Antipyretic measures, e.g.:
- Paracetamol
- Application:
- > 12 y. (>40 kg): single dose (ED): 500-1000 mg, max. daily dose (TD): 4 g
- 9-12 y. (30-40 kg): ED: 500 mg, max. TD: 2 g
- 6-9 y. (22-30 kg): ED: 250-500 mg, max TD: 750 mg
- KI: Liver damage, renal insufficiency, acute hepatitis, Meulengracht's disease, pregnancy, lactation
Topical therapy
| vaccination against |
category |
Indication |
Instructions for use |
| Measles |
S |
People born after 1970 ≥ 18 years with unclear vaccination status, without vaccination or with only one vaccination in childhood | Once vaccinated with an MMR vaccine |
| |
I |
If admission is imminent or if the child is attending a community facility (e.g. day care centre):
Infants from the age of 9 months |
Twice vaccination with an MMR/V-*vaccine
If the first vaccination is given at the age of 9 - 10 months, the 2nd MMR/V vaccination should already be given at the beginning of the 2nd year of life |
| |
I |
Born after 1970 from the age of 9 months with unclear vaccination status, without vaccination or with only one vaccination in childhood
exceptionally 6 - 8 month old infants after individual risk-benefit assessment (off-label-use) |
Once-only MMR(V)-**vaccination
Completion, if necessary, according to the recommendations applicable to the age group
If the first vaccination is given at 9-10 months of age, the 2nd MMR/V* vaccination should be given at the beginning of the 2nd year of life.
If the first vaccination is given at 6 - 8 months of age, a 2nd and 3rd MMR/V* vaccination should be given at 11 - 14 and 15 - 23 months of age
* MMR/V = MMRV or MMR in co-administration with VZV vaccine
** MMR(V) = MMR with or without co-administration of VZV vaccine
|
| |
B |
Working in health services or in the care of immunodeficient or -suppressed persons or in community settings: born after 1970 with unclear vaccination status, without vaccination or with only one vaccination in childhood | Once vaccinated with an MMR vaccine |
S: Standard vaccinations with general application
I: Indication vaccinations for risk groups with individually (not occupationally) increased risk of exposure, disease or complications as well as for the protection of third parties
B: Vaccinations due to an increased occupational risk, e.g. after risk assessment according to the Occupational Health and Safety Act/Biological Substances Ordinance/Ordinance on Occupational Medical Precautions (ArbMedVV) and/or for the protection of third parties in the context of occupational activities
Robert Koch Institute, Epidemiological Bulletin No. 34. (2015). Rki.de. Retrieved 10 May 2016, from https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2015/Ausgaben/34_15.pdf?__blob=publicationFile
| |
Adverse reactions after MMR vaccination per 1 million vaccinated | Complications of measles disease per 1 million measles vaccinated |
| Immune deficiency |
Very rare |
All sufferers |
| Ear infection |
0 |
70000-90000 |
| Pneumonia |
0 |
10000-60000 |
| Hospitalisation |
20-50 |
10000-25000 |
| Febrile convulsions |
30-300 |
5000-7000 |
| Brain inflammation |
0.6-1.6 |
200-2000 |
| Decrease in platelets |
30 |
330 |
|
Subacute sclerosing
Spanencephalitis (SSPE)*
|
0 |
1-10 |
|
Allergic shock reaction
(Anaphylaxis)
|
1-10 |
0 |
| Autism |
0 |
0 |
| Deaths |
< 1** |
300 to 1000 |
| Cost |
1 million vaccinations cost 140 million Swiss francs. |
1 million sick people cost between 3.6 and 5 billion Swiss francs. |
* SSPE is a late consequence of a measles infection. Years after the infection, an insidious brain inflammation develops that cannot be cured and is always fatal.
** No death is expected, and to date no death has been reported due to the vaccine; however, the risk cannot be completely ruled out.
Source:Federal Office of Public Health - Measles. (2016). Bag.admin.ch. Retrieved 10 May 2016, from http://www.bag.admin.ch/themen/medizin/00682/00684/01087/index.html?lang=de
- If a measles infection is suspected, a report must be made
- Kindergarten and school ban (unvaccinated children who have had contact with contagious persons must stay at home for max. 3 weeks). In case of suspicion, contact with non-immune persons must be avoided until 5 days after the appearance of the exanthema
- For the first few months, newborns are protected by the mother's antibodies
- MMR vaccination:
- MMRV vaccination should be given between 11 and 14 months of age. A booster vaccination is recommended 1 ½- 3 months later to detect vaccination failure. For children in childcare facilities, immunisation can be given as early as 9 months of age. The 2nd vaccine should then be given between 12-15 months of age. This is done to immunise the approx. up to 10% vaccination failures (thereafter there are only approx. 5% vaccination failures).
- The live vaccine can prevent the outbreak in immunocompetent children from 7 months of age onwards - provided it has been used within the first 3 days of exposure
- Passive immunisation:
- If in immunodeficient patients or children before 7-13 months of age at exposure using
- Intravenous immunoglobulins i.v. 250-400 mg/kg bw daily for 3-5 days every 3-4 weeks
- Initial dose: 0.4-0.8 g/kg bw
- In the course: 0.2 g/kg bw every 3 to 4 weeks
- Determination of the IgG serum level always immediately before the next infusion!
- An IgG valley level of at least 5 to 6 g/l should be reached before a new infusion
- indicated and should be given within 6 days of first exposure. In this case, there is no increased risk for the child, but the risk that the existing maternal antibodies neutralise the vaccine. In this case, the second vaccination should be given between the 12th and 15th month of life, as usual
- If a patient was born in 1964 or earlier and has not had measles, vaccination is recommended only in case of exposure
- A contraindication to vaccination is pregnancy. If vaccination is nevertheless given, this is not a reason to terminate the pregnancy
- Possible side effects: Local reaction, pain, swelling, redness. In rare cases, flu-like symptoms, thrombocytopenia and meningitis
- Unlike Dr Wakefield postulated at times, the current data is very clear that there is no link between autism and MMR vaccination
- Costs of MMR vaccination are covered by health insurance (except for the deductible)
- Topical therapy:
- Drying out shaking concoctions
