Principles of Epidemiology & Epidemiological methods
“I keep six honest serving men, they taught me all I know their names are what, why when, how where & who”
Introduction:
Preventive & Social Medicine è Epidemiology As siej are basic sciences. Epidemiology of gall to do choronic diseisellently works well. Epeedemic oti investigation dicit the place of origin of Epidemłology. Recent Hi Epidemiology oil is highly developed.
Epidemiology method is used to investigate every disease & medical condition and causes. It is also used for the planning of health services and nursing services for the development of every preventive program and therefore every health and nursing personnel involved in health care. It is very important for them to have knowledge of Epidemiology.
Epidemiology provides a more nuanced understanding of how diseases spread and how to manage them in individuals and communities. In relation to that, Epidemiology – Lilien feld” has been brought here by a scientist in 1980 as follows.
Epidemiology is the concern of the patterns of the disease occurrence in human population and of the factors that influence the patient. Epidemiology is the diseases occurring in human populion and in it
Correlates with influencing factors.
(2) Studies of distribution of dissent;
We are well aware that diseases are not uniformly present in the human population. The main idea of epidemiology is to know that a certain type of people in a population have a higher rate of disease. So the main task of epidemiology is to know about the disease occurring in different groups at time, place and in individuals and that is determined by the epidemiologist. Whether there has been an increase or decrease in the incidence of DCs over time, it is more common in certain geographical areas. Any disease occurs in a certain age group. etc. and the behavior of the affected host is different from that of the unaffected host.
(3) Studies of determinants :
The basic form of epidemiology is case finding of diseases by risk factors. This requires application of epidemiology principles and methods. This is the main part of epidemiology. This aspect is known as analytical epidemiology. Analytical states assist in research and policy making in developing scientific and group health programs.
@Ains of Epidemiology:
Following are the three main Aims of this by the International Epidemiological Association.
(1) Disfiling health and disease problems in human populntion and finding related problems,
(2) To find risk factors in the decision,
(3) To collect data necessary for the prevention, control and treatment of disease so as to enable planning, implementation and evaluation of health services and to prioritize them for delivery of services.
Three different types of epidemiological studies have been selected to realize all these aims. in which,
(1) Descriptive Studies
(2) Analytical Studies.
(3) Experimental or Intervention studies
The name of epidemiology is the final aim which can be done effectively
(1) To cure or reduce the severity of a health problem
(ii) to prevent future occurrence of that disease,
Basic tools of measurement in Epidemiology:
Basic measurements of epidemiology include rates, ratios and proportions.
(A) Rate.
Rate is always calculated in round figures of 1000. By that the incidence ratio can be known. According to the specified time, it can be known according to the population, so the number of incidents is calculated in numerate (according to the number), a population of 1000 is considered to see some incident and its death rate in any area, in addition to this, it is like a certain period. For example; In the year 2006, 500 deaths occur due to accidents in any single city. In this, 500 deaths occur due to accidents. It can be compared with any other seats to know the accident rate.
Date Rate = No. of death in one year Mid year population * 1000
(B) Ratio :
Another tool used by this epidemiology major is to measure the frequency ratio of diseases. Eg Sex Ratio Doctor Population Ratio etc……
X:Y OR. X/Y
The ratio of white blood cells relative to red cell is 1:600 means D A or each white cell there are 600 red cells,
(C) Proportions :
This is a ratio that shows which parts are related to what is called an indicate and a proportion is more specifically known as a percentage.
Proportions = The number of children with scabies certain time_*1000 The total no.of children in the village at the same time.
Epidemiology oti Commonmeasurement del
Mortality
Public health practices & Medical Science Hi Epidemiology has a very important contribution. It is not only useful in the context of infectious disease, but the methods of epidemiology are also useful for non-communication conditions.
(1) The study of historically the rise & fall of disease in the population: To study how disease arises and declines in the community,
In this wisdons charchile done. First lise of epidemiology disease’s history & human population’s study is done in this, in which the amount and ratio of any specific disease can be known. E.g. How many cancer patients are there? And how many diabetes patients there are, as well as the amount of any one type of disease in the community, and also other health related problems can also be known through it.
(2) Community diagnosis:
Health problems can be identified through community diagnosis. It can be known in which group and at which age the disease has occurred, and health care can be given to prevent it. Morbility & Mortality can also be known in the community. Along with this, Social Culture & Environment of the community can also be known.
(3) Planning & Evaluation:
Planning is an important factor and planning can be done after identification of particular clisense problem in the community and planning plays an important part in providing health services in the community. Also, after providing the health services, the results can be evaluated.
(4) Evaluation of individual risk & Chinese :
An important thing for an epidemiologist is what is the probability of disease in a population? What is the risk of disease among people. It is useful to make a statement. E.g. Cooker nan – smooker.
(5) Searching for cause & risk factor:
Causes of disease and risk factors can be known. Also, the psychology of diseases is how the disease occurs and the disease can be researched through it.
(6) Syndrome identification:
Syndrome disease can be recognized by epidemiology. E.g. peptic, ulcer, duodenal ulcer etc….
(7) Completing the natural history of disease :
Disease patterns can be known through natural history, and agent host environmental factors of disease can be understood.
Disorse Cvcle; In general, the definitive route to the occurrence of each communicable disease proceeds through certain stages. This stage is as follows 620l
(1) Incubation Period:
From the entry of the Medical Officer Body of Marikaom Disease till the Cust Clinical total seats are found,
(2) Prodromal Period :
This is a very short period. Usually 1-4 days. .It has the beginning of Prodromal Period. It cannot be clinically diagnosed.
(3) Fastigium:
This is high top disease. In this, all the signs/symptoms of the disease can be seen clean. A clinical diagnosis can be made.
(4) Defervescene Period :
This periol (Immunity has developed and the patient feels a little better.
(5) Convalescence Period :
During this period the patient starts to recover.
(6) Detection Period :- In this period the patient is completely cured from the disease.
Spectrum of diseases:
According to the severity of the disease, the signs/symmons of the disease are less or more, i.e. less in one person and more or more in another person. This concept is known as spectrum of disease. Which can be seen as below.
(1) Subclinical Clies which can be treated in the clinic.
(2) Extrimnly Mild Cuse: Which can be cured by taking medicine at home.
(3) Mild Case:
Which gets better by taking some home medicine.
(4) Modrality
which can infect others and are more harmful. He should be kept under close observation.
Death:
These include patients with malignant diagnoses. It is necessary to do hospitality. So that efforts can be made to save their lives in the hospital.
A single disease can be very mild in one person and very severe in another. While in some individuals the tumor remains in the subclinical stage and in others it is very high. In which subclinical and mild cases spread connleable fisease than other caches. Thus considered more harmful.
Level of Prevention of Disease:
Nowadays the concept of prevention has become very broad. It is defined in three levels.
(1) Primary Prevention:.
The measures which are taken to prevent the occurrence of disease or to prevent it as soon as it occurs is called primary prevention, which includes health promotion and specific protection.
(a) Health Promotion :
This is the first level of prevention. In which we can prevent the spread of diseases by improving the health of individuals and communities.
E.g. Nutritional deficiency disease which can be prevented by providing adequate nutrition.
cholera, typhoid, tuberculosis, for which we can improve the life standard of the community by providing health education about personal hygiene and periodic health check-up by making arrangements for safe environmenta, Sake watersupply & proper disposal of human excreta,
(b) Specific Protection :
Some diseases can be prevented by specific protection. Eg : T.B, diphtheria tetanus by BCG vaccine and pox, xerophthalmia by DPT vaccine. – Stopped by giving a solution
Accrosdents can be prevented by using protective, devitalizing devices in factories and industries. Also protection of the special organs of the body can be done.
For example, a person doing welding wears special glasses. Similarly, a person working in the X-ray department wears a special gown and glasses. Persons working in factories of Rs wear masks,
Good results can be obtained through primary prevention, most of the infecsius lisense in developed 14 countries can be prevented in this way. Some conic diseases can also be prevented by
Eg, by controlling diet and physical exercise etc…
(2) Secondary Prevention:
Secondary prevention prevents disease from occurring and its complications. For this early diagnosis and adequate treatment is given.
(a) Early canosis :
Which includes screening cache, hiding program etc.,
We do not have vaccines to prevent all diseases. Certain types of diseases. Early diagnosis and treatment is the only solution for syphilis leprosy etc. Which is very necessary to prevent the spread of diseases in the community.
(3) Tertorv Prevention:
When the spread of the disease is more and it is more than the early stage or when there is no time for its prevention, then it is called Territory Prevention, for the definition of this, it is said to take such measures for the prevention of diseases so that people’s health can be maintained and its development. happen, so that people can be able to live without medicine. The specific intervention for that is as follows.
(a) Disability limitation :
That is, to reduce the occurrence of defects,
(b) Rehabilitation :
Rehabilitation is as follows. are called differently. Kavar jarupi tree for cleaning in London
(i) Functional rehabilitation: And we are planti c karta in which the function of the patient’s own organs are lost to some extent, efforts are made to maintain the function of those organs and appropriate treatment, exercise, medicine etc. are given accordingly.
(ii) Vocational rehabilitation :
That is, it can be done for a person to run his own livelihood.
(iii) Social rehabilitation :
To make an effort to maintain family and social relationships, to make adjustments so that a person can communicate well with his family and society,
(iv) Psychological rehabilitation :
To make efforts to revive the self-esteem and confidence of the individual.
@ GENERAL EPIDEMIOLOGY :-
(1) INFECTION ::-
When an infectious agent enters the body of a human or animal and multiplies, it is called an infection.
(2) ENDEMIC:-
A certain disease found stable in a certain geographical area is called endemic disease. Eg Goiter, Typhoid, Malaria, Viral hepatitis etc in India…..
Bydney
(3) EPIDEMIC :-
When the same disease affects more than one person in the same community at the same time, it is called an epidemic. Epidemic diseases in India include measles, chickenpox, viral hepatitis etc. .
(4) Sporadic :-
The cases of disease seen scattered in the community are called Sporadic. For example; Fever, Common Cold.
5) Pandemic ::-
When a disease spreads all over the world or spreads from one country to another, it is called a pandemic.
For example; AIDS, Cholera, Plague etc., which happened earlier as Pandemic include Influenza, Cholera & Pagle.
(6) Zonosis :-
Disease or infection transmitted naturally from animals to human being is called Zoonosis. For example; Rabbis, Plague, Bovine, Tuberculosis,
(7) Isolution ::-
To prevent the spread of an infectious disease in the community, the process of isolating an infectious patient for as long as he is capable of spreading the infection is called Isolation.
(8) Carrier::
Currier means an infected person or animal which has an infectious agent in it, but although its body does not show any sign-symptoms of the disease, it can act as a source of infection and it can infect others,
(a) Temporary Carrier::-
which can spread disease only for a short period of time e.g. Chole, Diphtheriu ctcut
(b) Chronic Carrier :-
Disease agent stays in a person’s body for a certain period of time.
Eg: Typhoid, Amebiasis …….. Kalin no
(9) Communicable Disease ::-
Any disease spread in the community from a specific infectious agent or its toxic product under specific conditions is called a communicable disease.
10) Non Communicable Disease ::- NCD
So those diseases which are not contagious from one person to another are called Non Communicable Diseases.
Eg: Cancer, Diabetes, Cardio Vascular disease etc…….
(11) Incubation Period ::-
After the disease agenı enters the body of a person, the period of time until the first symptoms of the disease are seen is called Incubation Period.
(12) Fomites ::-
Articles contrarminated by the patient’s infection that spreads the infection to a healthy person.
E.g. Utensils, clothes, toys etc….
(13) Vector :-
Infectious agent like Arthropods in general which spread the infection * from an infected person to a healthy person. It is called Vector. Eg: Mosquito.
(14) Antiserum :-
Serum which contains specific antibody is called antiserum. Eg: A.T.S. (Anti-Tetanus Serum)
(15) Virulence ::-
This term is used to indicate the disease’s severity.
(16) Pathogenicity :–
Having the ability to determine the disease’s cause is called Pathogenicity.
@ Disense Transm|sslon OR Portnl Entry :
The disease spreads in many different ways. So it is important to know how the disease spreads. Knowing this can lead to better planning for infection control.
(1) Source of Infection: Mostly Carrier. This can be a person or an animal.
(2) Modes of Transmission : This is mainly spread in two ways.
[A] Direct Transmission ::-
By innoculation in the skin or Mucosn.
From each of these routes a person can get any disease direct infection.
[B In direct transmission ::-
@Direct Transmission ::-
(1) Direct Contact :-
Some diseases are transmitted from one person to another through direct contact. E.g. Kissing sexual contact, Contaminated Cloths Close Contact etc, diseases which are caused by direct contact. Sexually Transmitted Diseases like Syphilis, Gonorrhoea, AIDS, etc. are considered in it. Sabis, Skin Sepsis, etc. are also calculated.
(2) Droplet Infection ::-
Respiratory Infection aac cali Saliva, Coughing, Sneezing etc. contains a lot of bacteria. which spreads in the environment. This infection enters the body through the breath of a person with low resistance power and produces diseases in him. Among the diseases spread in this way is the common cold, Tuberclousis. Whooping cough, Diphtheria
(3) Contact with infected soil ::-
Infection spreads through infected soil. E.g. Tetanus
(4) Innoculation Into Scan OR Mucos ::–
Disease’s organisms directly skin & Mucosa 121 Innoculation takes place. Dat. Rubbi’s, virus inoculates through dog bite. Hepatitis-B Virus is innoculated through Contaminated Needle & Syringe,
(5) Transplacental OR Verticle Transmission :-
Through mother, through placenta, disease agent is transmitted during Pree, which is known as vertical transmission, teeth, Toxoplasmosis means infection with foxoplasma, Et, eg: Rubella, Syphillis, AIDS, Hepnitis etc. from each of these disease agents mn| Formation is seen to develop. (Defective Chill)’
@ Indirect Transmission :-
(1) Vehicle borne Transmission ::-
These include Water born, Milk born, Food born & Blood born (Blood Serum, Plasma) Diseases. Which spreads through contaminated water, milk, food or blood.
E.g. Enteric fever, Cholera, Diarrhea, Dysentery, Food Poisoning etc., while Hepatitis-B is a very important disease spread through blood contact.
(2) Vector borne Transmission ;;-
Which diseases are spread by vector like mosquito, rat, flea etc. Such diseases are called vector borne diseases. Eg: Malaria, Filaria, Cala azar, Plague etc…..
(3) Airborne Transmission ::-
This includes Droplet & Infected dust. As a droplet, droplet nuclei are very small infective particles. which floats in the air. Coughing, Sneezing makes airborne and spreads diseases. These include influenza, tuberculosis, mensles and other respiratory infections.
Through Infected dust, some large droplets which are settled in the form of dust on the ground, clothes, linen etc. through Coughing, Sneezing, are called infected dust. This dust mixes in the atmosphere and causes disease when inhaled by a person.
E.g. Tuberculosis, Pneumonia etc. especially Streptococcic infection.
(4) Fomite borne transmission:
Infections spread through contaminated articles. It is called Fomite borne disease. Eg Contaminated Cloths, Toys, Utensils etc…
(5) Unclean Hand & Fingers ::-
It is spread by eating or performing any nursing procedure without washing hands. If personal hygiene is poor, infection is transmitted from one person to another.
@ PORTALS OF EXIT ::-
Disease’s organisms leave the body and go to another new host is called Portal of Exit. Which is as follows.
(1) Rose & Throat Secretions ::-
Some organisms leave the body through Nasal & Throat Secretions. It includes diphtheria, bacilli tubercle bacilli, common cold, virus, mumps, measles etc.
(2) heces ::-
Some organisms excrete through faeces. It includes intestinal parasites like Salmonella, Shigella, polio virus, hepatitis virus, cholera vibrio, round warm, hook warm.
(3) Urine ::-
Organisms of some diseases are excreted through urine.
E.g. Almoneva Typhi (Salmoneva).
(4) Skin ::-
Some organisms enter the body through the skin. In this way coriander is excreted from the organism body through wound & body discharge. Which includes lepra bacilli, sexually transmitted disease’s organism, scubis & skin infection.
Malaria and filarial organisms are spread through insects.
@ Control of Infectious Disease::
General Measures of Control of Infectious Disease:
(General Measures to Control Infectious Diseases) The measures prescribed for FAITHE Infectious Disease Control are as follows.
(1) Controlling the Source of Infection OR Ićservoir of infection,
(2) Blocking the Channels of Transmission.
(3) Protecting the Susceptible Population.
(1) Controlling the Source of Infection ::-
(A) Early Diagnosis –
Accurate diagnosis of cases and carriers and use of laboratory tests for confirmation when the diagnosis is in doubt should be the first and foremost measure for disease control in the community.
(B) Notification:-
When any case of infectious disease occurs in a rural area, the health worker should report the case to the primary health center within 24 hours. Cases in urban areas should be reported to the local health authority. E.g. Health Officer of the Municipality OR corporation OR D.H.O.
The notification includes the name of the case, address, sex, diagnosis, date of onset of symptoms and the measures taken for it.
(C) Isolation ::-
(2) Isolation is very important to prevent disease spread. Hospital Isolation is better than Home Isolation. How long to keep the patient in Isolution depends on the disease, the patient should be kept in isolation for as long as the Infectious Ferio of that disease is.
(D) Treatment :-
Treatment reduces the communicability of the disease. DCs occurs quickly and secondary infection can be prevented.
(E) Surveillance :-
This is a new approach to disease control. For this it is very important to find the source of the case and infection. So that infection control can be done through exact Contolling Measure.
(F) Dis-infection :-
Nasal, Throat discharge, Cloths, Articles etc. to prevent the infection from spreading. Proper dis-infection should be done.
(2) Blocking the Channels of Transmission ::-
In the steps suggested to prevent the spread of infection.
(1) Disinfection of water
(2) Proper disposal of Human Excrea & Solid,
(3) Controlling Rodents & Insects.
(4) Improving Food Hygiene’s Standard etc.
Which of the above methods to use depends on the organisms involved and the portal of exit. Eg: Chlorination of Water Supply & Safe Disposal of human excreta are both particularly necessary if controlling measures are to be taken for cholera.
If malaria is to be controlled, it is necessary to control mosquitoes.
(3) Protecting the Susceptible Person OR Population ::-
(A) Immunization ::-
To prevent disease before it starts
Immunization. It should be given to maintain the level of immunity – Booster Bose is the main key for many infectious disense.
(B) Health, Education –
Community support is essential to control any disease and it is possible through health education. We should try to get people’s co-operation.
@_Dis-infection !!-
(1) Disinfectants:-
Dis infectant OR Germicide is an agent which destroys bacteria, virus, spore etc. Chemicals are used for that. or physical agents are used. Both of these are very corrosive or toxic to apply on the skin. So that fear is used only on inanimate objects.
(2) Antiseptic :-
It is an agent that inhibits the growth of, or destroys, the infective agent, and it can be applied to the leaving tissue, – dilated it acts as an antiseptic.
(3) Deodorants:-
This is a type of agent that removes foul or unpleasant odors.
E.g. Uno or lime, bleaching powder etc.
(4) Detergent ::-
This is a surface cleaning agent, which cleans the surface by reducing surface tension. Eg: soap, detergent powder,
(5) Disinfection ::-
Disinfection is the destruction of organisms by directly contacting the infectious agent outside the body with a chemical or physical agent.
(6) Dis-infestation ::-
Disinfection by any physical or chemical process of an arthropod or rodent S.
(7) Sterilization ::-
Districting of Micro Organisms & Spore.
Tvpes of Dis Infection ::-
(1) Concurrent Dis-infection::-
Concurrent dis infection is the way to immediately destroy the material or discharge from the infected person’s body, to take immediate action. Or the method of disinfecting articles or linen contaminated with infective discharge is called Concurrent Dis-infection.
(2) Terminal Dis infection ::-
Disinfection of all the articles, linen etc. used by the patient after discharge from the hospital or after death is called Terminal Disinfection.
(3) Proplvlactic Dis infection ::-
Boil water, pusturize milk. Washing hands with soapy water is called prophylactic dis infection.
@ Classification of Dis-infection ::-
Natural = (a) Sunlight (b) Air
Physical = (a) Dry hut – Burning, hot cry afr
(b) Moist heat – Boiling, Steam, Pasteurization (c) Radiation.
Chemical = (a) Liquids – Phenol, Cresol, Alcohol, Chlorine. (b) Solids – Bleaching Powder, Lime, (c) Gases – Fotmaldehydc, ethylene oxide.
@ Immunity ::-
Antigen is a substance that stimulates the formation of antibodies LUIS I Immuno globulins are a type of proteins that act against the antigen as a response to the antigen. And he prepares his own production. Produced by antibody-B, a type of W.B.C.
Befinition ::-
Immunity means the ability to recognize antigenic material and destroy it by destroying the organism of the disease, which includes bacteria, virus & foreign protein.
According to the current concept, the immunity mechanism has two components.
(1) Humoral Immunity ::-.
This produces antibodies. This is a specific antibody, simulating the production of antibodies by the same antigen. This antibody is known as specific antigen. Antibody circulates in blood & body fluid and protects the body against infection with its antigen.
(2) Cellular Immunity ::-
Cellular Immunity is more complex. It depends on the type of W.B.C. Which is called T-Cell. This T-Cell protects against some pathogenic agent which is present in the intra cellular fluid and against bacterial action. Including S-Typhi (Salmonella typhi) and M-Lepra (Microbacterium leprae) etc. Humor & Cellular immunity are interrelated and provide protection to the body against many types of infections.
1 } Natural Immunity ::- This Immunity is given to every person through Genes. For this reason, some DCs are found in humans and some DCs in animals.
E.g. Reindeer pest is found in animals, not in humans.
If a disease like typhoid occurs once, immunity develops in the body and it does not happen again to the person.
(2) Acquired Immunity ::-
This immunity is of two types, known as active and passive immunity.
(A) Active Immunity ::-
This immunity develops when a person is infected with pathogenic organisms or their toxic products enter the body, and the body produces antibodies or immunglobulin that provide protection against the infection. Active immunity is often acquired in a person under the following conditions. eg:
(1) Frequent attacks of diseases (chickenpox, measles etc.)
(2) Getting sub-clinical infections (eg polymyitis, diatheria etc.)
(3) Artificial immunity introduced into the body by a vaccine.
(B) Passive Immunity ;;-
When the body is unable to produce antibodies on its own, immunity is generated by giving antibodies from outside. It is called passive immunity. This immunity is temporary. In which diphtheria, antitoxin, protection against diphtheria is given.
Human Gamma Globulin (a type of protein):
Hurnnnn Gamna Globulin is of two types namely,
(1) Normal human immunoglobulin
(2) Specific human immunoglobulin is called.
(1) Norma| Human immunoglobulin-
16.5% solution from blood which is prepared by hurman plasma can be given commercially Sub-cutaneous & intramuscular. It provides protection against measles and hepatitis-A
(2) Specific Human Immunoglobulin ::-
These are prepared from donors who have been immunized against specific infecibus dinsense or who have recovered from such diseases. This preparation contains more specific Antlbody. It is given as Prophylexis against Rabbi’s, Mumps & Tetanus, Immunity produced by Gamma Globuhn is passive and temporary and lasts for a few weeks or months, then disappears.
@ Antisera OR Antitoxins ::-
It is prepared from animal. In which Tetanus, Gasgangrine, Dyphtheria, Botalism & Snake bite etc. are prepared from horse, when Human Immunoglobulin is not available, Antisera is still used to prevent the above diseases. The vaccines. Special care should be taken to prevent anaphylactic shock while administering.
@Hazards of Immunization ::-
. Hyper Sensitivity :: means allergy or reaction. When a foreign substance is introduced into the body, two main types of hyper sensitivity reactions occur.
Imidiate OR Antibody Mediate Reaction and Delayed or Selimidate Reaction.
(1) Reactions Inherent to Inoculation ::-
A local general reaction may be seen in this. These reactions include pain, swelling, redness, tenderness and the development of small lumps at the site of injection. Fever and other symptoms are sometimes seen in general reactions. Special Ju malaie gra) frame) as well as local and curry kildi in bacterial vaccine e.g. General reactions in typhoid include diphtheria and tetanus toxoid. When such a reaction is seen due to live polio vaccine.
(2) Reactions duetá fuhulty technique-
Faulty technique is related to faulty production of vaccines. In which the reaction occurs when the microbacteria are not adequately diluted or a dose of vaccine is not diluted and used or it is not shaken properly, or storage is not done properly or its contraindications are unknown. (How to give) not known) e.g. When a child has a severe reaction to the DPT vaccine, the same vaccine should be given. Or if continuity is not maintained in taking vaccine and sterile series and needle are not used properly and Hazards of hepatitis virus, Staphy 10 & Streptococoal infection are felt.
3) Anaphylactic shock is considered as a clinical example of immediate reaction.
Two types of anaphylactic reactions occur in humans. Which can be seen as local and systemic reactions.
Systemic reactions are seen when penicillin or UJ-A is given in sensitive patients. This reaction starts within a few minutes after giving UI, and disappears after an hour. In which synptoms like dysphagia, bronchial spasm, B. P. Col. Thaw etc. are seen. Asthma and alticaria are enumerated as examples of local reactions.
Delayed hive sensitivity is considered tuberculous hive sensitivity. In which the reaction occurs late to long after the injection and lasts for a long time or days,
@ Immunizing Agents ::-
Immunizing Agent’s Classification is done as Vaccine immunoglobulins & Antisira.
@VACCINE ::-
A vaccine is a preparation of a disease agent or its toxic product. When it is introduced in the body, it simulates specific antibody formation or the following things are important for preparing active immunity vaccine.
(1) Live attenuated organisms including polio vaccine.
(2) Killed organisms including cholera, typhoid.
(3) Toxoids – including Dyphtheria & Tetanus Vaccine
(4) Combination of the above vaccines including Live Combination of the Above,
A normal vaccine is counted as an attenuated vaccine. These include B.C.G Oral Polio, Measles, & Yellow Fever.
Those counted in Killed Vaccine are typhoid, cholera, whooping cough, meningitis, plague, rabies, indluenza etc.
@ Combined OR Mixed Vaccine ::-
This vaccine is easy to use. Also its price is less. And the prick of injection should also be given less. More than one agent is mixed in this vaccine. So it is called combined vaccine.
E.g. D.T.P, D.T and typhoid bivalent vaccine which protects against typhoid and paratyphoid
@Nactional Immunization Schedule ::-
Prevention of preventable diseases is of particular importance in Public Health Care, which is very important for child survival & child development.
Major Vaccine Preventable Diseases Hi Poliomylitis, Pertusis, Tetanus, Measels, Dyphtheria Tuberculosis are considered. About 2 to 30% of children die from these diseases. And among these 6 diseases measles is the number 1 killer disease, it is especially important to immunize a child in the first year of life. Also it is necessary that vaccination should be done only during the period given for it. If a dose is missed due to any reason, the missed dose should be administered as soon as possible after the schedule date. And now it is said that even if the child is sick and has fever, diarrhoea, vomiting or respiratory infection, giving the vaccine does not cause any problem. »
Note –
(1) The interval between 2 doses should not be less than 1 month.
(2) Vaccine can be given in common cold, cough, fever.
(3) If pregnancy occurs again within three years after giving two doses of TT in Primipara during pregnancy then single dose of TT should be given and if pregnancy occurs again after more than three years then TT to give two doses of
(4) Hepatitis-B routine immunization given Feb-Aug with 6-10-14 wk.
Cold Chain ::-
To maintain the potency of the vaccine, it should be tamped. If it is repeatedly exposed to heat, the population loses potency and it is not necessary to use such a vaccine.
@ Definition of Cold Chnin –
Clod Chain means the method of maintaining, transporting and storing the vaccine at its specified temperature from its production till it reaches the beneficiary is called Clod Chain.
The equipment used to maintain the cold chain includes Coolers, Refrigerators, Vicelined Refrigeratory Deep Freezers, Cold Boxes, Vaccine Carriers + Day Carriers, Refrigerated Vans & Vaccine Delivery Van etc. Each waxi[ 2 deg * c * 2l * 8 deg * cHtl can be stored for some time. D.PI, D.T &T.T. Never allow the vaccine to be frozen. Frozen vaccines become sterile.
(A) Cold Rooms ::-
At the regional level, there are such cold rooms in which the vaccine can be stored for up to 3 months. And the amount of vaccine that can be given to 4 to 5 districts can be stored in it.
(B) Deep Freezers (300Liters) & Ice lined Refrigerators (300/240 Liters)
Each district has these types of deep freezers and I.L.R. for cold room vaccine storage, in which deep freezers are used for making Icepacks and storing Oral Polio Vaccine and Measles Vaccine.
(C) Small Deep Freezers & I.L.R (140 L.Capacity) ::-
A set of small Deep Freezers & I.L.R are available at every PHC, Urban, Family Planning Center and PP Unit (Post Partum Unit).
In which to prepare deep freezers, Ice Packs which are used for vaccine transportation in the Ice Packs Cold box and also in the vaccine carrier during the vaccination session.
P.H.C. Levels are stored in each vaccine .L.R, DIPT, D.1 & TT. Placed in Frnze basket which is provided with 1.L.R spirit. Vaccine to I.L.R. Never keep it on the floor as it fizzes and destroys it. Dial thermometer should be specially rotated in I.L.R and its temperature should be recorded twice a day. While de-fostering the I.L.R, the vaccine contained in it should be sifted in a cold box which should contain adequate quantity of ice packs. 1. If any problem occurs in L.R. or light goes out, the vaccine stored in it should be immediately transferred to the cold box and taken to another storage place.
(D) Clod Boxes ::-
Each sub center has cold boxes. Which is especially used for vaccine transportation. Frozen ice packs should be placed on the bottom and sides of the box before placing the vaccine in the cold box. Then the vaccine should be placed in a polythene bag. In which the vials of D.PT, DIT & I.T etc. vaccine are placed. Never place the vaccine in direct contact with frozen ice packs.
(E) Vaccine Carriers ::-
Vaccine carriers are used when small quantities of vaccines are to be carried. In which 16 to 20 vials can be kept, 4 fully frozen icepacks should be kept on each side. Never put Vial Frozen icepacks of D.P.T, D.T &TT in direct contact. Close the vacin carrier lid properly and do not open it unnecessarily frequently.
(F) Day Carrier ::-
Day Carrier is used when small doses of vaccine are to be carried in the session. It can carry 6 to 8 vials. Which contains 2 fully frozen icepacks. Which can be used only for a period of few hours.
(G) Ice Packs :-
Ice Packs are filled with water only. Do not add salt to it. Fill with water according to the water level marking on the side of the ice pack. Discard the ice pack if there is leakage. The risk of cold chain failure is very high at the subcentre as well as at the village level and for this reason vaccines are not stored at the subcentre. It is also supplied on the day it is to be consumed.