What schedule do you recommend for a child who is not immunized?

The schedule is exactly as in infants. This means that if a child comes to us under the age of six, we can give this child BCG, DPT and polio on the first day of the visit. Every month DPT and polio is to be repeated for the next two months. The Smallpox vaccination can be given next. If a child comes after the age of six, then it should be DT and NOT DPT as explained above, but the rest of the schedule remains the same.

Tell us where we/can get immunizations for our baby.

Immunizations can be done in any big hospital, MCH centres or primary health centres. Most of these have various immunizing agents. The Polio vaccine may not be available in some places but in most centres where deep freeze or fridge is available, polio may also be available.

Does immunization provide 100% protection?

Well, immunization may not provide 100% protection but it does provide at least 90% protection for most of these diseases. The reason why I say 90% is because if the child is incubating, the protection may not be complete. At the worst, the child may have the diseases in a very mild form which may not affect the child's health, on the. other hand if immunizations are done early enough as advised, the protection is nearly 100%. Even for the polio vaccine, where it is said that immunized child might have the disease, I may assure you that it usually is not true if the immunizing agent was well stored, and given well. Further many viruses may cause similar pattern of diseases and unfortunately we do not have a vaccine against them at present.

Test “Immunization”

Variant 1.

I. Choose the sentences corresponding to the contents of the text:

1. a) Immunization against measles and whooping cough is advisable in the first year of life.

    b) The doctor suggests to immunize one year old babies only against Smallpox and Tuberculosis.

2. a) There exist no contraindications for immunization.

b) There are some contraindications for immunization.

3. a) Smallpox vaccination is not advisable to very small babies.

    b) It is not advisable to vaccinate a child with skin disorder against Smallpox.

4. a) BCG vaccination is recommended to do on the left arm.

   b) To use left or right arm for BCG vaccination makes no difference.

5. a) If a discharging sinus forms after a BCG injection, the lymphatic nodes should not be touched.

b) If there is an abscess after a BCG injection, surgical treatment is not recommended.

6. a) Smallpox vaccination should be repeated if it is possible.

   b) Smallpox vaccination should be repeated if it is negative (if there is no successful scar).

7. a) Polio vaccination must be repeated several times for continued protection.

b) Usually Polio vaccination is effective after the first or the second Booster.

8. a) BCG vaccination should be repeated if Mantoux was negative.

b) If Mantoux reaction was positive BCG vaccination must be given.

9. a) German measles immunization should be done in the last months of pregnancy.

b) German measles immunization must be done early in childhood.

10. a) The immunization may provide 100% protection if it is done early enough as advised.

b) The protection may be complete if the child is incubating.

II. Find the argument from “B” for the statement from “A”:

А                                                                    B

1. The doctor didn’t advise to give the         1. A discharging Sinus formed

child Polio drops                                          after BCG vaccination

2. The child needed surgical treatment          2. The child has had an infection

                                                                     before the reaction to BCG

3. BCG inoculation reaction was very          3. The child was suffering from

marked                                                          cold, cough and diarrhea

4. The Smallpox vaccination was repeated            4. Pertussis vaccine may be

every six weeks and later every three                     dangerous

years

5. It is not advisable to give DPT after         5. Protection against the disease

six years of age                                             is provided only for six months

6.The typhoid vaccine should be given         6. It was ineffective the first

just before summer                                       time

III. Match English and Russian equivalents:

1. on the other hand   1. хуже всего

2. similar pattern       2. сам собой

3. disease pattern       3. с другой стороны

4. as advised              4. структура заболевания

5. as regards              5. подобная модель

6. on (its) own           6. убедиться

7. take longer             7. занять больше времени

8. continued protection 8. длительная защита

9. at the worst            9. что касается

10. make it certain     10. по совету

Variant 2.

I. Choose the sentences corresponding to the contents of the text:

1. a) The order of immunization must depend upon the disease structure.

b) The order of immunization depends on the availability of vaccines.

2. a) Immunization is advised when the child is unhealthy.

b) Immunization is not advisable when the child is sick.

3. a) As a rule, there are no complications after Potio vaccination.

b) Polio vaccinations are usually accompanied by high temperature, redness and swelling.

4. a) BCG vaccination always heals without any complications.

   b) Sometimes BCG vaccination may result in enlargement of glands in the axillae.

5. a) Nothing should be applied on the BCG vaccination site, if there is discharge from it.

b) If the BCG vaccination site doesn't heal, apply some medicine or powder on it.

6. a) The discharging Smallpox vaccination site should be treated with spirit and powder as often as possible.

b) When the smallpox vaccination site is discharging, it is necessary to apply some spirit two-three times a day and to clean it with cotton.

7. a) A small vesicle appears at the site of BCG injection three weeks later.

b) Usually there is no reaction on the BCG vaccination site.

8. a) Vesicle is a small blister filled with opaque material.

b) Vesicle is a small blister filled with clear fluid.

9. a) Pertussis vaccination is not advisable after the age of six.

b) Whooping cough vaccination may be given at any age.

10. a) Typhoid vaccination as a routine is not advised.

   b) To save the child from typhoid it is necessary to vaccinate him before the onset of summer every year.

   II.   Find the argument from “B” for the statement from “A”:

А                                                                    В

1. Rubella immunization should be done      1. If the child is incubating, the

in early childhood                                         protection may not be complete

2. Immunization may not provide 100%      2. Being exposed to German

protection against diseases                           measles in pregnancy, the mother

                                                                      may transfer it to her child

3. The child was not immunized                   3. He had got Smallpox

                                                                      vaccination

4. The infant developed a high                               4. He had diarrhea

temperature

5. The vaccinated site became red and          5. He had got DPT vaccination

swollen

6. Lymphatic glands in the axillae were        6. This was a result of the BCG

enlarged                                                        vaccination carried out

III. Match English and Russian equivalents:

1. exposed              1. обычный, распространенный

2. ill                        2. беременная

3. common              3. врожденный

4. available             4. подвергнувшийся контакту

5. complete             5. неблагоприятный, болезненный

6. successful           6. полный, завершенный

7. pregnant             7. имеющийся в наличии, доступный

8. ordinary              8. обыкновенный, ординарный

9. congenital           9. cлепой

10. blind               10. успешный

Variant 3

I. Choose the sentences corresponding to the contents of the text:

1. a) One can protect the infant against a number of infections by immunization.

b) Immunization against every possible infection should be carried out within the first year of life.

2. a) Immunization should be done under medical advice if a child is not healthy.

b) Immunization is never done if the child is not healthy.

3. a) As a rule, DPT can’t give any complications.

b) With DPT the infant may have a high temperature.

4. a) There could be no complications after a Smallpox vaccination.

   b) There could be many complications after a Smallpox vaccination if the vaccinated site is not cared for well.

5. a) The pustule after a Smallpox vaccination bursts on the 7th day.

b) The pustule bursts on the 9^th-10^th day.

6. a) The Polio vaccine can be kept under different conditions in various health centres.

b) The Polio vaccine can only be kept frozen.

7. a) Ice-cream can carry Typhoid bacilli and it is necessary to protect children from Typhoid fever in summer.

b) Ice-cream must be prohibited from eating in summer.

8. a) A baby may be born with congenital abnormalities if his mother has been exposed to Rubella in early pregnancy.

b) If a pregnant woman is exposed to Rubella, he is likely to become blind or crippled.

9. a) Many viruses may cause the pattern of the disease similar to poliomyelitis but there is no vaccine against them.

   b) Many viruses cause various patterns of poliomyelitis, that is why there is no vaccine against it.

10. a) On the first or second day after a BCG vaccination a small vesicle appears at the site of injection.

b) A vesicle is formed at the vaccinated site about three weeks after a BCG vaccination.

   II.  Find the argument from “B” for the statement from “A”:

А                                                                    В

1. The mother of the vaccinated child                     1. The vaccination had been

decides to see the doctor                               carried out in a centre where the

                                                                      vaccine had not been stored in a

                                                                      deep freeze

2. A scar formed at the site of injection        2. He had been given Polio

                                                                      vaccination

3. The child was not advised DPT                3. The enlarged glands of the

                                                                      axillae did not resolve at the end of

                                                                      6 weeks

4. The baby was not fed for half an              4. The girl was 7 years old

hour after his visit to the doctor

5 . The Polio vaccination proved ineffective     5. The boy had been BCG

                                                                      immunized three weeks before

6. The Typhoid vaccination didn’t work      6. The girl had been vaccinated in

in this child                                                   December, and exposed to the

                                                                      disease in August

III. Match the Russian and English equivalents:

1. come down         1. поражать

2. keep down          2. обеспечивать, снабжать

3. suggest               3. развиваться

4. develop              4. снижать температуру

5. need                   5. снижаться (о температуре)

6. depend               6. предлагать

7. discharge            7. нуждаться

8. provide              S. выделяться

9. carry                  9. зависеть

10. affect                10. нести, переносить

 

Самостоятельная работа № 4

Kawasaki Disease

Exercise 1

Read the text and put the following points of the plan in proper order:

1) the causative agent of Kawasaki disease

2) its diagnosis

3) its prevention

4) the epidemiology of Kawasaki disease

5) the definition of Kawasaki disease

6) the risk of heart involvement

7) the affected patients

8) the complications after Kawasaki disease

9) the acute phase of the disease

10) its treatment

11) the clinical manifestations of Kawasaki disease

Exercise 2

Make up the summary of the text using the plan.

Kawasaki Disease

Description. Kawasaki disease (mucocutaneous lymph node syndrome) is a children’s illness characterized by fever, rash, swelling of the hands and feet, irritation and redness of the whites of the eyes, swollen lymph glands in the neck, and irritation and inflammation of the mouth, lips and throat. These immediate effects of Kawasaki disease are rarely serious: however, long-term heart complications result in some cases and can be seen as early as two weeks after the onset of the disease.

Named after Dr. Tomisaku Kawasaki, a Japanese pediatrician, the disease has probably been in existence for a long time, but was not recognized as a separate entity until 1967. The incidence is higher in Japan than in any other country. In the United States it is more frequent among children of Asian-American background, but can occur in any racial or ethnic group. The disease is not common, and its incidence in the United States has not been determined. In recent years, it has tended to occur in localized outbreaks, most often in the late winter or spring, but is seen year-round. Kawasaki disease almost always affects children; most patients are under 5 years old, and the average age is about 2 years. Boys develop the illness almost twice as often as girls.

The heart may be affected in as many as one of five children who develop Kawasaki disease. Damage sometimes occurs to the blood vessels that supply the heart muscle (the coronary arteries) and to the heart muscle itself. A weakening of a coronary artery can result in an enlargement or swelling of the blood vessel wall (an aneurism). Infants less than 1 year old are usually the most seriously ill and are at greatest risk for heart involvement.

The acute phase of Kawasaki disease commonly lasts 10 to 14 days or more. Most children recover fully. The likelihood of developing coronary artery disease later in life is not known, and remains the subject of medical investigation.

Cause. The cause of Kawasaki disease is unknown. It does not appear to be hereditary or contagious. Because the illness frequently occurs in outbreaks, an infectious agent (such as a virus) is likely the cause. It is very rare for more than one child in a family to develop Kawasaki disease.

Signs and Symptoms. Fever and irritability are often the first indications of the disease. Fever ranged from moderate (101° to 103° F) to high (above 104° F). The lymph glands in the neck may become swollen. A rash usually appears on the back, chest, and abdomen early in the illness; in infants it may develop in the groin. In some cases, the rash may spread to the face. The rash appears as poorly defined spots of various sizes, often bright red. Fever continues to rise and fall, sometimes for as long as 3 weeks. Bloodshot eyes (conjunctivitis) may develop, and the eyes can become sensitive to light.

The child’s tongue may be coated, slightly swollen, and resemble the surface of a strawberry, sometimes referred to as “strawberry tongue”. The lips may become red, dry, and cracked; the inside of the mouth may turn darker red than usual.

The palms of the hands and soles of the feet often become red, and hands and feet may swell. Occasionally, a stiff neck will develop. Abdominal pain and diarrhea occur in some children.

When the fever subsides, the rash and swollen lymph glands usually disappear. The skin around the toenails and fingernails often peels painlessly, usually during the second or third week of illness. The skin on the hands or feet may peel in large pieces.

The knees, hips, and ankles may become swollen and painful. Occasionally, joint pain and swelling persist after other symptoms have disappeared, but permanent joint damage does not occur. Lines or ridges on fingernails and toenails, formed during the illness, may be seen for weeks or months.

Diagnosis. The diagnosis of Kawasaki disease cannot be made by a single laboratory test or combination of tests. Physicians make the diagnosis after carefully examining a child, observing signs and symptoms, and eliminating the possibility of other diseases that are similar. Blood tests are used to detect mild anemia, an elevated white blood cell count, and an elevated sedimentation rate, indicating inflammation. A sharp increase in the number of platelets, a major clotting element in blood, may also be found. Urine tests may reveal the presence of protein (albumin) and white blood cells. An irregular heartbeat and evidence of heart muscle involvement can be detected by electrocardiogram (ECG). An echo-cardiogram (or echo) is used to look for possible damage to the heart or to the coronary arteries that supply blood to the heart muscle. Other blood tests or diagnostic studies may be requested by the physician.

Complications. The possibility of heart and coronary artery involvement makes Kawasaki disease unpredictable, but these problems usually are not serious and disappear with time. However, on occasion aneurisms of coronary or other arteries of the body can occur, and some may require medical or surgical treatment. Very rarely, complications may include heart attacks, which can be fatal.

Treatment. Kawasaki disease is frequently treated in the hospital, with a stay from a few days to a few weeks. Some children may receive care at home without hospitalization.

Since the cause of Kawasaki disease is unknown, no specific medication is available. Aspirin is often used to reduce fever, rash, joint inflammation, and pain, and to prevent formation of blood clots. Recent studies from Japan and the United States suggest that another medication, intravenous gamma globulin, may decrease the risk of developing heart disease when given early in the illness. A major goal of treatment both in the hospital and at home is to make a child as comfortable as possible while the illness runs its course.

If tests reveal an aneurysm or other heart or blood vessel abnormality, repeated echocardiograms or other tests may be necessary for several years following recovery from Kawasaki disease. Almost all children return to completely normal activity after the acute phase of the illness.

Prevention. There is no known prevention for Kawasaki disease. Approximately one child in a hundred may develop the disease a second time. Parents should know that nothing they could have done would have prevented the disease.

Exercise 3

Lexical test. Fill in the gaps using the following words:

1. assessment, 2. lesions, 3. alternative, 4. features, 5. treatment, 6. course, 7. infectious, 8. to examine, 9. opportunity, 10. experienced, 11. acute, 12. to determine, 13. physical, 14. illness, 15. thus, 16. intravenous.

KD (Kawasaki Disease)

Kawasaki disease is an 1... vasculitis of infants and children that results in coronary artery 2... in 15% to 25% of those affected. 3... of KD with aspirin plus high 4... doses of gamma-globulin, instituted within the first 10 days of 5... reduces cardiovascular sequelae, 6... it is highly desirable to identify patients with KD early in the 7... of their illness. In the absence of a definitive laboratory test result, the diagnosis of KD is dependent on the 8... of clinical features that may be mimicked by other disease processes. Indeed, the differentiation of KD from other 9... and immunologic diseases constitutes a major challenge for the practitioner. The purpose of our study was 10... those diseases that most closely mimic KD in the United States and 11... the details of the history, 12... examination, and laboratory investigation that influenced 13... clinicians to exclude the diagnosis of KD. We also used this 14... to compare certain epidemiologic 15... of KD patients and of those patients referred for evaluation of possible KD in whom 16... diagnoses were established.

Самостоятельная работа № 5

RSV

Text Key Concepts.

Mark the number of the text that gives the answer to the questions below: