The National Immunisation Programme now and in the future: developments in 2005

The National Immunisation Programme in the Netherlands is effective and safe. The target diseases are largely under control. However, in 2004/2005 a rubella outbreak occurred among individuals who had declined vaccination on religious grounds. Furthermore, there have been incidents of mumps (among vaccinated individuals) and measles (among unvaccinated individuals) in 2004 and 2005. In January 2005 the diphtheria, tetanus, whole-cell pertussis and Haemophilus influenzae vaccine was replaced by a combination vaccine including an acellular pertussis component and subsequently a decrease in adverse events was noticed. From January 2006 onwards, children of hepatitis B antigen-positive mothers will receive an extra vaccination at birth. The National Immunisation Programme could be extended with new target diseases. In April 2006, pneumococcal vaccination for infants will be introduced and to evaluate the effects of vaccination it is desired to enhance the surveillance of invasive pneumococcal disease. The desirability to introduce vaccinations for chickenpox, shingles, human papillomavirus and rotavirus must be considered on the short-term, because of the availability of vaccines for these diseases. To gain insight into the health and economic effects of these vaccinations, cost-effectiveness studies are advised. Due to various reasons, extension of the programme with vaccinations against influenza, hepatitis A, meningococcal serogroup B, respiratory synctial virus and tuberculosis is not yet recommended. Monitoring the effectiveness of the National Immunisation Programme remains important. Maintaining high vaccine uptake is vital to prevent (re)emergence of disease.Het Rijksvaccinatieprogramma in Nederland is effectief en veilig. De ziekten waartegen momenteel wordt gevaccineerd zijn grotendeels onder controle. In 2004/2005 heerste er echter een rubella epidemie voornamelijk onder personen waarbij vaccinatie was geweigerd op grond van bevindelijk gereformeerde overtuiging. Daarnaast zijn er in 2004 en 2005 incidenten van bof (onder gevaccineerden) en van mazelen (onder niet gevaccineerden) geweest. Per 1 januari 2005 is het difterie, tetanus, poliomyelitis, hele-cel kinkhoest en Haemophilus influenzae vaccin vervangen door een combinatievaccin met een a-cellulaire kinkhoestcomponent en is een daling zichtbaar in het aantal meldingen van postvaccinale verschijnselen. Vanaf 1 januari 2006 zullen kinderen die geboren worden uit moeders die chronisch geinfecteerd zijn met hepatitis B vlak na de geboorte een extra vaccinatie krijgen. Het Rijksvaccinatieprogramma kan met vaccins tegen andere ziekten uitgebreid worden. Vanaf 1 april 2006 zal pneumokokkenvaccinatie voor kinderen ingevoerd worden en om de effecten hiervan te evalueren is uitbreiding van surveillance van invasieve pneumokokken infecties gewenst. De wenselijkheid van opname van vaccinatie tegen waterpokken, gordelroos, humaan papillomavirus en rotavirus moet op korte termijn overwogen worden, gezien de beschikbaarheid van deze vaccins. Om inzicht te krijgen in de gezondheids- en economische effecten van deze vaccinaties is kosten-effectiviteitsonderzoek geindiceerd. Opname in het Rijksvaccinatieprogramma van vaccins tegen influenza, hepatitis A, meningokokken B, respiratoir synctieel virus en tuberculose is om verschillende redenen op korte termijn nog niet aan de orde. Voortdurende bewaking van de effectiviteit van het Rijksvaccinatieprogramma is van groot belang. Handhaven van de hoge vaccinatiegraad is essentieel om terugkeer van ziekten te voorkomen

The National Immunisation Programme now and in the future: developments in 2005

Het Rijksvaccinatieprogramma in Nederland is effectief en veilig. De ziekten waartegen momenteel wordt gevaccineerd zijn grotendeels onder controle. In 2004/2005 heerste er echter een rubella epidemie voornamelijk onder personen waarbij vaccinatie was geweigerd op grond van bevindelijk gereformeerde overtuiging. Daarnaast zijn er in 2004 en 2005 incidenten van bof (onder gevaccineerden) en van mazelen (onder niet gevaccineerden) geweest. Per 1 januari 2005 is het difterie, tetanus, poliomyelitis, hele-cel kinkhoest en Haemophilus influenzae vaccin vervangen door een combinatievaccin met een a-cellulaire kinkhoestcomponent en is een daling zichtbaar in het aantal meldingen van postvaccinale verschijnselen. Vanaf 1 januari 2006 zullen kinderen die geboren worden uit moeders die chronisch geinfecteerd zijn met hepatitis B vlak na de geboorte een extra vaccinatie krijgen. Het Rijksvaccinatieprogramma kan met vaccins tegen andere ziekten uitgebreid worden. Vanaf 1 april 2006 zal pneumokokkenvaccinatie voor kinderen ingevoerd worden en om de effecten hiervan te evalueren is uitbreiding van surveillance van invasieve pneumokokken infecties gewenst. De wenselijkheid van opname van vaccinatie tegen waterpokken, gordelroos, humaan papillomavirus en rotavirus moet op korte termijn overwogen worden, gezien de beschikbaarheid van deze vaccins. Om inzicht te krijgen in de gezondheids- en economische effecten van deze vaccinaties is kosten-effectiviteitsonderzoek geindiceerd. Opname in het Rijksvaccinatieprogramma van vaccins tegen influenza, hepatitis A, meningokokken B, respiratoir synctieel virus en tuberculose is om verschillende redenen op korte termijn nog niet aan de orde. Voortdurende bewaking van de effectiviteit van het Rijksvaccinatieprogramma is van groot belang. Handhaven van de hoge vaccinatiegraad is essentieel om terugkeer van ziekten te voorkomen.The National Immunisation Programme in the Netherlands is effective and safe. The target diseases are largely under control. However, in 2004/2005 a rubella outbreak occurred among individuals who had declined vaccination on religious grounds. Furthermore, there have been incidents of mumps (among vaccinated individuals) and measles (among unvaccinated individuals) in 2004 and 2005. In January 2005 the diphtheria, tetanus, whole-cell pertussis and Haemophilus influenzae vaccine was replaced by a combination vaccine including an acellular pertussis component and subsequently a decrease in adverse events was noticed. From January 2006 onwards, children of hepatitis B antigen-positive mothers will receive an extra vaccination at birth. The National Immunisation Programme could be extended with new target diseases. In April 2006, pneumococcal vaccination for infants will be introduced and to evaluate the effects of vaccination it is desired to enhance the surveillance of invasive pneumococcal disease. The desirability to introduce vaccinations for chickenpox, shingles, human papillomavirus and rotavirus must be considered on the short-term, because of the availability of vaccines for these diseases. To gain insight into the health and economic effects of these vaccinations, cost-effectiveness studies are advised. Due to various reasons, extension of the programme with vaccinations against influenza, hepatitis A, meningococcal serogroup B, respiratory synctial virus and tuberculosis is not yet recommended. Monitoring the effectiveness of the National Immunisation Programme remains important. Maintaining high vaccine uptake is vital to prevent (re)emergence of disease.VW

Evolução da prevalência de parasitoses intestinais em escolares em Caxias do Sul, RS Evolution of the prevalence of intestinal parasitosis among schoolchildren in Caxias do Sul, RS

Relatos da prevalência das parasitoses intestinais no Brasil são pontuais e têm sido descritos em diferentes populações, tornando difícil um diagnóstico abrangente. Visando estudar a variação em 35 anos da prevalência de enteroparasitoses em escolares de Caxias do Sul, RS, foram avaliados 9.787 exames parasitológicos de fezes realizados por centrífugo-sedimentação. Resultaram positivas 5.655 (58%) amostras sendo mais prevalente a infestação por Ascaris lumbricoides (47%), Trichuris trichiura (36%), Enterobius vermicularis (8%) e os protozoários: Giardia lamblia (24%) e Entamoeba coli (20%). A prevalência geral diminuiu de 89% para 37%, com um decréscimo médio de 1,4% ao ano. Houve redução na prevalência de Ascaris lumbricoides de 61 para 26% e de Trichuris trichiura de 38 a 18%. Para Giardia lamblia não houve alteração significativa. A prevalência de Entamoeba coli cresceu de 29 a 46%. Os decréscimos obtidos na prevalência dos helmintos são provavelmente devidos às melhorias da infra-estrutura e às ações formativas desenvolvidas nas escolas.<br>Reports on the prevalence of intestinal parasitosis in Brazil have been local in nature, with descriptions of different populations, which makes comprehensive diagnosis difficult. With the aim of studying the variation in the prevalence of intestinal parasitosis among schoolchildren in Caxias do Sul, Rio Grande do Sul, over a 35-year period, 9,787 parasitological stool tests that had been performed using centrifugal sedimentation were evaluated. There were positive results from 5,655 samples (58%), and the most prevalent infestations were of Ascaris lumbricoides (47%), Trichuris trichiura (36%), Enterobius vermicularis (8%) and the protozoa Giardia lamblia (24%) and Entamoeba coli (20%). The overall prevalence diminished from 89% to 37%, indicating an average decrease of 1.4% per year. Reductions in prevalence were observed for Ascaris lumbricoides (61 to 26%) and Trichuris trichiura (38 to 18%). No significant change was observed for Giardia lamblia. The prevalence of Entamoeba coli increased from 29 to 46%. The decreases in helminth prevalence were probably due to infrastructure improvements and educational actions undertaken in schools