After chapter of the most common vaccine , j here first where the vaccines are subject to discussion . is sometimes so complex that I had to make choices and keep it simple and simplistic.
Tuberculosis and BCG Rotavirus Haemophilus Pneumococcal Meningococcal La varicelle L'hépatite B La grippe Les papillomavirus Poster about tuberculosis in children and methods of transmission, showing a child wearing a bib. [New York] : WPA Federal Art Project, District 4, [between 1936 and 1941].
Source: Library of Congress, LC-USZC2-5369 On ne rigolait pas trop! La tuberculose et le vaccin antituberculeux: le BCG BCG signifie «
Bacille Calmette-Guerin "name the discoverers of this vaccine. It protects
"somewhat" against tuberculosis, but there's nothing else.
History:
Tuberculosis is caused by Mycobacterium tuberculosis
whose reservoir is man but also cattle and some birds such as pigeons, so numerous in our cities
The bacillus of tuberculosis there were three million years, the original strain would have appeared in East Africa, considered the cradle of humanity. The disease is therefore as old as humanity and its expansion through the world is intimately linked to that of man. That would be the man who allegedly transmitted the disease to domestic animals or commensals and not vice versa. The
tuberculosis complex would consist of two different evolutionary lineages, the first infecting that Homo sapiens, which would be the second animal that can also infect humans, but mostly affecting other mammals (cattle, goats , rodents ...) and some birds.
Tuberculosis was a common and very serious illness in the nineteenth and early twentieth century. It remains worrying in developing countries (Vietnam, India, Africa). In Russia but also in the U.S. among black people and poor of New Jersey emerged strains of bacilli resistant to almost all antibiotics. With the movement of people and while traveling less poor than the rich, it is likely that these bacilli disseminate to the entire planet. Microbes do not respect borders.
The World Health Organization (WHO) estimates that the total number of new TB cases remained stable in 2007 and the percentage of new patients in the world's population has declined slightly as he has done regularly since 2004. It is estimated that 9.27 million the number of TB cases in 2007 (against 9.24 million in 2006). Most are in Asia (55%) and Africa (31%). Alone, India has 2 million people. The vaccine used
simple to do with a ring has become difficult because the intradermal injection should be strictly and therefore painful and the success rate limiting local reactions requires a child completely still. Moreover, this vaccine as the previous protects only half of those vaccinated.
intradermal injection: the small bubble is a blister of that found in skin thickness In France, vaccination is recommended in regions rich in migrant children from countries at risk and / or likely to go.
In endemic countries, it is a good way, even if imperfect, to limit infections. The treatment is very long, expensive, not to mention the resistant forms.
The increase in poverty, the occurrence of multi-resistant strains probably lead to a revision of vaccination advice. Research is underway to develop a more effective vaccine.
Rotavirus: is responsible for severe gastroenteritis
s sometimes accompanied
dehydration can cause death. An estimated 15 or 20 deaths per year in France. Treatment Early statements by oral rehydration and adequate nutrition can be cured in 3 to 4 days. However it must be extremely vigilant, get up at night to supervise the child and offer him a drink. There are two effective oral vaccines. One manufactured by GSK was taken off the market because it was contaminated by a DNA fragment of porcine circovirus (PCV).
TO 50 € or more, the dose outstanding, it seriously leaden atmosphere all it takes 3. Haemophilus: The head is a bacterial group Pasteurellaceae (like the plague bacillus). It was Dr. Robert Pfeiffer was the first to describe in 1892 during the pandemic Flu (Influenza =). It was long believed that he was the head of the flu, until we put the show in 1933 viral flu. The encapsulated form
may be responsible for ear infections, meningitis, occurring almost exclusively in children until the age of six years, acute epiglottitis, which can cause death by asphyxiation and is also seen in children (in this case, do not sleep a small child who is breathing spontaneously and remains poorly seated this can tip the epiglottis and smother), septicemia, pneumonia.
A little history: both cases occurred before the existence of the vaccine Joan is a girl of 9 months, healthy . She became grumpy with a fever of 38 ° and runny nose. His pediatrician cares for. Two days later, she sees the pediatrician who finds some eardrums infiltrated and put on antibiotics. The next day, she is always grumpy with 38.5 ° of temperature. The mother consulted again. The pediatrician is doubtful fontanel, slightly bulging. He is hospitalized children. Lumbar puncture performed immediately confirm the diagnosis of purulent meningitis. Intravenous antibiotic treatment is initiated for 10 days. Although the fever persists for 6 days (with this germ is usual but scary) the child recovered without sequelae.
Question: The child she had meningitis at the outset, or meningitis has installed it in favor of an ear infection? Can not answer but this story has a happy ending is chilling.
Julien is 18 months. It has a temperature of 38, 5, is irritable, eat poorly. The examination found nothing more but the impression is wrong. A lumbar puncture was performed which allows the diagnosis of purulent meningitis. Given little signs marked, Haemophilus seems to be the most likely cause. This is confirmed by culture. Without waiting for the result, the child is treated as usual. After three days, the fever drops and the child is better. He recovered from his meningitis but the 9th day appears a swollen foot that will prove to be an osteitis. It is a very unusual complication. Antibiotics, amended, were taken and the child heals.
meningitis These are very sneaky, like a good bad cold, who plays evil and ultimately destroys the brain. Moreover, even when diagnosed early, the fever may persist for ten days on antibiotics, despite a favorable trend. In 20-30% of cases occur deafness or severe hydrocephalus, formidable complications.
The vaccine has eliminated this condition. I lived its discovery and initial use. In France, the first large-scale tests are made in the Val de Marne (94) in the 1990s where there are a dozen cases a year. All small children are vaccinated and surprise, no case occurred the following year. The vaccine is quickly adopted. It is a bit painful, because at the same time as the TETRACOQ (R) in two separate injections, and very quickly it appears that one can mix the two vaccines in the same syringe. In addition, the mixture is less painful than each vaccine séparément.Un true happiness!
The vaccine is spreading rapidly and is included in the "Tetracoq" becomes the "Pentacoq" now replaced by the "Pentavac"
After 20 years, it does There is no gray area for this vaccine. It is a good vaccine, I think he said. Moreover, the consensus is such that parents vaccinate their children without discussing .
Pneumococcus: The germ is responsible for just over 10% of all deaths of children under 5 years, mainly in the Third World, which is a major public health problem.
; ; Pneumonia of the right base
Pneumococcus is the bacterium responsible for pneumonia
frank lobar acute disease most often brutal and very excited once sensitive to all antibiotics, but no longer the case. The pneumococcus is also responsible for otitis
and especially
meningitis in children under 5 years. There are about 80 types of pneumococci.
This microbe has become over the years resistant to many antibiotics.
The first vaccine was directed against the 7 strains most dangerous and the second includes 13 strains.
It is well supported, giving few febrile reactions (38 ° sometimes) Its only drawback is that it is painful at the time of injection. Children cry for 10 or 15 seconds and then settle down soon.
This vaccine has a high efficiency on the strains it covers. Unfortunately, these strains are quickly replaced by others. ike C can be seen, the decrease in the incidence of invasive pneumococcal disease (vaccine strains in blue) has been limited by a new phenomenon but predictable, the replacement of vaccine serotypes (purple). The overall reduction of infection was thus limited.
Both places s: the vaccine's effectiveness diminishes over time because bacteria can be replaced. This vaccine is part of the
list of 59 drugs under close surveillance . It is naturally impossible to know why.
meningitis Although these are not very frequent, their gravity is such that he should think twice before giving up that protection. PS there is a vaccine "Pneumo 23" used primarily in adults, but the repetition of which leads to unpleasant reactions.
Meningococcal C: Here is already a bit more complicated.
Meningococcal C is a bacterium responsible for severe infections and belonging to different types
France: B (60% of cases), C (26% of cases), more rarely of type A, Y ( in 3% of cases) or W135 (6% of cases), especially during childhood and adolescence great.
Chart showing the number of cases per 100 000 before vaccination
Meningococcal A uncommon in Europe gives epidemics of meningitis in hot countries (South America and other tropical countries often poor). There is a vaccine.
L e B meningococcal now more common in Europe. In winter, it colonizes our noses. It is estimated that one in four
carries this microbe. Contamination is between those in well-heated environments: home, nursery school, auditorium. It is very sensitive to cold that destroyed within seconds when the temperature is near 0 °. Thus, in airing, it greatly reduces the concentration of the microbe. One in 100 to 200 000 will be an infection, sepsis or meningitis
. The disease occurs at all ages but with a few more cases of 0-5 years and between 15 and 20 years, perhaps because of the number of nurseries and large auditoriums.
A new vaccine is being tested . The first Vaccines have been failures and have not reached the stage of study on humans because there is a similarity between the antigen used and the myelin that causes neurological complications. We are told that the new vaccine is safe but the onset of neurological phenomena is sometimes very slow. It will therefore take a step back and great caution before widespread vaccination. This is especially troublesome that these are sometimes fulminating meningitis.
Meningococcal C very similar to B, the same habitat, even virulence. For him, it has an effective vaccine
5-10 years. Two reserves
this vaccine: 1. It is little used in the U.S. 2. Some experts believe that if this vaccine is used widely, meningococcal C will be replaced by the B or the other and so we have not won anything.
Meningococcal infections in France : C decreases but increases B: Effect of communicating vessels Meningococcal W is responsible for small epidemics in Saudi Arabia in Mecca where particular focus of many people who sometimes, without being sick are simply colonized and bring back the microbe in the pilgrimage. Currently the vaccine against this strain is mandatory for those who go there. The vaccine is available in the vaccination centers.
To summarize about the meningococcal C vaccine: The vaccine seems safe and effective. There are reservations about its long-term interest. I am unable to decide. So
parents to decide, based on their fears, their desire to be very protected. PS: There is a vaccine older "C + A" little used now. it is effective three years.
The Chickenpox: a vaccine unhelpful except in very rare people. Chickenpox is caused by a virus group which includes Zooster viruses including herpes, chickenpox and shingles (the same) these viruses have in their genome a specific tool for replication: the enzyme thymidine kinase The enzyme can be inactivated by antiviral treatment that blocks thus making the virus and causes a rapid cure of the disease. This has changed the course of herpes particularly primary infections in children sometimes forced hospitalization. The drug, also very effective for varicella, when used early is not accepted in France for this indication.
The disease causes a permanent protection.
A vaccine is therefore the last ten years. It has long been known that within 10 years after vaccination 30% of vaccinees have chickenpox. I can imagine what happens after 20 years. I gather that the vaccine is the best way to delay adulthood onset of chickenpox!
In case of chickenpox, there should be meetings of children, leaving children in kindergarten or school and provide school subjects at risk (in generalized eczema outbreak, immunocompromised, oral treatment with corticosteroids , and a few others) but the opposite is done because there are rumors that say anything and of course parents want their children get chickenpox, but not today, it falls badly! Hepatitis B is a viral disease due to infection by the hepatitis B virus (HBV) and causing inflammation of the liver. The infectious agent strictly human very strong (!) Survives 8 days in open air (20 min cons for HIV and 10 years for the tetanus bacteria).
Chronic hepatitis B in the World In France we see that 6% of people had a Hepatitis B and 0.65% have a chronic or about 300 000 people
Symptoms of acute disease are essentially inflammation of the liver, with or without jaundice and digestive disorders with nausea and vomiting. At this point, evolution is usually benign even if hepatitis B is the most severe form of viral hepatitis. There are, rarely, fulminant-onset fatal within days. The infection often goes unnoticed. In almost one out of ten cases of acute hepatitis B visible or invisible, do not heal and becomes chronic infection. The chronic carrier has no obvious symptoms but may contaminate his surroundings. In case of chronic active hepatitis, the symptoms may be mild fever, fatigue, digestive disorders (nausea, vomiting, abdominal pain), jaundice, dark urine or pale stools.
The potential seriousness of hepatitis B consists of the risk of progression to chronic hepatitis which may be complicated by liver cirrhosis and liver cancer, a deadly disease with a very low response rate treatment.
Other viruses (Hepatitis A, C, Ebstein Barr) give hepatitis. Some particularly toxic alcohol can lead to cirrhosis and liver cancer.
The vaccine is very effective : 2 injections one month apart and a booster one year later to give the child and probably the adult immune powerful and definitive. In the late 90s, a controversy has developed on the relationship between the vaccine and multiple sclerosis. Numerous studies have shown that there was no report. However
as multiple sclerosis is rare before 15 years, both before and why are not vaccinated during infancy since there no recall and that adolescents do not attend the doctors.
So your children get vaccinated against hepatitis B at your convenience. Flu vaccine and It has already been
lengthy discussions on this site . It is useful in patients at risk.
papillomaviruses responsible for cervical cancer. The vaccine developed outset been presented as potential lost 80% of cervical cancers.
efficiency will not be known until fifteen years.
risks of these vaccines are likely to be low, but under review and subject to controversy.
Papillomaviruses in question are especially prevalent in Africa.
map the distribution of cancer of the cervix published in August 2008 by the New York Times
earnings related to immunization, much debated, seems low in Europe.
The duration of immunization is not known. A reserve
more This vaccine is part of the list of 59 drugs
under high surveillance. It is naturally impossible to know why.
There are too many controversies of opacity , conflicts of interest about this vaccine and some manufacturers. For now, I indicate that this vaccine exists and I do not do as enthusiastic. "This article is the result of a long gestation, childbirth very medicalized but Dr. Gamin is doing well. The baby seems healthy enough and vaccines her life easier. Only three are mandatory but others are very useful. Thank you to those who read me, even diagonally! " References: Tuberculosis:
Eva Nathanson, M.Sc., Paul Nunn, FRCP, et al M DR tuberculosis - Critical Steps for Prevention and Control N Engl J Med 2010; 363:1050-1058 September 9, 2010 The mycobacteria Pneumococcal:
Agnes Lepoutre 1, 2 Emmanuelle Varon , George Scarlett 1, 2 Laurent Gutmann , Daniel Levy-Bruhl 1 and microbiologists of the network and EPIBAC Network of Regional Observatories
pneumococcal .
Meningococcus:
Epidemiological Bulletin of the Institute for Public Health Surveillance Papillomavirus: in link text
