diseases-vaccines1

Diseases & Vaccines

 

Diphtheria

About Diphtheria

Diphtheria is a bacterial infection caused by Corynebacterium diphtheriae. Before the introduction of routine vaccination, the disease ranked among the leading causes of infant mortality. Humans are the only animals that carry Corynebacterium diphtheriae. Transmission occurs through respiratory droplets and close physical contact.
Diphtheria is still present in many countries and epidemics have broken out during the 1990’s in Eastern Europe. [1]WHO., Diphtheria vaccine position paper.; Wkly Epidemiol Rec 2006, 81:24-32 http://www.who.int/immunization/wer8103Diphtheria_Jan06_position_paper.pdf last accessed November 28, 2011 Symptoms and complications: Typical diphtheria presents as pharyngitis with pseudomembranes that can spread, obstruct the airways and eventually lead to death by asphyxia. Complications of diphtheria include potentially fatal heart and neurological disorders.

Diphtheria-related mortality remains high (10%) even during recent outbreaks.

Diphtheria must be treated as an emergency in order to reduce the risk of complications and death.
Treatment relies mainly on the administration of diphtheria antitoxin by the intramuscular or intravenous route. Antibiotics are also used to contain bacterial growth, but they have no effect whatsoever on symptoms induced by toxin produced by the bacteria. Vaccination: Before vaccination against diphtheria became readily available in the 1980s, it was estimated that approximately 1 million cases occurred in the developing countries of Eastern Europe each year. [1]WHO., Diphtheria vaccine position paper.; Wkly Epidemiol Rec 2006, 81:24-32 http://www.who.int/immunization/wer8103Diphtheria_Jan06_position_paper.pdf last accessed November 28, 2011 Diphtheria vaccines are available. Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for diptheria click here.

Haemophilus influenzae type b invasive diseases

About Haemophilus influenzae type b invasive diseases

Haemophilus influenzae type b infections are widespread throughout the world. Hib infections may develop under various forms but meningitis is the most frequent one. Hib infections occur in children under the age of five years, and mostly during the first year of life. Hib infections are strictly human. Children infect each other through saliva droplets or by playing with contaminated toys.

Worldwide, Hib infections account for three million cases of severe illness, and 400,000 deaths annually, with a peak of incidence among infants of age four to 18 months. [1]Peltola H. Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates. Clin Microbiol Rev 2000;13:302-317 Symptoms and complications: Following colonization of the pharynx, the bacterium may enter the bloodstream, and subsequently spread to reach various target organs resulting in different clinical forms of Hib disease:meningitis, pneumonia, epiglottitis, arthritis, cellulitis, osteomyelitis.

Hib meningitis can be fatal and may lead to neurological sequelae such as deafness, motor deficit, or mental retardation. [2]– WHO. Haemophilus influenzae type B (HiB)Fact Sheet N°294 http://www.who.int/mediacentre/factsheets/fs294/en/index.html last accessed November 28, 2011 Medical management relies on intensive care and appropriate antibiotic therapy. Vaccination: The Hib vaccine is usually administered along with the other vaccines included in the childhood vaccination schedule. This vaccine has led to a rapid decline in the number of cases in industrialized countries. However, during 1996-2006, a total of 14 countries in Europe still reported 2836 cases of Hib infections 3 and vaccination efforts must be continued.
Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for Hib click here.

Hepatitis A

About Hepatitis A

Hepatitis A is a disease that causes an acute inflammation of the liver [1]WHO.Hepatitis A vaccines. fact sheet N°328. http://www.who.int/mediacentre/factsheets/fs328/en/index.html (last accessed on 28/11/2011). Hepatitis A is encountered frequently in the most disadvantaged geographical regions. Improvements in hygiene and sanitation have led to a reduction in the circulation of the virus, but not to its complete disappearance [2]Hadler SC. Global impact of hepatitis A virus infection: changing patterns. In Hollinger FB, Lemon SM, Margolis HS, eds Viral hepatitis and liver disease. Baltimore: Williams and Wilkins 1991;14-20 . Hepatitis A is a strictly human disease. Transmission occurs through the fecal-oral route, from person to person, or by ingestion of contaminated food or drinking water [1] WHO.Hepatitis A vaccines. fact sheet N°328. http://www.who.int/mediacentre/factsheets/fs328/en/index.html (last accessed on 28/11/2011) .
Approximately 1.4 million cases occur each year around the world. Symptoms and complications: Hepatitis A is often asymptomatic in young children, and can be more severe in adults. The onset of the disease is marked by a sensation of generalized malaise including, fever, headache, muscle soreness, fatigue, and gastrointestinal disorders. It is often accompanied by jaundice, particularly in adults [1] WHO.Hepatitis A vaccines. fact sheet N°328. http://www.who.int/mediacentre/factsheets/fs328/en/index.html (last accessed on 28/11/2011) .
The condition may be long-lasting, and recovery from symptoms following infection may be slow and take several weeks or months [1] WHO.Hepatitis A vaccines. fact sheet N°328. http://www.who.int/mediacentre/factsheets/fs328/en/index.html (last accessed on 28/11/2011) .
No specific treatment is available. Vaccination: Hepatitis A vaccines are available. They can be given as part of regular childhood immunizations programmes and with vaccines commonly given to people travelling to countries where the virus is endemic. Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for Hepatitis A click here.

Hepatitis B

About Hepatitis B

Hepatitis B is caused by a virus (HBV) that causes an inflammation of the liver. Severe outcomes may be observed following acute hepatitis, but they mainly result from the complications of chronic HBV infection (e.g., liver cirrhosis and cancer). HBV is transmitted primarily through blood, and to a lesser extent by other body fluids. WHO estimates that about two billion people worldwide have been infected with the virus. An estimated 600,000 persons die each year due to the acute or chronic consequences of hepatitis B [2]CDC.Hepatitis B..In:Atkinson W, Wolfe S, Hamborsky J.eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12th ed. Washington, DC: Public Health Foundation. 2011 p. 115-138. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/hepb.pdf last accessed November 28, 2011 . Symptoms and complications: After an incubation period of three to four months, acute hepatitis B is usually associated with a loss of appetite, weakness, nausea, abdominal pain, jaundice, skin rash, and joint pain that last several weeks.

1 to 2% of subjects develop fulminant hepatitis B, a total acute necrosis of the liver, for which mortality rate is extremely high. [1]WHO.Hepatitis B Factsheet N°204 http://www.who.int/mediacentre/factsheets/fs204/en/index.html last accessed November 28, 2011 [2]CDC.Hepatitis B..In:Atkinson W, Wolfe S, Hamborsky J.eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12th ed. Washington, DC: Public Health Foundation. 2011 p. 115-138. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/hepb.pdf last accessed November 28, 2011 Following HBV infection, 5% of patients will develop chronic hepatitis (i.e., persistence of HBV in the body) with the potential risk to develop cirrhosis and liver cancer [2]CDC.Hepatitis B..In:Atkinson W, Wolfe S, Hamborsky J.eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12th ed. Washington, DC: Public Health Foundation. 2011 p. 115-138. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/hepb.pdf last accessed November 28, 2011 .

The risk of transition to a chronic state is particularly frequent among immunodepressed individuals and newborns. Vaccination: Hepatitis B vaccines can be given as part of regular childhood immunizations programmes and with vaccines commonly given to people who may need medical treatment whilst travelling.

Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for Hepatitis B click here.

Human Papillomavirus diseases

About Human Papillomavirus (HPV)

Human Papillomavirus (HPV) is a very common virus which is highly contagious. Human papillomavirus is a family of viruses consisting of more than 100 different types [1]NHS. http://www.nhs.uk/Conditions/HPV-vaccination/Pages/Introduction.aspx Last accessed 17 January 2011. , with about 40 of them able to infect the genital area [1]NHS. http://www.nhs.uk/Conditions/HPV-vaccination/Pages/Introduction.aspx Last accessed 17 January 2011. .The infection is usually silent with no symptoms which means people infected with HPV are often unaware of their infection [2] Gerend MA, Magloire ZF. Awareness, knowledge and beliefs about Human Papillomavirus in a racially diverse sample of young adults. J Ado Health 2008;42:237-242 [11]Rodriguez MC. Is Increasing HPV Infection Awareness Promoting Increased Vaccine Compliance? Internet J Adv Nurs Pract 2010;11(1):1-15

  • 50% of sexually active adults will acquire genital HPV infection in their lifetime [3]Centers for Disease Control and Prevention. Genital HPV infection – fact sheet. http://www.cdc.gov/std/hpv/stdfacthpv.htm Last accessed 17 January 2011. Highest rates of infection are among females > 25 years [4]Peto J et al. Cervical HPV infection and neoplasia in a large population-based prospective study: the Manchester cohort. Br J Cancer 2004;91:942-53.
  • 15?19 years is the peak of HPV Infection [5]Schiffman MD and Castle PE. The promise of global cervical cancer prevention. N Engl J Med 2005;353(20):2101-4.

Symptoms and complications: Human Papillomavirus can affect many parts of the body, amongst all the cervix in women. Most of the time, Human Papillomavirus is eliminated naturally by the body. However, in some cases the virus stays active in the body for a long period of time, cervical cells may begin to change and cause precancerous lesions, which may in time turn into cervical cancer [6]Pagliusi SR and Aguado MT. Efficacy and other milestones for human papillomavirus. Vaccine 2004;23:569-578 The majority of HPV lesions regress spontaneously [7]Kadish AS et al. Regression of cervical intraepithelial neoplasia and loss of human papillomavirus (HPV) infection Is associated with cell-mediated immune responses to an HPV type 16 E7 peptide. Can Epidemiol Biomarkers Prev 2002;11:483-8. [8]Chan JK et al. HPV infection and number of lifetime sexual partners are strong predictors for ‘natural’ regression of CIN 2 and 3. Br J Cancer 2003;89:1062-6. Human Papillomavirus infection can cause a variety of diseases amongst others cervical, vulvar, and vaginal pre-cancers and cancers [10]De Vuyst H et al. Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: ameta-analysis. Int J Cancer 2009;124(7):1626-36. [9]De Vuyst H et al. HPV infection in Europe. Eur J Cancer 2009;45:2632-9. [13]National Cancer Institute. Human Papillomavirus and cancer: questions and answers. http://www.cancer.gov/cancertopics/factsheet/Risk/HPV. Last accessed on 27/09/2011. and genital warts [12]Aubin F and Al. Human Papillomavirus Genotype Distribution in External Acuminata Condylomata: A Large French National Study (EDiTH IV). Clin Infect Dis 2008; 47:610–5 . However, only some Human papillomavirus types can lead to cancer. Precancers lesions may require appropriate treatment depending on the severity of the lesions to help prevent development into cancer [16]NCI. Cervical cancer treatment. www.nci.nih.gov/cancertopics/pdq/treatment/cervical/healthprofessional/allpages. Last accessed on 04/09/2011 .

The burden of HPV-related diseases on the health of girls and women as well as boys and men is significant [14]Kreimer AR et al. Human Papillomavirus types in Head and neck squamous cell carcinomas worldwide: a systematic review. Cancer epidemio biomarkers Prev 2005,14 (2) 467-475 . Cervical cancer poses the greatest single burden: 31,038 cervical cancer cases are diagnosed per year in Europe and 13, 430 women will die from it [15]World Health Organization International Agency for Research on Cancer GLOBOCAN fast stats, http://globocan.iarc.fr/factsheets/populations/factsheet.asp?uno=990 last accessed October 26, 2011 .The four HPV types 6, 11, 16 and 18 together cause the vast majority of all HPV-related genital diseases

  • HPV Types 6 and 11 cause about 90% of genital warts cases in females and males [12]
  • HPV Types 16 and 18 cause about 75% of cervical cancer cases in females [17]Smith J, Lindsay L, Hoots B et al. Human papillomavirus type distribution in invasive cervical cancer and high-grade cervical lesions: a met-analysis update. Int J Cancer 2007;121: 621-632
  • HPV Types 16 and 18 also cause about 60% of vaginal cancer cases and above 40% of vulvar
    cancer cases in females [10]De Vuyst H et al. Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: ameta-analysis. Int J Cancer 2009;124(7):1626-36.

All HPV types that affect the genital area can cause abnormal diagnostic test results (Pap tests). Vaccination: Since 2006 [18] Gardasil. Summary of Product characteristics , vaccination has been available to help prevent cervical cancer and some genital diseases caused by certain types of Human Papillomavirus. Vaccination combined with screening could help prevent most of cervical cancer cases in the future. Vaccination should be in accordance with national recommendations. Footnotes a Analysis of cytology and histology records of a prospective cohort of 49,655 women attending clinics for routine cervical cytology in or near Manchester, UK, from 1988?1993. bA total of 256 women and 260 men who presented with EAC to French gynecologists, dermatologists, and proctologists were prospectively recruited during the period January through April 2007. Specimens were collected with a cytobrush, and the HPV genotype was determined using the INNO?LiPA assay (Innogenetics), which detects 24 HPV genotypes. cMeta?analysis of 93 studies conducted across 4 continents, using PCR assays. In total, 1,280 lesions were documented and 955 cases of cancer were identifi ed Based on articles published between January 1986 and March 2008. dEU 27 + Norway, Iceland and Switzerland, excluding Greece, Hungary, Luxembourg and Romania.

To learn more about the vaccine for HPV click here.

Influenza

About Influenza

Flu, or influenza, is a contagious disease caused by the Influenza virus. There are several different virus strains circulating each year. The proportions between different strains and even the characteristics of one strain can change from one year to another as flu viruses can mutate very rapidly.

Someone who has just been infected can spread the flu virus to other people before he feels the first symptoms of sickness [1]-CDC. How Flu spreads. http://cdc.gov/flu/about/disease/spread.htm (last accessed on 14/10/2011)) .

Flu is transmitted via droplets in the air (from someone who is sneezing or coughing) or by contact (like when touching surfaces contaminated with influenza virus and then touching the eyes, nose or mouth) [2]http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/flu.pdf (last accessed on 14/10/2011)) .

Symptoms and complications:
Seasonal influenza is characterised by a sudden onset of high fever, cough (usually dry), headache, muscle and joint pain, severe malaise (feeling unwell), sore throat and runny nose. The time from infection to illness, known as the incubation period, is about two days [4]Influenza (Seasonal); WHO fact sheet N°211 April 2009: http://www.who.int/mediacentre/factsheets/fs211/en/index.html (Last accessed on 14/10/2011) .

The infection usually lasts for about a week during which time the ill patient may be in bed with little or no capacity to work. For most people, recovery takes one to two week(s) [5]WHO. Influenza fact sheet – Aide mémoire sur la grippe. Wkly Epidemiol Rec 2003;78(11):77-80. .

Flu can disrupt your life at work, at home or on holidays, and it can result in serious complications, in particular in elderly people and those with other underlying diseases.
According to World Health Organization (WHO) estimates, the number of influenza-related deaths worldwide ranges between 250,000 and 500,000 per year [4]Influenza (Seasonal); WHO fact sheet N°211 April 2009: http://www.who.int/mediacentre/factsheets/fs211/en/index.html (Last accessed on 14/10/2011) . Vaccination: Vaccination is the only effective way to prevent infection for you and transmission of the flu to your relatives.

Each year, the composition of influenza vaccines is adapted according to the dominant strains in circulation. That’s why health authorities and health care professionals recommend to renew seasonal flu vaccination each year. According to the recommendation by the European Centre for Disease Control and Prevention (ECDC) populations recommended for seasonal flu vaccines in the 2010 – 2011 season are as follows: the public health justification for vaccinating people from the age of six months with chronic diseases, older people and healthcare workers seems to be sufficient to identify them as target groups for vaccination. There are also some reasons to believe that pregnant women, young children and young healthy adults will be at risk from a seasonal influenza dominated by the new influenza A(H1N1) viruses [6]Nokleby H, Nicoll A. Risk groups and other target groups – preliminary ECDC guidance for developing influenza vaccination recommendations forthe season 2010-11. Euro Surveill. 2010;15(12). Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19525 .

Seasonal flu vaccines have a good safety record [7]Delore V et al. Long-term clinical trial safety experience with the inactivated split influenza vaccine, Vaxigrip. Vaccine 2006;24:1586-592. . Some flu vaccines have been around for more than 40 years with at least a billion doses distributed around the world. Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for influenza click here.

Measles

About Measles

Measles is an acute, viral, eruptive, and extremely contagious disease which affected practically all children prior to the introduction of vaccination. Measles is a strictly human disease responsible in 2008 for an estimated 164,000 deaths in the world [1]WHO. Measles. Fact sheet N°286 http://www.who.int/mediacentre/factsheets/fs286/en/index.html last accessed November 28, 2011 [2]Strebel PM, Papania MJ, Dayan GH, Halsey NA. Measles Vaccine. In: Plotkin S, Orenstein WA, Offit P eds. Vaccines. 5th Ed. Philadelphia: Sauders Elsevier; 2008.p353-398 . More than 95% occur in low-income countries with weak health infrastructure [1]WHO. Measles. Fact sheet N°286 http://www.who.int/mediacentre/factsheets/fs286/en/index.html last accessed November 28, 2011 .

But European populations are still experiencing a high burden of this disease [3]EUVAC.NET.Measles Surveillance Report 2010 http://ecdc.europa.eu/en/publications/Publications/measles_report_2010_euvacnet.pdf, last accessed November 28, 2011 [4]ECDC.European monthly Measles Monitoring,September 2011 http://www.ecdc.europa.eu/en/publications/Publications/111018_EMMO_SEPT_2011.pdf, last accessed November 28, 2011 . Symptoms and complications: The WHO states that: the first sign of measles is usually a high fever, which begins about 10 to 12 days after exposure to the virus, and lasts four to seven days. A runny nose, a cough, red and watery eyes, and small white spots inside the cheeks can develop in the initial stage. After several days, a rash erupts, usually on the face and upper neck. Over about three days, the rash spreads, eventually reaching the hands and feet. The rash lasts for five to six days, and then fades. On average, the rash occurs 14 days after exposure to the virus (within a range of seven to 18 days).

Most measles-related deaths are caused by complications associated with the disease. Complications are more common in children under the age of five, or adults over the age of 20. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia.

As high as 10% of measles cases result in death among populations with high levels of malnutrition and a lack of adequate health care [1]WHO. Measles. Fact sheet N°286 http://www.who.int/mediacentre/factsheets/fs286/en/index.html last accessed November 28, 2011 Vaccination: The measles vaccine may be administered in combination with mumps and rubella vaccines (MMR vaccine).
Eradication of measles is theoretically feasible since the reservoir of the virus is exclusively human.
Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for measles click here.

Mumps

About Mumps

Mumps is a strictly human, highly contagious disease.

It is caused by a virus exhibiting glandular and nervous tissue tropism. Although mumps is considered a rather benign childhood disease, in some instances it can result in severe complications. Transmission occurs through direct contact or inhalation of respiratory droplets from infected patients. Patients with mumps are contagious during the two days preceding the swelling of the salivary glands and up to nine days following the onset of swelling.

In most regions throughout the world, the annual incidence of mumps is estimated between 100 and 1,000 cases per 100,000 people, with epidemic peaks occurring every two to five years [1]WHO. Mumps virus vaccines. WHO position paper. Epidemiol Rec 2007;82(7):51-60. http://www.who.int/wer/2007/wer8207.pdf Last accessed November 28, 2011 . Symptoms and complications: As stated by the WHO: Mumps typically begins with non-specifi c symptoms, such as myalgia, headache, malaise and low-grade fever; within a day these are followed by the characteristic unilateral or bilateral swelling of the parotid glands. Other salivary glands are visibly affected in approximately 10% of cases. After about 1 week, fever and glandular swelling disappear, and unless complications occur, the illness resolves completely.

In approximately 30% of cases, only non-specific symptoms occur or the infection is asymptomatic. Most infections in children aged

Although it is mostly a mild childhood disease, with peak incidence occurring among those aged 5–9 years, the mumps virus may also affect adults, among whom complications such as meningitis and orchitis are relatively more common. Encephalitis and permanent neurological sequelae are rare complications. No specific therapy for mumps exists. Vaccination: Approximately 120 countries have already introduced mumps vaccination into their national immunization program.2 Mumps vaccine is usually administered in combination with measles and rubella vaccines (MMR vaccine). Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for mumps click here.

Pertussis

About Pertussis

Pertussis is a highly contagious infection of the lower respiratory tract caused by the bacterium Bordetella pertussis. Pertussis is a slowly progressing disease (several weeks) that is particularly severe among young infants. Pertussis is a strictly human disease. It is easily transmitted by close contact, mainly through coughing. Symptoms and complications: Typical pertussis is characterized by a persistent cough (over three weeks) in most cases in the absence of fever. Paroxysmal cough is associated with the typical inspiratory whoop, apnea, cyanosis or post-tussive vomiting.

The disease may be particularly severe and even fatal in infants.

Adolescents and adults usually present atypical forms of the disease associated with a persistent cough. Vaccination: Since the 1950s, the incidence of pertussis has decreased by more than 90% in countries that have introduced vaccination [1]WHO. Pertussis vaccines. WHO position paper; Wkly Epidemiol Rec 2005; 80:29-40; http://www.who.int/immunization/topics/wer8004pertussis_Jan_2005.pdf last accessed November 28, 2011 [2]CDC. Impact of vaccines universally recommended for children–United States, 1990-1998. MMWR 1999;48(12):243-8. . Unfortunately, the disease still raises concern due to the increase in the proportion of cases occurring in infants too young to be vaccinated and in adolescents and adults in whom the protection provided by the disease or vaccination during their childhood is waning. The latter group may serve as a reservoir for the transmission to young infants.

Vaccination against pertussis is included in the routine vaccination of infants and children from two months to six years of age.

The availability of acellular pertussis vaccines now allows the administration of boosters for adolescents and adults. Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for pertussis click here.

Pneumococcal diseases

About Pneumococcal diseases

Pneumococcal bacteria, also called “pneumococci”, are a family of infectious bacteria which exist in many different types. They can cause various sorts of infections described as invasive pneumococcal disease (meningitis, bacteremic pneumonia and bacteremia) and non-invasive pneumococcal disease (pneumonia, otitis, sinusitis, and bronchitis). Symptoms and complications: Pneumonia is the most common form of pneumococcal infection. Symptoms include high fever, chills, and a productive cough accompanied by pulmonary pain and breathing difficulties. Pneumococcal pneumonia can be associated with bacteremia (i.e., the presence of bacteria in the blood). Pneumococcal bacteria can kill adults and elderly patients despite appropriate therapy and intensive care [2]23-valent pneumococcal polysaccharide vaccine. WHO position paper. Wkly Epidemiol Rec No. 42, 2008, 83, 373-384:http://www.who.int/wer/2008/wer8342.pdf (last accessed on 14/11/2011) .

Symptoms of pneumococcal meningitis are undistinguishable from those of other bacterial meningitis and include fever, headaches, vomiting, and stiffness of the neck. Pneumococcal meningitis can kill [1]Pneumococcal vaccines. WHO position paper. Wkly Epidemiol Rec 2003; 78(14):110-119: http://www.who.int/immunization/wer7814pneumococcal_Apr03_position_paper.pdf (last accessed on 14/11/2011) .

Pneumococci are transmitted by direct contact with respiratory secretions from infected patients or from healthy carriers.

Pneumococcal infections occur in all age groups, but the severity of invasive disease is highest in the very young and the elderly [1]Pneumococcal vaccines. WHO position paper. Wkly Epidemiol Rec 2003; 78(14):110-119: http://www.who.int/immunization/wer7814pneumococcal_Apr03_position_paper.pdf (last accessed on 14/11/2011) . Vaccination: Different vaccines are available to prevent Pneumococcal disease. Vaccination should be in accordance with national recommendations. Consult your doctor for more information about the right vaccine for you.

To learn more about the vaccine for pneumococcal diseases click here.

Poliomyelitis

About Poliomyelitis

Poliomyelitis is a contagious disease caused by three different serotypes of poliovirus (types 1, 2, and 3). It is responsible for incapacitating paralysis and death. Transmission is strictly human-to-human, and mainly fecal-oral. Whether symptomatic or not, an infected individual will transmit the virus to close contacts. Polio still causes epidemic outbreaks in a few countries: Nigeria, India, Pakistan and Afghanistan. Symptoms and complications: In most cases, the infected patient will remain asymptomatic or present only a flu-like syndrome similar to that observed with other benign viral infections.

In less then 1% of cases however, and after an incubation period ranging from six to 20 days, incapacitating paralysis develop resulting in sequelae of various intensity and sometimes death [1]CDC. Poliomyelitis.In: Atkinson W, Wolfe S, Hamborsky J eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12th ed. Washington, DC: Public Health Foundation. 2011, 249-262 http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/polio.pdf last accessed November 28, 2011 .

No specific antiviral treatment is available [2]WHO. Poliomyelitis. Fact sheet N°114 http://www.who.int/mediacentre/factsheets/fs114/en/ last accessed November 28, 2011 . Vaccination: Two types of vaccine are being used to eradicate the disease:

  • Injectable inactivated polio vaccine (IPV)
  • Live attenuated oral polio vaccine (OPV)

After smallpox, poliomyelitis is projected to be the second infection that will be eradicated.
Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for poliomyelitis click here.

Rotavirus gastroenteritis

About Rotavirus gastroenteritis

Rotavirus infections are contagious diseases caused by multiple rotavirus types. The types G1, G2, G3, G4 &G9 cause ? 90% of rotavirus infections in Europe [5]Iturriza-Gomara M et al. Rotavirus genotypes co-circulating in Europe between 2006 and 2009 as determined by EuroRotaNet, a pan-European collaborative strain surveillance network. Epidemiol Infect 2011;139 (6):895-909. [6]Santos N, Hoshino Y. Global distribution of rotavirus serotypes/genotypes and its implication for the development and implementation of an effective rotavirus vaccine. Rev Med Virol 2005;15 (1):29-56. . Rotavirus infection is the most common cause of severe gastroenteritis in infants and young children.1 Virtually all children will be infected with rotavirus by the age of 5 [2]Centers for Disease Control and Prevention (CDC). Rotavirus. In: Atkinson W, Wolfe S, Hamborsky J, McIntyre L, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 11th ed. Washington, DC: Public Health Foundation; 2009:245-256. [3]Cortese MM, Parashar UD. Prevention of rotavirus gastroenteritis among infants and children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2009;58:1–25. . Rotavirus is transmitted primarily through the fecal-oral route, through close person-to-person contact, and through vomits. The virus might also be transmitted in other ways, such as through fecally contaminated food and water and respiratory droplets [1]Parashar UD, Alexander JP, Glass RI. Prevention of rotavirus gastroenteritis among infants and children- Recommendations of the Advisory Committee on Immunization Practices. MMWR 2006;55:1–13. . Symptoms and complications: Rotavirus gastroenteritis ranges from mild, watery diarrhea of limited duration to severe diarrhea with vomiting and fever. The severity of rotavirus infection ranges from asymptomatic infection to severe dehydrating gastroenteritis. Symptoms typically include vomiting, fever, abdominal pain, and watery diarrhea, which can persist for 3 to 9 days [4]Raebel MA, Ou BS. Rotavirus disease and its prevention in infants and children. Pharmacotherapy 1999;19:1279-1295. . Vaccination: Vaccines are now available to prevent Rotavirus infection. Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for rotavirus gastroenteritis click here.

Rubella

About Rubella

Rubella is an acute viral eruptive disease. It is not always symptomatic and goes unnoticed in about half of the cases. The rubella virus is transmitted from one person to another through respiratory droplets of infected subjects. Rubella is particularly serious for a fetus when transmission of the virus by the mother occurs during the early stages of pregnancy, a condition known as congenital rubella syndrome or CRS [1]WHO.Rubella vaccines: WHO position paper Wkly Epidemiol Rec 2011;86:301–316. http://www.who.int/wer/2011/wer8629.pdf, last accessed November 28, 2011 . Symptoms and complications: In its typical clinical form, the disease is characterized by a transient erythematous rash with moderate fever, conjunctivitis, coryza, and sub-occipital adenopathy (swelling of neck lymph nodes).

In the case of CRS, infants develop ophthalmic, auditory, cardiac, and craniofacial malformations, which are more severe when transmission occurs early during pregnancy [1]WHO.Rubella vaccines: WHO position paper Wkly Epidemiol Rec 2011;86:301–316. http://www.who.int/wer/2011/wer8629.pdf, last accessed November 28, 2011 . Vaccination: Because the reservoir of the virus is exclusively human, eradication is theoretically possible.
The rubella vaccine is often used in combination with measles and mumps vaccines (MMR vaccine).
Within the past few years, vaccination has dramatically reduced rubella and CRS in many developed and some developing countries.

Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for rubella click here.

Shingles (herpes zoster)

About Shingles (herpes zoster)

Shingles (herpes zoster) is a frequent and painful disease. Nearly all adults (>95%) are at risk [1]Araujo LQ, Macintyre CR, Vujacich C. Epidemiology and burden of herpes zoster and post-herpetic neuralgia in Australia, Asia and South America. Herpes 2007;14 Suppl 2:40-4. and around 1 in 4 people will have an episode of shingles in their lifetime [2]Miller E, Marshall R, Vudien J. Epidemiology, outcome and control of varicella-zoster infection. Rev Med Microbiol 1993;4:222-30. [3]Bowsher D. The lifetime occurrence of Herpes zoster and prevalence of post-herpetic neuralgia: A retrospective survey in an elderly population. Eur J Pain 1999;3:335-42. .

Shingles results from the reactivation of varicella zoster virus, acquired during a childhood episode of varicella infection (also called chicken pox) and which stays latent in the body for life [5]Edmunds WJ, Brisson M, Rose JD. The epidemiology of herpes zoster and potential cost-effectiveness of vaccination in England and Wales. Vaccine 2001;19:3076-90. . 95% of adults have had this common illness, usually as children, and this is why nearly all adults are at risk of shingles [1]Araujo LQ, Macintyre CR, Vujacich C. Epidemiology and burden of herpes zoster and post-herpetic neuralgia in Australia, Asia and South America. Herpes 2007;14 Suppl 2:40-4. .

We never know when it happens or how severe it would be, but around 1 in 4 people will have an episode of shingles in their lifetime [2]Miller E, Marshall R, Vudien J. Epidemiology, outcome and control of varicella-zoster infection. Rev Med Microbiol 1993;4:222-30. [3]Bowsher D. The lifetime occurrence of Herpes zoster and prevalence of post-herpetic neuralgia: A retrospective survey in an elderly population. Eur J Pain 1999;3:335-42. . It is when we grow older, especially from the age of 50 [22]Hope-Simpson RE. Posherpetic neuralgia. JR Coll Gen Practice 1975; 25: 571-5 [23]Johnson R, McElhaney J,Pedalino B et al. Prevention of herpes zoster and its painful and debilitating complications. Int J Infect Dis 2007; 11: S43 that the immune system weakens and the risk of developing shingles increases [24]Burke BL et al. Immune responses to varicella-zoster in the aged. Arch Intern Med 1982; 142: 291-293 . Symptoms and complications: Shingles generally presents as a unilateral rash, but patients typically also experience pain [4]Oxman M.N. Clinical manifestations of herpes zoster. In Arvin AM. Gershon AA eds. Varicella-Zoster Virus. Virology and clinical management 2000; Cambridge University Press: 246-275 .

Shingles pain can be intermittent or continuous, every day or from time to time [6]Katz J,Cooper EM, Walther RR et al.. Acute Pain in Herpes Zoster and its Impact on Health-Related Quality of Life. Clin Infect Dis 2004; 39: 342-8 . Most patients complain of different sensations like: burning, stabbing, aching pain etc [7]Schmader KE. Herpes zoster in older adults. Clin Infect Dis 2001; 32: 1481-6 .

Pain in the acute phase may last for up to 30 days [9]Johnson RW. Zoster associtated pain: what is known, who is at risk and how can it be managed? Herpes 2007; 14 (s2): 30A-34A before recovery..

However, shingles can also lead to serious complications including long-term nerve pain [8]Scott FT, Leedham-Green ME,Barett-Muir WY et al. A study of shingles and the development of Post Herpetic Neuralgia in East London. J Med Virol 2003; 70: S24-S30 [9]Johnson RW. Zoster associtated pain: what is known, who is at risk and how can it be managed? Herpes 2007; 14 (s2): 30A-34A . A distressing feature of the long-term nerve pain is that it may be triggered by only a slight touch [7]Schmader KE. Herpes zoster in older adults. Clin Infect Dis 2001; 32: 1481-6 . Shingles can also lead to ocular complications: decrease or loss of vision, in the case of ophthalmic localisation [12]Shaikh S, Ta CN. Evaluation and Management of Herpes Zoster Ophthalmicus. Am Fam Physician 2002; 66 (9): 1723-30 [13]Emedicine. Herpes Zoster. Medscape Reference – Drugs, Diseases & Procedures 2011; http://emedicine.medscape.com/article/218683-overview#a0104 (last accessed on 14/10/2011) .

Treatment of shingles is challenging and insufficient [18]Johnson RW. Herpes Zoster and Postherpetic Neuralgia: a review of the effects of vaccination. Aging clinical and experimental research 2009; 21: 236-243 [19]The AIDS InfoNet; Herpes Zoster (Shingles). Fact Sheet 509 2010; http://aidsinfonet.org/fact_sheets/view/509 (last accessed on 14/10/2011) [20]NHS.Shingles – Information prescription – Treating shingles; http://www.nhs.uk/Conditions/Shingles/Pages/Treatment.aspx (last accessed on 14/10/2011) [21]Murtagh J. Herpes zoster (shingles): John Murtagh Information sheets: NEVDGP. North East Valley Division of General Practice Ltd; http://www.nevdgp.org.au/info/murtagh/Infections/Herpeszoster.htm (last accessed on 14/10/2011) . Once long-term pain is established, management is difficult [25]Oster G, Harding G, Dukes E et al. Pain, medication use, and health-related quality of life in older persons with postherpetic neuralgia: results from a population-based survey. J Pain 2005;6:356-63 Shingles may strongly affect daily life [10]Schmader K. Herpes Zoster in the Elderly: Issues Related to Geriatrics. Clin Infect Dis 1999; 28: 736-9 [11]Johnson RW, Rice ASC. Pain following herpes zoster: The influence of changing population characteristics and medical developments. Pain 2007; 128: 3-5 : work, leisure activities, mental task and enjoyment of life [17]Schmader KE,Sloane R,Pieper C et al.. The impact of acute herpes zoster pain and discomfort on functional status and quality of life in older adults. Clin J Pain 2007; 23: 490-6 . Vaccination: The first vaccine against shingles is already available in the US. It has been approved in Europe and will soon be available. Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for shingles click here.

Tetanus

About Tetanus

Tetanus is an often fatal infectious disease caused by the toxigenic strains of the tetanus bacillus (Chlostridium tetani). Tetanus is a devastating disease in developing countries and has not yet entirely disappeared from industrialized countries. In 2002, over 200,000 tetanus-related deaths were estimated to occur worldwide, of which approximately 180,000 were due to neonatal tetanus [1]WHO. Tetanus vaccine – WHO position paper. Wkly Epidemiol Rec 2006; 81:198-208 http://www.who.int/immunization/wer8120tetanus_May06_position_paper.pdf last accessed November 28, 2011 . Symptoms and complications: The bacterium penetrates the body through lesions (e.g., soiled wounds, open fractures, chronic ulcers…) or as a result of medical acts performed under insufficient aseptic precautions.

Following an incubation period of three to 21 days, tetanus most often presents as a generalized spastic disease. Contractions of the jaw muscle (or trismus) are a characteristic feature and are followed by spasms of the back muscles (opisthotonos) and sudden generalized convulsions.

In the absence of treatment, the outcome is almost always fatal, particularly in the very young or the elderly. Even after appropriate treatment, tetanus-related mortality remains high. Vaccination: Tetanus bacillus is ubiquitous and present in the soil in the form of highly resistant spores. Its reservoir can thus not be eliminated, but vaccination is a very effective weapon in the prevention of the disease.

Tetanus vaccines are available and are usually combined with other vaccines (e.g., diphtheria, pertussis, polio, Hib…). Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for tetanus click here.

Typhoid fever

About Typhoid fever

Typhoid fever is a bacterial infection that has become rare in industrialized countries, but that is still found in countries with poor hygiene where it is responsible for 600,000 cases each year worldwide [1]1Parry CM et al.Typhoid fever.N Engl J Med2002;347:1770-1782. .

Transmission usually occurs through the fecal-oral route by ingestion of contaminated food or water.
Effective antibiotics are available, and the prognosis in patients under treatment is usually favorable.
Nevertheless, recovery may be followed by chronic carriage during several months. Moreover, the emergence of drug-resistant strains makes the treatment more complex. Symptoms and complications: Following a seven to 14-day incubation period, typical signs, including diffuse abdominal pain, possibly high fever, anorexia, and very often diarrhea, progressively appear. Possible complications include gastrointestinal hemorrhage and perforation, heart failure, and encephalitis. Vaccination: Prevention relies on good hygiene and vaccination.

Vaccines against typhoid fever are available and can be given to people travelling to countries where the virus is endemic. Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for typhoid fever click here.

Varicella (chickenpox)

About Varicella (chickenpox)

Varicella is caused by varicella-zoster virus (VZV). It usually occurs in childhood and is characterized by a generalized pruritic vesicular exanthem and fever [1]CDC. Varicella. In: Atkinson W, Wolfe S, Hamborsky J eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12th ed. Washington, DC: Public Health Foundation. 2011:301–324. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/varicella.pdf last accessed November 28, 2011 . Varicella is usually contagious from 1 to 2 days before onset of rash through the first 4 to 5 days, or until lesions have formed crusts [1]CDC. Varicella. In: Atkinson W, Wolfe S, Hamborsky J eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12th ed. Washington, DC: Public Health Foundation. 2011:301–324. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/varicella.pdf last accessed November 28, 2011 . Transmission most likely occurs via respiratory droplets [2]Whitley RJ. Varicella-zoster virus. In: Mandell GE, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Vol 2. 6th ed. Philadelphia, PA: Churchill Livingstone; 2005:1780–1786. . Symptoms and complications: Constitutional symptoms that develop after onset of rash include malaise, pruritus, anorexia, and listlessness [2]Whitley RJ. Varicella-zoster virus. In: Mandell GE, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Vol 2. 6th ed. Philadelphia, PA: Churchill Livingstone; 2005:1780–1786. .

Skin manifestations in varying stages of evolution consist of maculopapules, vesicles, and scabs [2]Whitley RJ. Varicella-zoster virus. In: Mandell GE, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Vol 2. 6th ed. Philadelphia, PA: Churchill Livingstone; 2005:1780–1786. . At first, the lesions contain clear fluid, pustulating and scabbing over a short period of time. Rash initially appears on the trunk and face, quickly spreading to other areas of the body. Successive crops of lesions generally continue over a period of 2 to 4 days. Crusts completely fall off within 1 to 2 weeks after infection begins and can leave a slightly depressed area in the skin [2]Whitley RJ. Varicella-zoster virus. In: Mandell GE, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Vol 2. 6th ed. Philadelphia, PA: Churchill Livingstone; 2005:1780–1786. .

Adults may have more severe disease and have a higher incidence of complications [1]CDC. Varicella. In: Atkinson W, Wolfe S, Hamborsky J eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12th ed. Washington, DC: Public Health Foundation. 2011:301–324. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/varicella.pdf last accessed November 28, 2011 [2]Whitley RJ. Varicella-zoster virus. In: Mandell GE, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. Vol 2. 6th ed. Philadelphia, PA: Churchill Livingstone; 2005:1780–1786. .

Rarely, potentially severe complications of chickenpox can occur, including bacterial skin infections, pneumonia, and encephalitis [1]CDC. Varicella. In: Atkinson W, Wolfe S, Hamborsky J eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 12th ed. Washington, DC: Public Health Foundation. 2011:301–324. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/varicella.pdf last accessed November 28, 2011 . Vaccination: Vaccines are now available to prevent Varicella. Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for varicella click here.

Yellow Fever

About Yellow Fever

Yellow fever is a viral hemorrhagic fever that is transmitted by mosquitoes. Each year, 200,000 cases of yellow fever occur of which 30,000 are fatal. The disease is a threat for over three million travelers visiting endemic regions each year [1]WHO.Yellow fever vaccine. WHO position paper; Wkly Epidemil Rec 2003; 78:349-59 http://www.who.int/immunization/wer7840yellow_fever_Oct03_position_paper.pdf last accessed November 28, 2011 . Symptoms and complications: Following an incubation period of one week, the first signs of the disease typically include fever, chills, muscle pain, and headaches, suggestive of flu, dengue or malaria. In the most severe forms of the disease, a transient remission period occurs after three days, and is followed by the onset of a hemorrhagic syndrome associated with vomiting of black blood, jaundice (hence the name of the disease), and renal failure [1]WHO.Yellow fever vaccine. WHO position paper; Wkly Epidemil Rec 2003; 78:349-59 http://www.who.int/immunization/wer7840yellow_fever_Oct03_position_paper.pdf last accessed November 28, 2011 .

The outcome can be fatal in up to 50% of cases. All curable forms of the disease confer lifelong immunity to the patients [1]WHO.Yellow fever vaccine. WHO position paper; Wkly Epidemil Rec 2003; 78:349-59 http://www.who.int/immunization/wer7840yellow_fever_Oct03_position_paper.pdf last accessed November 28, 2011 No specific antiviral treatment is available against yellow fever. Vaccination: Although the usefulness of vaccination campaigns have been demonstrated to be beneficial over the past 60 years, yellow fever still remains a major concern in tropical regions in both Africa and South America. In countries at risk for yellow fever, vaccination is recommended in order to prevent and fight epidemics. It is also recommended for travelers visiting endemic regions.

Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for yellow fever click here.

Rabies

About Rabies

Rabies is a disease of viral origin that affects both wild and domestic animals. Rabies is transmitted mainly by rabid stray dogs, and continues to cause 55,000 human deaths each year [1]WHO.Rabies Fact Sheet N°99
http://www.who.int/mediacentre/factsheets/fs099/en/ last accessed November 28, 2011
. Symptoms and complications: Following infection, the virus replicates within muscle cells surrounding the wound. It then reaches the central nervous system and eventually spreads through the entire body. The mean incubation period is two to three months, but may range from several days to years.

The first signs of the disease include pain or an abnormal sensation at or around the wound, followed by other non-specific symptoms such as fever, anorexia, nausea, vomiting, headaches, malaise, and lethargy.
In the acute stage, rabies symptoms mimic encephalitis. The disease may evolve as one of two clinical forms: furious rabies or paralytic (dumb) rabies. In both cases, the outcome is coma followed by death within a few days [2]Plotkin SA, Koprowski H, Rupprecht CE.Rabies vaccines. In: Plotkin S, Orenstein WA, Offit P eds. Vaccines. 5th Ed. Philadelphia: Sauders Elsevier; 2008.p687-714 . Vaccination: To date, vaccination remains the only effective treatment against rabies and acts by neutralizing the virus before it actually reaches the central nervous system. Indeed, once the nervous system is infected, the outcome of the disease is inevitably fatal.

Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for rabies click here.

Meningococcal diseases

About Meningococcal diseases

Meningococci are a major cause of bacterial meningitis and septicemia. There are several meningococcal serogroups, but serogroups A, B, C, Y, and W135 account for almost all cases of invasive infection [1]Granoff DM, Harrison LH, Borrow R. Meningococcal vaccines. In: Plotkin S, Orenstein WA, Offit P eds. Vaccines. 5th Ed. Philadelphia: Sauders Elsevier; 2008.p399-434. .

Although invasive meningococcal infections mostly appear in the form of sporadic cases or minor epidemics, unpredictable and epidemics do occur in certain geographical areas, such as the “African meningitis belt [2]WHO. Meningococcal vaccines: polysaccharide and polysaccharide conjugate vaccines. WHO position paper. Wkly Epidemiol Rec 2002; 77: 331-340 http://www.who.int/immunization/wer7740meningococcal_Oct02_position_paper.pdf last accessed November 28, 2011 .”

Transmission of meningococci occurs via airborne respiratory droplets expelled by infected patients or healthy carriers. Symptoms and complications: Meningococcal meningitis usually occurs during infancy, adolescence and young adulthood and is characterized by an infectious syndrome (fever, severe headaches, vomiting.

Purpura fulminans (or fulminant meningococcal septicemia) is seen in 10 to 20% of patients [1]Granoff DM, Harrison LH, Borrow R. Meningococcal vaccines. In: Plotkin S, Orenstein WA, Offit P eds. Vaccines. 5th Ed. Philadelphia: Sauders Elsevier; 2008.p399-434. . It is characterized by infectious shock and extensive, often ecchymotic, purpura. The mortality rate is high and the sequelae can be drastic. Vaccination: Several types of meningococcal vaccines are available. Vaccination should be in accordance with national recommendations.

To learn more about the vaccine for meningococcal diseases click here.