2017 HCHB_digital

Childhood Diseases and Immunisation (continued)
Category Description Symptoms Refer to a doctor
CHICKENPOX
Chickenpox is a common, contagious disease caused
by the varicella zoster virus. From 1 July, 2017, varicella
vaccine (Varilrix) is funded on the NIS for all children
at 15 months old, and a catch-up dose for previously
unvaccinated children at 11 years old. The vaccine is also
funded for children and adults with reduced immunity or
at very high risk of contracting the disease (two doses
recommended).
Approximately 50,000 cases of chickenpox occur in New
Zealand each year. People who have had chickenpox
are also at risk of developing shingles later in life (see
Shingles).
Initially, fever, headache, tiredness or sore throat
for up to three days before the rash appears
(adults may develop a flu-like illness). The rash
begins as red itchy spots, usually in crops of three
to five that eventually become blisters. Most
commonly begin on the head and neck before
moving to the trunk and limbs. May also appear
inside the mouth or on the genitals. Blisters crust
over after three to five days and are extremely
itchy. Number of blisters can range from a few to
several hundred. Secondary bacterial infection is
common.
If the blisters become infected.
If there are spots in the eyes, ears, or mouth.
If the child has another illness affecting their
immune system.
If the child seems particularly unwell.
If the diagnosis is uncertain.
DIPHTHERIA
Diphtheria is a serious, often fatal disease caused by
Corynebacterium diphtheriae. Diphtheria is included in
the NIS as part of the Infanrix-hexa (diphtheria, tetanus,
pertussis, polio, hepatitis B, Haemophilus influenzae type
b) vaccine. It is also a component of some other vaccines
(ie, Boostrix, ADT booster, Infanrix-IPV).
Diphtheria is extremely rare in New Zealand but is
endemic in many developing countries.
The bacteria cause mucous membrane
inflammation so the most common symptom is a
sore throat, hoarseness, painful swallowing and
the development of a bluish-greyish membrane
that covers the inside of the throat and tonsils.
Other symptoms include a nasal discharge, fever
and chills. Some people have no symptoms.
Anybody with suspected diphtheria as the
diphtheria toxin can affect the lungs, heart,
peripheral nerves, and kidneys. Fatality rate
is 2%–10%.
HAEMOPHILUS
INFLUENZAE TYPE B
Haemophilus influenzae type b (Hib) is caused by a
bacterium. Humans are the only hosts of these bacteria
and children less than five years are especially at risk. Hib
(Hiberix replaces Act-Hib from 1 July, 2017) is funded on
the NIS for all children aged less than five years.
Before immunisation, most common presentations
were meningitis and epiglottitis.
Meningitis tends to occur in younger children aged
less than three years. Symptoms include fever, loss
of appetite, vomiting, bulging fontanelle (babies),
drowsiness, light sensitivity.
Epiglottitis usually occurs in children aged two to
four years. Symptoms include difficulty breathing
and swallowing and drooling. May extend neck
and stick tongue out. Rapid onset.
Anybody with suspected Hib infection.
Hospitalisation may be required.
HEPATITIS A
Hepatitis A is a virus that is more common in areas with
low living standards, poor hygiene and high population
density. In countries where the disease is endemic,
almost all adults are immune. Several cases of hepatitis
A infection were reported in New Zealand in 2015 linked
to imported frozen berries. Havrix and Havrix Junior
are funded on the NIS for transplant patients, children
with chronic liver disease, and close contacts of known
hepatitis A carriers.
In infants and preschool children most infections
are either asymptomatic or cause mild non-specific
symptoms without jaundice.
Adults typically develop symptomatic disease (eg,
jaundice, weight loss, abdominal discomfort, dark
urine), the severity of which increases with age.
Anybody with suspected hepatitis A
infection.
HEPATITIS B
Hepatitis B is a very infectious viral disease that infects
liver cells. It is the host’s immune response that leads
to the death of the infected liver cell. Two strengths of
HBvaxPRO are funded on the NIS for people meeting
certain criteria.
Symptoms of acute hepatitis B include nausea
and vomiting, jaundice, dark urine, pale faeces,
tiredness, anorexia, stomach and muscle aches and
fever. Some people are infected with the virus but
do not show symptoms for a long time (chronic
hepatitis).
Anybody with suspected hepatitis B.
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Page 26 HEALTHCARE HANDBOOK 2017-2018 Common Disorders