INFECTIOUS_DISEASES

stay in the body and can "reappear later as shingles. It takes fourteen to sixteen days after 5... the illness for the rash to 6... .

The day before the 7... appears your child may feel 8..., and have a slight 9... .Small, itchy red 10... appear over the chest and 1 1 . . .

and spread to the face and the rest of the body. W ithin a few hours these develop into 12... blisters, which then dry. into scabs and 13... .They don't usually leave a scar unless t he spots are 14... infected or your child scratches them. Your child is infec - tious—and so can give the 15.. to someone else —from the day

before the	rash appears until all		the	spots	are 16... .
1. watery	2. illness	3. appear	4. drop	off	5. infectious	6. badly
7. tempera-	8. caused	9. catching	10. spread		1 1 . virus	1 2 . unwell
ture
13. rash	14. back	15. spots	16. dry

D. Самостоятельная работа 2.

Прочитайте текст, пользуясь англо-русским словарем, и выполните тест.

IMMUNIZATION

Can infections be prevented in older infants?

There are a number of diseases from which one can protect the infant, by immunizing them. The mother must know about these. I would suggest immunization against Smallpox, Tuberculosis, Tetanus, Whooping Cough, Diphtheria, Polio and Measles, in the first one year of life, later on Boosters must be given for continued protection.

In what order would you advise immunization?

The order of immunizations should depend on the disease pattern in the community. In India we like to give BCG from birth to three months. DPT and Polio at monthly intervals for three doses starting from 4th month onwards. Measles vaccine is advised at 9 —12 months and Smallpox vaccination, at one year of age. First Booster of DPT and Polio is done at 18 months to 24 months and second Booster at 5 to 6 years of age. Later Diptheria, Tetanus and Typhoid inoculations are advised every five years for continued protection.

What are the cotraindications for immunization? Do they have any ill effects or complications?

There are a few contraindications for immunization. For example Polio drops should not be given when the child is sick. In fact

I would suggest that all these immunizations should be done when the child is normal and healthy. If the child has cold, cough, diarrhoea, fever or any skin disease like eczema, immunization is not advised. A doctor must be consulted before giving immunization in these conditions. Another condition where immunization should be done under medical advice is a child who had convulsions in the past.

Every immunization can have different complica tions. Let us take first, one which has no complication. As a rule Polio does not have any complication. With DPT (Triple Antigen) the infant might have temperature which should disappear within 48 hours on its own. But it is a good practice to give Baby A spirin and this could be repeated and temperature will come down. As regards Smallpox, there could be very many complications if the vaccinated site is not looked after well. Normally we do not expect complications. High temperature, redness or even swelling at the vaccination site are common accompaniments. At times one can get a rash which can be red in character like Measles or other skin complications.

Rash which is red in character usually disappears on its own. In a child, with eczema, secondary vaccination sites can appear on other parts of the body and that is the reason why it is not advisable to have vaccination done for a child with skin lesions. Other complications are uncommon. BCG vaccination usually heals within six weeks but at times there is enlargement of glands in the axilla, which is normal and should not cause any anxiety unless it does not resolve at the end of six weeks at which time the mother should see the doctor. The BCG mark should also form a scar during this period. If there is discharge from the vaccinated site, the doctor must be consulted, but please do not apply any thing on it.

What is the reaction of the Smallpox vaccination and what care should be taken?

The Smallpox vaccination once given usually shows a reddish reaction on the third day which becomes a vesicle on the 5th and pustule on the 7th day. This lasts for 48 —72 hours, when the pustule bursts discharging its contents and leaving an ulcer which usually crusts up by the 14th day and heals by leaving a sca r at the end of 3 weeks. High temperature may be there on the 8th and 9th day with a lot of redness on the vaccinated site. It is necessary to keep the temperature down (with paracetamol or aspirin). As regards the care of the vaccinated site, it is necess ary to' realise that nothing should be applied on it. No powder or medicines need be applied. If necessary, spirit may be applied two to three times a day. When the vaccinated site is discharging, it is very necessary that clean cotton is used for cleaning it.

What is the course of the BCG vaccination?

BCG is done on the left arm, high up. The mark caused by the injection usually disappears and for two to three weeks there may be no reaction on the site. After about three weeks a sma ll vesicle appears at the site of injection, this becomes opaque and later a discharging ulcer. In the course of 2 —3 weeks the whole thing clears up leaving a -scar at the site.

During this process the regional lymph-nodes in the axilla always enlarge, sibsiding on their own. In some infants they may take longer.

What are the untoward manifestations of BCG?

The ulcer on the arm may continue discharging for some time but usually heals by 12 weeks. In any case no medicines should be given before this period.

The regional lymph-nodes may enlarge and not regress. Again unless they soften up or become an abscess they should not be touched. If a discharging sinus forms, it needs surgical and medical treatment, so ask your doctor for advice.

Can BCG cause tuberculosis?

No, not in common terminology. I say this because by introducing the germs which are attenuated, one hopes to cause a small primary complex at the skin level, so that immunity is developed. But it does not cause tuberculosis as we understand it. If a child has had the infection earlier then the reaction to BCG inoculation will be very marked which should draw the attention of the treating physician for further investigations and treatment.

What is meant by the term vesicle and pustule?

The term vesicle means small blister filled with clear fluid and pustule means blister with opaque material.

Is it essential to repeat the Smallpox vaccine, if it does not errupt the first time and at what age should we repeat triple antigen vaccine?

If there is no effect of the Smallpox vaccination, i.e. no successful scar, it should be repeated every six weeks till it is p o s i t i v e , a nd l a t er e ve r y t h r e e ye a r s . T r i p le A n t i g e n m us t be repeated at 1 year after the last injection and then at 5 years a n d l a t e r i t s h o u l d n o t b e D P T b u t D T o n l y, e v e r y t h r e e years, till the child is 15 years of age. W e do not like to give DPT after six years of age. since pertussis vaccine may be dangerous.

Why is the whooping cough element dangerous?

The whopping cough vaccination, if given after the age of six, may produce encephalitis in one in 100,000 cases. W e do not want to take any risk with your precious child, hence we do not advise it after the age of six.

Please tell us something about immunization against Polio.

Polio vaccination is done by few drops of the vaccine being put in the baby's mouth. You should make it certain that the baby is not fed for at least 1/2 hour before and 1/2 hour after the vaccination. The baby should not have diarrhoea and upper respiratory tract infection like cold and cough for a successful vaccination to take place. It is very necessary that you should get the vaccine from an authorised centre, otherwise the chances of false protection may cost you heavily. The vaccination becomes ineffective if not given properly. The vaccine has to be stored in a deep freeze at a certain temperature, which very few centres can afford. So please be careful where you get the polio vaccination done for your baby. Polio immunization need not be repeated after the first, or maximum the second Booster.

How to save the child from Cholera and Typhoid?

The typhoid vaccination must be.done just before summer every year, since the protection provided by the vaccine is only for 6 months.

In fact if you think you can give your child water to carry in a flask I can assure you, that either he will share it with his friends or throw it away and drink the water from the tap. Carrying water singles him out and his desire is to be identified with his friends and socialise, to be one with them and not different. - Milk and ice-creams beside water are vehicles for this infection which is carried by fluids. Children love ice-creams in summer and hence it is necessary to protect them rather than prohibit them from eating the delicacies of summer. Cholera immunization as a routine is not advised.

Is Booster-shot required after BCG too?

Yes, once a child is vaccinated for BCG he should be tested at one year of age whether the BCG was effective. This is done by a test known as Mantoux. If it is negative, BCG vaccine should be repeated. If it is positive then the purpose has been served.

Tell us about the M.M.R. vaccine.

The M.M.R. vaccine stands for measles, mumps, and rubella (also known as German Measles).

Why is rubella dangerous for a pregnant mother?

Rubella is a disease like measles except that it is milder in severity and has other manifestations like glands in the neck which identify it from the ordinary measles. If a young girl has rubella, that gives her a long immunity from the disease. But the non -im- munized pregnant woman, especially in the first three months of pregnancy, if exposed to rubella, is likely to transfer th e disease to her unborn infant in which case the infant may be bom blind or may have many other congenital abnormalities and be crippled. That is the reason why we suggest that rubella immunization should be done in early childhood, because if the ^mother has had the disease or was immunized then; then if she is exposed to German measles in pregnancy, she is not going to suffer from the disease or transfer it to her unborn child.

What schedule do you recommend for a child who is not immunized?

The schedule is exactly as in infants. This means that if a child comes to us under the age of six, we can give this child BCG, DPT and polio on the first day o.f the visit. Every month DPT and polio is to be repeated for the next two months. The Smallpox vaccination can be given next. If a child comes after the age of six, then it should be DT and NOT DPT as explained above, but the rest of the schedule remains the same.

Tell us where we /can get immunizations for our baby.

Immunizations can be done in any big hospital, MCH centres or primary health centres. Most of these have various immunizing agents. The Polio vaccine may not be available in some places but in most centres where deep freeze or fridge is available, polio may also be available.

Does immunization provide 100% protection?

Well, immunization may not provide 100% protection but it does provide at least 90% protection for most of these diseases. The reason why I say 90% is because if the child is incubating, the protection may not be complete. At the worst, the child may have the diseases in a very mild form which may not affect the child's health, on the. other hand if immunizations are done early enough as advised, the protection is nearly 100%. Even for the polio vaccine, where it is said that immunized child might have the disease, I may assure you that it usually is not true if the immunizing agent was well stored, and given well. Further many viruses may cause similar pattern of diseases and unfortunately we do not have a vaccine against them at present.

	TEST 'IMMUNIZATION'
Вариант 1.
I. Choose the sentences			corresponding to the contents of the
chapter.
1. a) Immunization against measles and whooping cough is
advisable in the first	year	of	life.
b) The doctor suggests		to immunize one year old babies only
against Smallpox and	Tuberculosis.

2.a) There exist no contraindications for immunization, b) There are some contraindications for immunization.

3.a) Smallpox vaccination is not advisable to very small babies.,

b) It is not advisable to	vaccinate a child with skin disorder
against Smallpox.
4. a) BCG vaccination	is recommended to do on the left arm.

b)To use left or right arm for BCG vaccination makes no difference.

5.a) If a discharging sinus forms after a BCG injection, the

lymphatic		nodes should not be touched.
b)	If	there	is an abscess after a BCG		injection,			surgical
treatment		is not	recommended.
6.	a) Smallpox vaccination should			be repeated	if	it	is possible,
b)	Smallpox		vaccination should	be repeated	if	it	is	negative
(if there		is no successful scar).
7. a) Polio vaccination must be repeated several times for
continued		protection.
b)	Usually Polio vaccination is effective after the						f irst or the

second Booster.

8.a) BCG vaccination should be repeated if Mantoux was negative.

b) If Mantoux reaction was positive BCG vaccination must be given.

9.a) German measles immunization should be done in the last months of pregnancy.

b) German measles immunization must be done early in childhood.

10.a) The immunization may provide 100% protection if it is done early enough as advised.

	b)	The protection may be complete if the child is							incubating.
	11.	Find the	argument from		"B"	for the statement			from	"A".
		А					'	в
1.	The	doctor didn't advise to give the			1. A discharging Sinus formed after the
child Polio drops					BCG	vaccination.
2.	The	child needed	surgical	treatment.	2. The child has had an infection					before
					the reaction		to BCG.			^
3.	BCG	inoculation	reaction	was very 3. The		child	was	suffering	from	cold,
marked.					cough and diarrhea.

4.	The Smallpox vaccination was repeated 4.		Pertussis	vaccine		may		be	dangerous.
every six weeks and later every three
years.
5.	It is not advisable to	give DPT after 5.	Protection		against		the		disease is
six years of age.		provided		only	for	six months.
6.	The typhoid vaccine	should be given 6. It was		ineffective			the	first time.
just before summer.

III.

Match

English and

Russian equivalents:

1.

on

the

other

hand

1. в худшем

случае

2.

similar

pattern

2.

сам

собой

3.

disease

pattern

3.

с другой

стороны

4.

as

advised

4.

структура

заболевания

5.

as

regards

5.

подобная

модель

6.

on

(its)

own

6.

убедиться

7.

take longer

7.

занять больше времени

8.

continued protection

8.

длительная защита

9.

at

the

worst

9.

что

касается

10. make it

certain

10.

по

совету

Вариант 2.

I. Choose the sentences corresponding to the contents of the

text:

1. a) The order of immunization must depend upon the disease

structure.

b) The order of immunization depends on the availability of

vaccines.

2. a) Immunization is advised when

the child

is

unhealthy,

b)

Immunization is not

advisable when the child

is sick.

3. a) As a rule, there are no complications after Potio vaccination,

b) Polio vaccinations are usually accompanied by high temperature,

redness and swelling.

4. a) BCG vaccination always heals without any complications,

b) Sometimes BCG vaccination may result in enlargement of

glands

in

the

axilla.

5. a)

Nothing should

be applied

on

the

BCG vaccination

site,

if there is discharge from

it.

b) If the BCG vaccination site doesn't heal, apply some medicine

or

powder on

it.

6. a) The discharging Smallpox vaccination site should be treated

with spirit and powder as

often as

possible.

b)

When

the smallpox

vaccination site is

discharging,

it is

necessary to apply some spirit two-three times a day and to clean it with cotton.

7.	a) A	small vesicle appears at the site of BCG injection
three	weeks	later.

b)	Usually	there		is no	reaction		on	the BCG	vaccination	site.
8.	a) Vesicle		is	a small blister			filled	with opaque material.
b)	Vesicle	is	a	small	blister	filled with clear			fluid.
9.	a) Pertussis vaccination is					not advisable after the age of				six.

b)Whooping cough vaccination may be given at any age.

10.a) Typhoid vaccination as a routine is not advised, b) To save the child from typhoid it is necessary to vaccinate him before the onset of summer every year.

11.	Find the argument	from	"B"	for	the	statements from "A".
	А					В
1. Rubella immunization should		be done	1.	If the child is incubating the protection,
in early	childhood		may not		be	complete.

2. Immunization may not provide 100% 2. Being exposed to German measles, in protection against diseases. pregnancy the mother may transfer it to

her child.

3.	The child was not	immunized.	3. He	had	got	Smallpox	vaccination.
4.	The infant developed a high tempera- 4. He had diarrhea,
ture.
5.	The vaccinated site became red		and 5. He had		got	DPT vaccination,
swollen.
6.	Lymphatic glands	in the axilla were 6. This		was a		result	of the BCG
enlarged			vaccination		carried out.

III. Match English and Russian

equivalents:

1.

exposed

1. обычный, распространенный

2.

ill

2.

беременная

3.

common

3.

врожденный

4.

available

4.

подвергнувшийся

контакту

5.

complete

5.

неблагоприятный

6.

successful

6.

полный, завершенный

7.

pregnant

7.

имеющийся в наличии, доступный

8.

ordinary

8.

обыкновенный, ординарный

9.

congenital

'

9.

слепой

10. blind

10.

успешный

Вариант 3

I. Qhoose the sentences corresponding to the contents of the

text:

.

1.

a) One can

protect the infant against a number of infections

by

immunization.

b) Immunization against every possible infection should be

carried

out

within

the

first

year of

life.

2.

a) Immunization

should

be done under

medical

advice if a

child

is

not

healthy.

b)

Immunization is

never

done

if the child

is

not

healthy.

3.	a)	As	a rule,		DPT can't		give any	complications.
b)	With		DPT	the	infant	may have a		high	temperature.
4.	a)	There		could be		no	complications		after a Smallpox

vaccination, b) There could be many complications after a Smallpox

vaccination if

the

vaccinated

site

is

not cared

for

well.

5.

a) The

pustule after a

Smallpox

vaccination

bursts on the

7th

day.

b)

The pustule

bursts

on

the 9th—10th day.

6.

a) The

Polio

vaccine can be

kept under different

conditions

in

various health

centres.

b) The Polio

vaccine

can

only be

kept frozen.

7.

a) Ice-cream

can

carry Typhoid

bacilli and

it

is

necessary

to protect children from Typhoid fever in summer.

b)

Ice-cream

must be prohibited

from eating

in

summer.

8.a) A baby may be born with congenital abnormalities if his mother has been exposed to Rubella in early pregnancy.

b)If a pregnant woman is exposed to Rubella, he is likely to become blind or crippled.

9.a) Many viruses may cause the pattern of the disease similar

to poliomyelitis but there is no

vaccine against

them,

b)

Many

viruses cause

various

patterns of

poliomyelitis,

that

is

why

there

is no

vaccine

against

it.

10.

a)

On

the first or second day after a

BCG vaccination a

small

vesicle appears

at the

site of

injection.

b)

A

vesicle is

formed

at

the

vaccinated

site

about

three

weeks

after a

BCG vaccination.

11. Find the argument from "B" for the statements from "A".

А

в

1.

The

mother

of

the

vaccinated

child 1. The

vaccination

had

been carried out

decides

to see

the

doctor

in

a

centre

where the vaccine had not

been

stored in

a deep

freeze.

2.

A scar formed at the site of injection. 2. He

had been

given

Polio

vaccination.

3.

The child was not advised

DPT.

3.

The

enlarged glands

of

the axilla did

not

resolve

at the end of 6 weeks.

4

.The

baby

was

not

fed

for half an 4.

The

girl

was

7

years

old

hour after his

visit

to

the doctor.

5 The Polio vaccination proved ineffective. 5.

The

boy

had

been

BCG immunized

three

weeks before.

6. The

Typhoid

vaccination

didn't

work 6.

The

girl

had

been

vaccinated in

in

this

child.

December,

and

exposed

to

the disease

in

August.

III. Match the Russian and English equivalents:

1.	come down	1. поражать
2.	keep down	2.	обеспечивать, снабжать
3.	suggest	3.	развиваться

4.	develop	4.	снижать	температуру
5.	need	5.	снижаться (о температуре)
6.	depend	6. предлагать
7.	discharge	7.	нуждаться
8.	provide	S. выделяться
9.	carry	9.	зависеть
10.	affect	10. нести,		переносить

Самостоятельная работа с текстом Kawasaki Disease

Задание 1. Прочитайте текст и выпишите все неизвестные слова.

Задание 2. Составьте 15 вопросов к основному содержанию текста.

Задание 3. Ответьте на вопросы (письменно) и напишите тезисы к данной статье.

Kawasaki Disease

Description. Kawasaki disease (mucocutaneous lymph node syndrome) is a children's illness characterized by fever, rash, swelling of the hands and feet, irritation and redness of the whites of the eyes, swollen lymph glands in the neck, and irritation and inflammation of the mouth, lips and throat. These immediate effects of Kawasaki disease are rarely serious: however, long-term heart complications result in some cases and can be seen as early as two weeks after onset of the disease.

Named after Dr. Tomisaku Kawasaki, a Japanese pediatrician, the disease has probably been in existence for a long time, but was not recognized as a separate entity until 1967. The incidence is higher in Japan than in any other country. In the United States it is more frequent among children of Asian-American background, but can occur in any racial or ethnic group. The disease is not common, and its incidence in the United States has not been determined. In recent years, it has tended to occur in localized outbreaks, most often in the late winter or spring, but is seen year-round. Kawasaki disease almost always affects children; most patients are under 5 years old, and the average age is about 2 years. Boys develop the illness almost twice as often as girls.

The heart may be affected in as many as one of five child ren who develop Kawasaki disease. Damage sometimes occurs to the blood vessels that supply the heart muscle (the coronary arteries) and to the heart muscle itself. A weakening of a coronary artery can result in an enlargement or swelling of the blood vesse l wall ( an aneurism). Infants less than 1 year old are usually the most seriously ill and are at greatest risk for heart involvement.