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Worms in kids

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Few of my friends are always  worried about their child's growth. Natasha always keeps me asking why her daughter is not gaining weight and why she falls sick again and again.  The worms are parasites which feed off the host’s body and eventually result in malnutrition, affecting the healthy growth of the child.  Worms may get entry into abdomen and create health problems .          Though all age groups can get worms, kids are more susceptible. Worms in abdomen can affect the appetite and ultimately growth of a child. When a child is not eating properly we assume he is showing tantrums or too busy in playing and ignore it but it can be worms those are troubling the stomach. When to suspect worms? Itchy bottom, which is usually worse at night Redness around the bottom area Restlessness due to itching Difficulty in falling asleep Visible worms – small, white and 8-13 mm long (often mistaken for bits of toilet paper!) ...
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Vaccination and FAQs

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Vaccination and immunization both terms are used interchangeably. The body's ability to protect itself from infectious diseases is called as immunity. 

 Immunization is a process whereby a person is made immune or resistant to an infectious disease, typically by administration of vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or disease. Vaccination is a preventive tool from life threatening infections.

      The government of India runs the National immunization programme free of cost . The vaccines which satisfy following criteria are included in programe:
epidemiological relevance, immunological appropriateness, technical feasibility, economical viability and sociocultural acceptability. 

Age
Vaccine
Disease prevented
Note
Birth
BCG



OPV-Zero
Hepatitis-B-1
Tuberculosis

Polio
Hepatitis-B
If missed at birth, can be given within first 2 weeks after birth. 
6 weeks
OPV-1 +IPV-1

 DPT-1 +
Hepatitis-B-2 +
Hib-1
Or
 Pentavalent-1
Polio

 Diptheria,Pertusis,Tetanus

Haemophilia B
OPV alone if IPV can not be given
10 weeks
OPV-2 + IPV-2
DPT-2 +
Hib-2
Or 
Pentavalent-2

OPV alone if IPV can not be given
14 weeks
OPV-3 +IPV-3

Hepatitis-B-3 +

Hib-3
Or
 Pentavalent-3

OPV alone if IPV can not be given
Third dose of Hepatitis B can be given at 6 months of age
9 months
Measles
Measles

15-18 months
OPV-4
DPT Booster-1
MMR-1


Measles,Mumps,Rubella

2 years
Typhoid
Typhoid
Revaccination every 3-4 years
5 years
OPV-5
DPT Booster-2
MMR-2



Second dose of MMR can be given at any time 8 weeks after first dose
10 YEARS
Tdap

HPV
Tetanus and adolescent pertusis
Cervical and anal cancer


Only for girls, 3 doses at 0,1-2 and 6 months

Vaccines that can be given after discussion with parents
≥ 6 weeks
Pneumococcal conjugate vaccine
Pneumonia
3 primary doses at 6,10 and 14 weeks,followed by a booster at 15-18 months
≥ 6 weeks
Rotaviral vaccine
Gastroenteritis
2/3 doses (depending on brand) at 4-8 weeks interval
≥15months
Varicella vaccine
Chicken pox
Age less than 13 years- one dose
Age more than 13 years-2 doses at 4-8 weeks interval
≥18 months
Hepatitis A vaccine
Jaundice
2 doses at 6-12 months interval




  • In addition to routine OPV doses, the recommended 'Pulse OPV doses' are also mandatory.
  • Apart from earliest age indicated, MMR, typhoid, varicella and hepatitis A vaccines can be given at any age, relevant to local epidemiology.
  • Pentavalent vaccine includes Diptheria, Pertusis, Tetanus, Hep B and HIB vaccine.


FAQs :


 General:

1) Injection site should be massaged or not?

Do not rub the site vigorously. Gentle pressure for 1-2 minutes is enough.

2) What to do for sore injection site?

Place a wet cloth in potable water for 10 minutes. Do this 3 to 4 times a day. Do not use ice for fomentation.

BCG vaccine:


 1) What if the scar doesn't develop after BCG vaccine?

Normally it takes 10-12 weeks to develop scar. But non formation of scar does not mean that BCG has not been taken. in 10-12% infants the scar may not form at all. Repeat dose can be given after 10-12 weeks , but even after this repeat dose scar does not form then there is no need to repeat BCG  for 3 rd time.

 2) Who all can receive BCG vaccine?

 Anyone under age 16 yrs and under risk for developing TB can receive BCG vaccine.

 Polio vaccine:

1) Is it necessary to give OPV every time during pulse polio immunisation? 

Yes, as there won't be any immunological overload. The PPI doses are given with the objective of interrupting the transmission of wild polio virus.

2) Why OPV can't be given to older kids?

 In India upper limit for OPV is upto 5 years which is based on epidemiology of polio incidence. 

 3) What is the use of IPV vaccine if we are already giving OPV?

 IPV is inactivated polio vaccine , it gives additional protection from polio.

 4) Is it okay to skip OPV if baby has given IPV?

 No IPV does not substitute OPV. Both of them has to be given.

 Hepatitis B vaccine:


 1)  What if the child is late for subsequent doses?

 The normal course of Hep.B vaccine is at 0, 1 and 6 months. If the gap between first and second dose is less than 6 months and that between 2nd and 3 rd dose is less than 1 year, then there is no need to restart the course. But the doses should not be delayed as child remains unprotected till the full course is completed.

 2) What is the upper age limit for Hep.B vaccine?

 There is no age limit , anyone can have it at  anytime of  life but response to vaccination is low after 40s. 

 3) Is any booster dose required ?

 No booster dose is required as effect of vaccine is same even after several years of vaccination.

 DPT/DT/TT vaccine;

 1) Should TT be given following every trauma?

 No, It is not required. For clean, minor wounds it is okay till 10 years and for dirty, infected wounds it is required if 5 years from last dose.

 MMR vaccine:

 1) Why is it not advised to take MMR in pregnancy?

  There is a theoretical risk to the developing foetus of Iatrogenic congenital Rubella syndrome. If someone is planning for baby there should be a gap of 3 months after the MMR vaccination.

 Varicella vaccine:

1) What is the problem of getting chicken pox in adolescent or adults?

 Chicken pox has been a disease with peak age at 5-9 years, or school going preadolescent children. As compared to children, when adults develop chicken pox, it is more severe. Fever is higher,rash is also more severe. Complications like pneumonitis, encephalitis are more common in adults than in children.

 2) What is the effect of chicken pox on pregnancy?

 It is rare to develop chicken pox in pregnancy as most of the women get it in childhood. If it occurs in 1st half of pregnancy, it will lead to fetal varicella syndrome characterized by scarred skin, limb atrophy, ophthalmic anomalies etc. 

 HPV:


 1) What is the role of HPV vaccine in adolescent girls and women aged upto 45 years?

 HPV is found to be safe and effective against cervical cancer. It should be given as early as 10 yrsof age before sexual activity is established, since sexual exposure can cause micro- epithelial abrasions in vaginal epithelium favouring human papilloma infection.









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