PATCHS PROGRAM
PUBLIC HEALTH NURSING ADVOCATES TEACHING CHILD HEALTH AND SAFETY
HEALTH CARE PROGRAM FOR CHILDREN IN FOSTER CARE (HCPCFC)

Volume 1, Issue 28 JULY 2007
Inside This Issue
1

Four Diseases and Four Vaccines

2 Updates and Announcements

Medical Information Fact Sheet

Vaccines:
Part two of a two part series.

Part one overview: (Previous issue)
The previous newsletter addressed a basic description of immunity and how vaccines work. The previous newsletter also discussed the following diseases: Diphtheria, Hepatitis A, Hepatitis B, Hib disease (Haemophilus influenzae type B), Influenza (flu), Measles, Mumps, Pertussis, Pneumococcal disease, Polio, Rubella, Tetanus and Varicella as well as their corresponding vaccines. This information mostly pertains to infants and children.
All information pertaining to these diseases and vaccines can be obtained at the CDC National Immunization Program Website at http://www.cdc.gov/nip/.This website contains information for consumers as well as health care professionals. There are information sheets as well as a parent’s guide to understanding the topic. The website is user friendly and the materials are easy to understand and are available in Spanish.
Attached to this newsletter as well as the previous newsletter is a copy of the immunization schedule for children, adolescents and a catch up schedule. The schedule shows which vaccines are needed and at what intervals. The attachment can also be downloaded and printed at Centers for Disease Control and Prevention (CDC) website at http://www.cdc.gov/nip/recs/child-schedule.htm#Printable.

Part two overview: (current issue)
This issue will begin by covering rotavirus and rotavirus vaccine. This vaccine is new and is given primarily to infants. Due to the recent use of this vaccine it was not covered in the previous newsletter with the other childhood vaccines.
Then this newsletter will cover two vaccines that are primarily given to adolescents; meningococcal and human papillomavirus vaccines.
Finally, this newsletter will cover pneumococcal polysaccharide vaccine which is primarily given to older adults.

1. Rotavirus
Rotavirus is a virus that causes severe diarrhea mostly in babies and young children. It is often accompanied by vomiting and fever. Rotavirus is not the only cause of severe diarrhea but is one of the most serious.
It is estimated that each year in the United States Rotavirus is responsible for:

Almost all children in the United States will have been infected with rotavirus by their 5th birthday.
The most likely time for children to get rotavirus is between May and November and may vary depending on what part of the country you live in.
Children can get the rotavirus infection by being around other children who are already infected.

Rotavirus vaccine:

Rotavirus vaccine is the best way to protect children against rotavirus disease. Rotavirus vaccine is an oral (swallowed) vaccine; it is not given by injection.
Rotavirus vaccine will not prevent diarrhea and vomiting caused by other germs. The vaccine offers about 98% protection to children against severe rotavirus diarrhea, and about 74% do not get rotavirus diarrhea at all. Children who get the vaccine are also much less likely to be hospitalized or to see a doctor because of rotavirus infection.

It is recommended that children receive 3 doses of the rotavirus vaccine. The doses should be given at 2, 4, and 6 months of age. The first dose should be given between 6-12 weeks of age. Children should have received all 3 doses by 32 weeks of age. Rotavirus vaccine may be given with other vaccines.

It is noted that children who have suffered from intussusception (an uncommon type of bowel obstruction) should not receive the rotavirus vaccine.

2. Meningococcal Disease

Meningococcal disease is a serious illness, caused by a bacteria. It is the leading cause of bacterial meningitis in children 2-18 years old in the United States.
Meningitis is an infection of fluid surrounding the brain and spinal cord. Meningococcal disease also causes blood infections.
About 2,600 people get meningococcal disease each year in the United States. 10-15% of these people will die, in spite of being treated with antibiotics. Of those who live, another 11-19% lose their arms or legs, become deaf, have problems with their nervous systems, become mentally retarded, or suffer seizures or strokes.
Anyone can get meningococcal disease. It is most common in infants less than one year of age and people with certain medical conditions, such as a lack of a spleen. College freshman who live in dormitories have an increased risk of getting meningococcal disease.
Meningococcal infection can be treated with drugs such as penicillin. Still 1 out of every 10 people who get the disease will die from it and many others will be affected for life. This is why preventing the disease through use of meningococcal vaccine is important for people at highest risk.

Meningococcal Vaccine:

There are two types of meningococcal vaccines that are available in the United States:

Both vaccines prevent 4 types of meningococcal disease, including 2 of the 3 most common types in the United States. Meningococcal vaccines cannot prevent all types of the disease, but they can protect many people from getting sick.

Both vaccines work well, and protect 90% of those who get it. MCV4 is expected to give better, longer-lasting protection. MCV4 should also be better at preventing the disease from spreading person to person.
MCV4 is recommended for all children at their
routine preadolescent visit (11-12 years of age). For
those who have never gotten MCV4 previously, a dose is recommended at high school entry. Other adolescents who want to decrease their risk of
meningococcal disease can also get the vaccine.

Meningococcal vaccine is also recommended for other people at increased risk for meningococcal
disease:

meningococcal bacteria.

world where meningococcal disease is common,
such as parts of Africa.

spleen has been removed.


MCV4 is the preferred vaccine for people 11-55 years of age in these risk groups, but MPSV4 can be used if MCV4 is not available. MPSV4 should be used for children 2-10 years old, and adults over 55, who are at risk.

3. Human Papillomavirus (HPV)

Genital human papillomavirus (HPV) is the most common sexually transmitted virus in the United States. There are about 40 types of HPV.

About 20 million people in the U.S. are infected, and about 6.2 million more get infected each year. HPV is spread through sexual contact.

Most HPV infections don’t cause any symptoms, and go away on their own. But HPV is important mainly because it can cause cervical cancer in women. Every year in the U.S. about 10,000 women get cervical cancer and 3,700 die from it. It is the 2nd leading cause of cancer deaths among women around the world.

HPV is also associated with several less common types of cancer in both men and women. It can also cause genital warts and warts in the upper respiratory tract.

More than 50% of sexually active men and women are infected with HPV at sometime in their lives. There is no treatment for HPV infection, but the conditions it causes can be treated.

HPV vaccine:

HPV vaccine is an inactivated (not live) vaccine which protects against 4 major types of HPV.
These include 2 types that cause about 70% of cervical cancer and 2 types that cause about 90% of genital warts. HPV vaccine can prevent most genital warts and most cases of cervical cancer.
Protection from HPV vaccine is expected to be long-lasting. But vaccinated women still need cervical cancer screening because the vaccine does not protect against all HPV types that cause cervical cancer.
HPV vaccine is licensed for females 9-26 years of age. However, it is routinely recommended for girls 11-12 years of age. Doctors may give it to girls as young as 9 years.
It is important for girls to get HPV vaccine before their first sexual contact – because they have not been exposed to HPV. For these girls, the vaccine can prevent almost 100% of disease caused by the 4 types of HPV targeted by the vaccine.
However, if a girl or woman is already infected with a type of HPV, the vaccine will not prevent disease from that type.
The vaccine is also recommended for girls and women 13-26 years of age who did not receive it when they were younger.

HPV vaccine is given as a 3-dose series:

1st Dose: Now
2nd Dose: 2 months after Dose 1
3rd Dose: 6 months after Dose 1

4. Pneumococcal Disease

Pneumococcal disease is a serious disease that causes much sickness and death. In fact,
pneumococcal disease kills more people in the United States each year than all other vaccine preventable diseases combined. Anyone can get pneumococcal disease. However, some people are at greater risk from the disease. These include people 65 and older, the very young, and people with special health problems such as alcoholism, heart or lung disease, kidney failure, diabetes, HIV infection, or certain types of cancer.

Pneumococcal disease can lead to serious infections of the lungs (pneumonia), the blood (bacteremia), and the covering of the brain (meningitis). About 1 out of every 20 people who get pneumococcal pneumonia dies from it, as do about 2 people out of 10 who get bacteremia and 3 people out of 10 who get meningitis. People with the special health problems mentioned above are even more likely to die from the disease.

Pneumococcal polysaccharide vaccine (PPV):

The pneumococcal polysaccharide vaccine (PPV) protects against 23 types of pneumococcal bacteria. Most healthy adults who get the vaccine develop protection to most or all of these types within 2 to 3 weeks of getting the shot. Very old people, children under 2 years of age, and people with some long-term illnesses might not respond
as well or at all.

PPV should be given to:

Usually one dose of PPV is all that is needed.

However, under some circumstances a second dose
may be given.

Children 10 years old and younger may get this second dose 3 years after the first dose. Those older than 10 should get it 5 years after the first dose.

** Please note that Pneumococcal polysaccharide vaccine is different then pneumococcal conjugate vaccine which is given to children under the age of 5.

*** If you would like more information regarding immunizations please visit the Riverside County Disease Control website at http://www.rivco-diseasecontrol.org/ or contact them by phone at 951-358-5107

*** If you would like more information regarding low-cost immunizations and to locate a Family Care Center near you please visit the Riverside County Department of Public Health website at http://www.rivco-familycarecenters.org/imms.htm or contact Clinic Management at 951-358-5222

Source:
Centers for Disease Control and Prevention. (2007). National Immunization Program. Retrieved on April 22, 2007, from the World Wide Web: http://www.cdc.gov/nip

HCPCFC PROGRAM UPDATES and ANNOUNCEMENTS!!!

I would like to acknowledge National Nurses Week celebrated annually May 6-12.

I would like to say thank you to all the nurses and to let them know they are appreciated.

Keep up the great work!

Editor: Kristen Thompson, PHN
Contributors: Nicole Boyd, PHN, Assistant Nurse Manager and
Hermia Parks, MA, Director of Public Health Nursing.
Special thanks to:
Barbara Cole, RN, PHN, MSN, Branch Chief, Disease Control Branch,
for her input on this topic.

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