Childhood Immunization Schedule: Why we immunize • Diphtheria Toxin -> URT inflammation causes pseudomembrane with hardened exudates -> Sore throat with pharyngeal erythema, fever & lymphadenopathy; severe swelling causes stridor -> Sore throat with pharyngeal erythema, fever & lymphadenopathy; severe swelling causes stridor • Tetanus Toxin -> Spores release neurotoxin causing disinhibition of excitatory neurons -> Trismus, tachycardia, cardiac arrhythmias, seizures; muscle spasms lead to apnea & dysphagia • Pertussis Metabolites -> Transmitted via droplets, bacterial metabolites induce injury to URT -> Vigorous coughing, inspiratory whoop; respiratory failure, pneumonia & seizures are late findings • Polio Virus -> Fecal-oral route, virus replicates within CNS causing MN death -> Muscle weakness & asymmetric reduction in tone; severe cases cause quadriplegia & respiratory failure • Haemophilus Influenza B -> Droplet secretions invade URT & via hematologic spread attack meninges -> Fever, malaise, lethargy, poor feeding, SOB, N/V, stiff neck, altered LOC; septic arthritis & osteomyelitis • Meningococcal Toxin C -> N. meningitidis endotoxin induces vascular & CNS invasion via URT infection -> Sudden onset of fever, neck stiffness, altered LOC myalgia & hemorrhagic rash; symptoms of shock • Mumps Virus -> Viral replication within GI and URT causes CNS and hematologic infection -> Parotid swelling, myalgia, anorexia; sensorineural hearing loss, meningitis, orchitis & encephalitis in severe cases • Measles Virus -> Attacks respiratory mucosa & disseminates in blood and lymph -> Koplik's spots, conjunctivitis, coryza fever, rhinorrhea, cough; pneumonia occurs In severe cases • Rubella Virus -> Maternal viremia causes fetal blood vessel collapse leading to organ ischemia -> Congenital anomalies: hearing loss, cataracts, cardiac defects, IUGR, meningoencephalitis • Varicella-Zoster Virus -> Hematogenous spread causes viremia that persists as skin lesions -> Vesicular & pruritic rash, fever, pharyngitis; pneumonia, encephalitis and cellulitis in severe cases • Streptococcus pneumoniae -> Bacterial evasion techniques cause widespread infection -> Fever, cough, malaise, tachypnea, otitis media; pneumonia, meningitis & bacteremia are late findings • Hepatitis B Metabolites -> Inflammation causes hepatocellular necrosis & degeneration -> Mild non-specific viral symptoms with anorexia, nausea, jaundice and RUQ pain • Human Papillomavirus -> Transmitted by direct contact & infects basal layer of epithelium -> Usually asymptomatic, if symptomatic can have genital warts, abnormal vaginal bleeding or unusual discharge #Childhood #Immunization #peds #pediatrics #pathophysiology
