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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