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Immunization and the Patient

Immunization and the Patient. Low immunization rates. Opportunity missed Health care delivery Inadequate access Lack of public awareness Religious beliefs. Athletic Training and Vaccines. Tetanus status of all patients Hepatitis B status of all patients Meningococcus Influenza

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Immunization and the Patient

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  1. Immunization and the Patient

  2. Low immunization rates • Opportunity missed • Health care delivery • Inadequate access • Lack of public awareness • Religious beliefs

  3. Athletic Training and Vaccines • Tetanus status of all patients • Hepatitis B status of all patients • Meningococcus • Influenza • Travel vaccines

  4. Vaccine Schedule

  5. Adult Vaccination Schedule

  6. Tetanus • Lockjaw is a neurological disease manifested by trismus and severe muscular spasms • Clostridium tetani bacterium that causes nuerotoxin production • Onset is gradual, 1-7 days & progresses to severe generalized muscle spasms

  7. Clostridium Tetani • Wound contamination • Blocks contractile inhibitory pulses to motor neurons • Found in intestines and serum • Fewer that 60 cases in last 5 yrs

  8. Tetanus Treatment/Prevention • Tx: • (TIG) – used to treat and prevent • Extensive cleaning of wounds • Oral antibiotics • Prevention: • IM immunization • Primary series • Booster between 11-16 yrs old • Booster every 10 yrs

  9. Other Common Vaccines • Hepatitis B – series of 3 shots • Booster ~ 10 yrs • Meningitis – fever, chills, malaise, rash • Purpura • Common in young children • Common in semiclosed communities • All college students should get the vaccine • All Functional asplenia people • Duration is 5-6 yrs • 13 different types of disease, vaccine covers 4

  10. Other Common Vaccines • Influenza • Presents like meningitis, but s rash • Spread by large droplets, coughing, sneezing, sharing glasses, water bottles • You are most infectious 24 hrs before s/s and 7 days after they appear • 3 antigenic types (A, B & C). Strain A has two antigens; hemagglutinin (H) & neuraminidase (N) • 50-85 % effective, CDC “guesses” which strain may be the strain of the year (Bases on past 3 years)

  11. Other Common Vaccines • Influenza • Amantadine – Covers type A • Ramantidine – Covers type A & B • Type C - Weak • Meds: Relanza & Tamiflu • Who should get it? – asthma, chronic lung disease, CV disease, immune deficiency, old, young • Patient cannot play/practice if still have fever of 102°+

  12. Traveling?? • http://www.cdc.gov/travel/ • Follow info for your destination • Begin process early • Learn about their food, water, & insect protection • Common concerns: Hepatitis A & B, Japanese Encephalitis, Yellow fever, Malaria, Typhoid, Rabies

  13. Traveling??? • Plan for diarrhea • E. Coli – usually form bad water supply • Malaria – transmitted by mosquito • High fever, chills, sweats, HA, anemia • Vaccine 2-3 days before you go • Tuberucolosis – To and from Asia, Africa • Usually asymptomatic – auto-immune reaction • Pulmonary, fever chills, wt loss, sweats, cough • Have skin tested 1-2 months after returning • Mantoux, PPD • Test: Incarcerated, contact c confirmed case, immigrants, CXR or s/s • Tx: 9 month course of Isoniazid & Rifampin

  14. Summary • Protect yourself, especially when traveling • Keep record of your patients immunization records

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