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2017 HCHB_digital

Childhood Diseases and

Childhood Diseases and Immunisation (continued) Category Description Symptoms Refer to a doctor HUMAN PAPILLOMA VIRUS (HPV) HPV viruses are a group of more than 200 related viruses. At least 40 different types can be spread through sexual contact and HPV infections are the most commonly sexually transmitted infections. As of January 2017, the HPV vaccine Gardasil 9 (protects against HPV types 6, 11,16,18, 31, 33, 45, 52 and 58) is funded on the NIS for both males and females from age nine to 26. A two-dose schedule is recommended for those aged 14 and under, and a three-dose schedule for those aged 15 to 26. Any female who started a 3-dose 4-valent Gardasil regimen prior to the change-over is able to complete their remaining doses in 2017. The vaccine is licenced but unfunded for females aged 27 to 45 years. HPV is very common with four out of five people becoming infected with HPV during their lifetime. In most people, the infection clears by itself without causing any symptoms or long-lasting health problems. Low-risk HPVs 6 and 11 cause approximately 90% of genital warts. Genital warts appear as a small bump or cluster of bumps in the genital area. They may be raised or flat, small or large, or shaped like a cauliflower. High-risk HPVs cause cancer, including cancer of the cervix and anus and oropharyngeal cancer. HPVs 16 and 18 are the most commonly implicated viruses. Cancer often takes years to develop after a person gets HPV. If there is any suspicion of genital warts. For any abnormal bleeding, pain, or discharge in the genital area. Women aged 20 to 70 should undergo cervical screening at least every three years. MEASLES Measles is a highly contagious disease caused by a paramyxovirus of the genus Morbillivirus. A vaccination against measles is funded on the NIS and is given as a combined measles, mumps and rubella vaccine (Priorix replaces MMR-II from 1 July, 2017). Last reported epidemic in New Zealand was 2011 (595+ cases). Measles is endemic in many countries overseas and more than a million children die from the virus each year. First three days: high temperature, cough, cold, runny nose, sore throat, swollen neck glands. Red, sore, watery eyes and an inability to tolerate light. Day three: Koplik’s spots may appear (small red spots on inner surfaces of cheeks and soft palate). These are transient and not seen in every case of measles. Days four and five: blotchy, flat red rash, first appearing on the face then progressing down the trunk and limbs, with or without itch. If there is ear pain. If the child is unwell after the rash subsides. If the diagnosis is uncertain. MENINGOCOCCAL DISEASE Meningococcal disease is a bacterial infection caused by the bacterium Neisseria meningitidis, of which several different groups exist (A, B, C, W-135, Y). Between 40 and 100 cases of meningococcal disease occur in New Zealand each year, with most cases being caused by group B bacteria. Group C is the next most common cause. Humans are the only hosts of these bacteria. Although there are a number of meningococcal vaccines available, only Menactra and NeisVac-C are publicly funded for certain groups of few people at high risk (ie, those without a spleen, close contacts of meningococcal cases). Customers may chose to purchase these privately. NeisVac-C (only protects against Group C bacteria); Menactra and Nimenrix (both protect against Groups A, C, Y and W135) are conjugate vaccines and can be used in children under two years. Conjugate vaccines are considered superior to polysaccharide vaccines such as Menomune. Meningococcal B bacteria vaccines are difficult to develop and none are currently commercially available in New Zealand. Symptoms can develop suddenly and include: a high fever, headache, sleepiness, joint and muscle pains. More specific symptoms include: a stiff neck, photophobia (cannot tolerate light), vomiting, crying, and a reddish-purple, pin-prick, spotty rash or bruises that do not blanch (go white) when pressed. In babies and very young children, the signs may be more subtle. • Infants may refuse to feed. • The child may be listless or strangely quiet, irritable, or have a very high-pitched cry. • The child may have a bulging or tight fontanelle (top of the head). • Neck stiffness may be absent in infants. • Mothers are usually very instinctive about their children and, if they believe there is “something not quite right”, the child should be referred to a doctor. Be alert for the signs and symptoms of meningococcal disease and seek urgent medical treatment if it is suspected or cannot be ruled out. For more information go to the YourHealth topics on the New Zealand Ministry of Health’s website www.health.govt.nz (or phone Healthline: 0800 611 116 or 111 if it is an emergency). If your customer has already seen a doctor and been sent home but is still concerned, advise them to call their doctor again, or phone a different doctor, and insist on further tests or observation. MUMPS Mumps (epidemic parotitis) is caused by a paramyxovirus of the genus Paromyxovirus. Most reported cases are in children aged five to nine years. Mumps is funded on the NIS and is given as a combined measles, mumps and rubella vaccine (Priorix replaces MMR-II from 1 July, 2017). Last reported epidemic in New Zealand was 1994 (188 cases); however, mumps cases are still occurring. Some people do not experience any symptoms. Both parotid (salivary) glands on the side of the neck enlarge and become tender although one usually swells one to two days before the other. The glands become increasingly sore, especially when swallowing, talking, chewing and drinking. Dry mouth, fever, stiff neck, loss of appetite, nausea, vomiting, tiredness and convulsions may occur. If customer is going through puberty. If the customer has repeated vomiting, headache and a stiff neck. If the customer is an adult or adolescent male with the disease. If the diagnosis is uncertain. @PharmacyToday. A part of your everyday. New Zealand’s only e-newsletter designed specifically to provide a news snack for pharmacy. With links to PharmacyToday.co.nz you’re only a click away from the full story. Page 28 HEALTHCARE HANDBOOK 2017-2018 Common Disorders

CONTINUING OTC EDUCATION Infectious period and transmission HPV can be transmitted through skin-to-skin contact, although it is most commonly spread during vaginal or oral sex. Transmission can occur even when condoms are used and without penetrative intercourse. Incubation period: typically one to 20 months; however, in some people, symptoms do not develop until years after having sex with somebody who is infected. Complications and other management In most infections, a person’s own immune system eradicates cells infected with HPV within five years. Low-risk HPVs do not cause cancer but can cause skin warts on or around the genitals, anus, mouth and throat. HPV types 6 and 11 can also cause respiratory papillomatosis (a condition where bengin tumors grow within the respiratory system). More than 10 high-risk HPVs have been identified that cause cancer, including HPV types 16, 18, 31, 33, 45, 52, and 58. HPV types 16 and 18 cause the majority of cancers, including 70% of all cervical cancers. HPV viruses also cause 95% of anal cancers, 70% of oropharyngeal cancers, 65% of vaginal cancers, 50% of vulvar cancers, and 35% of penile cancers. Vaccination should ideally be performed before the onset of sexual activity. First dose in girls is recommended to be administered at age 12, with the course completed within six months. Cervical cancer screening is still recommended in women between the ages of 20 and 70, even if they have received the vaccine. The vaccine is also licensed but not funded for males between the ages of nine and 26 years. Transmission of the virus is by inhalation or ingestion of infected droplets that have become airborne when a person with measles coughs or sneezes. Incubation period: four to 12 days. There are usually no symptoms until the rash appears. An infected person is contagious from two days before any symptoms show to at least five days after the onset of rash. Children should stay away from school or childcare facilities throughout this contagious period. Transmission is by close or lengthy contact with an infected person's saliva or respiratory secretions; the bacteria are transferred during coughing or kissing. Transmission is more likely to occur between people living in the same household or in shared accommodation. Meningococcal bacteria are not as contagious as viruses that cause the cold and flu so a person is unlikely to become infected during casual contact or by breathing the same air as an infected person. Meningococcal disease is more common in infants, adolescents, and young adults; in people without a spleen, with HIV, or with persistent complement component deficiencies; and in sub-Saharan Africa. Risk of complications from contracting measles are far greater than risks associated with vaccination with the MMR vaccine. Those at risk of complications include those who are malnourished (particularly vitamin A deficient), immunocompromised and pregnant women. Diarrhoea leading to severe dehydration is the most common complication of measles. Other complications include otitis media which may lead to deafness, pneumonia which may be fatal, bronchitis, croup, conjunctivitis and/or corneal ulceration leading to blindness (especially if vitamin A deficient), mouth ulceration, acute glomerulonephritis (inflammation of kidneys) and acute renal failure. Measles infection during pregnancy increases the risk of premature labour and delivery, and foetal loss. There is also a risk of maternal death. There is no causal link between receiving the MMR vaccine and developing autism or bowel disease. An acute infection of measles almost always gives lifelong immunity. Vaccination induces probably lifelong immunity in most individuals. Other management: Severe cases of measles usually require hospitalisation and antibiotic administration for secondary bacterial infections. Antiviral medication may be prescribed to adults or those with severe infection. Infection can cause two very serious illnesses: meningitis (an infection in the brain) and septicaemia (blood poisoning). Both are medical emergencies and can occur suddenly causing a person to deteriorate rapidly. Haemorrhage, shock, coma and death can occur within several hours despite antibiotic therapy. People who survive may be left with permanent disability or hearing loss. Parenteral antibiotics should be administered to all cases as soon as meningococcal disease is suspected. Vaccination and/or prophylactic oral antibiotics should be considered for all people who qualify as close-contacts of a person with meningococcal disease. About one in 10 people harbour the bacterium that causes meningococcal disease in the back of their nose and throat without any signs or symptoms of the disease. Meningitis may also be caused by viruses and fungi. General health measures (such as covering the nose and mouth when sneezing or coughing, washing hands before eating, and not sharing eating or drinking utensils, toothbrushes, or pacifiers) should be practised by everybody to limit the risk of contracting Meningococcal disease, particularly those living in shared accommodation such as university hostels, flats or army barracks. Requires close personal contact for transmission to occur. Incubation period: 12–25 days. People with mumps are infectious from about one week before the onset of mumps to up to nine days after the swellings appear. Children should stay away from school or childcare facilities throughout this contagious period. Unvaccinated adolescents and adults are most at risk of severe mumps disease. Post-pubertal males are at risk of sterility if the disease affects the testicles. Mumps in pregnant women in their first trimester is associated with an increased rate of miscarriage. Complications include viral meningitis (15% of cases), encephalitis (1:6000 cases, of whom 1:100 die) and deafness (1:15,000 cases). Orchitis (testicle inflammation) affects one in five adult males, may be a risk factor for testicular cancer. Usually affects one testicle, sterility rare unless both testicles affected. Ovary inflammation affects one in 20 females. For most people one infection confers lifelong immunity. Vaccination is 95%–96% effective at preventing disease. Page 29

  • Page 1 and 2: HEALTHCARE HANDBOOK incorporating t
  • Page 3 and 4: 2017-2018 HEALTHCARE HANDBOOK PUBLI
  • Page 5 and 6: Index Common Disorders Acne--------
  • Page 7 and 8: Asthma and COPD CONTINUING OTC EDUC
  • Page 9 and 10: Head and scalp • Condition of hai
  • Page 11 and 12: HELP KIDS BE THEMSELVES AGAIN NEW L
  • Page 14 and 15: NUROFEN ZAVANCE* IS ABSORBED UP TO
  • Page 16 and 17: Acne Acne is a common skin problem
  • Page 18 and 19: Allergies An allergy occurs when th
  • Page 20 and 21: Asthma and COPD Asthma New Zealand
  • Page 22 and 23: Baby Feeding Breastfeeding is best
  • Page 24 and 25: Bites and Stings Bites and stings c
  • Page 26 and 27: Bruises, Scars, Spider Veins Bruise
  • Page 28 and 29: Childhood Diseases and Immunisation
  • Page 30 and 31: Childhood Diseases and Immunisation
  • Page 34 and 35: Childhood Diseases and Immunisation
  • Page 36 and 37: Childhood Pain and Baby Teething Pa
  • Page 38 and 39: Colds A cold is a contagious viral
  • Page 40 and 41: Cold Sores Cold sores are fluid-fil
  • Page 42 and 43: Constipation Constipation is the te
  • Page 44 and 45: Contraception & Sexual Wellbeing Co
  • Page 46 and 47: Contraception: Emergency Emergency
  • Page 48 and 49: Coughs: Dry Coughs are called dry o
  • Page 50 and 51: Coughs: Productive Coughs are consi
  • Page 52 and 53: Cuts, Abrasions and Blisters This t
  • Page 54 and 55: Cystitis [Bladder Infection] Cystit
  • Page 56 and 57: Dandruff Dandruff is a common condi
  • Page 58 and 59: Dermatitis/Eczema Dermatitis is a g
  • Page 60 and 61: Diabetes Diabetes is a condition in
  • Page 62 and 63: Diarrhoea and Vomiting Diarrhoea an
  • Page 64 and 65: Dry Skin Dry skin is skin that lack
  • Page 66 and 67: Ear Conditions Our ears allow us to
  • Page 68 and 69: Eye Conditions Almost two-thirds of
  • Page 70 and 71: Eye Conditions (continued) Type Sym
  • Page 72 and 73: Eyes: Contact Lenses Contact lenses
  • Page 74 and 75: Fever What is fever Fever is define
  • Page 76 and 77: Foot Care Common foot problems incl
  • Page 78 and 79: Fungal Infections: Superficial Supe
  • Page 80 and 81: Fungal Nail Infections (Onychomycos
  • Page 82 and 83:

    Gout Historically known as the “d

  • Page 84 and 85:

    Haemorrhoids Haemorrhoids (also cal

  • Page 86 and 87:

    Hair Loss Alopecia is the medical t

  • Page 88 and 89:

    Hay Fever Hay fever (also called in

  • Page 90 and 91:

    Hay Fever (continued) TREATMENT OPT

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    Headache Headaches are common and c

  • Page 94 and 95:

    Head Lice Head lice (pediculosis ca

  • Page 96 and 97:

    Heart Health Cardiovascular (CV) di

  • Page 98 and 99:

    Indigestion, Heartburn and Gastriti

  • Page 100 and 101:

    Influenza Influenza (flu) is a comm

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    Influenza (continued) TREATMENT OPT

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    Iron Deficiency Iron is an essentia

  • Page 106 and 107:

    Irritable Bowel Syndrome Irritable

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    Menopause Menopause - the “change

  • Page 110 and 111:

    Migraine Migraines are a type of se

  • Page 112 and 113:

    Muscular Aches, Pains and Tightness

  • Page 114 and 115:

    Nappy Rash Nappy rash is a red rash

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    Oral Health Oral health disorders i

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    Osteoarthritis Osteoarthritis is th

  • Page 120 and 121:

    Osteoporosis Osteoporosis (meaning

  • Page 122 and 123:

    Period Pain and Endometriosis Perio

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    Poisonings Any substance that has t

  • Page 126 and 127:

    Pregnancy Tests and Supplements Hom

  • Page 128 and 129:

    Preventive Health There are certain

  • Page 130 and 131:

    Probiotics and Prebiotics Probiotic

  • Page 132 and 133:

    Psoriasis Psoriasis is a long-term

  • Page 134 and 135:

    Scabies Scabies is a very contagiou

  • Page 136 and 137:

    Shingles Shingles (herpes zoster) i

  • Page 138 and 139:

    Sinus and Nasal Problems Sinuses ar

  • Page 140 and 141:

    Sleep Problems and Snoring Sleep is

  • Page 142 and 143:

    Smoking Cessation Almost 5000 New Z

  • Page 144 and 145:

    Sore Throat Sore throats are very c

  • Page 146 and 147:

    Strains and Sprains Sprains and str

  • Page 148 and 149:

    Sun Care Sunburn Sunburn occurs fro

  • Page 150 and 151:

    Sun Care: Eye Protection Protecting

  • Page 152 and 153:

    Sweating: Excessive (Hyperhidrosis)

  • Page 154 and 155:

    Toothache Toothache is the term use

  • Page 156 and 157:

    Travel Health (including Vaccinatio

  • Page 158 and 159:

    Travel Sickness Travel, or motion,

  • Page 160 and 161:

    Urinary Incontinence Urinary incont

  • Page 162 and 163:

    Urticaria (Hives) Urticaria refers

  • Page 164 and 165:

    Vaginal Health The vagina is a clos

  • Page 166 and 167:

    Varicose Veins and Support Stocking

  • Page 168 and 169:

    Vitamins and Dietary Supplements Vi

  • Page 170 and 171:

    Warts Warts are benign (non-cancero

  • Page 172 and 173:

    Weight Loss Obesity has reached epi

  • Page 174 and 175:

    Worms Pinworms (Enterobius vermicul

  • Page 176 and 177:

    Wound Care Our skin acts as a barri

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    Wound Care (continued) Wound type M

  • Page 180 and 181:

    Glossary WHAT DOES THAT WORD MEAN?

  • Page 182 and 183:

    Chapter References (continued) Diar

  • Page 184 and 185:

    Chapter References (continued) Gord

  • Page 186 and 187:

    Significant learning opportunity: W

  • Page 188 and 189:

    PharmacyToday A part of your everyd

  • Page 190 and 191:

    OTC Medicines: Interactions When se

  • Page 192 and 193:

    OTC Medicines: Interactions OTC Med

  • Page 194 and 195:

    OTC Medicines: Interactions OTC Med

  • Page 196 and 197:

    OTC Medicines: Interactions OTC Med

  • Page 198 and 199:

    OTC Medicines: Precautions OTC Medi

  • Page 200 and 201:

    OTC Medicines: Precautions OTC Medi

  • Page 202 and 203:

    OTC Medicines: Adverse Effects OTC

  • Page 204 and 205:

    Herbal Supplements: Interactions He

  • Page 206 and 207:

    Herbal Supplements: Interactions He

  • Page 208 and 209:

    Herbal Supplements: Interactions He

  • Page 210 and 211:

    Herbal Supplements: Interactions He

  • Page 212 and 213:

    Drugs in Sport Treating Athletes Me

  • Page 214 and 215:

    Drugs in Aviation AVIATION - PRECAU

  • Page 216 and 217:

    Drugs in Pregnancy Drug use in preg

  • Page 218 and 219:

    NZ Support Groups ADHD Association

  • Page 220 and 221:

    NZ Support Groups New Zealand AIDS

  • Page 222 and 223:

    HEAT or INFLAMMATION Unlike heat ru

  • Page 224 and 225:

    OTC Products Over-the-counter produ

  • Page 226 and 227:

    OTC Products Index Foot Care - Fung

  • Page 228 and 229:

    »» Acne CRYSTADERM CREAM AFT PHAR

  • Page 230 and 231:

    »» Childhood Pain and Baby Teethi

  • Page 232 and 233:

    »» Colds BONNINGTON’S IRISH MOS

  • Page 234 and 235:

    CODRAL RELIEF MAX STRENGTH COLD & F

  • Page 236 and 237:

    OTRIVIN JUNIOR GLAXOSMITHKLINE CONS

  • Page 238 and 239:

    DULCOLAX SANOFI CONSUMER HEALTHCARE

  • Page 240 and 241:

    BENADRYL MUCUS RELIEF DOUBLE ACTION

  • Page 242 and 243:

    »» Dandruff COCO-SCALP AFT PHARMA

  • Page 244 and 245:

    EAR CLEAR WILSON CONSUMER PRODUCTS

  • Page 246 and 247:

    »» Foot Care - Fungal Infections

  • Page 248 and 249:

    TELFAST ORAL LIQUID SANOFI CONSUMER

  • Page 250 and 251:

    NUROFEN ZAVANCE RECKITT BENCKISER (

  • Page 252 and 253:

    MOOV HEAD LICE SOLUTION DOUGLAS PHA

  • Page 254 and 255:

    GAVISCON DUAL ACTION LIQUID RECKITT

  • Page 256 and 257:

    CODRAL COLD & FLU + COUGH JOHNSON &

  • Page 258 and 259:

    »» Irritable Bowel Syndrome GASTR

  • Page 260 and 261:

    VOLTAREN EMULGEL GLAXOSMITHKLINE CO

  • Page 262 and 263:

    TURMERIC EXTRA STRENGTH GOOD HEALTH

  • Page 264 and 265:

    PREGNOSIS EARLY PREGNANCY TEST DIP

  • Page 266 and 267:

    »» Sexual Wellbeing - Contracepti

  • Page 268 and 269:

    SUDAFED PE SINUS DAY + NIGHT RELIEF

  • Page 270 and 271:

    NICORETTE INHALATOR JOHNSON & JOHNS

  • Page 272 and 273:

    STREPSILS PLUS LOZENGES RECKITT BEN

  • Page 274 and 275:

    TRAVACALM TRAVEL BAND WILSON CONSUM

  • Page 276 and 277:

    CRYSTADERM CREAM AFT PHARMACEUTICAL

  • Page 278 and 279:

    An ENHANCED ELearning Experience As

  • Page 280 and 281:

    Product Index ANIME LUBRICANT 50ML-

  • Page 282 and 283:

    Manufacturer’s Index AFT Pharmace

  • Page 284:

    Topiramate Actavis Topiramate 25mg,

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