There comes a time when every parent must bite the bullet and send their precious little one off to infant care, daycare or school. Besides having to deal with the separation anxiety—which is all too real—parents also want to ensure that their child is protected from pesky germs and bacteria.
The Most Important Job
Vaccination is one of the effective ways in protecting your child against certain infectious diseases. What you should do is to better prepare your child before they enter daycare and make sure that your child has completed all the necessary childhood vaccinations as per the National Childhood Immunisation Schedule1 in Singapore that is provided by the National Immunisation Registry. The National Immunisation Programme includes vaccinations against tuberculosis, hepatitis B, diphtheria, pertussis, tetanus, poliomyelitis, pneumococcal, measles, mumps and rubella.1
Influenza(flu) is present in Singapore throughout the year with 4 virus strains co-circulating.2 Flu is not the common cold. The symptoms of influenza are more severe and it could potentially cause complications leading to pneumonia, bronchitis, sinusitis, ear infections, meningitis and even death.3 Symptoms of flu include high fever and chills, sore throat and coughing, headache, muscle aches, stuffy nose, sneezing, fatigue and weakness.3 The Health Promotion Board advises that children between the ages of 6 to 59 months to take the influenza vaccination annually.3
Going the Extra Mile
In addition to these immunisations, children are increasingly being immunised against other diseases. Meningococcal meningitis and Japanese Encephalitis are diseases which you do not want to take chances as once they strike, they strike hard. Learn more how you can provide an extra layer of protection for your child.
Don’t be caught off guard as many people were in Philippines in 2004 to 2005, where a sudden outbreak happened.4 Meningococcal can cause meningitis (bacterial attack on the spinal cord and brain membrane) and the less common meningococcemia (infection of the blood).5 The classic symptoms of meningitis include the sudden onset of fever, headache, a stiff neck, nausea, vomiting, photophobia and altered mental status. It is important to note that in newborns and infants, the classic symptoms may be absent or difficult to discern.5 Check if the infant appears to be slow or inactive, irritable, vomiting or has a poor appetite.5 For toddlers and children, doctors may check the child’s reflexes for any signs of meningitis.5 The symptoms of meningococcal septicemia include fatigue, vomiting, cold hands and feet, cold chills, severe aches or pain in the muscles, joints, chest and abdomen, rapid breathing, and diarrhoea. In later stages, a dark purple rash may appear.5
Meningitis and meningococcemia can be a fatal disease, leading to death in as little as a few hours. In cases where it is non-fatal, complications include hearing loss, brain damage, or even amputation.5 As infection can progress from initial symptoms to death within a few hours, it leaves us with little time for diagnosis.6 While meningococcal diseases can be treated with a number of effective antibiotics if it is diagnosed in time,6 the disease can progress very rapidly and often without warning. Thus prevention is better than cure.
An innocent looking mosquito bite may also carry the less talked about but potentially deadly Japanese Encephalitis (JE) virus, a serious infection occurring mainly in Asia.7 It is often the case that people infected with the JE virus don’t show any symptoms.7 However, others may have fever, neck stiffness, seizures or more serious symptoms such as brain infection (encephalitis) or even a coma7. The infection has a 25 per cent fatality rate and up to half of those who don’t die have permanent disability.7
JE virus is transmitted to humans through the bite of infected Culex species mosquitoes.8 The transmission occurs primarily in rural agricultural areas. In some areas of Asia, these conditions can occur near urban centers.8
In most temperate areas of Asia such as China, Korea and Japan, the JE virus flourishes in warm climates or during the warm season, which is when large epidemics most often occur. 9,10 In the tropics and subtropics such as Malaysia, Indonesia and Philippines, cases of virus transmission occur year-round, but often intensify during rainy seasons.9,10
Unfortunately, there is currently no treatment for JE.8 The management of the infection focuses primarily on controlling the symptoms and complications.8 In light of this, it is far better to take preventive action, especially if your family travels to parts of Asia.
In Singapore, there are vaccines available for infants and children to prevent infectious diseases such as influenza, meningococcal disease and Japanese encephalitis. Consult your healthcare provider regarding how you can provide additional protection for your child.
1. National Immunisation Registry; National Childhood Immunisation Schedule Singapore; available at https://www.nir.hpb.gov.sg/nirp/eservices/immunisationSchedule. Last accessed June 2016.
2. World Health Organization. Available at http://www.who.int/influenza/gisrs_laboratory/flunet/charts/en/ Last accessed September 2016
3.Health Promotion Board. Essential Facts about Influenza. Available at http://www.healthhub.sg/live-healthy/953/essential-facts-about-influenza. Last accessed September 2016.
4. A. VYSE et al. Epidemiol. Infect. (2011), 139, 967–985
5. Centres for Disease Control and Prevention, USA. Meningococcal Disease. Available at http://www.cdc.gov/meningococcal/about/. Last accessed September 2016
6. Thompson MJ, et al. Clinical recognition of meningococcal disease in children and adolescents. Lancet 2006;367:397-403.
7. Japanese Encephalitis. CDC. Available at http://www.cdc.gov/japaneseencephalitis/. Last accessed September 2016.
8. Transmission of Japanese Encephalitis Virus. CDC. Available at http://www.cdc.gov/japaneseencephalitis/transmission/index.html. Last accessed September 2016.
9. Risk of Japanese Encephalitis by country, region and season – CDC 2010. Available at http://www.itg.be/itg/Uploads/MedServ/NJAPENC%20bijlage.pdf. Last accessed September 2016.
10. CDC Yellow Book 2016. Available at http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/japanese-encephalitis. Last accessed September 2016.