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2017 HCHB_digital

Childhood Diseases and

Childhood Diseases and Immunisation (continued) Category Description Symptoms Refer to a doctor PERTUSSIS PNEUMOCOCCAL disease POLIO ROTAVIRUS RUBELLA TETANUS Pertussis (whooping cough) is a highly contagious bacterial disease caused by Bordetella pertussis. Pertussis is one of the leading causes of vaccine-preventable deaths worldwide, with most deaths occurring in unvaccinated or incompletely vaccinated young infants. Pertussis is a component of several combination vaccines (such as Boostrix, Infanrix IPV, and Infanrix-Hexa) and is funded on the NIS in children. Boosters are funded for pregnant women between 28 and 38 weeks’ gestation during epidemics. Parents, grandparents and adults working in contact with young children should consider getting a booster vaccination every 10 years; however, these are not currently funded. Pneumococcal disease is caused by the Streptococcus pneumoniae bacterium. More than 90 types of this bacterium exist and infections can vary from minor to severe. From 1 July, 2017, the pneumococcal 10-valent protein conjugate vaccine (Synflorix) is funded on the NIS for infants up to their fifth birthday or children needing revaccination. The 13-valent vaccine (Prevenar 13) is funded for high-risk patients only. Poliomyelitis is a highly contagious viral disease caused by three types of polio virus (types 1,2 and 3). Prior to the development of polio vaccines, nearly every person became infected, especially infants and young children. Humans are the only hosts for polioviruses. Inactivated poliomyelitis vaccine is funded on the NIS for unvaccinated individuals and for revaccination following immunosuppression. The first dose is usually given at six weeks of age as part of Infanrix-hexa. Rotavirus is the leading cause of severe vomiting and diarrhoea in babies and young children in New Zealand. More than 90% of all unvaccinated children will have been infected by age three. Funded on the NIS (oral Rotarix replaces RotaTeq from 1 July, 2017). First dose must be given before 15 weeks of age. Rubella (German measles or three-day measles) is caused by a togavirus. Rubella is funded on the NIS and is given as a combined measles, mumps and rubella vaccine (Priorix replaces MMR-II from 1 July, 2017). Tetanus is a serious infection caused by the bacillus Clostridium tetani – found worldwide in soil. Tetanus is funded on the NIS and contained in several combination vaccines (such as Boostrix, Infanrix IPV, Infanrix-Hexa, ADT Booster). Booster doses are given to children aged four and 11, and to adults aged 45 and 65. People in certain occupations and travellers may benefit from tetanus booster doses every 10 years. Disease is more severe in infants and young children. Catarrhal stage: Lasts one to two weeks and includes a runny nose, sneezing, fever, and mild cough. Paroxysmal stage: Usually lasts one to six weeks, but can persist for up to 10. Burst, or paroxysm, of numerous, rapid coughs occurs followed by a long inhaling effort characterised by a high-pitched whoop. Some babies may not “whoop”. Convalescent stage: The cough may persist for up to three months although usually disappears after two to three weeks. Paroxysms may recur with subsequent respiratory infections. Major cause of ear infections and sinusitis. Pneumococcal pneumonia is the most common form of serious pneumococcal disease (fever, chills, cough, shortness of breath, rapid breathing). Pneumococcal meningitis and bacteraemia can also occur. Ninety-five per cent of infected people have no symptoms; 4%–8% have mild symptoms such as a low-grade fever, headache, fatigue, vomiting, neck stiffness, sore throat, muscle pain. Some may develop aseptic meningitis a few days after, but most recover fully. Two per cent develop acute irreversible flaccid paralysis with loss of reflexes, which may also affect the breathing muscles. Most common symptoms include diarrhoea, vomiting, and fever. In severe cases, children can have diarrhoea up to 20 times in one day. Symptoms can begin suddenly and last up to seven days. Symptoms are often mild and may be absent or missed in 30%–50% of cases. A pink macular rash occurs on the forehead and face about seven days following infection. This spreads rapidly to the body, especially the chest and lasts two to three days. There may also be a slight fever, a runny nose, mild conjunctivitis, cervical lymphadenopathy and aching joints. Small petechial lesions (forchheimer spots) may be seen on the palate. Bacteria in the wound produce a toxin which causes the muscles to stiffen around the jaw, neck, back, chest, abdomen and limbs; causing painful muscle spasms and lockjaw. Food may be difficult to chew or swallow. Some people may develop fever and sweating and have difficulty breathing. If the child is less than six months old. If the disease is in its early stages since antibiotics prescribed by a doctor can be effective. If there is ear pain. If there is vomiting, convulsions, exhaustion, dehydration, or the person is not eating. If the diagnosis is uncertain. Hospitalisation may be necessary for infants under six months – about half of older children may also need hospital care. Anybody with suspected serious pneumococcal disease. Anybody with suspected polio. Since 1962 only seven cases of polio have been reported in New Zealand. Six were vaccine or probably vaccine-associated before New Zealand changed to the inactivated polio vaccine in 2002. One case was acquired in Tonga and imported to New Zealand. Seek medical advice immediately if child becomes dehydrated – symptoms include drowsiness or floppiness in children, a sunken fontanelle, sunken eyes or no tears. All suspected cases of rubella should be notified so that public health control programmes can limit spread. Anybody with suspected tetanus needs to go to hospital immediately. The disease can be fatal (one in 10 people die). Children and the elderly are most at risk. MANAGING PAIN FREE PROFESSIONAL DEVELOPMENT FOR Pharmacy assistants, technicians and students 4 Page 30 HEALTHCARE HANDBOOK 2017-2018 Common Disorders

CONTINUING OTC EDUCATION Infectious period and transmission Spread by inhalation of infected droplets from a cough or sneeze. Incubation period: six to 20 days. Highly infectious and around 90% of nonimmune household contacts will contract it. Infectious period: seven days after exposure until three weeks after the cough begins. Children should stay away from school or childcare facilities throughout this contagious period. Pneumococcal bacteria are carried in the nose and throat of healthy adults and children. Transmitted through infected droplets released into the air by coughing or sneezing. Incubation period: varies, may be as short as one to three days. Complications and other management Babies aged less than six months are most at risk (75% require hospitalisation). Almost no maternal protection against pertussis is passed to the newborn from the mother. Children under 12 months who are ill enough to be admitted to hospital have a one in 200 chance of dying of whooping cough. In one to three per 1000 children whooping cough leads to permanent brain damage, paralysis, deafness or blindness (mortality rate of approximately 1%). Adolescents and adults may just present with a persistent cough similar to that found in other upper respiratory infections (but still infectious). Other management: Antibiotics do not cure pertussis, but may be given to reduce spread of infection to others. Cough medicines provide little relief and should never be used in children under six. A mist vaporiser may soothe dry, irritated airways. Keep the room free of irritants such as dust and smoke. Maintain a good fluid intake – keep meals small and more frequent. Ensure sick children get plenty of bedrest. Additional notes: Pertussis immunity wanes over time; both following natural disease and vaccination (immunity lasts five to 10 years). Pertussis is estimated to be responsible for up to 20% of severe coughs in adults lasting one to three months. These could be a significant reservoir of infection. Reinfection may present as a persistent cough, rather than typical pertussis. Currently available vaccines prevent disease much better than they prevent infection, so outbreaks still occur in countries with widespread vaccination although mortality and morbidity is greatly reduced. Pneumococcal disease is more common in autumn and winter and is the leading cause of bacterial pneumonia in young children and adults older than 65. Maori and Pacific children are affected by pneumococcal disease more than other ethnicities in New Zealand. Since introduction of a vaccine in 2008, the number of hospitalisations and recorded carriers of the bacteria has reduced. Combination antibiotic treatment is usually required, although resistance can be a problem. Supportive care may also be needed. Transmitted by the faecal-oral route or by ingestion of pharyngeal secretions. Asymptomatic people will shed the virus in their stool and through poor hygiene will spread the infection to others. Incubation period: three to 21 days. Virus persists in the pharynx for approximately one week and in the faeces for three to six weeks. Highly contagious. Virus is able to survive a long time on surfaces such as taps, bench tops and toys. Main route of infection is contamination of hands, utensils and other objects with faeces from an infected person. Incubation period: 24–72 hours. Transmission is through direct or droplet contact with infected nasopharyngeal secretions (through a cough or sneeze). Infants with congenital rubella shed virus in their pharyngeal secretions and urine for months after birth and should be considered infectious until they are 12 months old. Incubation period: 14–21 days. Humans are the only source of rubella infection. Soil is the most common source of Clostridium tetani spores and bacilli. Animals also carry the bacilli and spores in their intestine and release it in their faeces. Entry can be gained into the body through a relatively minor cut, graze or puncture wound. Incubation period: three to 21 days. A person with tetanus is not infectious to others. The disease is incurable. While the person is acutely unwell only supportive care can be provided to reduce complications associated with paralysis. Once recovered, rehabilitation can prevent or reduce post-polio deformities and increase independence. The Global Polio Eradication Initiative aims to immunise every last child on the globe with polio vaccine and ensure a polio-free world for future generations. Until eradication throughout the world is confirmed, there is a risk of polio returning to New Zealand. New Zealand started immunising against polio in 1961 using the oral polio vaccine, which was replaced in 2002 by the inactivated polio vaccine. Worldwide rates of polio have decreased by 99% since 1988. Polio is still endemic in Afghanistan, Nigeria and Pakistan. Most years, several previously polio-free countries are reinfected due to imports of the virus from endemic countries infecting nonimmune people. Strict hygiene is vital in preventing transmission. Hands should be thoroughly washed after changing nappies or cleaning up diarrhoea or vomit. Vaccination with the oral rotavirus vaccine is the most effective way to prevent infection. There is no specific treatment for rotavirus infection. The most important thing is to prevent dehydration by replacing fluid lost through diarrhoea and vomiting. Rubella is usually a mild disease in children; adults tend to have more complications. The most serious complication of rubella infection is Congenital Rubella Syndrome (CRS), which results when the rubella virus attacks a developing foetus. When infection occurs during the first trimester of pregnancy, up to 85% of infants will be born with some type of birth defect, including deafness, eye defects, heart defects, mental retardation and more. Defects are rare when infection occurs after 20 weeks’ gestation. Rubella vaccine, as contained in the combined measles, mumps, and rubella vaccine, is 95%–96% effective at preventing disease. Those who are not protected after the first dose almost always develop protection after the second dose. The last rubella outbreak in New Zealand was 1995/96 where 306 cases were notified (mostly involving young men). Intensive care treatment is required and recovery can take months. Almost all of the recent cases of tetanus reported in New Zealand occurred in individuals who had not received their primary immunisation course of a tetanus-containing vaccine. In 2010, seven cases of tetanus were notified, the highest number since 1992 and one person died. One case had received a primary course of tetanus vaccines but had not received a booster dose for 15 years. Most years between zero and two cases are notified. Booster doses should also be given to people travelling overseas if it has been more than 10 years since their last dose. To complete the work book assessment visit WIN ONE OF SEVEN $500 CASH PRIZES Page 31

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  • 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
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  • 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
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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

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    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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    »» Irritable Bowel Syndrome GASTR

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    »» Sexual Wellbeing - Contracepti

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    An ENHANCED ELearning Experience As

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    Product Index ANIME LUBRICANT 50ML-

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    Manufacturer’s Index AFT Pharmace

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    Topiramate Actavis Topiramate 25mg,

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