IMMUNIZABLE DISEASES

TUBERCULOSIS
Ranks the 6th in the leading cause of morbidity and mortality 6-12 months after the infection- the most hazardous period for the development of clinical disease

 Degree of Communicability depends on: Number of bacilli discharged Virulence of bacilli Aerosolization by coughing and sneezing

 Case Findings: DIRECT SPUTUM SMEAR MICROSCOPY (DSSM)- primary Diagnostic tool No TB Diagnosis will be made based on the results of the X-ray alone. HEMOPTYSIS is the only contraindication to sputum collection.

New Smear positive PTB

With extensive parenchymal lesions

Extrapulmonary TB Severe concomitant HIV Disease

6 months treatment

A. Intensive Phase: 2 mos RIPE (Rifampicin , INH, PZA, Ethambutol)

B. Continuation Phase: 4MONTHS RI (Rifampicin, INH)

8 months treatment

Treatment Failure

Relapse cases

Return after default

8 months treatment

A. Intensive Phase: 2 mos. RIPES (Rifampicin , INH, PZA, Ethambutoll, Streptomycin IM) B. Continuation Phase: 1 month RIPE (Rifampicin , INH, PZA, Ethambutol) 5 mos. RIE (Rifampicin , INH, Ethambutol)

4 months treatment Same Regimen as in Category 1.

Chronic-still smear positive supervised retreatment REFER:

DOTS center
Provincial City NTP Coordinator

FDC- number of dose will depend on body weight

BODY WEIGHT 30-37 kg 38-54 kg 55-70 kg Above 70 kg

NO. OF TABLETS PER DAY 2 3 4 5

DIPHTHERIA

 Period of Communicability: 2 weeks but usually shorten with the use of antibiotic Pathognomonic Sign: PSEUDOMEMBRANE Immunity:
Infants born of mothers who had diphtheria are relatively immune but disappear before 6 mos.

Immunity is often acquired through unrecognized infection

Usually lifelong immunity

 Prevention- DPT= 1 months x 3 doses = 4 weeks interval Absolute CONTRAINDICATIONS:

If the child has convulsions or shock w/in 3 days after DPT

DPT2 /DPT3

containing Neurological Vaccines the whole cell Disease pertussis component

Whooping Cough

PERTUSSIS

Period of Communicability: early Catarrhal

Sources of Infection: discharged from laryngeal and bronchial mucous membrane of infected persons Description of cough: Paroxysmal cough ending in a characteristic whoop or prolong crowing noise
Immunity: usually life long after infection

Lock Jaw

TETANUS

ANAEROBIC BACILLUS VEGETATIVE SPORATIVE

 Incubation period: 3 days to 1 month or more. The shorter the incubation period, the poorer the prognosis. Tetanus Neonatorum- a newborn with a history of:

Normal suck for the first 2 days of life

Onset of illness between 3-26 days

Inability to suck followed by stiffness of the body and or convulsion

TT Immunization Schedule
VACCINE TT1 TT2 TT3 TT4 TT5 MINIMUM INTERVAL As early as possible during pregnancy At least 4 weeks later At least 6 months At least 1 year later At least 1 year later PROTECTION -----80% 95% 99% 99%

POLIOMYELITIS

 Period of Communicability- from incubation period to prodromal stage Mode of entry: GIT (more common entry) Respiratory Paralysis- Asymmetrical

Prevention: OPV
Storage Temperature 15 C- 25 C

2 gtts- do not let dropper touch childs tongue If the child spits out, GIVE another dose

LEPROSY

 Methods of Transmission: Prolonged Skin to Skin Contact Respiratory Diagnosis-currently based on clinical signs and symptoms Slit Skin Smear (SSS)- an optional procedure R.A. 4073- Advocates Home treatment

MULTIPLE DRUG THERAPY

PAUBACILLARY (PB)
Duration of Treatment: 6-9 months Tuberculoid Type and Indeterminate

MULTIPAUBACILLARY (MB)
Duration of Treatment: 1218 months

Lepromatous type & Borderline or Mixed Time

PAUBACILLARY LEPROSY CASES

DRUGS/DURATION
RIFAMPICIN

ADULT
6OO mg once a month

CHILD (10-14 yrs)

450 mg once a month

DAPSONE

100 mg daily

50 mg daily

Duration of treatment

6 blister packs to be taken 6 blister packs to be taken monthly within a maximum monthly within a maximum period of 9 months period of 9 months

MULTIPAUBACILLARY LEPROSY CASES

DRUGS/DURATION
RIFAMPICIN

ADULT
6OO mg once a month

CHILD (10-14 yrs)

450 mg once a month

DAPSONE

100 mg daily

50 mg daily

CLOFAZIMINE

300 mg once a month and 50 mg daily

150 mg once a month, and 50 mg every other day

Duration of treatment

12 blister packs to be taken 12 blister packs to be taken monthly within a maximum monthly within a maximum period of 18 months period of 18 months