1. Immunization and the Patient

2. Low immunization rates Opportunity missed Health care delivery Inadequate access Lack of public awareness Religious beliefs Opportunity missed Health care delivery Inadequate access Lack of public awareness Religious beliefs

3. Athletic Training and Vaccines Tetanus status of all patients Hepatitis B status of all patients Meningococcus Influenza Travel vaccines Tetanus status of all patients Hepatitis B status of all patients Meningococcus Influenza Travel vaccines

4. Vaccine Schedule

5. Adult Vaccination Schedule

6. Tetanus Lockjaw is a neurological disease manifested by trismus and severe muscular spasms Clostridium tetani bacterium that causes nuerotoxin production Onset is gradual, 1-7 days & progresses to severe generalized muscle spasms Lockjaw is a neurological disease manifested by trismus and severe muscular spasms Clostridium tetani bacterium that causes nuerotoxin production Onset is gradual, 1-7 days & progresses to severe generalized muscle spasms

7. Clostridium Tetani Wound contamination Blocks contractile inhibitory pulses to motor neurons Found in intestines and serum Fewer that 60 cases in last 5 yrs Wound contamination Blocks contractile inhibitory pulses to motor neurons Found in intestines and serum Fewer that 60 cases in last 5 yrs

8. Tetanus Treatment/Prevention Tx: (TIG) – used to treat and prevent Extensive cleaning of wounds Oral antibiotics Prevention: IM immunization Primary series Booster between 11-16 yrs old Booster every 10 yrs Tx: (TIG) – used to treat and prevent Extensive cleaning of wounds Oral antibiotics Prevention: IM immunization Primary series Booster between 11-16 yrs old Booster every 10 yrs

9. Other Common Vaccines Hepatitis B – series of 3 shots Booster ~ 10 yrs Meningitis – fever, chills, malaise, rash Purpura Common in young children Common in semiclosed communities All college students should get the vaccine All Functional asplenia people Duration is 5-6 yrs 13 different types of disease, vaccine covers 4 Hepatitis B – series of 3 shots Booster ~ 10 yrs Meningitis – fever, chills, malaise, rash Purpura Common in young children Common in semiclosed communities All college students should get the vaccine All Functional asplenia people Duration is 5-6 yrs 13 different types of disease, vaccine covers 4

10. Other Common Vaccines Influenza Presents like meningitis, but s rash Spread by large droplets, coughing, sneezing, sharing glasses, water bottles You are most infectious 24 hrs before s/s and 7 days after they appear 3 antigenic types (A, B & C). Strain A has two antigens; hemagglutinin (H) & neuraminidase (N) 50-85 % effective, CDC “guesses” which strain may be the strain of the year (Bases on past 3 years) Influenza Presents like meningitis, but s rash Spread by large droplets, coughing, sneezing, sharing glasses, water bottles You are most infectious 24 hrs before s/s and 7 days after they appear 3 antigenic types (A, B & C). Strain A has two antigens; hemagglutinin (H) & neuraminidase (N) 50-85 % effective, CDC “guesses” which strain may be the strain of the year (Bases on past 3 years)

11. Other Common Vaccines Influenza Amantadine – Covers type A Ramantidine – Covers type A & B Type C - Weak Meds: Relanza & Tamiflu Who should get it? – asthma, chronic lung disease, CV disease, immune deficiency, old, young Patient cannot play/practice if still have fever of 102°+ Influenza Amantadine – Covers type A Ramantidine – Covers type A & B Type C - Weak Meds: Relanza & Tamiflu Who should get it? – asthma, chronic lung disease, CV disease, immune deficiency, old, young Patient cannot play/practice if still have fever of 102°+

12. Traveling?? http://www.cdc.gov/travel/ Follow info for your destination Begin process early Learn about their food, water, & insect protection Common concerns: Hepatitis A & B, Japanese Encephalitis, Yellow fever, Malaria, Typhoid, Rabies http://www.cdc.gov/travel/ Follow info for your destination Begin process early Learn about their food, water, & insect protection Common concerns: Hepatitis A & B, Japanese Encephalitis, Yellow fever, Malaria, Typhoid, Rabies

13. Traveling??? Plan for diarrhea E. Coli – usually form bad water supply Malaria – transmitted by mosquito High fever, chills, sweats, HA, anemia Vaccine 2-3 days before you go Tuberucolosis – To and from Asia, Africa Usually asymptomatic – auto-immune reaction Pulmonary, fever chills, wt loss, sweats, cough Have skin tested 1-2 months after returning Mantoux, PPD Test: Incarcerated, contact c confirmed case, immigrants, CXR or s/s Tx: 9 month course of Isoniazid & Rifampin Plan for diarrhea E. Coli – usually form bad water supply Malaria – transmitted by mosquito High fever, chills, sweats, HA, anemia Vaccine 2-3 days before you go Tuberucolosis – To and from Asia, Africa Usually asymptomatic – auto-immune reaction Pulmonary, fever chills, wt loss, sweats, cough Have skin tested 1-2 months after returning Mantoux, PPD Test: Incarcerated, contact c confirmed case, immigrants, CXR or s/s Tx: 9 month course of Isoniazid & Rifampin

14. Summary Protect yourself, especially when traveling Keep record of your patients immunization records Protect yourself, especially when traveling Keep record of your patients immunization records