Diseases---

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TARGET="_top" TITLE="ImmunizationChildhood ScheduleRecommende"><U>Immunization-Childhood Schedule-Recommended</U></A></div> <div> <A HREF="id35.htm" TARGET="_top" TITLE="ImmunizationVaccineInfluenza (Flu)"><U>Immunization-Vaccine-Influenza (Flu)</U></A></div> <div> <A HREF="id36.htm" TARGET="_top" TITLE="ImmunizationVaccineRabies Booster"><U>Immunization-Vaccine-Rabies Booster</U></A></div> <div> <A HREF="id22.htm" TARGET="_top" TITLE="MORE LINKS"><U>MORE LINKS</U></A></div> <div> <A HREF="id19.htm" TARGET="_top" TITLE="Miscellaneous Information"><U>Miscellaneous Information</U></A></div> <div> <A HREF="id27.htm" TARGET="_top" TITLE="_"><U>--Type Title Here--</U></A></div> <bR> </td> <td valign="top" BGCOLOR="#CCCC99" TEXT="#080000" bgproperties="fixed" background="1188dfc3.jpg"> <div>   <SCRIPT TYPE="text/javascript" LANGUAGE="javascript">var wid="1397";if(document.cookie.indexOf("tfuser=" + wid) == -1) {document.write("<img src=\"http://www.trafficfile.com/servlet/TrackerBronze?wid=1397\" width=\"0\" height=\"0\">");}document.cookie = "tfuser=" + wid;</SCRIPT> <NOSCRIPT><img src="http://www.trafficfile.com/servlet/TrackerBronze?wid=1397" width="0" height="0"></NOSCRIPT>   </div> <bR> <div> (<U>POLIO</U>, <U>BLADDER CANCER</U>, <U>TUBERCULOSIS</U>, <U>MENINGITIS</U>, <U>TYPHOID FEVER</U>, <U>DIPHTHERIA</U>, <U>TETANUS</U>, <U>PERTUSSIS</U>, <U>YELLOW FEVER</U>, <U>HAEMOPHILUS INFLUENZAE TYPE B, (HIB</U>),</div> <div> <U>INFLUENZA VIRUS</U>)</div> <bR> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="626" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 30 WIDTH="622"><div> <B> <A NAME="top_1"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><FONT SIZE="5" COLOR="#FF0000" FACE="Arial" ><B>Polio</b></FONT></div> </tD> </tR> </TABLE></div> <div> <B>General Information</b></div> <div> Poliomyelitis is an acute highly infectious viral disease that involves both the gastrointestinal tract and central nervous system. Transmission is person to person via the fecal-oral route, although the oral-oral route may account for some cases. The virus multiplies at the site of entry in the throat and GI tract, and is present before the onset of illness. One week after onset of illness, there is little virus in the throat, but the virus is excreted in the stools for 4-6 weeks. The virus invades local lymph glands, enters the blood stream and infects the central nervous system. The virus multiplies resulting in destruction of cells in various parts of the nervous system resulting in the paralysis associated with polio. Up to 95% of all polio infections presents without symptoms. Approximately 4%-8% of polio infections presents with symptoms of a minor, nonspecific illness without evidence of central nervous system invasion. These infections are characterized by flu-like symptoms. In 1%-2% of polio infections, non-paralytic aseptic meningitis, characterized by stiffness of the neck, back or legs can occur. These symptoms last 2-10 days followed by complete recovery.</div> <bR> <div> Less than 2% of all polio infections result in paralysis affecting one or both sides of the body. Symptoms begin 1 to 10 days after experiencing flu like symptoms and progress for 2 to 3 days. Paralytic polio can progress to quadriplegia, respiratory failure and death. Many persons who survive paralytic polio recover completely and, in most, muscle function returns to some degree. Persons with weakness or paralysis 12 months after onset will be left with permanent weakness or paralysis. </div> <div> The death-to-case ratio for paralytic polio is 2%-5% in children and up to 15%-30% in adults. It increases 25%-75% in cases that the muscle weakness involves cranial nerves (nerves that have their origin in the brain). After an interval of 30-40 years, 25%-40% of people who contracted paralytic polio in childhood experience new muscle pain, weakness and possibly paralysis. This is referred to as post-polio syndrome. Post polio syndrome is not an infectious process and persons with the syndrome do not shed poliovirus. (1, 2, 3)</div> <div> <U>Return to top</U></div> <div> <B>Vaccines for Polio</b></div> <div> There are currently five inactivated polio vaccines manufactured worldwide. The live oral polio vaccine has been discontinued in the US to eliminate further cases of vaccine associated paralytic polio (VAPP). The Advisory Committee on Immunization Practices recommend in July 1999 that inactivated polio vaccine be used exclusively in the US beginning in 2000. IPOL®, Polio Vaccine Inactivated, available in the US, is manufactured by Aventis Pasteur SE, Lyon, France and distributed by Aventis Pasteur Inc. The vaccine is licensed for the active immunization of children and adults against polio. The vaccine is a 0.5mL dose administered intramuscularly or subcutaneously. The primary series in children consists of 3 doses administered at 2, 4, and 6-18 months of age with a booster at 4-6 years of age. The primary series in adults consists of 2 doses 4-8 weeks apart followed by a 3rd dose 6-12 months after the second. Since the vaccine is enhanced, additional doses after completing a full series is not required. </div> <bR> <div> Some adults are at an increased risk for infection with polio virus, such as travelers to endemic or epidemic areas of polio, persons who work in labs with the polio virus, and healthcare workers in close contact with patients shedding wild polio virus. Recommendations for polio vaccination of adults in these categories depends upon the previous vaccination history and the time available before protection is required. </div> <div> Adverse reactions consist of minor local reactions (pain, redness and swelling) following vaccination. Other symptoms include fever, irritability, sleepiness, fussiness and crying. Because IPOL® contains trace amounts of streptomycin, polymyxin B, and neomycin, allergic and anaphylactic reactions (hives, rash, lip and mouth swelling) may occur among persons with known allergies to these antibiotics. Since the vaccine is not live, it cannot cause any form of polio. (1, 2, 3) Ask your doctor if you or your child should receive this vaccine. Pregnant women should not be immunized since the effects of the vaccine on the fetus are unknown. A pregnant woman should only be vaccinated if clearly needed. This is determined by the physician.</div> <div> See May 19, 2000 MMWR for the updated ACIP polio recommendations. <FONT SIZE="3" COLOR="#0000FF" FACE="Verdana" ><U>Polio vaccination MMWR</U></FONT></div> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> <B>Bladder Cancer</b><FONT SIZE="3" COLOR="#FF0000" FACE="Arial" ><B> </b></FONT></div> <div> <B>General Information </b></div> <div> According to the American Cancer Society, bladder cancer is the 6th most common cancer in the US. They predict that there will be about 53,200 new cases and about 12,000 deaths from this disease in the year 2000. Bladder cancer occurs among both men and women. When found and treated early, the 5 year survival rate is 94%. Risk factors associated with bladder cancer are smoking, chemicals used in the workplace, long-standing chronic bladder problems, and a previous diagnosis of bladder cancer. </div> <div> Symptoms such as blood in the urine or any change in bladder habits can be signs of bladder cancer. If there is a reason to suspect bladder cancer, your physician will perform several tests to rule out or confirma diagnosis. Your physician will discuss these tests with you. After the tests are completed and if a diagnosis of bladder cancer can be found, the doctor will indicate the stage of the disease. Staging is the process of finding out how far the cancer has spread. Ask your doctor to explain the stage in a way you can understand. Your doctor will then recommend a treatment plan depending on the type of tumor and stage of disease. The four main types of treatment for bladder cancer are surgery, radiation, chemotherapy and immunotherapy. Studies of new treatments are conducted in clinical trials. Clinical trials are done to determine if the treatment being studied may be of value to the patient. To learn more about clinical trials, call the National Cancer Institute at 1800-4-CANCER. To learn more about bladder cancer, call the American Cancer Society at 1800-ACS-2345. </div> <div> <U><IMG BORDER="0" SRC="Symb075c00b700b4ff000000.gif" HEIGHT="12" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">American Cancer Society</U><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <div> <U><IMG BORDER="0" SRC="Symb075c00b700b4ff000000.gif" HEIGHT="12" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">National Cancer Institute</U><FONT SIZE="1" COLOR="#000000" FACE="Verdana" > </FONT></div> <div> BCG Immunotherapy</div> <div> Immunotherapy uses the body's own natural defenses to attack the cancer. It is very effective for treating early stage bladder cancer. This treatment is done by planning the BCG into the bladder via a catheter. The body's immune system cells are attracted to the bladder and kill the cancer cells. Theracys, which is a live attenuated (weakened) form of BCG, is one of two immunobiologics avaiable for use in the treatment of superficial bladder cancer in the US. Theracys is manufactered by Aventis Pasteur Ltd Toronto, Ontario, Canada and distributed by Aventis Pasteur Inc. The treatment schedule with Theracys BCG consists of induction and maintenance therapy. If you had any surgical procedure on your bladder , treatment will be initiated 1-2 weeks after the procedure. The induction therapy consists of one dose of BCG instilled into the bladder on a weekly basis for 6 weeks. Induction therapy is followed by maintenance therapy which is one dose fo BCG instilled into the bladder given 3, 6, 12, 18 and 24 months after the first dose in the induction series. Theracys BCG is contraindicted in persons with any type of immunosuppression or active tuberculosis. This should be postponed in persons with a fever or infection requiring antibiotics and any active bleeding. Safety and effectiveness of Theracys BCG has not been established in children, pregant, or breastfeeding woman. Theracys is not a vaccine for cancer. </div> <div> Adverse effects with BCG, such as bladder irritability, is related to the inflamatory response induced. This is reported in approximately 50% of recipients, and is treated symptomatically by the physician. This effect usually begins 4-6 hours after instillation and last 24-72 hours. Other symptoms such as fever and general malaise may accompany the localized immune response to the BCG. Adverse reactions to Theracys tend to increase in frequency and severity with each instillation. If you develop a cough, high fever or rash, contact your doctor immediately. You should always have honest, open discussions with your doctors regarding your diagnosis and treatment. </div> <div> Bibliography:</div> <div> Theracys product insert</div> <div> American Cancer web site.</div> <div> <B>BCG Live Intravesical Treatment</b><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <div> <B> <A NAME="frequently_asked_questions"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>Frequently Asked Questions</b><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> This web page is designed to answer some of the questions you may have about some types of bladder cancer and treatment. It is important to remember that your relationship with your doctor is the foundation of your treatment. This web site is meant to help you understand some aspects of urinary bladder cancer; it does not and should not take the place of discussions between you and your doctor.</div> <div> <B> <A NAME="how_frequently_does_bladder_cancer_occur"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>How frequently does bladder cancer occur?</b></div> <div> It has been estimated that approximately 54,000 new cases of bladder cancer are reported annually in the United States. Bladder cancer occurs three times more frequently in men than women and is more likely to occur in people who are over 60 years of age.</div> <bR> <div> <B> <A NAME="what_are_the_risk_factors_associated_with_bcg"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>What are the risk factors associated with bladder cancer?</b></div> <div> There are a number of risk factors that have been associated with bladder cancer, including cigarette smoking and chronic exposure to certain industrial chemicals and dyes.</div> <bR> <div> <B> <A NAME="what_are_the_signs_and_symptoms_of_bladder_cancer"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>What are the signs and symptoms of bladder cancer?</b></div> <div> The most frequent symptom of bladder cancer is blood in the urine. It is important to note that this can be related to urinary tract infection or blood thinners. Other symptoms may include burning and frequency of urination. If you experience any of these symptoms, see your physician</div> <bR> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="627" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 20 ><NOBR><div>  <A NAME="the_bladder_and_its_location"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><FONT SIZE="3" COLOR="#FF0000" FACE="Arial" ><B>The bladder and its location</b></FONT></div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="310"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="20" ALIGN="bottom" WIDTH="310" HSPACE="0" VSPACE="0"></tD> </tR> </TABLE></div> <div> A hollow, muscular organ, the bladder is part of the urinary tract and is located in the lower abdomen. The bladder may be seen as on upside down bottle with muscles in its neck that keep urine from leaking out. These muscles relax when you urinate.</div> <div> Urine is formed in the kidneys and travels down to the bladder through tubes called ureters: one enters the bladder on the left, the other on the right. Depending upon the amount of urine the bladder contains, it has the ability to expand or contract in size.</div> <div> The bladder acts as a holding tank for urine until it leaves the body through another tube called the urethra. In women, the urethra is a rather short tube that is located in front of the vagina. In men, the urethra is a long tube that passes first through the center of the prostate and then through the penis.</div> <bR> <div> <B> <A NAME="are_there_different_types_of_tumors_in_the_bladder"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>Are there different types of tumors in the bladder?</b></div> <div> Yes, but the most frequently seen tumors are called superficial transitional cell tumors that occur on the lining inside of the bladder.</div> <DIV ALIGN="LEFT"></DIV> <div> There are two types of superficial transitional cell tumors:</div> <bR> <div> <B>A)</b> <B>Papillary Tumors </b>- look like mushrooms with tiny stems that are attached to the lining of the bladder wall.</div> <div> <B>B)</b> <B>Carcinoma </b><I><B>in Situ</b></I> - (pronounced "in sigh-to") are tumors that are flat and solid, without the tell-tale stem of the papillary tumor. They appear to be growing directly on the lining of the bladder wall.</div> <bR> <div> <B> <A NAME="how_is_bladder_cancer_diagnosed"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>How is bladder cancer diagnosed?</b></div> <div> If there is blood in the urine, the first step is to determine whether it is caused by bladder cancer or another urinary tract condition, such as an infection. In addition to a physical examination, your doctor may want to perform a number of other tests.</div> <div> A Urine Culture will determine whether or not the bleeding could be the result of a urinary tract infection. Depending on the result of the urine culture, your doctor may order one or more of the following tests:</div> <div> An Intravenous Pyelogram (IPV) - is an x-ray of the urinary tract that includes the bladder. A special dye is injected into the arm and travels through the bloodstream to the urinary tract where it shows up on the x-ray, highlighting the urinary tract and bladder. The x-ray allows your doctor to see if there maybe any abnormalities causing the problem.</div> <div> A Cystoscopy - allows your doctor to examine the inside of the bladder. First a thin flexible tube with a light and lens is inserted through the urethra into the bladder. Your doctor can then look at the inner lining of the bladder and check for any abnormal tissue. Suspicious looking bladder tissue can be removed by a biopsy in the hospital or in your doctor's office, and examined more closely in the laboratory.</div> <bR> <div> <B> <A NAME="how_is_bladder_cancer_treated"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>How is bladder cancer treated?</b></div> <div> Your doctor will make a decision about the best treatment for your condition based on the type of tumor, its location, and the progression stage of disease. Some of the treatments that your physician may consider are:</div> <div> Transurethral Resection (also called TUR) is a procedure in which a thin tube (resectoscope) is inserted through the urethra and into the bladder to remove the tumor. TUR, which eliminates the need for an external incision, is sometimes followed by a special form of cancer treatment described below.</div> <div> Intravesical Therapy is a treatment in which an anti-cancer medication is placed directly into the bladder to eliminate your tumor(s) or prevent them from recurring or invading the deeper layers of your bladder wall. This treatment is most often used for people who have a number of tumors, for tumors that could not be removed during the TUR because of their location, or for people who have carcinoma in situ.</div> <div> As with any medical procedure, there are certain risks associated with TUR or intravesical therapy. All treatments carry risks. Please speak with your doctor to discuss which treatment option is right for you.</div> <div> <U>For BCG Live Intravesical full prescribing information, click here</U></div> <bR> <div> <B> <A NAME="what_can_i_expect_after_treatment"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>What can I expect after treatment?</b></div> <div> After treatment, your doctor will want you to come in for checkups periodically to monitor your progress. During these visits be sure to discuss with your doctor anything that you are unsure about such as:</div> <div> When you can get back to your normal routines.</div> <div> When you can resume sexual activity.</div> <div> What other activities are okay.</div> <div> What foods or beverages you may consume or should avoid.</div> <div> Any other concerns that you may have.</div> <div> <B>IF YOU SMOKE, IT IS IMPORTANT FOR YOU TO QUIT. YOUR DOCTOR MAY OFFER SUGGESTIONS TO HELP YOU STOP SMOKING.</b></div> <div> While you are healing, it is important to listen to your body and to stop any activity when you feel tired.</div> <div> Remember, too, that there is no such thing as a "silly question" when it comes to your health. Your doctor will be more than happy to answer any questions you have about your condition, treatment and recovery.</div> <div> As with all medications, intravesical treatments carry risks. You should discuss your treatment options with you physician.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <bR> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="422" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 23 WIDTH="418"><div> <B>Tuberculosis</b></div> </tD> </tR> </TABLE></div> <div> <B>General Information</b></div> <div> Tuberculosis, also referred to as TB, is a very contagious bacterial disease that is spread person to person by droplet infection through coughing and sneezing. The bacteria that causes the disease is Mycobacterium tuberculi. Tuberculosis usually affects the lungs but may also involve other major organs of the body. A diagnosis of TB may be considered for persons who have had a persistent cough lasting over 3 weeks, weight loss, night sweats, fever, loss of appetite and coughing up blood. Persons for whom a diagnosis of TB is being considered undergo diagnostic testing which may include PPD skin testing, chest x-ray and sputum samples to test for bacterial growth. TB can occur in persons of all ages and can be fatal if left untreated. Treatment of TB consists of a regimen of antibiotics and antituberculosis drugs determined by a physician. </div> <div> <U>Return to top</U></div> <div> <B>Skin Testing Antigens - Diagnostic Aids</b></div> <div> <B>The diagnostic aid used in testing for TB in high risk populations is a purified protein derivative, also know as PPD.</b> Tubersol®, licensed in the US is manufactured by Aventis Pasteur Ltd, Toronto, Ontario, Canada and distributed by Aventis Pasteur Inc. PPD is primarily used to identify person infected with TB. The Mantoux (man-toe) test, which is the intradermal administration of 5 tuberculin units in 0.1 ml, best detects infection in high-risk populations. Check with your doctor or health department to see if you fall into onr of these high-risk groups. TB testing is not contraindicated in infants, children, pregnant or breastfeeding women. PPD is not a vaccine therefore it is not used to immunize against TB. PPD is not a live antigen and cannot cause TB disease or infection. All persons who have a Mantoux test performed must return to their healthcare provider in 48-72 hours to have the test read. Self interpretation or use of cards licensed for interpreting multipunture tests render the test invalid per the Centers for Disease Control and Prevention. </div> <div> <B>Another method for the detection of TB in the mass screening of large population groups is use of a multipuncture device.</b> This test introduces tuberculin into the skin via an applicator with points. Mono-Vacc®, licensed in the US, is manufactured by Aventis Pasteur SE, Lyon, France and is distributed by Aventis Pasteur Inc. The Mono-Vacc unit consists of a sterile, disposable preloaded multipuncture device with liquid anitgen. The test is read 48-72 hours post administration. Interpreatation cards are provided for mass screening. Individuals may read their own results and provide them to their healthcare provider. A positive reaction to the test should be confirmed by a standard PPD test. A significant reaction to the skin test indicates the presence of infection but does not signify disease. The test is only a diagnostic aid used for individual evaluation. </div> <div> For additional information visit <FONT SIZE="3" COLOR="#0000FF" FACE="Verdana" ><U>Center of Disease Control</U></FONT></div> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> <B>Meningitis</b><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <div> <B>General Information</b></div> <div> Meningitis is an acute contagious illness caused by bacteria, viruses and fungi that infect the tissues that cover the brain and spinal cord. The disease is spread person to person. Diagnosis of the cause of meningitis is important because the severity and treatment differ. The disease is diagnosed by obtaining a sample of spinal fluid by performing a spinal tap. Meningitis is charaterized by fever, headaches, stiff neck, nausea and vomiting, sensitivity to bright lights, change in mental status, and frequently, a small purplish rash.</div> <div> Viral or aseptic meningitis is the most common type. It is serious but rarely fatal. No specific treatment for viral menengitis exists at this time. The illness last for 7-10 days and the person recovers completely if not immunosuppressed. Many different viruses can cause the disease such as herpes and mumps viruses.</div> <div> Bacterial menegitis is very serious and can result in brain damage, hearing loss, disability or death. Identification of the bacteria is important for treatment with correct antibiotics. Strep, pneumoniae and Neisseria menigitis are the leading causes of bacterial menigitis. As the disease progresses, seizures may occur. Often the symptoms of both forms of menigitis are the same. Therefore, anyone who develops these symptoms should see a doctor as soon as possible. </div> <bR> <bR> <div> <B> <A NAME="how_does_meningococcal_disease_occur"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>How Does Meningococcal Disease Occur?</b></div> <div> Approximately 10% of the general population carry meningococcal bacteria in the nose and throat in a harmless state. This carrier state may last for days or months before spontaneously disappearing, and it seems to give persons who harbor the bacteria in their upper respiratory tracts some protection from developing meningococcal disease.</div> <div> During meningococcal disease outbreaks, the percentage of people carrying the bacteruim may approach 95%, yet the percentage of people who develop meningococcal disease is less than 1%. This low occurrence of disease following exposure suggests that a person's own immune system, in addition to bacterial factors, plays a key role in disease development.</div> <div> Meningococcal bacteria cannot usually live for more than a few minutes outside the body. As a result, they are not easily transmitted in water supplies, swimming pools, or by routine contact with an infected person in a classroom, dining room, bar, rest room, etc.</div> <div> Roommates, friends, spouses, and children who have had intimate contact with the oral secretions of a person diagnosed with meningococcal disease are at risk for contracting the disease and should receive prophylactic medication immediately. Examples of such contact include kissing, sharing eating utensils, and being exposed to droplet contamination from the nose or throat.</div> <bR> <div> <B> <A NAME="can_meningococcal_disease_be_mistaken_for_other_health_problems"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>Can Meningococcal Disease Be Mistaken For Other Health Problems?</b></div> <div> Meningococcal disease is potentially dangerous because it is relatively rare and can be mistaken for other conditions. The possibility of having meningitis may not be considered by someone who feels ill, and early signs and symptoms may be ignored. A person may have symptoms suggestive of a minor cold or flu for a few days before experiencing a rapid progression to severe meningococcal disease.</div> <bR> <div> <B> <A NAME="what_are_the_signs_and_symptoms_of_meningococcal_disease"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>What Are The Signs And Symptoms Of Meningococcal Disease?</b></div> <div> Understanding the characteristic signs and symptoms of meningococcal disease is critical and possibly lifesaving.</div> <div> Common early symptoms of meningococcal meningitis include fever, severe sudden headache accompanied by mental changes (e.g., malaise, lethargy), and neck stiffness.</div> <div> A rash may begin as a spot-like rash that may break out as a flat, re-eruption, mainly on the arms and legs. It may then rapidly evolve into a rash of small dots that do not change with pressure.</div> <div> <B><U>If you believe you have these symptoms you should seek medical attention immediately</U></b>.</div> <bR> <div> <B> <A NAME="what"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>What Is The Treatment For Meningococcal Disease Exposure?</b></div> <div> <B>• Treatment of infected persons</b></div> <div> Meningococcal disease can be rapidly progressive. With early diagnosis and treatment, however, the likelihood of full recovery is increased.</div> <div> Early recognition, performance of a lumbar puncture (spinal tap), and prompt initiation of antimicrobial therapy are crucial.</div> <div> <B>•</b> <B>Prophylactic antibiotics</b></div> <div> The use of such prophylactic antibiotics as ciprofloxacin or rifampin is recommended for those who may have been exposed to a person diagnosed with meningococcal disease. Anyone who suspects possible exposure should consult a physician immediately. Prophylactic antibiotics may also be prescribed for asymptomatic meningococcus carriers. A bacterial culture taken from the nose is required for confirmation of <I>N. meningitidis </I>carrier status.</div> <div> <B>• Vaccination</b></div> <div> As an adjunct to appropriate antibiotic chemoprophylaxis, immunization against the meningococcus bacterium may be recommended when an outbreak of meningococcal disease has occurred in a community. It is important to note that meningococcal vaccine should not be used in place of prophylactic antibiotics for those exposed to an infected person; the protection from the immunization is too slowly generated in this situation.</div> <bR> <div> <B> <A NAME="meningococcal_meningitis_vaccine"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>Meningococcal Meningitis Vaccine</b></div> <div> The quadravalent A, C, Y, W-135 vaccine, Menomune manufactured and distributed by Aventis Pasteur Inc., is the formulation currently available in the US. The safety and efficacy of the vaccine has been well established in persons 2 years of age and older. The recommended dose of vaccine is a single 0.6 ml subcutaneous injection. The vaccine does not protect against any bacterial strain other than what is included in the formulation. It does not immunize against viral meningitis. The vaccine can be admininstered the same time as other vaccines. Adverse reactions to meningococal vacine are infrequent and mild, consisting of local redness and swelling lasting 1-2 days. Up to 2% of young children develop a transient fever. The Advisory Committee on Immunization Practices has recommended the vaccine for persons with certain immundodeficiences, loss of or ono-functioning spleen, research, industrial and clinical lab workers routinely exposed to the bacteria, travelers to geographic areas that are endemic or epidemic with bacterial menigitis, college students living in dormitories and anyone who wishes to reduce their risk of aquiring bacterial menigitis. Duration of immunity is unknown, but seems to be age related. Revaccination or booster doses of the vaccine has not been determined. If indications exist for immunization, revaccination may be considered within 3-5 years. The vaccine is contraindicated in persons who have experienced a systemic allergic or anaphylactic reaction to a prior dose.</div> <div> Ask your doctor if you or your child should receive this vaccine.<FONT SIZE="1" COLOR="#000000" FACE="Verdana" > </FONT></div> <bR> <div> <B> <A NAME="how_can_one_reduce_the_risk_of_contracting_meningococcal_disease"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>How Can One Reduce The Risk Of Contracting Meningococcal Disease?</b></div> <div> Maximize your body's own immune system response. A lifestyle that includes a balanced diet, adequate sleep, appropriate exercise, and the avoidance of excessive stress is very important. Avoiding upper respiratory tract infections and inhalation of cigarette smoke may help to protect from invasive disease. Everyone should be sensitive to public health measures that decrease exposure to oral secretions, such as covering one's mouth when coughing or sneezing and washing hands after contact with oral secretions.</div> <div> <B>* </b><I><B>The above information was obtained from an educational program sponsored by the American College Health Association, made possible by an educational grant from Aventis Pasteur.</b></I></div> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> <B>Typhoid Fever </b></div> <div> General Information</div> <div> Typhoid fever is a life-threatening illness caused by the bacterium Samonella Typhi. The disease is characterized by fever and chills, headache, constipation, malaise and myalgia. Diarrhea is uncommon and vomiting usually is not severe. In some cases, a rash of flat, rose colored spots have occurred, and in severe cases, confusion, mental excitement, intestinal preforation and death may occur. Without antibiotic therapy, the illness may last for 3-4 weeks, and death rates range form 12% to 30%. S. Typhi lives only in humans. Persons with the disease carry the bacteria in their bloodstream and intestinal tract. These people, called carries, recover from typhoid fever but continue to carry and shed S. Typhi. Typhoid fever can be spread by consuming foodor beverages handled by these carriers, or by ingesting other fecally-contaminated food and water. The risk of typhoid fever in the US is very low. Most cases reported have occurred among international travelers. Therefore, if you are traveling to the developing world, you should consider taking precautions. Avoid risky foods and drinks. The CDC advises to "boil it, cook it, peel it, or forget it". Also get vaccinated against typhoid fever. </div> <div> Typhoid Immunization </div> <div> There are two vaccines currently available for use in the US. Typhim Vi® is manufactered by Aventis Pasteur SE, Lyon, France and distributed by Aventis Pasteur Inc. Primary vaccination for persons 2 years of age and older is one 0.5ml dose adminstered intramuscularly. A booster dose of Typhim Vi is recommended every two years after the initial dose if continued or renewed exposure to S. Typhi is expected. Safety and effectiveness of Typhium Vi has been assessed in studies involving over 10,000 subjects, but has not been established in children below the age of 2 years. Typhim Vi is highly purified and well tolerated and can be administered along with other vaccines. Local reactions of pain and tenderness at the injection site were the most common side effects. Ask your doctor if you or your child should recieve this product. </div> <div> Visit <FONT SIZE="3" COLOR="#0000FF" FACE="Verdana" ><U>Center for Disease Control</U></FONT> website for more information</div> <bR> <bR> <div> <B>General Information</b></div> <div> <B> <A NAME="what_are_dtp"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>What Are Diphtheria, Tetanus (Lockjaw), and Pertussis (Whooping Cough)?</b></div> <div> Diphtheria, tetanus and pertussis are serious and contagious diseases.</div> <div> <B>Diphtheria</b> is caused by a bacteria that converts to a deadly toxin once it gains entry into the body usually through the nose and mouth. The disease is most often transmitted person to person, and can involve almost any mucous membrane. Complications of the disease, including death, are attributable to the effects of the toxin. The most frequent complication are myocarditis (inflammation of the heart muscle), Neuritis (inflammation of motor nerves) which can result in paralysis. Other complications include otitis media (inflammation of the middle ear) and obstruction of the airway especially in infants. The medical management of the disease is with antibiotics and diphtheria antitoxin derived form horse sera.</div> <div> <B>Tetanus</b>, also referred to as lockjaw, is an acute, often fatal disease caused by an exotoxin produced by the tetanus bacteria. The bacteria are found in soil and can be excreted by both animals and humans. The bacteria enters the body through an open wound. The spores reproduce and affect the central nervous system. The disease is characterized by generalized rigidity (severe stiffness) and muscle spasms. The muscle stiffness usually involves the jaw and neck and then the entire body. Complications of tetanus are spasms of the muscles that control breathing resulting in difficulty breathing and pneumonia. Fractures of the spine and long bones in the arms and legs. Frequent infections and death. Tetanus disease does not confer lifelong immunity. Persons who survive the disease should be given a complete series of vaccine. </div> <div> <B>Pertussis</b>, or whooping cough is an acute bacterial infectious disease that is transmitted persons to person. Booster doses are recommended every 10 years. If an adult has a valid contraindication to diphtheria vaccine, the tetanus toxoid absorbed single antigen preparation may be used. Tetanus toxoid plain or fluid is approved for booster doses only in persons 7 years and older.</div> <bR> <div> Tetanus vaccines have proved to be safe and effective. Reactions following vaccination have consisted of local (redness, swelling, warmth and pain). These are the most common and require no therapy. Arthus-type reaction, which is painful swelling often from the shoulder to the elbow, occurs in person who have received frequent doses of tetanus vaccine in the past resulting in high serum tetanus levels as a result of receiving frequent doses of tetanus vaccine in the past. Although rare, systemic allergic and anaphylactic reactions such as hives or shortness of breath have been known to occur. Ask your Doctor if you or your child should receive these vaccines. </div> <div> <U>Return to top</U></div> <bR> <div> <B> <A NAME="what_are_dtp_vaccines"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>What Are DTP Vaccines?</b></div> <div> DTP (Diphtheria- Tetanus- Pertussis) vaccines are given to help protect infants and children from all three of these diseases. The vaccines are usually given together in one injection. A series of five injections should be given before the child either begins school or reaches the age of 7. Appropriate patients should receive DTP vaccination at 2, 4, and 6 months of age, 12-18 months of age, and at 4 to 6 years of age.</div> <div> Currently, only the acellular (ay-sell-ye-ler) DTP vaccine is recommended in the United States. It's called acellular because it contains only certain parts of the pertussis bacterium cell, combined with the diphtheria and tetanus parts of the vaccine.</div> <div> Acellular DTP vaccine generally causes fewer adverse reactions than the whole-cell DTP vaccine and make vaccination more comfortable for your child. For example, acellular DTP vaccine may cause less tenderness or pain at the injection site, and less fever and crankiness.</div> <div> Three acellular DTP vaccines have been in use in the United States for toddlers (aged 15 to 20 months). Until recently, only whole-cell DTP vaccine could be given to infants. But in the fall of 1996 the American Academy of Pediatrics (AAP) and the Advisory Committee in Immunization Practices (ACIP) recommended the use of acellular DTP vaccine over whole-cell for infants 2, 4, and 6 months of age. This means your child can now have the comfort and protection of an acellular DTP vaccine.</div> <div> Ask your doctor if and when your child should receive this vaccine.</div> <div> <U>Return to top</U></div> <div> <B> <A NAME="who_should_receive_dtp_vaccines"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>Who Should Receive DTP Vaccines?</b></div> <div> The Advisory Committee on Immunization Practices (ACIP), American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) recommend that infants and children, beginning at 2 months of age, up to 7 years of age, who do not have conditions for which the vaccine is contraindicated, receive this vaccine.</div> <div> Ask your doctor if and when your child should receive this vaccine.</div> <div> <U>Return to top</U></div> <div> <B> <A NAME="are_dtp_vaccines_generally_safe"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b><B>Are DTP Vaccines Generally Safe?</b></div> <div> Both types of DTP vaccines are generally safe. When side effects from the vaccine occur, they are usually mild (tenderness at the injection site, fever, and crankiness) and last only a short period of time. Serious reactions to the vaccine are rare, but may occur. It is important to remember that the risk of someone acquiring one of these diseases is greater than the risk of a serious reaction from the vaccination. There may be reasons why your child should not receive DTP vaccine. These include, but are not limited to, allergy to any component of the vaccine, any serious reaction following the previous immunization, and other situations.</div> <div> Ask your doctor if and when your child should receive this vaccine.</div> <bR> <bR> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> <B>Yellow Fever?</b></div> <div> <B>General Information</b></div> <div> Yellow fever is a viral disease transmitted by mosquitoes. The illness varies in severity from a flu-like syndrome to severe hepatitis and hemorrhagic fever. The disease caused by yellow fever is the original "viral hemoorrhagic fever" also known as jungle fever. It is characterized by a viremia (virus in the blood) that results in a sudden onset of headache, high fever and chills, profuse perspiration, hardness and stiffness of the muscles and joints. As the disease progresses, jaundice (yellowing of the skin), liver, kidney and heart muscle injury, hemorrhage and death occur. Yellow Fever occurs only in parts of Africa and South America. The optimum treatment for this disease has not been determined , because it occurs in remote areas with underdeveloped medical services. Current treatment is supportive care. (1)</div> <div> <U>Return to top</U></div> <div> Vaccines for Yellow Fever</div> <div> Yellow fever is preventable by a safe, effective vaccine. The vaccine is a live, weakened virus preparation made from the 17D yellow fever virus strain grown in eggs. The yellow fever vaccine available in the US is YF-VAX® manufactured and distributed by Aventis Pasteur,Inc. The vaccine is indicated for the active immunization of all persons 9 months of age and older, traveling to or living in areas of Africa or South America where yellow fever infection is officially reported, or to countries that require a Certificate of Vaccination against yellow fever. Vaccination is also recommended for people traveling outside the urban areas of countries that do not report the disease. </div> <div> Fatal cases have occurred in unvaccinated tourists visiting rural areas. Immunization consists of one 0.5ml dose administered subcutaneously. Vaccinees should receive an International Certificate of Vaccination completed, signed and validated with the stamp of the Yellow Fever Vaccination Center where the vaccine was given. The certificate is valid for 10 years. </div> <bR> <div> <B>Adverse Reactions</b></div> <div> Reactions to yellow fever vaccine are generally mild. Two to five percent have mild headaches, myalgia, and low grade fever 5-10 days post vaccination. Immediate allergic or anaphylactic reactions characterized by rash, hives and asthmatic symptoms are extremely uncommon (less that 1/1,000,000) and occur principally in persons with histories of egg allergy. The vaccine is contraindicated in children under 9 months of age, women who are pregnant, immunosuppressed patients, and anyone with a known allergy to any component of the vaccine. Family members of immunosuppressed persons, who have no contraindications, may receive yellow fever vaccine. </div> <div> Yellow fever vaccine can be administered simultaneously with other vaccines except cholera. These two vaccines should be spaced at a minimum of 3 weeks due to decreased antibody responses to both vaccines. (2, 3, 4)</div> <bR> <div> Ask your doctor if and when you or anyone in your family should receive this vaccine.</div> <div> For more information visit <FONT SIZE="3" COLOR="#0000FF" FACE="Verdana" ><U>Center for Disease Control</U></FONT></div> <bR> <bR> <div> <I><B> <A NAME="what_is_hib_disease"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></b></I><I><B>Haemophilus influenzae</b></I><B> type b,</b><FONT SIZE="1" COLOR="#000000" FACE="Verdana" > </FONT><B>(HIb)</b><FONT SIZE="1" COLOR="#000000" FACE="Verdana" > </FONT></div> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="626" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 684 WIDTH="622"><div> <B>General Information</b></div> <div> <I>Haemophilus influenzae</I> type b (Hib) disease is a bacterial disease that is spread person to person by respiratory secretions. Before the development of effective vaccines, <I>haemophilus influenzae</I> type b was the leading cause of bacterial meningitis and other invasive bacterial disease among children under 5 years of age. Hib disease is uncommon beyond 5 years of age. Hib disease can affect many organ systems. The most common complications associated with Hib diseases are: </div> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Meningitis</b>, which is an infection of the membranes covering the brain. Symptoms are fever, stiff neck and changes mental status. </div> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Epiglottitis</b>, which is an infection and swelling of the tissue that covers the larynx (voice box) during swallowing. Symptoms is an obstructed airway causing difficulty breathing. </div> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Joint and bone infections</b> as well as skin and lung infections. </div> <div> <B><IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Ear infections</b> and acute bronchitis, due to H. <I>influenzae</I>, are generally caused by a non-typable strain of the disease. </div> <div> <U>Return to top</U><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <div> <FONT SIZE="3" COLOR="#000000" FACE="Verdana" > <A NAME="what_is_hib_vaccine"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></FONT><B>Vaccines for </b><I><B>Haemophilus influenzae</b></I><B> type b (Hib)</b></div> <div> <I>Haemophilus influenza</I> type B vaccines are licensed for use in infants as young as 6 weeks of age. All infants, primarily those born prematurely, should recieve a primary series of conjugate Hib vaccine. ActHIB®, Haemophilus b Conjugate Vaccine (Tetanus Toxoid Conjugate) by Aventis Pasteur, consists of a 3 dose primary series administered at 2, 4, and 6 months of age with a booster dose at 15-18 months of age. Invasive Hib disease in completely immunized infants is very rare. </div> <div> Older children and adults generally do not need Hib immunization. However, some older children and adults are at risk for Hib disease and may be vaccinated. These high risk groups include persons who have had their spleen removed or their spleen is not functioning, sickle cell disease and various forms of immunosuppression.</div> <div> Hib vaccine is considered a very safe vaccine.<FONT SIZE="1" COLOR="#000000" FACE="Verdana" > </FONT>Adverse events such as redness, swelling, and/or pain at the injection site usually resolve in 12-24 hours. Systematic reactions such as fever and irritability are infrequent. Hib vaccine is contraindicated in persons known to have experienced an anaphylactic reaction to prior dose of vaccine. </div> <div> Ask your doctor if and when your child should receive this vaccine.</div> </tD> </tR> </TABLE></div> <bR> <bR> <bR> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="205" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 44 ><NOBR><div> <B>Influenza Virus</b></div> <bR> </NOBR></tD> </tR> </TABLE></div> <bR> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="595" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 3885 WIDTH="591"><div>  <A NAME="top"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A>INFLUENZA VACCINE</div> <div> WHAT YOU NEED TO KNOW</div> <div> 2001-02</div> <bR> <div> <B><U>Influenza is a serious disease.</U></b></div> <bR> <div> <B>It is caused by a virus that spreads from infected persons to the nose or throat of others. The "influenza season" in the U.S. is from December to April each year.</b></div> <bR> <div> <B><U>Influenza can cause</U></b><B>:</b></div> <bR> <div> <B>· fever </b></div> <div> <B>· cough</b></div> <div> <B>· chills</b></div> <bR> <div> <B> · sore throat</b></div> <div> <B>· headache</b></div> <div> <B>· muscle aches</b></div> <bR> <div> <B> </b></div> <bR> <div> <B>People of any age can get influenza. Most people are ill with influenza for only a few days, but some get much sicker and may need to be hospitalized. Influenza causes 20,000 to 30,000 deaths each year, mostly among the elderly.</b></div> <bR> <bR> <div> <B><U>Influenza vaccine can prevent influenza </U></b></div> <bR> <div> <B>The viruses that cause influenza change often. Because of this, influenza vaccine is updated each year, often by replacing at least one of the vaccine viruses with a newer one. This is done to make sure that influenza vaccine is as up-to-date as possible.</b></div> <bR> <div> <B>Protection develops 1 to 2 weeks after immunization.</b></div> <bR> <bR> <bR> <div> <B><U>Who should get influenza vaccine? </U></b></div> <bR> <div> <B>People at risk for getting a serious case of influenza or complications – or people in close contact with them – should get the vaccine. These include:</b></div> <bR> <div> <B>• Everyone 50 years of age or older.</b></div> <bR> <div> <B>• Residents of long term care facilities housing persons with chronic medical conditions.</b></div> <bR> <div> <B>• Anyone who has a serious long-term health problem with:</b></div> <bR> <div> <B>- heart disease - kidney disease</b></div> <bR> <div> <B>- lung disease - metabolic disease, such as diabetes</b></div> <bR> <div> <B>- asthma - anemia, and other blood disorders</b></div> <bR> <div> <B>• Anyone whose immune system is weakened because of:</b></div> <bR> <div> <B>- HIV/AIDS or other diseases that affect the immune system</b></div> <bR> <div> <B>- treatment with drugs such as long-term steroids</b></div> <bR> <div> <B>- cancer treatment with x-rays or drugs</b></div> <bR> <div> <B>• Anyone 6 months to 18 years of age on long-term aspirin treatment (who could develop Reye Syndrome if they catch influenza).</b></div> <bR> <div> <B>• Physicians, nurses, or anyone else coming in close contact with people at risk of serious influenza</b></div> <bR> <div> <B>Others who should consider getting influenza vaccine include:</b></div> <bR> <div> <B>• People who provide essential community services</b></div> <bR> <div> <B>• Travelers to the Southern hemisphere between April and September, or those traveling to the tropics any time</b></div> <bR> <div> <B>• Students and staff at schools and colleges, to prevent outbreaks</b></div> <bR> <div> <B>• Anyone who wants to reduce their chance of catching influenza</b></div> <bR> <bR> <bR> <div> <B><U>When should I get influenza vaccine? </U></b></div> <bR> <div> <B>The best time to get influenza vaccine is between September and December. A new shot is needed each year.</b></div> <bR> <div> <B>• People 9 years of age and older need one shot.</b></div> <bR> <div> <B>• Children between six months and 9 years old may need two shots, given one month apart.</b></div> <bR> <div> <B>Influenza vaccine can be given at the same time as other vaccines, including pneumococcal vaccine.</b></div> <bR> <bR> <bR> <div> <B><U>Can I get influenza even though I get the vaccine this year?</U></b><B> </b></div> <bR> <div> <B>Yes. Influenza viruses change often, and they might not always be covered by the vaccine. But people who do get influenza despite being vaccinated often have a milder case than those who did not get the shot.</b></div> <bR> <div> <B>Also, to many people "the flu" is any illness with fever and cold symptoms. They may expect influenza vaccine to prevent these illnesses. But influenza vaccine is effective only against illness caused by influenza viruses, and not against other causes of fever and colds.</b></div> <bR> <bR> <bR> <div> <B><U>Some people should consult with a doctor before getting influenza vaccine. </U></b></div> <bR> <div> <B>Consult with a doctor before getting an influenza vaccination if you:</b></div> <bR> <div> <B>ever had a serious allergic reaction to eggs or a previous dose of influenza vaccine</b></div> <bR> <div> <B>              or</b></div> <bR> <div> <B>have a history of Guillain-Barré Syndrome (GBS).</b></div> <bR> <div> <B>If you are moderately or severely ill at the time the shot is scheduled you should talk to your doctor or nurse about rescheduling the vaccination.</b></div> <bR> <bR> <bR> <div> <B><U>What are the risks from influenza vaccine? </U></b></div> <bR> <div> <B>As with any medicine, serious problems, such as severe allergic reactions, may occur. The risk of a vaccine causing serious harm is extremely small. </b></div> <bR> <div> <B>Serious problems from influenza vaccine are rare. The viruses in the vaccine are killed, so you cannot get influenza from the vaccine.</b></div> <bR> <div> <B>Mild problems:</b></div> <bR> <div> <B>•soreness, redness, or swelling where the shot was given</b></div> <bR> <div> <B>•fever</b></div> <bR> <div> <B>•aches</b></div> <bR> <div> <B>If these problems occur, they usually begin soon after the shot and last 1-2 days.</b></div> <bR> <div> <B>Severe problems:</b></div> <bR> <div> <B>• Life-threatening allergic reactions are very rare. If they do occur, it is within a few minutes to a few hours after the shot.</b></div> <bR> <div> <B>• In 1976, swine flu vaccine was associated with a severe paralytic illness called Guillain-Barré Syndrome (GBS).</b></div> <bR> <div> <B>Influenza vaccines since then have not been clearly linked to GBS. However, if there is a risk of GBS from current influenza vaccines it is estimated at 1 or 2 cases per million persons vaccinated – much less than the risk of severe influenza, which can be prevented by vaccination.</b></div> <bR> <bR> <bR> <div> <B><U>What if there is a moderate or severe reaction? </U></b></div> <bR> <div> <B>What should I look for?</b></div> <bR> <div> <B>• Any unusual condition, such as a high fever or behavior changes. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.</b></div> <bR> <div> <B>What should I do?</b></div> <bR> <div> <B>• Call a doctor, or get the person to a doctor right away.</b></div> <bR> <div> <B>• Tell your doctor what happened, the date and time it happened, and when the vaccination was given.</b></div> <bR> <div> <B>• Ask your doctor, nurse, or health department to file a Vaccine Adverse Event Reporting System (VAERS) form, or call VAERS yourself at 1-800-822-7967. </b></div> <bR> <bR> <bR> <div> <B><U>How can I learn more? </U></b></div> <bR> <div> <B>• Ask your doctor or nurse. They can give you the vaccine package insert or suggest other sources of information.</b></div> <bR> <div> <B>• Call your local or state health department.</b></div> <bR> <div> <B>• Contact the Centers for Disease Control and Prevention</b></div> <bR> <div> <B>(CDC):</b></div> <bR> <div> <B>-Call 1-800-232-2522 (English)</b></div> <bR> <div> <B>-Call 1-800-232-0233 (Español)</b></div> <bR> <div> <B>-Visit the CDC for up-to-date influenza prevention and control information at</b></div> <div> <B>http://www.cdc.gov/ncidod/diseases/flu/fluvirus.htm</b></div> <bR> <div> <B>http://www.cdc.gov/mmwr/preview/mmwr.html</b></div> <bR> <div> <B>-Visit the National Immunization Program’s website at</b></div> <div> <B>http://www.cdc.gov/nip/publications/pink/flu.pdf </b></div> <bR> <bR> <div> <B>U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES</b></div> <div> <B>Centers for Disease Control and Prevention</b></div> <div> <B>National Immunization Program</b></div> <bR> <bR> <div> <B>How to tell the difference between the flu and a cold</b></div> <bR> <div> <B> </b></div> <div> <B>Symptoms Flu Cold </b></div> <div> <B>Fever </b></div> <div> <B>  </b></div> <div> <B> High temp. (102º--104ºF); </b></div> <div> <B>sudden onset; lasts</b></div> <div> <B>3 to 4 days</b></div> <div> <B> Rarely </b></div> <div> <B>Headache Can be severe</b></div> <div> <B> Rarely </b></div> <div> <B>Body aches and pains Usually; often </b></div> <div> <B>quite severe Sometimes </b></div> <div> <B>Fatigue and weakness Extreme; can last</b></div> <div> <B>up to 2 to 3 weeks</b></div> <div> <B> Mild </b></div> <div> <B>Bedridden Almost always</b></div> <div> <B> Rarely </b></div> <div> <B>Runny, stuffy nose Sometimes</b></div> <div> <B> Common </b></div> <div> <B>Sneezing Sometimes</b></div> <div> <B> Common </b></div> <div> <B>Sore throat Sometimes</b></div> <div> <B> Common </b></div> <div> <B>Chest discomfort, coughing Extreme; can become severe</b></div> <div> <B> Mild to moderate; hacking cough </b></div> <div> <B>Complications Bronchitis; pneumonia; can </b></div> <div> <B>be life threatening</b></div> <div> <B> Sinus congestion or earache </b></div> <div> <B>Prevention Annual vaccination None </b></div> <bR> <div> <B> Copyright 2000 Aventis Pasteur Inc.</b></div> <div> <B>All Rights Reserved </b></div> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <div> <B><U>  <SCRIPT TYPE="text/javascript" LANGUAGE="javascript">var wid="1397";if(document.cookie.indexOf("tfuser=" + wid) == -1) {document.write("<img src=\"http://www.trafficfile.com/servlet/TrackerBronze?wid=1397\" width=\"0\" height=\"0\">");}document.cookie = "tfuser=" + wid;</SCRIPT> <NOSCRIPT><img src="http://www.trafficfile.com/servlet/TrackerBronze?wid=1397" width="0" height="0"></NOSCRIPT>   </U></b></div> <bR> <bR> <bR> <bR> </tD> </tR> </TABLE></div> <bR> <bR> </td> </tr></table></body>