2017 HCHB_digital

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.
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