Chickenpox is caused by a
virus, the varicella-zoster
virus.
• Chickenpox spreads from
person to person by direct
contact or through the air
by coughing or sneezing.
• It is highly contagious.
• It can also be spread
through direct contact with
the fluid from a blister of a
person infected with
chickenpox, or from direct
contact with a sore from a
person with shingles.
Chickenpox
• It takes from 10-21 days to develop symptoms
after being exposed to a person infected with
chickenpox. The usual time period is 14-16
days.
• The most common symptoms of chickenpox are
rash, fever, coughing, fussiness, headache, and
loss of appetite.
• The rash usually develops on the scalp and
body, and then spreads to the face, arms, and
legs.
• The rash usually forms 200-500 itchy blisters in
several successive crops. The illness lasts about
5-10 days.
Chickenpox Complications
• The most common complication is bacterial infection of
the skin or other parts of the body including the bones,
lungs, joints, and blood. The virus can also lead to
pneumonia or infection of the brain.
• These complications are rare but serious. Complications
are more common in infants, adults, and persons with
weakened immune systems.
Chickenpox Complications
• Infant with necrotizing
fasciitis, a complication of
varicella
• Newborn with
chickenpox
Chickenpox Treatment
• Most cases of chickenpox in otherwise healthy
children are treated with bed rest, fluids, and
control of fever.
• Children with chickenpox should NOT receive
aspirin because of possible subsequent risk of
Reye's syndrome.
• Acetaminophen may be given for fever control.
• Chickenpox may be treated with an antiviral
drug in serious cases, depending on the
patient's age and health, the extent of the
infection, and the timing of the treatment.
Anthrax
Anthrax
• Anthrax is a serious
disease caused by
Bacillus anthracis, a
bacterium that forms
spores.
• There are three types of
anthrax:
• skin (cutaneous)
• lungs (inhalation)
• digestive
(gastrointestinal)
Anthrax
• Anthrax is not known to spread from one person to
another.
• Humans can become infected with anthrax by handling
products from infected animals or by breathing in anthrax
spores from infected animal products (like wool, for
example).
• Gastrointestinal anthrax - by eating undercooked meat
from infected animals.
• Anthrax as a weapon. Anthrax also can be used as a
weapon. This happened in the United States in 2001.
Anthrax was deliberately spread through the postal
system by sending letters with powder containing
anthrax. This caused 22 cases of anthrax infection.
Anthrax: Signs/Symptoms
• Cutaneous: The first
symptom is a small
sore that develops
into a blister.
• The blister then
develops into a skin
ulcer with a black
area in the center.
• The sore, blister and
ulcer do not hurt.
Anthrax : signs & symptoms
• Gastrointestinal: The first symptoms are nausea,
loss of appetite, bloody diarrhea, and fever,
followed by bad stomach pain.
• Inhalation: The first symptoms of inhalation
anthrax are like cold or flu symptoms and can
include a sore throat, mild fever and muscle
aches. Later symptoms include cough, chest
discomfort, shortness of breath, tiredness and
muscle aches.
Anthrax
• Incubation: Symptoms can appear within 7 days of
coming in contact with the bacterium for all three types of
anthrax. For inhalation anthrax, symptoms can appear
within a week or can take up to 42 days to appear.
• How Is Anthrax Treated?
• Antibiotics are used to treat all three types of anthrax.
Early identification and treatment are important.
• Prevention after exposure. Treatment is different for a
person who is exposed to anthrax, but is not yet sick.
Health-care providers will use antibiotics (such as
ciprofloxacin, levofloxacin, doxycycline, or penicillin)
combined with the anthrax vaccine to prevent anthrax
infection.
• Treatment after infection. Treatment is usually a 60day course of antibiotics. Success depends on the type
of anthrax and how soon treatment begins.
Anthrax Vaccine
• There is a vaccine to prevent anthrax, but it is
not yet available for the general public.
• Anyone who may be exposed to anthrax, may
get the vaccine.
• In the event of an attack using anthrax as a
weapon, people exposed would get the vaccine.
Measles
• Measles is caused by a virus.
• It is spread through the air by
infectious droplets and is highly
contagious.
• It takes an average of 10-12 days
from exposure to the first symptom,
which is usually fever.
• The measles rash doesn't usually
appear until approximately 14 days
after exposure, 2-3 days after the
fever begins.
• Symptoms include fever, runny
nose, cough, loss of appetite, "pink
eye," and a rash. The rash usually
lasts 5-6 days and begins at the
hairline, moves to the face and
upper neck, and proceeds down the
body.
Measles (Rubeola)
• Before measles immunization
was available, nearly
everyone in the U.S. got
measles. An average of 450
measles-associated deaths
were reported each year
between 1953 and 1963.
• If Measles vaccinations were
stopped, each year about 2.7
million measles deaths
worldwide could be expected.
• There is no treatment for
measles.
• Bed rest, fluids, and control of
fever. Patients with
complications may need
treatment specific to their
problem.
Measles
• Diarrhea is the most common
complication of measles (occurring
in 8% of cases), especially in young
children.
• Ear infections occur in 7% of
reported cases. Pneumonia,
occurring in 6% of reported cases,
accounts for 60% of measles-related
deaths.
• Approximately one out of one
thousand cases will develop acute
encephalitis, an inflammation of the
brain.
• This serious complication can lead
to permanent brain damage.
• Measles during pregnancy
increases the risk of premature
labor, miscarriage, and low-birthweight infants, although birth defects
have not been linked to measles
exposure.
Measles
• Measles (rubeola)
pharyngitis in an adult
showing striking
inflammation
• Measles (rubeola) rash
and conjunctivitis
Measles
• Koplik spots,
blue-white spots
on the inside of
the mouth that
occur 24-48
hours before the
rash stage
Meningococcal Disease
• Meningococcal disease is caused by the bacterium
Neisseria meningitidis.
• The disease is spread person-to-person through the
exchange of respiratory and throat secretions
• Meningococcal bacteria can't live for more than a few
minutes outside the body.
Meningococcal Disease
• Bacterial meningitis can be treated with antibiotics. It is
critical to start treatment early.
• There are approximately 2,000-3,000 cases of
meningococcal disease each year in the United States.
An estimated 125 deaths from meningococcal disease
occurred in the United States in 2004.
Septicemic rash
Meningococcemia
• The most common symptoms are high fever, chills,
lethargy, and a rash.
• If meningitis is present, the symptoms will also include
headache and neck stiffness (which may not be present
in infants); seizures may also occur.
• Complications: shock, coma, and death can follow within
several hours, even with appropriate medical treatment.
• About 9-12% of persons with meningococcal disease
die. Of those who recover, up to 20% suffer from some
serious after-effect, such as permanent hearing loss,
limb loss, or brain damage.
Meningococcal Disease
• Four-month-old female with
gangrene of hand and foot
due to meningococcemia
• Rash from meningitis; spots
change into purple bruises
which don't blanch (lose
their color) when pressed by
glass
Hepatitis B Virus
• Hepatitis B is a liver disease caused
by the hepatitis B virus (HBV).
•
• The spread of HBV occurs when
blood from an HBV-infected person
enters the body of a person who is
not infected.
• This can occur through having sex
with an HBV-infected person without
using a condom.
• HBV is also easily spread by
sharing drugs, needles, or "works"
when "shooting" drugs.
• HBV is also spread through
needlesticks or sharps exposures on
the job
• From an infected mother to her baby
during birth.
• Breastfeeding has not been
associated with the spread of HBV.
This woman is suffering from liver
cancer caused by hepatitis B
Hepatitis B
• The incubation period ranges from 45 to 160 days
(average 120.)
• Signs and symptoms of hepatitis B might include nausea,
lack of appetite, tiredness, muscle, joint, or stomach pain,
fever, diarrhea or vomiting, headache, dark urine, lightcolored stools, and yellowing of the skin and whites of the
eyes (jaundice).
• In the United States, an estimated 3,000-4,000 people die
each year of HBV-related cirrhosis, and another 1,0001,500 die each year of HBV-related liver cancer.
• There are several FDA-approved medications that might
help a person who has chronic HBV infection.
• These medications cure, but they might decrease the
chance of the infected person developing severe liver
disease.
• There is no treatment (other than supportive care) for
people with acute hepatitis B.
Pertussis (Whooping Cough)
• Nearly all children
developed whooping
cough, before pertussis
immunizations were
available.
• In the U.S., prior to
pertussis immunization,
between 150,000 and
260,000 cases of
pertussis were reported
each year, with up to
9,000 pertussis-related
deaths. (CDC)
•
Child with broken blood vessels
in eyes and bruising on face
due to pertussis coughing.
Pertussis
• Pertussis is caused by a
bacterium, Bordetella
pertussis.
• It is spread through the
air by infectious droplets
and is highly contagious.
• Incubation period is
commonly seven to 10
days, with a range of 5-21
days.
• A photomicrograph of
Bordetella
(Haemophilus)
pertussis bacteria
Pertussis disease can be divided into three stages:
• Catarrhal stage: can last 1-2 weeks and includes
a runny nose, sneezing, low-grade fever, and a
mild cough (all similar symptoms to the common
cold).
• Paroxysmal stage: usually lasts 4-6 weeks, but
can persist for up to 10 weeks. The
characteristic symptom is a burst, or paroxysm,
of numerous, rapid coughs. At the end of the
paroxysm the patient suffers from a long inhaling
effort that is characterized by a high-pitched
whoop (hence the name, "whooping cough").
Infants and young children often appear very ill
and distressed, and may turn blue and vomit.
• Convalescent stage: usually lasts 2-6 weeks, but
may last for months.
Pertussis
• Although the cough usually
disappears after 2-3 weeks,
paroxysms may recur
whenever the patient suffers
any subsequent respiratory
infection.
• The disease is usually milder
in adolescents and adults,
consisting of a persistent
cough similar to that found in
other upper respiratory
infections.
• These individuals are still
able to transmit the disease
to others, including
unimmunized or incompletely
immunized infants.
Pertussis
• Pertussis can be a severe
illness, resulting in
prolonged coughing spells
that can last for many
weeks.
• These spells can make it
difficult for a child to eat,
drink, and breathe.
• Because vomiting often
occurs after a coughing
spell, infants may lose
weight and become
dehydrated.
• In infants, it can also cause
pneumonia and lead to
brain damage, seizures,
and mental retardation.
Pertussis Treatment
• Antibiotics may be helpful
in treating pertussis. The
drug of choice is
erythromycin.
• This antibiotic should also
be given for 14 days to all
household and other
close contacts of the
patient to minimize
transmission, regardless
of age and vaccination
status.
Poliomyelitis
• Before polio vaccine was
available, 13,000 to
20,000 cases of paralytic
polio were reported each
year in the United States.
• Polio left thousands of
victims--mostly children-in braces, crutches,
wheelchairs, and iron
lungs. The effects were
life-long.
Polio
• Patients whose
respiratory muscles
were affected were
placed in an "iron
lung" machine to
enable them to
breathe
Polio Ward
Polio Eradication
• 2,000 cases of polio
in 17 countries were
reported in 2006.
• Only four countries
remain endemic
(Afghanistan, India,
Nigeria, Pakistan).
Poliomyelitis
• Polio is caused by a virus.
• It is usually spread via the fecal-oral route (i.e.,
the virus is transmitted from the stool of an
infected person to the mouth of another person
from contaminated hands or such objects as
eating utensils). Some cases may be spread
directly via an oral to oral route.
• The incubation period of polio is commonly 6-20
days, with a range of 3-35 days.
• Surprisingly, 95% of all individuals infected with
polio have no apparent symptoms.
Polio Signs and Symptoms
• 95% of all individuals infected with polio have no
apparent symptoms.
• 4%-8% of infected individuals have minor
symptoms such as sore throat and fever,
nausea, vomiting, and other common symptoms
of any viral illness.
• 1%-2% of infected individuals develop
nonparalytic aseptic (viral) meningitis, with
temporary stiffness of the neck, back, and/or
legs.
• <1% of all polio infections result in the classic
"flaccid paralysis," where the patient is left with
permanent weakness or paralysis of legs, arms,
or both.
Polio
• Diagnostic tests: a stool or throat sample is
collected.
• Patients infected with the polio virus can pass
the virus on for 7-10 days before the onset of
disease.
• They can continue to shed the virus in their stool
for 3-6 weeks.
• There is no "cure" for polio. Persons infected
with polio need supportive therapy, such as bed
rest and fluids.
Rotavirus
• Rotavirus disease is caused the rotavirus
• The rotavirus enters the body through the mouth
and then infects the lining of the intestines.
• Rotavirus is very contagious, spreading easily
from children who are already infected to other
children and sometimes adults.
• The incubation period for rotavirus diarrhea is 13 days.
Rotavirus
• Rotavirus disease starts
with fever, an upset
stomach, and vomiting,
followed by diarrhea.
• Children who have
rotavirus disease develop
vomiting and watery
diarrhea that may last
from three to eight days.
• May become dehydrated
from loss of fluids.
• Children are typically
treated by replacing lost
body fluids through
drinking products that
contain water with sugar
and minerals.
• Severe dehydration may
lead to electrolyte
imbalance, and
metabolic acidosis.
• Treatment: IV fluid
replacement for severe
cases
Shingles (Herpes Zoster)
• Both chickenpox and shingles are
caused by the same virus.
• After a person has had
chickenpox, the virus rests in the
body permanently, but silently.
• About 20% of all people who have
been infected with chickenpox
later develop the disease known
as herpes zoster, or shingles.
• Symptoms of shingles are pain,
itching, blisters, and loss of feeling
along a nerve.
• Most cases occur in persons older
than 50, and the risk of developing
shingles increases with age.
Shingles
• Shingles starts as a rash
with blisters that scab after
3 to 5 days.
• Symptoms: Rash and pain
usually occur in a band on
one side of the body, or
clustered on one side of
the face.
• The rash usually clears
within 2 to 4 weeks.
• Before the rash develops,
there is often pain, itching,
or tingling in the area
where the rash will
develop. Other symptoms
of shingles can include
fever, headache, chills, and
upset stomach.
Shingles Complications
• Can lead to pneumonia, hearing
problems, blindness, scarring,
brain inflammation (encephalitis),
or death.
• Severe pain can continue even
after the rash clears up, a
situation called post-herpetic
neuralgia (PHN).
• Elderly are more likely to develop
PHN, and it is more likely to be
severe and long lasting.
• The pain may be sharp or
throbbing, and it may extend
beyond the area of the original
rash.
• The skin may be unusually
sensitive to touch and to
changes in temperature.
• PHN can last for months, or even
years.
Shingles Treatment
• Antiviral medicines can be
used to treat shingles.
• These medications should
be started as soon as
possible after the rash
appears.
• They can help shorten the
length and severity of the
episode.
• Pain medicine may also
help with pain caused by
shingles
• Diagnostic test: The test
consists of a laboratory
examination of cells taken
from a skin lesion.
Tetanus
• Tetanus is a
severe, often fatal
disease.
• The bacteria that
cause tetanus are
distributed in soil
and street dust,
are found in the
waste of many
animals, and are
very resistant to
heat and germkilling cleaners.
Tetanus
• People with tetanus suffer from stiffness and spasms of the
muscles.
• The larynx (throat) can close causing breathing and eating
difficulties, muscles spasms can cause fractures (breaks) of
the spine and long bones, and some people go into a coma,
and die.
• Approximately 20 percent of reported cases end in death.
Tetanus
• Child has painful
muscle contractions
from tetanus
• Tetanus is infectious,
but not contagious
• A number of tetanus
cases in younger
persons has been
observed recently in
the U.S. among
intravenous drug
users, particularly
heroin users.
• Worldwide, tetanus in newborn infants continues to be a
huge problem.
• Every year tetanus kills 300,000 newborns and 30,000
birth mothers who were not properly vaccinated.
• Below: baby has neonatal tetanus with complete
rigidity
Tetanus Treatment
• There is no treatment.
• Supportive treatment and
management of
complications.
• The best "treatment" is
prevention through
immunization.
• Diagnosis is not useful as
the C. tetani bacteria
often cannot be
recovered from the
wound of an individual
who has tetanus.
Diphtheria
• Diphtheria is caused by a
bacterium, Corynebacterium
diphtheriae.
• The disease is caused when
the bacteria release a toxin,
or poison, into the person's
body.
• This bacteria live in the
mouth, throat, and nose of
an infected person and can
be passed to others by
coughing or sneezing.
• Transmission occurs from
skin sores or through
articles soiled with
discharge from sores of
infected persons.
• The incubation period is
short: 2-5 days, with a
range of 1-10 days.
Diphtheria Symptoms
• Early symptoms of
diphtheria may mimic a
cold with a sore throat,
mild fever, and chills.
• Usually, the disease
causes a thick coating at
the back of the throat,
which can make it difficult
to breathe or swallow.
• Other body sites besides
the throat can also be
affected, including the
nose, larynx, eye, vagina,
and skin.
• “Bull neck” appearance of
diphtheritic cervical
lymphadenopathy
Diphtheria Complications
• In 1921, a total of 206,000
diphtheria cases and 15,520
diphtheria related deaths were
reported.
Child has diphtheria, thick gray
coating over back of throat
• Complications of diphtheria are
due to the release of the toxin, or
poison.
• The most common complications
are inflammation of the heart and
nerves, which may cause cardiac
arrhythmias and temporary
paralysis of some muscles.
• If the paralysis affects the
diaphragm, the patient may
develop pneumonia or respiratory
failure.
• The thick membrane coating at
the back of the throat may cause
serious breathing problems, even
suffocation.
Diphtheria Diagnosis and Treatment
• Diphtheria can only be
confirmed after a culture of
the infected material from
the patient's throat (or other
site) is collected.
• Diphtheria progresses
quickly, treatment usually
should begin based on the
health professional's
assessment of the patient.
• Diphtheria is treated with
both antibiotics and with
diphtheria antitoxin
Child has "bullneck diphtheria"
Diphtheria
• After 48 hours of antibiotic
treatment, the disease
usually becomes noncontagious.
• Antibiotic treatment should be
continued until the patient
has three consecutive
negative cultures.
• Some individuals may
continue to carry bacteria
even after treatment.
• Individuals can get diphtheria
more than once.
• Individuals recovering from
diphtheria should be
immunized against the
disease as soon as possible.
•
An Indonesian child with
diphtheria kept alive by a throat
operation
Diphtheria
• Pharyngeal
diphtheria with
membranes
covering the tonsils
and uvula
• Diphtheria,
pseudomembrane
Hepatitis A (HAV)
• Hepatitis A is a liver disease
caused by hepatitis A virus
(HAV).
• It is spread from person to
person by putting something in
the mouth that has been
contaminated with the stool of a
person with HAV infection.
• Contaminated food, water, and
ice.
• A person can also be infected by
drinking water contaminated with
HAV or drinking beverages
chilled with contaminated ice.
• Sex increases the risk of
exposure to HAV in the feces of
an infected person.
• Man with jaundice (yellowing
of the skin and eyes)
Hepatitis A
• It can take 15-50 days to
become infected (average 28
days).
• People with HAV infection
might not have any signs or
symptoms of the disease.
• Adults are more likely to have
symptoms than children.
• About 7 out of 10 adults have
symptoms, while children less
than age 6 years have no
symptoms, usually.
• Some people have symptoms
of hepatitis A recur for 6-9
months; this condition is called
relapsing hepatitis A.
Hepatitis A Symptoms & Complications
• Symptoms usually occur
suddenly and might include
fever, tiredness, loss of
appetite, nausea, abdominal
discomfort, dark urine, and
jaundice (yellowing of the skin
and eyes).
• This usually last less than 2
months; some people (10%15%) are ill for as long as 6
months.
• Studies show that 11%-22% of
people with hepatitis A are
hospitalized. Infected adults
who become ill lose an
average of 15½ days of work if
not hospitalized and 33¼ days
of work, if hospitalized.
• Hepatitis A is a serious
disease.
• Approximately 100 people die
each year in the United States
from HAV related causes.
• A blood test called IgM antiHAV is needed to diagnose
acute hepatitis A
• There is also a blood test
available that shows if a
person was infected with HAV
in the past (hepatitis A
antibody [anti-HAV]).
• There is no medicine that will
treat or "cure" hepatitis A.
• Supportive care includes bed
rest, fluids, and antipyretics.
HAV Incubation
• The most likely time for an HAV-infected person
to spread HAV to others is during the two weeks
before the infected person develops symptoms.
• The risk of spreading HAV becomes smaller
over time and can still be present one week or
longer after symptoms develop (e.g., yellowing
of skin and eyes).
• Infants are more likely to be capable of
spreading HAV for longer periods of time.
Infection with Haemophilus
influenzae type b. (Hib)
• Hib meningitis once
killed 600 children each
year and left many
survivors with
deafness, seizures, or
mental retardation.
• Since introduction of
conjugate Hib vaccine
in December 1987, the
incidence of Hib has
declined by 98 percent.
Child has swollen face due
to Hib infection
Hib
• Hib was the most
common cause of
bacterial meningitis in
U.S. infants and children
before the Hib vaccine
became available.
• Approximately two-thirds
of the 20,000 reported Hib
cases were meningitis,
and one-third were other
life-threatening invasive
Hib diseases such as
bacteria in the blood,
pneumonia, or
inflammation of the
epiglottis.
Haemophilus influenzae type b.
Cellulitis of the arm proven by
blood culture
Hib Disease
• Hib disease is caused by a
bacterium, Haemophilus
influenzae.
• It contains six different types
of these bacteria (a through
f).
• Type b organisms account for
95% of all strains that cause
invasive disease.
• Hib disease is spread personto-person by direct contact or
through respiratory droplets.
• The organisms remains in the
nose and throat.
• The bacteria may spread to
the lungs or bloodstream and
cause a serious infection in
the individual.
Haemophilus influenzae type
b. Cellulitis of the foot proven
by blood culture
Hib Complications
• The incubation period of Hib
disease could be as short as a few
days
• The most common type of invasive
Hib disease is meningitis.
• Symptoms of Hib meningitis are
fever, decreased mental status, and
stiff neck.
• The mortality rate is 2%-5%.
• 15%-30% of survivors suffer some
permanent neurologic damage,
including blindness, deafness, and
mental retardation.
• Another 17% of invasive Hib cases
include epiglottitis, an infection and
swelling in the throat that can cause
life-threatening airway blockage.
• Other forms of invasive Hib disease
include: joint infection (8%), skin
infection (6%), pneumonia (15%),
and bone infection (2%).
Periorbital cellulitis with
purulent exudate from which
Streptococcus pneumoniae
and Haemophilus influenzae
type b
Hib Diagnosis and Treatment
• The diagnosis of Hib disease is usually made
based on one or more laboratory tests using a
sample of infected body fluid, such as blood or
spinal fluid.
• Hib disease is treated with antibiotics for 10
days. Most cases require hospitalization.
• Even with antibiotic treatment, up to 5% of all
children with Hib meningitis die from the
disease.
Mumps
• Child very swollen
under the jaw and in the
cheeks due to mumps
• Mumps is highly
communicable and it only
takes a few unvaccinated
Individuals to initiate
transmission.
• Mumps was a major
cause of deafness in
children, occurring in
approximately 1 in 20,000
reported cases.
Mumps
• Mumps is usually a mild
viral disease.
• Rare conditions such as
swelling of the brain,
nerves and spinal cord
can lead to serious side
effects such as paralysis,
seizures, and fluid in the
brain.
• An increase in
miscarriages has been
found among women who
develop mumps during
the first trimester of
pregnancy.
Mumps
• Serious side effects of
mumps are more
common among
adults than children.
• Swelling of the testes
is the most common
side effect in males
past the age of
puberty, occurring in
up to 20 percent to 50
percent of men who
contract mumps.
Pneumococcal Disease
• Before pneumococcal
conjugate vaccine
became available for
children, pneumococcus
caused 63,000 cases of
invasive pneumococcal
disease and 6,100 deaths
in the U.S. each year.
• Many children who
developed pneumococcal
meningitis also
developed long-term
complications such as
deafness or seizures.
• Brain of a person
who died from
pneumococcal brain
infection
Pneumococcal Disease
• Pneumococcal disease is caused by
Streptococcus pneumoniae, a bacterium.
• The disease is spread from person to person by
droplets in the air.
• There are three major conditions caused by
invasive pneumococcal disease: pneumonia,
bacteremia, and meningitis. They are all caused
by infection with the same bacteria, but have
different symptoms.
Signs and Symptoms
• Pneumococcal
pneumonia: abrupt onset
of fever, shaking chills or
rigors, chest pain, cough,
shortness of breath, rapid
breathing and heart rate,
and weakness.
• Pneumococcal
bacteremia: (blood
infection) occurs in about
25%-30% of patients with
pneumococcal
pneumonia.
• Pneumococci bacterial
meningitis: Symptoms
may include headache,
tiredness, vomiting,
irritability, fever, seizures,
and coma.
• Pneumococci are also a
common cause of acute
otitis media (middle ear
infection).
Treatment
• Penicillin is the drug of choice
for treatment of pneumococcal
disease.
• Resistance to penicillin and
other antibiotics has been on
the rise.
• Studies indicate that in some
areas of the United States up to
40% of invasive pneumococci
are resistant to common
antibiotics.
• Treating patients infected with
resistant organisms requires
expensive alternative
antimicrobial agents and may
result in prolonged hospital
stays.
Child with pneumococcal
disease
Rubella (German Measles)
• Rubella is caused by a
virus.
• It spreads from person to
person through the air.
• Rubella is contagious.
• The incubation period
varies from 12 to 23 days
(average, 14 days).
• Symptoms are often mild
and may be unapparent
up to half of the time.
Rubella Signs and Symptoms
• Symptoms: usually first break out
in a rash, which starts on the
face and progresses down the
body.
• Older children and adults usually
first suffer from low-grade fever,
swollen glands in the neck or
behind the ears, and upper
respiratory infection before they
develop a rash.
• Adult women often develop pain
and stiffness in their finger, wrist,
and knee joints, which may last
up to a month.
• Up to half of people infected with
rubella virus have no symptoms
at all.
Characteristic maculopapular
rash indicative of rubella
Rubella Diagnosis & Treatment
• There is no "cure" for
rubella, only supportive
treatment (e.g., bed rest,
fluids, and fever
reduction).
• Because the rubella rash
looks similar to other
rashes, the only sure
way to diagnose rubella
is by a laboratory test
• The disease is most
contagious when the
rash is erupting, but the
virus can be spread from
seven days before, to 57 days after the rash
begins.
Characteristic maculopapular
rash indicative of rubella
Rubella Complications
• 90 percent of infants
born to mothers
infected with rubella
during the first
trimester of pregnancy
will develop congenital
rubella syndrome
(CRS), resulting in
heart defects,
cataracts, mental
retardation, and
deafness.
Infant with congenital rubella
syndrome
Cataracts caused by congenital
rubella syndrome
References & Sources
•
•
•
•
Immunization Action Coalition
The World Health Organization
Center for Disease Control and Prevention
Los Angeles County Department of Health
Services
• J.L. Bezzant, MD, Clinical Professor,
Department of Dermatology
University of Utah School of Medicine