11/26/2012
RED BOOK 2012 UPDATE
Financial Disclosure
Carol J. Baker, M.D.
In the past 12 months I have had
Professor of Pediatrics, Molecular Virology and Microbiology
no financial conflicts of interests to disclose that pertain to the topics
Bradford Infectious Diseases Symposium Kansas City November 15, 2012
in these lectures
Texas Children’s Hospital
1st Red Book: 1938
Objectives
Gain knowledge of some changes found in the Red Book 2012
Review information in a new chapter
Become skilled at diagnosing g g and managing g g congenital syphilis
Know how to use interferon-gamma release assay (IGRA) for diagnosis of tuberculosis
Learn the most recent recommendations for influenza vaccines
• • • • • • • • • • •
Diphtheria Epidemic meningitis Epidemic parotitis Measles Pertussis Poliomyelitis Rabies Tetanus Typhoid fever Varicella Variola
• • • • • •
Common cold Epidemic encephalitis Erysipelas Scarlet fever Staphylococcal infections Tuberculosis 18 diseases 8 pages No figures, tables, photos No websites
29th Red Book: 2012
Antimicrobial Agents
In 1938 sulfanilamide was the only agent to treat GAS infections, epidemic meningitis and pneumococcal pneumonia
5 sections, 882 chapters, numerous tables and figures, 13 appendices, > 2,500 photos and numerous websites
IIn 2012 there th are 71 pages describing d ibi principles of appropriate use, drugs for bacterial, fungal, viral and parasitic diseases with dosages and dosing intervals
16 vaccines recommended for infants, infants children and adolescents
Two of these vaccines prevent cancer (Hepatitis B and Human Papillomavirus)
15 new vaccine recommendations made in 2011 by ACIP; all included in the Red Book 2012
Guidance for use of tetracyclines and fluoroquinolones in pediatric patients
1
11/26/2012
Vaccine Updates
Red Book 2012: Sections
3. Summaries of infectious diseases 4. Antimicrobial agents and related therapy
Grave
Range: 2 to 7 days; g y; Ph Phase usually 3 to 5 days
Usually 3 to 5 days
Febrile Phase
Day of Illness
General (Section 1)
Age-specific schedules Health care personnel
Booster dose High-risk infants and toddlers
Mosquito-borne transmission by A. aegypti was reported in 1903; viral etiology in 1906
Since WWII dengue transmission has intensified and now is leading cause of febrile illness in travelers returning from Carribean
Incubation period: 8-12 days
Diagnosis: serology (IgM not + until day 4-5)
‐2 0 2 4 6 8 10 12 * Typically uncomplicated DHF/DSS lasts for 10 to 12 days
Booster dose of vero cell culture vaccine
Dengue Virus: Epidemiology, Incubation Period and Diagnosis*
Convalescent Phase
Viremia
Males and females
Laboratory evaluation revealed H/H of 11/34, WBC 2.1 (23 N, 18 B, 30 L, 20 M, 3 E, 1 baso, 5 metas), platelets 61K. AST and ALT were 550 and 421, respectively. Albumin was 2.2, Na 133, K 4.5, Cl 100, CO2 18, BUN 48, creatinine 1.1.
Range: 3 to 14 d; usually 4 to 7 days
Incubation
On examination, he was hypotensive and had mild cyanosis, he had petechiae on his arms without other rash, bilateral rales, hepatomegaly, abdominal distention, mild anasarca and tenderness with extreme pain “all over”.
Clinical Course of Dengue
Bite
JEV
Two days later, the pain became worse and he had onset of chills, emesis and a macular rash on the trunk.
New dengue chapter GBS infant management algorithm Diagnosis of treatment of syphilis algorithm Sexually transmitted infections therapy Tuberculosis testing (plus IGRAs) Stages of hepatitis B virus infections Vaccine updates: HPV, Influenza (egg allergic children), meningococcal, pneumococcal, Tdap
1 to 3 days; usually