Unit 5: Maternal & Childhood Diseases and it's impact
5.1 Prevention & Immunization
5.2 Infection and Intoxication
5.4 Accidents & First Aid
5.5 Genetics and Genetic Counselling
5.1 Prevention & Immunization
Diseases that used to be common in this country and around the world, including polio, measles, diphtheria, pertussis (whooping cough), rubella (German measles), mumps, tetanus, rotavirus and Haemophilus influenzae type b (Hib) can now be prevented by vaccination.
Immunity is the body’s way of preventing disease. Children are born with an immune system composed of cells, glands, organs, and fluids located throughout the body. The immune system recognizes germs that enter the body as “foreign invaders” (called antigens) and produces proteins called antibodies to fight them.
The first time a child is infected with a specific antigen (say measles virus), the immune system produces antibodies designed to fight it. This takes time . . . usually the immune system can’t work fast enough to prevent the antigen from causing disease, so the child still gets sick. However, the immune system “remembers” that antigen. If it ever enters the body again, even after many years, the immune system can produce antibodies fast enough to keep it from causing disease a second time. This protection is called immunity.
Vaccines contain the same antigens (or parts of antigens) that cause diseases. For example, measles vaccine contains measles virus. But the antigens in vaccines are either killed, or weakened to the point that they don’t cause disease. However, they are strong enough to make the immune system produce antibodies that lead to immunity. In other words, a vaccine is a safer substitute for a child’s first exposure to a disease. The child gets protection without having to get sick. Through vaccination, children can develop immunity without suffering from the actual diseases that vaccines prevent.
Vaccines are important. They not only help keep your child healthy, they help all children by limiting the spread of disease and possibly eliminating serious childhood diseases.
Because proof of immunization is often a prerequisite for enrollment in school or day care, it's important to keep your children up to date on their vaccines. The benefit of doing so is that your children will be protected from diseases that could cause them serious health problems. The recommended immunizations for children 0-6 years of age include:
At one time or another, each of the diseases addressed by these vaccines posed a serious health threat to children, taking their lives by the thousands; today most of these diseases are at their lowest levels in decades, thanks to immunizations.
5.2 Infection and Intoxication
Childhood is a period typified by change, both in the child and in the immediate environment. Changes in the child related to growth and development are so striking that it is almost as if the child were a series of distinct yet related individuals passing through infancy, childhood, and adolescence. Changes in the environment occur as the surroundings and contacts of a totally dependent infant become those of a progressively more independent child and adolescent. Health and disease during the period from conception to adolescence must be understood against this backdrop of changes.
Although, for the most part, the diseases of childhood are similar to those of the adult, there are several important differences. For example, certain specific disorders, such as precocious puberty, are unique to children; others, such as acute nephritis—inflammation of the kidney—are common in children and infrequent in adults. At the same time, some diseases that are common in adults are infrequent in children. These include essential hypertension (high blood pressure of unknown cause) and gout. Finally, a major segment of pediatric care concerns the treatment and prevention of congenital anomalies, both functional and structural.
Apart from variations in disease due to differences between children and adults, certain other features of diseases in children need to be emphasized. Infectious disorders are prevalent and remain a leading cause of death, although individual illnesses are often mild and of minor consequence. Most instances of the common communicable diseases, such as measles, chicken pox, and mumps, are encountered in childhood. Disorders of nutrition, still of great concern, especially but not exclusively in developing countries, are of extreme importance to the growing and developing child. The unique nutritional requirements of children make them unusually susceptible to deficiency states: vitamin-D deficiency causes rickets, a common disorder of children in developing countries, and only rarely causes any disease in adults. The major environmental hazards that endanger the health of young children are either unavoidable, as in air pollution, or accidental, as in poisoning and in traffic injuries. Older children, especially adolescents, are exposed, as are adults, to environmental hazards that they deliberately seek, such as cigarette smoking and the use of alcohol and other drugs.
The newborn infant is subject to the ordinary infections and, in addition, to infection with commonly encountered organisms such as Escherichia coli, Staphylococcus aureus, and group B hemolytic streptococci, which are not usual causes of serious infection in older age groups. Infection may be acquired in the uterus, during delivery, or later, in the nursery. Commonly encountered serious infections are pneumonia, meningitis (inflammation of the coverings of the brain and spinal cord), and septicemia (infection of the bloodstream). Often the infant shows few signs of the disease other than poor feeding, lethargy, pallor, or slight fever. Since the newborn infant’s resistance to infection is poor, early diagnosis and treatment are particularly important. Often, treatment is given when infection is merely suspected.
Congenital defects of each part of the immunologic system have been discovered. The most striking feature of these diseases is the inability of the patient to combat infection. Thus, untreated patients with some forms of agammaglobulinemia (lack of antibodies in the blood) may die from overwhelming infection in infancy or early childhood.
Epilepsy is a chronic disorder, the hallmark of which is recurrent, unprovoked seizures. A person is diagnosed with epilepsy if they have two unprovoked seizures (or one unprovoked seizure with the likelihood of more) that were not caused by some known and reversible medical condition like alcohol withdrawal or extremely low blood sugar.
The seizures in epilepsy may be related to a brain injury or a family tendency, but often the cause is completely unknown. The word "epilepsy" does not indicate anything about the cause of the person's seizures or their severity.
Many people with epilepsy have more than one type of seizure and may have other symptoms of neurological problems as well. Sometimes EEG (electroencephalogram) testing, clinical history, family history, and outlook are similar among a group of people with epilepsy. In these situations, their condition can be defined as a specific epilepsy syndrome.
Although the symptoms of a seizure may affect any part of the body, the electrical events that produce the symptoms occur in the brain. The location of that event, how it spreads, how much of the brain is affected, and how long it lasts all have profound effects. These factors determine the character of a seizure and its impact on the individual.
Having seizures and epilepsy can affect one's safety, relationships, work, driving, and so much more. Public perception and treatment of people with epilepsy are often bigger problems than actual seizures.
Causes of epilepsy
In epilepsy, the electrical signals in the brain become scrambled and there are sometimes sudden bursts of electrical activity. This is what causes seizures.
In most cases, it's not clear why this happens. It's possible it could be partly caused by your genes affecting how your brain works, as around 1 in 3 people with epilepsy have a family member with it.
Occasionally, epilepsy can be caused by damage to the brain, such as damage from:
· a stroke
· a brain tumour
· a severe head injury
· drug abuse or alcohol misuse
· a brain infection
· a lack of oxygen during birth
5.4 Accidents & First Aid
In developed countries, accidents cause more loss of life and disability among children (except infants) than any disease. Road-traffic mishaps account for nearly half of the accidental deaths—usually the child involved being a pedestrian or cyclist. Accidents in the home, by way of burns and falls, account for another quarter. Boys are more at risk than girls, particularly if they are from a large family living in a poor, inner-city area. Children are more likely to suffer serious burns and scalds than adults because of the fact that their skin is thin and more liable to full-thickness damage.
Accidental poisoning is very common, particularly among two- to four-year-olds, who are inquisitive and use their mouths to feel and taste new objects. Accidental ingestion of household fluids and medicines is common. Fortunately, it is usual for the child to swallow only a tiny amount, and severe illness from such poisoning is rare. Medicinal drugs are much more likely to cause illness than are household and garden products, berries, or toadstools.
Lead poisoning has become less common worldwide, though there is increasing worry about prolonged exposure to low levels of lead and its possible relationship to abnormal childhood behaviour and intelligence. Low-level lead poisoning generally results from unavoidable exposure to atmospheric lead pollutants. This is a problem in some heavily industrialized areas and in those regions where leaded gasoline is still burned in automobiles.
5.5 Genetics and Genetic Counselling
Genetics is the study of genes and the variation of characteristics that are influenced by genes—including physical and psychological characteristics. All human traits, from one's height to one's fear of heights, are driven by a complex interplay between the expression of inherited genes and feedback from the environment.
Many genes interact to influence the human brain. Almost all normal and disordered characteristics are polygenic, meaning that they are each shaped by a large number of genes.
Scientists are tasked with a massive but increasingly plausible mission: mapping the pathway from one's genes to the person one sees in the mirror. What they learn about the power of genes has implications for understanding mental illness and psychological differences between individuals, as well as the psychological effects of non-genetic factors.
Epigenetic involves the study of how non-genetic factors (including environmental and experiential ones) modify the influence of genes.
Human chromosomes are divided into two types—autosomes and sex chromosomes. Some genetic traits are linked to a person’s sex and therefore passed on by the sex chromosomes. The autosomes contain the remainder of a person’s genetic information. All human beings have 23 pairs of chromosomes by which genetic material is developed and characteristically demonstrated; 22 of these are autosomes, while the remaining pair (either XX, female, or XY, male) represents a person’s sex chromosomes. These 23 pairs of chromosomes work together to create the person we ultimately become.
Chromosomal abnormalities can occur during fetal development if something goes wrong during the replication of the cells. Common abnormalities include Down syndrome (caused by an extra chromosome #21), Klinefelter syndrome (caused by an extra X chromosome), and Turner syndrome (caused by a missing X chromosome). Genetic counseling is available for families in order to determine if any abnormalities exist that may be passed along to offspring. Many chromosomal abnormalities are of psychological importance, with substantial impacts on mental processes; for example, Down syndrome can cause mild to moderate intellectual disabilities.
As science advances, the ability to manipulate chromosomes is becoming more realized. Cloning is an example of taking chromosomal and genetic material and creating a new animal, and was first successfully achieved in the famous example of Dolly the sheep. There is much controversy surrounding the manipulation of chromosomes in human beings, with many people believing it to be unethical.
Genetic counseling gives you information about how genetic conditions might affect you or your family. The genetic counselor or other healthcare professional will collect your personal and family health history. They can use this information to determine how likely it is that you or your family member has a genetic condition. Based on this information, the genetic counselor can help you decide whether a genetic test might be right for you or your relative.
Genetic counselors help identify families at possible risk of a genetic condition by gathering and analyzing family history and inheritance patterns and calculating chances of recurrence. They provide information about genetic testing and related procedures. They are trained to present complex and difficult-to-comprehend information about genetic risks, testing, and diagnosis to families and patients. Genetic counselors can help families understand the significance of genetic conditions in relation to cultural, personal, and familial contexts. They also discuss available options and can provide referrals to educational services, advocacy and support groups, other health professionals, and community or state services. Genetic counselors can serve as a central resource of information about genetic conditions for other healthcare professionals, patients, and the general public.
In general, a genetic counseling session aims to:
Based on your personal and family health history, your doctor can refer you for genetic counseling. There are different stages in your life when you might be referred for genetic counseling:
Following your genetic counseling session, you might decide to have genetic testing. Genetic counseling after testing can help you better understand your test results and treatment options, help you deal with emotional concerns, and refer you to other healthcare providers and advocacy and support groups.