Sunday, June 6, 2010

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Vaccines (1): tetanus, polio, diphtheria, pertussis, measles, rubella, mumps

vaccines raise hopes and fears. Some reservations are well known and some more news. Three are mandatory : diphtheria, tetanus and polio , for historical reasons. The more recent are only recommended and often well accepted. In this first part we will as conventional vaccines: smallpox
the
the tetanus
the polio
the
the diphtheria pertussis
the
the measles rubella
the mumps
Provisional Conclusion
the other vaccines, most controversial or most recent

The smallpox is history: She has yet to speak again her after the attacks on the World Trade Center because, if the disease has disappeared, there are still potential candidates for the virus bio-terrorism in some laboratories. (Notice to fans worried and gloomy scenario)

Image: Gaston Mélingue 1894 - Dr. E. Jenner performing the first vaccine against smallpox in 1796 Lithograph. On the right, there is a woman who gives a bandage on his hand where the bubo charged for this "vaccine"
was a viral disease fatal in more than half of cas.Elle decimated the planet. Jenner, English physician, remarks like others before him, as boys cowboys are refractory to smallpox. He drew a comparison with vaccinia, a fairly benign disease which results from the swellings on the udders of cows. He practices
then inoculated with the serum of these buboes and performs the first vaccination and serious. These people, "vaccinated", have become resistant to smallpox. It will then popularize vaccination.
In France and in the world, vaccination against smallpox was eliminated in the early 1980s.

The tetanus

If e tetanus in the world, exists mainly in countries where vaccination is not made, vaccination for everyone.
The first signs are often dysphagia (pain and difficulty swallowing) and a pain in the neck.

In new-born baby starts with a refusal to breastfeed. Gradually, as the infection progresses, appear trismus (lock jaw closed), the sardonic grin (grimace characteristic due to the contraction of facial muscles) and opisthotonus (hyperextension of the neck and back by paraspinal muscle spasm).
Image: neonatal tetanus, extreme rigidity, wikipedia frequent in Africa

Few people refuse vaccination against tetanus, frightening and deadly disease half the time. The tank tetanus bacillus is the horse and some other mammals sometimes domestic (cows, sheep, goat, pig, dog, cat, mouse, guinea pig, rabbit, poultry ...) or man (especially among those in permanent contact with the horses). This bacillus forms spores that can survive 10 years in the ground or be blown away and end up in town, where you never expect it. For comparison, the AIDS virus can survive only about twenty minutes outside the human body, that of hepatitis B 8 days. The classic mode of contamination was once the culture of roses, rich in spines that are smoked with horse manure.
This disease does never disappear.

In France tetanus is now rare but does has not disappeared

The vaccine is well tolerated and very effective
Vaccinate your children! and check for you adults every 10 years.





The polio


The polio vaccine poses little problem because of polio years 50-60 with his paralysis, the iron lung (first artificial respirator) remained in the memories. After the "victory" against smallpox, WHO has toyed with the idea of losing polio but also the work is immense because the endemic areas are especially in many poor countries and hot.
The first live oral vaccine, which is taking "a sugar" is hardly used because it has resulted in very rare cases of poliomyelitis. The vaccine
injectable non-living is safe, effective and well tolerated.
Vaccinate your children! and check for you adults every 10 years.


The Diphtheria is caused by a bacillus everything nice, Corynebacterium diphtheriae, himself infected with a virus (a bacteriophage ) responsible for manufacturing of diphtheria toxin. This phage makes it very nasty.
The disease begins with severe angina suffocating (the "croup") and is complicated:
2-6 weeks after the first symptoms, under the effect of the toxin, neurological and cardiac appear. Death occurs from cardiac involvement.
Image: Public Health Agency of Canada. After vaccination began in 1926 , diphtheria has virtually disappeared except for a peak, worldwide, during the 1970s.
The diphtheria vaccine is surprisingly well accepted, although the memory of diphtheria or distant. Few people remember the "croup" terrible angina with tracheotomy and often dramatic change. But people still know that "Diphtheria: it's bad." The last epidemic, very deadly (125 000 cases 4000 deaths), took place in Russia in the 90s. Some tourists have reported to us in France without major consequences because everyone is vaccinated. Tetanus used to vaccine developed in 1923 by Gaston Ramon is poorly tolerated locally when multiplying recalls. Vaccines from 6 years are less dosed and better tolerated.
Vaccinate your children! and check for you adults, every 10 years.


The pertussis
Pertussis is a serious illness in babies under 6 months in which it can give respiratory arrest unpredictable and deadly. It has almost disappeared.
The pertussis vaccine raises questions. The old vaccine gave a fever and very rarely (1 to 3 million) encephalitis severe. For these reasons, the vaccine has been abolished in England in the late 70s. 3 years later came an epidemic infants with 17 Dead. The vaccine has been restored. Fortunately, a new vaccine currently exists. Immediate reactions are rare and encephalitis seem to have disappeared.

recently improved vaccine is effective and well tolerated 10 years. The current trend is to conduct a recall in young (future) parents so that they do not contaminate their children. Enjoy the DTP booster for 25-26 years to do so because there is a combination vaccine.

Vaccinate your children toddlers! it is illogical to wait until the baby is big because whooping cough is so annoying that.
drawing http://www.armando-presse.com

The measles


Image WHO Measles and encephalitis have virtually disappeared in countries where the vaccine is

Measles is a disease that seems benign but is responsible in 1 case of encephalitis in 1000 and leukoencephalopathies death 15 years later in adolescence when everything seemed in order ( as say the Swiss).

The measles vaccine is fairly well accepted. It raises, however, discussions :
In England he was suspected of being responsible for the occurrence of autism . A very recent development (2010) Lancet (British medical journal, fly high) indicates that section involving this vaccine as a cause of autism has been invalidated because it is based on work erroneous.
The vaccine is responsible for very rare cases of Guillain-Barre (polyradiculoneuropathy) usually rapidly resolvents but still very worrying.

When and how many injections for measles?
The vaccine is most effective at 14 months than at 12 and even more so than 9. The current trend (the precautionary principle?) Is to make the vaccine earlier, about a year (thereby justifying even more the reminder!) while in France, measles is rare.
Currently we offer a reminder, also discussed. The first injection was ineffective in 5% of cases. The idea is to eliminate measles in Europe, and rubella at the same time (as was done for smallpox and desired for polio, but we are very far). The recent epidemic Swiss watch that is "at least a partial failure " . That I become a diplomat. Ouch, where are my drops?
This idea was interesting 30 years ago and probably not crazy, but since then the political and health situation has changed.
To remove an exclusively human disease requires a coverage of 95 to 98% of the population. The disease is transmitted more and off. Now this became impossible with the current movements of population and increasing poverty. Just look at a map to find diseases that vaccines are used mainly in the rich . Moreover, as the vaccine is less immune than the disease, its effect is exhausted. We must raise points when people age.
People in rich countries feel saturated vaccines and sometimes begin to doubt even the point. The case of influenza A (H1N1) has not helped!

The strategic alternative would do only a single vaccination at 14 or 16 months because it is more effective in trying to maintain current coverage (92% in France) and rely on the few cases of measles in a sustainable way to revive the vaccination immunity.

This is not the path chosen by our experts. Currently, we have truncheons would push quickly to perform the second injection because the number of measles cases has increased. True, but this applies in France, thousands of children in communities refusing "immunizations."

The vaccine is effective. It can give a fever 8-10 days later and very rarely a very nice measles which provides the recall.
Vaccinate your children to prevent encephalitis. ! vaccine exists alone or in combination with rubella and mumps. I suggest the association, but the parents decide.


The rubella

is a very serious disease for fetuses month 3 months. She leads malformations when multiple organs are formed, while in the mother can sometimes be invisible.
Therefore vaccinate all girls, even those who think they have had because there are "copies" of rubella caused by other viruses. Perfectionists may be a serological test.
As the disease is very serious for the fetus, also vaccinating boys (thank you, gentlemen) so they do not contaminate their girlfriends and their mothers. That's good. On the other hand girls are vaccinated against mumps for they do not contaminate the boys. Mumps is toxic to the testes. (thank you ladies)
This vaccination can be done alone or combined with that of measles and mumps.
The vaccine is highly effective and well tolerated.
Vaccinate your children! and check for you, ladies old enough to have children (a happiness can happen quickly, even if you do not think!).
Ladies, Get vaccinated!

The mumps

This viral disease manifested by inflammation of the parotid glands under the ear, benign meningitis unpleasant but very rarely complications such deafness and orchitis (testicular inflammation) rather in adults. There are subclinical forms.
The vaccine is effective and well tolerated. He is alone or combined with measles and rubella.
Children are mostly vaccinated and protect the testicles of their fathers. Young fathers who have not had mumps can be vaccinated. The vaccine is safe and effective.


As a provisional conclusion:

Despite all the abominations they say, these vaccines have improved everyone's health and provide effective protection . In France, where the resistance is rare, it can be cool for dates, while remaining logic in personalized consultations.

" When the reserves are strong explain the rationale, benefits, known risks and those running through the minds of people and I mark on my prescription :
" According the desire of parents: XYZ vaccine, one dose "and surprisingly the parents are then more likely to agree next time."
of the sweetness, gentleness !

"too many vaccines killed vaccine"

Good reading, thank you all.

In another chapter we will see
vaccines that require more discernment (tuberculosis, meningococcal C meningitis, chicken pox etc ...), that raise concern (hepatitis B), which are newer (Haemophilus, pneumococcal, papilloma virus, rotavirus) or I forgot s!


Some vaccines are not covered (tularemia, pathogenic spirochetal, encephalopathy tick, cholera, typhoid etc. ..) but can be addressed on the occasion of questions.

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