Pink Book Webinar Series: Rotavirus and Hepatitis a Slides
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(ACIP) General Best Guidance for Immunization
8. Altered Immunocompetence Updates This section incorporates general content from the Infectious Diseases Society of America policy statement, 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host (1), to which CDC provided input in November 2011. The evidence supporting this guidance is based on expert opinion and arrived at by consensus. General Principles Altered immunocompetence, a term often used synonymously with immunosuppression, immunodeficiency, and immunocompromise, can be classified as primary or secondary. Primary immunodeficiencies generally are inherited and include conditions defined by an inherent absence or quantitative deficiency of cellular, humoral, or both components that provide immunity. Examples include congenital immunodeficiency diseases such as X- linked agammaglobulinemia, SCID, and chronic granulomatous disease. Secondary immunodeficiency is acquired and is defined by loss or qualitative deficiency in cellular or humoral immune components that occurs as a result of a disease process or its therapy. Examples of secondary immunodeficiency include HIV infection, hematopoietic malignancies, treatment with radiation, and treatment with immunosuppressive drugs. The degree to which immunosuppressive drugs cause clinically significant immunodeficiency generally is dose related and varies by drug. Primary and secondary immunodeficiencies might include a combination of deficits in both cellular and humoral immunity. Certain conditions like asplenia and chronic renal disease also can cause altered immunocompetence. Determination of altered immunocompetence is important to the vaccine provider because incidence or severity of some vaccine-preventable diseases is higher in persons with altered immunocompetence; therefore, certain vaccines (e.g., inactivated influenza vaccine, pneumococcal vaccines) are recommended specifically for persons with these diseases (2,3). Administration of live vaccines might need to be deferred until immune function has improved. -
Candidate Rotavirus Vaccine Recommendations for Consideration by the WHO Strategic Advisory Group of Experts (SAGE) on Immunization
Candidate rotavirus vaccine recommendations for consideration by the WHO Strategic Advisory Group of Experts (SAGE) on Immunization 1. Overall recommendation WHO strongly recommends the inclusion of rotavirus vaccination into the national immunization programmes of all regions of the world. In particular, countries where deaths among children due to diarrhoeal diseases account for ≥10% of under-5 mortality rate should prioritize the introduction of rotavirus vaccination. Countries where deaths among children due to diarrhoeal diseases account for <10% of under-5 mortality rate should also consider the introduction of rotavirus vaccination based on anticipated reduction in mortality and morbidity from diarrhoea, savings in health care costs, and the cost-effectiveness of vaccination. Justification: Rotavirus is a major cause of mortality in countries with high diarrhoeal disease mortality among children under five years of age. Every year, rotavirus gastroenteritis is estimated to cause approximately 527,000 (475,000-580,000) deaths globally among children <5 years old. Most of these deaths occur in developing countries and 90% of the rotavirus- associated fatalities occur in Africa and Asia alone. Globally, >2 million children are hospitalized each year for rotavirus infections. In a recent report of sentinel hospital-based rotavirus surveillance from 35 nations representing each of the six WHO regions between 2001 and 2008, an average of 40% (range= 34%-45%) of hospitalizations for diarrhea among children < 5 years old were attributable to rotavirus infection. 2. Detailed recommendation: Extrapolating efficacy data from a rotavirus vaccine study performed in one population to use of same rotavirus vaccine in other populations Efficacy/effectiveness data from a rotavirus vaccine study performed in a population from one of three under-5 mortality rate categories* can be extrapolated for use in populations in the same under-5 mortality rate category. -
Rotavirus Vaccine: Questions and Answers for Health Care Providers
Rotavirus Vaccine Questions and Answers for Health Care Providers In April 2014, Manitoba Health, Seniors and Active Living launched a publicly-funded Rotavirus Immunization Program for infants born on or after March 1, 2014. In 2018, Manitoba, along with the rest of Canada, switched from RotarixTM to RotaTeq®. As of May 15, 2021, Manitoba has switched back to Rotarix®, for use in its publicly-funded Rotavirus Immunization Program, for infants born on or after April 1, 2021. This document includes an updated list of questions and answers for your reference. 1. Why is there a Rotavirus Immunization Program in Manitoba? 2. Who qualifies for publicly-funded rotavirus vaccine? 3. Which rotavirus vaccine does Manitoba use? 4. Why does the vaccine series need to be completed before eight months of age? 5. How is Rotarix® packaged? 6. How are the oral tube and cap disposed of after use? 7. Should a spit-up dose of vaccine be repeated? 8. Are there any precautions that health care providers should take when administering the oral rotavirus vaccine? 9. Oral rotavirus vaccine contains sucrose in an amount expected to have an effect on immunization injection pain. When should Rotarix® be given in relation to other vaccines to elicit a reduction in pain? 10. How do I administer Rotarix®? 11. Is additional screening for potential contraindications required prior to administering rotavirus vaccine? 12. Can infants born to mothers on immunosuppressive medication be immunized? 13. Are there any issues related to circulating maternal antibodies interfering with the response to the live attenuated vaccine? 14. Are the two rotavirus vaccines, RotaTeq® and Rotarix™, interchangeable? 15. -
Case Studies Controversies in Vaccination
European Review, Vol. 21, No. S1, S56–S61 r 2013 Academia Europæa. The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution license ,http://creativecommons.org/licenses/by/3.0/.. doi:10.1017/S1062798713000227 Session 3 – Case Studies Controversies in Vaccination ROMAN PRYMULA University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic. E-mail: [email protected] Infectious diseases still jeopardize human health and even lives. In spite of the variety of advanced treatment methods, prevention is considered to be the most effective way to fight infections, and vaccination, no doubt, is one of the most effective preventive measures in the history of mankind. The vaccine controversy is based on a dispute over morality, ethics, effectiveness, and/or safety. There is no 100% safe or effective vaccine; however, benefits clearly overweigh risks. Ironically, as the numbers of cases of vaccine- preventable infectious diseases are falling, the controversies relating to vaccine safety are growing. Vaccines are generally victims of their own success. Controversies can afflict the positive acceptance of immunization, decrease the coverage and uptake and finally threaten the health of children and adults. The advent of vaccination has proven to be one of the most effective preventive measures in the history of medicine. Vaccines play a significant role in the prevention of debili- tating and, in many cases, life-threatening infectious diseases. Vaccines also provide important benefits in terms of reducing or avoiding costs associated with illness, both direct and indirect. In spite of the absence of any kind of ideal global healthcare system and lack of resources, the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) were able, in 1974, to establish a major global project called the Expanded Programme on Immunization (EPI). -
NSP4)-Induced Intrinsic Apoptosis
viruses Article Viperin, an IFN-Stimulated Protein, Delays Rotavirus Release by Inhibiting Non-Structural Protein 4 (NSP4)-Induced Intrinsic Apoptosis Rakesh Sarkar †, Satabdi Nandi †, Mahadeb Lo, Animesh Gope and Mamta Chawla-Sarkar * Division of Virology, National Institute of Cholera and Enteric Diseases, P-33, C.I.T. Road Scheme-XM, Beliaghata, Kolkata 700010, India; [email protected] (R.S.); [email protected] (S.N.); [email protected] (M.L.); [email protected] (A.G.) * Correspondence: [email protected]; Tel.: +91-33-2353-7470; Fax: +91-33-2370-5066 † These authors contributed equally to this work. Abstract: Viral infections lead to expeditious activation of the host’s innate immune responses, most importantly the interferon (IFN) response, which manifests a network of interferon-stimulated genes (ISGs) that constrain escalating virus replication by fashioning an ill-disposed environment. Interestingly, most viruses, including rotavirus, have evolved numerous strategies to evade or subvert host immune responses to establish successful infection. Several studies have documented the induction of ISGs during rotavirus infection. In this study, we evaluated the induction and antiviral potential of viperin, an ISG, during rotavirus infection. We observed that rotavirus infection, in a stain independent manner, resulted in progressive upregulation of viperin at increasing time points post-infection. Knockdown of viperin had no significant consequence on the production of total Citation: Sarkar, R.; Nandi, S.; Lo, infectious virus particles. Interestingly, substantial escalation in progeny virus release was observed M.; Gope, A.; Chawla-Sarkar, M. upon viperin knockdown, suggesting the antagonistic role of viperin in rotavirus release. Subsequent Viperin, an IFN-Stimulated Protein, studies unveiled that RV-NSP4 triggered relocalization of viperin from the ER, the normal residence Delays Rotavirus Release by Inhibiting of viperin, to mitochondria during infection. -
CAHAN San Diego Alert Template
To: CAHAN San Diego Participants Date: April 10, 2018 From: Public Health Services, Epidemiology and Immunizations Services Branch Update: Wound Botulism Cases Associated with Black Tar Heroin This health advisory updates providers about three recently reported wound botulism cases associated with black tar heroin use in San Diego County and provides recommendations on management. Three cases of wound botulism in local heroin users were reported in 2017, two of which were described in a previous CAHAN. Situation In the past month, two confirmed cases and one highly suspect case of wound botulism associated with black tar heroin injection have been reported in San Diego County. The cases are all male, range in age from 28 to 67, and apparently are unknown to each other. They presented with wound infections or abscesses and a recent history of skin or muscle popping black tar heroin. Other symptoms included diplopia, ptosis, extraocular palsy, dysphagia, slurred speech, and generalized weakness. All required intensive care treatment, and two have had respiratory failure requiring intubation. All patients were treated with Botulism Antitoxin Heptavalent (BAT®) released by the California Department of Public Health (CDPH). The sources of the black tar heroin remain unknown and additional cases may occur. Clusters of botulism cases associated with black tar heroin injection have occurred in Southern California in the past, including five cases in San Diego County in 2010. Background Botulism is a rare and potentially fatal illness caused by the neurotoxin produced by Clostridium botulinum and rarely by other Clostridia species. Routes of exposure vary: patients may present with wound botulism, commonly associated with injection drug use; with foodborne botulism from ingestion of contaminated food items; with infant botulism (the intestinal toxemia form of botulism in patients ≤15months of age); and, rarely, with adult intestinal botulism, or with an iatrogenic exposure to therapeutic botulinum toxin. -
Rotavirus Fact Sheet
ROTAVIRUS FACT SHEET What is Rotavirus? commonly spreads in families, hospitals, and childcare Rotavirus is a virus that commonly causes inflammation centers. A person with rotavirus disease is most likely to of the stomach and intestines (acute gastroenteritis). spread the virus from the time they are sick through the first 3 days after they recover. Who can get Rotavirus disease? Anyone. However, it is most common in infants and Is there a vaccine for Rotavirus? young children. A person may be infected more than Yes. The vaccine is highly effective at preventing severe once. Nearly every child who is not vaccinated as an rotavirus disease in infants and young children. The infant is expected to be infected within the first years of vaccine is given orally starting at age 2 months as a life. series of 2 doses or 3 doses, depending on the specific type. What are the symptoms of Rotavirus disease? Children with rotavirus disease may have severe watery How can the spread of Rotavirus be prevented? diarrhea, vomiting, fever, abdominal pain, and loss of The virus spreads so easily that frequent handwashing appetite. Vomiting and diarrhea can lead to dehydration. with soap and water is important, but not sufficient for Signs of dehydration include decreased urination, dry controlling the spread of the disease. Rotavirus mouth and throat, and feeling dizzy when standing up. A vaccination is the best way to protect children against child who is dehydrated may have few or no tears when rotavirus disease. crying and be unusually sleepy or fussy. Usually a person’s first infection with rotavirus tends to cause the How is Rotavirus disease treated? most severe symptoms. -
Detailed Review Paper on Rotavirus Vaccines
Rotavirus Vaccines 17 March 2009 Detailed Review Paper on Rotavirus Vaccines To be presented to the WHO Strategic Advisory Group of Experts (SAGE) on Immunization, April 2009 Ad-hoc group of experts on rotavirus vaccines Chair : G. Peter Members: T. Aguado, Z. Bhutta, L. De Oliveira, K. Neuzil, U. Parashar, D. Steele WHO Secretariat: C. Mantel, S. Wang, G. Mayers, E. Derobert Rapporteur: D. Payne 1 Rotavirus Vaccines 17 March 2009 Table of Contents I. Rotavirus Epidemiology and Rationale for Vaccination 1. Disease burden 2. Rationale for vaccination as the primary preventive measure II. Rotavirus Vaccine Efficacy and Safety in Pivotal Pre-Licensure Trials Brief summary of rotavirus vaccines 1. Rotarix ® 2. RotaTeq ® III. Newly Available Data from Clinical Trials in Africa and Asia and Post-introduction Vaccine Effectiveness Evaluations in the Americas 1. South Africa and Malawi clinical trials (Rotarix ®) 2. Hong Kong, Taiwan, and Singapore clinical trials (Rotarix ®) 3. Nicaragua post-introduction vaccine effectiveness case- control study (RotaTeq ®) 4. El Salvador post-introduction vaccine effectiveness case- control study (Rotarix ®) 5. United States post-licensure impact evaluation studies 6. Status of other ongoing studies IV. Vaccine Safety, Co-Administration, and Special Populations 1. Vaccine safety 2. Co-administration with other vaccines, particularly OPV 3. HIV-infected populations 4. Breast-feeding and Pre-term Infants V. Vaccine Schedules and Age Restrictions VI. Vaccine Cost-effectiveness and Decision-Making Regarding Program Implementation 1. Cost-effectiveness and affordability 2. Decision-making regarding vaccine introduction VII. Vaccine Program Implementation and Vaccine Delivery Logistics VIII. Integration with Diarrheal Control and Other Health Interventions and Communication 1. -
Hepatitis a Transmitted by Food
INVITED ARTICLE FOOD SAFETY David Acheson, Section Editor Hepatitis A Transmitted by Food Anthony E. Fiore Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta Hepatitis A is caused by hepatitis A virus (HAV). Transmission occurs by the fecal-oral route, either by direct contact with an HAV-infected person or by ingestion of HAV-contaminated food or water. Foodborne or waterborne hepatitis A outbreaks are relatively uncommon in the United States. However, food handlers with hepatitis A are frequently identified, and evaluation of the need for immunoprophylaxis and implementation of control measures are a considerable burden on public health resources. In addition, HAV-contaminated food may be the source of hepatitis A for an unknown proportion of persons whose source of infection is not identified. FEATURES OF HEPATITIS A and 40%–70% are jaundiced [6]. Children and occasionally young adults can also have inapparent infection, in which Hepatitis A virus (HAV) is classified as a picornavirus. Primates symptoms and elevation of ALT levels are absent but serocon are the only natural host [1]. There is only 1 HAV serotype, version occurs [7]. and immunity after infection is lifelong [2]. After ingestion, Hepatitis A begins with symptoms such as fever, anorexia, uptake in the gastrointestinal tract, and subsequent replication nausea, vomiting, diarrhea, myalgia, and malaise. Jaundice, in the liver, HAV is excreted in bile, and high concentrations dark-colored urine, or light-colored stools might be present at are found in stool specimens. Transmission occurs by the fecal- onset or might follow constitutional symptoms within a few oral route, either by direct contact with an HAV-infected person days. -
2 Model Forms, and Other Aids
ANNEX 2 Model Forms, and Other Aids 1. Applicant / Food Employee Interview Form 2. Applicant / Food Employee Reporting Agreement 3. Applicant / Food Employee Medical Referral Form 1 Applicant/Food Employee Interview Form Preventing Transmission of Diseases through Food by Infected Food Employees with Emphasis on illness due to Salmonella Typhi, Shigella spp., Escherichia coli 0157:H7, and Hepatitis A Virus The purpose of this form is to ensure that Applicants to whom a conditional offer of employment has been made and Food Employees advise the Person in Charge of past and current conditions described so that Person in Charge can take appropriate steps to preclude the transmission of foodborne illness. Applicant / Food Employee Name: (print)____________________________________________________________ Address: _______________________________________________________________________________________ _____________________________________________________________________________________________________________ Telephone: Daytime: _________________________ Evening: _________________________ TODAY: Are you now suffering from any of the following: 1. Symptoms Diarrhea? YES / NO Fever? YES / NO Vomiting? YES / NO Jaundice? YES / NO Sore throat with fever? YES / NO 2. Lesions containing pus on the hand, wrist or exposed body part? (such as boils and infected wounds, however small) YES / NO PAST: Have you ever been exposed to or suspected of causing a confirmed outbreak of typhoid fever (Salmonella Typhi), shigellosis (Shigella spp.), Escherichia coli O157:H7 infection (E. coli 0157:H7), or Hepatitis A (hepatitis A virus)? YES / NO If you have, what was the date of the diagnosis?_____________________________ HIGH-RISK CONDITIONS: 1. Have you been exposed to or suspected of causing a confirmed outbreak of typhoid fever, shigellosis, E. coli O157:H7 infection, or hepatitis A? YES / NO 2. Do you live in the same household as a person diagnosed with typhoid fever, shigellosis, hepatitis A, or illness due to E. -
RIDA®QUICK Rota/Adeno/Noro Combi Quick Detection of the Three Main Viral Gastroenteritis Agents
R-Biopharm – dedicated to food safety RIDA®QUICK Rota/Adeno/Noro Combi Quick detection of the three main viral gastroenteritis agents • Distinction between Noroviruses of genogroup I and genogroup II • Quick detection of outbreaks and mixed infections • Kit includes ready-to-use stool extraction vials • Simple test execution R-Biopharm – dedicated to food safety The three main viral gastroenteritis agents Despite the introduction of a vaccine, rotavirus is associated gastroenteritis and the third most still the most common cause of severe diarrhea common causal agent of viral gastroenteritis in in children under the age of five. In high-risk children. groups (children, immunosuppressed and elderly One in five cases of acute gastroenteritis worldwide patients) severe forms of disease can occur, making is caused by the norovirus. In developing countries, rotaviruses particularly significant in nosocomial norovirus causes the death of an estimated 50,000 infections in nursery and pediatric wards and children. Norovirus incurs a cost of 60 billion USD intensive care and oncology units. In 2013, an every year in medical care and productivity losses. estimated 215,000 children worldwide died from a rotavirus infection. The use of the RIDA®QUICK Rota/Adeno/Noro Combi, available as a double cassette, allows for Adenoviruses can cause infections of the eyes, quick and sensitive detection of the most significant respiratory or gastrointestinal tract. Types 40/41 of viral gastroenteritis agents. the adenovirus are the major cause of adenovirus- Perspective – Mixed infections In practice, mixed infections involving two or more gastroenteritis agents are often observed. RIDA®QUICK Rota/Adeno/Noro Combi enables rapid detection of single and mixed infections within 15 minutes. -
UNIVERSITY of CALIFORNIA Los Angeles Onsite Defluoridation
UNIVERSITY OF CALIFORNIA Los Angeles Onsite Defluoridation Systems for Drinking Water Production A dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Civil Engineering by Elaine Ying Ying Wong 2017 © Copyright by Elaine Ying Ying Wong 2017 ABSTRACT OF THE DISSERTATION Onsite Defluoridation Systems for Drinking Water Production by Elaine Ying Ying Wong Doctor of Philosophy in Civil Engineering University of California, Los Angeles, 2017 Professor Michael K. Stenstrom, Chair Fluoride in drinking water has several effects on the teeth and bones. At concentrations of 1-1.5 mg/L, fluoride can strengthen enamel, improving dental health, but at concentrations above 1.5 to 4 mg/L can cause dental fluorosis. At concentrations of 4 -10 mg/L, skeletal fluorosis can occur. There are many areas of the world that have excessive fluoride in drinking water, such as China, India, Sri Lanka, and the Rift Valley countries in Africa. Treatment solutions are needed, especially in poor areas where drinking water treatment plants are not available. On-site or individual treatment alternatives can be attractive if constructed from common materials and if simple enough to be constructed and maintained by users. This dissertation investigates using calcium carbonate as a cost effective sorbent for an onsite defluoridation drinking water system. Batch and column experiments were performed to characterize F- removal properties. Fluoride sorption was described by Freundlich, Langmuir and Dubinin- Radushkevich isotherm models, ii and it was found that the equilibrium time was approximately 3 hours, with approximately 77% of equilibrium concentration reached within 1 hour.