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Protecting against disease

The current immunisation program offers protection against eleven infectious diseases but because vaccinations have been so effective, many people know very little about these illnesses. Read on to find out more about the diseases you're protecting your child from.

Diphtheria
Tetanus
Pertussis (whooping cough)
Polio
Hib (Haemophilus influenzae type b)
Pneumococcal infection
Meningitis C
Measles
Mumps
Rubella
Tuberculosis

Diphtheria

Diphtheria is an extremely infectious disease which, thanks to vaccinations, is very rare in the UK. However, in poorer countries where immunisations are not so readily available, outbreaks of the disease are frequent causing the deaths of thousands of children.

The infection is airborne meaning it is spread through inhaling tiny droplets from the mouth or nose, and the incubation period (the time when a person can pass the disease to someone else) is between three and six days. First symptoms are usually a sore throat and fever, but if treatment is not received this can progress to breathing difficulties and possible death. The reason for this is that the disease causes a membrane to form over the throat, nose and bronchial tubes that go into the lungs. Further complications occur when the disease attacks the heart, leading to serious cardiac problems.

Babies are offered the vaccine at two, three and four months of age, then again at around four years old. A final booster is given in the early teen years. Further boosters may be required if travelling to a country where the disease is still common.

Tetanus

Tetanus, also known as 'lockjaw', is a painful disease that attacks the central nervous system and causes uncontrollable muscle spasms. Because of immunisations it is very rare, but the disease can be fatal.

The incubation period for tetanus is between four and 21 days, and the first symptoms are usually a headache and spasms of the jaw muscles, hence the name 'lockjaw'. Tetanus is caused by a toxin produced by spores of an environmental bacterium found in soil, dust, or animal waste. The organisms enter the body through open or infected wounds.

Babies are offered the vaccine at two, three and four months of age, then again at around four years old. A final booster is given in the early teen years. After these five doses of the vaccine, it is thought that immunity is lifelong.

Pertussis (whooping cough)

Pertussis is an infectious disease especially dangerous to young infants. It is caused by a bacterium and is spread in much the same way as the common cold. The incubation period is seven to ten days.

The first signs of infection mimic that of a cold - sneezing, slight fever, runny nose and a cough. However, after about two weeks the cough progresses to episodes of severe, spasmodic coughing, followed by a characteristic 'whoop' as the child tries to breathe in. Coughing is worse at night and episodes can last for two minutes at a time, making it difficult for a child to eat, drink, and breathe.

Pertussis can result in serious complications, including pneumonia, convulsions, brain damage, and brief episodes of stopped breathing. In some cases it can be fatal and globally, 300,000 children in unvaccinated areas die from the disease.

Babies are offered the vaccine at two, three and four months of age, then again at around four years old.

Polio

Polio, also called poliomylitis, is a viral illness that attacks the nerves in the brain and spinal column. It is spread by contact with faeces, mucus or saliva of an infected person and the incubation period is 21 days.

Symptoms of polio can vary from mild, flu-like sickness, to more severe conditions such as paralysis. Polio can be fatal in 0.1 to 2 per cent of cases.

Although common in poorer countries, thanks to mass immunisation following the discovery of the vaccine in the 1950s, polio was completely eliminated from the Western hemisphere by 1991. It is hoped that immunisation against the virus in the Eastern hemisphere will lead to a worldwide eradication, at which time the polio component will be removed from the immunisation schedule.

Babies are currently offered the vaccine at two, three and four months of age, then again at around four years old. A final booster is given in the early teen years. Since 2006, it has been given as part of the five-in-one vaccine, replacing the oral polio drops.

Haemophilus influenzae type b (Hib)

Hib is the commonest form of meningitis in young children and about one in ten children who have this illness will suffer lasting harm, such as brain damage, deafness, paralysis, epiglottitis, which is a severe swelling in the throat, pneumonia, blood poisoning and infections of the bones and joints.

The organism can also cause flu-like symptoms such as ear and chest infections.

Although effective against the Hib form of meningitis, the vaccine cannot protect against other forms of meningitis such as meningococcal, pneumococcal or viral.

Babies are offered the vaccine at two, three and four months of age, as part of the primary immunisation. A booster dose is offered along with the meningococcal C vaccine at about 13 months of age.

Pneumococcal disease

Pneumococcal disease is a severe infection caused by the pneumococcus bacteria that is spread by breathing in respiration droplets from an infected person. The incubation period is usually one to three days.

The infection can cause meningitis, septicaemia and pneumonia. It can affect anyone but is most dangerous for young children, the elderly and anyone with a weakened immune system. Infections are more common during winter and spring when respitatory illnesses are more likely. Early symptoms include a very sudden fever, chills and shaking, headaches, and a cough and cold.

The pneumococcal bacteria causes one in ten of all meningitis cases, and is more dangerous than meningitis C, with more long-term problems associated with it such as epilepsy and learning difficulties.

Babies are offered the vaccine at two and four months of age, then again at thirteen months old.

Meningitis C

Meningococcal group C is a type of bacteria that can cause meningitis and septicaemia, and is spread by respiration droplets. The incubation period is two to ten days.

Meningitis is an inflammation of the lining of the brain, and septicaemia is also known as blood poisoning.

Early symptoms are similar to flu, but can quickly progress to more serious signs including vomiting, fever, severe headache, arthralgia (painful joints), and a stiff neck. Babies may also have a high-pitched cry, and be difficult to wake. As the infection progresses, other symptoms may develop such as a dislike of light and a prurple rash that does not fade when pressed.

The Men C vaccine only immunises against the group C bacteria and is offered to babies at three and four months as part of the primary immunisations. A booster dose is given at twelve months old.

Measles

Measles is an infectious respiratory disease that is spread by droplets from the mouth or nose. The virus can live in the air for up to two hours making it extremely contagious. The incubation period is ten days and a person can be infectious even before they know they have the disease.

Measles used to be the most common childhood disease, but by adding MMR to the immunisation schedule, the number of cases reported each year have fallen dramatically.

Early signs of the disease include a runny nose, cough, and a slight fever, followed by eye redness and sensitivity. The rash occurs after three days, starting on the face then spreading to the chest, arms, back and legs. At the same time a high fever developes.

Measles can cause complications such as ear infections and seizures, as well as encephalitis (brain swelling) and pneumonia. Pneumonia is the cause of 60 per cent of all measles related deaths. Children under the age of two have a 30 per cent chance of developing complications from measles.

Infants are offered the vaccination as part of the MMR at thirteen months old, and a booster dose at about four years old.

Mumps

Mumps is a very infectious disease which affects the salivary glands under each ear. The virus is spread by coughing, sneezing, kissing and even talking. The incubation period is between 14 and 21 days.

Before the introduction of the MMR vaccination, nearly every child caught mumps.

Early symptoms include neck or ear pain, loss of appetite, tiredness, headache, and low fever, followed by severe, painful swelling of the cheeks and jaw. However, in a third of infections there are no signs or symptoms.

Mumps can cause meningitis, encephalitis and deafness. In boys it may lead to a swelling of the testes resulting in infertility.

Infants are offered the vaccination as part of the MMR at thirteen months old, and a booster dose at about four years old.

Rubella

Rubella is a mild but very contagious disease, spread by coughing and sneezing. The incubation period is 16 to 18 days, and children are infectious for five days before a rash appears and seven days after.

The disease is not usually serious in children, causing a mild fever and a head to toe rash that lasts for about three days. However, rubella is very dangerous to the unborn baby. If a pregnant woman gets rubella, especially during their first trimester, the infection is likely to spread to the foetus and cause congenital rubella syndrome (CRS), leading to miscarriage, stillbirth, and severe birth defects. The most common birth defects are blindness, deafness, heart damage, and mental retardation.

The rubella vaccination protects girls by immunising them against the disease so they are not at risk if they come into contact with an infected person, and by preventing the spread of the disease by also ensuring boys are immune.

Infants are offered the vaccination as part of the MMR at thirteen months old, and a booster dose at about four years old.

Tuberculosis

Tuberculosis is now very rare in this country. In babies and younger children it often goes unnoticed or appears as a fever of unknown cause. It may cause a cough in older children and adults, which lasts for many weeks, along with a fever, sweating in the night and weight loss. The illness can also affect other parts of the body such as the brain or bones.

Protection is given in the form of the BCG jab (BCG stands for Bacillus Calmette-Guerin, after the scientists who devoloped the vaccine). A skin test will show if you need a BCG jab. Teenagers are usually given it after they have been tested for immunity to tuberculosis.

Some health authorities routinely offer the BCG immunisation for new babies, particularly if you or your family come from areas where TB is more common. Ask your doctor or health visitor what the policy is in your are � they should also be able to give you written information to take away and read at home, such as the Health Education Authority leaflet �BCG and Tuberculosis�.

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