- BCG: Vaccine for tuberculosis.
- OPV: Oral Polio vaccine.
- DPT: Diphtheria, pertussis (whooping cough) and tetanus vaccine.
- TT: Tetanus toxoid.
- DT: Diptheria and tetanus.
|a) For Infants At Birth (for Institutional deliveries)||BCG and OPV–O dose|
|At 6 Weeks||BCG (if not given at birth)
DPT–1 and OPV–1
|At 10 Weeks||DPT–2 and OPV– 2|
|At 14 Weeks||DPT–3 and OPV– 3|
|At 9 months||Measles|
|b) At 16–24||DPT and OPV|
|c) At 5–6 years||DT–the second dose of DT should be given at the interval of one month if there is no clear history or documented evidence of previous immunization with DPT.|
|d) At 10 & at 16 years||Tetanus Toxoid–The second dose of TT vaccine should be given at an interval of one month if there is no clear history of documented evidence of previous immunization with DPT, DT or TT vaccine.|
|e) (For pregnant Women)Early in pregnancy||TT–1 or Booster|
|One month after TT–1||TT–2|
Immunization and Side Effects
Most killed bacterial vaccines (e.g. typhoid) cause some local and general reactions. The local reactions, which usually occur at the site of injection include pain, swelling, redness, tenderness and development of a localized abscess. The general reactions may be fever, malaise and headache. Diphtheria and tetanus toxoids and live polio vaccine cause little reactions. Hypersensitivity and vaccination: Present day vaccines are highly purified and the incidence of hypersensitive reactions is very rare. Sometimes the sensitivity may be to some of the antibiotics used for preservation.
Reactions due to faulty techniques. The risk of adverse reactions can be reduced by proper sterilization of syringes and needles, by proper selection of the subject and the product, and if due care is exercised in carrying out the procedure. Some vaccines have to reconstituted (i.e. mixing of vaccine and dilutants) before use. e.g. Measles and BCG. These should be reconstituted only with the dilutant supplied by the manufacturer. After the immunization reconstituted vaccines should never be used again. Neurological involvement: Involvement of the nervous system resulting in encephalitis is rare. The condition is called post–vaccinal encephalitis. It is important to note that live vaccines should not be given to pregnant women for there is a risk of harm to the fetus. e.g. rubella.
Control of Spread of Disease
Certain disease are notifiable. The diseases to be notified vary from country to country, and even within the same country. Notification is an important source of epidemiological information. It gives important information about the epidemiology of the disease and also helps to initiate measures to contain the disease. The notification is done to the local health authorities by practically any person. Under the International Health regulations (IHR) diseases such as cholera, plague and yellow fever are notifiable.
Isolation is done to prevent the spread of disease in the community. It is defined as “Separation for the period of communicability of infected persons or animals from others in such places and under such conditions, as to prevent or limit the direct or indirect transmission of the infectious agent from those infected to those who are susceptible, or who may spread the agent to others”. There are several types of isolation–standard isolation, strict isolation, protective isolation, high security isolation. For each patient, the relative risks to the patient and to others should be assessed and the appropriate type of isolation determined. The duration of isolation is determined by the duration of communicability of the disease and the effect of chemotherapy or infectivity.
Periods of isolation recommended
|Chicken pox||Until all lesions crusted, usually about 6 days after onset of rash..|
|Measles||From the onset of catarrhal stage trough 3rd day of rash.|
|Cholera Diphtheria||3 days after tetracyclines started until 48 hours of antibiotics (or negative cultures after treatment).|
|Polio||2 weeks adult 6 weeks pediatric.|
|Mumps||Until swelling subsides.|
|Pertussis||4 weeks or until paroxysms cease.|
|Meningococcal meningitis||Until the first 6 hours of effective antibiotic therapy are completed.|
Quarantine is a practice which is not practiced nowadays. It is a strict confinement of individuals suffering from a particular disease.
Control of Diseases
The following discussion will entail the measures that need to be taken to control disease. This concept is different from elimination of disease and also eradication of disease. The aim is to establish a state of equilibrium between the disease agent, host and environmental aspects of the disease.
The term ‘Eliminations’ used to describe interruption of transmission of disease, as for example, elimination of measles, polio and diphtheria from large geographic regions or areas.
Eradication of disease implies termination of all transmission of infection by elimination of the infectious agent. Small pox is the only disease that has been eradicated.
How can disease be prevented?
1. Primordial prevention
Primordial prevention, a new concept, is receiving special attention in the prevention of chronic diseases.. For example, many adult health problems (e.g. obesity, hypertension) have their early origins in childhood, because this is the time when lifestyles are formed.
2. Primary Prevention
Primary prevention can be defined as action taken prior to the onset of disease, which removes the possibility that a disease will ever occur. For example the preventive measures taken to prevent diseases such as heart attacks, high cholesterol levels is called primary prevention. Often these simple measures are not taken seriously, which leads us to the second stage of prevention i.e. secondary prevention.
3. Secondary Prevention
Secondary prevention can be defined as action which halts the progress of a disease at its incipient stage and prevents complications. Treating a diseases with medicines constitutes secondary prevention.. The health programs initiated by governments are usually at the level of secondary prevention.
4. Tertiary Prevention
Tertiary prevention is measure used late in the stage of the disease. It includes measures to limit disabilities and also carry out rehabilitation measures.