1	BLOODBORNE PATHOGENS FOR HEALTH RELATED PROFESSIONS & OTHER INFECTIONS DISEASES Version 2.0 Revised 05/2007
2	Acquired Immunodeficiency Syndrome (AIDS) First seen in 1981. Characterized by one or more opportunistic diseases. (Kaposi Sarcoma) HIV was identified in 1983 as the causative organism.
3	Global status of HIV/AIDS 40.0 million are living with HIV & AIDS In 2001 alone, 3 million people died of AIDS Just under 1 million people in the US have HIV infections (929,985 people) ¼ of these people are unaware of their infection That is 232,496 people are unaware!!!!
4	Global status of HIV/AIDS About 14,000 new infections occur daily 90% of these are in developing countries Majority of new HIV infected adults are <25 years old 11.7 million adults and 4.0 million children have died since the epidemic began Over 8 million children have been orphaned because of AIDS
5	Deaths Due to AIDS in the US Through 2004 it is estimated that 518,568 adults 5,492 children under 13 years Have died of the disease.
6	The Virus Has a protective coating which deters destruction Enters the bloodstream and attacks WBCs called “T cells”. T cells become functionally impaired. HIV antibodies are produced by other WBCs to combat the AIDS virus.
7	Antibodies Can be detected by a simple blood test. Test typically shows presence of virus between 2 weeks to 6 months after infection. However, it may take up to 10 or more years to show signs of the illness.
8	Aids Cases by age in the US
9	AIDS Cases by Race/Ethnicity in the US
10	Modes of HIV Transmission Accidental exposure to blood/blood products (e.g., blood transfusions, shared needles, contaminated instruments) Mother to child during: pregnancy birth breastfeeding
11	HIV Transmission Through Sexual Contact Of every 100 HIV infected adults, 75B85 have been infected through unprotected intercourse 70% of these infections are from heterosexual intercourse STDs, especially ulcerative lesions in genitalia, increase risk of transmission
12	HIV Transmission HIV cannot be transmitted by: Casual person to person contact at home or work or in social or public places Food, air, water Insect/mosquito bites Coughing, sneezing, spitting Shaking hands, touching, dry kissing or hugging Swimming pools, toilets, etc.
13	Signs and Symptoms Frequent yeast infections Shingles in persons under age 50-60 Frequent Herpes Unexplained weight loss Fever of unknown origin Skin rash and cough An infected individual may appear and feel fine, but is still capable of infecting others.
14	Kaposi Sarcoma
15	Body Fluids The virus has been isolated in all body fluids in varying degrees. Blood Semen Vaginal Secretions Stool Urine These have the highest concentration of the virus.
16	Women and HIV Biological risk factors Twice as easy for women to contract HIV from men Physiology of women (e.g., menstruation, intercourse) Pregnancy-associated conditions (e.g., anemia, menorrhagia and hemorrhage) increase the need for blood transfusion
17
18	AIDS Cases by Exposure Category Estimated # through 2003
19	Risk Factors Sex Between Men Multiple Partners IV Drug Users Hemophilia SO……….Why are we covering these risk factors if they don’t apply to you?……...
20	"Accidental needle sticks with blood..." Accidental needle sticks with blood contaminated needles occur among healthcare providers.
21	HIV and Healthcare Workers Most exposures do not result in infection Risk varies by: type of exposure amount of blood involved amount of virus in the patient’s blood at time of exposure whether post exposure treatment was taken
22	Public Education Another reason you need to know about AIDS is that you have chosen a career in the healthcare profession. Whether you want them to or not, people will ask your advice. You must be informed and educated so that you can properly instruct people on varying topics.
23	PREVENTION You should have a blood test to see if you have been infected with the AIDS virus if: You have been involved in high risk sexual activity. You have shared IV Drug needles.
24	Prevention (cont.) If your test is positive for HIV or you engage in high risk activities and choose not to have a test, you should: Discuss same with your sexual partner. Protect your partner by using a condom. If your partner has tested positive or if you expect exposure, condoms should be used.
25	Prevention (cont..) If you or your partner are at risk: Avoid oral contact. Avoid activities which could cause cuts to the rectum or vagina. Avoid sex with prostitutes. Be aware that needle exchange programs exist throughout the US. Most health departments provide confidentiality and anonymity groups.
26	Treatment Medications are available to lessen the onset of opportunistic infections: AZT DDI HIVID Numerous new drugs have recently been introduced. These are anti-viral agents. To date, no approved immunization or cure is available and the development of one doesn’t appear to be likely soon
27	Pregnancy The need to test all pregnant women for HIV is being considered. Research reveals that 30% of children born to infected mothers are HIV positive. The rate drops to 8% if the mother is properly treated during pregnancy and the newborn is given medication at birth.
28	Effect of AIDS on Pregnancy Infertility Repeated abortions Prematurity Intrauterine growth retardation Stillbirths Congenital abnormalities Embryopathies
29	HIV and Breastfeeding WHO, UNAIDS and UNICEF recommend that all women: be informed of the risk of HIV transmission through breastfeeding, have access to voluntary counseling and testing to find out their HIV status, and be supported in their choice of breastfeeding or replacement feeding.
30	HIV Transmission from Mother to Infant 90% of HIV-infected infants and children were infected by their mother 2/3 of babies born to HIV infected women are NOT infected Of infected infants: 2/3 infected in the womb or at birth 1/3 infected via breastfeeding
31	Risk of HIV Transmission from Breastfeeding Risk is increased if: Mother acquires infection while pregnant or during lactation Mother has cracked nipples, abscesses or other breast problems Mother is symptomatic for HIV-related disease Baby has sores in mouth or inflamed gut
32	Nutritional Support The person with AIDS typically presents with weight loss. Their diet is poor. They have no taste for food. Consequently they do not eat well. The diaphragm is one of the first muscles affected by malnutrition.
33	Nutritional Support (cont.) The diaphragm: Is the muscle below the lungs. Helps the lungs to move in and out during breathing. When weakened, allows the virus to invade the lungs Results in Pneumocystis.
34	Pneumocystis Carini Is the most common disease associated with AIDS. May be the mechanism for initial diagnosis. Is a type of pneumonia Is capable of production massive infection in the lungs of the infected individual.
35	Nutritional Support (cont.) It is extremely important for the person with AIDS to eat a healthy diet. Proteins are the substances of repair for the body. Individuals infected with HIV must be encouraged to eat a high quantity of protein in order to built their muscles. Examples of high protein foods are peanut butter and supplemental protein drinks.
36	Personal Protective Equipment During your career, you will care for a person with HIV. What measures do you need to take? GLOVES, GLOVES, GLOVES!
37	PPE (cont.) HIV has been isolated in every body fluid (including blood, sweat, and tears) The amount of contamination depends on the amount of body fluid involved. Although the virus is present in sweat, there have been NO documentations of infections from contact with a diaphoretic person. Researchers do not believe that tears or sweat transmits the virus.
38	PPE (cont.) SO WHEN DO YOU WEAR GLOVES? Any time and any place where you may come in contact with body fluids that have a high concentration of the virus:
39	PPE (cont.) Any time you expect a large contamination of body fluids, you should wear the full complement of personal protective equipment.
40	Post Exposure Treatment of Healthcare Workers Intact skin, mouth or nose: immediately wash with soap and water and rinse thoroughly to remove all potentially infectious particles. Cut or punctured skin: allow to bleed fully.
41	Post Exposure Treatment of Healthcare Workers Eye: flush immediately with water, then irrigate with normal saline for 30 minutes. Consider post exposure prophylaxis (PEP) if high risk of transmission: 4 week course of zidovudine (ZDV) preferable to start within 1-2 hours
42	Post Exposure Treatment of Healthcare Workers continued HIV testing immediately, 6 weeks, 6 months and 12 months Treatment, if started, should continue for 4 weeks. Any or all drugs may be declined by exposed worker. For lesser exposures, prophylaxis is not recommended.
43	What to do if a blood spill occurs? Use a solution of 1:9 bleach and water to disinfect the area. Research has proven that the virus lives outside the body for a considerable time. To prevent other contamination, be sure to clean ANY accidental spillage
44	Emotional Needs What is expected of you? How many of you will be afraid to care for patients with AIDS?
45	OSHA A copy of the Federal Register regarding Bloodborne Pathogens and a copy of the EMS Program’s policy on AIDS & AIDS-related conditions can be found in the office of the EMS Program Director. These documents are available for your review.
46	Hepatitis The term “hepatitis” means inflammation of the liver. Causes of hepatitis include: Toxic chemicals Alcohol Viruses
47	Seven Types of Viral Hepatitis (A through E), are well-recognized. Recently, researchers have identified a sixth type (hepatitis G), and a seventh is suspected but not yet confirmed (hepatitis F).
48	Hepatitis A Often caused by consuming fecal contaminated food or water. Produces only acute hepatitis.
49	Hepatitis A Sometimes called infectious hepatitis, although all viral hepatitis is infectious. Vaccine is available and recommended before travel in some parts of the world. The CDC estimates that 150,000 people in the united states are infected each year by hepatitis A.
50	Symptoms of Hepatitis A As is common with the other forms of viral hepatitis, the infected person may not have any symptoms. When they do occur, symptoms resembling the flu normally appear during the first four weeks of infection. These include fatigue, nausea, vomiting, pain in the liver area, dark urine or light colored stools and fever.
51	Symptoms of Hepatitis A Liver function tests are elevated, with many adults developing jaundice. Most people recover from the hepatitis A virus within six months without any serious health problems.
52	Transmission of Hepatitis A Fecal matter from an infected person has a high concentration of the virus. The virus can survive in fecal matter on a person's hand or other surfaces for three to four hours at normal room temperatures. Eating utensils are a frequent source of infection, as are contaminated shellfish and I.V. Drug use. Intimate contact of any kind with an infected person can also transmit the virus.
53	Typical Associations Close quartered institutions Third world countries due to poor sanitation In epidemic forms in U.S. Daycare centers where diapers are changed In some cases, where well water is used
54	Incubation Period Incubation period is 15 to 45 days. This type is not life threatening. Signs and Symptoms may include: Low grade fever Lethargy Nausea, diarrhea, and vomiting Urine may turn dark Feces may turn pale Skin may become jaundiced
55	Treatment There is no specific treatment for Hepatitis A Palliative treatment includes: Bedrest Good diet Treatment of symptoms
56	Gamma Globulin Some symptoms such as nausea and itching may be treated medically with an injection of Gamma Globulin. This injection reduces the severity of symptoms IF AND ONLY IF it is administered within one week of exposure. Is also administered with Hepatitis B exposure.
57	Hepatitis B Hepatitis B virus (HBV), formerly called serum hepatitis, is much more prevalent than HIV ( the virus that causes AIDS). Spread in numerous ways including sexual contact, blood products, and contaminated needles. May produce a severe acute hepatitis but only about 5 percent to 10 percent develop chronic hepatitis. Readily preventable by vaccination.
58	Transmission of Hepatitis B Through infected blood and other body fluids (seminal fluid, vaginal secretions, breast milk, tears, saliva and open sores). In the U.S., Hepatitis B is spread predominantly through sexual contact. Other risk groups include health care workers, prison inmates and personnel, IV drug users, and recipients of blood transfusions prior to 1975. In families, it appears that the virus can be casually spread from adults to children.
59	"AS A HEALTHCARE PROVIDER…." AS A HEALTHCARE PROVIDER….
60	"The incubation period is 50..." The incubation period is 50 to 180 days. Symptoms are the same as for Hep A. Jaundice is typically seen with type B. According to statistics, most people fully recover from Hep B in 1 to 2 months. It should be noted, however that 1-2% of individuals with Hepatitis B die shortly after infection due to liver failure. 5-10% develop chronic Hepatitis and become carriers of the disease.
61	Hepatitis B Vaccination As part of your admission to Calhoun’s Health Education Division, you are required to either receive the vaccine or sign a waiver against vaccination. The vaccine involves a series of three injections. Side effects are minimal and may include soreness and warmth at the injection site.
62	"Although there is no guarantee..." Although there is no guarantee of immunity, it is very important that you consider receiving the vaccine. The CDC has made it mandatory for employers to provide vaccinations to healthcare employees because the risk is so much greater for us. Gamma Globulin is administered to boost the effects of previous vaccinations.
63	End Stage Liver Cancer Associated with Hepatitis B
64	Hepatitis C A blood-borne virus first identified and successfully tested for in 1989. It is most often transmitted by intravenous drug users sharing contaminated needles.
65	Hepatitis C It An estimated 3 percent of the world's population — more than 170 million people — carry HCV. can live undetected in the body for years. In fact, up to 90 percent of people infected with HCV show no symptoms until decades later when damage from the virus' relentless assault on the liver shows up during medical tests. Those infected with the virus carry an increased risk of developing cirrhosis and cancer of the liver.
66	Impact on U.S. From HCV Hepatitis C affects an estimated 4 million people in the U.S., With 30,000 new cases diagnosed annually. By comparison, there are just under a million Americans infected with the AIDS virus (CDC). Currently, about 10,000 Americans die each year from HCV-related disease, compared with 14,000 from aids-related conditions. Source: http://www.mayohealth.org/index.htm
67	According to the World Health Organization (WHO), HCV Has Been Identified in Virtually Every Country in the World. It Is the Most Common Cause of Post-blood Transfusion Hepatitis, Accounting for About 90 Percent of Cases in the U.S., Japan and Western Europe. Source: Http://www.mayohealth.Org/index.htm
68	"Effective blood screening has dramatically..." Effective blood screening has dramatically reduced the chances of infection from transfusions. Contaminated drug injecting paraphernalia that is shared is now responsible for about half of all new hepatitis C cases. Those infected with hepatitis C should not donate blood, organs, tissues or semen, according to the CDC.
69	Hepatitis C Once infected, few become acutely ill, but up to 90 percent develop a chronic infection and 20 percent of those chronically infected individuals develop cirrhosis of the liver. May be identified by a simple blood test, but no vaccine is currently available.
70	HCV Symptoms 60 to 70 percent of patients with acute HCV infection are asymptomatic. 20 to 30 percent have jaundice. 10 to 20 percent have only fatigue, anorexia and abdominal pain.
71	"HCV ranks second behind alcoholism..." HCV ranks second behind alcoholism among the causes of liver disease and is the leading reason for liver transplants. About 85 percent of people infected with HCV go on to develop chronic hepatitis. About 20 percent develop cirrhosis, an incurable disease, within 20 years. And up to half of those cases progress to end-stage liver disease or liver cancer. Source: http://www.mayohealth.Org/index.htm
72	Risk Factors Contact with persons with jaundice Visits to environments with poor sanitation Ingestion of shellfish or raw fish Recent ear piercing or body tattooing Recent blood transfusions IV drug use (sharing needles) Occupational exposures (healthcare workers) Hemodialysis Multiple sex partners
73	Hepatitis D A person must be infected with hepatitis B to acquire this disease. Symptoms similar to hepatitis B.
74	Hepatitis E Similar to hepatitis A: acute rather than chronic. Very unusual in the U.S. Has produced large outbreaks in Asia and south America.
75	Hepatitis E Symptoms and methods of transmission resemble hepatitis A, although the period of illness may be as long as several months. Caused by a virus commonly found in the Indian ocean region, Africa, and in underdeveloped countries. Testing for hepatitis E is being developed but is not yet available commercially. Hepatitis E is rarely, if ever, responsible for causes of chronic hepatitis
76	Hepatitis F Appears to produce a type of hepatitis similar to hepatitis C. But scientists are not yet certain it is a separate hepatitis virus.
77	Hepatitis G Newly identified. Probably transmitted in a similar fashion to hepatitis C. Scientists are unsure of its impact or how often it produces chronic symptoms or liver disease.
78	Personal Protective Equipment Appropriate protection includes whatever items are necessary to prevent contact with body fluids. Typically, gloves are appropriate.
79	Tuberculosis A necrotizing infection occurring most commonly in the lungs. Also called Pulmonary TB. Transmission is airborne from a source person speaking, coughing, or sneezing. When the infective droplet is inhaled, the body produces an acute inflammatory response within 24 to 48 hours.
80	"The immune system kicks in..." The immune system kicks in within 10-20 days. Blood cells form around the bacteria and encapsulate it. These encapsulated cells dissolve within 13 to 24 weeks and then resemble thick white masses that look live cheese. After this occurrence, the previously encapsulated bacteria spread throughout the lung fields and to other parts of the body. In rare cases, the casing never dissolves, thus the bacteria never activates.
81	Clinical Findings Clinical findings include: Fever Fatigue Weight loss Productive cough Chills Anemia Bloody sputum
82	Treatment Drugs include INH and Rifampin The patient is no longer considered contagious after having received seven days of medication. Potential exposures occur among hospitalized patients who have not been identified as having TB.
83	High Risk Persons Persons with HIV infection Contact with patients recently diagnosed with TB Contact with patients who have had a recent skin test conversion Contact with persons who have been recently diagnosed and inadequately treated Leukemia/lymphoma, diabetes, and end stage kidney disease increase the risk of contracting TB
84	"As part of your admission..." As part of your admission to Calhoun’s Health Education Division, you are required to receive a two step TB skin test. A positive skin test does not mean that you have TB, it merely means that you have come in contact with the bacteria. Typically, when employed in healthcare, you will be required to have a yearly skin test and physical exam. The number of TB patients in the U.S. is growing and is closely associated with HIV.
85	Personal Protective Equipment Mask TB is an airborne disease. Infected patients must be transported wearing a mask.
86	Phthirius and Sarcoptes Lice and Scabies Lice are small wingless insects. Three kinds are common in humans: Head lice Body lice Pubic lice (crab lice) Body lice are generally sexually transmitted Spread occurs through physical contact with infested bedding, clothing, hats, towels or hair.
87	Incubation Period Itching may develop at the site of infestation about a month after infestation. In some cases, lice bites may cause a mild rash resembling blue spots. Lice should be suspected in anyone with an itchy eruption in a hairy area of the body.
88	Visualization of Lice A magnifying glass is needed to see adults. Lice appear as small yellow or gray insects unless they have recently fed and look red.
89	Head Lice
90	“Nits” Clinically, you may see the “nits” associated with lice. Head and pubic lice are attached by a cement-like substance. The nit (eggs) are laid at the hair/skin junction. As time goes by, the hair grows out and has a tangled appearance.
91	Treatment for lice Body lice may live for 10 days without a blood meal. Pubic lice live only 1-2 days. Treatment involves using Kwell lotion (a prescription medication). “Rid” is an over the counter version. Both medications require only one application.
92	Lice treatment (cont.) The lotion is applied undiluted to the infected areas and washed off after about 10 minutes with warm water and soap and shampoo. A comb is then used to remove the dead lice and eggs. Itching may continue for 2 weeks after treatment. Patients should also wash all clothing and bedding in hot water to prevent reinfestation
93	Lice treatment (cont.) In the acute care setting, gloves are sufficient to prevent personal infestation. Normal laundry guidelines treat all bedding as infected and are sufficient to prevent spread through linens. Bedding should be changed after each patient. (As you will see on clinicals.)
94	Scabies Scabies is a skin infestation by a mite. Scabies is transmitted by physical contact. Typically no symptoms for one month. The symptoms resemble an allergic reaction with the most common being itching. The most common areas of infestation are wrists, webs and sides of the fingers, elbows, around the navel and breasts, and the lower portion of the buttocks. Sometimes, the penis and scrotum are involved.
95	Scabies (cont.) Diagnosis is made by microscopic examination of skin scrapings. Treatment is again Kwell lotion. Symptoms may continue for several weeks. Bedding and clothing should be washed in hot water. Clinically, gloves are appropriate for prevention of transmission.
96	Scabies
97	Herpes Herpes is a class of viruses that include: Cold sores (herpes I) Genital herpes (herpes II) Herpes I usually infects the mouth and lips and causes the common cold sore or fever blister. Herpes II is almost always sexually transmitted and may lie dormant for years. Ten percent of genital herpes cases are caused by oral to genital contact.
98	Oral Herpes
99	Genital Herpes
100	Herpes (cont.) The average incubation period for genital herpes is 6 days and between 2 & 12 days. Transmission occurs while the virus is shedding. The contagious period begins just before the active outbreak of lesions and continues through the shedding period. Direct contact with actively shedding lesions is usually necessary to contract the virus.
101	Herpes (cont.) Herpes I infections are generally transmitted by mouth to mouth contact. Herpes II is transmitted through sexual contact. The virus may live outside the body for a short time in a warm environment. Chlorine kills the virus on contact.
102	Herpes (cont.) There is no current cure for the herpes virus. Research is underway to develop a vaccine. Sexual activity should be avoided during active periods of the virus. Condoms should be used between active episodes. Consult a physician for treatment. Sometimes treatment involves hospitalization and IV antibiotics.
103	MRSA: Methicillin Resistant Staphylococcus Aureus Staph aureus is a gram positive organism {bacteria} that can be cultured from the nose of 30 to 40% of the general population. Generally the organism can be killed with antibiotics. MRSA is a staph aureus that is resistant to the semi-synthetic penicillins.
104	"MRSA was first identified in..." MRSA was first identified in 1961. It first appeared in the U.S. in 1975. Around 1980, a study showed that MRSA was directly related to the cause of death in 44% of the cases studied. MRSA is deadly if not identified and treated properly. Diagnosis can only be made through laboratory testing.
105	Transmission and Prevention of MRSA MRSA is spread from person to person by direct skin contact. Hand carriage by hospital staff is thought to be one of the main methods of spread between patients. It is very important to wash your hands between patients. Hand washing before and after each patient contact with soap and water for a minimum of 20 seconds is the best way to prevent MRSA’s spread.
106	"Other measures to prevent becoming..." Other measures to prevent becoming infected or transmitting infection include: avoid cross contamination between clean & dirty linen daily environmental cleaning wearing gloves for all dressing changes proper handling of medical waste observing isolation precautions Do not let this organism frighten you. If you simply touch a patient, you are not likely to become sick yourself. Just be sure to wash your hands before and after each patient contact.
107	Stethoscopes and MRSA Stethoscopes, an almost universal tool of the medical profession, are an additional vector of infection since they touch so many patients. A study in 1992 of 29 stethoscopes found 26 of them contaminated with staph. Five of them had MRSA. Be sure to clean stethoscopes between patients. Alcohol preps should be sufficient for cleaning.
108	Isolation Precautions First, treat all patients as if they are infectious!! MRSA does require some special precautions. Patients with MRSA should be separated from the general patient population. The area of the body infected determines the amount of PPE needed.
109	"If the organism involves the..." If the organism involves the respiratory system, wear a mask. If the organism is in the urine, gloves are necessary. Gowns and masks are not necessary unless spillage is likely. Urine contamination usually does not require special isolation. Respiratory contamination requires placement in special rooms that filter air more efficiently than normal rooms.
110	"Remember" Remember, MRSA is deadly if untreated. Good hand washing is very effective in preventing transmission.
111	Vaccines
112	Diphtheria, Tetanus, and Pertussis (DTaP) Why get vaccinated? All three are caused by bacteria that can easily enter the body. Diphtheria causes a thick mucus covering to the back of the throat. Tetanus (lockjaw) – causes painful tightening of the muscles, usually all over the body. Pertussis (Whooping Cough) causes severe coughing spells that can lead to breathing difficulties, pneumonia, seizures, and even death.
113	Diphtheria
114	Pertussis and Tetanus
115	DTaP Who should get it…and when? Children should get 5 doses before age 6. 2 months 4 months 6 months 15-18 months 4-6 years
116	Hepatitis B Virus (HBV) Why get the vaccine? Hepatitis B is a severe viral infection of the liver? It can cause Loss of appetite Fatigue Muscle, joint and stomach pain Diarrhea and vomiting Jaundice Liver damage – cirrhosis (long term) Liver cancer (long term) Death ~ 1.25 million people in the U.S. have chronic HBV infection.
117	Hepatitis B Vaccine Who should get the vaccine…and when? Everyone 18 years old and younger. Adults over 18 that are at risk. Adults at risk of HBV infection include: People who have more than one sex partner in 6 months. Men who have sex with other men. People who inject illegal drugs. Health care and public safety workers who might be exposed to infected blood or body fluids. Household contacts of persons with chronic HBV infection. Hemodialysis patients.
118	Hepatitis B Vaccination Schedule
119	Polio Why get the vaccine? Polio is a viral disease that enters a child's body through the mouth. It can cause paralysis. It can kill people who get it by paralyzing the diaphragm. Before 1950 there were more than 20,000 cases of Polio each year in the U.S. Polio vaccination began in 1955, by 1979 there were only 10 cases in the U.S. Polio has not been reported in the U.S. in over 20 years.
120	Polio Vaccine
121	Polio Vaccine Who should get it…and when? Children should get 4 doses before age 6. 2 months 4 months 6 – 18 months 4 – 6 years
122	Haemophilus Influenzae Type b (Hib) What is the Hib disease??? Hib is a serious disease caused by a bacteria which usually strikes children under 5 years old. Hib can be found in the nose & throat but does not become a threat until it spreads into the bloodstream or lungs. Before Hib vaccine, Hib disease was the leading cause of bacterial meningitis among children under 5 years old in the U.S. Hib disease can also cause: Pneumonia Severe swelling in the throat, making it hard to breathe. Infections of the blood, joints, bones, and covering of the heart. death
123	Prevnar® Pneumococcal Conjugate Vaccine Why get the vaccine? Streptococcus pneumoniae bacteria can cause serious illness and death. Invasive pneumococcal disease is responsible for about 200 deaths each year among children under 5 years old. It is the leading cause of bacterial meningitis in the U.S. Pneumococcal conjugate vaccine can help prevent serious diseases, such as: Meningitis Blood infections Some ear infections
124	Prevnar® Vaccine Who should get it and when??? The routine schedule for the Prevnar® vaccine is 4 doses, one dose at each of these ages: 2 months 4 months 6 months 12 – 15 months Children who weren’t vaccinated at these ages can still get the vaccine. The number of doses needed depends on the child’s age.
125	Prevnar® Vaccine Who should get it…and when??? Children between 2 and 5 years of age The Prevnar® vaccine is also recommended for children between 2 and 5 years old who have not already gotten the vaccine and are at high risk of serious pneumococcal disease. This includes children who: Have sickle cell disease Have a damaged spleen or no spleen Have HIV/AIDS Have other diseases that affect the immune system, such as diabetes,cancer, or liver disease Take medications that affect the immune system such as chemotherapy or steroids Have chronic heart or lung disease Attend group day care
126	Measles, Mumps & Rubella Vaccines Why get the vaccine? Measles, mumps, and rubella are serious diseases. Measles: Measles virus causes rash, cough, runny nose, eye irritation,and fever. It can lead to ear infection, pneumonia, seizures, brain damage, and death. Mumps: Mumps Virus causes fever, headache, and swollen glands. It can lead to deafness, meningitis, painful swelling of the testicles or ovaries, and, rarely, death. Rubella: Rubella virus causes rash, mild fever, and arthritis. If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects.
127	Measles, Mumps, and Rubella
128	MMR Vaccine Who should get it and when??? Children should get 2 doses of MMR vaccine. The first at 1 – 15 months The second at 4 – 6 years of age Some adults should also get MMR vaccine: Generally, anyone 18 years of age or older, who was born after 1956, should get at least one dose of MMR vaccine unless they can show that they have had either the vaccines or the diseases.
129	Chicken Pox Why get the vaccine? Caused by a highly contagious virus that is spread through the air or by contact with fluid from the blisters. It causes fatigue, rash, fever, and itching. It can lead to skin infections, scars, pneumonia, or death. The virus can reappear later in a painful rash called shingles. 12,000 people are hospitalized in the U.S. annually from chickenpox infections. 100 people in the U.S. die annually from the chickenpox.
130	Chicken Pox
131	Chicken Pox vs. Small Pox
132	Chicken & Egg Pox
133	Chickenpox Vaccine Who should get it…and when? Children should receive one dose of the vaccine between the ages of 12 and 18 months. Anyone that is older than 13 that decides to receive the vaccine needs 2 doses received 4 weeks apart. There is no need to receive the vaccine if you have already been infected by the virus.
134	Influenza What is it? Influenza is a highly contagious virus that kills thousands each year in the U.S. It is spread by infected persons through airborne droplets.
135	Influenza What is it? “Influenza Season” is from November to April. Influenza Causes: Fever Cough Chills Sore Throat Headache Malaise Most people with the flu are ill for only a few days, but the very young and elderly often require hospitalization.
136	Influenza Vaccine Who should get it? The virus that causes the flu changes and is considered one of the “smartest” viruses known to man so this vaccine is not a perfect science. Everyone over 50 years old Residence of long term care facilities Anyone with autoimmune diseases Women who will be in the 3^rd trimester Children between the ages of 6 months to 5 years old People with heart or lung disease Childcare workers Healthcare workers
137	Influenza Vaccine Who should get it…and when? The best time to get the vaccine is between October to mid-November. People 9 years of age and older need one shot People less than 9 years old require 2 shots four weeks apart. Do not get the shot if you have a serious allergy to eggs or a previous flu shot. Also do not get the vaccine if you have a history of Guillian-Barre Syndrome.
138	Influenza Vaccine What are the risks? Mild Reaction Soreness Fever Malaise Sever reactions include behavior changes and very high fever as well as respiratory compromise. (less than 1 out of 1,000,000)
139	How can I learn more? Ask your doctor or nurse. Call your local health department. Contact the Center for Disease Control and Prevention (CDC). 1-800-232-2522 (English) 1-800-232-0233 (Spanish) www.cdc.gov/nip www.vaccine.org www.adph.org
140	Wrapping up Questions? Paperwork (attendance form) Gloves