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Sunday December 9, 2007
POSITIVE PARENTINGBy DR MUSA MOHD NORDIN
Early vaccination against pneumococcal disease means lifelong protection for your child and peace of mind for you.
YOUR baby has been feverish all morning. He is refusing to feed, is unusually drowsy and there is a strange stiffness in his neck and legs.
You rush your baby to the hospital where the doctor does a careful physical examination and checks his blood for evidence of an infection. The diagnosis is confirmed: your baby has meningitis – an inflammation of the lining of the brain or spinal cord. He is hospitalised for immediate medical treatment.
Should treatment have been delayed, your baby could have suffered permanent hearing loss, paralysis, brain damage or even death.
Meningitis is a terrifying experience and the most common bacterial cause in Malaysia is pneumococcus.
What is pneumococcus?
Pneumococcus is also known as the bacterium Streptococcus pneumoniae. It is responsible for pneumococcal disease (PnD), a highly contagious condition that easily spreads among children by droplets released into the air through sneezing or coughing.
Pneumococcus can cause not only meningitis, but other potentially deadly illnesses such as pneumonia, bacteraemia and middle ear infection.
Is PnD treatable?
Yes it is, provided it is detected early and your child gets immediate medical attention. PnD develops very quickly and any delay in treatment can lead to permanent damage.
The challenge is with infants as symptoms may be difficult to recognise or detect at such a tender age.
PnD is treated with antibiotics. Unfortunately, sometimes antibiotics do not work fast enough or the disease has advanced so much that the damaging effects of invasive PnD cannot be avoided.
More worrying, the pnemococcus has now developed resistance to many of the antibiotics, rendering them useless.
Is my child at risk?
Children below 24 months are at highest risk of PnD due to low levels of circulating pneumococcal antibodies.
Since 60% of preschool children are carriers of the pneumococcus, children who attend daycare centres are more likely to become infected due to increased exposure to the bacteria in the daycare setting.
Children with a weakened immune status due to an inherited absence or lack of antibodies or due to disease such as HIV are also at high risk.
How can I protect my child from PnD?
Practise good hygiene at home and in child care centres. Wash hands carefully, dispose all used tissues, prevent children from sharing cups, spoons and ensure toys are always kept clean. And do not allow unwell children from attending child care centres or schools.
The most effective method for preventing PnD, however, is by immunising your child against the pneumococcus. Even those who have been infected previously only enjoy a limited degree of immunity, which may not be sufficient to protect them from subsequent infections.
How does the pneumococcal vaccine work?
The pneumococcal vaccine is made from the outer layer of the bacteria conjugated to a special protein designed to “jump-start” your baby’s production of antibodies without actually infecting him with the disease.
This prompts his body to programme special cells that can fight pneumococcus when he is exposed to them later in life.
Benefits of early vaccination
Up until recently, the only vaccine available to protect against invasive PnD was the 23-valent pneumococcal polysaccharide vaccine.
However, this vaccine is unable to stimulate an adequate immune response in infants and children younger than two years of age.
By coupling the pneumococcal sugar coat to a special protein, a new pneumococcal vaccine is able to stimulate the production of antibodies in infants less than two years. It also activates the immune system memory.
Early immunisation therefore protects the child from ever acquiring PnD and all the devastating complications associated with it, including death.
When a large proportion of the population is vaccinated against the pneumococcus, the bacteria are eradicated from the upper airways. This reduces the chances of the disease being transmitted to the unvaccinated individuals, a phenomenon known as herd immunity.
Vaccines, by preventing the spread of disease, are an economic plus. Fewer children would need to miss school and parents would not have to take time off work to nurse their sick children.
The best time to vaccinate?
Although dosing schedules may vary from country to country, the manufacturers recommend that the vaccine be administered as a primary series of three injections in infants younger than six months old, with a fourth dose administered during the second year of life.
The first dose is usually given at two months of age and an interval of at least one month should elapse between doses.
For previously unvaccinated older infants, the following schedule applies: for infants seven to 11 months, two doses should be administered at least one month apart, with a third dose during the second year of life; for children aged 12 to 23 months, two doses should be administered at least two months apart; for children aged 24 months to five years, one single dose.
The pneumococcal vaccine can be administered simultaneously with other childhood vaccines in accordance with recommended vaccination schedules.
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