Christoph Diasio, MD, FAAP Sandhills Pediatrics Why Immunize? Christoph Diasio, MD, FAAP Sandhills Pediatrics

Diptheria Caused by bacteria which produces a toxin Kills 1 in 10 infected with it Prior to vaccine 206,000/yr Now- 1 case last yr. Epidemics in the former USSR due to collapse of public health

Pseudo-membrane

Bullneck diptheria

Tetanus (lockjaw) Caused by bacteria entering body through a cut or puncture Causes severe muscle spasms Death in 30% Neonatal tetanus from contaminated umbilical cord (prevent by immunize mom and clean cord clamp)

Tetanus muscle spasms

Neonatal tetanus

Sardonic grin

Pertussis (whooping cough) Caused by bacteria leading to prolonged coughing Can lead to seizures, pneumonia and death Prior to vaccine, 150,000 to 260,000 cases/yr. with 9,000 deaths Now 10 deaths/yr.

Pertussis Cont’d In 1970’s concern about side effects in England of DTP decreased vaccine usage leading to 100,000 cases and 36 deaths DTaP (acellular vaccine) now in use due to DTP side effects

Pertussis video

Polio Caused by virus spread fecal-oral Caused paralysis and death 13,000-20,000 cases per year prior to vaccine era Switch from oral to injected polio vaccine due to 1 case VAPP/2.4 million doses

Polio Ward LA 1952

1942 March of Dimes Billboard

Post polio deformity

Polio survivor, the Philippines

Measles Caused by a virus Leads to a rash with possible pneumonia, seizures, brain damage, and death Death in 1-3/1000 “count your children after the measles has passed”- Arabic proverb

Measles continued Study of Colorado immunization exemptors showed they were 22x more likely to get measles

4-5 days into illness

Mumps Caused by virus with swelling of salivary glands Leads to potential brain damage, deafness and sterility in men Used to be 212,000 cases/yr. Last yr. 327 cases/yr.

Rubella (german measles) Caused by virus Very dangerous to unborn babies- heart disease, deafness, blindness and MR Prior to vaccine 20,000 cases CRS Now- only 6 last year

Congenital Rubella Syndrome

CRS cataracts

Hib (Haemophilus influenza type B) Caused by bacteria Caused bacterial meningitis, sepsis, pneumonia, epiglottitis 20,000 cases per year- now 10/yr. Used to infect 1/200 US kids < 5yo See TN shot refuser article

Hib cheek cellulitis

Culture-proven Hib foot cellulitis

Hepatitis B Caused by virus Causes range of disease from no symptoms to liver failure and cancer Most people with chronic disease infected as children About 5,000 persons will die each year from hepatitis B-related liver disease

Woman from Cambodian refugee camp with liver cancer from Hep B

Varicella (chickenpox) Caused by virus Itchy rash with 250- 500 sores Pre-vaccine, 4 million cases with 100 deaths/yr Superinfection with bacteria can be deadly 67% kids now immunized

Congenital VZV

Superinfected VZV

Pneumococcal disease Caused by Streptococcus pneumoniae Currently most common cause of OM (ear infections) and invasive bacterial infection 16,500 cases invasive disease/yr., with 700 cases of meningitis/yr. and 200 deaths/yr. Prevnar (PCV7) introduced 1999

Pneumococcal meningitis

Influenza Spreads person to person through cough/sneeze Abrupt onset high fever, body aches, headaches, nonproductive cough, sore throat, runny nose (also vomiting in kids) Flu related deaths can be from pneumonia and worsening of underlying conditions

Influenza Intense media coverage Dec 2003 Recommended for otherwise healthy children 6 mo to 18 yo during flu season Also- 65 yo and older Chronic problems- Cancer, HIV, asthma At least 3 mo pregnant during Nov-March AND Household contacts!

Summary Vaccinating our children is one of the best things we can ever do for them These bad, scary diseases still circulate We are on your side!! Sources- Immunization Action Coalition, CDC