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I T Burns

Publications and source records attributed to I T Burns.

5 recordsLinked to original sources

Haemophilus influenzae type B disease, vaccines, and care of exposed individuals.

Before effective vaccines became available, approximately 1 in every 200 children aged younger than 5 years had invasive Haemophilus influenzae type b (Hib) disease. Hib was the most common cause of bacterial meningitis and other invasive bacterial diseases in this age group. Rapid diagnosis and treatment are essential for Hib meningitis, because the mortality rate is 2% to 5%, even with antibiotic treatment--usually a third-generation cephalosporin, such as cefotaxime or ceftriaxone. Because of the use of Hib vaccines, the incidence of invasive H. influenzae disease in children younger than 5 years old declined by 97% between 1987 and 1997. Recent data indicate that the conjugate Hib vaccines given in infancy can be used interchangeably.

Child, Preschool↗

Child vaccination, part 1: routine vaccines.

Despite the success of the national childhood vaccination program in the United States in decreasing mortality due to vaccine-preventable diseases, vaccination rates remain suboptimal. Contributing factors include the failure to appreciate the hazards of vaccine-preventable diseases, concerns about adverse reactions associated with vaccine administration, and missed opportunities to administer vaccines. The 2 major types of indications for vaccinating children are age and presence of a medical condition that increases the risk of a vaccine-preventable disease. Hepatitis B virus (HBV) infection becomes chronic in 90% of those infected as infants, and 25% of those so infected will die of related chronic liver disease as adults. Routine infant vaccination against hepatitis B has been recommended since 1991. Approximately 69% of infants who develop pertussis require hospitalization. Acellular pertussis vaccines have been licensed for use in infancy. Starting in 2000, the all-inactivated poliovirus vaccine (IPV) schedule is recommended. IPV should eliminate vaccine-associated paralytic poliomyelitis. Pneumococcal conjugate vaccine was licensed in 2000 for routine use on a schedule of 2, 4, 6, and 12 to 15 months. The first dose of measles-mumps-rubella vaccine is now recommended at age 12 to 15 months, simultaneous with varicella vaccine administration.

Child↗

Child vaccination, part 2: childhood vaccination procedures.

In 1996, the Advisory Committee on Immunization Practices (ACIP), the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), and the American Medical Association recommended a well-child office visit at age 11 to 12 years to check vaccination status. Vaccination status should be assessed for varicella, hepatitis B, the second dose of measles-mumps-rubella (MMR) vaccine, and tetanus-diptheria (Td) toxoid if not given in the past 5 years. Adolescent patients should be screened for high-risk conditions indicating the need for influenza, pneumococcal, or hepatitis A vaccines. The Accelerated Immunization Schedule and Minimal Interval Table should be consulted for children who are behind schedule.

Adolescent↗

Breaking the barriers to childhood immunization.

Although about 98 percent of children have received their basic series of immunizations at the time of school entry, only 67 percent of two-year-old children are appropriately immunized. Parental, provider, economic and system barriers to immunization must be overcome if the United States is to achieve the objective that 90 percent of two-year-old children receive the basic vaccination series against the major preventable childhood diseases by 1996. Parents must be educated about the importance of vaccines and the hazards of the diseases they prevent, and they must be given proper information about vaccine side effects and contraindications. Physicians should take advantage of all appropriate patient contacts, including acute office visits for minor illnesses, to keep children's immunizations current. Audits of office records, as well as tracking or reminder systems, improve vaccination rates. The Vaccines for Children Program is intended to remove cost as a barrier to the immunization of some children. The single immunization schedule endorsed by the American Academy of Family Physicians, the American Academy of Pediatrics and the Advisory Committee on Immunization Practices may alleviate confusion about the appropriate time to administer different vaccines.

Child↗

Childhood immunization guidelines: current and future.

Recent additions to the immunization schedule include acellular pertussis vaccine, and hepatitis B vaccine for all infants and selected adolescents. The third dose of OPV is recommended at 6 months of age and the first dose of MMR vaccine at 12 to 15 months. A new vaccine against Haemophilus influenzae type b has been licensed. Children aged 6 months and older with asthma, diabetes, or heart disease should receive influenza vaccine. Children aged 2 years and older with asplenia, immunosuppression, and nephrotic syndrome may be candidates for pneumococcal immunization.

Bacterial Capsules↗