TRAVELDOC BLOG

  • Rabies: Tragically, It Happens… And Is Preventable - Jan. 18, 2018

    Read More

  • KTRH Flu Story - Jan. 16, 2018

    Read More

Connect With Us

Tetanus, Diphtheria, Pertussis (ADACEL)

KEY POINTS

  1. Vaccine Targets,
    1. Age 7 – 64: If previously unvaccinated with Tdap (licensed in 2005).
    2. 65 yrs and older: If having contact with infants less than 1yrs-old
    3. All healthcare professionals
    4. Most travelers will require a booster for these diseases, as it is common for people to not maintain such standard immunizations and these diseases are much more prevalent in developing countries where universal vaccination is usually not practiced.
    5. With each pregnancy, between the 27th – 36th week.

 


Diseases:

  1. Tetanus: an often fatal (20%) muscle spasm/paralytic disease caused by the toxin of Clostridium tetani, a bacterium, is not transmitted person-to-person.
    1. Symptoms,
      • Fever
      • Headache
      • Jaw muscle stiffness (lockjaw)
      • Neck stiffness
      • Swallowing difficulty
      • Abdominal muscle spasm/rigidity
    2. Incubation: 3 days – 3 weeks
  2. Diphtheria: an acute bacterial disease caused by Corynebacterium diphtheriae. The illness is fever, sore throat, hoarseness, nasal drainage, and a gray membrane in the throat. It can lead to paralysis, heart failure, and death.

    Rare in the U.S, it may be encountered in developing countries (especially Eastern Europe).

     

  3. Pertussis (“whooping cough”): an highly contagious bacterial respiratory infection caused by Bordatella pertussis, starting as draining of the upper airways, then progressing to deep, convulsive coughs from bronchitis. It can be fatal. 95% of cases are in developing countries.

 

Prevalence:

  • Worldwide, but diphtheria and pertussis are mostly in the Third World.

 

Transmission:

  • Tetanus – usually by contaminated wounds in those unimmunized to it
  • Diphtheria/Pertussis – respiratory droplets

 

Treatment:

  • Tetanus -Tetanus immune globulin (antibody)
    • Wound management
  • Diphtheria- Antibiotics/airway management
  • Pertussis – Antibiotics/airway management

 

Prevention:

  1. Vaccines – Tdap(Adacel), Td (Decavac)
    1. Killed vaccines:
      1. Tdap = Tetanus, diphtheria, acellular pertussis
      2. Td = Tetanus, diphtheria
        1. Does not contain pertussis
    2. Dose: Single dose, intramuscular, 0.5cc
      1. Td: 7 – 64yrs-old
      2. Tdap: 11-64yrs-old
      3. One dose should be lifelong protection.
    3. Side-Effects:
      1. Local Reactions: minor redness, swelling, pain at injection site. Extensive swelling of the injected limb precludes further doses.
      2. Systemic Reactions
        1. Mild – Fever, decreased appetite, drowsiness, swollen glands, rash, irritability are frequent.
        2. Serious (mainly with Tdap) – High fever, crying more than 3hrs (children), collapse (decreased activity/responsiveness), fever convulsions are uncommon, with no permanent damage; Guillain-Barre’ syndrome, brachial neuritis; exaggerated painful swelling from shoulder to elbow 2-8Hrs after injection (Td)
    4. Precautions/Contraindications
      1. Postpone vaccination with moderate illness.
      2. Brain dysfunction within 7 days of pertussis vaccination (with no other cause) precludes further vaccination.
      3. Guillaine – Barre’ syndrome within 6 weeks of tetanus vaccine could preclude future vaccination.
      4. Reactions that might preclude any further vaccination with pertussis are,
        1. 105°F fever within 48hrs of vaccination.
        2. Collapse or shock – like state within 48hrs of vaccine.
        3. Crying persisting > 3hrs within 48hrs of vaccine.
        4. Convulsions.
      5. Vaccine response may be suboptimal in immune compromised persons.
      6. Latex allergy
      7. No data on harmful effects in pregnancy – should only be used after risk/benefit analysis. Theses vaccines are not contraindicated with breastfeeding.
    5. Targets
      1. Age 7 – 64: If previously unvaccinated with Tdap (licensed in 2005).
      2. 65yrs and older: If having contact with infants less than 1yrs-old
      3. All healthcare professionals
      4. Most travelers will require a booster for these diseases, as it is common for people to not maintain their standard immunizations and these diseases are much more prevalent in developing countries where universal vaccination is usually not practiced.
      5. With each pregnancy, between the 27th – 36th week.

Access the VIS Sheet here

How do I schedule an appointment?
Online: Schedule an Appointment.
Call Us: (713) 550-2000 A customer service representative will help you choose an appointment time, and can forward any documents you will need to complete.