• Early detection, diagnosis and intervention can prevent death or disability
September is newborn screening awareness month, geared towards sensitising parents about screening babies for early detection, diagnosis and intervention for any conditions or disorders.
Sometimes, babies can appear healthy when born, and a condition can go unnoticed or undiagnosed and later affect the child’s development and future life. So why is newborn screening important and what vaccines are crucial for babies?
Newborn screening identifies conditions that can affect a child’s long-term health or survival. Early detection, diagnosis and intervention can prevent death or disability. With a simple blood test, doctors can check for rare genetic, hormone-related and metabolic conditions that can cause serious health problems.
The conditions newborns are screened for include Congenital Hypothyroidism (CH), which can lead to mental retardation if not identified and treated within the first few weeks of birth.
This test is usually ordered on the fifth day of life at Aga Khan University Hospital. CH is a disorder which, if screened for early enough in every newborn, has a high benefit-to-risk ratio.
Vaccines stimulate the body’s immune system to make antibodies that provide protection against many diseases. Vaccination is the safest way to protect children against infectious diseases. Once vaccinated, they should have the ability to fight off the diseases that they have been vaccinated against. Vaccines are therefore very important in reducing infant and child mortality.
What vaccines are recommended for children up to the age of five years? The list includes BCG, polio, Hepatitis B, Pneumococcal, Diphtheria, Tetanus and Pertussis.
Others include Hib (Haemophilus Infuenzae B), Rotavirus and MMR (Measles, Mumps, and Rubella).
BCG is given at birth to prevent tuberculosis (TB). This disease is very infectious and mainly affects the lungs. It is a major cause of death worldwide but can be prevented by vaccination.
Polio is a highly infectious viral disease, which may lead to paralysis and death. The polio vaccine is administered at birth, six weeks, 10 weeks and 14 weeks of life. Additional boosters are given at 18 months and five years.
Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause chronic liver infection, liver failure as well as liver cancer. Hepatitis B vaccine is administered at birth, six weeks, 10 weeks and 14 weeks of life.
The Pneumococcus organism may cause pneumonia, which affects the lungs as well as meningitis, which affects the brain. This vaccine is given at six weeks, 10 weeks, 14 weeks and a booster dose at 15 months of life.
Infection with Diphtheria may lead to complications such as swelling of the heart muscle, heart failure, coma, paralysis and death. The vaccine to prevent Diphtheria is given at six weeks, 10 weeks and 14 weeks of life, with a booster administered at 18 months of life. A further booster is recommended at five years of life.
TETANUS AND MORE
Tetanus infection may lead to stiffness in the neck and abdominal muscles, difficulty in swallowing, muscle spasms as well as death. The vaccine to prevent this illness is given at six, 10 and 14 weeks of life, with boosters being at 18 months and five years of life.
Infection with Pertussis may lead to severe cough (whooping in nature), runny nose, apnea (a pause in breathing in infants), pneumonia (infection in the lungs) as well as death. Pertussis vaccine is given at six, 10 and 14 weeks of life, with boosters being administered at 18 months as well as five years of life.
Haemophilus Infuenzae B (HIB) infection may lead to Meningitis (infection of the covering around the brain and spinal cord), epiglottitis (life-threatening infection of the windpipe and lead to serious breathing problems), pneumonia (infection in the lungs) and death. This vaccine is given at six, 10 and 14 weeks of life, with boosters being given at 18 months of life.
Rotavirus can cause severe watery diarrhoea, vomiting, fever and abdominal pain. Children who contract rotavirus disease can become dehydrated and needing hospitalisation. Rotavirus vaccine is given orally and protects children against this disease. It can be given as two doses or three doses (dependent on the type given).
The MMR vaccine is very effective at protecting children against the complications caused by measles, mumps and rubella. Measles/Rubella (MR) vaccine is given at nine months of life, while the MMR vaccine is given at 15 months of life.
Infection with measles may lead to Encephalitis (brain swelling), pneumonia (infection in the lungs) and death. Mumps infection can present with swollen salivary glands (under the jaw), fever, headache, tiredness, muscle pain as well as Meningitis (infection of the covering around the brain and spinal cord), encephalitis (brain swelling), inflammation of testicles or ovaries and deafness.
Rubella infection may cause rash, fever, swollen lymph nodes and may lead to very serious complications in pregnant women, such as miscarriage, stillbirth, premature delivery and birth defects.
Children up to the age of five years may also be given flu, varicella, meningococcal, cholera, Hepatitis A and typhoid vaccines.
Flu vaccine is administered at six and seven months of life and annually thereafter.
Varicella vaccine, which helps to prevent chicken pox, is offered in two doses (one year and second dose after six weeks of receiving the first dose) helps prevent Chicken Pox Infection. Chicken Pox is a highly contagious illness, which may lead to complications such as infected blisters, swelling of the brain (Encephalitis) and pneumonia.
Meningococcal vaccine is given in two doses starting at ten months of life and helps to prevent diseases caused by the Neisseria Meningitidis Organism. These illnesses can be deadly and severe, they can cause infection of the lining of the brain and spinal cord (meningitis) as well as bloodstream infections (bacteremia or septicaemia).
Cholera vaccine is given when a child is one-year-old, with a repeat dose after two weeks of giving the first dose helps to prevent infection with cholera. This disease can cause severe diarrhoea and vomiting, which in turn can lead to dehydration and death.
Hepatitis A vaccine helps to prevent infection with Hepatitis A. The infection may lead to liver disease. The vaccine is administered at one year of life, with a second dose six months after the first dose.
Typhoid vaccine is given at the age of two years of life and helps to prevent typhoid fever. This infection can be life-threatening. Symptoms of infection include persistent high fever, weakness, stomach pain, headache, diarrhoea or constipation, cough and loss of appetite.
Dr Syama Sinuff is a consultant paediatrician at Aga Khan University Hospital Nairobi