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Tuesday, December 29, 2015

POLIO VACCINATION - IPV in the USA



Vaccines and Immunizations

Polio Vaccination

Pronounced [PO-lee-oh]

At a Glance

Polio vaccination Polio is an infectious disease caused by a virus that lives in the throat and intestinal tract. It is most often spread through person-to-person contact with the stool of an infected person and may also be spread through oral/nasal secretions. Polio used to be very common in the United States and caused severe illness in thousands of people each year before polio vaccine was introduced in 1955. Most people infected with the polio virus have no symptoms; however, for the less than 1% who develop paralysis it may result in permanent disability and even death.
There are two types of vaccine that protect against polio: inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV). IPV is given as an injection in the leg or arm, depending on the patient's age. Polio vaccine may be given at the same time as other vaccines. Most people should get polio vaccine when they are children. Children get 4 doses of IPV at these ages: 2 months, 4 months, 6-18 months, and a booster dose at 4-6 years. OPV has not been used in the United States since 2000 but is still used in many parts of the world.

What You Should Know

About the Disease

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Vaccine Information

A person is considered to be fully immunized if he or she has received a primary series of at least three doses of inactivated poliovirus vaccine (IPV), live oral poliovirus vaccine (OPV), or four doses of any combination of IPV and OPV. Until recently, the benefits of OPV use (i.e. intestinal immunity, secondary spread) outweighed the risk for vaccine-associated paralytic poliomyelitis (VAPP) which occurred in one child out of every 2.4 million OPV doses distributed. To eliminate the risk of vaccine-associated paralytic poliomyelitis (VAPP), as of January 1, 2000, OPV was no longer recommended for routine immunization in the United States. However, OPV continues to be used in the countries where polio is endemic or the risk of importation and transmission is high. OPV is recommended for global polio eradication activities in polio-endemic countries due to its advantages over IPV in providing intestinal immunity and providing secondary spread of the vaccine to unprotected contacts.
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Beliefs & Concerns

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Vaccine Safety

As with all vaccines, there can be minor reactions, including pain and redness at the injection site, headache, fatigue or a vague feeling of discomfort.
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Who Should Not be Vaccinated?

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For Health Professionals

Clinical Information on Polio

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Vaccine Recommendations

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References and Resources

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Materials for Patients


Global Initiatives

Global Polio Eradication

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Also Known As & Abbreviations

  • Polio=poliomyelitis
  • IPV=inactive polio vaccine
  • OPV=oral polio vaccine

Contact Us:
  • Centers for Disease Control and Prevention
    1600 Clifton Rd
    Atlanta, GA 30333
  • 800-CDC-INFO
    (800-232-4636)
    TTY: (888) 232-6348
    Contact CDC-INFO
USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Road Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO

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Sunday, December 27, 2015

PARASITIC MENINGOENCEPHALITIS / CONTAMINATED WATER AND SWIMMING







CDCMeningitis Home

Parasitic Meningitis


Causes

Primary amebic meningoencephalitis (PAM) is a very rare form of parasitic meningitis that causes a brain infection that is usually fatal. The parasite enters the body through the nose and is caused by the microscopic ameba (a single-celled living organism) Naegleria fowleri.

Risk Factors

Naegleria fowleri is found around the world. In the United States, the majority of infections have been caused by Naegleria fowleri from warm freshwater located in southern-tier states.1 The ameba can be found in:
  • Bodies of warm freshwater, such as lakes and rivers
  • Geothermal (naturally hot) water, such as hot springs
  • Warm water discharge from industrial plants
  • Geothermal (naturally hot) drinking water sources
  • Swimming pools that are poorly maintained, minimally-chlorinated, and/or un-chlorinated
  • Water heaters. Naegleria fowleri grows best at higher temperatures up to 115°F (46°C) and can survive for short periods at higher temperatures.2, 3
  • Soil
Naegleria fowleri is not found in salt water, like the ocean.

Transmission

Naegleria fowleri infects people by entering the body through the nose. This typically occurs when people go swimming or diving in warm freshwater places, like lakes and rivers.1 The Naegleria fowleri ameba travels up the nose to the brain where it destroys the brain tissue.
You cannot be infected with Naegleria fowleri by drinking contaminated water. In very rare instances, Naegleria infections may also occur when contaminated water from other sources (such as inadequately chlorinated swimming pool water or contaminated tap water) enters the nose, for example when people submerge their heads or cleanse their noses during religious practices4, 5, and when people irrigate their sinuses (nose) using contaminated tap water6.
The Naegleria fowleri ameba causes primary amebic meningoencephalitis (PAM) when it travels up the nose to the brain and destroys the brain tissue.Naegleria fowleri infections are very rare. In the 10 years from 2003 to 2012, 31 infections were reported in the U.S. All were fatal.
PAM cannot be spread from one person to another.
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Signs and Symptoms

Naegleria fowleri causes the disease primary amebic meningoencephalitis (PAM), a brain infection that leads to the destruction of brain tissue. In its early stages, symptoms of PAM may be similar to symptoms of bacterial meningitis.
Initial symptoms of PAM start 1 to 7 days after infection. The initial symptoms include headache, fever, nausea, vomiting, and stiff neck. Later symptoms include confusion, lack of attention to people and surroundings, loss of balance, seizures, and hallucinations. After the start of symptoms, the disease progresses rapidly and usually causes death within about 5 days (range 1 to 12 days).

Diagnosis

PAM is rare. The early symptoms of PAM are more likely to be caused by other more common illnesses, such as bacterial or viral meningitis. People should seek medical care immediately whenever they develop a sudden onset of fever, headache, stiff neck, and vomiting, particularly if they have been in warm freshwater recently.

Treatment

Several drugs are effective against Naegleria fowleri in the laboratory. However, their effectiveness is unclear since almost all infections have been fatal, even when people were treated.
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Prevention

Naegleria fowleri infects people when water containing the ameba enters the body through the nose. Infection is rare and typically occurs when people go swimming or diving in warm freshwater places, like lakes and rivers. Very rarely, infections have been reported when people submerge their heads, cleanse their noses during religious practices, or irrigate their sinuses (nose) using contaminated tap or faucet water. Naegleria fowleri can grow in pipes, hot water heaters, and water systems, including treated public drinking water systems.
Personal actions to reduce the risk of Naegleria fowleri infection should focus on limiting the amount of water going up the nose and lowering the chances that Naegleria fowleri may be in the water.
Please visit the following pages for information on lowering your risk of infection in specific situations:

References

  1. Yoder JS, Eddy BA, Visvesvara GS, Capewell L, Beach MJ. The epidemiology of primary amoebic meningoencephalitis in the USA, 1962-2008.Epidemiol Infect. 2010;138:968-75.
  2. Griffin JL. Temperature tolerance of pathogenic and nonpathogenic free-living amoebas. Science. 1972;178(63):869-70.
  3. Stevens AR, Tyndall RL, Coutant CC, Willaert E. Isolation of the Etiological Agent of Primary Amoebic Meningoencephalitis from Artificially Heated Waters. Appl Environ Microbiol. 1977;34(6):701-705.
  4. CDC. Primary amebic meningoencephalitis associated with ritual nasal rinsing — St. Thomas, U.S. Virgin Islands, 2012. MMWR Morb Mortal Wkly Rep. 2013;62(45):903.
  5. Shakoor S, Beg MA, Mahmood SF, Bandea R, Sriram R, Noman F, et al. Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan.[PDF - 4 pages] Emerg Infect Dis. 2011:17;258-61.
  6. Yoder JS, Straif-Bourgeois S, Roy SL, Moore TA, Visvesvara GS, Ratard RC, Hill V, Wilson JD, Linscott AJ, Crager R, Kozak NA, Sriram R, Narayanan J, Mull B, Kahler AM, Schneeberger C, da Silva AJ, Beach MJ. Deaths from Naegleria fowleri associated with sinus irrigation with tap water: a review of the changing epidemiology of primary amebic meningoencephalitis. Clin Infect Dis. 2012;1-7.
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