2012. Financial Disclosure. Objectives

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 Vir...
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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 

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