Immunization

Immunization is the process by which a person’s immune system becomes fortified against an agent known as an immunogen.   In other words, when the body system is exposed to foreign molecules it will orchestrate an immune response, and it will develop the ability to respond to a future encounter because of its immunological memory.  In this way, the body protects itself and can fight off future attacks of the immune system by that same immunogen.  This is called Active Immunization.   

Immunization can be done in various techniques the most commonly used is vaccination.   Before Vaccinations were available the only way to be immune to a disease was to get the disease and survive it. 

Vaccinations

Vaccinations are injections of antigenic material (vaccines) that are administered to stimulate a person’s immune system to develop immunity to an infectious pathogen.  Vaccines can prevent or lessen the death rate from these infections and are the most effective way to prevent infectious diseases from spreading.  Vaccinations have pretty much eradicated smallpox completely, and have caused restriction of diseases such as; polio, measles, and tetanus from most areas around the world.    

The Public Health Agency of Canada states that over the last 50 years, immunization has saved more lives that any other heath measure.  Vaccination is the best way to prevent serious diseases. 

Public Heath Agency of Canada recommends the following Immunization Schedules for Children, and Adults:  http://www.phac-aspc.gc.ca/publicat/cig-gci/p01-12-eng.php

Vaccination for Health Care Workers

Health Care Workers (HCW) are at a higher risk of being exposed to communicable diseases because of the contact they have with patients/clients and their environment.  Health care workers include a broad spectrum of workers including staff, students and volunteers from; hospitals, nursing homes, home care agencies, doctor’s offices, dental offices and clinical laboratories. 

Public Heath Agency of Canada recommends the following Immunization Schedules for Health Care Workers:

http://www.phac-aspc.gc.ca/publicat/cig-gci/p03-work-travail-eng.php#a1

Recommended Vaccines for Health Care Workers

Bacille Calmette-Guerin (BCG)

BCG is used in various countries as a vaccine to protect against Tuberculosis (TB).  Tuberculosis is an infection caused by bacteria that usually attacks the lungs but can attack any part of the body.  TB is deadly if it is not treated.  TB is spread from person to person through the air by coughing, laughing, sneezing, singing or talking.  However, it is not easy to become infected with TB.  Usually a person has to be in contact with someone with the disease for a very long time to contact the disease.  Symptoms of TB include; fever, extreme fatigue, weight loss, night sweats and a cough that can bring up thick, bloody mucus. 

There is a difference between being infected with TB and having the TB disease.  Someone who is infected with TB had the TB germs or bacteria in their body.  The body’s defense mechanisms are protecting them from the germs and they are not sick.   Someone with the TB disease is sick and can spread TB to others.  They need to see a doctor as soon as possible. 

BCG is also used to treat bladder cancer because it stimulates an immune response that can destroy cancer cells in the bladder. 

BCG is not recommended for every health care worker.  It is recommended for those who will have repeat exposure to people with TB. 

Diphtheria, Tetanus (Td)

Both Diphtheria and Tetanus are infectious diseases caused by bacteria.  They are very serious diseases. 

Diphtheria spreads from person to person through coughing and sneezing. Diphtheria causes breathing problems, paralysis, heart failure and death. 

 Tetanus (Lockjaw) bacteria enter the body through cuts, scratches or wounds.  Tetanus causes painful muscle tightening and stiffness all over the body.  However it is mainly the muscles in the head and neck so you can’t open your mouth, swallow, or breathe.  Tetanus kills about 1 out of every 5 people who get infected with it. 

A primary series of Td vaccines are given and a recommendation of a Td booster dose every 10 years. 

Hepatitis B (HBV)

Hepatitis B is a liver disease, which is caused by the hepatitis B virus (HBV).  It is spread through contact with infected blood and body fluids including, semen and vaginal fluids.  Hepatitis B cannot be spread by casual hugging, kissing, and shaking hands or from sneezing or coughing.  It also cannot be spread by breastfeeding unless the nipples are cracked and bleeding.  It is not found in food or water.  Also it is very uncommon to have transmission through saliva alone, but is highly likely to have transmission through saliva contaminated with blood. 

Symptoms of Hepatitis B include; fatigue, loss of appetite, fever, nausea, vomiting, dark urine, pale stools, stomach pain, joint pain, and jaundice (yellowing of the eyes and skin).  Many people do not know they have the disease because it takes 2 to 6 months for the symptoms to appear.    They can spread the disease to others during this time with out knowing they are spreading it.  Damage may already be done to the liver before they know you have the disease; including cirrhosis of the liver, liver failure, liver cancer and premature death.

Hepatitis B vaccinations are given many times as a child (2, 4, 6 and 18 months, and in Grade 8).  If you have been immunized before you likely only need 1 more booster dose every 10 years.  If you have never had the Hepatitis B immunization before, it starts with a 1st dose, then a dose 8 weeks later and a dose 6-12 months after that followed by a dose every 10 years. 

Hepatitis A

Hepatitis A, also known as infectious hepatitis, is an acute infectious disease of the liver.  The hepatitis A virus causes it.  Hepatitis A is spread by eating or drinking food or water that is contaminated with infected feces.  Shellfish that has not been cooked well enough is also a common source.  Close contact with an infected person can also spread the disease person to person.  Children with no symptoms are still able to infect others.  Once a person has been infected that person is immune for the rest of their life.  A blood test is used to diagnosis Hepatitis A. 

Symptoms take two to six weeks to occur.   In many cases though, there are little to no symptoms, especially in young children.  When symptoms do occur, they can last up to eight weeks and include: fever, nausea, vomiting, abdominal pain, yellow skin and diarrhea.  10 – 15% of people have a recurrence of symptoms within the six months after the infection initially occurred.  In rare cases and especially in the elderly, acute liver failure can occur. 

There are not treatments to cure Hepatitis A quickly, other than getting lots of rest and medications for the symptoms.  Eventually the infection will resolve completely and with out liver disease.   In rare cases of liver failure, a liver transplant is required. 

Hand washing and cooking food well are important factors in preventing the spread of Hepatitis A.   Vaccinations are also very important for prevention.   The Public Health Agency of Canada recommends only health care workers with high risks of exposure to Hepatitis A be vaccinated.  A single dose is given with a booster dose given 6 to 36 months later depending on the product. 

Influenza

Influenza is a highly contagious virus with many strains.  The virus is spread in the air from sneezing and coughing or from direct contact in human secretions.  A person can be contagious a day before the symptoms show and 5-7 days after the onset of the virus.  

Symptoms of influenza can include; fever, cough, sore throat, runny/stuffy nose, muscle and body aches, headaches, fatigue, vomiting and diarrhea. 

Influenza vaccines, also known as the flu shot, are annual injections of antigens of influenza virus strains.  Each year three to four strains of seasonal influenza vaccines are chosen and used to protect against the highly variable influenza virus.  Influenza vaccines usually are meant for people with higher risks of serious complications including people living with chronic diseases, healthcare workers and the elderly.   It can also be administered in a nasal spray. 

Adults are to receive only one dose of the influenza vaccine per year. 

Measles

Measles are a very severe disease caused by a virus, which is also known as rubeola or red measles.  It is a highly contagious virus.   It is spread through airborne droplets when an infected person coughs or sneezes. 

Symptoms are fever, runny nose, cough, red and watery eyes, inflammation of the eyelids and a red, blotchy rash that starts on the face and spreads down the body.  It also damages many parts of the body (cells lining the nose and throat) and weakens the immune system, which frequently leads to pneumonia.   In rare cases, Encephalitis (Inflammation of the brain) or SSPE (a fatal brain disease) can occur years after the attack of the measleas. 

Vaccination against the measles had been found to be the best way to keep the measles from spreading.  Children should have two doses starting at 12 -15 months old and at least 4 weeks before they receive the second dose.   If an person has never been vaccinated they would also receive 2 doses with at least 4 weeks between the first and second dose (likely an MMR vaccination – measles, mumps, rubella).  

Meningococcal (Meningitis)

Meningococcal disease or Meningitis is an infection that is caused by the Neisseria meningitides bacterium.   The infection causes inflammation of the membranes that cover the brain and spinal cord.  Meningitis is not near as contagious as the common cold and is not spread through casual contact.  It is transmitted through saliva and on occasion, though close contact with an infected person.  It has a very high mortality rate when it is untreated.   

Symptoms of Meningitis can include sudden high fever, neck stiffness, nausea or vomiting, drowsiness and difficulty awakening, joint pain, discomfort in bright lights, and confusion or other mental changes.  If a reddish or purple skin rash occurs it is likely a sign of blood poisoning and needs medical care immediately.  Other symptoms can at times include, irritability, fast breathing, seizures, shivering or cold hands and feet, excessive sleepiness, and stiff, jerky movements. 

Vaccination against Meningitis is key to keep the spread of the disease controlled.   Healthy children are given the meningococcal vaccine at 12 months of age.   Young adults can be vaccinated with a single dose even if they have been vaccinated as infants.   Anyone who has never been vaccinated would require a single dose of Men-C-C or Men-C-ACYW-135 vaccine.  

Mumps (Epidemic Parotitis)

The mumps virus causes the viral disease epidemic parotitis or Mumps.   Before vaccines were created, it was a very common childhood disease.  Even with vaccines outbreaks do still occur but are much rarer. 

Mumps are spread through mucus or droplets from the nose or throat of an infected person by sneezing or coughing.  It can also be spread from human contact with an infected person who has not washed their hands when an uninfected person rubs their eyes, mouth or nose after contact. 

Symptoms of the Mumps include, painful swelling of the salivary glands (mainly the parotid gland), painful testicular swelling (orchitis), and rash as well as fevers, headaches, overall discomfort and lack of appetite.  In adolescent men, infertility can occur but is rare.   Generally, the disease runs its course with no specific treatment apart from pain medications. 

Mumps vaccinations are called MMR and are given two dosed around the first birthday.  If you have never received the vaccinations you can have a blood test done to confirm immunity or get a set of the two doses of MMR given 4 weeks apart.

Pertussis

Pertussis, known as whooping cough or the 100 days cough, is a highly contagious bacterial disease, which is caused by Bordetella pertussis.  Pertussis is spread by coughing or sneezing while in close contact to others who then breathe in the pertussis bacteria. 

Symptoms are initially mild but develop into severe coughing fits in time.   The coughing can last up to six weeks.   Other symptoms occur because of the severe coughing such as; fainting, vomiting, rib fractures, urinary incontinences, hernias, and subconjunctival hemorrhages.  Antibiotics can shorten the duration of the coughing and are usually recommended.  Vaccinations are the best prevention for Pertussis. 

All adults should receive a single dose of Tdap for Pertussis protection if they have not previously received it.

Polio

Polio, also known as Poliomyelitis or infantile paralysis, is an infectious disease caused by the poliovirus. The virus is spread person to person through infected feces entering the mouth.  It can also spread from food or water containing infected human feces and also less commonly in-infected saliva. 

95% of cases have no symptoms.  5% of cases have minor symptoms, which include; fever, vomiting, diarrhea, headache, neck stiffness and pains in the arms and legs.  The symptoms last one to two weeks and in most people there is a full recovery.   Death can occur in cases with severe muscle weakness (2-5% children, 15-30% adults).

DTaP-IPV-Hib vaccines are given to children 2, 4, 6, and 12 – 23 months of age.  All adults who have not received this vaccine as children should receive a primary series of the vaccine.   Adults who have been vaccinated but are at increased risk require a single lifetime booster dose of IPV.  Health care workers are at a very high risk for contracting Polio.

Rubella

Rubella is a disease caused by the rubella virus.  It is also know as the German measles or the three- day measles.  It is spread by direct contact with throat or nasal secretions of infected people.  Inhaling droplets sprayed into the air when an infected person coughs, sneezes or talks can also transmit it. 

The disease is often very mild and the symptoms often pass unnoticed.  The disease usually lasts 1-3 days.  Children recover more quickly than adults.  If a pregnant woman is infected it can be very serious and can pass on congenital rubella syndrome to the infant. 

Regardless of the age, all health care workers should receive one dose of MMR vaccine if they don’t have documented evidence that they have received the vaccine or laboratory blood work evidence of immunity.

Varicella (Chickenpox)

Varicella is a highly contagious disease caused by the varicella zoster virus (VZV).  It is also known as the Chickenpox.  The virus is an airborne disease, which is spread through the sneezing and coughing of infected individuals or through direct contact with rash secretions.

Symptoms include a fluid filled, raised skin rash mainly on the body and head but not so much on the limbs at first.  The rash develops into an itchy, red, body rash that usually heals without scarring.  Early symptoms can include; nausea, aching muscles, headache and loss of appetite.  An individual is contagious 1-2 days before the symptoms appear and until all the lesions have crusted over (6 days or so). 

Health care workers should receive two doses of varicella vaccine if they have not been previously vaccinated or do not have evidence of immunity to varicella.

Resource Websites

http://en.wikipedia.org/wiki/Vaccination

http://www.phac-aspc.gc.ca/im/index-eng.php

http://www.cdc.gov/vaccines/hcp/vis/vis-statements/td.html                                             

http://www.phac-aspc.gc.ca/hcai-iamss/bbp-pts/hepatitis/hep_b-eng.php

http://en.wikipedia.org/wiki/Hepatitis_A

http://en.wikipedia.org/wiki/Influenza_vaccine

http://www.webmd.com/cold-and-flu/flu-guide/children-and-flu-influenza

http://www.phac-aspc.gc.ca/im/vpd-mev/measles-rougeole-eng.php

http://en.wikipedia.org/wiki/Meningococcal_disease

http://www.webmd.com/brain/meningococcal-meningitis-symptoms-causes-treatments-and-vaccines

http://en.wikipedia.org/wiki/Pertussis

http://en.wikipedia.org/wiki/Poliomyelitis

http://en.wikipedia.org/wiki/Rubella

http://en.wikipedia.org/wiki/Chickenpox

http://www.health.gov.sk.ca/immunization-manual

  EVENT CALENDAR
Saskatchewan Dental Assistants’ Association
P.O. Box 294 Kenaston SK S0G 2N0
T 306.252.2769 | F 306.252.2089
E sdaa@sasktel.net