Vaccine-Preventable Disease

2020 ◽  
pp. 123-136
Author(s):  
Loren G. Yamamoto
Keyword(s):  
Respiratory Syncytial Virus ◽  
Hepatitis B ◽  
Post Exposure Prophylaxis ◽  
Vaccine Preventable Disease ◽  
Varicella Zoster ◽  
Vaccine Preventable Diseases ◽  
Disease Entities ◽  
Syncytial Virus ◽  
Rabies Exposure ◽  
Exposure Prophylaxis

This chapter discusses disease entities that are vaccine preventable. Diseases not likely to be seen by physicians because of near eradication include diphtheria, tetanus, polio, and rabies. However, suspected rabies exposure is common, and initiating post-exposure prophylaxis is essential to preventing rabies. Clearly, other diseases that vaccines have reduced but not eliminated, such as pertussis, hepatitis A, hepatitis B, rotavirus, varicella/zoster, pneumococcal disease, meningococcal disease, influenza, respiratory syncytial virus, and tuberculosis, will be encountered. Haemophilus influenzae type b disease may also rarely be seen. There is great potential for physicians to never see a case of measles, mumps, and rubella, but because clusters of parents have chosen to not vaccinate their children, sporadic outbreaks will continue to occur.

scholarly journals Maternal and neonatal seroprevalence of Hepatitis B surface antigen (HBsAg) in Tripoli, Libya

2010 ◽  
Vol 4 (03) ◽  
pp. 168-170 ◽  
Author(s):  
Hamida El-Magrahe ◽  
Abdul Rahaman Furarah ◽  
Kheiria El-Figih ◽  
Sued El-Urshfany ◽  
Khalifa Sifaw Ghenghesh
Keyword(s):  
Hepatitis B ◽  
Pregnant Women ◽  
Medical Center ◽  
Hepatitis B Surface Antigen ◽  
Post Exposure Prophylaxis ◽  
Maternal Transmission ◽  
Blood Samples ◽  
Elisa Technique ◽  
The Difference ◽  
Exposure Prophylaxis

Background: Pregnant women with Hepatitis B virus HBV represent a major reservoir of the virus in the community. Data regarding the prevalence of HBV in pregnant women and maternal transmission of the virus in Libya are lacking. Methodology: Hepatitis blood samples from 1,500 pregnant women and 1,500 cord blood samples of their neonates delivered at Tripoli Medical Center, Tripoli, were tested for HBsAg by ELISA technique. HBsAg-positive samples were also tested for HBeAg. Results: HBsAg was detected in 1.5% (23/1,500) pregnant women and in 0.9% (14/1,500) neonates. Although HBsAg was detected at higher rate in pregnant women aged > 25 years [1.8% (22/1,235)] than in pregnant women aged < 25 years [0.4% (1/265)], the difference was not statistically significant (P > 0.05). All HBsAg-positive neonates were born to HBsAg-positive mothers with a rate of maternal transmission at 60.9% (14/23). HBeAg was detected in 21.7% (5/23) and in 7.1% (1/14) of HBsAg-positive pregnant women and neonates, respectively. Conclusions: Because of the high risk of developing chronic HBV infection at birth among infants born to HBsAg-positive mothers, administration of HBIG in combination with hepatitis B vaccine as post-exposure prophylaxis for such infants is of paramount importance. In addition, universal HBsAg screening of all pregnant women will greatly assist in reducing the maternal transmission of HBV in the country.

Rabies exposure in travellers to Asia, the Middle East, Africa, South and Central America—a German Airport study

2020 ◽  
Vol 27 (7) ◽  
Author(s):  
Christian Heitkamp ◽  
Daniel Robert Stelzl ◽  
Michael Ramharter ◽  
Silja Bühler
Keyword(s):  
Middle East ◽  
Medical Care ◽  
East Africa ◽  
Central America ◽  
Post Exposure Prophylaxis ◽  
Cross Sectional ◽  
High Exposure ◽  
Post Exposure ◽  
Rabies Exposure ◽  
Exposure Prophylaxis

Abstract Background Rabies causes thousands of deaths worldwide and trips to rabies endemic countries are popular. Travellers are often uncertain whether pre-exposure prophylaxis (PrEP) is advisable since they find it difficult to estimate the exposure risk during travel and the availability of post-exposure prophylaxis in endemic regions. The aim of this study was to determine the potential rabies exposures in travellers and to assess their knowledge on rabies. Secondly, we explored the access to appropriate post-exposure medical care in respective countries. Methods We conducted a cross-sectional study at Frankfurt Airport. Returning adult travellers arriving from Asia, the Middle East, Africa, South and Central America were invited to participate in this questionnaire-based study while waiting in the baggage claim area. Results Over a one-month recruitment phase in March 2019, we enrolled 3066 travellers; 2929 were included in the analysis. The gender ratio was balanced; the median age was 42 years (range 18–83 years). Participants arrived from Asia (46%), Africa (29%), Central/South America (13%), the Middle East (8%) and the Caribbean (8%). Forty-five per cent sought pretravel advice and 22% received ≥2 injections of rabies PrEP. Travellers with pretravel advice from tropical medicine specialists reached significantly higher knowledge scores than others. We found that potential rabies exposure occurred in 2.0% (57/2915) of travellers with 31% (13/42) of the contacts being unprovoked; 19% (8/42) of the exposed sought medical care and 3/8 were adequately treated before returning to Germany. Risk factors for animal exposure were: male sex, young age, trips to Asia and a long stay abroad (&gt;4 weeks). Conclusions A total of 2% of returning travellers (n = 2915) experienced a potential rabies exposure during their journey. A majority of the exposed individuals did not seek medical care; those seeking medical care were often treated inadequately. Rabies information must be emphasised during pretravel counselling and PrEP should be offered generously, especially to travellers with high exposure risks.

High time to prioritize rabies prevention—a new paradigm

2020 ◽  
Vol 27 (7) ◽  
Author(s):  
Robert Steffen ◽  
Davidson H Hamer
Keyword(s):  
Typhoid Fever ◽  
Hepatitis A ◽  
High Time ◽  
Post Exposure Prophylaxis ◽  
New Paradigm ◽  
Post Exposure ◽  
Rabies Exposure ◽  
Exposure Prophylaxis ◽  
Rabies Prevention

Almost 500 patients consulted a GeoSentinel clinic annually for post-exposure prophylaxis after a potential rabies exposure as compared to approximately 20 for hepatitis A and 40 for typhoid fever. Travellers’ response after potential rabies exposure is alarmingly inadequate. Thus, rabies pre-exposure prophylaxis should now become the #1 travel vaccine intervention.

Post-exposure Prophylaxis against Varicella Zoster Virus in Hospitalized Children after Inadvertent Exposure

2016 ◽  
Vol 23 (3) ◽  
pp. 180
Author(s):  
Song I Yang ◽  
Ji Hee Lim ◽  
Eun Jin Kim ◽  
Ji Young Park ◽  
Ki Wook Yun ◽  
...  
Keyword(s):  
Varicella Zoster Virus ◽  
Post Exposure Prophylaxis ◽  
Hospitalized Children ◽  
Varicella Zoster ◽  
Post Exposure ◽  
Exposure Prophylaxis

scholarly journals Ethical Assessment of Post-Exposure Prophylaxis Guidelines in Sexual Assault Patients Suspected of Hepatitis B Viral Infection

2021 ◽  
Vol 7 (3) ◽  
pp. 29-37
Author(s):  
Jimmy Mond ◽  
Jeffrey Gruenglas
Keyword(s):  
Sexual Assault ◽  
Hepatitis B ◽  
The United States ◽  
Homeless Persons ◽  
Treatment Modalities ◽  
Post Exposure Prophylaxis ◽  
Ethical Assessment ◽  
Increased Risk ◽  
The Disabled ◽  
Exposure Prophylaxis

More than 400,000 sexual assaults are reported annually in the United States in females and males above the age of 12. Victims are likely to include members of vulnerable populations such as the disabled, homeless persons, and immigrants. Victims of such assaults are at heightened risk of contracting the Hepatitis B virus (HBV) from their assailant. Unfortunately, approximately two-thirds of people with chronic HBV are unaware of their own status, exposing for victims the risk viral transmission, disease-related cirrhosis, and hepatocellular carcinoma. Victims are also at increased risk for posttraumatic stress disorder (PTSD). Although immediate vaccination of the assaulted victim is recommended, protective levels of antibody are not present for fourteen days post vaccination. Complementary treatment with a Hepatitis B immune globulin (HBIG), however, may provide immediate protective serum concentrations. Prompt prophylactic therapeutic intervention may not only protect patients from risk of infection but may also prevent the effects of PTSD by providing victims with psychological and emotional benefit. Yet, existing Centers for Disease Control and Preventions (CDC) recommendations for suspected HBV infection in sexual assault patients recommend initiating immunoprophylaxis only in cases where the perpetrator’s HBsAg status is known, a guideline that perpetuates inequities and injustice for those equally subject to the harms of sexual assault. This paper presents an ethical assessment of prophylactic treatment for sexual assault patients suspected of HBV exposure. In the absence of equitable guidelines, we argue for the clinician’s duty to rescue sexually assaulted patients from future harm and to protect the public through mitigation of transmission using currently available and evidence-based treatment modalities. The paper concludes with an ethical foundation to advocate for modification of current guidelines in view of existing prophylactic regimens.

scholarly journals Hepatitis B Virus Core Particles Containing a Conserved Region of the G Protein Combined with Interleukin-35 Protected Mice against Respiratory Syncytial Virus Infection without Vaccine-Enhanced Immunopathology

2020 ◽  
Vol 94 (13) ◽  
Author(s):  
Jie Yang ◽  
Chen Ma ◽  
Yu Zhao ◽  
Anjing Fan ◽  
Xiufen Zou ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
G Protein ◽  
Host Response ◽  
Virus Core ◽  
B Virus ◽  
Rsv Infection ◽  
Conserved Region ◽  
Syncytial Virus

ABSTRACT Respiratory syncytial virus (RSV) is the most important cause of lower respiratory tract infection in infants and young children. The vaccine-enhanced disease (VED) has greatly hindered the development of an RSV vaccine. Currently, there are no licensed vaccines for RSV. In this study, immunization of mice with hepatitis B virus core particles containing a conserved region of the G protein (HBc-tG) combined with interleukin-35 (IL-35) elicited a Th1-biased response and a high frequency of regulatory T (Treg) cells and increased the levels of IL-10, transforming growth factor β, and IL-35 production. Importantly, immunization with HBc-tG together with IL-35 protected mice against RSV infection without vaccine-enhanced immunopathology. To explore the mechanism of how IL-35 reduces lung inflammation at the gene expression level, transcription profiles were obtained from lung tissues of immunized mice after RSV infection by the Illumina sequencing technique and further analyzed by a systems biology method. In total, 2,644 differentially expressed genes (DEGs) were identified. Twelve high-influence modules (HIMs) were selected from these DEGs on the basis of the protein-protein interaction network. A detailed analysis of HIM10, involved in the immune response network, revealed that Il10 plays a key role in regulating the host response. The selected DEGs were consistently confirmed by quantitative real-time PCR (qRT-PCR). Our results demonstrate that IL-35 inhibits vaccine-enhanced immunopathology after RSV infection and has potential for development in novel therapeutic and prophylactic strategies. IMPORTANCE In the past few decades, respiratory syncytial virus (RSV) has still been a major health concern worldwide. The vaccine-enhance disease (VED) has hindered RSV vaccine development. A truncated hepatitis B virus core protein vaccine containing the conserved region (amino acids 144 to 204) of the RSV G protein (HBc-tG) had previously been shown to induce effective immune responses and confer protection against RSV infection in mice but to also lead to VED. In this study, we investigated the effect of IL-35 on the host response and immunopathology following RSV infection in vaccinated mice. Our results indicate that HBc-tG together with IL-35 elicited a balanced immune response and protected mice against RSV infection without vaccine-enhanced immunopathology. Applying a systems biology method, we identified Il10 to be the key regulator in reducing the excessive lung inflammation. Our study provides new insight into the function of IL-35 and its regulatory mechanism of VED at the network level.

scholarly journals Post-exposure prophylaxis following occupational exposure to HIV and hepatitis B: an analysis of a 12-year record in a Nigerian tertiary hospital

2017 ◽  
Vol 19 (4) ◽  
pp. 184-189 ◽  
Author(s):  
Salisu Abubakar ◽  
Garba Iliyasu ◽  
Farouq Muhammad Dayyab ◽  
Salisu Inuwa ◽  
Rabiu Alhassan Tudun Wada ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Hepatitis B ◽  
Healthcare Workers ◽  
Tertiary Hospital ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Increased Risk ◽  
Exposure Prophylaxis ◽  
North Western

Background: Healthcare workers (HCWs) have an increased risk of occupational exposure to blood-borne pathogens. Aims/objectives: We aim to examine the utilisation and outcome of post-exposure prophylaxis (PEP) for both HIV and hepatitis B (HBV) among HCWs. Methods: This was a retrospective study conducted in a tertiary hospital in North-Western Nigeria. We reviewed data on HIV or HBV PEP given to HCWs between 2004 and 2016. Results: A total of 115 HCWs presented for PEP during the study period. Intern doctors were the most exposed group (40/115; 34.8%). There were 86/115 (74.8%) needle stick exposures. While 53/115 (46.1%) of the sources of exposure were HIV-positive, 9/115(7.83%) were HBV-positive. Zidovudine-based regimen (40/70) was the most commonly prescribed. No seroconversion occurred among those that completed PEP treatment and follow-up. Discussion: No seroconversion occurred among those that received either or both HIV and HBV PEP and completed PEP treatment.

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