VACCINE

PREVENTABLE
DISEASES
1. DIPHTHERIA
2. PERTUSIS
3. TETANUS
4. MEASLES
5. POLIOMYELITIS
6. TUBERCULOSIS
7. HEPATITIS B.
8. HEAMOPHILUS INFLUENZA B
9. ROTAVIRUS DISEASE
DIPHTHERIA
 DIPHTHERIA
Etiology - Corynebacterium diphtheriae
• Aerobic gram-positive bacillus
Epidemiology
• Reservoir Human carriers
Usually asymptomatic
• Transmission Respiratory
Skin and fomites rarely
• Temporal Pattern Colder months
• Communicability Up to several weeks
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without antibiotics 4
 DIPHTHERIA
Clinical Features
• Incubation period 2-5 days (range, 1-10 days)
• May involve any mucous membrane
• Classified based on site of infection
– anterior nasal
– pharyngeal and tonsillar
– laryngeal
– cutaneous
– ocular
– genital
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 DIPHTHERIA
Clinical Features

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 DIPHTHERIA
Clinical Features

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 DIPHTHERIA
Diagnosis
• Made on the basis of clinical presentation
– to begin presumptive therapy
• Culture of lesion
– confirmatory
– swab of the pharyngeal areas, ulcerations,
tonsillar crypts
Complications
• Most attributable to toxin
• Most common complications are myocarditis and
neuritis
• Death occurs in 5%-10% for respiratory disease
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 DIPHTHERIA
Treatment / Management
• Antibiotics :
• Diphtheria antitoxin
• Respiratory support and airway
maintenance
Prevention
• High level of herd immunity

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PERTUSSIS or
WHOOPING
COUGH
 PERTUSSIS
Etiology - Bordetella pertussis
• Fastidious gram-negative bacteria
Epidemiology
• Reservoir Human
adolescents and adults
• Transmission Respiratory droplets
airborne rare
• Communicability Maximum in catarrhal
stage secondary attack
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rate up to 80% 11
 PERTUSSIS
Clinical Features
• Incubation period 5-10 days (up to
21 days)
• Insidious onset, similar to minor
upper respiratory infection with
nonspecific cough
• Fever usually minimal throughout course

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 PERTUSSIS
Clinical Features

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 PERTUSSIS
Diagnosis
• Characteristic history and physical
examination
• Isolation of B. pertussis by culture
–confirmatory but difficult to isolate
• Elevated WBC with lymphocytosis

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PERTUSSIS
Complications
• Pneumonia (bacterial)
• Seizures
• Encephalopathy
• Otitis media
• Dehydration
• Anorexia
• Death
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 PERTUSSIS
Treatment / Management
• Supportive
• Antibiotics – erythromycin
• Vaccination of contacts

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TETANUS
 TETANUS
Etiology - Clostridium tetani
• Anaerobic gram-positive, spore-forming
bacteria
• Spores found in soil, dust, animal feces;
may persist for months to years

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 TETANUS
Epidemiology
• Reservoir Soil and intestine of
animals and humans

• Transmission Contaminated wounds

tissue injury

• Temporal pattern Peak in summer or

wet season

• Communicability Not contagious

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 TETANUS
Pathogenesis
• Anaerobic conditions allow germination of
spores and production of toxins
• Toxin binds in central nervous system
• Interferes with neurotransmitter release to
block inhibitor impulses
• Leads to unopposed muscle contraction
and spasm

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 TETANUS
Clinical Features
• Incubation period; 8 days
(range, 3-21 days)
• Three clinical forms: Local (not common),
cephalic (rare), generalized (most
common)
• Generalized tetanus: descending
symptoms of trismus (lockjaw), difficulty
swallowing, muscle rigidity, spasms
• Spasms continue for 3-4 weeks; complete
recovery may take months
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 TETANUS
Clinical Features

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 NEONATAL TETANUS

• Generalized tetanus in newborn infant

• Infant born without protective passive
immunity
• High fatality rate without therapy

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 NEONATAL TETANUS
Complications
• Laryngospasm
• Fractures
• Hypertension
• Nosocomial infections
• Pulmonary embolism
• Aspiration
• Death
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 NEONATAL TETANUS
Prevention
• Immunization of infants with DPT
• For neonatal tetanus immunization
tetanus toxoid
• Clean and safe delivery

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MEASLES
 MEASLES
Etiology - Measles virus
• Paramyxovirus (RNA)
Pathognomonic Sign
• Koplik’s Spots

Epidemiology
• Reservoir Human
• Transmission Respiratory Airborne
• Communicability 4 days before -
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4 days after rash 27
 MEASLES
Clinical Features
• Incubation period : 10-12 days
• Maculopapular rashes AND
• Fever AND
• Cough OR coryza OR conjunctivitis

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 MEASLES
Clinical Features

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 MEASLES
Diagnosis
• Isolation of measles virus from a clinical
specimen (e.g., nasopharynx, urine)
• Significant rise in measles IgG by any
standard serologic assay (e.g., EIA, HA)
• Positive serologic test for measles IgM
antibody

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 MEASLES
Complications
• Diarrhea
• Otitis media
• Pneumonia
• Encephalitis
• Death

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 MEASLES
Treatment / Management
• Supportive treatment
– Nutritional support
– ORS
– Antibiotics for otitis media and severe ARI
– antipyretics
• Vitamin A- 2 doses, 24H apart

Prevention
• Immunization with measles vaccine
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POLIOMYELITIS
 POLIOMYELITIS
Etiology - Poliovirus
• Enterovirus (RNA)
• Three serotypes: 1, 2, 3
• Rapidly inactivated by heat,
formaldehyde, chlorine, ultraviolet
light

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 POLIOMYELITIS
Pathogenesis
• Entry into mouth
• Replication in pharynx, GI tract,
local lymphatics
• Hematologic spread to lymphatics and
central nervous system
• Viral spread along nerve fibers
• Destruction of motor neurons

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 POLIOMYELITIS
Clinical Features
• Incubation period : 6-20 days
• Minor non specific :
– URTI
– GI disturbances (diarrhea, nausea,
vomiting, abdominal pain)
– Influenza like illness
• Non-paralytic aseptic meningitis
– Stiffness of neck, back and/or legs
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 POLIOMYELITIS
Clinical Features
• Paralytic Poliomyelitis (flaccid paralysis)
– Symptoms begin 1-10days after prodromal
symptoms, progress for 2-3 days
– Usually asymmetrical, most often involves the
legs
– Many recover completely, in most muscle
function returns to some degree
– Weakness/paralysis still present 12months
after onset is usually permanent
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 POLIOMYELITIS
Clinical Features

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 POLIOMYELITIS
Diagnosis
• Viral isolation
– From the stool or pharynx
– Isolation from the CSF is diagnostic but rarely
accomplished
– If isolated tested using oligonucleotide
mapping or genomic sequencing to determine
virus type ( wild or vaccine derived)
• CSF – increased WBC and mildly elevated protein

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 POLIOMYELITIS
Treatment / Management
• Symptomatic for muscle pain and fever
• Respiratory assistance (respirator)
• Physical therapy for paralysis

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TUBERCULOSIS
 TUBERCULOSIS
Etiology - Mycobacterium tuberculosis
• Usually attacks the lungs but can also
affect other parts of the body
• Gram positive
• Acid fast bacilli
Pathognomonic Sign
• Hemoptysis

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 TUBERCULOSIS
Mode of Spread
• Person to person through the air when a
patient coughs or sneezes
• Deliberate inoculation of microorg or by
droplet.
• Spreads rapidly in areas where there is
overcrowding, poor access to health care
and malnutrition
• Risk of developing TB highest in children
<3yrs , in older people and those with HIV
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 TUBERCULOSIS
Clinical Features
• Incubation period : 4-12 weeks
• Signs & symptoms : general weakness,
weight loss, afternoon rise in temp, night
sweats, cough (dry to productive)
PTB : cough, chest pain, hemoptysis

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 TUBERCULOSIS
Complications
• Debility and death if left untreated
• More rapid in persons with HIV
Treatment / Management
• SCC (DOTS)
– INH-isoniazid
– PZA-pyrazinamide
– Rifampicin
– Ethambutol
– Streptomycin
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 TUBERCULOSIS
Diagnostic Procedures
• Sputum analysis –confirmatory
• Chest x-ray
• Tuberculin Testing
1. mantaux test
2. tine test
3. heaf test
Prevention
• Immunization with BCG
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HEPATITIS B
 HEPATITIS B
Etiology - Hepatitis B Virus
• Humans are only known host
• May retain infectivity for at least 1 month at room
temperature
Epidemiology
• Reservoir Human
• Transmission Blood borne
person-to-person contact via
infected body fluids
contaminated needles & syringes
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• Communicability 1-2 months before and after onset

symptoms
 HEPATITIS B
Clinical Features
• Incubation period 60-150 days (average 90
days)
• Nonspecific prodrome of malaise, fever,
headache, myalgia
• Illness not specific for hepatitis B
• At least 50% of infections asymptomatic

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 HEPATITIS B
Treatment / Management
• Supportive
• Medications
Prevention
• Immunization of infants with 3 doses
during the first year of life

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HEAMOPHILUS INFLUENZA B
 HEAMOPHILUS INFLUENZA TYPE B
Epidemiology
• Hib is one of the six related types of
bacterium
• Hib’s victim are mainly children younger
than five(5) years old
• Hib bacteria are commonly present in the
nose and throat
• The bacteria are transmitted from person
to person in droplets through sneezing and
coughing
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 HEAMOPHILUS INFLUENZA TYPE B
Signs and Symptoms
• Pneumonia and meningitis are the most
important diseases caused by Hib bacteria.
• In developing countries, pneumonia is
more common than meningitis in children
with Hib disease.
• Hib disease should be suspected in the
case of any child with signs and symptoms
of meningitis or pneumonia.

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 HEAMOPHILUS INFLUENZA TYPE B
Complications
• Children who survive Hib meningitis may
develop
– permanent disability, including brain
damage, hearing loss
– mental retardation
– 5% to 10% cases of Hib meningitis are at
risk of dying

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 HEAMOPHILUS INFLUENZA TYPE B
Treatment / Prevention
• Hib disease can be treated with antibiotics.
• Hib disease can be prevented with vaccine
given in early infancy

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ROTAVIRUS DISEASE
 ROTAVIRUS DISEASE
Etiology – Rotavirus
• Rotavirus disease is a diarrheal disease
caused by a virus called rotavirus
• The name rotavirus comes from a Latin
word “rota” the wheel-like appearance of
the virus under the microscope
• Rotavirus is a virus that infects the
intestines

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 ROTAVIRUS DISEASE
Epidemiology
• Rotavirus is the most common cause of
severe diarrheal disease in infants and
young children worldwide
• Rotavirus is not the only cause of diarrhea,
several other agents may also cause
diarrhea
• Rotavirus infection is highly contagious
• Rotavirus spread by fecal-oral route
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 ROTAVIRUS DISEASE
Signs and Symptoms
• Three main symptoms of rotavirus
infection:
– Fever
– Vomiting
– Watery diarrhea
• Abdominal pain may also occur
• Diarrhea usually stops after 3 to 7 days
• Young children can become dehydrated,
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requiring urgent treatment
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 ROTAVIRUS DISEASE
Treatment / Management

TREATMENT
Zinc
Oral rehydration
therapy (ORT)

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 ROTAVIRUS DISEASE
Prevention

Vaccination Good sanitation

and hygiene

PREVENTION

Improved
Exclusive
water quality
breastfeeding

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61
 Thank you!
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