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Cocooning Messages for the Practicing Pediatrician Laura Sally, MPH Texas Pediatric Society

Cocooning Messages for the Practicing Pediatrician Laura Sally, MPH Texas Pediatric Society. Cocooning Strategy. Parents. Siblings. Child Care Provider. Healthcare Worker. Grandparents.

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Cocooning Messages for the Practicing Pediatrician Laura Sally, MPH Texas Pediatric Society

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  1. Cocooning Messages for the Practicing PediatricianLaura Sally, MPHTexas Pediatric Society

  2. Cocooning Strategy Parents Siblings Child Care Provider Healthcare Worker Grandparents

  3. Pertussis is one of the few remaining poorly controlled infectious diseases for which children are routinely immunized. Pertussis (AKA: Whooping Cough)

  4. Comparison of 20th Century Annual Morbidity and Current Morbidity, Vaccine-Preventable Diseases, Texas

  5. Pertussis on the Rise • Increasing nationwide since 1980 • More significant in Texas in the past decade • Particularly evident in adolescent and adult populations

  6. Reported Cases of Pertussis in Texas, 1998-2008* * Provisional as of March 27, 2009

  7. Incidence of Pertussis in Texas

  8. Why is Pertussis so persistent? Waning immunity in adolescent and adult populations Waning expected 5-10 years after administration of childhood vaccine shots

  9. Why is Pertussis So Persistent? Percentage of Texas Pertussis Cases by Age Group

  10. Why is Pertussis So Persistent? Pertussis is on the rise due to waning immunity in the adult and adolescent populations Nearly 75% of the time, a family member is the source of pertussis disease in infants. It is crucial that adolescents and adults follow the CDC recommendations to receive a Tdap booster shot to prevent pertussis. These recommendations can be found at: http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/DTaP-Td-DT/Tdap.htm

  11. How is Pertussis So Persistent? • In adults, symptoms often resemble a cold • Pertussis is most contagious BEFORE coughing begins • Parents may not be aware that they have pertussis or are spreading this disease to their babies. • Disease is more severe for infants

  12. Ramifications • 65% of cases in kids under 1 year of age result in hospitalization.  • Nationally, there are 10-20 deaths from pertussis reported each year. • In 2008, there were 4 deaths in Texas. • Duration of cough as a result of this disease averages 36 days, but can last up to 60 days. • Pertussis can cause apnea, malnutrition, and seizures in infants.

  13. Personal Accounts VIDEO: What Every Parent Needs to Know -- Protecting Your Baby from Pertussis at http://www.texmed.org/Template.aspx?id=2656

  14. Recommendations • A single dose of Tdap for adults 19-64 years of age to replace the next booster dose of tetanus and diphtheria toxoids vaccine (Td). • Adolescents should receive their first Tdap shot after their 11th birthday. • Tdap is recommended for all adolescents and adults. It is particularly important to ensure that close contacts and caregivers of infants receive a Tdap booster. • Adults who have or who anticipate having close contact with an infant aged <12 months (e.g., parents, grandparents aged <65 years, child-care providers, and healthcare personnel) should receive a single dose of Tdap to reduce the risk for transmitting pertussis. • An interval of 2 years from the last Td is suggested; but shorter intervals can be used. • When possible, women should receive Tdap before becoming pregnant. • Women who have not previously received Tdap should receive a dose of Tdap in the immediate postpartum period.

  15. Why might parents not get immunized? • ACIP recommendations are recent • Pertussis is a relatively unknown disease, not considered a significant health threat • Competing interests • New child with significant needs • Lack of access

  16. Efforts to Immunize • Federal Stimulus Funding • Efforts by NICUs to offer mothers, and in some cases fathers Tdap in the post-partum period • Increase tetanus (Td) requirements in ERs to Tdap, using Tdap for wound prophylaxis • Make sure healthcare workers are vaccinated • New School Recommendations in Texas • Educate parents or adult caregivers at prenatal visits or newborn appointment with pediatricians on the importance for all close contacts of the baby to be vaccinated

  17. Talk to the caregiversof infants aboutprotecting their child:Encourage them to beimmunized againstpertussis by receivinga Tdap vaccination.

  18. Resources TPS Website: http://www.txpeds.org/extras/cocooning.php My Contact Info: laura.sally@txeds.org 512-370-1509

  19. Sources:Epidemiology of Pertussis in Texas: http://cdc.confex.com/cdc/nic2009/webprogram/Session9413.htmlImmunization of Newborn Close Contact: http://www.albany.edu/sph/coned/phl/immunizations.htmCenters for Disease Control and Prevention: http://www.cdc.gov/vaccines/vpd-vac/pertussis/default.htmTexas Department of State Health Services:http://www.dshs.state.tx.us/idcu/health/vaccine_preventable_diseases/statistics/

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