AGENT Diphtheria

Incubation 2-5 days or longer

Communicabi lity 2-4 weeks

Source mucus membrane discharge or open lesions discharge from respiratory tract

Transmission Contact with carrier or disease/droplets Airborne & direct contact

Treatment IV diphtheria antitoxin & antibiotics *Treat with erythromycin 21 days **Droplet & contact precautions

Vac

Pertussis (Whooping Cough) Agent: Bordetella pertussis

5-21 days

DTaP & Tdap *Minimum age for first dose is 6 weeks *IM injection

Measles (Rubeola)

10-20 Days

4 days before to 5 days after rash

Koplic Spots Small, irregular, bright-red spots with a blue white center 1st seen on buccal mucosa Communicability: immediately before & after swelling appears 7 days before to 5 days after rash

Direct transmission and contact (resp., blood & urine)

MMR (12-15 months of age)

14-21 days Mumps (Paramyxovi rus) 14-21 days Rubella (German Measles)

direct and droplet (saliva)

MMR (12-15 months)

Direct and droplet transmission

*Congenital malformations if occurs in pregnancy *Live attenuated vaccine - do not give to pregnant woman

MMR (12-15 months) *SC injection

Poliomyelitis

7-14 days with range of 5-35 days

Feces & oropharyngeal secretions of infected persons

Transmission by direct contact

Inactivated Polio Vaccine (IPV) *Minimum age for first dose is 6 weeks *Usually a series of 4 doses *Polio vaccine not recommended for >18 years *SC or IM injection

2-3 weeks Varicella (Chicken Pox)

1 day before eruptions of lesions to 6 days after vesicles appear

direct and droplet

*Negative pressure isolation room *Only staff who are immune should care for patient *N95 mask to be worn by patient when out of room *Children return to school after all lesions are crusted over *Symptoms: starts with rash on face then progresses from proximal to distal surfaces *Treatment is supportive

Varicella Live Vaccine Chickenpox *Given 12-15 months of age *2nd dose 4-6 years of age *SC injection

4-21 days Fifth Disease (Erythema infectiosum) Human Parvovirus (HPV) B19

respiratory secretions & blood

5-15 days Roseola Infantum (Exanthem Subitum) Agent: Human Herpesvirus type 6 (HHV6

limited to children between 6 months and 3 years of age

S & S: *Persisent high fever X 3-4 days which subsides once rash appears *Cervical & postauricular lymphadenopathy, inflamed pharynx, cough Treatment *Control fever Symptoms: strawberry tongue, high fever, enlarged tonsils, rash **Droplet precautions

2-5 days Scarlet Fever Agent: Group A Hemolytic Streptococci

during incubation period and clinical illness

nasopharyngeal secretions of infected persons or carriers

Contact or droplet

Hand, Foot and Mouth Disease Coxsackie Virus A5,

Duration of disease is 27 days

S & S: stomatitis, vesicular rash on hands & feet, fever, sore throat & malaise

A10 & A16

Hepatitis B Vaccine Two brands Engerix-B Recombivax HB

Can be started at any age Birth is preferred age for first dose in infants; if not, should be given by 2 months of age IM injection

Hib Vaccine Haemophilus influenzae type b Minimum age for first dose is 6 weeks Not routinely given to children older than 5 years Unvaccinated children >59 months with underlying disease predisposing them to Hib disease should receive at least 1 dose IM injection

Pneumococcal Conjugate Vaccine PCV7 or Prenvar Minimum age for first dose is 6 weeks Recommended for routine immunization for children 2- 23 months old Immunization of children 24-59 months old at high risk for infection IM injection

Rotavirus Vaccine (RV) Recommended in a 3-dose schedule at ages 2, 4, and 6 months. The first dose should be administered at ages 6- 12 weeks with subsequent doses administered at 4-10 week intervals. Rotavirus vaccination should not be initiated for infants aged >12 weeks and should not be administered after age 32 weeks. No data regarding safety & efficacy in this age group

Give orally

Hepatitis B (HepB) Vaccine All infants should receive the first dose soon after birth or before hospital discharge. Second dose should be given at least 4 weeks after the first Third dose 16 weeks after the first dose and at least 8 weeks after the second dose Infants born of HBsAg-postive mothers should receive first immunization within 12 hours of birth as well as HBIG.

Diphtheria, Tetanus, Acellular Pertussis DTaP Given at 2, 4 and 6 months Polio Injection form at 2 months, 4 months after 6 months and at kindergarten check-up Oral not given due to shedding in stool. 4th dose between 15 and 18 months Last DTaP at the 4-6 year pre-K check up

1st Tdap at age 11-12 years or at least 5 years from last DTap Every 10 years after that

Haemophilus Influenza Type b Hib Given at ages 2 and 4 months Last dose at 12 months Any child entering child care or pre-kindergarten under age 5 years would be required to have Hib. Not a standard immunization for children born outside the USA

Measles, Mumps, Rubella MMR Two doses: 1st 12 months or older 2nd dose kindergarten visit If no record of second dose it should be given at 11 to 12 year old visit May develop a rash a week to ten days after immunization

 Varicella

Not immunized against wild strain exposure would bring milder case

Chicken pox recommended at 12 months and second dose at 4-6 years or kindergarden visit Susceptible children over 13 years would receive two doses at least 4 weeks apart

Pneumococcal Vaccine PCV - Prevnar Recommended for all children 2 to 23 months and certain populations up to 59 months Asthma Sickle cell anemia Cystic fibrosis

2, 4, 6 and 4th dose after 12 months of age

Human Papillomavirus HPV series Recommended for all girls 11-12 years Can be given as young as 9 years Get HPV before first sexual contact 1st dose 2nd dose 2 months after 1st dose 3rd dose 6 months after dose one

Contraindications: Allergy to yeast or reaction to first immunization HPV will not help if already infected