The EPI Target Diseases

DISEASE STANDARD CASE AGENT/RESERVOIR SOURCE OF RISK FACTOR

DEFINITION INFECTION FOR
INFECTION
Measles A highly Agent: Close -Crowding
communicable disease Virus respiratory -Low socio
with the history of the contact and economic status
following: Reservoir: Humans aerosolized
-Generalized blotchy droplets
rash, lasting for 3
days 
-Fever (above 38℃ or
“hot” to touch and 
- any of the following:
~cough
~runny nose
~red eyes/conjunctiva
Tuberculosis -A child with history Agent: Droplet -Low access to
of contact with a Mycobacterium infection, that care
suspect or confirmed tuberculosis is through -
case of pulmonary inhalation of Immunodeficiency
tuberculosis Reservoir: bacilli from -Malnutrition
-Any child who does -Man patients -Alcoholism
not return to normal - Diseased cattle -Diabetes
health after measles or
whooping cough
- Loss of weight,
cough and wheeze
which does not
respond to antibiotic
therapy for acute
respiratory disease
- Abdominal swelling
with a hard painless
mass and free fluid
-Painful firm or
swelling in a group of
superficial lymph
nodes
- Any bone or joint
lesion or slow onset
- Signs suggesting
meningitis or disease
in the central nervous
system
Diphtheria It is an acute Agent: By respiratory -Crowding
pharyngitis, acute Corynebacterium droplets from -Low socio
nasopharyngitis or diphtheria discharge of a economic status
acute laryngitis with case or carrier
pseudo membrane Reservoir:
Man
Pertussis History of severe Agent: Bordetella -Primarily by -Young age
cough and history of pertussis direct contact -Crowding
any of the ff: with discharges
-cough persisting 2 or Reservoir: from
 more weeks Man respiratory
-cough followed by mucous
vomiting membranes of
infected
persons
-airborne route
probably by
droplets
-Contact with
articles freshly
soiled with the
discharges of
infected
persons
Poliomyelitis -A suspect cases of Agent: -Fecal-oral Poor
polio is defined as any Poliomyelitis type 1,2,3 route environmental
patient below 15 years -Oral route hygiene
of age with acute Reservoir:  through
flaccid Man, mostly children pharyngeal
paralysis(including secretion
those diagnosed to -Contact with
have Guilliane Barre infected
Syndrome) for which persons
no other cause can be
immediately identified
Neonatal A newborn with the Agent: -Unhygienic -Contamination of
Tetanus history of all the three Clostridium tetani cutting of umbilical cord
of the ff: umbilical cord  -Agricultural work
-normal suck for the -Improper
first two days of life Reservoir: handling of
-onset of illness -Soil cord stump
between 3 to 26 days  -Intestinal canals of especially
-inability to suck animals(esp. horses) when treated
followed by stiffness -Man with
and the body/or contaminated
convulsions substance
Hepatitis B It is the liver infection Agent:  Hepatitis B -HBeAg + mother
caused by the B type Hepatitis B virus spreads through Multiple sexual
of hepatitis virus. It the ff: partners
attacks the liver often -from child to
resulting in Reservoir: child or mother
inflammation Man to child after
birth
-from mother to
child during
birth
-through
sharing of
unsterilized
needles, knives
or razors
-through sexual
intercourse
The EPI Routine Schedule of Immunization
Every Wednesday is designated as immunization day and is adopted in all parts of the country.
In a barangay health station immunization is done monthly while in far flung areas it is done
quarterly. However, some areas adopted local practices to provide everyday vaccination in their
areas to cover all targets.
Routine Immunization Schedule for Infants - adopted to provide maximum immunity against
seven vaccine preventable diseases before a child’s first birthday
The standard routine immunization schedule for infants is adopted to provide maximum
immunity against seven vaccine preventable diseases before a child’s first birthday. A child is
said to be “Fully Immunized Child” when a child receives one dose of BCG, 3 doses of OPV, 3
doses of DPT, 3 doses of HB and one dose of measles before a child’s first birthday.
VACCINE MINIMUM NUMBER MINIMUM REASON
AGE AT 1 ST
OF DOSES INTERVAL
DOSE BETWEEN
DOSES
BCG Birth or 1 BCG given at earliest
bacille anytime after possible age protects
Calmette- birth the possibility of TB
Guerin meningitis & other TB
infections in which
infants are prone
DPT 6 weeks 3 4 weeks An early start with DPT
reduces the chance of
severe pertussis
OPV 6 weeks 3 4 weeks The extent of protection
against polio is
increased the earlier the
OPV is given
Hep B At birth 3 6 weeks interval An early start of Hep B
from the 1 dose reduces the chance of
st

and 8 weeks being infected and

interval from 2 becoming a carrier
nd

dose to 3 dose
rd
Prevent liver cirrhosis
and liver cancer
Measles 9 months At least 85% of measles
can be prevented by
immunization at this
age
Prevents death(2% die),
malnutrition,
pneumonia, diarrhea (at
least 20%k)
Tetanus Toxoid Immunization Schedule for Women
VACCINE MINIMUM PRECENT DURATION OF
AGE/INTERVAL PROTECTED PROTECTION
TT 1 As early as possible
during pregnancy
TT 2 At least 4 weeks later 80% -infants born to the mother
will be protected from
neonatal tetanus

3 years protection 
TT 3 At least 6 months later 95% -infants born to the mother
will be protected from
neonatal tetanus
-gives 5 years protection to
the mother
TT4 At least one year later 99% -infants born to the mother
will be protected from
neonatal tetanus

10 years protection 
TT 5 At least one year later 99% -gives life time protection for
the mother
-all infants born to that
mother will be protected

Administration of Vaccines
VACCINE DOSE ROUTE OF SITE OF
ADMINISTRATION ADMINISTRATION
BCG Infants 0.05ml Intradermal Right deltoid region of
the arm
DPT 0.5ml Intramuscular Upper outer portion of
the thigh
OPV 2 drops or depending Oral Mouth
on manufacturer’s
instructions
Measles 0.5ml Subcutaneous Outer part of the upper
arm
HEP B 0.5 ml Intramuscular Upper outer portion of
the thigh
Tetanus 0.5ml Intramuscular Deltoid region of the
Toxoid upper arm
SIDE EFFECTS OF VACCINATION AND THEIR MANAGEMENT
VACCINE SIDE EFFFECTS MANAGEMENT
BCG Koch’s phenomenon: an acute No management is needed
inflammatory reaction within 2-4 days
after vaccination, usually indicates
previous exposure to tuberculosis
Deep abscess at vaccination site, almost Refer to the physician for
invariably due to subcutaneous or incision and drainage
deeper injection
Indolent ulceration: an ulcer which Treat with INH powder
persists after 12 weeks from vaccination
date
Hepatitis B Local soreness at the injection site No treatment is necessary
vaccine
(Pentavalent Fever that usually lasts for only 1 day. Advise parents to give
vaccine) Fever beyond 24 hours is not due to the antipyretic
vaccine but to other causes
DPT Local soreness at the injection site Reassure parents that soreness
will disappear after 3-4 days
Abscess after a week or more usually Incision and drainage maybe
indicates that the injection was not deep necessary
enough or the needle was not sterile 
Convulsions: although very rare, may Proper management of
occur in children older than 2 months, convulsions: pertussis vaccine
caused by pertussis vaccine should not be given anymore
OPV None
Anti-measles Fever 5-7 days after vaccination is some Reassure parents and instruct
vaccine children, sometimes, there is mild rash them to give antipyretic to the
child
MMR Local soreness, fever, irritability and Reassure parents and instruct
malaise in some children them to give antipyretic to the
child
Rotavirus Some children might develop mild Reassure parents and instruct
vaccine vomiting and diarrhea, fever and them to give antipyretic and
irritability Oresol to the child
Tetanus Local soreness at the injection site Apply cold compress at the site 
Toxoid No other treatment is needed

Fully immunized children (FIC) are those who were given BCG, 3 doses of OPV, 3 doses of
DPT, and Hepatitis B vaccine or 3 doses of Pentavalent vaccine and 1 dose of anti-measles
vaccine before reaching 1 year of age