Why to the child hepatitis B inoculation? Many parents on reception with anxiety ask
the pediatrician why so early to do a hepatitis B inoculation to the kid? Where such small can catch? Actually, hepatitis can be now both at the newborn, and at the ancient old man. In modern living conditions from it nobody is insured. Why hepatitis is so dangerous and for what so infusions - howl on vaccination pediatricians? Let`s understand this complex problem in more detail.
About the hepatitis B
Hepatitis B is the infectious disease which is of interest not only to pediatricians, infectiologists and scientists. The illness has high social value on an equal basis with tumoral diseases, C and HIV hepatitis - an infection.
the Disease is caused by a specific virus of hepatitis B which, on - falling in an organism, causes inflammatory changes in hepatic fabric. And there are various forms of an illness - from an asymptomatic carriage of a virus, to jaundice, cirrhosis, a cancer of a liver and an acute liver failure. Allow to give some figures of statistics - according to official figures WHO, registered worldwide about 2 billion people in whom the virus or an anti-gene to hepatitis B are found, about 300 million are registered chronic carriers, and about 1 million people die of hepatitis consequences annually. And about a third from them children, teenagers and young people till 20 years.Where the child can catch
hepatitis B differently, there are several ways of penetration of a virus to an organism. It is possible not only at blood transfusion and its components, when performing medical manipulations not with disposable tools, way “through a needle“, widespread among drug addicts. The virus is transmitted sexually, there is a transfer of a virus from mother to the child, household contacts in a family with patients or virus carriers.different options are actual
For different age groups of children. For it is new - given rise by the most actual way of transfer is “vertical“ - from mother at the time of delivery. The matter is that the virus of hepatitis B does not get through normally functioning placenta. Therefore pregnancies can be infected about time only children of those mothers who have heavy pathologies of a placentary barrier. And here at childbirth the probability of infection sharply increases. Of course, doctors make the mass of efforts for a minimizirovaniye of this risk. But it only when at mother the carriage or an illness is confirmed. And if it is infected, but a virus in an incubation stage? Then it can also give him to the baby. whether
It is possible that the child was infected with viral hepatitis in maternity hospital, but not from parents? It cannot be. Constantly take blood on the analysis from all personnel which work in maternity hospitals and it without fail put hepatitis B inoculations. Any doctor, the midwife or the nurse will not be employed in such establishment if they are not imparted!
the Second option of a way of infection for the baby is a blood transfusion at a Rhesus factor - the conflicts, hemolytic anemias or other pathologies arising at childbirth and right after them. One doctors insist that mothers nursing the child, but this theory disputable can transmit a virus. Also there is an opinion that at close contact in a family the kid not - is premenno infected from the sick family member in next
various medical interventions - operations, treatment and removal of teeth (if it becomes reusable tools), blood transfusion or its components act. Household contact with the infected family members goes the second point.
For children and teenagers from 13 to 18 years to all above-mentioned at - also those that are usual for adults - sexual and “through a needle“ connect as probable ways of infection. For anybody not a secret as now the teenage subculture develops. Therefore parents of teenagers need to watch fixedly a circle of contacts of the young men or girls, to pay attention to the slightest changes in their behavior.
However, dear parents, you have to know that hepatitis B does not transfer - sya through water and food, at handshake or vozdushno - a drop way.
In what danger of hepatitis B?
the Infected person constitutes danger to his healthy environment. And it is always necessary to remember it. A hepatitis virus in hundreds of times zarazny HIV - if for infection of HIV needs several milliliters of the blood which got to a blood-groove, or long contact with the infected blood, then for hepatitis one prick with the infected needle or violations of integrity of skin the tool which is infected with hepatitis sometimes is enough. The virus is so small and so actively breeds that well gets through mucous membranes of a mouth, an eye, a nose and a genital tract.
the virus In itself does not ruin a cell of a liver. It is built in structure of a cage that in it to breed, leaving some kind of “indicators“ on its surface. These “indicators“ signal immune system that the cage was taken by the enemy. And though it and the, but for immunity the command for its destruction is given, and there is a self-damage of hepatic fabric - it is called autoimmune defeat. Destruction of a liver results from immune attack of the own organism. If at the same time the most part of a liver is mentioned. And then the acute liver failure develops.
the Liver possesses a good reserve for regeneration (restoration of damages), but, however, from - for viruses there is a transformation of gene material, and in a liver the cancer centers are formed. Then the carcinoma (cancer) of a liver develops. In the opportunity the acute inflammation in response to penetration of a virus and a classical picture of hepatitis with jaundice, violation of health, characteristic clinic develops. This disease comes to an end with recovery.
Unfortunately, at our little patients classical icteric to Techa - the scientific research institute happens seldom. Than the age of the kid, that a high probability of an asymptomatic current or a carriage which will pass into chronic incurable hepatitis B is less. For newborns it is 95% of probability. For children till three years - to 80%. With age the percent goes down, making at adults probability of a disease with jaundice more than 30 - 40%, and risk of transition to a chronic form - 6 - 10%.All this
it is connected with features of work of immune system - the child is younger, the its antiviral activity is lower, that a high probability for a virus freely to lodge and breed in an organism of the baby. If the child has a hepatitis B which proceeds with jaundice, parents need to rejoice - it means that the immune system of the kid actively resists, and the risk of transition to a chronic form is minimum.
At destruction of cells of a liver bile gets to blood therefore there are symptoms of jaundice - coloring of skin and mucous membranes, change of color a calla and urine. And this symptom forces parents to ask for the help the doctor.
Quite often hepatitis proceeds as a SARS or flu, with fever, appetite loss, weakness, weak belly-aches and a side therefore it is found already later - at inspection of blood and detection in it the specific “Australian anti-gene“. And it throws parents in shock because the incubatory period of hepatitis B lasts from forty to hundred eighty days (on average usually - hundred twenty days). These are about 4 months. Therefore it is sometimes very difficult to remember and establish precisely where and as there could be an infection. And considering a long asymptomatic carriage, the source sometimes cannot be established in general. All members of the family of the child will undergo inspection. And it is possible also those who with it it is long contacted.Diagnostics and treatment of hepatitis B
As we already told
- it is possible to confirm an illness or a carriage at detection at the child of a specific marker - the “Australian“ or superficial anti-gene. For this purpose take blood from a vein. Further researches are conducted already for definition of a stage of infection, on them estimate the sizes of an inflammation of a liver and extent of its defeat by a virus. is not present
of the Specific tablet, a prick or hepatitis B powder which would allow to clear completely an organism of viruses and in the near future will hardly appear. Treatment is carried out only symptomatic - that is inflammatory process decreases, reproduction vi - rus and destruction of cages by them is suppressed. All preparations for the medical purposes extremely of the road, the monthly course of treatment of hepatitis B makes about 5 000 dollars. And preparations have also numerous side effects...But needs all the same to be treated by
. It allows to achieve permanent remission approximately on
What to do?
the Answer is simple - to take root and to impart children, it is the only way to secure themselves and the children. Thus, we smoothly approached a question of need of vaccination of children a hepatitis B inoculation. Now we will stop on the key moments of the vaccination in detail.
Vaccination against hepatitis B became available since 1982, but in Russia began to impart much later. And now vaccination against hepatitis B is included in the National calendar of preventive inoculations. Considering ways of transfer of a virus, there is practically no alternative of vaccination - nobody is insured from infection, and one sanitarno - hygienic actions and educational work as a time are not enough. >
to All children it is recommended to p to receive the first dose of a vaccine in maternity hospital. But to many parents it is unclear why it to do so early. From the previous story about the virus it becomes more clear that even parents can infect the child.“ How so? I was examined during pregnancy! - you can tell“. Yes, surveyed. But we conduct quite active life - we go to treat teeth, we do manicure, a pedicure, we do a hairstyle in a hairdressing salon... Generally, it is possible not to continue. It becomes so clear - blood could be taken in disease incubation stages. You remember how many it lasts? It is nearly a half of pregnancy! And in some remote regions examination of future mothers on a carriage of a virus of hepatitis B and C is conducted not always and modern diagnostic tests have no 100% of a warranty of result - there are both false positive, and lozhnootritsatelny results.
the Newborn child risks to become at infection the chronic carrier. What sharply will reduce further his life and its quality too. By the way, efficiency of vaccination has inversely proportional dependence - it means what what earlier to begin to impart the child, especially it will be effective. At adults efficiency of vaccination makes about 70 - 90%, and at kids approaches 98% at the first prick. Besides vaccination will protect also those kids whose mothers are sick or are bearers of a virus.In maternity hospital vaccination process is simpler to organize
- after an extract various problems creating obstacles begin - there are no vaccines, quarantine on flu, a liquid chair, a SARS, the horror stories heard by the neigbour about vaccination, and other. It is so possible to postpone indefinitely... Or before infection. And then vaccination will be already inefficient and absolutely useless.What vaccines are used by
For vaccination use both domestic, and foreign vaccines. The main condition - the preparation has to be officially a zaregist - rirovan in Russia (in that state where you live). Usually vaccination is carried out in policlinic free of charge by those vaccines which were purchased by your regional Healthcare Committee. Domestic vaccines - they cheaper are most often bought, but is not worse than import at all. If you want, then in the paid medical centers a vaccine - the tion can be carried out by any vaccines - monocomponent or komb - nirovanny.the following vaccines are available to
In our country to application.
- a hepatitis B Vaccine recombinant barmy liquid (proizvo - “Kombiotekh Ltd“, Russia ditsya); usually this vaccine in large quantities at - vivat children in policlinics.
- “Endzheriks V“ (Smith Klein by Bich“, Belgium, 000 “special design bureau - BIOHONEY“, Belgium - Russia is made “); the children`s and adult form is made (10 and 20 mkg respectively). The adult dosage is applied at adults from 19 years.
- “Euvaks V“ (“LG Chem“ is made, Korea together with “Sanofi Paz - rubbed“, France); let out a children`s dose which is applied till 15 years inclusive.
- “Eberbiovak“ (Hebert Biotek“, Cuba together with “Vee`s MPO - rion“, Russia is made “); it is often bought for mass vaccination.
- N - In - Vax IInbsp; (“Merck Sharp Doum“, the USA is made); Let out a vaccine in several doses. Kombinirovanaya Bubo`s
- is the cook (AKDS+ Hepatitis B) also Bubo - M (ADS - M+ Gep. C) about - the izvoditel of NPK “Kombiotekh“ - NPO Biomed, is applied to vaccination and in paid medical institutions, and in polyclinic offices of vaccination.
, the technology of their production is almost identical therefore schemes of their application are uniform, dosages of a vaccine are almost identical. Therefore schemes approach all these preparations.the level of protective antibodies with - hranyatsya by
After introduction of a full course of vaccination to 20 years and at regular temporary use in its way of a revaccination effectively protects the child and the adult from hepatitis. whether
Can be imparted the child different vaccines?
Sometimes cases when the vaccine with which began vaccination is unavailable happen. Or not opportunities to do vaccination in the same place where also to a pra - dydushchy. Then it is possible to replace a type of a vaccine. According to the international recommendations all recombinant vaccines allowed for use are interchanged. But without special need you should not change a vaccine. All these vaccines are equivalent, hepatitis from them cannot catch, they lifeless, artificially created on one technology. Immunity from them is formed equally. whether
Can mix a hepatitis B vaccine with other vaccines to give less injections? If it is the vaccine which is not combined initially - then it is impossible. As a result of such actions there is a possibility of sharp increase in heavy local reactions, and efficiency of the vaccine will be reduced. According to a calendar it is recommended to do together with the second hepatitis vaccine also poliomyelitis with AKDS. In this case there is an opportunity to do the combined vaccine, for example, Bubo - the cook. In one day it is impossible to do hepatitis only with BTsZh.
the Scheme of introduction of a vaccine
the hepatitis B Vaccine is inactivated, that is does not contain zhi - a vy virus, and in its structure there is only one anti-gen. Therefore for formiro - the immunity vaniya for creation of full protection is required several introductions of a preparation. Two schemes are for this purpose developed: the first is applied to all kids who are not belonging to risk groups.by
carries out vaccination by a technique “0 - 3 - the 6th month“. It means that at with - glasiya of parents (if you decide to do inoculations), to the kid will enter the first dose in maternity hospital in the first days. The kid will take the second injection at the age of three months, and the third - in half a year.the Second scheme is applicable
for the children born from mothers - the bearers of HBsAg having viral hepatitis B, which transferred viral hepatitis B during pregnancy or who do not have results of inspection on hepatitis B. According to the same scheme do inoculations to the kids who were born from mothers carried to risk groups. In this case four pricks according to the scheme
How to be if the scheme is violated?
It is natural, for optimum formation of immunity it is not recommended to deviate from the standard scheme. But happens so that deadlines of vaccination are skirted, for example, from - for sharp diseases. Then it is necessary to know certain rules - minimum admissible term between introduction of doses of a vaccine 1 month is considered. For the second dose terms till 4 months, and for the third - from 4 to 18 months are considered maximum. In this case immunity will be created fully. If even these terms are exceeded, then arrive as follows - already executed inoculations are set off, and all other doses begin to be entered with usual intervals (as recommends a calendar of inoculations), despite of the admission. But, pay attention that then the analysis on the level of concentration of protective antibodies can be required by the child.
If you did not do vaccination to the child in maternity hospital, then as soon as you decide to take root, it is worth adhering to the scheme of vaccination 0 - 1 - 6 months, according to the same scheme impart teenagers and adults. Preliminary anat - for on identification of the “Australian“ anti-gene it is not required (it is carried out at will), the inoculation is safe even for infected and patients, but, of course, for them it is useless.
of the Revaccination, that is additional pricks after end of a full course of vaccination, for children it is not required.
the Technique of carrying out vaccination
As the vaccine contains adjuvant (an aluminum hydroxide), it surely has to be entered strictly intramuscularly. It is important because at introduction efficiency of a prick will hypodermically sharply decrease, the part of a vaccine can be postponed in fatty cellulose, and from - for it the anti-gene fractionally arrives, without allowing immune system to develop immunity actively. If the injection by mistake was given hypodermically - it is not set off, and it needs to be remade. When maintaining in a muscle all dose works at once, and actively there is an elaboration of protection. Besides, getting to hypodermic cellulose, the hydroxide of aluminum forms in it is long the resolving small knots. They develop from - for abilities of this structure to cause a specific inflammation which is extremely important for formation of the center of an inflammation in a muscle it is resulted by attraction of bigger quantity of immune cages and more effective immune answer. In hypodermic cellulose the same inflammation will last for several months since fatty tissue is badly supplied with blood, and all these inflammatory elements are slowly removed. >
At children it is recommended to p to carry out vaccination in lateral atop now - a leg nost (the top third of a hip). It is caused by what even at is new - given rise in this place a muscular layer is sufficient. At kids of 3 years and adults the vaccine is entered into the top third of a shoulder (area of a deltoid muscle), it is conveniently located and allows to enter all volume of a vaccine in one syringe.
But why do not do in a yagodichka how earlier? Maintaining a vaccine to the buttock area is undesirable because both at children, and at adults in this area the fatty layer is strongly expressed - efficiency will be reduced. Besides, there pass large vessels and nerves, the risk of their traumatizing is quite high.Side effects and contraindications
As at any preparation, at a hepatitis B vaccine development of side effects is possible
and there are contraindications about which it is necessary to know. And at once there is a wish to note that it is necessary to differentiate accurately normal post-inoculative reactions and side effects, often parents confuse one to another. So, that is admissible as normal reaction to an inoculation? From - for above described aluminum hydroxides in the place of a prick the inflammation - it develops and has to be there, it is normal inoculative process. Therefore norm consolidation, puffiness of fabrics and reddening on the place of an inoculation with a diameter up to 80 mm is considered. It is not necessary to smear it with drugs, to do compresses, lotions, to rub and press on this place. Everything will pass independently.
of the General manifestations on maintaining a vaccine practically does not happen. Very seldom there can be small temperature - to 37,3 degrees. If the child has an expressed fever, nausea, vomiting, neurologic or any other manifestations - the reason not in an inoculation here - the kid could catch any disease which coincided with vaccination. All these manifestations demand immediate medical consultation.
As any preparation, a vaccine can cause allergic reactions from a kr - pivnitsa to anaphylactic shock (the truth it happens extremely seldom). Especially it concerns to those children who have an intolerance of baking yeast - to such children the hepatitis B vaccine is contraindicated. The contraindication, general for all children, for a hepatitis B inoculation are sharp feverish diseases or exacerbations of chronic diseases. Specific restriction to application of a vaccine can be strong prematurity - weight less than 1,5 kg. In such cases vaccination will be postponed until the moment of achievement of weight by the child 2 also by more than a kg.
That it “the emergency prevention“?
situations when the kid owing to unwillingness of parents or the medical reasons was not imparted Happen. What to do if there is a probability of contact with the diseased or infections with hepatitis B?
of the Doctor is considered that from the moment of contact with the patient to that time when the illness becomes inevitable, there is a certain period when still it is possible to help the child. Usually it is the first one - two weeks when there is a possibility of prevention of hepatitis B by means of introduction of a vaccine according to the scheme
Immunoglobulin and a vaccine needs to be entered at the same time, but in different learning - the stka of a body rather remote from each other.Now you learned
about hepatitis B and vaccination a little more. Owning ob - ektivny information, it is easier to weigh all arguments in favor of vaccination or in favor of refusal of that. The main thing that your choice was conscious. Let your kids will be healthy, cheerful and happy - with inoculations or without them!