The primary aim of this study was to describe compliance with current Australian guidelines for vaccination of children and adolescents diagnosed with IBD. A secondary aim was to review the serological screening for VPD. Methods A random sample of patients (0-18 years at diagnosis), were selected from the Victoria Australia state based Pediatric Inflammatory Bowel Disease Register. A multi-faceted retrospective review of immunization status was undertaken, with hospital records audited, a telephone interview survey conducted with consenting parents and the vaccination history was checked against the primary care physician and Australian Childhood Immunization Register (ACIR) records. The routine primary childhood vaccinations and administration of the recommended additional influenza and pneumococcal vaccines was clarified. Results This 2007 audit reviewed the immunization status of 101individuals on the Victorian Pediatric IBD database. Median age at diagnosis was 12.1 years, 50% were on active immunosuppressive therapy. 90% (38/42) [95% confidence intervals (CI) 77%; 97%] with complete immunization information were up-to-date with routine primary immunizations. Only 5% (5/101) [95% CI 2%; 11%] received a recommended pneumococcal vaccine booster and 10% (10/101) [95% CI 5%; 17%] had evidence of having ever received a seasonal influenza vaccine. Those living in rural Victoria (p = 0.005) and younger at the age of diagnosis (p = 0.002) were more likely to have ever received an influenza vaccine Serological testing, reviewing historical protection from VPD, identified 18% (17/94) with evidence of at least one serology sample. Conclusion This study highlights poor compliance in IBD patients for additional recommended vaccines.
Our hidden epidemic: hepatitis in Australia
Hepatitis NSW CEO, Stuart Loveday, said if not diagnosed and managed properly, hepatitis B infection can lead to cirrhosis, liver cancer or liver failure. Deaths from primary liver cancer are climbing faster than any other cause of cancer death in Australia and untreated chronic hepatitis B is a major contributor, Loveday said. An estimated 383 deaths in 2012 were attributable to hepatitis B-related liver disease. It is important to remember that many people with hepatitis B dont experience any symptoms at all so getting tested is critical. Professor of Gastroenterology and Hepatology at Australian National University, Narci Teoh, said treatments currently available for hepatitis B were highly effective, well tolerated and very simple to administer. We can tailor and individualise those treatments to people, Professor Teoh said. It is critical for people with hepatitis B to be informed and start a conversation with their doctor in order to understand what this virus does and how to look after themselves and their liver. Loveday said vaccination was the simplest way to prevent contracting hepatitis B. While most children born in Australia have been vaccinated, if you think you might be at risk of contracting hepatitis B, consult your doctor about getting vaccinated, he said. The Annual Surveillance Report also found that an estimated 310,000 people living in Australia in 2012 had been exposed to hepatitis C with it thought 173,500 had chronic hepatitis C infection and early liver disease, 51,500 had chronic hepatitis C infection and moderate liver disease and 6,500 were living with hepatitis C related cirrhosis. The other 80,000 people believed to have to have been exposed have cleared their infection. The Kirby Institute estimates that almost 80 percent of all infections for hepatitis C occur among people who inject drugs, with only one percent of those people currently receiving treatment. Unlike other types of hepatitis, there is currently no vaccine to prevent hepatitis C and medication is the only way to manage the disease.