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Vaccination against poliomyelitis: when to do and how much? Plans and Reality In fact, to expel poliomyelitis from our planetThe World Health Organization (WHO) planned by the year 2000. And it would easily have done this if it had not been for the countries of the third world where the pernicious virus, transmitted by airborne droplets, is actively circulating, like influenza, and most importantly through unwashed fruit-vegetables and dirty hands. In the Central Asian republics with the collapse of the Soviet Union, the children were no longer vaccinated, and the defeated infection was again a serious international problem. This spring, in Tajikistan alone, physicians registered 278 cases of poliomyelitis, with 15 of them (mostly in children under 5 years old) with a fatal outcome. In this Central Asian country, the infection came from neighboring India, Pakistan and Afghanistan. It is very common in Africa. There have been many years of special UN programs for vaccinating children. As border infection does not comply, poliomyelitis wanders. In addition, nuts and dried fruits imported from disadvantaged regions may be infected. On products and in water it persists for 2-4 months, moreover, it tolerates drying and freezing well, but is only afraid of boiling, potassium permanganate solution and hydrogen peroxide. Water for children's drinking should be used only boiled or bottled. Vegetables, fruits, berries and greens thoroughly wash with running water and sprinkle with boiling water before giving the baby. Never drink it with milk, bought from the hands: it can be infected with a virus of poliomyelitis (as well as pathogens of many other intestinal infections). True, if milk is boiled, there will be no more risk. A droplet on health The most effective means of preventionPoliomyelitis is considered to be immunization. She is given a crumb at 3 months at the same time as vaccination against pertussis, diphtheria and tetanus. First, do an intramuscular injection of DTP (in the ass), and then drip the child into the mouth from the pipette vaccine against poliomyelitis. It would seem that it's much easier: swallowed - and it's ready! But even with this (child-friendly) way of administering the vaccine, you must follow the rules. You can not, for example, feed crumbs immediately before or immediately after immunization, because he can regurgitate the milk along with the vaccine. Then it will need to be given again! On the story of how the father brought a baby son to a vaccine against polio and did not pay attention to the fact that he had regurgitated the vaccine, and therefore remained unprotected from a dangerous virus, the plot of the last novel of the contemporary writer Alexandra Marinina was constructed. The boy, naturally, soon fell ill and as a result was confined to a wheelchair, and the pope had to pay brutally for his oversight. The story is very vital except for oneThe moment: in the years described by the author (the end of the last century) poliomyelitis, especially in Moscow, was a great rarity. But in the middle of the 20th century, the increase in the incidence of this infection in many countries of Europe and North America gave it the nature of a national disaster: in some cities the incidence was 13-20 people per year per 10 000 population - that's a lot! Illustrative example of the American President Theodore Roosevelt, who ruled the country in a wheelchair. He suffered poliomyelitis at 39, after which he could no longer walk. True, this form of the disease is more typical for young children, and among adults, only those who suffer from immunodeficiency are so hard to tolerate the infection. However, after the creation of vaccines against poliomyelitis and mass immunization of children in developed countries, including the territory of modern Ukraine, this infection was virtually eliminated. Even now, when the epidemiological situation can be complicated because of imported virus, outbreaks of infection do not occur, because our kids are protected from it by vaccination. Council. Be sure to keep a calendar of vaccinations for the baby, marking their dates in it. Please note: the vaccine against poliomyelitis in the first year is administered three times at intervals of 45 days. Try not to exceed this deadline! The protective effect of a single immunization is 50%, and when the child received 3 doses - 95%. If he gets into the remaining 5%, he will transfer the infection in an erased form and certainly will not become an invalid. The main thing is to make sure that your child's revaccination is strictly on schedule: at 18 and 20 months, and then at 14 years. Alive or dead? The vaccine against poliomyelitis is of two types: Containing live attenuated virus (OPV) and dead inactivated (IPV). Which of the two is best? In fact, the first one - it gives more permanent immunity. However, it is extremely rare (one case for 2-3 million), but even such a weakened virus can cause a vaccine-associated disease. To prevent this from happening, the child must be examined by the attending physician before vaccination. The doctor will determine if there are any contraindications to the vaccination. The latter include immunodeficiency and acute conditions accompanied by fever or systemic disorders, as well as malignant diseases (including oncohematology) and neurological disorders that accompanied the previous introduction of the polio vaccine. But in the US, OPV has not been used for more than 10 years. Since 1979, 144 cases of vaccine-associated poliomyelitis have been reported in the country (mainly in patients with AIDS over the age of 18), so doctors decided not to take any more risks, and switched to immunizing the population of IPV. Although it is weaker, it is not capable of provoking poliomyelitis. In American conditions, this step is justified: a baby born in the United States is unlikely to encounter a "wild" type 1 polio virus, and our children, as the events of recent months show, must be protected from it - however, a weak inactivated vaccine For example, babies treated with antibiotics (streptomycin and neomycin) may give anaphylactic reaction of varying degrees of severity in response to IPV from local edema to shock. There is no such thing as a safe vaccine - like drugs in general - but it is important to understand one thing: in case of refusal from vaccination, the child risks much more .10 to 20% of those with poliomyelitis suffer from paralysis, and the death rate in this disease reaches 4% . These figures - A strong argument for vaccination! Another important fact needs to be considered: scientists know three types (professionals usually use the term "strain") of the poliovirus. The aforesaid means that this infection can be picked up and ill once, but three times during life: in the process of recovery from infection, immunity is formed only to one viral strain, and the vaccine protects everyone from it. Correct diagnosis The incubation period of poliomyelitis (period of timeFrom infection with the virus until the appearance of the first clinical symptoms) lasts from 3 to 14 days. And the highest incidence is observed in late summer or early autumn. The infection begins sharply and at first resembles the flu. The classic picture of the flu looks like this: the baby raises the temperature to 38-39 ° C, he becomes sluggish, loses his appetite, starts sneezing and coughing, crying and capricious, because his neck hurts. And if these signs are joined by pain in the tummy and diarrhea (which, by the way, is not always met), Mom starts to think that the baby has a common intestinal infection. In a way, it is true. Physicians do not just refer poliomyelitis to diseases of dirty hands. Observance of hygiene skills significantly reduces its threat. It takes 4-5 days, and the child becomes noticeably better. In the person of the ignorant one gets the impression that the baby has recovered, but in fact such a picture can be called a calm before the storm. The light period lasts a week, and then the temperature rises again, with the paralysis of different muscles developing, most often the legs and hands, but the facial musculature, as well as the intercostal muscles and the diaphragm may suffer - in such cases the baby becomes difficult to breathe. It is very alarming if the virus affects the respiratory and vasomotor centers: in such a situation, the life of a crumb hangs literally in the balance. In some cases, poliomyelitis occurs without paralysis - under the guise of meningitis, and its relatively light forms are masked for a cold or intestinal infection: such erased manifestations of the disease are almost impossible to recognize. They are especially dangerous for others, because they contribute to the free spread of viruses. To treat a child who has fallen ill with poliomyelitis is necessary in the hospital - he needs a bed rest, absolute rest and round-the-clock supervision of specialists. Mom should hope for the best: in half of the cases, as the child recovers, paralysis also occurs. In the complex of restoration activitiesSpecialists pay great attention to massage and physical therapy, as well as sanatorium and resort treatment using sand and mud baths in the cities of Berdyansk and Yevpatoria, as well as radon and hydrogen sulphide (for example, in Sochi). To treat the kid it is necessary all life, however to despair, it is impossible to lower hands in no event. Any improvement should be seen as a victory over the disease, even a very small one. It is possible that over time - and this business is not such a distant future! - doctors will learn how to repair the "breakdowns" caused by the polio virus in neurons, which will save patients from the consequences of this disease. Therefore, one should always hope for the best and try to strengthen this belief in the child. Must, first of all, from Mommy!
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Cijepljenje protiv dječje paralize, kada to učiniti i koliko? Planovi i realnost U stvari, protjerati polio sa planetaSvjetska zdravstvena organizacija (WHO) je planirano do 2000. godine. I to je jednostavno to da nije zemlja trećeg svijeta, gdje je aktivno kruži zlonamjerni virus koji se prenosi kapljicama u zraku, kao što je gripa, i što je najvažnije - preko neopranih voće i povrće, te prljavim rukama. U Središnje Azije republika raspada Sovjetskog Saveza prestala cijepiti djecu, i opet je poražen infekcija je postala ozbiljan međunarodni problem. Ovog proljeća u Tadžikistanu sama, liječnici su registrirane 278 slučajeva dječje paralize, a njih 15 (najčešće u djece mlađe od 5 godina) - kobne. U zemljama središnje Azije infekcija dolazi iz susjedne Indija, Pakistan i Afganistan. To je vrlo čest u Africi. Ima već mnogo godina su poseban program UN-a za cijepljenje djece. Budući da je infekcija ne poštuje granice, polio luta. Osim toga, zaraženi mogu se uvoziti iz ugroženih područja orasi i sušeno voće. Na proizvodima u vodi, te je pohranjen 2-4 mjeseci, što je vrlo tolerantan i sušenja smrzavanjem i kuhanje samo strah, kalij permanganat (otopina kalij permanganata) i vodikov peroksid. Voda za piće bebe, koristite samo kuhano ili bocama. Povrće, voće, bobičasto voće i bilje temeljito čistom tekućom vodom i kuhati prije davanja djetetu. Nikad poite svoje mlijeko kupili s njom: ona može biti zaraženo sa polio virusa (kao i mnogih drugih uzročnika crijevnih infekcija). Međutim, ako se mlijeko kuha, rizik će nestati. Kap zdravlja Najučinkovitije sredstvo za prevencijuPolio imunizacija se smatra. To se provodi mrvice u 3 mjeseca na vrijeme uz cijepljenje protiv hripavca, difterije i tetanusa. Prvo, napraviti intramuskularne injekcije DTP (magarac), a zatim ispustila dijete u usta pipeta polio cjepiva. Čini se da je ono što može biti jednostavnije: lastavica - i gotovi ste! No, čak i sa takvim (udoban za dijete) načinu primjene cjepiva trebaju pridržavati pravila. Ne možete, na primjer, da nahrani mrvice neposredno prije imunizacije i neposredno nakon njega, jer on može bljuju mlijeko s cjepivom. Tada će morati vratiti! Na priče o tome kako grudi-tata doveo svoju malu sina da se cijepiti protiv dječje paralize, te ne obraćajući pozornost na činjenicu da je srygnul cjepiva i stoga nisu zaštićeni od opasnih virusa, izgrađena na parceli od posljednjeg romana suvremene spisateljice Aleksandry Marininoy. Dječak je, naravno, ubrzo razbolio i kao rezultat toga je bio zatvoren u invalidskim kolicima, a papa je teško platiti za svoje pogreške. Priča je vrlo bitno s izuzetkom jednetrenutak: opisano od strane autora u godinama (kraj prošlog stoljeća), dječje paralize, posebno u Moskvi, bio je vrlo rijetka. No, u sredini povećanja XX stoljeća u učestalosti infekcije u mnogim zemljama Europe i Sjeverne Amerike priskrbilo mu je karakter nacionalne katastrofe: u nekim gradovima, incidencija je 13-20 godišnje po 10 000 stanovnika - to je puno! Primjer američkog predsjednika Teodora Ruzvelta, koji je vladao zemljom u kolicima. Patio je polio na 39 godina, a onda više nije mogla hodati. Međutim, ovaj oblik bolesti je više tipičan za malu djecu, ali kod odraslih osoba kao što je teško nositi infekciju, samo oni koji pate od manjka imuniteta. Međutim, nakon uspostave poliomijelitisa cjepiva i masovne imunizacije djece u razvijenim zemljama, uključujući području suvremene Ukrajine, ove infekcije je praktički eliminiran. Čak i sada, kada je epidemiološka situacija može biti komplicirano zbog uvezene virusa, epidemije zaraze ne događa, jer su naša djeca zaštićena od nje cijepljenjem. Vijeće. Svakako treba imati bebe raspored cijepljenja, ističući u njoj njihove datume. Imajte na umu da je polio cjepivo se primjenjuje u prvoj godini tri puta u razmaku od 45 dana. Pokušajte da ne prelazi rok! Zaštitni učinak jedne imunizacije - 50%, a kad dijete dobio 3 doze - 95%. Ako on dobiva u preostalih 5%, to će prenijeti infekciju bio izbrisan i invalidsko sigurno neće. Glavna stvar - da se vidjeti da se vaše dijete booster održana prema rasporedu: u 18 i 20 mjeseci, a potom u 14 godina. Živ ili mrtav? Polio cjepivo je od dvije vrste: sadrži živi atenuirani virus cjepiva) i (OPV mrtvog inaktiviranog (IPV). Koji od ta dva je bolji? U stvari, prvi - to daje trajnije imunitet. Međutim, vrlo rijetko (jedan slučaj po 2,3 milijuna), ali čak i to oslabljena virus može uzrokovati bolest cjepiva povezana. Da bi se to izbjeglo, dijete prije cijepljenja moraju nužno ispitati liječnika. Liječnik će odrediti ako postoje kontraindikacije za cijepljenje. Potonji uključuju imunodeficijenciju i akutnih stanja popraćenih groznica ili sistemske bolesti i maligne bolesti (uključujući oncohematology) i neuroloških poremećaja koji prate raniji uvođenje vakcine. No, više od 10 godina OPV ne primjenjuje se u SAD-u. Od 1979. godine, 144 slučajeva cjepivo protiv dječje paralize povezane su izvijestili u zemlji (uglavnom u bolesnika s AIDS-om starije od 18 godina), pa su liječnici odlučili da je ne riskirati i prebacio na IPV imunizacije stanovništva. Iako je slabiji, ali nije u mogućnosti da se aktiviraju dječju paralizu. U američkim uvjetima takav korak opravdan: beba rođena u SAD-u, vrlo je mala vjerojatnost sudara s „divljim” polio virusom tipa 1 i naše djece, kao što je prikazano na događaje posljednjih mjeseci sigurno ga štiti - no slab inaktivirano cjepivo. . to je dovoljno za to je, usput, također mogu uzrokovati nuspojave, na primjer, djeca koja su liječena s antibioticima (streptomicin i neomicin), može dati odgovor na anafilaktičke reakcije IPV različite jačine. - od lokalne edem Ab šokirati. ni vrhunac sigurna cjepiva - poput droge općenito - ne desi, ali je važno da shvatite jednu stvar: u slučaju necijepljenih dijete u opasnosti od više od 10 do 20% slučajeva dječje paralize pretrpio paralizu, a smrtnost u ovoj bolesti je 4% Ove brojke - .. jak argument u korist cijepljenja treba uzeti u obzir još jednu važnu činjenicu: znanstvenici su poznate tri vrste (profesionalci obično koriste termin „natezanje”) virusa dječje paralize. Gore znači da je ova infekcija može se podići i vratiti ne jednom, nego tri puta u toku života: u procesu oporavka od infekcije će se razviti imunitet na samo jednog soja virusa, cjepivo štiti protiv svih. točna dijagnoza Razdoblje inkubacije dječje paralize (vremensko razdobljeod virusne infekcije u pojave kliničkih simptoma) traje od 3 do 14 dana. A najviša incidencija događa u kasno ljeto - početkom jeseni. Infekcija počinje akutno i isprva nalik gripi. Klasična slika gripe je: temperatura beba raste do 38-39 ° C, postaje bezvoljno, gubi apetit, počinje kihanje i kašalj, plače i glumi jer je imao upalu vrat. Ako su ti znakovi vezani za bol u želucu i proljev (koji je, usput rečeno, ne uvijek dogoditi), mama počinje misliti da je mrvica normalnu crijevnu infekciju. U određenoj mjeri, na način da je. Nije ni čudo da liječnici nose polio bolest prljavih ruku. Higijenski vještine značajno smanjuje njegovu opasnost. Potrebno je 4-5 dana, a dijete postaje mnogo bolje. Osoba neznalica čini se da je beba oporavila, ali u stvari takva slika bi se mogla nazvati mirno pred oluju. Lucid Interval traje tjedan dana, a zatim se temperatura diže opet, paraliza razvijaju različite mišiće, najčešće - noge i ruke, ali mogu patiti i oponašati mišiće i interkostalnog mišiće i dijafragmu - u takvim slučajevima, dijete postaje teško disati. Vrlo uznemirujuće, ako je virus utječe na dišne i vazomotorne centara: u takvoj situaciji mrvice života visi na tankoj niti. U nekim slučajevima, polio se javlja bez paralize - pod krinkom meningitisa i njegove relativno blage oblike prikriven kao hladno ili crijevne infekcije: Takve su izbrisani simptomi bolesti je gotovo nemoguće otkriti. Oni su posebno opasni za druge, jer promovirati slobodan protok virusa. Priuštite bolesna beba treba polio u bolnici - on treba mirovanje, apsolutni odmor i okrugli specijalista sat nadzora. Mama bi trebala nadati se najboljem: na pola puta kao dijete oporavi proći i paraliza. Kompleks aktivnosti restauratorskimStručnjaci platiti mnogo pozornosti masažu i fizikalnu terapiju, kao i liječenje Sanatoriju pomoću pijesak i mulj kupke u gradovima i Berdjansk Yalta, kao radona i vodikovog sulfida (na primjer, u Sočiju). Treat beba će imati cijeli život, ali ne očajavajte, ne možete odustati u svakom slučaju. Svaki napredak treba gledati kao na pobjedu nad bolesti, čak i vrlo male. Moguće je da s vremenom - a to nije tako dalekoj budućnosti! - liječnici uče za popravak „oštećenja” uzrokovana virusom dječje paralize u neuronima, što će osloboditi pacijenta o posljedicama ove bolesti, tako da uvijek treba nadati se najboljem i pokušati ojačati vjeru u djeteta pozitivan stav je posebno potrebna u teškim situacijama i početi .. moraju, prije svega, od mame!