10 months ago

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 (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 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 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
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    Gout Historically known as the “d

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    Haemorrhoids Haemorrhoids (also cal

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    Hair Loss Alopecia is the medical t

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    Hay Fever Hay fever (also called in

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    Hay Fever (continued) TREATMENT OPT

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    Headache Headaches are common and c

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    Head Lice Head lice (pediculosis ca

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    Heart Health Cardiovascular (CV) di

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    Indigestion, Heartburn and Gastriti

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    Influenza Influenza (flu) is a comm

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    Influenza (continued) TREATMENT OPT

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    Iron Deficiency Iron is an essentia

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    Irritable Bowel Syndrome Irritable

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    Menopause Menopause - the “change

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    Migraine Migraines are a type of se

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    Muscular Aches, Pains and Tightness

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    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

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    Osteoporosis Osteoporosis (meaning

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    Period Pain and Endometriosis Perio

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    Poisonings Any substance that has t

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    Pregnancy Tests and Supplements Hom

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    Preventive Health There are certain

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    Probiotics and Prebiotics Probiotic

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    Psoriasis Psoriasis is a long-term

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    Scabies Scabies is a very contagiou

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    Shingles Shingles (herpes zoster) i

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    Sinus and Nasal Problems Sinuses ar

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    Sleep Problems and Snoring Sleep is

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    Smoking Cessation Almost 5000 New Z

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    Sore Throat Sore throats are very c

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    Strains and Sprains Sprains and str

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    Sun Care Sunburn Sunburn occurs fro

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    Sun Care: Eye Protection Protecting

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    Sweating: Excessive (Hyperhidrosis)

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    Toothache Toothache is the term use

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    Travel Health (including Vaccinatio

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    Travel Sickness Travel, or motion,

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    Urinary Incontinence Urinary incont

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    Urticaria (Hives) Urticaria refers

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    Vaginal Health The vagina is a clos

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    Varicose Veins and Support Stocking

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    Vitamins and Dietary Supplements Vi

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    Warts Warts are benign (non-cancero

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    Weight Loss Obesity has reached epi

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    Worms Pinworms (Enterobius vermicul

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    Wound Care Our skin acts as a barri

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    Wound Care (continued) Wound type M

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    Chapter References (continued) Diar

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    Chapter References (continued) Gord

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    Significant learning opportunity: W

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    PharmacyToday A part of your everyd

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    OTC Medicines: Interactions When se

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    OTC Medicines: Interactions OTC Med

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    OTC Medicines: Interactions OTC Med

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    OTC Medicines: Interactions OTC Med

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    OTC Medicines: Precautions OTC Medi

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    OTC Medicines: Precautions OTC Medi

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    OTC Medicines: Adverse Effects OTC

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    Herbal Supplements: Interactions He

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    Herbal Supplements: Interactions He

  • Page 208 and 209:

    Herbal Supplements: Interactions He

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    Herbal Supplements: Interactions He

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    Drugs in Sport Treating Athletes Me

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    Drugs in Aviation AVIATION - PRECAU

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    Drugs in Pregnancy Drug use in preg

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    NZ Support Groups ADHD Association

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    NZ Support Groups New Zealand AIDS

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    HEAT or INFLAMMATION Unlike heat ru

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    OTC Products Over-the-counter produ

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    OTC Products Index Foot Care - Fung

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    »» Childhood Pain and Baby Teethi

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    »» Foot Care - Fungal Infections

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  • Page 258 and 259:

    »» Irritable Bowel Syndrome GASTR

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  • Page 266 and 267:

    »» Sexual Wellbeing - Contracepti

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  • Page 278 and 279:

    An ENHANCED ELearning Experience As

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    Product Index ANIME LUBRICANT 50ML-

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    Manufacturer’s Index AFT Pharmace

  • Page 284:

    Topiramate Actavis Topiramate 25mg,

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