Saturday, October 29, 2011

And now for Something Completely Different--Vaccine Preventable Diseases


Meningococcal Meningitis
The measles in a 2 year old.
German Measles (Rubella) 
Chickenpox in adults can spread to the lungs and kill adults and children alike
Cervical Cancer from HPV
 I have a friend who just had a stem cell transplant for CLL.  Please read this blog entry.  He put forth the need for vaccinations better than anything I’ve ever seen by making it personal. His whole blog rocks though...:  Journal from the Plague Year:

http://journalfromtheplagueyear.blogspot.com/2011/10/herd-immunity.html

The Diseases:
Influenza:

Influenza disease:  is a respiratory virus that causes a high fever, generally 102, although not all will get a fever,  severe muscle aches and pains,  stuffy nose, sore throat, fatigue, and cough.  Some people get vomiting and diarrhea, but that is more common in kids.
Complications which can occur include post influenza pneumonia, bronchitis, ear infections and sinus infections and death.
People with the following problems are at higher risk:   asthma or COPD/emphysema, Diabetes, those over 65, pregnant women, People with HIV/AIDS, people with cancer. children younger than 5 and especially younger than 2.


Measles:

There is an unexpectedly high number of cases in the US this year.  Measles had been declared eradicated in the US in 2000.  The cases are imported from abroad where the disease is still rampant.  These unvaccinated US travelers got sick and brought it back to the US and spread the disease in our communities because NOT ENOUGH people are vaccinated now.  Most of the people who got sick in the US from these people were unvaccinated or under vaccinated.

Measles causes fever with rash, cough, runny nose, conjunctivitis.  One out of 10 kids get an ear infection and 1 out of 20 get pneumonia.  For every 1000 children who get measles, one or two die.

Measles is preventable by taking a vaccine. From the following CDC.gov website:
http://www.cdc.gov/measles/vaccination.html#coverage

“Measles can be prevented by the combination MMR (measles, mumps, and rubella) vaccine. In the decade before the measles vaccination program began, an estimated 3–4 million people in the United States were infected each year, of whom 400–500 died, 48,000 were hospitalized, and another 1,000 developed chronic disability from measles encephalitis. Widespread use of measles vaccine has led to a greater than 99% reduction in measles cases in the United States compared with the pre-vaccine era, and in 2009, only 71 cases of measles were reported in the United States.
However, measles is still common in other countries. The virus is highly contagious and can spread rapidly in areas where vaccination is not widespread. It is estimated that in 2008 there were 164,000 measles deaths worldwide—that equals about 450 deaths every day or about 18 deaths every hour.”

Go to the CDC website to read about the vaccine.  It does not cause autism.

Mumps:
There is an ongoing outbreak of mumps in highly observant Jews in Orange County, NY and in NJ. This is a community where there was a high amount of vaccination with 1-2 doses of MMR.  Turns out the mumps vaccine isn’t as effective so in order to prevent person to person spread, you need to make sure even MORE people are vaccinated with 2 vaccine doses.  In this outbreak, they were giving a 3rd dose of MMR to increase the immune response in the schools affected.  It didn’t spread much outside the observant Jewish community.  Speculation includes that possibly the surrounding communities had a higher vaccination rate, or there just wasn’t much intermingling of the affected community with their surrounding non Jewish neighbors.
This article explains it well.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5905a1.htm

Mumps causes fever, headache, muscle aches, tiredness, loss of appetite and swollen and tender salivary glands under the ears or jaw on one or both sides (parotitis).  Most people fully recover. but boys who have reached puberty can get inflammation of the testicles, girls who have reached puberty can get inflammation of the ovaries or breasts.  Meningitis and encephalitis (brain infection) can occur.  Deafness can occur and may be permanent.  It is spread by saliva or mucous from the mouth, nose, throat.  It can be spread by sharing drinks, utensils, touching virally contaminated surfaces(counters, toys, doorknobs, toilet handle etc.).

HPV:
is the cause of cervical cancer in women and head and neck cancers in men.  It causes anal-rectal cancer in people who engage in anal intercourse.  It can cause throat infections through oral sex.  It can be passed through straight and gay sex.  Pregnant women can spread it to their babies during delivery causing warts to grow in the babies throats (Recurrent Respiratory Papillomatosis).  It also causes genital warts.  The types of HPV that cause genital warts aren’t the same as those that cause cervical cancer.
At least 50% of sexually active people will get HPV at some time.  In 90% of the cases, people clear the infection and are fine.  BUT there are over 40 HPV virus types.  Most people don’t even know they have an infection.
There is a vaccine available for boys and girls to prevent them from getting the types of HPV that can cause cancers.  Here is the link to the CDC website:
http://www.cdc.gov/std/HPV/STDFact-HPV.htm#common

Getting the vaccine does not mean that you are condoning premarital sex.  Where did that idea come from?  Would you deny your child Hepatitis B vaccine for that reason?  C’mon now.

DIPTHERIA:
Who’s ever heard of this?  You know why?  We practically never see it here because of immunization against it.  There are only about 5 cases a year in the United States.  It’s in the routine Tetanus vaccine.  In the 1990‘s, when they took it out of the tetanus vaccine in Russia  a while back, it made an amazing recovery and caused many cases and many deaths.  They used to call it the “strangling angel of children”.  It was a leading cause of death in children.
Diptheria is a bacteria that is spread by coughing and sneezing, or contaminated food or objects (milk, utensils).  It infects your throat and nose and causes a gray/black fibrous like covering which can block your windpipe and suffocate you.  It can cause skin infections like above.  Then, once it infects you, it makes a toxin (a chemical poison) that can spread to your heart and cause inflammation of your heart and other organs.  You turn blue, get a watery nasal drainage, have great difficulty breathing, get chills, a barking cough, drooling, fever, painful swallowing and skin lesions may occur in tropical areas of the world.


MENINGOCOCCAL MENINGITIS

Meningitis is an inflammation of the membranes which cover the brain and spinal cord.  Meningococcal meningitis is caused by a bacteria and occurs mostly in children and adolescents.  It is the most common cause of bacterial meningitis in children and the second most common cause of bacterial meningitis in adults.  It occurs in winter or spring and can cause epidemics in boarding schools, dorms, and miltary bases.
It causes sudden onset of fever and chills, altered mental status, nausea and vomiting, purple bruise like areas (purpura) and pinpoint red spots (petechiae), light sensitivity, severe headache, stiff neck, rapid heart rate, and rapidly progresses to death within 24 -48 hours.  The death rate varies from 5-15%.  Young children and adults over 50 are at highest risk of death.  It can cause permanent hearing loss, heart inflammation, seizures, brain damage, seizures, if you survive it.  It is preventable by getting the vaccine, washing hands before and after changing a diaper or after using the bathroom.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001633/

TETANUS

Also known as lockjaw.  It’s caused by a poison made by a bacteria called Clostridium tetani.  The spores live EVERYWHERE and can remain infectious for 40 years.  When the spore gets into a deep wound where there is little oxygen (hence “stepping on a nail” being a risk), the spore releases the bacteria which then makes a poison.  The poison stops the nerves from working and the muscles all over the body go into spasms so severe that they can tear muscles and break bones, especially in the spine.  It starts with mild spasms in the jaw (lock jaw).  The muscles in the chest, neck, back, and abdominal muscles can spasm too. “ Opisthotonus” is when all the back muscles spasm causing the back to arch and to break the vertebrae.
The spasms can affect breathing.  Loud noises can exacerbate the spasm.  They can have difficulty swallowing, uncontrolled urination and defecation, irritability, foot and hand spasms  and drooling.  Often you need to be in a dark room, on massive doses of muscle relaxers (valium like drugs), and to be on a breathing machine.
One out of four will die if not treated.  Newborns with untreated tetanus is even higher.  WITH treatment, < 10% die.

I’ve seen this in a patient from Mexico after childbirth and cutting of the cord with an unclean knife.
This disease is completely preventable with TdaP vaccine, dT vaccine boosters every ten years.  after the primary series is finished as a child.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001640/


SMALLPOX

Small pox is a virus that only infects humans and has been completely eradicated by vaccination.
The disease was eradicated by 1980.  Without vaccination, millions would still be dying from this terrible disease.  It is believed that Pharaoh Ramses V died of smallpox because of scars found on his mummy.  In the 18th century in Europe, 400,000 people died YEARLY of smallpox and 1/3 of the survivors went blind.  20-60% of the infected died from it.  It was 80-98% fatal in London and Berlin during the late 1800’s.
Here is a great article on the history of smallpox:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200696/


POLIO
Polio is a virus that can cause paralysis.  It is spread by person to person direct contact, mucous or phlegm, or feces.  It grows in your gut and then spreads to your blood and lymph and then causes symptoms.  Children, the elderly and pregnant women are at the highest risk during an outbreak.
Polio has virtually been eradicated in the US.  Outbreaks still occur in other countries amongst those not vaccinated.  It only exists in a few countries in Africa and Asia now.
It has two forms, paralytic, and nonparlytic.  It involves the brain and spinal cord.
It can cause back pain, diarrhea, fatigue, headache, irritability, leg /calf pain, moderate fever, muscle stiffness or pain or spasm, neck pain and stiffness, stiffness in arms, legs, abdomen, or back, rash, vomiting.
Paralytic polio causes abnormal sensations in an area, bloating, breathing problems, constipation, difficulty urinating, drooling, headache, muscle contractions, spasms, pain, and weakness that is only on one side or worse on one side.  stiff neck and back and difficulty swallowing.
I remember my father talking about not being able to go out to the pool because of outbreaks.



 
Polio NOW
Small pox affecting the eyes. It was around up until 1967 in millions
Tetanus in a baby...muscles all in spasm

2 comments:

  1. journal of the plague yearOctober 29, 2011 at 3:44 PM

    Love the Blog! Love the immunization update as well. I think it's important to point out that we live in a community and we have a certain responsibility to each other. If we refuse to vaccinate our kids and they contract measles, their disease will spread. The disease is usually benign, but can be life threatening to newborns and those with damaged immune systems. I suspect most people would not want to be the cause of life-threatning disease in newborns. This may be the most important reason to be vaccinated: Failure to do so threatens the lives of others.

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  2. I tell nurses and doctors who refuse to get flu vaccines that they can spread the disease the day before they have symptoms. How would they feel if they killed someone inadvertently because they didn't want to be inconvenienced by a fluvaccine? I think it is a moral and ethical imperative for teachers, health care workers, or anyone who has contact with potentially frail, sick, or immunocompromised people to get a fluvaccine.

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