ppt课件-immunization-homeuniversityofpittsburgh.pptVIP

4. Neurological involvement: Neuritic manifestations may be seen after the administration of serum or vaccine. The well-known examples are the post-vaccinial encephalitis and encephalopathy following administration of anti -rabies and smallpox vaccines. Guillain-Barre syndrome in association with the swine influenza vaccine is another example. 5. Provocative reactions: Occasionally following immunization there may occur a disease totally unconnected with the immunizing agent (e.g., provocative polio after DPT or DT administration against diphtheria). The mechanism seems to be that the individual is harboring the infectious agent and the administration of the vaccine shortens the incubation period and produces the disease or what may have been otherwise only a latent infection is converted into a clinical attack. 6. Others: These may comprise damage to the fetus (e.g., with rubella vaccination); displacement in the age-distribution of a disease (e.g., a potential problem in mass vaccination against measles, rubella and mumps). PRECAUTIONS TO BE TAKEN Before administration of the antiserum or antitoxin, it is necessary to test for sensitivity reaction. This can be done in 2 ways: (a) instilling a drop of the preparation into the conjunctival sac. A sensitized person will develop pricking of the conjunctiva. (b) a more reliable way of testing is by intradermal injection of 0.2 ml of antiserum diluted 1 : 10 with saline. A sensitized patient will develop a wheal and flare within 10 minutes at the site of injection. It should be borne in mind that these tests are not infallible. Adrenaline (1: 1000 solution) should be kept ready when giving foreign serum. In the event of anaphylaxis, for an adult, 0.5 ml of adrenaline solution should be injected intramuscularly immediately, followed by 0.5 ml every 20 minutes if the systolic blood pressure is below 100 mm of mercury. An injection of antihistaminic drug should also be given, e.g., 10-20 mg of chlorpheniramine malea